Search

Abstract Background Domestic violence during pregnancy is especially concerning due to its significant detrimental impact on a woman’s health and that of her unborn child. The study aims to evaluate the effects of a behavioural intervention package (BIP) delivered during pregnancy on the quality of life (QOL), domestic violence (DV), and reproductive and child health (RCH) of women experiencing DV. Methods A randomised controlled trial was conducted on 211 pregnant women recruited between 18 and 20 weeks of pregnancy and randomly assigned to one of two groups: intervention (n = 105) or control (n = 106). The intervention group received BIP and standard care, while the control group received only standard care for 28 weeks. Study tools included socio-demographic variables, a short-form health survey, an abuse assessment screening tool, and an RCH checklist. The tools were completed once before the intervention and again at 6 weeks postnatal. The tools and their subscales were compared pre- and post-intervention using a paired t-test, or Wilcoxon signed test as appropriate to estimate the effect size at baseline and post-intervention. Results Post-intervention, the QOL scores were found to be significant, with a positive effect favouring the intervention as compared to the control group. The BIP intervention, which was found to be significantly effective (P ≤ 0.001) in reducing DV for pregnant women experiencing DV, was higher in the intervention group than in the control group. Conclusion The BIP may be an appropriate method for treating pregnant women experiencing DV from low socioeconomic strata who attend public hospitals in India to improve their QOL. The approach may offer an intervention that healthcare institutions or other organizations in contact with women at risk of violence can implement. Trial registration Indian Registry of Clinical Trials CTRI/2019/01/017009. Registered on 09/01/2019.

Air purifiers (APs) and home sealing are interventions used to help protect U.S. diplomats against particle pollution in the home when working in polluted cities. We investigated the effect of these interventions on home indoor and personal PM _2.5 exposure in Kathmandu, Nepal. Twenty-one participants underwent repeated 48 hour personal monitoring before and after intervention. We analyzed these measurements by microenvironment. Indoor-outdoor ratios (I/O) using the home indoor PM _2.5 values were calculated in order to assess the air filtration capacity at home in light of increasing outdoor PM _2.5 post-intervention. To quantify the effect of intervention on home indoor PM _2.5 , we conducted a meta-analysis of the results of dwelling-by-dwelling regression of indoor-on-outdoor (I/O) PM _2.5 concentrations. On average, adding high-capacity APs and home sealing led to a 15% decrease in PM _2.5 measured at home, excluding cooking periods, with a mean (standard deviation) of 7.5 (6.4) μ g m ^−3 pre- to 6.4 (8.1) μ g m ^−3 post-intervention despite a 57% increase in outdoor PM _2.5 , from 43.8 (30.8) μ g m ^−3 pre- to 68.9 (40.7) μ g m ^−3 post-intervention. Overall mean personal exposure fell by 36% from 15.2 (10.6) μ g m ^−3 to 9.8 (8.7) μ g m ^−3 . I/O ratios decreased as outdoor PM _2.5 strata increased; when outdoor PM _2.5 < 25 μ g m ^−3 the I/O decreased from 0.38 pre- to 0.12 post-intervention and when outdoor PM _2.5 was 101–200 μ g m ^−3 the I/O decreased from 0.12 pre- to 0.07 post-intervention. The mean regression slope of indoor-on-outdoor PM _2.5 decreased from 0.13 (95% CI 0.09, 0.17) in pre-intervention dwellings to 0.07 (0.04, 0.10) post-intervention. I/O ratios showed a weak negative (not statistically significant) inverse association with air changes per hour at home. In the high pollution environment of Kathmandu, APs with home sealing provide substantial protection against ambient PM _2.5 in the home environment, including during periods when outdoor PM _2.5 concentration was above 100 μ g m ^−3 .

Abstract Background When using a continuous outcome measure in a randomised controlled trial (RCT), the baseline score should be measured in addition to the post-intervention score, and it should be analysed using the appropriate statistical analysis. Methods We derive the correlation between the change score and baseline score and show that there is always a correlation (usually negative) between the change score and baseline score. We discuss the following correlations and provide the mathematical derivations in the Appendix:Correlation between change score and baseline scoreCorrelation between change score and post scoreCorrelation between change score and average score. The setting here is a parallel, two-arm RCT, but the method discussed in this paper is applicable for any studies or trials that have a continuous outcome measure; it is not restricted to RCTs. Results We show that using the change score as the outcome measure does not address the problem of regression to the mean, nor does it take account of the baseline imbalance. Whether the outcome is change score or post score, one should always adjust for baseline using analysis of covariance (ANCOVA); otherwise, the estimated treat effect may be biased. We show that these correlations also apply when comparing two measurement methods using Bland-Altman plots. Conclusions The correlation between baseline and post-intervention scores can be derived using the variance sum law. We can then use the derived correlation to calculate the required sample size in the design stage. Baseline imbalance may occur in RCTs, and ANCOVA should be used to adjust for baseline in the analysis stage.

Introduction: Healthcare professionals have an important role in tackling the growing menace of Hospital Acquired Infections (HAI) and Antibiotic Resistance (ABR). Regular trainings imparted early in career can result in better understanding of these crucial issues. Aim: To identify the baseline Knowledge Attitude and Practices (KAP) of 5th semester MBBS undergraduate students of a University Medical College in Rajasthan, India, and to determine the changes in these parameters after the implementation of a vigorous “HAI and ABR Awareness campaign”. Materials and Methods: This prospective interventional study involved 86, 5th semester MBBS undergraduate students. The study instrument was a preformed pretested 30 item selfadministered questionnaire. The study intervention included a series of lectures, role plays, poster competition; and an audiovisual quiz. The performance of individual participants before and after the intervention was then statistically analysed with Microsoft Excel and software Statistical Package for the Social Sciences (SPSS) version 20. Results: The pre-intervention overall KAP score of each student was found to be poor in 17.4%, average in 61.6%, and excellent in 20.9% in study participants. Post-intervention grades were found to be poor, average, and excellent in 1.1%, 8.14%, and 90.7% study participants, respectively. A statistically significant decrease in the percentage of students with poor grade and a significant increase in those with excellent grade were observed. Conclusion: There is a need for suitable amendments in current MBBS curriculum to include modules which comprehensively address the core issues of ABR, HAIs and Antimicrobial Stewardship (AMS). This would help to bring out attitude and behavioural changes in students at the very grass-root level.

Pregnancy increases the risk of being overweight at a later time period, particularly when there is excessive gestational weight gain. There remains a paucity of data into the effect of low glycaemic index (GI) pregnancy interventions postpartum. Aim: To examine the impact of a low glycaemic index diet during pregnancy on maternal diet 3 months postpartum. Methodology: This analysis examined the diet, weight and lifestyle of 460 participants of the ROLO study 3 months postpartum. Questionnaires on weight, physical activity, breastfeeding, supplement use, food label reading and dietary habits were completed. Results: The intervention group had significantly greater weight loss from pre-pregnancy to 3 months postpartum than the control group (1.3 vs. 0.1 kg, p = 0.022). The intervention group reported greater numbers following a low glycaemic index diet (p < 0.001) and reading food labels (p = 0.032) and had a lower glycaemic load (GL) (128 vs. 145, p = 0.014) but not GI (55 vs. 55, p = 0.809) than controls. Conclusions: Low GI dietary interventions in pregnancy result in improved health-behaviours and continued reported compliance at 3 months postpartum possibly through lower dietary GL as a result of portion control. Greater levels of weight loss from pre-pregnancy to 3 months postpartum in the intervention group may have important positive implications for overweight and obesity.

Aim: This study was conducted with the aim of determining the prevalence of helminthes in cattle and treatment interventionstrategy in Kachia Grazing Reserve (KGR).Materials and Methods: A total of 3,651 cattle from 88 households were randomly selected, sampled and examined . Thesampling was spread over three (3) periods; Pre-intervention (1,609), Intervention (1,525) and Post-intervention (517). Bothphysical examination and laboratory investigation were employed in the study.Results: This study revealed the presence of different types of helminthes in the bovine population of the KGR which includethe helminth eggs of Nematodes (Oesophagostomum radiatum, Bonustonum phlebotomum, Tricuris globulosa, Cooperiapectinita, Toxocara vitulorum, Strongiloides papillosus, Strogylus langamus), Cestodes (Moneizia benedeni) and Trematodes( Schistosoma bovis, Paramphistomum cervi, Fasciola gigantica) at different intervention periods, where by 820 (53.77%)were positive for pre- intervention, 946 (58.79%) positive for intervention and 205 (39.65%) were positive for postinterventionperiod. Among the eleven species of helminthes identified, P. cervi was the most prevalent in all the periods,followed by O. radiatum. The study also revealed that the cattle in the study area were infected with single and multipleinfections. Furthermore, 498(32.66%), 585(36.36%) and 171(33.08%) of cattle for the pre- intervention, intervention andpost- intervention periods, respectively had single infection. However, 305 (20%), 381 (23.68%) and 37 (7.16%) of the cattlefor the three periods, respectively harbored multiple infections (polyparasitism) caused by two to six different parasites. Theresults also show that age was a factor in the abundance of the parasites in the cattle as parasites were demonstrated more inadult cattle than the young stock (calves and yearlings). Chi-square and Kruskal Wallis showed a significant difference (p