Search

Background: Digital learning tools have proliferated among healthcare workers in India. Evidence of their effectiveness is however minimal. We sought to examine the impact of the Safe Delivery App (SDA) on knowledge and confidence among frontline health workers (HW) in India. We also studied whether facilitation to address technical challenges enhanced self-learning. Methods: Staff nurses and nurse-midwives from 30 facilities in two states were divided into control and intervention groups through randomization. Knowledge and confidence were assessed at baseline and after 6 months. Three rounds of facilitation addressing technical challenges in downloading and usage along with reminders about the next phase of learning were conducted in the intervention group. A user satisfaction scale along with qualitative interviews was conducted in the intervention group at the endline along with qualitative interviews on facilitation. Results: The knowledge and confidence of the healthcare workers significantly increased from the baseline to endline by 4 percentage points (P < 0.001). The participants who received facilitation had a higher mean score difference in knowledge and confidence compared to those who did not receive facilitation (P < 0.001). The participants were highly satisfied with the app and video was the most-watched feature. They reported a positive experience of the facilitation process. Conclusion: The effectiveness and acceptability of the SDA indicate the applicability of mHealth learning tools at the primary healthcare level. In a time of rapid digitalization of training, facilitation or supportive supervision needs further focus while on-ground digital training could be invested in to overcome digital illiteracy among healthcare workers. [ABSTRACT FROM AUTHOR]

Plakophilin3 is a desmosomal plaque protein whose levels are reduced in poorly differentiated tumors of the oropharyngeal cavity and in invasive colon carcinomas, suggesting that plakophilin3 may function as a tumor suppressor. To test the above hypothesis, plakophilin3 expression was inhibited by short hairpin RNA's in two different epithelial cell lines, HCT116 and FBM. The down regulation of plakophilin3 led to a decreased deposition of the desmosomal cadherins - the desmogleins, at the cell surface but did not affect the deposition of plakoglobin and other desmosomal plaque proteins. The altered desmosomal composition was accompanied by colony formation in soft agar and growth to high density in culture, both properties of transformed cells. Additionally, the induction of skin papillomas in mice was accompanied by plakophilin3 loss. These data indicate that plakophilin3 loss contributes to cellular transformation and that plakophilin3 functions as a tumor suppressor gene. [ABSTRACT FROM AUTHOR]