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Åvik Persson H, Ahlström G, Årestedt K, Behm L, Drevenhorn E, Sandgren A. Palliative care delivery at nursing homes before and after an educational intervention from professionals' perspective: A pre-post design. Scand J Caring Sci 2023; 37:229-242. [PMID: 35524431 DOI: 10.1111/scs.13084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/09/2022] [Accepted: 04/17/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The principles of palliative care were developed in hospices and specialised palliative care units and have not been sufficiently adapted to and evaluated in nursing homes. Therefore, an educational intervention from an interprofessional education perspective was performed within the project Implementation of Knowledge-Based Palliative Care in Nursing Homes. The aim of this study was to evaluate professionals' experience of palliative care delivery before and after the educational intervention. METHODS The educational intervention for nursing home professionals consisted of five 2-h seminars over 6 months at 20 nursing homes. The intervention and control groups consisted of 129 and 160 professionals from 30 nursing homes respectively. The questionnaire 'Your experience of palliative care' was completed 1 month before (baseline) and after (follow-up) the intervention. Descriptive and inferential statistics were calculated. RESULTS The positive effects at follow-up concerned the use of a valid scale for grading symptoms, attendance to the needs of next of kin (including bereavement support), documentation of older persons' wishes regarding place to die and conversations about their transition to palliative care and about how they were treated. CONCLUSIONS This study demonstrates a promising interprofessional educational model. However, the paucity of improvements brought to light at follow-up indicates a need for research directed towards a revision of this model. Supervision of professionals during palliative care delivery is one suggestion for change.
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Affiliation(s)
- Helene Åvik Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.,The Research Section, Region Kalmar County, Kalmar, Sweden
| | - Lina Behm
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Eva Drevenhorn
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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Haque MA, Choudhury N, Ahmed SMT, Farzana FD, Ali M, Naz F, Khan A, Wahid BZ, Siddiqua TJ, Akter R, Rahman SS, Faruque ASG, Ahmed T. Food security status of Suchana-participating households in north-eastern rural Bangladesh. Front Public Health 2022; 10:950676. [PMID: 36176515 PMCID: PMC9513544 DOI: 10.3389/fpubh.2022.950676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/22/2022] [Indexed: 01/21/2023] Open
Abstract
Despite achieving remarkable progress, food insecurity remains a major public health challenge in Bangladesh, and severe food insecurity status has not been reduced in susceptible areas and vulnerable regions in Bangladesh. Wetlands that are susceptible to flooding can be found in Bangladesh's north-eastern Sylhet division. Suchana, a large-scale nutrition programme, implemented nutrition-specific and sensitive interventions in poor and very poor households in Sylhet and Moulvibazar districts in the north-eastern region of Bangladesh. The aim of this article is to assess the association between the Suchana intervention and household food security status among poor and very poor households in north-eastern rural Bangladesh using the Suchana baseline and endline survey databases. The baseline survey was conducted between November 2016 and February 2017, while the endline survey was undertaken 3 years later, during the same months. The outcome variable in this analysis was household food security status, which was measured using the Food and Nutrition Technical Assistance's Guideline. Descriptive statistics were used to summarize the data; after controlling for the union as a cluster and relevant covariates, a multiple multinomial logistic regression model was used to estimate the independent effect of the Suchana intervention as an exposure. Overall, 14.0% of households were food secure at the baseline survey (intervention: 14.1%, control: 14.0%) and 22.0% were food secure (intervention: 26.6%, control: 20.2%) at the endline survey. For households in the intervention area in comparison to the control area, the odds of being moderately food insecure [aOR: 1.36 (1.05, 1.76), p < 0.05], mildly food insecure [aOR: 1.83 (1.33, 2.51), p < 0.001], or food secure [aOR: 2.21 (1.47, 3.33), p < 0.001] compared to being severely food insecure was significantly higher. Thus, we infer that the 3 years of Suchana intervention marginally increased household food security status among the socio-economically disadvantaged population in north-eastern rural Bangladesh. If concerns regarding gender equity, women's education, and income-generating activities are addressed, the population could experience even greater benefits in food security. In order to overcome these challenges, all stakeholders including programme implementers and policymakers should work together to implement the appropriate measures.
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Affiliation(s)
- Md Ahshanul Haque
- Nutrition and Clinical Services Division, icddr, b, Dhaka, Bangladesh,*Correspondence: Md Ahshanul Haque
| | - Nuzhat Choudhury
- Nutrition and Clinical Services Division, icddr, b, Dhaka, Bangladesh
| | | | | | - Mohammad Ali
- Nutrition and Clinical Services Division, icddr, b, Dhaka, Bangladesh
| | - Farina Naz
- Nutrition and Clinical Services Division, icddr, b, Dhaka, Bangladesh
| | - Ashfaque Khan
- Child Poverty Sector, Save the Children Bangladesh, Dhaka, Bangladesh
| | | | | | - Rumana Akter
- Child Poverty Sector, Save the Children Bangladesh, Dhaka, Bangladesh
| | | | - A. S. G. Faruque
- Nutrition and Clinical Services Division, icddr, b, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddr, b, Dhaka, Bangladesh
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Myran DT, Chen JT, Giesbrecht N, Rees VW. The association between alcohol access and alcohol-attributable emergency department visits in Ontario, Canada. Addiction 2019; 114:1183-1191. [PMID: 30924983 DOI: 10.1111/add.14597] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/04/2018] [Accepted: 02/26/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The availability of alcohol through retail outlets is associated with alcohol-related harms, but few studies have demonstrated a causal relationship. We investigated the association between alcohol availability and alcohol-attributable emergency department (ED) visits in the province of Ontario during a period of deregulation of controls on the number of alcohol outlets. DESIGN Cross-sectional and pre-post design SETTING AND PARTICIPANTS: The study used data from two time-periods: pre-deregulation (2013-14) and post-deregulation (2016-17), to compare rates of ED visits for 513 defined geographic regions in Ontario Canada, called Forward Sortation Areas (FSAs). MEASUREMENTS The primary outcome was the age-standardized rates of alcohol-attributable ED visits. We compiled a list of all alcohol retail outlets in Ontario during 2014 and 2017 and matched them to their corresponding FSA. We fitted mixed-effects Poisson regression models to assess: (a) the cross-sectional association between number of outlets and hours of operation and ED visits; and (b) the impact of deregulation on ED visits using a difference-in-difference approach. FINDINGS Alcohol-attributed ED visits increased 17.8% over the study period: more than twice the rate of increase for all ED visits. Increased hours of operation and numbers of alcohol outlets within an FSA were positively associated with higher rates of alcohol-attributable ED visits. The increase in ED visits attributable to alcohol was 6% (incident rate ratio = 1.06; 95% confidence interval = 1.04-1.08) greater in FSAs that introduced alcohol sales in grocery stores following deregulation compared with FSAs that did not. CONCLUSIONS Deregulation of alcohol sales in Ontario, Canada in 2015 was associated with increased emergency department visits attributable to alcohol.
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Affiliation(s)
- Daniel T Myran
- School of Epidemiology and Public Health, University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Norman Giesbrecht
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, ON, Canada
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Rothmann K, Hillmer JM, Hosser D. [Evaluation of the Musical Concentration Training with Pepe (MusiKo mit Pepe) for children with attention deficits]. Z Kinder Jugendpsychiatr Psychother 2014; 42:325-35. [PMID: 25163995 DOI: 10.1024/1422-4917/a000308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study evaluates the Musical Concentration Training with Pepe ("MusiKo mit Pepe") for children aged 5 to 10 years with attention deficits. METHOD Using a pre-post-control design (N = 108), changes in attention capacity are measured by the Test of Attentional Performance for Children (KiTAP), whereas changes in the quality of life are assessed with the Children's Questionnaire (KINDL-R). Additionally, we utilized the Symptom Checklist for Attention Deficit Hyperactivity Disorders (FBB-ADHS) and for Conduct Disorder (FBB-SSV) of the Diagnostic System of Mental Disorders in Children and Adolescents II based on ICD-10 and DSM-IV as well as the Child Behavior Checklist and the Teacher's Report Form (CBCL, TRF). RESULTS Significant pre-post effects were found in both attention and quality of life for children treated by the training compared to controls. Moreover, significant reductions were detected in ADHD symptomatology in parents' and teachers' ratings, and in internal problems in parents' ratings. The effectiveness of the intervention was not affected by age, sex, intelligence, or migration background. CONCLUSION The music-based training "MusiKo mit Pepe" is an effective intervention for children with attention deficits, pending replication of these findings in future studies.
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Affiliation(s)
- Kathrin Rothmann
- Abteilung für Entwicklungs-, Persönlichkeits- und Forensische Psychologie, Institut für Psychologie, Braunschweig
| | - Jana-Mareike Hillmer
- Abteilung für Entwicklungs-, Persönlichkeits- und Forensische Psychologie, Institut für Psychologie, Braunschweig
| | - Daniela Hosser
- Abteilung für Entwicklungs-, Persönlichkeits- und Forensische Psychologie, Institut für Psychologie, Braunschweig
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