Public Health
http://hdl.handle.net/10576/4828
2024-03-29T00:32:24ZUSABILITY TESTING OF THE INTERNATIONAL CARDIAC REHABILITATION REGISTRY
http://hdl.handle.net/10576/33188
USABILITY TESTING OF THE INTERNATIONAL CARDIAC REHABILITATION REGISTRY
ABUKHADIJAH, HANA JIHAD
Background: Cardiac rehabilitation (CR) is a comprehensive model of secondary preventive care for cardiovascular diseases (CVDs). However, there is a wide variety of implementation characteristics globally, specifically in low-and-middle-income countries. Thus, the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) was urged to develop a CR registry to establish the quality of CR services in such settings. Aim: To explore the usability of the newly developed International Cardiac Rehabilitation Registry (ICRR) in the World Health Organization's six-designated regions of the world to ensure the applicability and optimal utility of the registry before its launch. Methods: This was a mixed methods study comprised of Think-Aloud method to elicit feedback on the ICRR while end-users were entering patient data, followed by semi-structured interviews and SUS survey. The Unified Theory of Acceptance and Use of Technology 2 framework (UTAUT 2) informed the analysis. During the interview, participants were asked to log in to the ICRR demonstration site and share their screen and enter the patient's data anonymously while thinking and talking aloud. Notes including facial expressions and gestures ideas raised by the participants were taken. After that, a semi-structured interviews were conducted to explore the topic in depth.. Interviews were transcribed verbatim, thematic analysis was undertaken to categorize the content using NVIVO software. Finally, participants were asked to fill out the System Usability scale survey (SUS), which provides a global measure of system satisfaction. SUS score was calculated based on Brooke's standard scoring method. Results: Four major themes emerged from the interviews and Think-Aloud method: (1) ease of approvals, adoption, and implementation; (2) benefits for programs, (3) variables and their definitions, as well as (4) patient report & follow-up assessment. Based on participant feedback and utterances, suggestions for changes to the ICRR were implemented, including changes to the program survey, on-boarding processes, navigational instructions, inclusion of program logos, direction on handling unavailable data, and optimizing data completeness, as well as policies for program certification. System usability score (SUS) was (83.75) indicating that the registry was "excellent" and rated as class "A" technology. Conclusions: Results of this study proved that ICRR is relevant, user-friendly with high end-user satisfaction, and showed high perceived usefulness to support CR service quality. The usability of the ICRR was enhanced based on participants' feedback. The ICRR is ready for the next stage, which is the pilot testing before the final launch.
0174-06-01T00:00:00ZFLUORIDE VARNISH APPLICATION AS AN ORAL HEALTH INTERVENTION IN THE WELL-BABY CLINIC FOR CHILDREN AGED 1-5 YEARS AT QATAR UNIVERSITY HEALTH CENTER: A FEASIBILITY STUDY
http://hdl.handle.net/10576/32113
FLUORIDE VARNISH APPLICATION AS AN ORAL HEALTH INTERVENTION IN THE WELL-BABY CLINIC FOR CHILDREN AGED 1-5 YEARS AT QATAR UNIVERSITY HEALTH CENTER: A FEASIBILITY STUDY
BATTA, NADEEN
Background: Early childhood caries (ECC) is one of the most common chronic conditions affecting children worldwide. It is considered a significant public health problem in most communities, with over 530 million children worldwide suffering from dental caries in their primary teeth. Qatar has reported a prevalence of 89% among preschool children aged 4 to 5 years old. ECC is often left untreated, leading to physical, psychosocial, and economic consequences, and if severe, it can result in potentially life- threatening infections. ECC is preventable through proper diet counseling, oral health promotion, and simple preventive measures. Strategies for preventing ECC require a multidisciplinary approach and should be integrated into different settings. Professionally applied fluoride varnish (FV) containing 5% sodium fluoride has been proven effective in ECC prevention. In addition to the high prevalence of ECC in Qatar, community water supplies are not fluoridated, and attending multiple health-related appointments is a challenge for families at high dental caries risk. When these factors are considered together, they indicate that integrating oral health assessment and prevention into places where young children already go and in settings other than the dental clinic could be a promising strategy for dealing with the high prevalence of ECC. This study investigated the feasibility of providing FV application for children aged 1- 5 years and at moderate to high risk of developing ECC during their regular vaccination visits in the well-baby clinic at Qatar University Health Center using the Donabedian model for measuring the quality of care. Aim: This study aimed to test the feasibility of providing Fluoride Varnish (FV) application in the Well-baby clinic at Qatar University Health Center for children aged 1-5 years who are at risk (moderate to high) of dental caries during their regular vaccination visits.
Methods: The design is a 3-month one-group feasibility study with a pre-and post-test design. All eligible participants (50 children) were at risk to dental caries and received the FV application intervention. Feasibility was assessed by examining the intervention’s acceptability, implementation, and practicality. Assessment methods included surveys of healthcare providers and parents, clinic logs and nurses’ notes, and a Cost Assessment Tool (CAT) adapted from EngenderHealth. Reporting followed the Template for Intervention Description and Replication (TIDieR) from the EQUATOR network (Enhancing the QUAlity and Transparency Of health Research).
Results: The results showed that the intervention was acceptable to parents and their children. We reached 90.9% of the eligible children based on their contact information. Of the contacted parents, 93.1% confirmed participation, and 96.7% of those showed up to their appointments. The majority of parents (92%) had no concerns about FV safety, and all participating parents reported they would allow a well-trained nurse to provide the application to their children during their vaccination visits. In a small number of cases (12%), parents reported feelings of stickiness and unpleasant flavor by their children. Despite a high level of acceptability, implementation rates were lower than expected. Nurses performed the caries risk assessments on all participated children and completed FV applications for the vast majority (47 children; 94%), while pediatricians participated by adding the preventive FV application to the general and oral health promotion they already offer during the vaccination visits. In terms of the intervention practicality, the time utilized for completing the dental caries risk assessment was 1.09 ± 0.33 minutes, whereas 1.37 ± 0.62 minutes was the average time for completing one FV application. The direct cost for providing FV to children in the well-baby clinic at Qatar University Health Center was 15QR per application. The most frequently perceived barriers to implementing the intervention were: unavailability of instruments, insufficient supportive staff, lack of physical space, and providing the FV for those who rarely visit the health center.
Conclusion: This study showed that integrating the FV application as a simple, cost- effective strategy for the primary prevention of dental caries in children less than five years old during their regular vaccination visits in a primary health care setting in Qatar is feasible after addressing gaps related primarily to the process inside the well-baby clinic. Increasing the appointment time by a minimum of 3 minutes, providing more structured mandatory oral health education and training to the providers, application of strategies to increase nurses’ adherence through reminding them of the oral assessment for each child, and affording enough staff to be able to carry out the intervention effectively without compromising the patient’s quality of medical care, all are limitations to be addressed by management before introducing the FV application in the well-baby clinic for children at risk of having dental caries.
0174-06-01T00:00:00ZTHE ASSOCIATION BETWEEN PRIOR ANTIBIOTIC EXPOSURE AND ANTIBIOTIC RESISTANT URINARY TRACT INFECTION IN PRIMARY HEALTH CARE CLIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
http://hdl.handle.net/10576/32112
THE ASSOCIATION BETWEEN PRIOR ANTIBIOTIC EXPOSURE AND ANTIBIOTIC RESISTANT URINARY TRACT INFECTION IN PRIMARY HEALTH CARE CLIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
ALI, RWEDAH ANWAR ALI AHMED
This systematic review and meta-analysis aimed to quantify the association between prior antibiotic exposure and subsequent antibiotic resistant urinary tract infection (UTI) in clients in primary healthcare settings. Additionally, it aimed to evaluate the relationships between the timeframe, type of antibiotic, number of courses, dose, and duration of antibiotic exposure, and the likelihood of subsequent antibiotic resistant UTI. A database search of PubMed, Embase, ProQuest and, Scopus was performed to identify relevant articles. Random-effects meta-analysis was conducted to provide pooled estimates of the associations. The data search yielded 1196 articles. Screening of titles and abstracts followed by full text screening yielded 27 relevant articles reporting 77 measurements of association between prior antibiotic exposure and subsequent resistant UTI in primary healthcare clients. Compared to those with no antibiotic treatment for UTI, participants with antibiotic exposure in the previous 12 months of UTI onset were more than twice as likely to have a subsequent antibiotic resistant UTI (pooled odds ratio = 2.289 [95% CI; 2.006-2.612]). Subgroup analysis indicated that participants with antibiotic exposure within the previous 1 month were more than 4 times more likely to have a subsequent antibiotic resistance UTI compared to those with no antibiotic exposure. Resistance to quinolones was the most likely, and participants exposed to quinolones had over five times the odds of subsequent resistance to quinolones. The likelihood of resistance was higher when a patient was exposed to 3 or more antibiotic courses in the previous 12 months compared to 2 or 1 antibiotic course. The OR of the association between resistance and consumption of >=3 antibiotic courses in the last 12 months was 3.315 [95%CI; 3.32-8.12], followed by 2.34 [95%CI; 1.38-4.16] for the consumption of two antibiotic courses, and 1.58 [95%CI; 1.22-2.04] for the consumption of a single antibiotic course. The OR of resistance was non-significant in one study that compared a high dose to lower dose of ?-lactams, OR = 1.00 [95%CI; 0.99-1.01], P-value=0.62. However, in the second included study, a lower dose of amoxicillin was associated with higher odds of ampicillin resistance compared to a higher dose, OR=2.19 [95%CI; 1.08-4.41]. The effect of a longer duration of prior AB course on the likelihood of resistance is greater than the effect of a shorter courses. Based on the results of the single included study evaluating this association, the OR comparing the effect of a longer course to a shorter course of trimethoprim on ampicillin resistance was 2.89 [95%CI; 1.44 to 5.78], and the OR comparing the effect a long course to a short course of amoxicillin on ampicillin resistance was 1.50 [95%CI; 0.76 to 2.92]. Results of this study can support clinicians' decisions upon AB prescribing for UTI in primary care clients when resistance is of concern.
0174-06-01T00:00:00ZEPIDEMIOLOGY OF CHLAMYDIA TRACHOMATIS IN LATIN AMERICA AND THE CARIBBEAN: SYSTEMATIC REVIEW, META-ANALYSES, AND META-REGRESSIONS
http://hdl.handle.net/10576/32111
EPIDEMIOLOGY OF CHLAMYDIA TRACHOMATIS IN LATIN AMERICA AND THE CARIBBEAN: SYSTEMATIC REVIEW, META-ANALYSES, AND META-REGRESSIONS
ABU-EL-RUZ, RASHA
Background: Chlamydia trachomatis (CT) is a Sexually Transmitted Disease (STD); it leads to health complications and infertility if not treated. Aim: To provide a comprehensive epidemiological assessment of CT in Latin America and the Caribbean (LAC). Methods: This study followed Cochran and PRISMA guidelines. We conducted the search in PubMed, Embase, and LILACS databases. We estimated the pooled-mean CT prevalence using random-effects meta-analyses. We conducted random-effects meta-regressions to identify sources of heterogeneity and possible predictors of high prevalence. Results: The pooled-mean urogenital CT prevalence was 8.2% (95% CI: 7.5-9.1) for general populations, 14.0% (95%CI: 12.7-15.4) for female sex workers, 10.8% (95% CI: 8.4-13.4) for men who have sex with men, male sex workers, and transgenders, 16.1% (95% CI: 12.6-19.8) for symptomatic women, 25.4 (95% CI: 18.6-38.5) for symptomatic men, 9.7% (95%CI: 6.1-14) for HIV-positive individuals and individuals in HIV-discordant couples, and 11.9% (95 CI: 8.5-15.8) for STI clinic attendees. Urogenital CT prevalence appears to decrease with age, to be higher in women compared to men, and to increase by 1% yearly. Anorectal CT appears to be higher in men compared to women but shows no temporal trend. Discussion: Urogenital CT prevalence among general populations is higher than that in other world regions. Conclusion: LAC is burdened by CT infection. Public health response in LAC region is required to effectively tackle CT infection.
0174-06-01T00:00:00Z