Effect of Premature Infant Oral Motor Intervention on Oral Feeding and Weight Gain: A Systematic Review and Meta-Analysis.

Background: Sucking and swallowing coordination did not achieve until 32-34 weeks of gestation in premature infants. Oral motor stimulations improve oral motor musculature and neurobehavioral synergism which improves the rate of oral feeding readiness and weight gain and ultimately reduces the duration of hospitalization. Premature Infant Oral Motor Interventions (PIOMI) is a specific oral motor therapy effective in improving the clinical outcomes among premature infants. Earlier no review had been conducted specifically to assess the effectiveness of PIOMI on oral feeding progression, weight gain, and Length of hospital Stay (LOS) among premature infants. So, the present review had been planned. Materials and Methods: Review was conducted by searching databases like PubMed/Medline, Embase, Ovid, Clinical Key and Academia, Google and Google Scholar (from PIOMI inception to October 2020). Published articles on RCTs and clinical trials were included. Results: Six studies, with a total of 301 premature infants, were included in Meta Analysis (MA). PIOMI was found effective in early attainment of feeding progression (Mean Difference (MD) = -4.63 days at 95% Confidence Interval (CI) = -4.97 to - 4.29, p < 0.001) and shifting from gavage to independent oral feeding (MD = -2.54 days at 95% CI = -3.13 to - 1.95, p < 0.001), shows weight gain at discharge (MD = 51.61 grams at 95% CI = 19.84 to 83.38, p = 0.001), and reduces LOS (MD = -2.81 days at 95% CI = -3.51 to - 2.10, p < 0.001). Conclusions: Review shows shows the effectiveness of PIOMI in improving oral feeding progression and early attainment of gavage to independent oral feedings, and it also showed weight gain at discharge and reduced LOS.

Perception of online learning among health sciences' students- A mixed methods study.

BACKGROUND: The outbreak of COVID-19 pandemic has led to a paradigm shift from the traditional classroom setting to online education and webinars. We could not identify any published multidisciplinary studies from Indian institutions that have explored the perception of online learning among health sciences students from different faculties. The study aimed to explore the perception of health sciences students regarding their experience, satisfaction, and challenges with online learning compared to offline learning. MATERIALS AND METHODS: An explanatory sequential (QUAN-qual) mixed-methods study was conducted between November 2020 and June 2021 among 474 medical, nursing, physiotherapy, and dental students attending online classes. All the students were invited to participate in the study using Google Form questionnaire. Quantitative data was analyzed using MS Excel. For qualitative data, focused group interviews were conducted with a group of six to eight students from each discipline on an online platform for 45 min to 1 h and transcripts were thematically analyzed. RESULTS: Totally 474 students responded to the survey questionnaire. Nearly 56.3% (267) of the students were not satisfied with the online learning program. Around 62.2% (294) of the students felt that online learning could not retain their interest. Students reported that learning the assigned syllabus was difficult during online lectures. They agreed that online learning could be distracting, time-consuming, and did not provide an adequate pace of learning. CONCLUSION: Though online learning is an effective learning strategy, it needs to be further improved considering the valuable inputs given by students.

Perception, burden and satisfaction of parents of children attending online classes during COVID-19 lockdown: A cross-sectional survey.

Introduction: Coronavirus has spread havoc globally, resulting in the closure of all sectors including education. Therefore, to continue a child's learning, the government started online classes from home by involving parents. This new learning method might be hectic and challenging for parents; therefore, this study aimed to assess the perception, burden, and satisfaction of parents of children attending online classes. Methods: A cross-sectional online survey was conducted in three schools of Rishikesh, Uttarakhand. A total of 220 parents of children attending online classes and studying between first and fifth standard responded voluntarily. Google Form was used to assess perception, burden, and satisfaction regarding online classes and analyzed using descriptive and inferential statistics. Results: The mean age of parents was 34.1 ± 5 years, and most of the respondents were mothers. Out of 220 parents, 52% showed negative perception, 42% experienced moderate to severe burden, and 51% were highly satisfied with the online classes during COVID-19 lockdown. Pearson's correlation coefficient showed a positive correlation between perception andsatisfaction of parents (P = 0.000, r = 0.616 *). Parental role and preferred teaching method had a significant association with parental perception (P < 0.01, P < 0.05). The app used and preferred teaching method during the pandemic had a significant association with parental satisfaction regarding online classes (p < 0.01, P < 0.05). Conclusion: Parents had negative perception and experienced moderate to severe burden concerning online classes. At the same time, they were highly satisfied with achieving educational objectives to some extent during the COVID-19 pandemic.

Depression in hospitalized older adults with chronic illness from a hilly Indian state.

PURPOSE: The study estimated the prevalence and determinants of depression among older adults with chronic illness. METHODS: A cross-sectional descriptive survey was done among 337 hospitalized older adults with chronic illness during February 2019-2020 at a selected tertiary care hospital, Rishikesh, India using total enumerative sampling by Geriatric Depression Scale. RESULTS: Among hospitalized older adults, depressive symptoms (80%) were highly prevalent and closely linked to an extended hospital stay [odds ratio = 2.106; 95% confidence interval [CI]: (1.30-3.411)], life events [odds ratio = 3.41; 95% CI: (1.48-7.88)], and multiple chronicity [odds ratio = 2.44; 95% CI: (1.49-3.98)]. IMPLICATIONS: This study demands liaison psychiatric nurses deployed at Indian tertiary care hospitals who can efficiently conduct screening and management of depression among older adults with chronic illness.

Managing Type 2 Diabetes: Beliefs and Daily Practices in First Generation Asian Indians in the United States.

INTRODUCTION: Diabetes management and control remain poor in Asian Indians (AI) and is influenced by personal beliefs and cultural practices. Since AIs have a high prevalence of diabetes and are more likely develop complications earlier than any other ethnic group, understanding their beliefs and practices of diabetes management is essential. The purpose of this study was to examine and understand beliefs and practices about diabetes self-management in first-generation AI Hindus and Sikhs. METHOD: Interpretative phenomenology was used to interview 12 first generation AI participants with type 2 diabetes to elicit beliefs and daily self-management practices of diabetes. Interpretative and thematic analysis were completed. RESULTS: Diabetes self-management was a balancing act influenced by Ayurvedic principles, allopathy and dietary practices; gender roles, insufficient knowledge and culturally inappropriate diabetes education. DISCUSSION: Culturally appropriate strategies that incorporate Ayurvedic principles, dietary practices, gender roles should be developed to improve diabetes management.

Beliefs About the Causes of Type 2 Diabetes Among First-Generation Asian Indians in the United States.

INTRODUCTION: Asian Indians (AIs) have the highest prevalence rates (18.3%-29%) of diabetes in any minority group in the United States, yet little is known about their beliefs about what causes type 2 diabetes. The purpose of this study was to examine first generation AIs causal beliefs about type 2 diabetes. METHOD: Interpretative phenomenology was used to interview 12 first-generation AI participants with type 2 diabetes to elicit causal beliefs of their disease. Interpretative and thematic analysis were completed. RESULTS: Beliefs about the causes of diabetes in AIs were influenced by a general familiarity with the disease, limited knowledge about causal and preventative factors of the disease, and gender specific roles and norms. DISCUSSION: Health programs that aim to incorporate AI's cultural and health beliefs about the causes of diabetes are warranted.

Impact of mobile phone dependence on behavior and academic performance of adolescents in selected schools of Uttarakhand, India.

BACKGROUND: Mobile phones are one of the excellent gifts of technology in the 21st century, which is most popular among adolescents. Today, mobile phones have infinite resources that have multiple benefits and applications. Its excessive use may impact adolescents in the form of behavioral changes and diminish the academic performance. This study explores the relationship between mobile phone usage with behavioral modifications and educational achievement among adolescents. MATERIALS AND METHODS: A descriptive correlational study was conducted among adolescents (n = 285 -male-210, female-75) at selected schools of Rishikesh, Uttarakhand, India. The test of mobile dependence was used to assess the mobile phone dependence, and a behavioral Likert scale to evaluate the behavioral changes through the self-report method. The academic performance was observed by school records; percentage of the last two examination results was considered. Collected data were analyzed using descriptive and inferential statistics. RESULTS: The study shows that 156 (54.70%) participants had a low mobile dependency, 191 (67%) participants had negative behavioral changes, and 125 (43.90%) participants had shown reduced academic performance due to overuse of the mobile phone. A significant relationship was seen between mobile phone dependency with behavioral changes (P < 0.001) and academic achievement (P < 0.035) seen among adolescents. Regression analysis predicted 49% of the differences among adolescents with selected variables due to the overuse of mobile phones. CONCLUSION: The study concluded that mobile dependency changes adolescent's behavior as well as reduces their academic performance due to the overuse of the mobile phone.

Near-Peer Tutor: A Solution For Quality Medical Education in Faculty Constraint Setting.

Near-peer mentoring is a formal relationship in which more qualified students guide immediate junior students. It is an innovative approach to increase students' engagement from varied backgrounds and cultures in the health profession. This systematic review and meta-analysis aimed to investigate and compare the effectiveness of near-peer tutoring and faculty/expert teaching in health science undergraduates on knowledge and skill outcome. The review question considered was "how effective is near-peer tutor compare to faculty/expert teaching for undergraduate health science students?" A comprehensive systematic search was undertaken in PubMed, Embase, Scopus, and Cochrane and screened initially in Rayyan software (Qatar Computing Research Institute, Qatar). Identified articles were screened independently for eligibility by two reviewers and extracted the data. Data were analyzed using standardized mean difference with Review manager version 5.5 (Cochrane Campbell Collaboration).  Sixteen studies were analyzed. Heterogeneity (I2) among studies was high in knowledge and skill scores. Heterogeneity was reduced by 30-40% after sensitivity analysis. No difference in knowledge and skill score was found among the near-peer and expert teaching groups. Students had a satisfactory learning experience with near-peer tutors except for some issues related to teaching proficiency in near-peers. Near-peer teaching was found to be as effective as faculty/expert teaching. Students were more comfortable with near-peers. As mentioned by students, some challenges were differences in teaching skills and level of knowledge among near-peers.

Effect of external cold and thermomechanical stimulation on anxiety and pain during intravenous cannulation among children.

Pain and anxiety are the most common and prevalent adverse stimuli experienced by hospitalised children. The most frightening and distressing source of pain and anxiety accounted for is due to venipuncture. This study aimed to assess the effect of cold and thermomechanical stimulation on pain and anxiety during intravenous (IV) cannulation among children. We conducted a prospective parallel-group randomised control trial in children who required IV cannulation. In the intervention group, external cold and thermomechanical stimulation was applied before 60 seconds, above 5 cm over IV cannulation site through Buzzy device, while the control group received routine care. Children's level of anxiety and pain was assessed using the Children's Fear Scale (CFS) and Wong-Baker Faces pain Scale (WBFS). Mean scores of the self-reported procedural level of pain were less in the intervention group as compared to the control group (2.80 ± 1.86, 7.47 ± 2.40). Median of procedural pain level showed a significant difference between the intervention and control group at p < 0.001, inferring that the Buzzy device strongly resulted in a reduction of perception of pain during the cannulation procedure. However, no significant difference was observed in the median of the procedural level of anxiety between the two groups (p = 0.208), stating that cold and thermomechanical stimulation did not affect the level of anxiety of children. Nevertheless, the combination of cold and thermomechanical stimulation through the Buzzy device did not have a significant impact on the procedural level of anxiety among children. Still, it could optimally alleviate the level of pain.

Obstructive sleep apnea risk and subclinical atherosclerosis in South Asians living in the United States.

OBJECTIVES: The objective of this study was to examine the association between high risk of obstructive sleep apnea (OSA) and subclinical atherosclerosis among South Asians in the United States. DESIGN: A secondary analysis of cross-sectional data. SETTING/PARTICIPANTS: A community-based cohort of 906 men and women participating in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. MEASUREMENTS: The Berlin Questionnaire was used to screen for OSA risk. Coronary artery calcium (CAC), common carotid artery intima-media thickness (IMT), and internal carotid artery IMT were used as measures of subclinical atherosclerosis. RESULTS: The majority of participants (59%) with high OSA risk had CAC scores >0 compared with only 41% of participants with low OSA risk (P <.001). The high OSA risk group was older (P =.005), male (P =.04), had higher body mass index (P <.001) and had greater common carotid artery IMT (0.96 ± 0.27 mm) and internal carotid artery IMT (1.33 ± 0.42 mm) measurements. Snoring, sleep-disordered breathing (SDB), and high OSA risk were associated with subclinical atherosclerosis. However, only high OSA risk remained significant in multivariable models after controlling for demographic and clinical factors that included hypertension (HTN), obesity, diabetes, and dyslipidemia. CONCLUSIONS: High OSA risk, which includes overlapping comorbidities of HTN and obesity, was not associated with the time living in the US but was associated with subclinical atherosclerosis markers. These cardiovascular disease risk factors should include evaluation of the spectrum of SDB among all adults, including South Asian men and women.

Risk of Obstructive Sleep Apnoea is Associated with Glycaemia Status in South Asian Men and Women in the United States.

AIMS: To examine the association between glycaemia status and the risk for obstructive sleep apnoea (OSA) in a cohort of South Asians living in the United States. METHODS: A secondary analysis of a community based cohort of 899 participants from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. The Berlin Questionnaire was used to screen for OSA. RESULTS: Almost one in four (24%) South Asians was at high risk for OSA. Compared to the normal glucose tolerance group (18%), high risk of OSA was significantly more likely in the prediabetes (24%) and diabetes (32%) groups (p = .007). More men (28%) than women (18%) were at high risk of OSA. Risk for OSA was also associated with higher haemoglobin A1c values, hypertension, large waist circumference, and BMI > 27.5 kg/m2. In a multivariate regression analysis, sleep disordered breathing (SDB) remained significantly associated with higher haemoglobin A1c values, even after controlling for waist circumference and other demographic and clinical factors. CONCLUSIONS: The risk for SDB and OSA was high among South Asian men and women. Given the association between dysglycaemia and risk for OSA, these health issues require simultaneous clinical assessment. Future studies using objective sleep measures such as polysomnography are warranted in the diagnosis and treatment of OSA in the South Asian adult population already at high risk for dysglycaemia.

Correlation of feeding practices and health profile of children.

Infants and children are assets of a country. The nutritional status of the infants mainly depends on feeding practices. Breastfeeding has been suggested as an influencing factor which can help in reduction of occurrence of respiratory and gastrointestinal tract infections most often associated with childhood deaths. One hundred and fifty mother-infant dyads were selected by convenience sampling technique. Structured checklists were used to assess the history of feeding practices and past physical illness in children. Physical assessment of children in the form of anthropometric measurements was done. The results of the study revealed that feeding practices had significant negative correlation with physical illness (r = -0.340, p < 0.001) in the children. No significant correlation was found between anthropometric measurements of the children and feeding practices of mothers (r = 0.056, p > 0.05). Children with good feeding practices had less physical illness as compared to children with average or poor feeding practices. So, it is recommended that exclusive breastfeeding must be provided to every child.

Health and psychosocial outcomes in U.S. adult patients with diabetes from diverse ethnicities.

Within the United States, diabetes is a serious public health concern and patients with diabetes are more likely to experience clinical depression, psychological distress, and depressive symptoms than those without. Negative psychosocial factors are associated with poorer diabetes management and glycemic control. Overall, both the rates of diabetes and related psychological distress are greater for persons of diverse ethnicities than for non-Latino whites, and have reached epidemic proportions in certain groups. The following article will provide an overview across ethnicities of the rates of diabetes, health outcomes, psychosocial outcomes, and unique cultural and linguistic challenges that contribute to disparities within US diabetes patients of diverse ethnicities. Using this information, our hope is that health care practitioners and researchers alike can better respond to the psychosocial needs of ethnically diverse patients.