Sub-chronic exposure to paroxetine disrupts ecologically relevant behaviours in fish.

The functional conservation of important selective serotonin reuptake inhibitor (SSRI) targets in non-target organisms raises concerns about their potential adverse effects on the ecosystems. Although the environmental levels of SSRIs like paroxetine (PAR) have risen, the knowledge regarding the effects of long-term exposure to PAR is limited. This study investigated the impact of sub-chronic exposure (21 days) to two sub-lethal concentrations of PAR (40 and 400 µg/L) on the behaviour of adult zebrafish in different scenarios: basal activity (under dark and light conditions), stress response (evoked by sudden light transitions) and stress response recovery. A new framework was employed for the integrative study of fish's swimming performance based on their innate ability to respond to light shifts. Several swimming-associated parameters (e.g., total swimming distance, time of inactivity, swimming angles) and thigmotaxis were monitored for an integrated analysis in each scenario. Data revealed reduced swimming activity, impaired behavioural response to stress and alterations in stress recovery of PAR-exposed fish. An anxiolytic effect was particularly noticeable in fish basal swimming activity in the dark at 400 µg/L and in the behavioural response to stress (from dark to light) and stress recovery (from light to dark) for organisms exposed to 40 µg/L. The detected PAR-induced behavioural modifications suggest a disruption of brain glucocorticoid signalling that may have implications at the individual level (e.g., changing behavioural responses to predators), with potential repercussions on the population and community levels. Therefore, the applied protocol proved sensitive in detecting behavioural changes induced by PAR.

Therapy and Prevention of Noise Fears in Dogs-A Review of the Current Evidence for Practitioners.

Noise fears represent the most common behavioural problem in dogs. This manuscript provides an overview of diverse approaches for alleviating fear of noises in dogs and the supporting evidence. In the treatment of noise fears, both short-term solutions to prevent trauma or the deterioration of fear during unavoidable noise events and longer-term training need to be considered. Environmental management, the provision of incentives (food/play) during noise exposure, and, when indicated, anxiolytic medication, can safeguard dogs' welfare during noise events. Most "alternative" products (such as nutraceuticals, herbal remedies, pheromones, homeopathy, Bach flowers, and essential oils) are unlikely to be sufficient as monotherapy for noise fears, whereas there is good evidence for the efficacy of several anxiolytic medications. In the longer term, counterconditioning to real-life noises, relaxation training, and desensitisation/counterconditioning using noise recordings have been shown to improve fear of noises in dogs. Preventative training appears to be highly effective in preventing the development of noise fears in puppies and adult dogs.

Are early and young life stages of fish affected by paroxetine? A case study with Danio rerio.

Paroxetine (PAR) is a selective serotonin reuptake inhibitor (SSRI) antidepressant increasingly detected in surface waters worldwide. Its environmental presence raises concerns about the potential detrimental effects on non-target organisms. Thus, this study aimed to increase knowledge on PAR's potential environmental impacts, assessing the effects of commercial formulation (PAR-c) and active ingredient (PAR-a) on fish. Therefore, the short-term exposure effects of PAR-c and PAR-a were assessed on zebrafish (Danio rerio) embryos/larvae to determine the most toxic formulation [through median lethal (LC50) and effective concentrations (EC50)]. PAR-c and PAR-a induced morphological abnormalities (scoliosis) in a dose-dependent manner from 96 hours post-fertilization onwards, suggesting the involvement of a fully functional biotransformation system. As PAR-c exhibited higher toxicity, it was selected to be tested in the subsequent stage (juvenile stage), which was more sensitive (lower LC50). PAR-c significantly decreased fish swimming activity and disrupted fish stress response. Overall, the results highlight the ability of PAR-c to adversely affect fish swimming performance, an effect that persisted even after exposure ceases (21-day depuration), suggesting that PAR-c may impair individual fitness.

Understanding and treating equine behavioural problems.

Behaviour-related issues are common in horses. Many 'undesirable behaviours' pose important safety concerns for the human handlers / riders / carers, as well as welfare concerns for the horse. Undesirable behaviours can also devalue a horse, or result in the horse being re-homed, relinquished, or euthanased. Undesirable behaviours occur for a range of reasons. These include physiological causes, poor management, and the use of inappropriate or poorly applied handling and training techniques. The potential contribution of each of these aspects must be considered when attempting to reduce or eliminate undesirable behaviours. Effectively modifying the existing behaviour includes investigation and treatment of potential physiological causes, assessing and adjusting existing handling, husbandry and management, and undertaking behaviour modifying training. Unlike in the treatment of dogs and cats, the use of psychotropic agents is uncommon in equine behaviour medicine but the benefits of using these agents in appropriate cases is gaining recognition. This review discusses potential causes for the development and maintenance of undesirable behaviours in horses and highlights the various considerations involved in determining the most appropriate course for reducing or eliminating these behaviours. There is also a brief discussion about the potential role of psychotropic agents as an additional component of an overall behaviour modification plan to reduce or eliminate undesirable behaviours in horses.

The role of behaviour-change theory in sleep interventions with emerging adults (aged 18-29 years): a systematic review and meta-analysis.

Previous systematic reviews and meta-analysis of sleep interventions with young adults have not reached consensus on what contributes to their efficacy. Behaviour-change theories may influence the efficacy of interventions; hence, the aim of this research was to investigate the role of such theories in sleep interventions with this population. Six electronic databases and reference lists were searched (April-May 2021) for published sleep behaviour-change interventions with emerging adults (aged 18-29 years) that used control groups. A selection of 20 studies fulfilled the inclusion criteria, but only six were based on behaviour-change theories. Meta-analysis was run with eight studies, as the others had a high risk of bias or did not present the necessary data to calculate Hedges' g. The estimation of a random effects model for the studies showed a small effect in the sleep quality of the participants in the experimental group (g = -0.26; 95% confidence interval -0.42 to -0.09), with low levels of heterogeneity (I2  = 21%), and a small 95% prediction interval (-0.59 to 0.08). Although we could not examine theory or any other moderators of the effect, a qualitative analysis of the behaviour-change techniques present in the interventions leads us to hypothesise that there is not a direct link between behaviour-change techniques and the success of the intervention. Other characteristics of the interventions may be linked to their variable levels of efficacy and should be investigated in the future, as for now there are no answers as to what the key is for successful sleep interventions.

Behaviour Change to Promote Diabetes Outcomes: Getting More From What We Have Through Dissemination and Scalability.

The potential benefits of advanced medical treatments (pharmacotherapies) and technologies (diagnostics, devices and apps) are unrealized due to lack of sustained behaviour change in individuals living with type 2 diabetes. The lack of scale-up of effective health behaviour change interventions limits health improvement. Identification of mediators of behaviour change (adherence, self-efficacy, intrinsic motivation) can address this limitation by shifting the focus of behaviour change from input (which behaviour change strategy to choose) to output (what can the person adhere to and sustain). Technology and accessing the workplace environment to promote change offer scalable opportunities for facilitating health behaviour change in populations.

Application of a Systematic Oral Health Promotion Model for Pregnant Women: A Randomised Controlled Study.

PURPOSE: To explore the effects of oral health promotion management on the improvement of oral healthcare knowledge, attitudes, and behaviours in pregnant women. MATERIALS AND METHODS: This randomised study included pregnant women in Shanghai (China) who were randomly assigned to receive oral-health promotion management (intervention group) or no interventions (control group). The primary outcome for this study was overall oral health. The secondary outcomes included oral health awareness and attitudes, oral health knowledge, oral healthcare behaviours, medical visits, and risk factors. The Fourth National Oral Health Questionnaire was self-administered in this study, and oral examinations included caries and periodontal status. Data consistency was assessed by the Kappa coefficient. RESULTS: After intervention, periodontal outcomes in the intervention group had improved statistically significantly, and the proportion of those without periodontal diseases had statistically significantly increased to 14.4% (p < 0.05). In the intervention group, statistically significant improvements were also observed in the number of active caries (p < 0.001), number of filled teeth (p = 0.014), and community periodontal index (CPI) scores (p < 0.001). Overall, after intervention, pregnant women demonstrated comprehension of the importance of children's deciduous teeth, and their knowledge of the importance of good oral health had greatly improved. Further, oral healthcare habits in the intervention group also showed statistically significant improvement: 56.8% established the habit of cleaning the tongue every week (p < 0.05) and 39.6% established the habit of regular oral examination (p < 0.05). CONCLUSION: Oral healthcare education and promotion management for pregnant women can effectively improve their oral health, knowledge, attitudes, and behaviours of oral health care.

Evaluation of different pre-treatment behaviour modification techniques in 4-7-year olds: A randomised controlled trial.

Purpose: The aim of this study is to evaluate and compare the effectiveness of five pre-treatment behaviour modification techniques in 4-7-year olds in reducing dental anxiety by evaluating pulse rate, partial pressure of oxygen, systolic blood pressure, diastolic blood pressure, salivary flow rate, salivary pH, and through modified facial anxiety scale. Material and Methods: Using simple random sampling technique (drawing of lots), 125 children were equally distributed into 5 groups of 25 each: Group 1: tell-show-do (control); Group 2: tell-show-play-doh; Group 3: Playmobil Dentist; Group 4: mobile dentist games; Group 5: role play as dentist. Samples in each group were treated in a single appointment after using the behaviour modification techniques. Class I or Class II cavities were prepared on carious primary molar and restored using glass ionomer cement. Patient's anxiety level was assessed by recording blood pressure, pulse rate, oxygen saturation, salivary pH, salivary flow rate, and facial anxiety scale at different time intervals, that is before the treatment, during the treatment, and after the treatment. Results: All the intervention Groups (Groups 2-5) showed reduced anxiety scores in both physiological and facial anxiety compared to the control group, that is tell, show do. The modified distraction techniques aid in better modification. Conclusion: Tell-show-play-doh, Playmobil dentist games, mobile dentist games and role play as dentist are effective distraction techniques as compared to conventional tell-show-do techniques which can be incorporated in day-to-day clinical practice to reduce dental anxiety in paediatric patients.

Understanding how general practice nurses support adult lifestyle risk reduction: An integrative review.

AIM: To review the literature exploring how general practice nurses support lifestyle risk reduction. DESIGN: Integrative literature review. SOURCES: CINAHL, Emcare, MEDLINE, Proquest and Scopus were searched for peer-reviewed primary research published in English from 2010 to 2022. METHODS: Sixteen papers met the inclusion criteria and were assessed for methodological quality using the Mixed Methods Appraisal Tool. Findings were extracted and thematically analysed. RESULTS: Four themes described general practice nurses: (1) Establishing relational connections; (2) Empowering active participation; (3) Engaging mutual motivation and (4) Enabling confident action. General practice nurses used complex interpersonal, risk communication and health coaching skills to build collaborative partnerships that supported patients' self-determination and self-efficacy. While mutual motivation and confidence were reciprocally enabling, gaps in skills, experience and knowledge plus time, resource and role constraints limited general practice nurses' ability to support lifestyle risk reduction. CONCLUSION: General practice nurses play a key role in lifestyle risk reduction. Ongoing education, funding, organizational and professional support are needed to enhance their commitment, confidence and capacity. IMPACT: What problem did the study address? While general practice nurses play a key role in health promotion and risk reduction, their potential is yet to be fully realized. Research examining methods by which nurses working in general practice support lifestyle risk reduction is limited. What were the main findings? Successful interactions depended on personal, professional, organisational and systemic factors which either enhanced or inhibited relational quality, shared decision-making, mutual commitment, and nurses' confidence and capacity to address lifestyle risks. Targeted professional development and peer mentoring are needed to build proficient practice. Where and on whom will the research have impact? Understanding how general practice nurses support risk reduction can inform policy and identify training and support needs to advance their skills and role. Research exploring synergies between themes may illuminate this process.

Effectiveness of psychological techniques in dental management for children with autism spectrum disorder: a systematic literature review.

BACKGROUND: A rise in the reported numbers of children with Autism Spectrum Disorder (ASD) highlights the need for dental practitioners to be more familiar with the treatment approaches for these special needs children to ensure comfortable, well-accepted and efficient management while in dental office. AIM: This paper aimed to acquire a deeper understanding of some of the innovative and best approaches to managing children with ASD in dental settings. DESIGN: A systematic literature search was performed in PubMed, Scopus, Web of Science, Cochrane databases, and grey literature based on the PRISMA 2020 statement, using main keywords such as: 'management', 'dental', 'children', and 'Autism Spectrum Disorder'. Original full-text papers including randomised controlled trials (RCT) and all other designs of non-randomised controlled studies (NRS) reporting relevant intervention studies in English were included without any publication time limit. The quality of the evidence found eligible for the review were then assessed using the ROB-2 and ROBINS-I tools. Subsequently, the details of management interventions and impact of treatment approaches were compared and discussed. RESULTS: Out of the 204 articles found, 109 unrelated articles were excluded during the initial screening. The full papers of remaining 28 were retrieved and only 15 (7%) articles were eligible to be reviewed; eight RCTs with 'some concerns' and 'high risk' categories particularly concerning their randomisation design, and seven NSRs with 'serious' to 'critical' bias largely due to confounding factors. CONCLUSION: Our review found inconclusive evidence on the strength of recent psychological and non-pharmacological approaches used to manage children with ASD in dental settings. Small sample size and lack of a control group in certain studies affected the strength of evidence and credibility of the findings. Nevertheless, this review shared informative details on some innovative approaches for better understanding of the management of children with ASD for dental professionals.

Counselling and Behaviour Modification Techniques for the Management of Obesity in Postpartum and Midlife Women: A Practical Guide for Clinicians.

Behaviour change is the basic foundation in the management of obesity. Such behaviour change is difficult to achieve due to several psychosocial and behavioural barriers that often remain unidentified and unaddressed in a weight management programme. This is even more challenging in postpartum and midlife women because of several biopsychosocial factors. The non-availability of psychologists or trained healthcare counsellors further complicates the attainment of behavioural changes. Therefore, clinicians, who are often the first point of contact for treating these population groups, are hamstrung by the lack of a multidisciplinary approach for weight reduction. Some of the common psychological, social and behavioural barriers have been identified in this article, and evidence-based techniques such as goal setting, stimulus control and cognitive restructuring are presented in a step-wise approach, to help clinicians cater to these population groups in a holistic manner.

Volatiles Produced by Yeasts Related to Prunus avium and P. cerasus Fruits and Their Potentials to Modulate the Behaviour of the Pest Rhagoletis cerasi Fruit Flies.

Yeast produced semiochemicals are increasingly used in pest management programs, however, little is known on which yeasts populate cherry fruits and no information is available on the volatiles that modify the behaviour of cherry pests including Rhagoletis cerasi flies. Eighty-two compounds were extracted from the headspaces of eleven yeast species associated with sweet and sour cherry fruits by solid phase micro extraction. Esters and alcohols were the most abundant volatiles released by yeasts. The multidimensional scaling analysis revealed that the odour blends emitted by yeasts were species-specific. Pichia kudriavzevii and Hanseniaspora uvarum yeasts released the most similar volatile blends while P. kluyveri and Cryptococcus wieringae yeasts produced the most different blends. Combined gas chromatographic and electroantennographic detection methods showed that 3-methybutyl acetate, 3-methylbutyl propionate, 2-methyl-1-butanol, and 3-methyl-1-butanol elicited antennal responses of both R. cerasi fruit fly sexes. The two-choice olfactometric tests revealed that R. cerasi flies preferred 3-methylbutyl propionate and 3-methyl-1-butanol but avoided 3-methybutyl acetate. Yeast-produced behaviourally active compounds indicated a potential for use in pest monitoring and control of R. cerasi fruit flies, an economically important pest of cherry fruits.

A pilot study to evaluate the impact of digital imaging on the delivery of oral hygiene instruction.

AIMS: To determine whether personalised Oral Hygiene Advice (OHA) using an intra-oral-camera (IOC) combined with standard OHA as provided in general dental practice reduces plaque levels after 4 weeks more than the provision of standard OHA. MATERIALS AND METHODS: 22 healthy adult participants diagnosed with gingivitis took part in this pilot parallel-designed, randomised, examiner-blind, 2x-treatment, study regarding their home-care oral hygiene habits and attitudes to oral health. An IOC-image was taken and plaque, gingival and bleeding scores were recorded. Test group participants received standard OHA with IOC-images to indicate areas for improvement, control group participants received standard OHA. Questionnaires and plaque, gingival and bleeding scores were repeated after 4 weeks. Plaque was scored from the IOC-images and scores compared to clinical plaque scores. RESULTS: Lifestyle habits, attitudes to oral health, plaque (0.63vs0.61, control vs test) and bleeding scores (1.17vs0.96, control vs test) were similar at baseline. After 4-weeks, plaque scores improved more in test as compared to control group (39.4vs20.6%, p<0.05, while gingival and bleeding scores approached significance. There was no difference in lifestyle habits between groups, but the test group reported significantly greater confidence in adhering to their bespoke oral health plan. Agreement between the clinical and IOC plaque scores was good. CONCLUSIONS: Use of IOC further personalises the prevailing standard of oral hygiene advice and generates great patient engagement with pictorial reports to facilitate a more in-depth patient explanation of their gingival health, resulting in significant plaque reduction and improved gingival health compared to the standard OHA alone.

Behaviour modification intervention for patients with chronic kidney disease could provide a mid- to long-term reduction in public health care expenditure: budget impact analysis.

BACKGROUND: A recent cost-effectiveness analysis (CEA) study evaluated the widespread diffusion of behaviour modification intervention for patients with chronic kidney disease (CKD). Incorporating this behaviour modification intervention, comprising educational sessions on nutrition/lifestyle and support for regular patient visits, to the current CKD guideline-based practice was found to be cost-effective. This study aimed to examine the affordability of this efficient new practice under the hypothesis that the behaviour modification intervention would be initiated by general physicians (GPs). METHODS: A budget impact analysis was conducted by defining the target population as patients aged 40-74 years with stage-3-5 CKD based on the prevalence of definitive CKD in the Japanese general population. Costs expended by social insurers without discount were counted as budgets. We estimated the annual budget impact for 15 years by running our CEA model, assuming that it would be good for the span. RESULTS: We estimated the number of patients with end-stage kidney disease (ESKD) to decrease by 4,496 in the fifteenth year of the new practice using our CEA model. Compared to that in the current practice, the budget impact as total additional expenditure of the new practice was estimated to be negative by the tenth year in the base case. CONCLUSIONS: The widespread diffusion of behaviour modification intervention would contain public health care expenditure over the mid-to-long term, resulting from a reduction in progression to ESKD. We suggest that providing sufficient economic incentives to GPs and strengthening recommendations in CKD guidelines would realise effective GP-initiated interventions.

Effectiveness of tobacco cessation counselling and behavioural changes Using Multi Theory Model (MTM): A follow-up study.

BACKGROUND: Effective tobacco cessation programs using advice and counselling, have helped a substantial proportion of people quit smoking. Effectiveness of this tobacco cessation counselling needs to be evaluated. AIM: The aim of the present study was to evaluate the effectiveness of tobacco cessation counselling and behavioural changes using Multi Theory Model (MTM). SETTING AND DESIGN: A non-randomised uncontrolled trial was conducted on 100 tobacco users visiting dental college in Bangalore. METHODS AND MATERIALS: A 28 item questionnaire multi-theory model (MTM) for health behaviour was administered at baseline, 2 weeks, 6 weeks and 12 weeks after providing standardized tobacco cessation counselling (TCC) intervention at baseline. STATISTICAL ANALYSIS: Data were analysed and comparison were made using repeated measure ANOVA and Bonferroni adjustment (p < 0.05). RESULTS: A total of 64 participants completed the 12 week follow-up. The mean age was 44.3 ± 10.1 years and 75.8% were males. There was significantly increase in mean MTM behaviour change score from baseline (32.78 ± 4.8) to 2 weeks (52.37 ± 5.27), 6 weeks (49.81 ± 4.34) and 12 weeks (48.7 ± 3.50) (p < 0.001). CONCLUSION: There was increase in MTM model scores in subsequent follow up suggesting behavioural changes and overall effectiveness of the Tobacco cessation counselling (TCC) among tobacco users.

Weight loss with bariatric surgery or behaviour modification and the impact on female obesity-related urine incontinence: A comprehensive systematic review and meta-analysis.

Women with obesity are at risk of pelvic floor dysfunction with a 3-fold increased incidence of urge urinary incontinence (UUI) and double the risk of stress urinary incontinence (SUI). The National Institute for Health and Care Excellence (NICE) and European Association of Urology (EAU) recommend that women with a body mass index ≥30 kg/m2 should consider weight loss prior to consideration for incontinence surgery. This systematic review and meta-analysis will assess this recommendation to aid in the counselling of women with obesity-related urinary incontinence (UI). Medical Literature Analysis and Retrieval System online (MEDLINE), EMBASE, Cochrane, ClinicalTrials.gov, and SCOPUS were systematically and critically appraised for all peer reviewed manuscripts that suitably fulfilled the inclusion criteria established a priori and presented original, empirical data relevant to weight loss intervention in the management of urinary incontinence. Thirty-three studies and their outcomes were meta-analysed. Weight loss interventions were associated in a decreased prevalence in UI (OR 0.222, 95% CI [0.147, 0.336]), SUI (OR 0.354, 95% CI [0.256, 0.489]), UUI (OR 0.437, 95% CI [0.295, 0.649]) and improved quality of life (PFDI-20, SMD -0.774 (95% CI [-1.236, -0.312]). This systematic review and meta-analysis provide evidence that weight loss interventions are effective in reducing the prevalence of obesity-related UI symptoms in women. Bariatric surgery in particular shows greater sustained weight loss and improvements in UI prevalence. Further large scale, randomized control trials assessing the effect of bariatric surgery on women with obesity-related UI are needed to confirm this study's findings.

Using selected behaviour modification practices to enhance reinforcement of reading abilities among dyslexic learners in Kenya.

BACKGROUND: Dyslexic learners have difficulties in accurate and fluent word recognition and poor spelling and decoding abilities. OBJECTIVE: The present study investigated the use of selected behaviour modification practices to enhance reinforcement of reading abilities amongst dyslexic learners in primary schools in Kenya. METHODS: The Solomon four research design was adopted. A sample size of 229 dyslexic learners in four selected schools was obtained using purposive sampling technique. The tools used were the Bangor Dyslexia Test and a short reading comprehension test. Internal validity of the constructs was tested using the Kaiser-Meyer-Oklin measure of sampling adequacy (KMO Index) and the Bartlett's test of sphericity. The reliability of the questionnaires was ascertained using Cronbach's alpha and internal consistencies of 0.673-0.807 were reported. RESULTS: The findings reported a statistical significant difference between pre-test and post-test scores of the experiment group 1, t (48) = -15.059, p < 0.01, implying that a significant effect was found in the use of behaviour modification strategies in improving learner English language reading skills. The regression model explained 54.7% (R 2 = 0.547) of the variability in the level of English language reading abilities amongst primary school learners with dyslexia. CONCLUSION: The study concludes that coaching behaviour modification practice had the highest influence on English language reading abilities as compared to prompting, shaping and modelling practices. The study recommended training of teachers on the use of behaviour modification practices to improve dyslexic learners' reading ability.

A Review on Mitigating Fear and Aggression in Dogs and Cats in a Veterinary Setting.

A high proportion of dogs and cats are fearful during veterinary visits, which in some cases may escalate into aggression. Here, we discuss factors that contribute to negative emotions in a veterinary setting and how these can be addressed. We briefly summarise the available evidence for the interventions discussed. The set-up of the waiting area (e.g., spatial dividers; elevated places for cat carriers), tailoring the examination and the treatment to the individual, considerate handling (minimal restraint when possible, avoiding leaning over or cornering animals) and offering high-value food or toys throughout the visit can promote security and, ideally, positive associations. Desensitisation and counterconditioning are highly recommended, both to prevent and address existing negative emotions. Short-term pain from injections can be minimised by using tactile and cognitive distractions and topical analgesics, which are also indicated for painful procedures such as ear cleanings. Recommendations for handling fearful animals to minimise aggressive responses are discussed. However, anxiolytics or sedation should be used whenever there is a risk of traumatising an animal or for safety reasons. Stress-reducing measures can decrease fear and stress in patients and consequently their owners, thus strengthening the relationship with the clients as well as increasing the professional satisfaction of veterinary staff.

Therapeutic benefits of blinking exercises in dry eye disease.

PURPOSE: Dry eye disease (DED) is an important public health concern given its increasing prevalence and impact on patient quality of life. Blinking frequency and completeness are reduced during digital screen exposure, compromising meibum secretion and distribution, causing tear film instability and leading to DED. This study evaluated the effects of blinking exercises on blink pattern and clinical signs and symptoms of DED. METHODS: Fifty-four participants with dry eye symptoms received instructions to perform a ten-second cycle of blinking exercises every 20 min during waking hours for four weeks. Symptoms were assessed using the 5-item Dry Eye Questionnaire (DEQ-5) and Ocular Surface Disease Index (OSDI); blinking patterns measured with the TearScience LipiView II; and tear film and ocular surface parameters assessed with the Oculus Keratograph 5M. Measures at baseline and on day 28 were compared. RESULTS: Forty-one participants completed the study, reporting an average of 25.6 daily blinking exercise cycles. Improvements were noted in DEQ-5 (from 11 ± 4 to 7 ± 3; p < 0.001), OSDI (36 ± 18 to 22 ± 17; p < 0.001), non-invasive tear film breakup time (6.5 ± 2.4 to 8.1 ± 4.8 s; p < 0.04), the proportion of incomplete blinks (54 ± 36 to 34 ± 29 %; p < 0.001), but not in tear meniscus height or tear film lipid layer thickness. CONCLUSION: Blinking exercises can modify poor blinking patterns and improve dry eye symptomology, with modest changes in objective measures of tear film quality. Incorporating such routines into clinical care recommendations may improve blinking habits and help protect against the impact of digital device use on tear film quality and DED onset and evolution.

SARS COV 2 positive healthcare workers in obstetrics and gynaecology- Save the saviour study.

Context: Health-care workers (HCWs), being the front-line warriors, have been at increased risk for COVID-19 throughout the pandemic. However, the current extent of SARS-CoV-2 transmission and associated risk factors is still unclear in low- and middle-income countries, like India, especially in the department of obstetrics and gynaecology, which propelled this study. Aims: (i) Frequency of infection among HCWs among OBGYN department and cycle threshold value (Ctv) of SARS-COV-2 on RT-PCR. (ii) Clinical presentation, assessment of risk factors, and its impact on HCWs. Settings and Design: This was a prospective study conducted at the Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi for the duration of 6 months. Methods and Material: All SARS-CoV-2-positive HCWs in the department were interviewed verbatim after recovery, through a self-formulated, validated questionnaire, and answers recorded on pre-designed proforma. Statistical Analysis Used: Categorical variables were presented as number and percentage (%), whereas continuous variables as mean ± standard deviation (SD) and median values. Data were transferred on Microsoft Excel spreadsheet and analysed using SPSS v 27.0. Results: Amongst 727 HCWs working in the department, 350 RT-PCR tests were performed, and 110 tested positive (prevalence of 15.13%). Mean Ctv of RT-PCR was 28.03. Most HCWs were symptomatic (n = 94) with mild infection; working as nursing officers (40%). Majority of them acquired virus while working in non-COVID wards (76%). Noncompliance with IPC practices (40%) and lack of social distancing (34.5%) were key risk factors. Conclusion: Adept knowledge of the risk factors and IPC practices can aid in averting casualties due to SARS-COV-2 amongst the HCWs.