5 research outputs found
Assessing the knowledge, attitude and practice of electronic cigarettes and their associated factors among undergraduate students of Institute of Medicine, Nepal: a cross-sectional study
No full textAbstract Background Electronic cigarettes (e-cigarettes) are gaining popularity globally and becoming popular among young people, including in Nepal. Easy accessibility, appealing ads, and the misconception that e-cigarettes are safer than traditional cigarettes have fueled their rising popularity among university students in Nepal. The lack of comprehensive data on the prevalence and determinants of e-cigarette use among university students in Nepal underscores the urgent need for targeted research in this area. This study aimed to examine the knowledge, attitudes, and practices regarding e-cigarettes, as well as their influencing factors, among undergraduate students at the Institute of Medicine in Kathmandu, Nepal. Methods We conducted a cross-sectional study with 302 undergraduate students. A self-administered questionnaire assessed their knowledge, attitudes, and practices related to e-cigarettes. Descriptive statistics were reported, and chi-square tests and multivariate logistic regression analyses were performed to determine the statistical association among variables using STATA 14. Results The mean age of participants was 21.4 ± 2.1 years. Of the 302 respondents, 214 (70.9%) had heard of e-cigarettes. Among them, 71.5% had good knowledge, 62.2% held supportive attitudes, and 79.0% had never used e-cigarettes. Males were more likely to smoke e-cigarettes than females (AOR: 2.27; 95% CI: 1.01–5.01; p = 0.046). Students with friends who smoke were nearly three times more likely to use e-cigarettes (AOR: 3.00; 95% CI: 1.12–7.99; p = 0.028). Supportive attitudes towards e-cigarettes also doubled the likelihood of smoking them (AOR: 2.10; 95% CI: 1.02–4.35; p = 0.045). Conclusion The study highlights important implications for interventions, policy, and education within Nepal’s medical system. With a notable percentage of students holding supportive attitudes toward e-cigarettes, there is a clear need for targeted behavior change campaigns that educate about the health risks associated with e-cigarettes
Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal
No full textBackgroundImproving the healthcare providers (HCP) basic resuscitation skills can reduce intrapartum related mortality in low- and middle-income countries. However, the resuscitation intervention’s successful implementation is largely dependent on proper facilitation and context. This study aims to identify the facilitators and barriers for the implementation of a novel resuscitation package as part of the quality improvement project in Nepal.MethodsThe study used a qualitative descriptive design. The study sites included four purposively chosen public hospitals in Nepal, where the resuscitation package (Helping Babies Breathe [HBB] training, resuscitation equipment and NeoBeat) had been implemented as part of the quality improvement project. Twenty members of the HCP, who were trained and exposed to the package, were selected through convenience sampling to participate in the study interviews. Data were collected through semi-structured interviews conducted via telephone and video calls. Twenty interview data were analyzed with a deductive qualitative content analysis based on the core components of the i-PARiHS framework.ResultsThe findings suggest that there was a move to more systematic resuscitation practices among the staff after the quality improvement project’s implementation. This positive change was supported by a neonatal heart rate monitor (NeoBeat), which guided resuscitation and made it easier. In addition, seeing the positive outcomes of successful resuscitation motivated the HCPs to keep practicing and developing their resuscitation skills. Facilitation by the project staff enabled the change. At the same time, facilitators provided extra support to maintain the equipment, which can be a challenge in terms of sustainability, after the project. Furthermore, a lack of additional resources, an unclear leadership role, and a lack of coordination between nurses and medical doctors were barriers to the implementation of the resuscitation package.ConclusionThe introduction of the resuscitation package, as well as the continuous capacity building of local multidisciplinary healthcare staff, is important to continue the accelerated efforts of improving newborn care. To secure sustainable change, facilitation during implementation should focus on exploring local resources to implement the resuscitation package sustainably.</p
Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal
No full textAbstract Background Improving the healthcare providers (HCP) basic resuscitation skills can reduce intrapartum related mortality in low- and middle-income countries. However, the resuscitation intervention’s successful implementation is largely dependent on proper facilitation and context. This study aims to identify the facilitators and barriers for the implementation of a novel resuscitation package as part of the quality improvement project in Nepal. Methods The study used a qualitative descriptive design. The study sites included four purposively chosen public hospitals in Nepal, where the resuscitation package (Helping Babies Breathe [HBB] training, resuscitation equipment and NeoBeat) had been implemented as part of the quality improvement project. Twenty members of the HCP, who were trained and exposed to the package, were selected through convenience sampling to participate in the study interviews. Data were collected through semi-structured interviews conducted via telephone and video calls. Twenty interview data were analyzed with a deductive qualitative content analysis based on the core components of the i-PARiHS framework. Results The findings suggest that there was a move to more systematic resuscitation practices among the staff after the quality improvement project’s implementation. This positive change was supported by a neonatal heart rate monitor (NeoBeat), which guided resuscitation and made it easier. In addition, seeing the positive outcomes of successful resuscitation motivated the HCPs to keep practicing and developing their resuscitation skills. Facilitation by the project staff enabled the change. At the same time, facilitators provided extra support to maintain the equipment, which can be a challenge in terms of sustainability, after the project. Furthermore, a lack of additional resources, an unclear leadership role, and a lack of coordination between nurses and medical doctors were barriers to the implementation of the resuscitation package. Conclusion The introduction of the resuscitation package, as well as the continuous capacity building of local multidisciplinary healthcare staff, is important to continue the accelerated efforts of improving newborn care. To secure sustainable change, facilitation during implementation should focus on exploring local resources to implement the resuscitation package sustainably. Trial Registration Not applicable
Durable immunogenicity, adaptation to emerging variants, and low-dose efficacy of an AAV-based COVID-19 vaccine platform in macaques
No full textThe COVID-19 pandemic continues to have devastating consequences on health and economy, even after the approval of safe and effective vaccines. Waning immunity, the emergence of variants of concern, breakthrough infections, and lack of global vaccine access and acceptance perpetuate the epidemic. Here, we demonstrate that a single injection of an adenoassociated virus (AAV)-based COVID-19 vaccine elicits at least 17-month-long neutralizing antibody responses in non-human primates at levels that were previously shown to protect from viral challenge. To improve the scalability of this durable vaccine candidate, we further optimized the vector design for greater potency at a reduced dose in mice and non-human primates. Finally, we show that the platform can be rapidly adapted to other variants of concern to robustly maintain immunogenicity and protect from challenge. In summary, we demonstrate this class of AAV can provide durable immunogenicity, provide protection at dose that is low and scalable, and be adapted readily to novel emerging vaccine antigens thus may provide a potent tool in the ongoing fight against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)
Whole-brain annotation and multi-connectome cell typing of Drosophila
No full textThe fruit fly Drosophila melanogaster has emerged as a key model organism in neuroscience, in large part due to the concentration of collaboratively generated molecular, genetic and digital resources available for it. Here we complement the approximately 140,000 neuron FlyWire whole-brain connectome1 with a systematic and hierarchical annotation of neuronal classes, cell types and developmental units (hemilineages). Of 8,453 annotated cell types, 3,643 were previously proposed in the partial hemibrain connectome2, and 4,581 are new types, mostly from brain regions outside the hemibrain subvolume. Although nearly all hemibrain neurons could be matched morphologically in FlyWire, about one-third of cell types proposed for the hemibrain could not be reliably reidentified. We therefore propose a new definition of cell type as groups of cells that are each quantitatively more similar to cells in a different brain than to any other cell in the same brain, and wevalidate this definition through joint analysis of FlyWire and hemibrain connectomes. Further analysis defined simple heuristics for the reliability of connections between brains, revealed broad stereotypy and occasional variability in neuron count and connectivity, and provided evidence for functional homeostasis in the mushroom body through adjustments of the absolute amount of excitatory input while maintaining the excitation/inhibition ratio. Our work defines a consensus cell type atlas for the fly brain and provides both an intellectual framework and open-source toolchain for brain-scale comparative connectomics. © The Author(s) 2024.TRUEsciescopu
