Adjustment and Completion of BASNEF Model to Provide a New Model for Educating Large Populations in Relation to Cutaneous Leishmaniasis

Background: Educational models that have been created for educating small populations do not have enough efficacy for educating large populations, so based on this premise and also high prevalence of Cutaneous Leishmaniasis (CL) in the Islamic Republic of Iran and lack of efficient methods for CL control, this study was designed and done with the aim of applying BASNEF model to provide a new model for educating large populations in relation to Cutaneous Leishmaniasis. Methods: In a quasi-experimental study, 60 Volunteer Health Workers (VHWS) and 120 households that were resident in endemic areas of CL in Yazd were selected through census and multi-stage sampling method, respectively. Then, educational intervention was designed and implemented on the basis of BASNEF model. After educating VHWS based on BASNEF model, they were asked to educate households on the basis of BASNEF model. Before and after 3 months of VHWS training activities, data were collected in intervention and control groups via valid and reliable questionnaires and were analyzed with the SPSS software. Results: The mean score of knowledge, attitude, behavioral intention, enabling factors, behaviors and influence of subjective norms after educational intervention in households in experimental were significantly increased (P<0.05) while the changes in control group were not significant. Conclusions: This educational program led to empowering of VHWS and a change in their educational behavior which in turn led to preventive measures in households under study region. It can be concluded that the new educational model presented in this research, formed based on the BASNEF model, is able to educate a large population. Keywords: BASNEF Model, Volunteer Health Workers, Health Education, Cutaneous Leishmaniasi

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients’ (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16–22) and failed intubation in 1 in 312 (95%CI 1 in 169–667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)