Highlights of the BMC Series – January 2023

How safe is hyperbaric oxygen therapy for individuals suffering from long COVID? How effective is a comprehensive lifestyle management program in improving health outcomes in women with polycystic ovary syndrome? Can the teach-back method improve postpartum maternal-infant health among women with limited maternal health literacy? Can Virtual Reality be used to teach Basic Life Support skills? What are the perspectives of adolescents regarding recruitment and retention in longitudinal health studies?

BMC Infectious DiseasesHyperbaric oxygen therapy for long COVID (HOT-LoCO), an interim safety report from a randomised controlled trial

Post COVID-19 Condition or long COVID, can affect anyone exposed to SARS-CoV-2, regardless of age or severity of original symptoms. It is commonly defined as the continuation or development of new symptoms three months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least two months. Such symptoms include fatigue, shortness of breath, and cognitive dysfunction, among others.

Hyperbaric oxygen therapy is suggested to be effective in similar conditions, such as Fibromyalgia and Chronic Fatigue syndrome, but is not an accepted treatment for patients diagnosed with long COVID. In a randomized controlled trial conducted at Karolinska University Hospital in Sweden, Kjellberg et al. sought to evaluate the safety and efficacy of hyperbaric oxygen therapy for individuals with long COVID symptoms.

Twenty previously healthy participants were randomly assigned to receive either hyperbaric oxygen therapy or a placebo treatment. Data on potential side effects or adverse events that occurred during the treatment were collected, and long COVID symptoms before and after the treatment were assessed. Hyperbaric oxygen therapy was found to be overall safe, with no serious adverse events reported during treatment or follow-up. The most common adverse effects were cough and chest pain or discomfort, however these were mild and transient.

Overall, this interim safety report published in BMC Infectious Diseases provides preliminary evidence that hyperbaric oxygen therapy might be a safe treatment for individuals suffering from long COVID and could help other researchers design similar trials.


BMC Endocrine DisordersLifestyle management in polycystic ovary syndrome – beyond diet and physical activity

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting reproductive-aged women. Women with PCOS might experience a combination of reproductive, metabolic, and psychological comorbidities. A review by Cowan et al. published in BMC Endocrine Disorders provides an overview of the evidence to date on lifestyle strategies used to optimize management of PCOS.

Modifying protein, carbohydrate or fat quality or quantity seem to affect similarly the presentation of the syndrome. Vigorous aerobic exercise, however, which has been shown to improve body composition, cardiorespiratory fitness, and insulin resistance, seems to benefit women with PCOS. Also, psychological interventions, such as cognitive-behavioral therapy and mindfulness-based stress reduction, to support the specific mental health needs of women with PCOS warrant further investigation, while improving sleep quality might be critical for promoting healthy lifestyle changes and help reduce related symptoms. The authors of the review highlight, however, that while optimizing sleep and emotional wellbeing may aid symptom management, research exploring the efficacy of clinical interventions is lacking. The use of traditional, Complementary and Integrative Medicine approaches, including acupuncture and yoga, by women with PCOS has been growing fast; however, the research evidence is not sufficiently robust to support their integration into routine clinical practice.

The evidence presented in this review provides support for the idea that a holistic approach to lifestyle management is likely to be beneficial for managing PCOS symptoms.


BMC Pregnancy and ChildbirthUsing the teach-back method to improve postpartum maternal-infant health among women with limited maternal health literacy: a randomized controlled study

In a study published in BMC Pregnancy and Childbirth, Cheng et al. aimed to evaluate the impact of the teach-back method on maternal health literacy, postpartum health behavior, and maternal-infant health among women with limited maternal health literacy.

In a randomized controlled trial, pregnant women with limited maternal health literacy were randomly assigned to either the control group, where they received routine education sessions, or the intervention group, where they received routine education sessions as well as the teach-back method. This method involves pregnant women being asked to use their own words to restate what they have just learned. The educator then assesses women’s understanding of the subject, identifies any misunderstandings, corrects mistakes, and provides additional information, if needed, until all women can correctly restate what they have learned.

The researchers observed that the teach-back method led to positive postpartum health behavior and improved postpartum maternal-infant health among women with limited maternal health literacy. In particular, women in the intervention group scored higher in terms of their knowledge, attitude, and self-efficacy related to postpartum maternal-infant health, and also had significantly fewer postpartum complications compared to women in the control group.

Overall, the study provides support for the idea that the teach-back method can improve postpartum maternal-infant health among women with limited maternal health literacy. The authors suggest that this method could be potentially incorporated into education programs to improve health outcomes for this population.


BMC Medical EducationUse of virtual reality compared to the role-playing methodology in basic life support training: a two-arm pilot community-based randomised trial

Virtual Reality has been increasingly used in the training of healthcare professionals, with several studies showing that students who participate in activities that use Virtual Reality tend to be more engaged and motivated than students who are trained via traditional methods. A study published in BMC Medical Education aimed to compare the effectiveness of using Virtual Reality versus role-playing methodology in teaching Basic Life Support skills.

Professionals working in healthcare facilities in Catalonia who were enrolled in Basic Life Support courses were randomly assigned to either the Virtual Reality group or the role-playing group. The primary aim of this randomized controlled trial was to compare learning outcomes in the two groups. Secondary aims included evaluating satisfaction levels in the two groups with regard to the training provided, as well as analyzing the costs associated with each type of training.

No significant differences between the two groups were observed in terms of learning outcomes. However, participants in the VR group reported greater satisfaction with the training compared to those in the role-playing group. Also, the costs of using Virtual Reality proved to be slightly higher per student than the costs of using traditional training. However, as noted by the authors, if Virtual Reality training were to be extensively used, platform costs would possibly decrease and such differences would likely disappear.

In sum, Virtual Reality can be particularly useful for online training programs. However, further research is needed to explore its potential benefits for different professionals.


BMC Medical Research MethodologyRecruitment and retention into longitudinal health research from an adolescent perspective: a qualitative study

Longitudinal health studies investigating the transition from adolescence into early adulthood are critical for understanding developmental changes, and for providing insights as to how health behavior might change as a function of age. However, the success of such studies depends on participant recruitment and retention, which prove to be challenging factors when conducting research with adolescents. In a study published in BMC Medical Research Methodology, Jong et al. investigated adolescents’ perspectives regarding signing up and continued involvement in longitudinal health studies.

Forty-eight individuals from England between the ages of 15 and 20 years participated in nine in-person focus groups about recruitment and retention in research. The main reasons for signing up included joining with peer groups, being offered financial incentives, and receiving personalized feedback. Recruitment via social media with simple messages tailored to their needs, building trust and rapport with the research staff, and user-friendly and flexible data collection were further perceived as key factors to continued involvement.

The findings from this study highlight the importance of understanding adolescents’ interests and motivations behind study enrolment and dropout, and can help inform the development of effective strategies for recruiting and retaining adolescents in longitudinal health research.

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