scholarly journals MP010: Wraparound care for youth injured by violence: a randomized control trial

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S69-S69
Author(s):  
C. Snider ◽  
W. Chernomas ◽  
K. Cook ◽  
D. Jiang ◽  
T. Klassen ◽  
...  
Keyword(s):  
Randomized Control Trial ◽  
Standard Care ◽  
Negative Impact ◽  
Health Concern ◽  
Research Approach ◽  
Violent Injury ◽  
Severity Of Injury ◽  
Randomized Control ◽  
Wraparound Care ◽  
One Year

Introduction: Youth injured by violence is a major public health concern in Canada. It is the fourth leading cause of death in youth and the foremost reason youth visit an emergency department (ED). In Winnipeg, 20% of youth who visit an ED with an injury due to violence will have an ED visit for a subsequent violent injury within one year. Youth injured by violence are in a reflective and receptive state of mind, rendering the ED setting appropriate for intervention. Methods: We completed a randomized control trial in November 2015 comparing wraparound care for youth age 14 - 24 who were injured by violence to standard ED care. Youth were excluded if their injury was due to child maltreatment, sexual assault or self-harm. An adapted pre-consent randomization methodology was used. The intervention was developed using a community based participatory research approach. Wraparound care was delivered by a support worker with lived experience with violence. Support workers were on call 24/7 in order to start the intervention in the ED and take advantage of the “teachable moment.” Care continued in the community for approximately one year. Results: A total of 133 youth were randomized (68 intervention, 65 control) in one year. There was no difference in age, gender, or severity of injury between the two groups. Patients randomized to the intervention spent a median of 30 minutes less in the ED than those receiving standard care (p=0.22). Youth are safely housed, have enrolled in education opportunities, and are engaged in addictions care. Results of a chart review examining repeat visits to the ED for violent injury, substance use and mental health will be completed in Spring 2016 and will be presented. Conclusion: There were no differences between standard care and intervention groups on baseline characteristics reflecting effective randomization. The introduction of an intervention at bedside in the ED did not have a negative impact on patient length of stay.

scholarly journals Effect of pentoxifylline on histological activity and fibrosis of nonalcoholic steatohepatitis patients: A one year randomized control trial

2017 ◽  
Vol 5 (3) ◽  
pp. 155-163 ◽  
Author(s):  
Shahinul Alam ◽  
SKM Nazmul Hasan ◽  
Golam Mustafa ◽  
Mahabubul Alam ◽  
Mohammad Kamal ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Nonalcoholic Steatohepatitis ◽  
Randomized Control Trial ◽  
Lifestyle Modification ◽  
Control Group ◽  
Open Label ◽  
Histological Activity ◽  
Randomized Control ◽  
One Year ◽  
Lobular Inflammation

AbstractBackground and ObjectivesTo observe the effect of Pentoxifylline for 1 year on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis (NASH).Materials and MethodsA single center, open label Randomized Control Trial. Patients were included if they had ultrasonographic evidence of fatty liver and nonalcoholic fatty liver disease activity score (NAS) ≥ 5 on liver histology. A total of 35 patients were selected; 25 of PL (Experimental) group and 10 of L (Control) group. PL group received 400 mg pentoxifylline thrice daily along with lifestyle modification and there was only lifestyle modification for the L group. After one year, NAS and fibrosis was compared in both groups.ResultsIn PL group, NAS improved 2.10 ± 1.07; whereas in L group, NAS was 0.90 ± 0.99 (P = 0.006). As per the protocol analysis, NAS ≥ 2 improved in 15/20 (75%) in PL group and in 3/10 (30%) in L group (P = 0.018). In PL group, the individual component of NAS, steatosis improved from 2.30 ± 0.66 to 0.95 ± 0.76 (P = 0.000), lobular inflammation from 1.65 ± 0.59 to 1.05 ± 0.51 (P = 0.002) and hepatocyte ballooning from 1.50 ± 0.51 to 1.30 ± 0.57 (P = 0.258). In L group, steatosis improved from 2.30 ± 0.68 to 1.40 ± 1.08 (P = 0.01), lobular inflammation and hepatocyte ballooning did not improve. The fibrosis score did not improve in any group. In PL group, NAS improved significantly (P = 0.027; OR=22.76, CI=1.43-362.40) independent of weight reduction.ConclusionPentoxifylline for 1 year improves the hepatic histological activity but not fibrosis of NASH patients.

Facilitators, barriers, and recommendations related to the informed consent of Marshallese in a randomized control trial

2020 ◽  
Vol 15 (2) ◽  
pp. 75-83
Author(s):  
Rachel S Purvis ◽  
Leah R Eisenberg ◽  
Christopher R Trudeau ◽  
Christopher R Long ◽  
Pearl A McElfish
Keyword(s):  
Informed Consent ◽  
Randomized Control Trial ◽  
Diabetes Management ◽  
Community Based Participatory Research ◽  
Informed Consent Process ◽  
Consent Process ◽  
Research Approach ◽  
Community Based ◽  
Randomized Control ◽  
Participatory Research Approach

Background The Pacific Islander population is the second fasting growing population in the United States and Arkansas is home to the largest Marshallese population in the continental US. The Marshallese community have significant health disparities with high prevalence of diabetes, heart disease, and obesity compared to the general US population. Using a community-based participatory research approach, researchers and Marshallese community stakeholders identified diabetes as the top health issue for research. Methods From 2014 to 2018, a randomized control trial was conducted comparing standard diabetes management education with a culturally adapted family model of standard diabetes management education delivered in participants’ homes by Marshallese community health workers and certified diabetes educators. Interviews were held with Marshallese participants to document their experiences with and perceptions of the informed consent process for this randomized control trial. Results Participants provided feedback on the process of enrolling in the study, describing barriers and facilitators to giving informed consent from their perspective, and offering recommendations for improving the informed consent process. Conclusion Findings suggest that informed consent with underserved communities, including immigrant and migrant populations who do not speak English or have limited English proficiency, is possible, and that using a community-based participatory research approach can help facilitate the informed consent process.

scholarly journals Blood Flow Restriction Therapy Versus Standard Care for Reducing Quadriceps Atrophy After Anterior Cruciate Ligament Reconstruction

2019 ◽  
Vol 28 (8) ◽  
pp. 897-901 ◽  
Author(s):  
Lauren Anne Lipker ◽  
Caitlyn Rae Persinger ◽  
Bradley Steven Michalko ◽  
Christopher J. Durall
Keyword(s):  
Randomized Control Trial ◽  
Standard Care ◽  
Cruciate Ligament ◽  
Moderate Pressure ◽  
Cross Sectional ◽  
Low Resistance ◽  
Flow Restriction ◽  
Muscular Training ◽  
Randomized Control ◽  
Anterior Cruciate

Clinical Scenario: Quadriceps atrophy and weakness are common after anterior cruciate ligament reconstruction (ACLR). Blood flow restriction (BFR) therapy, alone or in combination with exercise, has shown some promise in promoting muscular hypertrophy. This review was conducted to ascertain the extent to which current evidence supports the use of BFR for reducing quadriceps atrophy following ACLR in comparison with standard care. Clinical Question: Is BFR more effective than standard care for reducing quadriceps atrophy after ACLR? Summary of Key Findings: The literature was searched for studies that directly compared BFR treatment to standard care in patients with ACLR. Three level I randomized control trial studies retrieved from the literature search met the inclusion criteria. Clinical Bottom Line: Reviewed data suggest that a short duration (13 d) of moderate-pressure BFR combined with low-resistance muscular training does not appear to measurably affect quadriceps cross-sectional area. However, a relatively long duration (15 wk) of moderate-pressure BFR combined with low-resistance muscular training may increase quadriceps cross-sectional area to a greater extent than low-resistance muscular training alone. The results of the third randomized control trial suggest that employing BFR while immobilized in the early postoperative period may reduce quadriceps atrophy following ACLR. Additional data are needed to establish if the benefits of BFR on quadriceps atrophy after ACLR outweigh the inherent risks and costs. Strength of Recommendation: All evidence for this review was level 1 (randomized control trial) based on the Centre for Evidence-Based Medicine criteria. However, the findings were inconsistent across the 3 studies regarding the effects of BFR on quadriceps atrophy resulting in a grade “B” strength of recommendation.

scholarly journals Efficacy and Safety of Microdebrider Assisted Adenoidectomy over Conventional Adenoidectomy

2020 ◽  
Vol 28 (1) ◽  
pp. 59-66
Author(s):  
Anil S Harugop ◽  
Samanvaya Soni ◽  
Tejaswini J S
Keyword(s):  
Blood Loss ◽  
Randomized Control Trial ◽  
Operative Time ◽  
Conventional Group ◽  
Efficacy And Safety ◽  
Intraoperative Blood Loss ◽  
Average Amount ◽  
Adenoid Tissue ◽  
Randomized Control ◽  
One Year

Introduction Adenoidectomy has conventionally been performed by curetting the adenoid tissue blindly with St. Clair Thompson curette leading to inadequate removal of tissue. Here the use of endoscopic guided adenoidectomy with microdebrider has been employed to compare the two methods.   Materials and Methods It is a one-year randomized control trial conducted from January 2018 to December 2018. Patients were allocated into 2 groups i.e. conventional adenoidectomy and microdebrider adenoidectomy group. Pre and post-operative endoscopic grading of adenoid was compared and intraoperative blood loss and operative time were studied.   Results Total 45 patients included 25 in conventional and 20 in microdebrider group. Following adenoidectomy operation the percentage of reduction of adenoid grading in microdebrider group was 63.79 % whereas 30.29% in conventional group, the average time taken by microdebrider assisted surgery was 16.45 mins as compared to 13.28 mins in conventional curettage. The average amount of blood loss in conventional group was 44.76 ml whereas in microdebrider group was 77.30 ml.   Conclusion Microdebrider assisted adenoidectomy has proven to deliver completeness of clearance at the expense of slight increase in bleeding and the operative time.

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