scholarly journals U.S. Army Combat Medic eFAST Performance with a Novel Versus Conventional Transducers: A Randomized, Crossover Trial

2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 19-24 ◽  
Author(s):  
Brian J Ahern ◽  
Jonathan D Monti ◽  
Jason F Naylor ◽  
Aaron J Cronin ◽  
Michael D Perreault
Keyword(s):  
Diagnostic Accuracy ◽  
Crossover Trial ◽  
Ease Of Use ◽  
Technical Adequacy ◽  
Brief Training ◽  
Randomized Crossover Trial ◽  
Significant Difference ◽  
Combat Medics ◽  
Life Threatening ◽  
Conventional Ultrasound

ABSTRACT Background Point-of-injury extended focused assessment with sonography in trauma (eFAST) may identify life-threatening torso hemorrhage and expedite casualty evacuation. The purpose of this study was to compare combat medic eFAST performance between the novel and conventional ultrasound (US) transducers. Methods We conducted a randomized crossover trial. Medic participants, previously naïve to US, were randomized to the type of transducer first utilized. The primary outcome was eFAST completion time in seconds. Secondary outcomes included diagnostic accuracy, technical adequacy, and transducer ease-of-use rating. Results Forty medics performed 160 eFASTs. We found a statistically significant difference in eFAST completion times in favor of conventional transducers (304 vs. 358 s; P = 0.03). There was no statistically significant difference between the conventional and novel transducers in terms of diagnostic accuracy (97.7% vs. 96.0%; P = 0.25) and technical adequacy (65% vs. 72.5%; P = 0.11). Median transducer ease-of-use rating (Likert 1–5 scale) was statistically significant in favor of the conventional transducers (5 vs. 4; P = < 0.001). Conclusions Extended focused assessment with sonography in trauma exam times was faster with the conventional transducers. Combat medics performed diagnostically accurate eFASTs with both transducer types in a simulated aid station setting after a brief training intervention. Conventional transducers were rated higher for ease-of-use.

Comparative Study of Satisfaction and Acceptability between Using Menstrual Cup versus Sanitary Pads in Health Care Personnel: A Randomized Crossover Trial

2021 ◽  
Vol 104 (1) ◽  
pp. 1-9
Keyword(s):  
Health Care ◽  
Sexual Intercourse ◽  
Crossover Trial ◽  
Health Care Personnel ◽  
The Past ◽  
Randomized Crossover Trial ◽  
Significant Difference ◽  
Hcp Materials ◽  
Group A ◽  
Sanitary Pads

Background: In the past decade, menstrual cups (MC) have become increasingly popular in many countries but there was no previous reporting on MC usage in Thailand. Objective: To evaluate and compare the satisfaction and acceptability of using MC and sanitary pads (SP) in health care personnel (HCP). Materials and Methods: Participants were HCP in Bhumibol Adulyadej Hospital who were willing to participate in the study between October 2019 and March 2020. They were randomly assigned into groups A and B. During the first three cycles of menstruation, participants in group A and B used SP and MC, respectively. In the later three cycles of menstruation, they were switched from SP to MC and vice versa. The demographic and menstrual characteristics were recorded. Satisfaction was evaluated by using the five-point Likert scale. Acceptability of MC usage was recorded on the sixth cycle questionnaire. Results: Ninety-eight HCP were recruited and equally divided into two groups (A and B). Acceptability for MC was significantly lower than SP (89 versus 100 percent, respectively). Participants who had regular sexual intercourse had more acceptability with MC than those who had no regular intercourse (98.4 versus 68.7 percent, respectively). Participants reported more significant satisfaction for MC than SP in terms of leakage prevention, cleaning, odor prevention, land activity, daily activity, comfortable sleep, and overall satisfaction. Contact dermatitis associated with MC was less than with SP with a statistically significant difference. Conclusion: Acceptability for MC was lower than SP. MC’s acceptability was preferred among HCPs with regular sexual intercourse. MC had higher satisfaction and less side effects than SP. Keywords: Acceptability, Menstrual cup, Menstruation, Sanitary pads, Satisfaction

scholarly journals A single-blinded randomized crossover trial comparing peer-to-peer and standard instruction on airway management skill training

2019 ◽  
Author(s):  
Usapan Surabenjawong ◽  
Paul Edward Phrampus ◽  
John Lutz ◽  
Deborah Farkas ◽  
Apoorva Gopalakrishna ◽  
...  
Keyword(s):  
Nursing Students ◽  
Airway Management ◽  
Crossover Trial ◽  
Peer Group ◽  
Peer To Peer ◽  
Peer Instruction ◽  
P Value ◽  
Management Skills ◽  
Randomized Crossover Trial ◽  
Significant Difference

ABSTRACTBackgroundPeer-to-peer teaching, which is an alternative to standard teaching (by expert instructors), has the potential to emphasize student self-learning and reduce the cost and workload of the instructor. Self-instruction videos with peer feedback are highlighted in many medical and nursing school curricula.ObjectiveTo evaluate whether peer to peer instruction supported by a structured curriculum and video exemplars is not inferior to standard instructor-led teaching in basic airway management skill, knowledge, and confidence attainment.MethodThis single blinded randomized crossover trial was conducted with a sample of novice nursing students. Data was collected through the pre-to post-knowledge and confidence assessments. The students were randomly assigned to two crossover groups. Each student learned basic airway management skills through both methods. The students’ performances were recorded in every session with recordings reviewed by blinded expert instructors.ResultsThe study included 48 participants, who were assigned into both the expert instruction group and peer-to-peer group through computer generated randomization. The skill rating scores of the peer-to-peer group were not inferior to the standard teaching. With further analysis, we noted that the peer-to-peer group scores had significantly higher scores demonstrating a large effect size (Cohen’s d of 1.07 (p-value 0.002) for oropharyngeal airway insertion, 1.14 (p-value <0.001) for nasopharyngeal airway insertion and 0.81 (p-value 0.003) for bag mask ventilation). There was no significant difference between pre- and post-knowledge scores across groups (p-value of 0.13 and 0.22 respectively). Participants in both groups reported higher confidence after learning. However, the difference was not statistically significant.ConclusionsUndergraduate nursing students trained in basic airway management skills by peer-to-peer instruction and a structured curriculum did not show inferior scores compared to the students who were trained by expert instructors. There was no significant difference in the knowledge and confidence levels between the groups.

Effect of Ibuprofen on Blood Pressure Control by Propranolol and Bendrofluazide

1988 ◽  
Vol 16 (3) ◽  
pp. 173-181 ◽  
Author(s):  
J. G. Davies ◽  
D. C. Rawlins ◽  
M. Busson
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
Crossover Trial ◽  
Antihypertensive Effect ◽  
Pressure Control ◽  
Double Blind ◽  
Randomized Crossover Trial ◽  
Significant Difference ◽  
Change In Mean ◽  
Drug Free

The effect of 1600 mg/day ibuprofen in two groups of patients with hypertension controlled by either propranolol or bendrofluazide was studied in a double-blind, double-placebo, randomized crossover trial. No significant difference in blood pressure was found at the end of the crossover period in either group, suggesting that the routine co-administration of ibuprofen does not attenuate the antihypertensive effect of thiazide diuretics or propranolol. Significant weight gain, attributable to fluid retention, had occurred in the bendrofluazide-treatment group by the end of the drug-free washout period. No significant change in mean weight occurred in the crossover stages in either group, although substantial weight gain was noted during ibuprofen treatment in two patients given bendrofluazide and one given propranolol. Biochemical variables were unaffected by ibuprofen throughout the crossover period. This study suggests that ibuprofen may be administered routinely to patients receiving thiazides or propranolol without loss of control of the anti-hypertensive action of these drugs but it is recommended that individuals are monitored for possible weight gain or an increase in diastolic blood pressure.

scholarly journals Dried Fruit and Vascular Health: A Randomized Crossover Trial (P12-018-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Valerie Sullivan ◽  
Kristina Petersen ◽  
Penny Kris-Etherton
Keyword(s):  
Crossover Trial ◽  
Augmentation Index ◽  
Cardiometabolic Disease ◽  
Vascular Health ◽  
Dried Fruits ◽  
Randomized Crossover Trial ◽  
End Of Treatment ◽  
Increased Risk ◽  
Significant Difference ◽  
Dried Fruit

Abstract Objectives To evaluate the effect of consuming ¾ cup/day of mixed dried fruits versus a calorie- and carbohydrate-matched snack, on vascular health in adults at risk for cardiometabolic disease. Methods Men and women (n = 55) with overweight or obesity and at least one additional risk factor for cardiometabolic disease were enrolled in a 2-period single-blind randomized crossover trial. Participants received the following treatments for 4 weeks (separated by a 2–4 week washout): 1) ¾ cup mixed unsweetened dried fruits (equal parts raisins, dried plums, figs, and dates); 2) a calorie- and carbohydrate-matched processed snack. Endpoints were assessed at baseline, and the end of each treatment. Participants were advised to consume 1 serving/day of fresh fruit and incorporate study foods into their usual diets. The SphygmoCor XCEL was used to evaluate brachial and central blood pressure (BP), augmentation index, and carotid-femoral pulse wave velocity (PWV). Results At baseline, participants (47% female) had a mean BMI of 28.5 ± 2.7 kg/m2 and mean BP was 111 ± 9/77 ± 8 mmHg. More than half the subjects (56%) had a normal BP (<120/<80 mmHg) at baseline. End-of-treatment mean body weights were not different (P = 0.57). There was no difference in end-of-treatment mean values for brachial and central BP, augmentation index, augmentation pressure, or PWV (all P > 0.05). There was a significant difference in mean central pulse pressure (PP) following the dried fruit treatment versus control (1.6 ± 0.8 mmHg, P = 0.048). This was likely driven by a trend toward lower central diastolic BP (−1.2 ± 0.7 mmHg; P = 0.12) after the fruit, versus control. Conclusions Daily consumption of 1.5 cup-equivalents of mixed dried fruits for 4 weeks did not affect systolic BP or measures of arterial stiffness versus an isocaloric carbohydrate-matched snack in adults at increased risk of cardiometabolic disease. A significant difference in end-of-treatment mean central PP merits further study. Funding Sources International Nut & Dried Fruit Council; the California Dried Plum Board; National Center for Advancing Translational Sciences, NIH.

SCAPULAR TAPING IMPROVES FUNCTIONAL THROWING PERFORMANCE AMONG NORMATIVE YOUNG ADULTS: A RANDOMIZED CROSSOVER TRIAL

2020 ◽  
Vol 23 (01) ◽  
pp. 2050003
Author(s):  
Gaurav Saxena ◽  
Prem Venkatesan ◽  
Karvannan Harikesavan
Keyword(s):  
Young Adults ◽  
Performance Index ◽  
Repeated Measures ◽  
Crossover Trial ◽  
University Hospital ◽  
Randomized Crossover Trial ◽  
Significant Difference ◽  
Post Hoc ◽  
Trial Setting ◽  
Medicine Ball

Objective: To assess the effect of scapular taping on the functional throwing performance index and medicine ball throwing performance. Design: A Randomized crossover trial. Setting: Out-patient Physiotherapy department at a university hospital. Participants: Forty-four healthy participants were randomly assigned to scapular and sham taping procedure. Outcome measure: Functional throwing performance index (FTPI) and Medicine ball throw (MBT) were recorded at baseline and following each taping procedure. Results: Analysis of variance with repeated measures on the dependent variable (Index percentage for FTPI and distance in meters for MBT) were used for analysis. Significant improvements were observed following scapular taping ([Formula: see text]) on FTPI and MBT. Post hoc analysis for FTPI and MBT obtained a statistically significant difference between the scapular taping condition to baseline ([Formula: see text]) with a mean difference of [Formula: see text]%; [Formula: see text][Formula: see text]m, respectively. Similarly, scapular taping to sham taping ([Formula: see text]) shown a significant difference of [Formula: see text]% on FTPI and [Formula: see text][Formula: see text]m in MBT. No significant differences were found following sham taping on FTPI and MBT. Conclusion: Scapular taping improves functional throwing performance index and medicine ball throwing performance among normative young adults.

Evaluation of the NIO and T.A.L.O.N Intraosseous Devices as Placed by U.S. Army Conventional Force Combat Medics—A Randomized Crossover Study

2021 ◽  
Author(s):  
Pascal Lange ◽  
Mohamad Umar ◽  
Jerimiah D Walker ◽  
Mark Riddle ◽  
Paul Mochmer
Keyword(s):  
Crossover Study ◽  
Success Rate ◽  
Health Care Providers ◽  
Humeral Head ◽  
Proximal Tibia ◽  
Ease Of Use ◽  
Care Providers ◽  
Significant Difference ◽  
Combat Medics ◽  
Randomized Crossover Study

ABSTRACT Introduction In recent U.S. Military conflicts, hemorrhage remains the leading cause of preventable death with 30%-40% mortality rates. Management consists of effective bleeding control and rapid resuscitation with blood products. Rapid and accurate circulatory access is crucial in battlefield trauma management. This study evaluates the insertion success rate and time to successfully insert the NIO automatic intraosseous (IO) device and the Tactical Advanced Lifesaving IO Needle (TALON) manual IO device. The primary outcome is successful first attempt insertion. Secondary outcomes are the time taken for the successful insertion, user-reported “ease of use” for both devices, and user-reported device preference. Materials and Methods This is a prospective randomized crossover study comparing the NIO and TALON devices. As they are often the frontline health care providers, combat medics (68W) were recruited to participate in this study. They were randomized into two cohorts based on the IO device and location they would start first. Each medic performed a total of four IO cannulations on the proximal tibia and the humeral head of cadaveric human models. Results Sixty medics participated in the study, performing a total of 240 IO insertions, 120 with NIO (60 at the proximal tibia and 60 at the humeral head) and 120 with TALON (60 at the proximal tibia and 60 at the humeral head). The first attempt success rate was 89.2% for the NIO and 83.3% for the TALON, P = .19. The time to successful first attempt insertion for the NIO [M = 24.71 seconds, SD = 4.72] and the TALON, [M = 24.70 seconds, SD = 4.74] were similar, P = .98. The differences between the success of device insertion and time to successful insertion did not achieve statistical significance. The “ease of use” score (5-point Likert Scale) for the NIO [M = 4.73] and the TALON, [M = 4.11], demonstrated a significant difference, P &lt; .001. Ninety percent [n = 54] of the combat medics preferred the NIO versus only 10% [n = 6] preferred TALON. Conclusions Our findings indicate that the overall insertion success rate and time to successful insertion were similar between NIO automatic IO device and the TALON manual IO device. In our study, Army combat medics learned how to use both devices rapidly but felt the NIO automatic IO device easier to use and overwhelmingly preferred this device.

Diagnostic accuracy of visual urethral mobility exam versus Q-Tip test: a randomized crossover trial

2012 ◽  
Vol 206 (6) ◽  
pp. 528.e1-528.e6 ◽  
Author(s):  
Barbara Lynn Robinson ◽  
Elizabeth Joanne Geller ◽  
Brent Ashley Parnell ◽  
Andrea Kuntaraf Crane ◽  
Mary Lee Jannelli ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Crossover Trial ◽  
Urethral Mobility ◽  
Randomized Crossover Trial ◽  
Tip Test

The Effect of Antiplatelet Drugs on Plasma Betathromboglobulin in Coronary Artery Disease

1979 ◽  
Author(s):  
P Han ◽  
A Turpie ◽  
E Genton ◽  
M Gent
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Crossover Trial ◽  
Specific Protein ◽  
Antiplatelet Drugs ◽  
Significant Difference ◽  
Pre Treatment ◽  
Artery Disease ◽  
Therapeutic Doses ◽  
Granule Release

Platelets play a role in the development and complications of coronary artery disease (CAD) and a number of abnormalities of platelet function which can be corrected by antiplatelet drugs have been described. Betathromboglobulin (BTG), a platelet-specific protein which is released from α-granules during platelet activation is significantly elevated in patients with angiographically demonstrated CAD (51.0 ± 31.0 ng/ml., n = 50) compared to normal (28.0 ± 8.0 ng/ml., n = 70) p < 0.001. The effect of sulphinpyrazone (800 mg.) or aspirin (1200 mg.)/dipyridamole (200 mg.) on plasma BTG in CAD was studied in a blind prospective crossover trial in 25 patients. Mean BTG concentration pre-treatment was 52.3 ng/ml. and after 1 month’s treatment with placebo, sulphinpyrazone or aspirin/dipyridamole mean plasma BTG concentrations were 53.5, 49.6 and 56.7 ng/ml. respectively. Analysis of variance showed no significant difference between the means (p > 0.1) . This study confirms increased plasma BTG concentrations in patients with CAD and indicates that therapeutic doses of these antiplatelet drugs do not significantly effect the BTG level and thus appear not to prevent α-granule release in CAD.

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