A Trial of Detecting Impending Access-graft Failure by Simplified Weekly Flow Monitoring

2005 ◽  
Vol 28 (3) ◽  
pp. 237-243 ◽  
Author(s):  
D. Vilkomerson ◽  
T. Chilipka ◽  
H. Rafi ◽  
P. Homel ◽  
G. Ghadari ◽  
...  
Keyword(s):  
Graft Failure ◽  
Controlled Trial ◽  
Effective Means ◽  
New Method ◽  
Control Group ◽  
Flow Monitoring ◽  
Monitoring Procedure ◽  
Two Stages ◽  
Induced Changes ◽  
Access Graft

Access graft failure is a major problem in hemodialysis. Monitoring the flow through the access so that impending failure can be detected and prevented seems reasonable, but recent clinical trials have failed to show any benefit of such monitoring. Described here are plans for a clinical trial of a new flow monitoring procedure that measures access flow weekly instead of monthly and, being performed before dialysis, avoids the dialysis-induced changes in graft flow that may have affected earlier trials. The planned trial is to be carried out in two stages, the first to establish the sensitivity and specificity of the new method, and the second (if the results of the first stage warrant it) a controlled trial comparing access-costs and hospitalization days between a monitored group and a matched standard care control group. It is hoped that this trial of the new method will establish it as an effective means of extending access-graft life.

The effect of practicing yoga during pregnancy on labor stages length, anxiety and pain: a randomized controlled trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Ellahe Mohyadin ◽  
Zohreh Ghorashi ◽  
Zahra Molamomanaei
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Total Duration ◽  
Measurement Data ◽  
Labor Pain ◽  
Control Group ◽  
Chi Square ◽  
Nulliparous Women ◽  
Two Stages ◽  
And Control

AbstractBackgroundAnxiety and fear of labor pain has led to elevated cesarean section rate in some countries. This study was conducted to investigate the effect of yoga in pregnancy on anxiety, labor pain and length of labor stages.MethodsThis clinical trial study was performed on 84 nulliparous women who were at least 18 years old and were randomly divided into two groups of yoga and control groups. Pregnancy Yoga Program consisting of 6 60-min training sessions was started every 2 weeks from week 26 of pregnancy and continued until 37 weeks of gestation. Anxiety severity at maternal admission to labor was measured by the Spielbergers State-Trait Anxiety Inventory, and labor pain was measured by Visual Analogue Scale (VAS) at dilatation (4–5 cm) and 2 h after the first measurement. Data were analyzed using Chi-Square and t-test.ResultsIntervention group reported less pain at dilatation (4–5 cm) (p=0.001) and 2 h after the first measurement (p=0.001) than the control group. Stat anxiety was also lower in intervention group than the control group (p=0.003) at the entrance to labor room. Subjects in the control group required more induction compared to intervention group (p=0.003). Women in intervention group experienced shorter duration of the first phase of the labor than the control group (p=0.002). Also, the total duration of two stages of labor was shorter in intervention group than the control group (p=0.003).ConclusionsPracticing yoga during pregnancy may reduce women’s anxiety during labor; shorten labor stages, and lower labor pain.

scholarly journals Characterizing Highly Benefited Patients in Randomized Clinical Trials

2017 ◽  
Vol 13 (1) ◽  
Author(s):  
Vivek Charu ◽  
Paul B. Rosenberg ◽  
Lon S. Schneider ◽  
Lea T. Drye ◽  
Lisa Rein ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Controlled Trial ◽  
New Method ◽  
Usual Model ◽  
Randomized Controlled ◽  
Working Model ◽  
Large Numbers ◽  
High Benefit ◽  
Two Stages

AbstractPhysicians and patients may choose a certain treatment only if it is predicted to have a large effect for the profile of that patient. We consider randomized controlled trials in which the clinical goal is to identify as many patients as possible that can highly benefit from the treatment. This is challenging with large numbers of covariate profiles, first, because the theoretical, exact method is not feasible, and, second, because usual model-based methods typically give incorrect results. Better, more recent methods use a two-stage approach, where a first stage estimates a working model to produce a scalar predictor of the treatment effect for each covariate profile; and a second stage estimates empirically a high-benefit group based on the first-stage predictor. The problem with these methods is that each of the two stages is usually agnostic about the role of the other one in addressing the clinical goal. We propose a method that characterizes highly benefited patients by linking model estimation directly to the particular clinical goal. It is shown that the new method has the following two key properties in comparison with existing approaches: first, the meaning of the solution with regard to the clinical goal is the same, and second, the value of the solution is the best that can be achieved when using the working model as a predictor, even if that model is incorrect. In the Citalopram for Agitation in Alzheimer’s Disease (CitAD) randomized controlled trial, the new method identifies substantially larger groups of highly benefited patients, many of whom are missed by the standard method.

scholarly journals Development and evaluation of an online medication safety module for medical students at a rural teaching hospital: the Winchester District Memorial Hospital

2021 ◽  
Vol 10 (2) ◽  
pp. e001385
Author(s):  
Ali Elbeddini ◽  
Yasamin Tayefehchamani
Keyword(s):  
Online Learning ◽  
Medical Students ◽  
Medication Safety ◽  
Controlled Trial ◽  
Effective Means ◽  
Intervention Group ◽  
Control Group ◽  
Open Label ◽  
Online Module ◽  
Learning Module

ObjectiveTo design, implement and assess an online learning module for third-year and fourth-year medical students addressing medication safety.DesignThis study was a prospective, parallel, open-label, randomised controlled trial with two arms: (1) a control arm in which students were given five articles to read about medication safety, and (2) an intervention arm in which students were given access to an interactive web-based learning module on medication safety. Pretesting and post-testing were done online to evaluate change in medication safety knowledge.ResultsTen students completed the study in the intervention group (online module) and six students completed the study in the control group. The increase in score obtained on the post-test, relative to the pretest, was 15.4% in the group who completed the online module and 2.0% in the control group (difference=13.4%, 95% CI 0.5% to 26.2%, p=0.04).ConclusionStudents who completed an online educational tool about medication safety demonstrated a significantly greater increase in knowledge than those who completed a few readings. Online learning modules can be a convenient and effective means of teaching safe prescribing concepts to medical trainees.

scholarly journals Effects of a simple educational intervention in well-baby clinics on women’s knowledge about and intake of folic acid supplements in the periconceptional period: a controlled trial

2014 ◽  
Vol 18 (6) ◽  
pp. 1119-1126 ◽  
Author(s):  
Denhard J de Smit ◽  
Stephanie S Weinreich ◽  
Martina C Cornel
Keyword(s):  
Folic Acid ◽  
Controlled Trial ◽  
Effective Means ◽  
Intervention Group ◽  
Control Group ◽  
Post Intervention ◽  
Actual Use ◽  
Baby Clinic ◽  
Periconceptional Period ◽  
And Control

AbstractObjectiveTo test the hypothesis that a concise intervention to promote the preconception use of folic acid (FA) supplements among mothers who visit a well-baby clinic (WBC) for the 6-month check-up of their youngest child is effective. Effectiveness was measured as intention to use or actual use of FA supplements before a next pregnancy among women who expected to be pregnant within 0–12 months.DesignControlled intervention study with independent samples of intervention and control mothers. The intervention took place at the 6-month visit. A post-intervention measurement was done in the intervention group and a comparable measurement in the control group at the 11-month check-up visit.SettingThe intervention, verbal and in writing, was implemented in four Dutch WBC and given by the WBC physician to the mothers who visited the WBC.SubjectsAll mothers visiting the WBC were eligible for inclusion, unless they were unable to complete a questionnaire. The intervention group consisted of 198 (68 %) mothers recruited from 291 6-month intervention visits and the control group of 215 (84 %) mothers recruited from 255 11-month normal visits.ResultsIn mothers who expected to be pregnant within 0–12 months, the proportion using or intending to use FA was 65 % in the intervention group (n 49) v. 42 % in the control group (n 43; difference 23 %, 95 % CI 4, 43 %, P<0·05).ConclusionsHealth education intervention at the 6-month WBC visit is an effective means to promote the use of FA supplements or the intention to do so.

scholarly journals A randomized controlled trial evaluating antioxidant–essential oil gel as a treatment for gingivitis in orthodontic patients

2016 ◽  
Vol 86 (3) ◽  
pp. 407-412 ◽  
Author(s):  
Benjamin J. Martin ◽  
Phillip M. Campbell ◽  
Terry D. Rees ◽  
Peter H. Buschang
Keyword(s):  
Treatment Group ◽  
Essential Oil ◽  
Controlled Trial ◽  
Effective Means ◽  
Control Group ◽  
Placebo Control ◽  
Topical Gel ◽  
Percentage Points ◽  
Orthodontic Patients ◽  
T1 And T2

ABSTRACT Objective:  To evaluate the treatment effect of an antioxidant–essential oil gel on orthodontic patients with generalized gingivitis. The gel contains the essential oils menthol and thymol and the antioxidants ferulic acid and phloretin. Materials and Methods:  Thirty patients from the university’s orthodontic clinic were screened for gingivitis and randomly allocated into treatment and placebo-control groups. Each patient was evaluated at three orthodontic treatment visits (T1, T2, and T3). A periodontal examination, including probing depth (PD), bleeding on probing (BOP), gingival index (GI), and plaque index (PI) was performed at each visit. Between T1 and T2, patients were instructed to apply a topical gel (active or placebo) to their gingiva twice daily after brushing. From T2 to T3, patients were instructed to discontinue use of the gel. Results:  The treatment group showed statistically significant (P &lt; .05) reductions of BOP (−13.6 percentage points) and GI (−0.14) between T1 and T2, and significant increases in BOP (13.3 percentage points) and GI (0.14) between T2 and T3. Except for an increase in the GI between T2 and T3, the control group showed no significant changes in BOP or GI over time. The only other significant changes that occurred pertained to the treatment group, which showed significant increases in PD (0.08 mm) and PI (0.18) between T2 and T3. Conclusion:  Application of a topical antioxidant-essential oil gel is an effective means of reducing inflammation in orthodontic patients with gingivitis.

scholarly journals THE ROLE OF THE PHYSICIAN IN THE DETECTION AND TREATMENT OF OSTEOPOROSIS IN PATIENTS WITH FRACTURES OF THE RADIUS

2015 ◽  
Vol 18 (3) ◽  
pp. 18-22
Author(s):  
L P Yevstigneyeva ◽  
E V Kuznetsova ◽  
R M Nizamutdinova
Keyword(s):  
Distal Part ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Second Phase ◽  
Treatment Of Osteoporosis ◽  
Low Level ◽  
Treatment Information ◽  
Pathogenic Action ◽  
Two Stages

Introduction: fracture of distal part of forearm at a low level of a trauma with women in the age of 50 and elder is the index to osteoporosis and serves as reason to get tested for the diagnosis of OP. However, osteoporosis isn’t often diagnosed and treated with patients with such localization of fracture. The purpose: to estimate of detection and treatment of osteoporosis at the patients of senior age group with fracture of distal part of forearm and influence of traumatologist’s information on their changes. Materials and methods: The study was conducted in two stages. At the first stage a retrospective analysis of a sample of 104 patients aged 50 years and older who underwent fracture of distal part of forearm with a low level of injury was conducted. At the second stage a controlled trial with the inclusion of 121 women aged 50 years and older with fracture of distal part of forearm obtained with a low level of injury was carried out. The patients of intervention group (56 patients, the median age was 61.3 ± 8.6) received information about osteoporosis, assignment to densitometry and recommendation of treatment from traumatologist. The patients of control group (65 patients, the median age was 63.5 ± 8,1) were conducted as it was established in practice of the department of traumatology. There was a questioning of all patients who had been included in investigation after 6 months since fracture. Osteoporosis investigation and treatment were estimated at both stages. Results: osteoporosis was identified in 18 (17.3%) patients, densitometry was performed in 6 (5.8%) patients, calcium and D3 were taken 13 (12.5%) patients, medications of pathogenic action - 2 (1.9%) patients in a retrospective study. By the results of the second phase of the study densitometry was performed in 26 (46.4%) patients of intervention group and 2 (3.1%) patients of control group, р<0.0001. 31 (55.4%) patients of intervention group and 23 (35.4%) patients of control group began to take calcium and D3, p=0,0276. 7 (12.5%) patients of intervention group and 2 (3.1%) patients of control group began the treatment with pathogenetic medications, p=0.051, in 6 months pathogenetic medications took 12.5 % persons of intervention group and 1.5 % patients of control group, p=0.018. Conclusion: the patients with fracture of distal part of forearm at a low level of a trauma concern to group of the high risk of osteoporosis, but most of them remain without corresponding examination and treatment. Information about osteoporosis, assignment to densitometry and recommendation by treatment from traumatologist is an effective way to motivate patients to perform densitometry and start treatment.

Goal Attainment and Treatment Compliance in a Cognitive-Behavioral Telephone Intervention for Family Caregivers of Persons with Dementia

GeroPsych ◽  
2011 ◽  
Vol 24 (3) ◽  
pp. 115-125 ◽  
Author(s):  
Gabriele Wilz ◽  
Denise Schinköthe ◽  
Renate Soellner
Keyword(s):  
Family Caregivers ◽  
Mentally Ill ◽  
Goal Attainment ◽  
Outcome Measurement ◽  
Controlled Trial ◽  
Treatment Success ◽  
Treatment Compliance ◽  
Control Group ◽  
Telephone Intervention ◽  
Effective Interventions

Introduction: The evaluation of effective interventions is still needed to prevent family caregivers of persons with dementia from becoming physically or mentally ill. However, in most existing intervention studies, primary outcomes are not well matched to the treatment goals. Method: A randomized controlled trial (N = 229) was conducted to compare a treatment group (CBT), a treated control group, and an untreated control group. In theses analyses we focused on the primary outcome measurement (GAS) as a perceived treatment success as well as treatment compliance and participants’ evaluation. Results: Results showed that 30.1% achieved complete goal attainment, 39.8% partial goal attainment, and 24.1% declared no change (overachievement 2.4%; deterioration 3.6%). Discussion: The intervention can be considered to have been successful.

Promoting the Community's Ability to Detect and Respond to Suicide Risk Through an Online Bystander Intervention Model-Informed Tool

Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Karien Hill ◽  
Shawn Somerset ◽  
Ralf Schwarzer ◽  
Carina Chan
Keyword(s):  
Suicide Prevention ◽  
Suicide Risk ◽  
Controlled Trial ◽  
Intervention Group ◽  
Bystander Intervention ◽  
Self Report ◽  
Innovative Technology ◽  
Control Group ◽  
Intervention Model ◽  
Standard Material

Abstract. Background: The public health sector has advocated for more innovative, technology-based, suicide prevention education for the community, to improve their ability to detect and respond to suicide risk. Emerging evidence suggests addressing the bystander effect through the Bystander Intervention Model (BIM) in education material may have potential for suicide prevention. Aims: The current study aimed to assess whether BIM-informed tools can lead to improved readiness, confidence and intent in the community to detect and respond to suicide risk in others. Method: A sample of 281 adults recruited from the community participated in a randomized controlled trial comprising a factsheet designed according to the BIM (intervention group) and a standard factsheet about suicide and mental health (control group). Participants' self-reported detecting and responding to suicide risk readiness, confidence, and intent when presented with a suicidal peer was tested pre- and postintervention and compared across time and between groups. Results: The intervention group had significantly higher levels of detecting and responding to suicide risk readiness, confidence, and intent than the control group at postintervention (all p < .001) with moderate-to-large effect sizes. Limitations: The study was limited by a homogenous sample, too low numbers at follow-up to report, and self-report data only. Conclusion: This study demonstrates BIM-informed suicide prevention training may enhance the community's intervention readiness, confidence, and intent better than current standard material. Further testing in this area is recommended. While results were statistically significant, clinical significance requires further exploration.

Controlled Trial of the Sequential Use of Streptokinase and Ancrod in the Treatment of Deep Vein Thrombosis of Lower Limb

1977 ◽  
Vol 37 (02) ◽  
pp. 222-232 ◽  
Author(s):  
D. A Tibbutt ◽  
C. N Chesterman ◽  
E. W Williams ◽  
T Faulkner ◽  
A. A Sharp
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Improvement ◽  
Anticoagulant Therapy ◽  
Lower Limb ◽  
Oral Anticoagulant ◽  
Controlled Trial ◽  
Oral Anticoagulant Therapy ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryTreatment with streptokinase (‘Kabikinase’) was given to 26 patients with venographically confirmed deep vein thrombosis extending into the popliteal vein or above. Treatment was continued for 4 days and the patients were allocated randomly to oral anticoagulant therapy or a course of treatment with ancrod (‘Arvin’) for 6 days followed by oral anticoagulant therapy. The degree of thrombolysis as judged by further venographic examination at 10 days was not significantly different between the 2 groups. The majority of patients showed clinical improvement but there was no appreciable difference between the groups at 3 and 6 months. Haemorrhagic complications were a more serious problem during the period of treatment with ancrod than during the equivalent period in the control group.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

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