The Impact of Increasing the Daytime Dialysis Exchange Frequency on Peritoneal Dialysis Adequacy and Nutritional Status of Chinese Anuric Patients

2002 ◽  
Vol 22 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Cheuk-Chun Szeto ◽  
Teresa Yuk-Hwa Wong ◽  
Kai-Ming Chow ◽  
Chi-Bon Leung ◽  
Angela Yee-Moon Wang ◽  
...  

♦ Objective To study the effect of increasing the daytime dialysis exchange frequency on dialysis adequacy and nutritional status of Chinese anuric patients. ♦ Setting University teaching hospital. ♦ Patient 100 anuric patients on continuous ambulatory peritoneal dialysis (CAPD). ♦ Design 50 patients had one additional daytime 2-L exchange (intervention group); the dialysis regimen remained unchanged in the other 50 patients (control group). ♦ Outcome Dialysis adequacy [Kt/V, weekly creatinine clearance (wCCr), and net ultrafiltration (UF)] and nutritional status [serum albumin, dietary protein intake, represented by normalized protein nitrogen appearance (nPNA), and percent lean body mass (%LBM)] were measured at 0 and 6 months. ♦ Results Baseline dialysis adequacy and nutritional indices were comparable between the two groups. In the control group, all parameters remained stable at month 6. In the intervention group, there were significant increases in UF, Kt/V, wCCr, nPNA, and %LBM from months 0 to 6. The improvement in nPNA was affected by daily exchange volume. In 30 patients, the number of exchanges was increased from 3 to 4 per day; their Kt/V and nPNA rose significantly from month 0 to month 6. In the other 20 patients, the number of exchanges was increased from 4 to 5 per day; there was a significant increase in Kt/V but nPNA remained static. The change in nPNA correlated inversely with Kt/V at month 0 (Pearson's r = –0.352, p = 0.012). Multivariate analysis with a general linear model showed that age, Kt/V at month 0, and 3 dialysis exchanges per day at month 0 (versus 4 exchanges) were independent predictors of the change in nPNA. ♦ Conclusions Increasing the number of peritoneal dialysis exchanges effectively increased Kt/V in Chinese anuric CAPD patients. However, the improvement in nPNA correlated inversely with baseline Kt/V. Although increasing the number of exchanges from 3 to 4 per day improved nPNA, increasing the number of daily exchanges beyond 4 may not improve nPNA further.

2020 ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demelash Mulualem ◽  
Carol J. Henry

Abstract Background: Improving children's weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers' knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children's diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods: A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midline, and endline. ANOVA and descriptive statistics were used to analyzed data. Results: At baseline and endline, maternal KAP and the dietary diversity score of the children (mean age at endline 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p<0.001) at midline and endline compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p=0.001). Conclusions: NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial Registration: Clinicaltrials.gov #NCT02638571


Comunicar ◽  
2014 ◽  
Vol 22 (43) ◽  
pp. 153-161 ◽  
Author(s):  
Manuel Cebrián-de-la-Serna ◽  
José Serrano-Angulo ◽  
Mayerly Ruiz-Torres

Teamwork is one of the most widespread teaching methods used to achieve learning skills. Despite the difficulty of finding out the degree of individual learning taking place in each member of the group, these methods are having an increasingly greater importance in university teaching. The present article shows the results of an R+D+i1 project aimed at «analysing the impact of eRubrics ?electronic rubrics? on the assessment of university learning in various forms». Likewise, it aims to show the scope of eRubrics in improving cooperative skills, which are achieved through teamwork and cooperative assessment of tasks in the computer lab. The experiment takes place in three groups selected from a total of six groups of students from the First Year of Primary Education Teaching during the 2011-12 academic year. From the three groups, one acted as the control group and the other two as the experimental groups in which eRubrics were used. Differences were found in students’ results in a written test taken by all the groups, as the group using eRubrics achieved better results than the other two. Additionally, a qualitative analysis was conducted, by classifying the answers of students in the control group with regard to the evaluation criteria that they used, in order to check for coincidences with the eRubric criteria used by students in the experimental groups. El trabajo cooperativo mediante tareas y proyectos en equipo es una de las metodologías más generalizadas en educación para lograr las competencias de aprendizaje. Estas metodologías están teniendo cada vez mayor aceptación en la enseñanza universitaria, a pesar de la dificultad de conocer los aprendizajes individuales producidos en cada uno de sus miembros. Este artículo muestra los resultados de un proyecto de I+D+i cuyo objetivo general consiste en «Analizar el impacto de las eRúbricas –rúbricas electrónicas- en la evaluación de los aprendizajes universitarios en sus diferentes modalidades», y pretende mostrar el alcance de esta herramienta para mejorar el aprendizaje de las competencias o habilidades cooperativas, producto del trabajo en equipo y la evaluación cooperativa de tareas en el laboratorio. La experiencia se desarrolla con tres grupos elegidos (205 estudiantes) de un total de seis grupos de estudiantes de 1º del grado de Primaria en el curso 2011/12. De los tres grupos, uno actúa como grupo de control y los otros dos como grupos experimentales en los que se ha utilizado eRúbricas. Se observan diferencias en las notas de una prueba escrita común a todos, con mejores resultados en los grupos con eRúbrica. Además, se realiza un análisis cualitativo categorizando las respuestas dadas por los estudiantes del grupo de control sobre los criterios de evaluación que éstos utilizan, para ver las coincidencias con los criterios de las eRúbricas usadas en los grupos experimentales.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demmelash Mulualem ◽  
Carol J. Henry

Abstract Background Improving children’s weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers’ knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children’s diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midpoint, and end point. ANOVA and descriptive statistics were used to analyzed data. Results At baseline and end point, maternal KAP and the dietary diversity score of the children (mean age at end point 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p < 0.001) at midpoint and end point compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p = 0.001). Conclusions NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial registration Clinicaltrials.gov #NCT02638571. Date of registration: 12/18/2015. Prospectively registered.


2004 ◽  
Vol 24 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Cheuk-Chun Szeto ◽  
Teresa Yuk-Hwa Wong ◽  
Kai-Ming Chow ◽  
Chi-Bon Leung ◽  
Man-Ching Law ◽  
...  

Objective Previous studies show that peritoneal Kt/V is an independent predictor of survival in anuric patients receiving continuous ambulatory peritoneal dialysis (CAPD). We studied whether peritoneal Kt/V has the same effect in CAPD patients with residual renal function. Design Observational cohort study. Setting Single dialysis center in a university teaching hospital. Patients New and prevalent CAPD patients. Methods We examined the 5-year follow-up results of our prospective study previously reported ( Kidney Int 2000; 58:400–7). A total of 270 CAPD patients were followed for up to 6 years. Dialysis adequacy indices, residual renal function, and nutritional data were monitored. Outcome Measures Primary outcomes included mortality and technique failure. Peritoneal Kt/V rather than total Kt/V was used for multivariate survival analysis. Results Average duration of follow-up was 35.1 ± 22.0 months. Average peritoneal Kt/V throughout the study was 1.59 ± 0.37; median residual glomerular filtration rate (GFR) 0.82 mL/minute. Five-year actuarial patient survival was 41.5%, and technique survival was 23.1%. Multivariate analysis showed that sex, age, duration of dialysis, presence of diabetes, serum albumin, dialysate-to-plasma creatinine ratio at 24 hours, peritoneal Kt/V, residual GFR, and normalized protein nitrogen appearance were independent factors of both actuarial patient survival and technique survival. For every 0.1 unit higher peritoneal Kt/V, relative mortality risk was 0.94 (95% CI 0.89 – 0.99, p = 0.03). When prevalent and new CAPD cases were analyzed separately, peritoneal Kt/V predicted survival only for prevalent CAPD patients. Conclusion We conclude that, in prevalent CAPD patients with relatively low levels of peritoneal clearance and residual renal function, a higher peritoneal Kt/V is associated with better survival. Peritoneal clearance below 1.6 – 1.7 likely has a major detrimental effect on the clinical outcome of CAPD patients with little residual renal function.


2017 ◽  
Vol 3 (2) ◽  
pp. 110-119
Author(s):  
Harmiyati Harmiyati ◽  
Ariawan Soejoenoes ◽  
Sri Wahyuni M ◽  
Kun Aristiati ◽  
Soeharyo Hadisaputro

Background: Toddlers are vulnerable groups to malnutrition. Thus, to maintain their nutritional status is needed. Honey is considered having health benefits that might increase the nutritional status in children. However, little is known about the impact of honey on nutritional change in Sumbawa. Objectives: The aim of this study is to analyze the effect of honey on changes in nutritional status in children with poor nutrition in the area of the Health Center of Lopok, Sumbawa IndonesiaMethods: This study employed a quasi experiment design with pretest-posttest with control group. The total sample in this study were 60 children recruited by simple random sampling, divided into 2 groups, namely 30 children in intervention group and 30 children in control group. The sampling technique used simple random sampling. Data were analyzed using Mann Whitney and linear regression test. Results: Findings showed that there were significant mean differences between the intervention and control group in term of weight (intervention 1.316; control 0.903), height (intervention 1.586; control 1.030), weight-for-height (W/H) z-score (intervention 0.713; control 0.595), weight-for-age (W/A) z-score (intervention 0.717; control 0.531), and height-for-age (H/A) z-score (intervention 0.847; control 0.423) with p-value < 0.05.Conclusion: There was a significant effect of honey on changes in nutritional status in children with poor nutrition. It is suggested that health providers may use honey to deal with children under nutrition to increase their appetite and change their nutritional status.


2019 ◽  
Author(s):  
Stéphane Sanchez ◽  
Cécile Payet ◽  
Marie Herr ◽  
Anne Dazinieras ◽  
Caroline Blochet ◽  
...  

BACKGROUND The elderly are particularly exposed to adverse events from medication. Among the various strategies to reduce polypharmacy, educational approaches have shown promising results. OBJECTIVE We aimed to evaluate the impact of the implementation of a good medical practice booklet on polypharmacy in nursing homes. METHODS We identified nursing homes belonging to a geriatric care provider that had launched a policy of proper medication use using a good medical practice booklet delivered to prescribers and pharmacists. Data were derived from electronic pill dispensers. The effect of the intervention on polypharmacy was assessed with multilevel regression models, with a control group to account for natural trends over time. The main outcomes were the average daily number of times when medication was administered and the number of drugs with different presentation identifier codes per resident per month. RESULTS 96,216 residents from 519 nursing homes were included between 1 January 2011 and 31 December 2014. The intervention group and the control group both decreased their average daily use of medication (-0.05 and -0.06). The good medical practice booklet did not have a statistically significant effect (exponentiated difference-in-differences coefficient 1.00, 95% confidence interval 0.99-1.02, P=.45). CONCLUSIONS Although the good medical practice booklet itself did not seem effective in decreasing medication use, our data show the effectiveness of a higher-level policy to decrease polypharmacy.


Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 86
Author(s):  
Fauna Herawati ◽  
Yuni Megawati ◽  
Aslichah ◽  
Retnosari Andrajati ◽  
Rika Yulia

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.


2021 ◽  
pp. 019459982199474
Author(s):  
Maggie Xing ◽  
Dorina Kallogjeri ◽  
Jay F. Piccirillo

Objective To evaluate the effectiveness of cognitive training in improving tinnitus bother and to identify predictors of patient response. Study Design Prospective open-label randomized controlled trial. Setting Online. Methods Participants were adults with subjective idiopathic nonpulsatile tinnitus causing significant tinnitus-related distress. The intervention group trained by using auditory-intensive exercises for 20 minutes per day, 5 days per week, for 8 weeks. The active control group trained on the same schedule with non–auditory intensive games. Surveys were completed at baseline, 8 weeks, and 12 weeks. Results A total of 64 participants completed the study. The median age was 63 years (range, 25-69) in the intervention group and 61 years (34-68) in the control group. Mixed model analysis revealed that within-subject change in Tinnitus Functional Index in the intervention group was not different than the control group, with marginal mean differences (95% CI): 0.24 (–11.20 to 10.7) and 2.17 (–8.50 to 12.83) at 8 weeks and 2.33 (–8.6 to 13.3) and 3.36 (–7.91 to 14.6) at 12 weeks, respectively. When the 2 study groups were compared, the control group had higher Tinnitus Functional Index scores than the intervention group by 10.5 points at baseline (95% CI, –0.92 to 29.89), 8.1 at 8 weeks (95% CI, –3.27 to 19.42), and 9.4 at 12 weeks (95% CI, –2.45 to 21.34). Conclusion Auditory-intensive cognitive training was not associated with changes in self-reported tinnitus bother. Given the potential for neuroplasticity to affect tinnitus, we believe that future studies on cognitive training for tinnitus remain relevant.


Author(s):  
Taylor Kirby ◽  
Robert Connell ◽  
Travis Linneman

Abstract Purpose The impact of a focused inpatient educational intervention on rates of medication-assisted therapy (MAT) for veterans with opioid use disorder (OUD) was evaluated. Methods A retrospective cohort analysis compared rates of MAT, along with rates of OUD-related emergency department (ED) visits and/or hospital admission within 1 year, between veterans with a diagnosis of OUD who completed inpatient rehabilitation prior to implementation of a series of group sessions designed to engage intrinsic motivation to change behavior surrounding opioid abuse and provide education about MAT (the control group) and those who completed rehabilitation after implementation of the education program (the intervention group). A post hoc, multivariate analysis was performed to evaluate possible predictors of MAT use and ED and/or hospital readmission, including completion of the opioid series, gender, age (&gt;45 years), race, and specific prior substance(s) of abuse. Results One hundred fifty-eight patients were included: 95 in the control group and 63 in the intervention group. Rates of MAT were 25% (24 of 95 veterans) and 75% (47 of 63 veterans) in control and intervention groups, respectively (P &lt; 0.01). Gender, completion of the opioid series, prior heroin use, and marijuana use met prespecified significance criteria for inclusion in multivariate regression modeling of association with MAT utilization, with participation in the opioid series (odds ratio [OR], 9.56; 95% confidence interval [CI], 4.36-20.96) and prior heroin use (OR, 3.26; 95% CI, 1.18-9.01) found to be significant predictors of MAT utilization on multivariate analysis. Opioid series participation and MAT use were independently associated with decreased rates of OUD-related ED visits and/or hospital admission (hazard ratios of 0.16 [95% CI, 0.06-0.44] and 0.32 [95% CI, 0.14-0.77], respectively) within 1 year after rehabilitation completion. Conclusion Focused OUD-related education in a substance abuse program for veterans with OUD increased rates of MAT and was associated with a decrease in OUD-related ED visits and/or hospital admission within 1 year.


Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat

Background: During the COVID-19 pandemic, many primary care professionals were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psychosocial support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW interventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.


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