Burnout and distress in Australian physician trainees: Evaluation of a wellbeing workshop

Objective: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian physician trainees using a randomized-controlled design. Methods: Participants were randomly assigned into intervention and control groups. The intervention group attended a half-day workshop. Outcome measures included depression anxiety stress scale, professional quality of life scale and alcohol use disorders identification test. Demographic and work/life factors were measured. Measurements were recorded at baseline, 3 and 6 months, and the workshop was evaluated by participants. Results: High rates of burnout (76%) and secondary traumatic stress (91%) were detected among study participants and around half met screening criteria for depression (52%), anxiety (46%) and stress (50%) at baseline. Workshop evaluations showed that participants agreed that the training was relevant to their needs (96%) and met their expectations (92%). There was a small reduction in alcohol use, depression and burnout in the intervention group compared with the control group at 6 months, but these changes did not reach statistical significance. Conclusion: High rates of psychological morbidity detected in the study suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and changes in the workplace to reduce distress.

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Impact of ascorbic acid in reducing the incidence of vancomycin associated nephrotoxicity in critically ill patients: A preliminary randomized controlled trial

F1000Research ◽

10.12688/f1000research.55619.1 ◽

2021 ◽

Vol 10 ◽

pp. 929

Author(s):

Nouran Hesham El-Sherazy ◽

Naglaa Samir Bazan ◽

Sara Mahmoud Shaheen ◽

Nagwa A. Sabri

Keyword(s):

Ascorbic Acid ◽

Critically Ill ◽

Critically Ill Patients ◽

Statistical Significance ◽

Intervention Group ◽

Secondary Outcome ◽

Control Group ◽

Control Groups ◽

The Absolute ◽

And Control

Background Antioxidants show nephroprotective effect against vancomycin associated nephrotoxicity (VAN) in animals. This study aimed to assess the ascorbic acid nephro-protective role against VAN clinically. Methods Forty-one critically ill patients were randomly assigned to one of two groups: intervention group (vancomycin IV plus ascorbic acid, n=21) or control group (vancomycin IV only, n=20). Primary outcomes were the incidence of VAN and the absolute change in creatinine parameters, while mortality rate was the secondary outcome. Nephrotoxicity was defined as an increase in serum creatinine (S.cr) by at least 0.5 mg/dL or 50% of baseline for at least two successive measurements. This study is registered at Clinicaltrials.gov (NCT03921099), April 2019. Results Mean absolute S.cr increase was significant when compared between both groups, P-value = 0.036, where S.cr increased by 0.05(0.12) and 0.34(0.55) mg/dL in the intervention and control groups, respectively. Mean absolute Cr.cl decline was significant when compared between both groups, P-value = 0.04, where Cr.cl was decreased by 5.9(17.8) and 22.3(30.4) ml/min in the intervention and control groups, respectively. Incidence of VAN was 1/21(4.7%) versus 5/20(25%) in the intervention and control groups, respectively (RR: 0.19; CI: 0.024–1.49; P-value = 0.093). Mortality was higher in the control group; however, it was not statistically significant, P-value = 0.141. Conclusion Co-administration of ascorbic acid with vancomycin preserved renal function and reduced the absolute risk of VAN by 20.3%, however, the reduction in VAN incidence didn’t reach statistical significance level. Further large multicenter prospective trials are recommended.

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Efficacy of curcuminoids for reducing postoperative pain after laparoscopic gynecologic surgery: A pilot randomized trial

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2018-0224 ◽

2019 ◽

Vol 16 (4) ◽

Author(s):

Natacha Phoolcharoen ◽

Shina Oranratanaphan ◽

Chai Ariyasriwatana ◽

Pongkasem Worasethsin

Keyword(s):

Postoperative Pain ◽

Statistical Significance ◽

Intervention Group ◽

Gynecologic Surgery ◽

Control Group ◽

Analgesic Effects ◽

Good Safety Profile ◽

The Difference ◽

Laparoscopic Gynecologic Surgery ◽

And Control

Abstract Background Curcuminoids, which are substances extracted from turmeric, have been proved to have anti-inflammatory and analgesic effects along with a good safety profile. This study aimed to evaluate the clinical efficacy of curcuminoids for reducing postoperative pain in patients who undergo laparoscopic gynecologic surgery. Methods From November 2016 to December 2017, participants were randomly assigned, by blocks of four, to the intervention and control arms of the study. Altogether, 60 patients who were to undergo laparoscopic gynecologic surgery at our institution were enrolled. Intraoperative findings were not significantly different between the two groups. One tablet of curcuminoid extract 250 mg was given to patients in the intervention group four times a day on postoperative days 1–3. Pain was evaluated at 24 and 72 h postoperatively using a 10-point visual analog scale (VAS). Results The median VAS score 24 h after surgery was 3 (1–6) in the intervention group and 4.5 (3–7) in the control group, with the difference reaching statistical significance (p=0.001). The median VAS at 72 h after surgery was 1 (0–2) in the intervention group and 2 (1–5) in the control group (p<0.001). Conclusion Curcuminoids may be an effective supplement to reduce pain severity postoperatively following laparoscopic gynecologic surgery. Trial Registration TCTR20180215001 www.clinicaltrials.in.th

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Impact of Clinical Pharmacist Mediated Discharge Counseling and SMS Reminders Service on Medication Adherence in Chronic Disorders

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59b34402 ◽

2021 ◽

pp. 446-453

Author(s):

Y. Samhitha Reddy ◽

K. Somashekar Reddy

Keyword(s):

Medication Adherence ◽

Clinical Pharmacist ◽

Statistical Significance ◽

Intervention Group ◽

Pill Count ◽

Control Group ◽

Sms Reminders ◽

Chronic Disorders ◽

And Control

Aims: This study aimed to assess the effect of discharge counseling with SMS reminders on medication adherence in chronic disorders. Study Design: Prospective randomized open-label trial Place and Duration of Study: The study was conducted at the dispensing department of a secondary care referral charity hospital located in a small village. The study was conducted for a period of six months from October 2018 to April 2019. Methodology: Upon consent, a total of 364 patients were enrolled in this study and randomized into two groups viz., intervention group (n=182) and control group (n=182) respectively, with and without discharge counseling and SMS reminder on medication usage by the clinical pharmacist. The level of medication adherence was measured using a pill count and visual analog scale (VAS) methods at two follow-up visits includes baseline and final follow-up visit (gap of two months). A two-sample Wilcoxon rank‑sum (Mann–Whitney) was used to compare the statistical mean difference of medication adherence levels between two groups at each follow‑up visit. Results: The mean age of intervention and control groups were 57.1±8.55 and 58.5±8.53; most of the subjects were >60 years of age and were typically suffering from hypertension (30.2%) and diabetes (34.8%). Initially, at baseline, the values of medication adherence level (pill-count method) were closer in both intervention (82.4±7.3) and control group (81.35±6.4), whereas at follow up visits, the levels of the intervention group (93.2±6.0, 95.6±2.25) were significantly increased (p<0.0001) as compared to the control group (81.2±8.5, 80.6±8.1). Conclusion: Thus, the statistical significance infers that the clinical pharmacist-mediated discharge counseling with SMS reminders would increase medication adherence levels in chronic disorders.

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Effect of integrated health system leading-managing-and-governing for results model on institutional delivery: Team-based quasi-experiment

10.1101/775858 ◽

2019 ◽

Author(s):

Yeshambel Agumas Ambelie ◽

Getu Degu Alene ◽

Damen Hailemariam Gebrekiros

Keyword(s):

Institutional Delivery ◽

Statistical Significance ◽

Intervention Group ◽

Analysis Of Covariance ◽

Theory Of Change ◽

Control Group ◽

Control Groups ◽

Institutional Deliveries ◽

Quasi Experimental ◽

And Control

AbstractObjectiveThe objective of this study is to examine, based on theory of change, whether integrated leading-managing-and-governing for results model is plausible cause of improved institutional delivery.MethodsA team-based quasi-experimental study was conducted. One-hundred-thirty-four health facility teams were enrolled in the study. Teams were allocated to intervention and control groups in a 1:1 ratio, non-randomly. End line institutional delivery was the dependent variable while the group (main predictor) and the baseline institutional delivery (covariate) were independent variables. The intervention that was given over six months was integrated leading-managing-and-governing for results model. The institutional deliveries were measured with percentages whilst the group was measured with exposure status (yes or no) to the intervention. Data, from both groups, were collected at baseline and end line. Data were analyzed using analysis of covariance. Statistical significance was determined at (p<.05). The main effect of the intervention was determined by 95% CI, presented in the contrast results.ResultsThe adjusted mean institutional deliveries with 95% CI were 47.4 (46.2, 48.6) and 33.4 (32.2, 34.6) in the intervention and control groups, respectively. Contrast results showed that having an intervention group, p = .000, 95% CI (12.2, 15.8), of integrated leading-managing-and governing for results model significantly increased mean institutional delivery compared to having a control group.ConclusionsThis study provides some guidance regarding the plausible causation of integrated leading-managing-and-governing for results model on institutional delivery. It would serve as a baseline in identifying true causation using a randomized design.

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Impact of Improved Cooking Stove on Maternal Health in Rural Bangladesh: A Quasi-Experimental Study

Journal of Medical Research and Innovation ◽

10.15419/jmri.74 ◽

2017 ◽

Vol 1 (3) ◽

pp. 1-9

Author(s):

Sojib Bin Zaman ◽

Naznin Hossain ◽

Salamat Khandker

Keyword(s):

Maternal Health ◽

Rural Areas ◽

Statistical Significance ◽

Intervention Group ◽

Respiratory Illness ◽

Lung Function Test ◽

Control Group ◽

Rural Bangladesh ◽

Quasi Experimental ◽

And Control

Introduction: Two-thirds of all households in developing countries depend on unprocessed biomass fuel for cooking. Traditional stoves have poor combustion capacity which produce heavy smoke and numerous harmful pollutants. Switching to Improved Cooking Stove (ICS), a well-designed earthen made stove equipped with a chimney could be beneficial for health. The aim of this study was to assess the efficacy of ICS on maternal health in rural areas of Bangladesh. Methods: A quasi-experimental design was adopted to conduct the study. This study selected 150 Households from 5 villages (intervention) and 150 Households from 2 villages (control) from the Manikgonj District of Bangladesh during January 1, 2012 to July 30, 2012. Differences between control and intervention group were examined by applying t-test or one-way analysis of variance (ANOVA). The conventional cut-off value of 0.05 was taken as statistical significance. Stata (version 13) was used to do the analysis. Results: Most of the respondents (62%) were less than 30 years of age. About 94% participants resided in tin-shaded houses, and 51% kitchens were small. After the intervention period, the measured mean concentrations of Particulate Matter (PM2.5) for the intervention and control group was 259 µg/m3 and 1285 µg/m3, respectively (p<0.05). However, lung function test (LFT) did not reveal significant differences between the two groups (p>0.05). Conclusion: ICS reduced the incidence of respiratory illness among the intervention group, however, did not demonstrate significant changes in LFT during the six months of the follow-up period. Therefore, this study found ICS might have the potential to be used to improve the maternal health in rural Bangladesh. However, more longitudinal investigations are expected to demonstrate the efficacy and impact of ICS on maternal health to support the statement.

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Effect of aromatherapy massage with orange essential oil on postoperative pain after cesarean section: a randomized controlled trial

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2020-0138 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Seyedmohammad Mirhosseini ◽

Ali Abbasi ◽

Nastaran Norouzi ◽

Fatemeh Mobaraki ◽

Mohammad Hasan Basirinezhad ◽

...

Keyword(s):

Side Effects ◽

Essential Oil ◽

Cesarean Section ◽

Statistical Tests ◽

Intervention Group ◽

Nursing Intervention ◽

Anxiety Score ◽

Control Group ◽

And Control ◽

Orange Essential Oil

Abstract Objectives Many women in recent years have been willing to undergo puncture surgery for childbirth, which, like other surgeries, has physical and psychological side effects such as incision, infertility, chronic pain, and anxiety. Therefore, it is important to reduce and improve these side effects. The aim of this study was to determine the effect of foot massage with orange essential oil on pain and anxiety in women undergoing cesarean section. Methods This randomized clinical trial study was conducted in 2019 on 80 women referred to Bahar Shahroud Hospital after cesarean section surgery. The samples were divided into two groups by intervention (foot massage with orange essential oil) and control (foot massage without orange essential oil). The Spielberger scale was used to determine anxiety scores after cesarean section. In the intervention group, the feet were massaged with orange essential oil, and in the control group, the orange essential oil massage was performed without oil. Anxiety before, immediately after, and 60 min after the intervention was measured and evaluated in both groups. Data analysis was performed using descriptive and inferential statistics. Significant levels were considered for all statistical tests (p<0.05). Results The anxiety score before the intervention in the two groups of intervention and control was 57.12 ± 3.12 and 57.07 ± 3.54, respectively, which were not significantly different, but immediately after the intervention, the anxiety scores in both groups decreased significantly so that there was a further decrease in the intervention group (52.10 ± 4.75 and 56.02 ± 3.77), 1 h after the intervention, the anxiety score in the intervention group decreased compared to the previous stage and increased in the control group (50.40 ± 3.74 and 56.85 ± 4.27). Conclusions Foot massage with orange essential oil can probably be effective as a proper nursing intervention in reducing anxiety after cesarean section surgery.

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

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2019-0291 ◽

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.

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The Effect of Reflexology on Lactation in Women Who Had Cesarean Section: A Randomized Controlled Pilot Study

Complementary Medicine Research ◽

10.1159/000513924 ◽

2021 ◽

pp. 1-8

Author(s):

Sevde Aksu ◽

Pelin Palas Karaca

Keyword(s):

Pilot Study ◽

Cesarean Section ◽

Intervention Group ◽

Control Group ◽

Breast Pain ◽

Randomized Controlled ◽

Significant Difference ◽

The Right ◽

Documentation Tool ◽

And Control

Aim: The research was conducted as a randomized controlled pilot study to evaluate the effects of reflexology on lactation in mothers who delivered by cesarean section (CS). Methods: A single-blind randomized controlled experimental study was conducted with a total of 60 postpartum women in the reflexology application (n = 30) and control groups (n = 30). After the CS, the mothers in the control group were given approximately 3-h routine nursing care after recovering from the effects of anesthesia; the introductory information form was applied, and the Breastfeeding Charting System and Documentation Tool (LATCH) and visual analog scale (VAS) for the signs of the onset of lactation were implemented on the first and second days. Reflexology was applied to the women in the intervention group after an average of 3 h following the mother’s condition had become stable and she had recovered from the effects of anesthesia. Reflexology was applied a total of 20 min – 10 min for the right foot, 10 min for the left foot – twice a day with 8-h intervals on the first and second days after CS. After the last reflexology application, the LATCH and VAS for the signs of the onset of lactation were applied. Results: Of the women, 70% breastfed their babies within 60 min after delivery; 46.7% of the mothers received breastfeeding training and 81.7% needed support for breastfeeding after the CS. The LATCH breastfeeding scores of the women in the intervention group on both days were significantly higher compared to those of the women in the control group (p < 0.001). On the first day after the CS, apart from breast pain, there was no significant difference between the two groups in terms of breast heat and breast tension (p > 0.05). On the second day after the CS, apart from breast tension, there was no significant difference between the groups in terms of breast heat and breast pain (p < 0.05). In the study, women in the intervention group were found to have higher scores in terms of all three symptoms compared to the control group (p < 0.05). Conclusions: In the study, it was determined that LATCH scores and signs of the onset of breastfeeding increased in the mothers who received reflexology after CS.

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School-based obesity interventions in the metropolitan area of Rio De Janeiro, Brazil: pooled analysis from five randomised studies

British Journal Of Nutrition ◽

10.1017/s0007114521000076 ◽

2021 ◽

pp. 1-7

Author(s):

Renata da R. M. Rodrigues ◽

Bruna K. Hassan ◽

Michele R. Sgambato ◽

Bárbara da S. N. Souza ◽

Diana B. Cunha ◽

...

Keyword(s):

Eating Habits ◽

Intervention Group ◽

Pooled Analysis ◽

Control Group ◽

Intention To Treat ◽

School Year ◽

School Based ◽

Obesity Interventions ◽

The One ◽

And Control

Abstract School-based studies, despite the large number of studies conducted, have reported inconclusive results on obesity prevention. The sample size is a major constraint in such studies by requiring large samples. This pooled analysis overcomes this problem by analysing 5926 students (mean age 11·5 years) from five randomised school-based interventions. These studies focused on encouraging students to change their drinking and eating habits, and physical activities over the one school year, with monthly 1-h sessions in the classroom; culinary class aimed at developing cooking skills to increase healthy eating and attempts to family engagement. Pooled intention-to-treat analysis using linear mixed models accounted for school clusters. Control and intervention groups were balanced at baseline. The overall result was a non-significant change in BMI after one school year of positive changes in behaviours associated with obesity. Estimated mean BMI changed from 19·02 to 19·22 kg/m2 in the control group and from 19·08 to 19·32 kg/m2 in the intervention group (P value of change over time = 0·09). Subgroup analyses among those overweight or with obesity at baseline also did not show differences between intervention and control groups. The percentage of fat measured by bioimpedance indicated a small reduction in the control compared with intervention (P = 0·05). This large pooled analysis showed no effect on obesity measures, although promising results were observed about modifying behaviours associated with obesity.

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Toe Clearance Rehabilitative Slippers for Older Adults With Fall Risk: A Randomized Controlled Trial

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/21514593211029102 ◽

2021 ◽

Vol 12 ◽

pp. 215145932110291

Author(s):

Atsuko Satoh ◽

Yukoh Kudoh ◽

Sangun Lee ◽

Masumi Saitoh ◽

Miwa Miura ◽

...

Keyword(s):

Older Adults ◽

Fall Risk ◽

Controlled Trial ◽

Intervention Group ◽

Berg Balance Scale ◽

Control Group ◽

Mobility Assessment ◽

Before And After ◽

Day Services ◽

And Control

Introduction: To evaluate fall-prevention rehabilitative slippers for use by self-caring, independent older adults. Materials and Methods: This assessor-blinded, randomized, and controlled 1-year study included 59 self-caring, independent participants (49 women) who attended day services. The mean age of participants was 84.0 ± 5.3 years. Participants were randomly selected from 8 nursing homes. We tested slippers top-weighted with a lead bead (200, 300, or 400 g). Intervention group participants walked while wearing the slippers for 10-20 min, 1-3 days/week at the day service center. Fall risk was measured using the Berg Balance Scale and the Tinetti Performance-Oriented Mobility Assessment (POMA) before and at 3-month intervals after the intervention/control phase. Results: After 12 months, the intervention group demonstrated significant improvement. Berg Balance and POMA compared to the control group ( p < .05 p < .01, respectively). Mobility scores improved significantly for both measurements in the intervention group before and after ( p < .01), but the control group had significantly lower scores. Discussion: Overall, falls decreased in the intervention group from 10 to 7, and control group falls increased from 9 to 16 ( p = .02). No adverse events related to the intervention were reported. Conclusions: Rehabilitation training slippers may reduce falls in older adults.

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