Self-proning in COVID-19 patients on low-flow oxygen therapy: a cluster randomised controlled trial

Rationale and objectivesProne positioning as a complement to oxygen therapy to treat hypoxaemia in coronavirus disease 2019 (COVID-19) pneumonia in spontaneously breathing patients has been widely adopted, despite a lack of evidence for its benefit. We tested the hypothesis that a simple incentive to self-prone for a maximum of 12 h per day would decrease oxygen needs in patients admitted to the ward for COVID-19 pneumonia on low-flow oxygen therapy.Methods27 patients with confirmed COVID-19 pneumonia admitted to Geneva University Hospitals were included in the study. 10 patients were randomised to self-prone positioning and 17 to usual care.Measurements and main resultsOxygen needs assessed by oxygen flow on nasal cannula at inclusion were similar between groups. 24 h after starting the intervention, the median (interquartile range (IQR)) oxygen flow was 1.0 (0.1–2.9) L·min−1 in the prone position group and 2.0 (0.5–3.0) L·min−1 in the control group (p=0.507). Median (IQR) oxygen saturation/fraction of inspired oxygen ratio was 390 (300–432) in the prone position group and 336 (294–422) in the control group (p=0.633). One patient from the intervention group who did not self-prone was transferred to the high-dependency unit. Self-prone positioning was easy to implement. The intervention was well tolerated and only mild side-effects were reported.ConclusionsSelf-prone positioning in patients with COVID-19 pneumonia requiring low-flow oxygen therapy resulted in a clinically meaningful reduction of oxygen flow, but without reaching statistical significance.

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Jacobson and Truax Method: evaluation of the clinical effectiveness of a home care program after prostatectomy

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.2249.3003 ◽

2018 ◽

Vol 26 (0) ◽

Cited By ~ 1

Author(s):

Luciana Regina Ferreira Pereira da Mata ◽

Mariana Ferreira Vaz Gontijo Bernardes ◽

Cissa Azevedo ◽

Tânia Couto Machado Chianca ◽

Maria da Graça Pereira ◽

...

Keyword(s):

Radical Prostatectomy ◽

Home Care ◽

Clinical Significance ◽

Statistical Significance ◽

Intervention Group ◽

Nursing Intervention ◽

Telephone Counseling ◽

Control Group ◽

Teaching Program ◽

Knowledge Variable

ABSTRACT Objective: to exemplify the applicability of the Jacobson and Truax Method in a nursing intervention study that analyzed the effectiveness of a home care teaching program after radical prostatectomy. Method: this is a descriptive study concerning the applicability of the Jacobson and Truax Method in the data analysis of a clinical trial. The intervention consisted of a teaching program for hospital discharge after radical prostatectomy through oral guidance, writing, and telephonic reinforcement. Thirty-four men participated in the intervention group and 34 men participated in the control group. A reliable index of change and clinical significance was calculated for the knowledge variable in both groups. Scatterplots were presented to demonstrate the effectiveness of the method. Results: for 30 individuals in the intervention group, the intervention presented clinically relevant change than in knowledge. In the control group, none of the 34 individuals presented clinical significance of the results related to this variable, that is, the statistical significance identified by the inferential tests did not have clinically relevant changes in the knowledge variable. Conclusion: the educational intervention carried out through the combination of oral, written and telephone counseling was shown to be clinically effective in improving knowledge about home care.

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A Randomized Study to Assess the Impact of Pharmacist Counseling of Employer-Based Health Plan Beneficiaries With Diabetes

Journal of Pharmacy Practice ◽

10.1177/0897190011418513 ◽

2011 ◽

Vol 25 (2) ◽

pp. 169-179 ◽

Cited By ~ 29

Author(s):

Dale F. Kraemer ◽

Wayne A. Kradjan ◽

Theresa M. Bianco ◽

Judi A. Low

Keyword(s):

Diabetes Management ◽

Statistical Significance ◽

Glycosylated Hemoglobin ◽

Randomized Study ◽

Intervention Group ◽

Control Group ◽

Counseling Intervention ◽

Care Plans ◽

Pharmacist Counseling ◽

The Impact

Objective: To assess the impact of pharmacist counseling on empowering people with diabetes to better self-care. Introduction: Community-based pharmacists can play a key role in educating and empowering people in such programs. Methods: A randomized trial compared the effects of pharmacist counseling (intervention group) with printed materials (control group) in diabetic beneficiaries of several employer-based health care plans. All participants also received waiver of out-of-pocket expenses for diabetic-related medications and supplies. Clinical, humanistic, and claim outcomes were evaluated at baseline and at 1 year follow-up. Results: Sixty-seven beneficiaries participated in this study. The 0.50% decrease from baseline in glycosylated hemoglobin (A1c) was statistically significant ( P = .0008) in the intervention group and the difference between the groups approached statistical significance ( P = .076). Beneficiaries in both groups had greater claim costs for diabetic-related medications and supplies during the study year. Both groups also improved in ability to manage their diabetes with the counseling group showing a significantly better understanding of diabetes ( P = .0024). Conclusion: There was a trend toward improvement in A1c in patients counseled by pharmacist with an increased utilization of diabetes-related medications and supplies. Counseling also improved diabetes knowledge and empowered patients to better diabetes management.

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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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Impact of Multimodal Cognitive Training on Cognitive Traits of Children: A Multicentric Interventional Study

10.21203/rs.3.rs-468572/v1 ◽

2021 ◽

Author(s):

Manjunatha R ◽

Praveen Pankajakshan ◽

Alphonsa Joseph ◽

Gyan Kashyap ◽

Usha Manjunath ◽

...

Keyword(s):

Cognitive Training ◽

Statistical Significance ◽

Intervention Group ◽

Control Group ◽

Sleep State ◽

Eyes Closed ◽

Before And After ◽

Slow Sleep ◽

Mini Mental Status Examination ◽

External Behavior

Abstract In this article, we evaluate the hypothesis that a multimodal cognitive training (MCT) program, the Brighter Minds, can enhance certain inherent traits of a child and thus bring changes in the external behavior. For the study, 186 children (randomized to 93 each in intervention and control group) aged 10-15 years were enrolled from three different locations. Psychometric tests, parental/caregiver interviews and EEG (electroencephalography) tests were conducted before and after the program. Intervention group showed strong statistical significance for improvements in Mini Mental Status Examination (MMSE) (P<0.01) but no significance for Raven’s Standard Progrssive Matrices (SPM) or Susan Harter’s test. The parental/caregiver reported satistically significant improvements in focus (P<0.05), empathy (P<0.05), intuition (P<0.05), comprehension (P<0.05) and understanding of abstract concepts (P<0.05) for the intervention group. For the control, Power Spectral Density (PSD) of the baseline eyes-closed (EC) EEG recording, the spectrum below 20Hz exhibited the characteristic “1/f” spectral scaling of the power-law. This signature matches prior reported evidence in literature of those in wakeful state with EC. The intervention group EC PSD, however, exhibited a signature similar to those in a slow sleep state; reflective of the possible transfer effect of the training on other skills like relaxation. We used unsupervised learning methods with dice distance, on the psychometric and interview data, to show the effect of location and the exposure of a few control children to the program.

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The Effect of Baduanjin on Promoting the Physical Fitness and Health of Adults

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/784059 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Ran Li ◽

Li Jin ◽

Ping Hong ◽

Zi-Hong He ◽

Chuan-Ye Huang ◽

...

Keyword(s):

Physical Fitness ◽

Statistical Significance ◽

Intervention Group ◽

Blood Lipid ◽

The Body ◽

Control Group ◽

Triceps Brachii ◽

Fitness And Health ◽

Subcutaneous Adipose ◽

Lower Corner

The purpose of study was to assess the efficacy of a 16-week Baduanjin qigong training intervention in promoting physical fitness and health for adults. An experimental design was adopted, and subjects were assigned randomly into an experimental group (n=55) and a control group (n=55). In the intervention group comprised of adults, there were no significant variations in blood glucose, blood lipid, blood pressure, heart rate variability, and vital capacity indices. The body weight and body mass index (BMI) dropped in the intervention group. Compared with the control group, the skinfold thicknesses decreased at lower corner of scapula, triceps brachii, and abdomen, with a statistical significance (P<0.001;P=0.005;P=0.003). By comparing the physical fitness indices, it was found that the increase of the results of sit-and-reach test in the intervention group had statistical significance (P=0.001). In conclusion, it was found by our trial that Baduanjin exercise could significantly improve the physical flexibility and subcutaneous adipose accumulation in the healthy adults.

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Ultrasound-guided access to the axillary vein for implantation of cardiac implantable electronic devices: A systematic review and meta-analysis

The Journal of Vascular Access ◽

10.1177/11297298211054621 ◽

2021 ◽

pp. 112972982110546

Author(s):

Sonia D’Arrigo ◽

Francesco Perna ◽

Maria Giuseppina Annetta ◽

Mauro Pittiruti

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Statistical Significance ◽

Intervention Group ◽

Late Complications ◽

Control Group ◽

Complication Rates ◽

Axillary Vein ◽

Cardiac Implantable Electronic Devices ◽

The Us

The aims of our systematic review were to quantify the expected rate of procedural success, early and late complications during CIED implantation using US-guided puncture of the axillary vein and to perform a meta-analysis of those studies that compared the US technique (intervention) versus conventional techniques (control) in terms of complication rates. MEDLINE, ISI Web of Science, and EMBASE were searched for eligible studies. Pooled Odds Ratio (OR) and Pooled Mean Difference (PMD) for each predictor were calculated. The quality of evidence (QOE) was evaluated according to the GRADE guidelines. Thirteen studies were included a total of 2073 patients. The overall success of US-guided venipuncture for CIED implantation was 96.8%. As regards early complications, pneumothorax occurred in 0.19%, arterial puncture in 0.63%, and severe hematoma/bleeding requiring intervention in 1.1%. No cases of hemothorax, brachial plexus, or phrenic nerve injury were reported. As regards late complications, the incidence of pocket infection, venous thromboembolism, and leads dislodgement was respectively 0.4%, 0.8%, and 1.2%. In the meta-analysis (five studies), the intervention group (US-guided venipuncture) had a trend versus a lower likelihood of having a pneumothorax (0.19% vs 0.75%, p = 0.21), pocket hematoma (0.8% vs 1.7%, p = 0.32), infection (0.28% vs 1.05%, p = 0.29) than the control group, but this did not reach statistical significance. The overall QOE was low or very low. In conclusions we found that the US-guided axillary venipuncture for CIEDs implantation was associated with a low incidence of early and late complications and a steep learning curve.

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Abstract P211: Stroke Recovery Navigator to Improve Post Stroke Recovery

Stroke ◽

10.1161/str.52.suppl_1.p211 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Erin Rindels ◽

Anna Taylor ◽

Aurora Quigley ◽

Keyword(s):

Social Support ◽

Caregiver Burden ◽

Statistical Significance ◽

Intervention Group ◽

Demographic Characteristics ◽

Stroke Recovery ◽

Control Group ◽

Post Discharge ◽

Additional Information ◽

The Impact

Social support impacts recovery after stroke. Patient centered navigation programs provide social support and have shown benefit with other patient populations. The purpose of this study is to determine if there is a difference in outcomes for stroke survivors and caregivers who receive navigation services post-discharge. The study used a multi-center quasi-experimental before-after design to examine the impact of a telephone-based stroke navigation. Selected recruitment sites were nine facilities without navigation programs. Facilities provided information to survivors and caregivers about Stroke Recovery Navigator (SRN) prior to discharge and made referrals to the program. Participants were randomized into control and intervention groups using a computer-generated coin flip. Navigators completed telephone assessments within a week of referral. Navigators received the following trainings: Patient Navigation Fundamentals, motivational interviewing, and mental health first aid. The Reintegration to Normal Living (RNLI) scale was completed by all survivors and the Zarit Caregiver Burden scale was completed by all caregivers. The control group completed the initial and final assessments using these tools. In addition to these assessments, the intervention group received an individualized navigation plan and weekly contact by the SRN. The study randomized 301 individuals (82 caregivers, 219 survivors), with completion rate of 32%. Caregiver demographic characteristics and baseline caregiver burden scores were not statistically significant. Caregiver burden in the intervention group were lower compared to the control group, but not statistically significant (p=0.25). Demographic characteristics for survivors were similar between groups. RNLI score for survivors was slightly higher for the intervention group (p<0.10). To achieve statistical significance additional participants were needed. In conclusion differences in quality of life for survivors and caregivers were not statistically significant between the groups. Additional information on the benefits of an SRN program is needed to support its implementation. However, important lessons were learned to improve such program and its design.

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Office-Based Cholesterol Testing: Impact on Process-of-Care in Patients with Hypercholesterolemia a Pilot Study

Journal of Pharmacy Technology ◽

10.1177/875512259701300208 ◽

1997 ◽

Vol 13 (2) ◽

pp. 75-79 ◽

Cited By ~ 2

Author(s):

David M Ruffin ◽

James M McKenney

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Statistical Significance ◽

Intervention Group ◽

Office Visit ◽

Therapeutic Interventions ◽

Control Group ◽

Process Of Care ◽

Physician Office ◽

Significant Difference

Objective: To determine whether providing cholesterol results during a patient-physician office encounter would affect the process-of-care in patients with hypercholesterolemia. Methods: We used a randomized, parallel-group, control design to conduct the study. Thirty-five participants had a lipoprotein analysis performed using the L.D.X. cholesterol analyzer. Patients randomly assigned to the intervention group (n = 19) had their results provided to the physician during the office visit; the results of those in the control group (n = 16) were not made available to the physician. Each participant's medical record was reviewed to determine the physican's process-of-care with respect to cholesterol management. The indicators of the process-of-care for which we sought documentation included therapeutic interventions and the physician's assessment of risk for coronary heart disease. We used Fisher's exact test to determine statistical significance of the intervention. Descriptive analysis was also performed. Results: We were unable to detect a statistically significant difference in therapeutic interventions (p = 0.183). However, we did observe a statistically significant difference in the physician's assessment of risk for coronary heart disease (p = 0.0001). Conclusions: Our data suggest that providing a cholesterol test result during a patient-physician office encounter positively affects the process-of-care in patients with hypercholesterolemia. Future studies should include larger numbers of patients and longer follow-up periods.

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Physical activity and prenatal depression: going beyond statistical significance by assessing the impact of reliable and clinical significant change

Psychological Medicine ◽

10.1017/s0033291719003714 ◽

2020 ◽

pp. 1-6

Author(s):

Marina Vargas-Terrones ◽

Taniya S. Nagpal ◽

Maria Perales ◽

Harry Prapavessis ◽

Michelle F. Mottola ◽

...

Keyword(s):

At Risk ◽

Exercise Intervention ◽

Statistical Significance ◽

Intervention Group ◽

Prenatal Depression ◽

Control Group ◽

Post Intervention ◽

Point Change ◽

Significant Change ◽

The Impact

Abstract Background Previous literature supports exercise as a preventative agent for prenatal depression; however, treatment effects for women at risk for prenatal depression remain unexplored. The purpose of the study was to examine whether exercise can lower depressive symptoms among women who began pregnancy at risk for depression using both a statistical significance and reliable and clinically significant change criteria. Methods This study is a secondary analysis of two randomized controlled trials that followed the same exercise protocol. Pregnant women were allocated to an exercise intervention group (IG) or control group (CG). All participants completed the Center for Epidemiological Depression (CES-D) scale at gestational week 9–16 and 36–38. Women with a baseline score ⩾16 were included. A clinically reliable cut-off was calculated as a 7-point change in scores from pre- to post-intervention. Results Thirty-six women in the IG and 25 women in the CG scored ⩾16 on the CES-D at baseline. At week 36–38 the IG had a statistically significant lower CES-D score (14.4 ± 8.6) than the CG (19.4 ± 11.1; p < 0.05). Twenty-two women in the IG (61%) had a clinically reliable decrease in their post-intervention score compared to eight women in the CG (32%; p < 0.05). Among the women who met the reliable change criteria, 18 (81%) in the IG and 7 (88%) in the CG had a score <16 post-intervention, with no difference between groups (p > 0.05). Conclusions A structured exercise program might be a useful treatment option for women at risk for prenatal depression.

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Effects of Back Touching on Tidal Volume

Psych ◽

10.3390/psych1010031 ◽

2019 ◽

Vol 1 (1) ◽

pp. 412-419

Author(s):

Taichi Hitomi ◽

Chigusa Yachi ◽

Hajime Yamaguchi

Keyword(s):

Factor Analysis ◽

Tidal Volume ◽

Analysis Of Variance ◽

Statistical Significance ◽

Intervention Group ◽

Mixture Design ◽

Control Group ◽

Subjective Indicators ◽

Basic Experiment ◽

Positive Effect

The purpose of this basic experiment was to examine the effects of soft touching on an experiment participant’s back on tidal volume (TV), as an increase in TV was considered an indication of enhanced relaxation. Healthy experiment participants were divided into an intervention group, where soft touching was administered for two minutes on their back, and a control group, where they were asked to rest. Then the change in TV was measured using a spiro-meter two factor analysis of variance (ANOVA; mixture design) was conducted. As a result of two factor ANOVA, the intervention group’s TV changed with statistical significance, while no statistically significant change was observed in the control group. There was a possibility that soft touching on the back had a positive effect on the increase of TV and relaxation. As a result of soft touching on the back, TV was increased. Subjective indicators suggested that the relaxation was enhanced by soft touching on the back.

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