Study of the use of a personalized peripheral sealing device on surgical face masks in high-risk situations against COVID-19

A significant number of health care professionals subjected to high-risk situations have been infected by Covid-19 due to the lack of adequate protection equipment or the deficient safety margins that these present. The aim of this study was to investigate whether the use of a personal peripheral sealing device (PSD) on surgical face masks (SM) allows them to achieve double mask properties, by providing two-way protection to professionals or users. The proposed device is a thermoplastic resin ring composed of a reusable and biodegradable polylactic acid (PLA) designed to be used in a healthcare setting. Since it is a thermoplastic device, it can be molded and adapted to each individual, becoming personalized and ensuring a correct adjustment to the user’s face. First, a qualitative fit test was performed using a saccharin solution (SS) to evaluate respiratory protective equipment in recruited professionals exposed to high-risk situations of infection by Covid-19. Individuals were divided into an intervention group, who used SM with the PSD, and a control group, who used SM without the PSD. In addition, a quantitative inward air leakage fit test was performed using a 2% sodium chloride (NaCl) aerosol in a sealed cabinet with probes sensitive to this substance, in order to validate the SM with the PSD as a Face Filtering Mask (FFP). Only 5% of the individuals who performed the qualitative fit test with the PSD perceived the sweet taste of the SS, while 100% of the individuals who performed the test without the PSD sensed it (p = 0.0001). In the quantitative fit test, the percentage of air leakage of 2% NaCl aerosol into the SM with the PSD was 6.5%, achieving the same range of air leakage as a FFP mask. Thus, the use of a personalized PLA thermoplastic PSD, together with an inexpensive and widely available SM, could have a significant impact in terms of preventive safety by providing bi-directional protection to its user.

Download Full-text

Benefit of Digital Tools Used for Integrated Personalized Diabetes Management: Results From the PDM-ProValue Study Program

Journal of Diabetes Science and Technology ◽

10.1177/1932296819867686 ◽

2019 ◽

Vol 14 (2) ◽

pp. 240-249

Author(s):

Lutz Heinemann ◽

Wendelin Schramm ◽

Helena Koenig ◽

Annette Moritz ◽

Iris Vesper ◽

...

Keyword(s):

Health Care Professionals ◽

Diabetes Management ◽

Intervention Group ◽

Digital Tools ◽

Clinical Inertia ◽

Control Group ◽

Traffic Light ◽

Study Program ◽

Therapeutic Concept ◽

Cluster Randomized

Background: Integrated personalized diabetes management (iPDM) is a digitally supported therapeutic concept to improve patient-physician interaction to overcome the aspects of clinical inertia. Integrated personalized diabetes management can support decision making and improve therapeutic outcomes of suboptimally controlled persons with insulin-treated type 2 diabetes (T2D). In this paper, we report the results of an analysis of the PDM-ProValue study program on the effectiveness and perceived benefit of this approach, with a focus on how physicians used and assessed the digital tools provided for the iPDM process. Materials and Methods: The study program included two 12-month, prospective, controlled, cluster-randomized multicenter trials. A total of 101 practices participated with 907 patients. Practices were cluster-randomized to an intervention group and a control group. Digital tools for data visualization and analysis applied were used. HCP were asked to assess the use, relevance, and usefulness of the tools. Results: A clear preference was stated for the visual overview over more statistically complex analyses. A total of 83% of the participants rated a high relevance of the “daily profile,” 81% of the “total profile,” and 68% the “risk illustrated by traffic light symbols” for the therapy decision. The overall iPDM process was very favorably rated with respect to structuredness and potential for personalized treatment and well accepted among health care professionals (HCP). Conclusions: Embedding digital tools in a structured process (iPDM) were proved to provide a benefit for insulin-treated T2D patients and their physicians. These results offer insight for further development and improvement of the tools and add information on how to overcome clinical inertia.

Download Full-text

A randomized trial of the effect of peer education on the sexual quality of life in patients with myocardial infarction

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2019-0204 ◽

2020 ◽

Vol 17 (3) ◽

Author(s):

Ali Abbasi ◽

Hossein Ebrahimi ◽

Hossein Bagheri ◽

Mohammad Hasan Basirinezhad ◽

Seyedmohammad Mirhosseini ◽

...

Keyword(s):

Quality Of Life ◽

Myocardial Infarction ◽

Health Care Professionals ◽

Peer Education ◽

Intervention Group ◽

Control Group ◽

Controlled Clinical Trial ◽

Sexual Quality Of Life ◽

Significant Difference

AbstractBackgroundOne of the factors associated with readmission is inappropriate sexual activity after myocardial infarction (MI). This study aimed to assess the effect of peer education on the sexual quality of life (SQOL) in patients with MI.MethodsIn this randomized controlled clinical trial, 70 patients with MI meeting the inclusion criteria were assigned to experimental or control groups using block randomization. Peer education for the intervention group was provided on the third day after MI. Education sessions lasted from 90 to 120 minutes. Data were collected using demographic, sexual quality of life-female (SQOL-F), and sexual quality of life-male (SQOL-M) questionnaires during the fourth week after MI.ResultsThere was no significant difference between the two groups before the intervention in terms of demographic and SQOL. The mean of SQOL in the peer education group was significantly higher than the control group at the 4-week follow-up.ConclusionsAccording to the results, using peer education is recommended for the sexual health care professionals.

Download Full-text

INOVASIA Study: A Randomized Open Controlled Trial to Evaluate Pravastatin to Prevent Preeclampsia and its Effects on sFlt1/PLGF Levels

American Journal of Perinatology ◽

10.1055/a-1673-5603 ◽

2021 ◽

Author(s):

Muhammad Ilham Aldika Akbar ◽

Angelina Yosediputra ◽

Raditya Eri Pratama ◽

Nur Lailatul Fadhilah ◽

Sulistyowati Sulistyowati ◽

...

Keyword(s):

High Risk ◽

Pregnant Women ◽

Controlled Trial ◽

Intervention Group ◽

Perinatal Outcomes ◽

Neonatal Morbidity ◽

Clinical Risk Factor ◽

Control Group ◽

Significant Deterioration ◽

Plgf Ratio

Objectives To evaluate the effect of pravastatin to prevent preeclampsia (PE) in pregnant women at a high risk of developing preeclampsia and the maternal and perinatal outcomes and the sFlt1/PLGF ratio. Study Design This is an open labelled RCT part of INOVASIA trial. Pregnant women at a high risk of developing PE were recruited and randomized into an intervention group (40) and a control group (40). The inclusion criteria consisted of pregnant women with positive clinical risk factor and abnormal uterine artery doppler examination at 10-20 weeks gestational age. The control group received low dose aspirin (80 mg/day) and calcium (1 g/day), while the intervention group received additional pravastatin (20 mg twice daily) starting from 14-20 weeks gestation until delivery. Research blood samples were collected before the first dose of pravastatin and before delivery. The main outcome was the rate of maternal preeclampsia, maternal-perinatal outcomes, and sFlt-1, PLGF, sFlt-1/PlGF ratio and sEng levels. Results The rate of preeclampsia was (non-significantly) lower in the pravastatin group compared with the control group (17.5% vs 35%). The pravastatin group also had a (non-significant) lower rate of severe preeclampsia, HELLP syndrome, acute kidney injury and severe hypertension. The rate of (iatrogenic) preterm delivery was significantly (p=0.048) lower in the pravastatin group (n=4) compared with the controls (n=12). Neonates in the pravastatin group had significantly higher birthweights (2931 + 537 vs 2625 + 872 g; p=0.006), lower Apgar scores < 7 (2.5 vs 27.5%, p=0.002), composite neonatal morbidity (0 vs 20%, p=0.005) and NICU admission rates (0 vs 15%, p=0.026). All biomarkers show a significant deterioration in the control group compared with non significant changes in the pravastatin group. Conclusions Pravastatin holds promise in the secondary prevention of preeclampsia and placenta-mediated adverse perinatal outcomes by improving the angiogenic imbalance.

Download Full-text

A Geriatrics-Focused Hospitalist Trauma Comanagement Program Improves Survival and Quality Measures for Older Adults: A Propensity Score-Matched Analysis

10.21203/rs.3.rs-256284/v1 ◽

2021 ◽

Author(s):

Nasen J. Zhang ◽

Liron Sinvani ◽

Tung Ming Leung ◽

Michael Qiu ◽

Cristy L. Meyer ◽

...

Keyword(s):

High Risk ◽

Propensity Score ◽

Older Adult ◽

Quality Indicators ◽

Intervention Group ◽

Geriatric Trauma ◽

Categorical Variables ◽

Control Group ◽

Trauma Patients ◽

Medical Complexity

Abstract Background: Given the increasing age and medical complexity of trauma patients, medical comanagement has been adopted as a strategy for high-risk patients. This study aimed to determine whether a geriatrics-focused hospitalist trauma comanagement program improves outcomes.Methods: A pre- and post-implementation study compared older adult trauma patients who were comanaged by a hospitalist with those prior to comanagement at a Level 1 trauma center. Criteria for comanagement included: age 65+, multiple comorbidities, and use of high-risk medications. Comanagement focused on geriatric trauma management guidelines. One-to-one propensity score matching (PSM) was performed based on age, gender, Injury Severity Score, Charlson comorbidity index, and initial admission to the intensive care unit (ICU). Outcomes included hospital mortality, length of stay (LOS), and orders for geriatrics-focused quality indicators. Differences were compared with the Wilcoxon Rank Sum test for continuous variables and chi- square or Fisher’s exact test for categorical variables.Results: From 792 control and 365 intervention patients, PSM resulted in 290 matched pairs. Three intervention group patients died compared to 14 in the control group (p=0.0068). Hospital LOS, 30-day readmission, ICU LOS, and ICU upgrades were not significantly different between groups. There was an overall trend toward improved geriatrics-focused quality indicators in the intervention group. Intervention group was less likely to be restrained (p=0.04), received earlier physical therapy (p=0.01), more doses of acetaminophen compared to control patients (p<0.0001), and more subcutaneous enoxaparin rather than heparin (p=0.0027).Discussion: Our main findings highlight the higher medical complexity and increased risks in older adult trauma patients, as well as the mortality reduction and adherence increase to geriatrics-focused quality indicators. Limitations of our study included use of a single center, the possibility of selection bias in analyzing historical data, and a low sample size, all of which may limit generalizability. Conclusions: Our study demonstrates that a geriatrics-focused hospitalist trauma comanagement program improves survival and quality of care.

Download Full-text

The Effect of Lullaby Intervention on Anxiety and Prenatal Attachment in Women with High-Risk Pregnancy: A Randomized Controlled Study

Complementary Medicine Research ◽

10.1159/000520139 ◽

2021 ◽

pp. 1-9

Author(s):

Nazlı Baltacı ◽

Mürüvvet Başer

Keyword(s):

High Risk ◽

Intervention Group ◽

Group Versus ◽

Mean Difference ◽

High Risk Pregnancy ◽

Controlled Study ◽

Control Group ◽

Prenatal Attachment ◽

Randomized Controlled ◽

Risk Pregnancy

Background: Women with high-risk pregnancy experience anxiety and low mother-fetal attachment when faced with signs of danger and health problems. This study aimed to investigate the effects of lullaby intervention on anxiety and prenatal attachment in women with high-risk pregnancy. Materials and Methods: This randomized controlled trial was conducted in the perinatology clinic of a state maternity hospital in Turkey. Seventy-six women with high-risk pregnancy were included. The intervention group listened to lullabies for 20 min once a day, and accompanied by lullabies touched their abdomen and thought about their babies, but the control group did not. Data were collected using the Pregnant Information Form, the State Anxiety Inventory, and the Prenatal Attachment Inventory. Results: Baseline anxiety did not differ in the intervention versus control group (47.83 ± 10.74 vs. 44.10 ± 8.08, mean difference 3.73 [95% Cl –1.18 to 8.64], p = 0.13), but after the 2nd day lullaby intervention anxiety was lower in the intervention group versus control group (33.66 ± 9.32 vs. 43.06 ± 8.10, mean difference –9.40 [95% Cl –13.91 to –4.88], p < 0.01). Baseline prenatal attachment did not differ in the intervention versus control group (56.03 ± 10.71 vs. 53.86 ± 9.98, mean difference 2.16 [95% Cl –3.18 to 7.51], p = 0.42), but after the 2nd day lullaby intervention prenatal attachment was higher in the intervention group versus control group (66.70 ± 7.60 vs. 54.36 ± 9.52, mean difference 12.33 [95% Cl 7.87 to 16.78], p < 0.01). In the within-group analysis the intervention group had lower anxiety and better prenatal attachment (p < 0.01), but not in the control group (p > 0.05). Conclusion: Lullaby intervention can play an effective role in reducing anxiety and improving prenatal attachment. The use of this integrative, noninvasive, non-pharmacologic, time-efficient, and natural intervention is suggested in the care of pregnant women.

Download Full-text

Abstract TP168: Efficacy of a Pictogram to Promote Stroke Knowledge Among Illiterate Korean Elderly

Stroke ◽

10.1161/str.51.suppl_1.tp168 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Cha-Nam Shin ◽

Jeongha Sim ◽

Dongchoon Ahn

Keyword(s):

Older Adults ◽

High Risk ◽

Longitudinal Research ◽

Controlled Trial ◽

Intervention Group ◽

Warning Signs ◽

Repeated Measure ◽

Control Group ◽

Control Group Design ◽

Stroke Knowledge

Background and Purpose: Extensive research supports the importance of knowledge in stroke prevention and reducing prehospital delay time. However, the level of stroke knowledge among Korean older adults remains low. In particular, older adults who are illiterate lack of stroke information despite being at high risk. The purpose of this study was to develop and examine the efficacy of a pictogram to enhance stroke knowledge in the high-risk and illiterate older adults. Methods: We conducted a pretest-posttest nonequivalent control group design study and compared differences in stroke knowledge before and after the intervention. A total of 117 older adults (82 in the intervention group and 35 in the control group) who were 60 years and older residing in community participated in the study. Participants in the intervention group received a pictogram-based education, while participants in the control group received a powerpoint-based education. Stroke knowledge was measured by structured survey questionnaires. Descriptive statistics for sample characteristics, repeated measure ANOVA for the efficacy, and independent t-test for satisfaction comparison between groups were used. Results: The intervention group showed a higher increase in stroke knowledge (F=16.45), awareness of risk factors (F=15.71), stroke warning signs and symptoms (F=17.29), and action at stroke (F=19.36) compared to the control group at p <.001. Also, the intervention group reported that they would recommend the education program to others (t=2.64, p<.05) and the program was applicable to real situation (t=4.47, p <.001), which were scored higher than the control group. Conclusions: The data revealed that a pictogram-based education is more effective than a powerpoint-based education among illiterate older adults. Replicated studies with this pictogram in a larger randomized controlled trial is warranted, which may give greater validity to our findings. Future longitudinal research is recommended to examine retention of stroke knowledge over the long term.

Download Full-text

Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis

Nutrients ◽

10.3390/nu11061373 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1373 ◽

Cited By ~ 4

Author(s):

Kazue Yamaoka ◽

Asuka Nemoto ◽

Toshiro Tango

Keyword(s):

Type 2 Diabetes ◽

High Risk ◽

Lifestyle Modification ◽

Meta Analysis ◽

Intervention Group ◽

Control Group ◽

Lifestyle Modifications ◽

Randomized Controlled ◽

Indirect Comparisons

Background: Many clinical trials have been conducted to verify the effects of interventions for prevention of type 2 diabetes (T2D) using different treatments and outcomes. The aim of this study was to compare the effectiveness of lifestyle modifications (LM) with other treatments in persons at high risk of T2D by a network meta-analysis (NMA). Methods: Searches were performed of PUBMED up to January 2018 to identify randomized controlled trials. The odds ratio (OR) with onset of T2D at 1 year in the intervention group (LM, dietary, exercise, or medication) versus a control group (standard treatments or placebo) were the effect sizes. Frequentist and Bayesian NMAs were conducted. Results: Forty-seven interventions and 12 treatments (20,113 participants) were used for the analyses. The OR in the LM was approximately 0.46 (95% CI: 0.33 to 0.61) times lower compared to the standard intervention by the Bayesian approach. The effects of LM compared to other treatments by indirect comparisons were not significant. Conclusions: This meta-analysis further strengthened the evidence that LM reduces the onset of T2D compared to standard and placebo interventions and appears to be at least as effective as nine other treatments in preventing T2D.

Download Full-text

Worksite weight management program

Nutrition & Food Science ◽

10.1108/nfs-08-2016-0132 ◽

2017 ◽

Vol 47 (4) ◽

pp. 490-510 ◽

Cited By ~ 1

Author(s):

Jian Pei Kong ◽

Linda Jok ◽

Azlee Bin Ayub ◽

Rawa Ak Bau

Keyword(s):

Weight Loss ◽

Body Weight ◽

Primary Healthcare ◽

Fasting Blood Glucose ◽

Intervention Group ◽

Healthcare Setting ◽

Control Group ◽

Short Term ◽

Content Type ◽

Worksite Intervention

Purpose This study aims to pilot test a new multi-component worksite intervention for weight loss in a primary healthcare setting. Design/methodology/approach This randomized trial involved 88 participants (43, 45; intervention, control group). The intervention group enrolled in a 12-week lifestyle program that involved modification of dietary intake by community Registered Dietitian (RDs) and increasing high-intensity interval training (HITT) with motivational interviewing (MI) to support changes. The control group received traditional counselling and weekly aerobic exercise from Medical Officer and physiotherapist. The primary outcome measure was the changes in body weight. Secondary measures were changes in blood pressure, fasting blood glucose, fasting blood lipid and dietary changes. Assessments were repeated at a three-month interval. Findings There was a significant reduction in body weight and waist circumference within groups. Intervention group demonstrated a significant improvement in all cardiometabolic risk factors. This study showed that primary healthcare setting can be successful locations in promoting short-term health benefits. RDs were more successful and HITT appeared to be a favorable workout with MI in achieving drastic weight loss. Research limitations/implications The short-term worksite intervention and not recording of body composition were the major drawbacks in this study. Originality/value The efficacy of multi-component worksite intervention (Diet–HITT–MI) in primary healthcare setting has not been clearly defined.

Download Full-text

A brief educational intervention to increase communication about complementary and alternative medicine (CAM) in community oncology settings.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.6054 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 6054-6054

Author(s):

Lorenzo Cohen ◽

Diana Urbauer ◽

Michael Fisch ◽

Bryan Fellman ◽

Holly Hough ◽

...

Keyword(s):

Educational Intervention ◽

Health Care Professionals ◽

Intervention Group ◽

Oncology Nurses ◽

Control Group ◽

Community Based ◽

Community Oncology ◽

Cam Use ◽

Md Anderson ◽

Hispanic White

6054 Background: The widespread use of CAM in academic oncology settings has been well documented. However, there is a lack of communication between patients and health care professionals on CAM that may have negative health consequences. No comprehensive study of CAM use in community oncology settings exists. We examined the benefits of a brief educational intervention on nurse discussions of CAM with patients. Methods: A multi-site, randomized trial of an educational intervention (brief video, resource list) designed to encourage oncology nurses to discuss CAM use with their patients was conducted within the MD Anderson CCOP network. Nurses (N=175) and patients (baseline N=699 and different set of patients after intervention N=650) completed questions about CAM use, communication, and knowledge. Results: Nurses were 97% female, 96% non-Hispanic white. Two months after the intervention, nurses in the intervention group reported that they were more likely to ask about CAM use than those in the control group (OR=4.2; p<.005) and asked more of their last 5 patients about CAM use (p=.003). No significant intervention effect was found for the proportion of patients in the clinic who indicated they were asked about CAM use after the intervention (OR=1.6, p>.10). Approximately 40% of patients reported using CAM following their cancer diagnosis yet the majority of nurses estimated less than 25% of their patients used CAM. Conclusions: CAM use in community-based oncology patients is high and there is an underestimation of use by the oncology nurses. This very brief intervention significantly improved how often nurses reported asking patients about their CAM use. However, the patients of the nurses did not reflect this change in communication. Additional types of interventions are needed to increase communication between patients and nurses.

Download Full-text

Influence of moderate physical activity on the levels of plasma lipoproteins in subjects with impaired glucose tolerance

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1202051p ◽

2012 ◽

Vol 140 (1-2) ◽

pp. 51-57 ◽

Cited By ~ 4

Author(s):

Milanka Petkovic-Koscal ◽

Vlasta Damjanov ◽

Nela Djonovic

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Risk Factor ◽

High Risk ◽

Intervention Group ◽

Plasma Lipoproteins ◽

Control Group ◽

Moderate Physical Activity ◽

Essential Components ◽

One Year

Introduction. Physical activity and healthy diet, as lifestyle factors, are essential components in the prevention of chronic noncommunicable diseases. Impared glucose intolerance (IGT) is an independent cardiovascular risk factor. Dyslipidaemia is a cardiometabolic risk factor for the development of type 2 diabetes mellitus. Objective. The aim of the study was to investigate the influence of moderate physical activity of plasma lipoprotein indicators in high-risk subjects for diabetes mellitus during one-year planned intervention. Methods. We randomly assigned 60 overweight subjects with IGT aged 30-60 years. The subjects were divided into intervention group with 30 subjects, who were intensively and individually instructed on weight reduction, nutrition and increased physical activity, and control group with 30 subjects, who were counselled, as standard, on nutrition and increased exercise. Total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C) and triglycerides (Tg) were measured at the beginning of the study, and at 2 months, 6 months, and at the end of the study (12 months). Results. Compared to the beginning of the study, after 2 and 6 months there was no statistically significant difference in serum lipid values. After 12 months, the average values of the measured lipid levels in the intervention group decreased by 18.36% for TC, 27.3% for LDL-C, and 34.2% for Tg (compared to 10.27%, 13.45%, and 10.4%, respectively in the control group). Value of HDL-C in the intervention group increased by 19.12%, and decreased in the control group by 1.48%. Total/HDL-C ratio was reduced by 30.6% and LDL-C/H by 38.1% in the intervention group (compared to 12.36%, and 15.9% in the control group). After 12 months, significantly greater decrease in TC (p<0.01), LDL-C (p<0.01) and Tg (p<0.0001) and significantly greater increase in HDL-C (p<0.05) was detected in the intervention group compared to the control group. Conclusion. Plasma lipoproteins can be significantly decreased by changes in the lifestyles of high-risk subjects during one-year planned intervention.

Download Full-text