scholarly journals Effectiveness of Academic Detailing to Optimize Medication Prescribing Behaviour of Family Physicians

2013 ◽  
Vol 16 (4) ◽  
pp. 511 ◽  
Author(s):  
Harpreet K Chhina ◽  
Vidula M Bhole ◽  
Charles Goldsmith ◽  
Wendy Hall ◽  
Janusz Kaczorowski ◽  
...  
Keyword(s):  
Observational Studies ◽  
Drug Prescription ◽  
Family Physicians ◽  
Interquartile Range ◽  
Prescription Rate ◽  
Academic Detailing ◽  
Control Groups ◽  
The Difference ◽  
And Control ◽  
Relative Change

PURPOSE. To synthesize current knowledge about the effectiveness and the magnitude of the effect, of Academic Detailing (AD), as a stand-alone intervention, at modifying drug prescription behavior of Family Physicians (FPs) in primary care settings. METHODS. A search of MEDLINE, EMBASE, CENTRAL, and Web of Science databases of all English language articles between January 1983 and July 2010 was conducted. We hand-searched the bibliographies of articles retrieved from the electronic search to identify additional studies. Inclusion criteria were: full-length articles describing original research; randomized controlled trial (RCT), or observational study design with a control group; studies of AD delivered to FPs; AD as a stand-alone intervention; drug prescription as the target behavior. Data extraction was done independently by two reviewers. Outcomes evaluated were: the difference in relative change in prescription rate between the intervention and control groups; the difference in absolute change in prescription rate between the intervention and control groups; and effect size, calculated as the standardized mean difference. RESULTS. 11 RCTs and 4 observational studies were included. Five RCTS described results showing effectiveness, while 2 RCTs reported a positive effect on some of the target drugs. Two observational studies found AD to be effective, while 2 did not. The median difference in relative change among the studies reviewed was 21% (interquartile range 43.75%) for RCTs, and 9% (interquartile range 8.5%) for observational studies. The median effect size among the studies reviewed was - 0.09 (interquartile range 2.73). Conclusion. This systematic review demonstrates that AD can be effective at optimizing prescription of medications by FPs. Although variable, the magnitude of the effect is moderate in the majority of studies. This systematic review also provides evidence supportive of  the use of AD as a strategy to promote evidence based prescription of medications or incorporation of clinical guidelines into clinical practice. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.  

scholarly journals The effect of diminazene aceturate on cholinesterase activity in dogs with canine babesiosis

1997 ◽  
Vol 68 (4) ◽  
Author(s):  
R.J. Milner ◽  
F. Reyers ◽  
J.H. Taylor ◽  
J.S. Van den Berg
Keyword(s):  
Treatment Group ◽  
Underlying Mechanism ◽  
Time Interval ◽  
Control Groups ◽  
Canine Babesiosis ◽  
Diminazene Aceturate ◽  
Time Intervals ◽  
Significant Depression ◽  
The Difference ◽  
And Control

A clinical trial was designed to evaluate the effects of diminazene aceturate and its stabiliser antipyrine on serum pseudocholinesterase (PChE) and red blood cell acetylcholinesterase (RBC AChE) in dogs with babesiosis. The trial was conducted on naturally occurring, uncomplicated cases of babesiosis (n = 20) that were randomly allocated to groups receiving a standard therapeutic dose of diminazene aceturate with antipyrine stabiliser (n = 10) or antipyrine alone (n = 10). Blood was drawn immediately before and every 15 minutes for 1 hour after treatment. Plasma PChE showed a 4 % decrease between 0 and 60 min within the treatment group (p < 0.05). No statistically significant differences were found between the treatment and control groups at any of the time intervals for PChE. There was an increase in RBC AChE activity at 15 min in the treatment group (p < 0.05). No significant differences were found between the treatment and control groups at any time interval for RBC AChE. In view of the difference in PChE, samples from additional, new cases (n = 10) of canine babesiosis were collected to identify the affect of the drug over 12 hours. No significant depression was identified over this time interval. The results suggests that the underlying mechanism in producing side-effects, when they do occur, is unlikely to be through cholinesterase depression.

scholarly journals Effects of two different deep digital flexor tenotomy techniques on distal articular angles of equine cadaver forelimbs

2012 ◽  
Vol 42 (11) ◽  
pp. 2005-2010
Author(s):  
Antonio Cezar de Oliveira Dearo ◽  
Vitor Bruno Bianconi Rosa ◽  
Peter Reichmann ◽  
Milton Luis Ribeiro de Oliveira
Keyword(s):  
Quantitative Data ◽  
Statistical Significance ◽  
Surgical Approaches ◽  
Control Groups ◽  
Before And After ◽  
Distal Interphalangeal ◽  
The Difference ◽  
And Control ◽  
Flexor Tenotomy

Deep digital flexor (DDF) tenotomy is a technique employed for years to treat selected disorders of the musculoskeletal system in horses. Although two different surgical approaches (i.e. mid-metacarpal and pastern) have been described for performing the procedure, in vitro quantitative data regarding the modifications induced by either technique on the distal articular angles is lacking. Therefore, the purpose of the study reported here was to investigate the viability of a proposed biomechanical system of induced-traction used to compare the two DDF tenotomy techniques by measuring the distal articular angles of equine cadaver forelimbs. Ten pairs of forelimbs were collected and mounted to a biomechanical system developed to apply traction at the toe level. Dorsal articular angles of the metacarpophalangeal (MP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints were determined by geometric lines on radiographs taken before and after performing each technique. Comparisons between each tenotomy group and its own control, for each joint, and between the two tenotomy groups using as variable the difference between the tenotomy and control groups were tested. Despite the lack of statistical significance, the DDF tenotomy technique at the pastern level produced extension, to a lesser and greater extent, of the PIP and DIP joints, respectively when compared to the mid-metacarpal level. No remarkable differences could be observed for the MP joint. The developed traction-induced biomechanical construct seemed to be effective in producing valuable quantitative estimations of the distal articular angles of equine cadaver forelimbs subjected to different DDF tenotomy techniques.

scholarly journals A study on association of polymorphisms in calpain10 and TCF7l2 genes with type 2 diabetes mellitus

Genetika ◽  
2015 ◽  
Vol 47 (1) ◽  
pp. 161-170 ◽  
Author(s):  
Maryam Rezazadeh ◽  
Nasim Sohrabifar ◽  
Hossein Jafari ◽  
Ardabili Mohaddes ◽  
Jalal Gharesouran
Keyword(s):  
Type 2 Diabetes ◽  
Allelic Association ◽  
Diabetic Patients ◽  
Control Groups ◽  
Type2 Diabetes ◽  
North Of Iran ◽  
Calpain 10 ◽  
The Difference ◽  
And Control

Polymorphisms of the Calpain10 and TCF7L2 genes were identified as possible type 2 diabetes susceptibility genetic markers. We conducted a case-control study to evaluate the relation between SNP43 of calpain-10 and rs12255372 and rs7903146 in the TCF7L2 with type2 diabetes in western-north of Iran. The role of these variants in Iranian population was less clear. A total of 202 patients and healthy controls were enrolled to analysis the frequency distribution of Calpain10 and TCF7L2 polymorphisms (SNP43, rs12255372 and rs7903146) using polymerase chain reaction-restriction fragment length polymorphism (PCR - RFLP) method. The frequency of allele A in controls was significantly greater than that of diabetic patients (P=0.031), whereas the difference between distribution of SNP43 genotypes (A/A, A/G, G/G) were non- significant in case and control groups. Non significant association was also observed between G/G, A/G or A/A genotypes and type 2 Diabetes. The frequency of the ?T? allele of rs12255372 (G/T) was significantly associated with type 2 diabetes (OR= 0.55, 95% confidence interval [CI], 1.11-1.51; P<0.001). No allelic association was found for rs7903146(C/T) polymorphism. The distribution of alleles in case and control groups are significantly different indicating the G allele is associated with type 2 diabetes. The rs12255372 (G/T) may be associated with type 2 diabetes.

scholarly journals Effect of iRoot BP Plus Pulpotomy for Immediate Repair in Children with Young Permanent Teeth Crown Fracture

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Jiaying Song
Keyword(s):  
Success Rate ◽  
Clinical Effect ◽  
Permanent Teeth ◽  
Control Group ◽  
Observation Group ◽  
Control Groups ◽  
Before And After ◽  
Random Number Table ◽  
The Difference ◽  
And Control

Objective: To explore the clinical effect of iRoot BP Plus pulpotomy for immediate repair in children with young permanent teeth crown fracture. Methods: From September 2017 to October 2018, 80 children (80 affected teeth) with young permanent teeth crown fracture who treated in the hospital were selected as the research objects. Random number table method was used to divide them into observation and control groups with each group of forty patients (40 affected teeth). The children in the control group were treated with calcium hydroxide resin, while the observation group were treated with iRoot BP Plus for immediate repair. The surgical success rate was compared between the two groups, and the pulp vitality before and after treatment were compared. Results: At 3 months and 6 months after surgery, the success rate of children in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05). The percentage of children with negative pulp activity in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: Immediate repair with iRoot BP Plus pulpotomy in children with young permanent teeth crown fracture has significant clinical effect.

scholarly journals Changes in Diagnostic Patterns of Depression Among Family Physicians in Latvia after Participating in The Education Course on Depression Developed within the National Research Programme Biomedicine 2014–2017: Preliminary Results

2019 ◽  
Vol 73 (2) ◽  
pp. 192-194
Author(s):  
Elmārs Rancāns ◽  
Anda Ķīvīte-Urtāne
Keyword(s):  
Health Care Services ◽  
Family Physicians ◽  
Research Programme ◽  
Capital City ◽  
Control Groups ◽  
Treatment Of Depression ◽  
National Research Programme ◽  
Rural Places ◽  
And Control ◽  
Depressive Episodes

Abstract Annually, 7.9% of the general population in Latvia are suffering from depression. According to the official statistics, less than 8000 persons a year have been treated for depression in the state-paid health care services while the National Research Programme (NRP) BIOMEDICINE 2014–2017 found that more than 70 000 depressed patients annually are coming to family physicians (FPs) in Latvia. Within NRP researchers have developed an algorithm for diagnostics and treatment of depression and carried out ten educational courses for FPs all over Latvia in 2016. Data on the treatment of depression have been collected from the National Health Service (NHS) database from 01.01.2015 till 30.06.2017. Changes between the trained and control groups have been calculated for the time period before intervention — 2015–2016 and six months right after it. The “Depression School” was attended by 210 (15.2%) out of 1382 FPs, in contract with the NHS, who signed in for the course on first-to-come basis. There were no statistically significant demographic differences between trained and control groups, except, a larger proportion of FPs from rural places vs. the capital city attended the courses. Comparing the trained and control groups, during the period before the intervention there were on average 0.96 vs. 0.83 depressive episodes (F32) and 3.26 vs.1.74 recurrent depressive disorder (F33) episodes in 1/2 year (p < 0.001). Statistically significant increase was observed for F33 episodes (+1.42, p < 0.001), and numeric for F32 episodes (+0.18, p = 0.36) in the trained group of FPs in 2017. In total this gave a statistically significant (p < 0.001) increase by 43.6% of F33 diagnoses following the education course on depression for family physicians. Further analysis of data to access sustainability of training effect after 12 and 24 months are underway.

Auditory and Visual Executive Functions in Children and Response to Methylphenidate: A Randomized Controlled Trial

2017 ◽  
Vol 24 (2) ◽  
pp. 235-245
Author(s):  
Yaffa Hadar ◽  
Shraga Hocherman ◽  
Oren Lamm ◽  
Emanuel Tirosh
Keyword(s):  
Executive Functions ◽  
Visual Cues ◽  
Controlled Trial ◽  
Crossover Design ◽  
Control Groups ◽  
Children With Adhd ◽  
Randomized Controlled ◽  
The Difference ◽  
Visually Based ◽  
And Control

Objectives: The aim of the study was to assess auditory and visually based executive functions (EFs) and the effect of methylphenidate (MPH) in children with ADHD. Methods: Thirty-six boys between the ages of 8.3 and 9.7 years with ADHD and 36 matched controls were included. The study group was randomized into MPH and placebo for 7 days each in a crossover design. A Cued Choice Reaction Time (CCRT) test that included incongruent cuing was administered at baseline and following 1 and 2 weeks. Results: The difference between the study and control groups was more evident with visual cues and incongruent cuing. Increased gains by children with predominantly hyperactive–impulsive\combined (HI\C) type of ADHD were observed under MPH. Conclusions: The differences between children with ADHD and typical children are more pronounce under incongruent auditory cuing . The gains attributable to MPH are more specific to tasks involving auditory and visual EFs and in children with HI\C type ADHDs.

Effects of Mindfulness-Based Psychoeducation on the Internalized Stigmatization Level of Patients With Schizophrenia

2018 ◽  
Vol 29 (7) ◽  
pp. 496-503 ◽  
Author(s):  
Emine Yılmaz ◽  
Funda Kavak
Keyword(s):  
Health Centers ◽  
Control Group ◽  
Community Mental Health Centers ◽  
Control Groups ◽  
Face To Face ◽  
Significant Difference ◽  
The Difference ◽  
Mental Health Centers ◽  
And Control ◽  
Experimental Group

The aim of this study was to determine the effects of mindfulness-based psychoeducation on internalized stigma in patients with schizophrenia. The patients were recruited from the community mental health centers. This quasiexperimental study was conducted using pretests and posttests with a control group. The participants were 69 patients with schizophrenia; 34 were part of the experimental group and 35 were part of the control group. The patients in the experimental group participated 2 days a week for 6 weeks in a total of 12 sessions which were given in the form of face-to-face group training. The difference between the scale mean posttest scores of the patients in the experimental and control groups was found to be statistically significant ( p < .05). In the intragroup comparisons, a significant difference was found between the stigma mean scores in the experimental group ( p < .05). It was concluded that mindfulness-based psychoeducation was effective in reducing stigma in patients with schizophrenia.

Abstract 2211: Statin Therapy May Increase the Risk of Intracerebral Hemorrhage: A Meta-analysis of 26 Randomized Controlled Trials

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
James S McKinney ◽  
William J Kostis ◽  
John B Kostis
Keyword(s):  
Statin Therapy ◽  
Meta Analysis ◽  
Active Group ◽  
Controlled Trials ◽  
Control Groups ◽  
Randomized Controlled ◽  
All Cause Mortality ◽  
Group A ◽  
The Difference ◽  
And Control

Introduction--- Statin therapy decreases the risk of myocardial infarction and ischemic stroke. However, an increased risk of intracerebral hemorrhage (ICH) has been observed in some studies. To investigate this issue we performed a meta-analysis of all randomized controlled trials (RCTs) using statins that reported ICH. Methods--- We performed a Medline literature search through March 18, 2011 and identified additional RCTs by reviewing reference lists of retrieved studies and prior meta-analyses. All RCTs of statin therapy versus placebo or high dose versus low dose statin therapy that reported ICH or hemorrhagic stroke were included. The primary outcome variable was ICH. 26 RCTs were included. All analyses used random effects models and heterogeneity was not observed in any of the analyses. Results--- 84 831 subjects were included in the Active group, and 84 851 in the Control group. A trend towards a higher incidence of ICH was observed in the Active treatment group compared to Control (OR = 1.15; 95% CI = 0.91 to 1.45, p =0.24) (Figure). Significant relationships were not observed between the log OR for ICH with achieved LDL in the Active group (slope = 0.0002; 95% CI = -0.0098 to 0.0101, p =0.96) or with the difference in LDL drop between the Active and Control groups (slope = 0.0030; 95% CI = -0.0089 to 0.0149, p =0.62). Total stroke (OR = 0.84; 95% CI = 0.78 to 0.91, p <0.001) and all-cause mortality (OR = 0.91; 95% CI = 0.86 to 0.96, p <0.001) were significantly reduced in the Active group. A significant relationship between all-cause mortality and the difference in LDL drop between the Active and Control groups was observed (slope = -0.0030; 95% CI = -0.0009 to -0.0051, p<0.005). There was not evidence of publication bias in this meta-analysis. Conclusions--- Active therapy was associated with a trend towards increased ICH in this meta-analysis of 26 RCTs of statin therapy. However, this risk does not appear to be related to the degree of decline or achieved LDL. The risk of ICH is offset by a significant reduction in ischemic stroke and all-cause mortality and should not dissuade practitioners from prescribing statins in otherwise appropriate patients.

scholarly journals EFFECT OF 12.5% VIRGIN COCONUT OIL (COCOS NUCIFERA) MOUTHWASH ON PLAQUE INDEX OF FIXED PROSTHETIC DENTURE USERS

2018 ◽  
Vol 9 ◽  
pp. 41
Author(s):  
Leo Saputra ◽  
Farisza Gita ◽  
Ratna Sari Dewi
Keyword(s):  
Cocos Nucifera ◽  
Coconut Oil ◽  
Plaque Index ◽  
Control Groups ◽  
Index Measurement ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
And Gender ◽  
And Control

Objective: To find out the difference in the plaque index scores of FPD users before and after using a 12.5% VCO mouthwash.Methods: The plaque index measurement of an abutment tooth was taken on 40 subjects with FPD in both test and control groups. Subjects used a 12.5% VCO mouthwash or aquades twice a day for 4 days after brushing their teeth. Statistical analysis of the measurement result of the plaque index scores before and after using the coconut oil mouthwash was done using the Wilcoxon test.Results: There is a statistically significant difference in the plaque index scores of FPD users before and after using the 12.5% VCO mouthwash with a statistically significant decrease in plaque index scores among restoration margin locations and tooth brushing habits, but not among age and gender groups.Conclusion: Using a 12.5% VCO mouthwash may decrease the plaque index of fixed prosthetic denture users.

Seroprevalence of Helicobacter pylori infection in patients with chronic nonspecific pharyngitis: preliminary study

2007 ◽  
Vol 122 (1) ◽  
pp. 61-64 ◽  
Author(s):  
İ Aladag ◽  
Y Bulut ◽  
M Guven ◽  
A Eyibilen ◽  
K Yelken
Keyword(s):  
Helicobacter Pylori ◽  
Treatment Strategies ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Control Groups ◽  
Chi Square ◽  
Control Subjects ◽  
The Difference ◽  
H Pylori ◽  
And Control

AbstractBackground and objectives:Chronic nonspecific pharyngitis is a chronic inflammation of the pharynx. It is found worldwide, and treatment is difficult. The underlying aetiopathogenesis is still controversial. The aim of this study was to investigate Helicobacter pylori seroprevalence in chronic nonspecific pharyngitis patients without other possible causative factors for chronic pharyngeal irritation and without H pylori gastric mucosal infection.Materials and methods:Forty-one patients with symptoms of chronic nonspecific pharyngitis and 30 healthy control subjects were enrolled in this prospective, controlled, clinical study. In both study and control groups, selected patients were shown to have gastric mucosa uninfected by H pylori, as demonstrated by the 14C-urea breath test. Comprehensive otorhinolaryngological examination did not elicit any factor contributing to the chronic pharyngeal complaint. Serum H pylori immunoglobulin G antibody titres were assayed using serum enzyme-linked immunosorbent assay. The difference between the study and control groups was analysed by the chi-square test (the likelihood ratio was used).Results:Thirty-two of the 41 patients (78 per cent) and 14 of the 30 control subjects (46.7 per cent) were found to be H pylori positive. Patients with chronic nonspecific pharyngitis were found to have a significantly higher rate of H pylori seropositivity than the control group (p = 0.016).Conclusion:These data may be important in developing future treatment strategies for chronic nonspecific pharyngitis.

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