Efficacy of A Loading Dose of IV Salbutamol in Children With Severe Acute Asthma Admitted to A PICU: A Randomized Controlled Trial

Abstract The optimal dose regimen to start intravenous (IV) treatment in children with severe acute asthma (SAA), is still matter of debate. We assessed the efficacy of an additional salbutamol loading dose in children with SAA admitted to a pediatric intensive care unit (PICU). This multicenter, placebo-controlled randomized trial in the PICUs of four tertiary care children’s hospitals included children (2-18 years) with SAA admitted between 2017-2019. Children were randomized to receive either a loading dose IV salbutamol (15 mcg/kg, max.750 mcg) or normal saline while on continuous salbutamol infusion. The primary outcome was asthma score (Qureshi) 1 hour after the intervention. Analysis of covariance models were used to evaluate sensitivity to change in asthma scores. Serum concentrations of salbutamol were obtained. Fifty-eight children were included (29 in the intervention group). Median baseline asthma score was 12 (IQR 10-13) in the intervention and 11 (9-12) in the control group (p=0.032). The asthma score 1 hour after the intervention did not differ significantly between both groups (p=0.508, β-coefficient=0.283). The median increase in salbutamol plasma levels 10 minutes after the intervention was 13μg/L (5-24) in the intervention and 4μg/L (0-7) in the control group (p=0.001). Mixed model analyses showed a significant association between heart rate and asthma score, adjusted for salbutamol plasma levels. Conclusion: We found no clinical benefit of a loading dose IV salbutamol, compared to normal saline in children with SAA admitted to the PICU. Clinicians should be less reluctant to increase the dose of salbutamol infusion, solely based on tachycardia.

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Investigating the Impact of Cognitive Training for Individuals With Bothersome Tinnitus: A Randomized Controlled Trial

Otolaryngology ◽

10.1177/0194599821994742 ◽

2021 ◽

pp. 019459982199474

Author(s):

Maggie Xing ◽

Dorina Kallogjeri ◽

Jay F. Piccirillo

Keyword(s):

Randomized Controlled Trial ◽

Cognitive Training ◽

Mixed Model ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Functional Index ◽

Open Label ◽

Randomized Controlled ◽

The Impact

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

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Impact of pharmacist-conducted anticoagulation patient education and telephone follow-up on transitions of care: a randomized controlled trial

BMC Health Services Research ◽

10.1186/s12913-021-06156-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lamis R. Karaoui ◽

Elsy Ramia ◽

Hanine Mansour ◽

Nisrine Haddad ◽

Nibal Chamoun

Keyword(s):

Tertiary Care ◽

Intervention Group ◽

Bleeding Event ◽

Transitions Of Care ◽

Control Group ◽

Published Data ◽

Post Discharge ◽

Readmission Rates ◽

The Impact

Abstract Background There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact of pharmacist-conducted anticoagulation education and follow-up on bleeding and readmission rates. Methods This study was a randomized, non-blinded interventional study conducted between August 2017 and July 2019 in a tertiary care teaching Lebanese hospital. Participants were inpatients ≥18 years discharged on an oral anticoagulant for treatment. Block randomization was used. The control group received the standard nursing counseling while the intervention group additionally received pharmacy counseling. Phone call follow-ups were done on day 3 and 30 post-discharge. Primary outcomes included readmission rates and any bleeding event at day 3 and 30 post-discharge. Secondary outcomes included documented elements of education in the medical records and reported mortality upon day 30 post-discharge. Results Two hundred patients were recruited in the study (100 patients in each study arm) with a mean age of 73.9 years. In the pharmacist-counseled group, more patients contacted their physician within 3 days (14% versus 4%; p = 0.010), received explicit elements of education (p < 0.001) and documentation in the chart was better (p < 0.05). In the standard of care group, patients were more aware of their next physician appointment date (52% versus 31%, p < 0.001). No difference in bleeding rates at day 3 and 30 post-discharge was observed between the groups. Conclusions Although pharmacist-conducted anticoagulation education did not appear to reduce bleeding or readmission rates at day 30, pharmacist education significantly increased patient communication with their providers in the early days post-discharge. Trial registration Lebanon Clinical Trial Registry LBCTR2020033424. Retrospectively registered. Date of registration: 06/03/2020.

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Effects of Relationship Enrichment Training on Improving Marital Satisfaction of Infertile Couples: A Randomized Control Trial

Current Women s Health Reviews ◽

10.2174/1573404817666210111141202 ◽

2021 ◽

Vol 17 ◽

Author(s):

Seyedeh Zahra Masoumi ◽

Khodayar Oshvandi ◽

Masoumeh Rostami-Moez ◽

Arezoo Shayan ◽

Farideh Kazemi

Keyword(s):

Marital Satisfaction ◽

Intervention Group ◽

Analysis Of Covariance ◽

Control Group ◽

Chi Square ◽

Significance Level ◽

Significant Difference ◽

The Mean ◽

Infertile Couples ◽

Relationship Enrichment

Background: Infertility can cause low marital satisfaction. Marital satisfaction has an important effect on infertile couples’ health. Objective: This study aimed to assess the effect of relationship enrichment training on improving the marital satisfaction of infertile couples. Methods: This randomized clinical trial was conducted on 50 infertile couples in the infertility center of Fatemieh Hospital in Hamadan, Iran in 2018. Participants were matched for demographic characteristics and randomly assigned to intervention and control groups (each group had 25 couples). Informed consent was obtained from all participants. The Enrich Marital Satisfaction questionnaire and demographic information were used to collect data before the study and two months after the intervention. Two trained midwifery students taught only the intervention group the relationship enrichment topics in seven sessions (each session = 90 minutes). The data were analyzed by SPSS Statistics version 21 using analysis of covariance, independent t-test, chi-square, and Mann–Whitney. The significance level was set at p ≤ 0.05. Results: There was no significant difference in demographic and obstetric information between the two groups (p >0.05). The mean of marital satisfaction in the intervention group significantly increased among women and men from 151.00 ±28.61 to 154.88 ±22.62 and from 152.56 ±27.33 to 159.24 ±22.14, respectively, (p <0.001). Conversely, the mean of marital satisfaction decreased among women and men from 158.13 ±13.86 to 146.25 ±19.53 and from 164.25 ±17.00 to 153.17 ±27.50 in the control group (p=0.02). Conclusion: Relationship enrichment training can be effective in promoting the marital satisfaction of infertile couples. Registration number: The National Center for Strategic Research in medical education, No. 960185.

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The Use of Telehealth Technology in Assessing the Accuracy of Self-Reported Weight and the Impact of a Daily Immediate-Feedback Intervention among Obese Employees

International Journal of Telemedicine and Applications ◽

10.1155/2011/909248 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Nicolaas P. Pronk ◽

A. Lauren Crain ◽

Jeffrey J. VanWormer ◽

Brian C. Martinson ◽

Jackie L. Boucher ◽

...

Keyword(s):

Body Weight ◽

Mixed Model ◽

Linear Mixed Model ◽

Controlled Trial ◽

Intervention Group ◽

Study Groups ◽

Outcome Variable ◽

Control Group ◽

Immediate Feedback ◽

The Impact

Objective.To determine the accuracy of self-reported body weight prior to and following a weight loss intervention including daily self-weighing among obese employees.Methods.As part of a 6-month randomized controlled trial including a no-treatment control group, an intervention group received a series of coaching calls, daily self-weighing, and interactive telemonitoring. The primary outcome variable was the absolute discrepancy between self-reported and measured body weight at baseline and at 6 months. We used general linear mixed model regression to estimate changes and differences between study groups over time.Results.At baseline, study participants underreported their weight by an average of 2.06 (se=0.33) lbs. The intervention group self-reported a smaller absolute body weight discrepancy at followup than the control group.Conclusions.The discrepancy between self-reported and measured body weight appears to be relatively small, may be improved through daily self-monitoring using immediate-feedback telehealth technology, and negligibly impacts change in body weight.

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Nursing-Mini-CEX Combined with Online and Offline Hybrid Teaching Model Application Research in Basic Nursing Training Teaching

Lifelong Education ◽

10.18282/le.v9i6.1295 ◽

2020 ◽

Vol 9 (6) ◽

pp. 51

Author(s):

Hongmin Wang ◽

Yaru Feng ◽

Huan Li

Keyword(s):

Mixed Model ◽

Intervention Group ◽

Control Group ◽

Teaching Model ◽

Traditional Teaching ◽

Training Methods ◽

Hybrid Teaching ◽

Measurement Tools ◽

The Difference ◽

Nursing Training

Objective: To explore the application effects and countermeasures of Nursing-Mini-CEX combined with the online and offline hybrid teaching model in basic nursing training. Methods: Taking 150 students from the 2017 grade as an example, the effects of traditional teaching mode and Nursing-Mini-CEX combined with mixed model teaching were compared. Results: The performance of the intervention group combining Nursing-Mini-CEX evaluation and mixed teaching was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). Conclusion: The combination of Nursing-Mini-CEX measurement tools and mixed teaching is feasible and effective in basic nursing training.

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Influencing cardiovascular health habits in the rural, deep south: results of a cluster randomized trial

Health Education Research ◽

10.1093/her/cyy052 ◽

2019 ◽

Vol 34 (2) ◽

pp. 200-208

Author(s):

Laurie S Abbott ◽

Elizabeth H Slate ◽

Jennifer L Lemacks

Keyword(s):

Health Program ◽

Mixed Model ◽

Cardiovascular Health ◽

Linear Mixed Model ◽

Intervention Group ◽

The United States ◽

Control Group ◽

Cvd Risk ◽

Health Habits ◽

Cluster Randomized

Abstract Cardiovascular disease (CVD) is a major cause of death among people living in the United States. Populations, especially minorities, living in the rural South are disproportionately affected by CVD and have greater CVD risk, morbidity and mortality. Culturally relevant cardiovascular health programs implemented in rural community settings can potentially reduce CVD risk and facilitate health behavior modification. The purpose of this study was to examine the effects of a cardiovascular health promotion intervention on the health habits of a group of rural African American adults. The study had a cluster randomized controlled trial design involving 12 rural churches that served as statistical clusters. From the churches (n = 6) randomized to the intervention group, 115 participants were enrolled, received the 6-week health program and completed pretest–posttest measures. The 114 participants from the control group churches (n = 6) did not receive the health program and completed the same pretest–posttest measures. The linear mixed model was used to compare group differences from pretest to posttest. The educational health intervention positively influenced select dietary and confidence factors that may contribute toward CVD risk reduction.

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4016 Combined Eating Disorder and Weight-Loss Online Guided-Self Help Intervention: Updated Results from an Ongoing Pilot Study

Journal of Clinical and Translational Science ◽

10.1017/cts.2020.192 ◽

2020 ◽

Vol 4 (s1) ◽

pp. 54-54

Author(s):

Grace Elise Monterubio ◽

Ellen E. Fitzsimmons-Craft ◽

Denise E. Wilfley

Keyword(s):

Eating Disorder ◽

Pilot Study ◽

Mixed Model ◽

Intervention Group ◽

Baseline Survey ◽

Control Group ◽

Student Health Services ◽

Eating Disorder Examination ◽

Self Help ◽

Study Population

OBJECTIVES/GOALS: Aims 1&2: Develop (1) and implement (2) online, guided self-help intervention for ED psychopathology and weight reduction. Aim 3: Follow-up to track remission of ED psychopathology and symptoms and WL maintenance at end of treatment and 6-months. METHODS/STUDY POPULATION: N = 60 college students meeting criteria (clinical/sub-clinical binge-type ED with BMI > 25) will complete a baseline survey and then will be randomized into a condition. Students in the intervention group (n = 30) will be offered 8 weeks of an online, guided self-help intervention for ED and WL. Students in the control group (n = 30) will receive an email message to seek support from Student Health Services. All participants will receive follow-ups 9 weeks and 6 months after baseline. Data analysis will compare Eating Disorder Examination Questionnaire (EDE-Q) scores and WL (change in BMI) at all three time-points. Group comparisons will be assessed via two-way mixed-model ANOVA. RESULTS/ANTICIPATED RESULTS: Recruitment is still ongoing. Data collected by the time of the conference will be presented on the poster. DISCUSSION/SIGNIFICANCE OF IMPACT: Online, guided self-help interventions have been used for WL, as well as for treatment of EDs separately, but no program exists to manage these commonly comorbid conditions concurrently. Thus, this pilot study will examine the effectiveness of combined programs to breach this treatment gap.

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Effectiveness of Mindfulness-Based Cognitive Therapy in Sexual Self-Efficacy and Marital Satisfaction among Couples with Marital Conflicts

10.32592/ajnpp.2020.7.1.104 ◽

2019 ◽

pp. 29-36

Keyword(s):

Marital Satisfaction ◽

Cognitive Therapy ◽

Marital Conflict ◽

Self Efficacy ◽

Intervention Group ◽

Analysis Of Covariance ◽

Control Group ◽

Marital Conflicts ◽

Significant Difference

Background: Marital conflict is a type of lack of ongoing meaningful agreement between spouses. The present study aimed to investigate the effectiveness of mindfulness-based cognitive therapy on sexual self-efficacy and marital satisfaction in couples with marital conflicts. Materials and Methods: This quasi-experimental study was carried out on the intervention and control groups with a pretest/posttest design and follow-up. The study population consisted of 30 females who referred to counseling centers in district 1 of Tehran, Iran, in 2018 through simple random sampling. The participants were randomly divided into two groups, each with 15 members. The intervention group received mindfulness-based cognitive therapy, and the control group received no intervention. Data collection tools were the questionnaires of sexual self-efficacy, marital satisfaction, and marital conflicts. The questionnaires were filled out by the participants before and after the intervention and 3 months later. The collected data were analyzed using repeated measurement analysis and analysis of covariance by SPSS software (version 22). Results: The results of the study showed that mindfulness-based cognitive therapy led to increased sexual self-efficacy (P<0.033) and marital satisfaction (P<0.003) in the intervention group; however, in the control group, there was no significant difference in pretest, posttest and follow-up scores. Conclusion: Based on the results, it can be concluded that mindfulness-based cognitive therapy can improve sexual self-efficacy and marital satisfaction in couples with marital conflicts.

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A Structured Maternity Case Record to Improve Quality of Documentation in a Tertiary Care Hospital, Delhi

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/45693.14647 ◽

2021 ◽

Author(s):

AG Radhika ◽

Chetna Dengri ◽

Abhishek Kumar ◽

Shalini Singh

Keyword(s):

Tertiary Care ◽

Intervention Group ◽

Control Group ◽

Care Hospital ◽

Case Record ◽

Hospital Case ◽

Sequence Of Events ◽

Significant Difference ◽

Time Of Admission

Introduction: India contributes to about 18% of global maternal deaths and 22.6% of still births. Efforts to improve the quality of care are challenged by the lack of reliable documentation of data. Hence, a concise, structured maternity case sheet (PrasavRecord) was designed with the aim to bring about an improvement in documentation of treatment and events related to woman in labour from the time of admission till her discharge from the hospital. Aim: To study the improvement in quality of documentation from the time of admission till discharge of a woman in labour with the help of structured format i.e., PrasavRecord. Materials and Methods: The study was conducted in February 2017. A quasi experimental study design was used, and the completeness of data recorded by the resident doctors in the existing hospital case sheet (control group) with those recorded in PrasavRecord (intervention group) were assessed in a total of 65 deliveries in each arm. Details of the patient from admission to the labour room followed by the entire sequence of events during labour as well as hospital stay in postpartum period were recorded over 130 parameters under different sections in PrasavRecord. Statistical analysis was done by using SPSS version 21.0. Results: Completeness of the documentation in terms of history, investigations and findings at examination including those at labour, nearly, 92% of the doctors rated PrasavRecord as “good and very good” for appearance, recommended its routine use, and 75% agreed that the format will be useful for conversion to electronic medical record. There was highly significant difference between the average percentage of completeness in PrasavRecord 75.8 {95% CI (74.2-77.4)} and hospital case sheets 42.2 {95% CI (40.9-43.6)} i.e., z=5.38 p-value <0.001. Conclusion: PrasavRecord is a simple, acceptable and user-friendly data entry format which improves the quality of documentation of the processes and practices during childbirth. Larger trials are required to finetune it to facilitate its widespread use thereby, ensuring a uniform documentation process of labour and postpartum.

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Better balance: a randomised controlled trial of oculomotor and gaze stability exercises to reduce risk of falling after stroke

Clinical Rehabilitation ◽

10.1177/0269215520956338 ◽

2020 ◽

pp. 026921552095633

Author(s):

Anabela Correia ◽

Carla Pimenta ◽

Marta Alves ◽

Daniel Virella

Keyword(s):

Controlled Trial ◽

Tertiary Care ◽

Intervention Group ◽

Secondary Outcome ◽

Control Group ◽

Stroke Survivors ◽

Care Hospital ◽

Risk Of Falling ◽

Gaze Stability ◽

Estimated Risk

Objective: To assess the effect of a domiciliary program of oculomotor and gaze stability exercises on the incidence of falls and risk of fall in stroke survivors. Design: Two-arm, non-blinded parallel randomized controlled trial. Subjects: Stroke survivors older than 60 years, with positive Romberg test and autonomous gait after the stroke. Setting: Physiotherapy outpatient clinic of a tertiary care hospital. Interventions: Every participant accomplished the current rehabilitation program; the intervention group was randomly allocated into an additional three weeks intervention with a domiciliary program of oculomotor and gaze stability exercises. Main measures: Primary outcome was the incidence of falls through the three weeks after the intervention started; in addition, the variation of the estimated risk for falling assessed by both Berg Balance Scale (four points) and Timed Up and Go Test (four seconds) was the secondary outcome. Results: 79 patients were recruited and 68 completed the protocol (control group 35; intervention group 33). During the follow up, falls were registered in 4/35 participants in the control group and no event occurred in the intervention group ( P = 0.064). The estimated risk for falling decreased in 11/35 control group participants and in 28/33 intervention group participants (RR 0.37; 95%CI 0.22–0.62; P < 0.001). Conclusion: After three weeks of a domiciliary program of oculomotor and gaze stability exercises, the estimated risk of falling significantly diminished and no falls occurred among the intervention group. These findings encourage further exploration of this promising intervention. Trial Registration: ClinicalTrials.gov Identifier: NCT02280980.

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