scholarly journals The Effects of an Integrated Supportive Programme on Xerostomia and Salivary Characteristics in Patients With Head and Neck Cancer Undergoing Radiotherapy: a Randomized Controlled Trial

2021 ◽  
Author(s):  
Nan Jiang ◽  
Yue Zhao ◽  
Malin Stensson ◽  
Jan Mårtensson
Keyword(s):  
Head And Neck Cancer ◽  
Usual Care ◽  
Flow Rate ◽  
Intervention Group ◽  
Control Group ◽  
Face To Face ◽  
Saliva Flow Rate ◽  
Unstimulated Saliva ◽  
Saliva Flow

Abstract Aim: This study evaluates the effect of an integrated supportive programme on xerostomia and saliva characteristics at a one-year follow-up of patients with head and neck cancer (HNC) undergoing radiotherapy (RT).Methods: Participants were randomly allocated to an intervention group (n=47) or a control group (n=45). The intervention group received usual care and an integrated supportive programme, which included three steps: face-to-face education; face-to-face coaching at one-month post RT; and four telephone coaching sessions at 2-, 3-, 6-, and 9-months post RT. The face-to-face education consisted of oral hygiene instruction, oral self-care strategies, facial and tongue muscle exercises, and salivary gland massage. Adherence to the intervention was evaluated using a questionnaire completed during the nine-month follow-up. The control group received usual care. The unstimulated saliva flow rate, saliva pH, buffering capacity, and xerostomia were assessed in both groups.Results: A total of 79 participants (40 in the intervention group and 39 in the control group) completed the 12-month follow-up. There were statistically significant differences between the groups in level of xerostomia at the 3- and 12-month follow-up (P=0.027 and P<0.001, respectively) and in the mean value of unstimulated saliva flow rate at the 12-month follow-up (P=0.035), with better outcome in the intervention group. The adherence of the intervention was good but decreased slightly during the follow-up. Conclusion: This integrated supportive programme with good adherence relieved xerostomia and had a positive effect on unstimulated saliva flow rate among patients with HNC during the 12-month follow-up.

scholarly journals Effectiveness of the Internet-based Versus Face-to-Face Interaction on Reduction of Tobacco use among Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Rajesh Kumar ◽  
Ravi Kant ◽  
Poonam Yadav ◽  
Tamar Rodney ◽  
Mukesh Bairwa
Keyword(s):  
Developing Countries ◽  
Tobacco Use ◽  
Meta Analysis ◽  
Intervention Group ◽  
The Internet ◽  
Control Group ◽  
Forest Plot ◽  
Cochrane Central Register ◽  
Face To Face

Abstract BackgroundThe burden of tobacco-associated disorders is prevalent worldwide. Over the years, many innovative internet-based approaches have been utilized with variable success to quit tobacco. Though the effectiveness of internet-based and face-to-face interventions on quitting smoking are very well reported in the literature, due to limitation in methodology and limited sample size, it is required to integrate and analyze these studies' findings to reach a single conclusion. The study evaluated the effectiveness of the internet as an intervention approach versus face-to-face interaction on reducing tobacco use as control among adults.MethodsA systematic search was performed through various electronic databases such as Medline, PsychInfo, PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), ResearchGate, Google Scholar, and Academia. Reference lists of the eligible articles were also screened. Full-text articles were included as per eligibility criteria (PICO framework). No ethnicity restriction was applied.ResultsA total of 13 studies were selected for meta-analysis, with 3852 and 3908 participants in intervention and control groups respectively. Forest plot favours the intervention group at one month follow up for tobacco quitting (OR: 2.37, CI: 1.86-3.02, P-0.00001, I2 =0%), at three months (OR: 1.88, CI: 1.48-2.40, P-0.00001, I2 =42%) at six months (OR: 2.02, CI: 1.64-2.50, P-0.00001, I2 =38%) and at 1 year of follow-up (OR: 1.43, CI: 1.18-1.74, P-0.00001, I2 = 36%) comparing to control group. ConclusionInternet and web-based interventions are highly useful in tobacco quitting at one month, three months, six months, and one year of follow-up compared to face-to-face interaction or no intervention, although the level of evidence was moderate. Additionally, limited availability of trials in developing countries, arising need for research of internet use in developing countries to quit tobacco. Prospero Registration number- PROSPERO 2020 CRD42020214306

Abstract 225: A Depression Quality Program and Cardiovascular Disease: Assessing the Impact on Care

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Linda Gordon ◽  
Amanda Malecky ◽  
Andrew Althouse ◽  
Nicole Ansani
Keyword(s):  
Usual Care ◽  
Goal Attainment ◽  
Intervention Group ◽  
Phone Call ◽  
Categorical Variables ◽  
Care Group ◽  
Control Group ◽  
Surrogate Outcome ◽  
The Impact

Background: Data demonstrate an adverse association between depression and coronary artery disease prognosis. Therefore, a depression screening program was initiated in the catheterization (cath) lab. The goals were to improve HEDIS depression compliance rates and determine the impact on clinical outcomes. Methods: Adult patients in an inpatient cath lab from 3 cardiology practices were screened for enrollment in a randomized controlled trial. All cath lab patients received a PHQ-9 depression screener. Those who screened positive for depression (score ≥ 10) were randomized to intervention or usual care. The usual care group received a follow-up phone call to re-administer the PHQ-9 at 6-8 weeks and within 210 days of discharge. The intervention group was administered the PHQ-9 and received intensive education at baseline, 6-8 weeks, and within 210 days of discharge. Education included targeted depression information with a mental health care provider and comprehensive disease management education with a cardiovascular nurse practitioner. Outcomes included: differences in HEDIS depression goal attainment; depression response/remission rates; and cardiovascular goals. Differences between groups were tested using chi-squared tests (categorical variables) and t-tests (continuous variables). Results: Baseline characteristics were similar between control (N=43) and intervention (N=40) groups, with the exception of significantly fewer African American patients in the control group (N=2, 4.7%) vs intervention (N=9, 22.5%). Changes in HEDIS goal attainment show that patients in the intervention group were slightly more likely to be referred to a provider to address depression (95.0% vs 86.0%, p=0.314), or receive meds for depression (65.0% vs 51.2%, p=0.219), but these differences are not statistically significant. More patients in the intervention group refused meds for depression compared to control (15.0% vs. 2.3%, p=0.041); have received blood work (65.0% vs 41.9%, p=0.030); and have received follow-up within 210 days (82.5% vs 46.5%, p<0.001). Treatment adjustment rate was higher in the intervention group compared to control (85.0% vs. 65.1%, p=0.037). Hospital readmission rate was similar between groups (p=0.896) and there was no difference in depression remission or response rates (p=0.426). Further, no differences were seen in cardiovascular surrogate outcome parameters, including cholesterol, A1c, CRP, or BNP between groups; except SGOT was significantly different between groups (-5.0 intervention vs 2.0 control p=0.045). Conclusions: These data demonstrate improvements in attaining a surrogate outcome measure of quality (HEDIS goals); however, this does not appear to translate to a significant clinical impact. Quality measures may need to be continuously reassessed to ensure efficiency and effectiveness of care.

1108Effectiveness of nursing counseling for patients with cardiovascular risk factors: controlled clinical trial with a 24 months post-intervention follow-up

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Salazar ◽  
V Vilchez-Barboza ◽  
K Saez ◽  
T Paravic
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Intervention Group ◽  
Health Centers ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Post Intervention ◽  
Face To Face

Abstract Objective To establish the effect after 24 months of a face-to-face and telephone nursing counseling intervention, aimed at controlling cardiovascular risk factors (hypertension, dyslipidemia and overweight) and improving health-related quality of life (HRQoL) in patients of the cardiovascular health program of family health centers of Concepciόn, Chile. Methods Randomized controlled clinical trial with a 24 months post-intervention follow-up. 120 patients with cardiovascular risk factors under the cardiovascular health program were recruited from 6 family health centers and randomized into a control group (60) and an intervention group (60). The intervention group received the regular care in addition to face-to-face and telephone nursing counseling. Baseline measurements were taken and also at the end of the intervention (7 months). Participants returned then after 12 and 24 months for follow-up evaluations. A total of 109 subjects completed the intervention at 7 months and 45 returned at 24 months. During follow-up evaluations both groups continued to receive regular care given in the health centers. The measurements consisted of HRQoL (physical and mental health), systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), abdominal circumference (AC), total cholesterol (TC), low density lipoproteins (LDL-Chol), high density lipoprotein (HDL-Chol), atherogenicity index (LDL/HDL), cardiovascular risk factor (TC/HDL), 10-year coronary risk. Ethical requirements were considered and statistical analysis was carried out using MANCOVA and d-Cohen repeated measurements. Results The analysis of the effects of the intervention in the 24-month follow-up showed that subjects in the intervention group only maintained significant improvement of AC over time (F=3.18; p=0.03), compared to the control group. Conclusion Although participants in the intervention group only maintained the AC improvement over time, this can be regarded as an indirect indicator of the presence of intra-abdominal fat that makes it possible to predict and classify the risk of cardiovascular disease. Long-term follow-up studies are required to investigate behaviors and mechanisms that contribute to maintaining improvements in this indicator. Additionally, future research should include reinforcement activities, either face-to-face or by telephone, to help maintain the positive results of interventions. Acknowledgement/Funding Universidad de Concepciόn 214.082.049-1.0

scholarly journals A Children’s Asthma Education Program: Roaring Adventures of Puff (RAP), Improves Quality of Life

2010 ◽  
Vol 17 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Shawna L McGhan ◽  
Eric Wong ◽  
Heather M Sharpe ◽  
Patrick A Hessel ◽  
Puish Mandhane ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Education Program ◽  
Intervention Group ◽  
Asthma Management ◽  
Control Group ◽  
Asthma Education ◽  
Children With Asthma

BACKGROUND: It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.OBJECTIVE: To assess the feasibility and impact of ‘Roaring Adventures of Puff’ (RAP), a six-week childhood asthma education program administered by health professionals in schools.METHODS: Thirty-four schools from three health regions in Alberta were randomly assigned to receive either the RAP asthma program (intervention group) or usual care (control group). Baseline measurements from parent and child were taken before the intervention, and at six and 12 months.RESULTS: The intervention group had more smoke exposure at baseline. Participants lost to follow-up had more asthma symptoms. Improvements were significantly greater in the RAP intervention group from baseline to six months than in the control group in terms of parent’s perceived understanding and ability to cope with and control asthma, and overall quality of life (P<0.05). On follow-up, doctor visits were reduced in the control group.CONCLUSION: A multilevel, comprehensive, school-based asthma program is feasible, and modestly improved asthma management and quality of life outcomes. An interactive group education program offered to children with asthma at their school has merit as a practical, cost-effective, peer-supportive approach to improve health outcomes.

Early rehabilitation after hospital admission for road trauma using an in-reach multidisciplinary team: a randomised controlled trial

2017 ◽  
Vol 31 (9) ◽  
pp. 1189-1200 ◽  
Author(s):  
Jane Wu ◽  
Steven G Faux ◽  
John Estell ◽  
Stephen Wilson ◽  
Ian Harris ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Usual Care ◽  
Intervention Group ◽  
Psychological Status ◽  
Randomised Control Trial ◽  
Control Group ◽  
Rehabilitation Team ◽  
Secondary Outcomes ◽  
The Impact

Objective: To investigate the impact of an in-reach rehabilitation team for patients admitted after road trauma. Design: Randomised control trial of usual care versus early involvement of in-reach rehabilitation team. Telephone follow-up was conducted by a blind assessor at three months for those with minor/moderate injuries and six months for serious/severe injuries. Setting: Four participating trauma services in New South Wales, Australia. Subjects: A total of 214 patients admitted during 2012-2015 with a length of stay of at least five days. Intervention: Provision of rehabilitation services in parallel with ward based therapy using an in-reach team for the intervention group. The control group could still access the ward based therapy (usual care). Main measures: The primary outcome was acute length of stay. Secondary outcomes included percentage requiring inpatient rehabilitation, function (Functional Independence Measure and Timed Up and Go Test), psychological status (Depression Anxiety and Stress Score 21), pain (Orebro Musculoskeletal Pain Questionnaire) and quality of life (Short Form-12 v2). Results: Median length of stay in acute care was 13 days (IQR 8-21). The intervention group, compared to the control group, received more physiotherapy and occupational therapy sessions (median number of sessions 16.0 versus 11.5, P=0.003). However, acute length of stay did not differ between the intervention and control groups (median 15 vs 12 days, P=0.37). There were no significant differences observed in the secondary outcomes at hospital discharge and follow-up. Conclusion: No additional benefit was found from the routine use of acute rehabilitation teams for trauma patients over and above usual care.

Non-invasive home telemonitoring system for heart failure patients: A randomized clinical trial

2020 ◽  
pp. 1357633X1989926 ◽  
Author(s):  
Lucía M Yanicelli ◽  
Carla B Goy ◽  
Viviana del C González ◽  
Gerardo N Palacios ◽  
Ernesto C Martínez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Usual Care ◽  
Treatment Adherence ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Heart Failure Patients ◽  
Home Telemonitoring

Introduction The low quality of life in heart failure patients is related to low self-care and treatment adherence. Consequently, innovative strategies are needed to improve them. The objective of this work is to determine the effectiveness of the use of a home telemonitoring system to improve the self-care and treatment adherence of heart failure patients. Methods A randomized clinical trial that compares the efficacy of a home telemonitoring system –intervention group versus usual care control group – among heart failure outpatients over a 90-day monitoring period was carried out. The home telemonitoring system consists of an application that collects measurements of different parameters on a daily basis and provides health education to patients. The home telemonitoring system processes data gathered and generates an alert if a risky situation arises. The outcomes observed were significant changes in patients’ self-care (European Heart Failure Self-care Behaviour Scale), treatment adherence (Morisky Modified Scale) and re-hospitalizations over the follow-up period. Results 104 heart failure patients were screened; 40 met the inclusion criteria; only 30 completed the study. After the follow-up, intragroup analysis of the control group indicated a decrease in treatment adherence ( p = 0.02). The mean European Heart Failure Self-care Behaviour Scale overall score indicated an improved self-care in the intervention group patients ( p = 0.03) and a worsened self-care in the control group ( p = 0.04) with a p value of 0.004 in the intergroup analysis. Thanks to the home telemonitoring system alerts, two re-hospitalizations were avoided. Discussion This study demonstrated that the proposed home telemonitoring system improves patient self-care when compared to usual care and has the potential to avoid re-hospitalizations, even considering patients with low literacy levels. Trial Registration: Home Telemonitoring System for Patients with Heart Failure. clinicaltrials.gov Identifier: NCT04071093

scholarly journals A Novel Intelligent Two-Way Communication System for Remote Heart Failure Medication Uptitration (the CardioCoach Study): Randomized Controlled Feasibility Trial (Preprint)

2017 ◽  
Author(s):  
Christophe JP Smeets ◽  
Valerie Storms ◽  
Pieter M Vandervoort ◽  
Pauline Dreesen ◽  
Julie Vranken ◽  
...  
Keyword(s):  
Heart Failure ◽  
Usual Care ◽  
Information Exchange ◽  
Intervention Group ◽  
Feasibility Trial ◽  
Control Group ◽  
Care Providers ◽  
Converting Enzyme Inhibitors ◽  
Number Of Patients

BACKGROUND European Society of Cardiology guidelines for the treatment of heart failure (HF) prescribe uptitration of angiotensin-converting enzyme inhibitors (ACE-I) and β-blockers to the maximum-tolerated, evidence-based dose. Although HF prognosis can drastically improve when correctly implementing these guidelines, studies have shown that they are insufficiently implemented in clinical practice. OBJECTIVE The aim of this study was to verify whether supplementing the usual care with the CardioCoach follow-up tool is feasible and safe, and whether the tool is more efficient in implementing the guideline recommendations for β-blocker and ACE-I. METHODS A total of 25 HF patients were randomly assigned to either the usual care control group (n=10) or CardioCoach intervention group (n=15), and observed for 6 months. The CardioCoach follow-up tool is a two-way communication platform with decision support algorithms for semiautomatic remote medication uptitration. Remote monitoring sensors automatically transmit patient’s blood pressure, heart rate, and weight on a daily basis. RESULTS Patients’ satisfaction and adherence for medication intake (10,018/10,825, 92.55%) and vital sign measurements (4504/4758, 94.66%) were excellent. However, the number of technical issues that arose was large, with 831 phone contacts (median 41, IQR 32-65) in total. The semiautomatic remote uptitration was safe, as there were no adverse events and no false positive uptitration proposals. Although no significant differences were found between both groups, a higher number of patients were on guideline-recommended medication dose in both groups compared with previous reports. CONCLUSIONS The CardioCoach follow-up tool for remote uptitration is feasible and safe and was found to be efficient in facilitating information exchange between care providers, with high patient satisfaction and adherence. CLINICALTRIAL ClinicalTrials.gov NCT03294811; https://clinicaltrials.gov/ct2/show/NCT03294811 (Archived by WebCite at http://www.webcitation.org/6xLiWVsgM)

scholarly journals Web-Based and Face-To-Face Autonomy-Supportive Intervention for Physical Education Teachers and Students’ Experiences

2021 ◽  
pp. 672-683
Author(s):  
Henri Tilga ◽  
Hanna Kalajas-Tilga ◽  
Vello Hein ◽  
Andre Koka
Keyword(s):  
Physical Education ◽  
Intervention Group ◽  
Need Satisfaction ◽  
Control Group ◽  
Study Group ◽  
Web Based ◽  
Face To Face ◽  
Psychological Need ◽  
Supportive Interventions

The most of the previous autonomy-supportive interventions conducted have been partially effective and used only web-based or face-to-face approach. In the current study, a combined web-based and face-to-face intervention for physical education (PE) teachers was tested to examine whether it would lead to significant changes in students’ self-reports of autonomy-supportive and controlling behaviours, psychological need satisfaction and frustration, and intrinsic motivation. Participants were 57 PE teachers (Mage = 45.70, SD = 12.79) and their 858 middle-school students (Mage = 13.22, SD = 0.75). A randomized controlled design was adopted in which PE teachers and their students were assigned to the combined face-to-face and web-based, face-to-face alone, web-based alone or control group. Face-to-face intervention was provided to PE teachers within one day in an 8-hour workshop and web-based intervention was provided to PE teachers for a period of four weeks. The combined face-to-face and web-based intervention group was the only study group that demonstrated statistically significant changes in all the study variables (i.e., significant increase in cognitive, organisational, and procedural autonomy-supportive behaviour, in psychological need satisfaction for autonomy, competence and relatedness, and in intrinsic motivation, whereas significant decrease in intimidation, controlling use of grades, and negative conditional regard, and in psychological need frustration for autonomy, competence, and relatedness) compared to the control group at a one-month follow-up. There were no significant differences in any of the study variable, except organisational autonomy support and intimidation, between the web-based intervention group and face-to-face intervention group. Both web-based and face-to-face study group students reported significant gains in most of the study variables compared to the control group students at a one-month follow-up. The current findings suggest that future autonomy-supportive interventions for PE teachers should aim to use combined interventions of face-to-face and web-based approach to gain the greatest intervention effects.

scholarly journals The Effects of Postexercise Feeding on Saliva Antimicrobial Proteins

2012 ◽  
Vol 22 (3) ◽  
pp. 184-191 ◽  
Author(s):  
Ricardo J.S. Costa ◽  
Matthew B. Fortes ◽  
Katharine Richardson ◽  
James L.J. Bilzon ◽  
Neil P. Walsh
Keyword(s):  
Flow Rate ◽  
Prolonged Exercise ◽  
Amylase Activity ◽  
Antimicrobial Proteins ◽  
Minimal Impact ◽  
Saliva Flow Rate ◽  
Unstimulated Saliva ◽  
Lysozyme Concentration ◽  
Saliva Flow ◽  
Secretion Rates

The purpose of this study was to determine the effects of a carbohydrate (CHO) and protein (PRO) drink consumed immediately after endurance exercise on saliva antimicrobial proteins known to be important for host defense. Eleven male runners ran for 2 hr at 75% VO2max on 2 occasions and immediately postexercise were provided, in randomized order, either a placebo solution (CON) or a CHO-PRO solution containing 1.2 g CHO/kg body mass (BM) and 0.4 g PRO/kg BM (CHO-PRO). The solutions were flavor and volume equivalent (12 ml/kg BM). Saliva flow rate, lysozyme, α-amylase, and secretory (S) IgA concentrations were determined from unstimulated saliva samples collected preexercise, immediately postexercise, and every 30 min until 180 min postexercise. CHO-PRO ingestion immediately postexercise resulted in a lower saliva flow rate than with CON at 30 and 60 min postexercise. Saliva lysozyme concentration increased immediately postexercise in both trials compared with preexercise (p< .05), and CHO-PRO ingestion immediately postexercise resulted in a higher saliva lysozyme concentration in the first hour of recovery than with CON (125% greater at 30 min, 94% greater at 60 min; p< .01). Saliva SIgA concentration decreased below preexercise concentrations 90–150 min postexercise (p< .001), with no effect of CHO-PRO. Saliva α-amylase activity was unaffected by exercise or CHO-PRO refeeding. CHO-PRO refeeding did not alter the secretion rates of any saliva variables during recovery. In conclusion, immediate refeeding with CHO-PRO evoked a greater saliva lysozyme concentration during the first hour of recovery after prolonged exercise than ingestion of placebo but had minimal impact on saliva α-amylase and SIgA responses.

A randomized trial of a nurse-led decision aid to inform patients with advanced cancer about palliative chemotherapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20583-e20583
Author(s):  
P. B. Ottevanger ◽  
Linda JM Oostendorp ◽  
Winette T.A. Van Der Graaf ◽  
Peep FM Stalmeier
Keyword(s):  
Usual Care ◽  
Advanced Cancer ◽  
Palliative Chemotherapy ◽  
Negative Impact ◽  
Intervention Group ◽  
Well Being ◽  
Treatment Preference ◽  
Control Group ◽  
Second Line

e20583 Background: There is a lack of decision aids (DAs) for patients with advanced cancer considering palliative treatment. In this randomized study, we evaluated nurse-led DAs about second-line palliative chemotherapy for patients with advanced breast (BC) or colorectal cancer (CRC). Methods: Patients with advanced BC or CRC considering second-line treatment were randomized to receive only usual care (control group) or usual care plus a DA from a nurse (intervention group) (1:2 ratio). Using the DA, a nurse offered information on adverse events, tumor response, and survival. Patients completed a baseline questionnaire and two follow-up questionnaires 1 week and 8 weeks after the treatment-related information was provided. Outcome measures were well-being, coping, knowledge, and information and decision-related outcomes. Intent-to-treat analyses were performed using Chi Square tests, independent samples t-tests, and linear mixed models to examine differences between groups over time. Results: In all,128 patients participated in the study; median age 62 years (range 32-81), 37% male, 73% CRC. Of the 83 patients assigned to the intervention group, 77 received a DA. At the first follow-up, more patients receiving a DA preferred chemotherapy (96% vs. 84%; p=0.067). Seven weeks later, 88% of patients in the intervention group and 84% of patients in the control group had started chemotherapy (p=0.746). The only statistically significant effect was the stronger treatment preference of patients in the intervention group (3.0 vs. 2.5; p=0.030). The DAs did not negatively impact anxiety, depression, cancer worries, and hopelessness. Conclusions: It is possible to offer a DA with explicit information to patients with advanced cancer without negative impact on patients' well-being. Unexpectedly, this study did not show consistent effectiveness of the DAs. Our interpretation is that most patients receiving the DA had already decided to start chemotherapy. Clinical trial information: NTR1113.

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