scholarly journals Evaluation of an Ultrasound-Guided Palpation Intervention for Palpation Skill Training: A Single-Blind, Parallel Group, Randomised Controlled Trial

Author(s):  
Takashi Kitagawa ◽  
Yuma Aoki ◽  
Hotaka Sugimoto ◽  
Natsumi Ozaki

Abstract Although there are increasing reports on the usefulness of sonopalpation with ultrasound imaging, many previous studies have reported interventions without a control group. This single-blind, parallel group randomised controlled trial aimed to determine whether educational instruction with sonopalpation for medical students has a superior effect on skill improvement than traditional instruction without ultrasonography. Twenty-nine medical students participated in the study and were randomised using block randomisation into an ultrasound imaging group (n = 15) and a control group (n = 14). Then, they underwent three training sessions focusing on the shoulder joint. Participants underwent a scoring assessment of their palpation skills at pre-intervention, post-intervention, and follow-up 3 months after training. The raters were blinded to the subjects’ group. The Friedman and Mann–Whitney U tests were used for data analysis. The intervention group showed a significant increase in scores at post-intervention and at the 3-month follow-up when compared with the pre-intervention group (p < 0.05); the effect sizes were large (0.849 and 0.849, respectively). A comparison of the scores at different time points after the intervention at the 3-month follow-up revealed that there was no significant difference between the groups. Education using ultrasound images may improve the sonopalpation skills of medical students.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lucie Waedel ◽  
Anne Daubmann ◽  
Antonia Zapf ◽  
Olaf Reis

Abstract Background Boys with mild to borderline intellectual disabilities (MBID) are at particular risk to drink in harmful ways once they start to consume alcohol. Interventions based on mindfulness have been proven to be effective in preventing substance use, but mostly for adults with MBID. A mindfulness oriented intervention targeting 11–17 years old boys will be tested in a randomised controlled trial. Study aim is to investigate the benefits of this new intervention compared to an active control condition within a 12 months follow-up. Methods In this randomised controlled proof of concept study, 82 boys with MBID who consumed any alcohol during the last year will be randomised either to the 6 week mindfulness oriented intervention or the control group receiving a control intervention equal in dose and length. The intervention group undergoes mindfulness training combined with interactive drug education, while the control group completes a health training combined with the same education. In the intention-to-treat analysis the primary outcome is the self-reported delay of first post-intervention drunkeness within a 12 months follow-up time span, measured weekly with a short app-based questionnaire. Secondary outcome is the use of alcohol, tobacco and other drugs within 30 days post-intervention. Changes in neurobiological behavioural parameters, such as impulse control, reward anticipation, and decision making, are also investigated. Other secondary outcomes regard trait mindfulness, emotion regulation, psychopathological symptoms, peer networks, perceived stress, and quality of life. In addition, a prospective registry will be established to record specific data on the population of 11–17 year old boys with MBID without any alcohol experience. Discussion This study offers the opportunity to gain first evidence of the effectiveness of a mindfulness-oriented program for the prevention of substance use for boys with MBID. Trial registration German Clinical Trials Register, DRKS00014042. Registered on March 19th 2018.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
David A. Singleton ◽  
Angela Rayner ◽  
Bethaney Brant ◽  
Steven Smyth ◽  
Peter-John M. Noble ◽  
...  

AbstractRobust evidence supporting strategies for companion animal antimicrobial stewardship is limited, despite frequent prescription of highest priority critically important antimicrobials (HPCIA). Here we describe a randomised controlled trial where electronic prescription data were utilised (August 2018–January 2019) to identify above average HPCIA-prescribing practices (n = 60), which were randomly assigned into a control group (CG) and two intervention groups. In March 2019, the light intervention group (LIG) and heavy intervention group (HIG) were notified of their above average status, and were provided with educational material (LIG, HIG), in-depth benchmarking (HIG), and follow-up meetings (HIG). Following notification, follow-up monitoring lasted for eight months (April–November 2019; post-intervention period) for all intervention groups, though HIG practices were able to access further support (i.e., follow-up meetings) for the first six of these months if requested. Post-intervention, in the HIG a 23.5% and 39.0% reduction in canine (0.5% of total consultations, 95% confidence interval, 0.4-0.6, P = 0.04) and feline (4.4%, 3.4-5.3, P < 0.001) HPCIA-prescribing consultations was observed, compared to the CG (dogs: 0.6%, 0.5-0.8; cats: 7.4%, 6.0-8.7). The LIG was associated with a 16.7% reduction in feline HPCIA prescription (6.1% of total consultations, 5.3-7.0, P = 0.03). Therefore, in this trial we have demonstrated effective strategies for reducing veterinary HPCIA prescription.


Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 910
Author(s):  
Dorthe Djernis ◽  
Mia S. O’Toole ◽  
Lone O. Fjorback ◽  
Helle Svenningsen ◽  
Mimi Y. Mehlsen ◽  
...  

Here, we developed and examined a new way of disseminating mindfulness in nature to people without meditation experience, based on the finding that mindfulness conducted in natural settings may have added benefits. We evaluated a 5-day residential programme aiming to reduce stress and improve mental health outcomes. We compared an indoor and an outdoor version of the programme to a control group in a pilot randomised controlled trial (RCT). Sixty Danish university students experiencing moderate to high levels of stress were randomised into a residential mindfulness programme indoors (n = 20), in nature (n = 22), or a control group (n = 18). Participants completed the Perceived Stress Scale and the Self-Compassion Scale (primary outcomes) along with additional secondary outcome measures at the start and end of the program and 3 months after. Stress was decreased with small to medium effect sizes post-intervention, although not statistically significant. Self-compassion increased post-intervention, but effect sizes were small and not significant. At follow-up, changes in stress were not significant, however self-compassion increased for both interventions with medium-sized effects. For the intervention groups, medium- to large-sized positive effects on trait mindfulness after a behavioural task were found post-intervention, and small- to medium-sized effects in self-reported mindfulness were seen at follow-up. Connectedness to Nature was the only outcome measure with an incremental effect in nature, exceeding the control with a medium-sized effect at follow-up. All participants in the nature arm completed the intervention, and so did 97% of the participants in all three arms. Overall, the results encourage the conduct of a larger-scale RCT, but only after adjusting some elements of the programme to better fit and take advantage of the potential benefits of the natural environment.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037303
Author(s):  
Fumiya Tanji ◽  
Yasutake Tomata ◽  
Saho Abe ◽  
Sanae Matsuyama ◽  
Yumika Kotaki ◽  
...  

ObjectiveThe aim of this study was to investigate the effect of a financial incentive on the number of daily walking steps among community-dwelling adults in Japan.Study designTwo-arm, parallel-group randomised controlled trial.Setting/participantsWe recruited physically inactive community-dwelling adults from Sendai city, Japan. Eligible participants were randomly allocated to an intervention or a wait list control group. Pedometers were used to assess the mean number of daily steps in three periods: baseline (weeks 1–3), intervention (weeks 4–6) and follow-up (weeks 7–9).InterventionThe intervention group was offered a financial incentive (shopping points) to meet the target number of increased daily steps in the intervention period.Main outcome measuresThe primary outcome was an increase in the mean number of daily steps in the intervention and follow-up periods compared with baseline.ResultsSeventy-two participants (69.4% women; mean age, 61.2±16.2 years; mean number of daily steps at baseline, 6364±2804) were randomised to the intervention (n=36) and control groups (n=36). During the intervention period, the increase in mean daily steps was significantly higher in the intervention group (1650, 95% CI=1182 to 2119) than in the control group (514, 95% CI=136 to 891; p<0.001). However, the difference between groups was not significant at follow-up after the incentives were removed (p=0.311). In addition, compared with controls, a significantly higher proportion of participants in the intervention group showed an increase in mean daily steps of ≥1000 (69.4% vs 30.6%, respectively; OR=5.17, 95% CI=1.89 to 14.08). There were no adverse effects from the intervention.ConclusionsThe present results suggest that financial incentives are effective in promoting short-term increases in physical activity.Trial registration numberUMIN000033276.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042892
Author(s):  
Juan Pimentel ◽  
Anne Cockcroft ◽  
Neil Andersson

ObjectivesExplore the acceptability and feasibility of a randomised controlled trial (RCT) to assess game jams—participatory events to cocreate digital or board games in a time-constrained environment—in cultural safety training of medical students. The pilot tests methods and procedures and explores the validity and reliability of our research instrument.DesignTwo-arm parallel-group pilot RCT with a 1:1 allocation ratio.SettingFaculty of Medicine in Chia, Colombia.Participants79 final-year medical students completed the baseline questionnaire. 64 completed the assessment immediately after the intervention: 31 in the intervention group (20 female) and 33 in the control group (18 female). 35 completed the final assessment (18 control and 17 intervention) 4 months after the intervention.InterventionsThe intervention group joined a 5-hour game jam composed of a 1-hour lecture and a 4-hour session to create and to play educational games about cultural safety. The control group had a 1-hour conventional lesson, followed by a 4-hour study session of selected readings on cultural safety.Primary and secondary outcome measuresThe instrument, an online self-administered Likert-type questionnaire, assessed a self-reported cultural safety results chain based on a planned behaviour theory. Student recruitment, retention and perception of the activity determined acceptability. The methodological and logistical factors for a full-scale study determined feasibility.ResultsAfter the intervention, students randomised to that arm reported a slightly higher cultural safety score (26.9) than those in the control group (25.9) (difference −1, 95% CI −3.0 to 1.0). Students described game jam learning in favourable terms and considered cultural safety training relevant. The university authorised the conduct of the full-scale trial.ConclusionGame jam learning is feasible and acceptable for cultural safety training of Colombian medical students. Researchers and educators may find our results informative in the design of RCTs assessing educational interventions.Trial registration numberISRCTN14261595 (stage: pilot study results)


2018 ◽  
Author(s):  
Jamie Lingwood ◽  
Josie Billington ◽  
Caroline F Rowland

Background: Shared reading interventions can impact positively on preschool children’s language development and on their caregiver’s attitudes/behaviours towards reading. However, a number of barriers may discourage families from engaging with these interventions, particularly families from lower socioeconomic (SES) backgrounds. We investigated how families from such backgrounds responded to an intervention designed explicitly to overcome these barriers. Methods: In a pre-registered cluster randomised controlled trial, 85 lower SES families and their 3- to 4-year old children from 10 different preschools were randomly allocated to take part in The Reader’s Shared Reading programme (intervention) or an existing ‘Story Time’ group at a library (control), once a week for eight weeks. Three outcome measures were assessed at baseline and post-intervention: (i) attendance, (ii) enjoyment of the reading groups, and (iii) caregivers’ knowledge of, attitudes and behaviours towards reading. A fourth, - children’s vocabulary - was assessed at baseline and four weeks post-intervention. Results: Families were significantly more likely to attend the intervention group and rated them more favourably, compared to the control group. However, there were no significant effects on caregivers’ knowledge, attitudes and behaviours, or on children’s language. Conclusion: The intervention was only successful in engaging families from disadvantaged backgrounds in shared reading. Implications for the use, duration and intensity of shared reading interventions are discussed.


2021 ◽  
pp. 528-537
Author(s):  
Akinniyi A. Aje ◽  
Segun J. Showande ◽  
Titilayo O. Fakeye

Background: Medication reconciliation (MR) is a patient-centred evolving role of pharmacists that improves patient’s health outcomes. Aim: To assess the effect of an educational intervention on pharmacists’ MR knowledge in two Nigerian tertiary hospitals. Methods: A two-arm parallel non-randomised controlled trial was carried out at two tertiary hospitals in Nigeria, one as intervention and the other as control site. Pharmacists’ MR knowledge was assessed pre-intervention and at one-, three- and six-month post-intervention. The intervention consisted of seminar and role-plays. Data were summarised with descriptive and inferential statistics. Results: A total of 75 pharmacists completed the study. Scores for pre-intervention out of a total of 38 was 19.31±4.76 in the intervention group and 17.50±6.86 in the control group. Post-intervention assessment scores (University College Hospital vs University of Ilorin Teaching Hospital) at one, three and six months were 29.82±5.01 vs 25.97±5.31, 31.53±4.99 vs 26.10±5.20, and 31.69±4.10 vs 23.07±3.98, respectively (p < 0.01). Conclusion: The educational intervention led to improved pharmacists’ MR knowledge.


2020 ◽  
pp. bmjebm-2020-111378
Author(s):  
Dora Jakus ◽  
Dalibora Behmen ◽  
Ivan Buljan ◽  
Ana Marušić ◽  
Livia Puljak

ObjectivesThe aim of this study was to pilot test the effectiveness of reminders versus no intervention for increasing the number of translated Cochrane plain language summaries (PLSs) among volunteer translators.Study designParallel-group randomised controlled trial.SettingCochrane Croatia translation project.ParticipantsAdults who volunteered to translate Cochrane PLSs within the Cochrane Croatia translation project.InterventionThe participants were randomly allocated to intervention (receiving up to four bi-weekly email reminders to translate PLSs) or control group (no intervention).Primary outcomeThe number of translated PLSs within the 6-month trial period.ResultsWe included 80 participants. The median number of translated PLSs after 6 months was 9 in the intervention group (95% CI 2.0 to 15.0) and 4 in the control group (95% CI 2.9 to 7.0), but this was not significantly different (p=0.181, Mann-Whitney U test). There was no difference between the groups in the number of translations after 3 months, the average time-to-translation after 3 or 6 months, or the satisfaction at the end of the study period. The number of reminders received and the number of translated summaries were negatively correlated (r=−0.50; 95% CI −0.70 to −0.22).ConclusionsOur pilot trial showed that reminders do not seem to be significantly effective in increasing the number of PLS translations. Future studies could explore whether different frequency, timing and content of reminders have an influence on an increase in the engagement among volunteer translators of evidence synthesis.Trial registrationNCT03534791.


2020 ◽  
Vol 25 (1) ◽  
pp. 54-65
Author(s):  
Mohammad Ali Zakeri ◽  
Zohreh Khoshnood ◽  
Mahlagha Dehghan ◽  
Farokh Abazari

Background Adherence to treatment is one of the behaviours associated with successful outcomes following a myocardial infarction, which leads to successful treatment in the disease. Aims This study aimed to investigate the effect of the Continuous Care Model (CCM) on treatment adherence in patients with myocardial infarction. Methods This was a randomised controlled trial performed on 82 patients with myocardial infarction. Convenience sampling was used to select the participants, and then they were allocated into two groups by the stratified random method. In the intervention group, a CCM was implemented. In the intervention group, 4–6 educational sessions (1–2 h) were conducted during one month in the form of spoken questions and answers about the presented subjects. The control group received routine care. A questionnaire of demographic information and treatment adherence was completed by samples in the two groups, intervention and control, before and immediately after training and after follow-up. Results The results of this study showed that treatment adherence was significantly higher in the intervention group than in the control group immediately after training and after the follow-up phase (three months) ( p < 0.001). Also, diet, drug and physical activity adherence were significantly higher in the intervention group than in the control group immediately after training and after follow-up ( p < 0.001). Conclusions Implementation of CCM led to an increase in adherence to the treatment in patients with myocardial infarction. Therefore, it is suggested that this model could be used as a nursing intervention to increase treatment adherence in cardiac-rehabilitation programmes.


Author(s):  
A Tajdini ◽  
N Hatami ◽  
B Rahmaty ◽  
A Kouhi ◽  
S Dabiri ◽  
...  

Abstract Objective To investigate hearing and the take rate of crushed cartilage grafts in tympanoplasty. Methods In this double-blinded, randomised, controlled trial, 46 patients with tympanic membrane perforation were enrolled. A conchal cartilage graft was used for reconstruction in both intervention and control groups. In the intervention group, crushed cartilage was used. The success rate and hearing results were ascertained every four months over a one-year follow-up period. Results A total of 36 patients – 20 in the intervention group and 16 in the control group – completed one year of follow up. There were no statistically significant differences between the two groups in mean air–bone gap, bone conduction threshold, speech discrimination score or speech reception threshold. Conclusion The reduction in living cells after crushed cartilage tympanoplasty may decrease the rigidity and the volume of the graft, but may not necessarily improve the hearing results.


Sign in / Sign up

Export Citation Format

Share Document