scholarly journals The Impact of Endoscopy Sedation Information Sheets on the Level of Concern Regarding Possible Awareness in Patients Undergoing Endoscopy Sedation

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 34
Author(s):  
Zi Ping Tong ◽  
Lincoln Gan Gan Lim ◽  
Alison Pighills ◽  
Matthew Hiskens ◽  
Danny Bartlett
Keyword(s):  
Intervention Group ◽  
Control Group ◽  
Patient Counselling ◽  
Unmet Expectations ◽  
Level Of Concern ◽  
The Difference ◽  
Future Work ◽  
The Impact ◽  
Video Material

Sedation encompasses a continuum from complete unconsciousness to drowsiness and anxiolysis where some awareness might be expected. Most patients undergoing endoscopy sedation expect to be completely unconscious during the procedure and thus have unmet expectations regarding their state of consciousness. This study aimed to evaluate whether endoscopy sedation information sheets reduce the level of concern regarding possible awareness during endoscopy sedation at a major regional hospital. Our findings were that 28.8% of patients who received the endoscopy sedation information sheet (n = 82) were concerned about awareness during the procedure, compared to 36.5% of patients in the control group (n = 105). However, the difference was not statistically significant. We also found that the incidence of awareness was higher (13.9%) in the intervention group compared to 8.8% in the control group but, again, not statistically different. This study allowed us to elucidate the level of concern regarding possible awareness during sedation and the incidence of awareness during endoscopy sedation. This will enable future work investigating the role of endoscopy sedation information methods involving written and video material in assisting pre-procedure patient counselling.

scholarly journals The Impact of Patient Education on the Quality of Inpatient Bowel Preparation for Colonoscopy

2010 ◽  
Vol 24 (9) ◽  
pp. 543-546 ◽  
Author(s):  
Greg Rosenfeld ◽  
Darin Krygier ◽  
Robert A Enns ◽  
Janakie Singham ◽  
Holly Wiesinger ◽  
...  
Keyword(s):  
Patient Education ◽  
Bowel Preparation ◽  
Rating Scale ◽  
Tertiary Care ◽  
Intervention Group ◽  
Control Group ◽  
Inpatient Setting ◽  
Care Hospital ◽  
Patient Counselling ◽  
The Impact

BACKGROUND: For patients requiring colonoscopy while admitted to hospital, achieving adequate cleansing of the colon is often difficult.OBJECTIVES: To assess the impact of patient education, in the form of both counselling and written instructions, on bowel cleanliness at colonoscopy.METHODS: A total of 38 inpatients at a tertiary care hospital in Vancouver, British Columbia, who were referred to the gastroenterology service for colonoscopy were enrolled in the present study. Sixteen patients were randomly assigned to the intervention group, while 22 patients comprised the control group. Both groups received a clear liquid diet and 4 L of a commercially available bowel preparation. The intervention group also received a brief counselling session and written instructions outlining the methods and rationale for bowel preparation before colonoscopy. Bowel cleanliness was assessed by the endoscopist using a five-point rating scale.RESULTS: The two groups were similar with respect to demographics, the indication for colonoscopy and findings at colonoscopy. The median bowel cleanliness scores in the control group and the enhanced-instruction group were 3.0 and 2.0, respectively (P=0.001).CONCLUSION: Patient counselling and written instructions are inexpensive, safe and simple interventions. Such interventions are an effective means of optimizing colonoscopy preparation in the inpatient setting.

scholarly journals Improving surgical patient’s knowledge about safe use of opioids: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Helen R Doherty ◽  
Enoch Lam ◽  
Maria Garstka ◽  
Junior Chuang ◽  
David Tai Wong ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Knowledge Score ◽  
Controlled Study ◽  
Control Group ◽  
Routine Practice ◽  
Opioid Use ◽  
Randomized Controlled ◽  
The Difference ◽  
The Impact

Abstract Background Currently, it is not routine practice to provide standardized patient education for safe postoperative opioid use. The objective of our study was to evaluate the impact of an educational pamphlet for surgical patients on knowledge about safe use, proper storage, and disposal of opioids.Methods This multi-center randomized controlled study recruited 100 patients in the pre-operative clinic. Inclusion criteria were English-speaking, ≥ 18 years, able to give informed consent, and not on opioids for chronic pain or within the past 30 days. All patients completed a baseline knowledge questionnaire (maximum score 38) on opioid safety. Patients were randomized to intervention: educational pamphlet, or control: standard care (no pamphlet) group. Questionnaires were repeated immediately post-education in the intervention group, and at 15, and 30 days after surgery in both groups. The primary outcome was change in knowledge score post-education in the intervention compared to control group. Secondary outcomes were immediate post-education, 15, and 30-day score, and answering safe storage, and disposal questions correctly.Results Between groups, the post-education score immediately after the intervention was higher in the intervention vs. control group baseline 34.2 [95% CI 33.1–35.3] vs 28.3 [95% CI 26.6–29.9]; P < 0.0001). In the intervention vs control group, mean scores were higher 31.6 (95% CI 30.5–32.7) vs 29.1 (95% CI 27.9–30.2; P = .002) at 15 days, and 32.4 (95%CI 31.4–33.5) vs 30.5 (95% CI 29.2–31.7; P = .017) at 30 days. Within the intervention group, the mean score immediately post-education (34.2 [95% confidence interval (CI) 33.1–35.3]) was higher than baseline (27.8 [95% CI 26.3–29.3]); P < 0.0001. Within the intervention group, the difference in mean score versus baseline was 3.8 (95% CI 2.1–5.5) at 15 days, and 4.6 (95% CI 2.9–6.3) at 30 days, (P < 0.05 for all timepoints). For safe disposal, a correct answer was given (intervention vs control group) by 100% vs 89.7% at 30 days (P = 0.04).Conclusions Within the intervention group, there was a significant improvement in knowledge on safe opioid use immediately post-education, and retention of knowledge at 15 and 30 days postoperatively. The intervention group had better knowledge scores compared to the baseline control group, and 15 and 30 days after surgery.Trial Registration: This study was registered in clinicaltrials.gov: NCT03959787 on May 22, 2019.

scholarly journals Cognitive Flexibility Moderates the Efficacy of a Visuospatial Intervention Following Exposure to Analog Trauma

2021 ◽  
Author(s):  
Alla Hemi ◽  
Roxanne Sopp ◽  
Ariel Perel ◽  
Emily A Holmes ◽  
Einat Levy-Gigi
Keyword(s):  
Cognitive Flexibility ◽  
Interactive Effect ◽  
Intervention Group ◽  
Clinical Samples ◽  
Control Group ◽  
Post Traumatic Stress ◽  
Intrusive Memories ◽  
Post Traumatic ◽  
The Impact

Objective: Intrusive memories are the hallmark feature of Post-Traumatic-Stress-Disorder (PTSD). Recent studies have found that a visuospatial intervention after viewing traumatic films reduces intrusive memories in healthy individuals. However, many individuals still exhibit high levels of symptoms following such an intervention, warranting continued investigation into specific characteristics moderating intervention effect. One such candidate is cognitive flexibility, defined as the ability to update behavior in accordance with contextual demands. The present study aimed at examining the interactive effect of cognitive flexibility and a visuospatial intervention on intrusive memories, predicting that higher flexibility would be linked to stronger intervention effects. Method: Sixty participants (Mage = 29.07, SD = 4.23) completed a performance-based paradigm evaluating cognitive flexibility, watched traumatic films, and were allocated to either an intervention or control group. Intrusions were assessed by means of laboratory and ambulatory assessment, and the Impact of Events Scale – Revised (IES-R). Results: Participants in the intervention group experienced fewer laboratory intrusions than the control group. However, this effect was moderated by cognitive flexibility: Whereas individuals with below-average cognitive flexibility did not benefit from the intervention, it was significantly beneficial for individuals with average and above-average cognitive flexibility. No group differences emerged in the number of ambulatory intrusions or IES-R scores. However, cognitive flexibility was negatively correlated with IES-R scores across both groups. Conclusions: These results highlight the significant role of cognitive flexibility in intrusion development, both in general and as a moderator of a visuospatial interventions. Future studies should investigate effects’ generalizability to clinical samples.

The impact of microfinance programs on monetary poverty reduction

2019 ◽  
Vol 16 (1) ◽  
pp. 30-43
Author(s):  
Mustafa Hassan Elsafi ◽  
Elsadig Musa Ahmed ◽  
Santhi Ramanathan
Keyword(s):  
Poverty Reduction ◽  
Poverty Line ◽  
Control Group ◽  
Microfinance Institutions ◽  
Content Type ◽  
Welfare Indicators ◽  
The Difference ◽  
Loan Size ◽  
The Impact

Purpose The purpose of this paper is to examine the impact of microfinance programs sponsored by Sudanese microfinance institutions (SMFIs) on monetary poverty reduction in Sudan where poverty is widely spread. Design/methodology/approach The study adopted the control group approach, where income and expenditure are taken as welfare indicators. The updated World Bank’s international poverty line of 1.90 per person per day was adopted to separate the poor from non-poor. The data were collected by the means of a questionnaire distributed to a random sample of beneficiaries in the institution under study. The study adapted the Foster, Greer and Thorbecke (FGT) model to evaluate the role of microfinance programs in poverty reduction. Furthermore, to gain more insight into the impact of the program, a preliminary analysis was conducted using the independent-samples t-test to examine the difference in the welfare indicators for the sample of the control group and treatment group as well as that of the small loan group and micro-loan group. Findings The findings show that the microfinance program provided by SMFIs has reduced the monetary poverty among the participants. The results also reveal that beneficiaries who had received a larger volume of loan were noted lesser poverty than those who had received very small loan size. Moreover, the results demonstrate that poverty indices based on expenditure as a welfare indicator are far lower than those based on income for both groups. Originality/value This study contributes to the available literature by filling the gaps through including income and expenditure as monetary variables, which included separately in previous studies adopted the FGT model in the area of microfinance, in addition to exploring the role of loan size in the effect of microfinance on poverty reduction.

scholarly journals DAMPAK ALOKASI DANA DESA BAGI PEMBANGUNAN DAERAH DAN KESEJAHTERAAN MASYARAKAT

2019 ◽  
Vol 1 (2) ◽  
pp. 164
Author(s):  
Alfian Mujiwardhani ◽  
Heru Wibowo ◽  
Iman Tri Mulya
Keyword(s):  
Economic Growth ◽  
Intervention Group ◽  
Physical Capital ◽  
Welfare Economic ◽  
Control Group ◽  
Fund Allocation ◽  
Education And Health ◽  
The Difference ◽  
The Impact ◽  
The Village

This study aims to evaluate the impact of the Village Fund allocation on the improvement of regional development, which is measured by improvements in physical capital, human capital, economy, and community welfare (economic growth, poverty, and unemployment). The Difference in Difference (DID) method is applied to estimate the effects of village fund allocation by comparing the changes in outcome between the district that get village fund allocation (intervention group) and the cities that did not (control group). The results of the study show that the Village Fund has an impact on improving the achievement of outputs in infrastructure, education and health services, as well as improving economic performance, but has not been able to improve welfare indicators. The Village Fund is expected to be able to increase economic growth in the short term, but it has not yet affected poverty and unemployment.

scholarly journals Effects of the Interactive Web-Based Video “Mon Coeur, Mon BASIC” on Drug Adherence of Patients with Myocardial Infarction: A Randomized Study (Preprint)

2020 ◽  
Author(s):  
Christel Bruggmann ◽  
Julien Adjedj ◽  
Sylvain Sardy ◽  
Olivier Muller ◽  
Pierre Voirol ◽  
...  
Keyword(s):  
Emergency Room ◽  
Interactive Video ◽  
Randomized Study ◽  
Intervention Group ◽  
Control Group ◽  
Drug Adherence ◽  
Emergency Room Visits ◽  
Web Based ◽  
The Difference ◽  
The Impact

BACKGROUND Secondary prevention strategies after acute coronary syndrome (ACS) presentation with the use of drug combinations are essential to reduce the recurrence of cardiovascular events. However, the lack of drug adherence is known to be common in this population, and to be related to treatment failure. To improve drug adherence, we developed the “Mon Coeur, Mon BASIC” web-based interactive video to inform patients about ACS and their drug treatments. OBJECTIVE To assess the impact of the web-based video on drug adherence. METHODS This randomized study was conducted with consecutive patients admitted to Lausanne University Hospital for ACS. We randomized patients to an intervention group, which had access to the video, and a control group receiving usual care. The primary outcome was the difference in drug adherence, assessed with the Adherence to Refills and Medication Scale [ARMS; nine multiple-choice questions, scores ranging from 12 (perfect adherence) to 48 (lack of adherence)], between groups at 1, 3, and 6 months. We assessed the difference in ARMS score between both groups with Wilcoxon rank sum test. Secondary outcomes were differences in knowledge and readmissions and emergency room visits between groups, and patients’ satisfaction with the video. RESULTS Sixty patients were included at baseline. The median age of the participants was 59 (IQR 49–69) and 85% were male. At 1 month, 51 patients participated in the follow up, 50 patients participated at 3 months, and 47 patients participated at 6 months. The mean ARMS scores at 1 and 6 months did not differ between the intervention and control groups (13.24 and 13.15, 13.52 and 13.68, respectively). At 3 months, this score was significantly lower in the intervention group than in the control group (12.54 vs. 13.75, P = .034). We observed significant increases in knowledge from baseline to 1 and 3 months, but not to 6 months, in the intervention group. Readmissions and emergency room visits have been very rare and the proportion was not different among groups. Patients in the intervention group were highly satisfied with the video. CONCLUSIONS The “Mon Coeur, Mon BASIC” web-based interactive video improved patients’ knowledge and seemed to have an impact on drug adherence. These results are encouraging, and the video will be offered to all patients admitted to our hospital with ACS. CLINICALTRIAL ClinicalTrials.gov NCT03949608; https://clinicaltrials.gov/ct2/show/NCT03949608

Role of Residency Interview Preparatory Activities as a Determinant on Pharmacy Residency Match Rates

2016 ◽  
Vol 30 (2) ◽  
pp. 219-222 ◽  
Author(s):  
Joshua Caballero ◽  
Sandra Benavides ◽  
Kevin A. Clauson ◽  
Patrick C. Hardigan ◽  
Jennifer G. Steinberg ◽  
...  
Keyword(s):  
Intervention Group ◽  
Control Group ◽  
Grade Point ◽  
Postdoctoral Training ◽  
Match Rate ◽  
Academic Settings ◽  
The Impact ◽  
Interview Group ◽  
Residency Match

Purpose: Different strategies have been implemented to assist students in securing residency positions. The purpose of this study was to explore the impact of student participation in residency preparation activities on match rates. Methods: A retrospective observational study was conducted to explore the effect of participation in residency preparation activities and grade point average (GPA) on residency match rate. Match rates for students participating in the Residency Interview Preparation Seminar (RIPS) or mock interviews (ie, intervention group) were compared with students who participated in neither activity (ie, control group). Results: A total of 118 individuals were included in the comparison. Forty-eight students participated in RIPS (n = 29) or mock interviews (n = 19), while 70 students were in the control group. The intervention group had a statistically larger proportion of students securing residency than the control group (81% vs 57%; P = .009). Match rates between students enrolled in RIPS versus those in the mock interview group were not significant. No statistically significant differences were observed based on GPA. Conclusion: Students receiving additional preparation prior to interviews when seeking postdoctoral training were significantly more likely to obtain a residency position. In academic settings with limited resources, mock interviews may be preferred over comprehensive preparatory courses.

A Tablet-Based Educational Tool: Toward More Comprehensive Pediatric Patient Education

2018 ◽  
Vol 57 (10) ◽  
pp. 1176-1182 ◽  
Author(s):  
Dana C. Clifton ◽  
Robert W. Benjamin ◽  
Audrey R. Brown ◽  
Daniel A. Ostrovsky ◽  
Aditee P. Narayan
Keyword(s):  
Patient Education ◽  
Mobile Technology ◽  
Pediatric Population ◽  
Statistical Significance ◽  
Intervention Group ◽  
Control Group ◽  
Diabetes Clinic ◽  
Pediatric Diabetes ◽  
The Difference ◽  
The Impact

There is a paucity of data on the impact of mobile technology on physician-led education in the pediatric population. We performed a prospective pilot study in a pediatric diabetes clinic to evaluate the impact of tablet-based patient education. A total of 106 patients and caregivers completed postclinic surveys, 64 (60%) in the intervention group and 42 (40%) in the control group. The majority of the intervention group patients (86%) liked tablet use and felt it was better or similar (99%) to baseline. Moreover, a majority receiving tablet-based education perceived an increase in diabetes knowledge (57%) compared with baseline (39%), though the difference did not reach statistical significance ( P = .059). Those who received tablet-based education felt they were educated on more diabetes-related topics. As the use of mobile technology in medicine grows, additional research is needed to compare mobile technology with traditional methods in providing education to the pediatric population.

The role of supine and prone positions on central nervous system involvement in patients with acute lymphoblastic leukemia

2021 ◽  
Author(s):  
Azam Hashemi
Keyword(s):  
Prone Position ◽  
Lymphoblastic Leukemia ◽  
Intervention Group ◽  
Intrathecal Chemotherapy ◽  
Control Group ◽  
Post Injection ◽  
Cns Involvement ◽  
The Mean ◽  
The Difference

Background: Acute lymphoblastic leukemia (ALL) affects both children and adults, with a peak incidence between the ages of 2 and 5 years. ALL cells sometimes penetrate the central nervous system (CNS) and patients with CNS diseases at initial presentation have been reported to experience a significantly greater risk of treatment failure compared with CNS negative patients. This study hypothesized that the prone position may reduce the CNS involvement compared with the supine position, therefore the aim of this study was to evaluate the role of supine and prone positions on CNS involvement in ALL patients. Materials and Methods: This randomized clinical trial was conducted on 38 patients with ALL admitted in Shahid saddughi Hospital from 2006 to 2016. In this study, 14 patients received prophylaxis intrathecal chemotherapy with post-injection supine position (control group) and 22 patients received prophylaxis intrathecal chemotherapy with post-injection prone position (intervention group) White blood cell (WBC) count (CNS involvement) was evaluated in two groups. Results: Among 22 patients in the intervention group, 16 (72.7%) were males, and 6 (27.3%) were females and of the 14 patients in the control group, 8 (57.1%) were males and 6 (42.9%) were females. The difference in the mean WBCs in the cerebrospinal fluid between the two groups was as follows: the mean WBCs in the control group was 8.7143 and the mean WBCs in the intervention group was 4.9524. The difference between the two groups was statistically significant (P-value =0.039). However, no significant difference was seen between the two groups in terms of sex, age, and duration of disease (p>0.05). Conclusion: The incidence of CNS involvement was significantly decreased when patients were placed in the post-puncture prone position for 3 hours.

scholarly journals ‘Screen and Treat for Anaemia Reduction (STAR)’ strategy: study protocol of a cluster randomised trial in rural Telangana, India

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052238
Author(s):  
Bharati Kulkarni ◽  
Little Flower Augustine ◽  
Raghu Pullakhandam ◽  
Anju Sinha Pradhan ◽  
Teena Dasi ◽  
...  
Keyword(s):  
Rural Areas ◽  
Randomised Trial ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Cluster Randomised Trial ◽  
Control Group ◽  
Population Mean ◽  
Cluster Randomised ◽  
The Difference ◽  
The Impact

IntroductionCurrent anaemia control programme focusing on prophylactic iron supplementation and facility-based screening with haemoglobin estimation is inadequate to reduce the high prevalence of anaemia in India. This study aims to examine the impact of community level ‘screen and treat’ strategy for increasing population mean haemoglobin and reducing anaemia prevalence in the rural population.Methods and analysisAn open-labelled cluster randomised controlled trial will be conducted in rural areas of Medchal district, Telangana, India. All individuals served by one Accredited Social Health Activist (ASHA) constitute one cluster and will be randomised in the ratio of 1:1 by covariate constrained randomisation. Eligible members aged between 6 months and 50 years (men, women, children and adolescents) will be included in the study. Intervention group will be screened for anaemia using a point of care haemoglobin estimation followed by treatment with iron–folic acid for 3 months. The intervention delivered by the ASHAs will be supported by an electronic decision support system and simplified medication regimen. Educational videos and interactive voice response system will be used to enhance compliance. The control group will continue to receive benefits of ongoing anaemia control programmes but there will be no active intervention by the study team. At 6 months, haemoglobin will be measured in participants from both arms. The primary outcome will be the difference in population mean haemoglobin in two arms and the secondary outcome will be the difference in the anaemia prevalence in two arms among 6–59 months old children. Multilevel models will be used for analysis accounting for data clustering.Ethics and disseminationThe study is approved by the institutional ethics committee of National Institute of Nutrition, Hyderabad. The results will be published in peer-reviewed journals and disseminated to policymakers. Findings will also be shared with study participants and community leaders.Trial registration numberCTRI/2019/01/016918.

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