Remote Hospital Care for Recovering COVID-19 Patients Using Telemedicine: A Randomised Controlled Trial

Background: To ensure availability of hospital beds and improve COVID-19 patients’ well-being during the ongoing pandemic, hospital care could be offered at home. Retrospective studies show promising results of deploying remote hospital care to reduce the number of days spent in the hospital, but the beneficial effect has yet to be established. Methods: We conducted a single centre, randomised trial from January to June 2021, including hospitalised COVID-19 patients who were in the recovery stage of the disease. Hospital care for the intervention group was transitioned to the patient’s home, including oxygen therapy, medication and remote monitoring. The control group received in-hospital care as usual. The primary endpoint was the number of hospital-free days during the 30 days following randomisation. Secondary endpoints included health care consumption during the follow-up period and mortality. Results: A total of 62 patients were randomised (31 control, 31 intervention). The mean difference in hospital-free days was 1.7 (26.7 control vs. 28.4 intervention, 95% CI of difference −0.5 to 4.2, p = 0.112). In the intervention group, the index hospital length of stay was 1.6 days shorter (95% CI −2.4 to −0.8, p < 0.001), but the total duration of care under hospital responsibility was 4.1 days longer (95% CI 0.5 to 7.7, p = 0.028). Conclusion: Remote hospital care for recovering COVID-19 patients is feasible. However, we could not demonstrate an increase in hospital-free days in the 30 days following randomisation. Optimising the intervention, timing, and identification of patients who will benefit most from remote hospital care could improve the impact of this intervention.

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Assessing the impact of the European resilience curriculum in preschool, early and late primary school children

School Psychology International ◽

10.1177/01430343211025075 ◽

2021 ◽

pp. 014303432110250

Author(s):

Celeste Simões ◽

Anabela C. Santos ◽

Paula Lebre ◽

João R. Daniel ◽

Cátia Branquinho ◽

...

Keyword(s):

Mental Health ◽

Intervention Group ◽

Well Being ◽

Primary School Children ◽

Control Group ◽

Physical And Mental Health ◽

Quasi Experimental ◽

Mental Health Difficulties ◽

Prosocial Behaviours ◽

The Impact

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.

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Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients

Palliative & Supportive Care ◽

10.1017/s1478951511000423 ◽

2011 ◽

Vol 9 (4) ◽

pp. 401-406 ◽

Cited By ~ 20

Author(s):

Dana Lustbader ◽

Renee Pekmezaris ◽

Michael Frankenthaler ◽

Rajni Walia ◽

Frederick Smith ◽

...

Keyword(s):

Length Of Stay ◽

Palliative Medicine ◽

Intervention Group ◽

Hospital Length Of Stay ◽

Rank Test ◽

Control Group ◽

Do Not Resuscitate ◽

Log Rank Test ◽

The Impact ◽

Reduced Time

AbstractObjective:The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who died during hospitalization.Method:A comparison of two retrospective cohorts in a 17-bed MICU in a tertiary care university-affiliated hospital was conducted. Patients admitted to the MICU between January 1, 2003 and June 30, 2004 (N = 515) were compared to MICU patients who had had a palliative medicine consultation between January 1, 2005 and June 1, 2009 (N = 693). To control for disease severity, only patients in both cohorts who died during their hospitalization were considered for this study.Results:Palliative medicine consultation reduced time until death during the entire hospitalization (log-rank test,p < 0.01). Time from MICU admission until death was also reduced (log-rank test,p < 0.01), further demonstrating the impact of the palliative care consultation on the duration of dying for hospitalized patients. The intervention group contained a significantly higher percentage of patients with a DNR designation at death than did the control group (86% vs. 68%, χ2test,p < 0.0001).Significance of results:Palliative medicine consultation is associated with an increased rate of DNR designation and reduced time until death. Patients in the intervention group were also more likely to die outside the MICU as compared to controls in the usual care group.

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Supporting Children Who Experience Domestic Violence: Evaluating the Child Witness to Domestic Violence Program

Journal of Interpersonal Violence ◽

10.1177/08862605211035874 ◽

2021 ◽

pp. 088626052110358

Author(s):

Erin C. Schubert

Keyword(s):

Domestic Violence ◽

Intervention Group ◽

Well Being ◽

The United States ◽

Control Group ◽

Child Witness ◽

Negative Consequences ◽

Emotional Symptoms ◽

Child Gender ◽

The Impact

Impacting 1 in 4 children in the United States, childhood exposure to domestic violence predicts myriad negative sequelae. Intervening post exposure is critical to help children and their protective parent heal and avoid long-term negative consequences. Children aged 2-17 and their mothers who were victims of domestic violence participated in a 12-week group program delivered by domestic violence agency staff that provides psychoeducation on the impact of trauma and domestic violence and aims to improve parent and child well-being. The impact of the Child Witness to Domestic Violence (CWDV) program was tested in an intervention group ( n = 69 children, 33 mothers) who participated in CWDV and control group ( n = 80 children, 39 mothers) consisting of children whose mothers received adult-focused domestic violence services but were not enrolled in CWDV or other child-focused services. Multiple regression analyses controlling for child gender, child age, mother’s age, and the outcome of interest at time 1 found that participation in CWDV program significantly predicted better child functioning as indicated by less hyperactivity ( B = –.85, p = .06), fewer negative emotional symptoms ( B = –1.14, p = .01), and fewer total behavioral difficulties ( B = –2.48, p = .02) as well as higher maternal hope ( B = .57, p = .03). These data provide promising evidence of the impact of a brief, replicable group intervention that promotes healing and well-being among children and parents exposed to domestic violence. Limitations include a quasi-experimental design and reliance on maternal report.

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PHARMACEUTICAL CARE OF ADOLESCENTS WITH DIABETES MELLITUS TYPE 1: THE DIADEMA STUDY, A RANDOMIZED CONTROLLED TRIAL

Archives of Disease in Childhood ◽

10.1136/archdischild-2015-310148.7 ◽

2015 ◽

Vol 101 (1) ◽

pp. e1.67-e1

Author(s):

Emina Obarčanin ◽

Manfred Krueger ◽

Petra Mueller ◽

Verena Nemitz ◽

Holger Schwender ◽

...

Keyword(s):

Diabetes Mellitus ◽

Pharmaceutical Care ◽

Intervention Group ◽

Well Being ◽

Diabetes Mellitus Type ◽

Control Group ◽

Randomized Controlled ◽

Phone Calls ◽

The Impact

BackgroundAdolescents with type 1 diabetes mellitus (T1DM) often show low adherence to complex insulin regimens, leading to poor glycemic control. The benefit of pharmaceutical care in adults with diabetes mellitus type 2 (T2DM) has been widely explored; however, evidence in adolescents with T1DM remains scarce.ObjectiveTo evaluate the impact of pharmaceutical care in adolescents with T1DM provided by a multidisciplinary team on multiple important clinical outcomes.SettingAt the outpatient Helios Paediatric Clinic and at the 12 regular community pharmacies of the study patients with 14 pharmacists in the Krefeld area, Germany, and at the University Pediatric Clinic with one pharmacist on-site in Sarajevo, Bosnia-Herzegovina.MethodsA randomized, controlled, prospective, multicenter study in 68 adolescents with T1DM. The intervention group received monthly structured pharmaceutical care delivered by pharmacists plus supplementary phone calls for 6 months. The control group received usual diabetic care. Data were collected at baseline and after 3 and 6 months. In addition, HbA1c was measured after 12 months.Main outcome measures The between-group difference in the change from baseline in glycosylated hemoglobin (HbA1c), the number of severe hypoglycemic events in both groups, and patient well-being in the intervention group.ResultsThe improvement from baseline in HbA1c was significantly greater in the intervention group than in the control group after 6 months (change from baseline −0.54 vs. +0.32%, p=0.0075), even after adjustment for country-specific variables (p=0.0078). However, the effect was more pronounced after only 3 months (−1.09 vs. +0.23%, p=0.00002). There was no significant between-group difference in the number of severe hypoglycemia events. After 6 months, the well-being according to the WHO-5 index in the intervention group increased significantly from 52.8% to 63.3%. After 12 months the mean total HbA1c remained significantly reduced in the intervention compared to the control group (8.6% vs. 9.5%, p=0.0184).ConclusionThe improved outcomes seen in this study provide new evidence that pharmaceutical care adds value to the management of T1DM in adolescents. However, the optimal methods of achieving sustained long-term improvements in this specific patient population require further study.

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Evaluating the Impact of Teacher-designed, Wellbeing and Sustainability Play-based Learning Experiences on Young Children's Knowledge Connections: A Randomised Trial

Australasian Journal of Early Childhood ◽

10.23965/ajec.43.4.04 ◽

2018 ◽

Vol 43 (4) ◽

pp. 33-42

Author(s):

Heather Morris ◽

Susan Edwards ◽

Amy Cutter-Mackenzie ◽

Leonie Rutherford ◽

Janet Williams-Smith ◽

...

Keyword(s):

Digital Media ◽

Randomised Trial ◽

Learning Experiences ◽

Intervention Group ◽

Parent Report ◽

Control Group ◽

Post Intervention ◽

Waitlist Control Group ◽

Children's Interests ◽

The Impact

THIS PAPER REPORTS FINDINGS from a randomised investigation into the effect of teacher-designed, play-based learning experiences on preschool-aged children's knowledge connections between healthy eating and active play as wellbeing concepts, and sustainability. The investigation used a ‘ funds of knowledge’ theoretical framework to situate young children's interests in digital media and popular culture, as a site for learning these knowledge connections. The findings suggest that the intervention group children created more wellbeing and sustainability knowledge connections than the waitlist control group children. Additionally, the intervention group children demonstrated an increase in vegetable serves and a decrease in unhealthy food servings post intervention (measured by parent report). The paper suggests that more attention should be paid to early childhood teachers’ capacity for actively building children's knowledge about wellbeing and sustainability concepts through play-based learning, as opposed to top-down approaches towards obesity education and prevention alone.

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The Effect of Cyberspace-based Education on the Well-Being of Caregivers of Elderly People with Dementia

Current Aging Science ◽

10.2174/1874609814666210208180051 ◽

2021 ◽

Vol 14 ◽

Author(s):

Yadollah Abolfathi Momtaz ◽

Parisa Mollaei ◽

Parisa Taheri-Tanjani

Keyword(s):

Elderly People ◽

Negative Impact ◽

Intervention Group ◽

Well Being ◽

World Health ◽

Control Group ◽

People With Dementia ◽

Age Related ◽

Significant Difference ◽

The Impact

Introduction: One of the consequences of aging is the prevalence of chronic and age-related diseases, such as dementia. Caring for patients with dementia has a negative impact on the caregiver's well-being. This study aimed to examine the impact of cyberspace-based education on the well-being of caregivers of demented elderly people. Methods: This experimental study was done on a sample of 86 caregivers of elderly with dementia in 2018. The study sample was selected from memory clinic of Taleghani Hospital and randomly assigned into groups (intervention n = 43, control n = 43 groups). The well-being was measured using the World Health Organization - Five Well-Being Index (WHO-5), before and two months after the intervention. Cyberspace-based educational intervention was conducted for one month. The SPSS software version 23 was employed in data analysis. Results: The mean age of the caregivers in the intervention and control groups were (M = 51.95, SD = 10.90) and (M = 51.36, SD = 15.12) respectively. No significant difference was found between two groups in terms of age, gender and level of education. The results of analysis showed that while the well-being of the intervention group was significantly increased (t (38) = -11.38, P<0.001) the well-being in the control group was significantly reduced ( t(36) =4.71 , P<0.001). Conclusion: The findings showed that cyberspace-based education can improve the well-being of caregivers of the elderly with dementia.

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A Multicenter Stewardship Initiative to Decrease Excessive Duration of Antibiotic Therapy for the Treatment of Community-Acquired Pneumonia (CAP)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx162.151 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S63-S64

Author(s):

Farnaz Foolad ◽

Angela Huang ◽

Cynthia Nguyen ◽

Lindsay Colyer ◽

Megan Lim ◽

...

Keyword(s):

Antibiotic Therapy ◽

Clinical Outcomes ◽

Intervention Group ◽

Total Duration ◽

Audit And Feedback ◽

Patient Specific ◽

Control Group ◽

Duration Of Therapy ◽

The Impact ◽

Research Grant

Abstract Background Hospitals have implemented multifaceted approaches to quickly identify CAP, start timely therapy, and reduce hospital readmission, yet there has been minimal focus on providing appropriate duration of therapy. The IDSA CAP guidelines recommend 5 days of antibiotic therapy for patients that are clinically stable and quickly defervesce. However, previous publications suggest duration of therapy for CAP may be unnecessarily prolonged. Methods The objective of this multicenter, quasi-experimental study of hospitalized patients with CAP was to assess the impact of a prospective 6-month stewardship intervention on total duration of antibiotic therapy and associated clinical outcomes. All centers updated institutional CAP guidelines to promote IDSA-concordant durations of therapy and provided education to pharmacists and prescribers. Daily patient-specific prospective audit and feedback was provided by infectious diseases stewardship pharmacists to optimize compliance with guideline recommendations. Results A total of 600 patients were included (307 in the historic control group and 293 in the stewardship intervention group). The stewardship intervention led to significantly increased rates of compliance with IDSA duration of therapy recommendations (5.6% vs. 41.4%, P< < 0.01) and significantly reduced the duration of therapy for CAP (9 vs. 6 days, P < 0.01). Inappropriate days of antibiotic therapy was reduced in the intervention group (4 vs. 1.6 days, P < 0.01), and total avoidance of 720 excessive days of antibiotic therapy. Clinical outcomes, including mortality, length of hospitalization, readmission to hospital with pneumonia, presentation to the ER/clinic with pneumonia within 30 days of discharge, and incidence of C. difficilecolitis, were not different between groups. Conclusion This multicenter evaluation of a prospective stewardship intervention in hospitalized CAP patients reduced the total duration of antibiotic therapy and increased compliance with guideline-concordant duration of therapy without adversely affecting patient outcomes. This project was funded through a competitive stewardship grant provided by Merck & Co. Disclosures A. Huang, Merck: Grant Investigator, Research grant; C. Nguyen, Merck: Grant Investigator, Research grant; J. Grieger, Merck: Grant Investigator, Research grant; S. Revolinski, Merck: Grant Investigator, Research grant; J. Li, Merck: Grant Investigator, Research grant; M. Mack, Merck: Grant Investigator, Research grant; J. N. Wainaina, Merck: Grant Investigator, Research grant; G. Eschenauer, Merck: Grant Investigator, Research grant; T. Patel, Merck: Grant Investigator, Research grant; V. Marshall, Merck: Grant Investigator, Research grant; J. Nagel, Merck: Grant Investigator, Research grant

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Impact of nurse-initiated education on HeartScore in patients with hypertension: a randomised trial

British Journal of Nursing ◽

10.12968/bjon.2021.30.12.722 ◽

2021 ◽

Vol 30 (12) ◽

pp. 722-728

Author(s):

Anastasia A Chatziefstratiou ◽

Nikolaos V Fotos ◽

Konstantinos Giakoumidakis ◽

Hero Brokalaki

Keyword(s):

Cardiovascular Risk ◽

Randomised Trial ◽

Intervention Group ◽

Educational Interventions ◽

Control Group ◽

Randomised Study ◽

Best Management ◽

Significant Damage ◽

The Impact ◽

Increase In Risk

Background: People with hypertension experience significant damage to major organs due to insufficient management of cardiovascular risk factors. Aims: To assess the impact of nurse-led educational interventions on the total cardiovascular risk among people with hypertension. Method: the study was an interventional randomised study. The sample (n=92) was randomly assigned to the either the control or intervention group. The HeartScore tool was used to assess patients' total cardiovascular risk between December 2017 and March 2018. Findings: 56.6% of the control group and 55.4% of the intervention group were women, with a mean age of 64.4 years and 66.2 years respectively (P>0.05). Total cholesterol reduced in both groups; however, improvement was greater in the intervention group (P<0.05). Total cardiovascular risk fell in the intervention group from 4.75 to 4.33 (P>0.05), while the control group saw an increase in risk from 10.03 to 12.65 (P=0.035). Conclusion: Nurse-led educational interventions should be incorporated in the usual care of patients with hypertension, in order to achieve the best management of the condition.

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Assessing the Impact of an Intervention Project by the Young women's Christian Association of Malawi on Psychosocial Well-Being of Adolescent Mothers and Their Children in Malawi

Frontiers in Public Health ◽

10.3389/fpubh.2021.585517 ◽

2021 ◽

Vol 9 ◽

Author(s):

Mtisunge Kachingwe ◽

Ibrahim Chikowe ◽

Lotte van der Haar ◽

Nettie Dzabala

Keyword(s):

Early Childhood ◽

Adolescent Mothers ◽

Psychosocial Support ◽

Intervention Group ◽

Well Being ◽

Self Esteem ◽

Control Group ◽

Parenting Skills ◽

Young Women's Christian Association ◽

The Impact

Adolescent mothers in Malawi face psychosocial challenges such as low resilience level, low self-esteem, poor maternal-infant interaction, and exposure to intimate partner violence (IPV). Children of adolescent mothers often face numerous risks such as low birth-weight, stunted growth, infant death, low school enrolment, increased grade repetition, and dropouts that put them at greater risk of poor developmental outcomes and socio-emotional problems. This study assessed the impact of components of a community project conducted by the Young Women's Christian association of Malawi in providing psychosocial support to adolescent mothers and their children. The goals of the project were; (1) to improve early childhood development in babies born to adolescent mothers; and (2) to enhance the psychosocial well-being of adolescent mothers (self-esteem, resilience stress, and parenting skills). This descriptive mixed methods evaluation study comprised an intervention and control groups of adolescent mothers respectively. The project had 3 centers in southern region districts of Malawi. Target population was adolescent mothers 18 years of age and below. At baseline we enrolled 267 mothers and at the end of the project we had 211 mothers. The project involved monthly meetings with adolescent mothers imparting knowledge and skills and early childhood education activities. From July 2017 to June 2019, 58 sessions were conducted. In the first year the control group had no meetings, however they received the intervention in the second year. Overall results in the intervention group showed statistically significant increase in knowledge on parenting skills (p < 0.01), nutritional practice (p < 0.01), motor skills and cognitive functions in children (p < 0.01) as well as expressive language and socio-emotional capacities in children (p < 0.01), while the change in confidence and psychosocial well-being was not statistically significant (p = 0.8823). Community projects such as these enhance parenting skills and improve development of children born to adolescent mothers. Improving psychosocial support is complex and requires further research and a more holistic approach.

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The impact of preoperative education in satisfaction and postoperative outcomes of patients undergoing cardiac surgery

Health & Research Journal ◽

10.12681/healthresj.19643 ◽

2019 ◽

Vol 2 (1) ◽

pp. 46

Author(s):

Antonia Kalogianni ◽

Georgios Georgiadis ◽

Olga Katselou ◽

Olga Kadda ◽

Aikaterini Sotiropoulou ◽

...

Keyword(s):

Cardiac Surgery ◽

Intervention Group ◽

Hospital Length ◽

Postoperative Outcomes ◽

Hospital Length Of Stay ◽

Control Group ◽

Patient Centered ◽

Preoperative Education ◽

Elective Cardiac Surgery ◽

The Impact

Introduction: The effectiveness of preoperative education in postoperative course of cardiac surgery patients has been questioned. Aim: To estimate the impact of preoperative education in satisfaction and postoperative outcomes of patients undergoing cardiac surgery. Material and Method: A quasi-experimental trial was conducted. Sixty nine patients who admitted for elective cardiac surgery were divided randomly in intervention (34) and control group (35). Intervention group received written and verbal education based on patient centered communication by specially trained nurses. Patients’ satisfaction, postoperative complications and hospital length of stay (LOS) was measured. Results: Scores on all dimensions of satisfaction were greater for intervention group (p<0,001).No difference found for complications in intensive care unit (ICU) (p=0,150) in both groups. The total complications was lower (p=0,028) in intervention group with a lower proportion of arrhythmia (p=0,011). The median LOS in ICU was shorter for intervention group (p=0,035). No difference found in median hospital LOS in either group. Conclusions: Nurse-led preoperative education increases satisfaction of patients undergoing cardiac surgery and may have an effect on LOS shortening and complications control.

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