Effect of Nutrition Education in NAFLD Patients Undergoing Simultaneous Hyperlipidemia Pharmacotherapy: A Randomized Controlled Trial

Background: Patients with non-alcoholic fatty liver disease (NAFLD) have a high prevalence of combined hyperlipidemia. The importance of nutritional education is well-known in NAFLD, but the impact of medical nutrition therapy (MNT) is unclear in patients with NAFLD with hyperlipidemia. The purpose of this study is to investigate the effect of MNT on the improvement of steatohepatitis in patients with NAFLD taking antihyperlipidemic medications. Methods: Nondiabetic patients with dyslipidemia were prospectively randomized (1:1) either to the MNT group or the control group with standard advice for 48 weeks with simultaneous statin/ezetimibe combination pharmacotherapy at three tertiary centers in Korea. Results: Sixty-six patients were enrolled. Among them, 18 patients dropped out and, overall, 48 patients (MNT group 27, control group 21) were prospectively analyzed in the study. The serum ALT level at 48 weeks between the two groups was not significantly different (66.6 ± 37.7 IU/L vs. 57.4 ± 36.7 IU/L, p = 0.40). Serum liver enzymes, controlled attenuation parameter and fibrosis-4 index were significantly improved within the MNT group after 48 weeks compared to baseline. There was no significant difference between the two groups other than the NAFLD fibrosis score (p = 0.017). Conclusions: Although there were no significant differences between the two groups in terms of steatosis, metabolic and fibrosis surrogate indicators after 48 weeks, MNT groups showed significant improvement within patient analysis over time. Future studies with a larger number of subjects and a longer study period regarding the effect of MNT are warranted.

Download Full-text

Reducing the Social Stigma Associated with Obsessive Compulsive Disorder: A Controlled Trial of an Intervention Program in a Turkish Community Sample

Journal of Evidence-Based Psychotherapies ◽

10.24193/jebp.2020.2.14 ◽

2020 ◽

Vol 20 (2) ◽

pp. 101-120

Author(s):

Ayça Aktaç Gürbüz ◽

Orçun YORULMAZ ◽

Gülşah DURNA

Keyword(s):

Obsessive Compulsive Disorder ◽

Intervention Program ◽

Controlled Trial ◽

Community Sample ◽

Case Vignette ◽

Control Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Significant Difference ◽

The Impact

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.

Download Full-text

Impact of an Amaranth-Sorghum Grains Product on Nutrient Intake of Children Aged 6-23 Months in Kiandutu Slums, Thika, Kenya

10.37512/700 ◽

2020 ◽

Keyword(s):

Nutrition Education ◽

Nutrient Intake ◽

Controlled Trial ◽

Poor Quality ◽

Control Group ◽

Composite Flour ◽

Monthly Basis ◽

Sorghum Flour ◽

Baseline Characteristics ◽

The Impact

Poor quality complementary foods contribute to undernutrition in children aged 6-23 months. Therefore, there is need to explore foods that will provide adequate nutrients for this age group. This study aimed at determining the impact of a sorghum-amaranth composite flour porridge on nutrient intake of children aged 6-23 months. A randomized controlled trial was conducted at Kiandutu slum, Thika, Kenya. Children in the control group (CG), received a maize-sorghum flour while those in the treatment group (TG) received an amaranth-sorghum flour. The sample size per study group was 73 mother-child pairs. The children in the TG received Kcal 1000 worth of porridge/day while those in the CG received Kcal 266.8/day. Mothers of children in both groups were given nutrition education at baseline, and monthly, for six months. Food intake data was taken at baseline, then monthly for six months. Descriptive statistics were used to describe nutrient intake. Chi square and Mann Whitney U test were was used to compare the baseline characteristics of the two groups and their nutrient intake, respectively. At baseline characteristics of the two groups were similar. On a monthly basis, nutrient intake in the TG was significantly higher for a majority of the nutrients than in the CG. The product can contribute to preventing under-nutrition in children aged 6-23 months.

Download Full-text

A143 IMPACT OF A SIMULATION-BASED AUGMENTED REALITY CURRICULUM ON POLYPECTOMY SKILLS AMONG NOVICE ENDOSCOPISTS: A RANDOMIZED CONTROLLED TRIAL

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.142 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 5-7

Author(s):

R Khan ◽

M A Scaffidi ◽

N Gimpaya ◽

D Tham ◽

M Atalla ◽

...

Keyword(s):

Augmented Reality ◽

Ad Hoc ◽

Controlled Trial ◽

Skill Training ◽

Control Group ◽

Small Group Teaching ◽

Significant Difference ◽

Simulation Based ◽

Free Environment ◽

The Impact

Abstract Background Polypectomy is an essential endoscopic skill. Training in polypectomy has been identified as a major deficiency for endoscopists worldwide as polypectomy occurs ad hoc during a colonoscopy when a polyp is detected, and a lack of standardized curricula. Augmented reality (AR), which superimposes computer-generated images on a user’s view of the world, can address these gaps by standardizing encounters with polyps while completing simulated procedures and enabling polypectomy-specific teaching. Aims Evaluate the impact of a simulation-based augmented reality curriculum on polypectomy performance among novice endoscopists. Methods This study includes two cohorts of participants from 2019 to 2020. In 2019, participants were randomized into either: (1) a control curriculum, involving 6 hours of simulation-based training (SBT) supplemented by expert feedback, interlaced with 4 hours of small group teaching on the theory of colonoscopy; or (2) the augmented reality curriculum (ARC), in involving the same curriculum with integrated AR, wherein participants engaged with an AR-enhanced video demonstrating relevant therapeutic and pathologic details during polypectomy. The SBT for all participants involved a progressive curriculum starting on a bench-top model and then moving to the EndoVR® virtual reality simulator. The primary outcome was polypectomy-specific performance using the Direct Observation of Polypectomy Skills (DOPyS) tool during a simulated polypectomy after training, with a maximum score of 100. Results Demographic characteristics are summarized in Table. In 2019, 21 novice endoscopists were enrolled. Immediately after training, the mean DOPyS score among ARC group participants was 76.2 (SD=17.9) compared to 71.8 (SD=13.2) among control group participants (Figure). In this interim analysis, there was no significant difference between groups. Data analysis will be completed after 2020 participants complete the study. Conclusions Interim results show a trend towards improved polypectomy performance with no significant difference. The results of this study have the potential to impact polypectomy education among novices. Simulation-based AR interventions may allow learners to progress towards achieving competency in polypectomy in a risk-free environment prior to first patient contact. Funding Agencies None

Download Full-text

A Nutrition Education Intervention Using NOVA Is More Effective Than MyPlate Alone: A Proof-of-Concept Randomized Controlled Trial

Nutrients ◽

10.3390/nu11122965 ◽

2019 ◽

Vol 11 (12) ◽

pp. 2965

Author(s):

Aydin Nazmi ◽

Marilyn Tseng ◽

Derrick Robinson ◽

Dawn Neill ◽

John Walker

Keyword(s):

Nutrition Education ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Education Intervention ◽

Proof Of Concept ◽

Food Groups ◽

Randomized Controlled ◽

The Impact ◽

Level Of Processing

The ability to classify foods based on level of processing, not only conventional MyPlate food groups, might be a useful tool for consumers faced with a wide array of highly processed food products of varying nutritional value. The objective of this study was to assess the impact of a proof-of-concept nutrition education intervention on nutrition knowledge, assessed by correct classification of foods according to MyPlate food groups, MyPlate ‘limit’ status (for fat, sugar, sodium), and level of processing (NOVA categories). We utilized a randomized, controlled design to examine the impact of a MyPlate vs. combined MyPlate + NOVA intervention vs. control group. Intervention groups received educational flyers via email and participants were assessed using electronic baseline and follow-up surveys. The MyPlate + NOVA intervention group performed at least as well as the MyPlate group on classifying conventional food groups and ‘limit’ status. Moreover, the MyPlate + NOVA group far outperformed the other groups on classifying NOVA categories. Longer-term trials are needed, but our results suggest that NOVA principles may be more easily understood and applied than those of MyPlate. Education strategies focusing on level of food processing may be effective in the context of the modern food environment.

Download Full-text

Perioperative rifaximin is not associated with enhanced functional and volumetric recovery after major liver resection

Scientific Reports ◽

10.1038/s41598-021-97442-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jan Bednarsch ◽

Zoltan Czigany ◽

Sven H. Loosen ◽

Lara Heij ◽

Lorenz Ruckgaber ◽

...

Keyword(s):

Liver Function ◽

Primary Endpoint ◽

Major Hepatectomy ◽

Controlled Trial ◽

Liver Volume ◽

Relative Increase ◽

Control Group ◽

Open Label ◽

Significant Difference ◽

The Impact

AbstractThe objective of this randomized controlled trial (RCT) was to assess the impact of rifaximin on the course of liver function, liver regeneration and volumetric recovery in patients undergoing major hepatectomy. The ARROW trial was an investigator initiated, single-center, open-label, phase 3 RCT with two parallel treatment groups, conducted at our hepatobiliary center from 03/2016 to 07/2020. Patients undergoing major hepatectomy were eligible and randomly assigned 1:1 to receive oral rifaximin (550 mg twice daily for 7–10 or 14–21 days in case of portal vein embolization preoperatively and 7 days postoperatively) versus no intervention. Primary endpoint was the relative increase in postoperative liver function measured by LiMAx from postoperative day (POD) 4 to 7. Secondary endpoint were the course of liver function and liver volume during the study period as well as postoperative morbidity and mortality. Between 2016 and 2020, 45 patients were randomized and 35 patients (16 individuals in the rifaximin and 19 individuals in the control group) were eligible for per-protocol analysis. The study was prematurely terminated following interim analysis, due to the unlikelihood of reaching a significant primary endpoint. The median relative increase in liver function from POD 4 to POD 7 was 27% in the rifaximin group and 41% in the control group (p = 0.399). Further, no significant difference was found in terms of any other endpoints of functional liver- and volume regeneration or perioperative surgical complications following the application of rifaximin versus no intervention. Perioperative application of rifaximin has no effect on functional or volumetric regeneration after major hepatectomy (NCT02555293; EudraCT 2013-004644-28).

Download Full-text

Community-based culinary and nutrition education intervention promotes fruit and vegetable consumption

Public Health Nutrition ◽

10.1017/s1368980021003797 ◽

2021 ◽

pp. 1-13

Author(s):

Jessica Jarick Metcalfe ◽

Melissa Pflugh Prescott ◽

Melissa Schumacher ◽

Caitlin Kownacki ◽

Jennifer McCaffrey

Keyword(s):

Nutrition Education ◽

Vegetable Consumption ◽

Controlled Trial ◽

Fruit And Vegetable Consumption ◽

Control Group ◽

Fruit And Vegetable ◽

Structured Interviews ◽

Post Intervention ◽

Cooking Classes ◽

The Impact

Abstract Objective: The main objective of this study was to evaluate the impact of the Market to MyPlate (M2MP) program on fruit and vegetable consumption and cooking behaviours. Secondary objectives were to examine factors that affected participant retention and program completion, and analyse program feedback provided by participants. Design: This study conducted a mixed methods evaluation embedded within a cluster randomised controlled trial of the M2MP intervention. Adult participants completed a pre- and post-program survey reporting on their fruit and vegetable consumption and cooking behaviours. A subsample participated in structured interviews, providing feedback about M2MP and the impact of the program. Setting: Seven weekly classes took place in community centres and extension offices in central Illinois. Participants: 120 adults and their families participated. Class cohorts were randomly assigned to one of three treatment groups: (1) nutrition education and cooking classes with produce allocations (PAE, n 39); (2) nutrition education and cooking classes only (EO, n 36) or (3) control group (n 45). Results: Compared to control, PAE participants reported larger increases from pre- to post-intervention in fruit (P = 0·001) and vegetable consumption (P = 0·002), with no differences in cooking frequency. Interview analyses identified key themes in behaviour changes due to M2MP, including reported increases in dietary variety, cooking self-efficacy and children’s participation in cooking. Conclusions: PAE participants who received an intervention that directly increased their access to fresh produce (via produce allocations) increased their reported fruit and vegetable consumption. Though participants’ cooking frequency did not change, interviewees reported increased variety, cooking confidence and family participation in cooking.

Download Full-text

The Effect of Protein Supplementation and Nutrition Counselling on Protein Catabolic Rates Among Persons with End-Stage Renal Disease on Maintenance Haemodialysis (P12-035-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz035.p12-035-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Patrice Prout ◽

Selby Nichols

Keyword(s):

Nutrition Education ◽

West Indies ◽

Protein Supplementation ◽

Control Group ◽

The West ◽

Maintenance Haemodialysis ◽

Biochemical Variables ◽

Significant Difference ◽

The University ◽

The Impact

Abstract Objectives To compare the impact of protein supplementation versus nutrition education/counselling on protein intakes (indexed by normalized protein catabolic rates (nPCR)) among persons on maintenance haemodialysis. Methods An intervention study design was employed in this investigation. Participating dialysis centers were randomly selected and persons attending those centers were invited to participate in the study. Participants had anthropometry and biochemical variables recorded at baseline and on two occasion 1 month apart during each of the interventions. Persons in the intervention group (IVG) received a supplement containing 36 grams of whey protein daily for 6 weeks in. Following a 2-week washout period, they received personalized weekly nutrition education/counselling for an additional 6 weeks. The control group (NIVG) did not receive any supplementation or nutrition education/counselling. Both groups received received the routine facility care. Participation was voluntary. The study was approved by the Ethics Committee, The University of The West Indies. Results Sixty-eight persons (IVG = 32; NIVG = 36) participated in the study. There was no significant difference in the mean nPCR between IVG and NIVG at baseline (0.84 ± 0.17 vs. 0.84 ± 0.17 mg/kg; P = 0.76). IVG had significantly higher mean nPCR than NIVG during protein supplementation (0.95 ± 0.21 vs. 0.78 ± 0.15 mg/kg; P < 0.001) and nutritional education/counselling (0.87 ± 0.17 vs. 0.79 ± 0.18 mg/kg; P = 0.02 phases of the study. Among IVG, protein supplementation (+Δ 12.8 ± 3.0 mg/kg (±S.E.) but not nutrition education/counselling (+Δ 2.8 ± 2.7 mg/kg; P = 0.32) resulted in a significant increase in mean nPCR compared to baseline.with no significant changes in biochemical variables. Conclusions Among participants nPCR increased significantly with protein supplementation but not nutrition education/counselling without adversely affecting biochemical variables. Funding Sources Grant and Publication Fund, The University of The West Indies.

Download Full-text

Does Nursery-Based Intensified Anticipatory Guidance Reduce Emergency Department Use for Nonurgent Conditions in the First Month of Life? A Randomized Controlled Trial

International Journal of Pediatrics ◽

10.1155/2016/8356582 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6

Author(s):

Kelly Kamimura-Nishimura ◽

Vikram Chaudhary ◽

Folake Olaosebikan ◽

Maryam Azizi ◽

Sneha Galiveeti ◽

...

Keyword(s):

Emergency Department ◽

Controlled Trial ◽

Intervention Group ◽

Newborn Care ◽

Secondary Outcome ◽

Control Group ◽

Anticipatory Guidance ◽

Guidance Program ◽

Significant Difference ◽

The Impact

Objective.We aimed to evaluate the impact of an intensified anticipatory guidance program in the nursery on Emergency Department (ED) use for nonurgent conditions (NUCs) in the neonatal period.Methods. Parturient mothers of healthy newborns were randomized to an intervention group or control group. Baseline and 1-month follow-up knowledge surveys regarding newborn care were conducted. The primary outcome was the proportion of neonates who used the ED for a NUC. Secondary outcome was change in caregivers’ knowledge on NUC.Results. Of a total of 594 mothers, 323 (54%) agreed to participate and were randomized to intervention (n=170) or control (n=153) group. Most were Hispanic (68%), single (61%), primiparous (39%), and without high school diploma (44%). 35 (21%) neonates in the intervention group and 41 (27%) in the control group were brought at least once for a NUC to the ED (p=0.12). There was no statistically significant difference in within subject change on knowledge scores between the two study arms.Conclusions. Neonatal ED visits for NUCs occur frequently. This nursery-based intensified anticipatory guidance program had no statistically significant impact on neonatal ED use for NUC, nor on neonatal care-relevant knowledge among parturient mothers. Alternative modalities and timing of parental educational intervention may need to be considered. This trial is registered with Clinical Trials NumberNCT01859065(Clinicaltrials.gov).

Download Full-text

The Impact of a Smartphone App on the Quality of Pediatric Colonoscopy Preparations: Randomized Controlled Trial

JMIR Pediatrics and Parenting ◽

10.2196/18174 ◽

2020 ◽

Vol 3 (2) ◽

pp. e18174

Author(s):

James Brief ◽

Anupama Chawla ◽

Diana Lerner ◽

Bernadette Vitola ◽

Robert Woroniecki ◽

...

Keyword(s):

Arrival Time ◽

Controlled Trial ◽

Smartphone App ◽

Control Group ◽

Phone Calls ◽

Significant Difference ◽

Patient Arrival ◽

Colonoscopy Preparation ◽

The Impact ◽

Pediatric Colonoscopy

Background Smartphone apps have been successfully used to help adults prepare for colonoscopies. However, no study to date has investigated the effect of a smartphone app on pediatric colonoscopy preparation. Objective The aim of this study is to determine if an app (SB Colonoscopy Prep) designed to educate and guide patients through their colonoscopy preparation will yield benefits over paper-based instructions and information. Methods In total, 46 patients aged 5-18 years received either app-based or written material with instructions on how to take their prep medications as well as information about the colonoscopy procedure. Prep quality, the number of calls to the gastroenterology service, and patient arrival time were recorded. After the procedure, a questionnaire was given to each patient through which they graded their knowledge of the procedure both before and after receiving the app or written material. Results App users had higher mean Boston scores versus control subjects receiving written instructions (7.2 vs 5.9, P=.02), indicating better colonoscopy preps. In total, 75% (15/20) of app users and 41% (9/22) of written instruction users had preps categorized as “excellent” on the Boston scale. We found no significant differences in knowledge about the procedure (app users: 10/20 [50%], written instruction users 8/22 [36%]; P=.37), phone calls to the gastroenterology clinic (n=6 vs n=2; P=.27), or arrival times at the endoscopy suite (44 min vs 46 min before the scheduled procedure time; P=.56). Conclusions Smartphone app use was associated with an increased number of colonoscopy preps classified as “excellent” on the Boston scale. There was no significant difference between app users and the control group regarding the number of calls to the gastroenterology clinic, patient arrival time, or patient knowledge about the procedure. Trial Registration ClinicalTrials.gov NCT04590105; https://clinicaltrials.gov/ct2/show/NCT04590105

Download Full-text

EDUKASI GIZI BERBASIS APLIKASI ANDROID MENINGKATKAN PENGETAHUAN EMPAT PILAR PENATALAKSANAAN DIABETES MELITUS PADA PESERTA PROLANIS

JURNAL RISET GIZI ◽

10.31983/jrg.v8i1.5516 ◽

2020 ◽

Vol 8 (1) ◽

pp. 18-24

Author(s):

Musfiatul Nur Laila ◽

Dian Luthfita Prasetya Muninggar ◽

Mohammad Jaelani

Keyword(s):

Physical Exercise ◽

Nutrition Education ◽

Mobile Application ◽

Nutrition Therapy ◽

Pharmacological Therapy ◽

Control Group ◽

Medical Nutrition Therapy ◽

Control Group Design ◽

And Control ◽

Medical Nutrition

Background : Uncontrolled diabetes could lead to serious complication. Diabetes therapy consists of four pillars where nutrition education is very important in managing the disease.Objective : To analyze the effect of nutrition education (Diabetes’ four pillars management) through android mobile application on the knowledge of Diabetes’ four pillars management in patients with DMT2.Method : A quasi experiment research with a pretest posttest control group design. Twenty-six participants were selected by simple random sampling method. Data were collected based on identity and knowledge which were done by interviewing with questionnaires. Changes on knowledge levels were determined by Mann Whitney test.Result : There were significant changes on knowledges related to diabetes (p=0.034), medical nutrition therapy (p=0.008) and physical exercise (0.014) between intervention and control groups, and there was an increase in pharmacological therapy knowledge but we did not observe any significant differences between intervention and control group (p=0.976).Conclusion : Nutrition education (Diabetes’ four pillars management) through android mobile application can increase knowledge of diabetes, medical nutrition therapy and physical exercise.

Download Full-text