scholarly journals Effects of a 1-Day Training Course in Dermoscopy Among General Practitioners

2019 ◽  
pp. 195-199
Author(s):  
Anna Augustsson ◽  
John Paoli

Background: General practitioners (GPs) are often the first point of contact for Swedish patients seeking medical advice for skin lesions of concern, but many lack training in dermoscopy. Objective: To examine the effects of a 1-day training course in dermoscopy among Swedish GPs. Methods: The intervention group consisted of GPs who underwent a 1-day training course in dermoscopy and a control group that did not undergo any education. Before the training course, the intervention group performed a test consisting of 30 dermoscopy cases including 9 different benign and malignant melanocytic and nonmelanocytic diagnoses. The participants then took the same test directly after the course and again after 6 months. The control group took the same test twice with a 6-month interval in between tests in order to avoid recall bias. Results: Twenty-seven GPs in the intervention group took the test before and immediately after the course with an improvement of their median test scores by 8 points (13 vs 20 correct answers, P < 0.01). Eighteen participants also took the test a third time after 6 months with similar results compared with the second test (median scores of 20.5 vs 20.0, P = 0.3). In the control group, 16 persons preformed both tests with an improvement of their median score by 2 points (13.5 vs 15.5 correct answers, P = 0.06). Conclusions: The results of this study show positive effects on diagnostic accuracy in a test situation among GPs receiving a 1-day training course in dermoscopy.

Author(s):  
Niklas Sörlén ◽  
Andreas Hult ◽  
Peter Nordström ◽  
Anna Nordström ◽  
Jonas Johansson

Abstract Background We aimed to determine the effectiveness of 4 weeks of balance exercise compared with no intervention on objectively measured postural sway. Methods This was a single-center parallel randomized controlled, open label, trial. A six-sided dice was used for allocation at a 1:1-ratio between exercise and control. The trial was performed at a university hospital clinic in Sweden and recruited community-dwelling older adults with documented postural instability. The intervention consisted of progressively challenging balance exercise three times per week, during 4 weeks, with follow-up at week five. Main outcome measures were objective postural sway length during eyes open and eyes closed conditions. Results Sixty-five participants aged 70 years (balance exercise n = 32; no intervention n = 33) were randomized. 14 participants were excluded from analysis because of early dropout before follow-up at week five, leaving 51 (n = 22; n = 29) participants for analysis. No significant differences were detected between the groups in any of the postural sway outcomes. Within-group analyses showed significant improvements in hand grip strength for the intervention group, while Timed Up & Go improvements were comparable between groups but only statistically significant in the control group. Conclusions Performing balance exercise over a four-week intervention period did not acutely improve postural sway in balance-deficient older adults. The lower limit in duration and frequency to achieve positive effects remains unclear. Trial registration Clinical trials NCT03227666, July 24, 2017, retrospectively registered.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250965
Author(s):  
José Roberto de Souza Júnior ◽  
Pedro Henrique Reis Rabelo ◽  
Thiago Vilela Lemos ◽  
Jean-Francois Esculier ◽  
João Pedro da Silva Carto ◽  
...  

Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. The primary objective of this study will be to compare the effects of two different two-week partially supervised gait retraining programs, with a control intervention; on pain, function and lower limb kinematics of runners with PFP. It will be a single-blind randomized clinical trial with six-month follow-up. The study will be composed of three groups: a group focusing on impact (group A), a group focusing on cadence (group B), and a control group that will not perform any intervention (group C). The primary outcome measure will be pain assessed using the Visual Analog Pain scale during running. Secondary outcomes will include pain during daily activities (usual), symptoms assessed using the Patellofemoral Disorders Scale and lower limb running kinematics in the frontal (contralateral pelvic drop; hip adduction) and sagittal planes (foot inclination; tibia inclination; ankle dorsiflexion; knee flexion) assessed using the MyoResearch 3.14—MyoVideo (Noraxon U.S.A. Inc.). The study outcomes will be evaluated before (t0), immediately after (t2), and six months (t24) after starting the protocol. Our hypothesis is that both partially supervised gait retraining programs will be more effective in reducing pain, improving symptoms, and modifying lower limb kinematics during running compared with the control group, and that the positive effects from these programs will persist for six months. Also, we believe that one gait retraining group will not be superior to the other. Results from this study will help improve care in runners with PFP, while maximizing clinical applicability as well as time and cost-effectiveness.


Author(s):  
Angela Chu ◽  
Tyler M Rose ◽  
Danielle A Gundrum ◽  
Tressa E McMorris ◽  
Eytan A Klausner ◽  
...  

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Pharmacists report high levels of burnout. Mindfulness approaches have been demonstrated to have positive results in the general population and in other healthcare professions. However, limited studies have been performed evaluating mindfulness approaches in student pharmacists. The aim of this study was to evaluate the effectiveness of daily use of a mindfulness mobile application in improving student pharmacists’ perceived stress, burnout, and mindfulness. Methods This study was a randomized, longitudinal, waitlist-controlled trial. The intervention group was asked to meditate using the mindfulness application Headspace daily for at least 6 weeks. The waitlist control group was asked to abstain from using the application for the entire study. Stress, burnout, and mindfulness were assessed using validated survey instruments at baseline, 6 weeks, and 10 weeks. A secondary outcome was to assess the persistence of application use after the intervention period. Results Fifty-six participants completed the study. The intervention group reported significantly lower scores on stress and burnout at 6 weeks compared to the control group. The intervention group also reported significantly higher scores on mindfulness. The differences in stress, burnout, and mindfulness persisted at follow-up. The mean percentage of students in the intervention group who used the application each day was 90% over the intervention period and 62% over the follow-up period. Conclusion A mindfulness mobile application significantly improved student pharmacists’ stress, burnout, and mindfulness with daily use. Most participants continued to use the application for 4 weeks after the end of the intervention. Positive effects on stress and mindfulness persisted even with decreased use.


Author(s):  
Wytze P Oosterhuis ◽  
Wilhelmine PHG Verboeket-van de Venne ◽  
Cees TBM van Deursen ◽  
Henri EJH Stoffers ◽  
Bernadette AC van Acker ◽  
...  

Background Reflective testing, i.e. interpreting, commenting on and, if necessary, adding tests in order to aid the diagnostic process in a meaningful and efficient manner, is an extra service provided by laboratory medicine. However, there have been no prospective randomized controlled trials investigating the value of reflective testing in patient management. Methods In this trial, primary care patients were randomly allocated to an intervention group, where general practitioners received laboratory tests results as requested as well as add-on test results with interpretative comments where considered appropriate by the laboratory specialist, or to a control group, where general practitioners only received the laboratory test results requested. Patients’ medical records were evaluated with a follow-up period of six months. For both groups, the primary outcome measures, i.e. both intended action and actual management action, were blindly assessed by an independent expert panel as adequate, neutral or inadequate. Results In 226 of the 270 cases (84%), reflective testing was considered to be useful for the patient. In the intervention group ( n = 148), actual management by the general practitioner was scored as adequate ( n = 104; 70%), neutral ( n = 29; 20%) or not adequate ( n = 15; 10%). In the control group ( n = 122), these numbers were 57 (47%), 37 (30%) and 28 (23%). This difference was statistically significant ( P < 0.001). Conclusion This randomized controlled trial showed a positive effect of reflective testing in primary care patients on the adequacy of their management, as documented in medical records.


2010 ◽  
Vol 4 (4) ◽  
pp. 323-340 ◽  
Author(s):  
Mathieu Simon Paul Meeûs ◽  
Sidónio Serpa ◽  
Bert De Cuyper

This study examined the effects of video feedback on the nonverbal behavior of handball coaches, and athletes’ and coaches’ anxieties and perceptions. One intervention group (49 participants) and one control group (63 participants) completed the Coaching Behavior Assessment System, Coaching Behavior Questionnaire, and Competitive State Anxiety Inventory-2 on two separate occasions, with 7 weeks of elapsed time between each administration. Coaches in the intervention condition received video feedback and a frequency table with a comparison of their personal answers and their team’s answers on the CB AS. Repeated-measures ANOVAs showed that over time, athletes in the intervention group reported significantly less anxiety and perceived their coaches significantly more positively compared with athletes in the nonintervention condition. Over time, coaches in the intervention group perceived themselves significantly more positively than coaches in the nonintervention condition. Compared with field athletes, goalkeepers were significantly more anxious and perceived their coaches less positively. It is concluded that an intervention using video feedback might have positive effects on anxiety and coach perception and that field athletes and goalkeepers possess different profiles.


Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1813
Author(s):  
Jeffrey M. Beckett ◽  
Neeraj K. Singh ◽  
Jehan Phillips ◽  
Krishnakumar Kalpurath ◽  
Kent Taylor ◽  
...  

Gastroesophageal reflux disease (GERD) affects approximately 20% of Australians. Patients suffer a burning sensation known as heartburn due to the movement of acidic stomach content into the esophagus. There is anecdotal evidence of the effectiveness of prebiotic sugarcane flour in controlling symptoms of GERD. This pilot study aimed to investigate the effectiveness of a prebiotic sugarcane flour in alleviating symptoms in medically-diagnosed GERD patients. This pilot study was a single center, double-blinded, placebo-controlled randomized trial conducted on 43 eligible participants. The intervention group (n = 22) were randomized to receive 3 g of sugarcane flour per day, and the control group (n = 21) received 3 g of cellulose placebo per day. Symptoms of gastroesophageal reflux disease were assessed before and after three weeks treatment using the validated Gastroesophageal Reflux Disease-Health Related Quality of Life questionnaire (GERD-HRQL). After three weeks there were significant differences in symptoms for heartburn, regurgitation, and total symptoms scores (p < 0.05) between the sugarcane flour and placebo. Mean GERD-HRQL scores increased in the placebo group for regurgitation (mean increase 1.7; 95% CI 0.23 to 3.2; p = 0.015) and total symptom scores (2.9; 95% CI 0.26 to 5.7; p = 0.033). In contrast, there were significant reductions in heartburn (mean decrease −2.2; 95% CI −4.2 to −0.14; p = 0.037) and total symptom scores (−3.7; 95% CI −7.2 to −0.11; p = 0.044) in the intervention group. This pilot study has shown significant positive effects of sugarcane flour in the reduction of GERD symptoms, and a larger randomized controlled trial is warranted.


2019 ◽  
Vol 52 (5) ◽  
pp. 366-382 ◽  
Author(s):  
Ann-Christina Kjeldsen ◽  
Lic Educ ◽  
Silja K. Saarento-Zaprudin ◽  
Pekka O. Niemi

Training in phonological awareness has brought about well-documented positive effects on learning to read in lower-primary grades. Less is known about long-term gains extending to upper-primary and junior high school. The few longitudinal studies covering at least 5 years suggest that gains in decoding are sustained, whereas effects on reading comprehension have either not been studied or produced equivocal results. The present study followed up the reading development of 209 Finland Swedish students from kindergarten until Grade 9, half of whom participated in an 8-month phonological intervention in kindergarten. The intervention group outperformed the control group in both word reading and reading comprehension in Grades 1 through 9. However, albeit statistically significant, the differences at the group level were small. The main result was a clear-cut difference in both skills among readers at risk belonging to the lowest 25% in foundational skills at the beginning of kindergarten. In Grade 6, altogether 60% of the nontrained readers at risk still belonged to the lowest quartile in reading comprehension as opposed to 24% of their peers in the intervention group. The pattern was repeated in Grade 9, with trained readers at risk performing at the level of nontrained mainstream readers.


2021 ◽  
Vol 9 ◽  
Author(s):  
Gabriela Markova ◽  
Lukas Houdek ◽  
Zuzana Kocabova

In the present study we examined the positive effects of a healthcare clown intervention on children undergoing surgeries, and the role parent-child relationships may play in their effectiveness. Children between 5 and 12 years, who were scheduled to undergo elective surgical procedures in a large university hospital, were randomly assigned to an intervention group (IG; n = 35) that was visited by a healthcare clown, and a control group (CG; n = 27) that received treatment as usual (i.e., company of parents before the surgery). Children in both groups were videotaped and the videos were later used to rate their activity, arousal, emotional expressivity, and vocalizations. Additionally, children and parents rated their mood and perceived quality of life at several points during the procedure, and parents reported their perceptions of the relationship with their children. Results showed that children in the IG showed more positive emotions and vocalizations than children in the CG. Parents of children in the IG also reported more positive mood than parents of children in the CG. In contrast, children in the CG reported higher quality of life than children in the IG. Importantly, analyses showed considerable effects of the parent-child relationship on all outcome measures. Results of the present study demonstrate that a healthcare clown intervention had some positive effects on behaviors and mood of hospitalized children and their parents. Importantly, our findings also suggest that we need to consider the pre-existing “relationship microcosmos” that the clowns enter when assessing their effectiveness in the hospital.


2018 ◽  
Author(s):  
Thomas Timmers ◽  
Loes Janssen ◽  
Yvette Pronk ◽  
Babette C van der Zwaard ◽  
Sander Koëter ◽  
...  

BACKGROUND Modern health care focuses on shared decision making (SDM) because of its positive effects on patient satisfaction, therapy compliance, and outcomes. Patients’ knowledge about their illness and available treatment options, gained through medical education, is one of the key drivers for SDM. Current patient education relies heavily on medical consultation and is known to be ineffective. OBJECTIVE This study aimed to determine whether providing patients with information in a subdivided, categorized, and interactive manner via an educational app for smartphone or tablet might increase the knowledge of their illness. METHODS A surgeon-blinded randomized controlled trial was conducted with 213 patients who were referred to 1 of the 6 Dutch hospitals by their general practitioner owing to knee complaints that were indicative of knee osteoarthritis. An interactive app that, in addition to standard care, actively sends informative and pertinent content to patients about their illness on a daily basis by means of push notifications in the week before their consultation. The primary outcome was the level of perceived and actual knowledge that patients had about their knee complaints and the relevant treatment options after the intervention. RESULTS In total, 122 patients were enrolled in the control group and 91 in the intervention group. After the intervention, the level of actual knowledge (measured on a 0-36 scale) was 52% higher in the app group (26.4 vs 17.4, P<.001). Moreover, within the app group, the level of perceived knowledge (measured on a 0-25 scale) increased by 22% during the week within the app group (from 13.5 to 16.5, P<.001), compared with no gain in the control group. CONCLUSIONS Actively offering patients information in a subdivided (per day), categorized (per theme), and interactive (video and quiz questions) manner significantly increases the level of perceived knowledge and demonstrates a higher level of actual knowledge, compared with standard care educational practices. CLINICALTRIAL International Standard Randomized Controlled Trial Number ISRCTN98629372; http://www.isrctn.com/ISRCTN98629372 (Archived by WebCite at http://www.webcitation.org/73F5trZbb)


2019 ◽  
Vol 2019 (2) ◽  
Author(s):  
Merna Luis ◽  
Ramy Doss ◽  
Basel Zayed ◽  
Magdi Yacoub

Background. Music therapy has emerged as a promising evidence-based adjuvant method of intervention. This study aims to assess the effect of live oud music on physiological and psychological parameters in patients undergoing cardiac surgery, pre- and post-operatively.Methods. Twelve patients undergoing cardiac operations were randomly allocated into either intervention group or control group, six patients in each group. Patients in the intervention group listened to 20 minutes of improvised and personally customized live oud music before and after surgery while patients in the control group heard the normal hospital sounds. While anxiety scores were assessed preoperatively, vital signs and pain scores were assessed postoperatively together with serum levels of cortisol, which was used as a surrogate marker of the stress response.Results. In the intervention group, pain scores and respiratory rates showed statistically significant reduction after listening to music (P values of 0.043 and 0.034 respectively). Additionally, heart rates, anxiety scores and serum cortisol levels showed borderline significant reduction in patients who listened to music with P values, 0.063, 0.066 and 0.068 respectively. These changes were not found in the control group.Conclusions. This preliminary study suggests a role of live oud music therapy in decreasing stress response of the patients undergoing cardiac surgery, in addition to its positive effects on pain perception and anxiety scores.


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