Assessing the clinical significance of real-time quality of life data in cancer patients treated with radiation therapy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6108-6108
Author(s):  
Michele Y. Halyard ◽  
Angelina D. Tan ◽  
Pamela J. Atherton ◽  
William Wong ◽  
Steven E. Schild ◽  
...  
Keyword(s):  
Real Time ◽  
Effect Size ◽  
Symptom Management ◽  
Phase 1 ◽  
Intervention Group ◽  
Well Being ◽  
Pain Severity ◽  
Control Group ◽  
Phase 2 ◽  
Moderate Effect

6108 Background: This pilot study evaluated whether providing clinicians with patient(pt) QOL results and symptom management pathways linked to QOL domains at the time of clinical appointment would result in improvement in QOL and treatment (tx) satisfaction. The objective was to obtain preliminary effect size estimates and logistical evidence for design of a larger, definitive trial. Methods: Oncology pts receiving 5-7 weeks of radiotherapy (RT) electronically completed QOL assessments (LASA) at baseline and biweekly prior to seeing clinicians. Was It Worth It (WIWI) and Interpersonal Patient-Provider Relationship (IPPRS) were measured at tx end. Pt endpoints (pro-rated primary endpoint LASA area under the curve (AUC), LASA changes from baseline, and WIWI responses) and clinician endpoints (IPPRS) were compared between the control group (Phase 1: no QOL feedback) and the intervention group (Phase 2: QOL feedback) via Wilcoxon, Chi-square and Fisher Exact tests. There was 80% power to detect a 10 point difference in average AUC. Results: 148 pts enrolled (79 Phase 1, 69 Phase 2) from 11/28/2008 to 09/20/2011 (sites GI (27%), Lung (22%) and Head and Neck (52%)). 68% received RT and chemo. There were consistently moderate effect sizes observed but no statistically significant differences in any AUC nor end of tx change from baseline scores. 20% fewer pts in phase 2 reported clinical deficits in overall QOL (pain). In pts receiving 7 weeks of RT, end of tx average overall QOL, mental well-being (WB), physical WB and pain severity were significantly better in Phase 2 pts. WIWI results showed 76% found participation worthwhile, 95% would participate again, and 92% would recommend the study to others. No differences between groups were found in communication between clinicians and pts (IPPRS). Conclusions: Preliminary estimates indicate potentially clinically significant improvements of moderate effect size in mental and physical WB and pain severity when clinicians received QOL real time with symptom management pathways. Further study is warranted in larger trial setting.

scholarly journals A Phase 1 Randomized Controlled Trial of an At-Home Positive Psychology Intervention for Individuals with Multiple Sclerosis

2020 ◽  
Author(s):  
Melanie E. Freedman ◽  
Brian C. Healy ◽  
Jeff C. Huffman ◽  
Tanuja Chitnis ◽  
Howard L. Weiner ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Positive Psychology ◽  
Controlled Trial ◽  
Phase 1 ◽  
Intervention Group ◽  
Well Being ◽  
Control Group ◽  
Randomized Controlled ◽  
Phone Calls ◽  
At Home

Abstract Background: Positive psychology (PP) uses targeted activities to increase the frequency and intensity of positive feelings and may improve overall well-being in medically ill populations. In this pilot study, we examined the feasibility, acceptability and potential impact of a five-week, telephone-delivered, PP intervention for individuals with multiple sclerosis (MS). Methods: Participants were randomized 1:1 to a five-week at-home PP intervention or waitlist control condition. Participants engaged in weekly phone calls with a study trainer and completed one PP exercise, such as recalling a past success, each week. Feasibility was determined by the number of sessions completed, and acceptability was assessed by weekly post-exercise participant ratings (0–10) of ease and utility. Efficacy was explored by examining between-group differences in changes from baseline on psychological variables, health-related quality of life (HRQOL), and self-reported functional activities at five and ten weeks. Results: Thirty patients enrolled in the study. Ninety-three percent of participants (n = 28) completed all exercises. Ease scores ranged from 7.7–8.7 and utility scores ranged from 8.2–8.7. The PP intervention was associated with significantly greater increases (P < .05) in positive affect, optimism, state and trait anxiety, general health, and resilience in the intervention group compared to the control group. Approximately half of the PP participants maintained ≥ 50% of the improvement at 10 weeks. Conclusions: This five-week, telephone-based PP intervention was feasible and acceptable to individuals with MS. Larger randomized controlled trials are warranted to further investigate the utility of this intervention to improve well-being and other health outcomes in MS.

scholarly journals Sustained impact of electronic alerts on rate of prophylaxis against venous thromboembolism

2011 ◽  
Vol 106 (10) ◽  
pp. 734-738 ◽  
Author(s):  
Patrick Beeler ◽  
Nils Kucher ◽  
Jürg Blaser
Keyword(s):  
Venous Thromboembolism ◽  
Phase 1 ◽  
Intervention Group ◽  
Control Group ◽  
Phase 2 ◽  
Medical Patients ◽  
Phase 3 ◽  
Electronic Alerts ◽  
Over Time ◽  
Three Phases

SummaryAdvanced electronic alerts (eAlerts) and computerised physician order entry (CPOE) increase adequate thromboprophylaxis orders among hospitalised medical patients. It remains unclear whether eAlerts maintain their efficacy over time, after withdrawal of continuing medical education (CME) on eAlerts and on thromboprophylaxis indications from the study staff. We analysed 5,317 hospital cases from the University Hospital Zurich during 2006–2009: 1,854 cases from a medical ward with eAlerts (intervention group) and 3,463 cases from a surgical ward without eAlerts (control group). In the intervention group, an eAlert with hospital-specific venous thromboembolism (VTE) prevention guidelines was issued in the electronic patient chart 6 hours after admission if no pharmacological or mechanical thromboprophylaxis had been ordered. Data were analysed for three phases: pre-implementation (phase 1), eAlert implementation with CME (phase 2), and post-implementation without CME (phase 3). The rates of thromboprophylaxis in the intervention group were 43.4% in phase 1 and 66.7% in phase 2 (p<0.001), and increased further to 73.6% in phase 3 (p=0.011). Early thromboprophylaxis orders within 12 hours after admission were more often placed in phase 2 and 3 as compared to phase 1 (67.1% vs. 52.1%, p<0.001). In the surgical control group, the thromboprophylaxis rates in the three phases were 88.6%, 90.7%, 90.6% (p=0.16). Advanced eAlerts may provide sustained efficacy over time, with stable rates of thromboprophylaxis orders among hospitalised medical patients.

Feasibility of a Nurse Coached Walking Intervention for Informal Dementia Caregivers

2021 ◽  
pp. 019394592110013
Author(s):  
Jane Flanagan ◽  
Kathryn Post ◽  
Rebecca Hill ◽  
John DiPalazzo
Keyword(s):  
Perceived Stress ◽  
Effect Size ◽  
Statistical Difference ◽  
Retention Rate ◽  
Intervention Group ◽  
Well Being ◽  
Control Group ◽  
Large Effect Size ◽  
Dementia Caregivers ◽  
Walking Intervention

This study’s purpose was to determine the feasibility of a nurse coached walking intervention for informal caregivers of persons with dementia. Participants were randomly assigned to a nurse coached intervention or a control group. Five male and 27 female caregivers ( n = 32) participated. Measures included steps, walked well-being, and perceived stress. For steps walked, each group experienced a statistical difference ( p = .01 control; p = .02 intervention) and large effect size (0.90). Neither group had a statistical difference in well-being ( p = .38 control; p = .08 intervention) or perceived stress ( p = .56 control; p = .18 intervention). The intervention group achieved a large effect size in well-being (1.38) and moderate effect size in perceived stress (0.51). A 0.94 pedometer adherence, self-reported user ease with technology and 100% retention rate support feasibility. Many participants described feelings of loneliness and grief, but reported the pedometer motivated them to walk.

A Pilot Study on the Efficacy of Volunteer Mentorship for Young Adults With Self-Harm Behaviors Using a Quasi-Experimental Design

Crisis ◽  
2016 ◽  
Vol 37 (6) ◽  
pp. 415-426 ◽  
Author(s):  
Yik-Wa Law ◽  
Paul S. F. Yip ◽  
Carmen C. S. Lai ◽  
Chi Leung Kwok ◽  
Paul W. C. Wong ◽  
...  
Keyword(s):  
Experimental Design ◽  
Suicide Ideation ◽  
Intervention Group ◽  
Well Being ◽  
Control Group ◽  
Treatment As Usual ◽  
Prevention Services ◽  
Quasi Experimental ◽  
Self Harm ◽  
Volunteer Support

Abstract. Background: Studies have shown that postdischarge care for self-harm patients is effective in reducing repeated suicidal behaviors. Little is known about whether volunteer support can help reduce self-harm repetition and improve psychosocial well-being. Aim: This study investigated the efficacy of volunteer support in preventing repetition of self-harm. Method: This study used a quasi-experimental design by assigning self-harm patients admitted to the emergency departments to an intervention group with volunteer support and treatment as usual (TAU) for 9 months and to a control group of TAU. Outcome measures include repetition of self-harm, suicidal ideation, hopelessness, and level of depressive and anxiety symptoms. Results: A total of 74 cases were recruited (38 participants; 36 controls). There were no significant differences in age, gender, and clinical condition between the two groups at the baseline. The intervention group showed significant improvements in hopelessness and depressive symptoms. However, the number of cases of suicide ideation and of repetition of self-harm episodes was similar for both groups at the postintervention period. Conclusion: Postdischarge care provided by volunteers showed significant improvement in hopelessness and depression. Volunteers have been commonly involved in suicide prevention services. Further research using rigorous methods is recommended for improving service quality in the long term.

60. Using a pocket card to improve end-of-life care on clinical teaching units: A controlled trials

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
J. Downar ◽  
J. Mikhael
Keyword(s):  
End Of Life ◽  
Symptom Management ◽  
End Of Life Care ◽  
Palliative Medicine ◽  
Clinical Teaching ◽  
Intervention Group ◽  
Comfort Level ◽  
Control Group ◽  
Life Care ◽  
Comfort Levels

Although palliative and end-of-life is a critical part of in-hospital medical care, residents often have very little formal education in this field. To determine the efficacy of a symptom management pocket card in improving the comfort level and knowledge of residents in delivering end-of-life care on medical clinical teaching units, we performed a controlled trial involving residents on three clinical teaching units. Residents at each site were given a 5-minute questionnaire at the start and at the end of their medicine ward rotation. Measures of self-reported comfort levels were assessed, as were 5 multiple-choice questions reflecting key knowledge areas in end-of-life care. Residents at all three sites were given didactic teaching sessions covering key concepts in palliative and end-of-life care over the course of their medicine ward rotation. Residents at the intervention site were also given a pocket card with information regarding symptom management in end-of-life care. Over 10 months, 137 residents participated on the three clinical teaching units. Comfort levels improved in both control (p < 0.01) and intervention groups (p < 0.01), but the intervention group was significantly more comfortable than the control group at the end of their rotations (z=2.77, p < 0.01). Knowledge was not significantly improved in the control group (p=0.07), but was significantly improved in the intervention group (p < 0.01). The knowledge difference between the two groups approached but did not reach statistical significance at the end of their rotation. In conclusion, our pocket card is a feasible, economical educational intervention that improves resident comfort level and knowledge in delivering end-of-life care on clinical teaching units. Oneschuk D, Moloughney B, Jones-McLean E, Challis A. The Status of Undergraduate Palliative Medicine Education in Canada: a 2001 Survey. Journal Palliative Care 2004; 20:32. Tiernan E, Kearney M, Lynch AM, Holland N, Pyne P. Effectiveness of a teaching programme in pain and symptom management for junior house officers. Support Care Cancer 2001; 9:606-610. Okon TR, Evans JM, Gomez CF, Blackhall LJ. Palliative Educational Outcome with Implementation of PEACE Tool Integrated Clinical Pathway. Journal of Palliative Medicine 2004; 7:279-295.

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

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.

scholarly journals Effect of Inquiry-Based Stress Reduction (IBSR) Intervention on Well-Being, Resilience and Burnout of Teachers during the COVID-19 Pandemic

2021 ◽  
Vol 18 (7) ◽  
pp. 3689
Author(s):  
Tzofnat Zadok-Gurman ◽  
Ronit Jakobovich ◽  
Eti Dvash ◽  
Keren Zafrani ◽  
Benjamin Rolnik ◽  
...  
Keyword(s):  
Stress Reduction ◽  
Controlled Trial ◽  
Intervention Group ◽  
Well Being ◽  
Stressful Events ◽  
Control Group ◽  
Subjective Well Being ◽  
Intention To Treat ◽  
School Year ◽  
Blended Intervention

Objective: The COVID-19 pandemic has had a major impact on teachers professional and personal lives. Our primary aim was to assess the effect of a blended Inquiry-Based Stress Reduction (IBSR), an emerging mindfulness and cognitive reframing intervention on teacher’s well-being. Our secondary aims were to assess the effect of IBSR on resilience, burnout, mindfulness, and stress among teachers during the COVID-19 pandemic. Methods: The study was a prospective controlled trial with an intervention group (N = 35) and a comparison control group (N = 32). The intervention took place in the Jerusalem District throughout the school year from November 2019 to May 2020. The sessions were conducted in blended learning that included traditional learning (face-to-face) and online learning. Data was analyzed on an intention-to-treat basis. Results: IBSR blended intervention enhanced the resilience and improved the subjective and psychological well-being of teachers in spite of the breakout of the COVID-19 pandemic and the first lockdown in Israel. Simultaneously the control group suffered from enhanced burnout levels and a decline in psychological and subjective well-being. Conclusions: Implementation of IBSR blended intervention during the school year may benefit teachers’ well-being and ability to flourish, even during stressful events such as the COVID-19 pandemic.

scholarly journals Specific Absolute Velocity Thresholds during Male Basketball Games Using Local Positional System; Differences between Age Categories

2021 ◽  
Vol 11 (10) ◽  
pp. 4390
Author(s):  
Carlos Sosa ◽  
Alberto Lorenzo ◽  
Juan Trapero ◽  
Carlos Ribas ◽  
Enrique Alonso ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Real Time ◽  
Effect Size ◽  
High Speed ◽  
Maximum Speed ◽  
Large Effect Size ◽  
Moderate Effect Size ◽  
Positional System ◽  
Moderate Effect ◽  
Distance Zone

The aim of this study was (I) to establish absolute specific velocity thresholds during basketball games using local positional system (LPS) and (II) to compare the speed profiles between various levels of competitions. The variables recorded were total distance (TD); meters per minute (m·min); real time (min); maximum speed (Km h−1), distance (m), percentage distance, and percentage duration invested in four speed zones (standing–walking; jogging; running; and high-speed running). Mean and standard deviation (±SD) were calculated, and a separate one-way analysis of variance was undertaken to identify differences between competitions. TD (3188.84 ± 808.37 m) is covered by standing–walking (43.51%), jogging (36.58%), running (14.68%), and sprinting (5.23%) activities. Overall, 75.22% of the time is invested standing–walking, jogging (18.43%), running (4.77%), and sprinting (1.89%). M·min (large effect size), % duration zone 2 (moderate effect size); distance zone 4 (large effect size), and % distance zone 4 (very large effect size) are significantly higher during junior than senior. However, % distance zone 1 (large effect size) and % duration zone 1 (large effect size) were largely higher during senior competition. The findings of this study reveal that most of the distance and play time is spent during walking and standing activities. In addition, the proportion of time spent at elevated intensities is higher during junior than in senior competition.

scholarly journals Book Availability Revisited: Turnaround Time for Recalls versus Interlibrary Loans

2003 ◽  
Vol 64 (4) ◽  
pp. 283-299 ◽  
Author(s):  
David J. Gregory ◽  
Wayne A. Pedersen
Keyword(s):  
Real Time ◽  
Phase 1 ◽  
Academic Library ◽  
Turnaround Time ◽  
Phase 2 ◽  
Interlibrary Loan ◽  
Reasonable Alternative ◽  
Local Institution ◽  
Timely Access ◽  
Average Turnaround Time

Librarians typically view interlibrary loan (ILL) as a means of providing access to items not owned by the local institution. However, they are less likely to explore ILL’s potential in providing timely access to items locally owned, but temporarily unavailable, particularly in the case of monographs in circulation. In a two-part study, the authors test the assumption that, on average, locally owned books that a patron finds unavailable (due to checkout) can be obtained more quickly via recall than via ILL. Phase 1 of this study establishes an average turnaround time for circulation recalls in a large academic library for comparison with well-established turnaround times for ILL borrowing transactions. In Phase 2, a more rigorous paired study of recalls and ILL compares the ability of each system to handle identical requests in real time. Results demonstrate that, under some circumstances, ILL provides a reasonable alternative to the internal recall process. The findings also underscore the need for more holistic, interservice models for improving not just access, but also the timeliness of access, to monograph collections.

Evaluating the effectiveness of interventions to reducing screen time in children: meta-analysis of randomized controlled trials

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Duygu Akçay ◽  
Nuray Barış
Keyword(s):  
Effect Size ◽  
Subgroup Analysis ◽  
Screen Time ◽  
Meta Analysis ◽  
Intervention Group ◽  
Evidence Base ◽  
Control Group ◽  
Content Type ◽  
Mean Differences ◽  
The Impact

Purpose The purpose of this paper is to evaluate the impact of interventions focused on reducing screen time in children. Design/methodology/approach Studies that aim to investigate the effects of interventions aimed at reducing the time spent in front of the screen (i.e. screen time). A Random-effects model was used to calculate the pooled standard mean differences. The outcome was to evaluate the screen time in children in the 0–18 age range. A subgroup analysis was performed to reveal the extent to which the overall effect size varied by subgroups (participant age, duration of intervention and follow). Findings For the outcome, the meta-analysis included 21 studies, and the standard difference in mean change in screen time in the intervention group compared with the control group was −0.16 (95% confidence interval [CI], −0.21 to −0.12) (p < 0.001). The effect size was found to be higher in long-term (=7 months) interventions and follow-ups (p < 0.05). Originality/value Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention and follow-up was =7 months. As the evidence base grows, future researchers can contribute to these findings by conducting a more comprehensive analysis of effect modifiers and optimizing interventions to reduce screen time.

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