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Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial; Efeitos do treinamento da musculatura do assoalho pélvico sobre o parto e recém-nascido: estudo controlado randomizado

DIAS, Letícia A. R.; DRIUSSO, Patricia; AITA, Daniella L. C. C.; QUINTANA, Silvana M.; Bø, Kari; FERREIRA, Cristine H. J.
Fonte: Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia Publicador: Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
96.14%
BACKGROUND: The use of the pelvic floor muscle training for urinary incontinence treatment is well established but little is known about its effects in labor and newborn outcomes. OBJECTIVES: To evaluate the effects of antenatal pelvic floor muscle training and strength in labor and newborn outcomes in low-income pregnant women. METHODS: This is a randomized controlled trial that recruited forty-two nulliparous healthy pregnant women aged between 18-36 years old and able to contract the pelvic floor muscles. The participants were included in the study with 20 weeks of gestational age and had their pelvic floor muscles measured by vaginal squeeze pressure. They were randomly allocated into two groups: training group and a non-intervention control group. Then, all participants had their labor and newborn outcomes evaluated through consultation of medical records by a blinded researcher. RESULTS: There were no statistically significant differences between the groups regarding gestational age at birth, type of labor, duration of the second stage of labor, total time of labor, prevalence of laceration, weight and size of the baby, and Apgar score. No correlation was observed between pelvic floor muscle strength and the second stage or the total length of labor. CONCLUSIONS: This randomized controlled trial did not find any effect of pelvic floor muscle training or pelvic floor muscle strength on labor and newborn outcomes.; CONTEXTUALIZAÇÃO: O treinamento da musculatura do assoalho pélvico para tratamento da incontinência urinária é bem estabelecida...

Postural Control in Elderly Persons with Osteoporosis: Efficacy of an Intervention Program to Improve Balance and Muscle Strength A Randomized Controlled Trial

BURKE, Thomaz Nogueira; FRANCA, Fabio Jorge Renovato; MENESES, Sarah Rubia Ferreira de; CARDOSO, Viviam Inhasz; MARQUES, Amelia Pasqual
Fonte: LIPPINCOTT WILLIAMS & WILKINS Publicador: LIPPINCOTT WILLIAMS & WILKINS
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
96.08%
Burke TN, Franc, a FJR, de Meneses SRF, Cardoso VI, Marques AP: Postural control in elderly persons with osteoporosis: Efficacy of an intervention program to improve balance and muscle strength: A randomized controlled trial. Am J Phys Med Rehabil 2010; 89: 549-556. Objective: To assess the efficacy of an exercise program aiming to improve balance and muscular strength, for postural control and muscular strength of women with osteoporosis. Design: Sample consisted of 33 women with osteoporosis, randomized into one of two groups: intervention group, in which exercises for balance and improvement of muscular strength of the inferior members were performed for 8 wks (n = 17, age 72.8 +/- 3.6 yrs); control group, which was women not practicing exercises (n = 16, age 74.4 +/- 3.7 yrs). At baseline and after 8 wks of treatment, postural control was assessed using a force plate (Balance Master, Neurocom), and muscular strength during ankle dorsiflexion, knee extension, and flexion was assessed by dynamometry. Results: Adherence to the program was 82%. When compared with the control group, individuals in the intervention group significantly improved the center of pressure velocity (P = 0.02) in the modified clinical test of sensory interaction for balance test...

Diaphragmatic Breathing Training Program Improves Abdominal Motion During Natural Breathing in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Yamaguti, Wellington P.; Claudino, Renata C.; Neto, Alberto P.; Chammas, Maria C.; Gomes, Andrea C.; Salge, Joao M.; Moriya, Henrique Takachi; Cukier, Alberto; Carvalho, Celso R.
Fonte: W B SAUNDERS CO-ELSEVIER INC; PHILADELPHIA Publicador: W B SAUNDERS CO-ELSEVIER INC; PHILADELPHIA
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
96.14%
Yamaguti WP, Claudino RC, Neto AP, Chammas MC, Gomes AC, Salge TM, Moriya HT, Cukier A, Carvalho CR. Diaphragmatic breathing training program improves abdominal motion during natural breathing in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Arch Phys Med Rehabil 2012;93:571-7. Objective: To investigate the effects of a diaphragmatic breathing training program (DBTP) on thoracoabdominal motion and functional capacity in patients with chronic obstructive pulmonary disease. Design: A prospective, randomized controlled trial. Setting: Academic medical center. Participants: Subjects (N=30; forced expiratory volume in Is, 4270 +/- 13% predicted) were randomly allocated to either a training group (TG) or a control group (CG). Interventions: Subjects in the TG completed a 4-week supervised DBTP (3 individualized weekly sessions), while those in the CG received their usual care. Main Outcome Measures: Effectiveness was assessed by amplitude of the rib cage to abdominal motion ratio (RC/ABD ratio) (primary outcome) and diaphragmatic mobility (secondary outcome). The RC/ABD ratio was measured using respiratory inductive plethysmography during voluntary diaphragmatic breathing and natural breathing. Diaphragmatic mobility was measured by ultrasonography. A 6-minute walk test and health-related quality of life were also evaluated. Results: Immediately after the 4-week DBTP...

Duração da ventilação mecânica em pediatria: impacto da introdução de avaliações diárias e teste de respiração espontânea; The impact of daily evaluation and spontaneous breathing test on the duration of pediatric mechanical ventilation: A randomized controlled trial

Foronda, Flavia Andrea Krepel
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 25/04/2013 PT
Relevância na Pesquisa
96.11%
Introdução: Ventilação mecânica (VM) é frequente em crianças com insuficiência respiratória aguda e está associada a complicações, sendo, portanto, necessários esforços para encurtar a sua duração. Objetivos: Verificar se a realização de avaliações diárias e testes de respiração espontânea (TRE), poderiam encurtar a duração da VM em crianças, quando comparado ao desmame habitualmente realizado em pediatria. Objetivos secundários incluíram a avaliação da taxa de falha de extubação e a necessidade de ventilação não invasiva (VNI). Desenho: Estudo prospectivo, randomizado, controlado. Ambiente: Duas unidades de cuidados intensivos pediátricos, em Hospitais Universitários no Brasil. Pacientes: Crianças entre 28 dias e 15 anos de idade que estavam recebendo VM por pelo menos 24 horas no período de julho 2007 a julho 2009. Intervenções: Os pacientes foram aleatoriamente designados para um dos dois protocolos de desmame. No grupo de teste, as crianças foram submetidas a avaliações diárias para verificar prontidão para desmame, depois foi realizado TRE com pressão de suporte de 10 cm H2O e PEEP de 5 cm H2O por um período de 2 horas. O TRE foi repetido no dia seguinte nas crianças que não passaram no primeiro teste. No grupo controle...

Avaliação do uso "precoce" de albumina em crianças com queimadura extensa: um ensaio clínico randomizado controlado; Evaluation of the "early" use of albumin in children with extensive burns: a clinical randomized controlled trial

Dittrich, Maria Helena Müller
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 22/01/2015 PT
Relevância na Pesquisa
96.08%
Introdução: A reanimação fluídica da criança queimada é um desafio devido à intolerância à insuficiente ou excessiva oferta de líquidos. Há dúvidas em relação à utilização de solução coloide na ressuscitação volêmica e também quanto ao melhor momento a ser administrada. O momento ideal para a administração de albumina permanece em foco de debate, se deveria ser utilizada como estratégia de resgate, quando o volume de cristaloide infundido se torna excessivo, ou rotineiramente, como intervenção primária em pacientes com queimaduras extensas. Objetivos: Avaliar e comparar quanto a evolução clínica de crianças com lesões térmicas que receberam abordagem de infusão precoce (entre 8 e 12 horas do acidente) de solução coloide natural versus crianças que receberam abordagem de infusão tardia (após 24 horas do acidente) da mesma solução para reanimação na fase aguda. Metodologia: Ensaio Clínico Randomizado Controlado, realizado no Centro de Tratamento de Queimados do Hospital Universitário de Londrina. Foram estudadas 46 crianças (1 a 12 anos), apresentando entre 15% e 45% de Superfície Corporal Queimada, admitidas até a 12a hora após o acidente. Intervenção: Para a ressuscitação hídrica dos pacientes...

Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial

Dias,Letícia A. R.; Driusso,Patricia; Aita,Daniella L. C. C.; Quintana,Silvana M.; Bø,Kari; Ferreira,Cristine H. J.
Fonte: Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia Publicador: Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2011 EN
Relevância na Pesquisa
96.14%
BACKGROUND: The use of the pelvic floor muscle training for urinary incontinence treatment is well established but little is known about its effects in labor and newborn outcomes. OBJECTIVES: To evaluate the effects of antenatal pelvic floor muscle training and strength in labor and newborn outcomes in low-income pregnant women. METHODS: This is a randomized controlled trial that recruited forty-two nulliparous healthy pregnant women aged between 18-36 years old and able to contract the pelvic floor muscles. The participants were included in the study with 20 weeks of gestational age and had their pelvic floor muscles measured by vaginal squeeze pressure. They were randomly allocated into two groups: training group and a non-intervention control group. Then, all participants had their labor and newborn outcomes evaluated through consultation of medical records by a blinded researcher. RESULTS: There were no statistically significant differences between the groups regarding gestational age at birth, type of labor, duration of the second stage of labor, total time of labor, prevalence of laceration, weight and size of the baby, and Apgar score. No correlation was observed between pelvic floor muscle strength and the second stage or the total length of labor. CONCLUSIONS: This randomized controlled trial did not find any effect of pelvic floor muscle training or pelvic floor muscle strength on labor and newborn outcomes.

Comparative effectiveness of post-discharge strategies for hospitalized smokers: study protocol for the Helping HAND 2 randomized controlled trial

Reid, Zachary Z; Regan, Susan; Kelley, Jennifer HK; Streck, Joanna M; Ylioja, Thomas; Tindle, Hilary A; Chang, Yuchiao; Levy, Douglas E; Park, Elyse R; Singer, Daniel E; Carpenter, Kelly M; Reyen, Michele; Rigotti, Nancy A
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
96.2%
Background: Smoking cessation interventions for hospitalized smokers are effective in promoting smoking cessation, but only if the tobacco dependence treatment continues after the patient leaves the hospital. Sustaining tobacco dependence treatment after hospital discharge is a challenge for health care systems. Our previous single-site randomized controlled trial demonstrated the effectiveness of an intervention that facilitated the delivery of comprehensive tobacco cessation treatment, including both medication and counseling, after hospital discharge. We subsequently streamlined the intervention model to increase its potential for dissemination. This new model is being tested in a larger multi-site trial with broader eligibility criteria in order to enroll a more representative sample of hospitalized smokers. This paper describes the trial design and contrasts it with the earlier study. Methods/Design A 2-arm, 3-site randomized controlled trial is testing the hypothesis that a multi-component Sustained Care intervention is more effective than Standard Care in helping hospitalized cigarette smokers stop smoking after hospital discharge. The trial enrolls adult daily cigarette smokers who are admitted to 1 of 3 participating hospitals in Massachusetts or Pennsylvania. Participants receive the same smoking cessation intervention in the hospital. They are randomly assigned to receive either Standard Care or Sustained Care after hospital discharge. Participants in the Sustained Care arm receive a free 3-month supply of FDA-approved smoking cessation medication and 5 interactive voice response calls that provide tailored motivational messages...

Nutritional effect of including egg yolk in the weaning diet of breast-fed and formula-fed infants: a randomized controlled trial

Makrides, M.; Hawkes, J.; Neuman, M.; Gibson, R.
Fonte: Amer Soc Clinical Nutrition Publicador: Amer Soc Clinical Nutrition
Tipo: Artigo de Revista Científica
Publicado em //2002 EN
Relevância na Pesquisa
96.1%
Background: Egg yolks can be a source of docosahexaenoic acid (DHA) and iron but are often associated with adverse consequences on plasma cholesterol. Objective: Our goal was to investigate the effect of consumption of 4 egg yolks/wk on infant DHA status and hemoglobin, ferritin, and plasma cholesterol concentrations. Secondary outcomes included plasma iron, transferrin, and transferrin saturation. Design: This was a randomized controlled trial comparing no dietary intervention, consumption of 4 regular egg yolks/wk, and consumption of 4 n-3 fatty acid–enriched egg yolks/wk in breast-fed and formula-fed infants from 6 to 12 mo of age. Erythrocyte DHA concentrations, cholesterol, and iron status were assessed at 6 and 12 mo of age. Results: Of the 82 breast-fed infants recruited, 23 of 28 (no intervention), 23 of 27 (regular eggs), and 24 of 27 (n-3 eggs) completed the trial. Of the 79 formula-fed infants enrolled, 23 of 27 (no intervention), 24 of 26 (regular eggs), and 20 of 26 (n-3 eggs) completed the trial. Erythrocyte DHA concentrations were 30–40% higher after the n-3 egg intervention than after treatment with regular eggs or no eggs in both breast-fed and formula-fed infants. Egg treatment had no significant effect on plasma cholesterol...

Psychosocial outcomes of a randomized controlled trial of outpatient cervical priming for induction of labor

Turnbull, D.; Adelson, P.; Oster, C.; Bryce, R.; Fereday, J.; Wilkinson, C.
Fonte: Blackwell Publishing Inc Publicador: Blackwell Publishing Inc
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
96.14%
BACKGROUND: Induction of labor, an increasingly common intervention, is often preceded by the application of an agent to “prime” or “ripen” the cervix. We conducted a randomized controlled trial to compare clinical, economic, and psychosocial outcomes of inpatient and outpatient cervical priming before induction of labor. In this paper we present the psychosocial outcomes. METHODS: Women participating in a randomized controlled trial in two Australian metropolitan teaching hospitals completed questionnaires to measure anxiety and depression at enrollment, and to examine satisfaction, experiences, depression, and infant feeding 7 weeks after giving birth. Data analysis was by intention to treat and by having received the intervention as intended (approximately 50% in each group). RESULTS: Of 1,004 eligible women, 85 percent consented (n = 407, outpatient; n = 414 inpatient). No statistically significant or clinically relevant differences were found in immediate anxiety, depression, or infant feeding. Small, statistically significant differences favoring outpatient priming were found in seven of the nine subscales in the 7-week postpartum questionnaire. The direction of the effect was maintained, mostly with a larger effect size in women who received the intervention. CONCLUSION: Women allocated to outpatient priming were more satisfied with their priming experience than women allocated to inpatient priming. Being informed that they could go home after cervical priming did not increase women’s anxiety.; Deborah Turnbull...

Early regular egg exposure in infants with eczema: a randomized controlled trial

Palmer, D.; Metcalfe, J.; Makrides, M.; Gold, M.; Quinn, P.; West, C.; Loh, R.; Prescott, S.
Fonte: Mosby Inc Publicador: Mosby Inc
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
96.08%
BACKGROUND: Observational studies suggest that early regular ingestion of allergenic foods might reduce the risk of food allergy. OBJECTIVE: We sought to determine whether early regular oral egg exposure will reduce subsequent IgE-mediated egg allergy in infants with moderate-to-severe eczema. METHODS: In a double-blind, randomized controlled trial infants were allocated to 1 teaspoon of pasteurized raw whole egg powder (n = 49) or rice powder (n = 37) daily from 4 to 8 months of age. Cooked egg was introduced to both groups after an observed feed at 8 months. The primary outcome was IgE-mediated egg allergy at 12 months, as defined based on the results of an observed pasteurized raw egg challenge and skin prick tests. RESULTS: A high proportion (31% [15/49]) of infants randomized to receive egg had an allergic reaction to the egg powder and did not continue powder ingestion. At 4 months of age, before any known egg ingestion, 36% (24/67) of infants already had egg-specific IgE levels of greater than 0.35 kilounits of antibody (kUA)/L. At 12 months, a lower (but not significant) proportion of infants in the egg group (33%) were given a diagnosis of IgE-mediated egg allergy compared with the control group (51%; relative risk, 0.65; 95% CI...

Comparison of mailed invitation strategies to improve fecal occult blood test participation in men: protocol for a randomized controlled trial

Duncan, A.; Zajac, I.; Flight, I.; Stewart, B.; Wilson, C.; Turnbull, D.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
96.14%
BACKGROUND Men have a significantly increased risk of being diagnosed with, and dying from, colorectal cancer (CRC) than women. Men also participate in fecal occult blood test (FOBT) screening at a lower rate than women. This study will determine whether strategies that target men’s attitudes toward screening, and matched to stage of readiness to screen, increase men’s FOBT participation compared to a standard approach. METHODS/DESIGN Eligible trial participants will be a national sample of 9,200 men aged 50 to 74 years, living in urban Australia and randomly selected from the Australian electoral roll. Trial participants will be mailed an advance notification letter, followed 2 weeks later by an invitation letter and a free fecal immunochemical test (FIT) kit. The intervention is a factorial design, randomized controlled trial (RCT) with four trial arms, including a control. The content of the advance notification and invitation letters will differ by trial arm as follows: 1) standard advance notification and standard invitation (control arm); 2) targeted advance notification and standard invitation; 3) standard advance notification and targeted invitation; and 4) targeted advance notification and targeted invitation. The standard letters will replicate as closely as possible the letters included in the Australian National Bowel Cancer Screening Program (NBCSP). Modified advance notification and invitation letters will incorporate additional messages to target men in the precontemplation (advance notification) and contemplation stages (invitation). The primary outcome is return of the completed FIT within 12 weeks of invitation. Analysts will be blinded to trial assignment and participants will be blinded to the use of varying invitational materials. Subsamples from each trial arm will complete baseline and endpoint surveys to measure the psychological impact of the intervention...

A randomized controlled trial to assess the clinical and cost effectiveness of a nurse-led Antenatal Asthma Management Service in South Australia (AAMS study)

Grzeskowiak, L.; Dekker, G.; Rivers, K.; Roberts-Thomson, K.; Roy, A.; Davies, M.; Beilby, J.; Wilson, A.; Middleton, P.; Ruffin, R.; Karnon, J.; Clifton, V.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
96.17%
Background: Pregnancy presents a unique situation for the management of asthma as it can alter the course of asthma severity and its treatment, which in turn can affect pregnancy outcomes. Despite awareness of the substantial adverse effects associated with asthma during pregnancy, little has been done to improve its management and reduce associated perinatal morbidity and mortality. The aim of this randomized controlled trial is to evaluate the clinical and cost effectiveness of an Antenatal Asthma Management Service. Methods/design: Design: Multicentre, randomized controlled trial. Inclusion criteria: Women with physician diagnosed asthma, which is not currently in remission, who are less than 20 weeks gestation with a singleton pregnancy and do not have a chronic medical condition. Trial entry and randomization: Eligible women with asthma, stratified by treatment site, disease severity and parity, will be randomized into either the ‘Standard Care Group’ or the ‘Intervention Group’. Study groups: Both groups will be followed prospectively throughout pregnancy. Women in the ‘Standard Care Group’ will receive routine obstetric care reflecting current clinical practice in Australian hospitals. Women in the ‘Intervention Group’ will receive additional care through the nurse-led Antenatal Asthma Management Service...

A web- and mobile phone-based intervention to prevent obesity in 4-year-olds (MINISTOP): a population-based randomized controlled trial

Delisle, Christine; Sandin, Sven; Forsum, Elisabet; Henriksson, Hanna; Trolle-Lagerros, Ylva; Larsson, Christel; Maddison, Ralph; Ortega Porcel, Francisco B.; Ruiz, Jonatan R.; Silfvernagel, Kristin; Timpka, Toomas; L??f, Marie
Fonte: Biomed Central Publicador: Biomed Central
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
96.08%
Background: Childhood obesity is an increasing health problem globally. Overweight and obesity may be established as early as 2???5 years of age, highlighting the need for evidence-based effective prevention and treatment programs early in life. In adults, mobile phone based interventions for weight management (mHealth) have demonstrated positive effects on body mass, however, their use in child populations has yet to be examined. The aim of this paper is to report the study design and methodology of the MINSTOP (Mobile-based Intervention Intended to Stop Obesity in Preschoolers) trial.; Methods/Design: A two-arm, parallel design randomized controlled trial in 300 healthy Swedish 4-year-olds is conducted. After baseline measures, parents are allocated to either an intervention- or control group. The 6- month mHealth intervention consists of a web-based application (the MINSTOP app) to help parents promote healthy eating and physical activity in children. MINISTOP is based on the Social Cognitive Theory and involves the delivery of a comprehensive, personalized program of information and text messages based on existing guidelines for a healthy diet and active lifestyle in pre-school children. Parents also register physical activity and intakes of candy...

Efficacy of dignity therapy for depression and anxiety in terminally-ill patients: early results of a randomized controlled trial

Julião, M.; Barbosa, A.; Oliveira, F.; Nunes, Baltazar; Vaz Carneiro, A.
Fonte: Cambridge University Press (CUP) Publicador: Cambridge University Press (CUP)
Tipo: Artigo de Revista Científica
Publicado em 19/03/2013 ENG
Relevância na Pesquisa
96.08%
Objective: Dignity therapy (DT) is a short-term psychotherapy developed for patients living with a life-limiting illness. Our aim was to determine the influence of DT on symptoms of depression and anxiety in people with a life-threatening disease with high level of distress, referred to an inpatient palliative care unit. Method: This was an open-label randomized controlled trial. Sixty terminally ill patients were randomly assigned to one of two groups: intervention group (DT+ standard palliative care [SPC]) or control group (SPC alone). The main outcomes were symptoms of depression and anxiety, measured with the Hospital Anxiety and Depression Scale, assessed at baseline, day 4, day 15, and day 30 of follow-up. Results: Of the 60 participants, 29 were randomized to DT and 31 to SPC. Baseline characteristics were similar between the two groups. DT was associated with a significant decrease in depressive symptoms at day 4 and day 15 (mean = −4.46, 95% CI, −6.91–2.02, p = 0.001; mean= −3.96, 95% CI, −7.33 to −0.61; p = 0.022, respectively), but not at day 30 (mean = −3.33, 95% CI, −7.32–0.65, p = 0.097). DT was also associated with a significant decrease in anxiety symptoms at each follow-up (mean= −3.96, 95% CI...

Effects of full-mouth scaling on the periodontal health of indigenous Australians: a randomized controlled trial

Kapellas, K.; Do, L.; Bartold, P.; Skilton, M.; Maple-Brown, L.; O'Dea, K.; Brown, A.; Celermajer, D.; Slade, G.; Jamieson, L.
Fonte: Blackwell Munksgaard Publicador: Blackwell Munksgaard
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
96.11%
BACKGROUND: Simplified periodontal therapy might be a pragmatic strategy for public health programmes targeting Indigenous Australian adults. The objective of this randomized controlled trial was to evaluate oral health effects of single-visit, non-surgical periodontal therapy compared to no treatment. METHODS: This parallel-group, randomized, open label clinical trial enrolled 273 Indigenous Australians aged ≥18 years with periodontitis. Intervention participants received full-mouth periodontal scaling and root planing during a single visit while the control group received no treatment. Endpoints were summary variables derived from clinical assessments of probing depth, clinical attachment loss, plaque, calculus and gingival bleeding before treatment and 3 months later. RESULTS: Endpoints could be calculated for 169 participants with follow-up data. Compared to the control group, there were statistically significant reductions in extent of shallow pockets: PD ≥4 mm (mean difference -2.86, [95% CI -5.01 to -0.71], p = 0.009) and gingival bleeding (mean difference -0.25, [95% CI -0.43 to -0.08], p = 0.005) but not deeper pockets PD ≥5 mm (mean difference -0.48, [95% CI -1.78 to 0.82], p = 0.468) or plaque scores. CONCLUSIONS: Periodontal therapy produced improvements in shallow periodontal pockets and measures of gingival bleeding in these Indigenous Australians.; Kostas Kapellas...

Do small group workshops and locally adapted guidelines improve asthma patients' health outcomes? A cluster randomized controlled trial

Sulaiman, N.; Barton, C.; Liaw, S.; Harris, C.; Sawyer, S.; Abramson, M.; Robertson, C.; Dharmage, S.
Fonte: Oxford Univ Press Publicador: Oxford Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
96.08%
Objective. To improve health outcomes of children and adolescents with asthma using a multifaceted intervention for GPs. Methods. The design of the study was a cluster randomized controlled trial. GPs were randomized at a practice level in general practice clinics in Melbourne, Australia. Participants were children/adolescents aged 2–14 years with asthma and their caregivers identified from the medical records of participating clinics. Questionnaires were completed by 411 at baseline and 341 at follow-up. The intervention arm (n = 18 GPs) participated in a small group asthma education programme and was provided with locally adapted paediatric asthma guidelines. One control arm (n = 18 GPs) received only the adapted paediatric asthma guidelines, while the other control arm (n  = 15 GPs) received an unrelated educational intervention. The outcome measures of the study were children/adolescents and caregivers completed questionnaires about asthma management and control, asthma knowledge and quality of life at recruitment and 6 months later. Ownership of a written asthma action plan (WAAP) was the primary outcome. Results. There was no evidence for changes in ownership of WAAPs between the three study arms. Adolescents in the intervention group reported an improvement in quality of life subscale score ‘positive effects’ (mean difference = 2.64...

Modular Approach to Therapy for Anxiety, Depression, Trauma, or Conduct Problems in outpatient child and adolescent mental health services in New Zealand: study protocol for a randomized controlled trial

Lucassen, Mathijs F. G.; Stasiak, Karolina; Crengle, Sue; Weisz, John R.; Frampton, Christopher M. A.; Bearman, Sarah Kate; Ugueto, Ana M.; Herren, Jennifer; Cribb-Su’a, Ainsleigh; Faleafa, Monique; Kingi-’Ulu’ave, Denise; Loy, Jik; Scott, Rebecca M
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
96.13%
Background: Mental health disorders are common and disabling for young people because of the potential to disrupt key developmental tasks. Implementation of evidence-based psychosocial therapies in New Zealand is limited, owing to the inaccessibility, length, and cost of training in these therapies. Furthermore, most therapies address one problem area at a time, although comorbidity and changing clinical needs commonly occur in practice. A more flexible approach is needed. The Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC) is designed to overcome these challenges; it provides a range of treatment modules addressing different problems, within a single training program. A clinical trial of MATCH-ADTC in the USA showed that MATCH-ADTC outperformed usual care and standard evidence-based treatment on several clinical measures. We aim to replicate these findings and evaluate the impact of providing training and supervision in MATCH-ADTC to: (1) improve clinical outcomes for youth attending mental health services; (2) increase the amount of evidence-based therapy content; (3) increase the efficiency of service delivery. Methods: This is an assessor-blinded multi-site effectiveness randomized controlled trial. Randomization occurs at two levels: (1) clinicians (≥60) are randomized to intervention or usual care; (2) youth participants (7–14 years old) accepted for treatment in child and adolescent mental health services (with a primary disorder that includes anxiety...

A randomized controlled trial of fallopian tube sperm perfusion compared with standard intrauterine insemination for women with non-tubal infertility

Farquhar, C.M.; Brown, J.; Arroll, N.; Gupta, D.; Boothroyd, C.V.; Al Bassam, M.; Moir, J.; Johnson, N.P.
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
96.16%
STUDY QUESTION: Does fallopian tube sperm perfusion (FSP) result in better pregnancy and live birth rates than standard intrauterine insemination (SIUI) for couples with non-tubal infertility with or without gonadotrophin or clomiphene stimulation? SUMMARY ANSWER: There was no evidence of an improvement in live birth rates with FSP compared with SIUI. WHAT IS KNOWN ALREADY: Previous randomized controlled trials have suggested improved live birth rates with FSP but these trials were small. A systematic review published in 2004 suggested heterogeneity in results. STUDY DESIGN, SIZE, AND DURATION: This pragmatic, multicentre, randomized controlled trial compared SIUI and FSP in 417 women with non-tubal infertility. PARTICIPANTS/MATERIALS, SETTING, METHODS: The patients were treated at fertility clinics in New Zealand, Australia and the United Arab Emirates. MAIN RESULTS AND THE ROLE OF CHANCE: Four hundred and seventeen women were randomized to SIUI (n = 210) or FSP (n = 207). Data were available for analysis from 198 women in the SIUI group and 198 women in the FSP group. There were 19 women with incomplete data because of cycle cancellation or withdrawals and 2 women who conceived prior to commencing treatment. There were no significant differences in live birth rates between the two groups with 27 (12.9%) in the SIUI group and 21 in the FSP group (10.1%) [Odds Ratio (OR) 1.31 (0.71...

The Randomized Controlled Trial: Gold Standard, or Merely Standard?

Grossman, Jason; Mackenzie, Fiona
Fonte: Johns Hopkins University Press Publicador: Johns Hopkins University Press
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
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The randomized controlled trial (RCT) is not a gold standard: it is a good experimental design in some circumstances, but that's all. Potential shortcomings in the design and implementation of RCTs are often mentioned in passing, yet most researchers cons

A randomized controlled trial of buprenorphine in the management of short-term ambulatory heroin withdrawal

Lintzeris, Nicholas; Bammer, Gabriele; Jolley, Damien; Rushworth, Louise; Bell, James
Fonte: Carfax Publishing, Taylor & Francis Group Publicador: Carfax Publishing, Taylor & Francis Group
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
96.11%
Aim: To determine whether buprenorphine is more effective than clonidine and other symptomatic medications in managing ambulatory heroin withdrawal. Design: Open label, prospective randomized controlled trial examining withdrawal and 4-week postwithdrawal outcomes on intention-to-treat. Setting: Two specialist, out-patient drug treatment centres in inner city Melbourne and Sydney, Australia. Participants: One hundred and fourteen dependent heroin users were recruited. Participants were 18 years or over, and with no significant other drug dependence, medical or psychiatric conditions or recent methadone treatment. One hundred and one (89%) participants completed a day 8 research interview examining withdrawal outcomes, and 92 (81%) completed day 35 research interview examining postwithdrawal outcomes. Interventions: Participants randomized to control (n = 56) (up to 8 days of clonidine and other symptomatic medications) or experimental (n = 58) (up to 5 days of buprenorphine) withdrawal groups. Following the 8-day withdrawal episode, participants could self-select from range of postwithdrawal options (naltrexone, substitution maintenance, or counselling). Measurements: Retention in withdrawal; heroin use during withdrawal; and retention in drug treatment 4 weeks after withdrawal. Secondary outcomes: Withdrawal severity; adverse events...