2,162 results match your criteria improved postintervention


Supporting treatment adherence regimens in children with epilepsy: A randomized clinical trial.

Epilepsia 2021 May 12. Epub 2021 May 12.

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Objective: This study was undertaken to examine the efficacy of a family-tailored education and problem-solving behavioral intervention, Supporting Treatment Adherence Regimens (STAR), in young children (2-12 years old) with new onset epilepsy compared to an attention control (i.e., education only [EO]) intervention. Read More

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Enhancing the cardiovascular protective effects of a healthy dietary pattern with wolfberry (Lycium barbarum): A randomized controlled trial.

Am J Clin Nutr 2021 May 8. Epub 2021 May 8.

Department of Food Science & Technology, Faculty of Science, National University of Singapore, Singapore, Singapore.

Background: The consumption of wolfberry (Lycium barbarum), a rich source of carotenoids and bioactive polysaccharides, may serve as a potential dietary strategy for cardiovascular disease (CVD) risk management although limited studies examined its effects as whole fruits.

Objectives: To investigate the impact of wolfberry consumption as part of a healthy dietary pattern on vascular health-related outcomes and classical CVD risk factors in middle-aged and older adults in Singapore.

Methods: This is a 16-week, parallel design, randomized controlled trial. Read More

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Cost-Effectiveness of a Diabetes Self-Management Education and Support Intervention Led by Community Health Workers and Peer Leaders: Projections From the Racial and Ethnic Approaches to Community Health Detroit Trial.

Diabetes Care 2021 May 6;44(5):1108-1115. Epub 2021 May 6.

Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.

Objective: To simulate the long-term cost-effectiveness of a peer leader (PL)-led diabetes self-management support (DSMS) program following a structured community health worker (CHW)-led diabetes self-management education (DSME) program in reducing risks of complications in people with type 2 diabetes (T2D).

Research Design And Methods: The trial randomized 222 Latino adults with T2D to ) enhanced usual care (EUC); ) a CHW-led, 6-month DSME program and 6 months of CHW-delivered monthly telephone outreach (CHW only); or ) a CHW-led, 6-month DSME program and 12 months of PL-delivered weekly group sessions with telephone outreach to those unable to attend (CHW PL). Empirical data from the trial and the validated Michigan Model for Diabetes were used to estimate cost and health outcomes over a 20-year time horizon from a health care sector perspective, discounting both costs and benefits at 3% annually. Read More

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Enhancing Residents' Warmth in Greeting Caregivers: An Inpatient Intervention to Improve Family-Centered Communication.

J Healthc Qual 2021 May-Jun 01;43(3):183-193

Abstract: Hospitals are increasingly motivated to improve the patient and family experience and increase patient satisfaction scores. The manner by which a provider greets patients and their families sets the tone for the hospital stay. This study aimed to improve residents' greetings of caregivers in the inpatient pediatric setting to improve family-centered communication. Read More

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Corpus Callosum Integrity Relates to Improvement of Upper-Extremity Function Following Intensive Rehabilitation in Children With Unilateral Spastic Cerebral Palsy.

Neurorehabil Neural Repair 2021 May 6:15459683211011220. Epub 2021 May 6.

Burke Neurological Institute, Weill Cornell Medicine, New York, NY, USA.

Background: The corpus callosum (CC) plays an important role in upper extremity (UE) function. The impact on UE function in children with unilateral spastic cerebral palsy (USCP) and improvements following intensive interventions remain unknown.

Objectives: To examine the (1) relationship between UE function and CC integrity and (2) relationship between CC integrity and changes in UE function following intensive interventions. Read More

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The Impact of an Educational Intervention on Nursing Staff Attitudes Toward Patients Experiencing Homelessness and Mental Illness.

J Am Psychiatr Nurses Assoc 2021 May 5:10783903211011669. Epub 2021 May 5.

Sheryl B. Fleisch, MD, Vanderbilt University Medical Center, Nashville, TN, USA.

Objective: Patients who experience homelessness and have mental illness can have frequent and challenging hospitalizations. Nurses caring for this vulnerable population may have negative attitudes, which can be mitigated by education and improved for the benefit of patients. This study aimed to assess the impact of an educational intervention on the attitudes of nursing staff toward individuals experiencing homelessness and mental illness. Read More

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HiCommunication as a novel speech and communication treatment for Parkinson's disease: A feasibility study.

Brain Behav 2021 May 4:e02150. Epub 2021 May 4.

Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.

Introduction: Speech and communication problems are common in Parkinson's disease (PD) and can result in social withdrawal and reduced quality of life. Intervention may improve symptoms but transfer and maintenance remain challenging for many. Access to treatment may also be limited. Read More

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Mitigating the gender gap: How "DOCTOR" badges affect physician identity.

Am J Emerg Med 2021 Apr 24;46:141-145. Epub 2021 Apr 24.

Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South Bronx, NY 10461, United States of America. Electronic address:

Objectives: Patients and their families frequently misclassify female physicians in the Emergency Department (ED) as non-physicians. Physician misidentification impacts the environment of care on multiple levels; including patient satisfaction and physician well-being. Implementing "DOCTOR" badges may be a low-cost tool to rectify these problems. Read More

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Improvement of Inpatient Psychiatric Facility Quality Reporting program measure: Screening for metabolic disorders through pharmacy collaborative practice agreement.

J Am Pharm Assoc (2003) 2021 Apr 21. Epub 2021 Apr 21.

Background: Second-generation antipsychotics are associated with lower risks of extrapyramidal symptoms, including tardive dyskinesia. However, many second-generation antipsychotics are associated with metabolic adverse effects, including weight gain, impaired blood glucose control, and hyperlipidemia. Metabolic monitoring for patients prescribed antipsychotic medication is 1 of several measures of the Centers for Medicare & Medicaid Services' Inpatient Psychiatric Facility Quality Reporting program. Read More

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Cognitive Behavioral Therapy for Mood and Insomnia in Persons With Dementia: A Systematic Review.

Alzheimer Dis Assoc Disord 2021 Apr 28. Epub 2021 Apr 28.

McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth) Houston Veterans Affairs Health Services Research and Development Service Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center Baylor College of Medicine Houston Methodist Library University of Houston, Collaborative on Aging Research and Multicultural Assessment (CARMA), Houston, TX Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Little Rock, AR.

Background: Cognitive behavioral therapy (CBT) is a goal-oriented intervention that aims to improve detrimental emotional or behavioral distress by modifying individuals' thought processes. This review evaluates the efficacy and specific adaptations of CBT in persons with mild cognitive impairment and dementia.

Methods: A literature search of PubMed, Embase, and PsycINFO was conducted up to March 2020. Read More

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Human Papillomavirus Knowledge and Communication Skills: A Role-Play Activity for Providers.

MedEdPORTAL 2021 04 23;17:11150. Epub 2021 Apr 23.

Associate Professor, Department of Medicine, Division of Geriatric Medicine, NYU Long Island School of Medicine; Assistant Dean, Faculty Development and Mentoring, NYU Long Island School of Medicine.

Introduction: Human papillomavirus (HPV) infection and related cancers are a major cause of morbidity and mortality worldwide. Routine vaccination against HPV is recommended for patients starting at age 9-12 years. Discussing this vaccine with parents of young children can be challenging for clinicians. Read More

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Reducing Futile Acute Care Services for Terminally Ill Patients With Cancer: The Dignity Project.

JCO Oncol Pract 2021 Apr 27:OP2000922. Epub 2021 Apr 27.

Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Purpose: Patients with terminal diseases frequently undergo interventions that are futile and may be detrimental to their quality of life. We conducted a quality improvement project aimed to reduce the utilization of futile acute care services (ACSs) for patients with cancer treated with a palliative intent.

Methods: A multidisciplinary team reviewed the records of terminally ill patients with cancer who died between November 2017 and May 2018, during their admission at our institution. Read More

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Developing Effective Senior Nurse Leaders: The Impact of an Advanced Leadership Initiative.

J Nurs Adm 2021 May;51(5):271-278

Author Affiliations: Chief Nurse Executive, TriStar Division (Dr Sisk), and Chief Nurse Executive, National Group (Dr Mosier), HCA Healthcare, Nashville, Tennessee; Associate Chief Nurse (Dr Williams), Research, and Statistician (Mr Coppin), Central Texas Veterans Health Care System, Temple; and Regents Professor (Dr Robinson), School of Nursing, College of Health and Human Services, Northern Kentucky University, Highland Heights.

Objective: The aim of this study was to measure structural empowerment (SE) and capture short-term changes in perception for senior nurse leaders before and after a formal development experience.

Background: The body of literature related to SE in senior nurse leaders is limited. Applying the SE concept to senior levels of nursing leadership provides a vehicle to impact nurse leader retention and ultimately the organization beyond singular units. Read More

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Polymorphisms in SLC44A1 are associated with cognitive improvement in children diagnosed with fetal alcohol spectrum disorder: an exploratory study of oral choline supplementation.

Am J Clin Nutr 2021 Apr 19. Epub 2021 Apr 19.

Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN, USA.

Background: The essential nutrient choline provides one-carbon units for metabolite synthesis and epigenetic regulation in tissues including brain. Dietary choline intake is often inadequate, and higher intakes are associated with improved cognitive function.

Objective: Choline supplements confer cognitive improvement for those diagnosed with fetal alcohol spectrum disorder (FASD), a common set of neurodevelopmental impairments; however, the effect sizes have been modest. Read More

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Perioperative Peripheral Nerve Block Safety Education: A Quality Improvement Project.

Authors:
Pauline Zelaya

J Perianesth Nurs 2021 Apr 15. Epub 2021 Apr 15.

Department of Anesthesiology, Raymond G. Murphy Veterans Affairs Medical Center, Albuquerque, NM. Electronic address:

Purpose: The purpose of the quality improvement (QI) project was to improve patient safety by increasing the consistency of monitor application and oxygen administration during the placement of peripheral nerve blocks (PNBs), advance the knowledge of perianesthesia staff about PNB safety, and develop a PNB hospital policy.

Design: QI project using the focus, analyze, develop, and execute model.

Methods: The project had two parts, an educational component that was deployed in the three hospitals (hospital A, hospital B, hospital C) and an observation component that was conducted in only one of the hospitals (hospital A). Read More

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Do as I Do: Physician- and Learner-Led Mind-Body Medicine Group Visits.

PRiMER 2021 1;5. Epub 2021 Feb 1.

Division of Primary Care, Department of Medicine, Stanford University School of Medicine, Stanford, CA.

Introduction: Care of patients with chronic medical and mental health conditions can be a source of frustration for primary care clinicians and may present a challenge in modeling effective interventions for medical learners. Mind-body medicine (MBM) interventions have shown success for a variety of conditions, and training in MBM has been associated with decreased burnout and improved professional satisfaction.8 We piloted MBM collaborative visits led by faculty physicians and facilitated by medical learners. Read More

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February 2021

Improving Inpatient Consult Communication Through a Standardized Tool.

Pediatrics 2021 May 15;147(5). Epub 2021 Apr 15.

Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, California.

Objectives: To increase the number of essential consult elements (ECEs) included in initial inpatient consultation requests between pediatric residents and fellows through implementation of a novel consult communication tool.

Methods: Literature review and previous needs assessment of pediatric residents and fellows were used to identify 4 specific ECEs. From February to June 2018, fellows audited verbal consult requests at a medium-sized, quaternary care children's hospital to determine the baseline percentage of ECE components within consults. Read More

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Education M&M: Reviving Intraoperative Teaching and Learning.

J Surg Res 2021 Apr 10;264:462-468. Epub 2021 Apr 10.

Ohio State University Wexner Medical Center, Columbus, Ohio.

Background: Using the platform of morbidity and mortality conference, we developed and executed a combined faculty-resident intervention called "Education M&M" to discuss challenges faced by both parties in the operating room (OR), identify realistic solutions, and implement action plans. This study aimed to investigate the impact of this intervention on resident OR training.

Materials And Methods: Two resident case presentations were followed by audience discussion and recommendations regarding actionable solutions aimed at improving resident OR training from an expert faculty panel. Read More

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Evaluation of Time-Limited Trials Among Critically Ill Patients With Advanced Medical Illnesses and Reduction of Nonbeneficial ICU Treatments.

JAMA Intern Med 2021 Apr 12. Epub 2021 Apr 12.

Los Angeles County Department of Health Services, Los Angeles, California.

Importance: For critically ill patients with advanced medical illnesses and poor prognoses, overuse of invasive intensive care unit (ICU) treatments may prolong suffering without benefit.

Objective: To examine whether use of time-limited trials (TLTs) as the default care-planning approach for critically ill patients with advanced medical illnesses was associated with decreased duration and intensity of nonbeneficial ICU care.

Design, Setting, And Participants: This prospective quality improvement study was conducted from June 1, 2017, to December 31, 2019, at the medical ICUs of 3 academic public hospitals in California. Read More

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Self-compassion training for certified nurse assistants in nursing homes.

J Am Geriatr Soc 2021 Apr 10. Epub 2021 Apr 10.

The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States.

Background/objectives: Certified nursing assistants (CNAs) who work in nursing homes (NHs) face significant work and personal stress. Self-compassion training has been shown to decrease stress postintervention in previous studies among healthcare providers and those in helping professions. This study examines the feasibility, acceptability, and preliminary outcomes of self-compassion training to address CNA stress and well-being. Read More

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Predicting denture satisfaction and quality of life in completely edentulous: A mixed-mode study.

J Indian Prosthodont Soc 2021 Jan-Mar;21(1):88-98

Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pilliyarkuppam, Puducherry, India.

Aim: The aim of the study was to evaluate the effect of dentist's communication skills and patient's psychological factors in predicting denture satisfaction and quality of life.

Settings And Design: Cohort study.

Materials And Methods: Patient-related variables were obtained using questionnaires in both pre- and post-intervention phases. Read More

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January 2022

A Surgeon Badge or Text Message Sign-in Intervention Improves Operating Room Start Efficiency.

J Surg Res 2021 Apr 5;264:129-137. Epub 2021 Apr 5.

Department of Surgery, University of Virginia Health System, Charlottesville, Virginia. Electronic address:

Background: Operating room (OR) efficiency, often measured by first case on-time start (FCOTS) percentage, is an important driver of perioperative team morale and the financial success of a hospital.

Materials And Methods: In this quasi-experimental study of elective surgical procedures at a single tertiary academic hospital, an intervention requiring attending surgeon attestation of availability via SMS text message or identification badge swipe was implemented. Key measures of OR efficiency were compared before and after the change. Read More

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The Case for Virtual Sepsis Surveillance and Intervention.

Telemed J E Health 2021 Apr 7. Epub 2021 Apr 7.

Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

To determine whether deployment of an integrated virtual sepsis surveillance program could improve time to antibiotics and mortality in a longitudinal cohort of non-present on admission (NPOA) sepsis cases. We used an uncontrolled pre- and poststudy design to compare time to antibiotics and mortality between a time-based cohort of NPOA sepsis cases separated by the deployment of a virtual sepsis surveillance program. A total of 566 NPOA sepsis cases were included in this study. Read More

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A comprehensive intervention to enhance inpatient colon preparation quality for colonoscopy.

Minerva Gastroenterol (Torino) 2021 Apr 1. Epub 2021 Apr 1.

University of Utah School of Medicine, Salt Lake City, UT, USA -

Background: Adequate colon preparation is a critical component of high quality colonoscopy especially for inpatients undergoing colonoscopy for acute indications. Inpatient colonoscopy has a high incidences of inadequate preparations. We report implementation of a multifaceted quality improvement intervention to improve inpatient colonoscopy preparations. Read More

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Telephone consultation for myasthenia gravis care during the COVID-19 pandemic: Assessment of a novel virtual myasthenia gravis index.

Muscle Nerve 2021 Apr 1. Epub 2021 Apr 1.

Ellen & Martin Prosserman Centre for Neuromuscular Diseases, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Introduction/aims: The aim of the study was to determine the association between the virtual Myasthenia Gravis Impairment Index (vMGII) with other patient-reported outcomes (PROs) of myasthenia gravis (MG) and its usefulness in telephone consultations with MG patients.

Methods: This was a retrospective case series in which vMGII score along with virtual Single Simple Question (vSSQ), virtual Patient-Acceptable Symptom State PASS (vPASS) response, and patient disease status based on Myathenia Gravis Foundation of America postintervention status were collected during telephone consultation along with the MGII, SSQ, and PASS responses during the preceding in-person clinic visits.

Results: In 214 patients, the mean difference of vMGII between the vPASS "Yes" and "No" groups was -14. Read More

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No Added Benefit of 8 Weeks of Shoulder External Rotation Strength Training for Youth Handball Players Over Usual Handball Training Alone: A Randomized Controlled Trial.

J Orthop Sports Phys Ther 2021 04;51(4):174-187

Objective: To assess the effectiveness of a short (5-10 minutes) shoulder external rotation (ER) strength program, using elastic bands, in adolescent handball players.

Design: Randomized controlled trial.

Methods: The sample included 6 adolescent handball teams (3 female, 3 male) with a total of 92 players and a mean age of 16. Read More

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Effects of Three Months of Honey Supplementation on Quality of Life and Neuropathy in Type 2 Diabetic Patients.

Altern Ther Health Med 2021 Mar 31. Epub 2021 Mar 31.

Context: Diabetic neuropathy, a common debilitating complication of type 2 diabetes, can occur despite adequate treatment. To date, no studies have occurred on the use alternative medicine as an adjunct therapy for treating diabetic neuropathy.

Objective: The study assessed the effects of three months of honey supplementation on insulin resistance, lipid profiles, oxidant status, nerve conduction, and QOL in patients with diabetic neuropathy. Read More

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Joint Video Self-Modeling for Persons With Traumatic Brain Injury and Their Partners: A Case Series.

Am J Speech Lang Pathol 2021 04 30;30(2S):863-882. Epub 2021 Mar 30.

Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire.

Purpose Individuals with traumatic brain injury (TBI) experience impairments to self-regulation and social communication that strain relationships. Video self-modeling (VSM) provides visible and audible, tangible evidence of what they do well and what could improve. Conducting such training in the context of authentic exchanges with their everyday partners may support positive change in social communication. Read More

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Quality Improvement of Bowel Preparation for Screening Colonoscopies: A Study of Hospital Team Resource Management in Taiwan.

Qual Manag Health Care 2021 Apr-Jun 01;30(2):127-134

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan, Republic of China (Dr Chung); College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China (Dr Chung); Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan, Republic of China (Dr Lin); and Department of Healthcare Administration, Oriental Institute of Technology, New Taipei, Taiwan, Republic of China (Dr Chen).

Background And Objectives: This study aimed to investigate the impact of patient education using a medical team resource management (TRM) method on the adequacy of bowel preparation.

Methods: The study setting was a single hospital in northern Taiwan, and a total of 2104 (884 female, 1220 male) healthy subjects who underwent a health checkup colonoscopy screening were enrolled before and after the application of the TRM program intervention. The efficacy of the TRM intervention and the factors affecting bowel preparation were estimated using multivariate logistic regression. Read More

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Effect of Autologous Expanded Bone Marrow Mesenchymal Stem Cells or Leukocyte-Poor Platelet-Rich Plasma in Chronic Patellar Tendinopathy (With Gap >3 mm): Preliminary Outcomes After 6 Months of a Double-Blind, Randomized, Prospective Study.

Am J Sports Med 2021 May 30;49(6):1492-1504. Epub 2021 Mar 30.

Department of Musculoskeletal Disorders, University of Salerno School of Medicine, Surgery and Dentistry, Salerno, Italy.

Background: Patellar tendinopathy is common. The success of traditional management, including isometric or eccentric exercises combined with shockwave therapy and even surgery, is limited. Therefore, it is important to determine whether biological treatments such as ultrasound-guided intratendinous and peritendinous injections of autologous expanded bone marrow mesenchymal stem cells (BM-MSCs) or leukocyte-poor platelet-rich plasma (Lp-PRP) improve clinical outcomes in athletic patients with patellar tendinopathy. Read More

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