88 research outputs found
Web-Based Randomized Controlled Trial
Background: Patients often seek other patientsâ experiences with the disease.
The Internet provides a wide range of opportunities to share and learn about
other peopleâs health and illness experiences via blogs or patient-initiated
online discussion groups. There also exists a range of medical information
devices that include experiential patient information. However, there are
serious concerns about the use of such experiential information because
narratives of others may be powerful and pervasive tools that may hinder
informed decision making. The international research network DIPEx (Database
of Individual Patientsâ Experiences) aims to provide scientifically based
online information on peopleâs experiences with health and illness to fulfill
patientsâ needs for experiential information, while ensuring that the
presented information includes a wide variety of possible experiences.
Objective: The aim is to evaluate the colorectal cancer module of the German
DIPEx website krankheitserfahrungen.de with regard to self-efficacy for coping
with cancer and patient competence. Methods: In 2015, a Web-based randomized
controlled trial was conducted using a two-group between-subjects design and
repeated measures. The study sample consisted of individuals who had been
diagnosed with colorectal cancer within the past 3 years or who had metastasis
or recurrent disease. Outcome measures included self-efficacy for coping with
cancer and patient competence. Participants were randomly assigned to either
an intervention group that had immediate access to the colorectal cancer
module for 2 weeks or to a waiting list control group. Outcome criteria were
measured at baseline before randomization and at 2 weeks and 6 weeks Results:
The study randomized 212 persons. On average, participants were 54 (SD 11.1)
years old, 58.8% (124/211) were female, and 73.6% (156/212) had read or heard
stories of other patients online before entering the study, thus excluding any
influence of the colorectal cancer module on krankheitserfahrungen.de. No
intervention effects were found at 2 and 6 weeks after baseline. Conclusions:
The results of this study do not support the hypothesis that the website
studied may increase self-efficacy for coping with cancer or patient
competencies such as self-regulation or managing emotional distress. Possible
explanations may involve characteristics of the website itself, its use by
participants, or methodological reasons. Future studies aimed at evaluating
potential effects of websites providing patient experiences on the basis of
methodological principles such as those of DIPEx might profit from extending
the range of outcome measures, from including additional measures of website
usage behavior and usersâ motivation, and from expanding concepts, such as
patient competency to include items that more directly reflect patientsâ
perceived effects of using such a website. Trial Registration:
Clinicaltrials.gov NCT02157454;
https://clinicaltrials.gov/ct2/show/NCT02157454 (Archived by WebCite at
http://www.webcitation.org/6syrvwXxi
Phase refinement and extension by means of non-crystallographic symmetry averaging using parallel computers
Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake
Background. Tooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown. Objective. To conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB) intake among Alaska Native children. Design. Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, the terms “Alaska Native”, “children” and “oral health” were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970–2012) for relevant clinical trials and evaluation studies. Results. Eighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children. Conclusions. Few oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions are promising approaches to improve the oral and systemic health of Alaska Native children. Future investigators should evaluate the feasibility of implementing multilevel interventions and policies within Alaska Native communities as a way to reduce children's health disparities
Improving availability, promotion and purchase of fruit and vegetable and non sugar-sweetened drink products at community sporting clubs: a randomised trial
Clustering of energy balance-related behaviours and parental education in European preschool children: the ToyBox study
Adolescentsâ beverage choice at school and the impact on sugar intake
Background/Objectives:
To examine studentsâ beverage choice in school, with reference to its contribution to studentsâ intake of non-milk extrinsic (NME) sugars.
Subjects/Methods:
Beverage and food selection data for students aged 11â18 years (n=2461) were collected from two large secondary schools in England, for a continuous period of 145 (school A) and 125 (school B) school days. Descriptive analysis followed by cluster analysis of the beverage data were performed separately for each school.
Results:
More than a third of all items selected by students were beverages, and juice-based beverages were studentsâ most popular choice (school A, 38.6%; school B, 35.2%). Mean NME sugars derived from beverages alone was high (school A, 16.7âg/student-day; school B, 12.9âg/student-day). Based on beverage purchases, six clusters of students were identified at each school (school A: âjuice-basedâ, âassortedâ, âwaterâ, âcartoned flavoured milkâ, âbottled flavoured milkâ, âhigh volume juice-basedâ; school B: âassortedâ, âwater with juice-basedâ, âsparkling juice/juice-basedâ, âwaterâ, âhigh volume waterâ, âhigh volume juice-basedâ). Both schools included âhigh volume juice-basedâ clusters with the highest NME sugar means from beverages (school A, 28.6âg/student-day; school B, 24.4âg/student-day), and âwaterâ clusters with the lowest. A hierarchy in NME sugars was found according to cluster; students in the âhigh volume juice-basedâ cluster returned significantly higher levels of NME sugars than students in other clusters.
Conclusions:
This study reveals the contribution that school beverages combined with studentsâ beverage choice behaviour is making to studentsâ NME sugar intake. These findings inform school food initiatives, and more generally public health policy around adolescentsâ dietary intake
âWe talk it overâ - mixed-method study of interdisciplinary collaborations in private practice among urologists and oncologists in Germany
Effectiveness of school food environment policies on children's dietary behaviors: A systematic review and meta-analysis.
BACKGROUND: School food environment policies may be a critical tool to promote healthy diets in children, yet their effectiveness remains unclear. OBJECTIVE: To systematically review and quantify the impact of school food environment policies on dietary habits, adiposity, and metabolic risk in children. METHODS: We systematically searched online databases for randomized or quasi-experimental interventions assessing effects of school food environment policies on children's dietary habits, adiposity, or metabolic risk factors. Data were extracted independently and in duplicate, and pooled using inverse-variance random-effects meta-analysis. Habitual (within+outside school) dietary intakes were the primary outcome. Heterogeneity was explored using meta-regression and subgroup analysis. Funnel plots, Begg's and Egger's test evaluated potential publication bias. RESULTS: From 6,636 abstracts, 91 interventions (55 in US/Canada, 36 in Europe/New Zealand) were included, on direct provision of healthful foods/beverages (N = 39 studies), competitive food/beverage standards (N = 29), and school meal standards (N = 39) (some interventions assessed multiple policies). Direct provision policies, which largely targeted fruits and vegetables, increased consumption of fruits by 0.27 servings/d (n = 15 estimates (95%CI: 0.17, 0.36)) and combined fruits and vegetables by 0.28 servings/d (n = 16 (0.17, 0.40)); with a slight impact on vegetables (n = 11; 0.04 (0.01, 0.08)), and no effects on total calories (n = 6; -56 kcal/d (-174, 62)). In interventions targeting water, habitual intake was unchanged (n = 3; 0.33 glasses/d (-0.27, 0.93)). Competitive food/beverage standards reduced sugar-sweetened beverage intake by 0.18 servings/d (n = 3 (-0.31, -0.05)); and unhealthy snacks by 0.17 servings/d (n = 2 (-0.22, -0.13)), without effects on total calories (n = 5; -79 kcal/d (-179, 21)). School meal standards (mainly lunch) increased fruit intake (n = 2; 0.76 servings/d (0.37, 1.16)) and reduced total fat (-1.49%energy; n = 6 (-2.42, -0.57)), saturated fat (n = 4; -0.93%energy (-1.15, -0.70)) and sodium (n = 4; -170 mg/d (-242, -98)); but not total calories (n = 8; -38 kcal/d (-137, 62)). In 17 studies evaluating adiposity, significant decreases were generally not identified; few studies assessed metabolic factors (blood lipids/glucose/pressure), with mixed findings. Significant sources of heterogeneity or publication bias were not identified. CONCLUSIONS: Specific school food environment policies can improve targeted dietary behaviors; effects on adiposity and metabolic risk require further investigation. These findings inform ongoing policy discussions and debates on best practices to improve childhood dietary habits and health
âWeâre Justchrw⊠Food and Perverse Entertainmentâ: Supernaturalâs New God and the Narrative Objectification of Sam and Dean
- âŠ