Adolescent type 1 Diabetes Cardio-renal Intervention Trial (AdDIT).

BACKGROUND: The prognosis for young people diagnosed with diabetes during childhood remains poor and this is mainly related to the long-term risk of developing vascular complications.Microalbuminuria identifies subjects at risk for diabetic nephropathy (DN) and cardiovascular disease (CVD). It is often detected in adolescence but is rarely treated before the age of 18 years, as at the end of puberty albumin excretion may decline and in some subjects will return into the normal range. However, evidence indicates that subjects with both transient and persistent microalbuminuria have experienced renal damage during puberty and thus reno-protection to prevent long-term complications is warranted. In adults with diabetes and microalbuminuria, the use of angiotensin converting enzyme inhibitors (ACEI) and Statins is increasing, and in order to determine whether these agents are of value in the adolescent population a large randomized controlled clinical trial is needed. METHODS/DESIGN: The Adolescent type 1 Diabetes cardio-renal Intervention Trial (AdDIT) is a multi-center, randomized, double-blind, placebo-controlled trial of ACEI and Statin therapy in adolescents with type 1 diabetes. 500 high-risk adolescents, defined on the basis of their albumin excretion, are randomized to receive either ACEI (Quinapril) or Statins (Atorvastatin) or combination therapy or placebo for 3-4 years. There will also be a parallel open observational study, based on the follow-up of 400 low-risk non-randomized adolescents. The major endpoint of the study is the change in albumin excretion; secondary endpoints include markers of CVD, renal function, retinopathy, quality of life combined with assessment of compliance and potential health economic benefits. DISCUSSION: AdDIT will provide important data on the potential renal and cardiovascular protective effects of ACEI and Statins in high-risk adolescents. Long-term follow-up of the randomized subjects will provide direct evidence of disease outcomes, in addition to the data on early surrogate measures of DN and CVD. Follow-up of non-randomized low-risk subjects will determine the potential impact of intervention on DN and CVD. AdDIT will help to determine whether, in addition to encouraging young people to achieve good glycaemic control, pharmacological cardio-renal protection should also be implemented. EUDRACT NUMBER: 2007-001039-72 TRIAL REGISTRATION NUMBER: ISRCTN91419926.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Preparing Students for Success on Examinations: Readiness Assurance Tests in a Graduate-Level Statistics Course

Formative feedback is one way to foster students' readiness for statistics examinations. The use of Readiness Assurance Tests was examined as an educational intervention in which feedback was provided for both correct and incorrect responses in a graduate-level statistics course. Examination scores in the intervention group ( n = 56) were compared with those in a control group ( n = 42). Intervention group examination scores significantly improved from 75.92 ± 14.52 on the Readiness Assurance Test to 90.06 ± 7.06, p < .001, on the midterm, and final examination scores improved from 78.23 ± 17.29 to 85.6 ± 6.98, p = .002. Intervention group midterm scores were significantly higher than those of the control group (90.06 ± 7.06 versus 79.7 ± 11.6, p < .001); however, no differences were found between the groups on the final examination (85.35 ± 9.46 versus 85.6 ± 6.98, p = .91). Use of Readiness Assurance Tests was an effective modality to increase student self-efficacy, learning experience, and, relative to a control group, midterm examination performance in statistic

Using Email Communication to Increase Expatriate Parents' Knowledge of the Human Papillomavirus

Expatriates face a unique set of determinants to health which may influence their level of knowledge, perception of available preventative health care alternatives and their health seeking behaviors. The objective of this study is to understand the effect of an email communication intervention on expatriate parents' level of knowledge of the Human Papillomavirus (HPV). Repeated measurement of knowledge was conducted pre- and post-intervention among parents who received the study intervention (group 1) and those who received standard care (group 2). Intervention effect was measured by any change in knowledge within and between groups. The group 1 had a significant rise in knowledge mean from baseline to first and then second follow-up (m = 0.57 (SD 0.39), m = 0.84 (SD 0.16) and m = 0.87 (SD 0.11), respectively). In addition, after receiving the intervention, group 1 felt they had sufficient information to make an informed decision of whether to vaccinate their child(ren), with a significant difference from baseline to first post test, (χ² (1) = 8.50, p &lt; 0.05). Based on an increase in knowledge, the study's email intervention proved effective mode to disseminating HPV-related information

Positive Thinking Training Intervention for Caregivers of Persons with Autism: Establishing Fidelity

More than 3.5 million in the US are diagnosed with autism spectrum disorder (ASD) and caregivers experience stress that adversely affects their well-being. Positive thinking training (PTT) intervention can minimize that stress. However, before testing the effectiveness of PTT, its fidelity must be established. This pilot intervention trial examined fidelity of an online PTT intervention for ASD caregivers with a random assignment of 73 caregivers to either the online PTT intervention or to the control group. Quantitative data [Positive Thinking Skills Scale (PTSS)] and qualitative data (online weekly homework) were collected. The mean scores for the PTSS improved for the intervention group and decreased for the control group post intervention. Evidence for use of PTT was found in caregivers\u27 online weekly homework. The findings provide evidence of the implementation fidelity of PTT intervention and support moving forward to test PTT effectiveness in promoting caregivers\u27 well-being

Effectiveness of a Multimodal Mindfulness Program for Student Health Care Professionals: A Randomized Controlled Trial

Background: The effectiveness of a multimodal mindfulness program incorporating traditional and nontraditional forms of active and nonactive meditation practices with a sample of occupational and physical therapy students was assessed in this study. Method: Thirty-six participants were randomly assigned to an intervention or control group. The 8-week mindfulness program consisted of one weekly 40-min in-person group session and four weekly 10-min online guided meditations. Pre and postintervention measures included the Perceived Stress Scale (PSS), Student Stress Management Scale (SSMS), mindfulness activity log, open-ended qualitative questionnaire, GPA, and counseling visit frequency. Results: Statistically significant differences, with large effect sizes, were found between intervention and control group PSS (Z=-4.291, pd=-1.84) and SSMS (Z=-3.330, pd=-1.27) postintervention scores. Statistically significant differences, with large effect sizes, were found between intervention group pre and postmindfulness activity ratings for each week and all weeks combined (Z=-12.599, pd=1.29). Qualitative data revealed eight themes including greater sleep quality, energy levels, self-compassion, and life-work balance. No statistically significant differences were found between intervention and control group counseling visit frequency and GPA. Conclusion: As this is preliminary data about a novel intervention with a small student sample, effectiveness of this intervention should be further explored in a replication study

Effect of educational intervention on perceived susceptibility self-efficacy and DMFT of pregnant women

Background: The World Health Organization identifies oral health as a necessity for public health through the entirety of life. This issue has been considerably addressed due to susceptibility to tooth decay during pregnancy and maternal and fetal health. Objectives: Investigate the effect of educational intervention on perceived susceptibility, self-efficacy, and DMFT of pregnant women. Patients and Methods: A quasi-experimental survey (pretest, posttest, and control group) was implemented in 88 primiparous women in the first trimester of pregnancy who attended private clinics in Delfan city, Iran. It was conducted using random sampling and then assigned to intervention and control groups. Data were collected using a questionnaire that included demographic characteristics, a DMFT checklist, and some health belief model (HBM) constructs. After collecting baseline information, an educational intervention consisting of 4 training sessions for the intervention group was scheduled. In the sessions, lecture, focus-group discussion, video, and role-playing were used as the main educational strategies. Four months after the intervention, a post-test questionnaire and DMFT checklist were conducted. Data were analyzed using SPSS (ver20) software and Chi-square, independent t-test, and repeated measure ANOVA at the significant level of α 0.05), during the intervention, or after intervention. Repeated measure ANOVA explained that the aforementioned score was different in the three cases (pretest, 2 months after intervention, and 4 months after intervention) after intervention (P< 0.05). Paired t-test also showed that the DMFT mean increased 4 months after intervention in the control group (P < 0.001). It was not, however, augmented in the intervention group (P = 0.92). Conclusions: Results showed that education on some of the HBM constructs resulted in increased knowledge of oral health, perceived susceptibility, and self-efficacy of pregnant women. It is also possible to prevent increased DMFT during pregnancy. © 2016, Iranian Red Crescent Medical Journal

The effects of a 12-week leisure centre-based, group exercise intervention for people moderately affected with multiple sclerosis: a randomized controlled pilot study

&lt;b&gt;Objective:&lt;/b&gt; To establish the effects of a 12-week, community-based group exercise intervention for people moderately affected with multiple sclerosis. &lt;b&gt;Design:&lt;/b&gt; Randomised controlled pilot trial. &lt;b&gt;Setting:&lt;/b&gt; Two community leisure centres. &lt;b&gt;Participants:&lt;/b&gt; Thirty-two participants with multiple sclerosis randomised into intervention or control groups. &lt;b&gt;Intervention:&lt;/b&gt; The intervention group received 12 weeks of twice weekly, 60-minute group exercise sessions, including mobility, balance and resistance exercises. The control group received usual care. &lt;b&gt;Main outcome measures:&lt;/b&gt; An assessor blinded to group allocation assessed participants at baseline, after eight weeks and after 12 weeks. The primary outcome measure was 25-foot (7.6 m) walk time, secondary outcomes assessed walking endurance, balance, physical function, leg strength, body mass index, activity levels, fatigue, anxiety and depression, quality of life and goal attainment. &lt;b&gt;Results:&lt;/b&gt; The intervention made no statistically significant difference to the results of participants’ 25-foot walk time. However the intervention led to many improvements. In the intervention group levels of physical activity improved statistically between baseline and week 8 (P &#60; 0.001) and baseline and week 12 (P = 0.005). Balance confidence results showed a significant difference between baseline and week 12 (P = 0.013). Good effect sizes were found for dynamic balance (d = 0.80), leg strength (d = 1.33), activity levels (d = 1.05) and perceived balance (d = 0.94). &lt;b&gt;Conclusion:&lt;/b&gt; The results of the study suggest that community-based group exercise classes are a feasible option for people moderately affected with multiple sclerosis, and offer benefits such as improved physical activity levels, balance and leg strength

Effect of therapeutic massage on pain in patients with dementia

Introduction The aim was to investigate whether therapeutic massage was effective in relieving pain in elderly residents with dementia. Methods A randomized controlled study was conducted in an aged care facility. Ten participants with dementia or advanced dementia were allocated to an intervention group or a control group. The intervention group received 10 min of massage (effleurage, kneading, and trigger point therapy) four times per week for 4 weeks. The Pain Assessment in Advanced Dementia scale was used as the outcome measure. Results No significant changes in mean outcome measure scores were found post intervention (Intervention mean = 5.0 ± 3.49; Control mean = 5.2 ± 3.49: t(8) = 0.09, p = 0.93). However, the Intervention Group had a greater magnitude of change (1.200 ± 1.78) when compared to the control group (0.800 ± 2.16). Conclusion Therapeutic massage may provide a useful adjunct to the current pain management plan of patients with dementia. </jats:sec