Education Group Participants Research Articles

An Exploratory Randomized Controlled Trial of a 12-Week Yoga Versus Educational Film Program for the Management of Restless Legs Syndrome: Feasibility and Acceptability.

Objectives: The primary objectives of this pilot trial were to assess the study feasibility and acceptability of the 12-week yoga and educational film programs for the management of restless legs syndrome (RLS) in preparation for a future randomized controlled trial (RCT). Materials and Methods: This pilot, parallel-arm, randomized feasibility trial was conducted at two sites, Morgantown, WV and Columbus, OH. Yoga group participants attended 75-min Iyengar yoga classes, twice weekly for 4 weeks, then once a week for 8 weeks (16 total classes), and completed a 30-min homework routine on nonclass days. Educational film group participants attended once weekly, 75-min classes (12 total classes), which included information on RLS and other sleep disorders, RLS management including sleep hygiene practices, and complementary therapies. Feasibility and acceptability outcomes included program satisfaction and recruitment, retention, and adherence rates. In addition, participants were asked their preferences regarding three yoga class schedule scenarios for a future study. Attendance, yoga, and treatment logs were collected weekly. Program evaluation and yoga scheduling questionnaires were collected at week 12. Results: Forty-one adults with moderate to severe RLS were randomized to a 12-week yoga (n = 19) or educational film (n = 22) program. Thirty participants (73%) completed the program. Yoga and education group participants attended an average of 13.0 ± 0.84 (81%) and 10.3 ± 0.3 classes (85%), respectively. Participants from both groups indicated satisfaction with the study. All yoga group respondents to the program evaluation reported they would likely (n = 6) or very likely (n = 7) continue yoga practice; 86.7% of education group respondents (13 of 15) indicated that they were likely (n = 7) or very likely (n = 6) to make lasting changes based on what they had learned. The preferred schedule for a future study was a 16-week study with once-weekly yoga classes. Conclusions: The findings of this study suggest that a larger RCT comparing yoga with an educational film group for the management of RLS is feasible. Trial registration: Clinicaltrials.gov: NCT03570515; 02/01/2017.

Postdischarge Decolonization of Patients Harboring MRSA USA300 Strains: Secondary Analysis of the CLEAR Trial

Background: The Changing Lives by Eradicating Antibiotic Resistance (CLEAR) Trial was a trial of 2,121 recently discharged methicillin-resistant Staphylococcus aureus (MRSA) carriers randomized to MRSA education plus a 5-day decolonization regimen repeated twice monthly for the 6 months following discharge versus MRSA education alone. Decolonization resulted in a 30% reduction in MRSA infection and a 17% reduction in all-cause infection (Huang SS et al, NEJM, 2019) in the year following discharge. We pursued an evaluation of USA300 carriers to determine whether the decolonization benefit differed for this strain type. Methods: A secondary analysis of the CLEAR randomized controlled trial (RCT) was performed, limiting the cohort to participants known to harbor USA300 at or within 30 days of enrollment and who attended all follow-up visits in the year following discharge. Within this subset, we conducted a time-to-event analysis using unadjusted and adjusted Cox proportional-hazard models. Variables in adjusted analyses included demographic data, insurance type, presence of coexisting conditions or medical devices at enrollment, hospitalization or residence in a nursing home in the year before enrollment, receipt of anti-MRSA antibiotics, protocol adherence, and randomization strata. Results: USA300 was identified in 420 of the 783 participants who attended all visits and had strains genetically tested. MRSA infections occurred in 27 of 207 education group participants (0.149 per person year) and in 19 of 213 decolonization group participants (0.099 per-person year). Point estimates from the unadjusted hazard ratios of infection reduction were similar (0.59; 95% CI, 0.32–1.09) to the full trial population (0.61; 95% CI, 0.44–0.85), suggesting nondifferential benefit for the USA300 strain type. Adjusted models were highly similar. Conclusions: The reduction in MRSA infection associated with postdischarge decolonization in the subgroup of participants who harbored the USA300 strain-type was consistent with overall trial findings. Although the original trial was not powered for the evaluation of a USA300 subset, this RCT provides a valuable design for assessing the magnitude of strain-specific responsiveness to decolonization during a time when national rates of MRSA invasive disease have plateaued and USA300 is responsible for an increasing proportion of infections. These data suggest that postdischarge decolonization should be similarly effective in carriers of either USA300 or healthcare-associated MRSA strains.Funding: NoneDisclosure: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which antiseptic product is provided to participating hospitals and nursing homes. Mohamad Sater, Salary-Day Zero Diagnostics.

Gestantes em uso de substâncias psicoativas atendidas por enfermeiros na Atenção Primária à Saúde

Objetivo: discorrer sobre o pré-natal realizado por enfermeiros na Atenção Primária à Saúde a gestantesusuárias de substâncias psicoativas. Método: estudo descritivo-exploratório, de abordagem qualitativa, realizado em seis Unidades de Atenção Primária à Saúde em um município de Minas Gerais. A coleta de dados ocorreu por meio de entrevista semiestruturada com nove enfermeiros que realizavam consultas de pré-natal. A técnica de análise do conteúdo foi utilizada para o tratamento dos dados. Resultados: dificuldades com a adesão das gestantes ao pré-natal e sua participação em grupos educativos. Os enfermeiros também identificaram as substâncias psicoativas mais utilizadas pelas gestantes e relataram abordar os malefícios do uso das substâncias, a fim de estimularem a decisão pela redução. Conclusão: o interesse das gestantes pelo tratamento foi pequeno e resultou na baixa adesão aos programas oferecidos na Atenção Primária, o que se revelou um problema de saúde pública, que requer práticas reorientadas de atenção a esta clientela.

Minimal Impact of Nutrition Education and Fruit and Vegetable Consumption on Biomarkers of Inflammation and Oxidative Stress

Aims: To determine the effectiveness of a community-based fruit and vegetable education program and provision of fruits and vegetables on consumption of fruits, vegetables, antioxidants, and changes in biomarkers of inflammation and oxidative stress among overweight and obese adults. Study Design: Randomized controlled design. Place and Duration of Study: North Dakota State University, Fargo, North Dakota; 14 weeks. Methodology: Forty-seven adults (31 women; 45.9 ± 11.8 y; body mass index 32.7 kg/m 2 ) were randomly assigned to one of three intervention groups. The control group received no intervention, the education group attended weekly nutrition education lessons, the fruit and vegetable group attended weekly nutrition education lessons and received one serving of fruits and two servings of vegetables per day for 10 weeks. Fasting blood was drawn and consumption of fruits, vegetables, Original Research Article Wagner et al.; EJNFS, 5(3): 179-189, 2015; Article no.EJNFS.2015.017 180 and antioxidants was assessed using three-day food records. Results: Increased consumption of fruit from preto post-test was indicated among fruit and vegetable group participants, P = .01, and among education group participants, although this difference was not significant, P = .11. In contrast, a significant decrease in fruit servings consumed from preto post-test for control group participants was observed, P = .02. Vegetable consumption was the same for control group participants, decreased by 0.3 serving among education group participants, and increased by 0.4 serving among fruit and vegetable group participants. No significant differences in plasma TNF-α, TBARS, or CRP concentrations from preto post-test were indicated among the three groups, although the largest decrease was observed among fruit and vegetable group participants, P = .07. Conclusion: Changes in fruit and vegetable consumption among participants were minimally associated with improvements in inflammation and oxidative stress biomarkers. Adequate and varied fruit and vegetable consumption is recommended to aid in the prevention and regulation of inflammation and oxidative stress.

Efficacy of a 4-week yogic lifestyle education for promoting holistic health in Indian school adolescents

Context: Need for yogic lifestyle education in schools is being recognized eloquently. However, effectiveness of yogic lifestyle for enhancing adolescent health in schools remains partially or minimally attempted. Aims: To examine the relevance of yogic lifestyle education in improving holistic aspects of adolescent health in schools. Method: A four week field experiment was conducted among a sample of 100 students enrolled in a residential school located in a semi-urban setting by using a 2 (control and intervention group) ×2 (male and female students) ×2 (pre and post-test) factorial design. Standardized self-report adolescent health questionnaires were used before and after yogic lifestyle education to assess its holistic effects. Results: ANOVA was used to analyze efficacy of yogic lifestyle education in promoting different aspects of adolescent health. Results revealed that yogic lifestyle education group participants' responses displayed significantly greater enhancement on a variety of self-reported positive health outcomes and a reduction on different negative health outcomes than the control group participants. Conclusions: Yogic lifestyle education programme has promising potential to not only reduce health problems but also enhance positive aspects of health in school going adolescents.

A Continuous Glucose Monitoring and Problem-Solving Intervention to Change Physical Activity Behavior in Women with Type 2 Diabetes: A Pilot Study

Diabetes technology has the potential to provide useful data for theory-based behavioral counseling. The aims of this study are to evaluate the feasibility, acceptability, and preliminary efficacy of a continuous glucose monitoring and problem-solving counseling intervention to change physical activity (PA) behavior in women with type 2 diabetes. Women (n=29) with type 2 diabetes were randomly assigned to one of two treatment conditions: continuous glucose counseling and problem-solving skills or continuous glucose monitoring counseling and general diabetes education. Feasibility data were obtained on intervention dose, implementation, and satisfaction. Preliminary efficacy data were collected at baseline and 12 weeks on the following measures: PA amount and intensity, diet, problem-solving skills, self-efficacy for PA, depression, hemogoloin A1c, weight, and blood pressure. Demographic and implementation variables were described using frequency distributions and summary statistics. Satisfaction data were analyzed using Wilcoxon rank. Differences between groups were analyzed using linear mixed-modeling. Women were mostly white/non-Latina with a mean age of 53 years, a 6.5-year history of diabetes, and suboptimal glycemic control. Continuous glucose monitoring plus problem-solving group participants had significantly greater problem-solving skills and had greater, although not statistically significant, dietary adherence, moderate activity minutes, weight loss, and higher intervention satisfaction pre- to post-intervention than did participants in the continuous glucose monitoring plus education group. A continuous glucose monitoring plus problem-solving intervention was feasible and acceptable, and participants had greater problem-solving skills than continuous glucose monitoring plus education group participants.

Home blood glucose monitoring in type 1 diabetes mellitus

To determine which of two simplified blood glucose monitoring schemes promotes better metabolic control in type 1 diabetic patients during 12 months of participation in educational groups. A crossover clinical trial involving 21 patients divided into two groups was conducted. They were submitted to a two monitoring schemes: 2 alternate daily preprandial measurements and 2 alternate daily pre-and postprandial measurements. The effectiveness of the schemes was evaluated based on HbA1c. Variations in mean HbA1c were analyzed by Friedman test. The groups were homogenous in terms of sociodemographic and clinical variables (p>0.05). Mean HbA1c levels ranged from 8.48 (+/-1.00) to 7.37 (+/-0.99) over time in Group A and from 9.89 (+/-0.86) to 8.34 (+/-1.06) in Group B. The analysis of the HbA1c showed a significant reduction in the first and last 6 months and over the 12 months of the study in two groups (p<0.05). The preprandial scheme demonstrated the largest number and highest percentage of significant drops in HbA1c. The two monitoring improved the metabolic control and the preprandial scheme was more effective.

Education for people with progressive neurological conditions can have negative effects: Evidence from a randomized controlled trial

To test the effects of a home-based educational intervention in reducing the incidence and the risk of falls and pressure sores in adults with progressive neurological conditions. Randomized controlled trial with 12 months follow-up. Participants' homes in the City of Nottingham. One hundred and fourteen people with progressive neurological conditions recruited from general practices in Nottingham, including 53 with Parkinson's disease and 45 with multiple sclerosis. In the education group (EG), baseline data were reviewed by an expert panel which advised on actions most likely to promote each individual's physical, social and psychological well-being. An occupational therapist (OT) then visited EG participants to provide education and information and to discuss a personalized 12-month health action plan. The comparison group (CoG) received standardized printed information delivered to their home. Numbers of participants reporting falls and skin sores at two-monthly phone calls during the follow-up period of 12 months. The EG reported significantly more falls during the follow-up period and at 12 months (adjusted odds ratio 2.83 (95% CI 1.07-7.47), p=0.036) and significantly more skin sores (adjusted odds ratio 12.74 (95% CI 1.14-142.6), p =0.039) than the CoG. There was no difference between CoG and EG in the Nottingham Extended Activities of Daily Living score, but EG patients showed a significant rise in this score over the study period of 1.62 (95% CI 0.69-2.55, p=0.002). Our findings provide evidence that education for people with progressive neurological conditions can have negative effects.

Impact of an empowerment-based parent education program on the reduction of youth suicide risk factors.

To evaluate the impact of parent education groups on youth suicide risk factors. The potential for informal transmission of intervention impacts within school communities was assessed. Parent education groups were offered to volunteers from 14 high schools that were closely matched to 14 comparison schools. The professionally led groups aimed to empower parents to assist one another to improve communication skills and relationships with adolescents. Australian 8th-grade students (aged 14 years) responded to classroom surveys repeated at baseline and after 3 months. Logistic regression was used to test for intervention impacts on adolescent substance use, deliquency, self-harm behavior, and depression. There were no differences between the intervention (n = 305) and comparison (n = 272) samples at baseline on the measures of depression, health behavior, or family relationships. Students in the intervention schools demonstrated increased maternal care (adjusted odds ratio [AOR] 1.9), reductions in conflict with parents (AOR.5), reduced substance use (AOR.5 to.6), and less delinquency (AOR.2). Parent education group participants were more likely to be sole parents and their children reported higher rates of substance use at baseline. Intervention impacts revealed a dose-response with the largest impacts associated with directly participating parents, but significant impacts were also evident for others in the intervention schools. Where best friend dyads were identified, the best friend's positive family relationships reduced subsequent substance use among respondents. This and other social contagion processes were posited to explain the transfer of positive impacts beyond the minority of directly participating families. A whole-school parent education intervention demonstrated promising impacts on a range of risk behaviors and protective factors relevant to youth self-harm and suicide.