Evaluation Of Short-term Effects Research Articles

Evaluation of a Community Suicide Prevention Project (Roots of Hope): Protocol for an Implementation Science Study.

Roots of Hope (RoH) is a multisite Canadian community-based suicide prevention initiative developed by the Mental Health Commission of Canada (MHCC), which is based on evidence for intervention effectiveness and World Health Organization recommendations. Seven communities developed local activities in the following 5 pillars: specialized supports, training and networks, public awareness, means safety, and evaluation research. We aim to use an implementation research approach to understand the RoH model for reducing suicidal behaviors and their impacts in communities, and the lessons learned for the equitable development and implementation of RoH in different contexts. Moreover, we want to understand how the program is implemented in relation to the context, the causal pathways, and the factors influencing successful implementation. The evaluation includes assessments of short-term and intermediate effects at each site and overall. The principal investigator (PI) developed a consensus among local research coordinators on common approaches and indicators through ongoing participation in an online community of practice, and regular virtual and in-person meetings. At the completion of the pilot phase, the PI will summarize evaluation results across sites and conduct pooled analyses. The RoH theory of change and evaluation model shows how evaluation activities from the planning phase through the implementation of activities in each of the pillars can help clarify the viability of the RoH model and identify factors that facilitate and inhibit effective and equitable implementation in different contexts. Beginning with a situational analysis to identify resources in each community and local specificities, we will examine the implementation characteristics of conformity, dosage, coverage, quality, utility, equity, appreciation, facilitators, and impediments. Evaluation of short-term effects will focus on changes in knowledge, attitudes, behaviors, help-seeking, service use, stigma, media reports, empowerment, and care experiences. Intermediate effects, long-term effects, and impact will include assessments of the changes in suicides, suicide attempt rates, and suicide risk indicators. A variety of data sources, both quantitative and qualitative, will be used. The quantitative and qualitative data from all sites will be summarized by the PI in March 2023 to draw conclusions to help the MHCC in its improvements to the RoH model, and to inform communities about how to better implement RoH. Since the COVID-19 pandemic occurred at the beginning of program implementation, its impact and influence will be documented. The validity of RoH in contributing to the prevention of suicides and suicidal behaviors will be clarified in a variety of contexts. The final evaluation report will be available in September 2023. The evaluation results, including the identification of factors that facilitate and inhibit the implementation of RoH and the adaptations to challenges, will be useful to the MHCC, current RoH communities, and those considering adopting the RoH model. DERR1-10.2196/39978.

Evaluation of short term effects of first and second dose COVID-19 vaccination among critical care nurses in rural tertiary care hospital

The Corona virus disease 2019 is a contagious disease caused by severe acute respiratory syndrome coronavirus 2. The disease has since spread worldwide, leading to an ongoing pandemic. The attitude and knowledge of health care specialists towards vaccination is very important. Hence we conducted a study among critical care nurses.This cross sectional study is conducted among 76 adult critical care unit nurses who received Covishield vaccine. The survey included 13 questions.Post first dose of vaccination Out of 76 critical care nurse, 49 (64.5%) were males and 27 (35.5%) were females. 42(55.3%) nurses were posted for covid duty while 34( 44.7%) were never posted for covid duty, among these all 31( 40.8%) were suffered with covid infection before vaccination. Post first dose of COVID 19 vaccination, 65(85.5%) nurses developed symptoms while 11 (14.5%) were asymptomatic.Post second dose of vaccination; Out of Out of 76 critical care nurses participated in the study, 50 (66%) were males and 26 (34%) were females. 42(55%) nurses were posted for covid duty while 34 (45%) were never posted for covid duty. Among all critical care nurses 31 (40.8%) were diagnosed with COVID 19 positive before vaccination while 45(59.2%) were found to be COVID negative. Post second dose of COVID 19 vaccination, 50(66%) nurses developed symptoms while 26(34%) were asymptomatic.Based on our study the side effects are present with covishield vaccine. Nurses are willing to take booster dose and to promote vaccination too.

Oil Spill Disaster in Southwest Atlantic Coast: an Evaluation of Short-Term Effects on Coral Reef Benthic Assemblages

Oil pollution has significantly contributed to coral reef decline in the last five decades and a major oil spill reached Brazilian tropical coast in August 2019. Here, we report the first evidence of direct crude oil contact from that spill on reef coral species, and evaluate the effects of this disaster on coral vitality and benthic assemblage structure on the largest coastal marine protected area (MPA Costa dos Corais) in Brazil. We compared benthic cover in reefs with and without oil and monitored Siderastrea stellata colonies 90 days after oil contact. Oil stains between 0.5 and 150 cm were found in two of the 17 reef sites investigated. Multivariate analyses did not detect significant differences between oiled and non-oiled reefs and there was no evidence of S. stellata health deterioration. These results indicate minimal acute effects on coral vitality and intertidal reef benthic assemblage structure. Future studies should investigate oil effects on specific aspects of coral biology as growth, reproduction, bleaching susceptibility and metagenomics which can deteriorate over longer time frames, and we recommend long-term coral reef monitoring to support a robust assessment and mitigation of chronic oil impacts.

Evaluation of Short Term Effects of Hyperbaric Oxygen and Enoxaparin Treatments in Avascular Necrosis of Femoral Head

ABSTRACT Aim: Avascular necrosis of the femoral head (AVN) is the necrosis of the bone and the bone marrow resulting from the injury or the occlusion of the blood supplying vessels of the femoral head. Specially it is seen in mostly young and middle aged individuals and requiring mostly surgical procedures. Despite all advances in the surgical procedures, still a high rate of the hip prosthesis is a requirement in the treatment. Hyperbaric Oxygen Therapy (HBOT) alone or in combination with surgery is reported to be effective in some clinical AVN cases. HBOT is also a treatment method which is used in ischemic diseases resulting from vascular injuries or occlusions. Enoxaparin is an antagonist of factor Xa which is found in the coagulation system. Beside its anticoagulant effect it has been shown that it has an osteopenic effect, inhibits osteoblast maturation and increases osteoclast activity in the bone. Material and Methods: In this study effects of enoxaparin and HBOT were investigated in the treatment of experimentally formed AVN of the femoral heads of the rats. For this purpose, avascular necrosis model was applied to the left femoral heads of 64 rats and the results of the treatments alone and together were investigated. Results: In this study results have shown that an increase in the new bone formation, and remodelisation with less changes in the cartilage tissue than in the controls. An increase in the necrotic tissue clearing rate observed in the HBOT applied groups. The best results were achieved with the HBOT and enoxaparin combined applications. Conclusion: In this study HBOT alone, enoxaparin alone or combination of these two treatments have a positive effect in the experimental femoral head AVN and supporting the clinical studies in the femoral head AVN. Keywords: Hyperbaric oxygen therapy, avascular necrosis, enoxaparin

Fiscal Aid Initiatives in German States in Support of Financially Troubled Municipalities: An Evaluation of Short-Term Effects

Viele Bundesländer haben nach der Finanz- und Wirtschaftskrise spezielle Konsolidierungsprogramme für finanzschwache Kommunen aufgelegt. Mit dem Programmstart zeigten sich bei den teilnehmenden Kommunen deutliche Verbesserungen bei den Finanzkennzahlen. Allerdings ergeben sich als Reaktion auf die Programme auch einige adverse Effekte. Das betrifft insbesondere eine unterdurchschnittliche Entwicklung des Steueraufkommens, steigende Sozialausgaben und eine geringe Investitionstätigkeit. Daran zeigt sich, dass die finanzielle Lage der teilnehmenden Kommunen auch zukünftig belastet sein wird.

Development of an inter-professional educational program for home care professionals: Evaluation of short-term effects in suburban areas.

Objective To examine the short-term effects of an inter-professional educational program developed for physicians and other home care specialists to promote home care in the community.Methods From March 2012 to January 2013, an inter-professional educational program (IEP) was held four times in three suburban areas (Kashiwa city and Matsudo city in the Chiba prefecture, and Omori district in the Ota ward). This program aimed to motivate physicians to increase the number of home visits and to encourage home care professionals to work together in the same community areas by promoting inter-professional work (IPW). The participants were physicians, home-visit nurses, and other home care professionals recommended by community-level professional associations. The participants attended a 1.5-day multi-professional IEP. Pre- and post-program questionnaires were used to collect information on home care knowledge and practical skills (26 indexes, 1-4 scale), attitudes toward home care practice (4 indexes, 1-6 scale), and IPW (13 indexes, 1-4 scale). Data from all of the participants without labels about the type of professionals were excluded, and both pre-test and post-test responses were used in the analysis. A Wilcoxon signed-rank test and a paired t-test were conducted to compare pre- and post-program questionnaire responses stratified for physicians and other professionals, and the effect size was calculated.Results The total number of participants for the four programs was 256, and data from 162 (63.3%) were analyzed. The physicians numbered 19 (11.7%), while other professionals numbered 143 (88.3%). Attending this program helped participants obtain home care knowledge of IPW and a practical view of home care. Furthermore, indexes about IPW consisted of two factors: cooperation and interaction; non-physician home care professionals increased their interactions with physicians, other professionals increased their cooperation with other professionals, and physicians increased their cooperation with other physicians.Conclusion Short-term effects to motivate physicians to increase home visits were limited. However, physicians obtained a practical view of home care by attending the IEP. Also, the participation of physicians and other home care professionals in this program triggered the beginning of IPW in suburban areas. This program is feasible when adapted for regional differences.

Short-term effect on pain and function of neurophysiological education and sensorimotor retraining compared to usual physiotherapy in patients with chronic or recurrent non-specific low back pain, a pilot randomized controlled trial

Background: Non-specific chronic low back pain (NSCLBP) is a major health problem. Identification of subgroups and appropriate treatment regimen was proposed as a key priority by the Cochrane Back Review Group. We developed a multimodal treatment (MMT) for patients with moderate to severe disability and medium risk of poor outcome. MMT includes a) neurophysiological education on the perception of pain to decrease self-limitation due to catastrophizing believes about the nature of NSCLBP, b) sensory training of the lower trunk because these patients predominantly show poor sensory acuity of the trunk, and c) motor training to regain definite movement control of the trunk. A pilot study was conducted to investigate the feasibility of MMT, prior to a larger RCT, with focus on patients’ adherence and the evaluation of short-term effects on pain and disability of MMT when compared to usual physiotherapy. Method: We conducted a randomised controlled trial (RCT) in a primary care physiotherapy centre in Switzerland. Outcome assessment was 12 weeks after baseline. Patients with NSCLBP, considerable disability (five or more points on the Roland and Morris Disability Questionnaire (RMDQ) and medium or high risk of poor outcome on the Keele Start Back Tool (KSBT) were randomly allocated to either MMT or usual physiotherapy treatment (UPT) by an independent research assistant. Treatment included up to 16 sessions over 8 to 12 weeks. Both groups were given additional home training of 10 to 30 minutes to be performed five times per week. Adherence to treatment was evaluated in order to assess the feasibility of the treatment. Assessments were conducted by an independent blinded person. The primary outcome was pain (NRS 0-10) and the secondary outcome was disability (RMDQ). Between-group effects with Student’s t-test or the Mann-Whitney U test and the standardized mean difference of the primary outcome were calculated. (Continued on next page)

Short-term effect on pain and function of neurophysiological education and sensorimotor retraining compared to usual physiotherapy in patients with chronic or recurrent non-specific low back pain, a pilot randomized controlled trial.

BackgroundNon-specific chronic low back pain (NSCLBP) is a major health problem. Identification of subgroups and appropriate treatment regimen was proposed as a key priority by the Cochrane Back Review Group. We developed a multimodal treatment (MMT) for patients with moderate to severe disability and medium risk of poor outcome. MMT includes a) neurophysiological education on the perception of pain to decrease self-limitation due to catastrophizing believes about the nature of NSCLBP, b) sensory training of the lower trunk because these patients predominantly show poor sensory acuity of the trunk, and c) motor training to regain definite movement control of the trunk.A pilot study was conducted to investigate the feasibility of MMT, prior to a larger RCT, with focus on patients’ adherence and the evaluation of short-term effects on pain and disability of MMT when compared to usual physiotherapy.MethodWe conducted a randomised controlled trial (RCT) in a primary care physiotherapy centre in Switzerland. Outcome assessment was 12 weeks after baseline. Patients with NSCLBP, considerable disability (five or more points on the Roland and Morris Disability Questionnaire (RMDQ) and medium or high risk of poor outcome on the Keele Start Back Tool (KSBT) were randomly allocated to either MMT or usual physiotherapy treatment (UPT) by an independent research assistant. Treatment included up to 16 sessions over 8 to 12 weeks. Both groups were given additional home training of 10 to 30 minutes to be performed five times per week. Adherence to treatment was evaluated in order to assess the feasibility of the treatment. Assessments were conducted by an independent blinded person. The primary outcome was pain (NRS 0-10) and the secondary outcome was disability (RMDQ). Between-group effects with Student’s t-test or the Mann-Whitney U test and the standardized mean difference of the primary outcome were calculated.ResultsTwenty-eight patients (46% male, mean age 41.5 years (SD 10.6)) were randomized to MMT (n = 14) or UPT (n = 14). Patients’ adherence to treatment was >80% in both groups. Pain reduction (NRS; [95% CI]) was 2.14 [1.0 to 3.5] in the MMT and 0.69 [-2.0 to 2.5.] in the UPT. The between-group difference was 1.45 [0.0 to 4.0] (p = 0.03), representing a moderate effect size of 0.66 [-0.1 to 1.5]. Reduction in disability on the RMDQ was 6.71 [4.2 to 9.3] in MMT and 4.69 [1.9 to 7.4] in UPT, with a non-significant between-group difference of 2.02 [-1.5 to 5.6] (p = 0.25). The required sample size for a RCT with six months follow-up was estimated at 170 patients.ConclusionsMMT was found to be feasible and to significantly reduce pain in the short term when compared with UPT. A future RCT with a six-month follow-up would require approximately 170 patients.Trial registrationCurrent Controlled Trials ISRCTN66262199. Registered 8 January 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0533-2) contains supplementary material, which is available to authorized users.

Quantitative evaluation of short-term effect of cardiac resynchronization therapy by automated motion tracking of mitral annular displacement

Objective To evaluate the tissue motion tracking of mitral annular displaeement(TMAD) method in the assessment of short-term effect of cardiac resynchronization therapy (CRT). Methods Twenty six chronic heart failure (CHF) patients with CRT were detected by TMAD. The maximal displacement of the six points of mitral annulus(DS), the standard deviation of the time to regional peak systolie displacement of the six points (Td-sd) and the maximal temporal difference of any two points(Tds-diff) were compared before and one month after CRT. And the correlation between mean displacement and left ventricular ejection fraetion(LVEF),left ventricular end systolic volume(LVESV), fraction area change (FAC) was analyzed. Results Compared with the pre-operatively, the displacement and the mean displaeement of the six points of mitral annulus were significantly increased(P<0.01),Tds diff and Td-sd were decreased(P<0.05) one month after CRT. TMAD correlated with LVEF,LVESV and FAC (r =0.419, r = 0.529, r = 0.567, P <0.05) one month after CRT. Conclusions TMAD is a new technology to evaluate the short-term effect of CRT. Key words: Echoeardiography; Heart failure,congestive; Cardiac resynchronization therapy; Ventricular function,left

RCTs and observational studies to determine the effect of prophylaxis in severe haemophilia

It has been suggested that more RCTs should be conducted in the evaluation of haemophilia treatment, including prophylaxis. To draw valid conclusions from experimental or observational studies, internal validity should be ensured. In particular, similarity of prognosis between treatment groups compared in a particular study is needed. Because the use of prophylaxis in observational studies is nonrandomized by definition, special efforts should be made to achieve comparability of prognosis, that is, to avoid 'confounding by indication'; in RCTs this is ensured by randomized allocation of treatment. However, the high costs of an RCT results in a limitation of both patient numbers and length of follow up. Observational studies tend to be more generalizable and cheaper, as they may include a wider spectrum of morbidities, use treatment protocols in agreement with routine care, and use available data. Therefore, observational studies can be much larger and of longer duration than RCTs; and are the preferred design for the evaluation of long term treatment effects. Several valid observational studies comparing prophylaxis and on demand treatment have reported both a short term reduction of 75-90% in bleeding frequency, and significant improvement in arthropathy, quality of life, and socioeconomic parameters after more than 20 years of prophylactic treatment. RCTs provide the most powerful tool for the evaluation of short term effects of any treatment, but are infeasible for the evaluation of long term effects. The definitive assessment of the long-term benefits of prophylaxis requires observational studies that should be performed according to rigorous standards.

Efficient transmural cardiac gene transfer by intrapericardial injection in neonatal mice

Abstract An efficient cardiac gene transfer technique in murine models would greatly facilitate the elucidation of the pathophysiology of cardiomyopathies and the development of genetic therapies. Direct myocardial injection or catheter-based intracoronary infusion is not easily achievable in mice and resultant transgene expression is often limited in distribution. A replication-defective, recombinant adenovirus encoding luciferase (5×10 9 pfu) or lacZ (4–5×10 10 particles/animal) was injected percutaneously into the pericardial cavity of 4–5 day old mice. Chemiluminescence assay for luciferase activity at 3 days post-injection revealed the highest activity in the heart (heart=288±110, lungs=19±5, liver=11±5 ng/gm tissue, n =11). X-gal staining of cryostat sections demonstrated widespread transmural lacZ expression in the left ventricle, interventricular septum, right ventricle, and atrial appendages, and the average fractional area of X-gal staining in a left ventricle was 66±16% (range 40–92%, n =21 sections). However, the long-term survival of these mice was compromised. Reduction in the injectate volume by 50% significantly improved survival but concurrently reduced lacZ expression. Significant lacZ expression was observed in the right ventricle and interventricular septum but left ventricular expression was predominantly epicardial, with variable myocardial penetration. At 2 months post-injection, lacZ expression persisted only in atrial tissues, pulmonary veins, and great vessels. Despite lack of persistent transgene expression in ventricular tissues, the high degree of transgene expression achieved may be sufficient to allow evaluation of short-term effects of specific genetic manipulations in the heart.

Effects of therapy with methylene blue on hemodynamics and gas exchange in septic shock

Death of patients from septic shock is usually associated to severe reduction of systemic vascular resistances and severe hypotension despite elevated cardiac output values. The mediator of vasodilatation, nitric oxide (NO), is synthesised by the inducible NO synthase. Excess NO synthesis during septic shock causes abnormal vasodilatation [1]. A possible therapeutic approach is represented by the pharmacological inhibition of the enzyme guanylate cyclase by methylene blue (MB), a long known and safe pharmacological approach for the treatment of nitrate intoxication and methemoglobinemia [2]. The aim of the present study is the evaluation of short term effects of methylene blue on hemodynamics and gas exchange in patients with septic shock.