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https://www.readbyqxmd.com/read/28644115/evaluation-of-the-effectiveness-and-cost-effectiveness-of-lightweight-fibreglass-heel-casts-in-the-management-of-ulcers-of-the-heel-in-diabetes-a-randomised-controlled-trial
#1
William Jeffcoate, Frances Game, Vivienne Turtle-Savage, Alison Musgrove, Patricia Price, Wei Tan, Lucy Bradshaw, Alan Montgomery, Deborah Fitzsimmons, Angela Farr, Thomas Winfield, Ceri Phillips
BACKGROUND: Ulcers of the foot in people with diabetes mellitus are slow to heal and result in considerable cost and patient suffering. The prognosis is worst for ulcers of the heel. OBJECTIVE: To assess both the clinical effectiveness and the cost-effectiveness of lightweight fibreglass casts in the management of heel ulcers. DESIGN: A pragmatic, multicentre, parallel, observer-blinded randomised controlled trial. A central randomisation centre used a computer-generated random number sequence to allocate participants to groups...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28642308/predicting-risk-of-undiagnosed-copd-development-and-validation-of-the-targetcopd-score
#2
Shamil Haroon, Peymane Adab, Richard D Riley, David Fitzmaurice, Rachel E Jordan
Chronic obstructive pulmonary disease (COPD) is greatly underdiagnosed worldwide and more efficient methods of case-finding are required. We developed and externally validated a risk score to identify undiagnosed COPD using primary care records.We conducted a retrospective cohort analysis of a pragmatic cluster randomised controlled case-finding trial in the West Midlands, UK. Participants aged 40-79 years with no prior diagnosis of COPD received a postal or opportunistic screening questionnaire. Those reporting chronic respiratory symptoms were assessed with spirometry...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28641216/psychoeducational-groups-for-adults-with-adhd-and-their-significant-others-pegasus-a-pragmatic-multicenter-and-randomized-controlled-trial
#3
T Hirvikoski, T Lindström, J Carlsson, E Waaler, J Jokinen, S Bölte
OBJECTIVE: To examine the feasibility, efficacy, and effectiveness of PEGASUS, a group-based structured psychoeducation for adults with ADHD and their significant others. METHOD: A pragmatic parallel group add-on design multicenter randomized controlled trial was conducted, comparing an 8-session treatment with PEGASUS (allocated n=97; 48 with ADHD and 49 with significant others) to treatment as usual (TAU, allocated n=82; 39 with ADHD and 43 significant others)...
May 9, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28640977/neurogenic-bowel-dysfunction-clinical-management-recommendations-of-the-neurologic-incontinence-committee-of-the-fifth-international-consultation-on-incontinence-2013
#4
REVIEW
Nikki Cotterill, Helmut Madersbacher, Jean J Wyndaele, Apostolos Apostolidis, Marcus J Drake, Jerzy Gajewski, John Heesakkers, Jalesh Panicker, Piotr Radziszewski, Ryuji Sakakibara, Karl-Dietrich Sievert, Rizwan Hamid, Thomas M Kessler, Anton Emmanuel
BACKGROUND: Evidence-based guidelines for the management of neurological disease and lower bowel dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. AIMS: To update clinical management of neurogenic bowel dysfunction from the recommendations of the 4th ICI, 2009. MATERIALS AND METHODS: A series of evidence reviews and updates were performed by members of the working group...
June 22, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28638978/screening-score-for-early-detection-of-cardio-metabolic-risk-in-indian-adults
#5
Deepa Pandit-Agrawal, Anuradha Khadilkar, Shashi Chiplonkar, Vaman Khadilkar, Vivek Patwardhan
OBJECTIVES: To develop and to evaluate efficacy of screening score for early detection of cardio-metabolic risk (CMR) in adults. METHODS: Cross-sectional data on anthropometry, lipids, sugar levels, diet, and physical activity were collected on 720 adults (361 men, 35-50 year) using standardized techniques. Screening score was developed using regression analysis-cluster of risk conditions (blood pressure, lipids, and sugar levels) was dependent variable against age, sex, waist, diet, and physical activity as independent variables...
June 21, 2017: International Journal of Public Health
https://www.readbyqxmd.com/read/28637449/task-shifting-interpersonal-counseling-for-depression-a-pragmatic-randomized-controlled-trial-in-primary-care
#6
Camila T Matsuzaka, Milton Wainberg, Andrea Norcini Pala, Elis V Hoffmann, Bruno M Coimbra, Rosaly F Braga, Annika C Sweetland, Marcelo F Mello
BACKGROUND: Task shifting approaches (rational redistribution of tasks among health workforce teams) to train lay professionals to assist with integrating mental health treatment in primary care has been recommended to close the mental health treatment gap for depression in low- and middle-income countries. This study aims to examine the a new model for depression care in a low-resource environment compared to enhanced treatment at usual (E-TAU). METHODS: We trained non-specialist community health workers (local lay employees of the public health system) to provide Interpersonal Counseling (IPC) to treat depressive symptoms in the Brazilian, São Paulo city, family health strategy (FHS)...
June 21, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28636854/cluster-randomized-crossover-trial-of-head-positioning-in-acute-stroke
#7
Craig S Anderson, Hisatomi Arima, Pablo Lavados, Laurent Billot, Maree L Hackett, Verónica V Olavarría, Paula Muñoz Venturelli, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Kris Rogers, Sandy Middleton, Joyce Y Lim, Denise Forshaw, C Elizabeth Lightbody, Mark Woodward, Octavio Pontes-Neto, H Asita De Silva, Ruey-Tay Lin, Tsong-Hai Lee, Jeyaraj D Pandian, Gillian E Mead, Thompson Robinson, Caroline Watkins
BACKGROUND: The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. We wanted to determine whether outcomes in patients with acute ischemic stroke could be improved by positioning the patient to be lying flat (i.e., fully supine with the back horizontal and the face upwards) during treatment to increase cerebral perfusion. METHODS: In a pragmatic, cluster-randomized, crossover trial conducted in nine countries, we assigned 11,093 patients with acute stroke (85% of the strokes were ischemic) to receive care in either a lying-flat position or a sitting-up position with the head elevated to at least 30 degrees, according to the randomization assignment of the hospital to which they were admitted; the designated position was initiated soon after hospital admission and was maintained for 24 hours...
June 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28634906/delivery-of-brief-cognitive-behavioral-therapy-for-medically-ill-patients-in-primary-care-a-pragmatic-randomized-clinical-trial
#8
Jeffrey A Cully, Melinda A Stanley, Nancy J Petersen, Natalie E Hundt, Michael R Kauth, Aanand D Naik, Kristen Sorocco, Shubhada Sansgiry, Darrell Zeno, Mark E Kunik
BACKGROUND: Few studies have examined the practical effectiveness and implementation potential of brief psychotherapies that integrate mental and physical health. OBJECTIVE: To determine whether an integrated brief cognitive behavioral therapy (bCBT), delivered by mental health providers in primary care, would improve depression, anxiety and quality of life for medically ill veterans. DESIGN: Pragmatic patient-randomized trial comparing bCBT to enhanced usual care (EUC)...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28634708/speaker-versus-listener-oriented-disfluency-a-re-examination-of-arguments-and-assumptions-from-autism-spectrum-disorder
#9
Paul E Engelhardt, Oliver Alfridijanta, Mhairi E G McMullon, Martin Corley
We re-evaluate conclusions about disfluency production in high-functioning forms of autism spectrum disorder (HFA). Previous studies examined individuals with HFA to address a theoretical question regarding speaker- and listener-oriented disfluencies. Individuals with HFA tend to be self-centric and have poor pragmatic language skills, and should be less likely to produce listener-oriented disfluency. However, previous studies did not account for individual differences variables that affect disfluency. We show that both matched and unmatched controls produce fewer repairs than individuals with HFA...
June 20, 2017: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/28634280/surgical-clipping-or-endovascular-coiling-for-unruptured-intracranial-aneurysms-a-pragmatic-randomised-trial
#10
Tim E Darsaut, J Max Findlay, Elsa Magro, Marc Kotowski, Daniel Roy, Alain Weill, Michel W Bojanowski, Chiraz Chaalala, Daniela Iancu, Howard Lesiuk, John Sinclair, Felix Scholtes, Didier Martin, Michael M Chow, Cian J O'Kelly, John H Wong, Ken Butcher, Allan J Fox, Adam S Arthur, Francois Guilbert, Lu Tian, Miguel Chagnon, Suzanne Nolet, Guylaine Gevry, Jean Raymond
BACKGROUND: Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed and are commonly treated using endovascular treatment or microsurgical clipping. The safety and efficacy of treatments have not been compared in a randomised trial. How to treat patients with UIAs suitable for both options remains unknown. METHODS: We randomly allocated clipping or coiling to patients with one or more 3-25 mm UIAs judged treatable both ways. The primary outcome was treatment failure, defined as: initial failure of aneurysm treatment, intracranial haemorrhage or residual aneurysm on 1-year imaging...
June 20, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28632319/child-shyness-and-peer-likeability-the-moderating-role-of-pragmatics-and-vocabulary
#11
Hoi Shan Cheung, John M Elliott
The association between shyness and children's likeability by peers was examined, with pragmatic difficulty and receptive and expressive vocabularies as moderators. Participants were 164 preschoolers (72 boys, 92 girls) between 52 and 79 months old in Singapore. A cross-informant methodology was used, with peers and teachers contributing to separate peer likeability ratings. The findings highlighted a conceptual distinction between peer- and teacher-rated likeability by peers. For the latter only, a 3-way interaction involving shyness, vocabulary, and pragmatic difficulty was found, indicating that for shy children with low vocabulary scores, those who experienced less pragmatic difficulty tended to be seen by teachers as more well-liked by peers than those with more pragmatic difficulty...
June 20, 2017: British Journal of Developmental Psychology
https://www.readbyqxmd.com/read/28629700/designing-pragmatic-trials-what-can-we-learn-from-lessons-learnt
#12
Rolf H H Groenwold, Olaf M Dekkers
No abstract text is available yet for this article.
June 16, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28629699/understanding-the-applicability-of-results-from-primary-care-trials-lessons-learned-from-applying-precis-2
#13
Gordon Forbes, Kirsty Loudon, Shaun Treweek, Stephanie Jc Taylor, Sandra Eldridge
OBJECTIVE: To compare two approaches for trial teams to apply PRECIS-2 to pragmatic trials: independent scoring and scoring following a group discussion. STUDY DESIGN AND SETTING: We recruited multidisciplinary teams who were conducting or had conducted trials in primary care in collaboration with the Pragmatic Clinical Trials Unit, Queen Mary University of London. Each team carried out two rounds of scoring on the 9 PRECIS-2 domains: first independently using an online version of PRECIS-2 and secondly following a discussion...
June 16, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28629348/applying-the-plan-do-study-act-pdsa-approach-to-a-large-pragmatic-study-involving-safety-net-clinics
#14
Jennifer Coury, Jennifer L Schneider, Jennifer S Rivelli, Amanda F Petrik, Evelyn Seibel, Brieshon D'Agostini, Stephen H Taplin, Beverly B Green, Gloria D Coronado
BACKGROUND: The Plan-Do-Study-Act (PDSA) cycle is a commonly used improvement process in health care settings, although its documented use in pragmatic clinical research is rare. A recent pragmatic clinical research study, called the Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), used this process to optimize the research implementation of an automated colon cancer screening outreach program in intervention clinics. We describe the process of using this PDSA approach, the selection of PDSA topics by clinic leaders, and project leaders' reactions to using PDSA in pragmatic research...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28628785/looking-at-a-contrast-object-before-speaking-boosts-referential-informativeness-but-is-not-essential
#15
Catherine Davies, Helene Kreysa
Variation in referential form has traditionally been accounted for by theoretical frameworks focusing on linguistic and discourse features. Despite the explosion of interest in eye tracking methods in psycholinguistics, the role of visual scanning behaviour in informative reference production is yet to be comprehensively investigated. Here we examine the relationship between speakers' fixations to relevant referents and the form of the referring expressions they produce. Overall, speakers were fully informative across simple and (to a lesser extent) more complex displays, providing appropriately modified referring expressions to enable their addressee to locate the target object...
June 16, 2017: Acta Psychologica
https://www.readbyqxmd.com/read/28627929/design-of-the-hptn-065-tlc-plus-study-a-study-to-evaluate-the-feasibility-of-an-enhanced-test-link-to-care-plus-treat-approach-for-hiv-prevention-in-the-united-states
#16
Theresa Gamble, Bernard Branson, Deborah Donnell, H Irene Hall, Georgette King, Blayne Cutler, Shannon Hader, David Burns, Jason Leider, Angela Fulwood Wood, Kevin G Volpp, Kate Buchacz, Wafaa M El-Sadr
Background/Aims HIV continues to be a major public health threat in the United States, and mathematical modeling has demonstrated that the universal effective use of antiretroviral therapy among all HIV-positive individuals (i.e. the "test and treat" approach) has the potential to control HIV. However, to accomplish this, all the steps that define the HIV care continuum must be achieved at high levels, including HIV testing and diagnosis, linkage to and retention in clinical care, antiretroviral medication initiation, and adherence to achieve and maintain viral suppression...
June 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28624759/gps-attitudes-beliefs-and-behaviours-regarding-exercise-for-chronic-knee-pain-a-questionnaire-survey
#17
Elizabeth Cottrell, Nadine E Foster, Mark Porcheret, Trishna Rathod, Edward Roddy
OBJECTIVES: The aim of this study was to investigate general practitioners' (GPs) attitudes, beliefs and behaviours regarding the use of exercise for patients with chronic knee pain (CKP) attributable to osteoarthritis. SETTING: Primary care GPs in the UK. PARTICIPANTS: 5000 GPs, randomly selected from Binley's database, were mailed a cross-sectional questionnaire survey. OUTCOME MEASURES: GPs' attitudes and beliefs were investigated using attitude statements, and reported behaviours were identified using vignette-based questions...
June 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28624322/assessing-pragmatic-communication-in-children-with-down-syndrome
#18
Elizabeth Smith, Kari-Anne B Næss, Christopher Jarrold
PURPOSE: Successful communication depends on language content, language form, and language use (pragmatics). Children with Down syndrome (DS) experience communication difficulties, however little is known about their pragmatic profile, particularly during early school years. The purpose of the present study was to explore the nature of pragmatic communication in children with DS. METHOD: Twenty-nine six-year-old children with DS were assessed, in the areas of 1) initiation, 2) scripted language, 3) understanding context and 4) nonverbal communication, as reported by children's parents via the Children's Communication Checklist-2 (Bishop, 2003)...
June 9, 2017: Journal of Communication Disorders
https://www.readbyqxmd.com/read/28623899/renin-angiotensin-system-blockers-and-residual-kidney-function-loss-in-patients-initiating-peritoneal-dialysis-an-observational-cohort-study
#19
Jenny I Shen, Anjali B Saxena, Sitaram Vangala, Satvinder K Dhaliwal, Wolfgang C Winkelmayer
BACKGROUND: Although angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-II receptor blockers (ARB) have been shown to preserve residual kidney function in a select group of Asian patients undergoing continuous ambulatory peritoneal dialysis (PD) in two small randomized clinical trials, the effectiveness of these drugs has yet to be demonstrated in a more diverse population of patients with multiple comorbid conditions. We investigated the association between ACEI/ARB use and development of recorded anuria in a cohort of patients initiating PD in the U...
June 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28623892/improving-transitions-in-acute-stroke-patients-discharged-to-home-the-michigan-stroke-transitions-trial-mistt-protocol
#20
Mathew J Reeves, Anne K Hughes, Amanda T Woodward, Paul P Freddolino, Constantinos K Coursaris, Sarah J Swierenga, Lee H Schwamm, Michele C Fritz
BACKGROUND: For some stroke patients and caregivers, navigating the transition between hospital discharge and returning home is associated with substantial psychosocial and health-related challenges. Currently, no evidence-based standard of care exists that addresses the concerns of stroke patients and caregivers during the transition period. Objectives of the Michigan Stroke Transitions Trial (MISTT) are to test the impact of a social worker home-based case management program, as well as an online information and support resource, on patient and caregiver outcomes after returning home...
June 17, 2017: BMC Neurology
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