Immunogenicity and Safety of Intradermal Trivalent Influenza Vaccination in Nursing Home Older Adults: A Randomized Controlled Trial

2014 ◽  
Vol 15 (8) ◽  
pp. 607.e5-607.e12 ◽  
Author(s):  
Tuen-Ching Chan ◽  
Ivan Fan-Ngai Hung ◽  
Kwok-Hung Chan ◽  
Clara Pui-Yan Li ◽  
Patrick Tsz-Wai Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Influenza Vaccination ◽  
Controlled Trial ◽  
Randomized Controlled

scholarly journals Mood and influenza vaccination in older adults: A randomized controlled trial.

2019 ◽  
Vol 38 (11) ◽  
pp. 984-996
Author(s):  
Kieran Ayling ◽  
Lucy Fairclough ◽  
Heather Buchanan ◽  
Mark A. Wetherell ◽  
Kavita Vedhara
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Influenza Vaccination ◽  
Controlled Trial ◽  
Randomized Controlled

scholarly journals Addressing methodological challenges in implementing the nursing home pain management algorithm randomized controlled trial

2012 ◽  
Vol 9 (5) ◽  
pp. 634-644 ◽  
Author(s):  
Mary Ersek ◽  
Nayak Polissar ◽  
Anna Du Pen ◽  
Anita Jablonski ◽  
Keela Herr ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Pain Management ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Self Report ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Methodological Challenges

Background Unrelieved pain among nursing home (NH) residents is a well-documented problem. Attempts have been made to enhance pain management for older adults, including those in NHs. Several evidence-based clinical guidelines have been published to assist providers in assessing and managing acute and chronic pain in older adults. Despite the proliferation and dissemination of these practice guidelines, research has shown that intensive systems-level implementation strategies are necessary to change clinical practice and patient outcomes within a health-care setting. One promising approach is the embedding of guidelines into explicit protocols and algorithms to enhance decision making. Purpose The goal of the article is to describe several issues that arose in the design and conduct of a study that compared the effectiveness of pain management algorithms coupled with a comprehensive adoption program versus the effectiveness of education alone in improving evidence-based pain assessment and management practices, decreasing pain and depressive symptoms, and enhancing mobility among NH residents. Methods The study used a cluster-randomized controlled trial (RCT) design in which the individual NH was the unit of randomization. The Roger’s Diffusion of Innovations theory provided the framework for the intervention. Outcome measures were surrogate-reported usual pain, self-reported usual and worst pain, and self-reported pain-related interference with activities, depression, and mobility. Results The final sample consisted of 485 NH residents from 27 NHs. The investigators were able to use a staggered enrollment strategy to recruit and retain facilities. The adaptive randomization procedures were successful in balancing intervention and control sites on key NH characteristics. Several strategies were successfully implemented to enhance the adoption of the algorithm. Limitations/Lessons The investigators encountered several methodological challenges that were inherent to both the design and implementation of the study. The most problematic issue concerned the measurement of outcomes in persons with moderate to severe cognitive impairment. It was difficult to identify valid, reliable, and sensitive outcome measures that could be applied to all NH residents regardless of the ability to self-report. Another challenge was the inability to incorporate advances in implementation science into the ongoing study Conclusions Methodological challenges are inevitable in the conduct of an RCT. The need to optimize internal validity by adhering to the study protocol is compromised by the emergent logistical issues that arise during the course of the study.

83. Effects of exercise training on the immune response to influenza vaccination in older adults: A randomized controlled trial

2008 ◽  
Vol 22 (4) ◽  
pp. 26 ◽  
Author(s):  
Victoria Vieira ◽  
K. Todd Keylock ◽  
Thomas Lowder ◽  
William Zelkovich ◽  
Sara Dumich ◽  
...  
Keyword(s):  
Older Adults ◽  
Immune Response ◽  
Randomized Controlled Trial ◽  
Exercise Training ◽  
Influenza Vaccination ◽  
Controlled Trial ◽  
Randomized Controlled
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