Persistence of Medical Change at Implementation of Clinical Guidelines on Medical Practice: A Controlled Study in a Cancer Network

2005 ◽  
Vol 23 (19) ◽  
pp. 4414-4423 ◽  
Author(s):  
Isabelle Ray-Coquard ◽  
Thierry Philip ◽  
Guy de Laroche ◽  
Xavier Froger ◽  
Jean-Philippe Suchaud ◽  
...  

Purpose A cancer network of general or private hospitals of a French region was started in 1995 for improving quality of care and rationalizing medical prescriptions. The impact of implementing a clinical practice guidelines (CPG) project assessed conformity with guidelines in medical practice; significant changes were observed within the network, whereas no changes were observed in a control region without cancer network. In the present study, we evaluated the persistence of conformity to guidelines through a new medical audit. Patients and Methods In 1999, the hospitals of the previously compared experimental and control groups accepted to reassess the impact of CPG. A controlled transversal study was performed in the experimental group (cancer network) and in the control group (no regional cancer network). In 1996 (first audit) and in 1999 (present audit), all new patients with colon cancer (177 and 200 in experimental group and 118 and 100 in control group, respectively) and early breast cancer (444 and 381 in experimental group and 172 and 204 in control group, respectively) were selected. Results In the experimental group, the compliance of medical decisions with CPG was significantly higher in 1999 than in 1996 for colon cancer (73%; 95% CI, 67% to 79% v 56%; 95% CI, 49% to 63%, respectively; P = .003) and similar for the two periods for breast cancer (36%; 95% CI, 31% to 41% v 40%; 95% CI, 35% to 44%, respectively; P = .24). In the control group, compliance was significantly higher in 1999 than in 1996 for colon cancer (67%; 95% CI, 58% to 76% v 38%; 95% CI, 29% to 47%, respectively; P < .001) and identical for the two periods for breast cancer (4%; 95% CI, 1% to 7% v 7%; 95% CI, 3% to 11%, respectively; P = .19). Conclusion The CPG program for cancer management produced persistent changes in medical practice in our cancer network in terms of conformity with CPG.

2017 ◽  
Vol 8 (3) ◽  
pp. 172
Author(s):  
Waqar Ahmad ◽  
Zuraina Ali ◽  
Muhammad Aslam Sipra ◽  
Imtiaz Hassan Taj

Smartboards, which are now widely used in the teaching and learning process in Saudi Arabia, have turned the traditional environments of the classrooms, especially the EFL classrooms to be more interesting and encouraging. Literature reviews suggest that Saudi students usually lack motivation for studying English as a foreign language. This study tends to investigate the impact of Smartboards on preparatory year EFL learners motivation at a Saudi university. Two intact groups were selected, in which one was termed as experimental and the second as control group. The experimental group was taught using the Smartboard while the control group was taught with the traditional whiteboard, pen and book method. The treatment was given for seven weeks. A questionnaire was administered to both the groups at the beginning and the end of the study. The data was analysed using the SPSS and the results showed that there was significant difference between the experimental and control groups in terms of motivation.  


2019 ◽  
Vol 14 (4) ◽  
pp. 20-23
Author(s):  
M. M. Vasilyeva ◽  
I. P. Moshurov ◽  
L. Yu. Grivtsova ◽  
N. N. Tupitsyn ◽  
N. A. Kozlov ◽  
...  

Background. A new strategy of breast cancer management is required for effective disease prevention and control. Immunotherapy is one of promising options.Objective: to evaluate the effect of immunoadjuvant polyoxidonium on pathmorphological changes in breast tumors.Materials and methods. The study was performed in 75 patients with breast cancer: 50 patients received polyoxidonium in a neoadjuvant regimen (main group), 25 patients did not receive polyoxidonium (control group). Polyoxidonium at a dose of 12 mg was administered intramuscularly 1 time per day on the days 1, 2, 3, 5 and 7 before surgery; on the day 8, radical mastectomy was performed in patients of both groups, followed by histological examination and determination of the grade of therapeutic pathomorphosis of the tumor.Results. The proportion of cases with grade I therapeutic pathomorphosis was 58 %, grade II therapeutic pathomorphosis – 6 %. Pathomorphosis in metastatic lymph nodes was observed in 22.7 % of cases.Conclusion. The anti-tumor effect of polyoxidonium was confirmed on the basis of the induction of pathomorphosis of the tumor tissue of breast cancer.


Author(s):  
Abdul Latif Al-Zakri

This study aimed to examine the impact of the use of self-questioning in the understanding of fifth grade students in mathematics material. The researcher used the experimental methodology for independent groups to investigate the impact of the independent variable, which is a self-questioning strategy on the dependent variable, which is understanding. The study sample consisted of 42 students from the fifth grade students from Khubayb bin Udai School in Riyadh; equally divided into two groups of 21 students in each group (experimental and control), and after making sure from groups' equivalence by applying the tools of the study, having been taught the experimental group by using self-questioning strategy, while the control group has been studied the unit by using the traditional method. After the completion of the study of prescribed content study, study tools (achievement test) were applied then. The results indicated to the presence of a statistically significant difference (at the significance level <0. 05) between the mean scores of the two groups' students (experimental and control) in achievement test posttest for the experimental group. Since the results of the study were positive in increasing the achievement, the researcher recommended the need to use self-questioning to raise the level of achievement of learners in mathematics material


Author(s):  
Behnam Behforouz ◽  
Anca Daniela Frumuselu

This paper investigates the efficiency of text messaging as an English as a Foreign Language (EFL) instructional tool to enhance learner autonomy and perception at the Islamic Azad University-South Tehran Branch, Iran. The study considers seventy-four learners to participate in the study after the administration of an Oxford Placement Test to measure their proficiency level. Participants are randomly assigned in experimental and control groups, including 37 participants each. A questionnaire is used as a pretest and posttest to measure learners` autonomy. Participants from the experimental group use text messaging (the treatment) to receive instructions, whereas those from the control group receive traditional classroom instructions in a face-to-face channel. A semi-structured interview is also used to collect date on experimental group participants` perception in using MALL in classrooms. The results reveal remarkable differences between the experimental and control groups’ means on their learner autonomy scores. However, the impact of the independent samples t-test has shown that there is no statistically meaningful gender difference among the learners regarding their autonomy scores. The findings based on the semi-structured interview showed complimentary views on MALL. The current study is beneficial since its outcomes could be relevant for EFL curriculum developers and English language teachers in the use of mobile learning and text messaging in the English classroom.


2021 ◽  
Vol 1 (1) ◽  
pp. 35-39
Author(s):  
Sabeeha Hamza Dehham ◽  
Nadia Majeed Hussein

This research attempted to explore the effects of divergent and convergent tasks on the successful reading of EFL students at the preparatory stage. To verify the analysis, the null hypothesis was established that states "There are no differences of statistical significance at the level of (0,05) among the mean of scores of the experimental group who study according to divergent and convergent task technique and the mean of the scores of the control group who study according to the regular method".  The experimental approach is used by designing two equivalent experimental groups of 32 students studying the technique proposed, and an 8-week (2019-2020) control group of 32 students, three classes each week using the Google Classroom Platform and Telegram. The present study utilized the platform Google Classroom (GC) and Telegram as an educational platform to assist students during their course learning process. The writing skills test was administered after checking with the experts. The results show that there are statistical differences at level (0,05) between the average of the experimental and control groups' reading skills and those of the experimental group. This difference is because the experimental group uses divergent and convergent tasks.


Religions ◽  
2020 ◽  
Vol 11 (7) ◽  
pp. 361
Author(s):  
Maria Komariah ◽  
Urai Hatthakit ◽  
Nongnut Boonyoung

This research emphasizes the nurse’s role in incorporating Islamic teaching through the care practices provided in order to promote spiritual well-being in Muslim women with breast cancer undergoing chemotherapy. In addition, religion and spirituality have been recognized as the primary resources for coping. The aim of the study, therefore, was to explore the impact of an Islam-based caring intervention on the spiritual well-being of Muslim women with cancer. Furthermore, data were collected using a questionnaire and, also, the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp) on baseline (Time 1), days 3 (Time 2), 23 (Time 3), and 44 (Time 4). The results showed the significant impact of an Islam-based caring intervention on the participants’ level of spiritual well-being. In addition, the mean scores varied between the intervention and control group over time. Based on the reflection, participants stipulated feeling peace of mind, closer to God, spirit for further life, and healthier.


2018 ◽  
Vol 5 (1) ◽  
pp. 22 ◽  
Author(s):  
Saeedeh Rajayi ◽  
Mahpareh Poorahmadi ◽  
Mahpare Poorahmadi

A considerable body of research has been conducted on effective vocabulary instruction to improve vocabularylearning. However, no research has been done to empirically document the link between teaching vocabulary through“Kik’ application and vocabulary learning. Thus, this study was conducted to fill this gap in research related to thisphenomenon. To this effect, 61 intermediate EFL learners from Joyandegan language institute were selected throughconvenience sampling and randomly assigned to two groups; experimental and control group. In this pretest, posttestexperimental study, only the experimental group received training through “Kik” application. The comparison of thescores of Teacher Made Vocabulary Test showed that the scores of experimental group were higher than those of thecontrol group. The comparison of the scores of Teacher Made Vocabulary Test showed that the scores ofexperimental group were higher than those of the control group. This provided a statistically significant relationshipbetween the independent variable, teaching vocabulary through “Kik” application, and vocabulary learning which isthe dependent variable. The results of this study point to a probability that on using of “Kik” for teaching vocabularyand the results of this study showed that using “Kik” for teaching can have a significant impact on EFL learners’vocabulary learning.


2015 ◽  
Vol 1 (4) ◽  
pp. 199
Author(s):  
Angel Rajakumari G ◽  
Soli T. K ◽  
Malathy D

Aim: To evaluate the effectiveness of meditation lowers stress and supports forgiveness among nursing Students.Participants and setting: The study was conducted by adopting a Quasi-experimental, non-equivalent control group pre and post test design.50 nursing students who fulfilled the inclusion criteria were selected by using Non-probability purposive sampling technique. 50 women were assigned in experimental and control group. The study was conducted in Bhavana College of nursing, Nalgonda, Telugana, India.Intervention: A brief introduction about self and study was given to the nursing students and consent was obtained (both oral and written) and the confidentiality of the response was assured. Pre assessment was done in both experimental and control groups. In the experimental group meditation technique was practiced by the women and pre and post test level of stress was obtained using John D. Catherine & T. Mac Arthurs perceived stress scale. In the control group without any intervention, the pre and post test level of stress was obtained for both the groups and the level of stress was assessed.Measurement and findings: Analysis revealed that the women in the experimental group showed a highly significant decrease in the level of stress following meditation at P<0.001 level when compared with the control group.Conclusion: Evidence suggests that meditation-based stress-management practices reduce stress and enhance forgiveness among college undergraduates. Such programs merit further study as potential health-promotion tools for college populations.


2019 ◽  
Vol 31 (2) ◽  
pp. 166-191 ◽  
Author(s):  
Aurik Gustomo ◽  
Hary Febriansyah ◽  
Henndy Ginting ◽  
Imelia Martinovita Santoso

PurposeEmployee engagement has been directly linked to organizational outcomes, and at present, improving employee engagement has increasingly been a main focus for organizations. However, studies evaluating the impact of storytelling interventions on increasing the level of employee engagement are limited. Storytelling is one of the intervention methods that can provide cognitive stimulus to employees, which in turn could change their attitudes toward work including employee engagement. The purpose of this study is to determine the effectiveness of storytelling as an intervention tool for increasing employee engagement in one of the state-owned enterprises (SOEs) in West Java, Indonesia.Design/methodology/approachThis study uses a quantitative method. Employees from a West Java branch of large SOEs were randomly assigned into experimental and control groups. The research design used a pretest and a post-test with an expressive writing method to identify the extent of employee engagement by comparing participant groups and measuring the increase of employee engagement as a result of the storytelling intervention. The experimental group participated in three storytelling sessions that had been set up by panels of experts, while the control group was not given any treatment. The expressive writing analysis was conducted using software that has been developed and tested for validity and reliability. Furthermore, statistical analysis was used to test the results of expressive writing scoring to determine the impact of storytelling interventions.FindingsDirect storytelling is proven to be one of the most effective methods of increasing employee engagement in one of the SOEs in the West Java region. The results of this study showed that there were differences between the experiment and control groups after experiencing a direct storytelling intervention where there was a significant increase in the dimensions of employee engagement. Participants in experimental group had higher scores than participants in control group in most of the employee engagement dimensions. Additionally, expressive writing methods are also proven to be able to provide a stimulus for employees in expressing thoughts, perceptions and motivations for employee engagement in the company.Research limitations/implicationsAs direct storytelling has not been frequently used, especially to improve employee engagement, more studies should be conducted in various settings, with different measurement tools, and in a more controlled environment to confirm the effects of the intervention.Practical implicationsThis paper provides insight into how companies can use direct storytelling to improve the dimensions of employee engagement. Additionally, this research can also be used as a reference by companies in Indonesia, especially SOEs, for applying the same method in an effort to improve work-related attitudes, such as employee satisfaction and organizational commitment.Social implicationsThis study raises social implications in which employees enthusiasm increases in improving personal relationships between employees and storytellers, who are middle or upper management employees. In addition, employees also more appreciate their struggles when starting their careers, so they care more about increasing their role and involvement in the company.Originality/valueThis paper provides resources and information for companies and organizations to improve employee engagement through the implementation of direct storytelling. The focus of this paper is to gain information on the role of direct storytelling in improving employee engagement within a company or organization.


Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4591-4591
Author(s):  
Selim Corbacioglu ◽  
Simone Cesaro ◽  
Maura Faraci ◽  
Bernd Gruhn ◽  
Jaap J Boelens ◽  
...  

Background Acute GvHD (aGvHD) remains one of the most significant complications of allogeneic hematopoietic stem cell transplantation (HSCT) with a persistently high incidence despite a plethora of prophylactic approaches. The medical need for effective drugs to prevent aGvHD remains substantial. Methods A prospective, randomized, open-label controlled study has been conducted in 356 children at high-risk for hepatic VOD post-HSCT to demonstrate efficacy of prophylaxis with defibrotide (DF) to reduce the incidence of VOD (180 in the DF arm and 176 in the control arm [Corbacioglu, Lancet 2012]). A secondary objective of the study was to analyze the impact of DF prophylaxis on the incidence and severity of aGvHD. Among children undergoing allogeneic HSCT (allo-subset) 122 patients received DF prophylaxis and 117 were in the control arm. Results Demographic and baseline characteristics were similar in the DF and control arm of the allo-subset. Mean age (± SD) was 6.47±5.28 and 6.54±5.49 in DF arm and in the controls respectively, with 29% and 30% being <2 years; 64% and 58%, respectively, were males. Busulfan was used in conditioning in 62% and 64% of patients in the two arms, and melphalan in 60% and 53%, respectively. Grafts were from related donors in 40% and 30%, respectively, in DF and control arm. Prophylaxis with DF was shown to significantly reduce the occurrence and severity of aGvHD. At day+100 post-HSCT the incidence of aGvHD was 47% in the DF arm vs. 65% in the control group (p=0.0046). DF did not seem to affect the incidence of aGvHD grade I (25% vs 28%, respectively). However, Defibrotide showed a consistent reduction of the more severe grade II–IV aGvHD from 37% to 22% (p=0.0130). Of note the use of corticosteroids was significantly lower in patients receiving DF prophylaxis (37% vs 48% in control arm, p=0.0363), likely reflecting the lower incidence of aGvHD in the DF arm. This has also previously been observed in the treatment studies [Richardson, ASH 2012]. Standard GvHD prophylaxis was allowed according to best practice and was generally comparable (cyclosporine A: 81% vs. 89%; methotrexate: 46% vs. 56%; in DF and control arm, respectively). However, there was a difference in patients who received antithymocyte globulin (ATG) in the DF arm compared to controls (55% vs 70%). Exploratory analysis performed adjusting for ATG as covariate confirmed the significant effects of defibrotide [Adjusted Risk Difference (DF vs control) for aGvHD grade II–IV: -0.1470 (95%CI: -0.2618; -0.0322), p =0.0121]. Defibrotide did not seem to interfere with a graft-versus-leukemia effect. Relapse rates of combined leukemias were 8% (ALL 1.5%, AML 5%, others 1.5%) in DF group compared with 10% (ALL 3%, AML 7%) in controls by day +100; while 10% (ALL 1.5%, AML 7%, others 1.5%) patients in DF group relapsed by day +180 compared with 13% (ALL 8%, AML 5%) in the control arm. Conclusions The study shows that DF prophylaxis can reduce the incidence and severity of aGvHD in children undergoing allogeneic HSCT. This reduction observed with defibrotide is additional to standard GvHD prophylaxis that was fully implemented in these patients. Defibrotide has been reported to protect endothelial cells from damage as well as to downregulate heparanase activity. These clinical data would therefore suggest a benefit of defibrotide to reduce the incidence and severity of aGvHD. Further studies may be conducted to strengthen preclinical and clinical evidence for the role of defibrotide in aGvHD prevention. Ref: Corbacioglu S et al, Lancet 2012; 379:1301-9. Richardson PG et al, Blood 2012; 120:738. Disclosures: Corbacioglu: Gentium : Consultancy. Cesaro:Pfizer SpA: Honoraria; Gilead: Honoraria; Merck: Honoraria. Tudone:Gentium : Employment. Ballabio:Gentium : Employment. Heringa:Gentium S.p.A.: Employment.


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