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E Cain

Publications and source records attributed to E Cain.

10 recordsLinked to original sources
PubMed2000

A randomized controlled trial on the effect of educational interventions in promoting airway management skill maintenance.

STUDY OBJECTIVE: This study was conducted to determine the natural history of airway management skill decay and examine the effect of independent practice and periodic feedback on airway management skill maintenance. METHODS: This prospective, randomized controlled study conducted at Dalhousie University in Halifax, Nova Scotia, Canada, between November 1997 and September 1998. A convenience sample of 84 health sciences students with no prior airway management experience was used. Participants were trained using an advanced airway manikin and then were randomly assigned to control (n=24), periodic feedback only (n=30), and independent practice plus periodic feedback (n=30) groups. Performance was measured by a 52-point weighted checklist at 0, 16, 25, and 40 weeks after the initial program. RESULTS: Group scores were analyzed using a mixed-model repeated-measures analysis of variance and Bonferroni-adjusted P values. Overall group (P =.0002) and time (P =.0001) effects were significant. At time 0, there was no statistical difference in mean scores between groups (range 45.0 to 45.2). Control group performance fell over the first time interval (0 to 16 weeks) (mean score=34.0, P =.002) and remained lower at all intervals without further significant change. Scores in the independent practice plus feedback group revealed no significant changes over time and were significantly higher than the control group throughout. Performance in the periodic feedback only group showed a nonsignificant trend to improved performance over the control group. CONCLUSION: Airway management skill performance declines early after initial training. Independent practice combined with periodic feedback was effective in maintaining performance scores in an advanced airway management simulation. Periodic evaluation with feedback alone showed a nonsignificant trend toward improvement over control.

Airway Obstruction↗
PubMed1999

Validation of patient reports, automated pharmacy records, and pill counts with electronic monitoring of adherence to antihypertensive therapy.

OBJECTIVES: To evaluate the validity of patient report, pharmacy dispensing records, and pill counts as measures of antihypertensive adherence using electronic monitoring as the validation standard. METHODS: The study was conducted among 286 members of Harvard Pilgrim Health Care, a managed care organization, who were at least 18 years of age, on monotherapy for hypertension, and had prescription drug coverage. Prescription refill adherence during the 12 months before enrollment was determined from their automated pharmacy dispensing records. Participants were interviewed about their medication adherence before and after a 3-month electronic monitoring period during which pill counts were also performed. Adherence to both recommended number and timing of doses was estimated from electronic monitoring data. Data analysis was based on statistical correlation and analysis of variance. RESULTS: Electronic adherence monitoring revealed that the proportion of prescribed doses consumed was higher (0.92) than the proportion of doses taken on time (0.63). The correlation between adherence to quantity and timing of doses was 0.32. Concurrent pill counts and earlier refilling patterns were moderately correlated with electronic monitoring (pill count: r = .52 with quantity and r = .17 with timing; refill adherence r = .32 with quantity and r = .22 with timing). There was considerable misclassification of adherence reported by patients, although nonadherence was generally accurately reported. CONCLUSIONS: Deviation from recommended timing of doses appears to be greater than from prescribed number of doses. Pharmacy dispensing records demonstrate predictive validity as measures of cumulative exposure and gaps in medication supply. Adherence levels determined from pill counts and pharmacy dispensing records correlate more closely with quantity than with timing of doses. Nonadherence reported by patients can serve as a qualitative indicator and predictor of reduced adherence.

Adolescent↗
PubMed1999

An evaluation of aromatherapy massage in palliative care.

The use of complementary therapies, such as massage and aromatherapy massage, is rising in popularity among patients and healthcare professionals. They are increasingly being used to improve the quality of life of patients, but there is little evidence of their efficacy. This study assessed the effects of massage and aromatherapy massage on cancer patients in a palliative care setting. We studied 103 patients, who were randomly allocated to receive massage using a carrier oil (massage) or massage using a carrier oil plus the Roman chamomile essential oil (aromatherapy massage). Outcome measurements included the Rotterdam Symptom Checklist (RSCL), the State-Trait Anxiety Inventory (STAI) and a semi-structured questionnaire, administered 2 weeks postmassage, to explore patients' perceptions of massage. There was a statistically significant reduction in anxiety after each massage on the STAI (P < 0.001), and improved scores on the RSCL: psychological (P < 0.001), quality of life (P < 0.01), severe physical (P < 0.05), and severe psychological (P < 0.05) subscales for the combined aromatherapy and massage group. The aromatherapy group's scores improved on all RSCL subscales at the 1% level of significance or better, except for severely restricted activities. The massage group's scores improved on four RSCL subscales but these improvements did not reach statistical significance. Massage with or without essential oils appears to reduce levels of anxiety. The addition of an essential oil seems to enhance the effect of massage and to improve physical and psychological symptoms, as well as overall quality of life.

Adult↗
PubMed1999

Utility of obtaining radiographs in patients with trigger finger.

We performed a combined retrospective and prospective study on the utility of obtaining radiographs in patients with trigger finger. Ninety-three patients with a total of 110 involved fingers were reviewed. The average age of the patients was 52 years, and 61% had involvement of their dominant hand. There were 54 women and 39 men. Eighty-four percent of the radiographs were reviewed retrospectively, and 16% of the radiographs were reviewed prospectively. There were no abnormal findings in 62% of the radiographs [corrected]. Thirty-one percent had radiographic abnormalities that were not currently clinically significant. Four percent had radiographic findings that correlated with other clinical problems. No radiographic finding changed our management. Patients with stenosing flexor tenosynovitis without a history of injury or inflammatory arthritis do not need routine radiographs.

Female↗
PubMed1989

Effect of strain differences on the potency testing of rabies vaccines in mice.

Antigenic differences between several strains of rabies virus, namely CVS, SAD and Flury (LEP) strains, were studied in cross-challenge experiments or cross-neutralization tests performed on sera of mice immunized with vaccines containing each strain. A typical wild fox virus strain was also included as challenge virus. The strain differences affected the relative potencies of the three vaccines in the European Pharmacopoeia mouse protection test for veterinary rabies vaccines, in that higher antigenic values were obtained when the vaccine strain was homologous to the challenge virus. This observation was confirmed by neutralizing antibody induction in mice.

Animals↗
PubMed1986

[Genetic resistance to rabies infection. Trial of demonstrating the heritability of resistance to the infection (preliminary evaluation on a murine model)].

A model in mice was developed in order to check if a resistance against rabies could be naturally and genetically selected in a line of mammals. A more resistant strain of mice (DBA/2) was identified. However, up to present, all attempts have failed in view to create a resistant strain of swiss mice in breeding individuals surviving to rabies infection.

Animals↗
PubMed1983

[Comparison of 4 technics for serologic titration of antibodies against rabies virus in dogs].

Four different serological techniques were used for the determination of antibody levels against rabies virus in 55 vaccinated street dogs: mouse neutralization test (reference), rapid fluorescent focus inhibition test, plaque reduction test and immunoenzymatic test (protein A). The results obtained with each of the last three methods were compared with those obtained with the reference test: correlation coefficients were, respectively, 0.810, 0.812 and 0.682, each being significantly correlated with the others. Therefore the three techniques may each be recommended as an alternative to the mouse neutralization test for routine titrations; the immunoenzymatic method, which titrates not only neutralizing antibodies being, nevertheless, better used as a screening test.

Animals↗
PubMedDate not supplied

Prehospital cardiac arrest survival and neurologic recovery.

Many studies of prehospital defibrillation have been conducted but the effects of airway intervention are unknown and neurologic follow-up has been incomplete. A non-randomized cohort prospective study was conducted to determine the effectiveness of defibrillation in prehospital cardiac arrest. Two ambulance companies in the study area developed a defibrillation protocol and they formed the experimental group. A subgroup of these patients received airway management with an esophageal obturator airway (EOA) or endotracheal intubation (ETT). The control group was composed of patients who suffered a prehospital cardiac arrest and did not receive prehospital defibrillation. All survivors were assessed for residual deficits using the Sickness Impact Profile (SIP) and the Dementia Rating Scale (DRS). A total of 221 patients were studied over a 32-month period. Both the experimental group (N = 161) and the control group (N = 60) were comparable with respect to age, sex distribution, and ambulance response time. Survival to hospital discharge was 2/60 (3.3%) in the control group and 12/161 (6.3%) in the experimental group. This difference is not statistically significant. Survival in the experimental group by airway management technique was basic airway support (3/76 3.9%), EOA (3/67 4.5%), and ETT (6/48 12.5%). The improved effect on survival by ETT management was statistically significant. Survivors had minor differences in memory, work, and recreation as compared to ischemic heart disease patients as measured by the SIP and DRS. No effect of defibrillation was found on survival to hospital discharge. However, endotracheal intubation improved survival in defibrillated patients. Survivors had a good functional outcome.

Aged↗