Effectiveness of the Kids in Control of Food (KICk-OFF) structured education course for 11-16 year olds with Type 1 diabetes. Price K J,Knowles J A,Fox M,Wales J K H,Heller S,Eiser C,Freeman J V, Diabetic medicine : a journal of the British Diabetic Association AIM:To assess the effect of a 5-day structured education course (Kids in Control of Food; KICk-OFF) on biomedical and psychological outcomes in young people with Type 1 diabetes. METHODS:This was a cluster-randomized trial involving 31 UK paediatric centres. Participants were recruited prior to stratified centre randomization. Intervention centres delivered KICk-OFF courses, whereas control centres delivered usual care. Participants were 11-16 years of age and had Type 1 diabetes for at least one year. The KICk-OFF course was delivered by trained educators to eight participants per course. Glycaemic control and quality of life were measured at baseline, 6, 12 and 24 months. Secondary outcomes were hypoglycaemia, ketoacidosis, fear of hypoglycaemia and diabetes self-efficacy. RESULTS:Three hundred and ninety-six participants provided baseline data (199 intervention and 197 control). At 6 and 12 months the intervention group showed significantly improved total generic quality of life scores compared with controls (baseline: 80 vs. 82; 6 months: 82 vs. 82; P = 0.04). Across the whole intervention group mean HbA1c levels were not significantly different from controls; baseline HbA1c mean (95% confidence interval), 78 mmol/mol (75-81) vs. 76 mmol/mol (74-79) [9.3% (9-9.6%) vs. 9.1% (8.9-9.4%); 24 months: 77 mmol/mol (74-79) vs. 78 mmol/mol (75-81) (9.2% (8.9-9.4%) vs. 9.3% (9-9.6%)], adjusted mean difference, -2.0 mmol/mol (6.5-2.5) [2.3% (-2.7% to 2.4%)], P = 0.38. CONCLUSIONS:Attending a KICk-OFF course was associated with significantly improved total quality of life scores within 6 months. Glycaemic control, as measured by HbA1c , was no different at 24 months. (Clinical Trial Registry No: ISRCTN3704268). 10.1111/dme.12881

The effectiveness of aromatherapy on preoperative anxiety in adults: A systematic review and meta-analysis of randomized controlled trials. Guo Pingping,Li Ping,Zhang Xuehui,Liu Na,Wang Jie,Yang Shu,Yu Lin,Zhang Wei International journal of nursing studies BACKGROUND:Preoperative anxiety is very common in adults awaiting all types of surgical procedures, which can interfere with the start and completion of surgery and increase the risk of postoperative complications. In this context, many researchers and clinical practitioners have attempted to use aromatherapy to help adults reduce preoperative anxiety. OBJECTIVE:To investigate systematically the efficacy of aromatherapy on preoperative anxiety in adults. DESIGN:A systematic review and meta-analysis of randomized controlled trials was undertaken. DATA SOURCES:PubMed, Embase, Cochrane Library, Web of Science, PsycINFO and CINAHL were comprehensively searched from their inception to June 2020. REVIEW METHODS:Studies on the use of aromatherapy for treating preoperative anxiety in adults were included. Two reviewers assessed the risk of bias of the included studies independently using the Cochrane Collaboration 'Risk of Bias' tool. Overall meta-analysis and five subgroup analyses regarding the type of control, the type of aroma preparations, delivery mode, session length and surgery type were performed using RevMan 5.3. The Higgins' I (%) statistic was used to measure heterogeneity. A funnel plot and Egger's test were used to evaluate publication bias. RESULTS:Twenty studies comprising 1717 participants were included. The meta-analysis indicated that aromatherapy could significantly ameliorate preoperative anxiety (standard mean difference=-0.57, 95% confidence interval [-0.75, -0.39], p<0.00001) for adults awaiting surgical procedures, compared to placebo control, conventional care and no intervention. The subgroup analysis based on the surgery type showed that aromatherapy had a great improvement on preoperative anxiety for patients awaiting cardiac surgery and relatively low-risk surgery. Lavender oil, citrus species preparations and rose oil were the three most commonly used aroma preparations that could significantly improve preoperative anxiety. Most delivery modes of aromatherapy, including inhalation, massage, and oral administration, were effective. Moreover, short length (≤20 min per session) aromatherapy showed a better effect on preoperative anxiety (mean difference=-5.84, 95% confidence interval [-8.09, -3.59], p<0.00001) than aromatherapy lasting more than 20-minutes per session (mean difference=-2.15, 95% confidence interval [-3.81, -0.49], p = 0.01). CONCLUSION:Aromatherapy is an effective intervention for reducing preoperative anxiety in adults. Short-length aromatherapy inhalation seems to be more worthy of being recommended in clinical settings. More well-designed randomized controlled trials containing a wider range of surgical types and participants from more countries are needed to verify our findings before we can make strong recommendations. 10.1016/j.ijnurstu.2020.103747