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Assessing the Impact of a Training Intervention on Venous Compression Bandaging Application: A Factorial Design Randomised Trial

ABSTRACT

Venous leg ulcers (VLU) are a major complication of chronic venous disease, with compression therapy as the gold-standard treatment. This 2 × 2 factorial randomised open-label trial assessed the effect and three-month sustainability of a one-hour training intervention on compression bandaging quality among 50 advanced practice nursing students (APNS) in France, using two different compression bandage types (system A or system B) on a mannequin leg. The primary outcome was the Control Score of compression bandaging (CCB score, 0–7). Secondary outcomes included installation conformity, application time, and satisfaction. At baseline, mean CCB score was 3.78, with 52% installation conformity. The intervention did not significantly improve the CCB score compared to controls (adjusted difference: −0.43; 95% CI: −1.01 to 0.15). A significant interaction between bandage type and intervention was found for installation conformity: a tendency to improve with system B and decrease with system A. Improvements observed at 1 month were not sustained at 3 months. Application time decreased over follow-up, and system B was applied more efficiently than system A. Brief, behaviourist-based training was insufficient to achieve lasting skill improvement. Findings highlight the need for repeated group practice, feedback, and integration into relevant clinical contexts to enhance compression bandaging proficiency.

Efficacy and safety of microbiota-targeted therapeutics in autoimmune and inflammatory rheumatic diseases: protocol for a systematic review and meta-analysis of randomised controlled trials

Por: Kragsnaes · M. S. · Gilbert · B. T. P. · Sofiudottir · B. K. · Rooney · C. M. · Hansen · S. M.-B. · Mauro · D. · Mullish · B. H. · Bergot · A.-S. · Mankia · K. S. · Goel · N. · Bakland · G. · Johnsen · P. H. · Miguens Blanco · J. · Li · S. · Dumas · E. · Lage-Hansen · P. R. · Wagenaar
Introduction

An abnormal composition of gut bacteria along with alterations in microbial metabolites and reduced gut barrier integrity has been associated with the pathogenesis of chronic autoimmune and inflammatory rheumatic diseases (AIRDs). The aim of the systematic review, for which this protocol is presented, is to evaluate the clinical benefits and potential harms of therapies targeting the intestinal microbiota and/or gut barrier function in AIRDs to inform clinical practice and future research.

Methods and analysis

This protocol used the reporting guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. We will search Embase (Ovid), Medline (Ovid) and the Cochrane Library (Central) for reports of randomised controlled trials of patients diagnosed with an AIRD. Eligible interventions are therapies targeting the intestinal microbiota and/or gut barrier function including probiotics, synbiotics, faecal microbiota transplantation, live biotherapeutic products and antibiotics with the intent to modify disease activity in AIRDs. The primary outcome of the evidence synthesis will be based on the primary endpoint of each trial. Secondary efficacy outcomes will be evaluated and selected from the existing core domain sets of the individual diseases and include the following domains: disease control, patient global assessment, physician global assessment, health-related quality of life, fatigue, pain and inflammation. Harms will include the total number of withdrawals, withdrawals due to adverse events, number of patients with serious adverse events, disease flares and deaths. A meta-analysis will be performed for each outcome domain separately. Depending on the type of outcome, the quantitative synthesis will encompass both ORs and standardised mean differences with corresponding 95% CIs.

Ethics and dissemination

No ethics approval will be needed for this systematic review. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to disseminate the study results through a peer-reviewed publication.

PROSPERO registration number

CRD42025644244.

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