5 results on '"Lukasik, Jan"'
Search Results
2. Evaluation of ImpENSA technology‐enabled behaviour change module delivered to healthcare professionals in South Africa to improve micronutrient nutrition during the first 1000 days.
- Author
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Choi, Sunhea, Walsh, Corinna, Omer, Selma, Patro‐Golab, Bernadeta, Lawrence, Wendy, Havemann‐Nel, Lize, Yuen, Ho Ming, Koletzko, Berthold, Wentzel‐Viljoen, Edelweiss, Hendricks, Michael, Watson, Daniella, Kolodziej, Maciej, Lukasik, Jan, Goeiman, Hilary, and Godfrey, Keith M.
- Subjects
BEHAVIORAL assessment ,RESEARCH funding ,T-test (Statistics) ,EVALUATION of human services programs ,MOTHERS ,QUESTIONNAIRES ,INTERVIEWING ,FISHER exact test ,MICRONUTRIENTS ,EDUCATIONAL technology ,NUTRITIONAL requirements ,CHI-squared test ,MANN Whitney U Test ,INFANT nutrition ,PROFESSIONS ,PATIENT-centered care ,JOB satisfaction ,RESEARCH methodology ,LEARNING strategies ,NEEDS assessment ,DATA analysis software - Abstract
Healthcare professionals (HCPs) have vital roles in providing evidence‐based care to promote healthy micronutrient nutrition in early life. Providing such care requires scalable training to strengthen knowledge and confident application of effective behaviour change skills. Among 33 public and private HCPs (primarily dietitians) in South Africa, we evaluated the behaviour change aspects of a technology‐enabled National Qualification Sub‐Framework level 6 programme, Improving Early Nutrition and Health in South Africa ('ImpENSA'). This programme comprises two self‐directed micronutrient and behaviour change knowledge‐based eLearning and one facilitated online practical skills modules to improve maternal and infant micronutrient nutrition. Using assessments, questionnaires and interviews, we collected data at baseline, after module completion and at 3‐month follow‐up after programme completion. Questionnaire and interview data showed major improvements in understanding of and attitudes towards person‐centred behaviour change support immediately following the eLearning module on behaviour change. The assessment pass rate increased from 38% at baseline to 88% postmodule, demonstrating significant knowledge gain in behaviour change support. Intention to change practice towards a person‐centred approach was high and many had already started implementing changes. Three months postprogramme, support was centred around patients' needs. Open relationships with patients, improved patient outcomes and increased job satisfaction were among reported outcomes. Many reported becoming better change facilitators and reflective practitioners. Additional improvements in understanding and attitudes to behaviour change support were evident, reinforced by making changes and experiencing positive outcomes. The findings suggest that technology‐enabled learning can equip HCPs with knowledge and skills to effectively support behaviour change for healthy micronutrient nutrition during pregnancy and infancy. Key messages: After completing behaviour change skills eLearning, participants' attitudes and understanding of nutrition behaviour change support changed from expert to person centred.Participants adopted a person‐centred approach that focussed on patients' needs and implemented it in practice.At 3‐month follow‐up, consultations became more patient‐led, holistic and information given tailored and designed for patients. Participants reportedly became effective change facilitators and better listeners.Participants reported open relationships with patients, improved patient outcomes, increased job satisfaction and reflective practice.Technology‐enabled learning, when designed appropriately, offers a highly accessible and effective training method to support healthcare professionals to adopt person‐centred nutrition support in practice. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Strain-Specificity of Probiotics in Pediatrics
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Jankiewicz, Mateusz, Lukasik, Jan, Kotowska, Maja, Kolodziej, Maciej, and Szajewska, Hania
- Abstract
The dogma of probiotic strain-specificity is widely accepted. However, only the genus- and species-specific effects of probiotics are supported by evidence from clinical trials. The aim of this rapid review was to assess clinical evidence supporting the claim that the efficacy of probiotics in the pediatric population is strain-specific. The Cochrane Library, MEDLINE, and EMBASE databases were searched (up to August 2022) for randomized controlled trials (RCTs) conducted in children aged 0–18 years evaluating the effects of prophylactic or therapeutic administration of probiotics (well-characterized at the strain level) for conditions such as antibiotic-associated diarrhea, acute diarrhea, necrotizing enterocolitis, respiratory tract infections, Helicobacter pyloriinfection, and atopic dermatitis. To allow evaluation of strain-specificity, a trial could only be included in the review if at least one additional RCT assessed the effect of a different strain of the same species against the same comparator. RCTs without proper strain-level data were excluded. In the absence of identifying head-to-head strain versus strain RCTs, indirect comparisons were made between interventions. Twenty-three RCTs were eligible for inclusion. Out of the 11 performed comparisons, with 1 exception (two Lacticaseibacillus paracaseistrains in reducing atopic dermatitis symptoms), no significant differences between the clinical effects of different strains of the same probiotic species were found. Head-to-head comparison is an optimal study design to compare probiotic strains, but such comparisons are lacking. Based on indirect comparisons, this rapid review demonstrates insufficient clinical evidence to support or refute the claim that probiotic effects in children are strain-specific.
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- 2023
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4. Multispecies Probiotic for the Prevention of Antibiotic-Associated Diarrhea in Children: A Randomized Clinical Trial
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Lukasik, Jan, Dierikx, Thomas, Besseling-van der Vaart, Isolde, de Meij, Tim, and Szajewska, Hania
- Abstract
IMPORTANCE: The efficacy of multispecies probiotic formulations in the prevention of antibiotic-associated diarrhea (AAD) remains unclear. OBJECTIVE: To assess the effect of a multispecies probiotic on the risk of AAD in children. DESIGN, SETTING, AND PARTICIPANTS: This randomized, quadruple-blind, placebo-controlled trial was conducted from February 2018 to May 2021 in a multicenter, mixed setting (inpatients and outpatients). Patients were followed up throughout the intervention period. Eligibility criteria included age 3 months to 18 years, recruitment within 24 hours following initiation of broad-spectrum systemic antibiotics, and signed informed consent. In total, 646 eligible patients were approached and 350 patients took part in the trial. INTERVENTIONS: A multispecies probiotic consisting of Bifidobacterium bifidum W23, Bifidobacterium lactis W51, Lactobacillus acidophilus W37, L acidophilus W55, Lacticaseibacillus paracasei W20, Lactiplantibacillus plantarum W62, Lacticaseibacillus rhamnosus W71, and Ligilactobacillus salivarius W24, for a total dose of 10 billion colony-forming units daily, for the duration of antibiotic treatment and for 7 days after. MAIN OUTCOMES AND MEASURES: The primary outcome was AAD, defined as 3 or more loose or watery stools per day in a 24-hour period, caused either by Clostridioides difficile or of otherwise unexplained etiology, after testing for common diarrheal pathogens. The secondary outcomes included diarrhea regardless of the etiology, diarrhea duration, and predefined diarrhea complications. RESULTS: A total of 350 children (192 boys and 158 girls; mean [range] age, 50 [3-212] months) were randomized and 313 were included in the intention-to-treat analysis. Compared with placebo (n = 155), the probiotic (n = 158) had no effect on risk of AAD (relative risk [RR], 0.81; 95% CI, 0.49-1.33). However, children in the probiotic group had a lower risk of diarrhea regardless of the etiology (RR, 0.65; 95% CI, 0.44-0.94). No differences were observed between the groups for most of the secondary outcomes, including adverse events. CONCLUSIONS AND RELEVANCE: A multispecies probiotic did not reduce the risk of AAD in children when analyzed according to the most stringent definition. However, it reduced the overall risk of diarrhea during and for 7 days after antibiotic treatment. Our study also shows that the AAD definition has a significant effect on clinical trial results and their interpretation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03334604
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- 2022
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5. Probiotics and Antibiotic-Induced Microbial Aberrations in Children: A Secondary Analysis of a Randomized Clinical Trial.
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Dierikx TH, Malinowska AM, Lukasik J, Besseling-van der Vaart I, Belzer C, Szajewska H, and de Meij TGJ
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- Humans, Female, Male, Child, Child, Preschool, Adolescent, Infant, Probiotics therapeutic use, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents adverse effects, Gastrointestinal Microbiome drug effects, Feces microbiology, Diarrhea chemically induced, Diarrhea prevention & control, Diarrhea drug therapy, Diarrhea microbiology
- Abstract
Importance: Probiotics are often considered in children to prevent antibiotic-associated diarrhea. However, the underlying mechanistic effects and impact of probiotics on antibiotic-induced microbiota changes are not well understood., Objective: To investigate the effects of a multispecies probiotic on the gut microbiota composition in children receiving antibiotics., Design, Setting, and Participants: This is a secondary analysis of a randomized, quadruple-blind, placebo-controlled clinical trial from February 1, 2018, to May 31, 2021, including 350 children receiving broad-spectrum antibiotics in the inpatient and outpatient settings. Patients were followed up until 1 month after the intervention period. Fecal samples and data were analyzed between September 1, 2022, and February 28, 2023. Eligibility criteria included 3 months to 18 years of age and recruitment within 24 hours following initiation of broad-spectrum systemic antibiotics. In total, 646 eligible patients were approached and 350 participated in the trial., Intervention: Participants were randomly assigned to receive daily placebo or a multispecies probiotic formulation consisting of 8 strains from 5 different genera during antibiotic treatment and for 7 days afterward., Main Outcomes and Measures: Fecal stool samples were collected at 4 predefined times: (1) inclusion, (2) last day of antibiotic use, (3) last day of the study intervention, and (4) 1 month after intervention. Microbiota analysis was performed by 16S ribosomal RNA gene sequencing., Results: A total of 350 children were randomized and collected stool samples from 88 were eligible for the microbiota analysis (54 boys and 34 girls; mean [SD] age, 47.09 [55.64] months). Alpha diversity did not significantly differ between groups at the first 3 times. Shannon diversity (mean [SD], 3.56 [0.75] vs 3.09 [1.00]; P = .02) and inverse Simpson diversity (mean [SD], 3.75 [95% CI, 1.66-5.82] vs -1.31 [95% CI, -3.17 to 0.53]; P = 1 × 10-4) indices were higher in the placebo group compared with the probiotic group 1 month after intervention. Beta diversity was not significantly different at any of the times. Three of 5 supplemented genera had higher relative abundance during probiotic supplementation, but this difference had disappeared after 1 month., Conclusions and Relevance: The studied probiotic mixture had minor and transient effects on the microbiota composition during and after antibiotic treatment. Further research is needed to understand their working mechanisms in manipulating the microbiome and preventing antibiotic-associated dysbiosis and adverse effects such as antibiotic-associated diarrhea., Trial Registration: ClinicalTrials.gov Identifier: NCT03334604.
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- 2024
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