Effects of EX-PLISSIT Sex Counseling on Sexual Self-Concepts of Brides- To-Be: A Randomized Controlled Clinical Trial

The study aimed to determine the effects of adding cognitive behavioural therapy (CBT) to pulmonary rehabilitation to treat patients with chronic lung disease and comorbid anxiety and/or depression symptoms. An open, parallel group, randomised controlled trial (RCT) was conducted, with longitudinal follow-up of 12 months. CBT was delivered in 2 face-to-face sessions and 4 phone sessions to patients with depression or anxiety undergoing pulmonary rehabilitation. The main outcome measures were change in Geriatric Depression Scale (GDS) and Geriatric Anxiety Inventory (GAI); secondary outcomes were St. Georges Respiratory Questionnaire (SGRQ), 6-minute walk test (6MWT) and pulmonary rehabilitation attendance. A total of 65 patients were randomized to Intervention (n=24) and Control (n=41) groups. Of the 24 patients in the Intervention group, 6 patients (25%) withdrew and 4 patients (12.5%) failed to attend more than 2 CBT sessions, which was significantly more than the Control group. The majority of patients (75.4%) had chronic obstructive pulmonary disease. Fourteen (21.5%) had symptoms of depression only, 12 (18.4%) had symptoms of anxiety only, and 39 (60.0%) had symptoms of both anxiety and depression. In the Intervention group, GDS significantly improved at the end of pulmonary rehabilitation (mean difference -3.1, 95% CI: -4.39 to -1.70; P=0.0001), 3 months follow-up (mean difference -1.5, 95% CI: -4.17 to -0.75; P=0.008), and at 12 months follow-up (mean difference -1.6, 95% CI: -3.29 to -0.03, P=0.04), compared to baseline. The Control group demonstrated improvement in GDS by the end of pulmonary rehabilitation (mean difference -1.3, 95% CI: -2.4 to -0.27; P=0.01) which was not maintained at 3 months (P=0.14) and 12 months (P=0.25). GAI significantly improved by the end of rehabilitation in both the Intervention (mean difference -2.6, 95% -4.69 to -0.57; P=0.01) and Control groups (mean difference -2.6, 95% -4.16 to -1.14; P=0.001) and there was no significant improvement at 3 and 12 months. No statistically significant differences in changes in GDS or GAI were observed between the Intervention and Control groups at any time point. There was no significant improvement in SGRQ or 6MWT. There was a significant increase in attended pulmonary rehabilitation sessions in the Intervention group, compared to the Control group (mean difference 1.59; 95% CI: 0.11 to 3.07; P=0.03). In this RCT of patients with chronic lung diseases attending pulmonary rehabilitation, there was no evidence found for improved symptoms of anxiety or depression or health-related quality of life with the addition of CBT given in a mixed face-to-face and telephone format, compared to usual care. Slower than anticipated recruitment, leading to a smaller than planned sample size, and a high dropout rate in the group allocated to CBT may have limited the effectiveness of the behavioural intervention approach in this study.

To test the hypothesis that a screening and treatment intervention for early cryptococcal infection would improve survival among HIV-infected individuals with low CD4 cell counts. Newly enrolled patients at Family AIDS Care and Education Services (FACES) in Kenya with CD4≤100 cells/μl were tested for serum cryptococcal antigen (sCrAg). Individuals with sCrAg titre≥1:2 were treated with high-dose fluconazole. Cox proportional hazard models of Kaplan-Meier curves were used to compare survival among individuals with CD4≤100 cells/μl in the intervention and historical control groups. The median age was 34years [IQR: 29,41], 54% were female, and median CD4 was 43 cells/μl [IQR: 18,71]. Follow-up time was 1224 person-years. In the intervention group, 66% (514/782) were tested for sCrAg; of whom, 11% (59/514) were sCrAg positive. Mortality was 25% (196/782) in the intervention group and 25% (191/771) in the control group. There was no significant difference between the intervention and control group in overall survival [hazard ratio (HR): 1.1 (95%CI:0.9,1.3)] or three-month survival [HR: 1.0 (95%CI:0.8,1.3)]. Within the intervention group, sCrAg-positive individuals had significantly lower survival rates than sCrAg-negative individuals [HR:1.8 (95%CI: 1.0, 3.0)]. A screening and treatment intervention to identify sCrAg-positive individuals and treat them with high-dose fluconazole did not significantly improve overall survival among HIV-infected individuals with CD4 counts≤100 cells/μl compared to a historical control, perhaps due to intervention uptake rates or poor efficacy of high-dose oral fluconazole.

Effect of Fluid Management Guided by Bioimpedance Spectroscopy on Cardiovascular Parameters in Hemodialysis Patients: A Randomized Controlled Trial

A sample of emerging adult university students completed a survey with the goal of investigating components of "the sexual self" and how these constructs were influenced by romantic relationship status. Three general aspects of the sexual self were considered: sexual self-concept, comfort with sexuality, and past sexual behavior. Sexual self-concept was defined as composed of constructs such as sexual self-schema, self-efficacy, consciousness, optimism, problem self-blame, power/other control, and motivation to avoid risky sex. Sexual comfort, conceptualized as a personality disposition of erotophobia-erotophilia, was assessed using three instruments. This included the Sexual Opinion Survey, the original individual difference measure of erotophobia-erotophilia. Past sexual behavior was assessed with the Derogatis Sexual Functioning Inventory. Findings suggested that individuals in a relationship had more positive sexual self-concepts and were more erotophilic and comfortable with sexuality generally. These differences were modest, based on effect size statistics. Past sexual experience also differed, contingent on relationship status. Some sexual self-concept scales were predictive of sexual satisfaction, while comfort with sexuality was predictive of relational satisfaction. Romantic relationships may have important implications for sexual selfhood, but this is a tentative suggestion, as this was a correlational study and the relationships are likely bidirectional.

BackgroundOne of the new educational systems is the mentorship method. This study aimed to investigate the effect of peer mentoring program on clinical academic progress and psychological characteristics of operating room students.MethodsThis research was a randomized controlled trial that was conducted on undergraduate students in the operating room department of Khomein Faculty of Medical Sciences, Markazi Province in Iran. The number of operating room students were 70 that were divided into intervention and control groups by random allocation using Permuted Block Randomization. Inclusion criteria included all operating room students who were in internship, and exclusion criteria included failure to complete the questionnaires. The data collection tools were the demographic questionnaire, Depression Anxiety Stress Scale, Rosenberg Self-Esteem Scale and Situational Motivational Scale. In the control group, clinical training was done in the traditional way. In the intervention group, training was done by peer mentoring method. The obtained data were analyzed using descriptive statistics, independent t-test, paired t-test, chi-square test, ANCOVA, univariable and multivariable linear regression.ResultsThe study revealed significant differences between the intervention and control groups. Post-intervention, the intervention group demonstrated substantial increases in self-confidence (mean difference = 5.97, p < 0.001) and significant reductions in stress levels (mean difference = -3.22, p < 0.001). Conversely, minimal changes were noted in the control group for both self-confidence (mean difference = 0.057, p = 0.934) and stress levels (mean difference = 0.142, p = 0.656). Although both groups experienced decreases in anxiety and depression levels, these changes were not statistically significant (p > 0.05). Furthermore, the intervention significantly enhanced academic progress in the intervention group compared to the control group (mean difference = 20.31, p < 0.001).ConclusionThe results showed that the implementation of the peer mentoring program was effective in improving academic progress, self-confidence, and reducing the stress of operating room students. Therefore, this educational method can be used in addition to the usual methods to improve the education of operating room students.

Introduction: Playing together increases social connectedness, and it may be a tool to reduce loneliness. Research into the mental health benefits of board games is underdeveloped. Objectives: The study aims to examine the effects of the Kioku board game on well-being outcomes. The Kioku board game was developed in order to enable small group interactions with a focus on encouraging participants to create stories through mutual attention and interaction. We hypothesized that following a weekly intervention for 12 weeks, players would report a decrease in loneliness and an increase in well-being, compared with nonplayers. Methods: During the summer of 2022, participants in groups of 4-5 players, chose a cube word and narrated a story. A sample of 151 older adults (Mean age = 75.05 ± 6.46 years) recruited from seven community activity centers in Israel was assigned by block randomization to an intervention (n = 72) or a control group (n = 79), awaiting 4-6 weeks for future participation. Loneliness (UCLA loneliness scale) and well-being (World Health Organization 5-item scale) were evaluated at baseline and at 12 weeks. Results: A two-way repeated measures analysis of covariance (ANCOVA) (Group × Time) controlling for age, country of origin, and marital status revealed significant interaction effects for loneliness [F(1, 146) = 178.04, n2 = 0.549, P < 0.001] and well-being [F(1, 146) = 69.14, n2 = 0.321, P < 0.001]. Loneliness decreased in the intervention group (mean difference: 0.62 points, P < 0.001), and increased in the control group (mean difference: 0.18 points, P = 0.001). Well-being increased in the intervention group (mean difference: 0.79 points, P < 0.001) and decreased in the control group (mean difference: 0.20 points, P < 0.001). Conclusions: Our findings support the effectiveness of the Kioku board game intervention for decreasing loneliness and promoting well-being in older adults, who might still be coping with the effects of the COVID-19 pandemic.

In Indonesia, Yoga is currently one of the most popular sports, not only for the general public but also for pregnant women. Many benefits can be obtained from prenatal yoga including the mother feeling comfortable and relaxed throughout pregnancy and during childbirth, training the pelvic floor muscles and perineum, keeping the body's muscles relaxed, balanced during childbirth, reducing stress, increasing and improving oxygen circulation to the body and fetus. . This study aims to determine the effect of prenatal yoga on optimizing fetal position on third trimester Primigravida maternal delivery output at Puskesmas Cirebon City. This research is a quasi-experimental research pre post control group design and only post control group design with T test and Chi Square test. Paired T Test results of the intervention group (mean difference = 3.111, P value = 0.000, control group (mean difference = 0.833, P value = 0.318). Independent T Test results obtained (average difference = -1.944, P value = 0.024), Chi Square test obtained a value of P = 0.73. There is a difference in the average anxiety before and after the intervention in the intervention group, there is no difference in average anxiety before and after the intervention in the control group. There is a difference in the average anxiety between the intervention and control groups. There is a difference in mean Long I stage between the intervention and control groups There was no effect of prenatal yoga on the type of labor.

Introduction: Sexual violence during pregnancy causes adverse physical and psychological consequences for pregnant women and their fetuses. Objective: This study aimed to explore the effect of couple-centered counseling on sexual self-concept and violence among pregnant women. Materials and Methods: This randomized controlled clinical trial with two groups (26 women in each group) was conducted on pregnant women exposed to sexual violence who lived in Hamadan City in the west of Iran. The mothers exposed to sexual violence were randomly assigned to two groups. Data were collected using the sexual violence and the sexual self-concept questionnaires. For the experimental group, 6 one-hour couple counseling sessions were held. After the end of the sessions, the study questionnaires were completed again by two groups. Data analysis was done using the chi-square, Fisher exact, independent t-test, paired t-test, and analysis of covariance tests. The significance level of the tests was considered 0.05. Results: The Mean±SD age of pregnant women in the intervention group was 28.65±5.96, and in the control group was 28.77±6.73 years; the mean age of the spouses in the intervention group was 33.62±6.05 and in the control group was 35.04±7.34 years. The results showed that the mean scores of sexual violence after the intervention were 26.10±2.04 in the intervention group and 35.08±2.04 in the control group (P=0.001, Cohens’ d=4.40). The Mean±SD scores of sexual self-concept after the intervention were 8.13±2.02 in the intervention group and 13.33±2.02 in the control group (P=0.001, Cohens’ d=2.57). Moreover, the intervention group experienced a significant decrease (P=0.001) in the dimensions of negative sexual self-concept, including anxiety, fear, monitoring, and depression (P=0.001). Conclusion: According to these results, couple-centered counseling has effectively reduced sexual violence and negative sexual self-concept by raising couples’ awareness.

Childhood sexual abuse (CSA) is likely to have impacts on adult survivors' sexuality, particularly on their sexual self-concept. However, little is known about how survivors cope with CSA-related sexual impacts, including sexual self-concept impairments. Thus, this study aimed to examine the interplay between sexual self-concept and coping strategies in CSA survivors by (1) documenting the manifestations of their impaired sexual self-concepts; (2) identifying their strategies to cope with the sexual impacts of CSA; and (3) examining gender differences on sexual self-concept impairments and coping strategies. Content analysis was conducted on semi-structured interviews with 25 women and 26 men adult survivors of CSA recruited via social networks and victim support organizations. Analyses yielded three conceptual categories: (1) Developing an unconsolidated and unfavorable sexual self-concept following CSA; (2) Avoiding CSA-related sexual impacts and impaired sexual self-concept; (3) Approaching CSA-related sexual impacts with more authenticity. Men often managed their suffering and compensated for their impaired sexual self-concept by engaging in sexual dominance and over-investment, by accepting their sexual difficulties and relying on medication to overcome them. Women tended to restrict themselves and disconnect sexually to avoid suffering, complied with their partners' sexual demands out of a sense of duty, prioritized sexual intimacy over orgasm, and seek professional help. Interventions with survivors should promote the development of approach strategies to cope with sexual difficulties, including self-concept impairments, and foster sexual authenticity.

Context: Sexual health is an essential component of human health and wellness, encompassing not only physical but also emotional and psychosocial well-being related to sexuality. This domain of life among hospitalized patients has, however, received little attention from health workers globally, with existing gaps between patients' care needs and sexual health services provided by nurses. Aim: This study determined the relationship between nurses’ sexual self-concept and performance of sexual health care among inpatients in the South Rift, Kenya. Methods: This study employed an analytical cross-sectional design, utilizing a self-administered questionnaire that was adapted to suit the study's aim. The study involved 171 nurses, drawn from a sample of 300 nurses working in medical and surgical units of level four and five hospitals in two counties. Results: The results showed that 65.5% of nurses had satisfactory performance in implementing sexual healthcare. Nurses' sexual self-concepts had a strong bearing on the performance of sexual health care (p-value =0.021; R Square=0.586) Conclusion: Nurses performed fairly in providing sexual health care services; however, there existed significant gaps related to nurses' sexual self-concept characteristics. A significant relationship was revealed between nurses’ self-concept and their performance of sexual health care. The study recommends that hospitals adopt guidelines to support the incorporation of sexual health care in every patient's routine care protocols in all clinical settings, and sexual health content should be expanded in nursing training curricular.

Sexual self-concept has an influence on the sexual behaviors of women with breast cancer. Supportive programs for these women have demonstrable empirical efficacy; however, their effectiveness has not been examined. The aim of this study was to investigate the effect of a supportive program based on social networks on the sexual self-concept of women with breast cancer. In this randomized controlled single-blind trial, 60 women were assigned to the intervention (n = 30) and control (n = 30) groups using permuted block randomization. Overall, eight 45-min intervention sessions were held (twice a week). The primary outcome was sexual self-concept, and the secondary outcomes were women's sexual quality of life and participants' satisfaction. The questionnaires were completed by patients before the intervention and immediately and 1 month after the intervention. The generalized equation estimation test showed that the positive sexual self-concept score of the intervention group versus the control group had increased by 15.67 points (P < 0.001, effect size = 2.00) 1 month after the intervention. The negative sexual self-concept score had decreased by 2.65 points (P < 0.001, effect size = 0.74), and the situational sexual self-concept score had upturned by 6.82 points (P < 0.001, effect size = 2.08) in the intervention group at the same period. Also, the sexual quality of life score in the intervention group compared to the control group generally increased by 13.82 points (P < 0.001, Effect size = 2.08) 1 month following the intervention. A social networking support program can be a promising approach to improve the sexual self-concept of women with breast cancer. Iranian Clinical Trial Register, IRCT20150608022609N8. Registered on 2 July 2020.

No Effect of Individualized Nutrition on Quality of Life, Acute Graft-Versus-Host Disease or Oral Mucositis after Allogeneic Stem Cell Transplantation: A Randomized Controlled Trial

Aging, in conjunction with decreasing physical activity, is associated with a range of health problems. Simple, low-maintenance, population-based means of promoting activity to counteract the age-associated decline are required. We therefore assessed the effect of pedometry and buddy support to increase physical activity. We undertook a clustered randomized trial (HKCTR-346) of 24 community centers involving 399 older Chinese participants (≥ 60 yr). Centers were randomly allocated to 1) pedometry and buddy, 2) pedometry and no buddy, 3) no pedometry and buddy, and 4) no pedometry and no buddy with a 2 × 2 factorial design. The trial simultaneously tested the individual and combined effects of the interventions. The intervention groups also received monthly organized group activities to provide encouragement and support. Outcome measures were assessed at 6 and 12 months, including physical fitness and activity and cardiovascular disease risk factors (anthropometry and blood pressure). From the 24 centers, 356 volunteers (89.2%) completed the study. Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 (95% confidence interval (CI) = 1360-2290) and 1260 (95% CI = 780-1740) MET·min·wk(-1), respectively relative to the decrease in the control groups. The buddy peer support intervention significantly improved mean aerobic fitness (12% [95% CI = 4%-21%]) and reduced both body fat (-0.6% [95% CI = -1.1% to 0.0%]) and time to complete the 2.5-m get-up-and-go test (-0.27 [95% CI = -0.53 to -0.01] s). No other improvements in the cardiovascular disease risk factors were observed. The combination of motivational tools was no better than the individual interventions. Both motivational interventions increased physical activity levels, and the buddy style improved fitness. These tools could be useful adjuncts in the prevention of obesity and age-related complications.

BackgroundShoulder problems are highly prevalent among elite handball players. Reduced glenohumeral rotation, external rotation weakness and scapula dyskinesis have been identified as risk factors.AimEvaluate the effect of an exercise programme...

PurposeAdolescents with congenital heart disease transition from childhood to adulthood and transfer from pediatric-oriented to adult-oriented care. High-level empirical evidence on the effectiveness of transitional care is scarce. This study investigated the empowering effect (primary outcome) of a structured person-centered transition program for adolescents with congenital heart disease and studied its effectiveness on transition readiness, patient-reported health, quality of life, health behaviors, disease-related knowledge, and parental outcomes e.g., parental uncertainty, readiness for transition as perceived by the parents (secondary outcomes). MethodsThe STEPSTONES-trial comprised a hybrid experimental design whereby a randomized controlled trial was embedded in a longitudinal observational study. The trial was conducted in seven centers in Sweden. Two centers were allocated to the randomized controlled trial-arm, randomizing participants to intervention or control group. The other five centers were intervention-naïve centers and served as contamination check control group. Outcomes were measured at the age of 16 years (baseline), 17 years, and 18.5 years. ResultsThe change in empowerment from 16 years to 18.5 years differed significantly between the intervention group and control group (mean difference = 3.44; 95% confidence interval = 0.27–6.65; p = .036) in favor of intervention group. For the secondary outcomes, significant differences in change over time were found in parental involvement (p = .008), disease-related knowledge (p = .0002), and satisfaction with physical appearance (p = .039). No differences in primary or secondary outcomes were detected between the control group and contamination check control group, indicating that there was no contamination in the control group. DiscussionThe STEPSTONES transition program was effective in increasing patient empowerment, reducing parental involvement, improving satisfaction with physical appearance, and increasing disease-related knowledge.