Group Post-intervention Research Articles

Effects of naringenin supplementation on cardiovascular risk factors in overweight/obese patients with nonalcoholic fatty liver disease: a pilot double-blind, placebo-controlled, randomized clinical trial.

Although several experimental models have suggested promising pharmacological effects of naringenin in the management of obesity and its related disorders, the effects of naringenin supplementation on cardiovascular disorders as one of the main complications of nonalcoholic fatty liver disease (NAFLD) are yet to be examined in humans. In this double-blind, placebo-controlled, randomized clinical trial, 44 overweight/obese patients with NAFLD were equally allocated into either naringenin or placebo group for 4 weeks. Cardiovascular risk factors including atherogenic factors, hematological indices, obesity-related parameters, blood pressure, and heart rate were assessed pre- and postintervention. The atherogenic index of plasma value, serum non-HDL-C levels as well as total cholesterol/high-density lipoprotein cholesterol (HDL-C), triglyceride/HDL-C, low-density lipoprotein cholesterol/HDL-C, and non-HDL-C/HDL-C ratios were significantly reduced in the intervention group, compared to the placebo group post intervention (P < 0.05). Moreover, there was a significant reduction in BMI and visceral fat level in the intervention group when compared with the placebo group (P = 0.001 and P = 0.039, respectively). Furthermore, naringenin supplementation could marginally reduce systolic blood pressure (P = 0.055). Mean corpuscular hemoglobin increased significantly in the naringenin group compared to the placebo group at the endpoint (P = 0.023). Supplementation with naringenin also resulted in a marginally significant increase in the mean corpuscular hemoglobin concentration when compared with the placebo group (P = 0.050). There were no significant between-group differences for other study outcomes post intervention. In conclusion, these data indicate that naringenin supplementation may be a promising treatment strategy for cardiovascular complications among NAFLD patients. However, further trials are warranted.

Development and Effects of a Nursing Education Program Using Virtual Reality for Enhancing Clinical Decision-Making Ability in Respiratory Disease Nursing Care

Purpose: This study was conducted to develop and examine the effects of a nursing education program using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care by assessing students’ confidence in performance, clinical decision-making ability, practice flow, class evaluations, and simulation design evaluations.Methods: This study was developed based on the Jeffries simulation model and 5E learning cycle model, blending a virtual reality simulation and high-fidelity simulation. The participants were 41 third-year nursing students with no virtual reality and simulation education experience. The experimental group (n=21) received the virtual reality program, while the control group (n=20) received traditional simulation education. Data were collected from March 8 to May 28, 2021 and analyzed using SPSS version 27 for Windows.Results: Statistically significant differences were found between the experimental group and the control group post-intervention in confidence in performance (F=4.88, p=.33) and clinical decision-making ability (F=18.68, p＜.001). The experimental group showed significant increases in practice flow (t=2.34, p=.024) and class evaluations (t=2.99, p=.005) compared to the control group.Conclusion: Nursing education programs using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care can be an effective educational strategy in the clinical context.

The Effect of Benson Relaxation Technique on Depression, Anxiety, and Stress of Jordanian Patients Diagnosed with Multiple Sclerosis: A Cross-Sectional Study.

Depression, anxiety, and stress (DAS) are common symptoms of multiple sclerosis (MS) patients and are highly correlated with poor quality of life. Managing DAS among such patients can improve their quality of life (QoL), empowering them with improved autonomy, self-care, independency, and ability to perform daily activities. This study is aimed at examining the effectiveness of the Benson Relaxation Technique (BRT) on reducing DAS among patients diagnosed with MS in Jordan. This quasiexperimental study of 105 Jordanian patients diagnosed with multiple sclerosis tested an intervention group (60 patients) who received BRT and a control group (45 patients) who received normal treatment. Data were collected from January 2021 to April 2021, using the Arabic version of the Depression Anxiety Stress Scale (DASS21). The intervention group was instructed to perform the BRT two times a day for 10 minutes at home for eight weeks at two specific times, with 7-8-hour intervals between each episode. STROBE guidelines were followed in reporting the review. At the baseline comparison, there was no statistical difference between the interventional and control groups with regard to DAS. The levels of DAS between the two groups after three months of the last sessions of the intervention (postintervention) were compared. The results showed that the intervention group had significantly lower levels of DAS compared to the control group. The levels of the DAS were significantly lower for the intervention group postintervention. Adding relaxation techniques to the therapeutic routine is a cost-effective complementary treatment to decrease DAS among MS patients and improve their QoL. Relevance to Practice. This study provides a baseline of data that could facilitate further investigations in the future to improve the quality of services delivered to such patients and thus their QoL and satisfaction.

Effect of Omega-3 Supplementation on Self-Regulation in Typically Developing Preschool-Aged Children: Results of the Omega Kid Pilot Study-A Randomised, Double-Blind, Placebo-Controlled Trial.

Supplementation of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) may enhance self-regulation (SR) and executive functioning (EF) in children of preschool age. The aim of the Omega Kid Study was to investigate the effect of n-3 LCPUFA supplementation on SR and EF in typically developing preschool-aged children. A double-blind placebo-controlled pilot trial was undertaken, the intervention was 12 weeks and consisted of 1.6 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day compared to placebo. The HS-Omega-3 Index® was assessed by capillary blood samples at baseline and post-intervention. Seventy-eight children were enrolled and randomised to either the n-3 LCPUFA treatment (n = 39) or placebo (n = 39) group. Post intervention, there was a significant three-fold increase in the HS-Omega-3 Index® in the n-3 LCPUFA group (p < 0.001). There were no improvements in SR or EF outcome variables for the n-3 LCPUFA group post intervention compared to the placebo group determined by linear mixed models. At baseline, there were significant modest positive Spearman correlations found between the HS-Omega-3 index® and both behavioural self-regulation and cognitive self-regulation (r = 0.287, p = 0.015 and r = 0.242, p = 0.015 respectively). Although no treatment effects were found in typically developing children, further research is required to target children with sub-optimal self-regulation who may benefit most from n-3 LCPUFA supplementation.

MP34-06 IMPROVING THE AWARENESS OF RARE GENETIC DISEASE MULTIDISCIPLINARY TEAM (MDT) CLINICS

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety II (MP34)1 Sep 2021MP34-06 IMPROVING THE AWARENESS OF RARE GENETIC DISEASE MULTIDISCIPLINARY TEAM (MDT) CLINICS Wiktoria Milczynska, Amy de Wolf, Akhil Mohindra, and Tet Yap Wiktoria MilczynskaWiktoria Milczynska More articles by this author , Amy de WolfAmy de Wolf More articles by this author , Akhil MohindraAkhil Mohindra More articles by this author , and Tet YapTet Yap More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002043.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The recent guidelines from European Academy of Andrology recommend increasing knowledge of Klinefelter Syndrome and creating multidisciplinary teams to care for affected patients. However, raising awareness of rare genetic disease clinics represents a significant challenge, due to limited recognition amongst patients and clinicians as well as limited resources. Our aim was to look at cost-effective strategies to raise awareness of a national access Klinefelter Syndrome multidisciplinary (KSMDT) clinic among patients and healthcare professionals. METHODS: This longitudinal Quality Improvement Project was carried out over a 6-month period (2020 - 2021) at a tertiary hospital where the KSMDT clinic is located. Two Plan-Do-Study-Act (PDSA) cycles were carried out. The first intervention consisted of creating an informational video about the clinic which was disseminated through Facebook, Twitter and YouTube. The second intervention involved refining the user experience of the clinic’s website. Surveys were distributed amongst KS support group members (n=70) and local primary care practitioners (n=27) before and after intervention, and a focus group (n=6) was held for the second intervention. RESULTS: Awareness of the clinic in the community increased from 33% pre-intervention to 70%. Similarly, awareness of the clinic’s website increased by 31% with an increased retention rate of 61.2% for the multimedia resources accessed. A total of 81% of patients reported that the video helped them understand the aims of the KSMDT. The engagement associated with website use increased by 13% for the focus group post-intervention. The interventions were associated with no financial costs. CONCLUSIONS: Our results indicated that a multifactorial approach, working with both patient and clinician populations, is successful in increasing awareness of rare disease services like the KSMDT clinic. Future awareness strategies need to employ more effective ways of engaging clinician and patient alike, such as targeted programs on social media and virtual programmed sessions with the KSMDT team. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e618-e618 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wiktoria Milczynska More articles by this author Amy de Wolf More articles by this author Akhil Mohindra More articles by this author Tet Yap More articles by this author Expand All Advertisement Loading ...

The Effect of Humor Intervention Program on Positive and Negative Symptoms among Schizophrenic Patients

Background: Schizophrenia is a chronic disease characterized by distortions in thinking, perception, emotions, language, sense of self and behavior. Humor could be used as an alternative to conventional treatment with the goal of helping patients with schizophrenia cope with symptoms, enhance recovery through its emotional, cognitive, social and physiological effects. The aim of the study was to evaluate the effect of humor intervention program on positive and negative symptoms among schizophrenic patients. Design: Randomized control trial (RCT) design was used. Sample: Purposive sample consisted of 40) schizophrenic patients, the study group (n= 20) and control group (n= 20). The patients were selected and allocated randomly into two groups, intervention group (received the humor interventions program) and control group (received traditional care). The study conducted in the Psychiatry and Addiction Prevention "El Kasr AlAini University Hospital and al Rakhawy Hospital for Mental Health. Tools: three tools were used for data collection were; the Socio Demographic Data Sheet, Positive and Negative Syndrome Scale (PANSS) and Multidimensional Sense of Humor Scale (MSHS). Results: revealed that, there was a statistical significant difference between total score of PANSS between study and control groups post intervention. Conclusion: The present study emphasizes the importance of humor intervention program in reducing severity of symptoms of patients with schizophrenia. Key words: schizophrenia, humor intervention, positive symptoms, negative symptoms

Breastfeeding counseling based on formative research at primary healthcare Services in Mexico

BackgroundBreastfeeding rates in Mexico are far from World Health Organization (WHO) recommendations with 28.8% of Exclusive Breastfeeding (EBF) under 6 months of age, according to the 2018 National Health and Nutrition Survey. Formative research has shown that culturally appropriate counseling is an effective breastfeeding intervention. The objective of the current study was to evaluate the effect of interpersonal counseling on EBF in a primary healthcare center in Tijuana, México.MethodsThis was a randomized controlled trial pilot with a sample of mothers with infants under 4 months of age from a primary care center. Participants were randomized into two groups: 1) Control group, received counseling on immunizations and standard infant feeding information, and 2) Intervention group, receiving breastfeeding counseling using a socio-ecological framework. Changes in breastfeeding attitudes, self-efficacy and EBF were evaluated at 2 months post-intervention.ResultsA total of 80 mothers completed the 2 month follow up assessment (40 in each group). The mean age at baseline was 26.4 years for mothers and 1.4 months for infants. There was a 30% increase in EBF at 2 months follow up in the intervention group and 15% decrease in the control group post-intervention. We observed a significant improvement in breastfeeding attitudes (P = 0.0001), self-efficacy (P = 0.046) and EBF (P = 0.0001) in the intervention group. Reported obstacles were discomfort of breastfeeding in public (23%), infant dissatisfaction (23%), pain (19%), insufficient milk supply (15%) and returning to work (8%).ConclusionsBreastfeeding counseling based on previous formative research improved breastfeeding attitudes, self-efficacy and practices in this population. These findings suggest that the promotion of breastfeeding utilizing a socio-ecological framework may improve breastfeeding rates by addressing the needs of women within their varying sociocultural contexts.Trial registrationACTRN: ACTRN12621000915853. Retrospectively registered.

Effect of Sustained Natural Apophyseal Glides on Stiffness of Lumbar Stabilizer Muscles in Patients With Nonspecific Low Back Pain: Randomized Controlled Trial

ObjectiveThe aim of this study was to investigate the immediate effect of Mulligan sustained natural apophyseal glides (SNAGs) on muscular stiffness by using ultrasound shear wave elastography, pain, and function in patients with nonspecific low back pain. MethodsIn a prospective, randomized, controlled, double-blinded study, 30 participants with nonspecific low back pain were randomly divided into 2 groups: a real SNAG group (aged 21.0 ± 1.7, 5 men, 10 women) and sham SNAG group (aged 20.4 ± 0.5, 4 men, 11 women). Muscular stiffness of the multifidus and erector spinal muscles with ultrasound shear wave elastography, visual analog scale, the sit and reach, flamingo balance, the functional reach, side bridge, and Biering-Sorensen tests were made before and immediately after intervention. The Oswestry Disability Index score was recorded only baseline. ResultsAfter intervention, the change in visual analog scale, sit and reach, Biering-Sorensen, and side bridge tests scores were significantly different between real SNAG and sham SNAG groups (P < .05), but there was no significant difference in functional reach and flamingo balance test scores between the groups (P > .05). There was no significant difference for all measurements between pre- and post-intervention in sham SNAG group (P > .05). There was a significant reduction in muscular stiffness in the real SNAG group. But there was no change in muscular stiffness between pre- and postintervention in the sham group (P > .05). ConclusionsThis study demonstrated that the Mulligan SNAG technique had a positive effect on pain severity, flexibility, trunk muscle endurance, and muscle stiffness in patients with nonspecific LBP.

Effect of Manual Therapy (MET) Versus Conventional Therapy for Improving Tendo-Achilles Flexibility and Foot Posture in children with Autism Spectrum Disorder

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects individuals across social, ethnic, and geographic groups. Autistic children have difficulty with gross motor and fine motor functioning difficulties including a wide range of signs and symptoms. Toe walking due to tendo-achilles (TA) tightness is commonly observed gait in autistic children altering foot posture in them. The knowledge about the abnormalities may be useful for the assessment and treatment planning of ASD children. Material and Methods: We evaluated TA tightness, ROM of the ankle joint, and compare the effect of Manual Therapy (MET) and conventional therapy for improving TA flexibility and foot posture. Procedure: A comparative study included twenty diagnosed autistic children as per inclusion criteria which were divided into two groups, Group A was given conventional therapy in the form of passive stretching, whereas Group B was given manual therapy in the form of muscle energy technique. The participants were clinically examined and evaluate TA tightness in the form of elastography, range of motion, and foot posture. Data were taken at baseline pre and after postintervention. Results: There was a significant improvement in elastography readings, range of motion, and foot posture index in both groups postintervention but significant improvement was observed in Group B as compared to Group A, i.e., P &gt; 0.05. Conclusion: It was concluded that there is a significant effect of manual therapy in the form of muscle energy technique for improving TA flexibility and foot posture as compared to conventional therapy.

Effectiveness of an Educational Program on Nurses’ Knowledge and Attitudes about Pain Assessment and Management in Imam Hussein Medical City in Holy Karbala

Background: Pain is a physical and emotional distressing sensation that is associated with tissue damage,both actual and potential. Inadequate pain management has been shown to affect patient outcomes byprolonging the hospitalization period and delaying the recovery process; therefore, pain management hassignificant implications. A descriptive-analytic (quasi-experimental) design was conducted to determinethe effectiveness of an educational program on nurses’ knowledge and attitudes about pain assessment andmanagement in imam Hussein medical city in holy KarbalaMethodology: A quasi-experimental design was used to guide this study, it was applied by use of the preand post-test approach for two groups of samples (study and control). It was conducted at the Imam Husseinmedical city during the period from 15th November 2020 to 9th March 2021.Results: The study findings show that participants’ age group at a level (20-29 years) were (63.3%) of thestudy group, and (53.3%) of the control group. (50.0%) of the study group were male, while (46.7%) of thecontrol groups were female.Findings showed that the total mean score was unacceptable level for both study and control groups beforegiving intervention, while a good level for the study group post-intervention, regarding the knowledge andattitude of pain assessment and management. Highly statistically significant differences in post-test for thestudy group as compared with the control groups for knowledge and attitude domains.Conclusion: The study indicates that the education program had a positive effect on nurse’s knowledge andattitude about pain assessment and management. This conclusion is based on the result of our study thatreveals significant differences between pre-intervention and post-intervention.Recommendations: The study recommended that educational and training programs be routinely providedto develop their knowledge and attitude, and keep them up to date on pain management, also, the distributionof the applied educational program of this study as a booklet or posters for the hospital staff.

Immediate Effects of Neural Slider and Neural Tensioner on Forward Bending in Subjects with Hamstring Tightness

Background Two different neurodynamic techniques have been suggested: (i) the slider (ii) the tensioner. However, the effects of slider and tensioner on hamstring flexibility during forward bending have not been directly compared. Purpose This study aimed to compare the immediate effects of slider and tensioner on forward bending in asymptomatic subjects with hamstring tightness. Study design Two groups pre- and post-test design Methods Twenty male subjects with hamstring tightness participated in this study. The subjects were randomly allocated to the slider and tensioner groups, consisting of 10 participants each. To measure hip and lumbar flexion during forward bending, a smart motion sensor was employed. The paired <italic>t</italic>-test was applied to compare pre- and post-intervention within each group. The independent <italic>t</italic>-test was used to compare the hip and lumbar flexion angles between the two groups. Results Intragroup comparison found that the slider group had a significant increase in hip flexion range of motion at post-intervention. Intergroup comparison found a significant greater change in hip flexion range of motion between pre- and post-intervention in slider group. Conclusions Based on the results of this study, it was found that sliders are more effective than tensioners in enhancing hamstring flexibility during forward bending in subjects with hamstring tightness.

Consumption of Dietary Guidelines for Americans Types and Amounts of Vegetables Increases Subjective Happiness: A Randomized Controlled Trial

ObjectivesThe health benefits of diets rich in fruits and vegetables (FV) are well established and form the basis of the Dietary Guidelines for Americans (DGA). Furthermore, FV consumption may also exert a positive effect on psychological well-being. This study aimed to assess changes in global subjective happiness when consuming DGA recommended types and amounts of vegetables. It was hypothesized that increased vegetable consumption would increase happiness. MethodsThis study investigated secondary outcomes of a randomized, parallel, non-blinded controlled trial with a 1:1 allocation ratio to a provided vegetable intervention or attention control group. Men and women aged 18–65 yr, body mass index ≥ 25 kg/m2 with low habitual vegetable consumption (<1 serving/day) were recruited for this community-based study. The vegetable intervention consisted of an 8-week feeding phase during which participants were provided with vegetables in DGA recommended types and amounts. The attention control group was not provided vegetables but completed the same testing schedule as the vegetable intervention group. The Subjective Happiness Scale (SHS) was used to assess individual perceived happiness before and after the intervention. SHS scores were analyzed using a mixed model analysis of variance both with and without baseline SHS scores as a covariate. ResultsA significant interaction between treatment and visit (P = 0.005) revealed greater happiness at week 8 than at baseline in the vegetable intervention group but no change in the attention control group. When adjusted for baseline scores, a significant effect of treatment (P = 0.005) was found with greater happiness scores in the vegetable intervention group compared to the attention control group post intervention (P < 0.001). ConclusionsGreater subjective happiness was observed after increasing vegetable consumption to meet DGA recommendations. Funding SourcesUSDA-ARS #5450–51,530-057–00D.

Effects of School-Based Interventions on Reducing Sugar-Sweetened Beverage Consumption among Chinese Children and Adolescents.

We set up a series of school-based interventions on the basis of an ecological model targeting sugar-sweetened beverage (SSB) reduction in Chinese elementary and middle schools and evaluated the effects. A total of 1046 students from Chinese elementary and middle schools were randomly recruited in an intervention group, as were 1156 counterparts in a control group. The interventions were conducted in the intervention schools for one year. The participants were orally instructed to answer all the questionnaires by themselves at baseline and after intervention. The difference in difference statistical approach was used to identify the effects exclusively attributable to the interventions. There were differences in grade composition and no difference in sex distribution between the intervention and control groups. After adjusting for age, sex, and group differences at baseline, a significant reduction in SSB intake was found in the intervention group post intervention, with a decrease of 35.0 mL/day (p = 0.034). Additionally, the frequency of SSB consumption decreased by 0.2 times/day (p = 0.071). The students in the elementary schools with interventions significantly reduced their SSB intake by 61.6 mL/day (p = 0.002) and their frequency of SSB consumption by 0.3 times/day (p = 0.017) after the intervention. The boys in the intervention group had an intervention effect of a 50.2 mL/day reduction in their SSB intake (p = 0.036). School-based interventions were effective in reducing SSB consumption, especially among younger ones. The boys were more responsive to the interventions than the girls. (ChiCTR, ChiCTR1900020781.)

Effects of PMS50 supplementation on psychological symptoms of students with premenstrual syndrome.

To evaluate the effects of PMS50 supplementation on psychological symptoms in university students in Iran. This double-blind clinical trial was conducted at Ahvaz Jundishapur University of Medical Sciences, between December 2018 and March 2019. Fifty female students with moderate to severe premenstrual syndrome (PMS) randomly received either 550mg/day of PMS50 (n=25) or placebo (n=25), starting from 1week before till the end of menstruation for three consecutive menstrual cycles. Anthropometric indices, dietary intake, physical activity level, and severity of PMS were assessed at baseline and post-intervention. Data were analyzed by SPSS (version 22). Independent t test was used to compare the results between groups. Paired t test was used to compare the results within groups before and after study. There was a significant improvement in psychological symptoms including depression, anger, feeling of hopelessness, desire to be alone, mood swings, irritability, anxiety, and poor concentration observed in the intervention group compared with the control group post-intervention. Restlessness was significantly reduced in both groups post-intervention. The mean scores of low self-esteem, change in appetite, and food cravings were decreased in both groups, but not significant between groups. PMS50 supplementation may be effective in improvement of psychological symptoms in PMS. Clinical Trial Registration No.: IRCT20181218042038N1.

Examining the Impact of a Mobile Health App on Functional Movement and Physical Fitness: Pilot Pragmatic Randomized Controlled Trial.

BackgroundNumerous mobile apps available for download are geared toward health and fitness; however, limited research has evaluated the real-world effectiveness of such apps. The movr app is a mobile health app designed to enhance physical functioning by prescribing functional movement training based on individualized movement assessments. The influence of the movr app on functional movement and physical fitness (flexibility, strength, and cardiovascular fitness) has not yet been established empirically.ObjectiveThis study aims to examine the real-world impact of the movr app on functional movement, flexibility, strength, and cardiovascular fitness.MethodsA total of 48 healthy adults (24 women and 24 men; mean age 24, SD 5 years) completed an 8-week pilot pragmatic randomized controlled trial in which they were randomly assigned to either 8-week use of the movr app (n=24) or 8-week waitlist control (n=24). Measures of functional movement (Functional Movement Screen [FMS]), strength (push-ups, handgrip strength, and countermovement jump), flexibility (shoulder flexibility, sit and reach, active straight leg raise [ASLR], and half-kneeling dorsiflexion), and cardiovascular fitness (maximal oxygen uptake []) were collected at baseline and the 8-week follow-up.ResultsRepeated measures analyses of variance revealed significant group-by-time interactions for the 100-point FMS (P<.001), shoulder flexibility (P=.01), ASLR (P=.001), half-kneeling dorsiflexion (P<.001), and push-up tests (P=.03). Pairwise comparisons showed that FMS scores increased from pre- to postintervention for those in the movr group (P<.001) and significantly decreased for those in the control group (P=.04). For shoulder flexibility, ASLR, half-kneeling dorsiflexion, and push-up tests, improvements from pre- to postintervention were found in the movr group (all values of P<.05) but not in the control group (all values of P>.05). There were no changes in the sit and reach or handgrip strength test scores for either group (all values of P>.05). A significant main effect of time was found for the countermovement jump (P=.02), such that scores decreased from pre- to postintervention in the control group (P=.02) but not in the movr group (P=.38). Finally, a significant group-by-time interaction was found for (P=.001), revealing that scores decreased pre- to postintervention in the control group (P<.001), but not in the movr group (P=.54).ConclusionsThe findings revealed that movr improved indices of functional movement (FMS), flexibility (shoulder, ASLR, and dorsiflexion), and muscular endurance (push-ups) over an 8-week period compared with the control group while maintaining handgrip strength, lower body power (countermovement jump), and cardiovascular fitness (). Thus, this study provides initial evidence of the effectiveness of the movr app for enhancing functional movement and physical fitness among healthy adults.Trial RegistrationClinicalTrials.gov NCT04865666; https://clinicaltrials.gov/ct2/show/NCT04865666

Self-regulated learning versus activity-based intervention to reduce challenging behaviors and enhance school-related function for children with autism spectrum disorders: A randomized controlled trial

BackgroundSelf-regulated learning is an active learning cognitive approach which helps individuals to be aware of their own ability and environment and control their own learning. AimThis study examined the therapeutic effects of self-regulated learning on reducing challenging behaviors and enhancing school-related function in children with autism spectrum disorders. MethodsForty children (aged 6–12) were randomized into a 12-week Self-Regulated Learning or Activity-Based intervention control group. Three outcome measures, assessing the behavior and school-related function of the children in both groups, were administered before and after the intervention and at one-month follow-up. The results between the two groups were also compared. ResultsThe Self-Regulated Learning group showed significantly better results in reducing concerning behaviors and enhancing the school-related function than the activity-based group post-intervention and at one-month follow-up. ConclusionsThe Self-Regulated Learning intervention was more effective compared to the Activity-Based intervention with particular benefits for on-going learning and improvements.

365 Cognitive Behavioral Therapy and Light Dark Therapy for Postpartum Insomnia Symptoms: Findings from a Randomized Controlled Trial

Abstract Introduction Symptoms of insomnia are common in the postpartum period and are associated with a range of negative outcomes. Despite this, interventions to improve maternal postpartum sleep remain scarce. Cognitive Behavioral Therapy (CBT) and Light Dark Therapy (LDT) target two different mechanisms to reduce sleep disturbance. This randomized controlled trial examined the efficacy of CBT and LDT against a treatment-as-usual (TAU) condition in reducing maternal postpartum insomnia symptoms. Methods Nulliparous women 4–12 months postpartum with self-reported symptoms of insomnia (Insomnia Severity Index scores [ISI] &amp;gt;7) were included; excluded were those with: current severe health/psychiatric conditions, unsettled infant behaviors, sleep-affecting medication use and photosensitivity. Eligible women were randomized 1:1:1 to 6 weeks of CBT (CBT for insomnia and fatigue), LDT (morning bright light therapy, evening light hygiene), or TAU. Interventions were therapist-assisted and personalized through two telephone calls and included automated self-help intervention materials (i.e., emails) delivered over six weeks. Symptoms of insomnia (ISI; primary outcome), fatigue, sleepiness, depression, and anxiety were assessed at baseline, mid-intervention, post-intervention, and 1-month post-intervention. Analyses were intention-to-treat latent growth models. Results 114 women were randomized (mean age = 32.20 ± 4.62 years) and 108 women completed the intervention. Compared to TAU, symptoms of insomnia significantly reduced from baseline to post-intervention in both CBT and LDT groups (p-values &amp;lt;.001), with very large effect sizes (d &amp;gt; 1.5) at post-intervention; gains were maintained at follow-up. Fatigue symptoms significantly reduced in the CBT group (p&amp;lt;.0001; d = 0.85) but not LDT (p = 0.11) compared to TAU at post-intervention; gains were maintained for CBT at follow-up. Group differences in sleepiness, depression, and anxiety were nonsignificant (all p &amp;gt; 0.08). Conclusion Therapist-assisted self-help CBT and LDT with different therapeutic mechanisms are both efficacious for reducing maternal insomnia symptoms during the postpartum period. Findings were mixed for fatigue, sleepiness and mood. Future research on predictors of treatment responses is needed. Support (if any) Australian National Health and Medical Research Council, Department of Education RTP Scholarship. Lucimed SA supplied light therapy glasses. Funders had no role in design/implementation of the trial. ANZCTR: ACTRN12618000842268.

Pengaruh puasa intermiten 5:2 terhadap kadar malondialdehida pada karyawan pria dewasa dengan obesitas

Effect of intermittent fasting 5:2 on plasma malondialdehyde levels in adult male employees with obesityBackground: Obesity is a major risk factor for various non-communicable diseases such as type 2 diabetes mellitus and cardiovascular disease. In obesity, the free radical product will be produced, such as malondialdehyde (MDA) which plays a role in the pathogenesis of various diseases. Intermittent fasting (IF) is an alternative way to reduce free radical levels in the body therefore it can prevent complications of obesity. However, the effect of IF on MDA level in an obese adult male in Jakarta has not been reported.Objective: The objective of this study was to determine the effect of IF on malondialdehyde levels in adult male employees with obesity in Jakarta.Methods: This study used a randomized controlled clinical trial. The subjects were men aged 19-59 years with a body mass index (BMI) ≥ 25 kg/m2, divided into fasting and control groups, each group consists of 25 subjects. Intermittent fasting 5:2 is calorie restriction up to 20-25% was done every Monday and Thursday, and not allowed to eat and drink during 14 hours of fasting. Before the intervention, both groups were given education about balanced nutrition. Association of intermittent fasting with MDA and catalase was analyzed by means of difference formula with a significance limit of 5%.Results: MDA levels post-intervention significantly decreased compared to the pre-intervention both in the fasting group [1,3(0,9-2) nmol/mL to 0,4(0,3-0,6) nmol/mL] and in the control groups [1,4(0,9-1,9) nmol/mL to 0,5(0,3-0,7) nmol/mL]. MDA level post-intervention in the fasting group was significantly lower (p&lt;0,05) compared to the control group.Conclusions: Intermittent fasting 5:2 during 8 weeks can decrease MDA levels in adult males with obesity in Jakarta.

Effects of a Mindfulness-Based Intervention versus Health Self-Management on Subclinical Anxiety in Older Adults with Subjective Cognitive Decline: The SCD-Well Randomized Superiority Trial

Introduction: Older adults experiencing subjective cognitive decline (SCD) have a heightened risk of developing dementia and frequently experience subclinical anxiety, which is itself associated with dementia risk. Objective: To understand whether subclinical anxiety symptoms in SCD can be reduced through behavioral interventions. Methods: SCD-Well is a randomized controlled trial designed to determine whether an 8-week mindfulness-based intervention (caring mindfulness-based approach for seniors; CMBAS) is superior to a structurally matched health self-management program (HSMP) in reducing subclinical anxiety. Participants were recruited from memory clinics at 4 European sites. The primary outcome was change in anxiety symptoms (trait subscale of the State-Trait Anxiety Inventory; trait-STAI) from pre- to postintervention. Secondary outcomes included a change in state anxiety and depression symptoms postintervention and 6 months postrandomization (follow-up). Results: One hundred forty-seven participants (mean [SD] age: 72.7 [6.9] years; 64.6% women; CMBAS, n = 73; HSMP, n = 74) were included in the intention-to-treat analysis. There was no difference in trait-STAI between groups postintervention (adjusted change difference: –1.25 points; 95% CI –4.76 to 2.25) or at follow-up (adjusted change difference: –0.43 points; 95% CI –2.92 to 2.07). Trait-STAI decreased postintervention in both groups (CMBAS: –3.43 points; 95% CI –5.27 to –1.59; HSMP: –2.29 points; 95% CI –4.14 to –0.44) and reductions were maintained at follow-up. No between-group differences were observed for change in state anxiety or depression symptoms. Conclusions: A time-limited mindfulness intervention is not superior to health self-management in reducing subclinical anxiety symptoms in SCD. The sustained reduction observed across both groups suggests that subclinical anxiety symptoms in SCD are modifiable. ClinicalTrials.gov identifier: NCT03005652.

Effectiveness of a video-based advance care planning intervention in hospitalized elderly patients: A randomized controlled trial.

This study aimed to develop a video-based advance care planning intervention, and examine the effectiveness of the intervention on knowledge, behavioral intentions and advance directive signing among older patients admitted to a geriatric unit in Taiwan. This randomized controlled trial was carried out in two geriatric wards of a medical center in northern Taiwan, between June 2014 and June 2015. The participants were randomly assigned to the intervention (n=39) or control (n=43) group. Participants in the intervention group watched a 5-min video regarding advance care planning. The control group received usual care. Structured questionnaires on advance care planning knowledge and behavioral intentions were administered to both groups before and after the intervention. Advance directive signing was carried out until 2 weeks after hospital discharge through a chart review. The intervention group showed a significantly higher advance care planning knowledge score and behavioral intention score than the control group post-intervention. The rate of advance directive signing was 33.3% in the intervention group and 9.3% in the control group (P=0.01). This study showed the effectiveness of video-based interventions in increasing advance care planning knowledge, behavioral intention and advance directive signing among hospitalized older patients. Geriatric wards could use our model to promote advance care planning among older patients. Geriatr Gerontol Int 2021; 21: 478-484.