Individual Interventions Research Articles

Acceptability and feasibility of a comprehensive fall prevention model for independent older adults: A qualitative evaluation

BackgroundFalls amongst the elderly represent a global public health challenge because of their potential to cause illness, death, and reduce the autonomy of this group. They also impact the emotional, family, social and economic well-being of those involved. Various strategies to prevent falls have been reported in the literature, focusing mainly on addressing individual risk factors, and on the continuous assessment of the risk of falls in older people. ObjectiveThis study evaluated user satisfaction and acceptability of a comprehensive model, implemented in the community, to prevent falls amongst independent older adults aged 65 years and above. It sought to capture both the perceptions of the individuals who received the intervention and of the interventionists who implemented it. The study protocol was registered at ClinicalTrials.gov in November 2020 (ID: NCT04313062). DesignQualitative, exploratory study using a case study design. The evaluation of the intervention followed the recommendations proposed by the Medical Research Council for complex interventions. Methods and participants: In the period between April 2021 to April 2022, 11 semi-structured interviews were conducted with independent older adults between 65 and 80 years of age who participated in the implementation of the comprehensive model in Santiago, Chile. Data were also collected with eight interventionists through: three semi-structured interviews at the beginning of the intervention; and two focus groups with seven interventionists at the end of the implementation of the model. The team members undertook a content analysis of the data collected. ResultsThree themes emerged to account for the satisfaction and acceptability of the intervention with the model on the part of the participants and interventionists: (1) Previous experience of older persons and interventionists; (2) The older person-interventionist encounter and its context; and (3) Identification of facilitators, strengths and challenges for the implementation of the model. The results show a positive assessment of the model, highlighting the value of the social contact derived from the intervention by both participants and interventionists. Although the model involved an individual intervention, the participants’ accounts indicate that it reached out to others, including family members and other elderly acquaintances. Moreover, the interventionists helped identify challenges in implementation and made recommendations to strengthen the model. ConclusionThe evaluation of satisfaction and feasibility of implementing the model showed positive results that will nurture the next phase of development of this model, which involves scaling up the intervention.

La terapia Gestalt: una alternativa de atención psicológica a niños desplazados de Guerrero, México

Forced internal displacement is a phenomenon that has occurred throughout history in various countries and affects the victims who experience it in all areas of their lives. In this regard, for the child population, this phenomenon has had a devastating impact, as childhood is a stage of full development, and children feel insecure in a frightening context where all their human rights were violated. The objective of the present study was to provide Gestalt therapy to children who are victims of forced internal displacement from Sierra de Guerrero. A qualitative approach was used, with a descriptive scope, a phenomenological design, and a cross-sectional cohort. The sample is represented by 23 minors from a community in the Sierra de Guerrero. The instruments used were the interview guide and the field diary, with data analyzed through open coding. The results show that the personal psychosocial effects found in the children were sadness and happiness due to their parents' fights; within the community effects, it was found that parents exhibited hypervigilance due to the stress of protecting their families. Regarding socioeconomic effects, it was found that men resorted to poppy cultivation as a subsistence economic activity. In this sense, it is concluded that Gestalt therapy used for group and individual intervention was effective in providing emotional release for the minors and a better way to cope with family conflicts and the social context.

Role of Adverse Childhood Experiences in the Onset of Overweight/Obesity.

The goal of this chapter was to summarize the literature on childhood adversity and obesity, discuss treatment implications with a case example, and provide recommendations for trauma-informed care for clinicians who work with individuals living with obesity. Adversity in childhood is related directly and indirectly to obesity development. Upstream contributors like adverse childhood experiences (ACEs) and other factors can lead to experiences of toxic stress and increased allostatic load, resulting in downstream effects of obesity and other chronic health conditions. A well-established literature has linked ACEs and obesity suggesting complex interactions between genetic, biological, behavioral, mental health, social, and environmental factors and obesity. Trauma-informed care strategies can be used to optimize care for individuals living with obesity. Care pathways should include individual (clinician) and systemic (organizational) evidence-based interventions.

A scalable optimization approach to the intervention planning of complex interconnected infrastructures

The functioning of infrastructure networks is vital for modern communities. Maintenance should be planned to ensure infrastructure's functionality and safety at the lowest cost. Interconnected infrastructure networks can affect each other's functionality, and maintenance on one network can impact the serviceability of others. Planned intervention grouping across infrastructures reduces set-up costs and service interruption, improving infrastructure availability and serviceability at lower costs.Finding the best grouping strategy is a known NP-hard problem, with several optimization strategies have been proposed, mainly based on nonlinear models which are computationally expensive and do not guarantee scalability. Furthermore, infrastructure intervention planning models mostly focus on grouping of interventions which are considered as given. In this paper, we propose a new efficient optimization model to optimize intervention grouping for interconnected infrastructure networks. We develop a scalable two-step optimization model where we first plan each individual intervention type based on a preventive maintenance policy accounting for the degradation behavior of objects, then group interventions to minimize the net costs, considering dependencies within and accross infrastructure networks.We formulate the grouping problem as an Integer Linear Program, which can be solved exactly with standard solvers. The model accounts for interactions between infrastructure networks and considers the impact on all stakeholders. It also accommodates various intervention types like maintenance, removal, and upgrading.Using a demonstrative application, we show that our model significantly reduces net costs and outperforms alternative nonlinear formulations and related heuristics in terms of both solution quality and computation performance. Additionally, the optimal intervention plan shows repetitive patterns, which suggests that a rolling horizon strategy could be used where the optimization problem is solved for shorter time horizons, leading to significant computational benefits.

Identifying Children and Adolescents at Elevated Mental Health Risk Before and During COVID-19.

To determine whether the prevalence of psychosocial risk in children and adolescents changed from before to during the COVID-19 pandemic and whether these changes differed by age group, sex, and season, based on a standardized psychosocial measure completed as a routine part of primary care. Children and adolescents aged 5.5 to 17.9 years were screened with a parent report Pediatric Symptom Checklist-17 (PSC-17P) between November 2017 and June 2022. Changes in the prevalence of psychosocial risk (global, internalizing, externalizing, and attention scales) from before to during the pandemic were compared by age group, sex, and season. In a sample of 459,767 health supervision visits, the prevalence of PSC-17P global, internalizing, and attention risk worsened significantly from before to during the pandemic, especially among female adolescents (ages 12.0-17.9). For a pediatrician seeing a hypothetical sample of 1000 adolescent girls, the expected number at risk would have increased from 103 to 131 on the global scale (26.6% increase), from 189 to 231 on the internalizing subscale (22.0% increase), and from 60 to 82 on the attention subscale (35.7% increase). Seasonality had a large effect, with significantly lower PSC-17P risk in the summer every year. Data from a large, national sample of pediatric visits suggested that global, internalizing, and attention concerns increased slightly overall from before to during the COVID-19 pandemic, with different patterns by age group and sex. Adolescent girls showed substantially increased global, internalizing, and attention problems. These increases support the need for further research and additional individual and system-level interventions.

Development and implementation of a rehabilitation triage algorithm for disasters in the subacute phase: an experience from the 2024 Noto peninsula earthquake

Early rehabilitation during disasters such as earthquakes is an important but often undervalued responsibility of medical teams. Both the development of simple tools for assessing the life functioning of evacuees and the standardization of intervention methods are urgent issues in disaster rehabilitation. The Japanese Rehabilitation Assistance Team (JRAT), an officially recognized organization consisting of 10 suborganisations, was established after gaining important experience with disaster rehabilitation in the aftermath of the Great East Japan Earthquake. We, the Hiroshima JRAT, were dispatched to the Monzen area of Wajima City to support disaster recovery after the 2024 Noto Peninsula Earthquake. Since disaster rehabilitation assistance was not well established in the Monzen area of Wajima City, the medical team consulted JRAT for guidance on triaging evacuees based on their life functioning. We developed a rehabilitation triage algorithm that classifies evacuees into four triage tags based on their ability to perform three simple movements: sitting up, standing up from the floor, and one-leg standing. In our triage algorithm, an inability to sit up is classified as a red tag (difficulty living in a shelter without assistance), an inability to stand up from the floor is classified as a yellow tag (individual intervention: introduction of beds and handrails), one-leg standing for < 2 s is classified as a green tag (group intervention: installation of toilets and bath rails and use of walkers to prevent falls), and standing on one leg for more than 2 s is classified as a white tag (independent in ADLs). We worked with medical teams to triage 922 evacuees in 27 evacuation centers, resulting in the extraction of four red and eight yellow evacuees in 1 day. Our rehabilitation triage system has the potential to be a simple assessment tool for classifying the life functioning of disaster victims and linking them to appropriate supports.

Effectiveness of a nurse-led one-to-one education programme in addition to standard care in children with atopic dermatitis: a multicentre randomized control trial.

Therapeutic patient education (TPE) is recommended for children with atopic dermatitis (AD), but no consensus has been reached on the optimal tailoring of delivery. While repeated multidisciplinary group education sessions have shown effectiveness, the benefits of one-on-one educational interventions led by nurses for children with AD have not yet been assessed. To assess the benefits of additional, well-structured, 1-h nurse-led individual TPE interventions in children with AD and their families compared with standard care alone. Children with moderate-to-severe AD and their parents were randomized to receive a 1-h nurse-led education session in addition to standard care vs. standard care alone. The primary outcome was the area under the curve (AUC) of the SCORing of Atopic Dermatitis index (SCORAD) from baseline to week 24 (lower AUC values represent better long-term control of the disease). In our study, 176 patients were randomized across 11 centres, and 153 were included in the full analysis set. The mean (SD) age was 4.47 (4.57) years. By week 24, there were no significant differences in the AUCs of the SCORAD between the two groups (P = 0.3). Secondary outcomes including patient-reported severity and quality of life [AUCs of the patient-oriented SCORAD (PO-SCORAD) and Infants' Dermatitis Quality of Life Index (IDLQI), Children's Dermatitis Quality of Life Index (CDLQI) and Family Dermatitis Quality of Life Index (FDLQI)] were not significantly different between the two groups. The only significant change observed in the intervention group, when compared with the one receiving standard care, was a decrease in topical steroid phobia, as assessed by the topical corticosteroid phobia (TOPICOP) score. Prespecified subgroup analyses showed that disease severity in the intervention group was significantly lower throughout the study, compared with the standard-care group when participants had moderate AD at baseline (n = 47); while participants with severe AD at baseline (n = 106) did not show benefit from the intervention. Participants showed no additional benefit from the intervention regardless of age group. This study did not show any additional effectiveness, in long-term severity control, of a 1-h nurse-led TPE intervention in children with AD treated with standard care, compared with those treated with standard care alone. However, it should be noted that the intervention reduced the fear of using topical steroids and may be beneficial for patients in the subgroup with moderate AD.

Epigenetic alterations in patients with anorexia nervosa—a systematic review

AbstractAnorexia nervosa (AN) is a complex metabolic and psychological disorder that is influenced by both heritable genetic components and environmental factors. Exposure to various environmental influences can lead to epigenetically induced changes in gene expression. Epigenetic research in AN is still in its infancy, and studies to date are limited in determining clear, valid links to disease onset and progression are limited. Therefore, the aim of this systematic review was to compile and critically evaluate the available results of epigenetic studies specifically in AN and to provide recommendations for future studies. In accordance with the PRISMA guidelines, a systematic literature search was performed in three different databases (PubMed, Embase, and Web of Science) through May 2023. Twenty-three original papers or conference abstracts on epigenetic studies in AN were collected. Epigenome-wide association studies (EWASs), which analyze DNA methylation across the genome in patients with AN and identify potential disease-relevant changes in promoter/regulatory regions of genes, are the most promising for future research. To date, five EWASs on AN have been published, suggesting a potential reversibility of malnutrition-induced epigenetic changes once patients recover. Hence, determining differential DNA methylation levels could serve as a biomarker for disease status or early diagnosis and might be involved in disease progression or chronification. For future research, EWASs with a larger sample size, longitudinal study design and uniform methods should be performed to contribute to the understanding of the pathophysiology of AN, the development of individual interventions and a better prognosis for affected patients.

A multilevel intervention to promote HPV vaccination among young adults in Texas: protocol for a randomized controlled trial

BackgroundHuman papillomavirus (HPV) infections can cause cancers of the cervix, vagina, vulva, penis, anus, and oropharynx. The most recently approved HPV vaccine, Gardasil-9, protects against HPV infection and can prevent HPV-associated invasive cancers. However, Gardasil-9 is one of the most underused vaccines in the US today. Young adults are at risk for HPV infection, but many are not vaccinated. This study uses a randomized controlled trial (RCT) to test an innovative multilevel intervention to increase HPV vaccination rates among young adults. In this paper, we describe the research protocol.MethodsThe study uses a two by three factorial design. A total of 1200 young adults in Texas, age 18–26 years, who have not been previously fully vaccinated against HPV will be randomly assigned to one of six conditions to receive: (1) standard CDC information about HPV vaccination (control); (2) video narratives about HPV vaccination; (3) written narratives about HPV vaccination; or (4–6) enhanced access to HPV vaccine combined with (4) standard CDC information, (5) video narratives, or (6) written narratives. The two primary outcomes are the rate of HPV vaccination initiation by 3-month follow-up and rate of HPV vaccination completion by 9-month follow-ups. We will determine the impact of the individual level intervention (i.e., persuasive narratives through video or written format), the systemic level intervention (i.e., enhanced access to HPV vaccines), and the combination of both levels, on HPV vaccination initiation and completion. We will also use purposive sampling to select participants to take part in semi-structured interviews/focus groups to better understand the mechanisms of the intervention.DiscussionRecruitment and data collection began in March 2022. We expect to complete data collection by March 2026. We expect that narratives, enhanced access, and the combination of both will improve HPV vaccination initiation and completion rates among young adults. If proven successful, these individual- and system-level interventions can be easily disseminated in regions with low HPV vaccination rates to improve HPV vaccination, and ultimately decrease HPV-related cancer burden.Trial RegistrationNCT05057312.

Understanding ethnic inequities associated with tobacco use in Aotearoa New Zealand: a quantitative analysis.

Despite the inclusion of both individual interventions and population-based measures in the Aotearoa New Zealand (Aotearoa NZ) Tobacco Control Programme, the gap between Māori, Pacific peoples and European/Asian/Other (EAO) populations in tobacco use has not decreased significantly. Tobacco control interventions that focus on individual behaviour change have produced little impact towards reducing tobacco smoking inequities for Māori and Pacific peoples in Aotearoa NZ. Using data from the New Zealand Health Survey (NZHS), this research investigates the impact of the wider determinants of health and individual-level factors on inequities in tobacco use between Māori, Pacific peoples and EAO. A conceptual framework was developed to support the theoretical positioning of this research and to inform data categorization, framing, discourse, analyses and interpretation. We conducted hierarchical regression to examine the effect of factors from each domain on ethnic inequities in tobacco use. We found that socioeconomic factors accounted for a significant amount of the disparity in adults currently smoking between Māori and Pacific peoples and EAO. Our results suggest that socioeconomic factors may be a more effective target of intervention than individual behaviours for reducing tobacco-related inequities. Addressing the broader determinants of health through comprehensive cross-agency cooperation to reduce ethnic inequities in tobacco use in Aotearoa NZ is likely to be more effective than individual behaviour change approaches.

Measurement-based matching of patients to psychotherapists' strengths.

Treatment personalization has evolved into an important zeitgeist in psychotherapy research. To date, such efforts have principally embodied a unidirectional focus on personalizing interventions to the patient. For example, earlier work in this area attempted to determine whether, on average, certain patients with certain characteristics or needs would respond better to one treatment package versus others. To the extent such aggregate "Aptitude × Treatment interactions" emerged, they could help guide overarching treatment selection. More recently, and drawing on technological and statistical advancements (e.g., machine learning, dynamic modeling), predictive algorithms can help determine for which individual patients certain treatment packages (DeRubeis et al., 2014) or specific during-session interventions within them (Fisher & Boswell, 2016) confer the most advantage for clinical improvement. Again, such work can help guide treatment decisions, though now at multiple care points. Although the aforementioned innovations in personalized psychotherapy have been leading-edge, precision care need not remain unidirectional. Rather, it can be complemented by efforts to personalize treatment decisions to the therapist. Namely, we can harness therapist effectiveness data to help ensure that therapists treat the patients they are empirically most equipped to help and use the interventions with which they have had the most empirical success. Such threads have been the focus of our team's novel, evolving, and multimethod work on improving psychotherapy by leveraging therapists' own practice-based evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Utilizing data to drive solutions for healthcare worker wellbeing.

9012 Background: Oncology Healthcare Workers (HCWs) provide extraordinary treatment to patients coping with distinct challenges. While experiences of burnout, compassion fatigue, and moral distress are not new, the COVID-19 pandemic further emphasized that intentional effort is needed to mitigate these negative work-related consequences. While Roswell Park Comprehensive Cancer Center (Roswell) initiated pre-pandemic grassroots efforts to examine burnout and build organizational resilience, deliberate resources were deemed necessary to support HCW resilience and well-being. Roswell committed to building a division solely focused on employee resiliency and burnout prevention. Methods: Qualitative and quantitative data were collected to identify organizational needs and pain points. Qualitative data was collected by the Resiliency Director who held over 100 conversations in 100 days with diverse personnel across the institute. Discussions focused on two questions (e.g., What’s working well? and What are the pebbles in employees’ shoes?) to assess organizational strengths are growth areas. Quantitative data was obtained through the Mini-Z, a validated burnout screener. All employees were emailed an invitation to take the survey over an 8-week period starting in December 2022. Concerned employees could self-refer to the Employee Assistance Program at the screener’s conclusion. Results: Qualitative data was categorized into Maslach's burnout drivers (workload, relationships, recognition, fairness, autonomy, and values conflict). Highlights included staff shortages, eroding of relationships during the pandemic, siloed communication, inconsistent recognition, micromanagement, and use of antiquated systems. Mini-Z results are displayed in the table. An interactive dashboard helped further examine demographics, role, and departmental data. Press Ganey employee engagement data also supported improvements for staff well-being, transparent communication, collaboration, recognition, and enhanced technology. Conclusions: Quantitative and qualitative data can drive individual, departmental, and organizational interventions to support HCW well-being. The newly established MedStaff Satisfaction and Wellness group is using the data to focus on recognizing the needs of the medical staff on an organizational level and is preparing to offer solutions to key stakeholders. HCWs are now incorporating activities aiming to build psychological safety, enhance communication, and advance well-being into their work routines through training, wellness activities, and emotional support. The Mini-Z screener has been made available in the Employee Health Portal permitting ease of personal reassessment. [Table: see text]

When Will Real-World Data Fulfill Its Promise to Provide Timely Insights in Oncology?

Randomized trials provide high-quality, internally consistent data on selected clinical questions, but lack generalizability for the aging population who are most often diagnosed with cancer and have comorbid conditions that may affect the interpretation of treatment benefit. The need for high-quality, relevant, and timely data is greater than ever. Promising solutions lie in the collection and analysis of real-world data (RWD), which can potentially provide timely insights about the patient's course during and after initial treatment and the outcomes of important subgroups such as the elderly, rural populations, children, and patients with greater social health needs. However, to inform practice and policy, real-world evidence must be created from trustworthy and comprehensive sources of RWD; these may include pragmatic clinical trials, registries, prospective observational studies, electronic health records (EHRs), administrative claims, and digital technologies. There are unique challenges in oncology since key parameters (eg, cancer stage, biomarker status, genomic assays, imaging response, side effects, quality of life) are not recorded, siloed in inaccessible documents, or available only as free text or unstructured reports in the EHR. Advances in analytics, such as artificial intelligence, may greatly enhance the ability to obtain more granular information from EHRs and support integrated diagnostics; however, they will need to be validated purpose by purpose. We recommend a commitment to standardizing data across sources and building infrastructures that can produce fit-for-purpose RWD that will provide timely understanding of the effectiveness of individual interventions.

Anti-asthmatic activity of Tinospora cordifolia leaves extract against ach and citric acid-induced asthma in rats

Asthma is one of the common clutters experienced in clinical medication in both grown-ups and children are asthma and it is characterized by irritation of the aviation routes which causes aviation route brokenness. Breathed-in bronchodilators and anti-inflammatory drugs are accessible and compelling and they require long term utilize and are related with side impacts. Typically, why elective and complementary medication is being sort after to anticipate these side impacts. A few restorative plants have anti-inflammatory impact and have demonstrated successful within the treatment of asthma. Citric corrosive, Acetylcholine, Histamine is basically utilized for assessing anti-asthmatic movement of specific sedate. Numerous plants gotten from the normal source play a critical part within the wellbeing care framework. Writing overview on home grown drugs has appeared noteworthy anti-asthmatic movement which has not shown any momentous side impact. The pharmacological component that the phytoconstituents creating the hostile to asthmatic action are not clearly caught on till date. A few herbal formulations have been determined from the Ayurveda, conventional framework of Indian medicine and its extra framework of medication, however to be experimentally approved that they have exhibited pharmacological activity against Asthmatic. As it were less number of logical data of conventional medications is accessible for the treatment of Asthmatic. This survey contains list of restorative plant which have been tried for anti-asthmatic action within the Citric corrosive, Acetylcholine actuated asthmatic in Rodent demonstrate. Rats were divided into 4 groups and given each of them individual intervention based on the activity. Tinospora cordifolia leaf extract shows an anti-asthmatic activity in rats. hence, the data given in this inquiry will offer assistance the analysts for the advancement of elective strategies instead of inhalers and verbal anti-asthmatic drugs for the treatment of asthma and COPD which can minimize the complications.

Sustainable employability in supported employment and Individual Placement and Support interventions in the context of the characteristics of work and perspectives of the employers: A scoping review

BACKGROUND: In Supported Employment (SE) and Individual Placement and Support (IPS) research, less attention has been paid to employers’ interests and the quality and opportunities of jobs or the work itself for sustainable working careers. OBJECTIVE: To explore what is known about sustainable employability in SE and IPS interventions in the context of the characteristics of work and perspectives of employers. METHODS: A systematic literature search was conducted in the Medline, Scopus, PsycINFO, CINAHL, and Social Science Premium Collection (ProQuest) databases. The scoping review process was carried out in accordance with the methodological guidelines. The analysis included numerical summary, qualitative content, and thematic analysis processes. RESULTS: From the total of 2,729 articles, 20 studies were included. The majority of the jobs were entry-level, part-time and on fixed-term basis. There were only few descriptions of interaction at work. From the themes arising from the reviewed studies, “Productivity in the job performance”, “Making a job-person match” and “Workplaces strategies for integrating work, recovery and wellness” contained the most data. CONCLUSION: Research from the point of view of the employers and other workplace actors is scarce. More research is needed also about interactions at work and the meaningfulness of work for people with disabilities.

A multi-environmental source approach to explore associations between metals exposure and olfactory identification among school-age children residing in northern Italy.

Metal exposures can adversely impact olfactory function. Few studies have examined this association in children. Further, metal exposure occurs as a mixture, yet previous studies of metal-associated olfactory dysfunction only examined individual metals. Preventing olfactory dysfunctions can improve quality of life and prevent neurodegenerative diseases with long-term health implications. We aimed to test the association between exposure to a mixture of 12 metals measured in environmental sources and olfactory function among children and adolescents residing in the industrialized province of Brescia, Italy. We enrolled 130 children between 6 and 13 years old (51.5% females) and used the "Sniffin' Sticks" test to measure olfactory performance in identifying smells. We used a portable X-ray fluorescence instrument to determine concentrations of metals (arsenic (As), calcium, cadmium (Cd), chromium, copper, iron, manganese, lead (Pb), antimony, titanium, vanadium and zinc) in outdoor and indoor deposited dust and soil samples collected from participants' households. We used an extension of weighted quantile sum (WQS) regression to test the association between exposure to metal mixtures in multiple environmental media and olfactory function adjusting for age, sex, socio-economic status, intelligence quotient and parents' smoking status. A higher multi-source mixture was significantly associated with a reduced Sniffin' Sticks identification score (β = -0.228; 95% CI -0.433, -0.020). Indoor dust concentrations of Pb, Cd and As provided the strongest contributions to this association (13.8%, 13.3% and 10.1%, respectively). The metal mixture in indoor dust contributed more (for 8 metals out of 12) to the association between metals and olfactory function compared to soil or outdoor dust. Among a mixture of 12 metals measured in three different environmental sources (soil, outdoor and indoor dust), we identified Pb, Cd and As measured in indoor dust as the main contributors to reduced olfactory function in children and adolescents residing in an industrialized area. Exposure to indoor pollution can be effectively reduced through individual and public health interventions allowing to prevent the deterioration of olfactory functions. Moreover, the identification of the factors that can deteriorate olfactory functions can be a helpful instrument to improve quality of life and prevent neurodegenerative diseases as long-term health implications.

Characteristics and Effectiveness of Individual Psychotherapy for Palliative and End-of-Life Care: A Literature Review for Randomized Controlled Trials.

The introduction of psychotherapy in palliative and end-of-life care settings has become increasingly common and is effective in decreasing many psychological problems. This review reports the characteristics and effectiveness of individual psychotherapeutic interventions for patients receiving palliative and end-of-life care. In addition, the review reports the effectiveness of psychotherapies considering the expected life expectancy. The PubMed, Google Scholar, and Cochrane Library databases were searched for English-language articles published between January 2000 to May 2023. Twenty-six studies were included and classified into a total of nine types of psychotherapies, namely, dignity therapy (DT), life review therapy, narrative therapy, managing cancer and living meaningfully (CALM), individual meaning-centered psychotherapy, meaning and purpose therapy, meaning-making therapy, meaning-of-life therapy, and cognitive therapy. Most of the psychotherapies provided to patients receiving palliative and end-of-life care showed effectiveness in the reduction of negative emotions and positive factors related to end-of-life issues. Most studies targeted patients with advanced cancer; however, studies on DT did not limit the target group to patients with cancer. Considering the expected life expectancy, CALM was found to be suitable for patients receiving early palliative care.

Individual Intervention and Assessment of Students' Physical Fitness Based on the "Three Precision" Applet and Mixed Strategy Optimised CNN Networks

With the development of network technology and intelligent application platforms, the "Three Precision" applet as a method of individual intervention for students' physical fitness can not only enable students to obtain the improvement of physical fitness and lifelong sports habits, but also establish a new bridge of cooperation between home and school. The analysis method of student physical fitness individual intervention assessment is affected by a variety of factors such as the framework design of the WeChat applet platform and the subjectivity of the intervention, which leads to the inefficiency of the student physical fitness individual intervention assessment method. To address this problem, we analyse the mode and content of students' physical fitness individual intervention based on the "Three Precision" applet, extract the feature vectors of students' physical fitness individual intervention, construct a system of students' physical fitness individual intervention assessment indexes, and establish a method of students' physical fitness individual intervention assessment based on big data technology and WeChat applet by combining the mushroom propagation optimization algorithm and convolutional neural network. Individual intervention assessment method based on big data technology and WeChat applet. The effectiveness and robustness of the proposed method are verified by using the data recorded in the "Three Precision" applet as the input data of the model. The results show that the proposed method meets the real-time requirements and improves the prediction accuracy of the individual intervention assessment method, which significantly improves the efficiency of the individual intervention assessment of students' physical fitness.

Substance Use Within Trials of Psychological Interventions for Psychosis: Sample Inclusion, Secondary Measures, and Intervention Effectiveness.

Current clinical guidelines recommend that patients with co-occurring psychosis and alcohol or substance use disorders (A/SUD) receive evidenced-based treatment for both disorders, including psychological intervention for psychosis. However, the efficacy of such treatments for individuals with co-occurring psychosis and A/SUD is unclear. Randomized controlled trials (RCTs) of psychological interventions for psychosis were systematically reviewed, to investigate how alcohol and substance use has been accounted for across sample inclusion and secondary measures. Findings from trials including individuals with co-occurring alcohol or substance use issues were then narratively summarized using the Synthesis Without Meta-Analysis guidelines, to indicate the overall efficacy of psychological interventions for psychosis, for this comorbid population. Across the 131 trials identified, 60.3% of trials excluded individuals with alcohol or substance use issues. Additionally, only 6.1% measured alcohol or substance use at baseline, while only 2.3% measured alcohol or substance use as a secondary outcome. Across trials explicitly including individuals with alcohol or substance use issues, insufficient evidence was available to conclude the efficacy of any individual psychological intervention. However, preliminary findings suggest that psychoeducation (PE) and metacognitive therapy (MCT) may be proposed for further investigation. Overall, co-occurring alcohol and substance use issues have been largely neglected across the recent RCTs of psychological interventions for psychosis; highlighting the challenges of making treatment decisions for these individuals using the current evidence base.

Effect of family intervention on relapse rate of Chinese patients with alcohol-dependent.

This study explored the impact of a family intervention on the relapse rate of Chinese patients with alcohol dependence. A total of 151 male patients with alcohol dependence who were discharged from the Substance Dependence Department of the Wenzhou Seventh People's Hospital from January to December 2020 were selected. They were divided into the control (n = 73) and experimental (n = 78) groups. Patients in both groups received routine alcohol cessation treatment. Moreover, patients in the experimental group were followed up by a professional psychiatrist to carry out individual family intervention. The Family Function Rating Scale (FAD), a Self-made general information questionnaire, and the Chinese version of the Family Intimacy and Adaptability Scale (FACESI-CV) were performed. Re-drinking rate and readmission rate were assessed. Family intervention could reduce relapse rate (31, 39.74%) and rehospitalization (27, 34.62%) compared with the control group. After family training, FAD factor scores were improved in the experiment group in comparison with the control group. Family training improved communication (18.2 ± 3.7), role (20.8 ± 2.5), emotional response (10.8 ± 1.8), emotional involvement (13.7 ± 1.2), behavioral control (19.8 ± 1.2), and overall functionality (23.5 ± 2.1) in the experiment group in comparison with the control group. After family training, intimacy (70.5 ± 8.7) and adaptability (64.1 ± 6.9) in the experiment group was higher than in the control group. After family intervention, Michigan Alcohol Dependence Scale (MAST) (9.21 ± 0.68) and Short-Form 36 (SF-36) (80.32 ± 4.47) in the experiment group were higher than the control group. Family intervention for families of patients with alcohol dependence can improve their family function, increase their family intimacy and adaptability, and reduce the rate of relapse.