Mean Change In Score Research Articles

Various modalities of resistance exercise promote similar acute cognitive improvements and hemodynamic increases in young, healthy adults

The aim was to examine the effects of modalities of acute resistance exercise (RE) on cognition and hemodynamics including internal carotid artery (ICA) blood flow (BF). Twenty adults completed familiarization and experimental visits. One-repetition maximum (1RM) for bilateral leg extension was quantified, and baseline executive functioning was determined from three run-in visits. Subsequent visits included three randomized, volume-equated, acute exercise bouts of 30%1RM+blood flow restriction (BFR), 30%1RM, and 70%1RM. Both 30%1RM trials completed four sets of exercise (1 × 30, 3 × 15), and the 70%1RM condition completed four sets of 8 repetitions. BFR was induced with 40% of the pressure to occlude the femoral arteries. 11 minutes following each exercise, participants completed the Stroop and Shifting Attention Tests. Baseline and post-exercise values were used to calculate change scores. The resulting mean change scores were evaluated with mixed factorial ANOVAs. A p≤0.05 was considered significant. All measured outcome variables increased in response to exercise. The ANOVAs for cognitive scores indicated no significant (p>0.05) interactions. For cognitive flexibility and executive function index, there were main effects of Sex. Change scores of the females were significantly greater than the males for cognitive flexibility (7.6 ± 5.9 vs. -2.6 ± 8.4 au; p=0.007) and executive function index (7.4 ± 4.6 vs. -2.5 ± 6.5 au; p=0.001). For ICA BF, there was no significant interaction or any main effect. The females exhibited a smaller exercise-induced increase in blood pressure compared to the males (17.7 ± 5.9 vs. 11.0 ± 4.1 mmHg; p=0.010). Each RE modality yielded acute improvements in cognition, but only for females. There were no cognitive improvements related to BFR such that each RE bout yielded similar results.

Health coaching for hypertension control in primary care patients with uncontrolled hypertension in Egypt.

Health coaching effectively improves hypertension self-care activities and the control of blood pressure (BP) in hypertensive patients. Studies on the effects of health coaching on patients in primary care with uncontrolled hypertension in developing countries are limited. In this study, the effectiveness of health coaching on hypertension self-care and BP control was assessed in patients who have uncontrolled hypertension compared to standard care in Egypt. Our quasi-experimental study included control and intervention groups. The intervention group included 70 participants who received health coaching sessions (face-to-face and by telephone) besides the standard care, whereas the control group included 71 participants who only received the standard care. The study was conducted between July 2020 and November 2021. The participants were recruited from three primary healthcare settings in the Port Said Governorate. Personal and medical history, BP measurements, and hypertension self-care activity level effects (H-SCALE) were obtained. Paired-t-test was used to assess the changes in BP measurement, and H-SCALE score before and after receiving the health coaching. McNemar's test was used to assess changes in controlled BP and optimal hypertension self-care activities between control and health coached groups. Multiple logistic regression analysis assessed the predictors of better BP control. Health coaching resulted in more controlled BP (51.4%, P < 0.001) compared to the delivery of only usual care (11.3%, P = 0.008). The intervention showed a significant promotion in hypertension self-care activities, including medication usage (P < 0.001), low-salt diet (P < 0.001), and weight management (P < 0.001). The H-SCALE score mean change was the only predictor for BP control (odds ratio 1.057, P = 0.048) in the intervention group after 6 months. Intervention including traditional health coaching and phone calls is a beneficial modality for the promotion of hypertension self-care and improvement of BP control in primary care patients with uncontrolled hypertension.

Effect of Health Education on the Uptake of breast cancer screening among nursing students in Plateau State, Nigeria: A quasi-experimental study

Objective: This study aimed to assess the effect of health education on breast cancer screening uptake among female nursing students in Plateau State, Nigeria. Methods: A quasi-experimental study involving 50 female nursing students that were selected using a systematic random sampling each from the Colleges of Nursing Jos South Local Government Area (LGA) (experimental group) and Jos North LGA (control group) both in Plateau State. The intervention involved health education training in the experimental group only for six (6) weeks. The tool used was a structured questionnaire with Cronbach’s alpha coefficient of 0.782. Data analysis was done using IBM SPSS Version 22. ANOVA was used to compare mean changes in uptake scores as appropriate. Results were presented in tables and p&lt; 0.05 was taken as statistically significant. Results: The mean breast cancer screening uptake scores were 1.00 ± 0.700, 2.46 ± 0.706 and 2.54 ± 0.676 at baseline, one-month and three-month post-intervention respectively among the experimental group with a statistically significant difference in mean uptake score, (F[2, 147] = [77.982], p &lt;0.001) (Effect size, R2=0.515). In the control group, the uptake scores were 1.04 ± 0.755, 1.16 ± 0.738, and 1.26 ± 0.694 at baseline, one month post-intervention and three-month post-intervention respectively. There was no statistically significant difference in mean uptake scores between at least two phases (F [2, 147] = (1.140), p =0.323). Conclusion: Health educational intervention can significantly improve breast screening uptake. There is a need to constantly educate youths on this benefit.

COMPARISON OF LACOSAMIDE VERSUS LEVODOPA IN THE TREATMENT OF RESTLESS LEGS SYNDROME IN HEMODIALYSIS PATIENTS

ABSTRACT&#x0D; Objective: To compare Lacosamide and Levodopa for treating restless-legs-syndrome in hemodialysis patients in terms of mean change of International Restless Leg Syndrome (IRLS) score.&#x0D; Methods: It was a Randomize control trail done at Department of Medicine &amp; Nephrology Department of Mayo hospital, Lahore from April 2019 to March 2020. After taking approval from institutional-Review-board (IRB) of the King Edward Medical University (KEMU), sixty patients coming to hemodialysis unit of Mayo Hospital, Lahore and fulfilling the inclusion criteria were enrolled for study. We used lottery method and randomly divided them in to two groups that is Group-A: Lacosamide (50 mg) given at bedtime. (30 cases) and Group-B: Levodopa (110 mg) given daily 2 hours before bedtime (30 cases). Treatment was continued for 4 weeks. We calculated IRLS score at start of study and four week after treatment and any Change from baseline was calculated for every patient. That difference of –IRLS score documented on the attached Performa along with demographic details about patient.&#x0D; Results: This study showed that after 4 weeks of treatment there was not much difference seen in International Restless Leg Syndrome score in each treatment groups. i.e. [Pre-Treatment (Lacosamide: 20.80±4.78 vs. Levodopa: 22.60±4.66), Post Treatment (Lacosamide: 14.20±2.89 vs. Levodopa: 15.73±3.58), Mean change of score (Lacosamide: 7.10±4.99 vs. Levodopa: 6.86±6.63 . p - Value = 0.878)&#x0D; Conclusion: This trial concludes that Levodpoa and Lacosamide were equally good in treating Restless-Legs-Syndrome among patients who are on Hemodialysis.&#x0D; Key words: Restless legs syndrome, Hemodialysis, Lacosamide, Levodopa.

Impact of a pharmacist-led patient-centred care intervention along with textmessage reminders, on the management of newly diagnosed tubercular patients: A protocol for a randomized controlled trial.

Non-adherence to tuberculosis (TB) treatment is the leading cause of the increase in drug resistance cases. This study will determine the effectiveness of pharmaceutical-care-based interventions coupled with short messages delivered by a pharmacist on treatment outcomes and adherence among TB patients. The study will be conducted in TB Control Center of Pakistan Institute of Medical Sciences Hospital, Islamabad and District Bannu TB Control Center time period will be from August 2019 to September 2021. The patients will be included into the control group (usual care) or the intervention group pharmaceutical care and SMS reminder. The primary outcome includes a change in mean score from baseline in treatment outcomes and adherence, measured by Morisky Medication Adherence Scale, and clinic appointment attendance registration. Secondary outcomes include health-related quality of life of patients, disease knowledge, and patient satisfaction with the intervention. The major issues in patients with TB are cure rate and medication adherence. The method anticipated in this manuscript could set the foundation of pharmaceutical care and mobile SMS for the future provision of care to improve TB treatment outcomes. The study will make available fundamental information about the influence of the patient centered program on the adherence and clinical outcomes of patients with TB.Trial status and registration: Clinical Trials.gov assigned Identifier NCT04645836.

An investigation into the critical ingredients of intensive support teams for adults with intellectual disabilities who display challenging behaviour

Aims and method NHS England recommends the commissioning of intensive support teams (ISTs) to provide effective support to people with intellectual disability (ID) when in crisis. However, there is a paucity of evidence regarding how these services should be organised. This exploratory secondary analysis of data from the IST-ID study aimed to investigate IST characteristics that relate to clinical outcomes. The primary outcome was mean change in the total score on the Aberrant Behavior Checklist and its subscales. Results A measure of mental illness severity was the only variable associated with our primary outcome of reduction in challenging behaviour. Accommodation type, affective status and gender were associated with the subdomains of irritability, hyperactivity and lethargy in unadjusted and adjusted analyses. Clinical implications Our findings indicate that variation in clinical outcomes is influenced by individual rather than organisational factors. Further research on the theoretical fidelity of the IST-ID model is needed.

Interpreting the Significance of Changes in Health-Related Quality-of-Life Scores.

To determine the significance to patients of changes in health-related quality-of-life (HLQ) scores assessed by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). A subjective significance questionnaire (SSQ), which asks patients about perceived changes in physical, emotional, and social functioning and in global quality of life (global QL) and the QLQ-C30 were completed by patients who received chemotherapy for either breast cancer or small-cell lung cancer (SCLC). In the SSQ, patients rated their perception of change since the last time they completed the QLQ-C30 using a 7-category scale that ranged from "much worse" through "no change" to "much better." For each category of change in the SSQ, the corresponding differences were calculated in QLQ-C30 mean scores and effect sizes were determined. For patients who indicated "no change" in the SSQ, the mean change in scores in the corresponding QLQ-C30 domains was not significantly different from 0. For patients who indicated "a little" change either for better or for worse, the mean change in scores was about 5 to 10; for "moderate" change, about 10 to 20; and for "very much" change, greater than 20. Effect sizes increased in concordance with increasing changes in SSQ ratings and QLQ-C30 scores. The significance of changes in QLQ-C30 scores can be interpreted in terms of small, moderate, or large changes in quality of life as reported by patients in the SSQ. The magnitude of these changes also can be used to calculate the sample sizes required to detect a specified change in clinical trials.

Relationship between psychiatric symptoms and bidirectional change in subjective cognitive decline

AbstractBackgroundSubjective Cognitive Decline (SCD) is increasingly recognized as a prodromal risk state for Alzheimer’s disease. However, relatively little is known about trajectories of SCD within cognitively normal older adults, or the factors that associate with SCD change in this group. In this study, we examine the extent to which specific psychiatric symptoms including anxiety, depression, and apathy associate with an individual’s change in SCD over time.MethodParticipants were community dwelling cognitively normal older adults. SCD was measured using a 20‐item age‐anchored questionnaire that assessed complaints of cognitive functioning. Anxiety, depression, and apathy were assessed using the Beck Anxiety Inventory(BAI), Geriatric Depression Scale(GDS), and Apathy Evaluation Scale(AES), respectively. Measurements were conducted at two timepoints (T1 and T2). Average duration between visits was 35.62 months(SD = 13.28). High SCD change individuals(HC), as opposed to low SCD change individuals(LC), were defined as those who’s total SCD rating changed more than ±1 SD from the mean change score. Regression models were conducted to examine the association between SCD change group and psychiatric symptoms.ResultParticipants were 82 cognitively normal older adults (6.1% Hispanic, 93.9% Non‐Hispanic; 79.3% White, 15.9% Black; 67% female; mean age = 70.96(SD = 6.98); mean education = 16.38(SD = 2.26)). 22 participants were classified as HC(11 with increasing SCD; 11 with decreasing SCD). Anxiety symptoms were higher in the HC group than the LC group at T1(6.57 vs 3.53, p = 0.013) and T2(6.70 vs 2.91, p = 0.003). After adjusting for demographics(age, gender, and education), only T1 anxiety was associated with the HC group(B = 0.297, p = 0.017).ConclusionIndividuals with greater change in SCD over time had higher levels of anxiety at baseline than individuals with relatively stable SCD. This was true for individuals who had a large increase in SCD as well as a large decrease. Our results inform the factors that may contribute to variability in SCD among cognitively normal older adults and underscore the importance of assessing anxiety along with SCD. Importantly, as psychiatric symptoms may also confer risk for future dementia, current findings do not undercut the potential relevance of SCD for future cognitive decline and dementia. Ongoing longitudinal research is examining the interplay of SCD change, psychiatric symptoms, objective cognition, and diagnostic conversion.

Impact of rater change on data variability in ADAS‐Cog and CDR assessments

AbstractBackgroundThe past decade has seen numerous research trial failures in Alzheimer’s Disease. The CDR and ADAS‐Cog are the two most frequently used primary outcome measures of memory and cognition in clinical trials of Alzheimer’s Disease (AD). Given the high number of failed AD trials in recent years, data reliability of these measures is paramount. In an effort to minimize data variability and increase data quality, study designs often require the same rater assesses the subject/caregiver at each study visit. However, the impact of rater change on data reliability of these measures is largely unknown. This analysis investigates the impact of rater change on data variability in these measures.MethodData from 13 multinational clinical trials of early symptomatic and mild to moderate AD were analyzed. ADAS‐Cog and CDR assessments conducted by site raters were arranged according to visit sequence and divided into two groups: Rater Change (different raters administered subject’s consecutive visits) and No Rater Change (same rater administered consecutive visits). Visit‐to‐visit absolute score changes for CDR‐SB and ADAS‐Cog Total Score were calculated, and frequency distributions were evaluated.ResultWelch corrected, two sample t‐tests were conducted to compare score changes between rater change groups. For CDR, the Rater Change group showed a higher mean visit‐to‐visit score change (mean = 1.26, SD = 1.32) compared to the No Rater Change (mean = 1.02, SD = 1.13) group. The Rater Change group also showed a higher mean score change on ADAS‐Cog (mean = 4.44, SD: 3.77 and mean ‐ 4.06, SD = 3.50, for Rater Change and No Rater Change Groups, respectively). These group differences reached significance for both ADAS‐Cog (t = ‐7.2925, df = 9769.1, p &lt; .001) and CDR (t = ‐11.228, df = 6122.7, p &lt; .001).ConclusionThe analysis indicates significantly different score changes when there is a rater change between visits than not for both CDR and ADAS‐Cog assessments. These findings highlight the importance of rater consistency in reducing variability in an effort to improve data quality in AD trials.

Educational intervention based on health action model to promote safe behavior of hospital service workers

BackgroundHospitals are considered to be one of the most hazardous environments to work in, and their service workers are exposed to many serious risks. So The purpose of this study was to investigate the effect of educational intervention based on the Health Action Model to promote the safe behavior of hospital service workers.MethodsIn this quasi-experimental study, 45 workers in each of the control and experimental groups participated. Demographic information and data related to Health Action Model constructs were collected through a questionnaire and a checklist, immediately and three months after the intervention. Cronbach’s alpha coefficients were used to confirm the properties of the tools. Educational intervention accompanied was applied in the form of four training classes. The data were analyzed using SPSS 20 software.ResultsBefore the intervention, there was no significant difference between the two groups in terms of demographics and the study’s main variables. results showed significant changes in mean scores of safe behavior, Attitude, norms, belief, intention, knowledge in the experimental group three months after the intervention (P < 0.001).ConclusionsThe research results show that Health Action Model educational intervention can change workers’ awareness, attitudes, norms, beliefs, and intentions toward unsafe behavior and improve their safety performance.Trial registrationIRCTID: IRCT20160619028529N7.

Effect of adding hip exercises to general rehabilitation treatment of knee osteoarthritis on patients’ physical functions: a randomized clinical trial

BackgroundHip adductor and abductor strength were both reduced in KOA patients. But to date, most of the researches have only focused on quadriceps combined with hip abductor strengthening versus quadriceps strengthening.ObjectiveThe aim of the study is to evaluate the effect of adding hip abductor and adductor strengthening to quadriceps strengthening on lower limb strength, knee pain and physical function in patients with medial compartmental knee osteoarthritis.MethodsIn this study, 42 participants, were randomly divided into two groups: the general treatment group (GT group) and the added-hip-exercise group (AH group). All participants were given a general rehabilitation treatment. The AH group performed hip abductor and adductor strengthening in addition to the general rehabilitation treatment. Knee and hip muscle strength, Five Times Sit-to-Stand Test (FTSST), the Timed Up and Go Test (TUGT), Numerical Rating Scale (NRS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were assessed at baseline and 6 weeks. A two-sided 2-sample unpaired t test was performed to compare the difference in mean change scores between AH and GT groups.ResultsFinally, 36 participants completed the study: both groups consist of 18 participants. In the per-protocol analysis, the AH group had a greater improvement in knee extension strength (mean changes, 7.84 versus 36.48; P < 0.001) and hip abduction strength (mean changes, 5.05 versus 26.62; P = 0.001) than the control group. Similarly, the AH group had a greater improvement in the FTSST time (mean changes, 0.40 s versus 3.57 s; P < 0.001) and the TUFT time (mean changes, 0.18 s versus 1.67 s; P = 0.002) than the GH group. No statistical difference was found in the change of WOMAC pain scores and NRS between the 2 groups.ConclusionsOlder adults with knee OA in the AH group had superior muscle strength, symptoms and daily activity performance at the 6th week than those in the GT group. And adding hip exercises could expedite improvement of pain at the 2th week, but not at the 6th week.Trial registrationClinical trial registration numbers and date of registration: ChiCTR-IOR-16009124, Registered 30 August 2016.

Psychometric evaluation of the PROMIS SD-SF-8b instrument in individuals experiencing vasomotor symptoms due to menopause

BackgroundWomen with vasomotor symptoms (VMS) due to menopause frequently experience poor sleep quality. The Patient-Reported Outcomes Measurement Information System Sleep Disturbance – Short Form 8b (PROMIS SD-SF-8b) has been developed to assess sleep disturbance. The study objective was to use data from the fezolinetant SKYLIGHT 1 and 2 studies in individuals with VMS to assess the psychometric properties of the PROMIS SD-SF-8b.MethodsIndividuals (aged ≥ 40–≤65 years) with moderate-to-severe VMS (≥ 7 hot flashes/day) were enrolled. Besides PROMIS SD-SF-8b, eight other patient-reported outcome (PRO) measures were used for the psychometric evaluation. All the PRO assessments were completed at weeks 4 and 12 during the treatment period and most were completed at baseline. Psychometric analyses included factor analysis and reliability, construct validity, and sensitivity to change assessments. The within-patient threshold for a clinically meaningful change in sleep disturbance was derived.ResultsOverall, 1022 individuals were included from the SKYLIGHT 1 and 2 studies. Mean PROMIS SD-SF-8b total score at baseline was 26.80, which decreased to 22.68 at week 12, reflecting improved sleep disturbance. The confirmatory factor analysis supported the proposed PROMIS SD-SF-8b domain structure. Internal consistency was excellent, with Cronbach’s alpha values of 0.915 and 0.935 and a McDonald’s omega of 0.917. Item-to-item and item-total correlations were sufficient and moderate test-retest reliability was noted. The construct validity assessments showed that moderate Spearman rank correlations (r: 0.608 to 0.651) were observed between PROMIS SD-SF-8b total scores and measures of sleep disturbance and sleep-related impairment, and that significant differences were noted in the total scores across PRO categories. The responsiveness of PROMIS SD-SF-8b total scores was supported by the results from the correlations in change scores and comparisons of mean change scores by PRO categories. Statistically significant differences in mean scores were observed between responder and non-responder PRO groups. A PROMIS SD-SF-8b total score of 8 points was identified as the within-patient threshold to use to confirm a meaningful change in sleep disturbance.ConclusionsThe psychometric properties of the PROMIS SD-SF-8b support its use to measure sleep disturbance in women with VMS due to menopause.Trial registrationClinicalTrials.gov numbers: NCT04003155 and NCT04003142.

Safety and effectiveness of lurasidone in the treatment of Chinese schizophrenia patients: An interim analysis of post-marketing surveillance

BACKGROUND Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms. Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 mg/d. However, post-market surveillance (PMS) with an adequate sample size is required for further validation of the drug’s safety profile and effectiveness. AIM To conduct PMS in real-world clinical settings and evaluate the safety and effectiveness of lurasidone in the Chinese population. METHODS A prospective, multicenter, open-label, 12-wk surveillance was conducted in mainland China. All patients with schizophrenia from 10 sites who had begun medication with lurasidone between September 2019 and August 2022 were eligible for enrollment. Safety assessments included adverse events (AEs), adverse drug reactions (ADRs), extrapyramidal symptoms (EPS), akathisia, use of EPS drugs, weight gain, and laboratory values as metabolic parameters and the QTc interval. The effectiveness was assessed using the brief psychiatric rating scale (BPRS) from baseline to the end of treatment. RESULTS A total of 965 patients were enrolled in the full analysis set and 894 in the safety set in this interim analysis. The average daily dose was 61.7 ± 19.08 mg (mean ± SD) during the treatment. AEs and ADRs were experienced by 101 patients (11.3%) and 78 patients (8.7%), respectively, which were mostly mild. EPS occurred in 25 individuals with a 2.8% incidence, including akathisia in 20 individuals (2.2%). Moreover, 59 patients received drugs for treating EPS during the treatment, with an incidence of 6.6% which dropped to 5.4% at the end of the treatment. The average weight change was 0.20 ± 2.36 kg (P = 0.01687) with 0.8% of patients showing a weight gain of ≥ 7% at week 12 compared with that at the baseline. The mean values of metabolic parameters and the QTc interval at baseline and week 12 were within normal ranges. The mean changes in total BPRS scores were -8.9 ± 9.76 (n = 959), -13.5 ± 12.29 (n = 959), and -16.8 ± 13.97 (n = 959) after 2/4, 6/8, and 12 wk, respectively (P &lt; 0.001 for each visit compared with the baseline) using the last-observation-carried-forward method. CONCLUSION The interim analysis of the PMS of adult patients with schizophrenia demonstrate the safety and effectiveness of lurasidone in the Chinese population. No new safety or efficacy concerns were identified.

Tislelizumab in advanced/metastatic esophageal squamous cell carcinoma: health-related quality of life in Asian patients

Objective Post-hoc analysis examined health-related quality of life and esophageal squamous cell carcinoma (ESCC) symptoms in the Asian subgroup of patients in RATIONALE-302 (NCT03430843). Methods Patients were randomized 1:1 to either tislelizumab or investigator-chosen chemotherapy (paclitaxel, docetaxel, or irinotecan). Health-related quality of life was measured using the EORTC QLQ-C30 and the QLQ-OES18. Least-squares mean score changes from baseline to weeks 12 and 18 in health-related quality-of-life scores were assessed using a mixed model for repeated measurements. Reported nominal p-values are for descriptive purposes only. Results Of the 512 patients, this analysis was conducted in 392 Asian patients (tislelizumab, n = 192; investigator-chosen chemotherapy, n = 200). The tislelizumab arm had stable global health status/quality of life, but fatigue scores worsened in both arms. The change from baseline was similar for physical functioning in both arms at weeks 12 and 18. Eating and dysphagia scores remained stable in the tislelizumab arm. Reflux improved at week 12 in the tislelizumab arm and worsened in the investigator-chosen chemotherapy arm. Conclusions Overall, the health-related quality of life and ESCC-related symptoms of patients receiving tislelizumab in the Asian subgroup remained stable or improved, while patients receiving investigator-chosen chemotherapy experienced worsening. These results in Asian patients corroborate the findings in the intent-to-treat population, suggesting tislelizumab is a potential new second-line treatment option for patients with advanced or metastatic ESCC. Trial registration The RATIONALE-302 study is registered on clinicaltrials.gov as NCT03430843.

Cognitive-Behavioral Therapy (CBT) Versus Cognitive Retraining (CR) in Depression

Mood disorders are recurrent or episodic with significant cognitive deficits and incomplete recovery. Cognitive behavior therapy (CBT) has been a well-established evidence-based intervention, and Cognitive retraining (CR) is emerging to reduce cognitive deficits by application of techniques that improve attention, memory, and/or executive functions that enhance psychosocial functioning. Method: The present study compared CBT and CR delivered as independent interventions as well as combined with medicines employing pre-post intervention and experimental research design. Outcome measures were Beck Depression Inventory (BDI-II), Metacognitive Questionnaire (MCQ30), World Health Organization Quality of Life- Brief (WHOQOLBref), and Global Assessment of Functioning (GAF). Results: CBT group statistically had highest QOL supported by environment and global functioning. The change in mean scores on outcome measures was greater for CR groups. Conclusion: CR with or without medicine is a feasible treatment option when CBT promulgation is inhibited by patient, therapist, or environmental variables.

Abrocitinib efficacy and safety in moderate-to-severe atopic dermatitis by race, ethnicity, and Fitzpatrick skin type

BackgroundResponse to abrocitinib treatment for moderate-to-severe atopic dermatitis (AD) has not been evaluated across racial and ethnic subpopulations. ObjectiveTo assess the efficacy and safety of abrocitinib on the basis of patient race, ethnicity, and Fitzpatrick skin type (FST). MethodsData were pooled post hoc from patients treated with abrocitinib 200 mg, 100 mg, or placebo in 3 monotherapy trials (NCT02780167, NCT03349060, and NCT03575871). Race and ethnicity were self-reported; FST was determined by study investigators. Evaluations through Week 12 include the following: (1) Investigator's Global Assessment of clear or almost-clear skin; (2) greater than or equal to 75% improvement in Eczema Area and Severity Index or SCORing AD; (3) a greater-than-or-equal-to 4-point improvement in Peak Pruritus Numerical Rating Scale score; (4) least squares mean changes in Dermatology Life Quality Index and Patient-Oriented Eczema Measure scores; and (5) treatment-emergent adverse events. ResultsThe sample comprised 628 White, 204 Asian, and 83 Black patients; 37 were Hispanic or Latino; 624 had FST I to III and 320 had FST IV to VI. Treatment with either abrocitinib dose was associated with greater proportions of patients achieving Investigator's Global Assessment of clear or almost-clear skin, ≥ 75% improvement in Eczema Area and Severity Index, ≥ 75% improvement in SCORing AD, and a ≥ 4-point improvement in Peak Pruritus Numerical Rating Scale, or greater score changes from baseline in Dermatology Life Quality Index and Patient-Oriented Eczema Measure vs placebo regardless of race, ethnicity, or FST. Dose-response was most prominent in White patients. In Black patients, the effects of the 2 doses were similar. Treatment-emergent adverse events were more common in White and Black than in Asian patients. ConclusionAbrocitinib was more efficacious than placebo across the racial and ethnic groups and ranges of phototypes analyzed. Studies with increased representation of populations of color are warranted to elucidate potential variations in response across diverse populations. Trial RegistrationClinicaltrials.gov Identifier: NCT02780167 (phase 2b), NCT03349060 (phase 3 MONO-1), and NCT03575871 (phase 3 MONO-2).

The effect of happiness-based education on women’s success of water pipe smoking cessation and happiness: a quasi-experimental study

BackgroundWater pipe smoking by women threatens their health. Therefore, it is necessary to take measures to reduce this unhealthy behavior. This study aimed to determine the effect of happiness-based education on women’s success of water pipe smoking cessation and happiness.MethodsThis quasi-experimental study was conducted on female water pipe smokers in Iran, from September to January 2021. The participants (n = 68) were selected using convenience sampling and assigned to the intervention and control groups (34 subjects per group) by blocked randomization. The intervention group received a happiness-based education for one month (eight sessions) based on the Fordyce happiness program. The control group did not receive any special education. Data were collected using the Water Pipe Dependence Scale and the Oxford Happiness Questionnaire before and two months after the intervention. Data were analyzed using descriptive statistics, Chi-square, Fisher’s exact test, Independent t-test, Mann-Whitney, and Wilcoxon tests by SPSS software version 22.ResultsTwo months after the intervention, the mean change in the happiness score was significantly higher in the intervention group (2.32 ± 2.31) than that in the control group (-0.29 ± 1.81) (P < 0.001). Furthermore, the mean change in the score of water pipe dependence was significantly different between the intervention (-1.44 ± 1.4) and control (0.38 ± 0.85) groups (P < 0.001).ConclusionThe results showed that education based on Fordyce happiness program can increase the success of water pipe smoking cessation and happiness in women. Therefore, it is recommended to use similar interventions in women’s health promotion programs.

Comparison of the Effectiveness of Aromatherapy Massage with Ginger and Sesame Oil on Joint Pain and Stiffness in Patients with Knee Osteoarthritis: A Randomized Controlled Clinical Trial

Background: This study aimed to compare the effectiveness of aromatherapy massage with ginger and sesame oil on joint pain and stiffness in patients with knee joint osteoarthritis. Methods: This study was performed as a single-blind randomized clinical trial. Ninety patients with osteoarthritis were selected via convenience sampling from patients referring to rheumatology clinics affiliated with Birjand University of Medical Sciences. The subjects were randomly assigned into three groups: massage with oils ginger and sesame, and a control group (no massage). Symptoms were assessed using the Western Ontario McMaster Universities Arthritis Scale (WOMAC) index at baseline at three stages after the intervention (immediately, two weeks, and four weeks). Data analysis was performed with SPSS19 using Chisquare, Friedman and Kruskal-Wallis tests. Results: The findings of the study revealed that the mean pain scores in the ginger and sesame oil groups had a decreasing course before and immediately after the intervention compared to 2 weeks after the intervention. However, the changes in mean score showed an increase again 4 weeks after the intervention (P&lt;0.001). The mean score of joint stiffness in the ginger group suggested a decreasing course before intervention compared to immediately after and two weeks after intervention but showed an increase in changes in the mean score four weeks after intervention (P&lt;0.001). Moreover, the mean score of joint stiffness showed a decreasing course in the sesame group before intervention compared to immediately after intervention but showed an increase in the mean score again two weeks and four weeks after intervention (P&lt;0.001). Conclusions: The results of this study demonstrated that aromatherapy massage with ginger and sesame oils are both effective in improving joint pain and stiffness in patients with osteoarthritis; nonetheless, ginger is more effective in improving joint stiffness in patients with osteoarthritis. Moreover, ginger oil is more stable than sesame oil.

Predictors of Effects in Brief Psychiatric Treatment for Borderline Personality Disorder.

If evidence points to the equal efficacy of all bona fide treatments for borderline personality disorder (BPD) in general, it may not necessarily be true for a specific individual, nor do such general conclusions help in the triage of clients in clinical services. We investigated potential therapy outcome predictors for participants with a BPD diagnosis (N = 99). They were assessed on scales including the Outcome Questionnaire-45.2 (OQ-45), the Inventory of Interpersonal Problems-64, and the Borderline Symptom List. Our analyses revealed that individuals with low levels of symptom distress at intake had the smallest change in total OQ-45 score over the course of brief treatment, while the individuals with high levels of symptom distress had a mean large change in total score (-23). We observed that individuals with high symptom loads AND low levels of interpersonal problems at intake seemed to have the best progress.

Trends in adolescent mental health problems and the role of lifestyle factors

Abstract Background Adolescent mental health problems are on the rise globally, including in Sweden. One indicator is an increase in psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the trends in PSS. However, we found limited research on such associations. Methods This study is based on data collected every four years from nationally representative samples of 15-year-old boys and girls in Sweden (N = 9,196, 50.5% girls), as part of the Health Behavior in School-aged Children (HBSC) study. PSS was measured using a scale developed from the HBSC symptom checklist. We analyzed the trends in PSS from 2002 to 2018 and fitted models to investigate the associations between the trends and lifestyle factors. We included interaction terms between time and each lifestyle factor and fitted separate models for the high and low socioeconomic status (SES) groups. Results In general, the mean scores for PSS increased from 2.26 in 2002 to 2.49 in 2018 (p&amp;lt;.001). Compared to the average mean scores during preceding years, the changes in PSS mean scores at each survey year were also significant in all years except 2010. More frequent breakfast intake, daily consumption of fruits and vegetables, and higher PA were associated with lower PSS mean scores while smoking and alcohol consumption had the opposite association. The only significant interaction (B = .050; CI: .015, ¬ .085; p&amp;lt;.01) was observed in the high SES group, indicating that the increasing trend in PSS was stronger among those who had been drunk once or more in a lifetime, compared to those who had never been drunk. Conclusions The results indicate increasing trends in mental health problems among young people in Sweden. Furthermore, the study revealed that alcohol drunkenness was associated with a more substantial rise in PSS over time among those in the high SES group. Further research is needed to understand the reasons behind these findings. Key messages • Psychosomatic complaints have increased among Swedish adolescents in recent decades. • Although alcohol drunkenness has significantly declined among Swedish adolescents, it was not sufficient to influence trends in psychosomatic symptoms among those in the high socioeconomic group.