Single Group Pre-post Study Research Articles

Effects of Playback Theatre on cognitive function and quality of life in older adults in Singapore: A preliminary study.

This study investigated the effects of Playback Theatre on older adults' cognitive function and well-being, specifically in the Singapore context. Eighteen healthy older adults, older than 50years of age, participated in the study. Due to practical limitations, a single-group pre-post study design was adopted. Participants completed the outcome measures before and after the training program. There were six weekly sessions in total (about 1.5hours, once weekly). Participants experienced a significant improvement in their emotional well-being after training. However, there were no significant changes in participants' cognitive function or health-related quality of life. Our results suggest that Playback Theatre as a community program has potential to improve the mental and emotional well-being of older people.

The effectiveness of online pain resources for health professionals: a systematic review with subset meta-analysis of educational intervention studies.

Online educational interventions are increasingly developed for health professionals and students, although graduate and undergraduate medical curricula often contain limited information about how to assess and manage pain. This study reviews the literature on the effectiveness of pain-related online educational resources. Studies were identified through a search of Medline, PsychINFO, Web of Science, CINAHL, PubMed, Scopus, Cochrane Library, Google Scholar, and OpenGrey databases. Search terms included 3 concept blocks: (1) type of intervention-online education, computer-based, e-learning, web-based, and internet-based; (2) population-pediatrician, physician, nurse, psychologist, and medical; and (3) outcome-pain*. Thirty-two studies (13 randomised controlled trials, 5 nonrandomised controlled trials, and 14 single-group pre-post studies) were included. Ten provided data for inclusion in a series of between-groups meta-analyses. After intervention, participants receiving online instruction had significantly greater knowledge compared with those receiving training as usual/alternative training (Hedges' g = 0.80, 95% confidence interval [CI]: 0.12-1.49), and students had significantly greater skills compared with students receiving training as usual (g = 1.34, CI: 0.38-2.30). No significant differences were found for confidence/competence (g = 0.02, CI: -0.79 to 0.84) or attitudes/beliefs (g = 0.16, CI: -0.48 to 0.79). Although online educational resources show promise in improving learner knowledge, considerable heterogeneity exists between studies in quality, design, educational content, and outcomes. Furthermore, methodologically robust RCTs are required to establish the effectiveness of online educational interventions and a greater understanding of the key features of successful online resources, including cognitive interactivity. Few studies assessed health outcomes for patients, remaining a major priority for future investigations.

A systematic review of the effect ofphysicalexercise on cognition instrokeand traumatic brain injury patients.

To determine whether physical exercise enhances cognition following TBI or stroke. Studies were identified through searches of PubMed, ScienceDirect and the reference lists of papers that were included for full-text evaluation. Medical subject headings from three concepts, i.e. brain injury, physical exercise and cognition, were used to incorporate related search terms. Included were all trials published in English that assessed cognition before and after an exercise intervention in human adults with TBI or stroke. Nine randomized and two non-randomized controlled trials, as well as three single group pre-post studies were included. Relevant data concerning the methods and results of the included studies were extracted. Methodological quality of the RCT's was evaluated using the PEDro scale. Non-randomized trials were assessed using the Downs and Black checklist. The included trials were generally of medium methodological quality, though often plagued with issues of internal and external validity. The studies exhibited great heterogeneity, rendering a meta-analysis infeasible. Though well-designed studies are still needed, the preponderance of evidence suggests a positive effect of physical exercise on global cognitive functioning, especially in the chronic stages of a brain injury. Time after injury as well as the duration of the exercise program are mediating factors.

Outcome Quality of Open General Psychiatric Inpatient Treatment at the MesoLevel - an Observational Study in an Urban German General Hospital

Inpatient treatment (meso level) in psychiatric hospitals is commonly assumed to be effective. However, there is very little evidence-based data on this issue. First evaluation of the outcome quality of an inpatient general psychiatric treatment in a German general hospital using multifaceted quality indicators (symptom severity, wellbeing, self-efficacy, depressive avoidance, patients' satisfaction with the treatment) was carried out. Patients with a wide range of psychiatric diagnoses (ICD-10 F2-F6) were randomly assigned to this naturalistic single-group pre-post study. For ethical and methodological reasons, only adult inpatients treated in open general psychiatric wards were enrolled. The sample (n = 110, 58.2 % females) had a mean age of 47.2 (SD 15.9) years. 67 (60.9 %) and 29 (26.4 %) patients had at least one or two additional psychiatric diagnoses, respectively. 84 (76.4 %) and 62 (56.4 %) patients had a minimum of one or two additional somatic diagnoses, respectively. The treatment lasted 38 (SD 36; median 28.5) days. Significant positive treatment effects for all quality indicators were found at regular hospital discharge. The effect sizes varied between Cohen's d = 0.17 - 0.62 ("intention-to-treat" population, n = 110) and d = 0.28 - 0.99 ("completer" population, n = 70). This study provides direct evidence for the effectiveness of an open inpatient general psychiatric hospital treatment at the meso level. The results, however, are not representative for all German general psychiatric wards because of major differences between hospitals in personnel resources and framework conditions.

청소년 대상의 현미-채식 급식 프로그램이 주관적 건강상태, BMI 및 혈액지표에 미치는 효과

This study aimed to identify the effect of brown rice-vegetable school meals program on the subjective health status, BMI and hematological parameters of high school students. This is a single group pre-post study design that includes 17 high school boys and 18 high school girls. Students were catered for lunch and dinner with brown rice and a vegetarian diet for 12 weeks at the school. The collected data on subjective health status, BMI levels and hematological parameters were measured in pre and post, and changes were compared by paired t-test. Subjective health status of the participants has improved and BMI was reduced. Blood Hct, Hb, Hct, total protein and albumin have also been reduced. Ca and triglyceride levels decreased in females. However, all levels were reduced within the normal range. These results show that brown rice-vegetable intake of high school students reduces weight and helps them prevent from acquiring cardiovascular diseases in adulthood through the reduction of serum triglyceride and in practicing healthy eating habits.

Yoga reduces chronic low back pain

Background: Although yoga is an effective treatment for chronic low back pain (CLBP), little is known about the mechanisms responsible for its benefits. Objective: To study the effect of Integrated Approach of Yoga Therapy (IAYT) on disability, depression, and pain in patients with CLBP. Method: Seven days intensive residential IAYT program in a single group pre-post study was conducted in a holistic health centre at Bengaluru, India. Thirty-five patients (22 females, 13 males) with CLBP were selected conveniently to undergo the IAYT program. The IAYT program was a combination of Asanas (physical postures), Pranayama (breathing practices), and meditation, apart from interactive sessions on the philosophical concepts of yoga. The modified Roland-Morris Disability Questionnaire (RMDQ), Beck Depression Inventory (BDI), and Straight Leg Raising (SLR) Test were administered before and after the IAYT program. Statistical Analysis: The Statistical Package for the Social Sciences version 16 was used for statistical analysis. The Shapiro–Wilk test showed that the data was normally distributed. Paired samples t-test was used to compare the means. Results: The data analysis showed significant change (p< 0.001, in all cases) with 54.13% decrease in the RMDQ scores (t = 0.759), 36.46% increase in right (t = 0.887) and 36.04% (t = 0.884) in left SLR scores, and 71.47% decrease in BDI scores (t = 0.797). Conclusion: The present study suggests that 7-day intensive residential IAYT program reduces disability and depression and improves spinal mobility in patients with CLBP. Thus, yoga may play a vital role in the management of CLBP. Additional randomized control trials are needed before a strong recommendation can be made.

Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study

BackgroundFalls are the leading cause of injury death in older adults and present a significant public health problem and a major burden to healthcare. Although there is sufficient evidence from randomized controlled trials to indicate that exercise can prevent falls in older people, few effective, evidence-based fall prevention programs exist in community practice. Thus, there is a pressing need to translate and disseminate evidence-based exercise programs to community providers that serve older adults at increased risk of falling. The current study addresses this public health need by disseminating the evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program through community senior centers.Methods/DesignThe study uses a single-group design in which the TJQMBB program is being delivered to community-dwelling older adults through collaboration with senior centers in selected counties in Oregon, USA, for 48 weeks, followed by a 24-week post-intervention follow-up. Study process and outcome measures will be evaluated in accordance with the components of the RE-AIM framework that focus on Reach, Effectiveness, Adoption, Implementation and Maintenance.DiscussionThis study will determine whether the evidence-based TJQMBB fall prevention program can be disseminated through a broad spectrum of community-based senior centers that often cater to low-income, underserved community-dwelling older adults at risk of falling. If shown to be both practically implementable and sustainable, the TJQMBB program will provide an effective, potentially low-cost, easy-to-implement intervention that could be used by public health practitioners and community-based organizations to address the problem of falls among older adults.Trial registrationClinicalTrials.gov Identifier: NCT01854931

Process evaluation of an intervention to increase child activity levels in afterschool programs

BackgroundIdentifying effective strategies in Afterschool programs (ASPs) to increase children's moderate-to-vigorous physical activity (MVPA) in the ASP setting is crucial. This study describes the process evaluation outcomes from an intervention to reduce child sedentary time and increase MVPA in ASPs. MethodsFour ASPs participated in a quasi-experimental single-group pre-post study targeting child sedentary time and MVPA. The strategies implemented to help ASPs meet Physical Activity Standards consisted of detailed schedules, professional development trainings, on-site booster sessions, and technical assistance. Process evaluation related to staff behaviors was collected via systematic observation to identify the interventions impact on the physical and social environment of the ASP. Random-effects regression models examined the impact of the intervention on boys/girls observed sedentary behavior, MVPA, and changes in staff behaviors. ResultsIncreases in MVPA and reductions in sedentary behavior were observed during enrichment, academics, organized and free-play physical activities (PA). Corresponding changes in staff behaviors were observed during these ASP contexts. For example, staff reduced child idle-time during organized PA (38.9–1.8%) and provided energizers more often during enrichment (0.2–11.5%). ConclusionsThis study identified changes in staff behavior during ASP contexts that led to increases in child MVPA and decreases in child sedentary behavior.

Efficacy of interventions that include diet, aerobic and resistance training components for type 2 diabetes prevention: a systematic review with meta-analysis

Current recommendations for the prevention of type 2 diabetes advise modification of diet and exercise behaviors including both aerobic and resistance training. However, the efficacy of multi-component interventions involving a combination of these three components has not been established. The aims of this review were to systematically review and meta-analyze the evidence on multi-component (diet + aerobic exercise + resistance training) lifestyle interventions for type 2 diabetes prevention. Eight electronic databases (Medline, Embase, SportDiscus, Web of Science, CINAHL, Informit health collection, Cochrane library and Scopus) were searched up to June 2013. Eligible studies 1) recruited prediabetic adults or individuals at risk of type 2 diabetes; 2) conducted diet and exercise [including both physical activity/aerobic and resistance training] programs; and 3) reported weight and plasma glucose outcomes. In total, 23 articles from eight studies were eligible including five randomized controlled trials, one quasi-experimental, one two-group comparison and one single-group pre-post study. Four studies had a low risk of bias (score ≥ 6/10). Median intervention length was 12 months (range 4–48 months) with a follow-up of 18 months (range 6.5 - 48 months). The diet and exercise interventions varied slightly in terms of their specific prescriptions. Meta-analysis favored interventions over controls for weight loss (-3.79 kg [-6.13, -1.46; 95% CI], Z = 3.19, P = 0.001) and fasting plasma glucose (-0.13 mmol.L-1 [-0.24, -0.02; 95% CI], Z = 2.42, P = 0.02). Diabetes incidence was only reported in two studies, with reductions of 58% and 56% versus control groups. In summary, multi-component lifestyle type 2 diabetes prevention interventions that include diet and both aerobic and resistance exercise training are modestly effective in inducing weight loss and improving impaired fasting glucose, glucose tolerance, dietary and exercise outcomes in at risk and prediabetic adult populations. These results support the current exercise guidelines for the inclusion of resistance training in type 2 diabetes prevention, however there remains a need for more rigorous studies, with long-term follow-up evaluating program efficacy, muscular fitness outcomes, diabetes incidence and risk reduction.

Nootropic (medhya) effect of Bhāvita Śaṇkhapuṣpī tablets: A clinical appraisal

Background:Nootropic (medhya) potential of śaṅkhapuṣpī (Convolvulus pluricaulis Choisy.) is reported in Ayurvedic literature and modern studies are now validating the same. In spite of plentiful preclinical researches already carried out during the past decades, only meager clinical efforts exploring its nootropic activity have been reported. Present clinical study is an attempt to evaluate the nootropic effect of Śaṅkhapuṣpī tablets.Aims and Objective:To evaluate the nootropic effect of śaṅkhapuṣpī tablets prepared by three Bhāvanā (levigation) of its cūrṇa (powder) with its own Svarasa (fresh juice).Materials and Methods:Thirty volunteers between the age 16 and 25 years participated in this single group pre-post study. Weschler's memory scale was adopted to collect data before (pre) and after (post) intervention period (2 months). Paired t-test was used for analyzing the data.Results:In auditory immediate test and delayed test, 41.03% and 48% improvement was found which statistically highly significant (<0.001). In visual immediate and delayed test 32.5% and 44.87% improvement was found respectively, which shows highly significant result (<0.001).Conclusion:Results reveal that śaṅkhapuṣpī tablet shown highly significant results in improving memory, especially in long term memory loss in younger age group.

Efficacy of yoga for mental performance in university students

Background:With growing scientific evidence, yoga is emerging as an important health behavior-lifestyle modifying module to achieve holistic health at physical, mental, emotional, social and spiritual levels. Brain wave coherence (BWC) recordings from the surface of the skull are associated with different cognitive processes and plays both critical and useful roles in yoga with wide range of functional significance. The psycho-physiological changes that characterize the efficacy of yoga for better mental performance in university students have not been studied adequately.Objective:The study was designed to assess the mental performance through BWC analysis in university students undergoing Integrated Yoga Module (IYM).Materials and Methods:The IYM subjects (n=30) with 25.77±4.85 years of mean age participated in this single group pre-post study. The BWC data was collected before (pre) and after (post) the 21 days IYM using Brain Master (Model: 2E Part # 390-001), Michigan, USA.Statistical Analysis:Means, standard deviations, Kolmogorov-Smirnov test and Wilcoxon signed rank test were used for analyzing data with the help of SPSS-16.Results:A complete statistical and spectral analysis showed 43.24% increase (P<0.001) in Delta, 9.13% increase (P=0.289) in Theta, 57.85% increase (P<0.001) in Alpha, 17.65% decrease (P=0.136) in Beta and 9.19% increase (P=0.586) in Gamma BWC between pre and post intervention measurements.Conclusion:BWC study showed significant increase in both Delta and Alpha wave coherence suggesting that IYM can result in improvement of coherent and integrated brain functioning among students, thus paving the way for their better mental performance. Although this preliminary research is promising, more well-designed studies are needed before a strong recommendation can be made.

Yoga improves attention and self-esteem in underprivileged girl student

Background:A student under optimal stress does bring out his or her best; however, extreme stress can result in mental health problems and deteriorates their academic performance. Students who esteem themselves low are most likely to engage in destructive and self-destructive behaviors. Moreover, excessive stress is harmful to academic performance and may lead to dropping out in student. Can Yoga be of benefit in students for improving their attention and self-esteem (SE)?Objective:To assess attention and SE in girls undergoing Integrated Yoga Module (IYM).Materials and Methods:Sixty low-income high school girls with 15.17 + 0.64 years of mean age participated in this single group pre-post study. The data was collected before and after 5 days of IYM.Statistical Analysis:Means, standard deviations, Kolmogorov-Smirnov test, and Wilcoxon signed rank test were used to analyze the data with the help of SPSS 16.Results:The data analysis showed 9.04% increase (P = 0.001) in SE scores, whereas d2 test for attention revealed 10.12% increase (P < 0.001) in total number of symbols processed scores and 44.73% decrease (P < 0.001) in total number of errors.Conclusion:The present study suggests that of IYM can result in improvement of attention and SE among students and thereby enhancing their mental health and can help them in improving their academic achievement. Efforts aimed at reducing mental health problems among students may focus more on implementing effective and culturally acceptable interventions, such as Yoga, counseling, and social support. Additional well-designed studies are needed before a strong recommendation can be made.

Messen wir immer das Gleiche? Zur Invarianz von Messungen und Response-Shift in der Rehabilitation – Teil 2

Interventions in medical rehabilitation are often evaluated using a single-group pre-post study design with health-related quality of life (hrqol) as an outcome variable. Through comparison of mean values in hrqol subscales treatment effects are calculated. In many cases conclusions about changes in hrqol are made depending on the sizes of effects. The precondition for doing this, however, is that the answers to the items in questionnaires were given within the same frames of internal standards, values and conceptualizations at the different time points. Changes in these frames can be found, however, and are discussed under the term response shift, which can happen when adjusting to chronic and progressive diseases. Existence of response shift can be proven with confirmatory factor analysis (CFA) by measuring hrqol at different time points. This approach can be assigned to the broader issue of measurement of invariance in longitudinal studies and is described in a sample of 279 patients with diabetes mellitus. Different response shift processes were detectable. If response shift takes place but is not taken into account inferences from changes in scale scores to changes in hrqol are invalid. This means that the calculation of effect size is also influenced by response shift. By the use of CFA conventionally calculated effect size can be differentiated into either effects due to response shift or 'true change' of hrqol. Measurements of invariance within one group at 2 time points can be differentiated from multiple group analysis at one time point. Investigations of measurement of invariance in longitudinal studies allow for conclusions regarding sensitivity to change of instruments examining hrqol changes. This is important for clinicians who make decisions about which scales are appropriate to detect hrqol changes. For scientific research it is relevant for further analysis of sensitivity to change of hrqol instruments.

Ancient science of yogic life for academic excellence in university students

Background:Academic excellence is essential to provide opportunities for students to work together to improve their understanding of concepts in their academic core. Academic excellence helps students to teach problem-solving and collaborative learning strategies.Objective:The objective of this study was to assess Guna (personality traits) in students undergoing Yoga Instructor's Course (YIC).Materials and Methods:In all, 68 YIC students with a mean age of 28.03 ± 9.38 years participated in this single group pre–post study. The Personality Inventory data were collected before (pre) and after (post) the YIC.Statistical Analysis:Means, standard deviations, Kolmogorov–Smirnov test, and Wilcoxon signed rank test were used for analyzing the data with the help of SPSS 16.Results:The data analysis showed 11.33% decrease (P < 0.01) in Tamas Guna (dull personality trait), 0.68% decrease (P =0.819) in Rajas Guna (violent personality trait), and 10.34% increase (P <0.01) in Sattva Guna (balanced personality trait) scores.Conclusion:This study suggests that YIC can result in the improvement of Sattva Guna (balance personality trait) among students, thus paving the way for their academic excellence.

A Meta-Analysis of Interventions to Reduce Loneliness

Social and demographic trends are placing an increasing number of adults at risk for loneliness, an established risk factor for physical and mental illness. The growing costs of loneliness have led to a number of loneliness reduction interventions. Qualitative reviews have identified four primary intervention strategies: (a) improving social skills, (b) enhancing social support, (c) increasing opportunities for social contact, and (d) addressing maladaptive social cognition. An integrative meta-analysis of loneliness reduction interventions was conducted to quantify the effects of each strategy and to examine the potential role of moderator variables. Results revealed that single-group pre-post and nonrandomized comparison studies yielded larger mean effect sizes relative to randomized comparison studies. Among studies that used the latter design, the most successful interventions addressed maladaptive social cognition. This is consistent with current theories regarding loneliness and its etiology. Theoretical and methodological issues associated with designing new loneliness reduction interventions are discussed.

Speed mentoring: An innovative method to facilitate mentoring relationships

Background: Junior faculty members have difficulty in identifying mentors. Speed dating permits people to efficiently try out interpersonal relationships.Aim: Evaluate a “speed mentoring” event to help junior faculty answer questions and initiate mentoring relationships.Methods: This single-group pre–post study involved junior (mentee) and senior (mentor) faculty members at an academic medical center. During the event, each mentee spent 10 min talking with each mentor in rotation.Results: Seven mentees and six mentors participated. All participants felt that time was well spent (mentees, mean [SD] = 6.3 [0.8] on a seven-point Likert scale [7 = strongly agree]; mentors, 5.7 [1.4]). Topics discussed included mentoring relationships, getting started in research, and time management.Conclusions: Participants perceived benefits from this low-cost, brief intervention to facilitate mentoring relationships.

Klangmeditation in der onkologischen Rehabilitation: Pilotstudie zu einer rezeptiven Gruppenmusiktherapie mit dem Monochord

Hintergrund: Musiktherapie kann als rezeptives Angebot in der psychoonkologischen Behandlung von Krebspatienten eine wichtige Rolle spielen. Wichtige Zielsetzungen liegen in der Unterstützung der Entspannung sowie der Krankheitsverarbeitung. Diese Studie befasst sich mit der Evaluation eines rezeptiven Gruppenmusiktherapieangebotes, der Klangmeditation, in einer onkologischen Rehabilitationsklinik. Im Zentrum der Untersuchung steht die Frage nach dem Erleben der Patienten während der Klangmeditation. Patienten und Methoden: Es handelt sich um eine 1-Gruppen-Prä-Post-Studie, in der Patienten vor und nach vier Klangmeditationssitzungen innerhalb von 3 Wochen untersucht wurden. Ein selbst entwickelter bipolarer Stimmungsfragebogen wurde von den Patienten vor und nach jeder Sitzung ausgefüllt und mit einer ANOVA mit Messwiederholung analysiert. Die Lebensqualität wurde mit dem EORTC QLQ-C30 Fragebogen vor der 1. Sitzung und am Ende des gesamten Angebots erfasst. Das Gesamterleben wurde über ein schriftliches, strukturiertes Kurzinterview erfasst und mit der Inhaltsanalyse nach Mayring qualitativ ausgewertet. Ergebnisse: Es wurden die Daten von 105 Patienten ausgewertet. Der Stimmungsfragebogen zeigte über den Verlauf der Sitzungen signifikante Veränderungen hin zu einem Gefühl von mehr Ausgeglichenheit, geminderter Nervosität und geminderter Erschöpfung. Die Klangmeditation bewirkte bei 75,6% der Patienten positive Körpersensationen, wie z.B. Schwereempfindungen der Extremitäten oder ein Durchströmtwerden von Wärme. Schlussfolgerungen: Trotz der Vorläufigkeit der Ergebnisse einer Pilotstudie ergeben sich Hinweise darauf, dass sich die Klangmeditation von Anfang an positiv auf die Entspannungsfähigkeit auswirkt. In weiteren Studien sollte geklärt werden, wie die verschiedenen Wirkelemente der Klangmeditation zusammenspielen und ob Wirknachweise auch in einem kontrolliert randomisierten Design möglich sind.

A meta-analysis of exercise interventions among people treated for cancer

This review applied meta-analytic procedures to integrate primary research findings that tested exercise interventions among people treated for cancer. Extensive literature searching strategies located published and unpublished intervention studies that tested exercise interventions with at least five participants (k = 30). Primary study results were coded. Meta-analytic procedures were conducted. The overall weighted mean effect size (ES) for two-group comparisons was 0.52 (higher mean for treatment than control) for physical function, 0.35 for symptoms other than fatigue, and 0.27 for body composition. More modest positive ESs were documented for mood (0.19), quality of life (0.14), fatigue (0.11), and exercise behavior (0.04). ESs were larger among single-group pre-post design studies. ESs among control group participants were typically negative and not (statistically) significantly different from 0. Exercise interventions resulted in small positive effects on health and well-being outcomes among existing studies. Future research should examine intervention-specific characteristics that result in optimal results, such as dose.