Group Therapy Intervention Research Articles

Compassion Focused Group Psychotherapy for attachment and relational trauma: Engaging people with a diagnosis of personality disorder.

The research aimed to evaluate an exploratory Compassion Focused Group Psychotherapy Programme and the impact on participants' experiences of self-criticism, usage of services and general wellbeing. Participants included patients with a history of complex attachment and relational trauma (A&RT), who might attract a diagnosis of personality disorder. This study utilised a quasi-experimental non-randomised within subject controlled design for the evaluation of the efficacy of the programme. Participants were recruited from tertiary care services. The programme consisted of a 12-week Preparation and Engagement intervention (PEG) which was Compassionate Mind Training and Psychoeducation, followed by a 40-week Compassion Focused Trauma Group intervention. The cohort was then followed up after 12 months during which period they received treatment as usual. A comprehensive selection of self-report measures was administered at various points during the therapeutic process and following completion of the group interventions. The results of the research showed that the provision of a long-term, slow-paced, Compassion Focused Group Psychotherapy intervention, resulted in significant changes across all measures which were maintained at 12-month follow-up. These significant results were maintained following intention to treat and reliable change analyses. These data were supported by a significant reduction in service usage and a significant increase in engagement in employment and education. This study has identified that within Compassion Focused Group Psychotherapy, there is a therapeutic process of establishing group-based safeness as a necessary precursor to cultivating compassion and reworking early shame-based trauma memories.

Energy Management Education in Persons with Long COVID-Related Fatigue: Insights from Focus Group Results on Occupational Therapy Approach.

Long COVID is a growing condition among individuals, with fatigue being one of the main symptoms experienced. Energy Management Education (EME) is a structured occupational therapy group intervention that aims to reduce the impact of fatigue in daily life. This study utilized focus groups to explore the experiences of individuals with post-COVID-related fatigue who participated in the EME program. Six participants engaged in discussions about the program immediately after its completion and again two months later. Additionally, five occupational therapists shared their experiences. Former participants reported implementing strategies learned in the program to manage their condition effectively. They emphasized the importance of understanding fatigue and found the support provided by the peer group valuable. Occupational therapists highlighted the unique challenges faced by individuals with post-COVID-related fatigue compared to other populations with similar fatigue symptoms. Furthermore, insights were obtained regarding the ways individuals live and cope with post-COVID-related fatigue. EME participants were involved in a dynamic and complex occupational therapy process and were experiencing a slow change towards having more control over their daily routines. The study gathered valuable feedback and suggestions from participants and occupational therapists which can be used to optimize the EME program.

Efektivitas Citicoline dalam Terapi Demensia

Background: In the development of pharmacological therapy for dementia, especially Alzheimer's disease, several types of therapy are widely used: acethylcholine esterase inhibitors/AChEI, N-methyl-D-aspartate (NMDA) receptors inhibitors, and cholinergic precursor. Aim: To review the evidence on the effectiveness of citicoline supplementation to the standard therapy of dementia to prevent the progression or improve the manifestations of dementia. Methods: A literature search was performed in three following databases: Pubmed, EBSCOhost, Scopus, and Cochrane within the last ten years. Results: Of the 239 articles, five studies were eligible for critical appraisal. Four studies showed a significant mean MMSE score increase in the citicoline + standard therapy group (intervention) compared to the standard therapy group (control) during the follow up period between 3 – 12 months. One study showed a significant mean MMSE score increase of in the intervention group compared to the control group. Conclusion: Oral citicoline supplementation of 1,000 mg/day to the standard therapy showed a positive effect on cognitive function in dementia patients. Critical appraisal of validity and application of the included studies should be considered upon daily clinical application.

Acceptability of ACT group intervention for adolescents with type 1 diabetes

BackgroundType 1 diabetes (T1D) is a demanding condition for both adolescents and their parents. The first aim of this study was to investigate the acceptability of an acceptance and commitment therapy (ACT) group intervention for 12–16-year-old adolescents with T1D. The second aim was to investigate how adolescents whose glycemic control improved during the intervention differed from those who did not improve. MethodsA total of 28 adolescents and their parents who completed the intervention were interviewed at the end of the intervention. The adolescents filled in questionnaires regarding diabetes-related psychological flexibility (DAAS) and acceptance and mindfulness (CAMM) before and after the intervention. Glycosylated hemoglobin (HbA1c) levels were obtained from the medical records before and after the intervention. The experiences of the intervention were investigated using semi-structured questionnaires and a thematic analysis. Statistical analyses were performed to study the group differences between adolescents who improved in glycemic control and those who showed no improvement. ResultsOf those who completed the intervention, 86% of the adolescents and 89% of the parents reported being very satisfied or satisfied with the intervention. The thematic analysis showed that among the themes arising from the experiences of adolescents were increased motivation for the treatment of diabetes and a better attitude toward diabetes. Among the parents, themes such as positive changes in mood, a better attitude toward diabetes, and increased motivation for treatment emerged. In terms of group differences, those who improved with regard to glycemic control were older, their HbA1c was higher at the start, and they reported greater changes in diabetes-related psychological flexibility. ConclusionsThe ACT-based group intervention was well accepted and complemented the usual treatment. Thus, this intervention is recommended, especially for adolescents who have not met the glycemic targets.

Comparative Effectiveness of Interventional Therapy versus Exercise Rehabilitation in Stable Angina Patients with Severe Coronary Artery Stenosis.

Management strategies for stable angina include pharmacotherapy, revascularization, and exercise-based cardiac rehabilitation (CR). The optimal treatment for stable angina patients with severe coronary artery stenosis remains unclear. This study aimed to compare interventional therapy with exercise rehabilitation in this population. Fifty stable angina patients with severe coronary stenosis who underwent stent implantation were included in the optimal medical therapy (OMT) plus percutaneous coronary intervention (PCI) group, and 50 patients who did not undergo interventional treatment were included in OMT plus CR group receiving exercise rehabilitation guidance for one year. Cardiovascular composite endpoint events, cardiopulmonary fitness, and quality of life scale scores were assessed after one year. No significant difference in incidence of cardiovascular composite endpoint events was observed between OMT plus PCI group with OMT plus CR group (20.0% vs 14.6%) after one year. Cardiopulmonary fitness represented as peak VO2 (19.2±3.5 vs 17.6±3.2 mL/kg/min), peak load (120±19 vs 108±20 W), and AT (13.5±1.5 vs 12.1±1.3 mL/kg/min) were significantly higher in the rehabilitation group than the intervention group after one year. Both groups showed improvement in their quality of life, but the rehabilitation group improved in more scales. Interventional therapy did not reduce cardiovascular events compared to exercise-based rehabilitation in stable angina patients with severe coronary artery stenosis, but the rehabilitation can improve cardiovascular fitness and quality of life more.

Feasibility of Addressing the Spiritual Well-Being of Persons With Multiple Sclerosis: A Mixed-Methods Program Evaluation.

Spiritual well-being is an important aspect of health-related quality of life for persons with chronic illnesses such as multiple sclerosis (MS), yet research on interventions remains limited. To assess the feasibility of an occupational therapy intervention addressing the spiritual well-being of people with MS. Mixed-methods program evaluation using theoretical thematic analysis of qualitative data. Community center serving people with MS in a midwestern U.S. city. A total of 42 participants attended at least one session; 22 participants provided qualitative data. Ten met the inclusion criteria for quantitative analysis, including completion of pretest and posttest measures and attendance of at least half of the sessions. Making Meaning, a group intervention based on the Model of Occupational Wholeness, was conducted over eight weekly 45-min sessions. The focus was on exploring and integrating spiritual practices into daily life. Participants completed the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12-Item Scale (FACIT-Sp-12) to measure spiritual well-being and answered open-ended questions. Attendance was recorded and the facilitator and observers provided qualitative observations. Pretest-posttest comparisons of FACIT-Sp-12 scores indicated a moderate improvement in spiritual well-being (d = 0.41). Attendance and qualitative data supported the intervention's feasibility and suggested areas for refinement. Making Meaning is a feasible intervention, showing promise for promoting spiritual well-being for people with MS. Further research is warranted. Plain-Language Summary: This study introduces a practical and acceptable occupational therapy group intervention, Making Meaning, which shows promising potential for improving the spiritual well-being of people with multiple sclerosis.

Virtual Hybrid Versus In-Person Administration of Transcending Self Therapy for Veterans with Substance Use Disorders.

Veterans with substance use disorder (SUD) can show high severity and are at high risk of relapse due to trauma histories and other comorbid conditions. However, evidence-based SUD therapies may not be available to many veterans due to geographic or transportation constraints. Telehealth approaches have shown promise to improve access to different SUD therapy formats but have not been well-studied in open (rolling-admission) group therapy of in-person patients as administered by a single on-screen therapist. Social distancing required by the COVID-19 pandemic forced the transition of delivery of Transcending Self Therapy (TST) from an in-person therapist to a single remote (on-screen) therapist. In this virtual model, veterans continued to receive TST but the therapist was off site and provided therapy to veterans who were together in the same room during a 28 day residential Veterans Affairs treatment program. In a program evaluation, we compared their changes in quality of life (QoL), treatment satisfaction ratings and group therapy treatment outcomes with those of Veterans who received TST from an in-person therapist. In both groups, there was a significant increase in QoL Inventory scores from baseline to post-treatment, with no difference in improvement between treatment modalities (i.e., in-person group vs telehealth-delivered group). Veterans professed knowledge of therapy-driven skills at the end of treatment in both groups and overwhelmingly rated TST as helpful and understandable. These data extend previous findings of patient acceptability of remotely-delivered SUD treatment, here with a remote therapist administering open group therapy, as evidenced by improvement in QoL and positive patient feedback about the remote intervention.

READING AND TEXTING WHILE WALKING EFFECTS ON GAIT INDICES AMONG COLLEGIATE STUDENTS

Background: Dysmenorrhea divides into two type’s primary dysmenorrhea (PD) and secondary dysmenorrhea (SD). Dysmenorrhea with absence of pelvic abnormality is termed primary dysmenorrhea (PD) and is likely experience among young women population aged between 15 to 25 years. Despite the effectiveness of the exercise on managing PD, the immediate result of the intervention towards pain was not signified. The study aimed to evaluate the immediate effect of Brisk Walking (BW) with or without Music Therapy (MT) in reducing menstrual pain among youth with primary dysmenorrhea. Material and methods: This experimental study involving 102 female subjects with primary dysmenorrhea aged between 18 to 25 years were divided into two equal groups: a Brisk Walking group (n=51), and Brisk Walking with Music Therapy group (n=51). The menstrual pain was assessed using the Numeric Rating Scale (NRS) for pre and post-test taken within 2 menstrual cycle period. The Maximum Heart Rate of each subject were calculated prior Brisk Walking and exercise was conducted within 60 -70% of the individual’s Maximum Heart Rate for 20 minutes. The Music Therapy was completed in their home with music provided by researcher for 20 minutes duration. Results: The data was assessed using the Paired T-test and Independent T-test. The result within the group showed significant value with p<0.05 in both groups. Comparison between groups also showed significant difference p<0.05. Conclusion: A greater improvement was seen in the Brisk Walking with Music Therapy intervention group in managing primary dysmenorrhea. In specific, it is also proven that both study groups, Brisk Walking and Brisk Walking with Music Therapy promote pain reduction.

AN IMMEDIATE EFFECT OF BRISK WALKING WITH OR WITHOUT MUSIC THERAPY IN REDUCING MENSTRUAL PAIN AMONG YOUTH WITH PRIMARY DYSMENORRHEA

Background: Dysmenorrhea divides into two type’s primary dysmenorrhea (PD) and secondary dysmenorrhea (SD). Dysmenorrhea with absence of pelvic abnormality is termed primary dysmenorrhea (PD) and is likely experience among young women population aged between 15 to 25 years. Despite the effectiveness of the exercise on managing PD, the immediate result of the intervention towards pain was not signified. The study aimed to evaluate the immediate effect of Brisk Walking (BW) with or without Music Therapy (MT) in reducing menstrual pain among youth with primary dysmenorrhea. Material and methods: This experimental study involving 102 female subjects with primary dysmenorrhea aged between 18 to 25 years were divided into two equal groups: a Brisk Walking group (n=51), and Brisk Walking with Music Therapy group (n=51). The menstrual pain was assessed using the Numeric Rating Scale (NRS) for pre and post-test taken within 2 menstrual cycle period. The Maximum Heart Rate of each subject were calculated prior Brisk Walking and exercise was conducted within 60 -70% of the individual’s Maximum Heart Rate for 20 minutes. The Music Therapy was completed in their home with music provided by researcher for 20 minutes duration. Results: The data was assessed using the Paired T-test and Independent T-test. The result within the group showed significant value with p<0.05 in both groups. Comparison between groups also showed significant difference p<0.05. Conclusion: A greater improvement was seen in the Brisk Walking with Music Therapy intervention group in managing primary dysmenorrhea. In specific, it is also proven that both study groups, Brisk Walking and Brisk Walking with Music Therapy promote pain reduction.

Pengelolaan Diri dan Regulasi Emosi dengan Pendekatan Dialectical Behavior Therapy (DBT) Kelompok pada Gangguan Mood

Various interventions have been researched that are capable of reducing symptoms of mood disorders, including DBT (Goldstein et al., 2015; Van Dijk et al., 2013). In addition to individual interventions, group therapy interventions have also been widely used and proven to be effective in reducing symptoms of Bipolar disorder in participants (Costa et al., 2012; Rebeca et al., 2020). This study aims to examine the effectiveness of group therapy using a DBT approach on the emotional regulation and self-control of individuals with mood disorders. Group therapy was conducted on ten individuals with mood disorders. The Brief Self-Control Scale and Mindfulness Attention Awareness Scale were used as tools for quantitative data collection.Meanwhile, observation and interviews were conducted to assess group therapy's effectiveness qualitatively. The hypothesis testing results indicate no significant correlation between the two variables. These findings are helpful for the development of psychological interventions for individuals with mood disorders in Indonesia.

Effects of Acceptance and Commitment Therapy (ACT) group intervention for the treatment of anxiety in family carers of people with dementia: an exploratory randomised controlled trial

AbstractBackgroundThe prevalence of anxiety symptoms is estimated to be equal to or higher than the prevalence of depressive symptoms in family carers of people with dementia. However, anxiety is currently somehow neglected in the carer literature. Previous studies demonstrated that Acceptance and Commitment Therapy (ACT) is effective for treating anxiety symptoms in family carers of people with dementia, but these studies were mainly conducted in developed countries. The current study explored the effectiveness of an ACT group intervention on the anxiety symptoms in Brazilian family carers of people with dementia.MethodA single‐centre, unblinded, double‐arm exploratory randomised trial was conducted. Fifty‐seven family carers of people with dementia presenting with mild to severe anxiety symptoms were randomised to the intervention group (n = 29) or waiting list group (n = 28). The intervention group received eight weekly sessions of Group ACT, delivered through videoconference. Participants completed the measure of anxiety and depressive symptoms, caregiver burden, psychological flexibility and quality of life at Week 0, Week 9 and Week 20. Multiple linear regression analyses were performed to evaluate whether there was a significant difference in scores between the intervention and control groups, at week 9 and week 20, while controlling for the baseline scores using both intention‐to‐treat and completers data analyses.ResultParticipants were mostly women, from low‐ to middle‐income socioeconomic levels, with a mean age of 52 years and median education of 15 years. Participants in the intervention group had lower scores of anxiety and depression symptoms compared to participants in the control condition at weeks 9 and 20 in both the intention‐to‐treat and completer analyses. Only participants who attended six or more sessions (i.e. completer sample) demonstrated reduced caregiver burden at both follow‐up points. The completer sample also showed improvement in quality of life at week 9. The results did not show any effect of the intervention on psychological flexibility.ConclusionThis study provides evidence supporting the use of group ACT, delivered through videoconference, with family carers of people with dementia to help them cope better with anxiety and depressive symptoms.

A cognitive behavioural group treatment for somatic symptom disorder: a pilot study

BackgroundSomatic symptom disorder (SSD) presents challenges to the healthcare system, including frequent medical visits, lack of symptom relief experienced by individuals with this condition, high associated medical costs, and patient dissatisfaction. This study examined the utility of a novel, low-barrier, brief cognitive behavioural therapy (CBT) group intervention for individuals with SSD.MethodsParticipants were referred by their mental health providers or self-referral. Each participant underwent a telephone screen and in-person psychological and neuropsychological screen. Two cycles of the CBT-based group (n = 30), each consisting of six weekly two-hour sessions, were facilitated at a large outpatient mental healthcare facility in Ontario, Canada. The final sample consisted of 13 individuals of whom 11 completed the treatment. Clinical outcome measures were administered pre-, mid- and post-group, including the Generalized Anxiety Disorder–7, Perceived Stress Scale–4, Pain Self-Efficacy Questionnaire, Pain Disability Index, Revised Illness Perception Questionnaire, and sections of the Patient Health Questionnaire. Six healthcare utilization metrics were collected from electronic medical records at six months pre- and post-group. Paired samples t-tests were used to examine pre- to post-group differences in participants’ somatic symptoms, psychological functioning, health, and degree of healthcare utilization.ResultsWhen comparing pre- and post- group, we observed reductions in the mean scores for somatic symptom severity, depressive symptomatology, anxiety, perceived stress, and perceived disability related to pain. The change in depressive symptomatology yielded a small effect size (d = 0.30). Further, we observed downward trends across participants’ pre- to post-group healthcare utilization, with small effect sizes observed for hospital admission (d = 0.36), days admitted to hospital (d = 0.47), and inpatient consults (d = 0.42). Differences between pre- and post-group measures of somatic symptom severity, psychological functioning, health, or healthcare utilization did not reach significance.ConclusionsCurrent findings provide support for the potential effectiveness of an abbreviated CBT group for individuals with SSD in reducing psychiatric symptomatology. Further research is recommended, including randomized control trials, cost-benefit analyses, and comparisons between abbreviated versus longer-duration treatment programs for SSD.Trial registrationNot applicable.

Clinical efficacy of "Sancai therapy" for hyperplasia of the mammary glands: A systematic review and meta-analysis.

Hyperplasia of the mammary glands (HMG) is the most prevalent breast disease and can become malignant if left untreated. Although "Sancai therapy" has been widely used to treat HMG, its efficacy has not yet been systematically reviewed. This study aims to systematically evaluate the clinical efficacy of Sancai therapy for HMG treatment and provide a clinical basis for its future use. PubMed, Cochrane Library, Web of Science, EMBASE, CNKI, CBM, VIP, and Wanfang databases were reviewed for related data collection. Chinese and English databases were searched for randomized controlled trials on Sancai therapy for HMG. The retrieval date was February 27, 2023. Exclusion criteria: (1) Non-HMG patients; (2) case reports, literature reviews, animal experiments, systematic reviews; and (3) full text could not be obtained. Data obtained after literature screening were imported into the RevMan 5.4.1 software for meta-analysis, and the included literature was assessed for methodological quality using the "bias risk assessment" tool within the software. The meta-analysis included 11 studies. Compared to the control group, the Sancai therapy treatment group exhibited an overall increased efficacy (relative risk = 1.36, 95% confidence interval [CI] [1.18, 1.58], P < .0001), an increased cure rate (relative risk = 3.74, 95% CI [1.70, 8.25], P = .001), a significant improvement in breast pain (standard mean difference = -2.68, 95% CI [-3.41, -1.96], P < .00001), and a reduction in breast masses (standard mean difference = -2.87, 95% CI [-3.75, -1.99], P < .00001). Sancai therapy significantly improved the overall efficacy, cure rate, and breast pain and reduced breast mass compared with the control groups. However, further large-sample, high-quality, double-blind randomized controlled trials are required to increase the level of evidence. INPLASY202380124.

Effect of Vastus Medialis Oblique Strengthening Versus Mulligan Knee Taping Technique (Mcconnell Tape) on Patellofemoral Pain Syndrome: A Comparative Study.

This study aims to determine the effectiveness of Vastus medialis oblique (VMO) strengthening and conventional therapy treatment (group A) andMulligan knee taping technique(McConnell tape) and conventional therapy treatment (group B) in patients with patellofemoral pain syndrome by VAS for pain andKPS for anterior knee pain scale is to compare VMO strengthening Versus Mulligan knee taping technique using McConnell tape in patellofemoral pain syndromeusing VAS for assessing pain and Kujala patellofemoral scale to assess knee pain and function. The most frequent cause of knee discomfort with retro patellar orperipatellar pain is patellofemoral pain syndrome (PFPS). The need for further studies to better understand the causes and treatment of PFPS is essential to provideoptimal care for individuals experiencing pain in the knee. Physical therapy is considered the most effective treatment for PFPS, but more research is needed todetermine each individual's best course of action. Proper diagnosis is the key to successful treatment and prevention of PFPS. Early intervention is also important forbetter outcomes. Patellofemoral pain syndrome (PFPS), which is often used interchangeably with "anterior knee pain" or "runner's knee," is the clinical entity ofstiffness or pain or both on prolonged sitting with the knees flexed and pain with activities that load the patellofemoral joint, such as climbing or descending stairs,squatting, running and kneeling. Varieties of conservative treatments are suggested, like quadriceps strengthening, stretching, braces and straps, electrotherapy, footorthosis, patellar taping, etc. Hence, a comparison between the vastus medialis obliqus muscle strengthening and patellar taping was undertaken to determine theireffectiveness concerning pain and function. A well-organized research study was conducted over 12 months to investigate the impact of strengthening the vastusmedialis oblique muscle and applying conventional therapy treatment. Group A received this combination of treatments, while Group B was assigned a treatmentprotocol involving the use of McConnell tape along with conventional therapy treatment. After taking informed and written consent, 30 subjects diagnosed withunilateral or bilateral PFPS were randomly selected and allocated into two groups - Group A (VMO muscle strengthening and conventional therapy treatment) andGroup B (Mulligan knee taping technique (McConnell tape) and conventional therapy treatment). Both groups received 6 therapy sessions every alternate day for 6weeks. The visual analog scale (VAS) and Kujala patellofemoral scale (KPS) measured pre and post-pain and function. "T-Test" was used for statistical analysis. Therewas a significant improvement in pain and function in patients with Patellofemoral pain syndrome at the end of 6 weeks regarding VAS and KPS within both groups,i.e., groups A and B (p&lt;0.01). But there was no significant difference regarding improvement in pain and functional status in patients with Patellofemoral painsyndrome at the end of 6 weeks in terms of VAS and KPS between groups. The effect of conventional therapy treatment along with VMO muscle strengthening issimilar to the conventional therapy treatment along with patellar taping in improving pain and functional level in patients with patellofemoral pain syndrome at theend of 6 weeks.

3 Intensive Clinical Treatment and Rehabilitation for Veterans with Traumatic Brain Injury and Psychological Health Problems

Objective:Some active-duty military service members and veterans experience combinations of persistent traumatic stress, depression, suicidal ideation, anger, aggressive behavior, substance misuse, sleep disturbance, complicated grief, moral injury, headaches and migraines, chronic bodily pain, and cognitive weakness or deficits. The purpose of this study is to describe the clinical outcomes of active-duty service members and veterans who have completed the traumatic brain injury (TBI) and brain health track of a two-week intensive clinical treatment and rehabilitation program.Participants and Methods:The sample included 141 participants, with a history of TBI, in the Intensive Clinical Program (ICP). The ICP is a multidisciplinary, two-week treatment and rehabilitation program for active duty service members and veterans with complex psychological, cognitive, and physical health concerns. The program is comprised of daily individual therapy, group psychotherapy, psychoeducation, skills-building groups, and complementary and alternative medicine treatments. Participants in the ICP completed the following measures prior to initiating treatment and immediately following completion of treatment: Neurobehavioral Symptom Inventory (NSI), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Self-Efficacy for Symptom Management Scale (SE-SMS), and Patient-Reported Outcomes Measurement Information System (PROMIS)-Satisfaction with Participation in Social Roles and Activities-Short Form 8a, version 1.0 (PROMIS-S). Wilcoxon signed ranks tests were used to examine differences in scores on self-report measures from pretreatment to posttreatment for the full sample and within three subgroups stratified by age (in years: 20-34; 35-45; and 46-66). For the NSI, changes in the proportion of participants endorsing moderate or worse levels of individual symptoms from pretreatment to posttreatment were assessed using McNemar’s tests. Alpha levels were set at p&lt;0.05 for all analyses.Results:Participants reported statistically significant improvements across all of the administered measures (NSI, PCL-5, PHQ-9, PROMIS-S, and SE-SMS) upon conclusion of treatment. Effect sizes ranged from medium to large (d=0.34-1.04) for the full sample. Effect sizes were largely consistent across age subgroups (20-34: d=0.32-1.05; 35-45: d=0.55-0.96; 46-66: d=0.28-1.05). The magnitude of change on the SE-SMS appeared to be less with increasing age (20-34: d=1.05; 35-45: d=0.69; 46-66: d=0.28). Individual item analyses for the NSI revealed statistically significant reductions in the proportion of participants endorsing moderate or greater severity from pretreatment to posttreatment for 18 of 22 symptoms.Conclusions:Active duty service members and veterans participating in the two-week TBI and brain health intensive clinical program reported considerable symptom reduction at the conclusion of the program. Further research is indicated to assess the durability of symptom reduction.

Clinical Efficacy of Ulinastatin Combined with Azithromycin in the Treatment of Severe Pneumonia in Children and the Effects on Inflammatory Cytokines and Oxidative Stress: A Retrospective Cohort Study.

This retrospective cohort study aimed to evaluate the clinical efficacy of ulinastatin (UTI) and azithromycin (AZM) combination therapy in treating severe pneumonia in children and its impact on inflammatory cytokines and oxidative stress. This retrospective cohort study was conducted from January 1, 2019, to January 1, 2021, involving pediatric patients diagnosed with severe mycoplasma pneumonia (SMPP). The pediatric patients were divided into two groups: those receiving UTI and AZM combination therapy (treatment group) and those receiving azithromycin alone (control group). We compared the two groups regarding clinical data, disease outcomes, inflammatory cytokines, and oxidative stress levels. Baseline characteristics did not significantly differ between the two groups. UTI, in combination with AZM, significantly improved blood oxygen levels, inflammatory infection markers, and relevant clinical symptoms in patients with SMPP on the 3rd day of treatment. Additionally, it significantly reduced the levels of inflammatory cytokines TNF-a, IL-6, IL-1β, and IL-10, as well as oxidative stress markers GSH and SOD. Combining UTI and AZM can rapidly alleviate clinical symptoms and effectively control the progression of patients with SMPP. Therefore, this treatment approach deserves consideration for clinical promotion and utilization.

Music therapy modulates mothers’ perception of their preterm infants

Premature birth imposes considerable challenges on the preterm infant, but also challenges the mother, who may not yet be prepared for motherhood and encounter psychological stress during the post-partum period. This secondary analysis of a prospective randomized controlled trial (RCT) aimed to investigate how mothers perceive their preterm infants. We surveyed 33 mothers of preterm infants born before 32 weeks of gestation, who were participating in an RCT on music therapy. We employed the neonatal perception inventory (NPI), an instrument designed to assess the mother’s perception and expectations regarding her infant immediately after birth. Infants were randomly assigned to either standard care (control group) or standard care plus music therapy (intervention group). Eighteen mothers from the intervention group participated in the survey (mean age 34.1 ± 4.6 years) and 15 mothers from the control group (mean age 29.6 ± 4.2 years). At the time of the infant’s hospital discharge, mothers rated their expectations of how they felt a baby should behave (NPI I) and how they perceived their own infant (NPI II). The NPI score difference was calculated by subtracting the NPI II from the NPI I. Mean NPI I scores were comparable between both groups, but NPI II scores in the intervention group were better [18.0, 95% confidence interval (CI) 16.6–19.4] than in the control group (19.1, 95% CI 18.0–20.3). The relative probability of mothers rating their own baby as better than average was 1.94 (95% CI 1.00–3.79) for mothers whose infants received music therapy. These findings suggest that music therapy in the neonatal intensive care unit can positively influence mothers’ perception of their hospitalized preterm infant.

Effect of music therapy intervention on anxiety and pain during percutaneous renal biopsy: a randomized controlled trial.

Percutaneous renal biopsy (PRB) may subject patients to emotional distress and pain before and during the biopsy. The aim of this study was to evaluate the effects of complementary/non-pharmacological interventions such as music therapy (MT) on anxiety, pain and satisfaction in renal patients undergoing PRB. A prospective, single-centre, single-blind, randomized controlled two-arm trial was conducted. Patients ≥18years of age, hospitalized at the Nephrology, Dialysis and Transplantation Unit (Bari, Italy) and scheduled for PRB were screened. Participants were assigned to standard treatment (CG) or to the music therapy (MT) intervention group. Participants in the MT group received standard care and an MT intervention by a certified music therapist qualified in guided imagery and music. The CG patients received the standard of care. MT and CG patients were subjected to identical measurements (pre/post) of the parameters in the State Trait Anxiety Inventory Y1 (STAI-Y1), visual analogue scale for pain (VAS-P) and satisfaction (VAS-S) and heart rate variability. A statistically significant difference in the anxiety scores after PRB between MT and CG patients (STAI-Y1 35.4±6.2 versus 42.9±9.0) was observed. MT also had strong and significant effects on VAS-P compared with CG (5.0±1.4 versus 6.3±1.3, respectively; P<.001) and VAS-S (7.8±1.0 versus 6.0±0.9, respectively; P<.001). Decreased activity of the sympathetic nervous system and increased activity of the parasympathetic nervous system was observed after PRB in the MT group. Our study supports the use of MT to mitigate the psychological anxiety, pain and sympathetic activation associated with PRB.

Online remote behavioural intervention for tics in 9- to 17-year-olds: the ORBIT RCT with embedded process and economic evaluation

Background Behavioural therapy for tics is difficult to access, and little is known about its effectiveness when delivered online. Objective To investigate the clinical and cost-effectiveness of an online-delivered, therapist- and parent-supported therapy for young people with tic disorders. Design Single-blind, parallel-group, randomised controlled trial, with 3-month (primary end point) and 6-month post-randomisation follow-up. Participants were individually randomised (1 : 1), using on online system, with block randomisations, stratified by site. Naturalistic follow-up was conducted at 12 and 18 months post-randomisation when participants were free to access non-trial interventions. A subset of participants participated in a process evaluation. Setting Two hospitals (London and Nottingham) in England also accepting referrals from patient identification centres and online self-referrals. Participants Children aged 9–17 years (1) with Tourette syndrome or chronic tic disorder, (2) with a Yale Global Tic Severity Scale-total tic severity score of 15 or more (or &gt; 10 with only motor or vocal tics) and (3) having not received behavioural therapy for tics in the past 12 months or started/stopped medication for tics within the past 2 months. Interventions Either 10 weeks of online, remotely delivered, therapist-supported exposure and response prevention therapy (intervention group) or online psychoeducation (control). Outcome Primary outcome: Yale Global Tic Severity Scale-total tic severity score 3 months post-randomisation; analysis done in all randomised patients for whom data were available. Secondary outcomes included low mood, anxiety, treatment satisfaction and health resource use. Quality-adjusted life-years are derived from parent-completed quality-of-life measures. All trial staff, statisticians and the chief investigator were masked to group allocation. Results Two hundred and twenty-four participants were randomised to the intervention (n = 112) or control (n = 112) group. Participants were mostly male (n = 177; 79%), with a mean age of 12 years. At 3 months the estimated mean difference in Yale Global Tic Severity Scale-total tic severity score between the groups adjusted for baseline and site was −2.29 points (95% confidence interval −3.86 to −0.71) in favour of therapy (effect size −0.31, 95% confidence interval −0.52 to −0.10). This effect was sustained throughout to the final follow-up at 18 months (−2.01 points, 95% confidence interval −3.86 to −0.15; effect size −0.27, 95% confidence interval −0.52 to −0.02). At 18 months the mean incremental cost per participant of the intervention compared to the control was £662 (95% confidence interval −£59 to £1384), with a mean incremental quality-adjusted life-year of 0.040 (95% confidence interval −0.004 to 0.083) per participant. The mean incremental cost per quality-adjusted life-year gained was £16,708. The intervention was acceptable and delivered with high fidelity. Parental engagement predicted child engagement and more positive clinical outcomes. Harms Two serious, unrelated adverse events occurred in the control group. Limitations We cannot separate the effects of digital online delivery and the therapy itself. The sample was predominately white and British, limiting generalisability. The design did not compare to face-to-face services. Conclusion Online, therapist-supported behavioural therapy for young people with tic disorders is clinically and cost-effective in reducing tics, with durable benefits extending up to 18 months. Future work Future work should compare online to face-to-face therapy and explore how to embed the intervention in clinical practice. Trial registration This trial is registered as ISRCTN70758207; ClinicalTrials.gov (NCT03483493). The trial is now complete. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Technology Assessment programme (project number 16/19/02) and will be published in full in Health and Technology Assessment; Vol. 27, No. 18. See the NIHR Journals Library website for further project information.

Short-term Outcome of Social Skills Group Therapy Intervention in School Aged Children With Autism

Short-term Outcome of Social Skills Group Therapy Intervention in School Aged Children With Autism