Intervention Group Members Research Articles

The Concept of a Large Group-Based Approach for Intensive Smoking Cessation: The Gold Standard Program (GSP)

In this study, the effect of the intensive “Quitter” intervention for smoking cessation was examined and compared to the standardized intensive intervention used in Denmark. The Quitter intervention, based on the Gold Standard Program (Q-GSP), involves large groups of approximately 70 participants, while the standardized GSP typically involves groups of 10–15 participants. In total, 105 and 14,289 smokers participated in the Q-GSP and the standardized GSP, respectively, between 2022 and 2023. Data from the Danish STOPbase database were used, with validated information from one municipality for the Q-GSP. Successful smoking cessation was defined as abstinence from smoking at the end of the intervention and continuous abstinence at the 6-month follow-up. The results showed that 73% of the participants in the Quitter group successfully stopped smoking at the end of the interventions, compared to 50% in the standardized I-SCI group. At the 6-month follow-ups, 49% of the Quitter intervention group members maintained abstinence versus 31% of the standardized I-SCI group, with a statistically significant relative risk (RR) of 2.18 (95% CI 1.48–3.22). Compliance and satisfaction were high in both groups. These findings indicate the potential for large group-based interventions to be broadly integrated into public health strategies.

Coated oregano essential oil and cinnamaldehyde compounds supplementation improves growth performance, enhances immune responses, and inhibits cecal Escherichia coli proliferation of broilers.

Plant essential oils are unstable due to high volatility and easy oxidation, while microencapsulation provides a potentially effective strategy for increasing the stability of natural essential oils and preserving their function. This study examined the effects of feeding coated oregano essential oil and cinnamaldehyde (COEC) compounds on growth, immune organ development, intestinal morphology, mucosal immune function, and the cecal microbiota populations of broilers. Three hundred one-day-old male Arbor Acres broiler chicks were organized into 5 groups: 1) negative control fed basal diet alone (NC), 2) positive control receiving basal diet plus 50mg/kg of chlortetracycline (CTC), 3) basal diet plus 150mg/kg COEC (COEC150), 4) plus 300mg/kg COEC (COEC300), and 5) plus 450mg/kg COEC (COEC450). The supplement trial was continued for 42 d. The results showed that CTC, COEC300, and COEC450 treatments decreased the feed conversion ratio of broilers both in the starter and whole experiment phases, increased the height of jejunal villi at 21 d and the number of goblet cells and IgA-producing cells at 21 or 42 d compared with NC group (P < 0.05). Members of the COEC300 treatment group had a higher thymus weight index and jejunum length index than birds of NC or CTC groups at 21 d (P < 0.05). CTC and all COEC treatments decreased malondialdehyde content in jejunal mucosa at 42 d (P < 0.05). The population of Escherichia coli (E. coli) in the cecal digesta at 21 d was lower in the CTC, COEC300, and COEC450 treatment groups compared with the NC group (P < 0.05). In contrast to the CTC group, COEC supplementation dose-dependently accelerated body weight gain, improved jejunal morphology, decreased malondialdehyde content in jejunal mucosa, increased numbers of jejunal goblet cells and IgA-producing cells, and decreased the E. coli population in cecal digesta at 21 or 42 d (P < 0.05). Thus, we concluded that feeding broiler chickens with 300 or 450mg/kg in antibiotic-free diets can improve growth performance, enhance immune responses, and inhibit the proliferation of cecal pathogenic bacteria.

Effectiveness of the MyDiaMate application in reducing diabetes distress in adults with type 1 diabetes: Study protocol of the multi-national, randomised-controlled MyREMEDY trial.

Diabetes distress is common among people with type 1 diabetes (T1D), negatively affecting quality of life, self management, and diabetes outcomes. E-health-based interventions could be an effective and low-cost way to improve the psychological care for people with T1D experiencing diabetes distress. The MyREMEDY study aims to test the effectiveness of the online unguided self-help intervention MyDiaMate in decreasing diabetes distress in adults with T1D. MyDiaMate is based on Cognitive Behavioural Therapy and consists of eight modules, each focusing on a different aspect of living with T1D that is often experienced as burdensome (e.g. hypoglycaemia, fatigue). The effectiveness of MyDiaMate will be tested through a randomised-controlled trial across four European countries (the Netherlands, Germany, Spain and the United Kingdom). Six hundred and sixty adults (N = 165 per country) with T1D will be recruited and randomised with a balance of 2:1 into the intervention and care as usual groups. Intervention group members receive access to MyDiaMate for 6 months, care as usual group members receive access after 3 months for 3 months. Participants fill in questionnaires at 0 (baseline), 3 (effectiveness) and 6 months (follow-up). Primary outcome is diabetes distress at 3 months. Secondary outcomes are emotional well-being, psychological self-efficacy in relation to diabetes, social engagement, fatigue, and glycaemic outcomes. Moreover, logdata of MyDiaMate use is passively collected. Linear mixed model analyses will be used to test the effectiveness of MyDiaMate along with identifying which user subgroup benefits most from MyDiaMate use. Clinicaltrials.gov NCT06308549.

The Effect of Gastrointestinal Mucositis Care Training Given to Pediatric Leukemic Patients and Caregivers on Mucosal Barrier Injury

Background Management of chemotherapy-induced mucosal barrier damage and oral/anal mucositis in leukemia is challenging. Objective The aim of this study was to investigate the effect of mucositis care training given to children receiving leukemia treatment and their caregivers on caregiver knowledge and skills, the development of gastrointestinal mucositis in children, the mean oral mucositis area in children, and the mucosal barrier injury laboratory-confirmed bloodstream infection in the clinic. Methods A stepped-wedge, quasi-experimental, unpaired control group design was used. The participants in the control group were given routine training, and the intervention group members were given mucositis care training in accordance with the guideline recommendations. Results No significant difference was found between groups in developing anal mucositis, but a significant difference in developing oral mucositis was documented, with the mean mucositis area of children being 8.36 ± 3.97 cm2 in the control group and 4.66 ± 2.90 cm2 in the intervention group. The mucosal barrier injury laboratory-confirmed bloodstream infection ratio was 4 per 1000 catheter days in the control group and 3 per 1000 catheter days in the intervention group. Conclusion Mucositis care training had a significant positive effect on caregivers’ knowledge and skills, the development of oral mucositis, and the mean oral mucositis area in children. However, the training had no effect on the development of anal mucositis or the infection rate in the clinic. Implications for Practice Nurses might increase the knowledge and skill levels of caregivers with training on mucositis care, prevent the development of mucositis, and reduce the mean mucositis area. Training might also contribute to the reduction in the infection rate of the clinic.

A Quasi-Experimental Clinical Trial of the Detached Mindfulness Group Therapy for Married Women with Major Depressive Disorder

Background: In an effort to make psychotherapy more widely available, group therapy sessions have recently emerged as a type of treatment. Although there is a lack of evidence about the effectiveness of psychotherapy groups in treating Major Depressive Disorder (MDD) in adults, literature shows that married women with a diagnosis of MDD could benefit from these treatments. Objective: This research aims to shed light on a quasi-experimental trial of the Detached Mindfulness Group Therapy (DMGT) for married women with a diagnosis of MDD. Methods: This study examined the effect of a twelve-week intervention in a quasi-experimental trial by using a pre- and post-intervention design. Results. Based on the results, the DMGT treatment is an effective strategy for treating major depressive disorder. It was found to have a large significant pre-post effect sizes on self-reported depressive symptoms, level of depression, and knowledge development. The level of satisfaction with the intervention was quite high. Conclusions: The strong evidence on treatment protocol acceptability, effect magnitude, outcome variance, and group members variables strongly support a future study to test the effectiveness of the DMGT among married women. Quasi-experimental trials should be used in future studies to determine the effectiveness of this DMGT treatment.

Effect of Adding Personalized Instant Messaging Apps to a Brief Smoking Cessation Model in Community Smokers in Hong Kong: Pragmatic Randomized Clinical Trial.

While text messaging has proven effective for smoking cessation (SC), engagement in the intervention remains suboptimal. This study aims to evaluate whether using more interactive and adaptive instant messaging (IM) apps on smartphones, which enable personalization and chatting with SC advisors, can enhance SC outcomes beyond the provision of brief SC advice and active referral (AR) to SC services. From December 2018 to November 2019, we proactively recruited 700 adult Chinese daily cigarette users in Hong Kong. Participants were randomized in a 1:1 ratio. At baseline, all participants received face-to-face brief advice on SC. Additionally, they were introduced to local SC services and assisted in selecting one. The intervention group received an additional 26 personalized regular messages and access to interactive chatting through IM apps for 3 months. The regular messages aimed to enhance self-efficacy, social support, and behavioral capacity for quitting, as well as to clarify outcome expectations related to cessation. We developed 3 sets of messages tailored to the planned quit date (within 30 days, 60 days, and undecided). Participants in the intervention group could initiate chatting with SC advisors on IM themselves or through prompts from regular messages or proactive inquiries from SC advisors. The control group received 26 SMS text messages focusing on general health. The primary outcomes were smoking abstinence validated by carbon monoxide levels of <4 parts per million at 6 and 12 months after the start of the intervention. Of the participants, 505/700 (72.1%) were male, and 450/648 (69.4%) were aged 40 or above. Planning to quit within 30 days was reported by 500/648 (77.2%) participants, with fewer intervention group members (124/332, 37.3%) reporting previous quit attempts compared with the control group (152/335, 45.4%; P=.04). At the 6- and 12-month follow-ups (with retention rates of 456/700, 65.1%, and 446/700, 63.7%, respectively), validated abstinence rates were comparable between the intervention (14/350, 4.0%, and 19/350, 5.4%) and control (11/350, 3.1% and 21/350, 6.0%) groups. Compared with the control group, the intervention group reported greater utilization of SC services at 12 months (RR 1.26, 95% CI 1.01-1.56). Within the intervention group, engaging in chat sessions with SC advisors predicted better validated abstinence at 6 months (RR 3.29, 95% CI 1.13-9.63) and any use of SC services (RR 1.66, 95% CI 1.14-2.43 at 6 months; RR 1.67, 95% CI 1.26-2.23 at 12 months). An IM-based intervention, providing support and assistance alongside brief SC advice and AR, did not yield further increases in quitting rates but did encourage the utilization of SC services. Future research could explore whether enhanced SC service utilization leads to improved long-term SC outcomes. ClinicalTrials.gov NCT03800719; https://clinicaltrials.gov/ct2/show/NCT03800719.

Acute Diabetes Complications After Transition to a Value-Based Medication Benefit

The association of value-based medication benefits with diabetes health outcomes is uncertain. To assess the association of a preventive drug list (PDL) value-based medication benefit with acute, preventable diabetes complications. This cohort study used a controlled interrupted time series design and analyzed data from a large, national, commercial health plan from January 1, 2004, through June 30, 2017, for patients with diabetes aged 12 to 64 years enrolled through employers that adopted PDLs (intervention group) and matched and weighted members with diabetes whose employers did not adopt PDLs (control group). All participants were continuously enrolled and analyzed for 1 year before and after the index date. Subgroup analysis assessed patients with diabetes living in lower-income and higher-income neighborhoods. Data analysis was performed between August 19, 2020, and December 1, 2023. At the index date, intervention group members experienced employer-mandated enrollment in a PDL benefit that was added to their follow-up year health plan. This benefit reduced out-of-pocket costs for common cardiometabolic drugs, including noninsulin antidiabetic agents and insulin. Matched control group members continued to have cardiometabolic medications subject to deductibles or co-payments at follow-up. The primary outcome was acute, preventable diabetes complications (eg, bacterial infections, neurovascular events, acute coronary disease, and diabetic ketoacidosis) measured as complication days per 1000 members per year. Intermediate measures included the proportion of days covered by and higher use (mean of 1 or more 30-day fills per month) of antidiabetic agents. The study 10 588 patients in the intervention group (55.2% male; mean [SD] age, 51.1 [10.1] years) and 690 075 patients in the control group (55.2% male; mean [SD] age, 51.1 [10.1] years) after matching and weighting. From baseline to follow-up, the proportion of days covered by noninsulin antidiabetic agents increased by 4.7% (95% CI, 3.2%-6.2%) in the PDL group and by 7.3% (95% CI, 5.1%-9.5%) among PDL members from lower-income areas compared with controls. Higher use of noninsulin antidiabetic agents increased by 11.3% (95% CI, 8.2%-14.5%) in the PDL group and by 15.2% (95% CI, 10.6%-19.8%) among members of the PDL group from lower-income areas compared with controls. The PDL group experienced an 8.4% relative reduction in complication days (95% CI, -13.9% to -2.8%; absolute reduction, -20.2 [95% CI, -34.3 to -6.2] per 1000 members per year) compared with controls from baseline to follow-up, while PDL members residing in lower-income areas had a 10.2% relative reduction (95% CI, -17.4% to -3.0%; absolute, -26.1 [95% CI, -45.8 to -6.5] per 1000 members per year). In this cohort study, acute, preventable diabetes complication days decreased by 8.4% in the overall PDL group and by 10.2% among PDL members from lower-income areas compared with the control group. The results may support a strategy of incentivizing adoption of targeted cost-sharing reductions among commercially insured patients with diabetes and lower income to enhance health outcomes.

Effects of an Informal Place-based Educational Program on Knowledge and Perceptions of Invasive Species Management

Invasive species can generate negative impacts environmentally, socially, and economically. The interplay between human and natural systems renders management a complex problem that must be addressed by decision-makers. Perceptions of invasive species issues varies depending on an individual’s access to information. Although invasive species and their management are often discussed in formal higher education, not all members of the population have access to a formal educational setting. Informal educational experiences may be a mechanism to reach out to community members in a more accessible and perhaps engaging way than traditional higher education classroom experiences. The purpose of this study was to determine the effect of an informal, place-based educational program on perceptions and knowledge of invasive species and their management within the community. Place-based education is a pedagogy connection local places with intimate knowledge of the systems, processes, and outcomes that give it meaning to human and non-human species. First, we organized and administered short walks in two central Texas, USA, parks with conversational lessons and hands-on learning experiences. Second, we administered a follow-up retrospective-reflective survey to measure participants’ knowledge and perceptions of invasive species management and postwalk/lesson changes in them. We also compared between the treatment group of participants versus a control group within the community who did not participate in the informal lessons. Fifty-two people participated in both the educational program walks and testing over the course of 1 year, and 63 people were included in the follow-up retrospective-reflective survey control group. Results indicate a statistically significant positive change in knowledge and perception categories within the treatment group. Post hoc results indicate a positive change in knowledge and perceptions in our sample as a function of treatment group members’ age and income, respectively. The methodology used in this study was simple and inexpensive. Hence, our approach could be easily replicated in other areas to educate community members.

Rosie, a Health Education Question-and-Answer Chatbot for New Mothers: Randomized Pilot Study.

Stark disparities exist in maternal and child outcomes and there is a need to provide timely and accurate health information. In this pilot study, we assessed the feasibility and acceptability of a health chatbot for new mothers of color. Rosie, a question-and-answer chatbot, was developed as a mobile app and is available to answer questions about pregnancy, parenting, and child development. From January 9, 2023, to February 9, 2023, participants were recruited using social media posts and through engagement with community organizations. Inclusion criteria included being aged ≥14 years, being a woman of color, and either being currently pregnant or having given birth within the past 6 months. Participants were randomly assigned to the Rosie treatment group (15/29, 52% received the Rosie app) or control group (14/29, 48% received a children's book each month) for 3 months. Those assigned to the treatment group could ask Rosie questions and receive an immediate response generated from Rosie's knowledgebase. Upon detection of a possible health emergency, Rosie sends emergency resources and relevant hotline information. In addition, a study staff member, who is a clinical social worker, reaches out to the participant within 24 hours to follow up. Preintervention and postintervention tests were completed to qualitatively and quantitatively evaluate Rosie and describe changes across key health outcomes, including postpartum depression and the frequency of emergency room visits. These measurements were used to inform the clinical trial's sample size calculations. Of 41 individuals who were screened and eligible, 31 (76%) enrolled and 29 (71%) were retained in the study. More than 87% (13/15) of Rosie treatment group members reported using Rosie daily (5/15, 33%) or weekly (8/15, 53%) across the 3-month study period. Most users reported that Rosie was easy to use (14/15, 93%) and provided responses quickly (13/15, 87%). The remaining issues identified included crashing of the app (8/15, 53%), and users were not satisfied with some of Rosie's answers (12/15, 80%). Mothers in both the Rosie treatment group and control group experienced a decline in depression scores from pretest to posttest periods, but the decline was statistically significant only among treatment group mothers (P=.008). In addition, a low proportion of treatment group infants had emergency room visits (1/11, 9%) compared with control group members (3/13, 23%). Nonetheless, no between-group differences reached statistical significance at P<.05. Rosie was found to be an acceptable, feasible, and appropriate intervention for ethnic and racial minority pregnant women and mothers of infants owing to the chatbot's ability to provide a personalized, flexible tool to increase the timeliness and accessibility of high-quality health information to individuals during a period of elevated health risks for the mother and child. ClinicalTrials.gov NCT06053515; https://clinicaltrials.gov/study/NCT06053515.

EXAMINING A RANDOMLY ASSIGNED MUSIC PROGRAM ON STRESS AND WELLNESS: CARE PARTNERS OF OLDER ADULTS LIVING WITH DEMENTIA

Abstract OBJECTIVE The Mason CARES study examined the effects of a randomly assigned personalized music intervention (Phase II) for care partners of older adults living with dementia after implementation of a 9-week virtual stress management program (Phase I) to reduce stress and increase well-being. METHODS A total of 99 care partners completed the 20-week study across three cohorts in 2022. Baseline data on care partner stress levels and well-being were collected before beginning a 9-week stress management program (Phase I). Care partners were randomly assigned to a 4-week music intervention treatment or control group before the next stage of the intervention (Phase II). Researchers assisted care partners with identifying their family member’s favorite music during early adulthood years. MP3 players loaded with the favorite music were mailed to treatment group members. Focus groups were conducted to explore the utilization of personalized music. RESULTS: Nearly half (49%) were spousal care partners, ranging from 35-85 years old with 80% having at least a 4-year college degree, and 62% having an income greater than $70,000. Using ANOVAs to analyze mean stress levels and well-being, no significant differences in stress and well-being were found between the treatment and control groups. CONCLUSION: Despite the lack of statistically significant findings, preliminary analysis of focus group interviews revealed that many care partners benefited from the personalized music intervention. Effectiveness may depend on other factors, such as familiarity with using the technology, past experiences with music, care partner’s baseline level of stress, and the older adult’s stage of dementia.

Evaluating the impact of human rights education on the adjustment of Greek primary school students.

Human rights education has an encouraging effect on children's school routine. The aim of the present study was to investigate the effectiveness of a 12-session transformative human rights education intervention in improving children's school adjustment. Participants were 340 Greek primary school students assigned to intervention group (n = 187) and control group (n = 153). All members completed a written questionnaire 1 week before the implementation of the intervention, measuring their knowledge of human rights, school engagement, perceptions of the school environment, interpersonal relationships, empathy and perceptions, attitudes and feelings towards school. The completion process of the same questionnaire was repeated 1 week after the termination of the intervention and 4 months later. The results showed that the intervention was particularly beneficial as the intervention group members demonstrated a significant increase in their knowledge of human rights, school engagement, perceptions of the school environment, empathy and school liking, while experiencing a significant decrease in school avoidance and loneliness. Members of the control group did not report any significant improvement over time. The study's implications for future research on school-based human rights interventions are discussed.

Making a SmartStart for peanut introduction to support food allergy prevention guidelines for infants.

Food allergy affects up to 10% of Australian infants. It was hypothesized that if parents follow the Australasian Society of Clinical Immunology and Allergy guidelines, Australian food allergy rates may stabilize or decline. This project aimed to determine whether SmartStartAllergy influenced parental introduction of peanut by age 12 months, including in high-risk infants. SmartStartAllergy integrates with general practice management software to send text messages to parents via participating general practices. The intervention group participants were sent text messages when their child was aged 6, 9, and 12 months; the control group participants were parents of 12-month-old infants. When their child was aged 12 months, all participants completed a questionnaire regarding eczema and family history of atopy. Infants with severe eczema and/or a family history of atopy were considered high-risk. Between 21 September 2018 and 26 April 2022, a total of 29,092 parents were enrolled in SmartStartAllergy as intervention (n= 18,090) and control (n= 11,002) group members The intervention group was more likely to introduce peanut by 12 months (crude odds ratio= 5.18; P< .0001; 95% CI= 4.35-6.16). After adjustment for the infants' level of risk and family history of atopy and food allergy, the intervention group was more likely to introduce peanut by 12 months of age (adjusted odds ratio= 5.34; P< .01; 95% CI= 4.48-6.37). SmartStartAllergy appears to be an effective tool for encouraging parental introduction of peanut. The ability to provide parents with credible allergy prevention information, along with the capacity to collect simple responses via text along with additional information via an online questionnaire, make this a useful public health tool.

Impact of Data-Driven Feedback and Coaching on Preservice Teachers’ Questioning Skills for Higher-Order Thinking within a Mixed-Reality Simulation Environment

In this exploratory study, constructs related to self-efficacy theory were embedded in a treatment to improve the use of higher-order thinking (HOT) questioning skills in candidates enrolled in a teaching-methods course enhanced by mixed-reality simulations (MRS). The problem of designing an effective feedback and coaching model to improve the delivery of HOT questions in 10 min lessons was addressed. Thirty undergraduates were asked to incorporate HOT questions into each of the three lessons presented during a 15-week semester. Treatment candidates received individual data-driven feedback and coaching that included tailored guidance provided at regular intervals throughout the term. Quantitative analyses indicated that there was no significant difference in self-efficacy between conditions and that treatment group members posed significantly more HOT questions in their lessons (effect size = 1.26) than their non-treatment peers. An optimal ratio of two knowledge/comprehension to one HOT question in a 10 min period was proposed and three criteria for high-quality HOT questions are presented. Interviews revealed that those who participated in the treatment were more likely to recognize improvements in their self-efficacy, lesson planning, and performance than comparison group members. Data-driven feedback and coaching also provided candidates with opportunities for reflection.

An internet-based photography therapy intervention into the grief of persons who have lost a loved one

ABSTRACT Persons who have lost a loved one by death are increasingly searching for support from online peer groups to process their grief. One approach involves sharing photographs with peers online. The purpose of this study was to assess the impact of a four-week internet-based photography therapy intervention concerning participants’ grief reactions using the Hogan Grief Reaction Checklist (HGRC). Another aim was to assess the role of the moderator and describe development targets in the internet-based photography therapy group based on the participants’ experiences. The participants were individuals who had lost a loved one divided into an intervention group (n = 101) and a comparison group (n = 55). The changes in the dimensions of grief of the intervention group members were slightly greater than in the comparison group. The dimension of panic behaviour declined statistically significantly more in the intervention than in the comparison group during the follow-up period. While the participants from the intervention group valued the expertise of the moderator, the moderator’s role could have been more visible. The participants also wished that the therapeutic photography group would have included more active involvement. Additionally, the participants made suggestions on modifying intervention content and developing a platform better suited for sharing photographs.

The Effect of Body Relaxation Techniques on Pre-Eclampsia Syndrome.

Hypertension in the second trimester of pregnancy is accompanied by proteinuria that is called Preeclampsia Syndrome (PES). Body relaxation is a technique which makes harmony between mind and body. The aim of this study was to investigate the effect of Body Relaxation Technique (BRT) on some symptoms of Preeclampsia Syndrome (PES). This clinical trial was conducted on 96 high-risk pregnant women who were selected by random sampling method from among women referring to community health centers of Isfahan city. The samples were divided into intervention and control groups by even and odd numbers. The intervention group members received BRT during 16 sessions. Blood pressure and proteinuria were measured and recorded before and after the intervention in both groups at the beginning and in the 36th week of pregnancy. The collected data were analyzed. According to the Chi-square test, the frequency of PES was 11.10% and 23.50% in the intervention and control groups, respectively (χ2 = 3.95, df = 1, p = 0.046). After the intervention, there was no significant difference between the two groups in terms of the diastolic blood pressure and proteinuria. Systolic blood pressure and stress were also significantly reduced in the intervention group. However, proteinuria was not significantly different between the two groups. Based on the results, the relaxation technique, as an easy technique, is recommended for pregnant women who are susceptible to pregnancy hypertension and preeclampsia. Moreover, as a clinical complementary method, it can be recommended for preventing the symptoms of PES.

Postoperative Outcomes of a Digital Rehabilitation Program After Total Knee Arthroplasty: Retrospective, Observational Feasibility Study.

BackgroundSurgery can sometimes be the best solution for chronic musculoskeletal pain, but presurgical preparation and postsurgical rehabilitation are often required to achieve the maximum benefits. A digital musculoskeletal surgical care program was developed to support the population of patients undergoing total knee arthroplasty.ObjectiveWe aimed to demonstrate safety, engagement, and acceptability and explore clinical outcomes, health care use, and satisfaction among participants of a digital musculoskeletal surgical care program who were undergoing total knee arthroplasty.MethodsA retrospective, observational feasibility study comparing digital musculoskeletal surgical care program participants to a comparison group was conducted. The intervention group registered for a digital musculoskeletal surgical care program, which included health coaches, physical therapists, and tailored exercises and educational articles to provide preoperative and postoperative support to patients who had recently undergone total knee arthroplasty. Comparison group members received standard-of-care treatment. Engagement (number of exercise therapy sessions and educational articles accessed per week) and acceptability (Net Promoter Score) were examined among intervention group participants. Descriptive statistics for postoperative outcomes, including safety (postoperative complications), clinical improvement (pain, function, anxiety, and depression), and health care use and experiences (length of hospital stay, surgery satisfaction, and physical therapy adherence), were reported for both groups. Differences among postoperative results were compared by using the independent samples 2-tailed t test or Mann-Whitney test for continuous outcomes and the Fisher exact test or chi-square test for categorical outcomes.ResultsOf the 53 participants (intervention group: n=22; comparison group: n=31) who were included in this study, 35 (66%) were female and 25 (47%) were aged from 45 to 60 years. On average, the intervention group completed 23 exercise sessions, read 2.7 educational articles, sent 45.5 texts to their health coaches, and were actively engaged for 6 weeks after their operation. Among 21 participants, 14 (67%) self-reported as promoters on the Net Promoter Score scale. Intervention group members reported fewer postoperative complications (6/22, 27%) than the comparison group (15/31, 48%), and they experienced better outcomes with regard to function (Knee Injury and Osteoarthritis Outcome Score–Physical Function Short Form—intervention group: mean 23.0; comparison group: mean 32.5), depression (Patient Health Questionnaire 2-Item—intervention group: mean 0.4; comparison group: mean 1.6), anxiety (General Anxiety Disorder 2-Item—intervention group: mean 0.6; comparison group: mean 1.5), and impressions of change (Patient Global Impression of Change—intervention group: median 7.0; comparison group: median 6.0). Intervention group participants also reported less health care use, better adherence to their physical therapy exercises, and higher surgery satisfaction.ConclusionsOur digital musculoskeletal surgical care program shows promising levels of engagement and acceptability among those who recently underwent total knee arthroplasty. The surgical care program may also help with improving postsurgical complications and clinical outcomes and lowering health care use.

Медицинская реабилитация в спорте высших достижений после реконструкции передней крестообразной связки коленного сустава

The professional activity of high performance, or elite sportsmen involves loads approaching extreme exertion, which often leads to injuries of the lower limbs. Anterior cruciate ligament (ACL) injury is one of the most common types of knee injuries. This study aimed to evaluate the effectiveness of a comprehensive rehabilitation program for athletes that underwent arthroscopic ACL reconstruction. The study involved 64 athletes aged from 17 to 31 years. Treatment group participants were offered a comprehensive medical rehabilitation program that included isokinetic training sessions on the TECNOBODY IsoMove biomechanical exercising machine; the sessions followed a purpose-designed method. The results of medical rehabilitation of the athletes were assessed through gait analysis done with a DIERS Motion 4D complex. The assessments took place 8 and 15 weeks after the reconstruction. At 8 weeks after the surgery, gait analysis parameters revealed no significant differences between the groups. Fifteen weeks after the reconstruction, when treatment group (TG) members were through all the isokinetic training sessions, the results were as follows: for the Stand Time parameter, the operated limb (OL) support deficit was 0.04% compared to the healthy limb (HL) support, and for the Single Limb Support parameter it was 3.71%, while in the control group (CG) that had no isokinetic training sessions the values were 12.44% and 18.55%, respectively. As for the Swing Time parameter, TG participants showed the deficit of HL transfer symmetry (relative to OL) of 3.99%, while the value of this parameter in the CG was 20.54%. The difference is significant, which proves the effectiveness of the developed isokinetic training method as part of the comprehensive medical rehabilitation program, the application of which resulted in faster recovery of muscle strength and compromised walking-associated support and locomotor functions in TG athletes.

The effectiveness of a web-based education program for nurses’ self-assessed skills concerning the care of alcohol-intoxicated patients in an emergency department

The aim of this study was to measure the effectiveness of a web-based education program for nurses’ self-assessed skills concerning the care of alcohol-intoxicated patients in an emergency department. A quasi-experimental design with an intervention and comparison group was used. A quantitative approach was utilized to describe the nurses’ self-assessed skills before and after a web-based education program. Within the resources of the organization that participated in this study, it was possible to deliver the intervention to 20 nurses during one year. All ninety nurses working in the emergency department of one central hospital in Finland were randomly assigned to either the intervention group (n=20) or comparison group (n=25); in both groups, baseline (November 2017) and follow-up (December 2018) surveys were conducted before and after the intervention. The intervention group members showed a statistically significant increase in their self-assessed skills in several sections of the competence scale that was used. This may indicate that the web-based education program had a positive effect on the intervention group’s knowledge and improved their skills to care for alcohol-intoxicated patients.

Using mindfulness-based stress reduction group therapy to reduce perceived stress of vulnerable women in south of Iran

ABSTRACT Provision of educational and health services to vulnerable women in drop-in centers can reduce their traumas. Mindfulness-Based Stress Reduction (MBSR) group therapy is a psychological intervention to reduce perceived stress these women. This quasi-experimental study aimed to evaluate the effectiveness of MBSR group therapy in the perceived stress of 63 vulnerable women who referred to two drop-in centers in southeastern Iran. The participants were assigned into the intervention (n = 30) and control (n = 33) groups. The intervention group members were required to attend the MBSR intervention held in eight 90-minute sessions. Perceived Stress Scale (PSS) was administered to collect data before and one month after the MBSR. Based on the findings, the pre-test scores of perceived stress were not significantly different between the intervention (38.16 ± 6.04) and control (39.06 ± 5.30) groups (t = −0.62, p = 0.53). However, the perceived stress scores reduced significantly in the intervention group (30.20 ± 2.89) than the control group scores (37.96 ± 4.18) in the posttest (t = −8.35, P = 0.001). Given the significant reduction of perceived stress in participants after attending the MBSR group therapy, expert counselors, psychologists, and psychiatrists are recommended to conduct this therapy to reduce perceived stress in vulnerable women.

Assessing the usefulness of an mHealth strategy to support implementation of multi-faceted adaptive feeding interventions by community-based rehabilitation workers

ABSTRACT To assess the usefulness of an mHealth strategy to support assimilation of adaptive feeding interventions into daily practices of community-based rehabilitation (CBR) workers. The mHealth strategy was evaluated in a 4-week field test. At baseline, all participants received a 1-hour, hands-on training on adaptive feeding techniques. The intervention group (n = 12) subsequently received smartphones pre-loaded with training and demonstration videos; control group members (n = 12) did not. All were instructed to recommend adaptive feeding interventions to families on their caseload when appropriate. Both groups received weekly calls to monitor progress and discussed their experiences in post-study focus groups. The intervention group saw over twice the number of families with a child with cerebral palsy compared to the control group. For intervention group members, on-demand access to the videos increased their overall usefulness in everyday practice, enhanced their self-confidence, clarified their recommendations, and increased credibility with caregivers. In contrast, control group members implemented the adaptive feeding strategies less frequently and less confidently. mHealth strategies are a promising option for supporting geographically dispersed CBR workers implementing multi-faceted assistive technology interventions. The portability of video content reinforced learning, increased implementation of the adaptive feeding interventions, and enhanced communication with consumer.