Intervention Group Members Research Articles

Effects of an orientation tour on preoperative anxiety in candidates for coronary artery bypass grafting: A randomized clinical trial.

BACKGROUNDCandidates for cardiac surgery usually suffer from preoperative anxiety. Although there are various anxiety reduction techniques, it is unclear which one is the most effective. Therefore, the present study was conducted to explore the effects of an orientation tour on preoperative anxiety in candidates for coronary artery bypass grafting (CABG).METHODSIn this randomized clinical trial study, 70 patients who were candidate for CABG were recruited from February 2016 to May 2017. They were randomly assigned to two groups of 35. The intervention group members were taken on an orientation tour and the control group received routine care. Data were collected using the State-Trait Anxiety Inventory (STAI).RESULTSThe statistical tests revealed that there was no significant difference between the intervention group (42.43 ± 13.24) and the control group (45.11 ± 10.19) with respect to the pre-intervention state anxiety level (P = 0.340); however, before surgery, the state anxiety level was significantly lower in the intervention group (34.83 ± 11.15) than in the control group (47.69 ± 11.30) (P < 0.001). Moreover, the independent t-test showed that there was no significant difference between the intervention (43.71 ± 12.04) and control (45.03 ± 8.76) groups with respect to the pre-intervention trait anxiety level (P = 0.600). Nevertheless, before surgery, the trait anxiety level was significantly lower in the intervention group (35.40 ± 10.24) than in the control group (46.91 ± 9.51) (P < 0.001).CONCLUSIONThe preoperative orientation tour had a positive impact on the anxiety level in the candidates for CABG. Hence, the tour can be used as a remarkably effective technique for reducing anxiety.

Qualitative Perspectives Regarding Enabling Factors and Barriers to Success While Enrolled in a Weight Loss Intervention: Facilitators, Participants and Non Participants (P21-004-19)

ObjectivesAn investigation of enabling factors that promote weight loss and barriers to success while enrolled in a weight loss intervention with a duration of 16 weeks. MethodsAn exploratory study design using qualitative research techniques included three focus group discussions and 26 semi-structured in-depth interviews with intervention facilitators (six registered dietitians), participants (26 overweight/obese urban Zulu women enrolled in a weight loss intervention) and non-participants (13 overweight/obese urban Zulu women that have never attempted weight loss). Audio recordings were transcribed verbatim to generate seven qualitative data sets, followed by the development of a coding framework. Microsoft Word files were imported into NVivo software as primary documents for qualitative data analysis. Themes generated by focus group discussions, in-depth interviews and field notes were interpreted in conjunction with available literature. ResultsEnabling factors that contributed to enrolment and completion of the weight loss intervention included social support from intervention group members, facilitators, family, friends and colleagues. Other enabling factors included the knowledge gained through intervention facilitators, the weight loss manual used, as well as weight loss. Barriers to weight loss were related to cultural norms of an acceptable body weight, a lack of social support and the stigma associated with weight loss. Other barriers included time constraints, work commitments, family eating habits, an inability to exercise and lack of understanding regarding the concept of increased physical activity to facilitate weight loss, as well as psychological problems such as stress that contribute to an unhealthy lifestyle. ConclusionsFactors that enable weight loss success include social support, weight loss and knowledge gained in the course of a weight loss intervention. Creating public awareness of the relationship between non-communicable diseases of lifestyle and overweight/obesity among members of the target community through social marketing techniques will not only address the barriers to enrolment in a weight loss intervention, but will increase enrolment and curb drop out. Funding SourcesUniversity of KwaZulu-Natal, Medical Research Council.

The Effect of Educational Intervention based on the theory of planned behavior on Nutritional Behavior with Regard to Cardiovascular Diseases among Health Volunteers

Background: We sought to evaluate the effect of educational intervention based on the theory of planned behavior (TPB) on nutritional behaviors in relation to the cardiovascular disease (CVD) among health volunteers. Methods: In this quasi-experimental study, the participants included 128 active health volunteers. To conduct the study, 65 and 63 participants were randomly assigned into the intervention and control groups, respectively. Data were collected before and six weeks after the intervention using a validated researcher-made questionnaire. The questionnaire consisted of demographic variables, knowledge questions, and TPB constructs. Data were analyzed by Chi-square, t-test, Mann-Whitney U, and Wilcoxon test. Results: No significant difference was observed between the intervention and control groups with regard to the demographic characteristics, knowledge mean scores, and TPB constructs at the beginning of the study. However, the mean scores of knowledge, attitude, subjective norms, perceived behavioral control (PBC), and nutritional behavior increased significantly (P &lt; 0.001, P &lt; 0.001, P = 0.018, P = 0.007, and P &lt; 0.001, respectively) in the intervention group six weeks after the beginning of study. Significant differences were observed in nutritional performance of the intervention group, in other words the nutritional behavior of the intervention group members changed during the intervention. Conclusion: The PBC was the strongest construct in attitude. To optimize nutritional interventions in preventing the CVD, TPB should be implemented in educational interventions.

Evaluation of the Impacts of a Phone Warning and Advising System for Individuals Vulnerable to Smog. Evidence from a Randomized Controlled Trial Study in Canada.

Smog warning systems are components of adaptation strategies that are adopted by governments around the world to protect their citizens from extreme episodes of air pollution. As part of a growing research stream on the effectiveness of these systems, this article presents the results of a study on the impacts of an automated phone warning and advising system for individuals vulnerable to air pollution. A sample of 1328 individuals were recruited and randomly assigned to treatment and control groups. The treatment group received smog warning while the control group did not. Data were collected via three phone surveys, two before and one after issuing the smog warning. The comparison between treatment and control groups indicates that exposure to a smog warning improved information on the occurrence of smog episodes (n = 484, OR = 5.58, p = 0.00), and knowledge on protective behaviors. Furthermore, members of treatment group were more likely to avoid exposure to smog episodes by spending more time inside with the windows closed than usual (n = 474, OR = 2.03, p = 0.00). Members of treatment group who take medication in the form of aerosol pumps also kept these devices on themselves more frequently than those of control group (n= 109, OR = 2.15, p = 0.03). The system however had no discernible effects on the awareness of air pollution risks, reduction of health symptoms related to smog and the use of health system services. The absence of health benefits could be related to the lower actual exposure to air pollution of such vulnerable groups during winter.

Developing a Master Food Volunteer Continuing Education Program: A Model for Volunteer Capacity Building

We developed a master food volunteer (MFV) continuing education program (CEP) for MFVs assisting Extension agents with a diabetes self-management program. Our development process included two phases of pilot testing. First, seasoned MFVs tested and provided formative feedback on the first iteration of the MFV CEP modules. After revising the modules in response to their feedback, we evaluated program effectiveness by comparing pretraining/posttraining score change between MFVs who had completed the training (intervention group) and those who had not (comparison group). All test scores increased for intervention group members, whereas half declined for comparison group members. Our process of developing enhanced education to address program-specific volunteer capacity building has broad applicability.

Effectiveness of a theory-based sun-safe randomised behavioural change trial among Australian adolescents.

Sun safety is crucial for preventing skin cancer. This study evaluated a school-based intervention based on the theory of planned behaviour (TPB), which aimed to encourage sun-protective behaviour among adolescents. Secondary school students (N=382; 61.1% female; Mage =13.73y) in Queensland, Australia, participated in the study. Schools were randomly allocated to an intervention or control group. The intervention focussed on fostering positive attitudes, increasing perceptions of normative support, and strengthening control perceptions. Participants completed questionnaires assessing the TPB variables and sun-protective behaviour (weekday and weekend) 1week before intervention (time 1), 1week after intervention (time 2), and 4weeks after intervention (time 3). With baseline between-group differences in TPB variables matched, repeated-measures multivariate analysis of variance was used to evaluate the Time×Condition effects across time. Multigroup comparisons using path models traced the intervariable changes. From times 1 to 3, a significant improvement in weekend sun-protective behaviour was identified in the intervention group (but not the control group), whereas cognitions showed no significant changes across time for either conditions. Multigroup comparisons on path coefficients between the intervention and control group participants indicated that the intervention group members formed stronger positive associations between perceived behavioural control and intention at time 2 and between perceived control and behaviour at time 3. The significant behavioural change on weekends highlights the value of targeting control perceptions, which may encourage adolescents' sun-protective behaviour. Further studies are needed to understand the absence of significant changes in weekday sun-safe behaviour among this at-risk cohort.

Application of pomegranate (Punica granatum Linn.) fruit extract for accelerating post-tooth extraction wound healing

Background: Trauma occurring during tooth extraction can cause complications such as bleeding, infection, fracture and dry socket and constitutes an inflammatory response trigger. Pomegranate (Punica granatum Linn.) extract, which contains large amounts of punicallagin and ellagic acid, possesses various qualities, including; anti-inflammatory, anti-bacterial and anti-oxidant. Pomegranate extract can inhibit proinflammatory cytokine production, while also suppressing inflammation response thereby accelerating wound healing. Purpose: This study aimed to analyze the effect of pomegranate extract application to the tooth extraction wounds of Cavia cobaya (C. cobaya) on the expression of fibroblast growth factor-2 (FGF-2) and transforming growth factor β (TGF-β) on the fourth day of the wound-healing process. Methods: This study used 12 C. cobaya, divided into two groups, namely; control and treatment. The subjects were anesthetized, before their lower left central incisor was extracted and the entire socket filled with CMC-Na 3% in members of the control group and pomegranate extract in those of the treatment group. The twelve C. cobaya were sacrificed on day 4, their lower jaw subsequently being removed and decalcified for approximately 30 days. The mandibula tissue was stained using a immunohistochemical technique. FGF-2 and TGF-β were used to evaluate the healing process in the extracted tooth socket. Differences in the expression of FGF-2 and TGF-β were evaluated statistically by means of a t-test. Results: This study indicated a significant difference between the control and the treatment groups (p&lt;0.05). The treatment group members whose sockets were filled with pomegranate extract showed high FGF-2 and TGF-β expression. Conclusion: This study confirmed that the administration of pomegranate extract to post-extraction tooth wounds of C. cobaya increases the expression of FGF-2 and TGF-β on day 4, thereby accelerating the wound healing process.

A Community Choir Intervention to Promote Well-Being Among Diverse Older Adults: Results From the Community of Voices Trial.

To test effects of the Community of Voices choir intervention on the health, well-being, and health care costs of racial/ethnically diverse older adults. Twelve Administration-on-Aging-supported senior centers were cluster randomized into two groups: the intervention group started the choir immediately and a wait-list control group began the choir 6 months later. The choir program was designed for community-dwelling adults aged 60 years and older. The multimodal intervention comprises activities that engage participants cognitively, physically, and socially. Outcome measures assessed these three domains as well as health care utilization and costs. The intention-to-treat comparison was at 6 months. The sample (N = 390) had a mean age of 71.3 years (SD = 7.2); 65% were nonwhite. Six-month retention was 92%. Compared to controls, intervention group members experienced significantly greater improvements in loneliness (p = .02; standardized effect size [ES = 0.34] and interest in life (p = .008, ES = 0.39). No significant group differences were observed for cognitive or physical outcomes or for health care costs. Findings support adoption of community choirs for reducing loneliness and increasing interest in life among diverse older adults. Further efforts need to examine the mechanisms by which engagement in choirs improves aspects of well-being and reduces health disparities among older adults, including potential longer-term effects. NCT01869179 registered January 9, 2013.

HIV Testing With and Without a Clinical Consultation Among Men Who Have Sex With Men: A Randomized Controlled Trial

Increasing the frequency of HIV testing among men who have sex with men (MSM) maximizes the preventive effect of antiretroviral therapy, by reducing time to diagnosis and treatment. Melbourne Sexual Health Centre, Australia. This randomized controlled trial evaluated whether access to testing, without seeing a clinician would increase testing frequency. MSM attending for HIV testing between July 2014 and April 2015 were randomized in 1:1 ratio to the intervention arm (access to HIV and syphilis testing at 300 pathology centers, without requiring consultations) or the control arm (consultation at every test), without blinding. The primary outcome was the incidence of HIV testing over 12 months. Of 443 men referred, 422 were randomized, 3 HIV positives at baseline were excluded, and 419 were analyzed. Of 208 control, 202 (97.1%) and 200 (94.8%) of 211 intervention group members were followed to 12 months. The intervention group had 453 tests in 205.6 person-years, incidence rate was 2.2 (95% confidence interval [CI]: 2.0 to 2.4) tests per year. The control group had 432 tests during 204.0 person-years, incidence rate was 2.1 (95% CI: 1.9 to 2.3) tests per year, and incidence rate ratio was 1.04 (95% CI: 0.89 to 1.2; P = 0.63). The annual rate of consultations was as follows: intervention, 1.61 (95% CI: 1.44 to 1.79); controls, 2.12 (95% CI: 1.92 to 2.33); rate ratio, 0.76 (95% CI: 0.65 to 0.88; P = 0.0001). There was no difference in quality of life scores (P = 0.61). MSM permitted HIV and syphilis testing outside of clinical consultations did not test more frequently than controls but had 24% fewer consultations, reducing service demand. ACTRN12614000760673.

Long-Term Follow-Up of Individual Development Accounts: Evidence from the ADD Experiment

This report presents findings from the fourth wave of the American Dream Demonstration (ADD) experimental study of Individual Development Accounts (IDAs). The ADD was a set of 14 privately funded local IDA programs initiated in the late 1990s. It was the first large-scale test of IDAs in the United States and used a variety of research methods in order to learn about IDAs. One of these programs, in Tulsa, Oklahoma, was implemented as a random assignment experiment. This report is based on a 10-year follow study of impacts at the Tulsa site.In total, 1,103 low-income participants were surveyed at baseline and randomly assigned to either the treatment or control group. Treatment group members received access to an IDA as well as financial education and case management. The IDA provided matched withdrawals at a 2:1 rate for home purchase and a 1:1 rate for home repair, small business investment, post-secondary education, or retirement savings. Participants who made the maximum matchable deposits throughout the 3 years of the program could accumulate $6,750 (plus interest) for a home purchase or $4,500 (plus interest) for the other qualified uses.In examining the five allowable uses, the study finds some impacts of IDAs on education, especially for males, and on home maintenance and repair 10-years after the program. However, we find no impact on homeownership, businesses, and retirement savings in the follow-up study. The positive findings for education and home maintenance and repair may suggest that IDAs are best suited to support asset purchases that can be accomplished incrementally over a period of time. Targeting IDAs for education and home maintenance and repair may be more effective than applying them to “all-or-nothing” purchases like a house.

Can a twelve-week intervention reduce barriers to bicycling among overweight adults in low-income Latino and Black communities?

This pilot study summarizes perceived barriers to bicycling among overweight adults in two low-income communities of color and evaluates the impact of a bicycling intervention on these perceived barriers. A randomized controlled trial with 38 total participants from one predominantly Latino and one predominantly Black neighborhood in Milwaukee, Wisconsin was conducted during summer 2015. The twelve-week intervention consisted of group bicycle rides and bicycling instruction. Several barriers identified prior to the intervention declined significantly among intervention group members soon after it was completed: not feeling healthy enough to bike, being physically uncomfortable while biking, not having a bicycle to use, not having other people to bicycle with, not knowing the best routes to use, not feeling safe from crime, not feeling safe from car traffic, and worrying that neighbors do not think it is normal for an adult to ride a bike. Eight weeks after completion, the intervention group reported significantly greater reductions than the control group with respect to the barriers of not feeling healthy enough to bike and not feeling safe from car traffic. In addition to decreasing barriers, qualitative analysis suggested that increasing support from family and friends as well as emphasizing personal health benefits could help motivate people to bicycle.

Influence of WeChat platform on the compliance of continuous treatment of scar in adult burn patients

Objective: To explore influence of the WeChat platform on the compliance of continuous treatment of scar in adult burn patients. Methods: A total of 124 adult burn patients, conforming to the study criteria, admitted in the Department of Burns of our hospital from January 2015 to January 2016 were divided into WeChat group (n=63) and control group (n=61) according to the random number table. Patients in control group only received regular discharging rehabilitation guide, while patients in WeChat group received regular discharging rehabilitation guide and joined WeChat platform after being discharged from hospital. Through pushing rehabilitation plan and rehabilitation related knowledge, organizing support discussion of burn patients, answering the patients' questions, members of WeChat platform intervention group conducted continuous treatment for 6 months on patients of WeChat group. The compliance of functional exercise of patients in two groups in one week before discharge and 3 and 6 months after discharge was evaluated by using the self-made functional exercise compliance log sheet. The compliance of using anti-scar drug and appliance of patients in two groups in 3 and 6 months after discharge was evaluated by using self-made anti-scar drug and appliance usage log sheets. Data were processed with chi-square test, independent sample t test, non-parametric rank sum test of independent sample, and Wilcoxon rank sum test. Results: (1) The compliance ratio of functional exercise of patients in WeChat group (95.24%, 60/63) was close to 93.44% (57/61) in control group in one week before discharge (χ(2)=0.188, P>0.05). The compliance ratios of functional exercise of patients in WeChat group were respectively 93.65% (59/63) and 87.30% (55/63) in 3 and 6 months after discharge, which were higher than 68.85% (42/61) and 65.57% (40/61) in control group (χ(2)=12.615, 8.166, P<0.01). (2) The compliance of using anti-scar drug of patients in WeChat group was significantly better than that in control group in 3 and 6 months after discharge (Z=-4.150, -4.563, P<0.01). (3) The compliance of using anti-scar appliance of patients in WeChat group in 3 and 6 months after discharge was obviously better than that in control group (Z=-4.242, -4.301, P<0.01). Conclusions: By using WeChat platform to provide guide for scar rehabilitation continuous treatment, adult burn patients have better compliance to functional exercise and usage of anti-scar drug and appliance.

Does Knowing Your FICO Score Change Financial Behavior? Evidence from a Field Experiment with Student Loan Borrowers

One in five consumer credit accounts incur late fees each quarter. Evidence on the efficacy of regulations to improve behavior through enhanced disclosure of financial product attributes is mixed. We test a novel form of disclosure that provides borrowers with a personalized measure of their creditworthiness. In a field experiment with over 400,000 student loan borrowers, treatment group members received communications about the availability of their FICO Score. The intervention significantly reduced late payments and increased borrowers’ FICO Scores. Survey data show treatment group members were less likely to overestimate their FICO Scores, suggesting the intervention may correct for overoptimism.

Effectiveness of a participatory physical and psychosocial intervention to balance the demands and resources of industrial workers: A cluster-randomized controlled trial.

Objectives The aim of this study was to evaluate the effectiveness of a participatory physical and psychosocial workplace intervention (known as PIPPI) on work ability and recovery among industrial workers. Methods Eligible workers were cluster-randomized into intervention (N=193) and control (N=222) groups. Intervention group members participated in three workshops where they mapped positive and negative aspects of their physical and psychosocial work environment and developed action plans addressing the highlighted issues, which were subsequently implemented by the participants. Questionnaire-based data on work ability and recovery were collected at baseline and 8-, 10- and 12-month follow-up. Data on productivity, well-being, mental health, and physical demands and resources were collected at baseline and 12-month follow-up. Results The intervention was delivered and received as planned (100% planned workshops conducted, 69% [standard deviation (SD) 7%] participation in workshops) and with a response rate of 76% (SD 8%) to the questionnaires. No significant between-group improvements for any of the outcomes were found in intention-to-treat multi-level mixed models. On the contrary, tendencies were observed for poorer recovery and reduced work ability in the intervention compared to control group. Conclusion The intervention did not improve the outcomes. This result can have several explanations, such as a regression-toward-the-mean effect or that the intervention might have put an additional burden on the workers already facing high work demands. In addition, there may have been an insufficient match between the intervention components implemented and the predetermined outcomes, and implementation may have been unsuccessful. These potential explanations need to be investigated using process evaluation data.

Effect of electronic education based on health promotion model on physical activity in diabetic patients

BackgroundBy high prevalence of inactivity, particularly in diabetic patients, the need to effective interventions to promote physical activity is essential. The aim of this study was to determine the effects of education based on health promotion model (HPM) through multimedia on the physical activity in diabetic patients. MethodIn this quasi-experimental study, 76 patients with type II diabetes were evaluated (40 patents in intervention group and 36 patients in control group). The intervention group members and a friend or a family member, that could be supportive in physical activity, received teaching CD based on health promotion model. Both group members at the beginning of the study, two weeks and three months after the training, completed questionnaires. After data collection, statistical analysis was conducted using independent T-test, chi-square test, and repeated measurement of ANOVA. ResultsFinding showed that self-efficacy (P<0.001), health status (p=0.032), benefits (P<0.001) and friends support in physical activity (P<0.001) were perceived to be higher, and barrier of physical activity (P<0.001) was perceived to be lower in multimedia group compared to control group 3 months after training. There was a significant difference in average of metabolic equivalent of task (MET) between two groups after the intervention (P<0.001). ConclusionPlanning of education based on the HPM and implementation through multimedia can change belief about physical activity and increase participation in physical activity.

Development of Pyriform Sinus Suctioning Programs for Aspiration Pneumonia Prevention During the Acute Stroke.

Aspiration due to dysphagia is a factor associated with pneumonia during acute stroke. In such cases, it is likely that secretions in the pyriform sinuses enter the laryngeal inlet. The present study was based on the idea that it is possible to reduce aspiration pneumonia by periodically suctioning and removing such secretions (pyriform sinus suctioning), a study was conducted in a single facility. The incidence of pneumonia as a dependent variable was compared between before (control) and after (intervention group) intervention with pyriform sinus suctioning as an independent variable. With a view of unifying the quality and frequency of intervention, two programs to: initially confirm the safety of such suctioning; subsequently enhance/evaluate knowledge and skills related to the procedure (educational); and specify conditions for the implementation and criteria for determining its appropriateness (practical), were developed. The study involved 33 (mean age: 74.6±12.4) and 30 (80.0±8.8) control and intervention group members, respectively, 25 (83.3%) of the latter were treated with pyriform sinus suctioning for 5days after a stroke. Pneumonia developed in 7 (21.2%) and 2 (6.7%) of the former and latter, respectively. As individuals with a Japan Coma Scale (JCS) score of III or a midline shift on head CT tend to develop pharyngeal dysphagia, the patients were also divided into 2 groups to compare the incidence of pneumonia based on the risk level: low: Japan Coma Scale scores of I-II without a midline shift on head CT; and high: scores of II-III with it. In the latter, the incidence after intervention was markedly lower (p=0.06, φ=0.326), while the former did not show changes (p=0.574, φ=0.066), supporting the effectiveness of pyriform sinus suctioning to prevent aspiration pneumonia among patients with a low risk level.

The Effect of a combination of 12% spirulina and 20% chitosan on macrophage, PMN, and lymphocyte cell expressions in post extraction wound

Background: Tooth extraction is the ultimate treatment option for defective teeth followed by the need for dentures. Inflammation is one phase of the healing process that should be minimized in order to preserve alveolar bone for denture support. Macrophage, PMN and lymphocyte cells are indicators of acute inflammation. Spirulina and chitosan are natural compounds with the potential to be anti-inflammatory agents. Purpose: This research aimed to determine macrophage, PMN and lymphocyte cells of animal models treated with a combination of 12% spirulina and 20% chitosan on the 1st, 2nd and 3rd post-extraction day. Methods: Animal models were randomly divided into control (K) and treatment (P) groups. Each group was further divided into three subgroups (KI, KII, KIII and PI, PII, PIII). The post-extraction sockets of the control group animals were then filled with CMC Na 3%. Meanwhile, the post-extraction sockets of the treatment group members were filled with a combination of 12% spirulina and 20% chitosan. Subsequently, the number of PMN, macrophage and lymphocyte cells was analyzed by means of HE analysis on the 1st., 2nd. and 3rd. days. Statistical analysis was then performed using a T-test. Results: There was a decrease in PMN cells and an increase in macrophage and lymphocyte cells on Days 1, 2, and 3. Conclusion: It can be concluded that a combination of 12% spirulina and 20% chitosan can not only decrease PMN cells, but can also increase macrophage and lymphocyte cells on Days 1, 2 and 3 after tooth extraction.

Effect of Stress Management on Quality of Life in Females with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a systemic and immunologic disorder, which is characterized with feet, wrist and knee inflammatory destruction and morning stiffness. It mainly results in joint deformity and reduced ability, which can propagate into low quality of life (QOL). Recently, QOL has been demonstrated as one of the most important factors in male’s life and studies have showed the negative effect of physical and emotional stress on QOL. Objectives: This study aimed at evaluating the effect of stress management on QOL in females with RA referring to Baqiyatallah hospital during years 2012 to 2013. Methods: Fifty female patients with RA that had referred to Baqiyatallah hospital between March 2012 and March 2013 were evaluated in 2 equal groups, matched by age. The patients were enrolled conveniently. The intervention group members were trained with a 10-session stress management program and the control group did not undergo any intervention. The world health organization quality of life (WHOQOL-BREF) questionnaire was filled-out by both groups (α = 0.641) and the results were compared by suitable statistical tests. Results: Significant difference was observed in QOL between the intervention and control groups (effect size of ɛ2 = 0.845). No significant difference was seen in mean QOL results in early post-test and late follow-up test; however, a significant difference was seen between post-test and pre-test in the intervention groups (P < 0.05). Conclusions: This study demonstrated that stress management could benefit QOL in RA patients. The results suggest that the stress management package can be beneficial in these patients along with other medications.

Displacement of sexual partnerships in trials of sexual behavior interventions: A model-based assessment of consequences

We investigated the impact of the displacement of sexual activity from adherent recipients of an intervention to others within or outside a trial population on the results from hypothetical trials of different sexual behavior interventions. A short-term model of HIV-prevention interventions that lead to female rejection of male partnership requests showed the impact of displacement expected at the start of a trial. An agent-based model, with sexual mixing and other South African specific demographics, evaluated consequences of displacement for sexual behavior interventions targeting young females in South Africa. This model measured the cumulative incidence among adherent, non-adherent, control and non-enrolled females in a hypothetical trial of HIV prevention. When males made more than one attempt to seek a partnership, interventions reduced short-term HIV infection risk among adherent females, but increased it among non-adherent females as well as controls, non-enrolled (females eligible for the trial but not chosen to participate) and ineligible females (females that did not qualify for the trial due to age). The impact of displacement depends on the intervention and the adherence. In both models, the risk to individuals who are not members of the adherent intervention group will increase with displacement leading to a biased calculation for the effect estimates for the trial. Likewise, intent-to-treat effect estimates become nonlinear functions of the proportion adherent.

The Cash and Counseling model of self-directed long-term care: Effectiveness with young adults with disabilities

BackgroundYoung adults with disabilities face numerous barriers to independence and achieving markers of adulthood. Qualitative evidence suggests that flexible, self-directed budgets for purchasing home and community-based services might help fill an identified service gap and help improve the transition to adulthood for this group. ObjectiveOur aim was to evaluate the effectiveness of the Cash and Counseling model of self-directed budgets for young adults with long-term care disabilities by analyzing secondary data from the Cash and Counseling Demonstration and Evaluation randomized control trial. MethodsWe compared nine-month community involvement, satisfaction rating, health status rating compared to peers, and unmet needs outcomes using bivariate and multivariate logistic regression. Our sample included 456 participants aged 18 to 30 randomized to treatment groups with the opportunity to receive Cash and Counseling (n = 207) or control groups eligible for agency-based care (n = 249), whether self-reported (n = 128) or by proxy (n = 328). ResultsMultivariate logistic regression models showed that compared to controls at nine-month follow-up, treatment group members had significantly greater odds of being very satisfied with life, when care was received, the care arrangement, transportation, help around the house and community, personal care, and getting along with paid attendants, and significantly lower odds of unmet needs with medication and routine health care at home and with transportation. ConclusionsCash and Counseling performed better than or comparable with agency-based care for young adults with long-term care disabilities, suggesting its viability as a service option for this population.