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Background: Pain and anxiety management in patients undergoing medical and surgical procedures is an important competence area for nurses. Aim: This study aimed to determine and compare the effects of virtual reality and acupressure interventions on pain, anxiety, vital signs and comfort levels in the process of femoral catheter extraction for patients undergoing coronary angiography. Methods: The study was a single‐blind, three‐group, randomized controlled trial conducted in the cardiology clinics of a university hospital in 2021. A total of 153 patients (51 virtual reality, 51 acupressure, 51 control) participated in the study. Data were collected using a Visual Analogue Scale, the State–Trait Anxiety Inventory, a vital signs follow‐up form and the Perianesthesia Comfort Scale. Results: Both intervention groups had significantly lower pain and anxiety scores, as well as higher comfort scores, compared to the control group (p < 0.001). The virtual reality group had lower systolic blood pressure, respiratory rate and pulse rate than the control group (p < 0.05). The acupressure group had lower systolic and diastolic blood pressure and respiratory rate than the control group (p < 0.05). Conclusions: While neither intervention group was found to be superior to the other, both interventions improved vital signs and comfort levels by reducing pain and anxiety. Summary statement: What is already known about this topic? Uncontrolled pain and anxiety during medical and surgical procedures may increase the risk of complications and have negative effects on the pulmonary and cardiovascular systems, leading to changes in vital signs and compromising patients' hemodynamics.Virtual reality has demonstrated its potential to restore cognitive attention capacities, enabling patients to remain engaged and mentally focused during procedures, and thus reducing pain and anxiety.Acupressure, as a non‐pharmacological intervention, involves applying pressure to specific points on the body to alleviate pain and anxiety. It constitutes a safe, side‐effect‐free and cost‐effective option for improving patient outcomes.What this paper adds? This paper contributes to the knowledge of virtual reality and acupressure interventions as non‐pharmacological approaches that nurses can safely incorporate within their independent professional roles.The study evaluates the effects of traditional acupressure and technological virtual reality interventions on patients, comparing the two interventions for the first time to the best of our knowledge. Furthermore, to the best of our knowledge, these procedures were applied for the first time in femoral catheter extraction after coronary angiography.The implications of this paper: This study emphasizes the positive impacts of virtual reality and acupressure interventions administered by nurses for patients undergoing medical procedures.Overall, the findings suggest that non‐pharmacological techniques such as virtual reality and acupressure can contribute to a similar degree in improving patient outcomes during medical procedures. [ABSTRACT FROM AUTHOR]

Background: Continued professional development (CPD) is required for updated skills and knowledge. This study evaluates the efficacy of a CPD programme for mainstream school teachers. Aims: In an 11‐week intervention programme, speech–language therapists (SLTs) presented the participating teachers with whole‐class teaching techniques aimed at creating a language and communication‐supporting classroom environment. The effects of the intervention on the language development of the students in the teachers' classes were assessed. Methods & Procedures: A total of 211 first‐ and second‐year students (Mage = 7;6, range = 6;5–8;9) underwent standardized language assessments of receptive and expressive language abilities before and after their teachers' participation in the CPD. The students were divided into intervention and delayed intervention groups to enable randomized intervention allocation. Linear mixed modelling was used to estimate the individual and interaction effects of group, time and demographic factors. Outcomes & Results: Significant effects of time, group and school, respectively, but no interaction between time and group indicates that while all students advanced between assessments, the progress was not attributable to the teachers' participation in the CPD. Conclusions & Implications: Results are discussed in light of those of recent studies of universal services to support optimal language development. WHAT THIS PAPER ADDS: What is already known on this subject: Although inconclusive, previous research indicates that intervention delivered to teachers by SLTs has the potential to improve the language abilities of the students in the teachers' classrooms. What this paper adds to existing knowledge: This study explored the language development of first‐ and second‐year mainstream school students whose teachers took part in a CPD programme aimed at establishing language and communication‐supporting teaching techniques. Results indicate that the development of the students' language abilities could not be attributed to the teachers' participation in the CPD. What are the potential or actual implications of the work?: SLTs are often asked to guide teachers and teaching staff rather than themselves conduct individual assessments and interventions. The results of this trial can be used to inform the discussion on how to prioritize between tasks. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effects of solution‐focussed education and counselling on problematic internet usage, sleep quality and school achievement. Methods: This randomized controlled trial was conducted between January ‐ December 2016 with 44 adolescents who participated in a solution‐focussed intervention to address their problematic internet usage and poor sleep quality. After the intervention, the teens were followed up for 6 months to measure problematic Internet usage, sleep quality and school achievement using the Internet Addiction Test, Pittsburg Sleep Quality Index, Parent–Child Internet Addiction Scale and the students' end‐of‐term school grades. Data were analysed in Statistical Package for the Social Sciences programme using Chi‐square test, Independent t test, Man–Whitney U test, Friedman test and Spearman correlation analysis. Results: The median Internet Addiction Test and Pittsburg Sleep Quality Index scores of the adolescents in the intervention group were significantly lower than those of the controls (P < 0.05), and there was a positive and moderate association between problematic Internet usage and sleep quality in both groups after the follow‐up (r = 0.537, P = 0.010; r = 0.576 P = 0.005). Conclusion: The education and counselling intervention decreased problematic Internet usage and increased sleep quality. There was also an improvement in school achievement, but the difference was not significant. Summary statement: What is already known about this topic? Problematic internet usage is a common public health problem among adolescents, and it affects their physical, social and academic lives.There are some studies in the literature on the prevalence and treatment of problematic internet usage, but there are few on preventing its occurrence.Strengths‐based approaches in adolescent interventions encourage active learning. What this paper adds? A solution‐focussed approach was used for the first time in adolescents to prevent and manage problematic internet usage and accompanying problems.A programme of solution‐focussed health education and counselling was found to be an effective intervention for preventing problematic internet usage and some accompanying problems in adolescents. The implications of this paper: For the prevention and management of problematic internet usage school nurses should screen young adolescents for Internet addiction symptoms and accompanying problems.Nurses must have the benefit of multiple approaches to systematize health care in fulfilling their school health responsibilities.Health education programmes administered by school nurses to address Internet addiction in students can be based on solution‐focussed approaches. [ABSTRACT FROM AUTHOR]

Introduction: Media comparison studies examining the effectiveness of immersive virtual reality in education have yielded inconclusive findings, leaving the question of its impact on learning compared to conventional media unanswered. To address this issue, our study employs a novel approach that combines media comparison with an investigation on the influence of broader educational context. Methods: In the experiment, 262 students from two distinct types of lower secondary schools—comprehensive school and multi‐year gymnasium (a selective academic school)—participated. The students received a lesson on topography and contour line interpretation, using either an immersive virtual environment or a PowerPoint slideshow. A transfer test was carried out before, immediately after, and 1 month after the lesson to measure knowledge application. Results: The impact of the media (immersive virtual reality vs. PowerPoint slideshow) on learning outcomes was found to be minimal, with no clear advantage of one over the other in any experimental condition. In contrast, a significant influence on learning gains was observed due to school type. Multi‐year gymnasium students consistently outperformed comprehensive school students in the pre‐test and demonstrated greater learning gains, regardless of the learning media. Conclusion: The present study employs an innovative approach by integrating a comparative analysis of different media types with an investigation into the impact of learner characteristics. By including students from distinct types of schools, the study provides insights into the differential effects of immersive virtual reality in varied educational contexts. Lay Description: What is already known about this topic: Media comparison studies typically assess the effectiveness of immersive virtual reality as a learning medium in comparison to other instructional methods in education.The findings of these studies differ markedly.Numerous factors impact learning outcomes in an immersive virtual environment. What this paper adds: Recommendation that research in the field should explore not only if but also when and how IVR learning is effective.Evidence that learning achievements may not be affected by the medium used.Evidence that the type of school can significantly influence learning gains.Evidence that cognitive dispositions, such as spatial abilities, can be another factor that influence learning outcomes. Implications for practice: A technology‐centred approach alone does not allow for a proper evaluation of the learning gain potential of IVR, learner characteristics and broader educational context should also be taken into account.IVR as a learning medium may not be appropriate for all students and every educational setting.To ensure reliable evaluation of learning gains, it is necessary to align the content and format of the intervention in both learning mediums as closely as possible.Measuring learning gains not only immediately after the intervention but also with a significant time delay can contribute to a more comprehensive understanding. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking cessation is the best strategy for reducing tobacco-related morbimortality. The goal of this randomized controlled trial was to test whether using the genetically favorable markers to choose a smoking cessation drug treatment (precision medicine) was superior to using the most effective drug (varenicline) in terms of abstinence rates. Additionally, combination therapy was tested when monotherapy failed. METHODS This partially blind, single-center study randomized (1:1) 361 participants into two major groups. In the genetic group (n=184), CYP2B6 rs2279343 (genotype AA) participants started treatment with bupropion, and CHRNA4 rs1044396 (genotype CT or TT) participants started treatment with varenicline; when genetic favorable to both, participants started treatment with bupropion, and when favorable to neither, on both drugs. In the control group (n=177), participants started treatment with varenicline, regardless of genetic markers. Drug treatment lasted 12 weeks. Efficacy endpoints were abstinence rates at Weeks 4, and Weeks 8-12, biochemically validated by carbon monoxide in exhaled air. Participants who did not achieve complete abstinence at Week 4, regardless of group, were given the choice to receive combination therapy. RESULTS Abstinence rates were 42.9% (95% CI: 36-64) in the control group versus 30.4% (95% CI: 23-37) in the genetic group at Week 4 (p=0.01); and 74% (95% CI: 67-80) versus 52% (95% CI: 49-64) at Week 12 (p<0.001), respectively. The strategy of combining drugs after Week 4 increased abstinence rates in both groups and the significant difference between genetic and control groups was maintained. CONCLUSIONS Results show that using these selected genetic markers was inferior to starting treatment with varenicline (control group), which is currently the most effective smoking cessation drug; moreover, the addition of bupropion in cases of varenicline monotherapy failure improves the efficacy rate until the end of treatment. CLINICAL TRIAL IDENTIFIER: NCT03362099 [ABSTRACT FROM AUTHOR]

Biomarkers may serve as objective measures in complicated grief (CG) potentially capturing responses to stress reduction treatment. This paper reports challenges in obtaining and assessing salivary cortisol and α-amylase (sAA) for a recent randomized clinical trial. Within-session changes in salivary cortisol and sAA for 54 older adults with CG who received Accelerated Resolution Therapy were compared with perceived stress measured by Subjective Units of Distress Scale. Bivariate correlations and multiple regressions examined changes in biomarkers. Protocols, study logs, and audit reports identified challenges. Challenges included obtaining unstimulated passive drool salivary samples and their analyses. Our sample of older females on multiple medications may have resulted in a perfect storm of moderating and intervening variables which affected the stress response. This paper contributes to the discussion on designing clinical trials for older adults which must account for physiologic changes, multimorbidity, and polypharmacy common in this population and makes recommendations moving forward. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of combining a Pilates program with photobiomodulation therapy (PBMT) in patients with chronic nonspecific low back pain (CNLBP). Methods: Thirty-eight adults with CNLBP were randomly assigned to two groups: Pilates exercise + active PBMT (PIL + PBMT) or Pilates exercise + sham PBMT (PIL + SHAM). Both groups performed an 8-week mat Pilates program and received PBMT on their lumbar muscles 10 min before and after each session. The following variables were assessed before and after intervention: peak pain intensity, postural balance (i.e., center of the pressure [A-COP], velocity anteroposterior [Vel AP], and velocity mediolateral [Vel ML]), perceived disability (i.e., Oswestry Disability Index [ODI] and Roland Morris Disability Questionnaire [RMDQ]), and pain-related fear of movement (i.e., Tampa Scale of Kinesiophobia [TSK], Fear Avoidance Beliefs Questionnaire [FABQ], and Pain Catastrophizing Scale [PCS]). Results: Postural balance variables showed no statistically significant differences (p > 0.05) across time or between groups. The groups showed similar (p < 0.05) reductions in peak pain intensity, ODI, RMDQ, and PCS scores, but no statistically significant difference (p > 0.05) in TSK and FABQ scores. Conclusion: The mat Pilates program reduced peak pain intensity, perceived disability, and pain catastrophizing in adults with CNLBP, but PBMT had no additional effect on these variables. Mat Pilates alone or combined with PBMT was not able to improve postural balance. [ABSTRACT FROM AUTHOR]

Context: Cross-education (CE) refers to neuromuscular gains in the untrained limb upon contralateral limb training. To date, only laboratory-based exercise programs have demonstrated CE. Home-based exercise prescription eliciting CE could have greater clinical applicability. Objective: To determine the effect of an 8-week, home-based unilateral strength training intervention on isokinetic muscle strength, muscular excitation, and power in trained and untrained plantar flexors. Design: Randomized controlled trial. Methods: Thirty-four healthy participants were randomized to intervention (n = 20) or control (n = 14). The intervention group completed 3 sets of 12 repetitions of progressively loaded unilateral calf raises 3 days per week. Concentric and eccentric peak torque were measured using isokinetic dynamometry at 30°/s and 120°/s. Maximal electromyogram amplitude was simultaneously measured. Power was measured using a jump mat. All variables were measured at preintervention, midintervention, and postintervention. Results: Strength significantly increased bilaterally pre–post at both velocities concentrically and eccentrically in intervention group participants. Maximal electromyogram amplitude significantly increased pre–post bilaterally at both velocities in the medial gastrocnemii of the intervention group. Power significantly increased bilaterally pre–post in the intervention group, with a dose–response effect demonstrated in the untrained plantar flexors. The CE effects of strength, power, and electromyogram activation were 23.4%, 14.6%, and 25.3%, respectively. All control group values were unchanged pre–post. Conclusion: This study shows that a simple at-home unilateral plantar flexor exercise protocol induces significant increases in contralateral strength, muscular excitation, and power. These results suggest the applicability of CE in home rehabilitation programs aiming to restore or maintain neuromuscular function in inactive individuals or immobilized ankles. [ABSTRACT FROM AUTHOR]

Background: Various physical fitness qualities such as muscle strength, speed and endurance are related to soccer performance. Accordingly, the combination of strength and endurance training (i.e., concurrent training [CT]) is an often-encountered training regimen in soccer. Less is known about the effects of CT sequencing on performance in young soccer players. The aim of this study was to assess the sequencing effects of strength and intermittent endurance training applied within the same training session (intrasession) on measures of physical fitness and soccer performance in young soccer players. Methods: Fifty male adolescent soccer players volunteered to participate in this study which was conducted in the Netherlands in 2019. Players were randomly assigned to a strength-endurance (SE) or an endurance-strength (ES) group in matched pairs based on their countermovement jump (CMJ) performance at baseline. Both groups completed a 12-weeks in-season training program with two weekly CT sessions. Training sessions consisted of 15 min plyometric exercises and 15 min soccer-specific intermittent endurance training. Both groups performed the same training volumes and the only difference between the groups was the CT intrasession sequencing scheme (SE vs. ES). Pre and post intervention, proxies of muscle power (CMJ, squat jump [SJ]), linear sprint speed (30-m sprint test), agility (Illinois test with / without ball), and soccer performance (ball kicking velocity) were tested. Results: Data from 38 players aged 14.8 ± 1.0 years (body height 172.9 ± 8.1 cm, body mass: 57.0 ± 7.2 kg, soccer experience: 8.8 ± 2.8 years, age from peak-height-velocity [PHV]: +1.2 ± 1.0 years) were included. Significant main time effects were found for CMJ (p = 0.002, d = 0.55), SJ (p = 0.004, d = 0.51), the Illinois agility test with ball (p = 0.016, d = 0.51), and ball kicking velocity (p = 0.016, d = 0.51). Significant group-by-time interactions were observed for 30-m linear sprint speed (p < 0.001, d = 0.76) with ES showing greater improvements (p = 0.006, d = 0.85, Δ-5%). Conclusions: Both CT-sequencing types improved performance in the tests administered. The intrasession CT sequencing (SE vs. ES) appears not to have a major impact on physical fitness adaptations, except for linear sprint speed which was in favor of ES. Key points: • This study examined the effects of intrasession concurrent training. Findings showed that strength-endurance and endurance-strength sequencing resulted in similar changes in most measures of physical fitness in adolescent male soccer players. • If the goal is to improve linear sprint speed, endurance-strength sequencing appears to be better suited. • More research is needed to acquire further knowledge on concurrent training and effects of different types of sequencing schemes (e.g., training day, microcycle) as well as the strength training (e.g., power training) and endurance training type (e.g., high intensity interval training). [ABSTRACT FROM AUTHOR]

Mobilization with movement (MWM) and myofascial release (MFR) are treatment techniques that increase ankle dorsiflexion range of motion (DFROM). Manual lymphatic drainage (MLD) facilitates waste drainage and improves soft tissue tension in peripheral tissues. To date, no studies have investigated how the combination of MLD, MWM, and MFR influences the human body. The purpose of this study is to determine how the combination of MLD, MWM, and MFR affects DFROM and balance ability. We randomly assigned 16 individuals (26 feet) to one of three groups: MWM-MFR (MR), MWM-MLD (MD), or MWM-MFR-MLD (MRD) intervention. To confirm the intervention effect of each group, DFROM was assessed using a modified lunge test, and dynamic balance was measured using a modified star excursion balance test. In the results, differences were found between the MR and MRD groups in PL and mGCM activities in the 1 section (p = 0.008, p = 0.036) and between the MD and MRD groups in mGCM activity in the 4 and 5 sections (p = 0.049, p = 0.004). We suggest that the application of MRD is the most effective intervention for increasing muscle activation of the PL and mGCM during the modified star excursion balance test. [ABSTRACT FROM AUTHOR]

Muscle strength declines ~3% per year after the age of 70. Resistance training guidelines for older adults are often based on free-weight and machine exercises, which may be inaccessible and lack carryover to activities of daily living. We tested the hypothesis that resistance training adaptations in older adults are task-specific. Thirty adults (8 males, 22 females; mean age = 71 years) were randomly assigned to participate in 6 weeks of supervised, high-intensity resistance training (twice per week) utilizing free-weight and machine exercises (traditional) versus functional activities that were overloaded with a weighted vest (functional). Participants were thoroughly familiarized with the exercises and testing prior to beginning the study. Major outcome measures included assessments of functional performance, five-repetition maximum strength, isometric knee extensor force, and quadriceps muscle size. Physical activity and nutrition were monitored. The study results demonstrate that the magnitude of improvement within a given outcome was largely dependent on group assignment, with greater improvements in gait speed and the timed-up-and-go in the functional group, but 2-3x greater five repetition maximum strength improvements for the trap bar deadlift, leg press, and leg extension following traditional resistance training. Both groups showed improvements in isometric knee extensor force and muscle size, suggesting that some aspects of the observed adaptations were generic, rather than specific. Overall, these novel findings suggest that, among older adults, 1) resistance training adaptations exhibit a high degree of task specificity and 2) significant improvements in functional outcomes can be achieved with the use of a weighted vest. [ABSTRACT FROM AUTHOR]

Introduction: Teaching inhaler techniques to nursing students is crucial. Objective: This study aimed to investigate the effect of simulation-based education on patient training correct inhaler technique in nursing students. Methods: This is a single-blind, randomized controlled trial in which nursing students are randomly allocated into two groups of control (n = 41) and intervention (n = 40). The students' mean score of correct inhaler technique was measured before and one week after intervention, using checklists of inhaler techniques. Results: The mean score of control group was significantly lower than the intervention group (p <.001). The results also revealed that there was no significant difference in students' level of confidence regarding the ability to educate patients on inhaler techniques before the intervention, while all students were shown to have higher levels of confidence in this term after the intervention. Conclusions: Simulation is an effective way to train nursing students in the correct inhaler techniques. [ABSTRACT FROM AUTHOR]

The paradigm of comprehensive treatment approaches for children with cerebral palsy has gained traction, prompting clinicians to deliberate between independent and integrated treatment delivery. However, this decision-making process is often hindered by the dearth of empirical evidence available to inform optimal therapeutic strategies. This study, therefore, sought to compare the effects of Pilates-based core strengthening (PsCS), plyometric-based muscle loading (PlyoML), and their combination on postural control, balance, and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP (age: 12–18 years) were randomized to PsCS (n = 27), PlyoML (n = 27), or a combined intervention (n = 27; equated for total sets/repetitions) group. The three interventions were applied twice/week over 12 successive weeks. Postural control (directional and overall limits of stability—LoS), balance, and mobility (Community Balance and Mobility Scale—CB&M; Functional Walking Test—FWT; Timed Up and Down Stair test—TUDS) were assessed pre- and post-intervention. The combined group exhibited greater increases in directional LoS compared to PsCS and PlyoML including the backward (p = 0.006 and 0.033, respectively), forward (p = 0.015 and 0.036, respectively), paretic (p = 0.017 and 0.018, respectively), and non-paretic directions (p = 0.006 and 0.004, respectively)], and this was also the case for overall LoS (p < 0.001 versus PsCS and PlyoML). In addition, the combined group displayed greater improvements compared to the PsCS and PlyoML groups regarding CB&M (p = 0.037 and p = 0.002, respectively), FWT (p = 0.012 and p = 0.038, respectively), and TUDS (p = 0.046 and p = 0.021, respectively). In conclusion, the combined PsCS and PlyoML exercise program promotes considerably greater improvements in postural control, balance, and mobility compared to unimodal training in children with ULCP. [ABSTRACT FROM AUTHOR]

Purpose: Pronation in the foot is a normal rolling movement occurring at the subtalar joint during running. The human foot, as the primary interface with our environment, presents morphological and postural changes following prolonged running. This study aims to identify running mechanics while training on the sand in runners with pronated feet. Methods: Thirty runners with pronated feet were in the control group, and 30 runners with pronated feet were in the experimental group. An experimental group conducted an 8-week corrective exercise program, while a control group did not exercise. A force plate was included to collect ground reaction forces in the walkway. An analysis of variance (ANOVA) with repeated measures test was conducted to identify the presence of an interaction between the within-and between-subject factors on the dependent variables. The significance level was set at P<0.05. Results: The experimental group displayed lower first peak vertical ground reaction force (P=0.026), peak mediolateral ground reaction force (P=0.000), anterior-posterior impulse (P=0.032), loading rate (P=0.004) and a larger last peak vertical ground reaction force (P=0.000) during training on the sand. Irrespective of the group under consideration, a lower first peak mediolateral ground reaction force (P=0.000), peak positive free moment amplitude (P=0.001), and a larger last peak mediolateral ground reaction force (P=0.003) observed in the post-test compared to the pre-test. Conclusion: We suggest that training on sand may be a suitable intervention to change running mechanics in male runners with pronated feet. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the cardiometabolic and physical effects of 2 timematched high-intensity programs in a real-world environment. Forty-three active and healthy adults (sex =31 men and 12 women; age = 27 + 5 years; peak heart rate [HRpeak] = 190.7 + 10.6 beat·min-1) were randomized to 2 very low-volume protocols (;8 minutes): sprint interval training (SIT) (n=15), burpee interval training (BIT) (n=15), and control (CON) (n=13). Subjects in SIT and BIT performed 5 days of 10 3 4 second "all-out" efforts with 30 seconds of recovery. Body composition, blood pressure, countermovement jump (CMJ), 10-m sprint, shuttle run test (SRT), autonomic modulation, self-efficacy, and intention were evaluated before and after training. Sprint interval training elicited a higher %HRpeak, energy expenditure, rating of perceived exertion category ratio 10 scale, and feeling scale than BIT (p, 0.05). SRTdistance was significantly improved in SIT (p = 0.03, d = 0.62), whereas CMJ height was significantly enhanced in BIT (p=0.0014, d=0.72). Self-efficacy progressively worsened for SIT than for BIT as sessions increased, and significant differences were found in 5X week frequency between protocols (p=0.040, d50.79). No differences in intention to engage were detected between the regimens (p. 0.05). No changes were observed in body composition, blood pressure, 10-m sprint, SRTV-O2max, or autonomic variables with training (p. 0.05). Results exhibit that extremely low-volume SIT improved running performance, whereas BIT increased the vertical jump. [ABSTRACT FROM AUTHOR]

Photoactivated disinfection with sodium hypochlorite (NaOCl) has improved primary root canal treatment outcomes. This in vitro study aims to assess and compare the disinfecting efficacy of 2.5% sodium hypochlorite solution and 5.25% sodium hypochlorite gel, without laser activation and accompanied by laser activation, on Enterococcus faecalis-contaminated primary teeth root canals. After one month of incubating extracted teeth specimens with E. faecalis, 36 specimens were randomly divided into two groups: Group A (conventional method without laser-activated irrigation) and Group B (with laser-activated irrigation). Each group was further divided into three subgroups, with six samples in each subgroup. Subgroup 1 received irrigation with normal saline, Subgroup 2 with 2.5% sodium hypochlorite solution, and Subgroup 3 with 5.25% sodium hypochlorite gel. Diode laser activation at 810 nm was used in Group B. Bacterial colony counts were measured before and after the intervention. Student's t-test and one-way analysis of variance (ANOVA) with Tukey's post hoc test were used for statistical analysis. The significance level was set at p < 0.05. Microbial analysis revealed no bacterial growth in samples irrigated with 5.25% sodium hypochlorite gel activated with the laser. Activation with the laser significantly (p = 0.02) improved the disinfection ability of the irrigant compared to the non-activation group. The disinfection ability of sodium hypochlorite gel was better than that of saline (p = 0.02); however, it was comparable to that of sodium hypochlorite solution (p = 0.67). Conclusion: Root canal irrigation with 5.25% sodium hypochlorite gel activated with an 810 nm diode laser resulted in complete eradication of Enterococcus faecalis, indicating its effectiveness as an endodontic disinfection treatment modality. [ABSTRACT FROM AUTHOR]

Aim This paper aims to describe the research protocol that will be used to determine the effectiveness of a health-social partnership intervention programme among community-dwelling older adults. Background Ageing in place is a preferred option for overcoming challenges of the increasing prevalence of chronic diseases and the risk for hospitalization associated with the ageing population. Nevertheless, our knowledge of how to implement this concept is limited. The integrated efforts of health and social services may help to enable older adults to live with a sense of control over their daily life and to be independent to the fullest extent possible in the community. Design This is a randomized, controlled trial. Methods Participants are community-dwelling older adults referred from a community centre. Sample size calculation was based on power analysis. The intervention group will receive the programme with the standard protocols guided by a comprehensive assessment-intervention-evaluation framework. Home visits and telephones follow-up will be employed as means of conducting the interventions and monitoring their progress. The customary care group will receive placebo social calls. The duration of the interventions will be 3 months. The study was funded by the School of Nursing in Hong Kong. Research Ethics Committee approval was obtained in September 2014. Discussion The results of this research are expected to enable older adults to stay in the community with optimal health and well-being. Health and social sciences are integrated into the practice in this research protocol. The scarce literature on this topic means that this study can also provide an opportunity to bridge the caring gap among older adults. [ABSTRACT FROM AUTHOR]

Background/aim Engagement in desired occupations can promote health and wellbeing in older adults. Assessments of engagement often measure frequency, amount or importance of specific activities. This study aimed to develop a scale to measure older adults' evaluation of the extent to which their everyday activities are contributing to their health and wellness. Methods Eighteen items, each scored with a seven-point rating scale, were initially developed by content experts, covering perceptions of how daily activities contribute to physical and mental health, as well as satisfaction and activity participation in the last six months. Rasch analysis methods were used to refine the scale using the pencil and paper responses of 460 community-living older adults. Results Initial Rasch analysis indicated three unlabelled rating scale categories were seldom used, reducing measurement precision. Five items were conceptually different by misfit statistics and principal component analysis. Subsequently, those items were removed and the number of rating scale steps reduced to 4. The remaining 13-item, 4-step scale, termed the Activity Significance Personal Evaluation ( ASPEn), formed a unidimensional hierarchy with good fit statistics and targeting. Person separation reliability (2.7) and internal consistency (.91) indicated the tool is appropriate for individual person measurement. Relative validity indicated equivalence between Rasch measures and total raw scores. Conclusions ASPEn is a brief, easily administered assessment of older adults' perception of the contribution of everyday activities to personal health and wellness. ASPEn may facilitate occupational therapy practice by enabling clinicians to assess change in meaning of an older adult's activity over time. [ABSTRACT FROM AUTHOR]

Background The effectiveness of two treatment approaches (phonological therapy and articulation therapy) for treatment of 14 children, aged 4;0-6;7 years, with phonologically based speech-sound disorder (SSD) has been previously analysed with severity outcome measures (percentage of consonants correct score, percentage occurrence of phonological processes and phonetic inventory). Considering that the ultimate goal of intervention for children with phonologically based SSD is to improve intelligibility, it is curious that intervention studies focusing on children's phonology do not routinely use intelligibility as an outcome measure. It is therefore important that the impact of interventions on speech intelligibility is explored. Aims This paper investigates the effectiveness of the two treatment approaches (phonological therapy and articulation therapy) using intelligibility measures, both in single words and in continuous speech, as the primary outcome. Methods & Procedures Fourteen children with phonologically based SSD participated in the intervention. The children were randomly assigned to phonological therapy or articulation therapy (seven children in each group). Two assessment methods were used for measuring intelligibility: a word identification task (for single words) and a rating scale (for continuous speech). Twenty-one unfamiliar adults listened and judged the children's intelligibility. Reliability analyses showed overall high agreement between listeners across both methods. Outcomes & Results Significant improvements were noted in intelligibility in both single words (paired t(6) = 4.409, p = 0.005) and continuous speech (asymptotic Z = 2.371, p = 0.018) for the group receiving phonology therapy pre- to post-treatment, but no differences in intelligibility were found for those receiving the articulation therapy pre- to post-treatment, either for single words (paired t(6) = 1.763, p = 0.128) or continuous speech (asymptotic Z = 1.442, p = 0.149). Conclusions & Implications Intelligibility measures were sensitive enough to show changes in the phonological therapy group but not in the articulation therapy group. These findings emphasize the importance of using intelligibility as an outcome measure to complement the results obtained with other severity measures when exploring the effectiveness of speech interventions. This study presents new evidence for the effectiveness of phonological therapy in improving intelligibility with children with SSD. [ABSTRACT FROM AUTHOR]

Background: Bullying in nursing workplaces has been considered a serious problem that increases nurse turnover. Aim: To develop a cognitive rehearsal intervention for workplace bullying and examine its effects on nurses' bullying experiences and turnover intentions. Methods: We developed a smartphone application to cognitively train nurses to handle bullying situations in the workplace. This application included common bullying situations and appropriate non‐violent communication scenarios. A cluster quasi‐randomized trial was performed with 72 hospital nurses working in a university hospital in South Korea from November 2016 to January 2017. We measured workplace bullying experiences and turnover intention before intervention and 4 and 8 weeks after intervention in both intervention and control groups. Results: The cognitive rehearsal intervention developed in this study was effective for decreasing nurses' person‐related bullying, work‐related bullying experiences, and turnover intention. However, it had no effects on intimidation‐related bullying experiences. Conclusions: The smartphone application‐based cognitive rehearsal intervention can serve as a personal coping measure for person‐related and work‐related bullying among nurses. It is recommended that the intervention developed in this study be applied as a strategy to reduce nurse turnover. SUMMARY STATEMENT: What is already known about this topic? Bullying in the nursing workplace is prevalent and a major cause of turnover.Cognitive rehearsals that reproduce specific situations and train positive coping skills can serve as an intervention for workplace bullying. What does this paper add? Cognitive rehearsal using smartphone applications is effective in lowering workplace bullying and turnover intention.Unit‐based intervention for workplace bullying can be implemented effectively. The implications of this paper: Cognitive rehearsal application can be used as a personal training tool.Workplace bullying scenarios can be applied in simulated nursing education. [ABSTRACT FROM AUTHOR]

Background: The study objective was to examine the effect of arginine-sodium fluoride (Arg-NaF) varnish on preventing enamel erosion by acidic paediatric liquid medicaments (PLM). Methods: The treatment groups were: 1) 2% Arg-NaF; 2) 4% Arg-NaF; 3) 8% Arg-NaF; 4) NaF; 5) MI (CPP-ACFP) varnishes; and 6) no varnish. The pH of PLM (paracetamol and chlorpheniramine) was measured at baseline and after immersing the Perspex® blocks coated with varnishes at 0 min, 30 min, 1 h, and 4 h. Seventy-two enamel specimens (n = 72) were randomly divided into 2 groups by PLM and further by treatment groups. Then, the specimens were pre-treated with varnishes and subjected to erosive cycles (5 min, 2×/day for 4 days) by PLM. After each erosive challenge, the specimens were stored in artificial saliva. At baseline and after 4 days, the specimens were assessed for surface roughness (Ra) using 2D-surface profilometric analysis (SPA) and atomic force microscopy (AFM). Additionally, the Ca/P ratio was determined using scanning electron microscopy with energy-dispersive X-ray spectroscopy. Paired samples dependent t-test, 1-way ANOVA and 2-way ANOVA with Bonferroni post-hoc tests were used to analyse data with the level of significance set at p < 0.05. Results: The pH of PLM with 8% Arg-NaF was significantly higher than the other groups at 30 min and 4 h (p < 0.05). With paracetamol, no significant difference was observed between the baseline and post-erosive cycle measured enamel Ra (by SPA/AFM) and Ca/P ratio for all treatment groups (p > 0.05). The Ra determined by AFM, at the post-erosive cycle with chlorpheniramine, when treated with 4 and 8% Arg-NaF was significantly lower than the other groups (p < 0.05); except CPP-ACFP (p > 0.05). With the chlorpheniramine post-erosive cycle, the Ca/P ratio for 4, 8% Arg-NaF and CPP-ACFP treated specimens was significantly higher than the baseline Ca/P (p < 0.05). Conclusion: The 4%/8% Arg-NaF and MI varnish® application exhibit an enhanced preventive effect against low pH (pH < 3.0) PLM-mediated enamel erosive challenges compared to 5% NaF varnish. [ABSTRACT FROM AUTHOR]

Background: Exergames provide a promising new approach to implement simultaneous motor--cognitive training, which may support preventing the decline in cognitive functioning in older adults who have a mild neurocognitive disorder (mNCD). Objectives: To evaluate feasibility, system usability, and acceptance of "Brain- IT", a newly developed training concept combining exergame-based motor-cognitive training and heart rate variability (HRV) guided resonance breathing for the secondary prevention of mNCD. Methods: A pilot randomized controlled trial (RCT) with an allocation ratio of 2:1 (i.e., intervention:control) was conducted. The control group proceeded with usual care. The intervention group performed a 12-week training according to the "Brain-IT" training concept implemented with the "Senso Flex" (Dividat AG) exergaming system in addition to usual care. Feasibility and usability outcomes were analyzed using descriptive statistics. User acceptance was analyzed qualitatively and using Friedman analysis of variance (ANOVA), as well as Wilcoxon signed-rank tests. Results: Eighteen participants (77.3 ± 9.8 years; 44.4% females) were included. On average, we recruited 2.2 participants per month, and 35.3% of the individuals contacted were included. The intervention group had an attrition rate of 20% and mean adherence and compliance rates of 85.0 and 84.1%, respectively. The mean system usability score, measured with the system usability scale, was 71.7. High levels of exergame enjoyment, an increase in exergame enjoyment, and internalization of training motivation with large effect sizes (p = 0.03, r = 0.75 and p = 0.03, r = 0.74, respectively), as well as acceptable perceived usefulness, were observed. Preliminary data on the effects of the "Brain-IT" training are promising. Conclusion: The feasibility and usability of the "Brain-IT" training are acceptable. However, frequent occurrences of technical problems and difficulties in using the exergame training system were identified as barriers to performing the "Brain-IT" training. To optimize feasibility, either improvements or alternative solutions are required in the hardware and software of the exergame used to implement the "Brain-IT" training. The "Brain-IT" training itself was well-accepted by older adults who have mNCD. Therefore, the effectiveness of the "Brain-IT" training concept should be investigated in future studies. Trial registration: clinicaltrials.gov/ct2/show/NCT04996654. [ABSTRACT FROM AUTHOR]

In the South Korean study to prevent cognitive impairment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN), we evaluated the impact of a 24-week facility-based multidomain intervention (FMI) and homebased MI (HMI) on white matter integrity. Among 152 participants, aged 60–79  years without dementia but with ≥1 modifiable dementia risk factor, 19 FMI, 20 HMI, and 16 controls underwent brain MRI at baseline and 24  weeks. Between the intervention and control groups, we compared changes in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) at regions-of-interest (ROI) including the cingulum cingulate gyrus (CgC), cingulum hippocampus (CgH), superior longitudinal fasciculus (SLF), as well as the uncinate fasciculus (UF). In addition, correlations between total and standard scores cognitive domains of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or serum brain-derived neurotrophic factor (BDNF) and changes in brain image measures were evaluated at a statistical significance level of p  <  0.05 (uncorrected for multiple corrections). The FA, MD, AD, and RD at each ROI at the baseline were not different among groups after Bonferroni correction. In the statistical analysis using two-way repeated measures ANOVA, any significant difference in longitudinal changes in the FA, MD, AD, and RD was not revealed. The statistical analysis, among the significant regions in paired t-test of the intervention group, compared with the control group, the FMI, HMI, and intervention group yielded significantly more beneficial effects on the AD of the CgC. In addition, longitudinal AD changes of the left CgC correlated with the BDNF changes (r  =  0.280, p  =  0.048). In this study, enhanced cognitive reserve after the multidomain lifestyle intervention could be revealed by changes in brain imaging for white matter integrity [ABSTRACT FROM AUTHOR]

Background: Restricting parturient women in healthcare facilities from choosing positions that provide the greatest comfort and benefit during labor is a global barrier. Several complex factors, including caregiver preference and medical intervention, shape the limitation. Therefore, a practical need exists to train midwives on the knowledge and skills to change this condition. Methods: The study used a parallel, single-blind, randomized controlled trial at a provincial maternity and child health hospital in Fujian, China, from June 1 to December 31, 2019. The midwives in a birth suite were selected and randomly enrolled in a one-month simulation-based hybrid training or face-to-face teaching in September 2019. The four-level Kirkpatrick's model, including reaction, learning, behavior, and results, was used to evaluate training effects before and after the program. Data were analyzed with SPSS 25.0 using Student's t-test, Spearman's correlation test, Mann–Whitney U test, Wilcoxon signed-rank test, and chi-square test analysis of variance. The significance level was set at p < 0.05. Results: Forty-two midwives were initially randomized to either the virtual simulation group or the face-to-face group. One midwife was excluded from the analysis due to intervention discontinuation, resulting in a final analysis of 41 midwives (n1 = 21, n2 = 20). Post-intervention, the virtual simulation group exhibited higher satisfaction and learning effects compared to the face-to-face group, while the rate of perineal incision in primiparas was lower (p<0.05). No significant changes or differences were observed in self-rated behavior between the two groups (p>0.05). The virtual simulation group demonstrated an increase in non-supine birth rate (p = 0.030) and a decrease in perineal incision rate among primiparas compared to pre-intervention (p = 0.035). Moreover, knowledge performance was associated with the duration of virtual simulation (r = 0.664, p = 0.001). Conclusions: Virtual simulation is a fascinating innovation that enables midwives to develop birthing positions without practicing on real pregnant women and is one solution to achieve work competency within a shortened training period. [ABSTRACT FROM AUTHOR]

This online randomised controlled study evaluates benefits associated with structured topic-focussed narrative writing tasks versus unstructured narrative writing tasks, monitoring to what extent tasks impact well-being, psychopathology and satisfaction. Participants were randomised to structured topic-focussed or unstructured narrative writing conditions. Structured condition consisted of Conflict Analysis (CA), a self-guided narrative-based therapeutic assessment. Unstructured conditions consisted of narrative disclosure tasks about traumatic experiences. Both conditions consisted of ten 20-minute tasks completed within one week. One hundred and three participants completed baseline measures. Eighty-two participants completed two-week follow-up measures. Repeated measure ANOVA and t-tests were used to evaluate differences over time. Follow-up data suggest that CA participants had significantly improved outcomes when compared to narrative disclosure participants. Evidence supports continued structured narrative writing research. [ABSTRACT FROM AUTHOR]

Background: Clinical skills training is an essential component of nursing education. However, sometimes education does not sufficiently prepare nurses for the real world. Virtual reality (VR) is an innovative method to complement existing learning strategies, yet few studies investigate its effectiveness. This study compared educational outcomes achieved by three groups learning with either of two different VR simulation variants, with varying technological features, or a video training on the endotracheal suctioning skill. Methods: The investigated outcomes were knowledge and skill acquisition, learner satisfaction, and technology acceptance. 131 undergraduate nursing students were randomised into three groups, based on the interventions they received. Knowledge was assessed through a pre-post-test design, skill through a post-intervention objective structured clinical examination on a manikin, learning satisfaction and technology acceptance through standardised questionnaires, and qualitative feedback through focus groups. Results: All interventions led to a significant knowledge acquisition, with no significant difference between the groups. The video intervention group performed significantly better than the VR groups in skill demonstration. One of the two VR intervention groups had a significantly higher learner satisfaction than the video group. Technology acceptance was high for both VR groups, with the simpler VR simulation resulting in higher technology acceptance than the one with more experimental features. Students described the VR experience as realistic, interactive, and immersive, and saw the opportunity to practise skills in a safe environment, learn from mistakes, and increase knowledge and confidence. Conclusions: For the development of VR trainings, we recommend keeping them simple and targeting a specific educational outcome since trying to optimise for multiple outcomes is resource intensive and hard to achieve. Psychomotor skills were easier for participants to learn by watching a video on the procedure rather than practically learning it with the VR hardware, which is a more abstract representation of reality. We therefore recommend using VR as a complementing resource to skills labs, rather than replacing existing learning strategies. Perhaps VR is not ideal for practising practical psychomotor skills at the moment, but it can increase knowledge, satisfaction, motivation, confidence and prepare for further practical training. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

The study sought to determine the effects of a pilot home-based science intervention on deaf and typically hearing children's conceptual understanding of science and their abilities to reason about and communicate their understanding (scientific enquiry skills). Data show that by age 5 years a science attainment gap exists between deaf children and those typically hearing yet early interventions with deaf children typically neglect the development of science. We created an intervention to support caregivers (N = 17) to incorporate the language of science into their daily routines. Participants were placed into a control or intervention group; within each group were caregivers of deaf and typically hearing children. Over a period of 13 months, caregivers completed five assessments (each at two different time points); four on their child's understanding of concepts and one on their developing scientific enquiry skills. All caregivers, irrespective of group, reported positive gains in their child's conceptual understanding. Caregivers of deaf children reported greater gains in scientific enquiry skills than those of typically hearing children. This offers preliminary evidence to suggest that longer-term interventions may provide an opportunity to narrow the attainment gap between deaf and typically hearing children. [ABSTRACT FROM AUTHOR]

Purpose: Diabetes remission is a phenomenon described in the context of drastic weight loss due to bariatric surgery or low-calorie diets. Evidence suggests that increasing the intake of plant protein could reduce the risk of type 2 diabetes. We sought for association between changes in plant protein intake in the context of 2 healthy diets without weight loss nor glucose-lowering medication, and diabetes remission in coronary heart disease patients from the CORDIOPREV study. Methods: Newly diagnosed type 2 diabetes participants without glucose-lowering treatment were randomized to consume a Mediterranean or a low-fat diet. Type 2 diabetes remission was assessed with a median follow-up of 60 months according to the ADA recommendation. Information on patient's dietary intake was collected using food-frequency questionnaires. At first year of intervention, 177 patients were classified according to changes in plant protein consumption into those who increased or decreased its intake, in order to perform an observational analysis on the association between protein intake and diabetes remission. Results: Cox regression showed that patients increasing plant protein intake were more likely to remit from diabetes than those who decreased its intake (HR = 1.71(1.05–2.77)). The remission occurred mainly at first and second year of follow-up with diminished number of patients achieving remission in the third year onwards. The increase in plant protein was associated with lower intake of animal protein, cholesterol, saturated fatty acids, and fat, and with higher intake of whole grains, fibre, carbohydrates, legumes, and tree nuts. Conclusion: These results support the need to increase protein intake of vegetal origin as dietary therapy to reverse type 2 diabetes in the context of healthy diets without weight loss. [ABSTRACT FROM AUTHOR]

Background: Adolescents with depression often show barriers to seek treatment offers due to various reasons, including limited knowledge about the manifestation of the disorder, its treatment options, or fear of stigmatization. Psychoeducational approaches might reduce these barriers by increasing depression literacy. The aim of the present randomized controlled study was to evaluate whether an innovative and age-appropriate evidence-based information booklet about youth depression increases depression-specific knowledge in adolescents with depression and is also appealing to the target group. Methods: 50 adolescents with a history of depression (current/remitted) aged 12–18 years participated in the study including a pre-, post- and follow-up assessment. Participants were randomly assigned to one of two groups. The experimental group received a target group-specific information booklet about youth depression including seven subdomains. The active control group received an information booklet about asthma in youth that was highly comparable to the depression booklet in terms of format and length. Before and after reading, and at a four-week follow-up, we assessed knowledge about youth depression based on a questionnaire. Furthermore, participants evaluated the acceptability of the information booklets. Results: Unlike the active control group, the experimental group showed a significant increase in depression-specific knowledge from pre to post and from pre to follow-up across all subdomains. This increase was evident in four subdomains ("symptoms", "treatment", "antidepressants", and "causes"). The overall reception of the information booklet about depression was positive and participants stated that they would recommend the information booklet about depression to their peers. Conclusion: This is the first randomized controlled study to demonstrate that an information booklet about youth depression effectively imparts depression-specific knowledge to participants with a history of depression and shows high acceptance. Information booklets that are appealing and increase depression-specific knowledge might be a promising low-threshold and cost-effective approach to reduce barriers to treatment and raise awareness. [ABSTRACT FROM AUTHOR]

Aims Supervised exercise is a guideline-recommended treatment in intermittent claudication (IC). Hospital-based supervised exercise programmes (SEPs) are underutilized, while home-based structured exercise programmes (HSEPs) have attracted interest. The results from HSEP in IC are inconsistent and may confer no benefit over walk advice (WA) and be less effective than SEP. The aim of the study was to compare the effectiveness of best medical treatment, including Nordic pole WA alone, or WA + SEP or WA + HSEP for patients with IC. Methods and results This three-armed, multicentre randomized clinical trial enrolled patients with IC; all patients received best medical treatment including walking poles and the advice of regular Nordic pole walking (WA). For HSEP and SEP, additional exercise programmes were provided. The primarily investigated hypothesis was a non-inferiority analysis of SEP vs. HSEP regarding the 6-min walk test (6MWT) maximum distance, with a pre-defined non-inferiority margin of 50 m. Supporting outcomes included muscle endurance tests and the walking impairment questionnaire. Outcomes were assessed at baseline, 3, 6, and 12 months by a blinded evaluator. Altogether 166 patients (mean age 72 years; 59% males) were randomized. In HSEP and SEP, 24 and 26% patients, respectively, were fully exercise adherent. All three groups improved pain-free walking distance over time, but there were no significant intergroup differences. The intergroup 6MWT difference between SEP and HSEP from 0 to 12 months was –11.6 m, 95% confidence interval: –36.4 to 13.0 m (i.e. within the pre-specified non-inferiority margin). Conclusion The HSEP was non-inferior to SEP in patients with IC. There were no significant differences observed between the three groups at 1 year. Registration ClinicialTrials.gov: NCT02341716. [ABSTRACT FROM AUTHOR]

To assess the benefits of the Ida Institute's Why improve my hearing? Telecare Tool used before the initial hearing assessment appointment. A prospective, single-blind randomised clinical trial with two arms: (i) Why improve my hearing? Telecare Tool intervention, and (ii) standard care control. Adults with hearing loss were recruited from two Audiology Services within the United Kingdom's publicly-funded National Health Service. Of 461 individuals assessed for eligibility, 57 were eligible to participate. Measure of Audiologic Rehabilitation Self-efficacy for Hearing Aids (primary outcome) scores did not differ between groups from baseline to post-assessment (Mean change [Δ]= −2.28; 95% confidence interval [CI]= −6.70, 2.15, p=.307) and 10-weeks follow-up (Mean Δ= −2.69; 95% CI= −9.52, 4.15, p =.434). However, Short Form Patient Activation Measure scores significantly improved in the intervention group compared to the control group from baseline to post-assessment (Mean Δ= −6.06, 95% CI= −11.31, −0.82, p =.024, ES=.61) and 10-weeks follow-up (Mean Δ= −9.87, 95% CI= −15.34, −4.40, p =.001, ES= −.97). This study demonstrates that while a patient-centred telecare intervention completed before management decisions may not improve an individual's self-efficacy to manage their hearing loss, it can lead to improvements in readiness. [ABSTRACT FROM AUTHOR]

FindMyApps is a web-based selection-tool and errorless learning training program to help people with mild dementia/Mild Cognitive Impairment (MCI) and caregivers find user-friendly apps. In preparation of a definitive trial, the impact and feasibility of the FindMyApps intervention on self-management and engagement in meaningful activities, including social participation, was explored. An exploratory pilot randomised controlled trial (trial registration approval number: NL7210) with pre/post measurements was conducted with community-dwelling people with mild dementia/MCI and their caregivers (n = 59) in the Netherlands. Dyads in the experimental group (n = 28) received training to use the tablet and FindMyApps, and the errorless learning method was taught to their caregivers. Control group dyads (n = 31) received a tablet (without FindMyApps), instructions on tablet-use and links to dementia-friendly apps. Validated instruments were used to assess person with dementia's self-management, meaningful activities and social participation, caregiver's sense of competence and both their quality of life. No statistical significant group differences on the outcomes were found. Small to moderate effect-sizes in favour of the FindMyApps group were found for self-management and social participation. Caregivers tended to have more positive care experiences. Subgroup analyses showed that people older than 70 benefitted more from FindMyApps regarding self-management and higher educated people benefitted more regarding social participation. FindMyApps is feasible for the target group and may have potential to improve self-management and social participation. For a future definitive effectiveness trial a larger sample size is recommended, as well as taking into account the possible impact of education and age. The FindMyApps program is feasible for people with dementia/MCI and may have potential to improve their self-management and social participation. Informal caregivers may develop a more positive care experience when utilizing FindMyApps to find suitable apps for self-management and social participation for the person with dementia/MCI. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effect of a home-based self-management intervention in community-dwelling patients with early Parkinson's diseases (PD). A randomized-controlled design. Thirty-two patients participated (15=intervention, 17=control), and the intervention group received 16 weeks of the intervention. Physical activity and non-motor symptoms improved more in the intervention group than in the control group. Home-based self-management intervention was effective in improving physical activity and non-motor symptoms for them. Home-based intervention – comprising education, telephone counseling, smartphone-based message and information, and smart wearable devices – was feasible for patients with early PD. [ABSTRACT FROM AUTHOR]

Objective: This study compared in vitro the anastomosis cleaning efficacy of different irrigant activation techniques at different levels; control group non-activation (NA), passive ultrasonic irrigation (PUI) using Irrisafe, and EDDY sonic activation. Methods: Sixty anastomosis-containing mesial roots of mandibular molars were mounted in resin, sectioned at 2, 4, and 6 mm from the apex. Then reassembled and instrumented in a copper cube. For the irrigation technique roots were randomly divided into 3 groups (n = 20): group 1: NA, group 2: Irrisafe, group 3: EDDY. Stereomicroscopic images of anastomoses were taken after instrumentation and after irrigant activation. ImageJ program was used to calculate the percentage of anastomosis cleanliness. The percentage of cleanliness was calculated before and after final irrigation within each group and were then compared using paired t-tests. Intergroup and intragroup analyses were performed to compare between different activation techniques at the same root canal level (2, 4 and 6 mm) (intergroup) and to evaluate if each technique had different cleanliness efficacy according to the root canal level (intragroup) using one-way analysis of variance and post hoc tests (p < 0.05). Results: All three irrigation techniques significantly improved anastomosis cleanliness (p < 0.001). Both activation techniques were significantly better than the control group at all levels. Intergroup comparison revealed that EDDY significantly achieved the best overall anastomosis cleanliness. The difference between EDDY and Irrisafe was significant in favor to EDDY at 2 mm and insignificant at 4 and 6 mm. The intragroup comparison showed that improvement in anastomosis cleanliness (i2-i1) in the needle irrigation without activation group (NA) was significantly higher in the apical 2 mm level compared to the 4 & 6 levels. While the difference in anastomosis cleanliness improvement (i2-i1) between levels in both Irrisafe and EDDY groups was insignificant. Conclusions: Irrigant activation improves anastomosis cleanliness. EDDY was the most efficient in cleaning anastomoses located in the critical apical part of the root canal. Clinical relevance: Cleaning and disinfection of the root canal system followed by apical and coronal sealing is the key for healing or prevention of apical periodontitis. Remnants of debris and microorganisms retained within the anastomoses (isthmuses), or other root canal irregularities may lead to persistent apical periodontitis. Proper irrigation and activation are essential for cleaning root canal anastomoses. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the impact of velocity-based resistance training (VBRT) and percentage-based resistance training (PBRT) on anaerobic ability, sprint performance, and jumping ability. Eighteen female basketball players from a Sport College were randomly divided into two groups: VBRT (n = 10) and PBRT (n = 8). The six-week intervention consisted of two sessions per week of free-weight back squats with linear periodization from 65% to 95%1RM. In PBRT, the weights lifted were fixed based on 1RM percentage, while in VBRT, the weights were adjusted based on individualized velocity profiles. The T-30m sprint time, relative power of countermovement jump (RP-CMJ), and Wingate test were evaluated. The Wingate test assessed peak power (PP), mean power (MP), fatigue index (FI), maximal velocity (Vmax), and total work (TW). Results showed that VBRT produced a very likely improvement in RP-CMJ, Vmax, PP, and FI (Hedges' g = 0.55, 0.93, 0.68, 0.53, respectively, p < 0.01). On the other hand, PBRT produced a very likely improvement in MP (Hedges' g = 0.38) and TW (Hedges' g = 0.45). Although VBRT showed likely favorable effects in RP-CMJ, PP, and Vmax compared to PBRT (p < 0.05 for interaction effect), PBRT produced greater improvements in MP and TW (p < 0.05 for interaction effect). In conclusion, PBRT may be more effective in maintaining high-power velocity endurance, while VBRT has a greater impact on explosive power adaptations. [ABSTRACT FROM AUTHOR]

Background and aim: Previous studies have shown that Rheum ribes (R. ribes) could be effective in controlling the blood glucose levels. This study was conducted to determine the effects of R. ribes supplementation on glycemic indices and apolipoproteins in patients with type 2 diabetes mellitus (T2DM). Methods: In the present randomized double-blind controlled trial, 60 type 2 diabetic patients aged 30–60 years with a body mass index (BMI) of 20–30 kg/m2 and hemoglobin A1c (HbA1c) of 6–8% were enrolled. Patients were randomly assigned to receive 450 mg of aqueous R. ribes extract (AG), 450 mg of ethanolic R. ribes extract (EG), or placebo (PG) three times daily for 6 weeks. At the baseline and at the end of the study, blood glucose levels, homeostatic model assessment of insulin resistance (HOMA-IR) and the homeostatic model assessment of β-cell dysfunction (HOMA-B), as well as apolipoprotein A-I (ApoA1) and apolipoprotein B (ApoB) were measured. Results: There was a significant decrease in the serum levels of insulin in AG and EG groups (P = 0.003 and P = 0.001, respectively), HOMA-IR (P = 0.01 and P = 0.001, respectively), HOMA-B (P = 0.002 and P = 0.001, respectively), ApoB (P = 0.006 and P = 0.03, respectively), ApoB/ApoA1 ratio (P = 0.016 and P = 0.04, respectively). However, a significant increase in ApoA1 (P = 0.08 and P = 0.05, respectively) with no significant changes in blood glucose, at the end of study compared to beginning values, were observed. None of the variables showed a significant change in PG. At the end of the study; while there were significant differences in insulin (P = 0.04), HOMA-IR (P = 0.03), HOMA-B (P = 0.01), ApoB (P = 0.02), and ApoB/ApoA1 ratio (P = 0.03) among the groups but ApoA1 had no significant change. Conclusion: Consumption of R. ribes intake could have beneficial effects on insulin resistance and apolipoproteins in type 2 diabetic patients. (Registered at en.irct.ir, identification number: IRCT201410142709N31). [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the effect of family involvement in the educational sessions and follow-up meetings on compliance with the low-salt diet for hypertensive older adults. Design/methodology/approach: Randomized controlled trial was used in this study with a total of 30 hypertensive older adults divided into two groups (n = 15). The intervention group involved one family member during the educational sessions and follow-up meetings. Conversely, no family member was involved in the control group. Findings: The intervention group showed a significant (p < 0.05) increase in compliance level on the attitude (knowledge) and subjective norm (psychomotor and family support) subscales. The perceived obstacle subscale and the salt concentration in food and urine excretion significantly decreased both after educational sessions and follow-up meetings (p < 0.05). However, the control group did not. Research limitations/implications: A relatively small number of samples would have affected the results, but in this study, randomization was applied in sample collection. Practical implications: By encouraging the involvement of family members in the educational sessions and follow-up meetings, it could enhance compliance of low-salt diet among hypertensive older adults. Originality/value: The findings and outputs provide a combination of family involvement and the Geragogy learning model through educational sessions and follow-up meetings that could enhance a low-salt diet adherence among older adults with hypertension in the community. [ABSTRACT FROM AUTHOR]

Background: Increased sperm DNA damage is known as one of the causes of recurrent pregnancy loss (RPL) which can be due to increased levels of oxidative stress. Therefore, the aim of this study was to assess the effect of alphalipoic acid (ALA) on sperm parameters and sperm functions in couples with a history of RPL. Materials and Methods: In this post hoc analysis in clinical trial study, a total of 37 couples with RPL (n=12 and n=25 for placebo and ALA groups, respectively) were considered. Men were treated with ALA (600 mg/day) or placebo for 80 days. Semen samples were acquired from the participants before initiation and after completion of the medication course and assessed regarding conventional sperm parameters, chromatin damage/integrity, intracellular oxidative stress, lipid peroxidation, and seminal antioxidant characteristics. Individuals were further followed up for twelve months for pregnancy occurrence and outcomes. Finally, after excluding patients with no history of RPL, the data was analyzed. Results: No significant differences were observed between the baseline measures of the aforementioned parameters except for seminal volume. After the intervention, the mean sperm DNA damage, protamine deficiency, and persisted histones were significantly lower in the ALA group than in placebo receivers (P<0.05). A decrease in the mean of seminal total antioxidant capacity (P=0.03), malondialdehyde (P=0.02), and sperm DNA damage (P=0.004) as well as an increase in sperm total motility (P=0.04) after treatment with ALA was noticed. In addition, the mean of protamine deficiency and persisted histones were declined post-ALA therapy (P=0.003 and 0.002, respectively). The percentage of spontaneous pregnancy in the ALA group (4 of 25 cases; 16%) was higher than in the placebo group (1 of 12, 8.3%). Conclusion: ALA-therapy attenuates sperm DNA damage and lipid peroxidation while enhancing sperm total motility and chromatin compaction in the male partner of couples with PRL (registration number: IRCT20190406043177N1). [ABSTRACT FROM AUTHOR]

Background: Diabetic Foot Ulcers (DFUs), a serious complication of diabetes, have limited solutions in conventional therapies. The condition needs holistic management of blood glycemic levels; foot wounds; and possible regeneration of nerves in the soles of patients. Objective: To evaluate the efficacy of Pranic Healing as a complimentary therapy in managing Diabetic Foot Ulcers (DFUs). Methods: Thirty diabetic subjects already on standard therapy for Diabetes, co morbidities and wound care for Diabetic Foot Ulcers were assigned on a 1:1 basis to the trial and control groups. While both groups continued to receive standard therapy, the trial group additionally received Pranic Healing therapy. The Clinician, nursing staff, assessors and patients were blinded. Pranic Healers carried out healing on the trial group remotely, every day for 50 to 60 minute for stress, diabetes, local wound healing, blood cleansing and regeneration of nerves in the soles. The efficacy variables were the mean change from baseline in wound parameters and grade of DFU, overall well-being and HbAlc levels. Results: At the end of the trial, about 83.33% participants in the trial group demonstrated lowering of size and severity of the ulceration and improved to a lower grade of DFU compared to 44.4% in control group. The trial group reported a significant reduction in wound area and HbA1c levels. The trial group showed better readings for improved sensory perception in the soles through changes in the large fibre dysfunction and damaged nerves as compared to the control group. Approximately 76.9% of participants in the trial group reported lower stress levels compared to 22.22% in the control group. Conclusions: Pranic Healing intervention can be a safe and effective adjunct in managing Diabetic Foot Ulcers. [ABSTRACT FROM AUTHOR]

It is believed that clinical management of osteoarthritis should address muscle weakness to improve physical function and prevent disability and frailty This sub-study investigated the effects of supervised progressive resistance training (RT), supervised Nordic Walking (NW), and unsupervised home-based exercise (HBE) on muscle and functional performance; and associations between these exercise-induced changes in persons with hip osteoarthritis. Forty-two patients with hip osteoarthritis were recruited from a larger RCT (NCT01387867). All the groups (RT, n = 15; NW, n = 12; HBE, n = 15) exercised 1 h 3 times/week for 4 months. Quadriceps cross-sectional area (QCSA, MRI-determined); quadriceps strength (QMVC); leg extensor power (LEP); functional performance (chair stands (30sCS); stair climbs (TSC); and 6-minute walk (6MWT)) were assessed at baseline and 4 months. Per protocol analyses (one-way ANOVA and Bonferroni test) showed significant between-group differences for improvements in QCSA in the most symptomatic leg favoring RT versus NW (2.3 cm2, 95% CI [0.6, 3.9]) and HBE (2.3 cm2 [0.8, 3.9]); and 30sCS (1.8 repetitions [0.2–3.3]), and 6MWT (35.1 m [3.5–66.7]) favoring NW versus HBE. Associations existed between exercise-induced changes in QCSA and QMVC (r = 0.366, p =.019) for the most symptomatic leg and between changes in 6MWT and QMVC (r = 0.320, p =.04) and LEP (r = 0.381, p =.01), respectively, for the least symptomatic leg. Resistance training appeared effective for improving muscle mass, but less effective for improving muscle strength, power, and functional performance. Only exercise-induced changes in muscle strength and power of the least symptomatic leg, not the most symptomatic leg, were related to changes in functional performance. [ABSTRACT FROM AUTHOR]

In the SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN), we evaluated the impact of multidomain lifestyle intervention on regional homogeneity (ReHo) in resting-state functional brain magnetic resonance imaging (MRI) data. Of 152 participants aged 60–79 years without dementia assigned to either facility-based multidomain intervention (FMI), home-based MI, or controls, we analyzed 56 scanned MRIs at baseline and 24 weeks. ReHo values from regions with significant longitudinal changes were compared between the intervention and control groups and their correlations with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or serum brain-derived neurotrophic factor (BDNF) were evaluated. ReHo values in the left medial orbitofrontal gyrus and right superior parietal lobule were increased [p = 0.021, correlated positively with serum BDNF changes (r = 0.504, p = 0.047)] and decreased [p = 0.021, correlated negatively with changes in the total (r = −0.509, p = 0.044) and attention (r = −0.562, p = 0.023). RBANS], respectively, in the participants assigned to the FMI group than those of the controls. Our results suggest that facility-based group preventive strategies may have cognitive benefits through neuroplastic changes in functional processing circuits in the brain areas which play a crucial role in the adaptive learning and internally directed cognition. [ABSTRACT FROM AUTHOR]

To examine the effects of web-based SUpport PRogram (SUPR) for communication partners (CPs) of persons with hearing loss (PHLs) in a HA dispensing setting. Cluster randomised controlled trial (cRCT) with two arms (SUPR: Booklet, online videos; care as usual: no support) plus process evaluation. Measurements: baseline, and immediately-, six, and 12 months post-intervention. Outcomes: Significant Other Scale for Hearing Disability (SOS-HEAR), International Outcome Inventory for HAs/Alternative Interventions for Significant Others (IOI-HA/AI-SO). Process evaluation: dose-received, satisfaction, and benefit. The cRCT included 73 (SUPR) and 57 (care as usual) CPs. In the process evaluation study, 41 CPs (SUPR) participated. There were no significant effects of SUPR for third-party disability (SOS-HEAR), the proxy report (IOI-HA-SO item "use"), and third-party disability (IOI-HA-SO items "satisfaction", and "quality of life"). SUPR-videos were watched by 15-22% of the CPs. SUPR materials were rated as moderately beneficial and useful. Low baseline disability (floor effect) and low intervention dose-received may explain the findings. Directly targeting CPs rather than via their PHLs and providing intervention materials specifically for CPs may improve their engagement and contribute to SUPR's value supplementary to standard HA care. [ABSTRACT FROM AUTHOR]

The effect of directly observed therapy (DOT) versus self-administered therapy (SAT) on antiretroviral (ART) adherence and virological outcomes in prison has never been assessed in a randomized, controlled trial. Prisoners were randomized to receive ART by DOT or SAT. The primary outcome was medication adherence [percent of ART doses measured by the medication event monitoring system (MEMS) and pill counts] at the end of 24 weeks. The changes in the plasma viral loads from baseline and proportion of participants virological suppressed (<400 copies/mL) at the end of 24 weeks were assessed. Sixty-six percent (90/136) of eligible prisoners declined participation. Participants in the DOT arm ( n = 20) had higher viral loads than participants in the SAT ( n = 23) arm ( p = 0.23). Participants, with complete data at 24 weeks, were analyzed as randomized. There were no significant differences in median ART adherence between the DOT ( n = 16, 99% MEMS [IQR 93.9, 100], 97.1 % pill count [IQR 95.1, 99.3]) and SAT ( n = 21, 98.3 % MEMS [IQR 96.0, 100], 98.5 % pill count [95.8, 100]) arms ( p = 0.82 MEMS, p = 0.40 Pill Count) at 24 weeks. Participants in the DOT arm had a greater reduction in viral load of approximately −1 log 10 copies/mL [IQR −1.75, −0.05] compared to −0.05 [IQR −0.45, 0.51] in the SAT arm ( p value = 0.02) at 24 weeks. The proportion of participants achieving virological suppression in the DOT vs SAT arms was not statistically different at 24 weeks (53 % vs 32 %, p = 0.21). These findings suggest that DOT ART programs in prison settings may not offer any additional benefit on adherence than SAT programs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare markers of hydration during submaximal exercise and subsequent time trial performance when consuming water (PW) or coconut water (CW). There was also a secondary aim to assess the palatability of CW during exercise and voluntary intake during intense exercise. 10 males (age 27.9 ± 4.9 years, body mass 78.1 ± 10.1kg, average max minute power 300.2 ± 28.2W) completed 60-min of submaximal cycling followed by a 10-km time trial on two occasions. During these trials participants consumed either PW or CW in a randomized manner, drinking a 250 ml of the assigned drink between 10-15 min, 25-30 min and 40-45 min, and then drinking ad libitum from 55-min until the end of the time trial. Body mass and urine osmolality were recorded preexercise and then after 30-min, 60-min, and post time trial. Blood glucose, lactate, heart rate, rate of perceived exertion (RPE; 6-20) and ratings of thirst, sweetness, nausea, fullness and stomach upset (1 =very low/none, 5= very high) were recorded during each drink period. CW did not significantly improve time trial performance compared with PW (971.4 ± 50.5 and 966.6 ± 44.8 s respectively; p = .698) and there was also no significant differences between trials for any of the physiological variables measured. However there were subjective differences between the beverages for taste, resulting in a significantly reduced volume of voluntary intake in the CW trial (115 ± 95.41 ml and 208.7 ± 86.22 ml; p < .001). [ABSTRACT FROM AUTHOR]

While aging is characterized by neurodegeneration, musical training is associated with experience-driven brain plasticity and protection against age-related cognitive decline. However, evidence for the positive effects of musical training mostly comes from cross-sectional studies while randomized controlled trials with larger sample sizes are rare. The current study compares the influence of six months of piano training with music listening/musical culture lessons in 121 musically naïve healthy elderly individuals with regard to white matter properties using fixel-based analysis. Analyses revealed a significant fiber density decline in the music listening/musical culture group (but not in the piano group), after six months, in the fornix, which is a white matter tract that naturally declines with age. In addition, these changes in fiber density positively correlated to episodic memory task performances and the amount of weekly piano training. These findings not only provide further evidence for the involvement of the fornix in episodic memory encoding but also more importantly show that learning to play the piano at an advanced age may stabilize white matter microstructure of the fornix. [ABSTRACT FROM AUTHOR]

Introduction: Genetically determined violation of taste preferences leads to inversion of taste perception and overeating, distorting the homeostatic feedback of the peripheral energy status with hedonic centers, causing obesity. According to previous research the gene TAS2R38 (taste 2 receptor member 38) has the greatest contribution to the development of metabolically unhealthy obesity (MUO). Aim of the study was to study the role of the single nucleotide variant (SNV) gene TAS2R38 in the development of MUO in children. Material and methods: 205 obese children 6-18 years old were examined by clinical and laboratory methods, including anthropometric, immunobiochemical, and psychological, using the Food and Beverage Preference Questionnaire (FBPQ) and next-generation sequencing. The main group (n = 124) consisted of children with MUO, according to the recommendations of the expert group of the IDEFICS, 2014. The control group (n = 81) consisted of children with metabolically healthy obesity. The following statistical methods were used: analysis of variance, odds ratio, Spearman's correlation analysis, Wald's sequential analysis. Results: The level of the mean preference for bitter food in the main group was 2.75 ±0.15 points, while in the control group it was 3.24 ±0.14 points; Student's test, t = 2.39, p < 0.02. The analysis of food diaries in children showed a positive correlation between the daily rejection of fresh vegetables and the development of MUO (p = 0.32) with a prognostic coefficient of 2.7; p < 0.05. Three SNVs of the TAS2R38 gene (missense mutations) were diagnosed. The probability of detecting the heterozygous C/G variant of the rs713598 genotype of TAS2R38 in the main group was 1.75 times higher than in the control group (p < 0.05). Conclusions: Low taste preferences for bitter foods are associated with the development of MUO in children. rs713598 (C/G) has the greatest association with the development of metabolically unhealthy obesity among the SNVs of the TAS2R38 gene we have identified. [ABSTRACT FROM AUTHOR]

Objective To compare the insulin infusion management of critically ill patients by nurses using either a common standard (ie, human completion of insulin infusion protocol steps) or smart agent (SA) system that integrates the electronic health record and infusion pump and automates insulin dose selection. Design A within subjects design where participants completed 12 simulation scenarios, in 4 blocks of 3 scenarios each. Each block was performed with either the manual standard or the SA system. The initial starting condition was randomised to manual standard or SA and alternated thereafter. Setting A simulation-based human factors evaluation conducted at a large academic medical centre. Subjects Twenty critical care nurses. Interventions A systems engineering intervention, the SA, for insulin infusion management. Measurements The primary study outcomes were error rates and task completion times. Secondary study outcomes were perceived workload, trust in automation and system usability, all measured with previously validated scales. Main results The SA system produced significantly fewer dose errors compared with manual calculation (17% (n=20) vs 0, p<0.001). Participants were significantly faster, completing the protocol using the SA system (p<0.001). Overall ratings of workload for the SA system were significantly lower than with the manual system (p<0.001). For trust ratings, there was a significant interaction between time (first or second exposure) and the system used, such that after their second exposure to the two systems, participants had significantly more trust in the SA system. Participants rated the usability of the SA system significantly higher than the manual system (p<0.001). Conclusions A systems engineering approach jointly optimised safety, efficiency and workload considerations. [ABSTRACT FROM AUTHOR]

Background: Racial and ethnic minorities suffer significantly more than others in the wake of disasters. Despite the growing recognition of the importance of culturally competent health services, systematic cultural competence training in the medical education system is still scarce, especially in the field of emergency. The current study aimed to examine the effectiveness of an online culturally informed intervention for increasing cultural competence in emergencies among nursing students. Methods: A randomized controlled trial was used to test the intervention effectiveness in increasing nursing students' cultural competence in four domains: attitudes, knowledge, skills, and encounters. The study included 72 undergraduate nursing students recruited from two academic institutes. Participants were randomized (1:1 ratio) to an intervention (n = 34) and control group (n = 38). The study adheres to the Consolidated Standards of Reporting Trials (CONSORT). Data analysis was based on multivariate analysis of variance with repeated measures, followed by post hoc analyses with Bonferroni correction for multiple comparisons. Results: Results showed that the intervention was effective in increasing the participants' culturally competent knowledge. The effect of the intervention on the skills domain approached significance. No group differences were identified in the attitudes and the encounters domains. Conclusions: An online culturally informed intervention, incorporated in the curriculum, was effective in enhancing the cognitive aspect of cultural competence (especially at the basic knowledge and understanding levels), but not other domains. Our results encourage the development of future intervention programs that are based on a deep understanding of local values, needs, and preferences. [ABSTRACT FROM AUTHOR]

Background: One of the most prevalent complications of chemotherapy and radiotherapy is oral mucositis (OM) and manifests as erythema and ulceration. Curcumin is one of the components of turmeric and possesses anti-inflammatory and anti-oxidative features. Some of studies have proved the effectiveness of Curcumin in OM. This study aimed to investigate the effects of nanomicelle Curcumin on OM related chemotherapy and head and neck radiotherapy. Methods: In this clinical trial study, 50 patients underwent chemotherapy with or without head and neck radiotherapy were divided into study and control group. The study group was received Curcumin nanomicelle capsules 80 mg twice a day and the control group took placebo two times a day for 7 weeks and the severity and pain of OM was measured. Results: Oral mucositis severity in control group in the first (P = 0.010), fourth (P = 0.022) and seventh (P < 0.001) weeks were significantly more than the study group. Pain grade in study group was lower than control group only in the seventh week. (P = 0.001) Additionally, NRS incremental gradient in control group was more than study group. OM severity in patients who underwent only chemotherapy in the control group were significantly more than the study group in all weeks. In patients who were under chemotherapy and head and neck radiotherapy, OM in control group was significantly more intense than the study group only in the fourth and seventh weeks. Conclusions: Nabomicelle Curcumin capsules is effective on prevention and treatment of head and neck radiotherapy and especially chemotherapy induced OM. Trial registration: Registered 12 February 2019 at Iranian Registry of Clinical Trials (IRCT). IRCT code: IRCT20100101002950N6. https://en.irct.ir/trial/36665. GUMS ethical code: IR.Gums.Rec.1397.296. [ABSTRACT FROM AUTHOR]