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Background: Social anxiety is one of the most prevalent anxiety-related disorders among adolescents with many adverse effects on the social and academic lives of this population. In addition, poor social problem-solving skills can aggravate anxiety in individuals suffering from anxiety. Emotion regulation can help adolescents control and moderate their feelings, thereby enabling them to understand their emotions better, cope with their negative emotions in a positive way, and adopt a more realistic approach to solving their problems. The objective of the present study is to investigate the effects of educating female students in emotion regulation techniques on their social problem-solving skills and social anxiety., Method: This study was a randomized controlled trial conducted in Iran, utilizing a pretest-posttest design with control and intervention groups. The subjects were 47 female high-school second graders who were randomly divided into a control (25 students) and an intervention group (22 students). The intervention group was collectively educated in emotion regulation techniques in weekly one-hour sessions for eight weeks. The control group did not receive any intervention. The social anxiety and social problem-solving scales were completed by both groups before, immediately after, and one month after the intervention. The collected data were analyzed in SPSS v. 22 and level of significance was set at p < 0.05., Result: Data analysis of the intervention group compared to the control group demonstrated that group training in emotional regulation techniques effectively increased social problem-solving skills scores (p = 0.003) and decreased social anxiety scores (p < 0.0001) among students in the intervention group compared to their pretest scores. These effects remained stable during the follow-up phase., Conclusion: In view of the prevalence of social anxiety among adolescents, it is suggested that the policymakers and administrators in the education system promote emotion regulation skills in adolescent students to facilitate their psychological adaptation and improve their emotional capabilities., Trial Registration: The present study was registered under the code IRCT20220413054521N1 (Registration date: 27/02/2024) in the Iranian Registry of Clinical Trials., Competing Interests: Declarations. Ethics approval and consent to participate: The present research was approved by the University Ethics Committee in Iran (IR.SUMS.NUMIMG.REC.1402.139). Written informed consent was obtained from the participants. The researchers informed the participants of the purpose and content of this study and obtained consent from all the participants before data collection. Participation was voluntary, and the participants were assured that they could withdraw from the study for any reason. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The guidelines on physiotherapy and exercise for osteoporosis from 2008 have recently been extensively revised on the basis of new scientific findings and possible applications. The S3 guidelines have not yet been approved by consensus and the planned completion date (Association of the Scientific Medical Societies in Germany, AWMF online, registry number 183-002) is autumn 2024. Based on the publication in Issue 3 Osteology (August 2023), key points of the guidelines on physical training and fracture prophylaxis are summarized in abridged form. These are practice-oriented, evidence-based recommendations for optimal training for fracture prevention., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: U. Lange, A. Reißhauer und W. Kemmler geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien., (© 2025. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Various exercise types may slow disease progression and improve physical function for people with Parkinson's disease (PWP), including community-based boxing programs (CBP). Recent research suggests that high-intensity exercise may result in greater benefits for PWP. Participants in CBP, which are typically self-paced, may not be reaching this optimal intensity. This study examines if it is feasible and beneficial for PWP to perform high-intensity exercise in a CBP. Seven subjects diagnosed with Parkinson's disease participated in a multimodal CBP twice a week for six weeks while wearing heart rate (HR) monitors to help maintain an HR of 70-85% of the age-predicted maximum. Subjects completed pre- and post-testing, including Functional Gait Assessment (FGA), Five Time Sit to Stand (5xSTS), Timed Up and Go (TUG), and Activities-Specific Balance Confidence Scale (ABC). Data were analyzed using descriptive statistics, and paired-sample t-tests were used to evaluate improvements (p <0.05) from baseline. Both Cohen's d and minimally clinically important difference (MCID) were used to evaluate effect size and efficacy. Subjects completed 37.99±8.20 minutes of high-intensity interval training (HIIT) exercise. Results demonstrated significant improvement in FGA, TUG, and 5xSTS with large effect sizes and surpassing the MCID for the FGA and 5XSTS. It is feasible for PWP to perform high-intensity exercise in a CBP, which may improve balance and functional strength.

There is a need for well-described treatments targeting individuals at risk for suicidal behaviors. The present study aims to investigate the effectiveness of MBCT adapted to individuals who are suicidal (MBCT-S) in a randomized controlled trial, comparing an intervention group receiving MBCT-S and treatment as usual (TAU) with a control group receiving TAU only. Participants who were 18 years or older and experienced suicidal ideation were included. Assessments on suicidal ideation and symptoms associated with suicidal behavior were carried out at baseline, post-treatment, and 12 weeks after the end of the training. When comparing the intervention group with the control group, a significant reduction was found at follow-up in suicidal ideation and depressive symptoms. When focusing on the intervention group only, a significant reduction was found in suicidal ideation, depressive symptoms, hopelessness, worrying, defeat, and entrapment, and a significant increase in mindfulness both at post-treatment and at follow-up. The findings suggest that MBCT-S is a promising suicide-specific intervention as it may have the potential to reduce suicidal ideation and suicide-related components.

Aim: The aim of this study was to scrutinize how online occupational therapy group training for mothers influenced their attitudes and stress levels relating to feeding their children and the eating behaviours of the children. The secondary purpose of the study is to evaluate the satisfaction of the participants of this program. Twenty-nine mothers of children aged 3-6 years, experiencing feeding issues, were randomly allocated to either an intervention or control group., Background: Feeding problems including selective eating, loss of appetite, and mealtime behaviour problems are prevalent during childhood. Parents play a fundamental role in acquiring knowledge about feeding. Problems in the feeding process may lead to parental stress, feelings of despair, and incorrect attitudes., Results: The mothers in the research group participated in the 4-week training. Results indicated positive effects on both maternal attitudes and their children's eating behaviours (p < 0.05). No significant change was found in mothers' state and trait anxiety levels (p > 0.05). Participants were asked to score their satisfaction level with the program between 1 and 10, and the average of the scores was 9.78 ± 0.42., Conclusion: This study shows that online group education for mothers can support existing treatments and guide clinicians working with children with feeding problems., (© 2024 John Wiley & Sons Ltd.)

Purpose: To investigate the usability and effectiveness of standardized circuit class group training (CCT) compared to individualized goal-directed group training (GDT) in subacute stroke survivors., Materials and Methods: This study consists of three parts. Part 1 involved a pragmatic, non-randomized controlled trial with subacute participants and their therapists, who participated in four weeks either CCT or GDT. Superiority of the intervention was defined as significantly larger improvement on the Motor Activity Log for patients and lower workload for therapists. In Part 2, six additional workstations were developed for CCT. Part 3 replicated the study of Part 1 with the expanded CCT., Results: Part 1 showed no difference in effectiveness between training methods. CCT did not match the rehabilitation goals of the patient sufficiently, however mental workload seemed lower for therapists. An expansion of CCT could improve the match between the patient's goals and the training (Part 2). Results of Part 3 showed again no difference in effectiveness between methods. CCT was however perceived as less engaging compared to GDT, but mental load for therapists remained lower., Conclusions: A standardized training could reduce the mental workload for therapists, but patients seemed less engaged. A combination of both might be most beneficial. Trial registration: Dutch Trial Register: NL8844 and NL9471IMPLICATIONS FOR REHABILITATIONProviding a standardized training program after stroke reduces therapists' mental workload.Individualized goal-directed group training results in the best achievement of rehabilitation goals.A combination of standardized and individual training would use best of both intervention modalities.Patients should be involved in the co-creation developing process of training programs.

Introduction: While the effectiveness of cognitive-behavioral stress management trainings (SMTs) is well-documented, the underlying mechanisms, especially in an occupational context, are not fully understood. We tested whether SMT-induced improvements in stress management skills, particularly in the mastery of changing cognitions, may explain beneficial SMT effects., Methods: Our non-randomized controlled trial comprised 108 employees of a German health insurance company, with 65 of them participating in a cognitive-behavioral SMT and 43 participating in an alternative control training (AT). As outcome variables, we repeatedly assessed stress-related (functional stress management skills, relaxation, stress reactivity, exhaustion), work-related (job dissatisfaction), and specific-context-related (social support, trait anger) measures at baseline, 2 weeks, and 3 months after the trainings. Functional stress management skills and, in particular, a subscale assessing perceived mastery of changing cognitions ("cognitive-strategies-and-problem-solving") were tested as mediators of change., Results: Repeated measures (M)AN(C)OVAs and complementary multigroup latent difference models confirmed improvements in all outcomes in the SMT-group compared to the AT-group ( p' s ≤ 0.015). Multivariate mediation path analyses revealed that, regarding mechanisms of change, the subscale cognitive-strategies-and-problem-solving was identified as the most important mediator for all outcomes (95% CIs for expected increases in SMT- vs. AT-group = [lower limits (LLs) ≥ 0.004]; 95% CIs for expected decreases in the SMT- vs. AT-group = [upper limits(ULs) ≤ -0.078]) except for job dissatisfaction., Discussion: Our findings confirm that employees can effectively learn to master stress reduction techniques and consequently lower the resulting burden. Moreover, beneficial SMT effects seem to result from improvements in functional stress management skills, particularly in the ability to change cognitions. This points to the importance of training cognitive techniques., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wirtz, Auer, Semmer, Ehlert and Nussbeck.)

Background: As natural or man-made shocks, disasters are sudden events that require emergency and fundamental measures. The need to be prepared for disasters has become clearer than ever worldwide. This study aimed to investigate the effect of earthquake preparedness training using the face-to-face or cascade method in rural households living in Juybar County (Iran) in 2018., Methods and Material: Following an experimental design with a pretest and posttest, the study was performed on married women aged 10-49 living in Kurdkolay village of Juybar county ( n = 372). Participants were randomly categorized into two groups of training ( n = 95) and face-to-face cascade method ( n = 95). Data were collected using the Disaster Preparedness Assessment Index, comprising demographic and education sections. Data were collected using the disaster preparedness assessment index and analyzed using SPSS version 24., Results: The findings indicated improved preparedness in all five dimensions in both groups. There was a significant difference between the study groups immediately and one week after the intervention ( P < 0.05); i.e. a higher impact for the face-to-face cascade method. Meanwhile, both groups presented a similar level of preparedness 90 days after receiving the intervention ( P > 0.05)., Conclusions: The face-to-face cascade method was more effective in the short term, while no difference was found in the long term. Crisis managers and policymakers should choose their preferred method based on available facilities, human resources, and context to increase preparedness against earthquakes. Mothers play a vital role in educating and nurturing their children. It is suggested to conduct educational programs at the community level using the most appropriate methods that are chosen based on the best evidence., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Background: The process of aging involves numerous changes in the body, influencing physical, mental, and emotional well-being. Age-related changes and degradation can impact various functions of the swallowing process and lead to delayed word retrieval. Individuals with limited linguistic stimulation may experience a more rapid decline in cognitive performance. Thus, this project explores a preventive training program targeting swallowing and linguistic-communicative skills, aimed at preserving the social participation of older individuals residing in nursing homes., Methods: A preventive intervention program, combining orofaciopharyngeal and linguistic-communicative components, will be offered twice weekly over 12 weeks in long-term care facilities in the greater Hanover area. The program will aim at: (a) activating sensitive and motor skills in the orofaciopharyngeal area to counter age-related swallowing disorders, and (b) enhancing communicative abilities through semantic-lexical activation. A cluster randomized controlled trial will be conducted to investigate whether the intervention program improves swallowing skills in older adults. Additionally, a secondary analysis will explore the impact on language skills and social participation, as well as program acceptance., Discussion: The results will provide valuable insight into the effectiveness of preventive measures addressing swallowing and speech issues in older individuals., Trial Registration: The trial was registered with DRKS (German register for clinical trials) in June 2023 (study ID: DRKS00031594) and the WHO International Clinical Trail Registry Platform (secondary register)., (© 2024. The Author(s).)

Objective: To assess the effectiveness of exercise and education in addition to standard care (SC) compared to SC alone in patients with hip or knee osteoarthritis (OA) during 24 months follow-up., Design: We conducted a quasi-experimental pragmatic clinical trial in care centers of a health insurance company. Overall, 1,030 subjects with hip and/or knee OA were included. The intervention group was recruited from clients participating in a hip/knee training (HKT, n = 515) in addition to SC. The control group (CO, n = 515) receiving SC only was recruited from the insurance database. HKT comprised 8 group sessions (1/week) of exercise and education, complemented by a 11-week structured home-exercise program (2/week). Primary endpoints were change of joint-related pain and function (WOMAC Index, score 0-10) after 3 months. Secondary endpoints related to follow-ups at 6, 12 and 24 months. All patient reported outcome measures were analyzed using linear mixed models (LMMs) investigating a time x treatment effect. A multivariable cox proportional hazards regression model was used to identify differences of joint replacement during follow-up between groups., Results: LMMs revealed statistically significant differences in favor of HKT for the primary outcomes WOMAC pain = 0.47 (CI 0.27-0.66; Effect Size (ES) = 0.22, p < 0.001) and WOMAC function = 0.27 (CI 0.11-0.44; ES = 0.13, p < 0.001). HKT was superior to CO for 6, 12, and 24 months as well (ES < 0.2, p ≤ 0.006). HKT was inferior regarding the first incidence of hip or knee AJR during follow-up in comparison to CO (adjusted hazard ratio, HR = 1.57; CI 1.08-2.30; p = 0.020)., Conclusions: This trial demonstrated short-, mid- and long-term superiority of exercise versus control. However, differences were smaller than those reported in previous efficacy trials, raising questions regarding clinical importance. Responder analysis will follow to identify possible predictors for patient responsiveness on an individual level. Further studies should investigate the frequency and reasons for joint replacement following exercise therapy., Trial Registration: German Clinical Trial Register (DRKS00009251). Registered 10 September 2015., (© 2024. The Author(s).)

In autism spectrum disorders (ASD), social communication and stereotypical behaviour patterns affect all areas of life, and can result in a decrease of its quality. Previous research has shown promising results for the social skills of groups of children with ASD. Furthermore, a pilot study of the Tübingen Group Training for Autism Spectrum Disorders (TüTASS) has demonstrated that mindfulness-based elements achieve additional positive effects. To build on these findings, the TüTASS training was adapted and expanded. Indeed, the TüTASS currently includes 20 90-min appointments starting with the basic skills of emotions, body, and communication, which are then transferred to personal, family, peer, and school spheres. The appointments have a fixed, consistent structure and each includes a body awareness exercise. In this study, we evaluated the TÜTASS with 27 children with ASD. The results showed improvements in pre-post comparison in behaviours associated with autism, as well as in externalising and internalising behaviours as assessed by parent reports, participant self-reports, and independent raters in participating children. Furthermore, the perceived parent burden in relation to their children decreased, whereas the participants' self-rated quality of life increased. Overall, both the participants and their parents rated the TüTASS very positively in rating sheets and in free feedback. If replicated in larger controlled trials, TÜTASS training might be a useful treatment tool for groups of children with ASD., (© 2023. The Author(s).)

This article describes observations and findings related to home dialysis therapy. Dialyzing at home provides many benefits, giving patients more flexibility and autonomy. Ensuring proper education and training, and home adaptation is critical for patient safety. Survey findings related to group training, home visits, medical records, and the use of patient care technicians in home dialysis are reviewed. Implications for nephrology nursing in each scenario are discussed, including survey guidance for transitional care dialysis., Competing Interests: The authors reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)

While the message emanating from physiological and psychological research has extolled the general advantages of exercise in physical and cognitive health, the social distancing and the impossibility of group exercises have revealed more complex conditions. Therefore, we performed an experimental study comparing the effect of individual and group cognitive-motor training on reconstructing subjective well-being (SWB) and quality of life (QOL) in older males who recovered from COVID-19. The study's design is a single-blind, randomized controlled trial (RCT). The participants, 36 older men (65-80 yrs.) recovering from COVID-19, were randomly divided into (1) Group A (cognitive-motor training, G-CMT); (2) Group B (individual cognitive-motor training, I-CMT); and (3) Group C (control). Both training interventions involved performing a training protocol (cognitive-motor training) twice a week for four weeks. The outcomes included an assessment of the SWB and QOL of participants by SWB scale and world health organization QOL scale at baseline and two weeks after interventions. Except for the effect of age and number of children variables on QOL, other demographic variables had no significant effect on the results of SWB or WHOQOL of participants (P > 0.05). The SWB results in G-CMT were better than I-CMT and control groups in emotional and social well-being domains. Also, WHOQOL test results in G-CMT were better than control groups in domains of psychological and social relationships, whereas I-CMT performed better than G-CMT and control groups in domains of cognitive well-being, physical health, and environment. The results revealed that the mean test scores of SWB and WHOQOL in G-CMT and I-CMT were better than the control group (P ≤ 0.001). The positive effects of cognitive-motor training on reconstructing SWB and QOL are associated with the synchronicity of cognitive and motor components in these exercises. We suggest that the emotional, social, and psychological benefits of cognitive-motor training override cognitive, physical, and environmental changes. The future line of the present study will include pathophysiology and further clinical aspect of recovering from COVID-19., (© 2023. The Author(s), under exclusive licence to Marta Olivetti Belardinelli.)

Purpose: Considering the importance of education and its role in promoting self-efficacy and reducing anxiety, the aim of the present study was to determine the effect of group self-care education on self-efficacy and anxiety among women with gestational diabetes., Methods: The present quasi-experimental study was conducted on 110 women with gestational diabetes mellitus. They were selected using the convenience sampling method in centers with obstetric clinics and perinatal departments. In the intervention group, women ( n  = 55) received training in groups of 5-7 people during a 60-minute session weekly for four consecutive weeks. The State-Trait Anxiety Inventory (STAI) and diabetes self-efficacy scale (DSES-S) was completed by participants three times, before, immediately after training, and four weeks later. Data analysis was carried out using descriptive and inferential tests (Chi-square, Mann-Whitney U test, independent t-test, and general linear model repeated measures analysis of variance) in SPSS ver., Results: There was no different between the two groups in terms of the score of self-efficacy ( P  = 0.604) and anxiety ( P  = 0.780) constructs before the intervention. Time, group, and their interaction has a significant effect in three time periods, i.e. before, immediately and 4 weeks after self-care training intervention in self-efficacy ( p  < 0.001) and anxiety ( p  < 0.001) constructs at %99 confidence interval., Conclusion: Group self-care training reduced anxiety among women with gestational diabetes (GD) and increased self-efficacy. Self-care group training is an easy, affordable, and non-invasive method and can be easily performed by midwives. This method can be used to reduce anxiety and increase self-efficacy among women with GD., Competing Interests: Conflict of interestThe authors declare that there is no conflict of interest., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: The prevalence of physical inactivity after stroke is high and exercise training improves many outcomes. However, access to community training protocols is limited, especially in low-income settings., Objective: To investigate the feasibility and efficacy of a new intervention: Circuit walking, balance, cycling and strength training (CBCS) on activity of daily living (ADL) limitations, motor performance, and social participation restrictions in people after stroke., Methods: Forty-six community-dwelling individuals with chronic stroke who were no longer in conventional rehabilitation were randomized into an immediate CBCS group (IG; initially received CBCS training for 12 weeks in phase 1), and a delayed CBCS group (DG) that first participated in sociocultural activities for 12 weeks. In phase 2, participants crossed over so that the DG underwent CBCS and the IG performed sociocultural activities. The primary outcome was ADL limitations measured with the ACTIVLIM-Stroke scale. Secondary outcomes included motor performance (balance: Berg Balance Scale [BBS], global impairment: Stroke Impairment Assessment Set [SIAS] and mobility: 6-minute and 10-metre walk tests [6MWT and 10mWT] and psychosocial health [depression and participation]). Additional outcomes included feasibility (retention, adherence) and safety., Results: ADL capacity significantly improved pre to post CBCS training (ACTIVLIM-stroke, +3,4 logits, p < 0.001; effect size [ES] 0.87), balance (BBS, +21 points, p < 0.001; ES 0.9), impairments (SIAS, +11 points, p < 0.001; ES 0.9), and mobility (+145 m for 6MWT and +0.37 m/s for 10mWT; p < 0.001; ES 0.7 and 0.5 respectively). Similar improvements in psychosocial health occurred in both groups. Adherence and retention rates were 95% and 100%, respectively., Conclusion: CBCS was feasible, safe and improved functional independence and motor abilities in individuals in the chronic stage of stroke. Participation in CBCS improved depression and social participation similarly to participation in sociocultural activities. The benefits persisted for at least 3 months after intervention completion., Protocol Registration Number: PACTR202001714888482., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Many individuals diagnosed with intellectual and developmental disabilities (IDD) are uncooperative during routine dental exams, leading to poor oral health in this population. Few studies have evaluated methodologies for preparing dental students and professionals to work effectively with patients diagnosed with IDD. In this study, experimenters used remote behavioral skills training (BST) to train dental students and professionals how to implement a practical intervention that included tell-show-do, contingent praise, and noncontingent reinforcement. Results suggested that group training conducted via videoconferencing was effective for teaching six of seven participants to implement the intervention in the absence of post-training feedback. This approach appears useful for quickly and efficiently training current and future dental professionals to implement behavior techniques to promote patient compliance., Competing Interests: Conflicts of InterestThe authors have no relevant financial or non-financial interests to disclose., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.)

Background: Internet Use Disorder (IUD), Gaming Disorder (GD), and Social Network Use Disorder (SNUD) are common phenomena among adolescents and young adults. Negative consequences of such disorders can be observed in the individuals themselves and in the family system. Although parents can influence their children in many ways, they are rarely considered in interventions. The present study examines the effectiveness of a group-based training for parents of adolescents with IUD, GD, or SNUD., Methods: A total of 76 parents of adolescents (12 to 20 years) were randomly assigned to the intervention group (IG) or the waiting list control group. Parents in the IG participated over eight weeks in six sessions of training (topics: psychoeducation, parenting behaviour, parent-child relationships, parent-child communication, and stress and relaxation). Questionnaires on adolescent symptomatology, parent-child relationships, and parental burden were collected before and after the intervention/waiting period., Results: The training reduced the IUD symptomatology of adolescents from the parents' perspective. GD symptomatology improved for at-risk users, though not for pathological users. Some aspects of the parent-child relationships improved in the mothers' judgment. Parental stress was already low before the training., Conclusions: The presented parent group training can be used to improve IUD symptomatology in adolescents and is effective in the context of early intervention for at-risk computer gamers.

This study aimed to compare an individual weight-machine-based strengthening program (MbT) with a group-/homebased training offering strengthening/functional exercises (GHT) in a general health care setting. A total of 657 participants (GHT = 521, MbT = 136) suffering from hip/knee OA were included and analysed with a pre-post design (baseline (T0)/3-months (T1)). Primary outcomes were pain and physical functioning (Western Ontario and McMaster Universities Osteoarthritis Index, range 0-10). Additionally, adherence and perceived patient benefit were measured (T1). Data were analysed with linear mixed models (time, treatment, baseline pain/physical impairment severity) adjusted for patient characteristics. No significant between-group differences in pain reduction/functional improvements (time*treatment*baseline pain/physical impairment severity, pain/function: n.s.; time*treatment, pain: p = 0.884, function: p = 0.067). Within-group improvements were dependent on baseline severity: Higher severity levels demonstrated larger changes from baseline. Perceived patient-benefit (very high to high, GHT: 78%, MbT: 92%) and exercise adherence (Dropouts T1: GHT: 27.8%, MbT: 16.2%; adherence to supervised sessions: GHT: 89%, MbT: 92%) was slightly better in the MbT. In summary, both MbT and GHT, showed positive results for patients with at least moderate disease symptoms. Findings for physical functioning, perceived patient-benefit, exercise adherence hint towards a superiority of MbT. Individual preferences should be considered when prescribing exercise therapy. Trial registration: (1) German Clinical Trial Register DRKS00009251. Registered 10 September 2015. (2) German Clinical Trial Register DRKS00009257. Registered 11 September 2015.

Objective: People with intellectual disabilities (ID) are at higher risk of being sexually abused and developing psychiatric disorders in consequence. The effects of behavior prevention programs for children with ID have rarely been investigated. Previous studies suffer from methodical weaknesses, such as the lack of a control group, small sample size, or invalid outcome measures. This study aimed at demonstrating the efficacy of a prevention program by overcoming these flaws., Methods: A group prevention program was developed and evaluated. One hundred and six girls aged from 8 to 12 years with mild ID were enrolled in a randomized controlled study, comparing the training to a sham intervention. Effects were examined in a three-time follow-up design as individual changes in preventive knowledge (board game, verbal reports) and preventive behavior (role-play, in situ tests). Participants' behaviors were videotaped and rated by three blinded raters., Results: Girls from the intervention group ( n = 64) showed significant improvements in preventive knowledge compared with the control group ( n = 39) but showed non-significant improvements for preventive behavior. In situ tests with realistic seduction situations revealed no improvement. The intervention proved to be safe, but several risks need to be considered., Discussion: This is the first study that evaluates a behavioral prevention program on sexual abuse for children with ID on a high level of evidence. Group interventions empowering girls with ID to recognize abuse situations are suitable to enhance sexual preventive knowledge but are less suitable to enhance preventive behavior. Naturalistic settings are indispensable for providing evidence for preventive interventions in children with ID., (Copyright © 2022 Reis, Häßler, Daubmann and Chodan.)

Background: Adult patients cared for by cardiologists, neurologists, and diabetologists are highly vulnerable to cardiovascular diseases (CVDs), which are worsened by smoking. In the past, physicians of these three specialties at major hospitals in Taiwan always referred patients to family medicine and chest medicine departments for smoking cessation programs. However, the participation rate in these programs was unsatisfactory., Objectives: To encourage cardiologists, neurologists, and diabetologists to provide smoking cessation treatment services (SCTSs) to their patients through an annual contest., Methods: Sequential expert meetings, group training, a contest to reward service quantity and abstinence rate, and an annual awards ceremony were held over the past 3 years., Results: More than 350 cardiologists, neurologists, and diabetologists were certified to provide SCTSs, and in the second half of 2020, 3716 high CVD risk patients entered smoking cessation treatment programs, with an abstinence rate exceeding 30% at 3 months., Conclusions: The strategy used in this study was effective in overcoming physician inertia to provide SCTSs and encourage high CVD risk smokers to quit smoking.

Background and Purpose: Sleep disorder is one of the most common problems during menopause, which affects different areas of people's lives. Today, mindfulness is one of the concepts that have attracted a lot of attention due to its desirable effects and low side effects. The present study was conducted to investigate the effect of mindfulness-based stress reduction (MBSR) group training on sleep quality of postmenopausal women., Method: This is a quasi-experimental parallel study. The study involved 66 eligible postmenopausal women 45-60 years' old (n = 33 in each group) during 2019-2020. The minimum score of women was 5 from Pittsburgh questionnaire. Eight sessions weekly (120-min/session) MBSR group training was conducted in the intervention group and menopausal health in the control group for two months. Pittsburgh Sleep Quality Questionnaire was used as a data collection tool. Descriptive statistics and nonparametric tests were utilized to analyze the data using SPSS software (version 25). The significance level < 0.05 was considered., Results: Socio-demographic characteristics of participants were no statistically significant difference between the study groups before the intervention. The results showed that mean of overall quality of sleep score was before the intervention 10.21 ± 3.03, after the intervention 4.7 ± 2.45, and one month after the intervention 4.69 ± 2.4 respectively in intervention group (P < 0.001). While there was no significant change in the mean overall quality of sleep quality in the control group., Conclusion: According to the results, MBSR group training is an effective strategy for improving the sleep quality of postmenopausal women. Therefore, could be used to improve the sleep quality of postmenopausal women by midwifery consultants in health centers., (© 2022. The Author(s).)

Executive function disorder rehabilitation in neurological patients is associated with many difficulties. We investigated the effectiveness of group training, proposed by B. Wilson et al., which has the model of frontal lobes functioning by D. T. Stuss as the theoretical background. The study participants were 16 patients with executive function disorder caused by TBI, strokes, and infections. The training was shortened from 9 weeks to 3 and adopted to the conditions of the rehabilitation centre where the study was held. The evaluation of training effectiveness was carried out by the methods of neuropsychological diagnostics proposed by A. R. Luria as well as standardized quantitative tests (CWIT test, Raven test, FAB) and questionnaires (EBIQ) aimed at assessing the state of executive functions and general well-being. In result positive trends, but not reaching the level of significance, were revealed in the performance of all evaluating methods, with the exception of "arithmetic problems" and "inhibitory control" as part of the FAB test. Statistically significant result was obtained concerning such tests as "counting", "analysis of story pictures", and index of total uncorrected errors in the CWIT test. Thus, the results of eventual assessment showed positive dynamic of executive functions state.

Autism spectrum disorders (ASD) are often associated with intellectual disability (ID). ASD-specific group concepts usually focus on people on a high functioning level. The Autism-Competence-Group (AutCom) combines a psycho-educative approach with music and dance/movement interventions in adults with ASD and ID. AutCom includes 16 structured 90-minute sessions to foster social and emotional competencies. This study investigates the acceptability and effectiveness of AutCom. Practicability and acceptability were measured based on participation frequency and patient satisfaction (CSQ-8). Efficacy was assessed in a pre-post design ( N  = 12) based on self- and third-party assessment with a control group matched by gender and level of ID. Primary outcome variables were social and emotional competence, and secondary outcomes were challenging behavior and quality of life. A participation rate of 86% indicated practicability; high CSQ-8 scores ( M  = 30 of max. 32) indicated acceptability. Significant improvement was found in social competence compared to the control group and emotional competence in the pre-post self-assessment on the AutCom questionnaire. No significant improvement was found in challenging behavior and quality of life. AutCom is shown to be a promising and highly accepted group concept in fostering social and emotional skills in adults with ASD and ID., Competing Interests: None of the authors or other persons involved in this study have any interests that might be interpreted as influencing the research., (© The British Society of Developmental Disabilities 2021.)

Objective: The goal of this study was to determine if a 6-week, peer-led intervention improves health literacy and numeracy among people living with HIV (PLWH)., Methods: We used a randomized controlled trial with repeated measurements, which included six, 90-minute, group-based training sessions. We recruited PLWH participants (n = 359) from safety-net practices in the New York City Metropolitan area and Rochester, NY. Participants were randomly assigned (1:1) to an intervention group (n = 180) or a control group (n = 179). Outcome measures were collected at baseline, eight weeks post-baseline, and at six months using the Brief Estimate of Health Knowledge and Action-HIV (BEHKA-HIV), the Electronic Health Literacy Scale (eHEALS), the Rapid Estimate of Adult Literacy (REALM), and the Newest Vital Sign (NVS)., Results: The intervention group had statistically significant improvements in eHealth literacy and BEHKA-HIV compared to the control group. There were no statistically significant changes in general health literacy or numeracy in either group. The intervention had the greatest impact on participants with the lowest levels of eHealth literacy at baseline., Conclusion: The intervention had a positive impact on participants' HIV health literacy and eHealth literacy., Practice Implications: Our findings have implications for broadening the function of peer-workers in the health care continuum., Competing Interests: Declaration of Competing Interest The authors do not have any conflicts of interest to declare., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Introduction: The aim of residency is to acquire medical skills and abilities. One didactic model is "Peyton's four-step approach". The aim of the present study was to develop and evaluate a modified Peytonian approach for group interactions. The aim was to develop a course for the acquisition of practical skills and training assistants in suture techniques for urology., Methods: A prospective study was conducted with a total of 38 participants and 6 tutors. In a modified four-step Peytonian approach, various suturing and knotting techniques were taught in a structured manner. Tutors evaluated the procedural activity using observation sheets. In addition, the learning method was evaluated by the participants and the tutors at the end of the course. In order to check the long-term learning success, a renewed survey of the participants was conducted after 6 months., Results: 80% of the participants rated the modified teaching method as useful and 83% of the tutors rated the procedural implementation as good. Fluid movement sequences were difficult independent of the technique taught. After 6 months, the participants significantly improved their procedural skills in all techniques that were taught., Conclusion: This paper defines a four-step Peyton-based approach to teaching practical skills such as suturing and knotting used in urological training. The modified teaching method improved practical skills used in urology. This method should be considered in continuing education to promote self-confidence and increase the competence in surgical skills.

Even though physical activity is an important aspect of health, lack of time or motivation impede people from working out regularly. One type of training program that is both efficient and motivating is functional interval-type outdoor training. To evaluate this, our study had 81 participants complete a battery of physical performance tests (incremental treadmill test, core stability test and functional fitness test) before and after an 8-week outdoor interval-type training intervention. Training procedures included multimodal and high-intensity exercises performed in consistent, small groups. Results showed that the interval training program produced significant increases in the intervention group ( n = 43) in functional and strength exercises ( p < 0.001; squat (+27%), burpee (+24%), bridge (+39%), push-up (+34%), sit-up (+25%), high knees (+25%), row (+19%), effect sizes 0.4-0.11) for almost all parameters in comparison to a non-intervention control population ( n = 38). Interestingly, trunk stability increased significantly ( p < 0.001; flexion (+86%), extension (+43%), lateral left (+39%), lateral right (+32%), effect sizes 0.3-0.15) even though it was not explicitly trained; this was rather a secondary outcome of the functional exercises. Drop-out rates (Intervention group: 27%) suggest that this form of training seems to improve adherence to exercise and may help participants to stay committed to regular, intense activity. By simultaneously triggering adaptations in functional fitness, endurance and whole-body movements, this program can be used by people at different training levels., Competing Interests: AH is an employee of OBC Europe GmbH and works as a trainer besides her normal job as a Ph.D student at the university. They offered help in recruiting participants for this study by using their newsletter for informing about the study. The work inspired me to conduct the study. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Hendker and Eils.)

Many individuals with autism spectrum disorder (ASD) have deficits in conversation skills that can interfere with the development of personal and professional relationships. Further research is needed on efficient interventions for targeting conversation skills in adults with ASD and for evaluating the social validity of the outcomes. In this study, 2 practitioners implemented a 4-week training program for 5 adults with ASD that combined individualized computer-based instruction (CBI) and practice with peers to promote the acquisition, maintenance, and generalization of conversation skills. Training was associated with improvements in 12 of 13 skills across participants. These findings, along with peer ratings of the participants' conversation skills, suggest that this model is a promising, socially valid approach for improving conversation skills in adults with ASD., (© 2020 Society for the Experimental Analysis of Behavior (SEAB).)

Introduction: One of the most critical stages of women's lives is menopause. Meanwhile, group training can have a significant effect on reducing menopausal symptoms. The aim of this study was to investigate the effectiveness of group training on reducing menopausal symptoms in postmenopausal women., Methods: This study was a randomized controlled trial. The study population was 96 postmenopausal women visiting health centers in the city of Shazand (Markazi Province, Iran). Data collection tools in this study were the Menopausal Rating Scale Questionnaire and the Beck Depression Inventory. Group training intervention consisted of four training sessions. The duration of each session was 2 h. The questionnaires were completed in two stages of pre- and post-test (8 weeks later) for the intervention and control groups. Data were analyzed using descriptive statistics (absolute and relative frequency, mean and standard deviation) and analytical statistics (independent t -test, paired t -test, and analysis of covariance)., Results: The mean age in the intervention group and the control group was 49.93 ± 3.44 and 51.66 ± 2.93 years, respectively. In the intervention group, the mean menstrual time was 2.37 ± 167 years and in the control group, the mean time elapsed from the last menstrual period was 3.91 ± 2.68 years. The mean scores of menopausal physical symptoms ( F = 58.69), menopausal symptoms ( F = 43.45), menopausal urinary and genital symptoms ( F = 33.50), and depression ( F = 58.25) had a significant decrease in intervention group, while in the control group, these changes were not significant ( P < 0.001)., Conclusion: Regarding the findings of this study, which indicates the effect of group training program on the improvement of physical, psychological, urinary and genital symptoms, and menopausal depression, it seems that group training in menopause can be an effective method., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

We used behavioral skills training (BST) to teach multiple skills to 2 cohorts of 18 participants. BST consisted of the standard 4 components: (a) didactic instruction, (b) modeling, (c) role-play, and (d) feedback, modified to be delivered in a large-group format. All components were provided by 1 trainer, simultaneously to all participants, with peers delivering feedback during role-plays. Across 4 targeted skills (e.g., discrete-trial teaching), the average performance of Cohort 1 improved from less than 60% correct implementation in baseline to a performance of between 85% and 100% correct, across participants, following BST. We used social validity data collected from Cohort 1 to modify the length of instruction across skills for Cohort 2. BST was similarly effective for Cohort 2, with a decrease in the additional training required for trainees to demonstrate the skill in a novel role-play scenario or with a client. Implications for effectively scaling up BST are discussed., Competing Interests: Conflict of InterestThe authors have no conflicts of interest to disclose., (© Association for Behavior Analysis International 2020.)

Background: People with Parkinson's disease find that exercise helps to improve their physical performance. However, when performed in a group, they also tend to appreciate each other's company. Purpose: After people with Parkinson's disease participated in a community-based group balance exercise program, our aims were to explore the participants' general attitude to their balance ability and exercise, and specifically their experiences of participating in a group exercise. Materials and Methods: Informants were people living with Parkinson's disease at an early stage ( n  = 15) who had participated in a community-based "Somatosensory Focused Balance Training without Cues." Each informant took part in one face-to-face interview. The interviews were transcribed, according to content analysis, coded independently by two researchers and triangulated together with a third experienced researcher. Categories and themes were derived in consensus. Results: The participants felt limited by their body. They agreed that the group balance exercise program did help with their balance control. Moreover, the vast majority found that the group context implied a positive social contribution to their lives and to their ability to cope with living with the disease. Conclusion: Group balance exercise might constitute a context with potential to improve quality of life for people with Parkinson's disease, not only by improving balance control, but also contributing to social connections, fellowship and the exchange of mutual experiences.Implications for rehabilitationGroup-based exercise in early Parkinson seems to add more than just the physical effects of training, since it also gives a platform for meeting social and emotional needs, as well as addressing physical ability.The group dynamics and the support of peers seem to promote a positive attitude to life and enable people to learn coping strategies from each other.Community-based exercise groups for people with early Parkinson seem to be a way to get out in society and regain a feeling of being part of society.Due to body limits, people with Parkinson's disease must struggle daily, already at an early stage of their disease; this stresses the need to begin rehabilitation early.

Background: The imprisoned women usually have low self-esteem and suffer from various physical and mental complaints; they may suffer from feelings of emptiness, isolation, and depression. Transactional analysis (TA) is part of a comprehensive system attributed to the individual and social psychiatry for personal development of self-esteem among the imprisoned women. Therefore, the present study aimed to investigate the effect of TA group-training on the self-esteem of imprisoned women., Methods: This clinical trial was conducted among the imprisoned women in a prison in Southeastern Iran using pretest-posttest design. In this regard, 76 women were randomly allocated to the intervention (n = 35) and control (n = 41) groups. The TA group-training program was held for eight 90-min sessions for the intervention group. Data were collected using a demographic questionnaire and the Rosenberg's self-esteem scale (RSES). Later, all participants were evaluated before and 1 month after the intervention., Results: In pre-test, the mean scores of self-esteem were 11.8 ± 4.67 and 7.97 ± 4.52 for the intervention and control groups, respectively. These scores showed low levels of self-esteem and the difference between the two groups was significant (p = 0.001, t = - 3.61). In the post-test, the mean scores of self-esteem improved to the moderate level (22 ± 2.52) in the intervention group compared to the control group (8.92 ± 4.04). This indicates the significant improvement of self-esteem in the intervention group (p = 0.001, t = 17.15)., Conclusions: The results showed that TA group-training had a significant effect on self-esteem. Therefore, the experienced and expert counselors and psychologists are recommended to hold transactional analysis group-training courses to enhance self-esteem among women prisoners., Trial Registration: Iranian Registry of Clinical Trials, IRCT20170725035289N5 Date registered: 25/08/2018.

Social skills group training (SSGT) is widely used for intellectually able children and adolescents with autism spectrum disorder (ASD). Previous studies indicate small to moderate effects on social communication capacities. The duration of most available programs is relatively short, and extended training might lead to further improvement. This randomized controlled trial compared an extended 24-week version of the SSGT program KONTAKT with standard care. The weekly sessions gradually shifted in content from acquisition of new skills to real-world application of the acquired skills. A total of 50 participants with ASD (15 females; 35 males) aged 8-17 years were included. The study was conducted at two child and adolescent psychiatry outpatient units in Sweden. The primary outcome was the Social Responsiveness Scale-Second Edition (SRS-2) rated by parents and blinded teachers. Secondary outcomes included parent- and teacher-rated adaptive behaviors, trainer-rated global functioning and clinical severity, and self-reported child and caregiver stress. Assessments were made at baseline, posttreatment, and at 3-months follow-up. Parent-rated SRS-2 scores indicated large effects posttreatment [- 19.2; 95% CI - 29.9 to - 8.5; p < .001, effect size (ES) = 0.76], which were maintained at follow-up (- 20.7; 95% CI - 31.7 to - 9.7; p < .0001, ES = 0.82). These estimates indicate substantially larger improvement than previously reported for shorter SSGT. However, the effects on teacher-rated SRS-2 and most secondary outcomes did not reach statistical significance. Our results suggest added benefits of extended SSGT training, implying that service providers might reach better results by optimizing the delivery of SSGT.

Aims and Objectives: This study aimed to evaluate Tai Chi group training among patients with chronic heart failure (CHF) aged 70 years and older., Background: Physical activity is recommended for CHF treatment. Tai Chi is found to be beneficial to different patient groups, although few studies focus on older patients with CHF., Design: A mixed methods study. Participants were randomly assigned to Tai Chi training twice a week for 16 weeks ( N  =   25) or control ( N  =   20). Quantitative data were collected at baseline, at the end of the training period and 6 months after training, assessing self-rated fatigue and quality of life, natriuretic peptides and physical performance. Individual qualitative interviews were conducted with participants ( N  =   10) in the Tai Chi training group., Results: No statistical differences between the Tai Chi training group and the control group in quality of life or natriuretic peptides was found. After 16 weeks, the training group tended to rate more reduced activity and the control group rated more mental fatigue. Participants in the training group rated increased general fatigue at follow-up compared with baseline. Qualitative interviews showed that Tai Chi training was experienced as a new, feasible and meaningful activity. The importance of the leader and the group was emphasized. Improvements in balance were mentioned and there was no physical discomfort., Conclusion: Tai Chi was experienced as a feasible and meaningful form of physical exercise for patients with CHF aged over 70 years despite lack of achieved health improvement. Further investigations, using feasibility and meaningfulness as outcome variables seems to be useful.

There has been increased recognition of the 3Rs in laboratory animal management over the last decade, including improvements in animal handling and housing. For example, positive reinforcement is now more widely used to encourage primates to cooperate with husbandry procedures, and improved enclosure design allows housing in social groups with opportunity to escape and avoid other primates and humans. Both practices have become gold standards in captive primate care resulting in improved health and behavioural outcomes. However, training individuals and social housing may be perceived as incompatible, and so it is important to share protocols, their outcomes and suggestions for planning and improvements for future uptake. Here we present a protocol with link to video for training rhesus macaques ( Macaca mulatta) housed in single-male - multi-female breeding groups to sit at individual stations in the social enclosure. Our aim was that the monkeys could take part in welfare-related cognitive assessments without the need for removal from the group or interference by group members. To do this we required most individuals in a group to sit by individual stations at the same time. Most of the training was conducted by a single trainer with occasional assistance from a second trainer depending on availability. We successfully trained 61/65 monkeys housed in groups of up to nine adults (plus infants and juveniles) to sit by their individual stationing tools for >30 s. Males successfully trained on average within 30 min (2 training sessions); females trained on average in 1 h 52 min ± 13min (7.44 sessions), with rank (high, mid, low) affecting the number of sessions required. On average, dominant females trained in 1 h 26 min ± 16 min (5.7 sessions), mid ranked females in 1 h 52 min ± 20min (7.45 sessions), and subordinate females took 2 h 44 min ± 36 min (10.9 sessions). Age, group size, reproductive status, temperament, and early maternal separation did not influence the number of sessions a monkey required to reach criterion. We hope this protocol will be useful for facilities worldwide looking to house their animals in naturalistic social groups without impacting on animal husbandry and management.

Objectives: Overweight and obese individuals are recommended to perform regular resistance training, and the health- and fitness industry offer several exercise programs with purpose to improve muscle strength and body composition. This randomised controlled trial aimed to compare 12 weeks (45-60min, 3 sessions/weeks) of popular exercise programs, available at health- and fitness centers worldwide., Methods: Previous untrained women with BMI≥25 were allocated to either BodyPump (a high-repetition group session) (n=25), individual resistance training with a personal trainer (n=25), non-supervised individual resistance training (n=21) and non-exercising control group (n=21). Primary outcome was one repetition maximum (1RM) in squat and bench press, and secondary outcome was body composition (Inbody720)., Results: The BodyPump group did not improve muscle strength, compared to any of the other groups. In 1RM squat, the personal trainer group increased 17% (95% CI 5.1-23.0), 20% (95% CI 7.5-24.8) and 30% (95% CI 15.8-33.0kg) more than the non-supervised group, BodyPump and controls, respectively. In bench press the personal trainer group increased 10% (95% CI 1.5-7.2) and 16% (95% CI 3.5-9.3kg) more compared to BodyPump and controls. No difference was found compared to the non-supervised group in bench press. There were no between-group differences in body composition., Conclusion: Twelve weeks of BodyPump did not improve muscle strength in overweight women, but a personal trainer amplified the effects of individual resistance training on maximal strength in squat. None of the intervention groups showed effect in body composition., (Copyright © 2017 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Purpose of state: The aims of this study were to develop a Wheelchair Maintenance Training Programme (WMTP) as a tool for clinicians to teach wheelchair users (and caregivers when applicable) in a group setting to perform basic maintenance at home in the USA and to develop a Wheelchair Maintenance Training Questionnaire (WMT-Q) to evaluate wheelchair maintenance knowledge in clinicians, manual and power wheelchair users., Methods: The WMTP and WMT-Q were developed through an iterative process., Results: A convenience sample of clinicians (n = 17), manual wheelchair (n ∞ 5), power wheelchair users (n = 4) and caregivers (n = 4) provided feedback on the training programme. A convenience sample of clinicians (n = 38), manual wheelchair (n = 25), and power wheelchair users (n = 30) answered the WMT-Q throughout different phases of development. The subscores of the WMT-Q achieved a reliability that ranged between ICC(3,1) = 0.48 to ICC(3,1) = 0.89. The WMTP and WMT-Q were implemented with 15 clinicians who received in-person training in the USA using the materials developed and showed a significant increase in all except one of the WMT-Q subscores after the WMTP (p < 0.007)., Conclusion: The WMTP will continue to be revised as it is further implemented. The WMT-Q is an acceptable instrument to measure pre- and post-training maintenance knowledge. Implications for Rehabilitation The Wheelchair Maintenance Training Program can be used to educate rehabilitation clinicians and technicians to improve wheelchair service and delivery to end users. This training complements the World Health Organization basic wheelchair service curriculum, which only includes training of the clinicians, but does not include detailed information to train wheelchair users and caregivers. This training program offers a time efficient method for providing education to end users in a group setting that may mitigate adverse consequences resulting from wheelchair breakdown. This training program has significant potential for impact among wheelchair users in areas where access to repair services is limited.

The transition of adolescents with chronic conditions is a challenging task. This study aimed to explore the experiences and needs of adolescents with chronic conditions in the transition period and to apply these findings to the design of a generic patient education programme. Data were collected from a sample of 29 adolescents with chronic conditions from Northern Germany and Switzerland including a broad range of views due to variation in disease management and organisation of care both in paediatric and adult populations. Participants were interviewed in group (n = 18) or individual (n = 11) interviews between September 2011 and February 2012, and the data were analysed using qualitative content analysis. The findings revealed that the interviewees expressed high levels of competency in the management of their chronic conditions but identified gaps in healthcare and unmet needs during transition. In particular, they believed that they would benefit from opportunities to exchange ideas and more specific information with peers about vocational and medical issues concerning adolescent health. Identified themes reflecting adolescent needs were used to develop the transition workshop including modules regarding the following: transfer to adult medicine, their new role as a patient, orientation within the healthcare system, vocational issues, detachment from parents, social support, contraception, substance abuse, family planning, stress-management, activation of resources and developing personal goals. The workshop's content was largely generic and included some condition-specific components. The workshop was designed as a compact 2-day patient education programme in a group setting for adolescents prior to their transfer to adult care. The guiding principle was the idea of empowerment by supporting the adolescents through various interactive methods to develop adequate knowledge, skills, understanding and motivation regarding their chronic conditions. We conclude that patient education programmes promoting adolescent self-management and empowerment increase the preparedness for transition., (© 2016 John Wiley & Sons Ltd.)

Objective: Bipolar disorder (BD) is a disabling psychiatric disorder with frequent recurrences. Besides pharmacotherapy, psychoeducation could be helpful in reducing symptoms as well as recurrence of this disorder, leading to improvement of patients' quality of life. This study aimed at investigating the effectiveness of a culturally adjusted structured program for training Iranian BD patients. Method: In a 6-month course (spring and summer 2014), 24 BD patients, visiting the outpatient clinic of Ibn-Sina Hospital in Mashhad and experiencing euthymic phase, were allocated in to 2 groups of intervention and control. The intervention group received 8 sessions of psychoeducation in four weeks. Patients in the control group received the usual treatment. The patients were evaluated with Hamilton Depression Rating Scale, Young Mania Rating Scale, and Short Form 36 before the intervention and 4 weeks later, and the results were compared using independent t test. The patients were reexamined after 6 months for recurrence, hospitalization, treatment adherence, and visiting a psychiatrist, and were compared with patients in the control groups. Results: There was a significant difference in the intervention group in improvement in quality of life before and after treatment (p<0.003). In addition, the difference was significant between the 2 groups in the number of recurrence (p<0.001) and hospitalization (p<0.000) in 6 months. Conclusion : In addition to pharmacotherapy, psychoeducation of patients with BD can improve their quality of life and decrease the risk of disorder recurrence.

Background: Dysfunctional relationships and emotion dysregulation are hallmark features of borderline personality disorder (BPD). Women with BPD are, therefore, particularly challenged when raising a child. A group training program was developed for mothers with BPD to enhance their parenting skills and help them raise their children. The program is based on cognitive-behavioral principles and skills derived from Dialectical Behavior Therapy (DBT)., Methods: N  = 15 mothers with BPD who had young children (aged 0-6 years) participated in a 12-week training program. To estimate the participants' impairment, parental stress and psychological distress were assessed before the training. After the training, participants and trainers were asked to provide feedback regarding the evaluation of and the changes due to the training., Results: Participants' self-reported stress related to parenting, as well as psychological distress and depressive symptoms, was high. Participants' acceptance of the program was very good. Especially role plays were rated as useful. Trainers evaluated the program as helpful and reported visible changes in participants' behavior and attitudes towards parenting., Conclusions: The results on the acceptance of the training program are promising., Trial Registration: NCT02935218, Unique Protocol ID: RenRos01 Initial release 80 August 2016, last release 13 October 2016; 'retrospectively registered'.

Background: Osteoarthritis is the most common reason for pain in older adults, and the individual and economic burden of this disease is immense. The chronic character of osteoarthritis requires a long-term therapeutic treatment. In this regard life-style interventions such as physical exercises that can be carried out by the patient himself are recommended as first line treatment. There is evidence for the short-term benefit of exercise therapy in terms of pain reduction and physical functioning. Nonetheless research agendas highlight the need for multifaceted interventions that incorporate exercise strategies into patient care. Studies should be conducted with appropriate sample sizes and should allow statements on long-term effects as well as cost-utility and safety. These open questions are under the scope of this study., Methods/design: This is a controlled study in the context of health services research. The study population consists of n = 1400 subjects with hip or knee osteoarthritis. The intervention group will be recruited from participants of a country-wide health insurance offer for people with hip or knee osteoarthritis. Potential participants for the control group (ratio 10:1 (control vs. intervention) will be filtered out from the insurance data base according to pre-defined matching criteria and asked by letter for their participation. The final statistical twins from the responders (1:1) will be determined via propensity score matching. The progressive training intervention comprises 8 supervised group sessions, supplemented by home exercises (2/week over 11 weeks). Exercises include mobilization, strengthening and training of postural control. Primary outcomes are pain and function measured with the WOMAC Index immediately after the intervention period. Among other things, health related quality of life, self-efficacy, cost utility and safety will be evaluated as secondary outcomes. Participants will be followed up 6, 12 and 24 month after baseline., Discussion: Results of this trial will document the effects of clinical as well as economic outcomes in a regular health care setting on the basis of a large sample size. As such, results of this trial might have great impact on future implementations of group- and home-based exercises in hip or knee osteoarthritis., Trail Registration: German Clinical Trial Register DRKS00009251 . Registered 10 September 2015.

Objective: The aim of the study was to test the effects of a generic transition-oriented patient education program on adolescents' health service participation and quality of life (QoL)., Methods: We conducted a controlled trial comparing participants of 29 transition workshops with treatment as usual in 274 adolescents (16.8 mean age, SD=1.76) diagnosed with type I diabetes (DM), cystic fibrosis (CF) or inflammatory bowel disease (IBD). A two-day transition workshop was carried out at 12 sites in Germany, focusing in standardized modules on adjustment to adult care settings, organization of future disease management, career choices and partnership. Study outcomes were health-related transition competence, self-efficacy, satisfaction with care, patient activation and QoL. Measures were assessed at baseline and six-month follow-up., Results: Repeated-measurement covariance analysis using age as a covariate showed that the transition workshop significantly affected transition competence, self-efficacy and satisfaction with school care six months post intervention. The intervention did not significantly affect patient activation and QoL. However, post-hoc analysis suggested different effects across conditions., Conclusion: The program has a positive effect on the competence of adolescents in the transition phase., Practice Implications: The study demonstrates that an intervention can be effective in preparing adolescents with chronic conditions for transitions., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Since there is lack of up to date consensus exists as to whether group training is effective in improving lumbopelvic pain (LPP) after pregnancy, a review of the recent evidences is needed. To determine the effect of group exercise training for the management of LPP among pregnant women compared with usual antenatal care. An electronic database search for relevant randomized control trials published in English from 2006 to 2015 was conducted. Articles with outcome measures of self-reported LPP, visual analogue scale and sick leave due to LPP after pregnancy were included. Quality of the included articles was rated using Physiotherapy Evidence Database (PEDro) scale and the pooled effect of self-reported LPP was obtained by Review Manager (RevMan 5) software. Significant effect of group training was detected over usual antenatal care or no treatment with P=0.0035 (95% confidence interval, -0.2348 to -0.0044). The results of this systematic review proposed that group training reduces LPP significantly better than routine antenatal care for pregnant women suffered from LPP.

Background: Parenting style is one of the most important and effective factors in training and growth of children and adolescents and the method that parents communicate with their children is an effective factor on family contact models., Objectives: The aim of this study was to determine the impact of group training about parenting styles on maternal attitudes that were admitted to Isfahan Imam Ali (AS) health care center in 2013., Materials and Methods: This was an experimental study, which was conducted on a random sample of 25 mothers referred to this health care center. They were divided into two groups (experimental and control). The experimental group received five sessions of group training, and the control group received a booklet about parenting styles. The used tool in this study was the Bamerind Parenting Style Questionnaire that was completed by the mothers before and after the intervention and finally, their obtained scores were compared with each other., Results: The results of the present study showed that the mean score of attitude toward easy-going style in test group was less than the control group after intervention (P = 0.045). The mean score of attitude toward authoritative style in the experimental group was less than control group after intervention (P = 0.037) and the mean score of attitude toward authoritative style in the experimental group was more than the control group after intervention (P = 0.011)., Conclusions: Group training can be an appropriate method in changing maternal attitudes toward parenting styles.

Background: Diabetes mellitus (DM) is one of the most common metabolic and non-communicable disorders worldwide and the mortality rates caused by the complications associated with the disease, such as diabetic foot ulcer, is increasing dramatically. Patient education is considered as an essential part of controlling DM. Therefore, we aimed to compare the effects of individual and group training methods on self-efficacy in foot care among the patients with DM., Methods: In this single-blinded, randomized controlled clinical trial, we enrolled 150 patients with type 1 and 2 DM. The final participants were randomly assigned into two intervention groups (collective and individual training group) and a control group. Data were collected using foot-care self-efficacy questionnaire (Corrbet, 2003). A research assistant collected the data by interviewing the participants using the questionnaire once before and once one month after the intervention. The participants of the intervention groups attended a training program consisting of three sessions per week for one week. Statistical descriptive tests such as mean and standard deviation (SD) percentage were used to describe the features of the data inferential statistics test such as Chi-square, independent t-test and repeated measures analysis of variance and analysis co-variance (ANOVA, ANCOVA) tests were also used as appropriate. The significance level was set at <0.05., Results: The results indicated that there was no significant difference between the three groups regarding the mean of self-efficacy scores before foot-care training intervention (P=0.39). But, comparison of the scores before and after the intervention showed that both group and individual training interventions increased the patients' self-efficacy (P≤0/05)., Conclusion: It can be concluded that both group and individual training approaches could increase foot care self-efficacy in the patients with DM., Trial Registration Number: IRCT201203086918N6.

Objective: This study evaluates the Musical Concentration Training with Pepe ("MusiKo mit Pepe") for children aged 5 to 10 years with attention deficits., Method: Using a pre-post-control design (N = 108), changes in attention capacity are measured by the Test of Attentional Performance for Children (KiTAP), whereas changes in the quality of life are assessed with the Children's Questionnaire (KINDL-R). Additionally, we utilized the Symptom Checklist for Attention Deficit Hyperactivity Disorders (FBB-ADHS) and for Conduct Disorder (FBB-SSV) of the Diagnostic System of Mental Disorders in Children and Adolescents II based on ICD-10 and DSM-IV as well as the Child Behavior Checklist and the Teacher's Report Form (CBCL, TRF)., Results: Significant pre-post effects were found in both attention and quality of life for children treated by the training compared to controls. Moreover, significant reductions were detected in ADHD symptomatology in parents' and teachers' ratings, and in internal problems in parents' ratings. The effectiveness of the intervention was not affected by age, sex, intelligence, or migration background., Conclusion: The music-based training "MusiKo mit Pepe" is an effective intervention for children with attention deficits, pending replication of these findings in future studies.

Objective: Cognitive remediation therapy (CRT) seems to be increasingly interesting in the treatment of anorexia nervosa for adult patients. We attempted to apply this support to a group of young inpatients, initially to assess its feasibility and acceptability, and then to improve its content for therapeutic application and future research., Methods: Ten 12- to 17-year-old inpatients with primary DSM-IV diagnosis of anorexia nervosa participated in a 10-week intervention program with a one-hour group session of CRT per week. All 10 patients were assessed before the intervention and those who completed the 10 sessions were assessed after. Assessment included a clinical examination by a psychiatrist, a battery of clinical inventories, and set-shifting tests. Moreover, each patient wrote a letter providing feedback on the intervention for subsequent analysis., Results: Only two patients completed all 10 sessions, the other eight who were discharged from the hospital in the meantime could not attend the sessions for practical reasons. After the 10 sessions, an improvement in BMI and in measured levels of some psychopathological symptoms was observed in our two patients. Most neuropsychological task performances were improved after cognitive remediation. Feedback from the 10 patients was generally positive., Conclusion and Implications for Practice: This preliminary investigation suggests that cognitive remediation therapy is acceptable and feasible in this population. Replication of these findings requires a larger sample, improvement of the trial design, more sensitive measures, and another training format to avoid loss of so many participants., (Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Background: Population growth is still a global concern. In spite of the decrease in population growth and conception rate, Iran and the world population will grow in coming years. Participation of men in contraception interventions to control population growth is of great importance., Methods: This is a quasi-experimental study, in which the authors provided group training of contraceptive methods to 53 women, and then evaluated the effect of training on the dependent variable of husbands' participation in family planning. The data was gathered using a questionnaire and a checklist, and then was analyzed using SPSS software, by paired t-test., Results: The results indicated that the mean score of knowledge level of the case group members and their husbands changed significantly after the training program (p < 0.001). Also, it was found that 51% of the participants and their husbands used contraceptive methods after the training program., Conclusions: Considering the results, providing group training for couples to increase the participation rate of men in family planning programs is recommended.