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To verify the effectiveness of experimental occupational therapy plus intensive standard rehabilitation compared to intensive standard rehabilitation alone on the reintegration to social activities of complex patients three months after hospital discharge. Patients with a score ≥ 9 on the Rehabilitation Complexity Scale at admission to an intensive rehabilitation ward were randomized to the control or experimental group. Both groups received intensive multidisciplinary rehabilitation aimed at recovering independence in the basic activities of daily life (ADL). The experimental group also received experimental occupational therapy services to address goals identified through the administration of the Canadian Occupational Performance Measure (COPM). Experimental occupational therapy began during the in-hospital phase and continued in the home-based setting. It consisted of teaching strategies, recommending aids, and providing personalized information regarding available community support. Ninety-two individuals with a mean age of 65 years (female 44.6%) were enrolled. The experimental group significantly improved participation measured by the Reintegration to Normal Living Index (mean changes 8.61, 95% CI: 1–16.23, p = 0.027). The performance and satisfaction scores of the COPM, both during hospitalization and after discharge, and independence in ADL also improved. No differences in mood disturbances were found. Early post-discharge occupational therapy integrated with multidisciplinary rehabilitation improves the social participation of complex patients. Future research should investigate the concrete feasibility of implementing this complex intervention cost-effectively and in different contexts. ClinicalTrials.gov Identifier NCT03668938 (first posted date 13/09/2018) Early post-discharge rehabilitation assists patients' transition from hospital to home by improving the management of problems they encounter. In complex patients, occupational therapy initiated during hospitalization and extended to the early post-discharge phase improves social participation, independence in basic and instrumental daily activities, and performance and satisfaction when carrying out relevant occupational activities. The strong partnership between the Occupational Therapist and the patient improves compliance to treatment, enhancing the chances of success of rehabilitation interventions. [ABSTRACT FROM AUTHOR]

Paretic side collisions frequently occur in stroke patients, especially while walking through narrow spaces. We determined whether training for walking through an opening (T-WTO) while entering from the paretic side would improve collision avoidance behavior and prevent falls after 6 months. Thirty-eight adults with moderate-to-mild hemiparetic gait after stroke who were hospitalized in a rehabilitation setting were randomly allocated to the T-WTO (n = 20) or regular rehabilitation (R-Control; n = 18) program. Both groups received five sessions of 40 min per week, for three weeks total. T-WTO included walking through openings of various widths while rotating with the paretic side in front, and R-Control involved normal walking without body rotation. Obstacle avoidance ability, 10-m walking test, timed Up and Go test, Berg Balance Scale, Activities-specific Balance Confidence, the perceptual judgment of passability, and fall incidence were assessed. Collision rate and time to passage of the opening in obstacle avoidance task significantly improved in the T-WTO group compared with those in the R-Control group. Contrast, T-WTO did not lead to significant improvements in other outcomes. T-WTO improved efficiency and safety in managing subacute stroke patients. Such training could improve patient outcomes/safety because of the paretic body side during walking. R000038375 UMIN000033926 Individuals with stroke often collide with the paretic side while walking through narrow spaces. Training for walking through a narrow opening from the paretic side improved an individual's ability to avoid obstacles in similar tasks. Moreover, such training could improve patient outcomes/safety because such interventions may temporarily increase attentional focus to the paretic side in specific tasks. [ABSTRACT FROM AUTHOR]

A history of traumatic life events is associated with chronic pain in later life. Physical therapists utilize a variety of methods to treat pain, however, they have struggled to find effective interventions to improve patient outcomes. To compare impairment-based, regional (REGION-PT) physical therapy (PT) to a global (GLOBAL-PT) model consisting of pain neuroscience education, graded motor imagery, and exercise for adults with chronic pain and history of trauma. Randomized Controlled Trial. Adults ≥ 18 years of age with chronic pain and a history of ≥1 trauma identified through the Life Events Checklist received the allocated intervention once a week for six weeks. Treatment effects were assessed using linear mixed models. Ninety-eight participants completed the trial. There were no difference in outcomes between groups. There were significant interactions between race and intervention. Both interventions were associated with improvements in pain interference for white participants, but non-white participants experienced improvement only with GLOBAL-PT. Regardless of allocation, participants improved in physical function, six of the PROMIS-29 domains, and in pain interference measures. Both interventions are reasonable strategies for individuals with chronic pain and a history of trauma. [ABSTRACT FROM AUTHOR]

To determine the efficacy of the "Training for Occupational health physicians To Involve Significant others" (TOTIS) e-learning module for improving occupational health physicians' (OHPs) knowledge, attitudes, and self-efficacy regarding involving significant others in the return-to-work process. A randomized controlled trial with 87 OHPs, involving an intervention group and a wait-listed control group. Between-group differences in knowledge, attitude, and self-efficacy outcomes, and retention of effects were assessed using ANOVA and paired t-tests. Reactions to the e-learning module were analyzed with descriptive statistics and thematic analysis. We found moderate to large effects on OHPs' knowledge (p < 0.001, ηp2 = 0.202), attitudes (p = 0.003, ηp2 = 0.098), and self-efficacy (p < 0.001, ηp2 = 0.237), with retention of all changes at 10-week follow-up. OHPs graded the e-learning module with a mean score of 7.9 out of 10 (SD = 1.11) and indicated that the module increased their awareness of the role of significant others and encouraged them to address this more often. The TOTIS e-learning module and accompanying materials are valuable resources for OHPs to learn how significant others influence work outcomes of workers with chronic diseases and to manage their involvement in the re-integration process. This study is registered in the Netherlands Trial Register under trial number NL8744; . The TOTIS e-learning module is the first evidence-based training to improve the knowledge, attitudes, and self-efficacy of occupational health physicians with regard to involving significant others in the re-integration process of workers with chronic diseases. The e-learning module and accompanying tools can increase the awareness of occupational health physicians about the role of significant others and encourage them to address the role of significant others in the re-integration process of sick-listed workers. It could be beneficial to expand on the e-learning module with a face-to-face training program involving group interaction, peer discussion, and skills development. [ABSTRACT FROM AUTHOR]

Diagnosis and treatment of childhood brain tumor have detrimental effects on physical, neurocognitive, psychological, and social functioning that lasts into adulthood and effects quality of life (QOL). To address diminished QOL, an Internet-based behavioral activation (BA) intervention was developed. Behavioral activation aims to increase activities and behaviors likely to improve thoughts, mood, and QOL. Participants included 127 young adult survivors of childhood brain tumor (SCBT) randomized into the experimental group (n= 64) or the waitlist control group (n= 63). The dependent variables included: life satisfaction, stress, and activation and were assessed with a two-way mixed analysis of variance (ANOVA). Results revealed a significant interaction between the intervention and time on life satisfaction, F(1, 125)=4.793, p = 0.03. There were no significant main effects over time for perceived stress and activation. Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult SCBT. Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL. Behavioral activation (BA) is aimed at increasing positively reinforcing overt behaviors that are likely to promote improved thoughts, mood, and quality of life (QOL). Results indicated study participants in the experimental group demonstrated a significant gain in life satisfaction compared to the control group after receiving the Internet-based BA intervention; and provides support that the intervention was associated with positive changes across time. Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult survivors of childhood brain tumor (SCBT). Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL. [ABSTRACT FROM AUTHOR]

To examine the effects of ride-on car (ROC) training using different postures on mobility and social function in children with motor delays in comparison with conventional therapy. Thirty-eight children (22 males, 16 females) with motor delays were recruited and randomly assigned to three groups: ROC training while sitting (ROC-Sit, n = 15; mean age, 20.25 months; standard deviation [SD], 5.29), ROC training while standing (ROC-Stand, n = 12; mean age, 24.80 months; SD, 8.42), and conventional therapy (control, n = 11; mean age: 20.25 months, SD: 5.37). All groups underwent 2-h training sessions twice weekly over a 12-week intervention phase. The Pediatric Evaluation of Disability Inventory and Goal Attainment Scaling were performed before and after the intervention and at follow-up sessions after 12 weeks. Mobility and goal achievement improved significantly in all groups after the intervention (p < 0.001; p < 0.0001). However, social function improved significantly only in the ROC-Stand group (p = 0.001), which had the highest number of participants showing clinically meaningful changes in mobility and social function. Increased practice and caregivers' involvement can improve children's mobility and goal achievement. Adopting a standing posture in an ROC can enhance social function. Providing active exploratory experience through ride-on cars or practicing specific skills can improve children's mobility function. Ride-on car training in a standing posture allows children to access their distal environment visually, resulting in improved social function. Setting goals with caregivers maximizes the effects of treatment on goal achievement. [ABSTRACT FROM AUTHOR]

Despite overwhelming adoption of wearable fitness trackers (WFT), it is unclear if they affect physical activity (PA) engagement or PA motivation. We hypothesized that combining a WFT with an effective intervention, motivational interviewing (MI), would positively influence both motivation and PA. A 12-week randomized controlled trial was conducted in 40 adults who did not meet PA recommendations. The four conditions were: a PA education (Educational control, n = 10), a WFT (WFT, n = 10), bi-weekly MI sessions (MI, n = 10), or both interventions (WFT+, n = 10). Motivation and PA were measured through an online survey and actigraphy pre- and post-intervention. Both the WFT+ and MI groups improved autonomous forms and decreased controlled forms of motivation. They also had higher basic psychological needs scores when compared to the Education group post-intervention. We detected no changes in PA. High autonomous motivation at baseline predicted higher post-intervention PA in the WFT+ group but predicted lower post-intervention PA in the WFT group. Results suggests that MI alone or with a WFT can improve basic psychological needs and autonomous forms of motivation for PA, but not PA participation. Individual differences in motivation at baseline may moderate the effect of a WFT on PA. This study was registered at clinicaltrials.gov (NCT490014). [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]

To investigate the efficacy of a tailored counselling intervention for injured workers regarding different aspects of subjective well-being. Prospective randomized controlled trial with 192 mildly-to-moderately injured workers who were on sick leave for at least 18 weeks and showed a high-risk profile for a complicated rehabilitation process in a screening. Patients were assessed at baseline, 12 and 18 months post-injury. The outcome variables concerned five aspects of subjective well-being (negative feelings, life and job satisfaction, satisfaction related to family and health). Both the control and the experimental group received conventional case management. Participants in the intervention group additionally received tailored workplace interventions and/or mental health counselling sessions. Participants in the intervention group received an average of 2.23 (SD = 6.94) counselling sessions. Both groups showed a significant reduction (mean (95% CI) of negative feelings control group 2.6 (2.3–3.4), intervention group 2.4 (1.6–3.4)), with a significant difference in negative feelings between the groups (p = 0.01). Our results suggest that a tailored counselling intervention has a modest long-term effect (d = 0.74) on negative feelings for mildly-to-moderately injured workers. However, future studies should evaluate the feasibility of this study's treatment approach. Accidents and the resulting injuries often cause a wide range of burdens including psychosocial and emotional distress as well as long-time sick leaves. Tailored counselling led to significant reductions of negative feelings in mildly-to-moderately injured workers over time. By showing that even conventional case management can have a beneficial effect on subjective wellbeing, the results of this study reaffirm the holistic biopsychosocial nature of injury rehabilitation. [ABSTRACT FROM AUTHOR]

To compare the effects of Kinesio taping® (KT) and external electrical stimulation (ES) in addition to pelvic floor muscle exercise (PFME) and sole PFME in women with overactive bladder (OAB). Patients with OAB were randomly allocated into PFME, PFME + KT, PFME + ES groups. All treatments were carried out for 6 weeks. OAB symptoms with voiding diary and Overactive Bladder-Version8 (OAB-V8), pelvic floor muscle strength (PFMS) with perineometer, quality of life with King's Health Questionnaire (KHQ) were assessed before (BT) and after treatment (AT). AT, the perception of improvement was inquired. AT, OAB symptoms and KHQ scores decreased and PFMS improved in all groups (p < 0.05). The intergroup comparisons revealed a further decrease in voids/day, voids/night, OAB-V8, and some KHQ scores, and a further increase in the perception of improvement in the PFME + KT and PFME + ES groups compared to the PFME group (p < 0.05). In the PFME + ES group, there was a further decrease in numbers of incontinence compared to the PFME group, and in severity measures scores compared to the other groups (p < 0.05). KT and external ES in addition to PFME were more effective than PFME alone in the treatment of OAB. Pelvic floor muscle exercise was found to be effective in reducing overactive bladder symptoms and increasing quality of life. Kinesio taping or external electrical stimulation in addition to pelvic floor muscle exercise is more effective in improving overactive bladder symptoms, quality of life, and perception of improvement than pelvic floor muscle exercise alone. Kinesio taping and external electrical stimulation can be used as a complementary application in the treatment of overactive bladder. Pelvic floor muscle exercise, pelvic floor muscle exercise + Kinesio taping, and pelvic floor muscle exercise + electrical stimulation applications should be included in conservative treatment options in patients with overactive bladder to reduce symptoms and cost, and improve quality of life. [ABSTRACT FROM AUTHOR]

Background: There is insufficient study using Kinesio taping (KT) in bladder problems. Objectives: To investigate the effects of pelvic floor muscle training (PFMT) combined with KT on bladder symptoms, pelvic floor muscle strength, and quality of life in women with overactive bladder (OAB) syndrome and compare this combination with PFMT plus sham tape (ST). Methods: Women with OAB were randomly allocated into PFMT+KT and PFMT+ST groups. All patients were given PFMT for 6 weeks and applied taping according to groups. Before and after treatment, the OAB symptoms with the Overactive Bladder Assessment Form (OAB-V8) and Patients' Perception of Intensity of Urgency Scale (PPIUS), bladder function with a 3-day voiding diary, pelvic floor muscle strength with the Modified Oxford Scale, and quality of life with the King's Health Questionnaire (KHQ) were assessed. Results: OAB-V8, PPIUS, and KHQ scores decreased and the MOS improved in both groups (P <.05) after treatment. The intergroup comparisons revealed a further decrease in voids/day, voids/night, incontinence episodes/day, and personal limitation scores of the KHQ in the PFMT+KT group compared to the PFMT+ST group (P <.05). Conclusion: PFMT+KT was more effective in reducing the OAB symptoms compared to PFMT+ST. KT could be a complementary application for reducing symptoms in OAB. [ABSTRACT FROM AUTHOR]

To determine the effectiveness of manual therapy (MT) for functional outcomes in patients with distal radius fracture (DRF). An electronic search was performed in the Medline, Central, Embase, PEDro, Lilacs, CINAHL, SPORTDiscus, and Web of Science databases. The eligibility criteria for selecting studies included randomized clinical trials that included MT techniques with or without other therapeutic interventions in functional outcomes, such as wrist or upper limb function, pain, grip strength, and wrist range of motion in patients older than 18 years with DRF. Eight clinical trials met the eligibility criteria; for the quantitative synthesis, six studies were included. For supervised physiotherapy plus joint mobilization versus home exercise program at 6 weeks follow-up, the mean difference (MD) for wrist flexion was 7.1 degrees (p = 0.20), and extension was 11.99 degrees (p = 0.16). For exercise program plus mobilization with movement versus exercise program at 12 weeks follow-up, the PRWE was −10.2 points (p = 0.02), the DASH was −9.86 points (p = 0.0001), and grip strength was 3.9 percent (p = 0.25). For conventional treatment plus manual lymph drainage versus conventional treatment, for edema the MD at 3–7 days was −14.58 ml (p = 0.03), at 17–21 days −17.96 ml (p = 0.009), at 33–42 days −15.34 ml (p = 0.003), and at 63–68 days −13.97 ml (p = 0.002). There was very low to high evidence according to the GRADE rating. Adding mobilization with movement and manual lymphatic drainage showed statistically significant differences in wrist, upper limb function, and hand edema in patients with DRF. [ABSTRACT FROM AUTHOR]

Purpose: The efficacy of a community-based mentoring program for adolescents with a visual impairment vs. care-as-usual was tested on social participation including satisfaction with social support. Materials and methods: Adolescents (15–22 years; 46% boys) were randomized to an intervention group with mentors with visual impairment (N = 25), an intervention group with mentors without visual impairment (N = 26), or care-as-usual (N = 25). One-on-one mentoring activities regarded school/work, leisure activities, and social relationships. Results and conclusions: Multilevel growth modelling revealed no effect of mentoring on changes in social participation compared to the care-as-usual group (participation [95% CI –0.30, 0.21, d = 0.1]; social participation composite [95% CI –0.24, 0.26, d = 0.24]). Mentees matched to mentors with visual impairments increased more on satisfaction with their social support compared to mentees matched to mentors without impairments and the care-as-usual group [95% CI 0.02, 0.49, d = 0.38]. Age, characteristics of the impairment, and number of match meetings were not associated with change in social participation during the mentoring program. This evaluation showed no benefit of mentoring for social participation of adolescents with a visual impairment. The value of mentors and mentees sharing the same disability needs further investigation. This trial is registered in the Netherlands Trial Register NTR4768. A community-based mentoring program resulted in no benefits for adolescents with a visual impairment on their social participation. A community-based mentoring program should not replace care-as-usual provided to young people with a visual impairment in the Netherlands. It could only be thought of as an additional service within rehabilitation. Matching mentees and mentors based on sharing the same disability could strengthen the effect of a community-based mentoring program. However, these benefits are rather small. Providing additional support for the social participation of young people with a visual impairment might be especially helpful for those with a progressive impairment and with comorbid problems. [ABSTRACT FROM AUTHOR]

Purpose: Individuals diagnosed with a high-grade hematological malignancy are at high risk for psychosocial distress. This study aimed to examine the effectiveness of a web-based information tool and nurse delivered telephone support in reducing: (i) unmet information needs; (ii) depression; and (iii) anxiety, among hematological cancer patients and their support persons (SPs). Methods: Patients with a new diagnosis of acute myeloid leukemia, acute lymphoblastic leukemia, Burkitt lymphoma, or lymphoblastic lymphoma and their SPs were enrolled in a prospective multi-site randomized trial. Participants received either access to an online information tool and telephone support from a hematology nurse, or usual care. Outcome data were collected 2, 4, 8, and 12 weeks post-recruitment. The primary endpoint was unmet information needs. Results: Data from 60 patients and 15 SPs were included in the analysis. There were no statistically significant differences in unmet information needs, depression or anxiety between intervention and control groups for patients. Patients in both groups demonstrated a decrease in information needs over the intervention period. Post hoc analyses revealed that patients who did not achieve remission with the first cycle of treatment experienced increased anxiety from 4 weeks until the end of the study (p = 0.008). Conclusions: A web-based information tool and nurse delivered telephone support did not reduce unmet information needs, depression or anxiety among hematological cancer patients, however this finding is inconclusive given the low power of the study. Implications for Psychosocial Providers or Policy: Patients who do not achieve remission are at high risk of anxiety, and may benefit from targeted psychological intervention. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the effect of Wii training on hand function in children with hemiplegic cerebral palsy. Methods: A randomized controlled trial was conducted in 40 children with hemiplegic cerebral palsy (8–12 years). The experimental group received Wii training involving four games for 40 minutes a day, three times a week for 12 weeks plus usual care. The control group received usual care alone. Outcomes were spasticity measured using the modified Ashworth scale, grip strength measured using dynamometry, and hand function measured using the Peabody developmental motor scale (2nd ed.). Outcomes were measured at baseline and after 12 weeks of intervention. Results: Spasticity in the experimental group decreased by 0.4 out of 4.0 (95% CI 0.1 to 0.8) more than the control group by 12 weeks. Power grip strength increased by 1.6 kg (95% CI 0.7 to 2.5) and pinch grip strength by 1.2 kg (95% CI 0.8 to 1.6) more than the control group by 12 weeks. Hand function increased by 6 out of 52 (95% CI 5 to 7) more than the control group by 12 weeks. Conclusion: Wii training plus usual care decreases spasticity and increases grip strength and hand function in children with hemiplegic cerebral palsy. [ABSTRACT FROM AUTHOR]

Background: Evaluation of clinical skills is critically important for nursing students. However, the quality of evaluation tools is poor. Objectives: To evaluate the effectiveness of Direct Observation of Procedural Skills (DOPS) and Mini-Clinical Evaluation Exercise (Mini-CEX) on clinical skills of nursing students. Methods: This study was conducted among 108 senior nursing students. Mini-CEX and DOPS were utilized to evaluate clinical skills in the intervention group. Results: The mean of students' scores in all of the five procedures was significantly higher in the intervention group compared to control group.. Students' scores for the procedures significantly raised through the first stage of DOPS and Mini-CEX to the third stage. Conclusions: Utilization of DOPS and Mini-CEX for evaluation of clinical skills in nursing students effectively enhance their learning ability. Implementing of such assessment methods lead to promoting clinical skills of students which eventually help them to provide high quality care for their patients. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF) on range of motion (ROM) gain in young healthy adults. We performed a systematic review of randomized controlled trials and quasi-randomized trials, including young healthy adults. The interventions were: PNF compared with different PNF techniques, control, other muscle stretching exercises and musculoskeletal manipulations. The outcome measures were: articular ROM and adverse effects. The final number of included studies was 46, involving 1,864 adults. There was difference on ROM comparing assisted hold-relax (HR) on diagonal plane to control, based on very low-quality evidence. There was also difference on ROM comparing assisted HR to self-HR; self-contract-relax (CR) to control; assisted CR contract to control; and assisted HR contract to control, based on low-quality evidence. Moderate-quality evidence shows that results differ between self HR and control (SMD: 0.95; 95%CI 0.03, 1.86; I249%; P = 0.16) in terms of ROM gain. When performing the other comparisons, the results were based on low or very low-quality evidence and do not allow to state if PNF is more or less effective than other stretches for improving ROM in healthy young adults. No adverse effects were mentioned. [ABSTRACT FROM AUTHOR]

Compared to cancers at other sites, lung cancer often results in greater psychosocial distress to both the patients and their caregivers, due to the poor prognosis and survival rate, as well as the heavy symptom burden. In recent years, making protocols of proposed or on-going studies publicly available via clinical trial registries and/or peer-reviewed journals has benefited health sciences with timely communication of the latest research trends and improved transparency in reporting. However, such practice is yet to be a common sight in evidence-informed social work. Hence, this paper discusses the value of publishing protocols in social work research and presents the protocol of a randomized controlled trial that compares the effectiveness of integrative body-mind-spirit intervention with cognitive behavioral therapy for enhancing quality of life of patients with lung cancer and their family caregivers. The data collection process was still on-going at the time of manuscript submission. [ABSTRACT FROM AUTHOR]

Orphaned and vulnerable children (OVC) experience poverty, stigma, and abuse resulting in poor physical, emotional, and psychological outcomes. The Teachers' Diploma Programme on Psychosocial Care, Support, and Protection is a child-centered 15-month long-distance learning program focused on providing teachers with the knowledge and skills to enhance their school environments, foster psychosocial support, and facilitate school-community relationships. A randomized controlled trial was implemented in 2013–2014. Both teachers (n=325) and students (n=1378) were assessed at baseline and 15-months post-intervention from randomly assigned primary schools in Lusaka and Eastern Provinces, Zambia. Multilevel linear mixed models (MLM) indicate positive significant changes for intervention teachers on outcomes related to self-care, teaching resources, safety, social support, and gender equity. Positive outcomes for intervention students related to future orientation, respect, support, safety, sexual abuse, and bullying. Outcomes support the hypothesis that teachers and students benefit from a program designed to enhance teachers' psychosocial skills and knowledge. [ABSTRACT FROM AUTHOR]

Objectives: The aim was to evaluate an Acceptance commitment therapy (ACT) intervention for people with knee or hip osteoarthritis; a related aim was to compare treatment effects from Rasch-transformed and standard scales. Methods: Participants were recruited from a research database and outpatient rheumatology and orthopaedic clinics at two hospitals. Eligible participants were randomly allocated to either intervention or usual care. Intervention comprised six-sessions of group ACT. Outcomes were assessed two and four months after randomization. Rasch-transformed and standard self-report measures were compared. Qualitative interviews also explored the acceptability of the intervention. Results: Of 87 people assessed for eligibility, 31 (36%) were randomized. The main reason for non-randomization was that participants received surgery. Of the 16 participants randomized to intervention, 64% completed ≥50% of the scheduled group sessions. Follow-up data was complete for 84% participants at two months and 68% at four months. Outcome analysis demonstrated important differences between the Rasch-transformed and standard scales. There were significant differences between the groups in pain. Qualitative interviews with seven participants suggested the intervention was acceptable. Conclusions: ACT for osteoarthritis is likely to be an acceptable treatment option for people with osteoarthritis. Progress to a definitive trial is warranted. Rasch-transformed outcome scales are preferable in clinical trials where possible. Implications for Rehabilitation: Acceptance commitment therapy (ACT) is an effective treatment for many pain conditions andcould be a useful intervention for people with osteoarthritis who have high levels of pain. Rasch analysis is a measurement technique that may enable greater precision in detectingmeaningful treatment effects in routine clinical outcomes. The ACT intervention was successful in reducing pain and sleep difficulties and there werenotable differences in effects between standard and Rasch-transformed scales. In a relatively small trial, ACT may to be an acceptable intervention for people with osteoarthritisand progress to a definitive trial is warranted. [ABSTRACT FROM AUTHOR]

Objective: To compare simulated patients (SP) versus seminars for training audiology students to take a case history and give feedback with adult patients.Design: A randomized controlled trial with cross-over.Study sample: Twenty-four audiology students, five SPs, two clinical educators (CE) and three evaluators. Students were randomly allocated to Group 1 who completed SP then seminar training or Group 2 who completed seminar then SP training. The SP training saw each student work with an SP in a clinic room and receive individualized feedback. The seminar training saw the student group work with a single CE in a lecture room and receive group feedback. All students were assessed taking a case history and giving feedback to an SP before, between, and after the training blocks.Results: Mixed model analyses of derived factors for case history and feedback showed significant (p < 0.05) effects for assessment occasion (i.e. student skills improved with more training) but not for training sequence (i.e. order of training did not affect skill improvements) or training type (i.e. type of training did not affect skill improvements).Conclusion: SP training provided no benefit over seminar training in audiology students learning case history and feedback skills with adult patients. [ABSTRACT FROM PUBLISHER]

Background and Objectives: The present study evaluated the effectiveness of a single clinician delivered brief intervention (BI) to reduce problem alcohol use and illicit substance use in an opiate-dependent methadone maintained cohort of patients attending for treatment. Methods: Four addiction treatment centers were randomly assigned to either treatment as usual (TAU; control group) or BI (intervention group). Clinicians screened patients using the alcohol, smoking, and substance involvement screening test (ASSIST) screening tool at baseline and again at three-month follow up. Fidelity checks were performed to ensure that training was delivered effectively and uniformly across all study sites. Feasibility of administering a BI within daily practice was assessed through intervention fidelity checks, patient satisfaction questionnaires and process evaluation. Results: A total of 465 patients were screened (66% of the overall eligible population) with a total of 433 (93%) ASSIST positive cases. Randomization was effective, with no differences in the control versus the intervention arms at baseline for key demographic or clinical indicators including substance us. There was a statistically significant difference between global risk score for the intervention (x = 39.36, sd = 25.91) group and the control group (x = 45.27, SD = 27.52) at 3-month follow-up (t(341) = −2.07, p <.05). Conclusions: This trial provides the first evidence that a single clinician delivered BI can result in a reduction in substance use within a methadone maintained opiate-dependent cohort, and this effect is sustained at three month follow up. [ABSTRACT FROM AUTHOR]

In order to increase patient active engagement during patient–provider interactions, we developed and implemented patient training sessions in four antiretroviral therapy (ART) clinics in Namibia using a “Patient Empowerment” training curriculum. We examined the impact of these trainings on patient–provider interactions after the intervention. We tested the effectiveness of the intervention using a randomized parallel group design, with half of the 589 enrolled patients randomly assigned to receive the training immediately and the remaining randomized to receive the training 6 months later. The effects of the training on patient engagement during medical consultations were measured at each clinic visit for at least 8 months of follow-up. Each consultation was audiotaped and then coded using the Roter Interaction Analysis System (RIAS). RIAS outcomes were compared between study groups at 6 months. Using intention-to-treat analysis, consultations in the intervention group had significantly higher RIAS scores in doctor facilitation and patient activation (adjusted difference in score 1.19,p = .004), doctor information gathering (adjusted difference in score 2.96,p = .000), patient question asking (adjusted difference in score .48,p = .012), and patient positive affect (adjusted difference in score 2.08,p = .002). Other measures were higher in the intervention group but did not reach statistical significance. We have evidence that increased engagement of patients in clinical consultation can be achieved via a targeted training program, although outcome data were not available on all patients. The patient training program was successfully integrated into ART clinics so that the trainings complemented other services being provided. [ABSTRACT FROM PUBLISHER]

Patients’ expectations have shown to be a major psychological predictor of health outcome in cardiac surgery patients. However, it is unclear whether patients’ expectations can be optimized prior to surgery. This study evaluates the development of a brief psychological intervention focusing on the optimization of expectations and its effect on change in patients’ expectations prior to cardiac surgery. Ninety patients scheduled for coronary artery bypass graft were randomly assigned to (1) standard medical care, (2) additional expectation manipulation intervention (EMI), and (3) additional attention control group. Therapists’ fidelity to intervention manuals and patients satisfaction with the intervention were assessed for both active intervention conditions. Patients’ expectations about post-surgical disability, treatment control, personal control, and disease duration were assessed before and after the psychological intervention. Demographical, medical, and psychosocial characteristics and disability were assessed at baseline. Treatment fidelity and patient satisfaction was very high in both intervention conditions. Only patients receiving EMI developed higher personal control expectations and longer (more realistic) expectations of disease duration. The effect of intervention group on patients’ disability expectations and patients’ personal control expectations was moderated by patient’s level of disability. EMI patients with low to moderate disability developed positive expectations whereas patients with high disability did not. This study shows the successful development of a short psychological intervention that was able to modify patients’ expectations, especially in those with low to moderate disability. Given the robust association of expectations and surgery outcome, such an intervention might offer the opportunity to enhance patients’ health following cardiac surgery. [ABSTRACT FROM PUBLISHER]

Oxidative stress is implicated in the pathogenesis of osteoarthritis. Curcuminoids are natural polyphenols with strong antioxidant capacity and may thus be helpful in the treatment of osteoarthritis. The present randomized double-blind placebo-controlled trial investigated the efficacy of curcuminoids in reducing systemic oxidative burden in patients suffering from knee osteoarthritis. Forty patients with mild-to-moderate primary knee osteoarthritis were given curcuminoid capsules (1500 mg/day in 3 divided doses; n = 19) or matched placebo capsules (n = 21) for a period of 6 weeks. Curcuminoids were co-administered with piperine (15 mg/day) in order to improve the bioavailability. Serum activities of superoxide dismutase (SOD) and concentrations of reduced glutathione (GSH) and malonedialdehyde (MDA) were determined spectrophotometrically at baseline and at the end of the treatment period in both groups. Serum activities of SOD as well as GSH and MDA concentrations were comparable between the study groups at baseline (p > 0.05). There was a significant elevation in serum SOD activities (mean change: 2.94 ± 3.73 vs. −0.38 ± 1.33; p < 0.001), a borderline significant elevation in GSH concentrations (mean change: 1.39 ± 2.78 vs. −0.02 ± 1.62; p = 0.064) and a significant reduction in MDA concentrations (mean change: −5.26 ± 4.46 vs. −2.49 ± 3.81; p = 0.044) in the curcuminoids compared with the placebo group. Changes in serum activities of SOD and concentrations of GSH and MDA during the course of trial were significantly correlated. Short-term supplementation with curcuminoids attenuates systemic oxidative stress in patients with osteoarthritis. These antioxidant effects may account for the reported therapeutic effects of curcuminoids in relieving osteoarthritis symptoms. [ABSTRACT FROM AUTHOR]

Objective. To evaluate how municipality-based post-discharge follow-up visits including a general practitioner and municipal nurse affect early readmission among high-risk older people discharged from a hospital department of internal medicine. Design and setting. Centrally randomized single-centre pragmatic controlled trial comparing intervention and usual care with investigator-blinded outcome assessment. Intervention. The intervention was home visits with a general practitioner and municipal nurse within seven days of discharge focusing on medication, rehabilitation plan, functional level, and need for further health care initiatives. The visit was concluded by planning one or two further visits. Controls received standard health care services. Patients. People aged 65  years discharged from Holbæk University Hospital, Denmark, in 2012 considered at high risk of readmission. Main outcome measures. The primary outcome was readmission within 30 days. Secondary outcomes at 30 and 180 days included readmission, primary health care, and municipal services. Outcomes were register-based and analysis used the intention-to-treat principle. Results. A total of 270 and 261 patients were randomized to intervention and control groups, respectively. The groups were similar in baseline characteristics. In all 149 planned discharge follow-up visits were carried out (55%). Within 30 days, 24% of the intervention group and 23% of the control group were readmitted (p  0.93). No significant differences were found for any other secondary outcomes except that the intervention group received more municipal nursing services. Conclusion. This municipality-based follow-up intervention was only feasible in half the planned visits. The intervention as delivered had no effect on readmission or subsequent use of primary or secondary health care services. [ABSTRACT FROM AUTHOR]

The current study examined the efficacy of a web-based intervention (WBI; Avanti) on symptoms of depression and well-being for patients diagnosed with HIV. A two-armed randomized trial recruited patients on antiretroviral therapy (ART) at an outpatient clinic. Thirty-six patients were allocated to Avanti and 31 patients to a control group. Primary outcomes were symptoms of depression and subjective well-being (SWB), and secondary outcomes included life satisfaction and affect balance. Paired tests showed that only patients following Avanti had significant improvements in SWB by 3 months as well as affect balance. No significant differences between groups were detected in any of the outcome parameters at baseline after 3 months, as expected from group size and variability in the parameters. However, time since HIV diagnosis and ART initiation moderated the effects of Avanti. In conclusion, our data show that patients with HIV infection may benefit from a WBI in adjunct to medical treatment. [ABSTRACT FROM PUBLISHER]

As yet, no evidence is available about the cost-effectiveness of positive psychological interventions. When offered via the Internet, these interventions may be particularly cost-effective, because they are highly scalable and do not rely on scant resources such as therapists’ time. Alongside a randomized controlled trial of an online positive psychological intervention, a health-economic evaluation was conducted. Mild to moderately depressed adults seeking self-help and recruited in the general population were randomly assigned to the intervention group (n?=?143) and a waitlisted usual care group (n?=?141). Improved clinical outcomes were achieved in the intervention group (at least for depression) at higher costs. When outliers (the top 2.5%,n?=?5 in intervention group,n?=?2 in control group) were removed, cost-effectiveness was increased considerably. For positive psychology, economic evaluations may be a means to nudge policy decision-makers towards placing positive psychological interventions on the health agenda. [ABSTRACT FROM PUBLISHER]

The internet seems promising for delivering interventions to enhance well-being in a normal population. The aim of this study was to test the effects of an internet-based positive psychology intervention targeting gratitude, pleasant activities, strengths, mastery, acts of kindness, optimism, flow, attributions, and mindfulness. One-hundred and twelve participants were randomized to the intervention and 94 to the control group, and data were collected at baseline, one, two, and six months after intervention onset. The balance of positive to negative affect increased over time among participants in the intervention group (unstandardized beta coefficient [B]?=?0.07,p?

The aim of this study was to examine the impact of a brief psychoeducation group intervention on fear and anxiety in patients undergoing the coronary artery bypass grafting (CABG). Sixty consecutive patients undergoing CABG for the first time were recruited for a clinical trial and randomized into two groups. The control group received routine care. The study group received a brief psychoeducation group intervention combined with routine care. The psychoeducation session consisted of a discussion of fear and anxiety in a psychotherapeutic atmosphere and relaxation techniques. Fear was scored with the Bypass Grafting Fear Scale (BGFS) and anxiety was scored with the Spielberger State Inventory (STAI) Questionnaire. The BGFS and the STAI were given to the patients the day after hospital admission and a day before the operation to measure fear and anxiety. Fear scores decreased in the psychoeducation group. Of the 29 patients treated with psychoeducation, the mean (SD) fear score decreased from 4.6 (1.7) at baseline to 2.8 (1.2) before the operation (p < .001). In the 31 patients who received routine care, there was a nonsignificant trend from 3.7 (1.9) to 4.1 (2.1) (p > .05). The mean difference in fear score before the operation was significantly lower in the psychoeducation group than the routine care group (mean difference −1.3; 95% CI, −2.1, −.2;p < .05). There were no differences in anxiety scores before the operation between the psychoeducation and routine care groups. In patients undergoing CABG, adding psychoeducation to routine care had a significant positive effect on fear but not on anxiety scores. A larger study of psychoeducation in these patients is warranted to assess the efficacy of this intervention in greater detail. [ABSTRACT FROM PUBLISHER]

The aim of this study is to describe the reported quality of randomized controlled trials (RCTs) in pediatric physical therapy (PPT) and changes with time. All RCTs sourced from PEDro database and scored using the PEDro scale were included. RCTs were classified as high- or low quality both with the original cut-off of 6 and a modified cut-off of 5. The relationship between PEDro scores and year of publication was also investigated. One thousand three hundred sixty-seven articles were analyzed. According to the PEDro scale original and modified cut-off, 29% and 56% of the articles were classified as high-quality studies, respectively. The number of RCTs and the average PEDro score increased between 1962 and 2012. However, since some items of the scale could be more frequently satisfied, a further improvement of the quality of RCTs in PPT is recommended. [ABSTRACT FROM AUTHOR]

Background: UK guidelines recommend that patients with schizophrenia are offered access to social activities, however, the impact of such interventions have not been examined in a large randomized trial. Aims: To investigate the effect of an activity group intervention on mental health and global functioning 12 months after randomization compared to standard care alone. Methods: Secondary analysis of data from the MATISSE study. Primary outcomes were global functioning, assessed using the Global Assessment of Functioning (GAF), and mental health symptoms measured using the Positive and Negative Syndrome Scale (PANSS). Results: About 140 participants were randomized to activity groups and 137 to standard care alone. Follow-up data were collected from 242 (87%) participants. Mental health improved significantly among those offered activity groups (change in PANSS score = −6.0, 95% CI −2.3 to −9.8) but global functioning did not (change in GAF score = 0.8, 95% CI −1.7 to 3.3). No significant differences were found between treatment arms. Conclusions: Offering activity groups to patients with schizophrenia was not associated with any additional clinical benefits. There was poor uptake and attendance at activity groups. Interventions that aim to improve negative symptoms may be useful in enabling engagement in psychosocial interventions. [ABSTRACT FROM AUTHOR]

Aims: To explore the feasibility and assess the effect of a prefabricated soft thumb-base orthosis on pain, hand strength, and activity performance in persons with osteoarthritis of the CMC joint. Methods: In this randomized controlled trial, 29 patients received hand exercises only (control group) and 30 patients received hand exercises and an orthosis (orthosis group). The primary outcome was pain, while secondary outcomes included grip and pinch strength, and self-reported symptoms and activity performance. Outcome assessments, and measures of grip strength and pain with and without orthosis in the orthosis group, were made after two months. Results: 55 participants (mean age 70.5 years) completed all assessments. There were no significant differences between the groups in primary or secondary outcomes after two months. However, in the orthosis group, pain was significantly less when wearing the orthosis than when not wearing it. Participants reported that the orthosis felt uncomfortable during activities involving water and one-third wanted more support of the CMC joint. Conclusions: A soft prefabricated orthosis seems to have an immediate pain-relieving effect during use, but no effects in terms of less hand pain, or improved strength or activity performance when not worn. [ABSTRACT FROM AUTHOR]

Objective. Infantile colic is a painful condition in the first months of infancy. Acupuncture is used in Scandinavia as a treatment for infantile colic. A randomized controlled trial was carried out with the aim of testing the hypothesis that acupuncture treatment has a clinically relevant effect for this condition. Design. A prospective, blinding-validated, randomized controlled multicentre trial in general practice. Research assistants and parents were blinded. Setting. 13 GPs' offices in Southern Norway. Intervention. Three days of bilateral needling of the acupuncture point ST36, with no treatment as control. Subjects. 113 patients were recruited; 23 patients were excluded, and 90 randomized; 79 diaries and 84 interviews were analysed. Main outcome measures. Difference in changes in crying time during the trial period between the intervention and control group. Results. The blinding validation questions showed a random distribution with p = 0.41 and 0.60, indicating true blinding. We found no statistically significant difference in crying time reduction between acupuncture and control group at any of the measured intervals, nor in the main analysis of differences in changes over time (p = 0.26). There was a tendency in favour of the acupuncture group, with a non-significant total baseline-corrected mean of 13 minutes (95% CI -24 to + 51) difference in crying time between the groups. This was not considered clinically relevant, according to protocol. Conclusion. This trial of acupuncture treatment for infantile colic showed no statistically significant or clinically relevant effect. With the current evidence, the authors suggest that acupuncture for infantile colic should be restricted to clinical trials. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the training effects of an injury prevention programme on neuromuscular control, strength and performance in male amateur football players.Eighty-one players were allocated to the "FIFA 11+" (n = 42) or a control group (CON, n = 39). The "FIFA 11+" group performed the programme 3 times a week for 9 weeks; the control group completed the usual warm-up. Primary outcomes were: time-to-stabilisation test and eccentric/concentric flexors strength. Secondary outcomes were: eccentric/concentric extensors strength, star excursion balance test, core-stability test, vertical jump, sprint, and agility.After controlling for covariates, significant between-group differences after the intervention (in favour of the "FIFA 11+" players) were found for time-to-stabilisation (-2.8%, 90% confidence interval [CI] -4.4 to -1.2%) and core-stability (-8.9%, -14.6 to -3.1%). Differences were also found for eccentric (3.8%, 1.4 to 6.2%) and concentric flexors strength (3.2%, 0.6 to 5.9%) at 60° · s-1 but this difference was only possibly meaningful (62.4%) from a practical point of view. No substantial and/or significant differences were found for the other outcomes.Performing "FIFA 11+" for 9 weeks can improve neuromuscular control. Possible worthwhile differences were found for flexors strength but there were no substantial effects in the other performance measures. [ABSTRACT FROM AUTHOR]

Objective. To study the effects on sick leave from an early multidisciplinary assessment at a primary health care centre. Design. Randomized controlled trial. Setting. Patients who saw GPs at a primary health care centre in mid-Sweden and asked for a sickness certificate for psychiatric or musculoskeletal diagnoses were invited to participate. Patients included were sick-listed for less than four weeks; 33 patients were randomized either to an assessment within a week by a physiotherapist, a psychotherapist, and an occupational therapist or to 'standard care'. The therapists used methods and tools they normally use in their clinical work. Main outcome measure. Proportion of patients still sick-listed three months after randomization, total and net days on sick leave, and proportion who were on part-time sick leave. Results. At follow-up after three months, in contrast to the pre-trial hypothesis, there was a trend toward a higher proportion of patients still sick-listed in the intervention group (7/18) as compared with the control group (3/15). The intervention group also had significantly longer sick-listing periods (mean 58 days) than the control group (mean 36 days) (p = 0.038). The proportion of patients who were part time sick-listed was significantly higher in the intervention group (10/18) than in the control group (2/15) (p = 0.027). Conclusions. In this study an early multidisciplinary assessment was associated with longer periods on sick leave and more individuals on part-time sick leave. [ABSTRACT FROM AUTHOR]

Conclusion: A combined therapy of fluticasone propionate nasal drops (FPND) and functional endoscopic sinus surgery (FESS) can improve quality of life (QoL). When compared with prior data, the results imply that a generic measure of psychological aspects of QoL may be better than measures of respiratory symptoms and clinical parameters to capture a patient's perception of the disease and its treatment. Objective: To better understand effects of FPND and FESS on generic QoL. Methods: Sixty nasal polyposis patients with concomitant asthma completed participation in a randomized, double-blind, placebo-controlled, 14-week study in which they responded to the General Well-Being Schedule (GWBS). Results: GWBS scores (i) increased significantly after administration of FPND, independent of FESS (from lower than normal to normal), (ii) increased after FESS independent of FPND (from lower than normal to normal), and (iii) increased additively after FPND and FESS. [ABSTRACT FROM AUTHOR]

Objectives. The objectives of this study were to determine the efficacy and safety of aripiprazole for treatment of psychosis, retention and abstinence in patients with methamphetamine dependence. Methods. This was a double-blind study where 37 methamphetamine dependent patients with history of psychosis were randomly assigned to receive aripiprazole (5-10 mg daily, N = 19) or placebo ( N = 18) for 8 weeks. Follow-up evaluation was scheduled on day 7, 14, 28, 42 day 56 after enrolment. Results. Participants on aripiprazole were retained significantly longer in treatment (48.7 days, SD =4.0) compared to placebo (37.1 days, SD =5.0). The Kaplan-Meier survival analysis showed that participants on aripiprazole were less likely to drop out of the study than the placebo group ( P =0.02, χ2 =5.3). Psychotic symptoms significantly decreased among those on aripiprazole as compared to placebo ( P < 0.05). However, no statistically significance was found between the two groups in maintaining abstinence (generalised estimation equation (GEE) analysis, P = 0.41). No serious adverse events were reported in either group. Conclusion. Aripiprazole was no more effective than placebo in maintaining abstinence from methamphetamine use. However, it facilitated treatment retention and reduced the severity of psychotic symptoms. Aripiprazole was found to be generally safe and well tolerated. [ABSTRACT FROM AUTHOR]

Depressive symptoms are highly prevalent, underdiagnosed, and undertreated in people living with HIV/AIDS (PLWH), and are associated with poorer health outcomes. This randomized controlled trial examined the effects of the HIV/AIDS Symptom Management Manual self-care symptom management strategies compared with a nutrition manual on depressive symptoms in an international sample of PLWH. The sample consisted of a sub-group (N=222) of participants in a larger study symptom management study who reported depressive symptoms. Depressive symptoms of the intervention (n=124) and control (n=98) groups were compared over three months: baseline, one-month, and two-months. Use and effectiveness of specific strategies were examined. Depressive symptom frequency at baseline varied significantly by country (χ212.9;p=0.04). Within the intervention group there were significant differences across time in depressive symptom frequency [F(2, 207) = 3.27,p=0.05], intensity [F(2, 91) = 4.6,p=0.01], and impact [F(2, 252) = 2.92,p= 0.05), and these were significantly lower at one month but not at two months, suggesting that self-care strategies are effective in reducing depressive symptoms, however effects may be short term. Most used and most effective self-care strategies were distraction techniques and prayer. This study suggests that people living with HIV can be taught and will employ self-care strategies for management of depressive symptoms and that these strategies are effective in reducing these symptoms. Self-care strategies are noninvasive, have no side-effects, and can be readily taught as an adjunct to other forms of treatment. Studies are needed to identify the most effective self-care strategies and quantify optimum dose and frequency of use as a basis for evidence-based practice. [ABSTRACT FROM PUBLISHER]

Objective A single-blind randomized controlled trial was conducted to test the efficacy of Longden's counterstrain technique for restless legs syndrome (RLS). Methods Participants were adults with moderate-to-severe and persistent RLS, randomized to receive either active or control intervention. The control intervention (B) involved in counterstrain manipulation applied to the lower half of the body. The active intervention (A) was identical to the control intervention plus specific modifications to treat RLS as described by Longden. The success of blinding of participants was confirmed by a questionnaire. Results Thirty-nine patients entered the trial, 20 assigned to Group A and 19 to Group B. All patients were included in the intention-to-treat analysis. The primary outcome measure, the change on the International Restless Legs Scale total score at 6 weeks, showed a statistically significant difference of 8.06 points (95% confidence interval 3.15-12.96) between groups. This represented an improvement of 42.2% in the active group compared to 8.7% in the controls. No adverse effects were reported. Conclusions Longden's RLS-specific counterstrain treatment had a clinically important effect at 6 weeks. Trials of longer-term effects and comparison with the standard drug regimes are now required. [ABSTRACT FROM AUTHOR]

Objective: Stimulated by findings that continuous feedback on client progress improves therapy outcomes (Lambert, Whipple, & Smart, 2001a, Patient-focused research: Using patient outcome data to enhance treatment effects. Journal of Consulting and Clinical Psychology, 69, 159–172) and by arguments that any instrument taking more than 5 min to implement is impractical, this study was a randomised controlled trial investigating the effects of session-by-session progress feedback using the ultra-brief Outcome Rating Scale. Method: A between-subjects design was used. Participants (n = 110) were randomly assigned ‘feedback’ or ‘no feedback’ status, and attended one of eight therapists in a university counselling service. Results: The results showed that there was not a significant difference between the feedback and no-feedback conditions. Both conditions improved therapeutically; however, the feedback condition had a greater effect size (0.85 vs. 0.64), suggesting that with a larger sample statistical significance may have been attained. Between the two conditions there was not a significant difference found in participants classified as reliably changed, unchanged, or deteriorated. However, when the clients were divided into groups on the basis of their presenting issue, the clients with anxiety whose therapists used feedback had significantly better outcomes at the end of therapy than the clients whose therapists did not receive the feedback. Conclusion: Contrary to previous studies, the feedback on the client's progression provided to the therapist had only a small effect on improving therapy outcome. The feedback, however, improved outcomes of the clients presenting with anxiety. [ABSTRACT FROM PUBLISHER]

The purpose of the present study was to determine whether an interprofessional virtual patient educational activity improved interprofessional competencies in pharmacy, physician assistant, and physical therapy graduate students. Seventy-two fifth semester pharmacy (n = 33), fourth semester physician assistant (n = 27) and fourth semester physical therapy (n = 12) graduate students participated in the study. Participants were stratified by discipline and randomized into control (n = 38) and experimental groups (n = 34). At baseline and at study completion, all participants completed an original, investigator-developed survey that measured improvement in selected Interprofessional Education Collaborative (IPEC) competencies and the Readiness for Interprofessional Learning Scale (RIPLS). The experimental group had statistically significantly greater odds of improving on a variety of IPEC competencies and RIPLS items. The use of a single, interprofessional educational activity resulted in having a greater awareness of other professions' scopes of practice, what other professions have to offer a given patient and how different professions can collaborate in patient care. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to compare the effectiveness of three interventions designed to promote hearing protector device (HPD) use.Design: Randomized controlled trial.Study sample: Farm operators (n = 491) were randomly assigned to one of five intervention groups: (1) interactive web-based information with mailed assortment of HPDs; (2) Interactive web-based information only; (3) static web-based information with mailed assortment of HPDs; (4) Static web-based information only; or (5) mailed assortment of HPDs only. Data were analysed using a mixed model approach.Results: HPD use increased among all participants, and increased more among participants receiving the mailed HPDs (with or without information) compared to participants receiving other interventions. Participants receiving the interactive web-based information had comparable increased use of HPDs to those receiving the static web-based information. Participants receiving the mailed HPDs had more positive situational influences scale scores than other participants. Program satisfaction was highest among mailed and web-based information groups.Conclusions: A mailed assortment of hearing protectors was more effective than information. Interactive and static information delivered via web were similarly effective. Programs interested in increasing HPD use among farmers should consider making hearing protectors more available to farmers. [ABSTRACT FROM PUBLISHER]