Patients’ health outcomes after an implementation intervention targeting the physiotherapists’ clinical behaviour

Abstract Background A behavioural medicine approach in physiotherapy has shown positive effects on increased and sustained activities and participation, including reduced sick leave for patients with persistent musculoskeletal pain. The aim of this study was to explore the health outcomes of patients with persistent musculoskeletal pain treated by physiotherapists who had received active compared with passive support when implementing a behavioural medicine approach. Methods An explorative and comparative pre−/post-test trial was conducted. A total of 155 patients with musculoskeletal pain ≥4 weeks were consecutively recruited by physiotherapists in primary healthcare who had received active or passive support when implementing a behavioural medicine approach. Data concerning health outcomes for patients were collected using questionnaires before and after the physiotherapy treatment and at half-, one- and two-year follow-ups. Descriptive, non-parametric and parametric bi- and multivariate statistics were used. Results There were no differences over time between the patients treated by physiotherapists who had received active compared to passive implementation support regarding pain-related disability, pain intensity, self-rated health, self-efficacy in performing daily activities, catastrophic thinking related to pain, and fear of movement. Significant improvements over time were identified in both groups regarding all variables and the effect sizes were large. The percentage of patients on sick leave significantly decreased in the patient group treated by physiotherapists who had received active implementation support. Conclusion It is very important to include patient outcomes when evaluating the implementation of multicomponent interventions. It seems that the implementation method did not play a major role for the patients’ outcomes in this study. Most of the patients’ health outcomes improved regardless of whether they were treated by physiotherapists who had received active or passive support when implementing a behavioural medicine approach. This was likely because the active implementation support was not extensive enough to enable the physiotherapists to sustain the behavioural medicine approach. Trial registration The study protocol was retrospectively registered in ClinicalTrials.gov. ID NCT03118453, March 20, 2017.

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Enhancing neural markers of attention in children with ADHD using a digital therapeutic

PLoS ONE ◽

10.1371/journal.pone.0261981 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261981

Author(s):

Courtney L. Gallen ◽

Joaquin A. Anguera ◽

Molly R. Gerdes ◽

Alexander J. Simon ◽

Elena Cañadas ◽

...

Keyword(s):

Attentional Control ◽

Real Life ◽

Negative Consequences ◽

Behavioral Measures ◽

Multiple Features ◽

Children With Adhd ◽

Hyperactivity Disorder ◽

Positive Effects ◽

Link Type ◽

Before And After

Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition characterized by diminished attentional control. Critically, these difficulties are related to negative consequences in real-life functioning both during development and into adulthood. There is now growing evidence that modulating the underlying neural circuits related to attention can improve behavior and brain function in children with ADHD. We have previously shown that game-based digital therapeutics targeting a key neural marker of attention–midline frontal theta (MFT)–yield positive effects on attentional control in several populations. However, the effects of such digital therapeutics in children with ADHD and no other comorbidities has not been yet examined. To address this gap, we assessed a sample of 25 children with ADHD (8–12 years old) on neural, behavioral, and clinical metrics of attention before and after a 4-week at-home intervention on an iPad targeting MFT circuitry. We found that children showed enhancements on a neural measure of attention (MFT power), as well as on objective behavioral measures of attention and parent reports of clinical ADHD symptoms. Importantly, we observed relationships between the neural and behavioral cognitive improvements, demonstrating that those children who showed the largest intervention-related neural gains were also those that improved the most on the behavioral tasks indexing attention. These findings provide support for using targeted, digital therapeutics to enhance multiple features of attentional control in children with ADHD. Study registration: ClinicalTrials.gov registry (NCT03844269) https://clinicaltrials.gov/ct2/show/NCT03844269.

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Violence and its prediction at a psychiatric hospital

European Psychiatry ◽

10.1016/s0924-9338(01)00607-1 ◽

2001 ◽

Vol 16 (8) ◽

pp. 459-465 ◽

Cited By ~ 23

Author(s):

N. Sjöström ◽

D.N. Eder ◽

U. Malm ◽

J. Beskow

Keyword(s):

Sick Leave ◽

Psychiatric Hospital ◽

Nursing Staff ◽

Aggressive Behaviour ◽

Verbal Aggressiveness ◽

Training Course ◽

Staff Members ◽

The Social ◽

Before And After ◽

Over Time

SummaryAggressive behaviour in psychiatric inpatients was assessed before and after a training course for staff members. The Social Dysfunction Aggression Scale (SDAS) was used to report and assess aggressive behaviour over time, and the Staff Observation Aggression Scale (SOAS) to report and assess single aggressive incidents. In addition, the numbers of nursing staff members who were on sick leave because of injuries in the periods before and after the course were recorded and compared. No statistically significant reduction was found in the number of aggressive patients or in the number of staff members on sick leave. One interesting finding was a lower reporting on the SOAS of perceived aggressive incidents after the training course in comparison with the SDAS reports. Directed verbal aggressiveness and violence towards things were found to be predictors of violence.

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Effects of a 6-Week Straw Phonation in Water Exercise Program on the Aging Voice

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00124 ◽

2020 ◽

Vol 63 (4) ◽

pp. 1018-1032

Author(s):

Chia-Hsin Wu ◽

Roger W. Chan

Keyword(s):

Acoustic Analysis ◽

Vocal Tract ◽

Exercise Program ◽

Analysis Of Covariance ◽

Elderly Subjects ◽

Control Group ◽

Perceptual Evaluation ◽

Positive Effects ◽

Aging Voice ◽

Before And After

Purpose Semi-occluded vocal tract (SOVT) exercises with tubes or straws have been widely used for a variety of voice disorders. Yet, the effects of longer periods of SOVT exercises (lasting for weeks) on the aging voice are not well understood. This study investigated the effects of a 6-week straw phonation in water (SPW) exercise program. Method Thirty-seven elderly subjects with self-perceived voice problems were assigned into two groups: (a) SPW exercises with six weekly sessions and home practice (experimental group) and (b) vocal hygiene education (control group). Before and after intervention (2 weeks after the completion of the exercise program), acoustic analysis, auditory–perceptual evaluation, and self-assessment of vocal impairment were conducted. Results Analysis of covariance revealed significant differences between the two groups in smoothed cepstral peak prominence measures, harmonics-to-noise ratio, the auditory–perceptual parameter of breathiness, and Voice Handicap Index-10 scores postintervention. No significant differences between the two groups were found for other measures. Conclusions Our results supported the positive effects of SOVT exercises for the aging voice, with a 6-week SPW exercise program being a clinical option. Future studies should involve long-term follow-up and additional outcome measures to better understand the efficacy of SOVT exercises, particularly SPW exercises, for the aging voice.

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Weekly Exercise Consistently Reinstates Positive Mood

European Psychologist ◽

10.1027/1016-9040.3.4.271 ◽

1998 ◽

Vol 3 (4) ◽

pp. 271-280 ◽

Cited By ~ 12

Author(s):

Hannah Steinberg ◽

Briony R. Nicholls ◽

Elizabeth A. Sykes ◽

N. LeBoutillier ◽

Nerina Ramlakhan ◽

...

Keyword(s):

Physical Exercise ◽

Negative Mood ◽

Real Life ◽

Positive Mood ◽

Field Investigation ◽

Single Bout ◽

Before And After ◽

Exercise Class ◽

Negative Feelings ◽

Over Time

Mood improvement immediately after a single bout of exercise is well documented, but less is known about successive and longer term effects. In a “real-life” field investigation, four kinds of exercise class (Beginners, Advanced, Body Funk and Callanetics) met once a week for up to 7 weeks. Before and after each class the members assessed how they felt by completing a questionnaire listing equal numbers of “positive” and “negative” mood words. Subjects who had attended at least five times were included in the analysis, which led to groups consisting of 18, 20, 16, and 16 subjects, respectively. All four kinds of exercise significantly increased positive and decreased negative feelings, and this result was surprisingly consistent in successive weeks. However, exercise seemed to have a much greater effect on positive than on negative moods. The favorable moods induced by each class seemed to have worn off by the following week, to be reinstated by the class itself. In the Callanetics class, positive mood also improved significantly over time. The Callanetics class involved “slower,” more demanding exercises, not always done to music. The Callanetics and Advanced classes also showed significantly greater preexercise negative moods in the first three sessions. However, these differences disappeared following exercise. Possibly, these two groups had become more “tolerant” to the mood-enhancing effects of physical exercise; this may be in part have been due to “exercise addiction.”

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Testing the health literacy of twenty Bangladeshi patients before and 5 months after they begin to access their GP electronic record

British Journal of General Practice ◽

10.3399/bjgp18x697133 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X697133

Author(s):

Richard Fitton ◽

Amir Hannan ◽

Ingrid Brindle ◽

Shafia Begum ◽

Sarwar Shah

Keyword(s):

Health Literacy ◽

Health Outcomes ◽

Medical History ◽

Medical Records ◽

Practice Nurse ◽

Electronic Record ◽

Phone Calls ◽

Before And After ◽

Medical Histories ◽

Memory Knowledge

BackgroundPatients with higher health literacy enjoy better health outcomes and are more compliant with treatment. Health literacy is a product of memory, reason and imagination. Patients who can access their records have potentially more memory (knowledge) and make less phone calls to and have less consultations with their GP, practice nurse, HCA and other professionals.AimThe study aims to measure the knowledge that twenty Bangladeshi patients with poor English have of their medical history before and after access to their electronic record.Method55% of patients at Thornley House have access to their medical records. A simple questionnaire was given to 20 Bangladeshi patients before and 5 months after access to their electronic record. The questionnaires recorded the patients’ knowledge of their medical histories. The scores of the completed before and after questionnaires were compared to see if record access had increased patients’ knowledge.ResultsFive patients completed before and after questionnaires. Each achieved a higher score after record access. The differences in scores for the five patients were 2, 5, 1, 10, and 1, respectively.ConclusionHealth literacy for patients is similar to medical literacy for doctors. It requires knowledge, skills and attitudes. We will see whether record access can increase knowledge. Further studies might measure whether that increased knowledge improves skills and attitudes.

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UK Fiscal Squeezes over a Century

10.1093/oso/9780198779612.003.0002 ◽

2017 ◽

Author(s):

Christopher Hood ◽

Rozana Himaz

Keyword(s):

Data Sources ◽

Fiscal Consolidation ◽

Financial Outcomes ◽

Financial Conditions ◽

Deficit Reduction ◽

Before And After ◽

The Uk ◽

Changes Over Time ◽

Spending Cuts ◽

Over Time

This chapter draws on historical statistics reporting financial outcomes for spending, taxation, debt, and deficit for the UK over a century to (a) identify quantitatively and compare the main fiscal squeeze episodes (i.e. major revenue increases, spending cuts, or both) in terms of type (soft squeezes and hard squeezes, spending squeezes, and revenue squeezes), depth, and length; (b) compare these periods of austerity against measures of fiscal consolidation in terms of deficit reduction; and (c) identify economic and financial conditions before and after the various squeezes. It explores the extent to which the identification of squeeze episodes and their classification is sensitive to which thresholds are set and what data sources are used. The chapter identifies major changes over time that emerge from this analysis over the changing depth and types of squeeze.

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Dynamics of Multimorbidity Resilience and Health Outcomes Over Time in Community-Residing Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.3285 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 890-891

Author(s):

Yingzhi Xu ◽

Zahra Rahmaty ◽

Eleanor McConnell ◽

Tingzhong (Michelle) Xue ◽

Bada Kang ◽

...

Keyword(s):

Older Adults ◽

Health Outcomes ◽

Physical Health ◽

Social Life ◽

Structural Equation ◽

Equation Modeling ◽

Psychological Resilience ◽

Pain Level ◽

Reciprocal Relationships ◽

Over Time

Abstract Multimorbidity resilience may mitigate the adverse effects of multiple chronic diseases on older adults’ health. Wister et al.’s (2018) multimorbidity resilience index was developed and tested in a cross-sectional sample of older adults in Canada. Building on these findings, we examined the reciprocal relationships of resilience on outcomes to test these potentially mitigating effects in a community-based, U.S. sample of older adults over time. The study sample includes 1,054 older adults from waves 2 and 3 of the National Social Life, Health, and Aging Project (NSHAP) study (Waite et al 2020). Wister et al.’s (2018) index was mapped to NSHAP measures, and reciprocal relationships of multimorbidity resilience and health outcomes over a 5-year period was tested using structural equation modeling (SEM). Results indicated significant effects of multimorbidity resilience on self-rated physical health and pain. Interestingly, a better functional resilience at baseline conferred better self-rated physical health at follow-up, while better psychological resilience predicted lower pain level. By contrast, the influence of health outcomes on any domain of multimorbidity resilience was not detectable at all, supporting the direction of these associations from resilience to outcomes. The study systematically investigated the dynamic hypotheses between multimorbidity resilience and health outcomes. That is, whether they are determinants or consequences, or both. Our findings suggest multimorbidity resilience predicts subsequent 5-year change in health outcomes, especially self-rated physical health and pain level, but not vice versa, strengthening the evidence of the importance of resilience in the health of older adults.

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Is Brief Exposure to Green Space in School the Best Option to Improve Attention in Children?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147484 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7484

Author(s):

Asier Anabitarte ◽

Gonzalo García-Baquero ◽

Ainara Andiarena ◽

Nerea Lertxundi ◽

Nerea Urbieta ◽

...

Keyword(s):

Air Pollution ◽

School Children ◽

Green Space ◽

Meta Analysis ◽

Statistical Design ◽

Green Spaces ◽

Attention Network Test ◽

Positive Effects ◽

Gender Biases ◽

Before And After

The positive effects of Green Spaces on health are thought to be achieved through the mechanisms of mitigation, instoration and restoration. One of the benefits of Green Spaces may be the restoration of attention and so the objective of this research is testing empirically whether exposure to a green environment improves attention in school children. For so doing, we first used a split-unit statistical design in each of four schools, then combined the primary results via meta-analysis. The Attention Network Test (ANT) was used to measure attention before and after exposure and a total of 167 seven-year-old students participated in the experiments. Overall, our experimental results do not support the hypothesis that students’ exposure to activities in green vs. grey spaces affected their performance in ANT. This was so despite the fact that neither age nor gender biases have been detected and despite that our experiments have been proved to be sufficiently statistically powerful. It would be advisable to consider air pollution and noise. We also recommend that participants attend the experiment with mental exhaustion to maximize the ability to detect significant changes.

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Land Policy and Food Prices: Evidence from a Land Consolidation Program in Rwanda

Journal of Agricultural & Food Industrial Organization ◽

10.1515/jafio-2021-0010 ◽

2021 ◽

Vol 19 (1) ◽

pp. 63-73

Author(s):

Aimable Nsabimana ◽

Fidele Niyitanga ◽

Dave D. Weatherspoon ◽

Anwar Naseem

Keyword(s):

Food Prices ◽

Land Policy ◽

Land Consolidation ◽

Easy Access ◽

Food Crops ◽

White Potato ◽

Before And After ◽

Price Differences ◽

The Impact ◽

Over Time

Abstract Rwanda’s “Crop Intensification Program (CIP)” is primarily a land consolidation program aimed at improving agricultural productivity and food security. The program, which began in 2007, focuses on monocropping and commercialization of six priority crops: maize, wheat, rice, white potato, beans, and cassava. CIP has facilitated easy access to improved seed stocks, fertilizer, extension services, and postharvest handling and storage services. Although studies have documented the impact of CIP on changes in farm yield, incomes, and productivity, less is known about its impact on food prices. In this study, we examine the crop-food price differences in intensive monocropped CIP and non-intensive monocropped CIP zones in Rwanda. Specifically, the study evaluates price variations of beans and maize along with complementary food crops in intensive and non-intensive monocropped zones before and after the introduction of the CIP policy. We find that the CIP policy is not associated with differences in CIP crop prices between the intensive and non-intensive monocropped zones. Over time, prices increased for CIP crops but generally, the crop prices in the two zones were cointegrated. Prices for non-CIP crops in the two different zones did show price differentials prior to the implementation of CIP, with the prices in intensive monocropped zones being greater than in the non-intensive monocropped zones. Moreover, the prices in intensive areas are cointegrated with prices in non-intensive areas for maize and beans and these prices are converging. This indicates that farmers who intensively produced one CIP crop were able to go to the market and purchase other food crops and that price differences between zones have decreased over time, potentially making the CIP intensive farmers better off.

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How Collective-Action Failure Shapes Group Heterogeneity and Engagement in Conventional and Radical Action Over Time

Psychological Science ◽

10.1177/0956797620970562 ◽

2021 ◽

pp. 095679762097056

Author(s):

Morgana Lizzio-Wilson ◽

Emma F. Thomas ◽

Winnifred R. Louis ◽

Brittany Wilcockson ◽

Catherine E. Amiot ◽

...

Keyword(s):

Social Movements ◽

Collective Action ◽

Latent Profile Analysis ◽

Profile Analysis ◽

Social Identification ◽

Future Research ◽

Group Efficacy ◽

Before And After ◽

Using Data ◽

Over Time

Extensive research has identified factors influencing collective-action participation. However, less is known about how collective-action outcomes (i.e., success and failure) shape engagement in social movements over time. Using data collected before and after the 2017 marriage-equality debate in Australia, we conducted a latent profile analysis that indicated that success unified supporters of change ( n = 420), whereas failure created subgroups among opponents ( n = 419), reflecting four divergent responses: disengagement (resigned acceptors), moderate disengagement and continued investment (moderates), and renewed commitment to the cause using similar strategies (stay-the-course opponents) or new strategies (innovators). Resigned acceptors were least inclined to act following failure, whereas innovators were generally more likely to engage in conventional action and justify using radical action relative to the other profiles. These divergent reactions were predicted by differing baseline levels of social identification, group efficacy, and anger. Collective-action outcomes dynamically shape participation in social movements; this is an important direction for future research.

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