P012 Maternal and infant stress during a bedtime separation: a pilot RCT

Abstract Background Behavioural sleep interventions to improve infant sleep disturbance commonly include extinction where an unwanted behaviour (night time crying) is periodically ignored. There have been conflicting findings regarding the impact of extinction methods on infant stress levels as measured with cortisol and as perceived by mothers and only one that measured cortisol at the time of the separation. This study aimed to compare a responsive method to extinction (controlled crying) and a control group evaluating subjective and objective stress for mother/infant dyads at the time of bedtime separation. Methods Mother/infant dyads were randomly allocated to behavioural sleep interventions (Responsive - n= 7, Controlled Crying - n=6 or Controls - n=4). Cortisol (two oral swabs on two nights at T2), maternal self-reported stress (Subjective Units of Distress - SUDS), and perceived infant distress (PIS) were compared over eight weeks. Correlations tested relationships between PIS, SUDS and infant cortisol levels. Mixed models analysis were used for cortisol analyses. Results There were no significant differences in cortisol levels between groups across time points but significant inter and intra-individual variability. Maternal stress was positively correlated with infant cortisol and PIS (p<0.05) and mothers in the Responsive group were significantly less stressed (p=0.02). Conclusion In this small sample, infant cortisol during bedtime separation was variable, elevated in all sleep interventions and not significantly different. Mothers were less stressed in the Responsive group. Findings indicate responsive methods are comparable to extinction and less stressful for mothers offering a possible gentler choice at bedtime separation.

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MHealth Applications for People with Cognitive Impairment and Their Caregivers: A Scoping Review (Preprint)

10.2196/preprints.22474 ◽

2020 ◽

Author(s):

Qing Zhao ◽

Pei Chen ◽

Yu Zhang ◽

Haining Liu ◽

Xianwen Li

Keyword(s):

Cognitive Impairment ◽

Sample Size ◽

Research Design ◽

Scoping Review ◽

Life Support ◽

Small Sample ◽

Mobile Technologies ◽

Control Group ◽

Caregiver Support ◽

The Impact

BACKGROUND Mobile health application has become an important tool for healthcare systems. One such tool is the delivery of assisting in people with cognitive impairment and their caregivers. OBJECTIVE This scoping review aims to explore and evaluate the existing evidence and challenges on the use of mHealth applications that assisting in people with cognitive impairment and their caregivers. METHODS Nine databases, including PubMed, EMBASE, Cochrane, PsycARTICLES, CINAHL, Web of Science, Applied Science & Technology Source, IEEE Xplore and the ACM Digital Library were searched from inception through June 2020 for the studies of mHealth applications on people with cognitive impairment and their caregivers. Two reviewers independently extracted, checked synthesized data independently. RESULTS Of the 6101 studies retrieved, 64 studies met the inclusion criteria. Three categories emerged from this scoping review. These categories are ‘application functionality’, ‘evaluation strategies’, ‘barriers and challenges’. All the included studies were categorized into 7 groups based on functionality: (1) cognitive assessment; (2) cognitive training; (3) life support; (4) caregiver support; (5) symptom management; (6) reminiscence therapy; (7) exercise intervention. The included studies were broadly categorized into four types: (1) Usability testing; (2) Pilot and feasibility studies; (3) Validation studies; and (4) Efficacy or Effectiveness design. These studies had many defects in research design such as: (1) small sample size; (2) deficiency in active control group; (3) deficiency in analyzing the effectiveness of intervention components; (4) lack of adverse reactions and economic evaluation; (5) lack of consideration about the education level, electronic health literacy and smartphone proficiency of the participants; (6) deficiency in assessment tool; (7) lack of rating the quality of mHealth application. Some progress should be improved in the design of smartphone application functionality, such as: (1) the design of cognitive measurements and training game need to be differentiated; (2) reduce the impact of the learning effect. Besides this, few studies used health behavior theory and performed with standardized reporting. CONCLUSIONS Preliminary results show that mobile technologies facilitate the assistance in people with cognitive impairment and their caregivers. The majority of mHealth application interventions incorporated usability outcome and health outcomes. However, these studies have many defects in research design that limit the extrapolation of research. The content of mHealth application is urgently improved to adapt to demonstrate the real effect. In addition, further research with strong methodological rigor and adequate sample size are needed to examine the feasibility, effectiveness, and cost-effectiveness of mHealth applications for people with cognitive impairment and their caregivers.

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Caffeine may disrupt the impact of real-time drowsiness on cognitive performance: a double-blind, placebo-controlled small-sample study

Scientific Reports ◽

10.1038/s41598-021-83504-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

E. Aidman ◽

M. Balin ◽

K. Johnson ◽

S. Jackson ◽

G. M. Paech ◽

...

Keyword(s):

Real Time ◽

Cognitive Performance ◽

Small Sample ◽

Night Time ◽

Double Blind ◽

Infra Red ◽

Procedural Decisions ◽

Performance Gains ◽

The Impact ◽

Modest Reduction

AbstractCaffeine is widely used to promote alertness and cognitive performance under challenging conditions, such as sleep loss. Non-digestive modes of delivery typically reduce variability of its effect. In a placebo-controlled, 50-h total sleep deprivation (TSD) protocol we administered four 200 mg doses of caffeine-infused chewing-gum during night-time circadian trough and monitored participants' drowsiness during task performance with infra-red oculography. In addition to the expected reduction of sleepiness, caffeine was found to disrupt its degrading impact on performance errors in tasks ranging from standard cognitive tests to simulated driving. Real-time drowsiness data showed that caffeine produced only a modest reduction in sleepiness (compared to our placebo group) but substantial performance gains in vigilance and procedural decisions, that were largely independent of the actual alertness dynamics achieved. The magnitude of this disrupting effect was greater for more complex cognitive tasks.

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The impact of visual impairment on nutritional status: A systematic review

British Journal of Visual Impairment ◽

10.1177/0264619617730860 ◽

2018 ◽

Vol 36 (1) ◽

pp. 17-30 ◽

Cited By ~ 5

Author(s):

Nabila Jones ◽

Hannah Bartlett

Keyword(s):

Nutritional Status ◽

Visual Impairment ◽

Sample Size ◽

Visually Impaired ◽

Small Sample Size ◽

Small Sample ◽

Control Group ◽

Visually Impaired People ◽

Impaired People ◽

The Impact

The aim of this review was to evaluate the literature that has investigated the impact of visual impairment on nutritional status. We identified relevant articles through a multi-staged systematic approach. Fourteen articles were identified as meeting the inclusion criteria. The sample size of the studies ranged from 9 to 761 participants. It was found that visual impairment significantly affects nutritional status. The studies reported that visually impaired people have an abnormal body mass index (BMI); a higher prevalence of obesity and malnutrition was reported. Visually impaired people find it difficult to shop for, eat, and prepare meals. Most studies had a small sample size, and some studies did not include a study control group for comparison. The limitations of these studies suggest that the findings are not conclusive enough to hold true for only those who are visually impaired. Further studies with a larger sample size are required with the aim of developing interventions.

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Effects of Comorbid Alcohol Use Disorder on the Clinical Outcomes of Schizophrenia: A Nationwide Population-based Study

10.21203/rs.3.rs-322353/v1 ◽

2021 ◽

Author(s):

Soojin Ahn ◽

Youngjae Choi ◽

Woohyeok Choi ◽

Young Tak Jo ◽

Harin Kim ◽

...

Keyword(s):

Alcohol Use ◽

Clinical Outcomes ◽

Alcohol Use Disorder ◽

Medication Possession Ratio ◽

Small Sample ◽

Control Group ◽

Diagnostic Code ◽

Psychiatric Admissions ◽

Before And After ◽

The Impact

Abstract BackgroundAlcohol use disorder (AUD) is a common psychiatric comorbidity in schizophrenia, associated with poor clinical outcomes and medication noncompliance. Most previous studies on the effect of alcohol use in patients with schizophrenia had limitations of small sample size and a cross-sectional design. Therefore, this study aimed to use a nationwide population database to investigate the impact of AUD on clinical outcomes of schizophrenia.MethodsData from the Health Insurance Review Agency database in South Korea from January 1, 2007 to December 31, 2016 was used. Among 64,442 patients with incident schizophrenia, 1,598 with comorbid AUD were selected based on the diagnostic code F10. We performed between- and within-group analyses to compare the rates of psychiatric admissions and emergency room (ER) visits and medication possession ratio (MPR) with control patients having schizophrenia matched for the onset age, sex, and observation period.ResultsThe rates of psychiatric admissions and ER visits decreased after the diagnosis of AUD in both groups; however, the decrease was significantly greater in patients with comorbid AUD compared to the control group. While the case group showed an increase in MPR after the diagnosis of AUD, MPR decreased in the control patients. The rates of psychiatric admissions, ER visits and MPR were worse in the schizophrenia group with comorbid AUD both before and after the diagnosis of AUD.ConclusionsClinical outcomes were worse in the comorbid AUD group than in the control group before and after the diagnosis of AUD. Considering that patients with schizophrenia with comorbid AUD had poorer clinical outcomes even before the diagnosis of AUD, schizophrenia with comorbid AUD could be a distinct subtype of schizophrenia.

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Effects of suckling on milk yield and milk composition of dairy cows in cow–calf contact systems

Journal of Dairy Research ◽

10.1017/s0022029920000515 ◽

2020 ◽

Vol 87 (S1) ◽

pp. 133-137

Author(s):

Kerstin Barth

Keyword(s):

Milk Yield ◽

Mixed Models ◽

Milk Composition ◽

Control Group ◽

Research Station ◽

Suckling Period ◽

Night Time ◽

Milk Protein Content ◽

Cow Calf ◽

Short Time

AbstractIn this research communication I show the effect of various cow–calf contact systems on milk yield and milk composition during the periods when calves where allowed to suckle their dams and after the calves were separated in comparison to cows that were only machine milked throughout their lactation. Analyses were based on four different experiments, but conducted at the same research station and under comparable housing and feeding conditions. Nursing dams had contact to their calves during the whole day, during night-time or only twice per day shortly before milking. A control group of cows that had no contact to their offspring was part of every experiment. Data of the regular monthly milk recordings were analysed with linear mixed models. Results showed a significant effect of the suckling system on the machine milk yield over the whole lactation. While cows with night-time contact reached the milk production level of the control cows, cows with whole day or short-time contact still produced less milk after the calves were separated. Fat content was always lower during the suckling period but not afterwards. The significantly higher milk protein content in dams with calf contact requires further investigation. Somatic cell count in milk of nursing dams was slightly increased, probably due to the exposure of the teats to frequent suckling in addition to machine milkings. In conclusion, cow–calf contact systems influence the performance of cows during and after the suckling period but to varying degrees depending on the system adopted.

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Impact of Interventions by a Community Pharmacist on Care Burden for People with Dementia: Development and Randomised Feasibility Trial of an Intervention Protocol

10.21203/rs.3.rs-917446/v1 ◽

2021 ◽

Author(s):

Yoko Nanaumi ◽

Atsushi Yoshitani ◽

Mitsuko Onda

Keyword(s):

Community Pharmacist ◽

Intervention Group ◽

Small Sample ◽

Effect Sizes ◽

Feasibility Trial ◽

Control Group ◽

Care Burden ◽

People With Dementia ◽

Intervention Protocol ◽

The Impact

Abstract Background: Traditionally, the role of pharmacists has been to manage and monitor pharmacotherapy for patients with dementia. However, additional intervention by community pharmacists to collect and share patient information with other professionals may help reduce the care burden among caregivers. This study examined the impact of interventions by a community pharmacist, based on active information gathering from other professionals for people with dementia, on the caregivers’ burden of care.Methods: This was a randomised, open-label, parallel-group feasibility study, involving eight Nara City pharmaceutical association member pharmacies that provided consent to participate. These pharmacies were assigned to an intervention group or control group at a 1:1 ratio. The subjects were patients with dementia and their primary caregivers that visited the participating pharmacies and provided consent to participate. Pharmacists in the intervention group actively collected information from the patients’ family physicians and care managers and intervened to address medication-related problems, while those in the control group only performed their normal duties. The primary endpoint was a change in the caregiver’s score on the Japanese version of Zarit Caregiver Burden Interview (J-ZBI) from the baseline to after 5 months of follow-up. The changes in mean J-ZBI scores from the beginning to the end of the study period of the two groups were compared using Welch's t-test, and effect sizes were calculated. The level of significance was set at 5%.Results: Totally, nine patients and nine caregivers in the intervention group, and nine patients and eight caregivers in the control group completed the study. The changes in J-ZBI scores could be calculated for seven cases in the intervention group and five cases in the control group. The J-ZBI scores were found to decrease by 1.0 in the intervention group and increase by 3.0 in the control group (p = 0.075, effect size = 1.414).Conclusions: Although the differences in J-ZBI scores were not statistically significant between the two groups, owing to the small sample sizes, the effect sizes suggest that community pharmacist interventions for people with dementia may reduce the care burden for caregivers.Trial registration: Registration: UMIN000039949 (registration date: 4.1.2020, retrospectively registered)

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Kinetics and Kinematics of Working Trials Dogs: The Impact of Long Jump Length on Peak Vertical Landing Force and Joint Angulation

Animals ◽

10.3390/ani11102804 ◽

2021 ◽

Vol 11 (10) ◽

pp. 2804

Author(s):

Ellen Williams ◽

Anne Carter ◽

Jacqueline Boyd

Keyword(s):

Mixed Models ◽

Soft Tissue Injuries ◽

Individual Variability ◽

Vertical Force ◽

Jump Length ◽

Long Jump ◽

Left And Right ◽

Vertical Landing ◽

The Impact ◽

Police Dogs

Working trials is a competitive canine discipline based on work undertaken by military and police dogs. A 9 ft long jump is a key component of the discipline. Research into landing forces and joint angulation in other canine disciplines has highlighted the potential for the occurrence of soft tissue injuries, predominantly in the front limbs. There is a paucity of work into the impact of spread/long jumps on joint angulation and peak vertical force (PVF) on landing, and limited research on working trials dogs generally. This study aimed to determine whether altering the length of the long jump impacted PVF and apparent joint angulation upon landing. 21 dogs regularly competing in working trials cleared the long jump at three lengths: 9 ft (full length), 8 ft, and 7 ft. The impact of altered long jump length on the PVF, apparent shoulder and carpus angulation, and duration of landing, were analysed using general linear mixed models. There was no significant relationship between the length of the long jump and PVF or joint angulation on landing (p > 0.05). Greatest joint compression was observed on landing after clearing 9 ft. Individual variability in landing joint angulation, PVF and force distribution of the left and right front limbs on landing was observed across all three experimental lengths. We recommend further research is undertaken to examine individual variability and the effect of training and experience in working trials participants, to provide evidence-based recommendations for training people and competing dogs in this discipline.

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Effects of comorbid alcohol use disorder on the clinical outcomes of first-episode schizophrenia: a nationwide population-based study

Annals of General Psychiatry ◽

10.1186/s12991-021-00353-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Soojin Ahn ◽

Youngjae Choi ◽

Woohyeok Choi ◽

Young Tak Jo ◽

Harin Kim ◽

...

Keyword(s):

Alcohol Use ◽

Clinical Outcomes ◽

Alcohol Use Disorder ◽

Small Sample ◽

First Episode ◽

Control Group ◽

Diagnostic Code ◽

Psychiatric Admissions ◽

First Episode Schizophrenia ◽

The Impact

Abstract Background Alcohol use disorder (AUD) is a common psychiatric comorbidity in schizophrenia, associated with poor clinical outcomes and medication noncompliance. Most previous studies on the effect of alcohol use in patients with schizophrenia had limitations of small sample size or a cross-sectional design. Therefore, we used a nationwide population database to investigate the impact of AUD on clinical outcomes of schizophrenia. Methods Data from the Health Insurance Review Agency database in South Korea from January 1, 2007 to December 31, 2016 were used. Among 64,442 patients with first-episode schizophrenia, 1598 patients with comorbid AUD were selected based on the diagnostic code F10. We performed between- and within-group analyses to compare the rates of psychiatric admissions and emergency room (ER) visits, and medication possession ratio (MPR) between the patients with comorbid AUD and control patients matched for the onset age, sex, and observation period. Results The rates of psychiatric admissions and ER visits in both groups decreased after the time point of diagnosis of AUD; however, the decrease was significantly greater in the patients with comorbid AUD compared to the control patients. While the comorbid AUD group showed an increase in MPR after the diagnosis of AUD, MPR decreased in the control group. The rates of psychiatric admissions, ER visits, and MPR were worse in the comorbid AUD group both before and after the diagnosis of AUD. Conclusions The results emphasize an importance of psychiatric comorbidities, especially AUD, in first-episode schizophrenia and the necessity of further research for confirmative findings of the association of AUD with clinical outcomes of schizophrenia.

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Cooperative Parent-Mediated Therapy in Children with Fragile X Syndrome and Williams Beuren Syndrome: A Pilot RCT Study of a Transdiagnostic Intervention-Preliminary Data

Brain Sciences ◽

10.3390/brainsci12010008 ◽

2021 ◽

Vol 12 (1) ◽

pp. 8

Author(s):

Paolo Alfieri ◽

Francesco Scibelli ◽

Laura Casula ◽

Simone Piga ◽

Eleonora Napoli ◽

...

Keyword(s):

Fragile X Syndrome ◽

Preliminary Data ◽

Gold Standard ◽

Fragile X ◽

Autism Spectrum ◽

Small Sample ◽

Control Group ◽

Pilot Rct ◽

Experimental Group ◽

Communicative Skill

Children with fragile X syndrome and William Beuren syndrome share several socio-communicative deficits. In both populations, around 30/35% of individuals meets criteria for autism spectrum disorder on gold standard instruments. Notwithstanding, few studies have explored feasibility and validity of therapy for socio-communicative deficits in individuals with these genetic conditions. In this study, we present preliminary data on a pilot RCT aimed to verify the effectiveness of cooperative parent-mediated therapy for socio-communicative deficits in a transdiagnostic perspective in a small sample of 12 participants. Our preliminary data showed that the experimental group had significant improvement in one socio-communicative skill (responsivity) and in clinical global impression, while the control group in an adaptive measure of socialization and word production. Implications of these results are then discussed.

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Does True Inter-Individual Variability Exist in Individual Responses After Endurance Training?

Inquiry@Queen's Undergraduate Research Conference Proceedings ◽

10.24908/iqurcp.10458 ◽

2018 ◽

Author(s):

Simo Lu

Keyword(s):

Individual Differences ◽

Measurement Error ◽

Endurance Training ◽

Training Group ◽

Individual Variability ◽

Work Rate ◽

Control Group ◽

Random Measurement Error ◽

Random Measurement ◽

The Impact

Introduction: Despite the apparent existence of individual responses, it remains unknown whether the variability observed in peak oxygen consumption (VO2peak) and work rate at onset of blood lactate (OBLAWR) response following exercise training reflects true inter-individual differences. To date, few studies include a non-exercise control group to determine the impact of random/measurement error on the variability associated with VO2peak and OBLAWR responses to endurance training. Therefore, the purpose of this study was to determine whether true individual differences exist in responses to training by assessing whether the variability in VO2peak and OBLAWR responses following training exceeded the variability in a non-training control group. Methods: 16 recreationally active males completed two incremental ramp tests to determine VO2peak and OBLAWR. Participants were assigned into the control group (n = 7) or the training group (n = 9; endurance training: 30 minutes of 65% of work rate at VO2peak, four times per week) in a manner to counterbalance baseline VO2peak measures. Results: VO2peak increased significantly (p < 0.05) (+338 ± 416.2 mL/min/kg) and OBLAWR (+32.1 ± 29.2 W) increased following endurance training. The SD in change scores was greater in the training group for VO2peak and OBLAWR than the parallel control group. Specifically, this resulted in large and moderately-large effect sizes at respective values of 0.6 for VO2peak and 0.5 for OBLAWR. Conclusion: Although these preliminary results may suggest that the variability in VO2peak and OBLAWR responses to endurance training reflect true inter-individual variability beyond random/measurement error, a definitive conclusion can be made upon the completion of the study.

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