A community-based long-term follow up of women undergoing obstetric fistula repair in rural Ethiopia

AbstractBackground:Cognitive behavioural therapy (CBT) is an evidence-based treatment for chronic fatigue syndrome (CFS). Stepped care for CFS, consisting of a minimal intervention followed by face-to-face CBT, was found efficacious when tested in a CFS specialist centre. Stepped care implemented in a community-based mental health centre (MHC) has not yet been evaluated.Aims:(1) To test the effectiveness of stepped care for CFS implemented in a MHC at post-treatment and at long-term follow-up; and (2) compare post-treatment outcomes of implemented stepped care with treatment outcomes of a CFS specialist centre.Method:An uncontrolled study was used to test effectiveness of stepped care implemented in a MHC (n = 123). The outcomes of implemented care were compared with the outcomes of specialist care reported in previous studies (n = 583). Data on outcomes from implemented stepped care were gathered at post-treatment and at long-term follow-up. Mixed models were used as method of analysis.Results:Fatigue decreased and physical functioning increased significantly following implemented stepped care (both p < .001). The follow-up was completed by 94 patients (78%) within 1–6 years after treatment. Treatment effects were sustained to follow-up. Patients in the MHC showed less improvement directly following stepped care compared with patients in a CFS specialist centre (p < .01).Conclusion:Implemented stepped care for CFS is effective with sustained treatment gains at long-term follow-up. There is room for improvement when compared with outcomes of a CFS specialist centre. Some suggestions are made on how to improve stepped care.

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Long-term follow-up and objective physical activity measurements of community-based physical interventions in adults: a systematic review and meta-analysis

The Lancet ◽

10.1016/s0140-6736(19)32893-4 ◽

2019 ◽

Vol 394 ◽

pp. S96

Author(s):

Charlotte Wahlich ◽

Umar A R Chaudhry ◽

Rebecca Fortescue ◽

Derek G Cook ◽

Shashi Hirani ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Meta Analysis ◽

Community Based ◽

Activity Measurements ◽

Long Term Follow Up

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Long-term follow-up of a community-based smoke alarm installation programme

Injury Prevention ◽

10.1136/injuryprev-2016-042293 ◽

2017 ◽

Vol 23 (4) ◽

pp. 287-288

Author(s):

Mary A McCoy ◽

Shelli Stephens-Stidham ◽

Emily Caton ◽

Ted O Padgett ◽

Jeffrey J Barnard ◽

...

Keyword(s):

Smoke Alarm ◽

Community Based ◽

Long Term Follow Up

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THE PREDICTIVE VALUE OF DIFFERENT MOTOR FEATURES IN PARKINSON'S

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.179 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.89-e4

Author(s):

Angus Macleod ◽

Carl Counsell

Keyword(s):

Cox Regression ◽

Gait Disorder ◽

Community Based ◽

Yahr Stage ◽

Long Term Follow Up ◽

Multivariable Analyses ◽

Incident Cohort ◽

Updrs Part

BackgroundOther than tremor dominance (TD) or the postural instability-gait disorder phenotype (PIGD), little is known about what baseline motor characteristics influence prognosis in Parkinson's disease (PD).MethodsWe analysed data from the PINE study, a prospective, community-based incident cohort of PD in Aberdeen, Scotland, recruited between 2002–09, with long term follow-up. Baseline motor features derived from the UPDRS part 3 scale were assessed as independent predictors of four outcomes: death, dependence (Schwab & England <80), “death or dependence”, and progression to Hoehn & Yahr stage 3 (H&Y3) using Cox regression adjusting for age.Results198 patients were analysed (median 6.1 years follow-up). In univariable analyses, bradykinesia score, axial score, limb score, axial/limb ratio, dopa-responsive signs, and dopa-non-reponsive signs were significant predictors of all outcomes. In univariable analyses, asymmetry predicted dependency and death or dependency and TD/PIGD only predicted H&Y3. In multivariable analyses bradykinesia and axial/limb ratio were independent predictors of death and death or dependency and axial score and dopa non-responsive symptoms were predictors for dependency and H&Y3.DiscussionDifferent motor characteristics were independent predictors of different outcomes. However, a variable relating to severity of axial signs was a common theme across three of these outcomes. Thus, at diagnosis, axial motor features appear to be important predictors of prognosis, perhaps stronger than the TD/PIGD classification and deserve further study.

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