Reducing Night Waking in Infancy: A Primary Care Intervention

PEDIATRICS ◽  
1992 ◽  
Vol 89 (4) ◽  
pp. 585-588 ◽  
Author(s):  
Robin Adair ◽  
Barry Zuckerman ◽  
Howard Bauchner ◽  
Barbara Philipp ◽  
Suzette Levenson
Keyword(s):  
Sleep Onset ◽  
Intervention Group ◽  
Control Group ◽  
Parental Perception ◽  
Outcome Questionnaire ◽  
Cohort Design ◽  
Care Intervention ◽  
Pediatric Intervention ◽  
Historical Controls ◽  
Night Waking

Approximately 25% of infants wake regularly at night and need help in resettling. The purpose of this study was to implement and evaluate a brief intervention to prevent such night waking. The study used a prospective cohort design with historical controls. Information from the control group was collected at the 9-month visit. The intervention group was enrolled at the 4-month visit. The intervention consisted of information about sleep-onset associations, completion of a sleep chart, and discussion about sleep with the pediatrician. The outcome was also measured at the 9-month visit. To obscure the purpose of the study, the outcome questionnaire for both groups addressed feeding and sleeping. One hundred twenty-eight (74%) of 172 eligible infant-parent pairs comprised the control group and 164 (74%) of 222 the intervention group. The majority of families were white, married, and well-educated. The groups were similar with regard to sociodemographic variables and factors thought to be related to night waking such as current breast-feeding, thumb/pacifier sucking, maternal isolation, and parental perception of difficult child. At 9 months of age, the intervention infants were reported to experience 36% less night waking per week compared with those in the control group (2.5 vs 3.9 wakings per week, P = .02). Frequent night waking was twice as common in control infants (27% vs 14%, P =.01). It is concluded that this pediatric intervention can help parents reduce night waking in infants.

scholarly journals Moderate Exercise Plus Sleep Education Improves Self-Reported Sleep Quality, Daytime Mood, and Vitality in Adults with Chronic Sleep Complaints: A Waiting List-Controlled Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Carmen Gebhart ◽  
Daniel Erlacher ◽  
Michael Schredl
Keyword(s):  
Physical Exercise ◽  
Sleep Quality ◽  
Controlled Trial ◽  
Sleep Onset ◽  
Intervention Group ◽  
Waiting List ◽  
Control Group ◽  
Sleep Education ◽  
Sleep Complaints ◽  
Chronic Sleep

Research indicates that physical exercise can contribute to better sleep quality. This study investigates the six-week influence of a combined intervention on self-rated sleep quality, daytime mood, and quality of life. A nonclinical sample of 114 adults with chronic initiating and the maintaining of sleep complaints participated in the study. The intervention group of 70 adults underwent moderate physical exercise, conducted weekly, plus sleep education sessions. Improvements among participants assigned to the intervention group relative to the waiting-list control group (n=44) were noted for subjective sleep quality, daytime mood, depressive symptoms and vitality. Derived from PSQI subscores, the intervention group reported increased sleep duration, shortened sleep latency, fewer awakenings after sleep onset, and overall better sleep efficiency compared to controls. The attained scores were well sustained and enhanced over a time that lasted through to the follow-up 18 weeks later. These findings have implications in treatment programs concerning healthy lifestyle approaches for adults with chronic sleep complaints.

scholarly journals Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial

2013 ◽  
Vol 44 (7) ◽  
pp. 1521-1532 ◽  
Author(s):  
A. van Straten ◽  
J. Emmelkamp ◽  
J. de Wit ◽  
J. Lancee ◽  
G. Andersson ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Sleep Onset ◽  
Intervention Group ◽  
Sleep Diary ◽  
The Internet ◽  
Control Group ◽  
Sleep Onset Latency ◽  
Cognitive Behavioural ◽  
Co Morbidity ◽  
Significant Difference

BackgroundInsomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT delivered through the Internet might be a more accessible alternative. In this study we examined the effectiveness of a guided Internet-delivered CBT for adults with insomnia using a randomized controlled trial (RCT).MethodA total of 118 patients, recruited from the general population, were randomized to the 6-week guided Internet intervention (n = 59) or to a wait-list control group (n = 59). Patients filled out an online questionnaire and a 7-day sleep diary before (T0) and after (T1) the 6-week period. The intervention group received a follow-up questionnaire 3 months after baseline (T2).ResultsAlmost three-quarters (72.9%) of the patients completed the whole intervention. Intention-to-treat (ITT) analysis showed that the treatment had statistically significant medium to large effects (p < 0.05; Cohen's d between 0.40 and 1.06), and resulted more often in clinically relevant changes, on all sleep and secondary outcomes with the exception of sleep onset latency (SOL) and number of awakenings (NA). There was a non-significant difference in the reduction in sleep medication between the intervention (a decrease of 6.8%) and control (an increase of 1.8%) groups (p = 0.20). Data on longer-term effects were inconclusive.ConclusionsThis study adds to the growing body of literature that indicates that guided CBT for insomnia can be delivered through the Internet. Patients accept the format and their sleep improves.

scholarly journals Blended collaborative care in the secondary prevention of coronary heart disease improves risk factor control: Results of a randomised feasibility study

2019 ◽  
Vol 19 (2) ◽  
pp. 134-141 ◽  
Author(s):  
Lena Bosselmann ◽  
Stella V Fangauf ◽  
Birgit Herbeck Belnap ◽  
Mira-Lynn Chavanon ◽  
Jonas Nagel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Collaborative Care ◽  
Intervention Group ◽  
Psychosocial Risk ◽  
Control Group ◽  
Risk Factor Control ◽  
Care Intervention

Background: Risk factor control is essential in limiting the progression of coronary heart disease, but the necessary active patient involvement is often difficult to realise, especially in patients suffering psychosocial risk factors (e.g. distress). Blended collaborative care has been shown as an effective treatment addition, in which a (non-physician) care manager supports patients in implementing and sustaining lifestyle changes, follows-up on patients, and integrates care across providers, targeting both, somatic and psychosocial risk factors. Aims: The aim of this study was to test the feasibility, acceptance and effect of a six-month blended collaborative care intervention in Germany. Methods: For our randomised controlled pilot study with a crossover design we recruited coronary heart disease patients with ⩾1 insufficiently controlled cardiac risk factors and randomised them to either immediate blended collaborative care intervention (immediate intervention group, n=20) or waiting control (waiting control group, n=20). Results: Participation rate in the intervention phase was 67% ( n=40), and participants reported high satisfaction ( M=1.63, standard deviation=0.69; scale 1 (very high) to 5 (very low)). The number of risk factors decreased significantly from baseline to six months in the immediate intervention group ( t(60)=3.07, p=0.003), but not in the waiting control group t(60)=−0.29, p=0.77). Similarly, at the end of their intervention following the six-month waiting period, the waiting control group also showed a significant reduction of risk factors ( t(60)=3.88, p<0.001). Conclusion: This study shows that blended collaborative care can be a feasible, accepted and effective addition to standard medical care in the secondary prevention of coronary heart disease in the German healthcare system.

Responses to a Learning Task at 6 Months and I.Q. Test Performance During the Preschool Years

1989 ◽  
Vol 12 (1) ◽  
pp. 101-114 ◽  
Author(s):  
Dale C. Farran ◽  
Lucy Ann Harber
Keyword(s):  
Test Performance ◽  
Day Care ◽  
Intervention Group ◽  
Learning Task ◽  
Control Group ◽  
Intervention Programme ◽  
Subsequent Test ◽  
Assessment Tests ◽  
Care Intervention ◽  
Standard Assessment

This research focused on 45 6-month-olds who were at risk for developmental delay due to poor socioeconomic circumstances, their responses to a learning task, and the subsequent prediction to performance on standardised tests during the preschool years. A rank classification for qualitative differences in learning proved preferable to a more complex behavioural count system. Task Rank was used to predict subsequent test performance on the Stanford Binet at 24, 36, and 48 months. Half the infants had been randomly assigned at birth to a day care intervention programme. Both Task Rank and the Bayley MDI at 6 months were good predictors of later test scores for the control group but not the day care intervention group. Responses to the learning task added significantly to the predictions obtained from the Bayley. These results suggest that tasks measured in infancy involving information processing in a novel situation are related to later functioning on standard assessment tests for children reared in less than optimal circumstances.

scholarly journals The Smartphone-Assisted Intervention Improved Perception of Nutritional Status among Middle School Students

2020 ◽  
Vol 17 (16) ◽  
pp. 5932
Author(s):  
Yan-Hui Shen ◽  
Zheng Liu ◽  
Wen-Hao Li ◽  
Shuang Zhou ◽  
Jin-Hui Xu ◽  
...  
Keyword(s):  
Middle School ◽  
Middle School Students ◽  
Nutritional Status ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Parental Perception ◽  
School Students ◽  
Usual Practice ◽  
Accurate Perception

Misperception of nutritional status is common and hinders the progress of childhood obesity prevention. This study aimed to examine the effectiveness of a smartphone-assisted intervention to improve student and parental perception of students’ nutritional status (underweight, normal weight, overweight, obese). We conducted a parallel-group controlled trial with a non-randomized design in three junior middle schools of Beijing, China in 2019. One school was allocated to the intervention group and two schools to the control group. A total of 573 students (aged 13.1 ± 0.4 years) participated in the trial. The 3-month intervention included three components: health education sessions for students and parents, regular monitoring of students’ weight, and the provision of feedback via a smartphone application. Schools in the control group continued their usual practice. Primary outcomes included the student and parental accurate perception of students’ nutritional status. The percentage of students’ accurate perception of their own nutritional status in the intervention group increased from 49.0% to 59.2% from baseline to three months, whereas it decreased from 64.1% to 58.1% in the control group; the adjusted odds ratio (OR) between the two groups was 1.71 (95% confidence interval (CI): 1.13, 2.59). The intervention did not significantly improve parental perception of students’ nutritional status (p > 0.05). The study findings provided a brief approach for improving perception of nutritional status among middle school students.

scholarly journals HOME CARE ON THE AN INCREASING NUTRITIONAL STATUS FOR THE CHILDREN UNDER FIVE IN YOGYAKARTA

2018 ◽  
Vol 1 (2) ◽  
pp. 134
Author(s):  
Titih Huriah ◽  
Ema Waliyanti ◽  
Hanjayadi Hanjayadi
Keyword(s):  
Nutritional Status ◽  
Home Care ◽  
Intervention Group ◽  
T Test ◽  
Nutrition Status ◽  
Control Group ◽  
Children Under Five ◽  
Under Five ◽  
Care Intervention ◽  
Significant Difference

Introduction. Prevalence of children under five with malnutrition is an indicator of Millenium Development Goals (MDGs) that should be reach in a region (Regency/City) in 2015. Prevalence of nutrition base on weight for height (WFH) in Daerah Istimewa Yogyakarta showed that children under five prevalence with very lean nutrition status was about 2,6 percent and lean about 6,5 percent. Community Therapeutic Care combining three approaches to handling under five malnutrition children including community intervention, home based treatment for under five malnutrition children without complication and stabilitation center for under five malnutrition children with complication. The aim of this research was to find out the changing of malnutrition children under five through home care program in Yogyakarta. Method. This research used quantitative method through home care intervention for children under five with malnutrition and was conducted by nurse in public health center. Design of this research was pretest-posttest control group design. The population of this research was all children under five with malnutrition or not complication. Sample divided into two groups, 35 children for the intervention group and 25 children for control group. Analysis used was Paired t-test and independent t-test. Results. The result showed that before home care intervention, there is no significant difference of two groups. The result after intervention for three month with 7 times of visiting, home care intervention can increase nutritional status of children under five with malnutrition. The value of Independent t-test for control group and intervention group was significant with p<0,05. Discussion. The researcher conclude that Home Care has effect to increase nutrition status of children under five with malnutrition and also Z score value which is weight for height (WFH) was increase. Keywords: Home Care, Nutrition status , Malnutrition.

scholarly journals Efficacy of Face-to-Face Delivered Cognitive Behavioral Therapy in Improving Health Status of Patients With Insomnia: A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Dawei Xu ◽  
Elizabeth Cardell ◽  
Simon A. Broadley ◽  
Jing Sun
Keyword(s):  
Sleep Quality ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Intervention Group ◽  
Severity Index ◽  
Sleep Time ◽  
Control Group ◽  
Sleep Onset Latency ◽  
Face To Face

Background: Face-to-face cognitive behavioral therapy (CBT) is one of the most widely used non-pharmacological treatment approaches for insomnia. The aim of this study is to assess the efficacy of face-to-face delivered CBT on health outcomes and to evaluate the effect of CBT components as subgroup variables to explain the efficacy of face-to-face delivered CBT on health outcomes in adults over 18 years old with insomnia.Methods: Relevant randomized controlled trial studies published in the past 22 years were searched through the electronic databases. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of the 31 included studies. The mean difference and standard deviation of outcome variables and subgroup variables were analyzed using random effect model, and the heterogeneity among the articles was assessed with the Q-test and I2. Egger regression analysis was used to assess publication bias.Results: The meta-analysis showed a significant reduction in Insomnia Severity Index [standardized mean difference (SMD) = −2.56, 95% CI −3.81 to −1.30, p &lt; 0.001], Pittsburgh Sleep Quality Index (SMD = −0.96, 95% CI −1.25 to −0.68, p &lt; 0.001), sleep onset latency (SMD = −1.31, 95% CI −2.00 to −0.63, p &lt; 0.001), wakening after sleep onset (SMD = −1.44, 95% CI −2.14 to −0.74, p &lt; 0.001), number of awakenings (SMD = −1.18, 95% CI −2.10 to −0.26, p &lt; 0.05), depression (SMD = −1.14, 95% CI −1.85 to −0.42, p &lt; 0.01), and fatigue (SMD = −2.23, 95% CI −3.87 to −0.58, p &lt; 0.01), and a significant increase in total sleep time (SMD = 0.63, 95% CI 0.28 to 0.98, p &lt; 0.001), sleep efficiency (SMD = 1.61, 95% CI 0.92 to 2.29, p &lt; 0.001), and physical health (SMD = 0.42, 95% CI 0.08 to 0.76, p &lt; 0.05), in the CBT intervention group compared with the control group. There was no significant change in anxiety (SMD = −0.62, 95% CI −1.55 to 0.32, p &gt; 0.05) and mental health (SMD = 1.09, 95% CI −0.59 to 2.77, p &gt; 0.05) in CBT intervention group compared with control group. Group-delivered studies with larger number of intervention sessions and longer duration of single session provided a larger improvement in sleep quality.Conclusion: Face-to-face delivered CBT is effective in increasing total sleep time, sleep efficiency, and physical health, and reducing Insomnia Severity Index scores, Pittsburgh Sleep Quality Index scores, sleep onset latency, wakening after sleep onset, number of awakenings, depression, anxiety, and fatigue in patients with insomnia. Face-to-face delivered CBT is more effective when delivered through a larger number of sessions with longer duration of each session, and when delivered in groups. Face-to-face CBT is recommended to provide treatment to patients with insomnia in clinical settings.Systematic Review Registration:www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200091, identifier: CRD4202020009.

scholarly journals Effects of biofeedback-based sleep improvement program on urinary symptoms and sleep patterns of elderly Korean women with overactive bladder syndrome

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jooyeon Park ◽  
Choal Hee Park ◽  
Sang-Eun Jun ◽  
Eun-Ju Lee ◽  
Seung Wan Kang ◽  
...  
Keyword(s):  
Overactive Bladder ◽  
Sleep Onset ◽  
Intervention Group ◽  
Wilcoxon Test ◽  
Urinary Symptoms ◽  
Control Group ◽  
Overactive Bladder Syndrome ◽  
Korean Women ◽  
Sleep Patterns ◽  
Significant Difference

Abstract Background The prevalence of overactive bladder syndrome (OAB) increases with age. Sleep disturbances in elderly individuals with OAB is a common problem. The purpose of this study was to examine the effects of a biofeedback-based sleep improvement (BBSI) program on urinary symptoms and sleep patterns in elderly Korean women with OAB. Methods A non-equivalent control group pre−/post-test design was used. Elderly women with OAB were assigned to an intervention group (n = 20) or a control group (n = 18). The BBSI program was implemented in the intervention group for 12 weeks, while two educational sessions of general sleep hygiene and lifestyle modification were provided to the control group. Using SPSS 23.0, the data were analyzed by descriptive analysis using the chi-square test, Fisher’s exact test, Mann-Whitney test, and Wilcoxon test. Results After the 12-week BBSI program, significant improvements were found in the intervention group’s the square root of the mean squared differences of successive R-R intervals (p = 0.025), low frequency/high frequency ratio (p = 0.006), and epinephrine (p = 0.039). We also observed a significant difference in urinary symptoms, sleep efficiency, wake after sleep onset, number of awakenings, and number of awakenings within 3 h after sleep onset (p < 0.001, p = 0.004, p = 0.001, p = 0.001, and p = 0.048, respectively). However, no significant changes were found in these variables in the control group. Conclusions The BBSI program effectively improved urinary symptoms and sleep patterns of elderly Korean women with OAB. Further longitudinal research is required to investigate the sustainability and effects of the BBSI program. Trial registration KCT0003882. Date of registration: 02/05/2019. Retrospectively registered.

scholarly journals Effectiveness of a Home-Based Rehabilitation Program After Total Hip Arthroplasty Driven by a Tablet App and Remote Coaching: Nonrandomized Controlled Trial Combining a Single-Arm Intervention Cohort With Historical Controls (Preprint)

2019 ◽  
Author(s):  
Annet Wijnen ◽  
Jildou Hoogland ◽  
Tjerk Munsterman ◽  
Carina LE Gerritsma ◽  
Baukje Dijkstra ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Effect Sizes ◽  
Control Group ◽  
Functional Tests ◽  
Total Hip ◽  
Home Based ◽  
Historical Controls

BACKGROUND Recent technological developments such as wearable sensors and tablets with a mobile internet connection hold promise for providing electronic health home-based programs with remote coaching for patients following total hip arthroplasty. It can be hypothesized that such a home-based rehabilitation program can offer an effective alternative to usual care. OBJECTIVE The aim of this study was to determine the effectiveness of a home-based rehabilitation program driven by a tablet app and remote coaching for patients following total hip arthroplasty. METHODS Existing data of two studies were combined, in which patients of a single-arm intervention study were matched with historical controls of an observational study. Patients aged 18-65 years who had undergone total hip arthroplasty as a treatment for primary or secondary osteoarthritis were included. The intervention consisted of a 12-week home-based rehabilitation program with video instructions on a tablet and remote coaching (intervention group). Patients were asked to do strengthening and walking exercises at least 5 days a week. Data of the intervention group were compared with those of patients who received usual care (control group). Effectiveness was measured at four moments (preoperatively, and 4 weeks, 12 weeks, and 6 months postoperatively) by means of functional tests (Timed Up &amp; Go test and the Five Times Sit-to Stand Test) and self-reported questionnaires (Hip disability and Osteoarthritis Outcome Score [HOOS] and Short Form 36 [SF-36]). Each patient of the intervention group was matched with two patients of the control group. Patient characteristics were summarized with descriptive statistics. The 1:2 matching situation was analyzed with a conditional logistic regression. Effect sizes were calculated by Cohen <i>d</i>. RESULTS Overall, 15 patients of the intervention group were included in this study, and 15 and 12 subjects from the control group were matched to the intervention group, respectively. The intervention group performed functional tests significantly faster at 12 weeks and 6 months postoperatively. The intervention group also scored significantly higher on the subscales “function in sport and recreational activities” and “hip-related quality of life” of HOOS, and on the subscale “physical role limitations” of SF-36 at 12 weeks and 6 months postoperatively. Large effect sizes were found on functional tests at 12 weeks and at 6 months (Cohen <i>d</i>=0.5-1.2), endorsed by effect sizes on the self-reported outcomes. CONCLUSIONS Our results clearly demonstrate larger effects in the intervention group compared to the historical controls. These results imply that a home-based rehabilitation program delivered by means of internet technology after total hip arthroplasty can be more effective than usual care. CLINICALTRIAL ClinicalTrials.gov NCT03846063; https://clinicaltrials.gov/ct2/show/NCT03846063 and German Registry of Clinical Trials DRKS00011345; https://tinyurl.com/yd32gmdo

scholarly journals Early high antibody-titre convalescent plasma for hospitalised COVID-19 patients: DAWn-plasma

2021 ◽  
pp. 2101724 ◽  
Author(s):  
Timothy Devos ◽  
Quentin Van Thillo ◽  
Veerle Compernolle ◽  
Tomé Najdovski ◽  
Marta Romano ◽  
...  
Keyword(s):  
Clinical Status ◽  
Intervention Group ◽  
Standard Of Care ◽  
Control Group ◽  
P Value ◽  
Open Label ◽  
Care Intervention ◽  
Antibody Titres ◽  
Median Volume ◽  
High Antibody Titre

BackgroundSeveral randomised clinical trials have studied convalescent plasma (CP) for COVID-19 using different protocols, with different SARS-CoV-2 neutralising-antibody-titres, at different time-points and severities of illness.MethodsIn the prospective multicentre DAWN-plasma trial, adult patients hospitalised with COVID-19 were randomised to 4 units of open-label convalescent plasma combined with standard of care (intervention group) or standard of care alone (control group). Plasma from donors with neutralising-antibody-titres (NT50) ≥1/320 was the product of choice for the study.ResultsBetween May 2nd, 2020 and January 26th, 2021, 320 patients were randomised to convalescent plasma and 163 patients to the control group according to a 2:1 allocation scheme. A median volume of 884 mL convalescent plasma (IQR 806–906 mL) was administered, and 80.68% of the units came from donors with neutralising-antibody-titres (NT50) ≥1/320. Median time from onset of symptoms to randomisation was 7 days. The proportion of patients alive and free of mechanical ventilation on Day 15 was not different between both groups (convalescent plasma: 83.74% (n=267) versus control: 84.05% (n=137) – Odds ratio 0.99 (0.59–1.66) – p-value=0.9772). The intervention did not change the natural course of antibody titres. The number of serious or severe adverse events was similar in both study arms, and transfusion-related side effects were reported in 19/320 patients in the intervention group (5.94%).ConclusionsTransfusion of 4 units of convalescent plasma with high neutralising-antibody-titres early in hospitalised COVID-19 patients did not result in a significant improvement of the clinical status, or a reduced mortality.

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