scholarly journals Intensive Home Treatment for adolescents in psychiatric crisis

2019 ◽  
Author(s):  
Jet Muskens ◽  
Pierre C.M. Herpers ◽  
Caroline Hilderink ◽  
Patricia A.M. van Deurzen ◽  
Jan K. Buitelaar ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Treatment Time ◽  
Primary Diagnosis ◽  
Home Treatment ◽  
Control Group ◽  
Long Term Effects ◽  
New Model ◽  
Combined Application

Abstract Adolescents with acute psychiatric disorders are typically treated with long-term clinical admission. However, long term admission may be associated with a variety of negative outcomes. This pilot study presents a new model of care, that is, the combined application of intensive home treatment and the possibility of short term stay at a psychiatric high & intensive care. Methods In total 112 referred adolescents with mixed diagnoses participated in this longitudinal observational design. Clinical outcome was measured by the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) which measures the severity of multiple mental health problems. The HoNOSCA was clinician-rated at intake, after two months and after four months at discharge. Change in HoNOSCA total score was analysed with paired t-tests. Outcome moderators were gender, age, primary diagnosis, clinical admission, home treatment-time, medication and additional therapies. Follow up data were completed for 62 patients after two months and for 53 after four months. Results Participants aged between 11 and 18 years (M = 14.8 years, SD = 0.3; 52% female). Mean HoNOSCA total score at intake was 18.8 (SD = 5.2), after two months 13.0 (SD = 5.0); after four months resulting in a score of 9.3 (SD = 5.2). None of the moderators tested showed a significant effect on HoNOSCA scores. However, a control group could not be used because of the severe psychopathology and high risk for suicidality and the lack of an effective treatment intervention for a comparable study group. Conclusion With a symptom decrease of over 50% within four months as measured by the HoNOSCA, including less risk for hospitalization, this new model appears promising and of clinical relevance. Nevertheless, further research regarding stability of treatment outcome is warranted and evaluation of long-term effects of this model in follow-up studies is needed.

scholarly journals Intensive home treatment for adolescents in psychiatric crisis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jet B. Muskens ◽  
Pierre C. M. Herpers ◽  
Caroline Hilderink ◽  
Patricia A. M. van Deurzen ◽  
Jan K. Buitelaar ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Treatment Time ◽  
Primary Diagnosis ◽  
Home Treatment ◽  
Control Group ◽  
Long Term Effects ◽  
New Model ◽  
Combined Application

Abstract Background Adolescents with acute psychiatric disorders are typically treated with long-term clinical admission. However, long term admission may be associated with a variety of negative outcomes. This pilot study presents a new model of care, that is, the combined application of intensive home treatment and the possibility of short term stay at a psychiatric high & intensive care. Methods In total 112 referred adolescents with mixed diagnoses participated in this longitudinal observational design. Clinical outcome was measured by the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) which measures the severity of multiple mental health problems. The HoNOSCA was clinician-rated at intake, after two months and after four months at discharge. Change in HoNOSCA total score was analysed with paired t-tests. Outcome moderators were gender, age, primary diagnosis, clinical admission, home treatment-time, medication and additional therapies. Follow up data were completed for 62 patients after two months and for 53 after four months. Results Participants aged between 11 and 18 years (M = 14.8 years, SD = 0.3; 52% female). Mean HoNOSCA total score at intake was 18.8 (SD = 5.2), after two months 13.0 (SD = 5.0); after four months resulting in a score of 9.3 (SD = 5.2). None of the moderators tested showed a significant effect on HoNOSCA scores. However, a control group could not be used because of the severe psychopathology and high risk for suicidality and the lack of an effective treatment intervention for a comparable study group. Conclusion With a symptom decrease of over 50% within four months as measured by the HoNOSCA, including less risk for hospitalization, this new model appears promising and of clinical relevance. Nevertheless, further research regarding stability of treatment outcome is warranted and evaluation of long-term effects of this model in follow-up studies is needed.

scholarly journals Intensive Home Treatment for adolescents in psychiatric crisis

2019 ◽  
Author(s):  
Jet Muskens ◽  
Pierre C.M. Herpers ◽  
Caroline Hilderink ◽  
Patricia A.M. van Deurzen ◽  
Jan K. Buitelaar ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Treatment Time ◽  
Primary Diagnosis ◽  
Home Treatment ◽  
Control Group ◽  
Long Term Effects ◽  
New Model ◽  
Combined Application

Abstract Background Adolescents with acute psychiatric disorders are typically treated with long-term clinical admission. However, long term admission may be associated with a variety of negative outcomes. This pilot study presents a new model of care, that is, the combined application of intensive home treatment and the possibility of short term stay at a psychiatric high & intensive care. Methods In total 112 referred adolescents with mixed diagnoses participated in this longitudinal observational design. Clinical outcome was measured by the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) which measures the severity of multiple mental health problems. The HoNOSCA was clinician-rated at intake, after two months and after four months at discharge. Change in HoNOSCA total score was analysed with paired t-tests. Outcome moderators were gender, age, primary diagnosis, clinical admission, home treatment-time, medication and additional therapies. Follow up data were completed for 62 patients after two months and for 53 after four months. Results Participants aged between 11 and 18 years ( M = 14.8 years, SD = 0.3; 52% female). Mean HoNOSCA total score at intake was 18.8 (SD = 5.2), after two months 13.0 (SD = 5.0); after four months resulting in a score of 9.3 (SD = 5.2). None of the moderators tested showed a significant effect on HoNOSCA scores. However, a control group could not be used because of the severe psychopathology and high risk for suicidality and the lack of an effective treatment intervention for a comparable study group. Conclusion With a symptom decrease of over 50% within four months as measured by the HoNOSCA, including less risk for hospitalization, this new model appears promising and of clinical relevance. Nevertheless, further research regarding stability of treatment outcome is warranted and evaluation of long-term effects of this model in follow-up studies is needed.

scholarly journals Intensive Home Treatment for adolescents in psychiatric crisis

2019 ◽  
Author(s):  
Jet Muskens ◽  
Pierre C.M. Herpers ◽  
Caroline Hilderink ◽  
Patricia A.M. van Deurzen ◽  
Jan K. Buitelaar ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Treatment Time ◽  
Primary Diagnosis ◽  
Home Treatment ◽  
Control Group ◽  
New Model ◽  
Combined Application ◽  
Observational Cohort ◽  
Severe Psychopathology

Abstract Background Adolescents with acute psychiatric disorders are typically treated with long-term clinical admission. However, long term admission may be associated with a variety of negative outcomes. This pilot study presents a new model of care, that is, the combined application of intensive home treatment and the possibility of short term stay at a psychiatric high & intensive care. Methods In total 112 referred adolescents with mixed diagnoses (M = 14.8 years, range 11-18; 52% female) participated in this longitudinal observational cohort design. Clinical outcome was measured by the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) which measures the severity of multiple mental health problems. The HoNOSCA was clinician-rated at intake, after two months and after four months at discharge. Change in HoNOSCA total score was analysed with paired t-tests. Outcome moderators were gender, age, primary diagnosis, clinical admission, home treatment-time, medication and additional therapies. Follow up data were completed for 62 patients after two months and for 53 after four months. Results Mean HoNOSCA total score at intake was 18.8 (SD = 5.2), after two months 13.0 (SD = 5.0); after four months resulting in a score of 9.3 (SD = 5.2). None of the moderators tested showed a significant effect on HoNOSCA scores. However, a control group could not be used because of the severe psychopathology with high risk for suicidality and the lack of an effective treatment intervention for a comparable study group. Conclusion With a symptom decrease of over 50% within four months as measured by the HoNOSCA, including less risk for hospitalization, this new model appears promising and of clinical relevance. Nevertheless, further research regarding stability of treatment outcome is warranted.

Early Post-Partum Contact and Later Attitudes

1980 ◽  
Vol 3 (3) ◽  
pp. 273-286 ◽  
Author(s):  
Peter de Chateau
Keyword(s):  
Post Partum ◽  
Postnatal Period ◽  
Child Rearing ◽  
Control Group ◽  
Maternal Behaviour ◽  
Relative Importance ◽  
Long Term Effects ◽  
Infant Behaviour

In a randomized, prospective study the long-term effects of early post-partum skin-toskin and suckling contact was studied. In follow-up studies 36 hours, 3 and 12 months after delivery maternal behaviour, infant behaviour, the duration of breast feeding and certain attitudes towards child rearing procedures were shown to develop differently in a group of mothers and infants with early post-natal contacts as compared to a control group. Three years after delivery parents with early contact appreciated their children's language development to be faster; the number of siblings born in these families was greater than in controls. In the discussion, the relative importance of the immediate postnatal period is emphasized, a more family oriented development seems to occur in the presence of early post-delivery interaction.

scholarly journals Long-Term Outcomes of Rheohaemapheresis in the Treatment of Dry Form of Age-Related Macular Degeneration

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Jan Studnička ◽  
Eva Rencová ◽  
Milan Bláha ◽  
Pavel Rozsíval ◽  
Miriam Lánská ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Treated Patient ◽  
Pigment Epithelium ◽  
Age Related Macular Degeneration ◽  
Rheological Parameters ◽  
Control Group ◽  
Long Term Effects ◽  
Age Related

Purpose. Determining long-term effects of rheohaemapheresis on the dry form of age-related macular degeneration.Methods. This study evaluates 19 patients, average age of 67.6 years, treated with rheohaemapheresis and 18 patients, average age of 72.8 years, comprising the control group. Minimum follow up period was 3.5 years. Each treated patient received a series of 8 sessions of rheohaemapheresis of 1.5 plasma volumes within 10 weeks. We measured the drusenoid pigment epithelium detachment (DPED), best-corrected visual acuity (BCVA), electroretinography (ERG), and rheological parameters.Results. In the treatment group, the baseline BCVA was 0.74 (0.36–1.0) 95% CI and BCVA after 3.5 years was 0.79 (0.41–1.0) 95% CI (P=0.726). In the control group, the baseline BCVA was 0.71 (0.15–1.0) 95% CI and BCVA after 3.5 years decreased to 0.7 (0.32–0.87) 95% CI (P=0.031). Baseline DPED was 6.78 ± 3.79 mm2; after 3.5 years, it decreased to 4.13 ± 3.84 mm2(P<0.001). In the control group, the baseline DPED was 4.09 ± 3.48 mm2; after 3.5 years, it increased to 6.69 ± 4.2 mm2(P=0.001). We noted increasing levels of positive wave peaking at 50 milliseconds (P50) after treatment (P=0.022) and a stable amplitude of photopic responses of treated patients.Conclusion. Over the long term, rheohaemapheresis reduced the DPED, improved the function of photoreceptors, and prevented the decline of BCVA.

scholarly journals Efficacy and Safety of Immunosuppressive Monotherapy Agents for IgA Nephropathy: A Network Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Shisheng Han ◽  
Tianwen Yao ◽  
Yan Lu ◽  
Min Chen ◽  
Yanqiu Xu ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Clinical Remission ◽  
Meta Analysis ◽  
Immunosuppressive Agents ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Long Term Effects

Background: The efficacy and safety of immunosuppressive monotherapy agents were evaluated for immunoglobulin A nephropathy (IgAN) using a network meta-analysis approach.Methods: Randomized controlled trials (RCTs) published prior to October 1, 2019, using immunosuppressive agents for treating IgAN, were systematically searched in PubMed, Embase, Cochrane Library, and Web of Science databases. Relative risks (RRs) or standard mean differences with 95% confidence intervals (CIs) were estimated using the random-effects model. The primary outcomes were clinical remission, end-stage renal disease (ESRD), and serious adverse events (SAEs). The secondary outcomes were urinary protein excretion and serum creatinine.Results: Twenty-five RCTs with 2,005 participants were deemed eligible. Six medications were evaluated: corticosteroids, mycophenolate mofetil (MMF), tacrolimus (TAC), cyclosporine, leflunomide, and hydroxychloroquine (HCQ). Steroids (RR 1.50, 95% CI 1.17–1.93), MMF (RR 2.05, 95% CI 1.15–3.65), TAC (RR 3.67, 95% CI 1.06–12.63), and HCQ (RR 3.25, 95% CI 1.05–10.09) significantly improved clinical remission rates compared to supportive care alone. Only steroids reduced the risk of ESRD (RR 0.35, 95% CI 0.12–0.98); however, there were significantly more SAEs than in the control group (RR 2.90, 95% CI 1.37–6.13). No significantly different effects in serum creatinine levels were found among the therapies. MMF showed no significant improvement in remission when excluding studies with a follow-up of fewer than 2 years in the sensitivity analysis (RR 1.41, 95% CI 0.40–4.92). The effect of TAC in the decrease of proteinuria was reversed after discontinuing medication for 3 months; the long-term effects of HCQ could not be evaluated due to the short follow-up duration.Conclusion: Corticosteroids might induce remission and increase renal survival in IgAN; however, adverse reactions should be taken into consideration. MMF, TAC, and HCQ might improve the remission of proteinuria when treating IgAN, but showed no superiority compared to steroids, and the long-term effects require further study.

scholarly journals Efficacy and safety of immunosuppressive agent monotherapy for IgA nephropathy: a network meta-analysis

2020 ◽  
Author(s):  
Shisheng Han ◽  
Tianwen Yao ◽  
Yan Lu ◽  
Min Chen ◽  
Yanqiu Xu ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Clinical Remission ◽  
Meta Analysis ◽  
Immunosuppressive Agent ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Long Term Effects

Abstract BackgroundThe efficacy and safety of immunosuppressive agent monotherapy were evaluated for Immunoglobulin A nephropathy (IgAN) using a network meta-analysis approach based on randomised controlled trials (RCTs).MethodsPubMed, Embase, the Cochrane library, and the Web of Science were systematically searched for RCTs published before October 2019 using immunosuppressive agents for treating IgAN. Quality assessments were performed according to the Cochrane Handbook. Pooled relative risks (RRs) or standard mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were calculated for discrete or continuous variables, respectively. The primary outcomes were clinical remission, end-stage renal disease (ESRD), and serious adverse events (SAEs); the secondary outcomes were urinary protein excretion and serum creatinine. Data were synthesised by the random-effects model.ResultsTwenty-five RCTs with 2005 participants were deemed to be eligible, and six medications were evaluated: corticosteroids, mycophenolate mofetil (MMF), tacrolimus (TAC), cyclosporine (CsA), leflunomide (LEF), and hydroxychloroquine (HCQ). Compared to supportive care alone, steroids (RR 1.50, 95% CI 1.17–1.93), MMF (RR 2.05, 95% CI 1.15–3.65), TAC (RR 3.67, 95% CI 1.06–12.63), and HCQ (RR 3.25, 95% CI 1.05–10.09) each significantly improved clinical remission rates; only steroids reduced the risk of ESRD (RR 0.35, 95% CI 0.12–0.98), but the SAEs were significantly higher than those in the control group (RR 2.90, 95% CI 1.37–6.13). Furthermore, steroids, LEF, and HCQ showed lower proteinuria in the pairwise meta-analysis. There was no evidence of different effects of the therapies on serum creatinine levels. The effect of MMF, whereby it induced remission, was reversed when excluding studies with follow-up of fewer than two years in the sensitivity analysis (RR 1.41, 95% CI 0.40–4.92). The anti-proteinuric effect of TAC was reversed three months after discontinuing medication; the long-term effects of HCQ could not be evaluated due to the short follow-up.ConclusionsCorticosteroids might induce remission and increase renal survival in IgAN; however, the adverse reactions should be considered. TAC, LEF, HCQ, and MMF, might improve remission of proteinuria when treating IgAN, but showed no superiority compared to steroids, and the long-term effects require further study.

scholarly journals Long-term Effectiveness of mHealth Physical Activity Interventions: Systematic Review and Meta-analysis of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Annette Mönninghoff ◽  
Jan Niklas Kramer ◽  
Alexander Jan Hess ◽  
Kamila Ismailova ◽  
Gisbert W Teepe ◽  
...  
Keyword(s):  
Physical Activity ◽  
Meta Analysis ◽  
Control Group ◽  
Long Term Effects ◽  
Short Term ◽  
Mhealth Intervention ◽  
Group Type ◽  
Randomized Controlled

BACKGROUND Mobile health (mHealth) interventions can increase physical activity (PA); however, their long-term impact is not well understood. OBJECTIVE The primary aim of this study is to understand the immediate and long-term effects of mHealth interventions on PA. The secondary aim is to explore potential effect moderators. METHODS We performed this study according to the Cochrane and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched PubMed, the Cochrane Library, SCOPUS, and PsycINFO in July 2020. Eligible studies included randomized controlled trials of mHealth interventions targeting PA as a primary outcome in adults. Eligible outcome measures were walking, moderate-to-vigorous physical activity (MVPA), total physical activity (TPA), and energy expenditure. Where reported, we extracted data for 3 time points (ie, end of intervention, follow-up ≤6 months, and follow-up &gt;6 months). To explore effect moderators, we performed subgroup analyses by population, intervention design, and control group type. Results were summarized using random effects meta-analysis. Risk of bias was assessed using the Cochrane Collaboration tool. RESULTS Of the 2828 identified studies, 117 were included. These studies reported on 21,118 participants with a mean age of 52.03 (SD 14.14) years, of whom 58.99% (n=12,459) were female. mHealth interventions significantly increased PA across all the 4 outcome measures at the end of intervention (walking standardized mean difference [SMD] 0.46, 95% CI 0.36-0.55; <i>P</i>&lt;.001; MVPA SMD 0.28, 95% CI 0.21-0.35; <i>P</i>&lt;.001; TPA SMD 0.34, 95% CI 0.20-0.47; <i>P</i>&lt;.001; energy expenditure SMD 0.44, 95% CI 0.13-0.75; <i>P</i>=.01). Only 33 studies reported short-term follow-up measurements, and 8 studies reported long-term follow-up measurements in addition to end-of-intervention results. In the short term, effects were sustained for walking (SMD 0.26, 95% CI 0.09-0.42; <i>P</i>=.002), MVPA (SMD 0.20, 95% CI 0.05-0.35; <i>P</i>=.008), and TPA (SMD 0.53, 95% CI 0.13-0.93; <i>P</i>=.009). In the long term, effects were also sustained for walking (SMD 0.25, 95% CI 0.10-0.39; <i>P</i>=.001) and MVPA (SMD 0.19, 95% CI 0.11-0.27; <i>P</i>&lt;.001). We found the study population to be an effect moderator, with higher effect scores in sick and at-risk populations. PA was increased both in scalable and nonscalable mHealth intervention designs and regardless of the control group type. The risk of bias was rated high in 80.3% (94/117) of the studies. Heterogeneity was significant, resulting in low to very low quality of evidence. CONCLUSIONS mHealth interventions can foster small to moderate increases in PA. The effects are maintained long term; however, the effect size decreases over time. The results encourage using mHealth interventions in at-risk and sick populations and support the use of scalable mHealth intervention designs to affordably reach large populations. However, given the low evidence quality, further methodologically rigorous studies are warranted to evaluate the long-term effects.

scholarly journals Long term effects of olfactory training in patients with post-infectious olfactory loss

2016 ◽  
Vol 54 (2) ◽  
pp. 170-175
Author(s):  
I. Konstantinidis ◽  
E. Tsakiropoulou ◽  
J. Constantinidis
Keyword(s):  
Control Group ◽  
Subjective Ratings ◽  
Long Term Effects ◽  
Short Term ◽  
Olfactory Loss ◽  
Olfactory Testing ◽  
Olfactory Training ◽  
Post Infectious

Background: There is evidence of the effectiveness of repeated exposure to odours on short-term olfactory function. The aim of this study was to assess the long-term effects of olfactory training. Methods: We conducted a prospective study of 111 patients with post-infectious olfactory dysfunction. Two groups of patients performed olfactory training for 16 and 56 weeks, respectively, and were compared with a control group. The training was performed twice daily using four odours (phenyl ethyl alcohol, eucalyptol, citronellal, eugenol). Olfactory testing was performed by means of the Sniffin Sticks test as a baseline assessment and then every 8 weeks for 56 weeks. Subjective ratings were performed using a visual analogue scale (0-100). Results: Both training groups presented significantly higher scores than the controls. The long-term group had better results than the short-term group. Short-term training patients sustained their improvement within the follow-up period. Subsets analysis showed that training patients mainly increased identification and discrimination. Subjective ratings were in accordance with the olfactory test results. Conclusion: Long-term olfactory training seems to be associated with better results in patients with post-infectious olfactory loss than a short-term scheme. Short-term training provides sustainable results at 56 weeks follow-up assessment.

Methodological Considerations for Auditory Training Interventions for Adults With Hearing Loss: A Rapid Review

2021 ◽  
Vol 30 (1) ◽  
pp. 211-225
Author(s):  
Laura Gaeta ◽  
Rachel Keiko Stark ◽  
Erika Ofili
Keyword(s):  
Hearing Loss ◽  
Outcome Measures ◽  
Auditory Training ◽  
Rapid Review ◽  
Future Research ◽  
Control Group ◽  
Long Term Effects ◽  
Training Interventions

Purpose The aim of this study was to evaluate literature on auditory training published since 2013. Method A rapid review or a streamlined approach to systematically identify and summarize relevant studies was performed. Selected health sciences databases were searched using a search strategy developed with the PICO (population, intervention, comparison, and outcome) framework. Studies eligible for inclusion had older adult participants with hearing loss and utilized technology-based auditory training in laboratory or home settings. Results The study quality of most studies was found to be low to moderate, with concentrations between low and moderate. Major issues were related to study design and reporting, such as the need for blinding and a control group, larger sample sizes, and a follow-up for long-term outcomes of auditory training interventions. Wide variability in training approaches, participant backgrounds (e.g., audiograms, hearing aid use), and outcome measures are also noted. Conclusions Evidence on the effectiveness of auditory training is mixed. Future research should include high-quality randomized controlled trials with representative populations; follow-up periods to study long-term effects; and exploration of behavioral, electrophysiological, and self-reported outcome measures. Recommendations for study designs and methodologies are also discussed.

Sign in / Sign up

Export Citation Format

Share Document