Selective head–neck cooling after concussion shortens return-to-play in ice hockey players

We aimed to investigate whether selective head–neck cooling could shorten recovery after sports-related concussions (SRCs). In a nonrandomized study of 15 Swedish professional ice hockey teams, 29 concussed players received immediate head and neck cooling for ≥30 min (initiated at 12.3 ± 9.2 min post-SRC by a portable cooling system), and 52 SRC controls received standard management. Players receiving head–neck cooling had shorter time to return-to-play than controls (7 vs 12.5 days, p < 0.0001), and 7% in the intervention group versus 25% in the control group were out of play for ≥3 weeks (p = 0.07). Immediate selective head–neck cooling is a promising option in the acute management of SRC that should be addressed in larger cohorts.

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Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial

Healthcare ◽

10.3390/healthcare9040463 ◽

2021 ◽

Vol 9 (4) ◽

pp. 463

Author(s):

Mar Gomis-Pastor ◽

Sonia Mirabet Perez ◽

Eulalia Roig Minguell ◽

Vicenç Brossa Loidi ◽

Laura Lopez Lopez ◽

...

Keyword(s):

Heart Transplantation ◽

Patient Experience ◽

Mobile Application ◽

Standard Care ◽

Controlled Trial ◽

Intervention Group ◽

Group Versus ◽

Control Group ◽

P Value ◽

Adherence Score

Non-adherence after heart transplantation (HTx) is a significant problem. The main objective of this study was to evaluate if a mHealth strategy is more effective than standard care in improving adherence and patients’ experience in heart transplant recipients. Methods: This was a single-center, randomized controlled trial (RCT) in adult recipients >1.5 years post-HTx. Participants were randomized to standard care (control group) or to the mHeart Strategy (intervention group). For patients randomized to the mHeart strategy, multifaceted theory-based interventions were provided during the study period to optimize therapy management using the mHeart mobile application. Patient experience regarding their medication regimens were evaluated in a face-to-face interview. Medication adherence was assessed by performing self-reported questionnaires. A composite adherence score that included the SMAQ questionnaire, the coefficient of variation of drug levels and missing visits was also reported. Results: A total of 134 HTx recipients were randomized (intervention N = 71; control N = 63). Mean follow-up was 1.6 (SD 0.6) years. Improvement in adherence from baseline was significantly higher in the intervention group versus the control group according to the SMAQ questionnaire (85% vs. 46%, OR = 6.7 (2.9; 15.8), p-value < 0.001) and the composite score (51% vs. 23%, OR = 0.3 (0.1; 0.6), p-value = 0.001). Patients’ experiences with their drug therapy including knowledge of their medication timing intakes (p-value = 0.019) and the drug indications or uses that they remembered (p-value = 0.003) significantly improved in the intervention versus the control group. Conclusions: In our study, the mHealth-based strategy significantly improved adherence and patient beliefs regarding their medication regimens among the HTx population. The mHeart mobile application was used as a feasible tool for providing long-term, tailor-made interventions to HTx recipients to improve the goals assessed.

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Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients

Anesthesiology ◽

10.1097/aln.0000000000001804 ◽

2017 ◽

Vol 127 (4) ◽

pp. 633-644 ◽

Cited By ~ 18

Author(s):

Keyword(s):

Postoperative Pain ◽

Postoperative Delirium ◽

Intervention Group ◽

Group Versus ◽

Length Of Hospital Stay ◽

Treated Group ◽

Assessment Method ◽

Hospital Length Of Stay ◽

Control Group ◽

Opioid Use

Abstract Background Postoperative pain and opioid use are associated with postoperative delirium. We designed a single-center, randomized, placebo-controlled, parallel-arm, double-blinded trial to determine whether perioperative administration of gabapentin reduced postoperative delirium after noncardiac surgery. Methods Patients were randomly assigned to receive placebo (N = 347) or gabapentin 900 mg (N = 350) administered preoperatively and for the first 3 postoperative days. The primary outcome was postoperative delirium as measured by the Confusion Assessment Method. Secondary outcomes were postoperative pain, opioid use, and length of hospital stay. Results Data for 697 patients were included, with a mean ± SD age of 72 ± 6 yr. The overall incidence of postoperative delirium in any of the first 3 days was 22.4% (24.0% in the gabapentin and 20.8% in the placebo groups; the difference was 3.20%; 95% CI, 3.22% to 9.72%; P = 0.30). The incidence of delirium did not differ between the two groups when stratified by surgery type, anesthesia type, or preoperative risk status. Gabapentin was shown to be opioid sparing, with lower doses for the intervention group versus the control group. For example, the morphine equivalents for the gabapentin-treated group, median 6.7 mg (25th, 75th quartiles: 1.3, 20.0 mg), versus control group, median 6.7 mg (25th, 75th quartiles: 2.7, 24.8 mg), differed on the first postoperative day (P = 0.04). Conclusions Although postoperative opioid use was reduced, perioperative administration of gabapentin did not result in a reduction of postoperative delirium or hospital length of stay.

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Impact of a 12-month web and smartphone-based intervention initiated during spa therapy to improve long-term physical activity of patients with chronic diseases: randomized controlled trial. (Preprint)

10.2196/preprints.29640 ◽

2021 ◽

Author(s):

Florie FILLOL ◽

Ludivine PARIS ◽

Sébastien PASCAL ◽

Aurélien MULLIEZ ◽

Christian-François ROQUES ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Waist Circumference ◽

Controlled Trial ◽

Intervention Group ◽

Group Versus ◽

Control Group ◽

Spa Therapy

BACKGROUND Lack of physical activity (PA) and sedentary behaviors are leading risk factors for non-communicable diseases (NCD). Web-based interventions are effective in increasing PA in older adults and in NCD patients. In many countries a course of spa therapy is commonly prescribed to NCD patients and represents an ideal context to initiating lifestyle changes. OBJECTIVE The main objective of this study was to evaluate in NCD patients the effectiveness of an intervention combining an individual face-to-face coaching during spa therapy and, when returning home, a web- and smartphone-based PA program including a connected wrist pedometer and a connected weighing scale, on the achievement of physical activity guidelines (PAG) 12 months after the end of spa therapy. METHODS This was a 12-month, prospective, parallel-group, randomized controlled trial. Patients were enrolled during spa therapy and randomized 1:1 to intervention or control group who received usual advices about PA. From the end of spa therapy, PA, weight, waist circumference, and quality of life of the participants in both groups, were assessed by phone every 2 months. Primary outcome was meeting PAG (PA≥600 METs) at 12 months after the end of spa therapy. Secondary outcomes were: meeting current PAG at 6 months of follow-up; sedentary time, weight and waist circumference, PA and quality of life, at 6 and 12 months. Objective use data of the web-and smartphone-based PA program were collected. Analytic methods include intention-to-treat and constrained longitudinal data analyses. RESULTS The study sample was 228 patients (female : 77.2% (176/228), mean age: 62.4 years (SD 6.7), retired: 53.9% (123/228), mean BMI = 28.2 kg.m-2 (SD 4.2)). No group differences were found for any baseline variable. At 12 months, the proportion of patients achieving PAG was significantly higher in intervention group versus control group (81% vs 67% respectively, OR = 2.34 (95% CI 1.02- 5.38; P=.045). No difference between intervention and control group was found neither in achieving PAG at 6 months nor for sedentary time, weight and waist circumference, at 6 and 12 months. Regarding quality of life, the physical component subscale score was significantly higher at 12 months in intervention group versus control group (mean difference: 4.1 (95% CI 1.9-6.3; P<.001). The mean duration use of the program was 7.1 months (SD 4.5). Attrition rate during the first 2 months of the program was 20.4% (23/113) whereas 39.8% (45/113) of the participants used the program for at least 10 months. CONCLUSIONS The results showed significantly more participants meeting PAG at one year in the intervention group compared to controls. A course of spa therapy offers the ideal time and setting to implement education in PA. Digital coaching seems to be more efficient than usual coaching for increasing the level of PA and decreasing sedentariness on the long term. CLINICALTRIAL ClinicalTrials.gov NCT02694796; https://clinicaltrials.gov/ct2/show/NCT02694796.

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The Effect of Lullaby Intervention on Anxiety and Prenatal Attachment in Women with High-Risk Pregnancy: A Randomized Controlled Study

Complementary Medicine Research ◽

10.1159/000520139 ◽

2021 ◽

pp. 1-9

Author(s):

Nazlı Baltacı ◽

Mürüvvet Başer

Keyword(s):

High Risk ◽

Intervention Group ◽

Group Versus ◽

Mean Difference ◽

High Risk Pregnancy ◽

Controlled Study ◽

Control Group ◽

Prenatal Attachment ◽

Randomized Controlled ◽

Risk Pregnancy

Background: Women with high-risk pregnancy experience anxiety and low mother-fetal attachment when faced with signs of danger and health problems. This study aimed to investigate the effects of lullaby intervention on anxiety and prenatal attachment in women with high-risk pregnancy. Materials and Methods: This randomized controlled trial was conducted in the perinatology clinic of a state maternity hospital in Turkey. Seventy-six women with high-risk pregnancy were included. The intervention group listened to lullabies for 20 min once a day, and accompanied by lullabies touched their abdomen and thought about their babies, but the control group did not. Data were collected using the Pregnant Information Form, the State Anxiety Inventory, and the Prenatal Attachment Inventory. Results: Baseline anxiety did not differ in the intervention versus control group (47.83 ± 10.74 vs. 44.10 ± 8.08, mean difference 3.73 [95% Cl –1.18 to 8.64], p = 0.13), but after the 2nd day lullaby intervention anxiety was lower in the intervention group versus control group (33.66 ± 9.32 vs. 43.06 ± 8.10, mean difference –9.40 [95% Cl –13.91 to –4.88], p < 0.01). Baseline prenatal attachment did not differ in the intervention versus control group (56.03 ± 10.71 vs. 53.86 ± 9.98, mean difference 2.16 [95% Cl –3.18 to 7.51], p = 0.42), but after the 2nd day lullaby intervention prenatal attachment was higher in the intervention group versus control group (66.70 ± 7.60 vs. 54.36 ± 9.52, mean difference 12.33 [95% Cl 7.87 to 16.78], p < 0.01). In the within-group analysis the intervention group had lower anxiety and better prenatal attachment (p < 0.01), but not in the control group (p > 0.05). Conclusion: Lullaby intervention can play an effective role in reducing anxiety and improving prenatal attachment. The use of this integrative, noninvasive, non-pharmacologic, time-efficient, and natural intervention is suggested in the care of pregnant women.

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Reading comprehension gains in a differentiated reading intervention in Spanish based on the Simple View

Child Language Teaching and Therapy ◽

10.1177/0265659020967985 ◽

2020 ◽

pp. 026565902096798

Author(s):

Gabriela Silva-Maceda ◽

Blanca Flor Camarillo-Salazar

Keyword(s):

Reading Comprehension ◽

Listening Comprehension ◽

Intervention Group ◽

Group Versus ◽

Control Group ◽

Simple View ◽

Comprehension Skill ◽

School Year ◽

Mixed Analysis ◽

Post Test

This experimental study aimed to influence reading comprehension skills through the development of one or both components of the Simple View of Reading (decoding and listening comprehension), by using a differentiated instruction approach. Reading comprehension skill gains were compared in an intervention group versus a control, after the delivery of a program designed to target one or both of such components. Fifty-four children from two 1st grade classrooms in a public school in Mexico were screened for difficulties in decoding and listening comprehension at the end of the school year. At the beginning of 2nd grade, 27 students identified with difficulties were randomly assigned to either an intervention ( n = 14) or a control group ( n = 13). Students selected for the targeted intervention attended the sessions aimed at their specific needs: five students with poor decoding only received the Phonological and Orthographic Awareness sessions of the intervention (9 sessions); seven students with poor listening comprehension only attended the Oral Vocabulary sessions (5 sessions); two students with mixed difficulties attended the full program (14 sessions). A 2 × 2 mixed analysis of variance showed that the interaction between the Time and Group variables had a significant effect, i.e. students in the intervention group had significantly higher scores in the post-test evaluation with respect to their baseline and compared to the growth observed in the control group. Results are discussed concerning their implications for teaching practices and for the use of strategies that target reading specific difficulties in students using both oral and written language.

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Feasibility of Social-Network-Based eHealth Intervention on the Improvement of Healthy Habits among Children

Sensors ◽

10.3390/s20051404 ◽

2020 ◽

Vol 20 (5) ◽

pp. 1404 ◽

Cited By ~ 1

Author(s):

José Alberto Benítez-Andrades ◽

Natalia Arias ◽

María Teresa García-Ordás ◽

Marta Martínez-Martínez ◽

Isaías García-Rodríguez

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Body Mass ◽

Eating Habits ◽

Intervention Group ◽

Group Versus ◽

Daily Basis ◽

Control Group ◽

Healthy Habits ◽

Ehealth Intervention

This study shows the feasibility of an eHealth solution for tackling eating habits and physical activity in the adolescent population. The participants were children from 11 to 15 years old. An intervention was carried out on 139 students in the intervention group and 91 students in the control group, in two schools during 14 weeks. The intervention group had access to the web through a user account and a password. They were able to create friendship relationships, post comments, give likes and interact with other users, as well as receive notifications and information about nutrition and physical activity on a daily basis and get (virtual) rewards for improving their habits. The control group did not have access to any of these features. The homogeneity of the samples in terms of gender, age, body mass index and initial health-related habits was demonstrated. Pre- and post-measurements were collected through self-reports on the application website. After applying multivariate analysis of variance, a significant alteration in the age-adjusted body mass index percentile was observed in the intervention group versus the control group, as well as in the PAQ-A score and the KIDMED score. It can be concluded that eHealth interventions can help to obtain healthy habits. More research is needed to examine the effectiveness in achieving adherence to these new habits.

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Sports Hernia in National Hockey League Players

The American Journal of Sports Medicine ◽

10.1177/0363546512462679 ◽

2012 ◽

Vol 41 (1) ◽

pp. 107-110 ◽

Cited By ~ 30

Author(s):

Andre Jakoi ◽

Craig O’Neill ◽

Christopher Damsgaard ◽

Keith Fehring ◽

James Tom

Keyword(s):

Statistical Significance ◽

Return To Play ◽

National Hockey League ◽

Control Group ◽

Sports Hernia ◽

Level Of Evidence ◽

Athletic Pubalgia ◽

Hockey Players ◽

Group A ◽

Group B

Background: Athletic pubalgia is a complex injury that results in loss of play in competitive athletes, especially hockey players. The number of reported sports hernias has been increasing, and the importance of their management is vital. There are no studies reporting whether athletes can return to play at preinjury levels. Purpose: The focus of this study was to evaluate the productivity of professional hockey players before an established athletic pubalgia diagnosis contrasted with the productivity after sports hernia repair. Study Design: Cohort study; Level of evidence, 3. Methods: Professional National Hockey League (NHL) players who were reported to have a sports hernia and who underwent surgery from 2001 to 2008 were identified. Statistics were gathered on the players’ previous 2 full seasons and compared with the statistics 2 full seasons after surgery. Data concerning games played, goals, average time on ice, time of productivity, and assists were gathered. Players were divided into 3 groups: group A incorporated all players, group B were players with 6 or fewer seasons of play, and group C consisted of players with 7 or more seasons of play. A control group was chosen to compare player deterioration or improvement over a career; each player selected for the study had a corresponding control player with the same tenure in his career and position during the same years. Results: Forty-three hockey players were identified to have had sports hernia repairs from 2001 to 2008; ultimately, 80% would return to play 2 or more full seasons. Group A had statistically significant decreases in games played, goals scored, and assists. Versus the control group, the decreases in games played and assists were supported. Statistical analysis showed significant decreases in games played, goals scored, assists, and average time on ice the following 2 seasons in group C, which was also seen in comparison with the control group. Group B (16 players) showed only statistical significance in games played versus the control group. Conclusion: Players who undergo sports hernia surgeries return to play and often perform similar to their presurgery level. Players with over 7 full seasons return but with significant decreases in their overall performance levels. Less veteran players were able to return to play without any statistical decrease in performance and are likely the best candidates for repair once incurring injury.

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Application of Community-Based Social Marketing (CBSM) to Increase Recycling Behavior (RB) in Primary Schools

Social Marketing Quarterly ◽

10.1177/1524500420962789 ◽

2020 ◽

Vol 26 (4) ◽

pp. 297-308

Author(s):

Sahar Haghighatjoo ◽

Rahim Tahmasebi ◽

Azita Noroozi

Keyword(s):

Social Norms ◽

Social Marketing ◽

Primary Schools ◽

Environmental Changes ◽

Research Question ◽

Intervention Group ◽

Group Versus ◽

Control Group ◽

Community Based ◽

Recycling Behavior

Background: Recycling and waste separation is one of the most important policies for the management of municipal solid waste, and notwithstanding the importance of recycling especially at the school age, little research have been conducted in this field. Focus of the Article: In this quasi-experimental study, five steps of community-based social marketing (CBSM) were used for changing of the recycling behavior (RB). Research Question: Do CBSM strategies increase use of recycling containers versus the sole availability of containers? Program Design/Approach: The intervention was implemented in five steps and through seven CBSM strategies that include communication, social diffusion, convenience, incentives, social norms, commitment, and prompts. Importance to the Social Marketing Field: Since the RB will be influenced by environmental context, it cannot be assumed that application of CBSM theory is effective in school field. Therefore, the findings of this study are used to determine the effectiveness of environmental changes based on CBSM theory in the school field. Method: One thousand four hundred fifty-three male and female students from fourth to sixth grade in Bushehr, Iran, were evaluated in intervention and control groups from December 2018 to May 2019. In intervention group, CBSM steps were implemented, and in the control group, only blue bins and containers for recyclable materials were provided. To assess behavior change, a questionnaire consisting of three sections of demographic information, knowledge, and barrier questions was used. RB was evaluated by daily weighing waste and recyclable materials (separated) in two groups from 10 days before to 4 months after intervention. The data were analyzed using Statistical Package for Social Sciences (Version 16.0). Results: Results reveal that CBSM based strategies increased knowledge in the intervention group versus the control group. Also, CBSM strategies significantly increased the amount of recycling and reduced the waste in the intervention group. The results of this study showed that the sole availability of containers does not increase RB and reduce waste; applying CBSM based strategies is very useful and effective in removing barriers and increasing RB in schools. Recommendation for Research: It is recommended to compare the effectiveness of the application of only some CBSM strategies such as social norms, incentives, and diffusion versus all CBSM strategies for changing of RB in school setting. Limitation: A limitations of this study is that the number of students in the two groups is not the same due to the random selection of schools. Additionally, we could not control for students’ textbook content on recycling.

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Return to play after an initial or recurrent concussion in a prospective study of physician-observed junior ice hockey concussions: implications for return to play after a concussion

Neurosurgical FOCUS ◽

10.3171/2010.9.focus10210 ◽

2010 ◽

Vol 29 (5) ◽

pp. E5 ◽

Cited By ~ 34

Author(s):

Paul Sean Echlin ◽

Charles H. Tator ◽

Michael D. Cusimano ◽

Robert C. Cantu ◽

Jack E. Taunton ◽

...

Keyword(s):

Clinical Evaluation ◽

Consensus Statement ◽

Assessment Tool ◽

Ice Hockey ◽

Return To Play ◽

Cognitive Test ◽

Time Interval ◽

Test Results ◽

Hockey Players ◽

The Mean

Object The authors investigated return-to-play duration for initial and recurrent concussion in the same season in 2 teams of junior (16–21-year-old) ice hockey players during a regular season. Methods The authors conducted a prospective cohort study during 1 junior regular season (2009–2010) of 67 male fourth-tier ice hockey players (mean age 18.2 ± 1.2 years [SD], range 16–21 years) from 2 teams. Prior to the start of the season, every player underwent baseline assessments that were determined using the Sideline Concussion Assessment Tool 2 (SCAT2) and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). The study protocol also required players who entered the study during the season to complete a baseline SCAT2 and ImPACT. If the protocol was not followed, the postinjury test results of a player without true baseline test results were compared with previously established age- and sex-matched group normative levels. Each game was directly observed by a physician and at least 1 neutral nonphysician observer. Players suspected of suffering a concussion were evaluated by the physician during the game. If a concussion was diagnosed, the player underwent clinical evaluation at the physician's office within 24 hours. The return-to-play decision was based on clinical evaluation guided by the Zurich return-to-play protocol (contained in the consensus statement of international expert opinion at the 3rd International Conference on Concussion in Sport held in Zurich, November 2008). This clinical evaluation and return-to-play protocol was augmented by the 2 tests (SCAT2 and ImPACT) also recommended by the Zurich consensus statement, for which baseline values had been obtained. Results Seventeen players sustained a physician-observed or self-reported, physician-diagnosed concussion during a physician-observed ice hockey game. The mean clinical return-to-play duration (in 15 cases) was 12.8 ± 7.02 days (median 10 days, range 7–29 days); the mean number of physician office visits by players who suffered a concussion (15 cases) was 2.1 ± 1.29 (median 1.5 visits). Five of the 17 players who sustained a concussion also suffered a recurrent or second concussion. One of the 5 individuals who suffered a repeat concussion sustained his initial concussion in a regular season game that was not observed by a physician, and as a result this single case was not included in the total of 21 concussions. This initial concussion of the player was identified during baseline testing 2 days after the injury and was subsequently medically diagnosed and treated. The mean interval between the first and second concussions in these 5 players was 78.6 ± 39.8 days (median 82 days), and the mean time between the return-to-play date of the first and second concussions was 61.8 ± 39.7 days (median 60 days). Conclusions The mean rates of return to play for single and recurrent concussions were higher than rates cited in recent studies involving sport concussions. The time interval between the first and second concussions was also greater than previously cited. This difference may be the result of the methodology of direct independent physician observation, diagnosis, and adherence to the Zurich return-to-play protocol.

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