The DIAMONDS intervention to support self-management of type 2 diabetes in people with severe mental illness: study protocol for a single-group feasibility study

IntroductionThe DIAMONDS programme aims to evaluate a novel supported diabetes self-management intervention for people with severe mental illness (the “DIAMONDS intervention”). The purpose of this study is to test the feasibility of intervention delivery and data collection procedures to inform a definitive randomised controlled trial (RCT).MethodsAdults aged 18 years or over with a diagnosis of type 2 diabetes and severe mental illness (schizophrenia, schizoaffective disorder, or bipolar disorder) will be eligible for inclusion. Individuals with other types of diabetes or non-psychotic mental illness and those lacking capacity to consent will not be eligible. Participants will be recruited from NHS mental health trusts and general practices across the North of England. All participants will receive the DIAMONDS intervention: weekly one-to-one sessions with a trained facilitator (“DIAMONDS Coach”) to support goal setting, action planning, and diabetes education; ongoing self-management supported by a paper-based workbook and optional digital application (app); and monthly peer-support group sessions with other participants. The primary outcomes are: 1. Recruitment rate, measured as proportion of the recruitment target (N=30) achieved at 5 months from start of recruitment, 2. Attrition measured as the proportion of missing outcomes data at the end of the recruitment period (5 months from start of recruitment) for physiological and self-reported data items, 3. Intervention delivery rate recorded as the proportion of planned sessions delivered (measured by the number of completed intervention session logs per participant within 15 weeks of the first intervention session). Secondary outcomes include completeness of data collection at baseline and of process evaluation data at follow-up as well as the feasibility and acceptability of the intervention and of wearing a blinded continuous glucose monitoring device. An intervention fidelity framework will also be developed. Recruitment started in July 2021. The study was prospectively registered: ISRCTN15328700 (12th March 2021).DiscussionThe results of this feasibility study will inform the refinement of the content and delivery of the DIAMONDS intervention, as well as research procedures, including recruitment and data collection, in preparation for the main DIAMONDS RCT.

Effect of warm-up and muscle fatiguing exercise on knee joint sounds in motion by vibroarthrography: A randomized crossover trial

Vibroarthrography measures joint sounds caused by sliding of the joint surfaces over each other. and can be affected by joint health, load and type of movement. Since both warm-up and muscle fatigue lead to local changes in the knee joint (e.g., temperature increase, lubrication of the joint, muscle activation), these may impact knee joint sounds. Therefore, this study investigates the effects of warm-up and muscle fatiguing exercise on knee joint sounds during an activity of daily living. Seventeen healthy, physically active volunteers (25.7 ± 2 years, 7 males) performed a control and an intervention session with a wash-out phase of one week. The control session consisted of sitting on a chair, while the intervention session contained a warm-up (walking on a treadmill) followed by a fatiguing exercise (modified sit-to-stand) protocol. Knee sounds were recorded by vibroarthrography (at the medial tibia plateau and at the patella) at three time points in each session during a sit-to-stand movement. The primary outcome was the mean signal amplitude (MSA, dB). Differences between sessions were determined by repeated measures ANOVA with intra-individual pre-post differences for the warm-up and for the muscle fatigue effect. We found a significant difference for MSA at the medial tibia plateau (intervention: mean 1.51 dB, standard deviation 2.51 dB; control: mean -1.28 dB, SD 2.61 dB; F = 9.5; p = .007; η2 = .37) during extension (from sit to stand) after the warm-up. There was no significant difference for any parameter after the muscle fatiguing exercise (p > .05). The increase in MSA may mostly be explained by an increase in internal knee load and joint friction. However, neuromuscular changes may also have played a role. It appears that the muscle fatiguing exercise has no impact on knee joint sounds in young, active, symptom-free participants during sit to stand.

The effects of short-term mindfulness-based group intervention utilising a school setting for Japanese adolescents with trauma

The use of mindfulness as a tool to improve mental health has received increased attention. Schools provide ideal environments for short-term prevention and skill development for mental health. Further, teachers can promote and reinforce students’ daily use of mindfulness. This study explored the effects of a short-term group mindfulness-based intervention on the mental health of adolescents who have experienced trauma. A total of 49 high school students received a mindfulness-based intervention session followed by homework and teacher reinforcement. The results suggest that a short-term group intervention for mindfulness can potentially improve mindfulness attention awareness and reduce depression and anxiety symptoms in adolescents. As there was no control group, additional research examining the effectiveness of the intervention is essential.

Autonomy-supportive exercise behaviors promote breast cancer survivors’ well-being

Background: Grounded in self-determination theory (SDT), this pilot study aimed to test an autonomy-supportive exercise instructing style to promote hedonic (seeking comfort and pleasure) and eudaimonic (seeking to develop the best within one and pursue excellence)orientations, exercise motivation, and psychological well-being of breast cancer survivors. Methods: Twenty-four breast cancer survivors were randomized in either autonomy-supportive exercise instructing style (treatment condition) or usual exercise instructing style (control condition). The study consisted of a pre-intervention session followed by 22 exercise sessions and a post-intervention session. Hedonic and eudaimonic orientations, exercise motivation, and psychological well-being (subjective vitality) measured at baseline and post-intervention sessions. Results: As expected, participants in the treatment condition reported greater eudaimonic and hedonic orientations and subjective vitality compared to the participants in the control condition. The results showed no difference in exercise motivation across conditions. Conclusion: We concluded that the SDT-based intervention was successful in helping breast cancer survivors increase hedonic and eudaimonic orientations and subjective vitality. Practical and theoretical implications, along with limitations and future research suggestions are discussed inside.

Development, Validity and Reliability of Cognitive Therapy Intervention (CTI)

ABSTRACT The purpose of this paper is to evaluate the validity and reliability of Cognitive Therapy Intervention (CTI) which focusing on the resilience of adolescents with behavioural problems. CTI is developed based on Cognitive Theory and the Sidek Module Development Model. The CTI has eight interventions. The CTI manuscript was distributed to five content experts to determine intervention’s validity. The finding shows that the validity index 0.87 was obtained. Meanwhile, thirty two adolescents were selected to measure the reliability of each intervention by evaluating the objectives in each intervention session. As a result, the reliability index 0.85 was obtained. From these two indexes, the Cognitive Therapy Intervention (CTI) possesses high validity and good reliability, and is ready to use. The intervention implies the counselling intervention in working resilience of adolescents with behavioural behaviour. This CTI is recommended to be used by school counsellor to handle adolescents with behavioural problems. Keywords: Cognitive Therapy Intervention, Validity, Reliability, Resilience, Adolescent

From Swallowing to Savoring Emotions

This article presents a Therapeutic Assessment case study of a 48-year-old Catholic nun who was evaluated for concerns related to recurrent depression, difficulty relating to others, trouble following through on tasks, and lack of self-care. Maria was given the Rorschach, MMPI-2-RF, Wartegg Drawing Completion Test, and Thurston Cradock Test of Shame (TCTS). Testing results suggested depression, problems regulating emotion, incongruence between external presentation and internal state, and impaired functional intelligence when negative emotions are triggered. Maria’s TCTS protocol indicated a tendency to deflate in the presence of shame or criticism. She used tentative language around emotion, did not access support, and struggled to resolve emotionally charged situations. The TCTS results appeared to access and explain Maria’s core difficulties. TCTS Cards 6 and 8 were selected for an assessment intervention session (AIS) designed to help Maria understand what she does with negative feelings. Maria was asked to tell a story focusing on the main character. Through half-steps and affective scaffolding, Maria identified how she “swallows” her negative feelings and “isolates” when emotions are strong. The authors discuss how the AIS helped Maria access her split-off affect, and understand its relation to her symptoms, poor self-care, impaired follow-through, and relational difficulties.

The Beneficial Influence of Combining Motor Imagery and Coach’s Feedback on Soccer Pass Accuracy in Intermediate Players

This study compared the effects of motor imagery, feedback, and feedback+imagery interventions on soccer pass performance in non-elite players (intermediate, regional level). Participants were randomly divided into Control, Feedback, Imagery, and Feedback+Imagery groups, within a pre- post- intervention design. The intervention lasted 7 weeks, and the task consisted of passing the ball to a target 20-meters away. In each intervention session, the participants performed 3 blocks of four physical trials. The participants of the Feedback and Feedback+Imagery groups received expert feedback, given by the coach, after each block and then, all the participants realized a mental task (countdown or motor imagery). Results showed that the Feedback+Imagery group had the greatest pre- to post-test improvement compared to the other groups, and highlight the beneficial effect of combining verbal feedback and motor imagery to improve soccer passing accuracy. It is suggested to coaches or physical education teachers to adapt their training by incorporating feedback and imagery.

Acceptability of online sun exposure awareness-raising interventions among young Australian women: an exploratory mixed-methods study

Melanoma is the most common cancer among young Australians. Despite school-based programs such as ‘Sun Smart’ leading to increased knowledge among children of the harmful effects of sun exposure, many young adults continue to desire a darker skin tone because of a general perception among their peers that tanned skin is attractive. This ‘tanned-ideal’ may be challenged through exposure to material posted on social media. This study aimed to investigate the impact of two online interventions on knowledge of skin cancer and intentions to engage in sun tanning and protective behaviours, as assessed by survey. In addition, the likelihood that the intervention would be ‘shared’ on social media was explored by interview during an intervention session. Eighteen women aged 18–24 years participated in this pilot, mixed-methods intervention study. Participants completed surveys 2 weeks before and 2 weeks after attending an intervention session in which they viewed a video and completed a face-aging activity, with the order of completion balanced within the sample. Two weeks after the intervention, there was a significant increase in knowledge and intended sun protection behaviours and a significant decrease in intended future tanning hours. There was no effect of intervention order. Interview data indicated that younger participants would share the ageing application with peers because it was fun; older participants reported that they would share the video because it was educational. Factors that encourage sharing on social media include being realistic, instructive or personally meaningful, and short in duration.