Who benefits from digital interventions for bipolar disorder? Stage of illness characteristics as predictors of changes in quality of life.

OBJECTIVES: This study explored the potential role of stage-related variables in intervention outcomes in bipolar disorder (BD). Specifically, we aimed to identify which subgroups of individuals were most likely to experience improved quality of life following digitally delivered psychosocial interventions for BD. METHODS: The study involved a secondary analysis of combined data from two randomised control trials (RCTs). Each trial assessed the effectiveness of digitally delivered interventions for improving quality of life, in late-stage (ORBIT RCT) or early-stage (BETTER RCT) BD. Three iterations of cluster analyses were performed, identifying subgroups of individuals based on (i) current phenomenology, (ii) course of illness and (iii) medication response. The resultant subgroups were compared with regard to changes in quality of life pre-post intervention, via repeated measures ANOVAs. RESULTS: In each cluster analysis, two clusters were found. The current phenomenology clusters reflected two impairment levels, 'moderate impairment' and 'low impairment'. The course of illness clusters reflected 'more chronicity' and 'less chronicity' and the medication response clusters reflected 'good medication response' and 'poor medication response'. Differences in changes in quality of life over time were observed between the two current phenomenology clusters and between the medication response clusters, while the course of illness subgroups did not respond differently. CONCLUSIONS: There are at least two distinct groups of treatment-seeking individuals with established BD, based on illness features with previously established links to different illness stages. Clusters within the current phenomenology and medication response domains demonstrated significantly different trajectories of QoL change over time in the context of our interventions, highlighting potential implications for treatment selection aligned with precision psychiatry.

Remote physical activity intervention to promote physical activity and health in adolescent girls (the HERizon project): a multi-arm, pilot randomised trial.

BACKGROUND: Engaging in physical activity (PA) during adolescence is beneficial for health and positive development. However, most adolescent girls have low PA levels, and there is a need for interventions outside of school hours. This pilot randomised controlled trial aimed to explore the preliminary effectiveness of three different remote PA interventions in increasing adolescent girls' moderate-to- vigorous PA (MVPA), fitness and psychosocial outcomes. METHODS: Girls living in the UK or Ireland, aged between 13 and 16 years old, who wished to increase their activity levels, were eligible for the study. Using a random number generator, participants (n = 153; 14.8y ± 1.4) were randomised into one of three 12-week intervention groups (i) PA programme, (ii) Behaviour change support, or (iii) Combined PA programme and Behaviour change support, or (iv) a Comparison group. Outcome measures included accelerometer and self-reported PA, physical fitness (cardiorespiratory fitness; 20 m shuttle run, muscular endurance; push up, muscular strength; long jump), and psychosocial assessments (perceived competence; body appreciation; self-esteem; behavioural regulation). Linear mixed models were used to analyse differences between each intervention arm and the comparison group immediately postintervention (12 weeks) and at follow up (3-months post-intervention), while adjusting for potential confounders. RESULTS: Participation in the PA programme group was associated with higher perceived competence (0.6, 95% CI 0.1 to 1.2), identified regulation (0.7, 95% CI 0.2 to 1.1) and intrinsic motivation (0.9, 95% CI 0.2 to 1.6) at post-intervention. Participation in the Behaviour change group was associated with higher perceived competence at post-intervention (0.6, 95% CI 0.1 to 1.2), and higher push-up scores at the 3-month follow-up (4.0, 95% CI 0.0 to 7.0). Participation in the Combined group was also associated with higher perceived competence at post-intervention (0.8, 95% CI 0.2 to 1.4), and higher push-up scores at the 3-month follow-up (5.0, 95% CI 1.0 to 8.0). No other significant differences were found between the intervention arms and the comparison group. CONCLUSION: Results suggest perceived competence increased across all intervention arms, while the PA programme group enhanced autonomous motivation in the short term. Intervention arms with behaviour change support appear most promising in improving muscular endurance. However, a larger scale trial is needed for a better understanding of between-group differences and the impact of intervention arms on MVPA and fitness, given the small sample size and short-term follow-up.

Arriba por la Vida Estudio: a randomized controlled trial promoting standing behavior to reduce sitting time among postmenopausal Latinas.

Postmenopausal Hispanic/Latina (N = 254) women with a body mass index (BMI) ≥ 25 kg/m2 were randomized to an intervention to reduce sitting time or a comparison condition for 12 weeks. The standing intervention group received three in-person health-counseling sessions, one home visit, and up to eight motivational interviewing calls. The heart healthy lifestyle comparison group (C) received an equal number of contact hours to discuss healthy aging. The primary outcome was 12-week change in sitting time measured via thigh-worn activPAL. Group differences in outcomes were analyzed using linear mixed-effects models. Participants had a mean age of 65 (6.5) years, preferred Spanish language (89%), BMI of 32.4 (4.8) kg/m2, and sat for an average of 540 (86) minutes/day. Significant between-group differences were observed in reductions of sitting time across the 12-week period [Mdifference (SE): C - 7.5 (9.1), SI - 71.0 (9.8), p < 0.01]. Results demonstrate that coaching models to reduce sitting are feasible and effective.

Can mindfulness-based training impact explicit and implicit attitudes and sustainable nutrition behavior? A focus on vegetarianism.

OBJECTIVES: The aim of this study was to investigate the impact of a mindfulness intervention (IG) compared to an inactive control group (CG) on explicit and implicit attitudes toward vegetarian and meat-based foods, nutrition behavior measures, trait mindfulness and wellbeing. METHODS: In the IG (N = 66), we implemented a mindfulness-based intervention consisting of eight weekly group sessions online, along with an additional half-day session held on campus. The CG (N = 71) received no intervention or training. We employed a pre-/post-intervention design involving questionnaires (trait mindfulness, wellbeing, sustainable nutrition behavior scale), an online supermarket scenario, as well as an explicit rating task and an implicit association task using pictures of vegetarian and meat-based foods. Additionally, a voluntary follow-up testing was conducted two months after the final group session. RESULTS: No intervention effects were observed on explicit and implicit attitudes, wellbeing, or nutrition behavior measures. However, there was an increase in trait mindfulness within the IG. Exploratory cross-sectional findings indicated that trait mindfulness facets such as "Acting with Awareness" and "Outer Awareness", along with explicit attitudes, were significant predictors of self-reported sustainable consumption behavior. Additionally, sex and explicit attitudes were identified as significant predictors of vegetarian consumption behavior in the online supermarket task. CONCLUSION: Our findings could not substantiate previous claims regarding the potential causal effects of mindfulness practice on sustainable consumption behavior, specifically in the realm of sustainable and vegetarian nutrition, as well as subjective wellbeing. Future studies may benefit from implementing longer-term mindfulness-based interventions and considering other potential decisive factors, such as connectedness to nature and others. Integrating training elements focusing on these specific variables into the intervention could be valuable.

Interventions to improve ethical decision-making skills in nursing students: A systematic review.

BACKGROUND: Interventions to improve ethical decision-making are available in nursing education. Evidence of its effectiveness is essential. OBJECTIVE: This review examined the effectiveness of interventions to improve nursing students' ethical decision-making skills. METHODS: A structured search was performed in Google Scholar, Web of Science, Science Direct, Pubmed, Scopus, Cochrane Library, Elsevier, CINAHL EBSCO, and ULAKBIM. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments (JBI-MAStARI) was used to assess the quality of studies. ETHICAL CONSIDERATIONS: Ethical approval was not required for this systematic review. FINDINGS: The final review was composed of six studies of published between January 2013 and 2023. Nine different teaching methods applied to students. Although the importance of ethical decision-making skills in solving ethical problems that nurses may encounter at any time is known, it is thought that there is a lack of data in the literature in the last 10 years. The last 10 years were chosen as this aims to provide a review based on the most current, relevant and quality information. The review indicated that all of the teaching methods improved ethical decision-making. CONCLUSION: Different teaching methods can be used in the nursing education curriculum to meet the learning needs of nursing students in ethical decision-making.

[Evidence mapping of clinical studies on 23 commonly used Chinese patent medicines for treating insomnia].

Evidence mapping was performed to systematically search and review the clinical studies about the treatment of insomnia with Chinese patent medicines. The evidence distribution in this field was analyzed and the problems of the studies were summarized. Chinese-and English-language articles of the studies involving the Chinese patent medicines specified in three national drug catalogs for the treatment of insomnia were searched against the databases with the time interval from inception to August 2023. Figures and tables were established to present the results. Finally, 23 Chinese patent medicines were screened out, which were mentioned in 299 articles involving 236 randomized controlled trials(RCTs), 35 non-randomized controlled trials(non-RCTs), 7 retrospective studies, 17 systematic reviews/Meta-analysis, and 4 guidelines/expert recommendations or consensus. Bailemian Capsules, Wuling Capsules, and Yangxue Qingnao Granules were mentioned in a large proportion of articles. The outcome indicators included sleep rating scale, clinical response rate, safety indicators, and anxiety and depression scores. The results showed that the studies about the treatment of insomnia with Chinese patent medicines were growing. However, there was a scarcity of research evidence, and the available studies were single-center with small sample sizes and short periods. These studies spanned broad clinical scopes with inadequately emphasized advantages of TCM and insufficient outcome indicators about quality of life, follow-up, and recurrence rate. RCT exhibited a high risk of bias, and the systematic reviews/Meta-analysis demonstrated low overall quality. The retrospective studies received suboptimal scores, and the non-RCT failed to mention follow-up time, loss rate to follow-up, and sample size estimations, which compromised result reliability. It is recommended that the research protocol for Chinese patent medicines in treating insomnia should adhere to the clinical research standards of TCM. The TCM syndrome score can serves as a crucial outcome measure, and emphasis should be placed on patients' quality of life, follow-up, and recurrence prevention. Measures should be taken to enhance the accessibility and affordability of Chinese patent medicines and strengthen the connection between medical insurance policies and the policies pertaining to Chinese patent medicines. Furthermore, it is advisable to reasonably increase the inclusion of Chinese patent medicines with well-established efficacy and safety evidence in the category A list of medical insurance.

A new modality of colorectal cancer screening based on chronic disease management.

BACKGROUND: To develop a new modality of colorectal cancer screening based on chronic disease management (CDM) to improve the participation rate of screening, and maximize the benefits of limited resources. METHODS: Patients under CDM were assigned to screening intervention group (SI) and screening control group1 (SC1), residents from natural community were assigned to screening control group2 (SC2). A parallel controlled community intervention study was performed. Only SI would achieve "one-to-one" intervention services. Meanwhile, 200 subjects were selected from each of the three groups for the Knowledge-Attitude-Practice (KAP) questionnaire before and after intervention, named questionnaire intervention group(QI), questionnaire control group1(QC1) and questionnaire control group2(QC2). The outcome of the intervention was evaluated using the difference-in-differences method and multiple regression analysis. RESULTS: The preliminary screening participation rate was 43.63%(473/1084) in SI, 14.32%(132/922) in SCI, and 5.87%(105/1789) in SC2. The baseline questionnaire showed low knowledge scores in the three questionnaire groups with no statistically significant differences, while attitude scores in QI and QC1 were significantly higher than QC2. The differences between baseline and terminal showed QI increased larger in knowledge and attitude scores than QC1 and QC2, while no difference was detected between QC1 and QC2. CONCLUSION: The colorectal cancer screening model based on chronic disease management effectively improved the screening participation rate, and the "one-to-one" intervention and the inherent characteristics of the patient population under CDM were the core elements of the new modality.

Exploring the effect of novel six moments on hand hygiene compliance among hospital cleaning staff members: a quasi-experimental study.

My 5 moments (M5M) was used less frequently among cleaning staff members, suggesting that a poor compliance score in this group may not indicate deficient handwashing. This quasi-experimental study compared hand hygiene compliance (HHC), hand hygiene (HH) moments, and HH time distribution in the control group (no HH intervention; n = 21), case group 1 (normal M5M intervention; n = 26), case group 2 (extensive novel six moments (NSM) training; n = 24), and case group 3 (refined NSM training; n = 18). The intervention's effect was evaluated after 3 months. The HHC gap among the four groups gradually increased in the second intervention month (control group, 31.43%; case group 1, 38.74%; case group 2, 40.19%; case group 3, 52.21%; p < 0.05). After the intervention period, the HHC of case groups 2 and 3 improved significantly from the baseline (23.85% vs. 59.22%, 27.41% vs. 83.62%, respectively; p < 0.05). 'After transferring medical waste from the site' had the highest HHC in case group 3, 90.72% (95% confidence interval, 0.1926-0.3967). HH peak hours were from 6 AM to 9 AM and 2 PM to 3 PM. The study showed that the implementation of an NSM practice can serve as an HHC monitoring indicator and direct relevant training interventions to improve HH among hospital cleaning staff.

Can counter-advertising exposing alcohol sponsorship and harms influence sport spectators' support for alcohol policies? An experimental study.

BACKGROUND: Exposure to alcohol advertising and sponsorship through elite sport is associated with harmful use of alcohol. Owing to strong financial and cultural ties between alcohol and sport in Australia, policy action to restrict alcohol sport sponsorship is unlikely to occur without strong public support for change. This study tested whether exposure to counter-advertising exposing industry marketing of harmful products-a technique shown to be effective in tobacco control-promotes higher support for policy change and less favourable beliefs about the alcohol industry among sport spectators. METHODS: A sample of 1,075 Australian adults aged 18-49 years who planned to watch an National Rugby League (NRL) State of Origin series game, featuring prominent alcohol sponsorship, was recruited through an online panel and randomly assigned to one of three conditions: control (neutral advertisement); counter-advertisement exposing alcohol harms; counter-advertisement exposing alcohol sponsorship and harms. Participants completed a pre-test questionnaire and viewed their assigned counter-advertisement multiple times in the 5-7 days before the NRL game. Within four days of watching the game, participants completed post-test measures. RESULTS: Compared to both the control advertisement and the counter-advertisement exposing alcohol harms, participants who viewed the counter-advertisement exposing alcohol sponsorship and harms were significantly more likely to indicate support for each of four policies aimed at restricting sports-related alcohol marketing, including the complete removal of alcohol sponsorship from sport (51% vs. 32% and 37%). They were also significantly less likely to agree with statements such as "alcohol companies should be allowed to sponsor sport since their products are legal" (39% vs. 63% and 60%) and significantly less likely to report liking alcohol companies in general (38% vs. 59% and 54%). There were no significant differences in policy support or industry beliefs between participants who saw the counter-advertisement exposing alcohol harms and those who saw the control advertisement. CONCLUSION: Counter-advertising employing messages that expose and critique the intent and impact of pervasive alcohol sponsorship in sport has potential to bolster public support for policies targeting alcohol sport sponsorship, diminish beliefs supportive of alcohol industry marketing strategies and enhance negative views of alcohol companies and their marketing practices.

Experiences from the Philippine grassroots: impact of strengthening primary care systems on health worker satisfaction and intention to stay.

BACKGROUND: Inequities in health access and outcomes persist in low- and middle-income countries. While strengthening primary care is integral in improving patient outcomes, primary care networks remain undervalued, underfunded, and underdeveloped in many LMICs such as the Philippines. This paper underscores the value of strengthening primary care system interventions in LMICs by examining their impact on job satisfaction and intention to stay among healthcare workers in the Philippines. METHODS: This study was conducted in urban, rural, and remote settings in the Philippines. A total of 36 urban, 54 rural, and 117 remote healthcare workers participated in the study. Respondents comprised all family physicians, nurses, midwives, community health workers, and staff involved in the delivery of primary care services from the sites. A questionnaire examining job satisfaction (motivators) and dissatisfaction (hygiene) factors was distributed to healthcare workers before and after system interventions were introduced across sites. Interventions included the introduction of performance-based incentives, the adoption of electronic health records, and the enhancement of diagnostic and pharmaceutical capabilities over a 1-year period. A Wilcoxon signed-rank test and a McNemar's chi-square test were then conducted to compare pre- and post-intervention experiences for each setting. RESULTS: Among the factors examined, results revealed a significant improvement in perceived compensation fairness among urban (p = 0.001) and rural (p = 0.016) providers. The rural workforce also reported a significant improvement in medicine access (p = 0.012) post-intervention. Job motivation and turnover intention were sustained in urban and rural settings between periods. Despite the interventions introduced, a decline in perceptions towards supply accessibility, job security, and most items classified as job motivators was reported among remote providers. Paralleling this decline, remote primary care providers with the intent to stay dropped from 93% at baseline to 75% at endline (p < 0.001). CONCLUSION: The impact of strengthening primary care on health workforce satisfaction and turnover intention varied across urban, rural, and remote settings. While select interventions such as improving compensation were promising for better-supported settings, the immediate impact of these interventions was inadequate in offsetting the infrastructural and staffing gaps experienced in disadvantaged areas. Unless these problems are comprehensively addressed, satisfaction will remain low, workforce attrition will persist as a problem, and marginalized communities will be underserved.

A multicomponent quasi-experimental ergonomic interventional study: long-term parallel four-groups interventions.

BACKGROUND: Musculoskeletal disorders (MSDs) are known as one of the main problems affecting the health of industrial workers and can lead to lost working days, functional disability of workers and wasting the financial resources of an organization. Therefore, the present study aimed to evaluating the effect of ergonomic interventions on reducing MSDs and improving working posture in the in a foundry industry workers. METHODS: A field multicomponent cross-interventional study was conducted on workers working in a foundry industry. In this study, 117 male workers were divided into 4 groups, including a control group, a group with specialized ergonomics training, a group with workstation intervention, and a group simultaneously undergoing training and workstation intervention. All 4 groups were evaluated during a period of baseline, 6 and 12-months follow- up. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and direct observations of working postures by using the Quick Exposure Check (QEC) method were used. RESULTS: The results showed that the implemented interventions in the shoulder/arm, back and stress level were effective and the difference in the final score was significant among different groups (P-value > 0.05). In addition, the interventions led to a significant decrease in the QEC scores and musculoskeletal symptom scores in the neck, shoulder, lower back, knee, and lower leg regions among different groups (P-value > 0.05). CONCLUSION: The results showed that workstation modification and training and workstation intervention simultaneously had a greater effect on MSDs and improving working posture compared to training alone.

An eight-week randomized intervention study on Korean adults to evaluate the effect of milk intake on obesity.

The anti-obesity effect of milk intake has been suggested via a variety of designed studies, but findings of obesity interventions for Korean adults are scarcely reported. The study aimed to investigate the anti-obesity effect of cow milk in Korean adults with an 8-wk randomized intervention. A total of 121 adults overweight aged 19 to 60 yr old were randomly assigned to 1 of the 2 groups: milk or control. During the intervention, both groups were encouraged 500 kcal of restriction a day, and the milk group consumed 200 mL of milk twice a day; the same energy intake as the control group, including milk intake, was recommended for 8 wk. We detected no significant differences in body weight (BW) and body mass index (BMI) between the milk and control groups during the 8-wk intervention, although the changes in BW and BMI of those within the milk group were significant. High-density lipoprotein cholesterol levels and serum calcium levels increased significantly in the milk group compared with the control group. Calcium, phosphorus, vitamin A, and riboflavin intakes increased significantly, when compared with the control. In conclusion, 8-wk milk consumption had no effect on weight loss and BMI change but improved some blood biomarkers and nutrient intake in Korean adults who were overweight. To evaluate the effect of milk on obesity reduction, well-designed, long-term, and large-scale studies are needed.

The combined effect of motivational interviewing and wearable fitness trackers on motivation and physical activity in inactive adults: A randomized controlled trial.

Despite overwhelming adoption of wearable fitness trackers (WFT), it is unclear if they affect physical activity (PA) engagement or PA motivation. We hypothesized that combining a WFT with an effective intervention, motivational interviewing (MI), would positively influence both motivation and PA. A 12-week randomized controlled trial was conducted in 40 adults who did not meet PA recommendations. The four conditions were: a PA education (Educational control, n = 10), a WFT (WFT, n = 10), bi-weekly MI sessions (MI, n = 10), or both interventions (WFT+, n = 10). Motivation and PA were measured through an online survey and actigraphy pre- and post-intervention. Both the WFT+ and MI groups improved autonomous forms and decreased controlled forms of motivation. They also had higher basic psychological needs scores when compared to the Education group post-intervention. We detected no changes in PA. High autonomous motivation at baseline predicted higher post-intervention PA in the WFT+ group but predicted lower post-intervention PA in the WFT group. Results suggests that MI alone or with a WFT can improve basic psychological needs and autonomous forms of motivation for PA, but not PA participation. Individual differences in motivation at baseline may moderate the effect of a WFT on PA. This study was registered at clinicaltrials.gov (NCT490014).

Increasing Physical Activity in Empty Nest and Retired Populations Online: A Randomized Feasibility Study.

The onset of retirement and children leaving the family home may offer a "window of opportunity" for individuals to influence regular moderate- to vigorous-intensity physical activity; therefore, this study examines the feasibility of a moderate- to vigorous-intensity physical activity intervention among recently retired participants (RET) and parents (P) with children who recently left the family home. A total of 46 inactive RET and nine inactive P were randomized to a 10-week web intervention (n = RET = 25/P = 4) or waitlist control (n = RET = 21/P = 5). Intervention techniques followed the multiprocess action control framework. Enrollment (37.5% for P; 40% for RET), retention (89% for P; 83% for RET), and satisfaction were high. One hundred percent of intervention-sectioned participation increased moderate- to vigorous-intensity physical activity compared with 52% of controls; large effect size differences were observed for key multiprocess action control constructs. Participants were highly satisfied with the intervention; however, recruitment challenges of P support moving to a randomized controlled trial for only the RET group.

Polyphenol-Rich Beverage Consumption Affecting Parameters of the Lipid Metabolism in Healthy Subjects.

Polyphenols are a diverse and widely distributed class of secondary metabolites, which possess numerous beneficial properties including a modulation of glucose and lipid metabolism. This placebo-controlled human intervention study was performed to explore effects of polyphenol-rich beverage (PRB) uptake on lipid metabolism, as well as DNA integrity. In this case, 36 healthy men were randomly divided to consume either 750 mL of a PRB (containing 51% chokeberry, cranberry, and pomegranate) or a placebo drink daily for eight weeks. Only PRB consumption was found to decrease fat and protein intakes significantly compared to the preceding one-week washout period. During the intervention with PRB an increased fat-free mass was shown after four weeks, whereas a significant elevation in body weight and leptin was observed in placebo group. Blood lipids were not significantly altered after PRB consumption, while triglyceride levels increased after placebo drink intake. In platelets, a significant inhibition of phosphodiesterase (PDE) activity was observed, more pronounced in test group. Consuming the PRB decreased total DNA strand breaks in whole blood as well as H2O2-induced breaks in isolated lymphocytes. Overall, our study suggested beneficial effects on lipid metabolism by reduced energy intake, modulation of biomarkers such as PDE activity and improved DNA integrity associated with PRB consumption.

Patients' experiences of Daily Talks: a patient-driven intervention in inpatient mental healthcare.

BACKGROUND: Recovery is known to be enhanced by meaningful interactions between patients and mental health staff. However, nurses may become distanced from patients, and patients may spend most of their time in inpatient mental health care alone. AIMS: This study aimed to explore how patients experience the intervention Daily Talks, a patient-driven innovation intended to enhance meaningful interactions between patients and staff. METHODS: Fourteen in-depth interviews were performed with patients who participated in Daily Talks. The interviews were analysed using reflexive thematic analysis. RESULTS: The results of the participants' experiences of Daily Talks are presented in four themes: 1.Interpersonal and active interaction where individual factors matter 2.A patient-controlled space 3.A multi-use intervention and 4.A part of the daily healthcare structure. Participants stated that Daily Talks improved the relationship between patients and their nursing staff, and they stressed the importance of patients having control over both time and content in the Daily Talks. Daily Talks was used to vent emotions and thoughts, handle situations and create strategies, and become part of a helpful structure. CONCLUSIONS: The results support the value of Daily Talks, indicating that Daily Talks may facilitate helpful structures and meaningful relationships between patients and nursing staff.

Documentation for Assessing Pain in Postoperative Pain Management Pre- and Post-intervention.

PURPOSE: Although Norwegian law requires the documentation of patients' care processes, including pain assessment, research has shown that the quality of postoperative documentation for assessing pain does not meet an acceptable standard and requires improvement. The purpose of this study was to investigate whether an educational intervention can increase nurses' documentation of postoperative pain assessments, alter patients' opioid consumption, and ensure that patients have at least one documented Numeric Rating Scale (NRS) ≤3 at rest before being discharged. A secondary aim was to investigate whether the nurses' education and experience influenced their pain assessments. DESIGN: An observational study with a pre-post intervention. METHODS: The study following a pre-post design involved documenting pain assessments of 304 patients undergoing cancer surgeries in a postoperative unit at the Norwegian Radium Hospital, Oslo University Hospital. In an educational intervention, two 45-minutes teaching sessions within two weeks, addressed validated pain assessment tools and the documentation of pain assessment. Descriptive frequency analysis and partial correlation with Pearson's r - value were used, with P < .05 indicating significance. FINDINGS: Postintervention, pain assessments in general increased significantly from a mean of two times per patient to three times. Overall, the use of assessment tool Critical -Care Pain Observation Tool increased from 6.1% to 25.8%, opioid consumption increased in mean from 3.34 to 4.79 in milligram and the documentation at discharge increased from 81.4% to 91.4%. The documentation of nurses with more than 10 years' experience in the unit especially improved from 17.5% to 31.7%. CONCLUSIONS: Educational intervention and reminders about basic systematic pain assessment and the evaluation of pain measures improved nurses' documentation of postoperative pain management and documentation at discharge. The findings underscore the importance of regularly ensuring the quality of patients' treatment by systematically documenting nurses' clinical tasks and the outcome of patients' care.

Open Label Pilot Study on Posttrauma Health Impacts of the Processing of Positive Memories Technique (PPMT).

Processing of Positive Memories Technique (PPMT) was proposed as a novel intervention for posttraumatic stress disorder (PTSD). PPMT comprises of 5 sessions focused on identifying and processing positive memories. As an open label pilot study, we explored PPMT's effects on PTSD severity, depression severity, affect and cognitive processes, and therapeutic alliance. A sample of 12 trauma-exposed participants seeking services at a University Psychology Clinic participated in 5 PPMT sessions (Mage=29.25 years; 58.30% women). We used the reliable change indices and clinically significant change score approach. The following number of participants showed statistically reliable changes: 9 participants for PTSD severity (8 recovered/improved); 6 participants for depression severity (5 improved); 5 participants for positive affect levels (2 recovered/improved); 9 participants for negative affect levels (8 recovered); 9 participants for posttrauma cognitions (7 recovered/improved); 5 participants for positive emotion dysregulation (4 recovered); 11 participants for number of retrieved positive memories (3 recovered); and 5 participants for therapeutic alliance (4 recovered). PPMT may impact certain posttrauma targets more effectively (PTSD, depression, negative affect, posttrauma cognitions). PPMT may be more helpful in improving regulation rather than levels of positive affect. PPMT, if supported in further investigations, may add to the clinician tool-box of PTSD interventions.

[Pilot study of Experience Focused Counselling by nurses with people who hear voices: Evaluation of the implementation of the study protocol]. / Pilotstudie zu Erfahrungsfokussierter Beratung durch Pflegende bei Menschen, die Stimmen hören.

Pilot study of Experience Focused Counselling by nurses with people who hear voices: Evaluation of the implementation of the study protocol Abstract: Background: Hearing voices and the treatment and support of people who hear voices and are distressed by the experience are defined differently in psychiatry. In contrast to the medical approach to define and treat voices as symptoms of a disease, the EFC counselling approach developed with voice-hearers focuses on non-pathologizing acceptance and a constructive relationship to voices. Mental health nurses with their focus on everyday life are predestined for the dissemination and application of alternative therapeutic approaches in practice. Aim: The aim was to evaluate the study protocol as part of a pilot study regarding its suitability for a larger trial. Method: The multi centre pilot study had a single-blind randomised controlled design. The intervention consisted of EFC counselling by nurses with people who hear voices. The control group received Treatment As Usual (TAU). The suitability of the study design was evaluated in terms of recruitment, burden on study participants, suitability of assessment tools, the application of EFC counselling and the use of study nurses. Results: As planned 21 participants could be included in the study within fifteen months across the two study sites. Overall, the participants rated the study as not very burdensome and the intervention as helpful. The application of EFC by the nurses as well as the use of study nurses was assessed as good and suitable respectively. Discussion: The evaluation of the study protocol shows that with minor adjustments it is suitable for conducting a larger study.

Olive Oil Phenolics and Platelets-From Molecular Mechanisms to Human Studies.

Chronically activated, dysfunctional platelets mediate the progression of the majority of non-communicable diseases in a pleiotropic fashion. Antiplatelet therapy remains an attractive therapeutic means which however hasn't reached the expected targets according to the promising preclinical studies. It is therefore obvious that the consumption of foods demonstrating antiplatelet activity may be a less drastic but on the other hand a more sustainable way of achieving daily antiplatelet therapy, either alone or in combination with antiplatelet drugs. Olive oil is probably the main cardioprotective component of the Mediterranean Diet according to the results of observational and dietary intervention studies. Among all phytochemicals of olive oil, its unique phenolics seems to be responsible for the majority of its cardioprotective properties. This review article aims to highlight the platelet modulating roles of olive oil polyphenols, trying to critically assess whether those properties could partially explain the cardioprotective role of olive oil. The cellular and animal studies clearly show that extra virging olive oil (EVOO) phenolics, mainly hydroxytyrosol, are able to inhibit the activation of platelets induced by several endogenous agonists and pathologies. However, the outcomes of the pre-clinical studies are difficult to be translated to humans mainly because the dosages and the chemical forms of the phenolics used to these studies are much higher and different to that found in human circulation. Despite the heterogeneity of the few human trials on the field so far, the results are promising showing that EVOO can exert antiplatelet actions in real, acute or long-term, trials and at least part of this antiplatelet action can be attributed to the phenolic content of EVOOs. Although we clearly need better, well-powered studies to give certain answers on this field the antiplatelet properties of olive oil phenolics is a promising, emerging mechanism which may explain some of the health properties of EVOO and the Mediterranean Diet.