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Les aînés qui vivent avec des problèmes de santé mentale ou des difficultés psychosociales sont souvent isolés et marginalisés. Le programme Participe-présent a été développé dans le but de promouvoir leur participation communautaire. Les objectifs de cette étude étaient de 1) décrire la pertinence, l’acceptabilité, et la faisabilité du programme lors de sa mise à l’essai et 2) d’explorer les bienfaits et les effets à court-terme du programme pour les participants. Vingt-trois aînés, quatre animateurs et trois responsables provenant de quatre organismes ont participé à l’étude. Les aînés ont été satisfaits de leur expérience de participation au programme et ont rapporté une meilleure connaissance des ressources et une plus grande satisfaction à l’égard de leur vie sociale. Les animateurs et les responsables d’organismes ont souligné l’adaptabilité de Participe-présent aux besoins de leur clientèle et à leur contexte de pratique, et ont identifié les facilitateurs et les obstacles à sa mise en œuvre. D’autres études mèneront à des recommandations favorisant le succès de la mise en œuvre de Participe-présent dans différents contextes.
Conservation action plans need to be devised and implemented if we are to reduce the extinction risk faced by globally threatened plants. However, most plant species categorized as threatened globally on the IUCN Red List lack conservation action plans. In West Africa, Guinea is one of the most diverse countries in terms of botanical species. In total, 273 plant species in Guinea have been assessed as being threatened globally, reflecting increasing pressure from the extractive industry and a growing population requiring food and fuel. In parallel with the implementation of an Important Plant Area programme in Guinea, we developed conservation action plans for 20 threatened plant species through a pilot study. We outline the methods we used and demonstrate the importance of adopting a collaborative approach and having up-to-date field information. The need for such plans is urgent, with recent estimates suggesting that one-third of African plants are threatened with extinction. Based on our experience with the first 20 conservation action plans for Guinea species, we suggest that the preparation of multi-species conservation action plans would be an efficient use of the limited resources available for species conservation.
The aim of this pilot study is to evaluate a Japanese version of brief Cognitive Behavioral Therapy for Insomnia (CBT-I) and contribute to primary care which leads to prevention of a lifestyle-related disease or a psychiatric disorder.
Method:
A single-arm study in nine patients with chronic insomnia who were under the pharmacotherapy was executed. The Insomnia Severity Index (ISI), the Athens Insomnia Scale (AIS), and the European Quality of Life 5 Items (EQ-5D) were assessed at the beginning of intervention, at the end of intervention, and after 12 weeks.
Findings:
There were no patient dropouts nor adverse events. The average change in ISI score was −7.33 (95% CI: −10.31 to −4.36) at post-treatment and −6.11 (95% CI: −8.20 to −4.03) at the 12-week follow-up point (Cohen’s d = 2.25). The AIS score improved as well, and the EQ-5D score improved after 12 weeks. The safety and efficacy of the brief CBT-I were suggested.
In the early stage of dementia, persons living with dementia (PLwD) can identify their values and wishes for future care with a high degree of accuracy and reliability. However, there is a paucity of research to guide best practices on how best to incorporate advance care planning (ACP) in older adults diagnosed with mild dementia and therefore only a minority of these individuals participate in any ACP discussions. We developed an intervention called Voice Your Values (VYV) that healthcare professionals can implement to identify and document the values of PLwD and their trusted individuals such as friends or family.
Purpose
This single-group pre-test and post-test design aimed to determine the feasibility, acceptability, and preliminary efficacy of the VYV intervention.
Methods
A convenience sample of 21 dyads of PLwD and their trusted individuals were recruited from five outpatient geriatric clinics. The tailored VYV intervention was delivered to the dyads over two sessions using videoconferencing.
Results
In terms of feasibility, the recruitment rate was lower (52%) than the expected 60%; the retention rate was high at 94%, and the intervention fidelity was high based on the audit of 20% of the sessions. In terms of preliminary efficacy, PLwD demonstrated improvement in ACP engagement (p = <0.01); trusted individuals showed improvements in decision-making confidence (p = 0.01) and psychological distress (p = 0.02); whereas a minimal change was noted in their dementia knowledge (p = 0.22).
Conclusion
Most of the feasibility parameters were met. A larger sample along with a control group, as well as a longitudinal study, are requisite to rigorously evaluate the efficacy of the promising VYV intervention. There is emerging evidence that people living with mild dementia can effectively participate in identifying and expressing their values and wishes for future care.
The entire family is affected when a parent is severely ill. Parents often need and appreciate professional support when talking to children about illness and death. The family talk intervention (FTI) is family-centered and intends to promote communication about the illness and its consequences, support parenting to enhance family coping and help family members share experiences with each other to create a shared family history. This study aimed to explore potential effects of FTI in specialized palliative home care, as reported by parents.
Method
This pre-post test intervention pilot was conducted in specialized palliative home care. A convergent mixed-method design was used to analyze interview and questionnaire data. Twenty families with dependent children were recruited from two specialized palliative home care units in Stockholm, Sweden.
Results
Parents reported that family communication improved after participation in FTI as family members learned communication strategies that facilitated open sharing of thoughts and feelings. Increased open communication helped family members gain a better understanding of each other's perspectives. Parents reported that relationships with their partner and children had improved as they now shared several strategies for maintaining family relationships. Parents were also less worried following participation in FTI. The ill parents stated that they gained a sense of security and were less worried about the future.
Significance of results
This study adds to the evidence that FTI may be a useful intervention for families with dependent children and an ill parent in a palliative care setting. This trial is registered at ClinicalTrials.gov Identifier NCT03119545.
A stated goal of language documentation is to make language resources available for use in language revitalization. This chapter identifies some limitations and challenges of working with language documentation materials, particularly legacy (historical) documents and resources in digital language archives. It then suggests ways that language documenters can make their work more useful for revitalization purposes. It identifies often-ignored areas that documentation should target, such as family language, everyday usage and young people’s speech, and suggests further contextual information and metadata that should be included. Language revitalizers can also adopt the methods, practices and tools of language documenters and should be encouraged to document the processes, decision-making, events, successes and failures of their work so that they and others can learn from them. The capsules present technical advice on making audio and video language documentation recordings; a community-based research model for field methods courses on revitalization; and outcomes of a pilot study on Alznerish conducted during a field school in Poland, with methodological proposals for short-term studies.
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.
Chronic non-cancer pain (CNCP) involves one-third of the US population, and prescription opioids contribute to the opioid epidemic. The Centers for Disease Control and Prevention emphasizes maximizing non-opioid treatment, but many rural populations cannot access alternative therapies. Clinical and Translational Science Award hubs across four rural states performed a multi-site, single-arm intervention feasibility study testing methods and procedures of implementing a behavioral intervention, acceptance and commitment therapy, in primary care CNCP patients on chronic opioids. Using the CONSORT extension for feasibility studies, we describe lessons learned in recruiting/retaining participants, intervention implementation, data measurement, and multi-site procedures. Results inform a future definitive trial and potentially others conducting rural trials.
Many institutions evaluate applications for local seed funding by recruiting peer reviewers from their own institutional community. Smaller institutions, however, often face difficulty locating qualified local reviewers who are not in conflict with the proposal. As a larger pool of reviewers may be accessed through a cross-institutional collaborative process, nine Clinical and Translational Science Award (CTSA) hubs formed a consortium in 2016 to facilitate reviewer exchanges. Data were collected to evaluate the feasibility and preliminary efficacy of the consortium.
Methods:
The CTSA External Reviewer Exchange Consortium (CEREC) has been supported by a custom-built web-based application that facilitates the process and tracks the efficiency and productivity of the exchange.
Results:
All nine of the original CEREC members remain actively engaged in the exchange. Between January 2017 and May 2019, CEREC supported the review process for 23 individual calls for proposals. Out of the 412 reviews requested, 368 were received, for a fulfillment ratio of 89.3%. The yield on reviewer invitations has remained consistently high, with approximately one-third of invitations being accepted, and of the reviewers who agreed to provide a review, 88.3% submitted a complete review. Surveys of reviewers and pilot program administrators indicate high satisfaction with the process.
Conclusions:
These data indicate that a reviewer exchange consortium is feasible, adds value to participating partners, and is sustainable over time.
Good research needs good planning. A detailed research plan helps you determine the feasibility of your study and anticipate the issues you will face. In this chapter, I cover logistics and practicalities, how we use pilot studies to test the feasibility of a project, making a timeline, assessing risk, and budgeting.
In this period of unprecedented levels of displacement, scalable interventions are needed to address mental health concerns of forced migrants in low-resource settings. This paper describes the adaptation and piloting of a guided, multi-media, self-help intervention, Self-Help Plus (SH+), which was developed to reduce psychological distress in large groups of people affected by adversity.
Methods.
Using a phased approach that included community consultations, cognitive interviewing, facilitator training, pilot implementation, and a qualitative process evaluation, we adapted SH+ for use among South Sudanese refugees in a refugee settlement in northern Uganda.
Results.
The SH+ materials, including audio-recorded sessions and an accompanying illustrated manual, were translated into Juba Arabic. Cognitive interviewing primarily resulted in adaptations to language with some minor adaptations to content. Facilitator training and supervision led to further suggested changes to delivery methods. An uncontrolled pilot study (n = 65) identified changes in the expected direction on measures of psychological distress, functional impairment, depression, wellbeing, and psychological flexibility. The process evaluation resulted in further adaptations to intervention materials and the decision to focus future effectiveness evaluations of the intervention in its current form on South Sudanese female refugees.
Conclusions.
We found that this potentially scalable, guided self-help intervention could be adapted for and feasibly implemented among female South Sudanese refugees in northern Uganda. These findings lay the groundwork for a future rigorous evaluation of SH+ in this context.
Background: In Japan, cognitive behavioural therapy (CBT) has been introduced in the ‘Rework Programme’, but its impact on return to work (RTW) has not been fully clarified. Aims: This pilot study investigated the initial efficacy of a work-focused cognitive behavioural group therapy (WF-CBGT) for Japanese workers on sick leave due to depression. Method: Twenty-three patients on leave due to depression were recruited from a mental health clinic. WF-CBGT including behavioural activation therapy, cognitive therapy, and problem-solving therapy techniques was conducted for eight weekly 150-minute sessions. Participants completed questionnaires on depression and anxiety (Kessler-6), social adaptation (Social Adaptation Self-Evaluation Scale), and difficulty in RTW (Difficulty in Returning to Work Inventory) at pre- and post-intervention time points. Rates of re-instatement after the intervention were examined. Results: One participant dropped out, but 22 participants successfully completed the intervention. All scale scores significantly improved after intervention and, except for difficulty in RTW related to physical fitness, all effect sizes were above the moderate classification. All participants who completed the intervention succeeded in RTW. Conclusions: Results suggested the possibility that WF-CBGT may be a feasible and promising intervention for Japanese workers on leave due to depression regardless of cross-cultural differences, but that additional research examining effectiveness using controlled designs and other samples is needed. Future research should examine the efficacy of this programme more systematically to provide relevant data to aid in the continued development of an evidence-based intervention.
Repeated epidemiological surveys show no decline in depression although uptake of treatments has grown. Universal depression prevention interventions are effective in schools but untested rigorously in adulthood. Selective prevention programmes have poor uptake. Universal interventions may be more acceptable during routine healthcare contacts for example antenatally. One study within routine postnatal healthcare suggested risk of postnatal depression could be reduced in non-depressed women from 11% to 8% by giving health visitors psychological intervention training. Feasibility and effectiveness in other settings, most notably antenatally, is unknown.
Method
We conducted an external pilot study using a cluster trial design consisting of recruitment and enhanced psychological training of randomly selected clusters of community midwives (CMWs), recruitment of pregnant women of all levels of risk of depression, collection of baseline and outcome data prior to childbirth, allowing time for women ‘at increased risk’ to complete CMW-provided psychological support sessions.
Results
Seventy-nine percent of eligible women approached agreed to take part. Two hundred and ninety-eight women in eight clusters participated and 186 termed ‘at low risk’ for depression, based on an Edinburgh Perinatal Depression Scale (EPDS) score of <12 at 12 weeks gestation, provided baseline and outcome data at 34 weeks gestation. All trial protocol procedures were shown to be feasible. Antenatal effect sizes in women ‘at low risk’ were similar to those previously demonstrated postnatally. Qualitative work confirmed the acceptability of the approach to CMWs and intervention group women.
Conclusion
A fully powered trial testing universal prevention of depression in pregnancy is feasible, acceptable and worth undertaking.
To study whether service of a free school lunch has an impact on weight development and food intake among pupils at a lower secondary school, and to assess the association between self-perceived school behaviour and food intake.
Design
A controlled intervention study involving service of a free healthy school lunch to 9th grade pupils took place over 4 months, from January to May 2007. Weight and height were measured before and after the intervention. The pupils also completed a short FFQ and a questionnaire concerning self-perceived school behaviour and the classroom environment before and after the intervention. A healthy food score was calculated using the FFQ data.
Setting
All 9th graders at three different lower secondary schools in southern Norway were invited to participate. One school was randomly selected as the intervention school.
Subjects
Fifty-eight pupils (91 %) from the intervention school and ninety-two pupils (77 %) from the control schools participated.
Results
BMI did not increase among the girls at the intervention school, but increased significantly among the boys at the intervention school and among the control school groups. The healthy food score correlated positively with the trait ‘satisfied with schoolwork’ (P < 0·001). Fifteen per cent of the variance in food score could be explained by gender and the trait ‘satisfied with schoolwork’.
Conclusions
Serving of a healthy free school lunch to secondary-school pupils may result in restricted weight gain. Further studies are needed to clarify the impact of school meals on overweight and academic performance.
This pilot study was intended to examine and to document whether the use of the garden environment and the activities that make up horticulture could be considered a possible method to be used in the vocational rehabilitation of persons sick-listed due to high levels of stress. The study is based on a theoretical (four-step) model using horticulture and the garden environment to provide the foundation of vocational rehabilitation for individuals with prolonged fatigue, chronic fatigue and burnout. The general interpretation is that the results are positive and promising but that further research is needed and should be pursued to examine what causal relationship(s) exist between the garden environment and the reduction of arousal levels; the effectiveness of pursuing this VR process for persons sick listed for stress-related complaints.
A pilot RCT of cognitive therapy (CT; based on Fowler, Garety, and Kuipers, 1995) for early psychosis adjunctive to treatment as usual (TAU) compared to TAU alone is presented. Recruitment is problematic and numbers are small. Levels of symptomatology are low at baseline; and both CT (n = 12) and TAU (n = 9) groups improve, with few significant group differences and high levels of individual variation. This pattern is common to other studies (Jackson et al., 1998; Lewis et al., 2002). The body of evidence to date seems to suggest that CT for early psychosis is not strongly indicated as an adjunctive treatment for all people with early psychosis, but should perhaps focus on the sub-group of patients whose recovery is incomplete.
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