scholarly journals The SENSE study: Post intervention effects of a randomized controlled trial of a cognitive–behavioral and mindfulness-based group sleep improvement intervention among at-risk adolescents.

2016 ◽  
Vol 84 (12) ◽  
pp. 1039-1051 ◽  
Author(s):  
Matthew Blake ◽  
Joanna M. Waloszek ◽  
Orli Schwartz ◽  
Monika Raniti ◽  
Julian G. Simmons ◽  
...  
Keyword(s):  
At Risk ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Post Intervention ◽  
Intervention Effects ◽  
Randomized Controlled ◽  
At Risk Adolescents ◽  
Improvement Intervention

scholarly journals Cognitive behavioral therapy positively affects fatigue in patients with multiple sclerosis: Results of a randomized controlled trial

2017 ◽  
Vol 23 (11) ◽  
pp. 1542-1553 ◽  
Author(s):  
Lizanne E van den Akker ◽  
Heleen Beckerman ◽  
Emma H Collette ◽  
Jos WR Twisk ◽  
Gijs Bleijenberg ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Randomized Controlled Trial ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Control Treatment ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Societal Participation

Background: Fatigue is a common symptom in multiple sclerosis (MS) and often restricts societal participation. Cognitive behavioral therapy (CBT) may alleviate MS-related fatigue, but evidence in literature is inconclusive. Objective: To evaluate the effectiveness of CBT to improve MS-related fatigue and participation. Methods: In a multi-center, assessor-masked, randomized controlled trial, participants with severe MS-related fatigue were assigned to CBT or control treatment. CBT consisted of 12 individual sessions with a psychologist trained in CBT, the control treatment consisted of three consultations with a MS nurse, both delivered over 16 weeks. Assessments were at baseline, 8, 16 (i.e. post-intervention), 26, and 52 weeks post-baseline. Primary outcomes were the Checklist Individual Strength-fatigue subscale (CIS20r fatigue) and the Impact on Participation and Autonomy questionnaire (IPA). Data were analyzed according to the intention-to-treat principle, using mixed-model analysis. Results: Between 2011 and 2014, 91 patients were randomized (CBT: n = 44; control: n = 47). Between-group analysis showed a positive post-intervention effect for CBT on CIS20r fatigue (T16: −6.7 (95% confidence interval (CI) = −10.7; −2.7) points) that diminished during follow-up (T52: 0.5 (95% CI = −3.6; 4.4)). No clinically relevant effects were found on societal participation. Conclusion: Severe MS-related fatigue can be reduced effectively with CBT in the short term. More research is needed on how to maintain this effect over the long term.

scholarly journals Door to needle time for thrombolysis: A secondary analysis of the TIPS cluster randomized controlled trial

2019 ◽  
Author(s):  
Md Hasnain ◽  
Christine L Paul ◽  
John R Attia ◽  
Annika Ryan ◽  
Erin Kerr ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Intravenous Thrombolysis ◽  
Practice Change ◽  
Intervention Period ◽  
Post Intervention ◽  
Intervention Effects ◽  
Post Intervention Period ◽  
Active Intervention ◽  
Randomized Controlled

Abstract Background The Thrombolysis ImPlementation in Stroke (TIPS) study evaluated a hospital-based intervention aimed at improving the rates of intravenous thrombolysis in Australia. The current study assessed the effects of this intervention on the door-to-needle time for intravenous thrombolysis and also determined the intervention effects on door-to-needle time within metropolitan and non-metropolitan hospital locations. Methods TIPS was a clustered randomized controlled trial that involved 20 hospitals in Australia, with 10 hospitals receiving a multi-component practice-change intervention. De-identified patient data collected in the trial included the arrival, assessment, and treatment times for acute ischemic stroke patients. A posthoc exploration using mixed-effects regression modelling was used to assess intervention effects on door-to-needle time, and the effects within hospital location (metropolitan versus non-metropolitan). Results The intervention vs. control difference in the door-to-needle times was non-significant overall or within a hospital location. To provide additional context for the findings, we also evaluated the results within each intervention hospitals. During the active-intervention period, the intervention hospitals showed a significant decrease in the door-to-needle time of 9.25 minutes (95%CI: -16.93, -1.57), but during the post-intervention period, the result was not significant. During the active intervention period, control hospitals showed a significant decrease in the door-to-needle time of 5.26 minutes (95% CI: -8.37; -2.14) and during the post-intervention period, the decrease was 12.13 minutes (95%CI: -17.44, -6.81). Conclusion Across these primary stroke care centres in Australia, a secular trend towards shorter door-to-needle times across both intervention and control hospitals was evident. The intervention resulted in only a modest but significant reduction within experimental groups during the active intervention period, which was not sustained during the post-intervention period.

scholarly journals Indirect Effects of a Cognitive-Behavioral Intervention on Adolescent Weight and Insulin Resistance Through Decreasing Depression in a Randomized Controlled Trial

2019 ◽  
Vol 44 (10) ◽  
pp. 1163-1173 ◽  
Author(s):  
Lauren D Gulley ◽  
Lauren B Shomaker ◽  
Nichole R Kelly ◽  
Kong Y Chen ◽  
Eric Stice ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
At Risk ◽  
Randomized Controlled Trial ◽  
Indirect Effects ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Depression Symptoms ◽  
Targeted Prevention ◽  
Glucose Testing ◽  
Randomized Controlled

Abstract Objective Depression is linked to excess weight, insulin resistance, and type 2 diabetes (T2D). We previously reported that in adolescent girls at-risk for T2D with moderately elevated depression, randomization to cognitive-behavioral therapy (CBT) produced greater decreases in depression at post-treament and greater decreases in fasting/2-h insulin at 1 year, compared to health education (HE). The current study is a secondary analysis of this parallel-group randomized controlled trial. We examined whether decreasing depression explained intervention effects on body composition and insulin outcomes. We hypothesized that decreases in depression would be an explanatory mediator and that indirect effects would be strongest at higher levels of baseline depression. Methods Participants were 12–17 years girls with overweight/obesity and family history of T2D randomized to 6-week group CBT (n = 58) or HE (n = 61). Procedures took place at an outpatient pediatric clinic. At baseline, post-treatment, and 1 year, adolescents completed the Center for Epidemiologic Studies-Depression Scale to assess depression symptoms; body mass index (BMI [kg/m2]) was measured from height/fasting weight; insulin resistance was derived from 2-h oral glucose testing. Adiposity was assessed with dual-energy X-ray absorptiometry at baseline and 1 year. Indirect effects of intervention were tested on 1-year changes in BMI, adiposity, and insulin through decreases in depression. Baseline depression was tested as a moderator of mediation. Results There was an indirect effect of CBT on decreased 1-year fasting insulin via decreases in depression during treatment, among adolescents with more elevated baseline depression. Conclusions Decreasing elevated depression may be one mechanism in the targeted prevention of T2D in at-risk adolescents.

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