Prevention of Progression to Severe Obesity in a Group of Obese Schoolchildren Treated With Family Therapy

PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. 880-884
Author(s):  
Carl-Erik Flodmark ◽  
Torsten Ohlsson ◽  
Olof Rydén ◽  
Tomas Sveger
Keyword(s):  
Family Therapy ◽  
Conventional Treatment ◽  
Severe Obesity ◽  
Therapy Group ◽  
Control Group ◽  
Obese Children ◽  
Treatment Groups ◽  
Conventional Treatment Group ◽  
The Family

Study objective. To evaluate the effect of family therapy on childhood obesity. Design. Clinical trial. One year follow-up. Setting. Referral from school after screening. Participants. Of 1774 children (aged 10 to 11), screened for obesity, 44 obese children were divided into two treatment groups. In an untreated control group of 50 obese children, screened in the same manner, body mass index (BMI) values were recorded twice, at 10 to 11 and at 14 years of age. Intervention. Both treatment groups received comparable dietary counseling and medical checkups for a period of 14 to 18 months, while one of the groups also received family therapy. Results. At the 1-year follow-up, when the children were 14 years of age, intention-to-treat analyses were made of the weight and height data for 39 of 44 children in the two treatment groups and for 48 of the 50 control children. The increase of BMI in the family therapy group was less than in the conventional treatment group at the end of treatment, and less than in the control group (P = .04 and P = .02, respectively). Moreover, mean BMI was significantly lower in the family therapy group than in the control group (P < .05), and the family therapy group also had fewer children with BMI > 30 than the control group (P = .02). The reduction of triceps, subscapular, and suprailiac skinfold thicknesses, expressed as percentages of the initial values, was significantly greater in the family therapy group than in the conventional treatment group (P = .03, P = .005 and P = .002, respectively), and their physical fitness was significantly better (P < .05). Conclusions. Family therapy seems to be effective in preventing progression to severe obesity during adolescence if the treatment starts at 10 to 11 years of age.

scholarly journals NAFLD Nutritional Management: Results from a Multidisciplinary Approach

2021 ◽  
pp. 1-8
Author(s):  
Sara Raquel Osório Policarpo ◽  
Mariana V. Machado ◽  
David Barreira ◽  
Helena Cortez-Pinto
Keyword(s):  
Weight Loss ◽  
Treatment Group ◽  
Conventional Treatment ◽  
Multidisciplinary Approach ◽  
Lifestyle Changes ◽  
Conventional Group ◽  
Control Group ◽  
Conventional Treatment Group ◽  
Lifestyle Recommendations

<b><i>Introduction:</i></b> Lifestyle changes are the mainstay treatment of nonalcoholic fatty liver disease (NAFLD). We aimed to assess the magnitude of weight loss in a group of NAFLD patients followed on a combined lifestyle intervention by a multidisciplinary team. <b><i>Methods:</i></b> Patients were assessed before and after a 12-month dietary intervention (Mediterranean diet aiming at weight loss). Patients who received a structured dietary plan along with general lifestyle recommendations were designated as the multidisciplinary treatment (MdT) group. Patients who declined follow-up still received general lifestyle recommendations and were designated as the conventional treatment group, being used as a control group. <b><i>Results:</i></b> From the 77 patients with documented NAFLD, 31.2% of patients were overweight and 55.8% obese; 66 patients constituted the MdT group and 11 the conventional treatment group. After 3 months, 89% of patients lost weight; at 6 months, 75.4% maintained the weight lost. At 12 months, 65% of patients still decreased their weight, with 92.2% of patients in the MdT group still maintaining a lower weight than baseline versus just 50% in the conventional group (<i>p</i> = 0.008). Only patients in the MdT group presented a weight loss higher than 10% (9.6%; <i>n</i> = 6). At 12 months patients in the MdT group presented an average reduction of 4.2 kg versus a reduction of just 0.6 kg in the conventional treatment group (<i>p</i> = 0.016). The MdT group, but not the conventional group, presented significant differences in liver enzymes at 12 months compared to baseline. <b><i>Conclusion:</i></b> Adherence to a multidisciplinary approach, compared to management solely by a hepatologist, in NAFLD patients, is effective with greater weight loss after a 12-month follow-up and a lower rate of weight gain recurrence.

Capsular closure versus unrepaired interportal capsulotomy after hip arthroscopy in patients with femoroacetabular impingement, results of a patient-blinded randomised controlled trial

2021 ◽  
pp. 112070002110057
Author(s):  
Niels H Bech ◽  
Inger N Sierevelt ◽  
Sheryl de Waard ◽  
Boudijn S H Joling ◽  
Gino M M J Kerkhoffs ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Controlled Trial ◽  
Poor Quality ◽  
Control Group ◽  
Treatment Groups ◽  
Significant Difference ◽  
Randomised Controlled

Background: Hip capsular management after hip arthroscopy remains a topic of debate. Most available current literature is of poor quality and are retrospective or cohort studies. As of today, no clear consensus exists on capsular management after hip arthroscopy. Purpose: To evaluate the effect of routine capsular closure versus unrepaired capsulotomy after interportal capsulotomy measured with NRS pain and the Copenhagen Hip and Groin Outcome Score (HAGOS). Materials and methods: All eligible patients with femoroacetabular impingement who opt for hip arthroscopy ( n = 116) were randomly assigned to one of both treatment groups and were operated by a single surgeon. Postoperative pain was measured with the NRS score weekly the first 12 weeks after surgery. The HAGOS questionnaire was measured at 12 and 52 weeks postoperatively. Results: Baseline characteristics and operation details were comparable between treatment groups. Regarding the NRS pain no significant difference was found between groups at any point the first 12 weeks after surgery ( p = 0.67). Both groups significantly improved after surgery ( p < 0.001). After 3 months follow-up there were no differences between groups for the HAGOS questionnaire except for the domain sport ( p = 0.02) in favour of the control group. After 12 months follow-up there were no differences between both treatment groups on all HAGOS domains ( p  > 0.05). Conclusions: The results of this randomised controlled trial show highest possible evidence that there is no reason for routinely capsular closure after interportal capsulotomy at the end of hip arthroscopy. Trial Registration: This trial was registered at the CCMO Dutch Trial Register: NL55669.048.15.

Abstract P478: One-Year Outcome After Endovascular Treatment for Acute Basilar Artery Occlusion

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Fengli Li ◽  
Hongfei Sang ◽  
Jiaxing Song ◽  
Zhangbao Guo ◽  
Shuai Liu ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Basilar Artery ◽  
Conventional Treatment ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Modified Rankin Scale ◽  
Treatment Groups ◽  
Excellent Outcome ◽  
Follow Up Study

Background and Objective: To report the results of clinical follow-up at 1 year among patients in the BASILAR registry. Design, Setting, and Participants: The BASILAR study was an investigator-initiated prospective registry, which consecutively enrolled stroke patients with acute basilar artery occlusion from 47 comprehensive stroke centers in China between January, 2014, and May, 2019. Patients were divided into conventional treatment or endovascular treatment groups according to the treatment their received. We assessed clinical outcomes 1 year after patients were enrolled in the BASILAR registry. Main Outcomes and Measures: The primary outcome was the score on the modified Rankin scale (range, 0 to 6 points, with higher scores indicating more severe disability) at 1 year assessed as a common odds ratio using ordinal logistic regression shift analysis, adjusted for prespecified prognostic factors. Secondary outcomes included categories scores of the modified Rankin scale at 1 year (0 to 1 [excellent outcome], 0 to 2 [good outcome], and 0 to 3 [favorable outcome]), and death from any cause during the 1-year period after enrollment. Results: Of the 829 patients who were enrolled in the original study, 1-year data for this extended follow-up study were available for 785 patients (94.7%). The distribution of outcomes on the modified Rankin scale favored endovascular treatment over conventional treatment (adjusted common odds ratio, 4.50; 95% confidence interval [CI], 2.81 to 7.29; P < 0.001). There were significant differences between the treatment groups in the percentage of patients who had excellent outcome, good outcome and favorable outcome. The cumulative 1-year mortality rate was 54.6% in the endovascular treatment group and 83.5% in the conventional treatment group (adjusted hazard ratio, 4.36; 95% CI, 2.69 to 7.29; P < 0.001). Conclusions and Relevance: In this extended follow-up study, the beneficial effect of endovascular treatment on functional outcome at 1 year in patients with acute basilar artery occlusion was similar to that reported at 90 days in the original study.

scholarly journals The Effects of Mycophenolate on the Formation of Granulation Tissue Post-operatively in Canine Tracheal Stent Patients (2014–2020)

2021 ◽  
Vol 8 ◽  
Author(s):  
Kevin F. Barber ◽  
Catherine A. Loughin ◽  
Dominic J. Marino ◽  
Martin Lesser
Keyword(s):  
Mycophenolate Mofetil ◽  
Granulation Tissue ◽  
Control Group ◽  
Tracheal Lumen ◽  
Loss To Follow Up ◽  
Treatment Groups ◽  
Tracheal Stent ◽  
Significant Difference ◽  
Tracheal Collapse

Objectives: To determine if mycophenolate mofetil reduces the incidence and severity of granulation tissue in-growth in canine tracheal stent patients.Study design: Randomized clinical trial.Animals: 111 dogs from the hospital population.Methods: Client-owned dogs that received an endoluminal self-expanding tracheal stent for canine tracheal collapse between 2014 and 2020 were randomly assigned into one of two treatment groups. Control group medication protocol consisted of prednisone 0.5 mg/kg PO BID/SID/EOD × 30 days, hydrocodone 0.25 mg/kg PO TID × 30 days, and cefovecin 8 mg/kg SQ post-placement. Mycophenolate group medication protocol was identical to the control group medication protocol with the addition of mycophenolate mofetil 10 mg/kg PO BID × 30 days, SID for life. Recheck tracheoscopy was performed at 1, 3, and 6 months post-stent placement. Presence and severity of granulation tissue were determined by tracheoscopy and were recorded as a percentage of tracheal lumen obstruction by blinded evaluators (none present, &lt;25%, &gt;25–50%, and &gt;50%).Results: At none of the three time points was there a statistically significant difference in grade between controls and those receiving mycophenolate (p = 0.467, p = 0.330, and p = 0.410).Conclusions and Clinical Significance: Our results suggest that mycophenolate can be safely given to these patients but do not support that its administration will reduce the incidence and severity of granulation tissue. Although a difference was observed in the severity of granulation tissue between the two groups, loss to follow-up may have influenced conclusions. A larger study would be warranted to further evaluate the effect of mycophenolate on the development of granulation tissue.

scholarly journals Effect of regional arterial infusion combined with early enteral nutrition on severe acute pancreatitis

2019 ◽  
Vol 47 (12) ◽  
pp. 6235-6243
Author(s):  
Xiaojuan Wang ◽  
Jinbu Xu ◽  
Jiguang Li ◽  
Yajuan Cheng ◽  
Lu Liu ◽  
...  
Keyword(s):  
Treatment Group ◽  
Combination Therapy ◽  
Conventional Treatment ◽  
Therapy Group ◽  
Early Enteral Nutrition ◽  
Combination Therapy Group ◽  
Arterial Infusion ◽  
Conventional Treatment Group ◽  
Effectiveness Rate ◽  
Biochemical Indices

Objective To measure the therapeutic effects of regional arterial infusion (RAI) in combination with early enteral nutrition (EEN) in patients with severe acute pancreatitis (SAP). Methods A prospective randomized controlled study enrolled patients with SAP. They were randomly divided into a conventional treatment group that served as the control and a combination therapy group that received RAI combined with EEN. The Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) scores, the levels of serum biochemical indices, functional recovery, the incidence of complications and total effectiveness rate were evaluated. Results A total of 100 patients were enrolled in the study. The APACHE II scores and the concentrations of blood glucose, serum amylase, white blood cell count, C-reactive protein, tumour necrosis factor-α, interleukin (IL)-6, IL-10 and IL-17 were significantly decreased, while albumin and serum calcium and total effectiveness rate in the combination therapy group were significantly higher than in the conventional treatment group. The combination therapy group had a significantly reduced time to abdominal pain relief, time of first defaecation, hospital stay and incidence of complications compared with the conventional treatment group. Conclusion The combination of RAI and EEN improved clinical biochemical indices, reduced the incidence of complications and promoted early recovery in patients with SAP.

Adjuvant therapy with imatinib in gastrointestinal stromal tumor (GIST) patients with intermediate or high risk: Analysis from a single-center contrast study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10556-10556
Author(s):  
J. Li ◽  
F. J. Gong ◽  
J. Li ◽  
W. A. Wu ◽  
L. Shen
Keyword(s):  
High Risk ◽  
Adjuvant Therapy ◽  
Therapy Group ◽  
Tumor Resection ◽  
Control Group ◽  
Contrast Study ◽  
Complete Tumor Resection ◽  
Free Survival ◽  
Complete Tumor

10556 Background: Imatinib benefits the patients with metastatic GIST but whether it is effective in the adjuvant setting after complete tumor resection of primary GIST is questionable. Methods: Patients who had undergone complete tumor resection with intermediate or high risk of recurrence (define) were enrolled in a single-center non-randomized open contrast study. Patients had adjuvant therapy with imatinib (400mg once a day) for 3 years commencing within 12 weeks of tumor resection, or had follow-up alone. We performed c-kit and PDGFRA mutation analysis for patients with archival tumor samples. The primary objective was recurrence-free survival (RFS) and the second objective was correlation of gene mutation profile with efficacy of adjuvant therapy. Results: One hundred and five patients were enrolled: 56 patients in adjuvant therapy group and 49 patients in control group. Median follow-up was 30 months (range 12–62); Median treatment duration in adjuvant therapy group were 20 months (range 12–36); There was relatively higher 1-year and 2-year RFS in the adjuvant therapy group compared with the control group (100% vs 89.8%,94.4% vs 60.0%) (Log-RankP< 0.001). Hazard risk was 0.13 (95% CI 0.039–0.438, P= 0.001) in Cox proportional hazard regression model. For further sub-group analysis, Log-rank and Cox regression analysis showed that adjuvant therapy could significantly decrease recurrence risk in patients with high risk disease (define)(2-year RFS: 91.5% vs 46,2%, Log-Rank: P<0.001, HR:0.107 (95%CI 0.031–0.370), P<0.001). c-kit and PDGFRA mutation were analyzed in forty-nine patients. There was a better survival benefit from adjuvant therapy for patients with c-kit exon 11 mutation. Conclusions: Adjuvant therapy with imatinib can improve 1-year and 2-year recurrence-free survival for patients with an intermediate or high risk of recurrence after complete tumor resection. No significant financial relationships to disclose.

Autonomous Mode of Systematic Dilemma Counseling

1981 ◽  
Vol 48 (1) ◽  
pp. 231-246 ◽  
Author(s):  
Morton Wagman
Keyword(s):  
Group Treatment ◽  
Previous Experiment ◽  
Complete System ◽  
Future Research ◽  
Control Group ◽  
Treatment Groups ◽  
Autonomous Mode ◽  
Contact Control ◽  
And Control

The autonomous dilemma counseling system is described and evaluated. The Dilemma Counseling Module teaches the dilemma problem-solving method. Solution components contain 75 representative life-choice problems and over 400 specific and general solutions. The Dilemma Therapeuter Component provides, on cassettes, supportive commentary from a counselor. 75 students with troublesome psychological dilemmas were randomly assigned to treatment groups or to a no-contact control group. One treatment condition consisted of the complete system while the other condition omitted the Dilemma Therapeuter. Treatment and control subjects responded to measures of problem improvement at a 1-wk. follow-up session. Each treatment group improved significantly more than the control group. Treatment groups did not differ. Findings are compared with those of a previous experiment in which the same design and dependent measures were used but in which treatment was given counselors using either the Dilemma Counseling ( n = 20) or an eclectic method ( n = 20). A combined analysis indicated no difference between the autonomous and counselors' treatments. It was concluded that the system can be independently applied. Future research is discussed.

scholarly journals The Effectiveness of the Discrimination Model-Based Counseling Supervisory Program in Improving Crisis Counseling Skills among Family Reform Counselors in Jordan

2020 ◽  
Vol 14 (3) ◽  
pp. 481
Author(s):  
Rami A. Tashtoush
Keyword(s):  
Control Group ◽  
Counseling Skills ◽  
Crisis Counseling ◽  
Family Crisis ◽  
Discrimination Model ◽  
The Family ◽  
Group 15 ◽  
The Impact ◽  
Experimental Group

This study aimed to explore the effectiveness of a counseling supervisory program based on the discrimination model in improving crisis counseling skills for family reform counselors in Jordan. The sample of the study consisted of 30 female and male counselors, who were randomly assigned to two groups: the experimental group (15) male and female counselors received the supervisory program according to the discrimination model with 90-minute 18 weekly sessions over 9 weeks, whereas  the control group (15) female and male counselors did not receive the supervisory program. The  Family Crisis Skills  Scale which  consists  of 59 items was divided into three subscales: Family Crisis Counseling, Counseling Relation Skills, and Procedures of Intervention & Response to Crisis. It  was  used with the total sample in the pre-post-test, and in the follow-up test only with experimental group. The results of the study showed that there are statistically significant differences in the overall mean scores of  the  posttest and all sub-scales of the Family Crisis Skills Scale between the two study group, in favor of the experimental group. Also, the results showed that although the differences between the two groups  in the overall mean scores of the post-follow-up test and all sub-scales of the Family Crisis Skills Scale were not statistically significant, there was a positive gain of improvement for the experimental group. These findings suggest that the counselors in the experimental group retained the impact of the program, and provided  evidence that the impact of the program was efficient and sustainable.

scholarly journals Family Therapy and Young Abusers

2009 ◽  
Vol 4 (1) ◽  
pp. 23-37
Author(s):  
Siri Søftestad ◽  
Margareth Bjørtvedt ◽  
Jorunn Haga ◽  
Karin E. Hildén
Keyword(s):  
Sexual Abuse ◽  
Child Care ◽  
Family Therapy ◽  
Treatment Program ◽  
Child Protection ◽  
Multiprofessional Team ◽  
The Family ◽  
Experienced Child ◽  
And Control

This article focuses on young abusers participating in a treatment program for families where one or more children have experienced child sexual abuse and/or have abused other children. TVERS is a multiprofessional team where the treatment is performed within a frame of control ,“care and control hand in hand”. Three trained family therapists from three different agencies come together and form the therapy. The caseworker from the child care protection service (Children`s Service) becomes a part of the TVERS-team during their therapeutic work with the young abuser and his family. The therapists are given access to all reports and documents from the police, the court and medical services. The caseworker can follow up the family between appointments as well as initiate child protection procedures if necessary. The article describes our experience of working with families where the son in the family has abused other children outside or inside their own family.

Randomised controlled trial of compliance therapy

1998 ◽  
Vol 172 (5) ◽  
pp. 413-419 ◽  
Author(s):  
Roisin Kemp ◽  
George Kirov ◽  
Brian Everitt ◽  
Peter Hayward ◽  
Anthony David
Keyword(s):  
Randomised Controlled Trial ◽  
Social Functioning ◽  
Psychotic Disorders ◽  
Therapy Group ◽  
Controlled Trial ◽  
Psychotic Episode ◽  
Control Group ◽  
Group Survival ◽  
Randomised Controlled

BackgroundA randomised controlled trial was conducted in an acute treatment setting to examine the effectiveness of compliance therapy, a brief pragmatic intervention targeting treatment adherence in psychotic disorders, based on motivational interviewing and recent cognitive approaches to psychosis.MethodSeventy-four patients with psychotic disorders according to DSM–III–R criteria recruited from consecutive admissions to an acute in-patient unit, received 4–6 sessions of either compliance therapy or non-specific counselling, and were followed-up over 18 months. The principal outcome measures were observer-rated compliance, attitudes to treatment, insight and social functioning.ResultsSignificant advantages were found for the compliance therapy group post-treatment on measures of insight, attitudes to treatment and observer-rated compliance which were retained over the follow-up period. Global social functioning improved relatively more over time in the compliance therapy group compared with the control group. Survival in the community prior to readmission was significantly longer in the compliance therapy group.ConclusionsThe results support the effectiveness of compliance therapy in improving functioning and community tenure after an acute psychotic episode.

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