Act In case of Depression: The evaluation of a care program to improve the detection and treatment of depression in nursing homes. Study Protocol

Contains fulltext : 95616.pdf (publisher's version ) (Open Access)BACKGROUND: The aim of this study is evaluating the (cost-) effectiveness of a multidisciplinary, evidence based care program to improve the management of depression in nursing home residents of somatic and dementia special care units. The care program is an evidence based standardization of the management of depression, including standardized use of measurement instruments and diagnostical methods, and protocolized psychosocial, psychological and pharmacological treatment. METHODS/DESIGN: In a 19-month longitudinal controlled study using a stepped wedge design, 14 somatic and 14 dementia special care units will implement the care program. All residents who give informed consent on the participating units will be included. Primary outcomes are the frequency of depression on the units and quality of life of residents on the units. The effect of the care program will be estimated using multilevel regression analysis. Secondary outcomes include accuracy of depression-detection in usual care, prevalence of depression-diagnosis in the intervention group, and response to treatment of depressed residents. An economic evaluation from a health care perspective will also be carried out. DISCUSSION: The care program is expected to be effective in reducing the frequency of depression and in increasing the quality of life of residents. The study will further provide insight in the cost-effectiveness of the care program. TRIAL REGISTRATION: Netherlands Trial Register (NTR): NTR1477

Omega-3-vetzuren en depressie:: Hoeveel wetenschappelijk bewijs is er?

Bijna een op de vijf volwassenen in Nederland krijgt ooit in het leven te maken met een depressie.1 Wereldwijd is depressie volgens de Wereldgezondheidsorganisatie de belangrijkste oorzaak van ziekte en uitval.2 In totaal werden in 2016 zo’n tien miljoen recepten voor antidepressiva voorgeschreven.3 Slechts ongeveer een derde van depressieve mensen komen van de klachten af na een behandeling met antidepressiva.

Omega-3-fatty acids and depression::How much scientific evidence is there?

Bijna een op de vijf volwassenen in Nederland krijgt ooit in het leven te maken met een depressie.1 Wereldwijd is depressie volgens de Wereldgezondheidsorganisatie de belangrijkste oorzaak van ziekte en uitval.2 In totaal werden in 2016 zo’n tien miljoen recepten voor antidepressiva voorgeschreven.3 Slechts ongeveer een derde van depressieve mensen komen van de klachten af na een behandeling met antidepressiva.

Sample size for partially nested designs and other nested or crossed designs with a continuous outcome when adjusted for baseline

In a randomized controlled trial, outcomes of different subjects may be independent at baseline, but correlated at a follow-up measurement due to treatment. This treatment-related clustering at follow-up can arise for instance because the treatment is given in a group or because subjects are treated individually but by the same therapist (therapist effect). There is substantial literature on the design and analysis of such trials when estimation of the intervention effect is based on a follow-up measurement (eg, directly after treatment or at a later time point). However, often the baseline measurement of the outcome is highly correlated with the follow-up measurement, and this information can be used in the analysis. For a randomized design with a baseline and a follow-up measurement, we compare sample size requirements for analyses with and without adjustment for this baseline measure. We show that adjusting for baseline reduces required sample size. This reduction depends on the variance of the difference between arms at baseline, the variance of this difference at follow-up, and the correlation between the two. From this, we derive sample size formulas for partially or fully nested designs, and cluster randomized trials with treatment as a partially or fully cross-classified factor. Also, we discuss situations where clusters are already present at baseline or where treatment by cluster interaction is present. For the partially nested design, we work out practical design considerations (eg, use of content-matter input, design factors and optimal allocation ratio) and investigate small sample properties of the sample size formula.</p

Effects of Dog Assisted Therapy for Adults with Autism Spectrum Disorder:An Exploratory Randomized Controlled Trial

Contains fulltext : 225520.pdf (Publisher’s version ) (Open Access)Effective treatments of highly prevalent stress-related outcomes such as depression and anxiety are understudied in adults with autism spectrum disorder (ASD). A randomized controlled trial with baseline, post-intervention, and 10-week follow-up, that explores the effects of animal assisted therapy (AAT) was conducted. In total, 53 adults with ASD with normal to high intelligence were randomized in an intervention (N = 27) versus waiting list control group (N = 26). The remarkable adherence to the therapy program by study participants and the program's clinically relevant effects indicate that AAT with dogs can be used to reduce perceived stress and symptoms of agoraphobia, and to improve social awareness and communication in adults with ASD with normal to high intelligence

Analyzing cyclic patterns in psychological research_ a tutorial

A growing number of studies on psychological phenomena employ the Ecological Momentary Assessment (EMA) method for obtaining intensive longitudinal data in daily life. Whereas cyclic processes may underlie different psychological and physiological outcomes, the cyclic model that describes such processes is rarely used for fitting EMA data. The aim of this paper is to introduce the cyclic model to researchers, and to demonstrate its use in an empirical data set. It is shown how the cyclic terms can be incorporated in multilevel models. Based on secondary analyses on an existing EMA data set, it can be concluded that adding cyclic terms in EMA analyses may improve model fit and may help understanding the dynamic processes