Social support and belonging

دَعۡوَىٰهُمۡ فِيهَا سُبۡحَٰنَكَ ٱللَّهُمَّ وَتَحِيَّتُهُمۡ فِيهَا سَلَٰمࣱۚ وَءَاخِرُ دَعۡوَىٰهُمۡ أَنِ ٱلۡحَمۡدُ لِلَّهِ رَبِّ ٱلۡعَٰلَمِينَ

Their prayer in them will be, ‘Glory be to You, God!’ their greeting, ‘Peace,’ and the last part of their prayer, ‘Praise be to God, Lord of the Worlds.’

وَأُدۡخِلَ ٱلَّذِينَ ءَامَنُواْ وَعَمِلُواْ ٱلصَّٰلِحَٰتِ جَنَّٰتࣲ تَجۡرِي مِن تَحۡتِهَا ٱلۡأَنۡهَٰرُ خَٰلِدِينَ فِيهَا بِإِذۡنِ رَبِّهِمۡۖ تَحِيَّتُهُمۡ فِيهَا سَلَٰمٌ

but those who believed and did good deeds will be brought into Gardens graced with flowing streams, there to remain with their Lord’s permission: their greeting there is ‘Peace’

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ لَا تَدۡخُلُواْ بُيُوتًا غَيۡرَ بُيُوتِكُمۡ حَتَّىٰ تَسۡتَأۡنِسُواْ وَتُسَلِّمُواْ عَلَىٰٓ أَهۡلِهَاۚ ذَٰلِكُمۡ خَيۡرࣱ لَّكُمۡ لَعَلَّكُمۡ تَذَكَّرُونَ

Believers, do not enter other people’s houses until you have asked permission to do so and greeted those inside- that is best for you: perhaps you will bear this in mind

لَّيۡسَ عَلَى ٱلۡأَعۡمَىٰ حَرَجࣱ وَلَا عَلَى ٱلۡأَعۡرَجِ حَرَجࣱ وَلَا عَلَى ٱلۡمَرِيضِ حَرَجࣱ وَلَا عَلَىٰٓ أَنفُسِكُمۡ أَن تَأۡكُلُواْ مِنۢ بُيُوتِكُمۡ أَوۡ بُيُوتِ ءَابَآئِكُمۡ أَوۡ بُيُوتِ أُمَّهَٰتِكُمۡ أَوۡ بُيُوتِ إِخۡوَٰنِكُمۡ أَوۡ بُيُوتِ أَخَوَٰتِكُمۡ أَوۡ بُيُوتِ أَعۡمَٰمِكُمۡ أَوۡ بُيُوتِ عَمَّٰتِكُمۡ أَوۡ بُيُوتِ أَخۡوَٰلِكُمۡ أَوۡ بُيُوتِ خَٰلَٰتِكُمۡ أَوۡ مَا مَلَكۡتُم مَّفَاتِحَهُۥٓ أَوۡ صَدِيقِكُمۡۚ لَيۡسَ عَلَيۡكُمۡ جُنَاحٌ أَن تَأۡكُلُواْ جَمِيعًا أَوۡ أَشۡتَاتࣰ اۚ فَإِذَا دَخَلۡتُم بُيُوتࣰ ا فَسَلِّمُواْ عَلَىٰٓ أَنفُسِكُمۡ تَحِيَّةࣰ مِّنۡ عِندِ ٱللَّهِ مُبَٰرَكَةࣰ طَيِّبَةࣰۚ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَعۡقِلُونَ

No blame will be attached to the blind, the lame, the sick.Whether you eat in your own houses, or those of your fathers, your mothers, your brothers, your sisters, your paternal uncles, your paternal aunts, your maternal uncles, your maternal aunts, houses you have the keys for, or any of your friends’ houses, you will not be blamed: you will not be blamed whether you eat in company or separately. When you enter any house, greet one another with a greeting of blessing and goodness as enjoined by God. This is how God makes His messages clear to you so that you may understand

وَإِذَا حُيِّيتُم بِتَحِيَّةࣲ فَحَيُّواْ بِأَحۡسَنَ مِنۡهَآ أَوۡ رُدُّوهَآۗ إِنَّ ٱللَّهَ كَانَ عَلَىٰ كُلِّ شَيۡءٍ حَسِيبًا

But [even in battle] when you [believers] are offered a greeting, respond with a better one, or at least return it: God keeps account of everything

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِذَا ضَرَبۡتُمۡ فِي سَبِيلِ ٱللَّهِ فَتَبَيَّنُواْ وَلَا تَقُولُواْ لِمَنۡ أَلۡقَىٰٓ إِلَيۡكُمُ ٱلسَّلَٰمَ لَسۡتَ مُؤۡمِنࣰ ا تَبۡتَغُونَ عَرَضَ ٱلۡحَيَوٰةِ ٱلدُّنۡيَا فَعِندَ ٱللَّهِ مَغَانِمُ كَثِيرَةࣱۚ كَذَٰلِكَ كُنتُم مِّن قَبۡلُ فَمَنَّ ٱللَّهُ عَلَيۡكُمۡ فَتَبَيَّنُوٓاْۚ إِنَّ ٱللَّهَ كَانَ بِمَا تَعۡمَلُونَ خَبِيرࣰ ا

So, you who believe, be careful when you go to fight in God’s way, and do not say to someone who offers you a greeting of peace, ‘You are not a believer,’ out of desire for the chance gains of this life- God has plenty of gains for you. You yourself were in the same position [once], but God was gracious to you, so be careful: God is fully aware of what you do

And their greeting therein will be " Peace!, " and the last of their supplication will be " Praise belongs to God, the Lord of the Worlds. " On that desert of the Mustering and station of the Resurrection, the disobedient of AḤmad's com- munity will be kept back at the place of the exposure of the reckoning. The preceders will have gone on ahead with the light of obedience, and the disobedient will stay there alone with the heavy burden of disobedience. In the end, God's mercy will take them by the hand. He will have pity on their aloneness and helplessness. With the call of generosity, He will say, " My servants! " When this address of exaltedness and call of generosity in the attribute of mercy reaches their ears, it will put their spirits at ease and open up their hearts to repose and ease [56:89]. He will say, " My servants, surely the companions of the Garden are today busy rejoicin

Those who have faith and do wholesome deeds were given entry into the Garden....Their greeting therein is “Peace!” The meaning is that tomorrow the faithful and the friends will be brought into paradise, the house of victory, subsistent bliss, and everlasting kingship. The outward meaning of the word were given entry is that this decree was issued on the first day at the Beginningless Covenant and that the faithful were brought into paradise on the day when the decree was issued. It is not a new want that He puts into effect; it is a beginningless deed that He makes appear. He does not caress them today, for He caressed them in the Beginningless and finished the work. The worshipper is always looking toward the Endless, fearing what will be done to him tomor- row. The recognizer is always looking toward the Beginningless, burning because of what may have been done to him then. He who loo

(O ye who believe! Enter not houses other than your own�) [24:27-29]. Ahmad ibn Muhammad ibn Ibrahim al-Tha�labi informed us> al-Husayn ibn Muhammad ibn �Abd Allah al-Dinawari> �Abd Allah ibn Yusuf ibn Ahmad ibn Malik> al-Husayn ibn Sakhtawayh> �Umar ibn Thawr and Ibrahim ibn Abi Sufyan> Muhammad ibn Yusuf al-Firyabi> Qays> Ash�ath ibn Siwar> �Adiyy ibn Thabit who said: �A woman from the Helpers went to see the Prophet and said: �O Messenger of Allah, sometimes I am in my house in a state in which I do not like anyone to see me, neither father nor son. But then the father comes in or another man of the family comes in while I am in that state, what shall I do?� [As a response] this verse was revealed (O ye who believe! Enter not houses other than your own without first announcing your presence and invoking peace upon the folk thereof)�. The commentators of the Qur�an said: �When this ver

(No blame is there upon the blind�) [24:61]. Said ibn �Abbas: �When Allah, glorious and exalted is He, revealed (O ye who believe! Squander not your wealth among yourselves in vanity�) [4:29], the Muslims felt vexed to eat with the sick, the old, the blind and the lame. They said: �Food is the best part of one�s wealth, and Allah, exalted is He, has warned against squandering wealth in vanity. The blind cannot see where wholesome food is, the lame cannot compete over food and the sick cannot eat properly�. As a response, Allah, exalted is He, revealed this verse�. Sa�id ibn Jubayr and al-Dahhak said: �The lame and the blind used to feel vexed at eating with healthy people because the latter found them despicable and disliked eating with them. The people of Medina did not allow the blind, lame or sick person to share their food because they considered them dirty. For this reason, Allah, e

When you are greeted with a greeting, greet with one more beautiful than it, or return it. In this verse, the majestic compeller, the magnificent God, the lovingly kind beautiful-doer, teach- es His servants the courteous acts of social intercourse and companionship, for anyone not adorned with courtesy is not worthy of companionship. Companionship is of three sorts: the courtesy of conformity with the Real, the courtesy of sincerity with people, and the courtesy of opposition to the soul. Anyone not nurtured by these sorts of courtesy has nothing to do with the path of MuṣṬafā and has no worth in the world of No god but God. The exalted Lord first adorned MuṣṬafā with courtesy, as his come in the report: “My Lord taught me courtesy, so how beautifully I have been made courteous!” Thus on the night of the miʿrāj in that most tremendous station, he acted courteously toward the Presence, s

O you who have faith! When you strike forth on the path of God, look clearly, and say not to him who offers you peace, “You are not of the faithful,” seeking the chance goods of this world's life. By way of allusion, He is saying that when you go on a journey, go for the sake of reaching one of the friends of God so that he may be the intimate of your days and the witness of your heart and spirit. No matter how far you go, never be at ease from seeking and do not hold back the foot of effort. The friends are the favorites of the Exalted Threshold and accepted by the Presence of Divinity. Not everyone sees them, not every eyesight perceives them. When you find them, give ear, and when you see them, cling to them, for the brightness of the heart lies in witnessing them and endless felicity in being their companion. The pir of the Tariqah Junayd was asked, “Which do you prefer? Two cycles o

حَدَّثَنَا هَنَّادٌ، حَدَّثَنَا أَبُو مُعَاوِيَةَ، عَنِ الأَعْمَشِ، عَنْ أَبِي صَالِحٍ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ وَالَّذِي نَفْسِي بِيَدِهِ لاَ تَدْخُلُوا الْجَنَّةَ حَتَّى تُؤْمِنُوا وَلاَ تُؤْمِنُوا حَتَّى تَحَابُّوا أَلاَ أَدُلُّكُمْ عَلَى أَمْرٍ إِذَا أَنْتُمْ فَعَلْتُمُوهُ تَحَابَبْتُمْ أَفْشُوا السَّلاَمَ بَيْنَكُمْ ‏"‏ ‏.‏ وَفِي الْبَابِ عَنْ عَبْدِ اللَّهِ بْنِ سَلاَمٍ وَشُرَيْحِ بْنِ هَانِئٍ عَنْ أَبِيهِ وَعَبْدِ اللَّهِ بْنِ عَمْرٍو وَالْبَرَاءِ وَأَنَسٍ وَابْنِ عُمَرَ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ ‏.‏

Narrated Abu Hurairah:that the Messenger of Allah (ﷺ) said: "By the One in Whose Hand is my soul! You will not enter Paradise until you believe, and you will not believe until you love one another. Shall I inform you about a matter which if you do it, then you will love one another? Spread the Salam among each other

حَدَّثَنَا عَلِيُّ بْنُ الْجَعْدِ، أَخْبَرَنَا شُعْبَةُ، عَنْ سَيَّارٍ، عَنْ ثَابِتٍ الْبُنَانِيِّ، عَنْ أَنَسِ بْنِ مَالِكٍ ـ رضى الله عنه أَنَّهُ مَرَّ عَلَى صِبْيَانٍ فَسَلَّمَ عَلَيْهِمْ وَقَالَ كَانَ النَّبِيُّ صلى الله عليه وسلم يَفْعَلُهُ‏.‏

Narrated Anas bin Malik:that he passed by a group of boys and greeted them and said, "The Prophet (ﷺ) used to do so

حَدَّثَنَا عَمْرُو بْنُ عَاصِمٍ، حَدَّثَنَا هَمَّامٌ، عَنْ قَتَادَةَ، قَالَ قُلْتُ لأَنَسٍ أَكَانَتِ الْمُصَافَحَةُ فِي أَصْحَابِ النَّبِيِّ صلى الله عليه وسلم قَالَ نَعَمْ‏.‏

Narrated Qatada:I asked Anas, "Was it a custom of the companions of the Prophet (ﷺ) to shake hands with one another?" He said, "Yes

حَدَّثَنَا أَحْمَدُ بْنُ أَبِي شُعَيْبٍ، حَدَّثَنَا زُهَيْرٌ، حَدَّثَنَا الأَعْمَشُ، عَنْ أَبِي صَالِحٍ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ وَالَّذِي نَفْسِي بِيَدِهِ لاَ تَدْخُلُوا الْجَنَّةَ حَتَّى تُؤْمِنُوا وَلاَ تُؤْمِنُوا حَتَّى تَحَابُّوا أَفَلاَ أَدُلُّكُمْ عَلَى أَمْرٍ إِذَا فَعَلْتُمُوهُ تَحَابَبْتُمْ أَفْشُوا السَّلاَمَ بَيْنَكُمْ ‏"‏ ‏.‏

Abu Hurairah reported the Messenger of Allah (May peace be upon him) as saying:By him in whose hand my soul is, you will not enter Paradise until you believe, and you will not believe until you love one another: should I not guide you to something doing which you will love one another: spread out salutation among you

حَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ، حَدَّثَنَا أَبُو خَالِدٍ، وَابْنُ، نُمَيْرٍ عَنِ الأَجْلَحِ، عَنْ أَبِي إِسْحَاقَ، عَنِ الْبَرَاءِ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَا مِنْ مُسْلِمَيْنِ يَلْتَقِيَانِ فَيَتَصَافَحَانِ إِلاَّ غُفِرَ لَهُمَا قَبْلَ أَنْ يَفْتَرِقَا ‏"‏ ‏.‏

Narrated Al-Bara' ibn Azib: The Prophet (ﷺ) said: Two Muslims will not meet and shake hands having their sins forgiven them before they separate

حَدَّثَنَا عَلِيُّ بْنُ مُحَمَّدٍ، حَدَّثَنَا وَكِيعٌ، عَنْ جَرِيرِ بْنِ حَازِمٍ، عَنْ حَنْظَلَةَ بْنِ عَبْدِ الرَّحْمَنِ السَّدُوسِيِّ، عَنْ أَنَسِ بْنِ مَالِكٍ، قَالَ قُلْنَا يَا رَسُولَ اللَّهِ أَيَنْحَنِي بَعْضُنَا لِبَعْضٍ قَالَ ‏"‏ لاَ ‏"‏ ‏.‏ قُلْنَا أَيُعَانِقُ بَعْضُنَا بَعْضًا قَالَ ‏"‏ لاَ وَلَكِنْ تَصَافَحُوا ‏"‏ ‏.‏

It was narrated that Anas bin Malik said:"O Messenger of Allah! Should we bow to one another?" He said: "No." We said: "Should we embrace one another?" He said: "No, but shake hands with one another

ومن ذلك أن تشكره على صنيعه في حقك، وأن تذب عنه في غيبته إذا قصد بسوء، فحق الأخوة التشمير في الحماية والنصرة.

و الدليل عليه أن ترك المؤاخاة و الصحبة ابتداء ليس مذموما ولا مكروها بل قال قائلون الانفراد أولى فأما قطع الأخوة عن دوامها فمنهى عنه ومذموم في نفسه ونسبته إلى تركها ابتداء كنسبة الطلاق إلى ترك النكاح و الطلاق أبغض إلى الله تعالى من ترك النكاح قال صلى الله عليه وسلم شرار عباد الله المشاءون بالنميمة المفرقون بين الأحبة + حديث شرار عباد الله المشاءون بالنميمة المفرقون بين الأحبة رواه أحمد من حديث أسماء بنت يزيد بسند ضعيف +

قال علي رضي الله عنه من لم يحمد أخاه على حسن النية لم يحمده على حسن الصنيعة وأعظم من ذلك تأثيرا في جلب المحبة الذب عنه في غيبته مهما قصد بسوء أو تعرض لعرضه بكلام صريح أو تعريض فحق الأخوة التشمير في الحماية و النصرة وتبكيت المتعنت وتغليظ القول عليه و السكوت عن ذلك موغر للصدر ومنفر للقلب وتقصير في حق الأخوة

لأبيه وأمه دون أخيه لأبيه وقال عمرو بن شعيب قضي رسول الله صلى الله عليه وسلم أن الأخ للأب والأم أولي الكلالة بالميراث ثم الأخ للأب وهذا أيضا مما يدخل في قوله عليه الصلاة والسلام فما بقي فلأولي رجل ذكر والتحقيق في ذلك أن كل ما دل عليه القرآن ولو بالتنبيه فليس هو مما أبقته الفرائض بل هو من إلحاق الفرائض المذكورة في القرآن بأهلها كتوريث الأولاد ذكورهم وإناثهم الفاضل عن الفروض للذكر مثل حظ الأنثيين وتوريث الإخوة ذكورهم وإناثهم كذلك ودل ذلك بطريق التنبيه على أن الباقي يأخذه الذكر منهم عند الانفراد بطريق الأولي ودل أيضا بالتنبيه عليه أن الأخت تأخذ الباقي مع البنت كما كانت تأخذه مع أخيها ولا يقدم عليها من هو أبعد منه كابن الأخ والعم وابنه فإن أخاها إذا لم يسقطها فكيف يسقطها من هو أبعد منه فهذا كله من باب إلحاق الفرائض بأهلها ومن باب قسمة المال بين أهل الفرائض على كتاب الله وأما من لم يذكر باسمه من العصبات في القرآن كابن الأخ والعم وابنه فإنما دخل في عمومات مثله قوله تعالى وأولوا الأرحام بعضهم أ

يحتمل أن يريد بالإنخلاع عن العصمة انخلاعه عن اعتصامه بالله فإنه لو اعتصم بالله لما خرج عن هداية الطاعة قال الله تعالى @QB@ ومن يعتصم بالله فقد هدي إلى صراط مستقيم @QE@ فلو كملت عصمته بالله لم يخذله أبدا قال الله تعالى @QB@ واعتصموا بالله هو مولاكم فنعم المولى ونعم النصير @QE@ أي متى اعتصمتم به تولاكم ونصركم على أنفسكم وعلى الشيطان وهما العدوان اللذان لا يفارقان العبد وعداوتهما أضر من عداوة العدو الخارج فالنصر على هذا العدو أهم والعبد إليه أحوج وكمال النصرة على العدو بحسب كمال الإعتصام بالله

# ### | كتاب آداب الصحبة والأخوة ومعاشرة الخلق ونحو ذلك

A systematic review of correlates of depression among older Chinese and Korean immigrants: what we know and do not know.: Objectives: Guided by the stress and coping theory, this study provides a systematic review of existing research on acculutration, family support, and social support related correlates of depression among older Chinese and Korean immigrants in the United States. Method: A comprehensive literature search was conducted in CINAHL Plus, Abstracts in Social Gerontology, AgeLine, Social Work Abstracts, PubMed, PsychINFO, and Social Science Citation Index databases to identify relevant articles that pr

Systematic review on Internet Support Groups (ISGs) and depression (1): Do ISGs reduce depressive symptoms?: Background: Internet support groups (ISGs) enable individuals with specific health problems to readily communicate online. Peer support has been postulated to improve mental health, including depression, through the provision of social support. Given the growing role of ISGs for both users with depression and those with a physical disorder, there is a need to evaluate the evidence concerning the efficacy of ISGs in reducing depressive symptoms. Objective: The objective was to systematically revi

A systematic review of qualitative studies on adjusting after stroke: lessons for the study of resilience.: Purpose: To synthesize qualitative studies on adjusting after stroke, from stroke survivors' and carers' perspectives, and to outline their potential contribution to an understanding of resilience. Methods: A systematic review of qualitative studies in peer reviewed journals from 1990 to 2011 was undertaken. Findings from selected studies were summarized and synthesized and then considered alongside studies of resilience. Results: Forty studies were identified as suitable. These suggested that t

Are Community Gardening and Horticultural Interventions Beneficial for Psychosocial Well-Being? A Meta-Analysis.: Recent literature has revealed the positive effect of gardening on human health; however, empirical evidence on the effects of gardening-based programs on psychosocial well-being is scant. This meta-analysis aims to examine the scientific literature on the effect of community gardening or horticultural interventions on a variety of outcomes related to psychosocial well-being, such as social cohesion, networking, social support, and trust. From 383 bibliographic records retrieved (from 1975 to 20

The relationship between self-reported received and perceived social support: a meta-analytic review.: Social support is broad term encompassing a variety of constructs, including support perceptions (perceived support) and receipt of supportive behaviors (received support). Of these constructs, only perceived support has been regarded as consistently linked to health, and researchers have offered differing assessments of the strength of the received-perceived support relationship. An overall estimate of the received-perceived support relationship would clearly further the dialogue on the relatio

Social support and subjective burden in caregivers of adults and older adults: A meta-analysis.: Background: Despite the generally accepted belief that social support improves caregiver adjustment in general and subjective burden in particular, the literature shows mixed findings, and a recent review concluded that the predictive strength of caregiver social support in determining caregiver burden is less evident, due to the conceptual diversity of this determinant. Objective: The purpose of this review is to analyse the relationship of perceived and received social support with subjective

Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial.

Context: There are few randomized controlled trials on the effectiveness of palliative care interventions to improve the care of patients with advanced cancer. Objective: To determine the effect of a nursing-led intervention on quality of life, symptom intensity, mood, and resource use in patients with advanced cancer. Design, setting, and participants: Randomized controlled trial conducted from November 2003 through May 2008 of 322 patients with advanced cancer in a rural, National Cancer Institute-designated comprehensive cancer center in New Hampshire and affiliated outreach clinics and a VA medical center in Vermont. Interventions: A multicomponent, psychoeducational intervention (Project ENABLE [Educate, Nurture, Advise, Before Life Ends]) conducted by advanced practice nurses consisting of 4 weekly educational sessions and monthly follow-up sessions until death or study completion …

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Evaluation of a standard provision versus an autonomy promotive exercise referral programme: rationale and study design.

Background: The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation. Methods/design: Design: An exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT) exercise on prescription intervention. Participants: 347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n = 7) or to the SDT-based intervention (n = 6).Outcomes measu…

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Reducing conduct problems among children exposed to intimate partner violence: a randomized clinical trial examining effects of Project Support.

This study was a randomized clinical trial of Project Support, an intervention designed to reduce conduct problems among children exposed to intimate partner violence. Participants were 66 families (mothers and children) with at least 1 child exhibiting clinical levels of conduct problems. Families were recruited from domestic violence shelters. The Project Support intervention involves (a) teaching mothers child management skills and (b) providing instrumental and emotional support to mothers. Families were randomly assigned to the Project Support intervention condition or to an existing services comparison condition. They were assessed on 6 occasions over 20 months, following their departure from the shelter. Children in families in the Project Support condition, compared with those in the comparison condition, exhibited greater reductions in conduct problems. Mothers in the Project Su…

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The project ENABLE II randomized controlled trial to improve palliative care for rural patients with advanced cancer: baseline findings, methodological challenges, and solutions.

Objective: There is a paucity of randomized controlled trials (RCTs) to evaluate models of palliative care. Although interventions vary, all have faced a variety of methodological challenges including adequate recruitment, missing data, and contamination of the control group. We describe the ENABLE II intervention, methods, and sample baseline characteristics to increase intervention and methodological transparency, and to describe our solutions to selected methodological issues. Methods: Half of the participants recruited from our rural U.S. comprehensive cancer center and affiliated clinics were randomly assigned to a phone-based, nurse-led educational, care coordination palliative care intervention model. Intervention services were provided to half of the participants weekly for the first month and then monthly until death, including bereavement follow-up call to the caregiver. The ot…

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The effect of a culturally tailored smoking cessation for Chinese American smokers.

Introduction: Tobacco use is a serious public health problem among low-income Chinese Americans with limited English proficiency. Chinese men are at high risk for smoking-related morbidity and mortality. We tested the feasibility of a culturally and linguistically sensitive smoking intervention program with combined counseling and pharmacological components for Chinese smokers in New York City; identified factors and techniques that enhance the administration and appropriateness of the intervention program; and examined the overall impact of this program on quit attempts, quit rates, and overall smoking reduction. Methods: We were guided by the transtheoretical model and used an adapted motivational interviewing (MI) approach. The study involved a randomized sample with pretreatment assessment and multiple follow-up measures. Eligible participants (N = 122) were randomly assigned to inte…

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Seriously ill patients' discussions of preparation and life completion: an intervention to assist with transition at the end of life.

Objective: Patients approaching the end of life not only face challenges to physical well-being but also threats to emotional and spiritual integrity. Yet, identifying appropriate, effective, and brief interventions to address those concerns has proven elusive. We developed an intervention based on life review and emotional disclosure literatures and conducted a pilot study to determine feasibility and acceptability. This article presents qualitative intervention responses. Method: We conducted a three-armed randomized control trial to evaluate the effects of preparation and life completion discussion on health outcomes in patients with advanced serious illness. Hospice-eligible subjects were randomly assigned to one of three groups: (1) intervention (life completion discussion intervention), (2) attention control (relaxation meditation), and control (no intervention). Subjects in the in…

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Self-management and peer support among people with arthritis on a hospital joint replacement waiting list: a randomised controlled trial.

Introduction: To evaluate the efficacy of a self-management support program including a 6 week self-management course, individualised phone support and goal setting in osteoarthritis patients on a waiting list for arthroplasty surgery. Method: Randomised controlled trial of 152 public hospital outpatients awaiting hip or knee replacement surgery who were not classified as requiring urgent surgery. Participants were randomised to a self-management program or to usual care. The primary outcome was change in the Health Education Intervention Questionnaire (HeiQ) from randomisation to 6 month follow-up. Quality of life and depressive symptoms were also measured. Changes in pain and function were assessed using the Western Ontario and McMaster Universities (WOMAC) Arthritis Index. Results: At 6 month follow-up, health-directed behaviour was significantly greater in the intervention [mean 4.29…

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Online psychoeducational support for infertile women: a randomized controlled trial.

Background: The study goal was to develop and test the effectiveness of a brief online education and support program for female infertility patients. Methods: A randomized-controlled trial was conducted. Using a Solomon-four group design, 190 female patients were recruited from three US fertility centers and were randomized into two experimental and two no-treatment control groups. The psychological outcomes assessed included infertility distress, infertility self-efficacy, decisional conflict, marital cohesion and coping style. Program dosage and satisfaction were also assessed at four weeks follow-up. Results: Women exposed to the online program significantly improved in the area of social concerns (P = 0.038) related to infertility distress, and felt more informed about a medical decision with which they were contending (P = 0.037). Trends were observed for decreased global stress(P =…

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A randomized trial of interpersonal therapy versus supportive therapy for social anxiety disorder.

Seventy patients seeking treatment for social anxiety disorder (SAD) were randomly assigned to 14 weekly individual sessions of interpersonal therapy (IPT) or supportive therapy (ST). We hypothesized that IPT, a psychotherapy with established efficacy for depression and other psychiatric disorders, would lead to greater improvement than ST. Patients in both groups experienced significant improvement from pretreatment to posttreatment. However, improvement with IPT was not superior to improvement with ST. Mean scores on the Liebowitz Social Anxiety Scale decreased from 67.7 to 46.9 in the IPT group and 64.5 to 49.8 in the ST group. There were also no differences in proportion of responders between IPT and ST. Only for a scale measuring concern about negative evaluation (Brief Fear of Negative Evaluation Scale) was IPT superior. Limitations of this initial controlled trial of IPT include a…

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The role of engagement in a tailored web-based smoking cessation program: randomized controlled trial.

Background: Web-based programs for health promotion, disease prevention, and disease management often experience high rates of attrition. There are 3 questions which are particularly relevant to this issue. First, does engagement with program content predict long-term outcomes? Second, which users are most likely to drop out or disengage from the program? Third, do particular intervention strategies enhance engagement? Objective: To determine: (1) whether engagement (defined by the number of Web sections opened) in a Web-based smoking cessation intervention predicts 6-month abstinence, (2) whether particular sociodemographic and psychographic groups are more likely to have lower engagement, and (3) whether particular components of a Web-based smoking cessation program influence engagement. Methods: A randomized trial of 1866 smokers was used to examine the efficacy of 5 different treatme…

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Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial.

Background: The treatment of perinatal depression is a public-health priority because of its high prevalence and association with disability and poor infant development. We integrated a cognitive behaviour therapy-based intervention into the routine work of community-based primary health workers in rural Pakistan and assessed the effect of this intervention on maternal depression and infant outcomes. Methods: We randomly assigned 40 Union Council clusters in rural Rawalpindi, Pakistan, in equal numbers to intervention or control. Married women (aged 16-45 years) in their third trimester of pregnancy with perinatal depression were eligible to participate. In the intervention group, primary health workers were trained to deliver the psychological intervention, whereas in the control group untrained health workers made an equal number of visits to the depressed mothers. The primary outcomes…

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Can social capital be intentionally generated? a randomized trial from rural South Africa.

While much descriptive research has documented positive associations between social capital and a range of economic, social and health outcomes, there have been few intervention studies to assess whether social capital can be intentionally generated. We conducted an intervention in rural South Africa that combined group-based microfinance with participatory gender and HIV training in an attempt to catalyze changes in solidarity, reciprocity and social group membership as a means to reduce women's vulnerability to intimate partner violence and HIV. A cluster randomized trial was used to assess intervention effects among eight study villages. In this paper, we examined effects on structural and cognitive social capital among 845 participants and age and wealth matched women from households in comparison villages. This was supported by a diverse portfolio of qualitative research. After two …

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Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: a randomized efficacy trial.

In this depression prevention trial, 341 high-risk adolescents (mean age = 15.6 years, SD = 1.2) with elevated depressive symptoms were randomized to a brief group cognitive-behavioral (CB) intervention, group supportive-expressive intervention, bibliotherapy, or assessment-only control condition. CB participants showed significantly greater reductions in depressive symptoms than did supportive-expressive, bibliotherapy, and assessment-only participants at posttest, though only the difference compared with assessment controls was significant at 6-month follow-up. CB participants showed significantly greater improvements in social adjustment and reductions in substance use at posttest and 6-month follow-up than did participants in all 3 other conditions. Supportive-expressive and bibliotherapy participants showed greater reductions in depressive symptoms than did assessment-only controls …

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The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: a randomised controlled trial from Goa, India.

Objectives: To develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. Methodology and principal findings: This was a randomised controlled trial in which the person with dementia-caregiver dyad was randomly allocated either to receive the intervention immediately or to a waiting list group which received the intervention after 6 months. It was carried out in communities based in two talukas (administrative blocks) in Goa, India. Mild to moderate cases with dementia (diagnosed using the DSM IV criteria and graded using the Clinical Dementia Rating scale) and their caregivers were included in the trial. Community based intervention provided by a team consisting of Home Care Advisors who were supervised by a counselor and a psychiatrist, focusing o…

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Psychosocial intervention for family caregivers of people with dementia reduces caregiver's burden: development and effect after 6 and 12 months.

A number of different intervention programmes have been described in the literature for caregivers of people with dementia, but the nature of intervention has varied widely. The aim of the present study was to evaluate the efficacy of psychosocial intervention on family caregiver's level of burden and satisfaction, and possible influence of the caregiver's relationship and health and the patient's severity of the disease on the effects of intervention. All persons, 70 years and older, from two districts of a municipality (2721 individuals) who were in receipt of any form of social services were invited to participate in a screening of cognitive decline, and 1656 home visits were made. Those with symptoms of cognitive decline, and having a family caregiver, were invited for a further medical examination. Data were analysed from 308 family caregivers: 153 caregivers who underwent intervent…

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Role of home visiting in improving parenting and health in families at risk of abuse and neglect: results of a multicentre randomised controlled trial and economic evaluation.

Objectives: To evaluate the effectiveness and cost effectiveness of an intensive home visiting programme in improving outcomes for vulnerable families. Design: Multicentre randomised controlled trial in which eligible women were allocated to receive home visiting (n = 67) or standard services (n = 64). Incremental cost analysis. Setting: 40 general practitioner practices across 2 counties in the UK. Participants: 131 vulnerable pregnant women. Intervention: Selected health visitors were trained in the Family Partnership Model to provide a weekly home visiting service from 6 months antenatally to 12 months postnatally. Main outcome measures: Mother-child interaction, maternal psychological health attitudes and behaviour, infant functioning and development, and risk of neglect or abuse. Results: At 12 months, differences favouring the home-visited group were observed on an independent asse…

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Randomized clinical trial of a family intervention for prostate cancer patients and their spouses.

Background: Few intervention studies have been conducted to help couples manage the effects of prostate cancer and maintain their quality of life. The objective of this study was to determine whether a family-based intervention could improve appraisal variables (appraisal of illness or caregiving, uncertainty, hopelessness), coping resources (coping strategies, self-efficacy, communication), symptom distress, and quality of life in men with prostate cancer and their spouses. Methods: For this clinical trial, 263 patient-spouse dyads were stratified by research site, phase of illness, and treatment; then, they were randomized to the control group (standard care) or the experimental group (standard care plus a 5-session family intervention). The intervention targeted couples' communication, hope, coping, uncertainty, and symptom management. The final sample consisted of 235 couples: 123 co…

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Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial).

Background: Studies have shown that a proportion of children as young as two years are already overweight. This indicates that obesity prevention programs that commence as early as possible and are family-focused are needed. This Healthy Beginnings Trial aims to determine the efficacy of a community-based randomized controlled trial (RCT) of a home visiting intervention in preventing the early onset of childhood overweight and obesity. The intervention will be conducted over the first two years of life to increase healthy feeding behaviours and physical activity, decrease physical inactivity, enhance parent-child interaction, and hence reduce overweight and obesity among children at 2 and 5 years of age in the most socially and economically disadvantaged areas of Sydney, Australia. Methods/design: This RCT will be conducted with a consecutive sample of 782 first time mothers with their n…

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Resilience and transitions from dementia caregiving.

Longitudinal studies have documented how dementia caregivers adapt to their role. Less is known about how resilience (defined as lower or higher perceived burden in the face of frequent care demands) affects key dementia caregiving outcomes. The present study utilized data from 1,979 dementia caregivers over a 3-year period to ascertain whether resilience influences transitions from dementia caregiving, such as institutionalization, care recipient death, or loss to follow-up. Multinomial logistic regression models revealed that high baseline resilience (low burden, high care demands) was associated with less frequent institutionalization and loss to follow-up as well as more frequent care recipient mortality. The findings suggest the need for researchers to capture the heterogeneity of caregiver resilience when examining the longitudinal implications of informal long-term care and delive…

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Reducing emotional distress in people caring for patients receiving specialist palliative care. Randomised trial.

Background: Caring for relatives with advanced cancer may cause psychological and physical ill health. Aims: To evaluate the effectiveness of increased support for distressed, informal carers of patients receiving palliative care. Method: The sample was composed of 271 informal carers who scored over 5 on the 28-item General Health Questionnaire (GHQ-28). The intervention comprised six weekly visits by a trained advisor. Primary outcome was carer distress (GHQ-28) at 4-week, 9-week and 12-week follow-up. Secondary outcomes were carer strain and quality of life, satisfaction with care, and bereavement outcome. Results: Scores on the GHQ-28 fell below the threshold of 5/6 in a third of participants in each trial arm at any follow-up point. Mean scores in the intervention group were lower at all time points but these differences were not significant. No difference was observed in secondary …

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Reducing conduct problems among children brought to women's shelters: intervention effects 24 months following termination of services.

This study evaluated the long-term effects of Project SUPPORT, an intervention designed to reduce conduct problems among children in domestically violent families. Participating mothers had sought shelter because of domestic violence and had at least one child (4-9 years old) exhibiting clinical levels of conduct problems. Results indicated that at 2 years posttreatment, 15% of children in families in the Project SUPPORT condition exhibited clinical levels of conduct problems compared with 53% of those in the existing services condition. In addition, mothers of children in the Project SUPPORT condition reported their children to be happier, to have better social relationships, and to have lower levels of internalizing problems, relative to children in the comparison condition. Mothers in the Project SUPPORT condition were less likely to use aggressive child management strategies and were…

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An intervention to increase father involvement and skills with infants during the transition to parenthood.

This study examined whether a group educational intervention during the transition to parenthood can enhance the quality of father-child interaction and increase father involvement with their children. A randomized experimental design was used to evaluate an 8-session program with 165 couples who were first-time parents, beginning during the second trimester of pregnancy and ending at 5 months postpartum. Outcomes were assessed with time diaries, coded observations of parent-child play, and self-reports of fathers and mothers. The intervention had positive effects on fathers' skills in interacting with their babies and their involvement on work days but not home days. It is concluded that a relatively brief intervention during the transition to parenthood can improve fathering, and possible reasons for differential effects on areas of parenting are explored.

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Randomized trial of the Early Start program of home visitation: parent and family outcomes.

Objective: To examine the extent to which the Early Start program of home visitation had beneficial consequences in the areas of maternal health, family functioning, family economic circumstances, and exposure to stress and adversity. Methods: The study used a randomized, controlled trial design in which 220 families receiving the Early Start program were contrasted with a control series of 223 families not receiving the program. Families were enrolled in the program after population screening conducted by community health nurses. Families were enrolled in the program for up to 36 months. Outcomes were assessed at 6, 12, 24, and 36 months after trial entry. Results: There was a consistent lack of association between maternal and family outcomes and group membership. There were no significant differences between the Early Start and control series in any comparisons. Conclusions: This eval…

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Controlled trial of prescribed heroin in the treatment of opioid addiction.

Aim: This study aimed to assess the efficacy of the prescription of intravenous diacetylmorphine (DAM) versus oral methadone with medical and psychosocial support, with a view of improving physical and mental health as well as social integration among socially excluded, opioid-dependent individuals for whom standard treatments have failed. Design: This study used an open, randomized controlled trial. Setting: This study took place in Granada, Spain. Participants: Sixty-two opioid-dependent participants were randomized, 31 in each treatment group, and 50 of them were analyzed. The participants were recruited directly from the streets, through peer outreach, in well-known meeting places for drug-addicted individuals. Interventions: Participants in the experimental group received injected DAM, twice a day, plus oral methadone, once a day, for 9 months. The control group received only oral m…

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Impact of coping skills intervention with family caregivers of hospice patients with cancer: a randomized clinical trial.

Background: Family caregivers for cancer patients experience high levels of stress and burden and diminished quality of life (QOL). Interventions to improve coping skills of caregivers have been shown to be effective with other populations, but their impact has not been assessed in the difficult context of hospice care. The purpose of this study was to determine whether hospice plus a coping skill training intervention improved family caregivers' QOL, burden, coping, and mastery, compared with hospice plus emotional support, and usual hospice care. Methods: A three group randomized controlled trial was conducted including baseline, 16 day, and 30 day assessments conducted from March 1999 to May 2003. The sample consisted of 354 family caregivers of community dwelling hospice patients with advanced cancer. Patient/caregiver dyads were randomly divided into three groups, including a contro…

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