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There is a considerable disparity between clinical practice and recommendations based on meta-analyses of antipsychotic polypharmacy in clozapine resistant schizophrenia. For this reason, we investigated the clinical response to reducing the use olanzapine that had been previously added on clozapine treatment among seriously ill hospitalized patients. In a randomized controlled trial with crossover design, we studied volunteer patients (N=15) who had olanzapine added on to clozapine in a state mental hospital. Clozapine monotherapy was just as effective as clozapine-olanzapine therapy, according to results from Clinical Global Impression Scale and Global Assessment of Functioning as primary outcome measures. Polypharmacy is widely used in treating schizophrenia, and usually, add-on medications are started because of worsening of the clinical state. A major confounding feature of these add-ons is whether observed improvements are caused by the medication or explained by the natural fluctuating course of the disorder. The present study, in spite of its small size, indicates the necessity of reconsidering the value of polypharmacy in treating schizophrenia.

The purpose of this paper is to conduct systematic reviews on Indonesian papers, to examine the most recent evidence of the efficacy of the combination of cognitive training and physical exercise, and to make recommendations in order to improve prevention, care and treatment services in elderly patients with mild cognitive impairment (MCI).

The databases of Cochrane, Medline, NIH (US National Library Medicine), ProQuest, EbscoHost, Clinical Key, EMBASE, Medical Librarian (TWE) in Ovid, Science Direct, Scopus, The Lancet Global Health, PubMed, Emerald, Indonesian National Library, Google Scholar, Google Indonesia, and Garuda Portal were systematically searched using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to obtain empirical papers published between June 1976 and January 2018.

Out of the 3,293 articles collected, 10 were included in this analysis. The result of this combined meta-analysis compares the combination therapy group (cognitive therapy and physical exercise) with a control group. It shows that the control group was likely to experience MCI 1.65 times more often than the combination therapy group. According to the result acquired from the synthesized meta-analysis, the control group experienced MCI 1.65 times higher than the combination therapy. The finding is proven to be statistically significant (95% CI= 1.42–1.93).

The research considers only English and Indonesian articles.

It is important to explore the most effective training characteristics in a special combined intervention differentiated by the duration, frequency, intervention, type and combination mode. There is a need for further investigation that focuses on the physiological mechanisms underlying the positive effects, by inserting a more comprehensive neuro-imaging measurement to assess specifically the domain that benefits in terms of cognitive functions and molecular markers. Finally, exploratory studies are definitely required, which will specifically examine maintenance and treatment effects as well as derive theoretical explanations related to the interventions and predictors.

A combination of cognitive training and physical exercise intervention may improve the global health or cognitive functions.

A combination of cognitive training and physical exercise has been found to improve prevention, care and treatment services in elderly patients with MCI. There is an increase in value in comparison to the study of Karssemeijer, which considered five Indonesian articles.

The purpose of this paper is to evaluate an English Proficiency (EP) programme and its efficacy with respect to students' academic performance in a university within a multi-lingual context, as the programme had been in effect for some years.

A quasi-experimental approach was used to study the efficacy of an EP programme in a university within a multilingual context. Data across two academic years were used, along with regression discontinuity design.

Results suggest that the EP programme had a significant and positive intervention effect on students' initial semester grade point average. The programme effect size was found to be medium to large.

It might be useful to extend the study for one more year for more concrete conclusions. As the study was anchored upon the structure of the 2016 EP programme, any major curricular/structural change to the programme warrants another study.

This study demonstrated that the implementation of EP programmes in higher education institutions is essential not only for international students who are foreign language speakers of English but also for domestic students in English-speaking countries, especially for bi/multilingual speakers.

Previous studies related to the efficacy of EP within higher education have focused on international students who speak English as an additional/foreign language. Further, most studies have focussed on students' self-reported experiences and have yielded disparate findings. This study contributes to scholarship as it addresses the under-researched area related to domestic students who speak English as the first language in a bi/multi-lingual context.

To date, little research has been undertaken to test the effectiveness of team coaching, with past work focusing on models, frameworks and competencies. This study aimed to examine the effectiveness of team coaching within real world organizational teams and its impact on individual perceptions of team cohesion and psychological safety.

A randomized control trial (RCT) using the comparable interventions: (1) team coaching (intervention) and (2) team facilitation (control) was employed with multiple teams and multiple facilitators, measuring the impact on team cohesion and psychological safety.

The data indicate participants engaging in the team coaching intervention made greater gains in terms of their individual perceptions of psychological safety and team cohesion than individuals who received the team facilitation intervention (T1–T2).

Facilitators should apply a team coaching approach when seeking to address issues of cohesion and psychological safety within workplace teams.

This study provides the first evidence, using an RCT method, of the effectiveness of team coaching as a workplace intervention for enhancing individual perceptions of psychological safety and team cohesion.

This paper evaluates the implementation of a school-based physical activity intervention and discusses how the intervention outcomes can be influenced by the implementation.

In four of the nine lower secondary schools in which the intervention was conducted, the authors examined implementation fidelity, adaptation, quality, responsiveness and dose received. The authors conducted focus group interviews with teachers (n = 8) and students (n = 46) and made observations. Dose delivered was examined quantitatively, with weekly registrations.

Results showed that two out of four schools made few and positive adaptations, implemented the intervention with high fidelity and quality and responded positively. Four main factors were found to influence implementation: frame factors, intervention characteristics, participant characteristics and provider characteristics.

A cross-sectional design was used and may not represent implementation throughout the whole school year.

In terms of large-scale implementation, the intervention may be generalizable. However, intervention criteria such as adequate facilities and a flexible timetable may be unattainable for some schools. The intervention can be adapted without compromising its purpose, but adaptations should be a result of cooperation between students and teachers.

Process evaluations on this topic are rare. This study adds to a limited knowledge base concerning what factors may influence implementation of school-based physical activity interventions for adolescents.

Goal setting is a crucial aspect of client-centered practice in occupational therapy (OT) for mental health conditions. However, it remains to be seen how goal-setting has been delivered in mental health, particularly the OT process. The purpose of this scoping review was to explore the nature and extent of goal setting delivered in mental health and informed OT practice.

The authors followed the guidelines of Arksey and O’Malley (2005) and searched three databases using key search terms: “mental disorder,” “goal setting,” and “occupational therapy” and their synonyms.

After excluding duplicate records, the authors initially screened 883 records and resulted in 20 records in total after the screening process. Most of the identified articles used goal-setting delivered by both a health professional and a client (n = 14), and focused on people with schizophrenia or schizoaffective disorder (n = 13), but three interventions were delivered by occupational therapists. Further research needs on goal-setting in mental health OT, exploring the reliability and validity of different goal-setting strategies and investigating the effectiveness of goal-setting for promoting behavior change and client engagement across various mental health conditions and settings.

The scoping review has some limitations, such as not investigating the validity and reliability of goal-setting strategies identified, and excluding conference papers and non-English articles.

This scoping review presents a mapping of how goal-setting has been delivered in mental health and informed OT practice. The findings suggest limited research in OT and highlight the need for more studies to address the evidence gap in individualized client-centered OT.

This article reports the results of a randomized field experiment that tested the effects of a new business intervention among managers of small- and medium-sized enterprises (SMEs) in England.

Individual managers (learners) were randomly assigned in clusters (companies) to either an intervention group (265 learners; 40 SMEs) receiving a novel virtual, blended training program designed to stimulate a change in management behavior or a no-intervention group (118 learners; 22 SMEs).

The results show that the primary objective of changing management behavior to use more of an Operational Coaching™ style of management has been achieved (to a statistically significant level), and this is against the backdrop of the devastating COVID-19 pandemic. Positive trends in SME productivity metrics were also observed in the intervention group companies.

These important results could be indicative of the economic and productivity impact that a change in management behavior could have, and they warrant serious further investigation.

Contract farming (CF) is seen as a tool for creating new market opportunities hence increasing incomes for smallholder farmers. Critics, however, argue that CF is likely to pass risks to small scale farmers, thus favouring large scale farmers at the expense of smallholder farmers. The purpose of this paper is to examine the effect of CF on smallholder farmers’ income using a case study of avocado farmers in Kandara district in Kenya.

The study uses data collected from 100 smallholder avocado farmers in Kandara district in Kenya and employs an instrumental variable model (Probit-2SLS) to control for endogeneity in participation in the contract and examine the effect of CF on household, farm and avocado income.

The results indicate that participation in CF is not sufficient to improve household, farm and avocado income. Question remains regarding efficient implementation of CF arrangements to promote spill over effects on other household enterprises.

The research was carried out using farmers in Kandara district in Kenya as a case study, findings might therefore not reflect the status of CF in all countries.

The paper contributes to the growing debate on the effect of value chain upgrading strategies such as contracting on smallholder farmers’ welfare. The form of contracting studied in this paper differs from the standard contracts in that the key stakeholders (producers) are loosely enjoined in the contract through officials of their groups.

Reluctance to change therapy has clinical and economic implications. Therapists are expected to deliver treatment in a oneto-one setting ending up with patient improvement. Such an achievement is difficult to overview. There is great uncertainty as to what works in psychotherapies despite research efforts. Prolonged treatment duration with little positive effect may be caused by factors inherent in therapist and patient and the external environment. Two cases are discussed illustrating the need for better surveillance of what happens in the therapy room. Responsibility for the progress in therapy rests on the shoulders of the therapist. When therapy becomes detrimental to patient and therapist, we do not have a comprehensive system to interfere or help. Delayed recovery emanates as an increase in costs to society and the family. This is the case when return to work after treatment is partly or completely retarded.

This study examines the adoption drivers of scale-appropriate mechanization in Nepal's maize-based farming systems. The authors also assess the contribution of scale-appropriate mechanization to the United Nations Sustainable Development Goals (SDGs) of zero hunger (SDG2) and no poverty (SDG1).

Propensity score matching and doubly robust inverse probability-weighted regression adjusted methods were applied to estimate the effects of mini-tiller adoption. These methods control the biases that arise from observed heterogeneities between mini-tillers users and nonusers.

The study findings show that farm size, labor shortages, draft animal scarcity, market proximity, household assets and household heads' educational level influence the adoption of mechanization in Nepal. Mechanized farms exhibited enhanced maize productivity, profits and household food self-sufficiency. Reduced depth and severity of poverty were also observed. Nevertheless, these effects were not uniform; very small farms (≤0.41 ha) facing acute labor shortages benefited the most.

The study results suggest that policymakers in developing nations like Nepal may wish to expand their emphasis on scale-appropriate mechanization to improve farm productivity and household food security, reduce poverty and contribute to the SDGs.

This first-of-its-kind study establishes the causal effects between scale-appropriate farm mechanization and SDG1 (no poverty) and SDG2 (zero hunger) in a developing nation.