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Sample records for case management intervention

  1. Arbitration Intervention Worker (AIW) Services: Case Management Overlay in a Juvenile Diversion Program

    ERIC Educational Resources Information Center

    Poythress, Norman G.; Dembo, Richard; DuDell, Gary; Wareham, Jennifer

    2006-01-01

    In this issue we describe a clinical trials study of the impact of adding specific case manager overlay services to "treatment as usual" services for youths in a Juvenile Arbitration Program. In this first article we describe the experimental intervention, the Arbitration Intervention Worker (AIW) service, which was provided to a randomly selected…

  2. Nurse Case Management and Housing Interventions Reduce Allergen Exposures: The Milwaukee Randomized Controlled Trial

    PubMed Central

    Breysse, Jill; Wendt, Jean; Dixon, Sherry; Murphy, Amy; Wilson, Jonathan; Meurer, John; Cohn, Jennifer; Jacobs, David E.

    2011-01-01

    Objective We examined the impact of a combination of home environmental interventions and nurse case management services on total settled dust loadings and on allergen concentrations in the homes of asthmatic children. Methods Using a randomized longitudinal controlled trial study design, we randomly assigned homes of asthmatic children in Milwaukee to either a control (n=64) or an intervention (n=57) group. Control group homes received a visual assessment, education, bed/pillow dust mite encasings, and treatment of lead-based paint hazards. The intervention group received these same services plus nurse case management that included tailored, individual asthma action plans, provision of minor home repairs, home cleaning using special vacuuming and wet washing, and integrated pest management. Dust vacuum samples were collected from measured surface areas of floors in the TV room, kitchen, and child's bedroom at baseline and at three-, six-, and 12-month follow-up visits. Dust loading (mass per surface area) is a means of measuring total dust and the total amount of allergen present. Results For the intervention group, geometric mean dust loadings declined significantly from baseline (39 milligrams per square foot [mg/ft2]) to post-intervention (11 mg/ft2) (p<0.001). Baseline dust loading, treatment group, visit, and season were significant predictors of follow-up dust loadings. Mean post-intervention dust loadings were 72% higher in the control group. The total amount of allergen in settled house dust declined significantly following the intervention because total dust loading declined; the concentration of allergens in settled dust did not change significantly. Conclusion The combination of nurse case management and home environmental interventions promotes collaboration between health and housing professionals and is effective in reducing exposures to allergens in settled dust. PMID:21563716

  3. Childhood tuberculosis deskguide and monitoring: An intervention to improve case management in Pakistan

    PubMed Central

    2011-01-01

    Background Childhood tuberculosis (TB) has been a neglected area in national TB control programme (NTCP) in high burden countries. The NTP Pakistan adapted the global approaches by developing and piloting its policy guideline on childhood TB in ten districts of the country. We developed an intervention package including a deskguide and a monitoring tool and tested with the ongoing childhood TB care in a district. The objective of our study was to measure effectiveness of intervention package with deskguide and monitoring tool by comparing TB case finding and treatment outcomes among districts in 2008, and performance assessment in intervention district. Method An intervention study with cohort design within a routine TB control programme comparing case findings and treatment outcomes before and after the intervention, and in districts with and without intervention. We enrolled all children below 15 years registered at all nine public sector hospitals in three districts of Pakistan. The data was collected from hospital TB records. Results In eight months during 2007 there were 164 childhood TB cases notified, and after intervention in 2008 a total of 194 cases were notified. In intervention district case finding doubled (110% increase) and correct treatment practice significantly increased in eight months. Successful outcomes were significantly higher in intervention district (37,100%) compared to control district A (18, 18%, p < 0.05) and control district B (41, 72%, p < 0.05). Conclusion Childhood TB deskguide and structured monitoring was associated with improved case management and it augmented NTP policy. More development and implementation in all health services of the district are indicated. PMID:21831308

  4. Parents' Perspectives: An Evaluation of Case Management Interventions in Home Visiting Programs for Young Children

    ERIC Educational Resources Information Center

    Allen, Susan F.

    2007-01-01

    In home visiting programs for children younger than age three, home visitors work with parents to enhance the child's environment. This study examined how the home visitor-parent relationship, amount of contact, and level of need affected the intensity of case management interventions received. Researchers interviewed 90 mothers to measure the…

  5. Effect of diabetic case management intervention on health service utilization in Korea.

    PubMed

    Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George

    2015-12-01

    This study is to estimate the effectiveness of a diabetic case management programme on health-care service utilization. The study population included 6007 as the intervention group and 956,766 as the control group. As the indicators of health-care service utilization, numbers of medical ambulatory consultations, days of medication prescribed and medical expenses for one year were used, and we analysed the claim data of the health insurance from 2005 to 2007. The study population was classified into three subgroups based on the number of medical ambulatory consultations per year before this intervention. In the under-serviced subgroup, the intervention group showed a significant increase in the number of consultations (3.2), days of prescribed medication (66.4) and medical expenses (287,900 KRW) compared with the control group. Conversely, in the over-serviced subgroup, the intervention group showed a less decrease days of prescribed medication (1.6) compared with the control group. This showed that the case management programme led the intervention group to optimize their utilization of health-care services by subgroups. It is necessary to evaluate the appropriateness of health-care usage and clinical outcome to show the direct effectiveness of the case management programme by subgroups. PMID:24821209

  6. Beyond police crisis intervention: moving "upstream" to manage cases and places of behavioral health vulnerability.

    PubMed

    Wood, Jennifer D; Beierschmitt, Laura

    2014-01-01

    Law enforcement officers continue to serve on the front lines as mental health interventionists, and as such have been subject to a wave of "first generation" reform designed to enhance their crisis response capabilities. Yet, this focus on crisis intervention has not answered recent calls to move "upstream" and bolster early intervention in the name of long-term recovery. This paper reports on findings from an action research project in Philadelphia aimed at exploring opportunities for enhanced upstream engagement. Study methods include spatial analyses of police mental health transportations from an eight year period (2004-2011) and qualitative data from twenty-three "framing conversations" with partners and other stakeholders, seven focus groups with police and outreach workers, five key informant interviews as well as document reviews of the service delivery system in Philadelphia. Recommendations include the need to move beyond a focus on what police can do to a wider conception of city agencies and business stakeholders who can influence vulnerable people and vulnerable spaces of the city. We argue for the need to develop shared principles and rules of engagement that clarify roles and stipulate how best to enlist city resources in a range of circumstances. Since issues of mental health, substance use and disorder are so tightly coupled, we stress the importance of establishing a data-driven approach to crime and disorder reduction in areas of the city we term "hotspots of vulnerability". In line with a recovery philosophy, such an approach should reduce opportunities for anti-social behavior among the "dually labeled" in ways consistent with "procedural justice". Furthermore, crime and disorder data flowing from police and security to behavioral health analysts could contribute to a more focused case management of "repeat utilizers" across the two systems. Our central argument is that a twin emphasis on "case management" and "place management" may provide

  7. Ayurvedic intervention in the management of uterine fibroids: A Case series

    PubMed Central

    Dhiman, Kamini

    2014-01-01

    Uterine enlargement is common in reproductive life of a female. Other than pregnancy, it is seen most frequently in the result of leiomyomas. Leiomyomas, are benign smooth muscle neoplasmas that typically originate from the myometrium, due to fibrous consistency and are also called as fibroid. They may be identified in asymptomatic women during routine pelvic examination or may cause symptoms. Typical complaints include pain, pressure sensations, dysmenorrhea or abnormal uterine bleeding. Management of uterine fibroid through surgery is available to meet urgent need of the patient, but challenges remain to establish a satisfactory conservatory medical treatment till date. Hence, it was critically reviewed in the context of Granthi Roga (disease) and treatment protocol befitting the Samprapti Vighatana of Granthi (encapsulated growth) was subjected in patients of uterine fibroids. Seven cases of uterine fibroid were managed by Ayurvedic intervention. Ultrasonography (USG) of the lower abdomen was the main investigative/diagnostic tool in this study. After 7 weeks, patients presented with USG report as absence of uterine fibroid. Ayurvedic formulations Kanchanara Guggulu, Shigru Guggulu, and Haridra Khand are found to be effective treatment modality in uterine fibroid. PMID:26664240

  8. Ayurvedic intervention in the management of uterine fibroids: A Case series.

    PubMed

    Dhiman, Kamini

    2014-01-01

    Uterine enlargement is common in reproductive life of a female. Other than pregnancy, it is seen most frequently in the result of leiomyomas. Leiomyomas, are benign smooth muscle neoplasmas that typically originate from the myometrium, due to fibrous consistency and are also called as fibroid. They may be identified in asymptomatic women during routine pelvic examination or may cause symptoms. Typical complaints include pain, pressure sensations, dysmenorrhea or abnormal uterine bleeding. Management of uterine fibroid through surgery is available to meet urgent need of the patient, but challenges remain to establish a satisfactory conservatory medical treatment till date. Hence, it was critically reviewed in the context of Granthi Roga (disease) and treatment protocol befitting the Samprapti Vighatana of Granthi (encapsulated growth) was subjected in patients of uterine fibroids. Seven cases of uterine fibroid were managed by Ayurvedic intervention. Ultrasonography (USG) of the lower abdomen was the main investigative/diagnostic tool in this study. After 7 weeks, patients presented with USG report as absence of uterine fibroid. Ayurvedic formulations Kanchanara Guggulu, Shigru Guggulu, and Haridra Khand are found to be effective treatment modality in uterine fibroid. PMID:26664240

  9. Anger Management Interventions

    ERIC Educational Resources Information Center

    Lochman, John E.; Palardy, Nicole R.; McElroy, Heather K.; Phillips, Nancy; Holmes, Khiela J.

    2004-01-01

    Two anger management interventions for aggressive children, Anger Coping and Coping Power, are described in this review article, including conceptual underpinnings, session format and content, and outcome research findings. Important issues and considerations in the implementation of such interventions are also presented. Overall, Anger Coping and…

  10. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial

    PubMed Central

    Anderson, Jacqueline; Dolk, Anders; Torgerson, Jarl; Nyberg, Svante; Skau, Tommy; Forsberg, Birger C.; Werr, Joachim; Öhlen, Gunnar

    2016-01-01

    Background A small group of frequent visitors to Emergency Departments accounts for a disproportionally large fraction of healthcare consumption including unplanned hospitalizations and overall healthcare costs. In response, several case and disease management programs aimed at reducing healthcare consumption in this group have been tested; however, results vary widely. Objectives To investigate whether a telephone-based, nurse-led case management intervention can reduce healthcare consumption for frequent Emergency Department visitors in a large-scale setup. Methods A total of 12 181 frequent Emergency Department users in three counties in Sweden were randomized using Zelen’s design or a traditional randomized design to receive either a nurse-led case management intervention or no intervention, and were followed for healthcare consumption for up to 2 years. Results The traditional design showed an overall 12% (95% confidence interval 4–19%) decreased rate of hospitalization, which was mostly driven by effects in the last year. Similar results were achieved in the Zelen studies, with a significant reduction in hospitalization in the last year, but mixed results in the early development of the project. Conclusion Our study provides evidence that a carefully designed telephone-based intervention with accurate and systematic patient selection and appropriate staff training in a centralized setup can lead to significant decreases in healthcare consumption and costs. Further, our results also show that the effects are sensitive to the delivery model chosen. PMID:25969342

  11. Case management.

    PubMed

    Rosenstein, A H; Propotnik, T

    1997-03-01

    Providing cost-effective high quality healthcare services ranks as the number one concern for anyone involved with the healthcare delivery system. While quality of care should always be the number one priority, controlling healthcare costs receives most of the attention. With limited healthcare dollars and providers assuming more of the financial risk for services rendered, a whole assortment of cost-containment strategies are being introduced in an effort to maintain some semblance of financial viability. Healthcare providers can approach cost control from two different angles. On the fixed-cost operational overhead side, traditional cost-containment techniques have focused on downsizing, maximizing productivity, staffing redesign, improved purchasing contracts, standardization, inventory control, and other more individualized restructured service models. On the variable-cost clinical side, cost control has been approached by introducing a variety of cost-containment strategies designed to improve efficiency and effectiveness of provider performance. While many of these strategies, previously discussed in the Journal of Healthcare Resource Management have stressed the importance of education, guidelines, pathways, and other clinical "tools for improvement," the success of many of these tools resides in the ability to provide real-time intervention. Real-time intervention rather than the more passive retrospective variance analysis has the greatest potential for producing cost savings by actually making a recommendation that prevents the unwanted event from occurring. In many institutions, the case manager bears the responsibility for monitoring and managing these programs. This article describes various case management models currently used by different institutions. PMID:10166062

  12. Population-based worksite obesity management interventions: a qualitative case study.

    PubMed

    Romney, Martha C; Thomson, Erin; Kash, Kathryn

    2011-06-01

    Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify. PMID:21323459

  13. Acceptability and Feasibility of a Mobile Phone-Based Case Management Intervention to Retain Mothers and Infants from an Option B+ Program in Postpartum HIV Care.

    PubMed

    Schwartz, Sheree R; Clouse, Kate; Yende, Nompumelelo; Van Rie, Annelies; Bassett, Jean; Ratshefola, Mamothe; Pettifor, Audrey

    2015-09-01

    The objective of this study was to assess the acceptability and feasibility of a cell phone based case manager intervention targeting HIV-infected pregnant women on highly-active antiretroviral therapy (HAART). Pregnant women ≥36 weeks gestation attending antenatal care and receiving HAART through the Option B+ program at a primary care clinic in South Africa were enrolled into a prospective pilot intervention to receive text messages and telephone calls from a case manager through 6 weeks postpartum. Acceptability and feasibility of the intervention were assessed along with infant HIV testing rates and 10-week and 12-month postpartum maternal retention in care. Retention outcomes were compared to women of similar eligibility receiving care prior to the intervention. Fifty women were enrolled into the pilot from May to July 2013. Most (70%) were HAART-naive at time of conception and started HAART during antenatal care. During the intervention, the case manager sent 482 text messages and completed 202 telephone calls, for a median of 10 text messages and 4 calls/woman. Ninety-six percent completed the postpartum interview and 47/48 (98%) endorsed the utility of the intervention. Engagement in 10-week postpartum maternal HIV care was >90% in the pre-intervention (n = 50) and intervention (n = 50) periods; by 12-months retention fell to 72% and was the same across periods. More infants received HIV-testing by 10-weeks in the intervention period as compared to pre-intervention (90.0 vs. 63.3%, p < 0.01). Maternal support through a cell phone based case manager approach was highly acceptable among South African HIV infected women on HAART and feasible, warranting further assessment of effectiveness. PMID:25656728

  14. Interim Evaluation of the Pilot Program of the Truancy Case Management Partnership Intervention in the District of Columbia

    ERIC Educational Resources Information Center

    Liberman, Akiva; Cahill, Meagan; Cramer, Lindsey

    2012-01-01

    The Case Management Partnership Initiative (CMPI) addresses chronic truancy by linking truant ninth graders and their families to social services and case management, along with regular interagency case management meetings. A pilot was conducted at Anacostia and Ballou High Schools in 2011-2012. The implementation evaluation found that the pilot…

  15. Nonpharmacologic interventions for pain management.

    PubMed

    Doody, S B; Smith, C; Webb, J

    1991-03-01

    Managing pain is a complex and inexact science. Acute and chronic pain physically and psychologically affects and disables an overwhelming number of people. Nonpharmacologic interventions for pain management have been reviewed. These methods can be used independently or in combination with other nonpharmacologic or pharmacologic methods of pain control. The goals of nonpharmacologic interventions for pain management include the reduction of pain, minimal adverse effects, and allowing patients to become active participants in their own care. Nurses are called on many times to comfort patients in pain. It is through their expertise and intervention that the goals of pain management succeed. PMID:2043331

  16. Beyond police crisis intervention: Moving “upstream” to manage cases and places of behavioral health vulnerability

    PubMed Central

    Wood, Jennifer; Beierschmitt, Laura

    2014-01-01

    Law enforcement officers continue to serve on the front lines as mental health interventionists, and as such have been subject to a wave of “first generation” reform designed to enhance their crisis response capabilities. Yet, this focus on crisis intervention has not answered recent calls to move “upstream” and bolster early intervention in the name of long-term recovery. This paper reports on findings from an action research project in Philadelphia aimed at exploring opportunities for enhanced upstream engagement. Study methods include spatial analyses of police mental health transportations from an eight year period (2004–2011) and qualitative data from twenty-three “framing conversations” with partners and other stakeholders, seven focus groups with police and outreach workers, five key informant interviews as well as document reviews of the service delivery system in Philadelphia. Recommendations include the need to move beyond a focus on what police can do to a wider conception of city agencies and business stakeholders who can influence vulnerable people and vulnerable spaces of the city. We argue for the need to develop shared principles and rules of engagement that clarify roles and stipulate how best to enlist city resources in a range of circumstances. Since issues of mental health, substance use and disorder are so tightly coupled, we stress the importance of establishing a data-driven approach to crime and disorder reduction in areas of the city we term “hotspots of vulnerability”. In line with a recovery philosophy, such an approach should reduce opportunities for anti-social behavior among the “dually labeled” in ways consistent with “procedural justice”. Furthermore, crime and disorder data flowing from police and security to behavioral health analysts could contribute to a more focused case management of “repeat utilizers” across the two systems. Our central argument is that a twin emphasis on “case management” and

  17. School-Based Case Management: An Integrated Service Model for Early Intervention with Potential Dropouts. A Series of Solutions and Strategies. Number 10.

    ERIC Educational Resources Information Center

    Smith, Albert J., Jr.

    This publication introduces school personnel concerned with early intervention with potential school dropouts to a promising school-based interprofessional case management model that has been successfully field-tested in 25 very different elementary school communities of Idaho and Washington State over the past 7 years: C-STARS (Center for the…

  18. The Impact of Integrated Community Case Management of Childhood Diseases Interventions to Prevent Malaria Fever in Children Less than Five Years Old in Bauchi State of Nigeria

    PubMed Central

    Abegunde, Dele; Orobaton, Nosa

    2016-01-01

    Background Malaria accounts for about 300,000 childhood deaths and 30% of under-five year old mortality in Nigeria annually. We assessed the impact of intervention strategies that integrated Patent Medicines Vendors into community case management of childhood-diseases, improved access to artemisinin combination therapy (ACT) and distributed bed nets to households. We explored the influence of household socioeconomic characteristics on the impact of the interventions on fever in the under-five year olds in Bauchi State Nigeria. Methods A cross-sectional case-controlled, interventional study, which sampled 3077 and 2737 under-5 year olds from 1,588 and 1601 households in pre- and post-intervention periods respectively, was conducted from 2013 to 2015. Difference-in-differences and logistic regression analyses were performed to estimate the impact attributable to the interventions: integrated community case management of childhood illness which introduced trained public and private sector health providers and the possession of nets on the prevalence of fever. Results Two-week prevalence of fever among under-fives declined from 56.6% at pre-intervention to 42.5% at post-intervention. Fever-prevention fraction attributable to nets was statistically significant (OR = 0.217, 95% CI: 0.08–0.33). Children in the intervention group had significantly fewer incidence of fever than children in the control group had (OR = 0.765, 95% CI: 0.67–0.87). Although being in the intervention group significantly provided 23.5% protection against fever (95% CI: 0.13–0.33), the post-intervention likelihood of fever was also significantly less than at pre-intervention (OR = 0.57, 95% CI: 0.50–0.65). The intervention protection fraction against fever was statistically significant at 43.4% (OR = 0.434, 95% CI: 0.36–0.50). Logistic regression showed that the odds of fever were lower in households with nets (OR = 0.72, 95% CI: 0.60–0.88), among children whose mothers had higher

  19. Medical management after parathyroid intervention

    PubMed Central

    Tanaka, Motoko; Fukagawa, Masafumi

    2008-01-01

    Vitamin D or vitamin D analogues pulse therapy is seldom effective in patients with at least one parathyroid gland with nodular hyperplasia, and surgical parathyroidectomy or parathyroid intervention is indicated. In parathyroid interventions, especially in selective percutaneous ethanol injection therapy (PEIT), the enlarged parathyroid gland(s) with nodular hyperplasia is selectively destroyed by ethanol injection, while other glands with diffuse hyperplasia are managed by medical therapy. Thus, medical management, e.g., use of appropriate dose of vitamin D or vitamin D analogues after the PEIT procedure, is as important as the destruction of the hyperplastic tissue itself. Recent studies showed that the combination of PEIT and intravenous vitamin D pulse therapy lead to reduce serum PTH level and calcium-phosphorus products in haemodialysis patients. In this article, we focus on the importance of medical therapy after PEIT, and review the efficacy of the combination of PEIT and intravenous vitamin D pulse therapy for haemodialysis patients with secondary hyperparathyroidism. PMID:25983966

  20. “Puestow modified procedure in the era of advanced endoscopic interventions for the management of chronic lithiasic pancreatitis. A two cases report”

    PubMed Central

    Fragulidis, Georgios P.; Vezakis, Αntonios; Dellaportas, Dionissios; Sotirova, Ira; Koutoulidis, Vassilis; Kontis, Elliseos; Polydorou, Andreas

    2015-01-01

    Introduction Pancreatic duct calculi in chronic pancreatitis (CP) patients are the main cause of intractable pain which is their main symptom. Decompression options of for the main pancreatic duct are both surgical and advanced endoscopic procedures. Presentation of cases A 64-year-old male with known CP due to alcohol consumption and a 36-year-old female with known idiopathic CP and pancreatic duct calculi were managed recently in our hospital where endoscopic procedures were unsuccessful. A surgical therapy was considered and a longitudinal pancreaticojejunostomy (modified Puestow procedure) in both patients was performed with excellent results. Discussion Over the last 30 years, endoscopic procedures are developed to manage pancreatic duct strictures and calculi of the main pancreatic duct in CP patients. In both of our cases endoscopic therapy was first attempted but failed to extract the pancreatic duct stones, due to their size and speculations. Modified Puestow procedure was performed for both and it was successful for long term pain relief. Conclusion Despite advancement in endoscopic interventions and less invasive therapies for the management of chronic lithiasic pancreatitis we consider that classic surgical management can be appropriate in certain cases. PMID:26318135

  1. Interventional management for complications following caesarean section

    PubMed Central

    Ko, S Y; Park, S W; Sohn, I S; Lee, J Y; Kwon, H S; Hwang, H S; Jung, S I

    2011-01-01

    Objectives This study aimed to evaluate the efficacy and safety of interventional management for various intractable complications following caesarean section. Methods Between August 2005 and September 2009, 18 consecutive women were referred to interventional radiology for treatment of complications developing after caesarean section. Complications included vaginal bleeding (n = 14), haemoperitoneum with abdominal wall haematoma (n = 2), caesarean scar pregnancy (CSP) (n = 1) and post-caesarean fluid collection (n = 1). Results 17 women underwent transcatheter arterial embolisation (TAE) with a variety of embolic materials, and two women underwent percutaneous drainage (PCD) for fluid collection and haemoperitoneum. 5 of the 14 women with vaginal bleeding had extravasation of contrast media on angiography; the other 9 had no visible bleeding foci. The two women with haemoperitoneum with abdominal wall haematoma had injury to the inferior epigastric artery from angiography. TAE and PCD were successfully performed in both women. The CSP was successfully managed and the serum β-human chorionic gonadotropin (β-hCG) level finally normalised. Hysterectomy or dilatation and curretage was required in women with placenta accrete and undetectable bleeding foci. Conclusion Interventional management including TAE and PCD is effective and safe in controlling complications following caesarean section. Use of these procedures can help avoid high-risk surgery, but subsequent procedures including hysterectomy may be required in cases of placental abnormalities and undetectable bleeding foci. PMID:20959367

  2. Cryoanalgesia in interventional pain management.

    PubMed

    Trescot, Andrea M

    2003-07-01

    Cryoneuroablation, also known as cryoanalgesia or cryoneurolysis, is a specialized technique for providing long-term pain relief in interventional pain management settings. Modern cryoanalgesia traces its roots to Cooper et al who developed in 1961, a device that used liquid nitrogen in a hollow tube that was insulated at the tip and achieved a temperature of - 190 degrees C. Lloyd et al proposed that cryoanalgesia was superior to other methods of peripheral nerve destruction, including alcohol neurolysis, phenol neurolysis, or surgical lesions. The application of cold to tissues creates a conduction block, similar to the effect of local anesthetics. Long-term pain relief from nerve freezing occurs because ice crystals create vascular damage to the vasonervorum, which produces severe endoneural edema. Cryoanalgesia disrupts the nerve structure and creates wallerian degeneration, but leaves the myelin sheath and endoneurium intact. Clinical applications of cryoanalgesia extend from its use in craniofacial pain secondary to trigeminal neuralgia, posterior auricular neuralgia, and glossopharyngeal neuralgia; chest wall pain with multiple conditions including post-thoracotomy neuromas, persistent pain after rib fractures, and post herpetic neuralgia in thoracic distribution; abdominal and pelvic pain secondary to ilioinguinal, iliohypogastric, genitofemoral, subgastric neuralgia; pudendal neuralgia; low back pain and lower extremity pain secondary to lumbar facet joint pathology, pseudosciatica, pain involving intraspinous ligament or supragluteal nerve, sacroiliac joint pain, cluneal neuralgia, obturator neuritis, and various types of peripheral neuropathy; and upper extremity pain secondary to suprascapular neuritis and other conditions of peripheral neuritis. This review describes historical concepts, physics and equipment, various clinical aspects, along with technical features, indications and contraindications, with clinical description of multiple conditions

  3. Unique patient issues: early interventions and management.

    PubMed

    Combelles, Catherine

    2012-06-01

    Patient cases that present with recurring fertilization failure or complete abnormality in either the oocytes or sperm before fertilization are uncommon, yet they are devastating. This review presents several such instances, including oocyte maturation blocks, empty follicle syndrome, oocyte activation failures, defects in sperm phospholipase C isoform ζ, sperm structural anomalies, spontaneous oocyte activation, and unexplained cases. Diagnostic efforts have not only provided insight into possible etiologies but also have helped manage such challenging cases. Interventions may comprise cellular, molecular, or genetic analyses of gametes, as well as functional assays and/or modified treatment strategies. Consequently, infertility professionals can increasingly rely on evidence-based counseling with respect to prognosis and treatment options. PMID:22585636

  4. External Nursing Applications in the Supportive Management of Prolonged Postoperative Ileus: Description of Interventions and Case Report.

    PubMed

    Deckers, Bernhard; von Schoen-Angerer, Tido; Voggenreiter, Bernd; Vagedes, Jan

    2016-01-01

    Prolonged postoperative ileus is a common but clinically challenging problem that leads to patient discomfort and prolonged hospitalization; the condition is managed through a multimodular program of supportive measures. In anthroposophic nursing, the management of prolonged postoperative ileus involves additional tools, including external abdominal compresses and massages with plant or silver-containing oils and ointments. We describe 3 typical techniques: Oxalis tincture compresses, Thuja/Argentum ointment compresses, and massage with "Wala Melissenöl" (containing Melissa officinalis, Carvum cari, Foeniculum amari, and Origanum majorana). A 61-year-old man with chronic pain from adhesions after multiple abdominal surgical procedures developed a prolonged postoperative ileus after an elective ileostomy reversal. Following slow recovery during the first postoperative days, he began vomiting. A nasogastric tube was inserted, and daily Oxalis tincture compresses and massage with "Wala Melissenöl" and Thuja/Argentum ointment compresses were applied on the abdomen. The patient's symptoms gradually improved over the next 10 days. No prokinetic medications were needed to manage this episode. External abdominal nursing applications with plant substances and silver can be an additional tool in the management of prolonged postoperative ileus. PMID:27309410

  5. Managing Case Managers: Case Management in Service Integration. Resource Brief.

    ERIC Educational Resources Information Center

    Marks, Ellen L.

    As the case management approach has become increasingly popular, a new phenomenon has emerged. A client may have several case managers, each employed by a different project, and these managers may not be aware of each other. The National Center for Children in Poverty has recently conducted research on case management in service integration…

  6. Interagency Intervention: A Case Study.

    ERIC Educational Resources Information Center

    West-Stern, Jane

    The paper reviews the legal basis for interagency collaboration in providing services to the handicapped, notes the rationale for such an approach, and examines the obstacles encountered in an interagency intervention project for emotionally disturbed children and adolescents. The Cheltenham Project, an interdisciplinary approach featuring a…

  7. Self-management interventions for chronic illness.

    PubMed

    Newman, Stanton; Steed, Liz; Mulligan, Kathleen

    An increasing number of interventions have been developed for patients to better manage their chronic illnesses. They are characterised by substantial responsibility taken by patients, and are commonly referred to as self-management interventions. We examine the background, content, and efficacy of such interventions for type 2 diabetes, arthritis, and asthma. Although the content and intensity of the programmes were affected by the objectives of management of the illness, the interventions differed substantially even within the three illnesses. When comparing across conditions, it is important to recognise the different objectives of the interventions and the complexity of the issues that they are attempting to tackle. For both diabetes and asthma, the objectives are concerned with the underlying control of the condition with clear strategies to achieve the desired outcome. By contrast, strategies to deal with symptoms of pain and the consequences of disability in arthritis can be more complex. The interventions that were efficacious provide some guidance as to the components needed in future programmes to achieve the best results. But to ensure that these results endure over time remains an important issue for self-management interventions. PMID:15500899

  8. "Tuberculosis Case Management" Training.

    ERIC Educational Resources Information Center

    Knebel, Elisa; Kolodner, Jennifer

    2001-01-01

    The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to practice acquired skills in a simulated…

  9. Case Management Directors

    PubMed Central

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations

  10. Modeling sustainable groundwater management: packaging and sequencing of policy interventions.

    PubMed

    Esteban, Encarna; Dinar, Ariel

    2013-04-15

    Of the many studies estimating effectiveness of policy reforms most have been considering various types of policy reforms in isolation from each other. Such pattern has also been the case in water resource regulations. In the case of groundwater almost all policy interventions considered in the literature have been implemented individually, without taking into account the possible interactions and impacts among them. In this paper, we focus on two policy instruments: water quota and uniform water tax. The paper demonstrates how packaging and sequencing sets of policy interventions, with possible triggers to initiate their time of implementation, may be more effective in achieving a sustainable groundwater management than single policies when environmental externalities exist. The policy instruments are applied to the Western la Mancha aquifer in Southeast Spain, a major aquifer that is managed by a command and control approach. PMID:23467104

  11. Case Management Directors

    PubMed Central

    Bankston-White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role. We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes. Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them. Findings/Conclusions: Case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another. Implications for Case Management: As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time. To operate most effectively, case management directors must understand the full range of their

  12. Design of a case management model for people with chronic disease (Heart Failure and COPD). Phase I: modeling and identification of the main components of the intervention through their actors: patients and professionals (DELTA-icE-PRO Study)

    PubMed Central

    2010-01-01

    Background Chronic diseases account for nearly 60% of deaths around the world. The extent of this silent epidemic has not met determined responses in governments, policies or professionals in order to transform old Health Care Systems, configured for acute diseases. There is a large list of research about alternative models for people with chronic conditions, many of them with an advanced practice nurse as a key provider, as case management. But some methodological concerns raise, above all, the design of the intervention (intensity, frequency, components, etc). Methods/Design Objectives: General: To develop the first and second phases (theorization and modeling) for designing a multifaceted case-management intervention in people with chronic conditions (COPD and heart failure) and their caregivers. Specific aims: 1) To identify key events in people living with chronic disease and their relation with the Health Care System, from their point of view. 2) To know the coping mechanisms developed by patients and their caregivers along the story with the disease. 3) To know the information processing and its utilization in their interactions with health care providers. 4) To detect potential unmet needs and the ways deployed by patients and their caregivers to resolve them. 5) To obtain a description from patients and caregivers, about their itineraries along the Health Care System, in terms of continuity, accessibility and comprehensiveness of care. 6) To build up a list of promising case-management interventions in patients with Heart Failure and COPD with this information in order to frame it into theoretical models for its reproducibility and conceptualization. 7) To undergo this list to expert judgment to assess its feasibility and pertinence in the Andalusian Health Care. Design: Qualitative research with two phases: For the first five objectives, a qualitative technique with biographic stories will be developed and, for the remaining objectives, an expert

  13. Management of Dysfunctional Catheters and Tubes Inserted by Interventional Radiology

    PubMed Central

    Huang, Steven Y.; Engstrom, Bjorn I.; Lungren, Matthew P.; Kim, Charles Y.

    2015-01-01

    Minimally invasive percutaneous interventions are often used for enteral nutrition, biliary and urinary diversion, intra-abdominal fluid collection drainage, and central venous access. In most cases, radiologic and endoscopic placement of catheters and tubes has replaced the comparable surgical alternative. As experience with catheters and tubes grows, it becomes increasingly evident that the interventional radiologist needs to be an expert not only on device placement but also on device management. Tube dysfunction represents the most common complication requiring repeat intervention, which can be distressing for patients and other health care professionals. This manuscript addresses the etiologies and solutions to leaking and obstructed feeding tubes, percutaneous biliary drains, percutaneous catheter nephrostomies, and drainage catheters, including abscess drains. In addition, we will address the obstructed central venous catheter. PMID:26038615

  14. Case Management: A Resource Manual.

    ERIC Educational Resources Information Center

    Adams, Anne Thomas; Franklin, Sundra; Taylor, Rebecca

    This resource manual has been developed to assist both case managers and management staff in implementing a case management system as an infrastructure for delivering services that will facilitate the positive growth and development of youth and the achievement of individual and organizational performance goals. (The goal of case managers is to…

  15. [Peri-interventional management of acute endovascular stroke treatment].

    PubMed

    Schönenberger, S; Bösel, J

    2015-10-01

    Due to the ground breaking consistent evidence that supports the effect of endovascular stroke treatment (EST), many acute care hospitals and stroke centers will have to be prepared to provide this treatment in an optimal way within the coming years. In addition to the intervention itself, patient preparation, stabilization and monitoring during the treatment as well as the aftercare represent significant challenges and have mostly not yet been sufficiently investigated. Under these aspects, the questions of optimal sedation and airway management have received the highest attention. Based on retrospective study results it already seems to be justified, respecting certain criteria, to prefer EST with the patient under conscious sedation (CS) in comparison to general anesthesia (GA) and to only switch to GA in cases of emergency until this question has been clarified by prospective studies. This and other aspects of peri-interventional management, such as logistics, monitoring, blood pressure, ventilation settings, postprocedural steps of intensive or stroke unit care and imaging follow-up are summarized in this overview. The clinical and radiological selection of patients and thus the decision for intervention or technical aspects of the intervention itself will not be part of this article. PMID:26311331

  16. Lessons Learned through Implementing a Positive Behavior Support Intervention at Home: A Case Study on Self-Management with a Student with Autism and His Mother

    ERIC Educational Resources Information Center

    Lee, Suk-Hyang; Poston, Denise; Poston, A. J.

    2007-01-01

    As positive behavior support (PBS) interventions have received increased attention as an effective means to address problem behaviors of individuals with disabilities in family contexts, partnerships with families are crucial for the application of PBS interventions with families at home. Understanding family perspectives on problem behaviors and…

  17. Bleeding Scrotal Vascular Lesions: Interventional Management with Transcatheter Embolization

    SciTech Connect

    Jaganathan, Sriram; Gamanagatti, Shivanand Mukund, Amar; Dhar, Anita

    2011-02-15

    Vascular lesions of the scrotum are uncommon; the most common among them are varicocele lesions. The other vascular lesions that may involve the scrotum are hemangioma, lymphangioma, and arteriovenous malformations, which are exceedingly rare. The imaging modalities useful in the diagnosis and management of scrotal vascular lesions are grayscale sonography, color Doppler sonography, magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography. We present two cases of scrotal vascular lesions involving the extratesticular scrotal soft tissues. Patients presented with bleeding and were treated by radiological interventional technique. We emphasize the importance of superselective catheterization and distal embolization.

  18. Angiographic and Interventional Management for a Esophagopericardial Fistula

    SciTech Connect

    Wu, Keng You, Qiong He, Song-Jian; Mo, Hai-Liang

    2013-06-19

    We reported a case of a 78-year-old patient with esophagopericardial fistula who was referred for angiographic and interventional management. Emergent implantation of the esophageal stent could not lengthen or even save the patient’s life. One week later, the patient died of multiple organ failure, which was probably from formation of granulation tissue and stent migration. Therefore, if the inflammatory to the esophagopericardial fistula had been better controlled initially, and the implantation of the esophageal stent delayed, our patient would have survived.

  19. Principles of Empirically Supported Interventions Applied to Anger Management

    ERIC Educational Resources Information Center

    Deffenbacher, Jerry L.; Oetting, Eugene R.; DiGiuseppe, Raymond A.

    2002-01-01

    This article applies the Principles of Empirically Supported Interventions (PESI) in counseling psychology to anger management with adults. The review suggests that there is empirical support for cognitive-behavioral interventions generally and for four specific interventions (relaxation, cognitive, behavioral skill enhancement, and combinations…

  20. Diversity in case management modalities: the Summit model.

    PubMed

    Peterson, G A; Drone, I D; Munetz, M R

    1997-06-01

    Though ubiquitous in community mental health agencies, case management suffers from a lack of consensus regarding its definition, essential components, and appropriate application. Meaningful comparisons of various case management models await such a consensus. Global assessments of case management must be replaced by empirical studies of specific interventions with respect to the needs of specific populations. The authors describe a highly differentiated and prescriptive system of case management involving the application of more than one model of service delivery. Such a diversified and targeted system offers an opportunity to study the technology of case management in a more meaningful manner. PMID:9211044

  1. Integration of interventional bronchoscopy in the management of lung cancer.

    PubMed

    Guibert, Nicolas; Mazieres, Julien; Marquette, Charles-Hugo; Rouviere, Damien; Didier, Alain; Hermant, Christophe

    2015-09-01

    Tracheal or bronchial proximal stenoses occur as complications in 20-30% of lung cancers, resulting in a dramatic alteration in quality of life and poor prognosis. Bronchoscopic management of these obstructions is based on what are known as "thermal" techniques for intraluminal stenosis and/or placement of tracheal or bronchial prostheses for extrinsic compressions, leading to rapid symptom palliation in the vast majority of patients. This invasive treatment should only be used in cases of symptomatic obstructions and in the presence of viable bronchial tree and downstream parenchyma. This review aims to clarify 1) the available methods for assessing the characteristics of stenoses before treatment, 2) the various techniques available including their preferred indications, outcomes and complications, and 3) the integration of interventional bronchoscopy in the multidisciplinary management of proximal bronchial cancers and its synergistic effects with the other specific treatments (surgery, radiotherapy or chemotherapy). PMID:26324799

  2. A Case Management and Family Support Handbook: Lessons Learned from the Development and Implementation of Marin City Families First, an Early Intervention Program.

    ERIC Educational Resources Information Center

    Lally, J. Ronald; And Others

    Families First, an early intervention program implemented in Marin City, California, was designed to integrate and coordinate the provision of a wide range of services to families of children in a low-income, mostly African-American community, from the third trimester of pregnancy to 8 years of age. The program is intended to enhance the…

  3. Case management's value is finally recognized. What happens now? .

    PubMed

    2015-10-01

    In recent years, case management has been recognized as a key in improving healthcare quality and reducing costs, but while hospitals are giving case managers more responsibilities, many administrators are not approving an increase in staff to handle the extra work. Case managers can help their hospital succeed with the Centers for Medicare & Medicaid Services' Value-based Purchasing program, the readmission reduction program, and bundled payments. Case management directors should make sure the hospital's senior leadership understands the roles and responsibilities of case managers and how their interventions can affect outcomes and the bottom line. The number of caseloads depends on the case management model, the responsibilities of case managers, and whether they have assistants or case management extenders who can take over some tasks and allow the licensed staff to work at the top of their licenses. Don't let technology replace communication and patient-centered interactions. PMID:26427224

  4. Case management: a management system for quality and cost effective outcomes.

    PubMed

    Dees, J P; Anderson, N L

    1996-08-01

    1. Case management is an effective strategy for occupational health nurses to use to reduce corporate health insurance, workers' compensation, and disability expenditures. 2. Case management has evolved from a reactive to a proactive strategy useful in many arenas. While there are differences among group health, workers' compensation, and disability, the basic case management process is the same. 3. Early intervention and comprehensive assessment are the foundation of a successful case management process. 4. Occupational health nurses have extensive clinical, interpersonal, and management skills enabling them to excel as case managers. PMID:8852236

  5. Role of Interventional Radiology in the Emergent Management of Acute Upper Gastrointestinal Bleeding

    PubMed Central

    Navuluri, Rakesh; Patel, Jay; Kang, Lisa

    2012-01-01

    Approximately 100,000 cases of upper gastrointestinal bleeding (UGIB) require inpatient admission annually in the United States. When medical management and endoscopic therapy are inadequate, endovascular intervention can be lifesaving. These emergent situations highlight the importance of immediate competence of the interventional radiologist in the preangiographic evaluation as well as the endovascular treatment of UGIB. We describe a case of UGIB managed with endovascular embolization and detail the angiographic techniques used. The case description is followed by a detailed discussion of the treatment approach to UGIB, with attention to both nonvariceal and variceal algorithms. PMID:23997408

  6. Is surgical intervention avoidable in cases of emphysematous gastritis? A case presentation and literature review

    PubMed Central

    Szuchmacher, Mauricio; Bedford, Tyler; Sukharamwala, Prashant; Nukala, Melanie; Parikh, Neil; DeVito, Peter

    2013-01-01

    INTRODUCTION Gas located within the gastric wall is a rare finding that is associated with a mortality rate of 50%. It confers two main diagnoses: gastric emphysema and emphysematous gastritis. Due to its high mortality rate, emphysematous gastritis must be differentiated from gastric emphysema early to avoid adverse outcomes and plan the management of these patients. PRESENTATION OF CASE We introduce a 55 year-old male who presents with diffuse abdominal pain associated with fever, nausea, vomiting, and diarrhea. Patient has positive peritoneal signs with fever and leukocytosis. Air in the gastric wall and portal venous system was visualized on Computed Tomography (CT). The patient underwent emergent laparotomy which showed normal bowel with few adhesions. DISCUSSION Various etiologies can cause gas within the gastric wall but concomitant air in the hepatic venous system is highly suspicious for emphysematous gastritis. CT imaging is the most sensitive and specific way to differentiate emphysematous gastritis versus gastric emphysema. Although rare, there are many cases of emphysematous gastritis that undergo prompt surgical exploration. Recently, however, medical treatment has become more common and surgical management reserved for complications. CONCLUSION We conclude by stating that this case of emphysematous gastritis, due to gastric ulcers, would have no difference in outcome if treated medically instead of surgically. Historically, patients with emphysematous gastritis warranted surgical intervention. More recently, case reports of emphysematous gastritis are favoring conservative management. The consensus still remains that there is no standard approach for these patients and most patients in extremis are undergoing surgical intervention. PMID:23537915

  7. Interventional Radiology in the Management of Budd Chiari Syndrome

    SciTech Connect

    Beckett, David; Olliff, Simon

    2008-09-15

    Budd Chiari syndrome is an uncommon condition in the Western world but interventional radiology can contribute significantly to the management of the majority of patients. This review examines the role and technique of interventions including hepatic vein dilatation and stent insertion as well as thrombolysis and TIPS. Liver transplantation and surgical shunt surgery are discussed in relation to radiological interventions. With appropriate selection and technique, surgery is only required in a minority of patients.

  8. Management of vitiligo patients with surgical interventions.

    PubMed

    Shokeen, Divya

    2016-05-01

    Vitiligo is an acquired depigmentation disorder of unknown etiology. Medical treatments are usually reasonably effective for nonstable vitiligo patches; however, for vitiligo patches that have been stable for a substantial period of time, surgical intervention should be considered. In this article, surgical interventions for vitiligo are reviewed, including split-thickness skin grafting, suction blister grafting, miniature punch grafting, and cultured melanocyte transplantation. PMID:27274556

  9. Demonstrating the Experimenting Society Model with Classwide Behavior Management Interventions.

    ERIC Educational Resources Information Center

    Johnson, Taya C.; Stoner, Gary; Green, Susan K.

    1996-01-01

    Demonstrates the experimenting society model using data-based decision making and collaborative consultation to evaluate behavior-management intervention strategies in 25 seventh graders. Each intervention results in improved behavior, but active teaching of classroom rules was determined to be most effective. (Author/JDM)

  10. A Case Study of a "Double-Dose" Mathematics Intervention

    ERIC Educational Resources Information Center

    Kratofil, Michelle Dahlsten

    2014-01-01

    The purpose of this case study was to discover and describe the components of a "double-dose" math intervention that resulted in increased mathematics achievement for high school Algebra I intervention participants in an effort to inform local decisions regarding program improvements and to provide insight to other educators…

  11. Choosing among Techniques for Quantifying Single-Case Intervention Effectiveness

    ERIC Educational Resources Information Center

    Manolov, Rumen; Solanas, Antonio; Sierra, Vicenta; Evans, Jonathan J.

    2011-01-01

    If single-case experimental designs are to be used to establish guidelines for evidence-based interventions in clinical and educational settings, numerical values that reflect treatment effect sizes are required. The present study compares four recently developed procedures for quantifying the magnitude of intervention effect using data with known…

  12. Boosting Reading Fluency: An Intervention Case Study at Subword Level

    ERIC Educational Resources Information Center

    Kairaluoma, Leila; Ahonen, Timo; Aro, Mikko; Holopainen, Leena

    2007-01-01

    This study is an intervention case study of fluency in Finnish-speaking children with dyslexia. Two 7-year-old children, a girl and a boy, were selected from the Jyvaskyla Longitudinal Study of Dyslexia. The intervention emphasised syllables as reading units, and proceeded from reading syllables to reading words and text. Letter knowledge, reading…

  13. Aortic Dissection Caused by Percutaneous Coronary Intervention: 2 New Case Reports and Detailed Analysis of 86 Previous Cases

    PubMed Central

    Bajaj, Sharad; Shamoon, Fayez

    2016-01-01

    Aortic dissection, a rare sequela of percutaneous coronary intervention, can be fatal when it is not recognized and treated promptly. Treatment varies from conservative management to invasive aortic repair and revascularization. We report the cases of 2 patients whose aortic dissection was caused by percutaneous coronary intervention. In addition, we present detailed analyses of 86 previously reported cases. Aortic dissection was most often seen during intervention to the right coronary artery (in 76.7% of instances). The 2 most frequently reported causes were catheter trauma (in 54% of cases) and balloon inflation (in 23.8%). The overall mortality rate was 7.1%. We conclude that most patients can be treated conservatively or by means of stenting alone, with no need for surgical intervention. PMID:27047287

  14. Self-Management Support Interventions for Persons With Chronic Disease

    PubMed Central

    Franek, J

    2013-01-01

    outcomes: There was a small, statistically significant improvement in favour of CDSMP across all healthy behaviours, including aerobic exercise, cognitive symptom management, and communication with health care professionals (GRADE quality low). Self-efficacy: There was a small, statistically significant improvement in self-efficacy in favour of CDSMP (GRADE quality low). Health care utilization outcomes: There were no statistically significant differences between modalities with respect to visits with general practitioners, visits to the emergency department, days in hospital, or hospitalizations (GRADE quality very low). All results were measured over the short term (median 6 months of follow-up). Limitations Trials generally did not appropriately report data according to intention-to-treat principles. Results therefore reflect “available case analyses,” including only those participants whose outcome status was recorded. For this reason, there is high uncertainty around point estimates. Conclusions The Stanford CDSMP led to statistically significant, albeit clinically minimal, short-term improvements across a number of health status measures (including some measures of health-related quality of life), healthy behaviours, and self-efficacy compared to usual care. However, there was no evidence to suggest that the CDSMP improved health care utilization. More research is needed to explore longer-term outcomes, the impact of self-management on clinical outcomes, and to better identify responders and non-responders. Plain Language Summary Self-management support interventions are becoming more common as a structured way of helping patients learn to better manage their chronic disease. To assess the effects of these support interventions, we looked at the results of 10 studies involving a total of 6,074 people with various chronic diseases, such as arthritis and chronic pain, chronic respiratory diseases, depression, diabetes, heart disease, and stroke. Most trials focused

  15. Decreasing Students' Stress through Time Management Training: An Intervention Study

    ERIC Educational Resources Information Center

    Häfner, Alexander; Stock, Armin; Oberst, Verena

    2015-01-01

    The aim of this study was to examine the effects of a time management training program on perceived control of time and perceived stress in the context of higher education. Twenty-three undergraduate students attended a time management training intervention and reported demands, perceived stress and perceived control of time directly before 2 and…

  16. Managing uncertainty in complex interventional fluoroscopic procedures.

    PubMed

    Leuenberger, Ronald; Meade, Jason A

    2014-11-01

    There was a concern for potential patient skin burns indicated by air kerma as recorded by fluoroscopy equipment during two interventional fluoroscopic procedures. Two sentinel events as defined by The Joint Commission were indicated. Dose reconstruction based on measurements of machine output showed the air kerma readings were high by approximately a factor of four and no patient injury or sentinel event occurred. The radiation safety program in effect at the time of the incidents allowed discovery of equipment problems before a serious patient injury occurred, but additional controls have been implemented as a result, including quality control checks performed by cardiology, additional training, a database for tracking equipment maintenance, and mandatory entry of patient dose into electronic health records with follow-up orders automatically generated by the electronic health records. Most unexpected injuries are a result of multiple failures, but there are also multiple opportunities to prevent the injury. This paper provides a comprehensive look at patient safety concerns during two interventional cardiology fluoroscopic procedures and offers ways to further reduce risks to patients. It focuses on lessons learned and a systems-based approach to improving and promoting radiation safety during complex interventional fluoroscopic procedures. PMID:25272028

  17. Successful management of dislodged stents during percutaneous coronary intervention.

    PubMed

    Farman, Muhammad Tariq; Sial, Jawaid Akbar; Saghir, Tahir; Rizvi, Syed Nadeem Hasan; Rasool, Syed Ishtiaq; Jamal, Syed Zahid

    2010-02-01

    Stent dislodgement is a very rare but recognized and potentially serious complication of percutaneous coronary intervention (PCI). This case series describe the incidence and etiology of such cases at National Institute of Cardiovascular Diseases, Karachi during the year 2008 and the method of treatment of this complication. PMID:20209706

  18. Exercise intervention for management of obesity.

    PubMed

    Deusinger, Susan S

    2012-01-01

    Obesity touches the lives of most Americans regardless of age. In adults, accrual of co-morbidities, including frank disability, impacts health in ways that mandate aggressive public health action. In children, the rising prevalence of overweight and obesity raises serious prospective concerns for life as these children enter adulthood. Action is imperative to provide medical interventions and preventive strategies to reduce the threat this condition poses to future generations. Obesity primarily results from an energy regulation imbalance within the body; understanding its origin and effects requires considering both the intake (via eating) and output (via moving) of energy. This article focuses on how exercise and physical activity (i.e., energy output) can influence the primary condition of obesity and its health sequelae. Components, strategies, and expected outcomes of exercise and lifestyle activity are addressed. Successful long-term participation in daily movement requires matching exercise regimens and physical activity outlets to individual preferences and environmental conditions. Activity habits of Americans must change at home and in the workplace, schools and the community to positively influence health. Although the goals of Healthy People 2010 to reduce sedentary behavior have not been met, success of other public health interventions (e.g., immunizations, use of bicycle helmets) suggests that social change to alter activity habits can be achieved. Failure to reach our public health goals should serve as a catalyst for broad-based action to help children, adolescents, and adults attain and maintain behaviors that reduce the risk of obesity and its health insults. PMID:22009641

  19. Development and Implementation of a Telehealth-Enhanced Intervention for Pain and Symptom Management

    PubMed Central

    Eaton, Linda H.; Gordon, Debra B.; Wyant, Sheryl; Theodore, Brian R.; Meins, Alexa R.; Rue, Tessa; Towle, Cara; Tauben, David; Doorenbos, Ardith Z.

    2014-01-01

    Managing chronic pain effectively is often challenging for health care providers and patients. Telehealth technologies can bridge geographic distance and improve patients' quality of care in communities where access to pain specialists has previously been unavailable. This paper describes the development and evaluation of a telehealth intervention (TelePain) designed to address the need for pain specialist consultation regarding pain and symptom management issues in non-academic medical centers. We describe the theoretical foundation and development of a multifaceted intervention using a cluster randomized clinical trial design. Health care providers and their patients with chronic pain are enrolled in the study. Patient participants receive the intervention (report of symptoms and receipt of a pain graph) weekly for 8 weeks and are contacted at 12 weeks for completion of post-intervention follow-up measures. Their providers attend Telepain sessions which involve a didactic presentation on an evidence-based topic related to pain management followed by patient case presentations and discussion by community clinicians. Symptom management recommendations for each patient case are made by a panel of pain specialists representing internal medicine, addiction medicine, rehabilitation medicine, anesthesiology, psychiatry, and nursing. The outcomes assessed in this randomized trial focus on pain intensity, pain's interference on function and sleep, and anxiety, depression, and cost-effectiveness. Some of the challenges and lessons that we have learned early in implementing the TelePain intervention are also reported. PMID:24846620

  20. Development and implementation of a telehealth-enhanced intervention for pain and symptom management.

    PubMed

    Eaton, Linda H; Gordon, Debra B; Wyant, Sheryl; Theodore, Brian R; Meins, Alexa R; Rue, Tessa; Towle, Cara; Tauben, David; Doorenbos, Ardith Z

    2014-07-01

    Managing chronic pain effectively is often challenging for health care providers and patients. Telehealth technologies can bridge geographic distance and improve patients' quality of care in communities where access to pain specialists has previously been unavailable. This paper describes the development and evaluation of a telehealth intervention (TelePain) designed to address the need for pain specialist consultation regarding pain and symptom management issues in non-academic medical centers. We describe the theoretical foundation and development of a multifaceted intervention using a cluster randomized clinical trial design. Health care providers and their patients with chronic pain are enrolled in the study. Patient participants receive the intervention (report of symptoms and receipt of a pain graph) weekly for 8 weeks and are contacted at 12 weeks for completion of post-intervention follow-up measures. Their providers attend TelePain sessions which involve a didactic presentation on an evidence-based topic related to pain management followed by patient case presentations and discussion by community clinicians. Symptom management recommendations for each patient case are made by a panel of pain specialists representing internal medicine, addiction medicine, rehabilitation medicine, anesthesiology, psychiatry, and nursing. The outcomes assessed in this randomized trial focus on pain intensity, pain's interference on function and sleep, and anxiety, depression, and cost-effectiveness. Some of the challenges and lessons that we have learned early in implementing the TelePain intervention are also reported. PMID:24846620

  1. Anger Management: Immediate Intervention by Counselor Coach.

    ERIC Educational Resources Information Center

    Besley, Kate R.

    1999-01-01

    Investigates whether a well-defined coaching process used at the moment of anger will help students internalize the cognitive processes learned in counseling sessions and enable them to use the anger management strategies independent of coaching. Offers school counselors reasons to implement such a model as an adjunct to individual or small group…

  2. Non-interventional management of resistant hypertension

    PubMed Central

    Doumas, Michael; Tsioufis, Costas; Faselis, Charles; Lazaridis, Antonios; Grassos, Haris; Papademetriou, Vasilios

    2014-01-01

    Hypertension is one of the most popular fields of research in modern medicine due to its high prevalence and its major impact on cardiovascular risk and consequently on global health. Indeed, about one third of individuals worldwide has hypertension and is under increased long-term risk of myocardial infarction, stroke or cardiovascular death. On the other hand, resistant hypertension, the “uncontrollable” part of arterial hypertension despite appropriate therapy, comprises a much greater menace since long-standing, high levels of blood pressure along with concomitant debilitating entities such as chronic kidney disease and diabetes mellitus create a prominent high cardiovascular risk milieu. However, despite the alarming consequences, resistant hypertension and its effective management still have not received proper scientific attention. Aspects like the exact prevalence and prognosis are yet to be clarified. In an effort to manage patients with resistant hypertension appropriately, clinical doctors are still racking their brains in order to find the best therapeutic algorithm and surmount the substantial difficulties in controlling this clinical entity. This review aims to shed light on the effective management of resistant hypertension and provide practical recommendations for clinicians dealing with such patients. PMID:25349652

  3. What's funny about case management?

    PubMed

    Saxton, S E

    1997-01-01

    Humor is an effective tool to prevent and resolve burnout, a common problem associated with the practice of case management. Easily accessed by almost everyone, humor has many physiological and psychological benefits. The conscious use of humor in an organization requires a commitment at all levels in order for the organization to benefit as a whole. Offering formal seminars, using humor in company newsletters, and encouraging cartoon or joke sharing impacts on the physical and mental health of the employees. Techniques for bringing laughter to the workplace are outlined, as well as examples from the practice of case management. PMID:9335722

  4. Quick management of accidental tritium exposure cases.

    PubMed

    Singh, Vishwanath P; Badiger, N M; Managanvi, S S; Bhat, H R

    2012-07-01

    Removal half-life (RHL) of tritium is one of the best means for optimising medical treatment, reduction of committed effective dose (CED) and quick/easy handling of a large group of workers for medical treatment reference. The removal of tritium from the body depends on age, temperature, relative humidity and daily rainfall; so tritium removal rate, its follow-up and proper data analysis and recording are the best techniques for management of accidental acute tritium exposed cases. The decision of referring for medical treatment or medical intervention (MI) would be based on workers' tritium RHL history taken from their bodies at the facilities. The workers with tritium intake up to 1 ALI shall not be considered for medical treatment as it is a derived limit of annual total effective dose. The short-term MI may be considered for tritium intake of 1-10 ALI; however, if the results show intake ≥100 ALI, extended strong medical/therapeutic intervention may be recommended based on the severity of exposure for maximum CED reduction requirements and annual total effective dose limit. The methodology is very useful for pressurized heavy water reactors (PHWRs) which are mainly operated by Canada and India and future fusion reactor technologies. Proper management will optimise the cases for medical treatment and enhance public acceptance of nuclear fission and fusion reactor technologies. PMID:22349318

  5. [Early Intervention.

    ERIC Educational Resources Information Center

    Pawl, Jeree, Ed.

    1992-01-01

    This newsletter focuses on the theme of early intervention which infants and young children with special needs in nine brief articles: "Early Intervention: A Matter of Context" (Samuel J. Meisels); "Early Intervention Research: Asking and Answering Meaningful Questions" (Jack P. Shonkoff); "From Case Management to Service Coordination: Families,…

  6. Adoption of Self-management Interventions for Prevention and Care

    PubMed Central

    Rotheram-Borus, Mary Jane; Ingram, Barbara L.; Swendeman, Dallas; Lee, Adabel

    2013-01-01

    Seventy-five percent of spiraling healthcare costs can be attributed to chronic diseases, making prevention and management of chronic conditions one of our highest healthcare priorities, especially as we organize for patient-centered medical homes. Collaborative patient self-management in primary care has been repeatedly demonstrated to be efficacious in reducing both symptoms and increasing quality of life, yet there is no consensus on what, how, when, and by whom self-management programs are best implemented. In this article, we argue that self-management interventions effectively span the continuum of prevention and disease management. Self-management interventions rest on a foundation of five core actions: 1) activate motivation to change; 2) apply domain-specific information from education and self-monitoring; 3) develop skills; 4) acquire environmental resources; and 5) build social support. A range of delivery vehicles, including group interventions, primary care providers, and advanced wireless technology, are described and evaluated in terms of diffusion and cost-containment goals. PMID:23148958

  7. Classroom Management: Teacher Training, Attitudes and Beliefs, and Intervention Practices

    ERIC Educational Resources Information Center

    Ladner, Margaret Catherine Davis

    2009-01-01

    This study examined the factors that are associated with teacher classroom management with regard to training, attitudes and beliefs, and intervention practices of general and special education teachers in dealing with classroom control. These factors were examined in general and special education classrooms. The participants for this study were…

  8. Avoiding Procrastination through Time Management: An Experimental Intervention Study

    ERIC Educational Resources Information Center

    Häfner, Alexander; Oberst, Verena; Stock, Armin

    2014-01-01

    The purpose of this study was to examine the effects of a short-term time management intervention on procrastination. Procrastination is a serious issue for many students and associated with different negative consequences, such as anxiety or low grades. As procrastination is described as a self-regulatory failure, a training programme focussing…

  9. Design element alternatives for stress-management intervention websites.

    PubMed

    Williams, Reg A; Gatien, Gary; Hagerty, Bonnie

    2011-01-01

    Typical public and military-sponsored websites on stress and depression tend to be prescriptive. Some require users to complete lengthy questionnaires. Others reproduce printed flyers, papers, or educational materials not adapted for online use. Some websites require users to follow a prescribed path through the material. Stress Gym was developed as a first-level, evidence-based, website intervention to help U.S. military members learn how to manage mild to moderate stress and depressive symptoms using a self-help intervention with progress tracking and 24/7 availablility. It was designed using web-based, health-management intervention design elements that have been proven effective and users reported they prefer. These included interactivity, self-pacing, and pleasing aesthetics. Users learned how to manage stress by accessing modules they choose, and by practicing proven stress management strategies interactively immediately after login. Test results of Stress Gym with Navy members demonstrated that it was effective, with significant decreases in reported perceived stress levels from baseline to follow-up assessment. Stress Gym used design elements that may serve as a model for future websites to emulate and improve upon, and as a template against which to compare and contrast the design and functionality of future online, health-intervention websites. PMID:21684565

  10. Teaching Classroom Management-- A Potential Public Health Intervention?

    ERIC Educational Resources Information Center

    Marlow, Ruth; Hansford, Lorraine; Edwards, Vanessa; Ukoumunne, Obioha C; Norman, Shelley; Ingarfield, Sara; Sharkey, Siobhan; Logan, Stuart; Ford, Tamsin

    2015-01-01

    Purpose: The purpose of this paper is to explore the feasibility of a classroom management course as a public health intervention. Improved socio-emotional skills may boost children's developmental and academic trajectory, while the costs of behaviour problems are enormous for schools with considerable impact on others' well-being.…

  11. Partnership as an Intervention Strategy in Self-Managing Schools.

    ERIC Educational Resources Information Center

    Timperley, Helen S.; Robinson, Viviane M. J.

    2003-01-01

    Describes strategy used by New Zealand Ministry of Education to intervene in 26 self-managing schools by developing a partnership with the schools and their communities. Documents difficulties encountered in the first phase (year one) of the intervention and the successes of the second phase (year two). (Contains 1 figure, 3 tables, and 27…

  12. Nursing case management for children with failure to thrive.

    PubMed

    MacPhee, M; Hoffenberg, E

    1996-01-01

    The case management approach is described for children with nonorganic failure to thrive in the pediatric tertiary care setting. An advanced practice nurse facilitated the organization of a planning committee, the construction of a care path, and the evaluation of the case management model. A 4-day care path is presented to show staff nursing functions in the nurse case manager role. Special issues are discussed for developing care paths for organic-based failure to thrive where parent reports can help guide health care interventions. PMID:8847607

  13. Varicocele – a case for early intervention

    PubMed Central

    Bach, Phil V.; Najari, Bobby B.; Goldstein, Marc

    2016-01-01

    Testicular varicocele, which is defined as the dilation of the veins draining the testicle, has long been associated with a detrimental effect on testicular function. Despite a lack of high-quality, prospective data, recent evidence has shed light on potential links between varicocele and male infertility and serum testosterone levels. Similarly, varicocele repair has increasingly been shown to have a beneficial impact on pregnancy rates, semen parameters, and on improving serum testosterone in adult men. Numerous studies have assessed the optimal technique for varicocele repair and the bulk of the evidence has shown the microsurgical inguinal/subinguinal approach to have the highest success rates, the lowest overall complication rates, and the lowest recurrence rates. The management of varicocele in adolescents remains a clinical conundrum, but contemporary evidence suggests early deleterious effects of varicocele on testicular function in some patients. Well-designed prospective trials are critical to delineate the true impact and role of varicocele repair on male infertility and hypogonadism in adult and adolescent men. PMID:27508071

  14. Varicocele - a case for early intervention.

    PubMed

    Bach, Phil V; Najari, Bobby B; Goldstein, Marc

    2016-01-01

    Testicular varicocele, which is defined as the dilation of the veins draining the testicle, has long been associated with a detrimental effect on testicular function. Despite a lack of high-quality, prospective data, recent evidence has shed light on potential links between varicocele and male infertility and serum testosterone levels. Similarly, varicocele repair has increasingly been shown to have a beneficial impact on pregnancy rates, semen parameters, and on improving serum testosterone in adult men. Numerous studies have assessed the optimal technique for varicocele repair and the bulk of the evidence has shown the microsurgical inguinal/subinguinal approach to have the highest success rates, the lowest overall complication rates, and the lowest recurrence rates. The management of varicocele in adolescents remains a clinical conundrum, but contemporary evidence suggests early deleterious effects of varicocele on testicular function in some patients. Well-designed prospective trials are critical to delineate the true impact and role of varicocele repair on male infertility and hypogonadism in adult and adolescent men. PMID:27508071

  15. Evaluating an online stress management intervention for college students.

    PubMed

    Hintz, Samuel; Frazier, Patricia A; Meredith, Liza

    2015-04-01

    The goal of this study was to assess the feasibility and effectiveness of a theory-based online intervention designed to improve stress management in undergraduate students. The intervention focused on present control because it has been found to be associated with a range of positive outcomes, including lower levels of depression, anxiety, and stress, controlling for a range of other variables (e.g., Frazier et al., 2011, 2012). Two pilot studies were first conducted to confirm that our intervention could increase present control. We then randomly assigned psychology students (n = 292) who were prescreened to have lower scores on the present control subscale of the Perceived Control Over Stressful Events Scale (Frazier et al., 2011) to 1 of 3 conditions: the present control intervention, the present control intervention plus feedback, and stress-information only. Seventy-six percent (n = 223) began the intervention, and 87% (n = 195) of those completed the posttest and 3-week follow-up. The 2 present control intervention groups had lower levels of stress, depression, and anxiety symptoms (on the Depression Anxiety Stress Scales; Lovibond & Lovibond, 1995) and perceived stress (on the Perceived Stress Scale; Cohen, Kamarck, & Mermelstein, 1983) relative to the stress-information-only group at posttest and 3-week follow-up (mean between group d at follow-up = .35, mean within group d for intervention groups at follow-up = -.46). Further, mediation analyses revealed that these effects were mediated by changes in present control. Our intervention represents a potentially valuable tool for college mental health services. PMID:24635586

  16. Case Studies in Broadcast Management.

    ERIC Educational Resources Information Center

    Coleman, Howard W.

    This collection of case studies, based on factual situations which have challenged broadcast managers in recent years, is designed to stimulate thinking about and solving of "real world" problems in commercial radio and television operations. Topics of a serious, long-run nature include enlarging the radio audience; station revenue and economy;…

  17. Autism spectrum disorders: early detection, intervention, education, and psychopharmacological management.

    PubMed

    Bryson, Susan E; Rogers, Sally J; Fombonne, Eric

    2003-09-01

    Our understanding and treatment of children with autism have changed dramatically since Leo Kanner first formally documented the disorder in 1943. With reference to the historical context, this paper reviews recent research addressing 4 major issues: early detection, intervention, education, and psychopharmacological management of children with autism and related (autistic) spectrum disorders (hereafter, "autism"). We conclude from our review of the evidence that, in the absence of additional, more compelling data, the clinical usefulness of existing screening instruments remains questionable. However, the potential importance of such research is underscored by the clear benefits of early behavioural intervention: despite differences in orientation, outcomes for children with autism can be significantly enhanced with early intensive intervention. Although many questions remain (notably, What are the critical therapeutic components? For whom? For what domains of development? For what level of intensity and duration?), interventions shown to be effective are all carefully planned, engineered, monitored, and designed to target specific skill domains. Including children with autism in regular classes within the public school system poses several challenges, the most pressing of which is the large number of school personnel who need to be trained in evidence-based teaching and behavioural management practices. Finally, psychotropic drugs may help to reduce some symptoms, but they are neither curative nor a substitute for other forms of support and intervention. PMID:14574826

  18. Effectiveness of Workplace Weight Management Interventions: a Systematic Review.

    PubMed

    Weerasekara, Yasoma Kumari; Roberts, Susan B; Kahn, Mira A; LaVertu, Amy E; Hoffman, Ben; Das, Sai Krupa

    2016-06-01

    A systematic review was conducted of randomized trials of workplace weight management interventions, including trials with dietary, physical activity, environmental, behavioral, and incentive-based components. Main outcomes were defined as change in weight-related measures. Keywords related to weight management and workplace interventions were used to search relevant databases, and 23 eligible studies were reviewed in detail using a data extraction form and quality assessment checklist. The trials were conducted mainly in the USA and Europe, with four additional countries represented. Interventions were mostly multicomponent and were implemented in both sexes and in a range of employment categories. Intervention effectiveness appeared unrelated to region of the world and was highest in 6-12-month trials. The results ranged widely from clinically significant 8.8-kg weight loss in one trial to less effective than the control treatment in others. Some workplace interventions achieve clinically significant benefits, and further studies are needed to replicate those results in wider sociocultural and geographical contexts. PMID:27023071

  19. Planning Intervention Using Dynamic Assessments: A Case Study

    ERIC Educational Resources Information Center

    Hasson, Natalie; Dodd, Barbara

    2014-01-01

    Dynamic assessments (DA) of language have been shown to be a useful addition to the battery of tests used to diagnose language impairments in children, and to evaluate their skills. The current article explores the value of the information gained from a DA in planning intervention for a child with language impairment. A single case study was used…

  20. Training the Practitioner Scientist: Bridging Case Conceptualization, Assessment, and Intervention.

    ERIC Educational Resources Information Center

    Meier, Scott T.

    1999-01-01

    Describes didactic material linking assessment, case conceptualization, and analysis of intervention effects. Analyses were conducted with data provided by 131 students who completed a counseling process course where this material was taught. Results indicate that students increased their self-efficacy for conceptualization and assessment tasks…

  1. Community based intervention to optimize osteoporosis management: randomized controlled trial

    PubMed Central

    2010-01-01

    Background Osteoporosis-related fractures are a significant public health concern. Interventions that increase detection and treatment of osteoporosis are underutilized. This pragmatic randomised study was done to evaluate the impact of a multifaceted community-based care program aimed at optimizing evidence-based management in patients at risk for osteoporosis and fractures. Methods This was a 12-month randomized trial performed in Ontario, Canada. Eligible patients were community-dwelling, aged ≥55 years, and identified to be at risk for osteoporosis-related fractures. Two hundred and one patients were allocated to the intervention group or to usual care. Components of the intervention were directed towards primary care physicians and patients and included facilitated bone mineral density testing, patient education and patient-specific recommendations for osteoporosis treatment. The primary outcome was the implementation of appropriate osteoporosis management. Results 101 patients were allocated to intervention and 100 to control. Mean age of participants was 71.9 ± 7.2 years and 94% were women. Pharmacological treatment (alendronate, risedronate, or raloxifene) for osteoporosis was increased by 29% compared to usual care (56% [29/52] vs. 27% [16/60]; relative risk [RR] 2.09, 95% confidence interval [CI] 1.29 to 3.40). More individuals in the intervention group were taking calcium (54% [54/101] vs. 20% [20/100]; RR 2.67, 95% CI 1.74 to 4.12) and vitamin D (33% [33/101] vs. 20% [20/100]; RR 1.63, 95% CI 1.01 to 2.65). Conclusions A multi-faceted community-based intervention improved management of osteoporosis in high risk patients compared with usual care. Trial Registration This trial has been registered with clinicaltrials.gov (ID: NCT00465387) PMID:20799973

  2. Interventional management of neuropathic pain: NeuPSIG recommendations

    PubMed Central

    Dworkin, Robert H.; O’Connor, Alec B.; Kent, Joel; Mackey, Sean C.; Raja, Srinivasa N.; Stacey, Brett R.; Levy, Robert M.; Backonja, Miroslav; Baron, Ralf; Harke, Henning; Loeser, John D.; Treede, Rolf-Detlef; Turk, Dennis C.; Wells, Christopher D.

    2015-01-01

    Neuropathic pain (NP) is often refractory to pharmacologic and non-interventional treatment. On behalf of the International Association for the Study of Pain Neuropathic Pain Special Interest Group (NeuPSIG), the authors evaluated systematic reviews, clinical trials, and existing guidelines for the interventional management of NP. Evidence is summarized and presented for neural blockade, spinal cord stimulation (SCS), intrathecal medication, and neurosurgical interventions in patients with the following peripheral and central NP conditions: herpes zoster and postherpetic neuralgia (PHN); painful diabetic and other peripheral neuropathies; spinal cord injury NP; central post-stroke pain; radiculopathy and failed back surgery syndrome (FBSS); complex regional pain syndrome (CRPS); and trigeminal neuralgia and neuropathy. Due to the paucity of high-quality clinical trials, no strong recommendations can be made. Four weak recommendations based on the amount and consistency of evidence, including degree of efficacy and safety, are: (1) epidural injections for herpes zoster; (2) steroid injections for radiculopathy; (3) SCS for FBSS; and (4) SCS for CRPS type 1. Based on the available data, we recommend not to use sympathetic blocks for PHN nor RF lesions for radiculopathy. No other conclusive recommendations can be made due to the poor quality of available of data. Whenever possible, these interventions should either be part of randomized clinical trials or documented in pain registries. Priorities for future research include randomized clinical trials; long-term studies; and head-to-head comparisons among different interventional and non-interventional treatments. PMID:23748119

  3. Effectiveness of management interventions to control invasion by Rhododendron ponticum.

    PubMed

    Tyler, Claire; Pullin, Andrew S; Stewart, Gavin B

    2006-04-01

    Rhododendron ponticum is an invasive species in many countries, including the United Kingdom, Ireland, Belgium, and France. It poses a serious threat to native flora and fauna, as it is capable of altering entire seminatural communities through its vigorous spread. Control is essential if the conservation value of some communities, such as oak woodland and lowland heath, are to be successfully maintained. Commonly used interventions are herbicide application, herbicide application postcut, and cutting (manual or mechanical) alone. Various techniques have been developed to apply these interventions, but often retreatment of the area is required, increasing the cost of control. Here, we evaluate the effectiveness of some commonly used interventions for R. ponticum control using a systematic review methodology. Eleven studies provided data for statistical analysis. Meta-analyses of captured data show that postcut application of the herbicide Glyphosate or applying the herbicides Metsulfuron-methyl or Imazapyr (no cut) can effectively reduce a R. ponticum stand. There is insufficient available experimental evidence for effectiveness of any other intervention. The systematic review process has demonstrated the lack of replicated studies with controls or long-term monitoring and increases the call for more rigorous monitoring of all conservation management interventions. The quality of experimental evidence of the effectiveness of some interventions contrasts with the acceptance of their use through dissemination of experience. The collection and objective review of experience will require active collaboration of organizations concerned with R. ponticum control. PMID:16456628

  4. Digital Asthma Self-Management Interventions: A Systematic Review

    PubMed Central

    Morrison, Deborah; Wyke, Sally; Agur, Karolina; Cameron, Euan J; Docking, Robert I; MacKenzie, Alison M; McConnachie, Alex; Raghuvir, Vandana; Thomson, Neil C

    2014-01-01

    Background Many people with asthma tolerate symptoms and lifestyle limitations unnecessarily by not utilizing proven therapies. Better support for self-management is known to improve asthma control, and increasingly the Internet and other digital media are being used to deliver that support. Objective Our goal was to summarize current knowledge, evidenced through existing systematic reviews, of the effectiveness and implementation of digital self-management support for adults and children with asthma and to examine what features help or hinder the use of these programs. Methods A comprehensive search strategy combined 3 facets of search terms: (1) online technology, (2) asthma, and (3) self-management/behavior change/patient experience. We undertook searches of 14 databases, and reference and citation searching. We included qualitative and quantitative systematic reviews about online or computerized interventions facilitating self-management. Title, abstract, full paper screening, and quality appraisal were performed by two researchers independently. Data extraction was undertaken using standardized forms. Results A total of 3810 unique papers were identified. Twenty-nine systematic reviews met inclusion criteria: the majority were from the United States (n=12), the rest from United Kingdom (n=6), Canada (n=3), Portugal (n=2), and Australia, France, Spain, Norway, Taiwan, and Greece (1 each). Only 10 systematic reviews fulfilled pre-determined quality standards, describing 19 clinical trials. Interventions were heterogeneous: duration of interventions ranging from single use, to 24-hour access for 12 months, and incorporating varying degrees of health professional involvement. Dropout rates ranged from 5-23%. Four RCTs were aimed at adults (overall range 3-65 years). Participants were inadequately described: socioeconomic status 0/19, ethnicity 6/19, and gender 15/19. No qualitative systematic reviews were included. Meta-analysis was not attempted due to

  5. Racial Differences in Two Self Management Hypertension Interventions

    PubMed Central

    Bosworth, Hayden B.; Olsen, Maren K.; Grubber, Janet M.; Powers, Benjamin J.; Oddone, Eugene Z.

    2011-01-01

    Background Only one-half of Americans have their blood pressure controlled and there continue to be significant racial differences in blood pressure control. The goal of this study was to examine the effectiveness of two patient-directed interventions designed to improve blood pressure control within white and non-white subgroups (49% African Americans). Methods Post-hoc analysis of a 2 by 2 randomized trial with two-year follow-up in 2 university-affiliated primary care clinics. Within white and non-white patients (n=634), four groups were examined: 1) usual care; 2) home blood pressure monitoring (three times per week); 3) tailored behavioral self-management intervention administered via telephone by a nurse every other month; or, 4) a combination of the two interventions. Results The overall race by time by treatment group effect suggested differential intervention effects on blood pressure over time for whites and non-whites (systolic blood pressure, p=0.08; diastolic blood pressure, p=0.01). Estimated trajectories indicated that among the 308 whites, there was no significant effect on blood pressure at either 12 or 24 months for any intervention compared to control group. At 12 months, the non-whites (n=328) in all three intervention groups had systolic blood pressure decreases of 5.3–5.7 mm hg compared to usual care (p<0.05). At 24 months, in the combined intervention, non-whites had sustained lower systolic blood pressure as compared to usual care (7.5 mm hg; p<0.02). A similar pattern was observed for diastolic blood pressure. Conclusion Combined home blood pressure monitoring and a telephone tailored-behavioral intervention appeared to be particularly effective for improving blood pressure in non-white patients. PMID:21531237

  6. Interventional bronchoscopy in the management of thoracic malignancy

    PubMed Central

    Hardavella, Georgia

    2015-01-01

    Educational Aims To highlight the various methods of interventional bronchoscopy. To inform about the indications for palliation and curative bronchoscopy in lung cancer. Interventional bronchoscopy is a rapidly expanding field in respiratory medicine offering minimally invasive therapeutic and palliative procedures for all types of lung neoplasms. This field has progressed over the last couple of decades with the application of new technology. The HERMES European curriculum recommendations include interventional bronchoscopy skills in the modules of thoracic tumours and bronchoscopy [1]. However, interventional bronchoscopy is not available in all training centres and consequently, not all trainees will obtain experience unless they rotate to centres specifically offering such training. In this review, we give an overview of interventional bronchoscopic procedures used for the treatment and palliation of thoracic malignancy. These can be applied either with flexible or rigid bronchoscopy or a combination of both depending on the anatomical location of the tumour, the complexity of the case, bleeding risk, the operator’s expertise and preference as well as local availability. Specialised anaesthetic support and appropriately trained endoscopy staff are essential, allowing a multimodality approach to meet the high complexity of these cases. PMID:26632425

  7. Prevention and Management of Infectious Complications of Percutaneous Interventions

    PubMed Central

    Huang, Steven Y.; Philip, Asher; Richter, Michael D.; Gupta, Sanjay; Lessne, Mark L.; Kim, Charles Y.

    2015-01-01

    Infectious complications following interventional radiology (IR) procedures can cause significant patient morbidity and, potentially, mortality. As the number and breadth of IR procedures grow, it becomes increasingly evident that interventional radiologists must possess a thorough understanding of these potential infectious complications. Furthermore, given the increasing incidence of antibiotic-resistant bacteria, emphasis on cost containment, and attention to quality of care, it is critical to have infection control strategies to maximize patient safety. This article reviews infectious complications associated with percutaneous ablation of liver tumors, transarterial embolization of liver tumors, uterine fibroid embolization, percutaneous nephrostomy, percutaneous biliary interventions, central venous catheters, and intravascular stents. Emphasis is placed on incidence, risk factors, prevention, and management. With the use of these strategies, IR procedures can be performed with reduced risk of infectious complications. PMID:26038616

  8. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series

    PubMed Central

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  9. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series.

    PubMed

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  10. Integrative Medicine and Case Management.

    PubMed

    Powell, Suzanne K

    2016-01-01

    The evolution of the integration of health care modalities has changed. The National Institutes of Health founded office of the National Center for Complementary and Alternative Medicine in the early 1990s to investigate integrative therapies through scientific research. In December 2014, the name and mission were updated to the National Center for Complementary and Integrative Health. Case managers, the coordinators of health care, must understand the changes to "integrative medicine" and the allure of the alternative modalities. PMID:27035081

  11. Obamacare 2012: prognosis unclear for interventional pain management.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2012-01-01

    The Patient Protection and Affordable Care Act (ACA), informally referred to as ObamaCare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. ACA has substantially changed the landscape of medical practice in the United States and continues to influence all sectors, in particular evolving specialties such as interventional pain management. ObamaCare has been signed into law amidst major political fallouts, has sustained a Supreme Court challenge and emerged bruised, but still very much alive. While proponents argue that ObamaCare will provide insurance for almost everyone, with an improvement in the quality of and reduction in the cost of health care,, opponents criticize it as being a massive bureaucracy laden with penalties and taxes, that will ultimately eliminate personal medicine and individual practices. Based on the 2 years since the passage of ACA in 2010, the prognosis for interventional pain management is unclear. The damage sustained to interventional pain management and the majority of medicine practices is irreparable. ObamaCare may provide insurance for all, but with cuts in Medicare to fund Obamacare, a limited expansion of Medicaid, the inadequate funding of exchanges, declining employer health insurance coverage and skyrocketing disability claims, the coverage will be practically nonexistent. ObamaCare is composed of numerous organizations and bureaucracies charged with controlling the practice of medicine through the extension of regulations. Apart from cutting reimbursements and reducing access to interventional pain management, administration officials are determined to increase the role of midlevel practitioners and reduce the role of individual physicians by liberalizing the scope of practice regulations and introducing proposals to reduce medical education and training. PMID:22996858

  12. Use of CT Angiogram in Interventions Involving Coronary Artery Anomalies: A Case Series

    PubMed Central

    Ramesh, Dwarakanath; Setty Natraj Setty, Huliyurdurga S.; Patil, Veeresh; Swamy, Kumar; Kumar, Sunil; Guruprasad, Guruprasad; Manjunath, Cholenahalli Nanjappa

    2015-01-01

    Case series Patient: — Final Diagnosis: Coronary anamolies Symptoms: Chest pain Medication: None Clinical Procedure: PTCA with stent/CABG Specialty: Cardiology Objective: Challenging differential diagnosis Background: Coronary artery anomalies are rare, accounting for about 0.3–1.3% of patients undergoing diagnostic coronary angiography. Interventions in these cases are still rare, and therefore pose technical challenges during intervention. CT Angiography provides a non-invasive means of assessment of coronary artery disease and also shows the anatomy of the coronary tree. This helps in knowing the origin of the coronaries and also to plan selection of hardware. There are no specific guidelines for use of guiding catheters and guide wires in anomalous coronary artery intervention. Case Report: We report a series of 5 patients presenting with effort angina who had anomalous coronary arteries with coronary stenosis diagnosed by CT angiography. Three patients received percutaneous intervention, 1 patient underwent CABG, and 1 patient received medical management. Conclusions: CT Angiography provides a useful tool for showing the coronary anatomy and for selecting the guiding catheter and the guide wire that remain the mainstay of interventions in coronary artery anomalies. PMID:26637639

  13. The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

    PubMed

    Hogan, Tierney D

    2005-01-01

    A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff. PMID:16205207

  14. Interventional bronchoscopy in the management of thoracic malignancy.

    PubMed

    Hardavella, Georgia; George, Jeremy

    2015-09-01

    Interventional bronchoscopy is a rapidly expanding field in respiratory medicine offering minimally invasive therapeutic and palliative procedures for all types of lung neoplasms. This field has progressed over the last couple of decades with the application of new technology. The HERMES European curriculum recommendations include interventional bronchoscopy skills in the modules of thoracic tumours and bronchoscopy [1]. However, interventional bronchoscopy is not available in all training centres and consequently, not all trainees will obtain experience unless they rotate to centres specifically offering such training. In this review, we give an overview of interventional bronchoscopic procedures used for the treatment and palliation of thoracic malignancy. These can be applied either with flexible or rigid bronchoscopy or a combination of both depending on the anatomical location of the tumour, the complexity of the case, bleeding risk, the operator's expertise and preference as well as local availability. Specialised anaesthetic support and appropriately trained endoscopy staff are essential, allowing a multimodality approach to meet the high complexity of these cases. PMID:26632425

  15. 75 FR 27375 - Postal Rate Case Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... From the Federal Register Online via the Government Publishing Office POSTAL REGULATORY COMMISSION Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is seeking comments relevant to management of an anticipated exigent postal rate case. It...

  16. Effectiveness of case management for homeless persons: a systematic review.

    PubMed

    de Vet, Renée; van Luijtelaar, Maurice J A; Brilleslijper-Kater, Sonja N; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D; Wolf, Judith R L M

    2013-10-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  17. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    PubMed Central

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  18. The Role of Interventional Radiology in the Management of Deep Venous Thrombosis: Advanced Therapy

    SciTech Connect

    O'Sullivan, Gerard J.

    2011-06-15

    Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This 'usual treatment' is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases. Interventional radiologists are now using advanced endovascular techniques to achieve thrombus removal in a minimally invasive manner in a very short treatment time, thereby quickly restoring patency, relieving acute symptoms, and potentially limiting the subsequent development of postthrombotic syndrome when followed with anticoagulation and compression regimens. This article provides an overview of the interventions available for treating DVT. One of the newer 'single-session' techniques is isolated pharmacomechanical thrombolysis, which is described here in detail with supporting cases.

  19. A Review of Web Based Interventions for Managing Tobacco Use

    PubMed Central

    Balhara, Yatan Pal Singh; Verma, Rohit

    2014-01-01

    Web based interventions (WBIs) have been developed for various health conditions. These include interventions for various psychoactive substance use disorders including tobacco and alcohol. Tobacco use has remained the single largest preventable cause of global mortality and morbidity for many years. It is responsible for around 6 million deaths annually world-wide. Ironically, most of the tobacco users reside in resource poor low and middle-income countries. The article reviews the existing literature on WBIs for management of tobacco use. The literature search was performed using MedLine, PubMed, PsycINFO, Embase and Cochrane Review for relevant English language articles published from 1998 up to 2013. There is limited support for effectiveness of WBIs for managing tobacco use among adolescents. Although most of the trials among adults found WBIs to be more effective at short term follow-up (a few days to weeks), the benefits failed to extend beyond 3 months in most of the studies. All but one interventions studied in a randomized controlled trial is for smoking forms. PMID:25035543

  20. Role of interventional radiology in the management of complications after pancreatic surgery: a pictorial review.

    PubMed

    Mauri, Giovanni; Mattiuz, Chiara; Sconfienza, Luca Maria; Pedicini, Vittorio; Poretti, Dario; Melchiorre, Fabio; Rossi, Umberto; Lutman, Fabio Romano; Montorsi, Marco

    2015-04-01

    Pancreatic resections are surgical procedures associated with high incidence of complications, with relevant morbidity and mortality even at high volume centres. A multidisciplinary approach is essential in the management of these events and interventional radiology plays a crucial role in the treatment of patients developing post-surgical complications. This paper offers an overview on the interventional radiological procedures that can be performed to treat different type of complications after pancreatic resection. Procedures such as percutaneous drainage of fluid collections, percutaneous transhepatic biliary procedures, arterial embolisation, venous interventions and fistula embolisation are viable treatment options, with fewer complications compared with re-look surgery, shorter hospital stay and faster recovery. A selection of cases of complications following pancreatic surgery managed with interventional radiological procedure are presented and discussed. Teaching Points • Interventional radiology is crucial to treat complications after pancreatic surgery • Percutaneous drainage of collections can be performed under ultrasound or computed tomography guidance • Percutaneous biliary procedures can be used to treat biliary complications • Venous procedures can be performed effectively through transhepatic or transjugular access • Fistulas can be treated effectively by percutaneous embolisation. PMID:25516470

  1. Personalized Weight Management Interventions for Cardiovascular Risk Reduction: A Viable Option for African-American Women.

    PubMed

    Franklin, Nina C; Arena, Ross

    2016-01-01

    Obesity is an independent contributor to cardiovascular disease (CVD) and a major driving force behind racial/ethnic and gender disparities in risk. Due to a multitude of interrelating factors (i.e., personal, social, cultural, economic and environmental), African-American (AA) women are disproportionately obese and twice as likely to succumb to CVD, yet they are significantly underrepresented in behavioral weight management interventions. In this selective review we highlight components of the limited interventions shown to enhance weight loss outcomes in this population and make a case for leveraging Web-based technology and artificial intelligence techniques to deliver personalized programs aimed at obesity treatment and CVD risk reduction. Although many of the approaches discussed are generally applicable across populations burdened by disparate rates of obesity and CVD, we specifically focus on AA women due to the disproportionate impact of these non-communicable diseases and the general paucity of interventions targeted to this high-risk group. PMID:26908050

  2. Automatic management system for dose parameters in interventional radiology and cardiology.

    PubMed

    Ten, J I; Fernandez, J M; Vaño, E

    2011-09-01

    The purpose of this work was to develop an automatic management system to archive and analyse the major study parameters and patient doses for fluoroscopy guided procedures performed in cardiology and interventional radiology systems. The X-ray systems used for this trial have the capability to export at the end of the procedure and via e-mail the technical parameters of the study and the patient dose values. An application was developed to query and retrieve from a mail server, all study reports sent by the imaging modality and store them on a Microsoft SQL Server data base. The results from 3538 interventional study reports generated by 7 interventional systems were processed. In the case of some technical parameters and patient doses, alarms were added to receive malfunction alerts so as to immediately take appropriate corrective actions. PMID:21831869

  3. Reported Use and Acceptability of Self-Management Interventions to Target Behavioral Outcomes

    ERIC Educational Resources Information Center

    Briesch, Amy M.; Briesch, Jacquelyn M.; Mahoney, Corrine

    2014-01-01

    Although self-management interventions have a long history of empirical evaluation, attention has not been paid toward understanding actual use of this class of interventions. From a nationally representative sample of school psychology practitioners, a total of 295 respondents were presented with a description of a self-management intervention as…

  4. Parent Management Training and Asperger Syndrome: A Randomized Controlled Trial to Evaluate a Parent Based Intervention

    ERIC Educational Resources Information Center

    Sofronoff, Kate; Leslie, Anthony; Brown, Wendy

    2004-01-01

    This controlled trial of a parent management intervention aimed to increase parental competence in management of problem behaviours associated with Asperger syndrome. The intervention compared two formats, a 1 day workshop and six individual sessions. Measures were taken on three occasions: pre-intervention, at 4 weeks, and at 3 month follow-up.…

  5. Interventional Radiological Management of Prehepatic Obstruction the Splanchnic Venous System

    SciTech Connect

    Semiz-Oysu, Aslihan Keussen, Inger; Cwikiel, Wojciech

    2007-07-15

    Purpose. The purpose of this study was to retrospectively evaluate interventional radiological management of patients with symptomatic portal hypertension secondary to obstruction of splanchnic veins. Material and Methods. Twenty-four patients, 15 males and 9 females, 0.75 to 79 years old (mean, 36.4 years), with symptomatic portal hypertension, secondary to splanchnic venous obstruction, were treated by percutaneous methods. Causes and extent of splanchnic venous obstruction and methods are summarized following a retrospective evaluation. Results. Obstructions were localized to the main portal vein (n = 22), intrahepatic portal veins (n = 8), splenic vein (n = 4), and/or mesenteric veins (n = 4). Interventional treatment of 22 (92%) patients included recanalization (n = 19), pharmacological thrombolysis (n = 1), and mechanical thrombectomy (n = 5). Partial embolization of the spleen was done in five patients, in two of them as the only possible treatment. TIPS placement was necessary in 10 patients, while an existing occluded TIPS was revised in two patients. Transhepatic embolization of varices was performed in one patient, and transfemoral embolization of splenorenal shunt was performed in another. Thirty-day mortality was 13.6% (n=3). During the follow-up, ranging between 2 days and 58 months, revision was necessary in five patients. An immediate improvement of presenting symptoms was achieved in 20 patients (83%). Conclusion. We conclude that interventional procedures can be successfully performed in the majority of patients with obstruction of splanchnic veins, with subsequent improvement of symptoms. Treatment should be customized according to the site and nature of obstruction.

  6. Cervical zygapophysial (facet) joint pain: effectiveness of interventional management strategies.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A; Kaye, Alan D; Boswell, Mark V

    2016-01-01

    Diagnostic facet joint nerve blocks have been utilized in the diagnosis of cervical facet joint pain in patients without disk herniation or radicular pain due to a lack of reliable noninvasive diagnostic measures. Therapeutic interventions include intra-articular injections, facet joint nerve blocks and radiofrequency neurotomy. The diagnostic accuracy and effectiveness of facet joint interventions have been assessed in multiple diagnostic accuracy studies, randomized controlled trials (RCTs), and systematic reviews in managing chronic neck pain. This assessment shows there is Level II evidence based on a total of 11 controlled diagnostic accuracy studies for diagnosing cervical facet joint pain in patients without disk herniation or radicular pain utilizing controlled diagnostic blocks. Due to significant variability and internal inconsistency regarding prevalence in a heterogenous population; despite 11 studies, evidence is determined as Level II. Prevalence ranged from 36% to 67% with at least 80% pain relief as the criterion standard with a false-positive rate ranging from 27% to 63%. The evidence is Level II for the long-term effectiveness of radiofrequency neurotomy and facet joint nerve blocks in managing cervical facet joint pain. There is Level III evidence for cervical intra-articular injections. PMID:26653406

  7. The empirical foundations of telemedicine interventions for chronic disease management.

    PubMed

    Bashshur, Rashid L; Shannon, Gary W; Smith, Brian R; Alverson, Dale C; Antoniotti, Nina; Barsan, William G; Bashshur, Noura; Brown, Edward M; Coye, Molly J; Doarn, Charles R; Ferguson, Stewart; Grigsby, Jim; Krupinski, Elizabeth A; Kvedar, Joseph C; Linkous, Jonathan; Merrell, Ronald C; Nesbitt, Thomas; Poropatich, Ronald; Rheuban, Karen S; Sanders, Jay H; Watson, Andrew R; Weinstein, Ronald S; Yellowlees, Peter

    2014-09-01

    The telemedicine intervention in chronic disease management promises to involve patients in their own care, provides continuous monitoring by their healthcare providers, identifies early symptoms, and responds promptly to exacerbations in their illnesses. This review set out to establish the evidence from the available literature on the impact of telemedicine for the management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. By design, the review focuses on a limited set of representative chronic diseases because of their current and increasing importance relative to their prevalence, associated morbidity, mortality, and cost. Furthermore, these three diseases are amenable to timely interventions and secondary prevention through telemonitoring. The preponderance of evidence from studies using rigorous research methods points to beneficial results from telemonitoring in its various manifestations, albeit with a few exceptions. Generally, the benefits include reductions in use of service: hospital admissions/re-admissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings. PMID:24968105

  8. Postoperative management of hip fractures: interventions associated with improved outcomes.

    PubMed

    Colón-Emeric, Cathleen S

    2012-01-01

    The annual number of hip fractures worldwide is expected to exceed 6 million by 2050. Currently, nearly 50% of hip fracture patients will develop at least one short-term complication including infection, delirium, venous thromboembolism (VTE), pressure ulcers or cardiovascular events. More than half will experience an adverse long-term outcomes including worsened ambulation or functional status, additional fractures and excess mortality. This paper summarizes current evidence for postoperative interventions attempting to improve these outcomes, including pain management, anemia management, delirium prevention strategies, VTE prophylaxis, rehabilitation type, nutritional supplements, anabolic steroids and secondary fracture prevention. Models of care that have been tested in this population including interdisciplinary orthogeriatric services, clinical pathways and hospitalist care are summarized. In general, good quality evidence supports routine use of VTE prophylaxis, and moderate quality evidence supports multifactorial delirium prevention protocols, and a conservative transfusion strategy. Aggressive pain control with higher doses of opiates and/or regional blocks are associated with lower delirium rates. Low-moderate quality evidence supports the use of clinical pathways, and dedicated orthogeriatric consultative services or wards. After hospital discharge, good quality evidence supports the use of bisphosphonates for secondary fracture prevention and mortality reduction. Rehabilitation services are important, but evidence to guide quantity, type or venue is lacking. Additional research is needed to clarify the role of nutritional supplements, anabolic steroids, home care and psychosocial interventions. PMID:24340216

  9. The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

    PubMed Central

    Shannon, Gary W.; Smith, Brian R.; Alverson, Dale C.; Antoniotti, Nina; Barsan, William G.; Bashshur, Noura; Brown, Edward M.; Coye, Molly J.; Doarn, Charles R.; Ferguson, Stewart; Grigsby, Jim; Krupinski, Elizabeth A.; Kvedar, Joseph C.; Linkous, Jonathan; Merrell, Ronald C.; Nesbitt, Thomas; Poropatich, Ronald; Rheuban, Karen S.; Sanders, Jay H.; Watson, Andrew R.; Weinstein, Ronald S.; Yellowlees, Peter

    2014-01-01

    Abstract The telemedicine intervention in chronic disease management promises to involve patients in their own care, provides continuous monitoring by their healthcare providers, identifies early symptoms, and responds promptly to exacerbations in their illnesses. This review set out to establish the evidence from the available literature on the impact of telemedicine for the management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. By design, the review focuses on a limited set of representative chronic diseases because of their current and increasing importance relative to their prevalence, associated morbidity, mortality, and cost. Furthermore, these three diseases are amenable to timely interventions and secondary prevention through telemonitoring. The preponderance of evidence from studies using rigorous research methods points to beneficial results from telemonitoring in its various manifestations, albeit with a few exceptions. Generally, the benefits include reductions in use of service: hospital admissions/re-admissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings. PMID:24968105

  10. Effects of a Dynamic Progressive Orthotic Intervention for Chronic Hemiplegia: A Case Series

    PubMed Central

    Doucet, Barbara M.; Mettler, Joni A.

    2014-01-01

    Study Design: Case series design on a single subgroup of participants Introduction: Management of hypertonicity and resistance to passive movement (RTPM) in the upper extremity is an intractable problem for persons with stroke and the therapists who provide their care. Therapists have limited options for assessment and treatment of this condition which can profoundly limit functional performance and quality of life. Purpose of the Study: To evaluate the effect of a 12-week dynamic progressive orthotic intervention in persons with chronic stroke exhibiting wrist flexion contracture who are residents of a long term skilled nursing facility. Methods: A custom fitted dynamic progressive wrist extension orthotic was applied to 6 residents with chronic stroke. The orthotic was worn for 4 hours daily, 4X/week for 12 weeks. Wrist passive range of motion (PROM) and RTPM were measured weekly and after discontinuation of the orthotics using the Modified Ashworth Scale and the Tardieu Scale of Spasticity. Signal analysis of electromyographical (EMG) flexor response to extensor stretching was also measured before and after orthotic intervention using maximal root mean square (RMS) values and EMG burst onset time. Results: A moderate effect was found for changes in PROM with the orthotic intervention. Progress made diminished following discontinuation. Moderate effects were also seen in EMG measures which indicated increases in amount of resistive-free movement following intervention. Conclusions: A dynamic progressive orthotic intervention can be an effective option for increasing wrist PROM and reducing RTPM in persons with chronic stroke. Level of Evidence: 4 PMID:23149271

  11. Case Studies for Management Development in Bangladesh.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    Eight case studies appropriate for use in a course in management development were prepared and are provided in this document. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision. Questions for…

  12. Study on Case Teaching of Financial Management

    ERIC Educational Resources Information Center

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  13. Intervention strategies for the management of human error

    NASA Technical Reports Server (NTRS)

    Wiener, Earl L.

    1993-01-01

    This report examines the management of human error in the cockpit. The principles probably apply as well to other applications in the aviation realm (e.g. air traffic control, dispatch, weather, etc.) as well as other high-risk systems outside of aviation (e.g. shipping, high-technology medical procedures, military operations, nuclear power production). Management of human error is distinguished from error prevention. It is a more encompassing term, which includes not only the prevention of error, but also a means of disallowing an error, once made, from adversely affecting system output. Such techniques include: traditional human factors engineering, improvement of feedback and feedforward of information from system to crew, 'error-evident' displays which make erroneous input more obvious to the crew, trapping of errors within a system, goal-sharing between humans and machines (also called 'intent-driven' systems), paperwork management, and behaviorally based approaches, including procedures, standardization, checklist design, training, cockpit resource management, etc. Fifteen guidelines for the design and implementation of intervention strategies are included.

  14. A brief intervention for weight management in primary care: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Obesity affects 25% of the UK adult population but modest weight loss can reduce the incidence of obesity-related chronic disease. Some effective weight loss treatments exist but there is no nationally available National Health Service (NHS) treatment service, and general practitioners (GPs) rarely discuss weight management with patients or support behavior change. Evidence shows that commercial weight management services, that most primary care trusts have 'on prescription', are more effective than primary care treatment. Methods/design We propose a controlled trial where patients will be randomized to receive either the offer of help by referral to a weight management service and follow-up to assess progress, or advice to lose weight on medical grounds. The primary outcome will be weight change at 12-months. Other questions are: what actions do people take to manage their weight in response to the two GP intervention types? How do obese patients feel about GPs opportunistically discussing weight management and how does this vary by intervention type? How do GPs feel about raising the issue opportunistically and giving the two types of brief intervention? What is the cost per kg/m2 lost for each intervention? Research assistants visiting GP practices in England (n = 60) would objectively measure weight and height prior to GP consultations and randomize willing patients (body mass index 30+, excess body fat, 18+ years) using sealed envelopes. Full recruitment (n = 1824) is feasible in 46 weeks, requiring six sessions of advice-giving per GP. Participants will be contacted at 3 months (postintervention) via telephone to identify actions they have taken to manage their weight. We will book appointments for participants to be seen at their GP practice for a 12-month follow-up. Discussion Trial results could make the case for brief interventions for obese people consulting their GP and introduce widespread simple treatments akin to the NHS Stop

  15. Chiropractic management of breast-feeding difficulties: a case report

    PubMed Central

    Holleman, Annique C.; Nee, John; Knaap, Simone F.C.

    2011-01-01

    Objective The purpose of this study is to discuss a chiropractic case of management and resolution of breast-feeding difficulties. Clinical Features The case involves an 8-day-old baby unable to breast-feed since 4 days old. Initial examination revealed cervical, cranial, and sacral restrictions. She was diagnosed with craniocervical syndrome by a doctor of chiropractic. Intervention and Outcome Following history and examination, the infant received gentle chiropractic manipulation based on clinical findings. Immediate improvement and complete resolution of the nursing problems were observed after 3 treatments over 14 days. Conclusion The results of this case suggest that neuromusculoskeletal dysfunction may influence the ability of an infant to suckle successfully and that intervention via chiropractic adjustments may result in improving the infant's ability to suckle efficiently. PMID:22014911

  16. Pediatric nurses' beliefs and pain management practices: an intervention pilot.

    PubMed

    Van Hulle Vincent, Catherine; Wilkie, Diana J; Wang, Edward

    2011-10-01

    We evaluated feasibility of the Internet-based Relieve Children's Pain (RCP) protocol to improve nurses' management of children's pain. RCP is an interactive, content-focused, and Kolb's experiential learning theory-based intervention. Using a one-group, pretest-posttest design, we evaluated feasibility of RCP and pretest-posttest difference in scores for nurses' beliefs, and simulated and actual pain management practices. Twenty-four RNs completed an Internet-based Pain Beliefs and Practices Questionnaire (PBPQ, alpha=.83) before and after they completed the RCP and an Acceptability Scale afterward. Mean total PBPQ scores significantly improved from pretest to posttest as did simulated practice scores. After RCP in actual hospital practice, nurses administered significantly more ibuprofen and ketorolac and children's pain intensity significantly decreased. Findings showed strong evidence for the feasibility of RCP and study procedures and significant improvement in nurses' beliefs and pain management practices. The 2-hr RCP program is promising and warrants replication with an attention control group and a larger sample. PMID:21172923

  17. Multidisciplinary interventions in the management of atopic dermatitis.

    PubMed

    LeBovidge, Jennifer S; Elverson, Wendy; Timmons, Karol G; Hawryluk, Elena B; Rea, Corinna; Lee, Margaret; Schneider, Lynda C

    2016-08-01

    Atopic dermatitis (AD) is the most common pediatric skin disease. AD has a significant effect on patient and family quality of life caused by intense pruritus, sleep disruption, dietary and nutritional concerns, and psychological stress associated with the disease and its management. Multidisciplinary approaches to AD care have been developed in appreciation of the complex interplay among biological, psychological, behavioral, and dietary factors that affect disease control and the wide range of knowledge, skills, and support that patients and families require to effectively manage and cope with this condition. Common components of multidisciplinary treatment approaches include medical evaluation and management by an AD specialist, education and nursing care, psychological and behavioral support, and nutritional assessment and guidance. Models of care include both clinical programs and structured educational groups provided as adjuncts to standard clinical care. Available evidence suggests beneficial effects of multidisciplinary interventions in improving disease severity and quality of life, particularly for patients with moderate-to-severe disease. Additional research is needed to identify the best candidates for the various multidisciplinary approaches and evaluate the cost-effectiveness of these programs. PMID:27497275

  18. Current Status of Interventional Radiology in the Management of Gastro-Entero-Pancreatic Neuroendocrine Tumours (GEP-NETs)

    SciTech Connect

    Orgera, Gianluigi; Krokidis, Miltiadis; Cappucci, Matteo; Gourtsoyianni, Sofia; Tipaldi, Marcello Andrea; Hatzidakis, Adam; Rebonato, Alberto; Rossi, Michele

    2015-02-15

    Within the group of Gastro-Entero-Pancreatic Neuroendocrine tumours (GEP-NETs), several heterogeneous malignancies are included with a variety of clinical manifestations and imaging characteristics. Often these cases are inoperable and minimal invasive treatment offered by image-guided procedures appears to be the only option. Interventional radiology offers a valid solution in the management of primary and metastatic GEP-NETs. The purpose of this review article is to describe the current status of the role of Interventional Radiology in the management of GEP-NETs.

  19. Medicare in interventional pain management: A critical analysis.

    PubMed

    Manchikanti, Laxmaiah

    2006-07-01

    Recent years have been quite eventful for interventional pain physicians with numerous changes in the Medicare payment system with a view for the future and what it holds for interventional pain management for 2006 and beyond. On February 8, 2006, President Bush signed the Deficit Reduction Act of 2005, which cuts the federal budget by 39 billion dollars and Medicare and Medicaid by almost 11 billion dollars over five years. The Act contains a number of important provisions that effect physicians in general and interventional pain physicians in particular. This Act provides one year, 0% conversion factor update in payments for physicians services in 2006. Medicare has four programs or parts, namely Medicare Parts A, B, C, and D, and two funds to pay providers for serving beneficiaries in each of these program. Part B helps pay for physician, outpatient hospital, home health, and other services for the aged and disabled who have voluntarily enrolled. Before 1922, the fees that Medicare paid for those services were largely based on physician's historical charges. Despite Congress's actions of freezing or limiting the fee increases, spending continued to rise because of increases in the volume and intensity of physician services. Medicare spending per beneficiary for physician services grew at an average annual rate of 11.6% from 1980 through 1991. Consequently Congress was forced to reform the way that Medicare sets physician fees, due to ineffectiveness of the fee controls and reductions. The sustained growth rate (SGR) system was established because of the concern that the fee schedule itself would not adequately constrain increases in spending for physicians' services. The law specifies a formula for calculating the SGR, based on changes in four factors: (1) estimated changes in fees; (2) estimated change in the average number of Part B enrollees (excluding Medicare Advantage beneficiaries); (3) estimated projected growth in real gross domestic product (GDP

  20. A case report: Clinical application of celiac plexus block in bile duct interventional procedures.

    PubMed

    Karm, Myong-Hwan; Cho, Hyun-Seok; Lee, Jae-Young; Bae, Heon-Yong; Ahn, Ho-Soo; Kim, Yeon Ju; Leem, Jeong-Gil; Choi, Seong-Soo

    2016-07-01

    Although percutaneous transhepatic biliary drainage (PTBD) and tract dilatation (TD) are very painful procedures, almost all of those procedures have been conducted under local anesthesia and opioid injection due to the lack of manpower and time. Celiac plexus block (CPB) is an interventional technique used for diagnostic and therapeutic purposes in the treatment of abdominovisceral pain. CPB decreases the side effects of opioid medications and enhances analgesia from medications. We present the case of a patient who underwent PTBD and TD under CPB in order to reduce procedure-related abdominal pain.CPB can be a useful alternative technique for pain management during and after biliary interventional procedures, although CPB-induced complications must always be kept in mind. PMID:27399112

  1. NASW Standards for Social Work Case Management.

    ERIC Educational Resources Information Center

    National Association of Social Workers, Washington, DC.

    This document presents the standards for social work case management created by the National Association of Social Workers (NASW). Social work case management is defined as "a method of providing services whereby a professional social worker assesses the needs of the client and the client's family, when appropriate, and arranges, coordinates,…

  2. Reviewing case management in community psychiatric care.

    PubMed

    Bush, Tony

    Case management is a process of psychiatric care provision that uses a structured and focused approach to effectively assess individual patient's needs. The aim of this article is to examine the current status of case management in NHS community mental health care in terms of therapeutic impact and relevance. PMID:16209396

  3. Iowa Case Management for Rural Drug Abuse

    ERIC Educational Resources Information Center

    Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

    2009-01-01

    Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

  4. Psychotherapeutic and psychosocial interventions for managing stress in multiple sclerosis: the contribution of mindfulness-based interventions.

    PubMed

    Muñoz San José, A; Oreja-Guevara, C; Cebolla Lorenzo, S; Carrillo Notario, L; Rodríguez Vega, B; Bayón Pérez, C

    2016-03-01

    Depression or anxiety in multiple sclerosis (MS) has been linked to a more severe course of the disease and higher numbers of relapses, in addition to poorer treatment adherence and exacerbated immune system dysregulation. Recent investigations indicate that psychotherapeutic interventions for stress management, such as mindfulness-based interventions (MBIs), could improve quality of life, depression, anxiety, and fatigue in MS patients. Mindfulness fosters the ability to slow down and observe experiences as they truly are, which improves affect regulation. Mindfulness is acquired through training; its advantage over other psychotherapeutic interventions is that effects may remain over time, since cultivating mindfulness depends on regular practising of abilities learned during training. The objective of this article is to review the current evidence of psychotherapeutic and psychosocial interventions, including MBIs for stress management, and their beneficial effects on MS patients. PMID:26385015

  5. Science, Social Work, and Intervention Research: The Case of "Critical Time Intervention"

    ERIC Educational Resources Information Center

    Jenson, Jeffrey M.

    2014-01-01

    Intervention research is an important, yet often neglected, focus of social work scholars and investigators. The purpose of this article is to review significant milestones and recent advances in intervention research. Methodological and analytical developments in intervention research are discussed in the context of science and social work.…

  6. Implications of fraud and abuse in interventional pain management.

    PubMed

    Manchikanti, Laxmaiah

    2002-07-01

    The federal government has enacted a comprehensive strategy to fight healthcare waste, fraud and abuse. As a result of the federal government's comprehensive strategy, in 2002, the Office of Inspector General announced that improper Medicare payments to doctors, hospitals and other healthcare providers declined 54% from the fiscal year 1996 to the fiscal year 2001. The Office of Inspector General in its 2002 work plan focuses on procedure coding for outpatient services billed by hospital and doctor, coding for evaluation and management services in physician offices and conditions under which a doctor's bill is "incident to" services or supplies among other things. The distinction between fraud and abuse can be very important in determining the potential fines and penalties that might apply, even though it is not clear. Fraud is much more serious than abuse. The degree of intent by the individual or entity under investigation is often the determining factor. The most commonly used statutes for prosecuting or facilitating such a prosecution of healthcare fraud or abuse include HIPAA of 1996, the False Claims Act, healthcare fraud, theft or embezzlement, obstruction of criminal investigations of healthcare offenders, the False Statement Statute, mail and wire fraud statutes, the Social Security Act Civil Monetary Penalties, criminal penalties, and/or Stark laws. This review focuses on various aspects of implications of fraud and abuse in interventional pain management practices including various activities of potential fraud and abuse. PMID:16902658

  7. Community-Based Intervention to Manage an Outbreak of MRSA Skin Infections in a County Jail

    PubMed Central

    Elias, Abdallah F.; Chaussee, Michael S.; McDowell, Emily J.; Huntington, Mark K.

    2012-01-01

    This article describes a community-based intervention to manage an outbreak of communityassociated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections in a midwestern county jail. A systematic investigation conducted by a family medicine residency program identified 64 total cases and 19 MRSA cases between January 1 and December 31, 2007. Factors contributing to MRSA transmission included inadequate surveillance, lack of antibacterial soap, and a defective laundry process. All 19 isolates were CA-MRSA and all seven tested by pulsed-field gel electrophoresis (PFGE) were USA300. Four of the seven isolates showed variation of their PFGE patterns. A primary care approach using community-based resources effectively reduced the number of cases in this heterogeneous outbreak of CA-MRSA, with the last MRSA being isolated in October 2007. PMID:20466702

  8. Community-based intervention to manage an outbreak of MRSA skin infections in a county jail.

    PubMed

    Elias, Abdallah F; Chaussee, Michael S; McDowell, Emily J; Huntington, Mark K

    2010-07-01

    This article describes a community-based intervention to manage an outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections in a midwestern county jail. A systematic investigation conducted by a family medicine residency program identified 64 total cases and 19 MRSA cases between January 1 and December 31, 2007. Factors contributing to MRSA transmission included inadequate surveillance, lack of antibacterial soap, and a defective laundry process. All 19 isolates were CA-MRSA and all seven tested by pulsed-field gel electrophoresis (PFGE) were USA300. Four of the seven isolates showed variation of their PFGE patterns. A primary care approach using community-based resources effectively reduced the number of cases in this heterogeneous outbreak of CA-MRSA, with the last MRSA being isolated in October 2007. PMID:20466702

  9. A Randomized Controlled Trial of a Standardized Behavior Management Intervention for Students with Externalizing Behavior

    ERIC Educational Resources Information Center

    Forster, Martin; Sundell, Knut; Morris, Richard J.; Karlberg, Martin; Melin, Lennart

    2012-01-01

    This study reports the results from a Swedish randomized controlled trial of a standardized behavior management intervention. The intervention targeted students with externalizing behavior in a regular education setting. First- and second-grade students (N = 100) from 38 schools were randomly assigned to either the intervention or an active…

  10. Stress Management in the Health Care Setting: Matching Interventions with Patient Coping Styles.

    ERIC Educational Resources Information Center

    Martelli, Michael F.; And Others

    1987-01-01

    Prospective preprosthetic oral surgery patients were presented with a problem-focused, emotion-focused, or mixed-focus stress management intervention. The mixed-focus intervention produced the best overall response to surgery; the emotion-focused intervention produced the lowest adjustment levels. Better adjustment and satisfaction and lower…

  11. Consultation, Follow-up, and Implementation of Behavior Management Interventions in General Education.

    ERIC Educational Resources Information Center

    Noell, George H.; Duhon, Gary J.; Gatti, Susan L.; Connell, James E.

    2002-01-01

    Examines general education teachers' implementation of behavior management interventions following consultation. Interventions were implemented for 8 elementary school students referred for consultation and intervention due to disruptive behavior in the classroom. Initial implementation varied across teachers, but became unstable or exhibited a…

  12. The Effect of a "Mindful Restaurant Eating" Intervention on Weight Management in Women

    ERIC Educational Resources Information Center

    Timmerman, Gayle M.; Brown, Adama

    2012-01-01

    Objective: To evaluate the effect of a "Mindful Restaurant Eating" intervention on weight management. Design: Randomized control trial. Setting: Greater metropolitan area of Austin, Texas. Participants: Women (n = 35) 40-59 years old who eat out at least 3 times per week. Intervention: The intervention, using 6 weekly 2-hour, small group sessions,…

  13. Integrating behavior change theory into geriatric case management practice.

    PubMed

    Enguidanos, S

    2001-01-01

    Case management practices have continued to grow despite a lack of clear evidence of their efficacy. With the expanding segment of the elderly population, there is a critical need to develop and identify programs that will address the many needs of the aging. Geriatric Case Management has been the avenue selected by many health care providers to address these issues, focusing on maintaining health status and improving linkages with medical and community resources. Studies testing the effectiveness of these models have failed to demonstrate their effectiveness in reducing depression, reducing acute care service use, and improving or maintaining health status. The Geriatric Case Management models presented in these lack an evidence-based, theoretical framework that provides definition and direction for case management practice. This article introduces behavior change theories as a method of structuring and delineating the case management intervention. The Transtheoretical Model and the Theory of Planned Behavior are discussed and methods of integrating these theories into practice are discussed. PMID:11878076

  14. Chiropractic management of chronic idiopathic meralgia paresthetica: a case study

    PubMed Central

    Houle, Sébastien

    2012-01-01

    Objectives This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care. Clinical Features A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction. Intervention and Outcomes Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh. Conclusion In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient. PMID:22942840

  15. Intensive outpatient comprehensive behavioral intervention for tics: A case series

    PubMed Central

    Blount, Tabatha H; Lockhart, Ann-Louise T; Garcia, Rocio V; Raj, Jeslina J; Peterson, Alan L

    2014-01-01

    Recent randomized clinical trials have established the efficacy of Comprehensive Behavioral Intervention for Tics (CBIT) in treating children and adults with Tourette syndrome and persistent tic disorders. However, the standard CBIT protocol uses a weekly outpatient treatment format (i.e., 8 sessions over 10 wk), which may be inconvenient or impractical for some patients, particularly patients, who are required to travel long distances in order to receive care. In contrast, an intensive outpatient program may increase accessibility to evidence-based behavioral treatments for Tourette syndrome and other persistent tic disorders by eliminating the necessity of repeated travel. This case series evaluated the use of an intensive outpatient program CBIT (IOP CBIT) for the treatment of 2 preadolescent males (ages 10 and 14 years) with Tourette syndrome. The IOP CBIT treatment protocol included several hours of daily treatment over a 4-d period. Both children evidenced notable reductions in their tics and maintained treatment gains at follow-up. Moreover, both patients and their parents expressed treatment satisfaction with the IOP CBIT format. This case series addresses an important research gap in the behavioral treatment of tic disorders literature. The patients’ treatment outcomes indicate that IOP CBIT is a promising treatment that warrants more systematic investigation. PMID:25325069

  16. Adaptive management and the value of information: learning via intervention in epidemiology

    USGS Publications Warehouse

    Shea, Katriona; Tildesley, Michael J.; Runge, Michael C.; Fonnesbeck, Christopher J.; Ferrari, Matthew J.

    2014-01-01

    Optimal intervention for disease outbreaks is often impeded by severe scientific uncertainty. Adaptive management (AM), long-used in natural resource management, is a structured decision-making approach to solving dynamic problems that accounts for the value of resolving uncertainty via real-time evaluation of alternative models. We propose an AM approach to design and evaluate intervention strategies in epidemiology, using real-time surveillance to resolve model uncertainty as management proceeds, with foot-and-mouth disease (FMD) culling and measles vaccination as case studies. We use simulations of alternative intervention strategies under competing models to quantify the effect of model uncertainty on decision making, in terms of the value of information, and quantify the benefit of adaptive versus static intervention strategies. Culling decisions during the 2001 UK FMD outbreak were contentious due to uncertainty about the spatial scale of transmission. The expected benefit of resolving this uncertainty prior to a new outbreak on a UK-like landscape would be £45–£60 million relative to the strategy that minimizes livestock losses averaged over alternate transmission models. AM during the outbreak would be expected to recover up to £20.1 million of this expected benefit. AM would also recommend a more conservative initial approach (culling of infected premises and dangerous contact farms) than would a fixed strategy (which would additionally require culling of contiguous premises). For optimal targeting of measles vaccination, based on an outbreak in Malawi in 2010, AM allows better distribution of resources across the affected region; its utility depends on uncertainty about both the at-risk population and logistical capacity. When daily vaccination rates are highly constrained, the optimal initial strategy is to conduct a small, quick campaign; a reduction in expected burden of approximately 10,000 cases could result if campaign targets can be updated on

  17. Adaptive Management and the Value of Information: Learning Via Intervention in Epidemiology

    PubMed Central

    Shea, Katriona; Tildesley, Michael J.; Runge, Michael C.; Fonnesbeck, Christopher J.; Ferrari, Matthew J.

    2014-01-01

    Optimal intervention for disease outbreaks is often impeded by severe scientific uncertainty. Adaptive management (AM), long-used in natural resource management, is a structured decision-making approach to solving dynamic problems that accounts for the value of resolving uncertainty via real-time evaluation of alternative models. We propose an AM approach to design and evaluate intervention strategies in epidemiology, using real-time surveillance to resolve model uncertainty as management proceeds, with foot-and-mouth disease (FMD) culling and measles vaccination as case studies. We use simulations of alternative intervention strategies under competing models to quantify the effect of model uncertainty on decision making, in terms of the value of information, and quantify the benefit of adaptive versus static intervention strategies. Culling decisions during the 2001 UK FMD outbreak were contentious due to uncertainty about the spatial scale of transmission. The expected benefit of resolving this uncertainty prior to a new outbreak on a UK-like landscape would be £45–£60 million relative to the strategy that minimizes livestock losses averaged over alternate transmission models. AM during the outbreak would be expected to recover up to £20.1 million of this expected benefit. AM would also recommend a more conservative initial approach (culling of infected premises and dangerous contact farms) than would a fixed strategy (which would additionally require culling of contiguous premises). For optimal targeting of measles vaccination, based on an outbreak in Malawi in 2010, AM allows better distribution of resources across the affected region; its utility depends on uncertainty about both the at-risk population and logistical capacity. When daily vaccination rates are highly constrained, the optimal initial strategy is to conduct a small, quick campaign; a reduction in expected burden of approximately 10,000 cases could result if campaign targets can be updated on

  18. Percutaneous endovascular management of atherosclerotic axillary artery stenosis: Report of 2 cases and review of literature

    PubMed Central

    Vijayvergiya, Rajesh; Yadav, Mukesh; Grover, Anil

    2011-01-01

    With recent advancement in percutaneous endovascular management, most atherosclerotic peripheral arterial diseases are amenable for intervention. However, there is limited published literature about atherosclerotic axillary artery involvement and its endovascular management. We report two cases of atherosclerotic axillary artery stenosis, which were successfully managed with stent angioplasty using self expanding nitinol stents. The associated coronary artery disease was treated by percutaneous angioplasty and stenting. The long term follow-up revealed patent axillary stents in both cases. PMID:21666817

  19. Social Competence Intervention in Autistic Spectrum Disorders (ASDS) - A Case Study

    ERIC Educational Resources Information Center

    Amin, Noor A.; Oweini, Ahmad

    2013-01-01

    The purpose of this case study was to determine the effectiveness of a combined intervention in remediating the social skills in a first-grader with a disorder from the autism spectrum disorders (ASDs). The researcher also aimed to identify the changes observed during the intervention period. The combined intervention consisted of reading…

  20. Using Self-Management Interventions to Address General Education Behavioral Needs: Assessment of Effectiveness and Feasibility

    ERIC Educational Resources Information Center

    Briesch, Amy M.; Daniels, Brian

    2013-01-01

    A comprehensive self-management intervention was utilized to increase the on-task behavior of three African American students within an urban middle-school setting. The intervention was designed to necessitate minimal management on the part of the general education classroom teacher by utilizing an electronic prompting device, as well as a…

  1. Parents' Use of Physical Interventions in the Management of Their Children's Severe Challenging Behaviour

    ERIC Educational Resources Information Center

    Allen, David; Hawkins, Sarah; Cooper, Viv

    2006-01-01

    Background: Although training staff supporting people with challenging behaviour in physical interventions has become accepted practice, parents are often left to fend for themselves while managing equivalent behaviours. The study explores parents' experience of managing severe challenging behaviours, their use of physical interventions and access…

  2. Critical factors in case management: practical lessons from a cardiac case management program.

    PubMed

    Stafford, Randall S; Berra, Kathy

    2007-08-01

    Case management (CM) is an important strategy for chronic disease care. By utilizing non-physician providers for conditions requiring ongoing care and follow-up, CM can facilitate guideline-concordant care, patient empowerment, and improvement in quality of life. We identify a series of critical factors required for successful CM implementation. Heart to Heart is a clinical trial evaluating CM for coronary heart disease (CHD) risk reduction in a multiethnic, low-income population. Patients at elevated cardiac risk were randomized to CM plus primary care (212 patients) or to primary care alone (207). Over a mean follow-up of 17 months, patients received face-to-face nurse and dietitian visits. Mean contact time was 14 hours provided at an estimated cost of $1250 per patient for the 341 (81%) patients completing follow-up. Visits emphasized behavior change, risk-factor monitoring, self-management skills, and guideline-based pharmacotherapy. A statistically significant reduction in mean Framingham risk probability occurred in CM plus primary care relative to primary care alone (1.6% decrease in 10-year CHD risk, p = 0.007). Favorable changes were noted across individual risk factors. Our findings suggest that successful CM implementation relies on choosing appropriate case managers and investing in training, integrating CM into existing care systems, delineating the scope and appropriate levels of clinical decision making, using information systems, and monitoring outcomes and costs. While our population, setting, and intervention model are unique, these insights are broadly relevant. If implemented with attention to critical factors, CM has great potential to improve the process and outcomes of chronic disease care. PMID:17718658

  3. Surgical and interventional management of complications caused by acute pancreatitis

    PubMed Central

    Karakayali, Feza Y

    2014-01-01

    Acute pancreatitis is one of the most common gastrointestinal disorders worldwide. It requires acute hospitalization, with a reported annual incidence of 13 to 45 cases per 100000 persons. In severe cases there is persistent organ failure and a mortality rate of 15% to 30%, whereas mortality of mild pancreatitis is only 0% to 1%. Treatment principles of necrotizing pancreatitis and the role of surgery are still controversial. Despite surgery being effective for infected pancreatic necrosis, it carries the risk of long-term endocrine and exocrine deficiency and a morbidity and mortality rate of between 10% to 40%. Considering high morbidity and mortality rates of operative necrosectomy, minimally invasive strategies are being explored by gastrointestinal surgeons, radiologists, and gastroenterologists. Since 1999, several other minimally invasive surgical, endoscopic, and radiologic approaches to drain and debride pancreatic necrosis have been described. In patients who do not improve after technically adequate drainage, necrosectomy should be performed. When minimal invasive management is unsuccessful or necrosis has spread to locations not accessible by endoscopy, open abdominal surgery is recommended. Additionally, surgery is recognized as a major determinant of outcomes for acute pancreatitis, and there is general agreement that patients should undergo surgery in the late phase of the disease. It is important to consider multidisciplinary management, considering the clinical situation and the comorbidity of the patient, as well as the surgeons experience. PMID:25309073

  4. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain.

    PubMed

    Manchikanti, Laxmaiah; Staats, Peter S; Singh, Vijay; Schultz, David M; Vilims, Bradley D; Jasper, Joseph F; Kloth, David S; Trescot, Andrea M; Hansen, Hans C; Falasca, Thomas D; Racz, Gabor B; Deer, Timothy R; Burton, Allen W; Helm, Standiford; Lou, Leland; Bakhit, Cyrus E; Dunbar, Elmer E; Atluri, Sairam L; Calodney, Aaron K; Hassenbusch, Samuel J; Feler, Claudio A

    2003-01-01

    Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain are systematically developed and professionally derived statements and recommendations that assist both physicians and patients in making decisions about appropriate health care in the diagnosis and treatment of chronic or persistent pain. The guidelines were developed utilizing an evidence-based approach to increase patient access to treatment, to improve outcomes and appropriateness of care, and to optimize cost-effectiveness. All types of relevant and published evidence and consensus were utilized. The guidelines include a discussion of their purpose, rationale, and importance, including descriptions of the patient population served, the methodology, and the pathophysiologic basis for intervention. Multiple diagnostic and therapeutic interventional techniques are included in this document. Strong evidence was shown for diagnostic facet joint blocks for the diagnosis of facet joint pain, and lumbar provocative discography for discogenic pain. Moderate evidence was shown for sacroiliac joint blocks in the diagnosis of sacroiliac joint pain, and for transforaminal epidural injections in the preoperative evaluation of patients with negative or inconclusive imaging studies, but with clinical findings of nerve root irritation. Moderate to strong evidence was shown for multiple therapeutic interventional techniques including medial branch blocks and medial branch neurotomy; caudal epidural steroid injections and transforaminal epidural steroid injections; lumbar percutaneous adhesiolysis; and implantable therapies. These guidelines do not constitute inflexible treatment recommendations. It is expected that a provider will establish a plan of care on a case-by-case basis, taking into account an individual patient's medical condition, personal needs, and preferences, and the physician's experience. Based on an individual patient's needs, treatment different from that

  5. Social Support for Diabetes Self-Management via eHealth Interventions.

    PubMed

    Vorderstrasse, Allison; Lewinski, Allison; Melkus, Gail D'Eramo; Johnson, Constance

    2016-07-01

    eHealth interventions have been increasingly used to provide social support for self-management of type 2 diabetes. In this review, we discuss social support interventions, types of support provided, sources or providers of support, outcomes of the support interventions (clinical, behavioral, psychosocial), and logistical and clinical considerations for support interventions using eHealth technologies. Many types of eHealth interventions demonstrated improvements in self-management behaviors, psychosocial outcomes, and clinical measures, particularly HbA1c. Important factors to consider in clinical application of eHealth support interventions include participant preferences, usability of eHealth technology, and availability of personnel to orient or assist participants. Overall, eHealth is a promising adjunct to clinical care as it addresses the need for ongoing support in chronic disease management. PMID:27155606

  6. Evaluation of a case management service to reduce sickness absence

    PubMed Central

    Smedley, Julia; Harris, E. Clare; Cox, Vanessa; Ntani, Georgia; Coggon, David

    2013-01-01

    Background It is unclear whether and to what extent intensive case management is more effective than standard occupational health services in reducing sickness absence in the healthcare sector. Aims To evaluate a new return to work service at an English hospital trust. Methods The new service entailed intensive case management for staff who had been absent sick for longer than four weeks, aiming to restore function through a goal-directed and enabling approach based on a bio-psycho-social model. Assessment of the intervention was by controlled before and after comparison with a neighbouring hospital trust at which there were no major changes in the management of sickness absence. Data on outcome measures were abstracted from electronic databases held by the two trusts. Results At the intervention trust, the proportion of 4-week absences which continued beyond 8 weeks fell from 51.7% in 2008 to 49.1% in 2009 and 45.9% in 2010. The reduction from 2008 to 2010 contrasted with an increase at the control trust from 51.2% to 56.1% – a difference in change of 10.7% (95%CI 1.5% to 20.0%). There was also a differential improvement in mean days of absence beyond four weeks, but this was not statistically significant (1.6 days per absence, 95%CI −7.2 to 10.3 days). Conclusion Our findings suggest that the intervention was effective, and calculations based on an annual running cost of £57,000 suggest that it was also cost-effective. A similar intervention should now be evaluated at a larger number of hospital trusts. PMID:23365116

  7. Managing severe peripartum hyponatraemia: A case report

    PubMed Central

    Lim, Jerry; Laing, Christopher M; MacCallum, Niall S; Brealey, David A

    2014-01-01

    We present a case of severe peripartum hyponatraemia that occurred following a major obstetric haemorrhage causing both an ischaemic stroke and Sheehan's syndrome and outline the investigations and management strategy required.

  8. Multimedia case management system implemented in Java

    NASA Astrophysics Data System (ADS)

    Stewart, Howard D.; Davis, Midge L.; Handy, Dale L.; Kvarfordt, Kent B.; Ford, Glenn

    1999-01-01

    Managing the timely access of information is a major challenge facing law enforcement agencies. One of the areas of greatest need is that of the case management process. During the course of FY98, the Office of National Drug Control Policy (ONDCP), the Counterdrug Technology Assessment Center (CTAC), the Idaho National Engineering and Environmental Laboratory (INEEL), and the Criminal Investigative Bureau (CIB) of the state of Idaho, created a Northwest testbed to develop and integrate a multimedia case management system. A system was developed to assist investigators in tracking and maintaining investigative cases and improving access to internal and external data resources. In this paper, we discuss the results of our case management system development and the ability to present state and federal information incorporating object oriented and multimedia techniques. We then outline our plans for future research and development.

  9. Is mindfulness-based therapy an effective intervention for obsessive-intrusive thoughts: a case series.

    PubMed

    Wilkinson-Tough, Megan; Bocci, Laura; Thorne, Kirsty; Herlihy, Jane

    2010-01-01

    Despite the efficacy of cognitive-behavioural interventions in improving the experience of obsessions and compulsions, some people do not benefit from this approach. The present research uses a case series design to establish whether mindfulness-based therapy could benefit those experiencing obsessive-intrusive thoughts by targeting thought-action fusion and thought suppression. Three participants received a relaxation control intervention followed by a six-session mindfulness-based intervention which emphasized daily practice. Following therapy all participants demonstrated reductions in Yale-Brown Obsessive-Compulsive Scale scores to below clinical levels, with two participants maintaining this at follow-up. Qualitative analysis of post-therapy feedback suggested that mindfulness skills such as observation, awareness and acceptance were seen as helpful in managing thought-action fusion and suppression. Despite being limited by small participant numbers, these results suggest that mindfulness may be beneficial to some people experiencing intrusive unwanted thoughts and that further research could establish the possible efficacy of this approach in larger samples. PMID:20041421

  10. Case Studies in Managing Psychological Depth.

    ERIC Educational Resources Information Center

    Ringer, Martin; Gillis, H. L.

    This paper outlines a model for assessing and managing psychological depth in outdoor and experiential group work, and presents two case studies of the complexity of such management in real life. The model contains eight levels of emotional risk and presents four criteria for assessing the level to which a particular event or discussion may lead…

  11. Three Student Case Examples of Response to Intervention Programming

    ERIC Educational Resources Information Center

    Dunn, Michael; Browning, Ruth

    2012-01-01

    Many schools across the United States and Canada are now implementing response-to-intervention (RTI) as a means to address the needs of students who struggle with reading, writing, or math by using dual discrepancy (i.e., low ability and little to no progress over time with targeted intervention programming) as a means to classify for learning…

  12. Recognizing and managing boundary issues in case management.

    PubMed

    Walsh, J

    2000-01-01

    Much of the literature on worker-client boundaries in clinical practice is based on assumptions that the relationship between the two parties is structured and formal. These assumptions do not always apply in community-based case management practice, where the worker and client interact in a wide variety of settings and circumstances. The relative informality of case management makes the establishment of appropriate worker-client boundaries both critical and difficult. In this article key principles for recognizing and managing boundary issues are presented and discussed. PMID:11107659

  13. Outage management: A case study

    SciTech Connect

    Haber, S.B.; Barriere, M.T. ); Roberts, K.H. . Walter A. Haas School of Business)

    1992-01-01

    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission's (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

  14. Outage management: A case study

    SciTech Connect

    Haber, S.B.; Barriere, M.T.; Roberts, K.H.

    1992-09-01

    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission`s (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

  15. The Empirical Evidence for the Telemedicine Intervention in Diabetes Management

    PubMed Central

    Shannon, Gary W.; Smith, Brian R.; Woodward, Maria A.

    2015-01-01

    Abstract Objective: The research presented here assesses the scientific evidence for the telemedicine intervention in the management of diabetes (telediabetes), gestational diabetes, and diabetic retinopathy. The impetus derives from the confluence of high prevalence of these diseases, increasing incidence, and rising costs, while telemedicine promises to ameliorate, if not prevent, type 2 diabetes and its complications. Materials and Methods: A purposeful review of the literature identified relevant publications from January 2005 to December 2013. These were culled to retain only credible research articles for detailed review and analysis. The search yielded approximately 17,000 articles with no date constraints. Of these, 770 appeared to be research articles within our time frame. A review of the abstracts yielded 73 articles that met the criteria for inclusion in the final analysis. Evidence is organized by research findings regarding feasibility/acceptance, intermediate outcomes (e.g., use of service, and screening compliance), and health outcomes (control of glycemic level, lipids, body weight, and physical activity.) Results: Definitions of telediabetes varied from study to study vis-à-vis diabetes subtype, setting, technology, staffing, duration, frequency, and target population. Outcome measures also varied. Despite these vagaries, sufficient evidence was obtained from a wide variety of research studies, consistently pointing to positive effects of telemonitoring and telescreening in terms of glycemic control, reduced body weight, and increased physical exercise. The major contributions point to telemedicine's potential for changing behaviors important to diabetes control and prevention, especially type 2 and gestational diabetes. Similarly, screening and monitoring for retinopathy can detect symptoms early that may be controlled or treated. Conclusions: Overall, there is strong and consistent evidence of improved glycemic control among persons with type 2

  16. Management of Ectopically Erupting Maxillary Incisors: A Case Series.

    PubMed

    Suresh, Kotumachagi Sangappa; Uma, H L; Nagarathna, J; Kumar, Pravin

    2015-01-01

    Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  17. Management of Ectopically Erupting Maxillary Incisors: A Case Series

    PubMed Central

    Suresh, Kotumachagi Sangappa; Uma, HL; Nagarathna, J

    2015-01-01

    ABSTRACT Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  18. Case managers' roles and functions: Commission for Case Manager Certification's 2004 Research, Part I.

    PubMed

    Tahan, Hussein A; Huber, Diane L; Downey, William T

    2006-01-01

    The Commission for Case Manager Certification (CCMC) conducted its third case managers' role and functions study in 2004. The purpose of this research was to validate the currency and relevancy of the certified case manager examination. The results of this study are shared in 2 parts of an article. Part I discusses the process the CCMC used for the development of the Case Manager's Role and Functions Survey Instrument (CMRFSI). The research leads to the identification of 6 new essential functions and 6 new knowledge areas, which describe case management practice. These findings were based on the survey of a large national sample of practicing case managers. Part II continues the analysis of the survey results and focuses on identifying the empirical activity and knowledge domains of case management practice, using factor analysis. It also discusses the similarities and differences found among various subgroups of case managers who were compared on the basis of certain demographic variables. In addition, it summarizes future changes in the field of case management as perceived by those who participated in the study. PMID:16444117

  19. Case managers' roles and functions: Commission for Case Manager Certification's 2004 research, part II.

    PubMed

    Tahan, Hussein A; Downey, William T; Huber, Diane L

    2006-01-01

    The Commission for Case Manager Certification (CCMC) conducted its third case managers' role and functions study in 2004 for the purpose of validating the currency and relevancy of the certified case manager examination. The results of this study are shared in an article of 2 parts. Part I, which was published in the previous issue of this journal, discussed the process the CCMC used for the development of the Case Managers' Role and Functions Survey Instrument and the identification of new 6 essential functions and 6 knowledge areas that describe case management practice. These findings were based on the survey of a large national sample of practicing case managers. Part II continues the analysis of the results and focuses on identifying the empirical (statistically derived) activity and knowledge domains of case management practice, using exploratory factor analysis. It discusses the similarities and differences found among various subgroups of case managers who were compared on the basis of certain demographic variables. In addition, Part II summarizes future changes in the field of case management as perceived by those who participated in the study. PMID:16582699

  20. Intensive case management for severe mental illness

    PubMed Central

    Dieterich, Marina; Irving, Claire B; Park, Bert; Marshall, Max

    2014-01-01

    Background Intensive Case Management (ICM) is a community based package of care, aiming to provide long term care for severely mentally ill people who do not require immediate admission. ICM evolved from two original community models of care, Assertive Community Treatment (ACT) and Case Management (CM), where ICM emphasises the importance of small caseload (less than 20) and high intensity input. Objectives To assess the effects of Intensive Case Management (caseload <20) in comparison with non-Intensive Case Management (caseload > 20) and with standard community care in people with severe mental illness. To evaluate whether the effect of ICM on hospitalisation depends on its fidelity to the ACT model and on the setting. Search methods For the current update of this review we searched the Cochrane Schizophrenia Group Trials Register (February 2009), which is compiled by systematic searches of major databases, hand searches and conference proceedings. Selection criteria All relevant randomised clinical trials focusing on people with severe mental illness, aged 18 to 65 years and treated in the community-care setting, where Intensive Case Management, non-Intensive Case Management or standard care were compared. Outcomes such as service use, adverse effects, global state, social functioning, mental state, behaviour, quality of life, satisfaction and costs were sought. Data collection and analysis We extracted data independently. For binary outcomes we calculated relative risk (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data we estimated mean difference (MD) between groups and its 95% confidence interval (CI). We employed a random-effects model for analyses. We performed a random-effects meta-regression analysis to examine the association of the intervention’s fidelity to the ACT model and the rate of hospital use in the setting where the trial was conducted with the treatment effect. Main results We included 38 trials

  1. Review and Analysis of Literature on Self-Management Interventions to Promote Appropriate Classroom Behaviors (1988-2008)

    ERIC Educational Resources Information Center

    Briesch, Amy M.; Chafouleas, Sandra M.

    2009-01-01

    In the late 1980s, J. W. Fantuzzo and colleagues conducted a review of the self-management literature in order to better define the characteristics of this class of interventions. Results indicated that many interventions were minimally student-directed despite the title "self-managed" and that student-managed interventions demonstrated…

  2. Interventional Pain Management in Rheumatological Diseases - A Three Years Physiatric Experience in a Tertiary Medical College Hospital in Bangladesh

    PubMed Central

    Hasan, Suzon Al; Das, Gautam; Khan, Amin Uddin A

    2011-01-01

    Background Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Results The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusions All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties. PMID:22220242

  3. A Scoping Review of Behavioral Weight Management Interventions in Overweight/Obese African American Females.

    PubMed

    Sutton, Suzanne M; Magwood, Gayenell S; Jenkins, Carolyn H; Nemeth, Lynne S

    2016-08-01

    African American females are adversely affected by overweight and obesity and accompanying physical, psychosocial, and economic consequences. Behavioral weight management interventions are less effective in addressing the needs of overweight and obese African American females. The objective of this scoping review was to explore weight management research in this population to identify key concepts, gaps in the literature, and implications for future research. Analyses revealed a broad array in purpose, theoretical frameworks, settings, study designs, interventions, intervention strategies, and outcome variables, making comparison difficult. Many of the articles included in this review did not provide a rich description of methods, which hinder their use in the development of future studies. Consistent application of a combined theory may address the gaps identified in this review by providing a reliable method for assessing needs, developing interventions, and evaluating the effectiveness and fidelity of behavioral weight management interventions in overweight and obese African American females. PMID:26927607

  4. Developing a Manualized Occupational Therapy Diabetes Management Intervention: Resilient, Empowered, Active Living With Diabetes.

    PubMed

    Pyatak, Elizabeth A; Carandang, Kristine; Davis, Shain

    2015-07-01

    This article reports on the development of a manualized occupational therapy intervention for diabetes management. An initial theoretical framework and core content areas for a Stage I intervention manual were developed based on an in-depth needs assessment and review of existing literature. After evaluation by a panel of experts and completion of a feasibility study, the intervention was revised into a Stage 2 manual in preparation for a randomized study evaluating the intervention's efficacy. In developing the initial manual, we delineated core theoretical principles to allow for flexible application and tailoring of the intervention's content areas. Expert panel feedback and feasibility study results led to changes to the intervention structure and content as we developed the Stage 2 manual. Through describing this process, we illustrate the dynamic evolution of intervention manuals, which undergo revisions due to both theoretical and practical considerations at each stage of the research-to-clinical practice pipeline. PMID:26594741

  5. Surgical Management of Stuttering Ischemic Priapism: A Case Report and Concise Clinical Review.

    PubMed

    Raslan, M; Hiew, K; Hoyle, A; Ross, D G; Betts, C D; Maddineni, S B

    2016-03-01

    Stuttering priapism is an extremely rare and poorly understood entity. We present a rare case of a 47-year-old Afro-Caribbean gentleman who required proximal shunt procedure to treat his ischemic stuttering priapism after he had failed medical management. We provided a concise review of the literature on the surgical management of ischemic priapism. This case highlighted the importance of prompt surgical intervention in prolonged stuttering priapism to avoid serious psychological and functional complications. PMID:26977408

  6. Differences in Osteoarthritis Self-Management Support Intervention Outcomes According to Race and Health Literacy

    ERIC Educational Resources Information Center

    Sperber, Nina R.; Bosworth, Hayden B.; Coffman, Cynthia J.; Lindquist, Jennifer H.; Oddone, Eugene Z.; Weinberger, Morris; Allen, Kelli D.

    2013-01-01

    We explored whether the effects of a telephone-based osteoarthritis (OA) self-management support intervention differed by race and health literacy. Participants included 515 veterans with hip and/or knee OA. Linear mixed models assessed differential effects of the intervention compared with health education (HE) and usual care (UC) on pain…

  7. Translating Training Science into Practice: A Study of Managers' Reactions to Posttraining Transfer Interventions.

    ERIC Educational Resources Information Center

    Huint, Philip; Saks, Alan M.

    2003-01-01

    In a randomized 2x2 study, 174 managers and students read one of four scenarios with one of two posttraining transfer interventions (relapse prevention, supervisor support training) and information types (utility analysis, research). They showed no preference for adopting either intervention to increase staff productivity. Research information was…

  8. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

    PubMed Central

    Moise, Imelda K.; Mulhall, Peter F.

    2016-01-01

    and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking clients to adequate services rather than reporting performance. Case managers favored measurable deliverables rather than operational work products. A proposed solution to current challenges emphasizes and encourages the iterative learning process and shared decision making between program targets, funders and providers. Case managers are aware of the challenging environment in which they operate for their clients and for themselves. However, future interventions will require clearly identified performance measures and increased systems support. PMID:27149061

  9. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study.

    PubMed

    Moise, Imelda K; Mulhall, Peter F

    2016-01-01

    and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking clients to adequate services rather than reporting performance. Case managers favored measurable deliverables rather than operational work products. A proposed solution to current challenges emphasizes and encourages the iterative learning process and shared decision making between program targets, funders and providers. Case managers are aware of the challenging environment in which they operate for their clients and for themselves. However, future interventions will require clearly identified performance measures and increased systems support. PMID:27149061

  10. Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012

    PubMed Central

    Kohatsu, Neal D.; Paciotti, Brian M.; Byrne, Jennifer V.; Kizer, Kenneth W.

    2015-01-01

    Introduction Prevention is the most cost-effective approach to promote population health, yet little is known about the delivery of health promotion interventions in the nation’s largest Medicaid program, Medi-Cal. The purpose of this study was to inventory health promotion interventions delivered through Medi-Cal Managed Care Plans; identify attributes of the interventions that plans judged to have the greatest impact on their members; and determine the extent to which the plans refer members to community assistance programs and sponsor health-promoting community activities. Methods The lead health educator from each managed care plan was asked to complete a 190-item online survey in January 2013; 20 of 21 managed care plans responded. Survey data on the health promotion interventions with the greatest impact were grouped according to intervention attributes and measures of effectiveness; quantitative data were analyzed using descriptive statistics. Results Health promotion interventions judged to have the greatest impact on Medi-Cal members were delivered in various ways; educational materials, one-on-one education, and group classes were delivered most frequently. Behavior change, knowledge gain, and improved disease management were cited most often as measures of effectiveness. Across all interventions, median educational hours were limited (2.4 h), and median Medi-Cal member participation was low (265 members per intervention). Most interventions with greatest impact (120 of 137 [88%]) focused on tertiary prevention. There were mixed results in referring members to community assistance programs and investing in community activities. Conclusion Managed care plans have many opportunities to more effectively deliver health promotion interventions. Establishing measurable, evidence-based, consensus standards for such programs could facilitate improved delivery of these services. PMID:26564012

  11. Development and Feasibility of a COPD Self-Management Intervention Delivered with Motivational Interviewing Strategies

    PubMed Central

    Benzo, Roberto; Vickers, Kristin; Ernst, Denise; Tucker, Sharon; McEvoy, Charlene; Lorig, Kate

    2013-01-01

    BACKGROUND Self-management (SM) is proposed as the standard of care in chronic obstructive pulmonary disease (COPD) but details of the process and training required to deliver effective SM are not widely available. In addition, recent data suggest that patient engagement and motivation are critical ingredients for effective self-management. This manuscript carefully describes a self-management intervention using Motivational Interviewing skills, aimed to increase engagement and commitment in severe COPD patients. METHODS The intervention was developed and pilot tested for fidelity to protocol, for patient and interventionist feedback (qualitative) and effect on quality of life. Engagement between patient and interventionists was measured by the Working Alliance Inventory. The intervention was refined based in the results of the pilot study and delivered in the active arm of a prospective randomized study. RESULTS The pilot study suggested improvements in quality of life, fidelity to theory and patient acceptability. The refined self-management intervention was delivered 540 times in the active arm of a randomized study. We observed a retention rate of 86% (patients missing or not available for only 14% the scheduled encounters). CONCLUSIONS A self-management intervention, that includes motivational interviewing as the way if guiding patient into behavior change, is feasible in severe COPD and may increase patient engagement and commitment to self-management. This provides a very detailed description of the SM process for (the specifics of training and delivering the intervention) that facilitates replicability in other settings and could be translated to cardiac rehabilitation. PMID:23434613

  12. Interventional Spine Procedures for Management of Chronic Low Back Pain—A Primer

    PubMed Central

    Iannuccilli, Jason D.; Prince, Ethan A.; Soares, Gregory M.

    2013-01-01

    Chronic low back pain is a common clinical condition. Percutaneous fluoroscopic-guided interventions are safe and effective procedures for the management of chronic low back pain, which can be performed in an outpatient setting. Interventional radiologists already possess the technical skills necessary to perform these interventions effectively so that they may be incorporated into a busy outpatient practice. This article provides a basic approach to the evaluation of patients with low back pain, as well as a review of techniques used to perform the most common interventions using fluoroscopic guidance. PMID:24436553

  13. The Family Check-Up in Early Childhood: A Case Study of Intervention Process and Change

    ERIC Educational Resources Information Center

    Gill, Anne M.; Hyde, Luke W.; Shaw, Daniel S.; Dishion, Thomas J.; Wilson, Melvin N.

    2008-01-01

    This article describes a case study in the use of the Family Check-Up (FCU), a family-based and ecological preventive intervention for children at risk for problem behavior. The FCU is an assessment-driven intervention that utilizes a health maintenance model; emphasizes motivation for change; and offers an adaptive, tailored approach to…

  14. Implementing an Early Intervention Program for Residential Students Who Present with Suicide Risk: A Case Study

    ERIC Educational Resources Information Center

    Rivero, Estela M.; Cimini, M. Dolores; Bernier, Joseph E.; Stanley, Judith A.; Murray, Andrea D.; Anderson, Drew A.; Wright, Heidi R.

    2014-01-01

    Objective: This case study examined the effects of an early intervention program designed to respond to residential college students demonstrating risk for suicide. Participants: Participants were 108 undergraduates at a large northeastern public university referred to an early intervention program subsequent to presenting with risk factors for…

  15. A Tale of 2 Teachers: A Preschool Physical Activity Intervention Case Study

    ERIC Educational Resources Information Center

    Howie, Erin K.; Brewer, Alisa E.; Dowda, Marsha; McIver, Kerry L.; Saunders, Ruth P.; Pate, Russell R.

    2016-01-01

    Background: Preschool settings vary greatly, and research has shown that interventions are more successful when they can be adapted to individual settings. This is a descriptive case study of how 2 teachers successfully adapted and implemented a preschool physical activity intervention. Methods: The Study of Health and Activity in Preschool…

  16. 28 CFR 0.21 - Authorizing intervention by the Government in certain cases.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Authorizing intervention by the Government in certain cases. 0.21 Section 0.21 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Office of the Solicitor General § 0.21 Authorizing intervention by...

  17. Intervention for Infants at Risk of Developing Autism: A Case Series

    ERIC Educational Resources Information Center

    Green, Jonathan; Wan, Ming Wai; Guiraud, Jeanne; Holsgrove, Samina; McNally, Janet; Slonims, Vicky; Elsabbagh, Mayada; Charman, Tony; Pickles, Andrew; Johnson, Mark

    2013-01-01

    Theory and evidence suggest the potential value of prodromal intervention for infants at risk of developing autism. We report an initial case series (n = 8) of a parent-mediated, video-aided and interaction-focused intervention with infant siblings of autistic probands, beginning at 8-10 months of age. We outline the theory and evidence base…

  18. Using Problem-Based Case Studies to Learn about Knowledge Translation Interventions: An Inside Perspective

    ERIC Educational Resources Information Center

    Bhogal, Sanjit K.; Murray, Mary Ann; McLeod, Katherine M.; Bergen, Anne; Bath, Brenna; Menon, Anita; Kho, Michelle E.; Stacey, Dawn

    2011-01-01

    Knowledge translation (KT) interventions can facilitate the successful implementation of best practices by engaging and actively involving various stakeholders in the change process. However, for novices, the design of KT interventions can be overwhelming. In this article, we describe our experience as participants in a problem-based case study on…

  19. Intervention for Infants and Toddlers Exposed to Methadone in Utero: Three Case Studies.

    ERIC Educational Resources Information Center

    Burns, M. Susan; And Others

    1996-01-01

    Three case studies describe intervention with infants/toddlers who were exposed to methadone in utero. Intervention included providing therapeutic nursery services and addressing developmental and mental health needs of the children and the high-risk family systems, including parents' knowledge of child development and parents' emotional support…

  20. The Understanding Words Reading Intervention: Evidence from a Case Series Design

    ERIC Educational Resources Information Center

    Wright, Craig; Conlon, Elizabeth G.; Wright, Michalle

    2012-01-01

    Using a case-series design with double baseline and 10-week maintenance phase, 5 struggling readers from middle- to high-income families (age range 6.4-7.9 years) completed a 5-times-weekly intervention (96 sessions) administered by a parent. All participants completed the intervention with phonological decoding, text-reading accuracy and reading…

  1. Barriers to Implementation of Case Management for Patients With Dementia: A Systematic Mixed Studies Review

    PubMed Central

    Khanassov, Vladimir; Vedel, Isabelle; Pluye, Pierre

    2014-01-01

    PURPOSE Results of case management designed for patients with dementia and their caregivers in community-based primary health care (CBPHC) were inconsistent. Our objective was to identify the relationships between key outcomes of case management and barriers to implementation. METHODS We conducted a systematic mixed studies review (including quantitative and qualitative studies). Literature search was performed in MEDLINE, PsycINFO, Embase, and Cochrane Library (1995 up to August 2012). Case management intervention studies were used to assess clinical outcomes for patients, service use, caregiver outcomes, satisfaction, and cost-effectiveness. Qualitative studies were used to examine barriers to case management implementation. Patterns in the relationships between barriers to implementation and outcomes were identified using the configurational comparative method. The quality of studies was assessed using the Mixed Methods Appraisal Tool. RESULTS Forty-three studies were selected (31 quantitative and 12 qualitative). Case management had a limited positive effect on behavioral symptoms of dementia and length of hospital stay for patients and on burden and depression for informal caregivers. Interventions that addressed a greater number of barriers to implementation resulted in increased number of positive outcomes. Results suggested that high-intensity case management was necessary and sufficient to produce positive clinical outcomes for patients and to optimize service use. Effective communication within the CBPHC team was necessary and sufficient for positive outcomes for caregivers. CONCLUSIONS Clinicians and managers who implement case management in CBPHC should take into account high-intensity case management (small caseload, regular proactive patient follow-up, regular contact between case managers and family physicians) and effective communication between case managers and other CBPHC professionals and services. PMID:25354410

  2. Telehealth interventions to reduce management complications in type 1 diabetes: A review

    PubMed Central

    Balkhi, Amanda M; Reid, Adam M; Westen, Sarah C; Olsen, Brian; Janicke, David M; Geffken, Gary R

    2015-01-01

    Type 1 diabetes is a chronic illness with a high burden of care. While effective interventions and recommendations for diabetes care exist, the intensive nature of diabetes management makes compliance difficult. This is especially true in children and adolescents as they have unique psychosocial and diabetes needs. Despite the development of effective in-person interventions targeting improving self-management and ameliorating psychosocial difficulties there are still a number of barriers to implementing these interventions, namely time, cost, and access. Telehealth interventions allow for the dissemination of these interventions to a broader audience. Self-management and psychosocial telehealth interventions are reviewed with a special emphasis on mobile phone and internet based technology use. While efficacy has been demonstrated in a number of telehealth interventions with improved cost effectiveness over in-person interventions, many challenges remain including high participant attrition and difficulties with receiving reimbursement for services rendered. These and other challenges are discussed with recommendations for researchers and telehealth providers provided. PMID:25897348

  3. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    .... (2) Not use case management (including targeted case management) services to restrict an individual's access to other services under the plan. (3) Not compel an individual to receive case management services... services (including targeted case management services), as defined in § 440.169 of this chapter, the...

  4. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... (2) Not use case management (including targeted case management) services to restrict an individual's access to other services under the plan. (3) Not compel an individual to receive case management services... services (including targeted case management services), as defined in § 440.169 of this chapter, the...

  5. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    .... (2) Not use case management (including targeted case management) services to restrict an individual's access to other services under the plan. (3) Not compel an individual to receive case management services... services (including targeted case management services), as defined in § 440.169 of this chapter, the...

  6. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Primary care case management services. 440.168... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case management...

  7. How Multiple Interventions Influenced Employee Turnover: A Case Study.

    ERIC Educational Resources Information Center

    Hatcher, Timothy

    1999-01-01

    A 3-year study of 46 textile industry workers identified causes of employee turnover (supervision, training, organizational communication) using performance analysis. A study of multiple interventions based on the analysis resulted in changes in orientation procedures, organizational leadership, and climate, reducing turnover by 24%. (SK)

  8. Response to Intervention in Middle School: A Case Story

    ERIC Educational Resources Information Center

    Johnson, Evelyn S.; Smith, Lori A.

    2011-01-01

    Response to Intervention (RTI) is a tiered model of service delivery being implemented in many middle grades schools. The authors provide an overview of RTI and describe the experience and outcomes of RTI implementation at Cheyenne Mountain Junior High. A discussion of lessons learned and implications for other middle schools considering RTI…

  9. Use of new minimum intervention dentistry technologies in caries management.

    PubMed

    Tassery, H; Levallois, B; Terrer, E; Manton, D J; Otsuki, M; Koubi, S; Gugnani, N; Panayotov, I; Jacquot, B; Cuisinier, F; Rechmann, P

    2013-06-01

    Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF® and DIAGNOdent® ) and autofluorescence (Soprolife® and VistaCam®), electric current/impedance (CarieScan(®) ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1- minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 - minimally invasive therapy 2) using several clinical cases as examples. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the

  10. Classwide Intervention to Manage Disruptive Behavior in the Kindergarten Classroom

    ERIC Educational Resources Information Center

    McGoey, Kara E.; Schneider, Dana L.; Rezzetano, Kristin M.; Prodan, Tana; Tankersley, Melody

    2010-01-01

    The authors present an investigation of a classwide intervention to reduce disruptive behavior in a kindergarten classroom. Participants included children in 3 kindergarten classrooms and their teachers in an at-risk school district in Northeast Ohio. On the basis of student behaviors and teacher goals, the authors chose the Good Behavior Game…

  11. Psychological Intervention: Case Studies in School Psychological Services, Volume 3, 1979.

    ERIC Educational Resources Information Center

    Iowa State Dept. of Public Instruction, Des Moines. Div. of Pupil Personnel Services.

    The book presents 27 case studies illustrating psychological interventions with behavior problem school children. Studies ususally introduce the target population, describe the method of psychological evaluation, report the results of treatment, and discuss the case's implications. Among cases reported are investigations of stimulant medication on…

  12. A systematic review of self-management interventions for children and youth with physical disabilities

    PubMed Central

    Kingsnorth, Shauna; Mcdougall, Carolyn; Keating, Heather

    2014-01-01

    Purpose: Evidence shows that effective self-management behaviors have the potential to improve health outcomes, quality of life, self-efficacy and reduce morbidity, emergency visits and costs of care. A better understanding of self-management interventions (i.e. programs that help with managing symptoms, treatment, physical and psychological consequences) is needed to achieve a positive impact on health because most children with a disability now live well into adulthood. Method: A systematic review of self-management interventions for school age youth with physical disabilities was undertaken to assess their effectiveness. Comprehensive electronic searches using international web-based reference libraries were conducted for peer-reviewed and gray literature published between 1980 and January 2012. Eligible studies examined the effectiveness of self-management interventions for children and youth between 6 and 18 years of age with congenital or acquired physical disabilities. Studies needed to include a comparison group (e.g. single group pre/post-test design) and at least one quantifiable health-related outcome. Results: Of the 2184 studies identified, six met the inclusion criteria; two involved youth with spina bifida and four with juvenile arthritis. The majority of the interventions ran several sessions for at least 3 months by a trained interventionist or clinician, had one-to-one sessions and meetings, homework activities and parental involvement. Although outcomes varied between the studies, all of the interventions reported at least one significant improvement in either overall self-management skills or a specific health behavior. Conclusions: While self-management interventions have the potential to improve health behaviors, there were relatively few rigorously designed studies identified. More studies are needed to document the outcomes of self-management interventions, especially their most effective characteristics for children and youth with physical

  13. Managing Student Behavior with Class-Wide Function-Related Intervention Teams: An Observational Study in Early Elementary Classrooms

    ERIC Educational Resources Information Center

    Caldarella, Paul; Williams, Leslie; Hansen, Blake D.; Wills, Howard

    2015-01-01

    Comprehensive evidence-based interventions are needed to help early childhood educators manage challenging student behaviors. One such intervention, class-wide function-related intervention teams (CW-FIT), is a multi-tiered behavioral intervention program based on positive behavior support principles, including four main elements: (a) teaching…

  14. Case Management of Adolescents with Chronic Disease.

    ERIC Educational Resources Information Center

    Lankard, Bettina A.

    This training guide presents a model for optimum delivery of the primary duties, tasks, and steps required in the comprehensive case management of adolescents with chronic disease. Using a team approach to coordinated health care, the guide involves the patient and family as key members of the care team along with the physician, nurse, dietitian,…

  15. Management of Acute Patellar Dislocation: A Case Report

    PubMed Central

    Enix, Dennis E.; Sudkamp, Kasey; Scali, Frank; Keating, Robbyn; Welk, Aaron

    2015-01-01

    Objective The purpose of this case study is to describe the evaluation and management of patellar dislocations and the different approaches used from providers in different countries. Clinical Features An individual dislocated her left patella while traveling abroad and received subsequent care in Thailand, China, and the United States. Intervention and Outcome Nonoperative treatment protocols including manual closed reduction of the patella, casting of the leg, and rehabilitation exercises were employed. Conclusion Receipt of care when abroad can be challenging. The patient’s knee range of motion and pain continued to improve when she was diligent about performing the home exercise program. This case highlights the importance of a thorough examination, a proper regimen of care, and patient counseling to ensure a full recovery and minimize the chance of re-injury. PMID:26778935

  16. Can theory be embedded in visual interventions to promote self-management? A proposed model and worked example.

    PubMed

    Williams, B; Anderson, A S; Barton, K; McGhee, J

    2012-12-01

    Nurses are increasingly involved in a range of strategies to encourage patient behaviours that improve self-management. If nurses are to be involved in, or indeed lead, the development of such interventions then processes that enhance the likelihood that they will lead to evidence that is both robust and usable in practice are required. Although behavioural interventions have been predominantly based on written text or the spoken word increasing numbers are now drawing on visual media to communicate their message, despite only a growing evidence base to support it. The use of such media in health interventions is likely to increase due to technological advances enabling easier and cheaper production, and an increasing social preference for visual forms of communication. However, the development of such media is often highly pragmatic and developed intuitively rather than with theory and evidence informing their content and form. Such a process may be at best inefficient and at worst potentially harmful. This paper performs two functions. Firstly, it discusses and argues why visual based interventions may be a powerful media for behaviour change; and secondly, it proposes a model, developed from the MRC Framework for the Development and Evaluation of Complex Interventions, to guide the creation of theory informed visual interventions. It employs a case study of the development of an intervention to motivate involvement in a lifestyle intervention among people with increased cardiovascular risk. In doing this we argue for a step-wise model which includes: (1) the identification of a theoretical basis and associated concepts; (2) the development of visual narrative to establish structure; (3) the visual rendering of narrative and concepts; and (4) the assessment of interpretation and impact among the intended patient group. We go on to discuss the theoretical and methodological limitations of the model. PMID:22874588

  17. The use of functional and traditional mobilization interventions in a patient with chronic thoracic pain: a case report

    PubMed Central

    Aiken, David L; Vaughn, Dan

    2013-01-01

    There is little information in the literature regarding the efficacy of spinal manual therapy (SMT) interventions for patients with chronic thoracic spinal pain. In addition, information regarding the clinical decision-making associated with the application of SMT for this patient population is deficient. The purpose of this case report is to present the rationale for and results of applying specific SMT interventions on a patient with chronic spinal pain. A 51-year-old female with 9 months of significant thoracic, chest, sternal, and left shoulder pain was managed with both mobilization with movement and spinal manipulative procedures. The report offers insight into the decisions that guided the selection of these SMT techniques in this case. The outcome provides preliminary support for using these specific SMT procedures in patients with chronic thoracic spinal pain. PMID:24421624

  18. Impact of a Classroom Behavior Management Intervention on Teacher Risk Ratings for Student Behavior

    ERIC Educational Resources Information Center

    Hansen, William B.; Bishop, Dana C.; Jackson-Newsom, Julia

    2010-01-01

    Classroom behavior management interventions have been used successfully with drug prevention programs to prevent subsequent antisocial behavior and substance use among youth. This article presents results from implementation of the All Stars Challenge, a classroom-based behavior management component to a drug prevention program for fifth graders.…

  19. Classroom Management Strategies and Behavioral Interventions to Support Academic Achievement

    ERIC Educational Resources Information Center

    Gilpatrick, Robin Sue Holzworth

    2010-01-01

    This mixed method project study identified the need for effective classroom management strategies to dissuade student noncompliant behavior and to ensure academic success for all students. Enhancing classroom management practices is vital to improved student achievement and teacher self-efficacy. Within a constructivist framework, it is critical…

  20. Rethinking Classroom Management: Strategies for Prevention, Intervention, and Problem Solving.

    ERIC Educational Resources Information Center

    Belvel, Patricia Sequeira; Jordan, Maya Marcia

    This book illustrates an approach to achieving a positive, harmonious classroom environment which enables educators to evolve effectively from managers to leaders by rethinking their roles as teachers, discussing how to create classrooms where students are more self-managing and demonstrate mutual respect, self-esteem, and responsibility. Key…

  1. Interventions to Promote Diabetes Self-Management in Children and Youth: A Scoping Review.

    PubMed

    Cahill, Susan M; Polo, Katie M; Egan, Brad E; Marasti, Nadia

    2016-01-01

    As children and youth with diabetes grow up, they become increasingly responsible for controlling and monitoring their condition. We conducted a scoping review to explore the research literature on self-management interventions for children and youth with diabetes. Eleven studies met the inclusion criteria. Some of the studies reviewed combined the participant population so that children with Type 1 as well as children with Type 2 diabetes were included. The majority of the studies focused on children age 14 yr or older and provided self-management education, self-management support, or both. Parent involvement was a key component of the majority of the interventions, and the use of technology was evident in 3 studies. The findings highlight factors that occupational therapy practitioners should consider when working with pediatric diabetes teams to select self-management interventions. PMID:27548858

  2. Issues in health care: interventional pain management at the crossroads.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2007-03-01

    Emerging strategies in health care are extremely important for interventional pain physicians, as well as with the payors in various categories. While most Americans, including the US Congress and Administration, are looking for ways to provide affordable health care, the process of transformation and emerging health care strategies are troubling for physicians in general, and interventional pain physicians in particular. With the new Congress, only new issues rather than absolute solutions seem to emerge. Interventional pain physicians will continue to face the very same issues in the coming years that they have faced in previous years including increasing national health care spending, physician payment reform, ambulatory surgery center reform, and pay for performance. The national health expenditure data continue to extend the spending pattern that has characterized the 21st century, with US health spending continuing to outpace inflation and accounting for a growing share of the national economy. Health care spending in 2005 was $2.0 trillion or $6,697 per person and represented 16% of the gross domestic product. In 2005, Medicare spending reached $342 billion, while Medicaid spending was $315 billion. Physician and clinical services occupied approximately 21% of all US health care spending in 2005, reaching $421.2 billion. Overall, health spending in the US is expected to double to $4.1 trillion by 2016, then consuming 20% of the nation's gross domestic product, up from the current 16%. It is predicted that by 2016 the government will be paying 48.7% of the nation's health care bill, up from 38% in 1970 and 40% in 1990. The Medicare Physician Payment system based on the Sustainable Growth Rate (SGR) formula continues to be a major issue for physicians. The Congressional Budget Office has projected budget implications of change in the SGR mechanism, with consideration for allowing payment rates to increase by the amount of medical inflation, costing Medicare an

  3. Evaluation of a complex, population-based injury claims management intervention for improving injury outcomes: study protocol

    PubMed Central

    Collie, Alex; Gabbe, Belinda; Fitzharris, Michael

    2015-01-01

    Introduction Injuries resulting from road traffic crashes are a substantial cause of disability and death worldwide. Injured persons receiving compensation have poorer recovery and return to work than those with non-compensable injury. Case or claims management is a critical component of injury compensation systems, and there is now evidence that claims management can have powerful positive impacts on recovery, but can also impede recovery or exacerbate mental health concerns in some injured people. This study seeks to evaluate the impact of a population-based injury claims management intervention in the State of Victoria, Australia, on the health of those injured in motor vehicle crashes, their experience of the compensation process, and the financial viability of the compensation system. Methods and analysis Evaluation of this complex intervention involves a series of linked but stand-alone research projects to assess the anticipated process changes, impacts and outcomes of the intervention over a 5-year time frame. Linkage and analysis of routine administrative and health system data is supplemented with a series of primary studies collecting new information. Additionally, a series of ‘action’ research projects will be undertaken to inform the implementation of the intervention. A program logic model designed by the state government Transport Accident Commission in conjunction with the research team provides the evaluation framework. Ethics and dissemination Relatively few studies have comprehensively examined the impact of compensation system processes on the health of injured persons, their satisfaction with systems processes, and impacts on the financial performance of the compensation scheme itself. The wholesale, population-based transformation of an injury claims management model is a rare opportunity to document impacts of system-level policy change on outcomes of injured persons. Findings will contribute to the evidence base of information on the

  4. The role of interventional radiology in the management of hepatocellular carcinoma

    PubMed Central

    Molla, N.; AlMenieir, N.; Simoneau, E.; Aljiffry, M.; Valenti, D.; Metrakos, P.; Boucher, L.M.; Hassanain, M.

    2014-01-01

    Background Hepatocellular carcinoma (hcc) is one of the most common causes of cancer-related death worldwide. Overall, liver transplantation and resection are the only available treatments with potential for cure. Various locoregional therapies are widely used to manage patients with advanced hcc or as a bridging therapy for patients with early and intermediate disease. This article reviews and evaluates the role of interventional radiology in the management of such cases by assessing various aspects of each method, such as effect on rates of survival, recurrence, tumour response, and complications. Methods A systemic search of PubMed, medline, Ovid Medline In-Process, and the Cochrane Database of Systematic Reviews retrieved all related scientific papers for review. Results Needle core biopsy is a highly sensitive, specific, and accurate method for hcc grading. Portal-vein embolization provides adequate expansion of the future liver remnant, making more patients eligible for resection. In focal or multifocal unresectable early-stage disease, radiofrequency ablation tops all other thermoablative methods. However, microwave ablation is preferred in large tumours and in patients with Child–Pugh B disease. Cryoablation is preferred in recurrent disease and in patients who are poor candidates for anesthesia. Of the various transarterial modalities—transarterial chemoembolization (tace), drug-eluting beads, and transarterial radio-embolization (tare)—tace is the method of choice in Child–Pugh A disease, and tare is the method of choice in hcc cases with portal vein thrombosis. Conclusions The existing data support the importance of a multidisciplinary approach in hcc management. Large randomized controlled studies are needed to provide clear indication guidelines for each method. PMID:24940108

  5. Applying Case-Based Reasoning in Knowledge Management to Support Organizational Performance

    ERIC Educational Resources Information Center

    Wang, Feng-Kwei

    2006-01-01

    Research and practice in human performance technology (HPT) has recently accelerated the search for innovative approaches to supplement or replace traditional training interventions for improving organizational performance. This article examines a knowledge management framework built upon the theories and techniques of case-based reasoning (CBR)…

  6. A Randomized Trial of Probation Case Management for Drug-Involved Women Offenders

    ERIC Educational Resources Information Center

    Guydish, Joseph; Chan, Monica; Bostrom, Alan; Jessup, Martha A.; Davis, Thomas B.; Marsh, Cheryl

    2011-01-01

    This article reports findings from a clinical trial of a probation case management (PCM) intervention for drug-involved women offenders. Participants were randomly assigned to PCM (n = 92) or standard probation (n = 91) and followed for 12 months using measures of substance abuse, psychiatric symptoms, social support, and service utilization.…

  7. Case management: entry-level practice for occupational therapists?

    PubMed

    Baldwin, Tina M; Fisher, Thomas

    2005-01-01

    As American businesses have sought means to control employee health benefits, managed care has evolved. This evolution has brought greater demand for case management. Case management is not a profession but a practice area within one's own profession. Case managers come from a variety of disciplines and work in a variety of practice settings, which include medical, psychosocial, educational, vocational, and rehabilitation. PMID:16061158

  8. Reframing tobacco dependency management in acute care: A case study.

    PubMed

    Schultz, Annette S H; Guzman, Randolph; Sawatzky, Jo-Ann V; Thurmeier, Rick; Fedorowicz, Anna; Fulmore, Kaitlin

    2016-08-01

    Effective tobacco dependence treatment within acute care tends to be inadequate. The purpose of the Utilizing best practices to Manage Acute care patients Tobacco Dependency (UMAT) was to implement and evaluate an evidence-based intervention to support healthcare staff to effectively manage nicotine withdrawal symptoms of acute surgical patients. Data collection for this one-year longitudinal case study included: relevant patient experiences and staff reported practice, medication usage, and chart review. Over the year each data source suggested changes in tobacco dependence treatment. Key changes in patient survey responses (N=55) included a decrease in daily smoking and cigarette cravings. Of patients who used nicotine replacement therapy, they reported an increase in symptom relief. Staff (N=45) were surveyed at baseline, mid-point and end of study. Reported rates of assessing smoking status did not change over the year, but assessment of withdrawal symptoms emerged as daily practice and questions about cessation diminished. Also delivery of nicotine replacement therapy products increased over the year. Chart reviews showed a shift in content from documenting smoking behavior to withdrawal symptoms and administration of nicotine replacements; also frequency of comments increased. In summary, the evidence-based intervention influenced unit norms and reframed the culture related to tobacco dependence treatment. PMID:27392584

  9. Integrating the Principles of Effective Intervention into Batterer Intervention Programming: The Case for Moving Toward More Evidence-Based Programming.

    PubMed

    Radatz, Dana L; Wright, Emily M

    2016-01-01

    The majority of batterer intervention program (BIP) evaluations have indicated they are marginally effective in reducing domestic violence recidivism. Meanwhile, correctional programs used to treat a variety of offenders (e.g., substance users, violent offenders, and so forth) that adhere to the "principles of effective intervention" (PEI) have reported significant reductions in recidivism. This article introduces the PEI-the principles on which evidence-based practices in correctional rehabilitation are based-and identifies the degree to which they are currently integrated into BIPs. The case is made that batterer programs could be more effective if they incorporate the PEI. Recommendations for further integration of the principles into BIPs are also provided. PMID:25573844

  10. Managing Loss and Change: Grief Interventions for Dementia Caregivers in a CBT-Based Trial.

    PubMed

    Meichsner, Franziska; Schinköthe, Denise; Wilz, Gabriele

    2016-05-01

    Dementia caregivers often experience loss and grief related to general caregiver burden, physical, and mental health problems. Through qualitative content analysis, this study analyzed intervention strategies applied by therapists in a randomized-controlled trial in Germany to assist caregivers in managing losses and associated emotions. Sequences from 61 therapy sessions that included interventions targeting grief, loss, and change were transcribed and analyzed. A category system was developed deductively, and the intercoder reliability was satisfactory. The identified grief intervention strategies were recognition and acceptance of loss and change,addressing future losses,normalization of grief, and redefinition of the relationship Therapists focused on identifying experienced losses, managing associated feelings, and fostering acceptance of these losses. A variety of cognitive-behavioral therapy-based techniques was applied with each strategy. The findings contribute to understanding how dementia caregivers can be supported in their experience of grief and facilitate the development of a manualized grief intervention. PMID:26311735

  11. Role of interventional radiology in the management of acute gastrointestinal bleeding

    PubMed Central

    Ramaswamy, Raja S; Choi, Hyung Won; Mouser, Hans C; Narsinh, Kazim H; McCammack, Kevin C; Treesit, Tharintorn; Kinney, Thomas B

    2014-01-01

    Acute gastrointestinal bleeding (GIB) can lead to significant morbidity and mortality without appropriate treatment. There are numerous causes of acute GIB including but not limited to infection, vascular anomalies, inflammatory diseases, trauma, and malignancy. The diagnostic and therapeutic approach of GIB depends on its location, severity, and etiology. The role of interventional radiology becomes vital in patients whose GIB remains resistant to medical and endoscopic treatment. Radiology offers diagnostic imaging studies and endovascular therapeutic interventions that can be performed promptly and effectively with successful outcomes. Computed tomography angiography and nuclear scintigraphy can localize the source of bleeding and provide essential information for the interventional radiologist to guide therapeutic management with endovascular angiography and transcatheter embolization. This review article provides insight into the essential role of Interventional Radiology in the management of acute GIB. PMID:24778770

  12. A preliminary report of an educational intervention in practice management

    PubMed Central

    Crites, Gerald E; Schuster, Richard J

    2004-01-01

    Background Practice management education continues to evolve, and little information exists regarding its curriculum design and effectiveness for resident education. We report the results of an exploratory study of a practice management curriculum for primary care residents. Methods After performing a needs assessment with a group of primary care residents at Wright State University, we designed a monthly seminar series covering twelve practice management topics. The curriculum consisted of interactive lectures and practice-based application, whenever possible. We descriptively evaluated two cognitive components (practice management knowledge and skills) and the residents' evaluation of the curriculum. Results The mean correct on the knowledge test for this group of residents was 74% (n = 12) and 91% (n = 12) before and after the curriculum, respectively. The mean scores for the practice management skill assessments were 2.62 before (n = 12), and 3.65 after (n = 12) the curriculum (modified Likert, 1 = strongly disagree, 5 = strongly agree). The residents rated the curriculum consistently high. Conclusions This exploratory study suggests that this curriculum may be useful in developing knowledge and skills in practice management for primary care residents. This study suggests further research into evaluation of this curriculum may be informative for practice-based education. PMID:15380023

  13. The effectiveness and practicality of occupational stress management interventions: a survey of subject matter expert opinions.

    PubMed

    Bellarosa, C; Chen, P Y

    1997-07-01

    Stress management (SM) subject matter experts (SMEs) evaluated 6 widely used occupational SM interventions (relaxation, physical fitness, cognitive restructuring, meditation, assertiveness training, and stress inoculation) on the basis of 10 practicality criteria and 7 effectiveness objectives. Relaxation was evaluated overall as the most practical intervention, while meditation and stress inoculation were judged as the least practical. Physical fitness was chosen to be the most effective intervention, while both meditation and assertiveness training were rated overall as the least effective. The findings also revealed that the SMEs considered history of success and duration of effect, rather than "relevance to program objectives," as the most important factors when selecting SM interventions. Incongruence between effectiveness ratings and actual choices of interventions are discussed. PMID:9552295

  14. The Science Manager's Guide to Case Studies

    SciTech Connect

    Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.; Vallario, Robert W.

    2001-09-24

    This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

  15. Behavioral interventions and stress management training for hospitalized adolescents and young adults with cystic fibrosis.

    PubMed

    Spirito, A; Russo, D C; Masek, B J

    1984-07-01

    Recent studies have demonstrated that the majority of cystic fibrosis (CF) patients are not at high risk for developing psychological problems. Clinical studies emphasizing the development of adaptive coping mechanisms in these patients have been suggested as a more appropriate line of research. The purpose of the present paper is to describe our experience in teaching various behavioral and stress management strategies to help CF patients. Behavioral counseling, relaxation training, and biofeedback have all been used with these patients to help them manage a number of problems more effectively. The predominant presenting problems have included elevated anxiety levels, sleeping difficulties, pain, and hyperventilation episodes. The typical treatment course with these patients is described and a case example is given to help elucidate the nature of behavioral interventions. Patient satisfaction ratings indicate that most patients view these techniques positively. Clinical observations suggest that the acquisition of behavioral coping skills may enhance the CF patient's perceived control of his/her situation, reduce the level of pain and anxiety, and enhance the quality of life. PMID:6378718

  16. Weight management interventions in adults with intellectual disabilities and obesity: a systematic review of the evidence

    PubMed Central

    2013-01-01

    To evaluate the clinical effectiveness of weight management interventions in adults with intellectual disabilities (ID) and obesity using recommendations from current clinical guidelines for the first line management of obesity in adults. Full papers on lifestyle modification interventions published between 1982 to 2011 were sought by searching the Medline, Embase, PsycINFO and CINAHL databases. Studies were evaluated based on 1) intervention components, 2) methodology, 3) attrition rate 4) reported weight loss and 5) duration of follow up. Twenty two studies met the inclusion criteria. The interventions were classified according to inclusion of the following components: behaviour change alone, behaviour change plus physical activity, dietary advice or physical activity alone, dietary plus physical activity advice and multi-component (all three components). The majority of the studies had the same methodological limitations: no sample size justification, small heterogeneous samples, no information on randomisation methodologies. Eight studies were classified as multi-component interventions, of which one study used a 600 kilocalorie (2510 kilojoule) daily energy deficit diet. Study durations were mostly below the duration recommended in clinical guidelines and varied widely. No study included an exercise program promoting 225–300 minutes or more of moderate intensity physical activity per week but the majority of the studies used the same behaviour change techniques. Three studies reported clinically significant weight loss (≥ 5%) at six months post intervention. Current data indicate weight management interventions in those with ID differ from recommended practice and further studies to examine the effectiveness of multi-component weight management interventions for adults with ID and obesity are justified. PMID:24060348

  17. Targeting and Managing Behavioral Symptoms in Individuals with Dementia: A Randomized Trial of a Nonpharmacologic Intervention

    PubMed Central

    Gitlin, Laura N.; Winter, Laraine; Dennis, Marie P.; Hodgson, Nancy; Hauck, Walter W.

    2010-01-01

    Objectives Test effects of an intervention that helps families manage distressful behaviors. Design Two-group randomized trial Setting In-home Participants 272 caregivers and dementia patients Intervention Up to 11 home/telephone contacts over 16-weeks by health professionals who identified potential triggers of patient behaviors including communication, environment, patient undiagnosed medical conditions (by obtaining blood/urine samples), and trained caregivers in strategies to modify triggers and reduce caregiver upset. Between 16–24 weeks, 3 telephone contacts reinforced strategy use. Measurements Primary outcomes included frequency of targeted problem behavior, and caregiver upset with and confidence managing it at 16-weeks. Secondary outcomes included caregiver well-being and management skills at 16 and 24 weeks, and caregiver perceived benefits. Prevalence of medical conditions for intervention patients were also examined. Results At 16 weeks, 67.5% of intervention caregivers reported patient improvement in targeted problem behavior compared to 45.8% of caregivers in a no-treatment control group (p=.002), reduced upset with (p=.028) and enhanced confidence managing (p=.011) the behavior. Additionally, compared to controls, intervention caregivers reported less upset with all problem behaviors (p=.001), negative communication (p=.017), burden (p=.051), and improved well-being (p=.001). Fewer intervention caregivers had depressive symptoms (53.0%) than control group caregivers (67.8%, p=.020). Similar caregiver outcomes occurred at 24-weeks. Compared to controls, intervention caregivers perceived more study benefits (p values <.05) including ability to keep patients home. Blood/urine samples of intervention patients showed 40 (34.1%) had undiagnosed illnesses requiring physician follow-up. Conclusion Targeting behaviors upsetting to caregivers and modifying potential triggers improves patient symptomatology and caregiver well-being and skills. PMID:20662955

  18. Weight management interventions in adults with intellectual disabilities and obesity: a systematic review of the evidence.

    PubMed

    Spanos, Dimitrios; Melville, Craig Andrew; Hankey, Catherine Ruth

    2013-01-01

    To evaluate the clinical effectiveness of weight management interventions in adults with intellectual disabilities (ID) and obesity using recommendations from current clinical guidelines for the first line management of obesity in adults. Full papers on lifestyle modification interventions published between 1982 to 2011 were sought by searching the Medline, Embase, PsycINFO and CINAHL databases. Studies were evaluated based on (1) intervention components, (2) methodology, (3) attrition rate (4) reported weight loss and (5) duration of follow up. Twenty two studies met the inclusion criteria. The interventions were classified according to inclusion of the following components: behaviour change alone, behaviour change plus physical activity, dietary advice or physical activity alone, dietary plus physical activity advice and multi-component (all three components). The majority of the studies had the same methodological limitations: no sample size justification, small heterogeneous samples, no information on randomisation methodologies. Eight studies were classified as multi-component interventions, of which one study used a 600 kilocalorie (2510 kilojoule) daily energy deficit diet. Study durations were mostly below the duration recommended in clinical guidelines and varied widely. No study included an exercise program promoting 225-300 minutes or more of moderate intensity physical activity per week but the majority of the studies used the same behaviour change techniques. Three studies reported clinically significant weight loss (≥ 5%) at six months post intervention. Current data indicate weight management interventions in those with ID differ from recommended practice and further studies to examine the effectiveness of multi-component weight management interventions for adults with ID and obesity are justified. PMID:24060348

  19. Critical path case management: the headache clinic.

    PubMed

    Sobkowski, D A; Maquera, V

    1996-01-01

    A practical application of a neurology case management healthcare delivery mode results in increased access to specialty providers, shorter follow-up periods, and improved continuity of medical care. The program described in the following sections was developed at a naval hospital for the ongoing evaluation of therapeutic schemes to optimize headache therapy and, 1 year after implementation, shows improvement in patient outcomes and resource use. PMID:9192570

  20. Rice management interventions to mitigate greenhouse gas emissions: a review.

    PubMed

    Hussain, Saddam; Peng, Shaobing; Fahad, Shah; Khaliq, Abdul; Huang, Jianliang; Cui, Kehui; Nie, Lixiao

    2015-03-01

    Global warming is one of the gravest threats to crop production and environmental sustainability. Rice, the staple food of more than half of the world's population, is the most prominent cause of greenhouse gas (GHG) emissions in agriculture and gives way to global warming. The increasing demand for rice in the future has deployed tremendous concerns to reduce GHG emissions for minimizing the negative environmental impacts of rice cultivation. In this review, we presented a contemporary synthesis of existing data on how crop management practices influence emissions of GHGs in rice fields. We realized that modifications in traditional crop management regimes possess a huge potential to overcome GHG emissions. We examined and evaluated the different possible options and found that modifying tillage permutations and irrigation patterns, managing organic and fertilizer inputs, selecting suitable cultivar, and cropping regime can mitigate GHG emissions. Previously, many authors have discussed the feasibility principle and the influence of these practices on a single gas or, in particular, in the whole agricultural sector. Nonetheless, changes in management practices may influence more than one gas at the same time by different mechanisms or sometimes their effects may be antagonistic. Therefore, in the present attempt, we estimated the overall global warming potential of each approach to consider the magnitude of its effects on all gases and provided a comprehensive assessment of suitable crop management practices for reducing GHG emissions in rice culture. PMID:25354441

  1. Methods for Assessing Single-Case School-Based Intervention Outcomes

    ERIC Educational Resources Information Center

    Busse, R. T.; McGill, Ryan J.; Kennedy, Kelly S.

    2015-01-01

    The purpose of this article is to present various single-case outcome assessment methods for evaluating school-based intervention effectiveness. We present several outcome methods, including goal attainment scaling, visual analysis, trend analysis, percentage of non-overlapping data, single-case mean difference effect size, reliable change index,…

  2. Enhancing the Scientific Credibility of Single-Case Intervention Research: Randomization to the Rescue

    ERIC Educational Resources Information Center

    Kratochwill, Thomas R.; Levin, Joel R.

    2010-01-01

    In recent years, single-case designs have increasingly been used to establish an empirical basis for evidence-based interventions and techniques in a variety of disciplines, including psychology and education. Although traditional single-case designs have typically not met the criteria for a randomized controlled trial relative to conventional…

  3. Evaluation of Core Vocabulary Intervention for Treatment of Inconsistent Phonological Disorder: Three Treatment Case Studies

    ERIC Educational Resources Information Center

    McIntosh, Beth; Dodd, Barbara

    2009-01-01

    Children with unintelligible speech differ in severity, underlying deficit, type of surface error patterns and response to treatment. Detailed treatment case studies, evaluating specific intervention protocols for particular diagnostic groups, can identify best practice for children with speech disorder. Three treatment case studies evaluated the…

  4. Evaluation of Core Vocabulary Intervention for Treatment of Inconsistent Phonological Disorder: Three Treatment Case Studies

    ERIC Educational Resources Information Center

    McIntosh, Beth; Dodd, Barbara

    2008-01-01

    Children with unintelligible speech differ in severity, underlying deficit, type of surface error patterns and response to treatment. Detailed treatment case studies, evaluating specific intervention protocols for particular diagnostic groups, can identify best practice for children with speech disorder. Three treatment case studies evaluated the…

  5. Mechanisms of Change in a Group Career Exploration Intervention: The Case of "Bryan"

    ERIC Educational Resources Information Center

    Kerner, Emily A.; Fitzpatrick, Marilyn R.; Rozworska, Karolina A.; Hutman, Heidi

    2012-01-01

    This article presents the case of one 16-year-old male who failed a career exploration class and then participated in a group intervention designed to increase his motivation to explore. Using a case study method, the authors triangulated video, questionnaire, observational, interview, and artefact data to identify the main themes that emerged for…

  6. Electronic case management with homeless youth.

    PubMed

    Bender, Kimberly; Schau, Nicholas; Begun, Stephanie; Haffejee, Badiah; Barman-Adhikari, Anamika; Hathaway, Jessica

    2015-06-01

    Case management, a widely practiced form of service brokerage, is associated with a variety of positive outcomes for homeless youth, but it may be difficult to implement, as youth face logistical barriers to attending in-person meetings. As part of a larger clinical trial, the current study investigates the feasibility of providing electronic case management (ECM) to homeless youth, using cell-phones, texts, email, and Facebook. Youth were given prepaid cell-phones and a case manager who provided four ECM sessions every 2-3 weeks over a 3-month period. Contact logs were used to record how many youth engaged in ECM, how many attempts were necessary to elicit engagement, and youths' preferred technology methods for engaging. Although engagement in the number of ECM sessions varied, the majority of youth (87.5%) engaged in at least one ECM session. Youth (41%) most commonly needed one contact before they engaged in an ECM session, and the majority responded by the third attempt. While youth most commonly answered calls directly, their chosen method of returning calls was texting. The majority of youth (80%) described ECM positively, reporting themes of convenience, connection, and accountability. The use of ECM, particularly of texting, offers promising implications for providing services to homeless youth. PMID:25748603

  7. Case managers reorganize to challenge claims denials.

    PubMed

    1999-08-01

    A combination of diminished reimbursement, decreased funding for residency programs, an epidemic of claims denials, and the skilled nursing crisis has imperiled teaching hospitals across the country. Increasingly, these hospitals are looking to case management departments as potential saviors. In the short term, that could mean more staff and a beefier budget, but if your department can't produce, cuts later on could be drastic. The University of Pennsylvania Health System in Philadelphia lost $90 million in FY1998 and responded by cutting 1,100 positions--9% of its work force. The case management department lost eight positions and is trying to take up the slack with a massive reorganization of its care delivery system and a rigorous education program designed to reduce claims denials. At Georgetown University Medical Center in Washington, DC, however, case management staff and resources have been increased for now. The department is using its new-found prosperity to thoroughly screen all incoming patients for appropriateness of admission, upgrade its discharge planning capabilities, and hire a full-time employee to appeal denied claims. PMID:10557727

  8. Case management: planning and coordinating strategies.

    PubMed

    Walden, T; Hammer, K; Kurland, C H

    1990-01-01

    In summary, planning a case management system involves moving through sequenced stages; namely, (1) a developmental stage; (2) a phase-in stage; and (3) an operational stage. During the developmental stage, before processes have been formalized, attention is given to the political realities, the formation of a representative planning group, formulating goals and objectives, obtaining administrative support, information gathering, assessment of needs, resource procurement, program structure and design, selection of a case management model, participatory decision making, determining organizational fit, and beginning networking. During the phase-in or early implementation state, the formal stage of system introduction, attention is given to the establishment of interorganizational relationships, contracting for services, job descriptions, work assignments, training, problem solving, and conflict resolution. During the operational or full implementation stage, a period when the system should become more stabilized, attention needs to be given to managing movement of the client through the system, the flow of information, program updating, quality assurance, recordkeeping, resource management, evaluating, and system refurbishing. In practice, these stages will interact and overlap. Closure, if the system is to remain viable and open to change, should never occur. PMID:10110505

  9. Nonpharmacological Interventions for Pain Management in Paramedicine and the Emergency Setting: A Review of the Literature

    PubMed Central

    Pak, Sok Cheon; Micalos, Peter S.; Maria, Sonja J.; Lord, Bill

    2015-01-01

    Paramedicine and the emergency medical services have been moving in the direction of advancing pharmaceutical intervention for the management of pain in both acute and chronic situations. This coincides with other areas of advanced life support and patient management strategies that have been well researched and continue to benefit from the increasing evidence. Even though paramedic practice is firmly focused on pharmacological interventions to alleviate pain, there is emerging evidence proposing a range of nonpharmacological options that can have an important role in pain management. This review highlights literature that suggests that paramedicine and emergency medical services should be considering the application of complementary and alternative therapies which can enhance current practice and reduce the use of pharmacological interventions. PMID:25918548

  10. Management of retained intervention guide-wire: a literature review.

    PubMed

    Al-Moghairi, Abdulrahman M; Al-Amri, Hussein S

    2013-08-01

    Percutaneous coronary angioplasty is increasingly employed in the treatment of patients with complex coronary artery disease. Different steerable guide wires used to open occluded vessel and facilitate balloon and stent deployment. However, the guide-wire itself is not without hazard: it may perforate or dissect the vessel, but fracture or entrapment is uncommon. Its management depends on the clinical situation of the patient, as well as the position and length of the remnant. In this review we discuss the angioplasty guide-wire fracture and entrapment risk factors, potential risks and management. PMID:23116055

  11. Speech and Language Therapy Intervention in Schizophrenia: A Case Study

    ERIC Educational Resources Information Center

    Clegg, Judy; Brumfitt, Shelagh; Parks, Randolph W.; Woodruff, Peter W. R.

    2007-01-01

    Background: There is a significant body of evidence documenting the speech and language abnormalities found in adult psychiatric disorders. These speech and language impairments can create additional social barriers for the individual and may hinder effective communication in psychiatric treatment and management. However, the role of speech and…

  12. Web-based interventions for behavior change and self-management: potential, pitfalls, and progress.

    PubMed

    Murray, Elizabeth

    2012-01-01

    The potential advantages of using the Internet to deliver self-care and behavior-change programs are well recognized. An aging population combined with the increasing prevalence of long-term conditions and more effective medical interventions place financial strain on all health care systems. Web-based interventions have the potential to combine the tailored approach of face-to-face interventions with the scalability of public health interventions that have low marginal costs per additional user. From a patient perspective, Web-based interventions can be highly attractive because they are convenient, easily accessible, and can maintain anonymity/privacy. Recognition of this potential has led to research in developing and evaluating Web-based interventions for self-management of long-term conditions and behavior change. Numerous systematic reviews have confirmed the effectiveness of some Web-based interventions, but a number of unanswered questions still remain. This paper reviews the progress made in developing and evaluating Web-based interventions and considers three challenging areas: equity, effectiveness, and implementation. The impact of Web-based interventions on health inequalities remains unclear. Although some have argued that such interventions can increase access to underserved communities, there is evidence to suggest that reliance on Web-based interventions may exacerbate health inequalities by excluding those on the "wrong" side of the digital divide. Although most systematic reviews have found a positive effect on outcomes of interest, effect sizes tend to be small and not all interventions are successful. Further work is needed to determine why some interventions work and others do not. This includes considering the "active ingredients" or mechanism of action of these complex interventions and the context in which they are used. Are there certain demographic, psychological, or clinical factors that promote or inhibit success? Are some behaviors or

  13. Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review

    PubMed Central

    Parke, Hannah L.; Epiphaniou, Eleni; Pearce, Gemma; Taylor, Stephanie J. C.; Sheikh, Aziz; Griffiths, Chris J.; Greenhalgh, Trish; Pinnock, Hilary

    2015-01-01

    Background There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients. Design Systematic meta-review of the evidence for self-management support interventions with stroke survivors to inform provision of healthcare services. Methods We searched MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, BNI, Database of Abstracts of Reviews for Effectiveness, and Cochrane Database of Systematic Reviews for systematic reviews of self-management support interventions for stroke survivors. Quality was assessed using the R-AMSTAR tool, and data extracted using a customised data extraction form. We undertook a narrative synthesis of the reviews' findings. Results From 12,400 titles we selected 13 systematic reviews (published 2003-2012) representing 101 individual trials. Although the term ‘self-management’ was rarely used, key elements of self-management support such as goal setting, action planning, and problem solving were core components of therapy rehabilitation interventions. We found high quality evidence that supported self-management in the context of therapy rehabilitation delivered soon after the stroke event resulted in short-term (< 1 year) improvements in basic and extended activities of daily living, and a reduction in poor outcomes (dependence/death). There is some evidence that rehabilitation and problem solving interventions facilitated reintegration into the community. Conclusions Self-management terminology is rarely used in the context of stroke. However, therapy rehabilitation currently successfully delivers elements of self-management support to stroke survivors and their caregivers with improved outcomes. Future research should focus on managing the emotional, medical and social tasks of long-term survivorship. PMID:26204266

  14. A Systematic Review of Stress-Management Interventions for Multiple Sclerosis Patients

    PubMed Central

    Reynard, Alison K.; Rae-Grant, Alexander

    2014-01-01

    Background: The objective of this study was to identify stress-management interventions used for people with multiple sclerosis (MS) and systematically evaluate the efficacy of these interventions. Methods: Several strategies were used to search for studies reported in articles published up to 2013. Results: Our initial search retrieved 117 publications, of which 8 met our criteria for review. Of the eight studies, one provided Class I evidence, five provided Class III evidence, and two provided Class IV evidence for the efficacy of stress-management interventions according to the evidence classification established by the American Academy of Neurology. Most studies showed positive changes in outcomes assessed; however, the range of methodological quality among the published studies made it difficult to draw conclusions. Conclusions: The promising findings for stress-management interventions highlight the need for future studies. Additional large, prospective, multicenter studies will help to define the role of stress-management interventions in the treatment and course of MS. Furthermore, including outcome measures based on biological and clinical markers of disease will prove useful in understanding potential underlying mechanisms. PMID:25337056

  15. Heart Disease Management by Women: Does Intervention Format Matter?

    ERIC Educational Resources Information Center

    Clark, Noreen M.; Janz, Nancy K.; Dodge, Julia A.; Lin, Xihong; Trabert, Britton L.; Kaciroti, Niko; Mosca, Lori; Wheeler, John R.; Keteyian, Steven

    2009-01-01

    A randomized controlled trial of two formats of a program (Women Take PRIDE) to enhance management of heart disease by patients was conducted. Older women (N = 575) were randomly assigned to a group or self-directed format or to a control group. Data regarding symptoms, functional health status, and weight were collected at baseline and at 4, 12,…

  16. Heart Disease Management by Women: Does Intervention Format Matter?

    ERIC Educational Resources Information Center

    Clark, Noreen M.; Janz, Nancy K.; Dodge, Julia A.; Lin, Xihong; Trabert, Britton L.; Kaciroti, Niko; Mosca, Lori; Wheeler, John R.; Keteyian, Steven

    2014-01-01

    A randomized controlled trial of two formats of a program (Women Take PRIDE) to enhance management of heart disease by patients was conducted. Older women (N = 575) were randomly assigned to a group or self-directed format or to a control group. Data regarding symptoms, functional health status, and weight were collected at baseline and at 4, 12,…

  17. Role of Interventional Radiology in the Management of Chylothorax: A Review of the Current Management of High Output Chylothorax

    SciTech Connect

    Lyon, Stuart Mott, Nigel Koukounaras, Jim; Shoobridge, Jen; Hudson, Patricio Vargas

    2013-06-15

    Chylothorax is an uncommon type of pleural effusion whose etiology may be classified as traumatic or nontraumatic. Low-output chylothoraces usually respond well to conservative management, whereas high-output chylothoraces are more likely to require surgical or interventional treatment. Conservative management focuses on alleviation of symptoms, replacement of fluid and nutrient losses, and reduction of chyle output to facilitate spontaneous healing. Surgical management can be technically difficult due to the high incidence of variant anatomy and the high-risk patient population. Percutaneous treatments have rapidly developed and evolved during the past 14 years to represent a minimally invasive treatment compared with the more invasive nature of surgery. Percutaneous therapies provide a range of treatment options despite difficult or variant anatomy, with a reported high success rate coupled with low morbidity and mortality. This article is a review of etiology, diagnosis, and treatment of chylothorax, with a focus on interventional management techniques.

  18. Impact of a classroom behavior management intervention on teacher risk ratings for student behavior.

    PubMed

    Hansen, William B; Bishop, Dana C; Jackson-Newsom, Julia

    2010-01-01

    Classroom behavior management interventions have been used successfully with drug prevention programs to prevent subsequent antisocial behavior and substance use among youth. This article presents results from implementation of the All Stars Challenge, a classroom-based behavior management component to a drug prevention program for fifth graders. Risk ratings for shyness and lack of awareness of social norms among high-risk students who received the All Stars Challenge were reduced compared with fifth graders who did not receive the intervention. In contrast, physical and social aggressivity among low-risk students who received the program increased when compared to similar control students. PMID:21038765

  19. A Patient-Centric, Provider-Assisted Diabetes Telehealth Self-management Intervention for Urban Minorities

    PubMed Central

    Carter, Ernest L; Nunlee-Bland, Gail; Callender, Clive

    2011-01-01

    This article describes the design and implementation of an online diabetes self-management intervention for a sample of inner-city African Americans with diabetes. Study participants were randomly assigned to the treatment (26) and control (21) conditions. The results indicate that treatment group participants were more likely to achieve positive outcomes in terms of lowered hemoglobin A1c and body mass index measurements than were control group members. These findings support the development of telehealth interventions to promote effective chronic disease management in medically underserved communities. PMID:21307985

  20. Community mental health nursing and early intervention in dementia: developing practice through a single case history.

    PubMed

    Keady, John; Woods, Bob; Hahn, Sue; Hill, Jim

    2004-09-01

    People Nursing in association with Journal of Clinical Nursing 13, 6b, 57-67 Community mental health nursing and early intervention in dementia: developing practice through a single case history This paper reports on a single case history taken from the 'Dementia Action Research and Education' project, a 15-month primary care intervention study that was undertaken in North Wales in the early part of 2000. The study sought to address the meaning, context and diversity of early intervention in dementia care and employed a community mental health nurse and a psychiatric social worker to undertake early and psychosocial interventions with older people with dementia (aged 75 years and over) and their families. The workers tape-recorded, documented and analysed their interventions with 27 older people with dementia and their families over the 15-month duration of the study. Clinical supervision was also undertaken during the intervention phase. One case history is presented in this paper to illustrate the work of the community mental health nurse and to identify areas of practice development. Greater role transparency, collaborative working and improvement in educational preparation for practice are called for. PMID:15724820

  1. Pediatric neurofunctional intervention in agenesis of the corpus callosum: a case report☆

    PubMed Central

    Pacheco, Sheila Cristina da Silva; Queiroz, Ana Paula Adriano; Niza, Nathália Tiepo; da Costa, Letícia Miranda Resende; Ries, Lilian Gerdi Kittel

    2014-01-01

    Objective: To describe a clinical report pre- and post-neurofunctional intervention in a case of agenesis of the corpus callosum. Case description: Preterm infant with corpus callosum agenesis and hypoplasia of the cerebellum vermis and lateral ventricles, who, at the age of two years, started the proposed intervention. Functional performance tests were used such as the neurofunctional evaluation, the Gross Motor Function Measure and the Gross Motor Function Classification System. In the initial evaluation, absence of equilibrium reactions, postural transfers, deficits in manual and trunk control were observed. The intervention was conducted with a focus on function, prioritizing postural control and guidance of the family to continue care in the home environment. After the intervention, there was an improvement of body reactions, postural control and movement acquisition of hands and limbs. The intervention also showed improvement in functional performance. Comments: Postural control and transfers of positions were benefited by the neurofunction intervention in this case of agenesis of the corpus callosum. The approach based on function with activities that involve muscle strengthening and balance reactions training, influenced the acquisition of a more selective motor behavior. PMID:25479858

  2. Improving management of type 2 diabetes in South Asian patients: a systematic review of intervention studies

    PubMed Central

    Bhurji, N; Javer, J; Gasevic, D; Khan, N A

    2016-01-01

    Objectives Optimal control of type 2 diabetes is challenging in many patient populations including in South Asian patients. We systematically reviewed studies on the effect of diabetes management interventions targeted at South Asian patients with type 2 diabetes on glycaemic control. Design Systematic review of MEDLINE, EMBASE and CINAHL databases for randomised controlled trials (RCTs) and pre-post-test studies (January 1990 to February 2014). Studies were stratified by where interventions were conducted (South Asia vs Western countries). Participants Patients originating from Pakistan, Bangladesh or India with type 2 diabetes. Primary outcome Change in glycated haemoglobin (HbA1c). Secondary end points included change in blood pressure, lipid levels, anthropomorphics and knowledge. Results 23 studies (15 RCTs) met criteria for analysis with 7 from Western countries (n=2532) and 16 from South Asia (n=1081). Interventions in Western countries included translated diabetes education, additional clinical care, written materials, visual aids, and bilingual community-based peers and/or health professionals. Interventions conducted in South Asia included yoga, meditation or exercise, community-based peers, health professionals and dietary education (cooking exercises). Among RCTs in India (5 trials; n=390), 4 demonstrated significant reductions in HbA1c in the intervention group compared with usual care (yoga and exercise interventions). Among the 4 RCTs conducted in Europe (n=2161), only 1 study, an education intervention of 113 patients, reported a significant reduction in HbA1c with the intervention. Lipids, blood pressure and knowledge improved in both groups with studies from India more often reporting reductions in body mass index and waist circumference. Conclusions Overall, there was little improvement in HbA1c level in diabetes management interventions targeted at South Asians living in Europe compared with usual care, although other outcomes did improve. The

  3. Psychological interventions in managing postoperative pain in children: a systematic review.

    PubMed

    Davidson, Fiona; Snow, Stephanie; Hayden, Jill A; Chorney, Jill

    2016-09-01

    Pediatric surgeries are common and painful for children. Postoperative pain is commonly managed with analgesics; however, pain is often still problematic. Despite evidence for psychological interventions for procedural pain, there is currently no evidence synthesis for psychological interventions in managing postoperative pain in children. The purpose of this review was to assess the efficacy of psychological interventions for postoperative pain in youth. Psychological interventions included Preparation/education, distraction/imagery, and mixed. Four databases (PsycINFO, PubMed, EMBASE, and Certified Index to Nursing and Allied Health Literature) were searched to July 2015 for published articles and dissertations. We screened 1401 citations and included 20 studies of youth aged 2 to 18 years undergoing surgery. Two reviewers independently screened articles, extracted data, and assessed risk of bias. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using RevMan 5.3. Fourteen studies (1096 participants) were included in meta-analyses. Primary outcome was pain intensity (0-10 metric). Results indicated that psychological interventions as a whole were effective in reducing children's self-reported pain in the short term (SMD = -0.47, 95% CI = -0.76 to -0.18). Subgroup analysis indicated that distraction/imagery interventions were effective in reducing self-reported pain in the short term (24 hours, SMD = -0.63, 95% CI = -1.04 to -0.23), whereas preparation/education interventions were not effective (SMD = -0.27, 95% CI = -0.61 to 0.08). Data on the effects of interventions on longer term pain outcomes were limited. Psychological interventions may be effective in reducing short-term postoperative pain intensity in children, as well as longer term pain and other outcomes (eg, adverse events) require further study. PMID:27355184

  4. Periodontal Intervention in Speedy Orthodontics-A Case Report

    PubMed Central

    Srivastava, Amitabh; Sharma, Ashish; Garg, Aarti; Kumar, Surubhi

    2016-01-01

    The use of orthodontic treatment in adult patients is becoming more common and these patients have more specific objectives and concerns related to facial and dental aesthetics, specially regarding duration of treatment. Dentists are on the lookout for techniques for increased efficiency in orthodontic treatment. Alveolar Corticotomy-assisted orthodontic treatment is a recent orthodontic technique that is recently gaining wide acceptance and is recorded as effective means of accelerating orthodontic treatment. A 17-year-old female patient was undergoing orthodontic treatment for the past one year but during her space closure, a visual examination confirmed a buccal thickening that was encountered in the buccal plate between premolars and canine. Periodontal intervention involved elective alveolar decortication in the form of dots performed around the teeth that were to be moved. This was carried out to induce a state of increased tissue turnover and a transient osteopenia, which further helps in faster rate of orthodontic tooth movement. Its main advantages are reduction of treatment time and post-orthodontic stability. PMID:26894189

  5. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... case management providers; or (iii) The methodology under which case management providers will be paid..., including for foster care programs, services such as, but not limited to, the following: (1)...

  6. Randomized controlled trial of a collaborative care intervention to manage cancer-related symptoms: lessons learned

    PubMed Central

    Steel, Jennifer; Geller, David A; Tsung, Allan; Marsh, J Wallis; Dew, Mary Amanda; Spring, Michael; Grady, Jonathan; Likumahuwa, Sonja; Dunlavy, Andrea; Youssef, Michael; Antoni, Michael; Butterfield, Lisa H; Schulz, Richard; Day, Richard; Helgeson, Vicki; Kim, Kevin H; Gamblin, T Clark

    2012-01-01

    Background Collaborative care interventions to treat depression have begun to be tested in settings outside of primary care. However, few studies have expanded the collaborative care model to other settings and targeted comorbid physical symptoms of depression. Purpose The aims of this report were to: (1) describe the design and methods of a trial testing the efficacy of a stepped collaborative care intervention designed to manage cancer-related symptoms and improve overall quality of life in patients diagnosed with hepatobiliary carcinoma; and (2) share the lessons learned during the design, implementation, and evaluation of the trial. Methods The trial was a phase III randomized controlled trial testing the efficacy of a stepped collaborative care intervention to reduce depression, pain, and fatigue in patients diagnosed with advanced cancer. The intervention was compared to an enhanced usual care arm. The primary outcomes included the Center for Epidemiological Studies-Depression scale, Brief Pain Inventory, and Functional Assessment of Cancer Therapy (FACT)-Fatigue, and the FACT-Hepatobiliary. Sociodemographic and disease-specific characteristics were recorded from the medical record; Natural Killer cells and cytokines that are associated with these symptoms and with disease progression were assayed from serum. Results and Discussion The issues addressed include: (1) development of collaborative care in the context of oncology (e.g., timing of the intervention, tailoring of the intervention, ethical issues regarding randomization of patients, and changes in medical treatment over the course of the study); (2) use of a website by chronically ill populations (e.g., design and access to the website, development of the website and intervention, ethical issues associated with website development, website usage, and unanticipated costs associated with website development); (3) evaluation of the efficacy of intervention (e.g., patient preferences, proxy raters

  7. Evaluation of a Family-Centred Children's Weight Management Intervention

    ERIC Educational Resources Information Center

    Jinks, Annette; English, Sue; Coufopoulos, Anne

    2013-01-01

    Purpose: The purpose of this paper is to conduct an in-depth quantitative and qualitative evaluation of a family-based weight loss and healthy life style programme for clinically obese children in England. Design/methodology/approach: The mixed method case study evaluation used included obtaining pre and post measurements of anthropometry and a…

  8. Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults

    PubMed Central

    Desroches, Sophie; Lapointe, Annie; Ratté, Stéphane; Gravel, Karine; Légaré, France; Turcotte, Stéphane

    2016-01-01

    Background It has been recognized that poor adherence can be a serious risk to the health and wellbeing of patients, and greater adherence to dietary advice is a critical component in preventing and managing chronic diseases. Objectives To assess the effects of interventions for enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Search methods We searched the following electronic databases up to 29 September 2010: The Cochrane Library (issue 9 2010), PubMed, EMBASE (Embase.com), CINAHL (Ebsco) and PsycINFO (PsycNET) with no language restrictions. We also reviewed: a) recent years of relevant conferences, symposium and colloquium proceedings and abstracts; b) web-based registries of clinical trials; and c) the bibliographies of included studies. Selection criteria We included randomized controlled trials that evaluated interventions enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Studies were eligible if the primary outcome was the client’s adherence to dietary advice. We defined ‘client’ as an adult participating in a chronic disease prevention or chronic disease management study involving dietary advice. Data collection and analysis Two review authors independently assessed the eligibility of the studies. They also assessed the risk of bias and extracted data using a modified version of the Cochrane Consumers and Communication Review Group data extraction template. Any discrepancies in judgement were resolved by discussion and consensus, or with a third review author. Because the studies differed widely with respect to interventions, measures of diet adherence, dietary advice, nature of the chronic diseases and duration of interventions and follow-up, we conducted a qualitative analysis. We classified included studies according to the function of the intervention and present results in a narrative table using vote counting for each category of intervention. Main results

  9. Human Interventions versus Climate Change: Impacts on Water Management

    NASA Astrophysics Data System (ADS)

    Gautam, M. R.; Acharya, K.

    2009-12-01

    Water availability and occurrence of water induced disasters are impacted by both natural and human centric drivers. Climate change is considered to be one of the noted drivers in this regard. Human interventions through land use/land cover change, stream and floodplain regulations via dams, weirs, and embankments could be other equally important group of drivers. Unlike developed countries that have both resources and capabilities to adapt and mitigate the impact of such drivers, developing countries are increasingly at more risk. Identifying roles of such drivers are fundamental to the formulation of any adaptation and mitigation plans for their impacts for developing countries. In this study, we present a few examples from three regions of Nepal- a developing country in South Asia generally considered as a water rich country. Through results of modeling and statistical analyses, we show which driver is in control in different watersheds. Preliminary results show that climate change impact appears to be more prominent in large snow-fed river basins. In the smaller non-snow-fed watersheds originating from the middle hill, the impacts are not explicit despite perception of local people about changes in the water availability. In the southern belt bordering India, the impacts of river regulation on downstream areas are found to be the principal cause of flooding/inundation.

  10. Methods for Streamlining Intervention Fidelity Checklists: An Example from the Chronic Disease Self-Management Program

    PubMed Central

    Ahn, SangNam; Smith, Matthew Lee; Altpeter, Mary; Belza, Basia; Post, Lindsey; Ory, Marcia G.

    2015-01-01

    Maintaining intervention fidelity should be part of any programmatic quality assurance (QA) plan and is often a licensure requirement. However, fidelity checklists designed by original program developers are often lengthy, which makes compliance difficult once programs become widely disseminated in the field. As a case example, we used Stanford’s original Chronic Disease Self-Management Program (CDSMP) fidelity checklist of 157 items to demonstrate heuristic procedures for generating shorter fidelity checklists. Using an expert consensus approach, we sought feedback from active master trainers registered with the Stanford University Patient Education Research Center about which items were most essential to, and also feasible for, assessing fidelity. We conducted three sequential surveys and one expert group-teleconference call. Three versions of the fidelity checklist were created using different statistical and methodological criteria. In a final group-teleconference call with seven national experts, there was unanimous agreement that all three final versions (e.g., a 34-item version, a 20-item version, and a 12-item version) should be made available because the purpose and resources for administering a checklist might vary from one setting to another. This study highlights the methodology used to generate shorter versions of a fidelity checklist, which has potential to inform future QA efforts for this and other evidence-based programs (EBP) for older adults delivered in community settings. With CDSMP and other EBP, it is important to differentiate between program fidelity as mandated by program developers for licensure, and intervention fidelity tools for providing an “at-a-glance” snapshot of the level of compliance to selected program indicators. PMID:25964941

  11. The Family Check-Up in Early Childhood: A Case Study of Intervention Process and Change

    PubMed Central

    Gill, Anne M.; Hyde, Luke W.; Shaw, Daniel S.; Dishion, Thomas J.; Wilson, Melvin N.

    2009-01-01

    This article describes a case study in the use of the Family Check-Up (FCU), a family-based and ecological preventive intervention for children at risk for problem behavior. The FCU is an assessment-driven intervention that utilizes a health maintenance model; emphasizes motivation for change; and offers an adaptive, tailored approach to intervention. This case study follows one Caucasian family through their initial assessment and subsequent treatment for their toddler daughter’s conduct problems over a 2-year period. Clinically meaningful improvements in child and family functioning were found despite the presence of child, parent, and neighborhood risk factors. The case is discussed with respect to the findings from a current multisite randomized control trial of the FCU and its application to other populations. PMID:18991138

  12. Lung squamous cell carcinoma metastasizing to the nasopharynx following bronchoscopy intervention therapies: a case report

    PubMed Central

    2014-01-01

    Metastatic carcinoma to the nasopharynx is extremely rare, and few cases have been reported in the literature. In the present report, we describe the case of a patient with a mass in the nasopharynx found by bronchoscopy. Our patient was a 61-year-old man receiving multiple bronchoscopy intervention therapies for advanced lung squamous cell carcinoma (SCC), which was histopathologically confirmed. The SCC metastasized to the nasopharynx following the bronchoscopy intervention therapies. The lesion was considered metastatic from lung cancer on the basis of clinical and histological clues. The exact mechanism of lung cancer metastasis to the nasopharynx in this case remains unclear because either implantation or hematogenous and lymphatic spread is possible. A thorough head and neck examination should be undertaken during bronchoscopic evaluation, especially in patients receiving bronchoscopy intervention therapies. The early detection of a silent nasopharyngeal metastasis is important to choosing from among the multiple treatment options available. PMID:24673971

  13. A systematic review of the effectiveness of knowledge translation interventions for chronic noncancer pain management

    PubMed Central

    Ospina, Maria B; Taenzer, Paul; Rashiq, Saifee; MacDermid, Joy C; Carr, Eloise; Chojecki, Dagmara; Harstall, Christa; Henry, James L

    2013-01-01

    BACKGROUND: Reliable evidence detailing effective treatments and management practices for chronic noncancer pain exists. However, little is known about which knowledge translation (KT) interventions lead to the uptake of this evidence in practice. OBJECTIVES: To conduct a systematic review of the effectiveness of KT interventions for chronic noncancer pain management. METHODS: Comprehensive searches of electronic databases, the gray literature and manual searches of journals were undertaken. Randomized controlled trials, controlled clinical trials and controlled before-and-after studies of KT interventions were included. Data regarding interventions and primary outcomes were categorized using a standard taxonomy; a risk-of-bias approach was adopted for study quality. A narrative synthesis of study results was conducted. RESULTS: More than 8500 titles and abstracts were screened, with 230 full-text articles reviewed for eligibility. Nineteen studies were included, of which only a small proportion were judged to be at low risk of bias. Interactive KT education for health care providers has a positive effect on patients’ function, but its benefits for other health provider- and patient-related outcomes are inconsistent. Interactive education for patients leads to improvements in knowledge and function. Little research evidence supports the effectiveness of structural changes in health systems and quality improvement processes or coordination of care. CONCLUSIONS: KT interventions incorporating interactive education in chronic noncancer pain led to positive effects on patients’ function and knowledge about pain. Future studies should provide implementation details and use consistent theoretical frameworks to better estimate the effectiveness of such interventions. PMID:24308029

  14. Medical Management of Tumor Lysis Syndrome, Postprocedural Pain, and Venous Thromboembolism Following Interventional Radiology Procedures

    PubMed Central

    Faramarzalian, Ali; Armitage, Keith B.; Kapoor, Baljendra; Kalva, Sanjeeva P.

    2015-01-01

    The rapid expansion of minimally invasive image-guided procedures has led to their extensive use in the interdisciplinary management of patients with vascular, hepatobiliary, genitourinary, and oncologic diseases. Given the increased availability and breadth of these procedures, it is important for physicians to be aware of common complications and their management. In this article, the authors describe management of select common complications from interventional radiology procedures including tumor lysis syndrome, acute on chronic postprocedural pain, and venous thromboembolism. These complications are discussed in detail and their medical management is outlined according to generally accepted practice and evidence from the literature. PMID:26038627

  15. Effects of management intervention on post-disturbance community composition: an experimental analysis using bayesian hierarchical models.

    PubMed

    Giovanini, Jack; Kroll, Andrew J; Jones, Jay E; Altman, Bob; Arnett, Edward B

    2013-01-01

    As human demand for ecosystem products increases, management intervention may become more frequent after environmental disturbances. Evaluations of ecological responses to cumulative effects of management interventions and natural disturbances provide critical decision-support tools for managers who strive to balance environmental conservation and economic development. We conducted an experiment to evaluate the effects of salvage logging on avian community composition in lodgepole pine (Pinus contorta) forests affected by beetle outbreaks in Oregon, USA, 1996-1998. Treatments consisted of the removal of lodgepole pine snags only, and live trees were not harvested. We used a bayesian hierarchical model to quantify occupancy dynamics for 27 breeding species, while accounting for variation in the detection process. We examined how magnitude and precision of treatment effects varied when incorporating prior information from a separate intervention study that occurred in a similar ecological system. Regardless of which prior we evaluated, we found no evidence that the harvest treatment had a negative impact on species richness, with an estimated average of 0.2-2.2 more species in harvested stands than unharvested stands. Estimated average similarity between control and treatment stands ranged from 0.82-0.87 (1 indicating complete similarity between a pair of stands) and suggested that treatment stands did not contain novel assemblies of species responding to the harvesting prescription. Estimated treatment effects were positive for twenty-four (90%) of the species, although the credible intervals contained 0 in all cases. These results suggest that, unlike most post-fire salvage logging prescriptions, selective harvesting after beetle outbreaks may meet multiple management objectives, including the maintenance of avian community richness comparable to what is found in unharvested stands. Our results provide managers with prescription alternatives to respond to severe

  16. Effects of Management Intervention on Post-Disturbance Community Composition: An Experimental Analysis Using Bayesian Hierarchical Models

    PubMed Central

    Giovanini, Jack; Kroll, Andrew J.; Jones, Jay E.; Altman, Bob; Arnett, Edward B.

    2013-01-01

    As human demand for ecosystem products increases, management intervention may become more frequent after environmental disturbances. Evaluations of ecological responses to cumulative effects of management interventions and natural disturbances provide critical decision-support tools for managers who strive to balance environmental conservation and economic development. We conducted an experiment to evaluate the effects of salvage logging on avian community composition in lodgepole pine (Pinus contorta) forests affected by beetle outbreaks in Oregon, USA, 1996–1998. Treatments consisted of the removal of lodgepole pine snags only, and live trees were not harvested. We used a Bayesian hierarchical model to quantify occupancy dynamics for 27 breeding species, while accounting for variation in the detection process. We examined how magnitude and precision of treatment effects varied when incorporating prior information from a separate intervention study that occurred in a similar ecological system. Regardless of which prior we evaluated, we found no evidence that the harvest treatment had a negative impact on species richness, with an estimated average of 0.2–2.2 more species in harvested stands than unharvested stands. Estimated average similarity between control and treatment stands ranged from 0.82–0.87 (1 indicating complete similarity between a pair of stands) and suggested that treatment stands did not contain novel assemblies of species responding to the harvesting prescription. Estimated treatment effects were positive for twenty-four (90%) of the species, although the credible intervals contained 0 in all cases. These results suggest that, unlike most post-fire salvage logging prescriptions, selective harvesting after beetle outbreaks may meet multiple management objectives, including the maintenance of avian community richness comparable to what is found in unharvested stands. Our results provide managers with prescription alternatives to respond to

  17. Evidence-based Clinical Practice Guidelines for Interventional Pain Management in Cancer Pain

    PubMed Central

    Bhatnagar, Sushma; Gupta, Maynak

    2015-01-01

    Intractable cancer pain not amenable to standard oral or parenteral analgesics is a horrifying truth in 10–15% of patients. Interventional pain management techniques are an indispensable arsenal in pain physician's armamentarium for severe, intractable pain and can be broadly classified into neuroablative and neuromodulation techniques. An array of neurolytic techniques (chemical, thermal, or surgical) can be employed for ablation of individual nerve fibers, plexuses, or intrathecalneurolysis in patients with resistant pain and short life-expectancy. Neuraxial administration of drugs and spinal cord stimulation to modulate or alter the pain perception constitutes the most frequently employed neuromodulation techniques. Lately, there is a rising call for early introduction of interventional techniques in carefully selected patients simultaneously or even before starting strong opioids. After decades of empirical use, it is the need of the hour to head towards professionalism and standardization in order to secure credibility of specialization and those practicing it. Even though the interventional management has found a definite place in cancer pain, there is a dearth of evidence-based practice guidelines for interventional therapies in cancer pain. This may be because of paucity of good quality randomized controlled trials (RCTs) evaluating their safety and efficacy in cancer pain. Laying standardized guidelines based on existing and emerging evidence will act as a foundation step towards strengthening, credentialing, and dissemination of the specialty of interventional cancer pain management. This will also ensure an improved decision-making and quality of life (QoL) of the suffering patients. PMID:26009665

  18. Evidence-based Clinical Practice Guidelines for Interventional Pain Management in Cancer Pain.

    PubMed

    Bhatnagar, Sushma; Gupta, Maynak

    2015-01-01

    Intractable cancer pain not amenable to standard oral or parenteral analgesics is a horrifying truth in 10-15% of patients. Interventional pain management techniques are an indispensable arsenal in pain physician's armamentarium for severe, intractable pain and can be broadly classified into neuroablative and neuromodulation techniques. An array of neurolytic techniques (chemical, thermal, or surgical) can be employed for ablation of individual nerve fibers, plexuses, or intrathecalneurolysis in patients with resistant pain and short life-expectancy. Neuraxial administration of drugs and spinal cord stimulation to modulate or alter the pain perception constitutes the most frequently employed neuromodulation techniques. Lately, there is a rising call for early introduction of interventional techniques in carefully selected patients simultaneously or even before starting strong opioids. After decades of empirical use, it is the need of the hour to head towards professionalism and standardization in order to secure credibility of specialization and those practicing it. Even though the interventional management has found a definite place in cancer pain, there is a dearth of evidence-based practice guidelines for interventional therapies in cancer pain. This may be because of paucity of good quality randomized controlled trials (RCTs) evaluating their safety and efficacy in cancer pain. Laying standardized guidelines based on existing and emerging evidence will act as a foundation step towards strengthening, credentialing, and dissemination of the specialty of interventional cancer pain management. This will also ensure an improved decision-making and quality of life (QoL) of the suffering patients. PMID:26009665

  19. Case Management in Community Corrections: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

    2012-01-01

    Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence…

  20. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... chapter. (b) Targeted case management services means case management services furnished without regard to....240 (related to comparability). Targeted case management services may be offered to individuals in any defined location of the State or to individuals within targeted groups specified in the State plan. (c)...

  1. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... chapter. (b) Targeted case management services means case management services furnished without regard to....240 (related to comparability). Targeted case management services may be offered to individuals in any defined location of the State or to individuals within targeted groups specified in the State plan. (c)...

  2. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case management services. (a) Case management services means services furnished to assist individuals, eligible under the... 42 Public Health 4 2011-10-01 2011-10-01 false Case management services. 440.169 Section...

  3. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case management services. (a) Case management services...

  4. Case Management Takes Hold in Long-Term Care.

    ERIC Educational Resources Information Center

    Rose, Stephen M.; And Others

    1992-01-01

    Includes "Empowering Case Management Clients" (Rose); "Case Management in Rural Japan" (Maeda, Takahashi); "Coordinated-Care Teams" (Brodsky, Sobol); "Comparing Practice in the United States and the United Kingdom" (Sturges); "Business of Case Management Flourishing in the U.S." (Cress); and "Community Options Bring Change to Long-Term Care in…

  5. A Randomized Controlled Trial of a Cognitive Behavioural Intervention for Anger Management in Children Diagnosed with Asperger Syndrome

    ERIC Educational Resources Information Center

    Sofronoff, Kate; Attwood, Tony; Hinton, Sharon; Levin, Irina

    2007-01-01

    The purpose of the study described was to evaluate the effectiveness of a cognitive behavioural intervention for anger management with children diagnosed with Asperger syndrome. Forty-five children and their parents were randomly assigned to either intervention or wait-list control conditions. Children in the intervention participated in six 2-h…

  6. Educating Resident Physicians Using Virtual Case-Based Simulation Improves Diabetes Management: A Randomized Controlled Trial

    PubMed Central

    Sperl-Hillen, JoAnn; O’Connor, Patrick J.; Ekstrom, Heidi L.; Rush, William A.; Asche, Stephen E.; Fernandes, Omar D.; Apana, Deepika; Amundson, Gerald H.; Johnson, Paul E.; Curran, Debra M.

    2014-01-01

    Purpose To test a virtual case-based Simulated Diabetes Education (SimDE) intervention developed to teach primary care residents how to manage diabetes. Method Nineteen primary care residency programs, with 341 volunteer residents in all post-graduate years (PGY), were randomly assigned to a SimDE intervention group or control group (CG). The web-based interactive educational intervention used computerized virtual patients who responded to provider actions through programmed simulation models. Eighteen distinct learning cases (L-cases) were assigned to SimDE residents over 6 months from 2010–2011. Impact was assessed using performance on 4 virtual assessment cases (A-cases), an objective knowledge test, and pre-post changes in self-assessed diabetes knowledge and confidence. Group comparisons were analyzed using generalized linear mixed models, controlling for clustering of residents within residency programs and differences in baseline knowledge. Results The percentage of residents appropriately achieving A-case composite clinical goals for glucose, blood pressure, and lipids was: A-Case 1, SimDE = 21.2%, CG = 1.8%, P = .002; A-Case 2, SimDE = 15.7%, CG = 4.7%, P = .02; A-Case 3, SimDE = 48.0%, CG = 10.4%, P < .001; A-Case 4, SimDE = 42.1%, CG = 18.7%, P = .004. The mean knowledge score and pre-post changes in self-assessed knowledge and confidence were significantly better for SimDE group than CG participants. Conclusions A virtual case-based simulated diabetes education intervention improved diabetes management skills, knowledge, and confidence for primary care residents. PMID:25006707

  7. Adapting and testing telephone-based depression care management intervention for adolescent mothers.

    PubMed

    Logsdon, M Cynthia; Foltz, Melissa Pinto; Stein, Bradley; Usui, Wayne; Josephson, Allan

    2010-08-01

    This phase 1 clinical trial combined qualitative and quantitative methods to modify a collaborative care, telephone-based, depression care management intervention for adolescent mothers and to determine the acceptability, feasibility, and initial efficacy of the intervention in a sample of adolescent mothers (n = 97) who were recruited from a Teen Parent Program. Outcomes included measures of depressive symptoms, functioning, and use of mental health services. Acceptability of the intervention was demonstrated, but feasibility issues related to the complex life challenges confronting the adolescent mother. Although only four adolescent mothers received mental health treatment, there was a trend for improved depressive symptoms over time. Results of the study provide data for the need of further refinement of the intervention before a large clinical trial is conducted for adolescent mothers with symptoms of depression. PMID:20020164

  8. Chronic Grief Management for Dementia Caregivers in Transition: Intervention Development and Implementation

    PubMed Central

    Paun, Olimpia; Farran, Carol J.

    2013-01-01

    Research reveals that Alzheimer’s disease (AD) caregivers (CGs) do not relinquish their role after placing a family member in long-term care. Caregivers report increased emotional upset around the time of placement, with sustained losses over time leading to chronic grief. Chronic grief increases caregivers’ risk for depression and suicide. There are no documented interventions designed to decrease CGs chronic grief post placement. The Chronic Grief Management Intervention (CGMI) builds on existing evidence to target caregiver chronic grief in the transition of a family member into long-term care. The intervention is structured into three major components: 1) knowledge, 2) skill in communication and conflict resolution, and 3) chronic grief mangement skill. The 12-week intervention was pilot tested with thirty four caregivers for feasibility and preliminary effects on caregiver skill, knowledge, chronic grief, and depression. This article presents a general study description while focusing on the development and implementation of the CGMI. PMID:22084962

  9. Adapting and Testing Telephone Based Depression Care Management Intervention for Adolescent Mothers

    PubMed Central

    Logsdon, M. Cynthia; Pinto-Foltz, Melissa D.; Stein, Bradley; Usui, Wayne; Josephson, Allan

    2011-01-01

    Purpose and Methods This Phase 1 clinical trial combined qualitative and quantitative methods to modify a collaborative care, telephone based, depression care management intervention for adolescent mothers, and to determine the acceptability, feasibility, and initial efficacy of the intervention in a sample of adolescent mothers (n=97) who were recruited from a Teen Parent Program. Outcomes included measures of depressive symptoms, functioning, and use of mental health services. Results Acceptability of the intervention was demonstrated, but feasibility issues related to the complex life challenges confronting the adolescent mother. Although only four adolescent mothers received mental health treatment, there was a trend for improved depressive symptoms over time. Conclusion Results of the study provide data for the need of further refinement of the intervention before a large clinical trial is conducted for adolescent mothers with symptoms of depression. PMID:20020164

  10. Development testing of mobile health interventions for cancer patient self-management: A review.

    PubMed

    Darlow, Susan; Wen, Kuang-Yi

    2016-09-01

    As the vision of mobile health (mHealth) is beginning to be realized, rigorous intervention development protocols are needed in order to draw optimal efficacy and effectiveness to support patient-centered oncology care. The purpose of the current study was to conduct a review of published articles that describe the development process of mHealth interventions for patients' cancer care self-management. The review search yielded 11 interventions, reported by 14 manuscripts. The following trends emerged: importance of stakeholder engagement during the development process, addressing the unique needs and experiences of cancer patients and care providers, ensuring user satisfaction with the system, and identifying perceived benefits and limitations of the system. This review provides practical suggestions for mHealth intervention development. Assessments of user perceptions should be both qualitative and quantitative, and researchers should follow an established framework when developing a randomized controlled trial employing mHealth. PMID:25916831

  11. Transition management as an intervention for survivor syndrome.

    PubMed

    Rogers, K A

    2000-01-01

    In today's health care environment of merged organizations, downsizing and restructuring, employees can be experiencing a debilitating syndrome called "layoff survivor syndrome." This syndrome can have a crippling effect on workers and organizations as employees struggle to adapt to the changed working environment. This article represents my self-reflection as a nursing unit manager who personally experienced survivor sickness and witnessed its impact on the unit staff that I was leading at the time. The work of Noer (1993) is explored to clarify the syndrome and describe how the nursing staff and I manifested the syndrome. The writings of Bridges (1991), Brockner (1992) and Noer (1993) provide timely and relevant insights into managing the impact of layoffs and downsizing on those left behind to carry on. Noer (1993) sees the adaptation to the change as the ability to make the psychological shift from the old business paradigm that perpetuated codependency to the new business paradigm of fostering empowered employees. Bridges (1991) takes us a step further in making this psychological shift to adapt to the new work environment by providing a three phase process he calls transitions. The works of these three authors hold an important message for organizations and employees working in environments that abound with constant change. PMID:15495386

  12. Heart disease management by women: does intervention format matter?

    PubMed

    Clark, Noreen M; Janz, Nancy K; Dodge, Julia A; Lin, Xihong; Trabert, Britton L; Kaciroti, Niko; Mosca, Lori; Wheeler, John R; Keteyian, Steven

    2009-04-01

    A randomized controlled trial of two formats of a program (Women Take PRIDE) to enhance management of heart disease by patients was conducted. Older women (N = 575) were randomly assigned to a group or self-directed format or to a control group. Data regarding symptoms, functional health status, and weight were collected at baseline and at 4, 12, and 18 months. The formats produced different outcomes. At 18 months, the self-directed format was better than the control in reducing the number (p < or = .02), frequency (p < or = .03), and bothersomeness (p < or = .02) of cardiac symptoms. The self-directed format was also better than the group format in reducing symptom frequency of all types (p < or = .04). The group format improved ambulation at 12 months (p < or = .04) and weight loss at 18 months (p < or = .03), and group participants were more likely to complete the program ( p < or = .05). The availability of different learning formats could enhance management of cardiovascular disease by patients. PMID:18084052

  13. A primer for billing in interventional pain management.

    PubMed

    Yong, R Jason; Nelson, Ehren R; Urman, Richard D; Kaye, Alan David

    2015-01-01

    The surge of interest in pain from many types of physicians over the past few decades has resulted in a specialty with unique challenges. In response to the growth in pain medicine, pain fellowships have emerged to appropriately diagnose and to treat a wide variety of pain conditions. Despite improvements and standardization among pain fellowships, education in the basics of billing and coding is typically limited. Though courses on proper billing practices exist within the specialty of pain medicine, many new practitioners are challenged by clinical responsibilities with limited training with regards to billing and coding of pain services. Inaccurate billing and coding can result in financial issues and legal ramifications. ICD-10, which is expected later this year, will present additional challenges to effective billing and coding. In summary, there are frequent changes to the rules and regulations governing pain management that can significantly impact practice management. Strong consideration should be made by stakeholders in any pain practitioner to attend regular educational meetings and take steps necessary for continued compliance, efficiency, quality, and profitability. A basic primer on concepts related to billing and code terminology, therefore, is presented for clinicians. PMID:26062319

  14. A goal management intervention for polyarthritis patients: rationale and design of a randomized controlled trial

    PubMed Central

    2013-01-01

    Background A health promotion intervention was developed for inflammatory arthritis patients, based on goal management. Elevated levels of depression and anxiety symptoms, which indicate maladjustment, are found in such patients. Other indicators of adaptation to chronic disease are positive affect, purpose in life and social participation. The new intervention focuses on to improving adaptation by increasing psychological and social well-being and decreasing symptoms of affective disorders. Content includes how patients can cope with activities and life goals that are threatened or have become impossible to attain due to arthritis. The four goal management strategies used are: goal maintenance, goal adjustment, goal disengagement and reengagement. Ability to use various goal management strategies, coping versatility and self-efficacy are hypothesized to mediate the intervention’s effect on primary and secondary outcomes. The primary outcome is depressive symptoms. Secondary outcomes are anxiety symptoms, positive affect, purpose in life, social participation, pain, fatigue and physical functioning. A cost-effectiveness analysis and stakeholders’ analysis are planned. Methods/design The protocol-based psycho-educational program consists of six group-based meetings and homework assignments, led by a trained nurse. Participants are introduced to goal management strategies and learn to use these strategies to cope with threatened personal goals. Four general hospitals participate in a randomized controlled trial with one intervention group and a waiting list control condition. Discussion The purpose of this study is to evaluate the effectiveness of a goal management intervention. The study has a holistic focus as both the absence of psychological distress and presence of well-being are assessed. In the intervention, applicable goal management competencies are learned that assist people in their choice of behaviors to sustain and enhance their quality of life

  15. Interventional radiology in the multidisciplinary management of liver lesions: pre- and postoperative roles.

    PubMed

    Ward, Thomas J; Madoff, David C; Weintraub, Joshua L

    2013-08-01

    The management algorithm for patents with liver lesions, most often hepatocellular carcinoma (HCC) or colorectal cancer metastasis, are complex, ever-changing, and involve multiple treatment modalities including chemotherapy, external-beam radiation, surgery, and locoregional therapies (LRTs). This complexity necessitates a multidisciplinary approach including hepatologists, oncologists, hepatobiliary surgeons, radiation oncologists, and interventional radiologists to coordinate and deliver the complex care that these patients need in a timely manner. The interventional radiologist and hepatobiliary surgeon work closely together in both the pre- and postoperative setting. Preoperative roles include delivering LRTs to patients with HCC and interventions aimed at hepatic optimization prior to resection or transplantation. LRT in this setting is performed either to bridge the patient to transplant or to downstage the initially nontransplant candidate so appropriate transplant criteria are met. Postoperative roles include the management of biliary and vascular complications that may occur after resection or transplantation. PMID:23943102

  16. Psychotherapy Interventions for Managing Anxiety and Depressive Symptoms in Adult Brain Tumor Patients: A Scoping Review

    PubMed Central

    Kangas, Maria

    2015-01-01

    Background Adult brain tumor (BT) patients and longer-term survivors are susceptible to experiencing emotional problems, including anxiety and/or depression disorders, which may further compromise their quality-of-life (QOL) and general well-being. The objective of this paper is to review psychological approaches for managing anxiety and depressive symptoms in adult BT patients. A review of psychological interventions comprising mixed samples of oncology patients, and which included BT patients is also evaluated. The review concludes with an overview of a recently developed transdiagnostic psychotherapy program, which was specifically designed to treat anxiety and/or depressive symptoms in adult BT patients. Methods Electronic databases (PsycINFO, Medline, Embase, and Cochrane) were searched to identify published studies investigating psychological interventions for managing anxiety and depressive symptoms in adult BT patients. Only four randomized controlled trials (RCTs) were identified. Results Only one of the RCTs tested a psychosocial intervention, which was specifically developed for primary BT patients, and which was found to improve QOL including existential well-being as well as reducing depressive symptoms. A second study tested a combined cognitive rehabilitation and problem-solving intervention, although was not found to significantly improve mood or QOL. The remaining two studies tested multidisciplinary psychosocial interventions in heterogeneous samples of cancer patients (included BT patients) with advanced stage disease. Maintenance of QOL was found in both studies, although no secondary gains were found for improvements in mood. Conclusion There is a notable paucity of psychological interventions for adult BT patients across the illness trajectory. Further research is required to strengthen the evidence base for psychological interventions in managing anxiety and depressive symptoms, and enhancing the QOL of distressed adults diagnosed with a BT

  17. Measuring impact of protected area management interventions: current and future use of the Global Database of Protected Area Management Effectiveness.

    PubMed

    Coad, Lauren; Leverington, Fiona; Knights, Kathryn; Geldmann, Jonas; Eassom, April; Kapos, Valerie; Kingston, Naomi; de Lima, Marcelo; Zamora, Camilo; Cuardros, Ivon; Nolte, Christoph; Burgess, Neil D; Hockings, Marc

    2015-11-01

    Protected areas (PAs) are at the forefront of conservation efforts, and yet despite considerable progress towards the global target of having 17% of the world's land area within protected areas by 2020, biodiversity continues to decline. The discrepancy between increasing PA coverage and negative biodiversity trends has resulted in renewed efforts to enhance PA effectiveness. The global conservation community has conducted thousands of assessments of protected area management effectiveness (PAME), and interest in the use of these data to help measure the conservation impact of PA management interventions is high. Here, we summarize the status of PAME assessment, review the published evidence for a link between PAME assessment results and the conservation impacts of PAs, and discuss the limitations and future use of PAME data in measuring the impact of PA management interventions on conservation outcomes. We conclude that PAME data, while designed as a tool for local adaptive management, may also help to provide insights into the impact of PA management interventions from the local-to-global scale. However, the subjective and ordinal characteristics of the data present significant limitations for their application in rigorous scientific impact evaluations, a problem that should be recognized and mitigated where possible. PMID:26460133

  18. Measuring impact of protected area management interventions: current and future use of the Global Database of Protected Area Management Effectiveness

    PubMed Central

    Coad, Lauren; Leverington, Fiona; Knights, Kathryn; Geldmann, Jonas; Eassom, April; Kapos, Valerie; Kingston, Naomi; de Lima, Marcelo; Zamora, Camilo; Cuardros, Ivon; Nolte, Christoph; Burgess, Neil D.; Hockings, Marc

    2015-01-01

    Protected areas (PAs) are at the forefront of conservation efforts, and yet despite considerable progress towards the global target of having 17% of the world's land area within protected areas by 2020, biodiversity continues to decline. The discrepancy between increasing PA coverage and negative biodiversity trends has resulted in renewed efforts to enhance PA effectiveness. The global conservation community has conducted thousands of assessments of protected area management effectiveness (PAME), and interest in the use of these data to help measure the conservation impact of PA management interventions is high. Here, we summarize the status of PAME assessment, review the published evidence for a link between PAME assessment results and the conservation impacts of PAs, and discuss the limitations and future use of PAME data in measuring the impact of PA management interventions on conservation outcomes. We conclude that PAME data, while designed as a tool for local adaptive management, may also help to provide insights into the impact of PA management interventions from the local-to-global scale. However, the subjective and ordinal characteristics of the data present significant limitations for their application in rigorous scientific impact evaluations, a problem that should be recognized and mitigated where possible. PMID:26460133

  19. Are Self-Management Interventions Suitable for All? Comparing Obese Versus Nonobese Type 2 Diabetes Patients

    ERIC Educational Resources Information Center

    Kroese, Floor M.; Adriaanse, Marieke A.; De Ridder, Denise T. D.

    2013-01-01

    Objective: The aim of the current study was to compare obese and nonobese type 2 diabetes patients at baseline and after participating in an existing self-management intervention (i.e., "Beyond Good Intentions") on cognitive, self-care, and behavioral measures to examine whether both groups are equally prepared and able to adopt…

  20. Analysis of Self-Recording in Self-Management Interventions for Stereotypy

    ERIC Educational Resources Information Center

    Fritz, Jennifer N.; Iwata, Brian A.; Rolider, Natalie U.; Camp, Erin M.; Neidert, Pamela L.

    2012-01-01

    Most treatments for stereotypy involve arrangements of antecedent or consequent events that are imposed entirely by a therapist. By contrast, results of some studies suggest that self-recording, a common component of self-management interventions, might be an effective and efficient way to reduce stereotypy. Because the procedure typically has…

  1. Leadership Styles and Management Practices of Russian Entrepreneurs: Implications for Transferability of Western HRD Interventions.

    ERIC Educational Resources Information Center

    Ardichvili, Alexander; Cardozo, Richard N.; Gasparishvili, Alexander

    1998-01-01

    Interviews with 256 Russian owners of companies created since 1986 found that owners involved peers, but not subordinates, in decision making; had fewer authoritarian and many situational leadership styles; women used more consultative decision making; work design and performance-management interventions used more often than training/development…

  2. The Effects of Function-Based Self-Management Interventions on Student Behavior

    ERIC Educational Resources Information Center

    Hansen, Blake D.; Wills, Howard P.; Kamps, Debra M.; Greenwood, Charles R.

    2014-01-01

    Children with emotional and behavioral disorders (E/BD) struggle to achieve social and academic outcomes. Many studies have demonstrated self-management interventions to be effective at reducing problem behavior and increasing positive social and academic behaviors. Functional behavior assessment (FBA) information may be used in designing…

  3. A Randomized Clinical Trial of Alternative Stress Management Interventions in Persons with HIV Infection

    ERIC Educational Resources Information Center

    McCain, Nancy L.; Gray, D. Patricia; Elswick, R. K., Jr.; Robins, Jolynne W.; Tuck, Inez; Walter, Jeanne M.; Rausch, Sarah M.; Ketchum, Jessica McKinney

    2008-01-01

    Research in psychoneuroimmunology suggests that immunosuppression associated with perceived stress may contribute to disease progression in persons with HIV infection. While stress management interventions may enhance immune function, few alternative approaches have yet been tested. This randomized clinical trial was conducted to test effects of…

  4. The Anger Management Project: A Group Intervention for Anger in People with Physical and Multiple Disabilities

    ERIC Educational Resources Information Center

    Hagiliassis, Nick; Gulbenkoglu, Hrepsime; Di Marco, Mark; Young, Suzanne; Hudson, Alan

    2005-01-01

    Background: This paper describes the evaluation of a group program designed specifically to meet the anger management needs of a group of individuals with various levels of intellectual disability and/or complex communication needs. Method: Twenty-nine individuals were randomly assigned to an intervention group or a waiting-list comparison group.…

  5. Definition of a COPD self-management intervention: International Expert Group consensus.

    PubMed

    Effing, Tanja W; Vercoulen, Jan H; Bourbeau, Jean; Trappenburg, Jaap; Lenferink, Anke; Cafarella, Paul; Coultas, David; Meek, Paula; van der Valk, Paul; Bischoff, Erik W M A; Bucknall, Christine; Dewan, Naresh A; Early, Frances; Fan, Vincent; Frith, Peter; Janssen, Daisy J A; Mitchell, Katy; Morgan, Mike; Nici, Linda; Patel, Irem; Walters, Haydn; Rice, Kathryn L; Singh, Sally; Zuwallack, Richard; Benzo, Roberto; Goldstein, Roger; Partridge, Martyn R; van der Palen, Job

    2016-07-01

    There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management experts using Delphi technique features and an additional group meeting.In each consensus round the experts were asked to provide feedback on the proposed definition and to score their level of agreement (1=totally disagree; 5=totally agree). The information provided was used to modify the definition for the next consensus round. Thematic analysis was used for free text responses and descriptive statistics were used for agreement scores.In total, 28 experts participated. The consensus round response rate varied randomly over the five rounds (ranging from 48% (n=13) to 85% (n=23)), and mean definition agreement scores increased from 3.8 (round 1) to 4.8 (round 5) with an increasing percentage of experts allocating the highest score of 5 (round 1: 14% (n=3); round 5: 83% (n=19)).In this study we reached consensus regarding a conceptual definition of what should be a COPD self-management intervention, clarifying the requisites for such an intervention. Operationalisation of this conceptual definition in the near future will be an essential next step. PMID:27076595

  6. Social Validity of the Critical Incident Stress Management Model for School-Based Crisis Intervention

    ERIC Educational Resources Information Center

    Morrison, Julie Q.

    2007-01-01

    The Critical Incident Stress Management (CISM) model for crisis intervention was developed for use with emergency service personnel. Research regarding the use of the CISM model has been conducted among civilians and high-risk occupation groups with mixed results. The purpose of this study is to examine the social validity of the CISM model for…

  7. Comparing Student Perceptions of Coping Strategies and School Interventions in Managing Bullying and Cyberbullying Incidents

    ERIC Educational Resources Information Center

    Paul, Simone; Smith, Peter K.; Blumberg, Herbert H.

    2012-01-01

    A total of 407 students in a central London secondary school participated in a survey of different approaches to managing traditional bullying and cyberbullying. Student perceptions of individual coping strategies and school interventions for traditional bullying and cyberbullying were measured. Rankings of the strategies for traditional bullying…

  8. Psychological Intervention in Portuguese College Students: Effects of Two Career Self-Management Seminars

    ERIC Educational Resources Information Center

    Pinto, Joana Carneiro; Loureiro, Nazaré; Taveira, Maria do Céu

    2015-01-01

    This article describes the evaluation of a psychological intervention--the Career Self-Management Seminar, Version A, for undergraduate students, and Version B for postgraduate students--developed to support Portuguese college students in career exploration, goal setting, design and implementation of action plans, and decision-making. A total of…

  9. A Web-Based Self-Management Intervention for Intermittent Catheter Users

    PubMed Central

    Wilde, Mary H.; Fairbanks, Eileen; Parshall, Robert; Zhang, Feng; Miner, Sarah; Thayer, Deborah; Harrington, Brian; Brasch, Judith; Schneiderman, Dan; McMahon, James M.

    2016-01-01

    A new Web-based self-management intervention was developed for persons with spinal cord injury who use intermittent urinary catheters. Included are a description of the components, examples from the educational book, and multiple screen shots of the online urinary diary. PMID:26298947

  10. A Contingency Management Intervention for Adolescent Marijuana Abuse and Conduct Problems.

    ERIC Educational Resources Information Center

    Kamon, Jody; Budney, Alan; Stanger, Catherine

    2005-01-01

    Objective: To describe an innovative treatment for adolescent marijuana abuse and provide initial information about its feasibility, acceptability, and potential efficacy. Method: Provided an intervention composed of (1) a clinic-administered, abstinence-based incentive program; (2) parent-directed contingency management targeting substance use…

  11. A Community "Hub" Network Intervention for HIV Stigma Reduction: A Case Study.

    PubMed

    Prinsloo, Catharina D; Greeff, Minrie

    2016-01-01

    We describe the implementation of a community "hub" network intervention to reduce HIV stigma in the Tlokwe Municipality, North West Province, South Africa. A holistic case study design was used, focusing on community members with no differentiation by HIV status. Participants were recruited through accessibility sampling. Data analyses used open coding and document analysis. Findings showed that the HIV stigma-reduction community hub network intervention successfully activated mobilizers to initiate change; lessened the stigma experience for people living with HIV; and addressed HIV stigma in a whole community using a combination of strategies including individual and interpersonal levels, social networks, and the public. Further research is recommended to replicate and enhance the intervention. In particular, the hub network system should be extended, the intervention period should be longer, there should be a stronger support system for mobilizers, and the multiple strategy approach should be continued on individual and social levels. PMID:26627447

  12. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, Gerold; Greening, Holly; Yates, Kimberly K.

    2011-01-01

    Tampa Bay, Florida, USA, is a shallow, subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of seagrasses and other selected habitat types, to support estuarine-dependent faunal guilds. Over the past three decades, nitrogen controls involving sources such as wastewater treatment plants, stormwater conveyance systems, fertilizer manufacturing and shipping operations, and power plants have been undertaken to meet these and other management objectives. Cumulatively, these controls have resulted in a 60% reduction in annual total nitrogen (TN) loads relative to earlier worse-case (latter 1970s) conditions. As a result, annual water-clarity and chlorophyll a targets are currently met in most years, and seagrass cover measured in 2008 was the highest recorded since 1950. Factors that have contributed to the observed improvements in Tampa Bay over the past several decades include the following: (1) Development of numeric, science-based water-quality targets to meet a long-term goal of restoring seagrass acreage to 1950s levels. Empirical and mechanistic models found that annual average chlorophyll a concentrations were a primary manageable factor affecting light attenuation. The models also quantified relationships between TN loads, chlorophyll a concentrations, light attenuation, and fluctuations in seagrass cover. The availability of long-term monitoring data, and a systematic process for using the data to evaluate the effectiveness of management actions, has allowed managers to track progress and

  13. Meta-Analysis of Single-Case Design Research on Self-Regulatory Interventions for Academic Performance

    ERIC Educational Resources Information Center

    Perry, Valerie; Albeg, Loren; Tung, Catherine

    2012-01-01

    The current study examined the effects of self-regulatory interventions on reading, writing, and math by conducting a meta-analysis of single-case design research. Self-regulatory interventions have promise as an effective approach that is both minimally invasive and involves minimal resources. Effects of the interventions were analyzed by…

  14. 22 CFR 1422.6 - Withdrawal, dismissal or deferral of petitions; consolidation of cases; denial of intervention...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... petition or deny the request for intervention. (b) If the Regional Director determines, after investigation...; consolidation of cases; denial of intervention; review of action by Regional Director. 1422.6 Section 1422.6... intervention; review of action by Regional Director. (a) If the Regional Director determines, after...

  15. Ensuring the quality of asthma case management.

    PubMed

    Aït-Khaled, N; Enarson, D A

    2006-07-01

    An evaluation based on recording the number of patients and evaluating their treatment outcomes provides the information necessary to plan the provision of care, determine the analysis of the situation and revise practice if the results are not satisfactory. The standardised tools proposed for this evaluation are: a district register for new persistent asthma patients, quarterly reports of case finding and an annual report of cohort patient follow-up. The main indicators of quality of care based on register information given by the cohort analysis are the percentage of defaulters and the percentage of patients whose asthma is controlled or well controlled after 1 year of follow-up. The services involved in asthma management should be adapted to the local situation in each country. In particular, the health service structure and national guidelines must be respected, and services involved in asthma management should be implemented in stages. Operational research within the services is essential to ensure that the services provided are appropriate. This type of research involves the health personnel responsible for patient management, provides them with new knowledge and helps them to resolve problems they are confronted with on a regular basis. It also inspires critical thinking, which is crucial to both research and practice. PMID:16848332

  16. Applying e-health to case management.

    PubMed

    Adams, J M

    2000-01-01

    The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care. PMID:16397993

  17. The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016 statement: Énoncé concernant la Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016.

    PubMed

    Tate, Robyn L; Perdices, Michael; Rosenkoetter, Ulrike; Shadish, William; Vohra, Sunita; Barlow, David H; Horner, Robert; Kazdin, Alan; Kratochwill, Thomas; McDonald, Skye; Sampson, Margaret; Shamseer, Larissa; Togher, Leanne; Albin, Richard; Backman, Catherine; Douglas, Jacinta; Evans, Jonathan J; Gast, David; Manolov, Rumen; Mitchell, Geoffrey; Nickels, Lyndsey; Nikles, Jane; Ownsworth, Tamara; Rose, Miranda; Schmid, Christopher H; Wilson, Barbara

    2016-06-01

    We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE) 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016) that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts.Reporting guidelines, such as the Consolidated Standards of Reporting Trials (CONSORT) Statement, improve the reporting of research in the medical literature (Turner et al., 2012). Many such guidelines exist and the CONSORT Extension to Nonpharmacological Trials (Boutron et al., 2008) provides suitable guidance for reporting between-groups intervention studies in the behavioral sciences. The CONSORT Extension for N-of-1 Trials (CENT 2015) was developed for multiple crossover trials with single individuals in the medical sciences (Shamseer et al., 2015; Vohra et al., 2015), but there is no reporting guideline in the CONSORT tradition for single-case research used in the behavioral sciences. We developed the Single-Case

  18. Culturally Sensitive Intervention for Latina Women with Eating Disorders: A Case Study

    PubMed Central

    Reyes-Rodríguez, Mae Lynn; Baucom, Donald H.; Bulik, Cynthia M.

    2014-01-01

    Objective We describe cognitive-behavioral therapy for bulimia nervosa (CBT-BN) with a Latina woman that incorporates culturally relevant topics. Method A single case report of a 31-year-old monolingual Latina woman with BN describes the application of a couple-based intervention adjunctive to CBT-BN. Results The patient reported no binge and purge episodes by session 20 and remained symptom free until the end of treatment (session 26). Improvement was observed in the Eating Disorders Examination (EDE) comparing baseline (EDE=5.74) with post treatment (EDE=1.25). Conclusions The case illustrates how cultural adaptations such as including a family member, being flexible on topics and scheduling, and providing culturally relevant interventions can lead to successful completion of a course of therapy and facilitate ongoing interventions to ensure continued recovery. PMID:25598951

  19. Early sleep psychiatric intervention for acute insomnia: implications from a case of obsessive-compulsive disorder.

    PubMed

    Abe, Yuichiro; Nishimura, Go; Endo, Takuro

    2012-04-15

    Insomnia is a common problem among patients with obsessive-compulsive disorder (OCD), and patients suffering from acute insomnia with psychiatric comorbidity are more likely to develop chronic insomnia without appropriate intervention. Here we report a case of obsessive-compulsive disorder with acute insomnia, successfully treated with early sleep psychiatric non-pharmacological intervention. The augmentation of medication runs a risk of exacerbating daytime impairment. Clinicians usually prescribe medication, such as antidepressants and hypnotics without reflections for such complaints. However, the use of these sedative agents is often problematic, especially when patients have kept a good QOL activity in daily life. The rapid recovery from acute insomnia in this case suggests that the appropriate use of actigraphy is a favorable non-pharmacological intervention in acute insomnia. PMID:22505865

  20. Case management for frequent users of the emergency department: study protocol of a randomised controlled trial

    PubMed Central

    2014-01-01

    Background We devised a randomised controlled trial to evaluate the effectiveness and efficiency of an intervention based on case management care for frequent emergency department users. The aim of the intervention is to reduce such patients’ emergency department use, to improve their quality of life, and to reduce costs consequent on frequent use. The intervention consists of a combination of comprehensive case management care and standard emergency care. It uses a clinical case management model that is patient-identified, patient-directed, and developed to provide high intensity services. It provides a continuum of hospital- and community-based patient services, which include clinical assessment, outreach referral, and coordination and communication with other service providers. Methods/Design We aim to recruit, during the first year of the study, 250 patients who visit the emergency department of the University Hospital of Lausanne, Switzerland. Eligible patients will have visited the emergency department 5 or more times during the previous 12 months. Randomisation of the participants to the intervention or control groups will be computer generated and concealed. The statistician and each patient will be blinded to the patient’s allocation. Participants in the intervention group (N = 125), additionally to standard emergency care, will receive case management from a team, 1 (ambulatory care) to 3 (hospitalization) times during their stay and after 1, 3, and 5 months, at their residence, in the hospital or in the ambulatory care setting. In between the consultations provided, the patients will have the opportunity to contact, at any moment, the case management team. Participants in the control group (N = 125) will receive standard emergency care only. Data will be collected at baseline and 2, 5.5, 9, and 12 months later, including: number of emergency department visits, quality of life (EuroQOL and WHOQOL), health services use, and relevant costs

  1. Designing and implementing interventions to change clinicians’ practice in the management of uncomplicated malaria: lessons from Cameroon

    PubMed Central

    2014-01-01

    Background Effective case management of uncomplicated malaria is a fundamental pillar of malaria control. Little is known about the various steps in designing interventions to accompany the roll out of rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT). This study documents the process of designing and implementing interventions to change clinicians’ practice in the management of uncomplicated malaria. Methods A literature review combined with formative quantitative and qualitative research were carried out to determine patterns of malaria diagnosis and treatment and to understand how malaria and its treatment are enacted by clinicians. These findings were used, alongside a comprehensive review of previous interventions, to identify possible strategies for changing the behaviour of clinicians when diagnosing and treating uncomplicated malaria. These strategies were discussed with ministry of health representatives and other stakeholders. Two intervention packages - a basic and an enhanced training were outlined, together with logic model to show how each was hypothesized to increase testing for malaria, improve adherence to test results and increase appropriate use of ACT. The basic training targeted clinicians’ knowledge of malaria diagnosis, rapid diagnostic testing and malaria treatment. The enhanced training included additional modules on adapting to change, professionalism and communicating effectively. Modules were delivered using small-group work, card games, drama and role play. Interventions were piloted, adapted and trainers were trained before final implementation. Results Ninety-six clinicians from 37 health facilities in Bamenda and Yaounde sites attended either 1-day basic or 3-day enhanced training. The trained clinicians then trained 632 of their peers at their health facilities. Evaluation of the training revealed that 68% of participants receiving the basic and 92% of those receiving the enhanced training strongly

  2. Creating Qungasvik (a Yup'ik intervention "toolbox"): case examples from a community-developed and culturally-driven intervention.

    PubMed

    Rasmus, Stacy M; Charles, Billy; Mohatt, Gerald V

    2014-09-01

    This paper describes the development of a Yup'ik Alaska Native approach to suicide and alcohol abuse prevention that resulted in the creation of the Qungasvik, a toolbox promoting reasons for life and sobriety among youth. The Qungasvik is made up of thirty-six modules that function as cultural scripts for creating experiences in Yup'ik communities that build strengths and protection against suicide and alcohol abuse. The Qungasvik manual represents the results of a community based participatory research intervention development process grounded in culture and local process, and nurtured through a syncretic blending of Indigenous and Western theories and practices. This paper will provide a description of the collaborative steps taken at the community-level to develop the intervention modules. This process involved university researchers and community members coming together and drawing from multiple sources of data and knowledge to inform the development of prevention activities addressing youth suicide and alcohol abuse. We will present case examples describing the development of three keystone modules; Qasgiq (The Men's House), Yup'ik Kinship Terms, and Surviving Your Feelings. These modules each are representative of the process that the community co-researcher team took to develop and implement protective experiences that: (1) create supportive community, (2) strengthen families, and (3) give individuals tools to be healthy and strong. PMID:24764018

  3. Managing dental emergencies: A descriptive study of the effects of a multimodal educational intervention for primary care providers at six months

    PubMed Central

    2012-01-01

    Background Clinicians providing primary emergency medical care often receive little training in the management of dental emergencies. A multimodal educational intervention was designed to address this lack of training. Sustained competency in managing dental emergencies and thus the confidence to provide this care well after an educational intervention is of particular importance for remote and rural healthcare providers where access to professional development training may be lacking. Methods A descriptive study design with a survey instrument was used to evaluate the effectiveness of a brief educational intervention for primary care clinicians. The survey was offered immediately before and at six months following the intervention. A Wilcoxon signed rank test was performed on pre and six month post-workshop matched pair responses, measuring self-reported proficiency in managing dental emergencies. The level of significance was set at p < 0.001. Confidence intervals (CI) were calculated for participants who scored an improved proficiency. Results The educational intervention was associated with a significant and sustained increase in proficiency and confidence to treat, especially in oral local anaesthesia, management of avulsed teeth and dental trauma, as reported by clinicians at six months after the education. This was associated with a greater number of cases where dental local anaesthesia was utilised by the participants. Comments from participants before the intervention, noted the lack of dental topics in professional training. Conclusions The sustained effects of a brief multimodal educational intervention in managing dental emergencies on practice confidence and proficiency demonstrates its value as an educational model that could be applied to other settings and health professional groups providing emergency primary care, particularly in rural and remote settings. PMID:23110579

  4. From Risk Assessment to Risk Management: Matching Interventions to Adolescent Offenders’ Strengths and Vulnerabilities

    PubMed Central

    Singh, Jay P.; Desmarais, Sarah L.; Sellers, Brian G.; Hylton, Tatiana; Tirotti, Melissa; Van Dorn, Richard A.

    2013-01-01

    Though considerable research has examined the validity of risk assessment tools in predicting adverse outcomes in justice-involved adolescents, the extent to which risk assessments are translated into risk management strategies and, importantly, the association between this link and adverse outcomes has gone largely unexamined. To address these shortcomings, the Risk-Need-Responsivity (RNR) model was used to examine associations between identified strengths and vulnerabilities, interventions, and institutional outcomes for justice-involved youth. Data were collected from risk assessments completed using the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) for 120 adolescent offenders (96 boys and 24 girls). Interventions and outcomes were extracted from institutional records. Mixed evidence of adherence to RNR principles was found. Accordant to the risk principle, adolescent offenders judged to have more strengths had more strength-based interventions in their service plans, though adolescent offenders with more vulnerabilities did not have more interventions targeting their vulnerabilities. With respect to the need and responsivity principles, vulnerabilities and strengths identified as particularly relevant to the individual youth's risk of adverse outcomes were addressed in the service plans about half and a quarter of the time, respectively. Greater adherence to the risk and need principles was found to predict significantly the likelihood of externalizing outcomes. Findings suggest some gaps between risk assessment and risk management and highlight the potential usefulness of strength-based approaches to intervention. PMID:25346561

  5. Understanding patients’ health and technology attitudes for tailoring self-management interventions

    PubMed Central

    O’Leary, Katie; Vizer, Lisa; Eschler, Jordan; Ralston, James; Pratt, Wanda

    2015-01-01

    Healthcare providers are moving towards tailoring self-management interventions to include the communication technologies patients use in daily life. Accurate understanding of patients’ attitudes towards both technology and involvement in managing chronic conditions will be critical for informing effective self-management strategies. The tailoring of these interventions, however, could be undermined by providers’ implicit biases based on patient age, race, and education level that have been shown to negatively affect care. To inform the design and tailoring of self-management interventions, we elicited attitudes toward technology use and participation in care of 40 participants in a maximum variation sample. The analysis revealed three participant clusters—“Proactive Techies,” “Indie Self-Managers,” and “Remind Me! Non-Techies”—that represent varying attitudes toward health behaviors and technologies that were independent of race, education level, and age. Our approach provides insight into how people prioritize important values related to health participation and technology. PMID:26958236

  6. Engaging Mexican Immigrant Families in Language and Literacy Interventions: Three Case Studies

    ERIC Educational Resources Information Center

    Kummerer, Sharon E.; Lopez-Reyna, Norma A.

    2009-01-01

    This article describes the experiences of three Mexican immigrant mothers and their young children who were participating in early intervention speech-language therapy. Mother interviews, children's therapy files, observation field notes, and parent journals contributed to the construction of instrumental case studies. Highlighting the potential…

  7. Psychological Intervention: Case Studies in School Psychological Services. Volume 2, 1978.

    ERIC Educational Resources Information Center

    Grimes, Jeff, Ed.

    The 16 case studies illustrate the nature and scope of psychological intervention with emotionally disturbed and otherwise handicapped students. Included are papers with the following titles and authors: "Reducing Math Anxiety while Increasing Independent Work Habits in a Learning Disabled Elementary School Boy" (K. Hoogeveen); "Coping with…

  8. Large Scale Interventions: An Historical Case Study of Florida Schoolyear, 2000.

    ERIC Educational Resources Information Center

    Russo-Converso, Judith A.

    This research study focuses an historical case study on a large-scale intervention called Florida SchoolYear (SY2000), which was a visionary example of how the state of Florida tried to design and develop a means for delivering quality education. By studying the Florida SY2000 Initiative, this research study examined issue-oriented questions…

  9. Hearing Voices: A Response to "Case Study of a Participatory Health-Promotion Intervention in School"

    ERIC Educational Resources Information Center

    Harrist, Christopher J.

    2012-01-01

    Venka Simovska's article "Case Study of a Participatory Health-Promotion Intervention in School" provides important insights regarding the active involvement of youths in service programs. This response essay extends Simovska's discussions and frames them within three key areas: positive youth development, youth voice, and meaningful…

  10. Case Study of a Participatory Health-Promotion Intervention in School

    ERIC Educational Resources Information Center

    Simovska, Venka

    2012-01-01

    This article discusses the findings from a case study focusing on processes involving pupils to bring about health-promotion changes. The study is related to an EU intervention project aiming to promote health and well-being among children (4-16 years). Qualitative research was carried out in a school in the Netherlands. Data sources include…

  11. One Texas Elementary School's Successful Response to Intervention Program: Case Study

    ERIC Educational Resources Information Center

    Iles, Abby

    2013-01-01

    This phenomenological case study addressed gaps in the literature related to successful implementation of Response to Intervention (RtI) in rural settings by exploring the experiences of educators in a rural Texas school district that has implemented a successful RtI program. Ten educators involved with the RtI process were interviewed about their…

  12. Literacy in Early Intervention for Children with Visual Impairments: Insights from Individual Cases

    ERIC Educational Resources Information Center

    Erickson, Karen A.; Hatton, Deborah; Roy, Vicky; Fox, DanaLee; Renne, Diane

    2007-01-01

    A qualitative case study design was used to investigate the ways in which two early interventionists supported emergent literacy development for infants and toddlers with visual impairment. Three themes are addressed: (1) the importance of a family-centered approach in addressing emergent literacy in early intervention; (2) the role of the early…

  13. Working Together with Children and Families: Case Studies in Early Intervention.

    ERIC Educational Resources Information Center

    McWilliam, P. J., Ed.; Bailey, Donald B., Jr., Ed.

    This book presents 21 case studies of young children with disabilities in a variety of family situations and settings, for early interventionists to study in planning and applying recommended practices. Section I, "Defining and Delivering Quality Services in Early Intervention," provides two introductory chapters: "The Search for Quality…

  14. Meta-Analysis of Interventions for Basic Mathematics Computation in Single-Case Research

    ERIC Educational Resources Information Center

    Methe, Scott A.; Kilgus, Stephen P.; Neiman, Cheryl; Riley-Tillman, T. Chris

    2012-01-01

    This study examined interventions for addition and subtraction that were implemented through single-case design (SCD) research studies. We attempted to extend prior SCD meta-analyses by examining differences in effect sizes across several moderating variables and by including a novel index of effect, improvement rate difference (IRD). We also…

  15. Self-management interventions in stages 1 to 4 chronic kidney disease: an integrative review.

    PubMed

    Welch, Janet L; Johnson, Michelle; Zimmerman, Lani; Russell, Cynthia L; Perkins, Susan M; Decker, Brian S

    2015-05-01

    The prevalence, effect on health outcomes, and economic impact of chronic kidney disease (CKD) have created interest in self-management interventions to help slow disease progression to kidney failure. Seven studies were reviewed to identify knowledge gaps and future directions for research. All studies were published between 2010 and 2013; no investigations were conducted in the United States. Knowledge gaps included the focus on medical self-management tasks with no attention to role or emotional tasks, lack of family involvement during intervention delivery, and an inability to form conclusions about the efficacy of interventions because methodological rigor was insufficient. Educational content varied across studies. Strategies to improve self-management skills and enhance self-efficacy varied and were limited in scope. Further development and testing of theory-based interventions are warranted. There is a critical need for future research using well-designed trials with appropriately powered sample sizes, well-tested instruments, and clear and consistent reporting of results. PMID:25239136

  16. Self-Management Interventions in Stages 1-4 Chronic Kidney Disease: An Integrative Review

    PubMed Central

    Johnson, Michelle; Zimmerman, Lani; Russell, Cynthia L.; Perkins, Susan M.; Decker, Brian S.

    2014-01-01

    The prevalence, effect on health outcomes, and economic impact of chronic kidney disease (CKD) have created interest in self-management interventions to help slow disease progression to kidney failure. Seven studies were reviewed to identify knowledge gaps and future directions for research. All studies were published between 2010 and 2013; no investigations were conducted in the United States. Knowledge gaps included the focus on medical self-management tasks with no attention to role or emotional tasks, lack of family involvement during intervention delivery, and an inability to form conclusions about the efficacy of interventions because methodological rigor was insufficient. Educational content varied across studies. Strategies to improve self-management skills and enhance self-efficacy varied and were limited in scope. Further development and testing of theory-based interventions are warranted. There is a critical need for future research using well-designed trials with appropriately powered sample sizes, well-tested instruments, and clear and consistent reporting of results. PMID:25239136

  17. Internet Interventions to Support Lifestyle Modification for Diabetes Management: A Systematic Review of the Evidence

    PubMed Central

    Cotterez, Alex; Durant, Nefertiti; Agne, April; Cherrington, Andrea

    2013-01-01

    Background The Internet presents a widely accessible, 24-hour means to promote chronic disease management. The objective of this review is to identify studies that used Internet based interventions to promote lifestyle modification among adults with type 2 diabetes. Methods We searched PubMed using the terms: [internet, computer, phone, smartphone, mhealth, mobile health, web based, telehealth, social media, text messages] combined with [diabetes management and diabetes control] through January 2013. Studies were included if they described an Internet intervention, targeted adults with type 2 diabetes, focused on lifestyle modification, and included an evaluation component with behavioral outcomes. Results Of the 2803 papers identified, nine met inclusion criteria. Two studies demonstrated improvements in diet and/or physical activity and two studies demonstrated improvements in glycemic control comparing web-based intervention with control. Successful studies were theory-based, included interactive components with tracking and personalized feedback, and provided opportunities for peer support. Website utilization declined over time in all studies that reported on it. Few studies focused on high risk, underserved populations. Conclusion Web-based strategies provide a viable option for facilitating diabetes self-management. Future research is needed on the use of web-based interventions in underserved communities and studies examining website utilization patterns and engagement over time. PMID:24332469

  18. A brief office-based intervention to facilitate diabetes dietary self-management.

    PubMed

    Glasgow, R E; Toobert, D J; Hampson, S E; Noell, J W

    1995-12-01

    There is a pressing need for brief, practical interventions that address diabetes management. We have developed an office-based intervention to prompt both patients and providers to focus on behavioral issues relevant to dietary self-management that is being evaluated in a randomized trial. The intervention is designed to be broadly applicable to the majority of adult diabetes outpatients during medical visits; uses touchscreen computer assessment to provide immediate feedback on key issues to patients and providers just prior to their interaction; and provides goal setting and problem-solving assistance to patients following their meeting with the physician. Follow-up components include phone calls and videotape or interactive video instruction as needed. The program is described, and demographic and behavioral characteristics of participants are presented for the first 95 patients randomized. Initial process results suggest success in producing modest, targeted behavior changes among a broad cross-section of patients. If the long-term results are equally positive, this intervention could provide a prototype for a feasible, cost-effective way to integrate patient views and behavioral management into office-based care for diabetes. PMID:10159676

  19. Reconceptualizing case management in theory and practice: a frontline perspective.

    PubMed

    Yarmo Roberts, Deborah

    2002-08-01

    'Case management' in the health and social service sector is controversial, highly political and saturated with conflicting agendas among stakeholders. Research was conducted recently to explore the role of case managers in three evolving, Australian-based, long-term care, case management models. The findings have relevance to countries worldwide that contend with delivering quality care that is cost effective. The research captures the perspectives of 51 open-ended interviews with front-line case managers who have first-hand knowledge of the models' effect on their clients and on their own roles. Contrary to the rhetoric that case management is client-centred, case management is concluded to be 'system centred' based on a unilateral approach taken by each of the three models. Case managers had a limited ability to attain necessary services for clients. Success was dependent on the range of case managers' skills and experience, relationship with the client, degree of job satisfaction, level of influence in the health and social system and ability to collaborate with relevant professionals. The relationship between the three primary influences (system, model, client) affecting case managers' pursuit of achieving appropriate client services was also reviewed. A reconceptualized multidimensional approach, or 'neo-process-centred' case management, is proposed. The revised approach can be applied to existing and new models and has direct implications for policy makers, management and practitioners aspiring to improve client care within existing constraints. PMID:12184835

  20. A qualitative examination of a spiritually-based intervention and self-management in the workplace.

    PubMed

    Richards, T Anne; Oman, Doug; Hedberg, John; Thoresen, Carl E; Bowden, Jeanne

    2006-07-01

    This qualitative study assesses the experience of an intervention that provided spiritually based self-management tools to hospital-based nurses. Drawing on wisdom traditions of the major world religions, the eight point program can be practiced by adherents to any religious faith, or those outside of all traditions. Five of eight program points were perceived as directly useful in improving the nurses' workplace interactions and enhancing fulfillment of compassionate caregiving missions. The findings suggest that this program can be an effective intervention among nurses in dealing with the demands of the healthcare environment and may be a resource for continuing education curricula. PMID:16757790

  1. Enabling Older Homeless Minority Women to Overcome Homelessness by Using a Life Management Enhancement Group Intervention

    PubMed Central

    Washington, Olivia G. M.; Moxley, David P.; Taylor, Jacquelyn Y.

    2010-01-01

    This paper describes the importance of a life management enhancement (LME) group intervention for older minority women in developing personal control and self-confidence in social relationships as they overcome homelessness. Women in the treatment group showed significantly greater personal control and higher levels of self-confidence following the six-week intervention than women in the control group. Increasing personal control and developing self-confidence in social relationships can help individuals achieve desired outcomes as a result of their actions, efforts, and abilities. These attributes can help women increase and sustain appropriate coping methods and overcome homelessness. PMID:19212866

  2. The growth of interventional pain management in the new millennium: a critical analysis of utilization in the medicare population.

    PubMed

    Manchikanti, Laxmaiah

    2004-10-01

    Interventional pain management has been growing by leaps and bounds with the introduction of an array of new CPT codes, the expansion of interventional techniques, and utilization. Interventional pain management dates back to the origin of neural blockade and regional analgesia, in 1884. Over the years, pain medicine and interventional pain management have taken many approaches, including biological, biopsychosocial, and psychosocial. In the late 1990s and early 2000s, a new philosophy of precision diagnosis and high-tech management has evolved. An interventional pain physician may be either a reductionist, a monotherapist or a combination of the two. Interventionalists have been criticized for excessive undisciplined application of needle procedures. Interventional techniques are performed by many primary specialists (anesthesiology, physiatry, neurology, etc.) and physicians designated by CMS in interventional pain management (-09) and pain management or pain medicine (-72) which went into effect in 2003 and 2002. Overall, the frequency of utilization of interventional procedures has increased substantially since 1998. It is estimated that among Medicare recipients, the frequency of interventional procedures, which includes epidural, spinal neurolysis, and adhesiolysis procedures; facet joint interventions and sacroiliac joint blocks; and other types of nerve blocks, excluding continuous epidurals, implantables, disc procedures, intraarticular injections, trigger point and ligament injections, had increased by 95% from 1998 to 2003. In the Medicare population, facet joint interventions and sacroiliac joint blocks have increased by 222% from 1998 to 2003. Overall, the utilization of various nerve blocks (excluding epidurals, disc injections, and facet joint blocks) in Medicare recipients from 1998 to 2003 were performed approximately 50% of the time by non-pain physicians. Interventional pain management is growing rapidly, under the watchful eye of the government

  3. Case management insider. The 2-midnight rule--a game-changer for case management.

    PubMed

    Cesta, Toni

    2014-04-01

    As a case manager or case management leader, it is important for you to stay in touch with how CMS continues to roll out the two-midnight rules as well as the manner of auditing on a go-forward basis. It is also important that your department continue to have a close working relationship with the billing department in your hospital to ensure that the hospital remains compliant with this new rule. Finally, it is also critical that your emergency department and its physicians are kept up to date on the rule and its implications for hospital admissions. Having a case management presence in the emergency department will help to ensure a sound review process at this important route of entry to the hospital. A working team should be created to review the cases that fall outside of the rule, and these cases should also be presented to the utilization review committee so that the hospital can continue to learn and move forward. Finally, listen to the CMS National Provider Calls (www.cms. gov/NPC) to gain additional and updated information as it becomes available! For additional information on the two-midnight rule go to www.cms.gov and search for CMS-1599-F. PMID:24697139

  4. Economic evaluations of interventions to manage hyperphosphataemia in adult haemodialysis patients: A systematic review.

    PubMed

    Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Evers, Silvia Maa

    2016-03-01

    Managing hyperphosphataemia in haemodialysis patients is resource-intensive. A search for cost-effective interventions in this field is needed to inform decisions on the allocation of healthcare resources. NHSEED, MEDLINE, EMBASE and CINAHL were searched for full economic evaluations of hyperphosphataemia-managing interventions in adult haemodialysis patients, published between 2004 and 2014, in English, French, Dutch or German. Incremental cost-effectiveness ratios of the interventions were up-rated to 2013US$ using Purchasing Power Parity conversion rates and Consumer Price Indices. The quality of included studies was assessed using the Extended Consensus on Health Economic Criteria List. Twelve out of the 1681 retrieved records fulfilled the inclusion criteria. They reported only on one aspect of hyperphosphataemia management, which is the use of phosphate binders (calcium-based and calcium-free, in first-line and sequential use). No economic evaluations of other phosphorus-lowering interventions were found. The included articles derived from five countries and most of them were funded by pharmaceutical companies. The incremental cost-effectiveness ratios of phosphate binders ranged between US$11 461 and US$157 760 per quality-adjusted life-year gained. Calcium-based binders (especially calcium acetate) appear to be the optimal cost-effective first- and second-line therapy in prevalent patients, while the calcium-free binder, lanthanum carbonate, might provide good value for money, as second-line therapy, in incident patients. The studies' overall quality was suboptimal. Drawing firm conclusions was not possible due to the quality heterogeneity and inconsistent results. Future high-quality economic evaluations are needed to confirm the findings of this review and to address other interventions to manage hyperphosphataemia in this population. PMID:26246269

  5. Evaluation of a practice-based intervention to improve the management of pediatric asthma.

    PubMed

    Ragazzi, Helen; Keller, Adrienne; Ehrensberger, Ryan; Irani, Anne-Marie

    2011-02-01

    Pediatric asthma remains a significant burden upon patients, families, and the healthcare system. Despite the availability of evidence-based best practice asthma management guidelines for over a decade, published studies suggest that many primary care physicians do not follow them. This article describes the Provider Quality Improvement (PQI) intervention with six diverse community-based practices. A pediatrician and a nurse practitioner conducted the year-long intervention, which was part of a larger CDC-funded project, using problem-based learning within an academic detailing model. Process and outcome assessments included (1) pre- and post-intervention chart reviews to assess eight indicators of quality care, (2) post-intervention staff questionnaires to assess contact with the intervention team and awareness of practice changes, and (3) individual semi-structured interviews with physician and nurse champions in five of the six practices. The chart review indicated that all six practices met predefined performance improvement criteria for at least four of eight indicators of quality care, with two practices meeting improvement criteria for all eight indicators. The response rate for the staff questionnaires was high (72%) and generally consistent across practices, demonstrating high staff awareness of the intervention team, the practice "asthma champions," and changes in practice patterns. In the semi-structured interviews, several respondents attributed the intervention's acceptability and success to the expertise of the PQI team and expressed the belief that sustaining changes would be critically dependent on continued contact with the team. Despite significant limitations, this study demonstrated that interventions that are responsive to individual practice cultures can successfully change practice patterns. PMID:21337050

  6. Are Behavioural Interventions Doomed to Fail? Challenges to Self-Management Support in Chronic Diseases.

    PubMed

    Vallis, Michael

    2015-08-01

    Self-management and self-management support are concepts very familiar to those of us in diabetes care. These concepts require openness to understanding the behaviours of persons with diabetes broadly, not only behaviours restricted to the biomedical perspective. Understanding the importance of health behaviour change and working within the Expanded Chronic Care Model define the context within which self-management support should occur. The purpose of this perspective is to identify a potential limitation in existing self-management support initiatives. This potential limitation reflects provider issues, not patient issues; that is, true self-management support might require changes by healthcare providers. Specifically, although behavioural interventions within the context of academic research studies are evidence based, behaviour change interventions implemented in general practice settings might prove less effective unless healthcare providers are able to shift from a practice based on the biomedical model to a practice based on the self-management support model. The purpose of this article is to facilitate effective self-management support by encouraging providers to switch from a model of care based on the expert clinician encountering the uninformed help seeker (the biomedical model) to one guided by collaboration grounded in the principles of description, prediction and choice. Key to understanding the value of making this shift are patient-centered communication principles and the tenets of complexity theory. PMID:25837809

  7. Pharmacologic management of borderline personality disorder: a case study.

    PubMed

    Links, Paul S; Cook, Michele; Quastel, Adam

    2005-01-01

    General principles of the "outcome-focused" model of psychopharmacologic management of patients with BPD are illustrated using the case of Ms. A, a patient with borderline personality disorder (BPD) experiencing impulsivity such as suicidal behavior, chronic insomnia and concurrent substance abuse. The model includes (1) measurement of specific behavioral outcomes related to functioning; (2) assessment of the role of substance use/abuse in patients with BPD; (3) consideration of interventions to clarify and strengthen the boundaries of the therapeutic relationship-including short lengths of time between prescription refills, medication contracts outlining consequences if substances are obtained outside of the relationship, and urine testing to ascertain compliance; (4) an understanding of the psychodynamic meanings attributed to medication while positive and negative medication effects are monitored with treatment response or transference issues, and; (5) use of the N-of-1 approach to test the new medication vs previous medications using patient specific outcomes that are anticipated to change with the pharmacologic management. PMID:16459755

  8. Increasing the prevalence of successful children: The case for community intervention research

    PubMed Central

    Biglan, Anthony; Metzler, Carol W.; Ary, Dennis V.

    1994-01-01

    This paper makes a case for research on community interventions on child rearing. Sufficient evidence has accumulated about the development of children's problem behavior to justify evaluating efforts to reduce the prevalence of these problems in whole communities. The contextual risk factors for diverse child behavior problems are well understood, and interventions to ameliorate individual risk factors have been developed and evaluated. Because interventions with individual children have proven to be efficacious, it is now appropriate to direct energy toward reducing the prevalence of children with behavior problems. At the same time, existing interventions have limitations. Community interventions may be needed to modify the larger social context for families. This paper enumerates possible components of a community intervention to improve child-rearing outcomes. Existing evidence indicates that communities would benefit from making parent training and family support programs available to parents. Validated methods of identifying and remediating academic and behavioral problems in schools are available, but influencing schools to adopt them remains a problem. Community organizing could mobilize communities to allocate the resources necessary to support such parenting and schooling programs as well as encourage their adoption. Media campaigns could foster community support and directly influence parenting practices. Efforts to modify peer influences to use illicit substances have received empirical support; similar efforts may be relevant to preventing other problems. The development of a science of community interventions on child rearing is hampered by overreliance on randomized control trials. For this reason, two examples of time-series experimental evaluations of community intervention components are described here. PMID:22478196

  9. Impact of waste management training intervention on knowledge, attitude and practices of teaching hospital workers in Pakistan

    PubMed Central

    Kumar, Ramesh; Somrongthong, Ratana; Ahmed, Jamil

    2016-01-01

    Objective: To evaluate the sustainability and effectiveness of training as an intervention to improve the knowledge, attitude and practices of hospital workers on health care waste management. Method: We conducted this quasi-experimental study in two tertiary care teaching hospitals in Rawalpindi in October 2013. Training, practical demonstrations and reminders on standard waste management were given to 138 hospital workers in one hospital and compared with 137 workers from the control hospital. We collected data 18 months after intervention through a structured questionnaire to assess the impact of the intervention. We used paired t-test to compare the scores on knowledge, attitude and practices at baseline and first follow up and final impact assessment. Chi square test was used to compare group variables between intervention and control groups. Results: After 18 months since intervention the mean scores on knowledge attitude and practices differed statistically significantly since baseline and intervention group had statistically significantly better knowledge positive attitudes and good health care waste management practices (p < 0.001). Health care and sanitary workers in intervention group scored statistically significantly higher (p < 0.001). Conclusion: Trainings of health and sanitary workers on health care waste management guidelines were sustainable among the intervention group after 18 months which shows the positive impact of our intervention. It is recommended that the trainings as intervention be included in the overall policies of the public and private sector hospitals in Pakistan and other similar settings. PMID:27375718

  10. The effectiveness of a stress-management intervention program in the management of overweight and obesity in childhood and adolescence

    PubMed Central

    Stavrou, Stavroula; Nicolaides, Nicolas C.; Papageorgiou, Ifigenia; Papadopoulou, Pinelopi; Terzioglou, Elena; Chrousos, George P; Darviri, Christina; Charmandari, Evangelia

    2016-01-01

    Background Obesity in childhood and adolescence represents a major health problem of our century, and accounts for a significant increase in morbidity and mortality in adulthood. In addition to the increased consumption of calories and lack of exercise, accumulating evidence suggests that childhood obesity is strongly associated with prolonged and excessive activation of the stress system. Aim The aim of our study was to assess the effectiveness of a stress-management intervention program, which included progressive muscle relaxation, diaphragmatic breathing, guided imagery and cognitive restructuring, in overweight and obese children and adolescents. Methods Forty-nine children and adolescents (mean age ± SEM: 11.15 ± 1.48 years) were prospectively recruited to participate in this randomized controlled study. Of those, 23 participants were assigned into the intervention group, while 26 participants represented the control group. Anthropometric measurements were recorded at the beginning and at the end of the study, and participants were asked to complete the Screen for Child Anxiety Related Disorders (S.C.A.R.E.D.), the Child Depression Inventory (C.D.I.), the Child Behavior Checklist (C.B.C.L.) and the Youth Self Report (Y.S.R.). Results The applied stress-management methods resulted in a significant reduction in the body mass index (BMI) in the intervention group compared with the control group [ΔBMI=1.18 vs 0.10 kg/m2 (p<0.001)]. In addition to BMI, these methods ameliorated depression and anxiety, and reduced the internalizing and externalizing problems in the intervention group. Conclusions Our study demonstrated that the application of an 8-week stress management program could facilitate weight loss in Greek overweight and obese children and adolescents. Further larger studies are required to evaluate the effectiveness of stress-management methods in overweight and obese subjects. PMID:27570747

  11. Case management in the social health maintenance organization demonstrations

    PubMed Central

    Yordi, Cathleen L.

    1988-01-01

    In this article, case management departments and roles during the early years of the social health maintenance organization (S/HMO) demonstrations are compared. These organizations provide acute and chronic care services under a prepaid plan for the elderly. Eligibility criteria for case management and chronic care services at each site are compared, followed by a description of the resultant case mix of members receiving chronic care benefits. Case managers principal activities are described, and a preliminary assessment is made about the strength of the linkages that have been developed between the case management component of these plans and the larger health care system. PMID:10312977

  12. Who Signs Up for and Engages in a Peer Support Heart Failure Self-Management Intervention

    PubMed Central

    Mase, Rebecca; Halasyamani, Lakshmi; Choi, Hwajung; Heisler, Michele

    2014-01-01

    Background Many programs for patients with heart failure (HF) fail to improve clinical outcomes in part due to low rates of patient enrollment and engagement. A better understanding of patient characterstics associated with willingness to enroll and then engage in HF self-management programs will improve the design and targeting of programs. Methods and Results Analyses of screening, baseline and engagement data from a randomized controlled effectiveness trial of a HF peer self-management support program. The median age of the 266 recently hospitalized HF patients who enrolled in the study was 69 years, 51% were female, and 26% were minorities (primarily African American). Of 135 randomized to the peer support intervention, only 39% engaged in either the group sessions or telephone peer support calls. Older white women who reported higher baseline health status, functioning, social support, confidence in their ability to manage, and less difficulty with the physical and emotional aspects of living with heart failure were the most likely to engage in program activities. Minority status and reporting a need for social support were both correlated with higher enrollment but lower engagement in the intervention. Conclusions Although minority patients with poorer reported health status and social support were most likely to consent to participate in the study, participants who engaged in program activities were more likely to have higher baseline health status, functioning, and social support. Developing HF interventions that successfully engage participants most in need of HF self-management support remains a difficult challenge. PMID:24978160

  13. Managing temptation in obesity treatment: A neurobehavioral model of intervention strategies.

    PubMed

    Appelhans, Bradley M; French, Simone A; Pagoto, Sherry L; Sherwood, Nancy E

    2016-01-01

    Weight loss outcomes in lifestyle interventions for obesity are primarily a function of sustained adherence to a reduced-energy diet, and most lapses in diet adherence are precipitated by temptation from palatable food. The high nonresponse and relapse rates of lifestyle interventions suggest that current temptation management approaches may be insufficient for most participants. In this conceptual review, we discuss three neurobehavioral processes (attentional bias, temporal discounting, and the cold-hot empathy gap) that emerge during temptation and contribute to lapses in diet adherence. Characterizing the neurobehavioral profile of temptation highlights an important distinction between temptation resistance strategies aimed at overcoming temptation while it is experienced, and temptation prevention strategies that seek to avoid or minimize exposure to tempting stimuli. Many temptation resistance and temptation prevention strategies heavily rely on executive functions mediated by prefrontal systems that are prone to disruption by common occurrences such as stress, insufficient sleep, and even exposure to tempting stimuli. In contrast, commitment strategies are a set of devices that enable individuals to manage temptation by constraining their future choices, without placing heavy demands on executive functions. These concepts are synthesized in a conceptual model that categorizes temptation management approaches based on their intended effects on reward processing and degree of reliance on executive functions. We conclude by discussing the implications of our model for strengthening temptation management approaches in future lifestyle interventions, tailoring these approaches based on key individual difference variables, and suggesting high-priority topics for future research. PMID:26431681

  14. Hypnotic intervention in a 7-year-old thumbsucker: a case study.

    PubMed

    Grayson, David N

    2012-01-01

    Thumbsucking is a common habit among younger children. Usually, the child outgrows this habit by age 6. When a child over the age of 6 continues to suck his or her thumb, it can be a cause of potential harm due to peer pressure, ridicule, and shunning. It can also lead to malocclusions requiring eventual orthodontic interventions. In this case study, the author demonstrates a hypnotic intervention in a 7-year-old girl. Validation of her habit and imaging a role model sucking her thumb were employed in trance. Using this approach, the child was able to end her dependence on thumbsucking in 1 session. PMID:22443022

  15. Single-Case Experimental Designs to Evaluate Novel Technology-Based Health Interventions

    PubMed Central

    Cassidy, Rachel N; Raiff, Bethany R

    2013-01-01

    Technology-based interventions to promote health are expanding rapidly. Assessing the preliminary efficacy of these interventions can be achieved by employing single-case experiments (sometimes referred to as n-of-1 studies). Although single-case experiments are often misunderstood, they offer excellent solutions to address the challenges associated with testing new technology-based interventions. This paper provides an introduction to single-case techniques and highlights advances in developing and evaluating single-case experiments, which help ensure that treatment outcomes are reliable, replicable, and generalizable. These advances include quality control standards, heuristics to guide visual analysis of time-series data, effect size calculations, and statistical analyses. They also include experimental designs to isolate the active elements in a treatment package and to assess the mechanisms of behavior change. The paper concludes with a discussion of issues related to the generality of findings derived from single-case research and how generality can be established through replication and through analysis of behavioral mechanisms. PMID:23399668

  16. Nonpharmacologic Pain Management Interventions in German Nursing Homes: A Cluster Randomized Trial.

    PubMed

    Kalinowski, Sonja; Budnick, Andrea; Kuhnert, Ronny; Könner, Franziska; Kissel-Kröll, Angela; Kreutz, Reinhold; Dräger, Dagmar

    2015-08-01

    The reported prevalence of pain among nursing home residents (NHRs) is high. Insufficient use of analgesics, the conventional pain management strategy, is often reported. Whether and to what extent nonpharmacologic therapies (NPTs) are used to manage the pain of NHRs in Germany is largely unknown. The aim of this cluster-randomized trial was to assess the NPTs provided and to enhance the application and prescription of NPTs in NHRs on an individual level. There were six nursing homes in the intervention group and six in the control group. There were 239 NHRs, aged ≥65 years, with an average Mini-Mental State Examination score of at least 18 at baseline. Pain management interventions (cluster level) included an online course for physicians and 1-day seminar for nurses. Data on NPT applied by nurses and therapeutic NPT prescribed by physicians were obtained from residents' nursing documentation. Face-to-face interviews with NHRs assessed the NPT received. At baseline, 82.6% of NHR (mean age 83 years) were affected by pain, but less than 1 in 10 received NPT. The intervention did not result in a significant increase in the NPT applied by nurses, but did significantly increase the therapeutic NPT prescribed by physicians. Residents were active in using NPT to self-manage their pain. Given the prevalence of pain in NHRs, there is a clear need to improve pain management in this population. Extended use of NPT offers a promising approach. We recommend that nurses provide residents with education on pain-management techniques to support them in taking a proactive role in managing their pain. PMID:26256216

  17. Impact of a social network-based intervention promoting diabetes self-management in socioeconomically deprived patients: a qualitative evaluation of the intervention strategies

    PubMed Central

    Vissenberg, C; Stronks, K; Nijpels, G; Uitewaal, P J M; Middelkoop, B J C; Kohinor, M J E; Hartman, M A; Nierkens, V

    2016-01-01

    Objective There is a need for effective interventions that improve diabetes self-management (DSM) among socioeconomically deprived patients with type 2 diabetes. The group-based intervention Powerful Together with Diabetes (PTWD) aimed to increase social support for DSM and decrease social influences hindering DSM (eg, peer pressure, social norms) in patients living in deprived neighbourhoods. Through a qualitative process evaluation, this paper aims to study whether this intervention changed social support and social influences, and which elements of the intervention contributed to this. Methods The intervention group (IG) was compared with a standard group-based educational intervention (control group, CG). 27 qualitative in-depth interviews with participants (multiethnic sample) and 24 interviews with group leaders were conducted. Interviews were coded and analysed using MAXQDA according to framework analysis. Results Patients in the IG experienced more emotional support from group members and more instrumental and appraisal support from relatives than those in the CG. Also, they were better able to recognise and cope with influences that hinder their DSM, exhibited more positive norms towards DSM and increased their priority regarding DSM and their adherence. Finally, the engagement in DSM by relatives of participants increased. Creating trust between group members, skills training, practising together and actively involving relatives through action plans contributed to these changes. Conclusions A group-based intervention aimed at creating trust, practising together and involving relatives has the potential to increase social support and diminish social influences hindering DSM in socioeconomically deprived patients with diabetes. Promising elements of the intervention were skills training and providing feedback using role-playing exercises in group sessions with patients, as well as the involvement of patients' significant others in self-management tasks, and

  18. 75 FR 23582 - Annular Casing Pressure Management for Offshore Wells

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... published the proposed rule Annular Casing Pressure Management for Offshore Wells (74 FR 38147). The comment... the published proposed rule 1010-AD47 Annular Casing Pressure Management for Offshore Wells (74 FR... subsea wellhead. (3) hybrid well, a riser or the production casing pressure is greater than 100...

  19. Case Studies for Management Development in Bangladesh. Second Book.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    These 15 case studies developed by faculty at institutions in Bangladesh are appropriate for use in a course in management development. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision.…

  20. Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials

    PubMed Central

    2012-01-01

    Background Osteoarthritis (OA) of the hip and knee are among the most common chronic conditions, resulting in substantial pain and functional limitations. Adequate management of OA requires a combination of medical and behavioral strategies. However, some recommended therapies are under-utilized in clinical settings, and the majority of patients with hip and knee OA are overweight and physically inactive. Consequently, interventions at the provider-level and patient-level both have potential for improving outcomes. This manuscript describes two ongoing randomized clinical trials being conducted in two different health care systems, examining patient-based and provider-based interventions for managing hip and knee OA in primary care. Methods / Design One study is being conducted within the Department of Veterans Affairs (VA) health care system and will compare a Combined Patient and Provider intervention relative to usual care among n = 300 patients (10 from each of 30 primary care providers). Another study is being conducted within the Duke Primary Care Research Consortium and will compare Patient Only, Provider Only, and Combined (Patient + Provider) interventions relative to usual care among n = 560 patients across 10 clinics. Participants in these studies have clinical and / or radiographic evidence of hip or knee osteoarthritis, are overweight, and do not meet current physical activity guidelines. The 12-month, telephone-based patient intervention focuses on physical activity, weight management, and cognitive behavioral pain management. The provider intervention involves provision of patient-specific recommendations for care (e.g., referral to physical therapy, knee brace, joint injection), based on evidence-based guidelines. Outcomes are collected at baseline, 6-months, and 12-months. The primary outcome is the Western Ontario and McMasters Universities Osteoarthritis Index (self-reported pain, stiffness, and function), and secondary outcomes are the

  1. Stress-reduction interventions in an Australian university: a case study.

    PubMed

    Pignata, Silvia; Winefield, Anthony H

    2015-02-01

    We examined the effects of awareness of stress-reduction interventions on employee well-being and work attitudes using a mixed methods design. Cross-sectional data are presented from 247 employees who completed questionnaires in 2004 at one Australian university. Analyses indicated that employees, who reported that interventions had been undertaken, scored higher on job satisfaction, affective organizational commitment, perceived procedural justice and trust in senior management than those who were not aware of the measures, although they did not differ in psychological strain. Details of the stress-reduction interventions implemented by the Occupational Health and Safety department at the university are also reported. Thematic analyses of the perceived causes of both decreases and increases in stress for employees showed that staff reported workload and staffing pressures as key sources of increases in stress. On the other hand, new supervisors and/or management were identified as sources of decreased stress. Areas for consideration in future efforts to develop and refine stress interventions are also discussed. PMID:23878071

  2. Assessing Interventions to Manage West Nile Virus Using Multi-Criteria Decision Analysis with Risk Scenarios.

    PubMed

    Hongoh, Valerie; Campagna, Céline; Panic, Mirna; Samuel, Onil; Gosselin, Pierre; Waaub, Jean-Philippe; Ravel, André; Samoura, Karim; Michel, Pascal

    2016-01-01

    The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual

  3. Assessing Interventions to Manage West Nile Virus Using Multi-Criteria Decision Analysis with Risk Scenarios

    PubMed Central

    Hongoh, Valerie; Campagna, Céline; Panic, Mirna; Samuel, Onil; Gosselin, Pierre; Waaub, Jean-Philippe; Ravel, André; Samoura, Karim; Michel, Pascal

    2016-01-01

    The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual

  4. Recalcitrant Hidradenitis Suppurativa: An Investigation of Demographics, Surgical Management, Bacterial Isolates, Pharmacologic Intervention, and Patient-reported Health Outcomes.

    PubMed

    Thomas, Cristina; Rodby, Katherine A; Thomas, Jessina; Shay, Elizabeth; Antony, Anuja K

    2016-04-01

    Hidradenitis suppurativa (HS) is characterized by chronic inflammation, recurrent abscesses, and scarring. Surgery is performed when medical management and antibiotic therapy fails. This study sought to evaluate the demographics, surgical procedures, bacteriology, pharmacologic intervention, and quality of life of patients with recalcitrant HS requiring surgical intervention. A retrospective chart review was performed of 76 recalcitrant HS patients at the University of Illinois Medical Center. Patient demographics, bacterial culture, and surgery data were reviewed. Quality of life was assessed using the 36-item short-form health survey. Patients were mostly female (73.7%) and African American (81.6%) with a mean duration of symptoms of 8.6 years before surgery. Patients underwent at least one surgical procedure, most often to the axillae (57.6%) and 73.7 per cent received antibiotics. The most common culture isolates were Corynebacterium species (14.0%), Staphylococcus epidermidis (13.1%), and Staphylococcus aureus (10.4%) with varying resistance patterns. Surveyed patients had depressed 36-item short-form health survey physical functioning and social functioning scores. Recalcitrant HS patients with progressive symptomology over approximately nine years before surgical intervention were more likely to be African American women with axillary HS. Quality of life was diminished. We recommend initial treatment of HS with clindamycin and trimethoprim-sulfamethoxazole in clindamycin refractory cases. PMID:27097631

  5. Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

    ERIC Educational Resources Information Center

    Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

    2005-01-01

    Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

  6. Nonsurgical management of multiple splenic abscesses in an obese patient that underwent laparoscopic sleeve gastrectomy: case report and review of literature.

    PubMed

    Schiavo, Luigi; Scalera, Giuseppe; De Sena, Gabriele; Ciorra, Francesca R; Pagliano, Pasquale; Barbarisi, Alfonso

    2015-10-01

    Sleeve gastrectomy (SG) is a surgical weight-loss procedure. Splenic abscess is a rare complication of SG. Four cases of splenic abscess after SG have been reported, all managed by surgical intervention. We report the first documented case of multiple splenic abscesses following SG managed conservatively by an integrated medical treatment. PMID:26509027

  7. An assessment of patient education and self-management in diabetes disease management--two case studies.

    PubMed

    Fitzner, Karen; Greenwood, Deborah; Payne, Hildegarde; Thomson, John; Vukovljak, Lana; McCulloch, Amber; Specker, James E

    2008-12-01

    Diabetes affects 7.8% of Americans, nearly 24 million people, and costs $174 billion yearly. People with diabetes benefit from self-management; disease management (DM) programs are effective in managing populations with diabetes. Little has been published on the intersection of diabetes education and DM. Our hypothesis was that diabetes educators and their interventions integrate well with DM and effectively support providers' care delivery. A literature review was conducted for papers published within the past 3 years and identified using the search terms "diabetes educator" and "disease management." Those that primarily addressed community health workers or the primary care/community setting were excluded. Two case studies were conducted to augment the literature. Ten of 30 manuscripts identified in the literature review were applicable and indicate that techniques and interventions based on cognitive theories and behavioral change can be effective when coupled with diabetes DM. Better diabetes self-management through diabetes education encourages participation in DM programs and adherence to recommended care in programs offered by DM organizations or those that are provider based. Improved health outcomes and reduced cost can be achieved by blending diabetes education and DM. Diabetes educators are a critical part of the management team and, with their arsenal of goal setting and behavior change techniques, are an essential component for the success of diabetes DM programs. Additional research needs to be undertaken to identify effective ways to integrate diabetes educators and education into DM and to assess clinical, behavioral, and economic outcomes arising from such programs. PMID:19108648

  8. Telephone-Based Psychiatric Referral-Care Management Intervention Health Outcomes

    PubMed Central

    Bush, Heather; Oslin, David

    2010-01-01

    Abstract Objective: This study examined the effectiveness of a telephone-based referral-care management (TBR-CM) intervention on psychiatric health outcomes. Materials and Methods: Between September 2005 and May 2006, primary care patients (n = 169) at the Philadelphia Veterans Affairs Medical Center completed a psychiatric interview over the telephone, of which 113 gave consent and were randomized into the TBR-CM usual care or intervention groups (n = 40 [39%] depression, n = 40 [39%] substance abuse, and n = 33 [22%] comorbid condition: depression and substance abuse). Usual care consisted of participants receiving a psychiatric appointment, followed up with standard institutional reminders. The intervention care group received the same, with the addition of brief motivational telephone sessions. Baseline and 6-month interviews were used to obtain study data. Results: Results indicated that there was improvement in mental health functioning (p < 0.0001), depression (p < 0.0001), and binge (p < 0.0332) outcomes over the 6-month interview (78% retention). However, there was no change observed for physical health functioning and drinks per week outcomes. For mental health functioning, depression, and binge rates there were no randomization group assignment effects, indicating that the intervention care group did not show better health outcomes despite showing higher levels of psychiatric appointment attendance. Conclusions: Patients who are exposed to the intervention have similar health outcomes as patients in usual care. In conclusion, the TBR-CM intervention does not lead to relatively improved psychiatric health outcomes. Further research is necessary to examine the efforts needed to extend increased treatment engagement into improved health outcomes for intervention recipients. PMID:20575721

  9. Systematic identification and intervention for reading difficulty: case studies of children with EAL.

    PubMed

    Fawcett, A J; Lynch, L

    2000-01-01

    Literacy underpins education. There is now very widespread concern over standards of literacy for children from multi-cultural backgrounds, who are learning English as a second or subsequent language, and who may have special educational needs. Research evidence suggests that the earlier children's difficulties can be identified, the more effective (and cost-effective) intervention will be, provided that the intervention is tailored to the child's abilities and skills. Nicolson and Fawcett have developed systematic procedures for identifying children at risk for reading difficulty, together with systematic teaching strategies to overcome reading difficulty. In this paper we present case studies of children with EAL (English as an additional language) drawn from a controlled study using computer interventions with secondary school children. Our findings indicate that children with EAL may be more resistant to remediation than some children with learning difficulties. The prognosis is more problematic for children with both EAL and dyslexia. PMID:10840507

  10. CT-guided interventional procedures for pain management in the lumbosacral spine.

    PubMed

    Gangi, A; Dietemann, J L; Mortazavi, R; Pfleger, D; Kauff, C; Roy, C

    1998-01-01

    The lumbosacral spine is the source of pain, suffering, and disability more frequently than any other part of the body. Pain in the lower back can be managed with computed tomography-guided analgesic interventional procedures, such as periradicular infiltration, percutaneous laser disk decompression, facet joint block, and percutaneous vertebroplasty. Periradicular injection of steroids provides short-term and sometimes even long-term relief of low back pain. Percutaneous laser disk decompression is used to treat radiculalgia caused by disk herniation. Facet joint block is useful in diagnosis and treatment of facet syndrome. Percutaneous vertebroplasty provides short- and long-term pain relief in patients with vertebral body disease. However, precise patient selection is essential to the success of each of these techniques. The interventional radiologist has an active role to play in minimally invasive management of lower back pain and should be part of an interdisciplinary team that determines the appropriate therapy. PMID:9599387

  11. [A rare case of surgical management of a patient with thoracic aortic aneurysm].

    PubMed

    Kospanov, N A; Mierbekov, E M; Eshmuratov, T Sh; Kodasbaev, A T; Kirgizbaev, S Zh

    2012-01-01

    Described in the article is a clinical case of successful surgical management of a male patient diagnosed with a syphilitic-origin aneurysm of the thoracic aorta isthmus, complicated by an aortopulmonary fistula. Also presented herein are the clinical pattern, findings of examination, and treatment policy. This is followed by a detailed description of both the course of the surgical intervention and outcomes obtained. PMID:22929686

  12. Two Self-management Interventions to Improve Hypertension Control: A Randomized Trial

    PubMed Central

    Bosworth, Hayden B.; Olsen, Maren K.; Grubber, Janet M.; Neary, Alice M.; Orr, Melinda M.; Powers, Benjamin J.; Adams, Martha B.; Svetkey, Laura P.; Reed, Shelby D.; Li, Yanhong; Dolor, Rowena J.; Oddone, Eugene Z.

    2010-01-01

    Background Less than 40% of Americans with hypertension have adequate blood pressure (BP) control. Objectives To compare two self-management interventions for improving BP control among hypertensive patients. Design A 2 by 2 randomized trial stratified by enrollment site and patient literacy status with two-year follow-up (5/2004-1/2008). Setting Two university-affiliated primary care clinics. Patients 636 patients were randomized (31% recruitment rate) among the 2060 eligible hypertensive patients. Interventions Research assistants randomized eligible patients via a centralized blinded and stratified randomization algorithm to receive either: 1) usual care; 2) bi-monthly tailored nurse-administered telephone intervention targeting hypertension-related behaviors; 3) BP monitoring consisting of measuring BP three times per week, or; 4) a combination of the two interventions. Measurements The primary outcome was BP control evaluated at six-month intervals over 24 months. 475 (75%) completed the 24-month BP follow-up. Results Improvements in proportion of BP control for the intervention groups relative to the usual care group at 24 months were: behavioral group, 4.3% (95% CI: −4.5%, 12.9); home BP monitoring group, 7.6% (95% CI: −1.9%, 17.0%); and, combined interventions, 11.0% (95% CI: 1.9%, 19.8%). For systolic BP, relative to usual care, the 24 month difference was, +0.6 mmHg (95% CI: −2.2, 3.4) for the behavioral intervention group, −0.6 mmHg (95% CI: −3.6, 2.3) for the home monitoring group, and −3.9 mmHg (95% CI: −6.9, −0.9) for the combined interventions. Similar patterns were observed for diastolic BP at 24 months. Limitations Changes in medication use and diet were only monitored in intervention participants; 25% lacked 24 month outcome data; 73% had adequate BP control at baseline; the study setting was an academic health center, all factors that potentially limit generalizability. Conclusion Combined home BP monitoring and tailored

  13. Examining End-of-Life Case Management: Systematic Review

    PubMed Central

    Thomas, Roger E.; Wilson, Donna M.; Birch, Stephen

    2014-01-01

    Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL) case management identified 17 research articles, with content analysis revealing two themes: (a) seeking to determine or establish the value of EOL case management and (b) identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care. PMID:24999433

  14. Effects of Diabetic Case Management on Knowledge, Self-Management Abilities, Health Behaviors, and Health Service Utilization for Diabetes in Korea

    PubMed Central

    Shin, Soon Ae; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

    2015-01-01

    Purpose This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. Materials and Methods The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. Results The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. Conclusion This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program. PMID:25510771

  15. Interventions encouraging the use of systematic reviews by health policymakers and managers: A systematic review

    PubMed Central

    2011-01-01

    Background Systematic reviews have the potential to inform decisions made by health policymakers and managers, yet little is known about the impact of interventions to increase the use of systematic reviews by these groups in decision making. Methods We systematically reviewed the evidence on the impact of interventions for seeking, appraising, and applying evidence from systematic reviews in decision making by health policymakers or managers. Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, Health Technology Assessment Database, and LISA were searched from the earliest date available until April 2010. Two independent reviewers selected studies for inclusion if the intervention intended to increase seeking, appraising, or applying evidence from systematic reviews by a health policymaker or manager. Minimum inclusion criteria were a description of the study population and availability of extractable data. Results 11,297 titles and abstracts were reviewed, leading to retrieval of 37 full-text articles for assessment; four of these articles met all inclusion criteria. Three articles described one study where five systematic reviews were mailed to public health officials and followed up with surveys at three months and two years. The articles reported from 23% to 63% of respondents declaring they had used systematic reviews in policymaking decisions. One randomised trial indicated that tailored messages combined with access to a registry of systematic reviews had a significant effect on policies made in the area of healthy body weight promotion in health departments. Conclusions The limited empirical data renders the strength of evidence weak for the effectiveness and the types of interventions that encourage health policymakers and managers to use systematic reviews in decision making. PMID:21524292

  16. Translating Research Into Practice: Case Study Of A Community-Based Dementia Caregiver Intervention

    PubMed Central

    Mittelman, Mary S.; Bartels, Stephen J.

    2015-01-01

    One of the most devastating impacts of Alzheimer’s disease and related dementias is the toll on caregivers. Evidence from randomized clinical trials has demonstrated the effectiveness of providing psychosocial interventions for caregivers to lessen their burden. However, the implementation of such interventions in community settings has proved challenging. This case study describes outcomes of the implementation of an evidence-based intervention in a multisite program in Minnesota. Consistent with the original randomized clinical trial of the intervention, assessments of this program showed decreased depression and distress among caregivers. Participating in a greater number of caregiver counseling sessions was also associated with longer time to nursing home placement for the person with dementia. Some of the challenges in the community setting included having caregivers complete the full six counseling sessions and acquiring complete outcome data. Given the challenges faced in the community setting, web-based training for providers may be a cost-effective way to realize the maximum benefits of the intervention for vulnerable adults with dementia and their families. PMID:24711319

  17. The Basics of Interventional Radiology Management in a Large Radiology Group: A Bird's-Eye View.

    PubMed

    Hill, Gregory Q; Bob Smouse, H

    2006-12-01

    Through nearly 6 decades of growth we have enjoyed and suffered under many different types of management structures. From these experiences we have become believers in a central committee structure that advances our agenda with hospital administrators and third-party payers. The best way to illustrate what we think is a winning solution is by describing our present management system. Herein we describe what we do and what works for our large radiology group as well as our interventional practice. Although this structure works well for our large medical group, it will likely work equally well for a smaller medical group. PMID:21326780

  18. Opioids, adjuvants, and interventional options for pain management of symptomatic metastases.

    PubMed

    Ghosh, Amrita; Berger, Ann

    2014-07-01

    Cancer pain is a complex issue that unfortunately affects a majority of cancer patients, the assessment and treatment of which are equally essential in alleviating many facets of this pain. The objective of this section is to address the many facets of cancer pain: its assessment, management, and its varied treatment modalities. We will discuss characteristics of pain, essential aspects of the patient interview, and management using opioids, adjuvants, and interventional and invasive strategies as well as side effects of these techniques. Many of these modalities are used for palliation but may and should be used in cancer patients who experience side effects from both their cancer and their chemotherapeutics. PMID:25841694

  19. Translating Research into Practice Intervention Improves Management of Acute Pain in Older Hip Fracture Patients

    PubMed Central

    Titler, Marita G; Herr, Keela; Brooks, John M; Xie, Xian-Jin; Ardery, Gail; Schilling, Margo L; Marsh, J Lawrence; Everett, Linda Q; Clarke, William R

    2009-01-01

    Objective To test an interdisciplinary, multifaceted, translating research into practice (TRIP) intervention to (a) promote adoption, by physicians and nurses, of evidence-based (EB) acute pain management practices in hospitalized older adults, (b) decrease barriers to use of EB acute pain management practices, and (c) decrease pain intensity of older hospitalized adults. Study Design Experimental design with the hospital as the unit of randomization. Study Setting Twelve acute care hospitals in the Midwest. Data Sources (a) Medical records (MRs) of patients ≥65 years or older with a hip fracture admitted before and following implementation of the TRIP intervention and (b) physicians and nurses who care for those patients. Data Collection Data were abstracted from MRs and questions distributed to nurses and physicians. Principal Findings The Summative Index for Quality of Acute Pain Care (0–18 scale) was significantly higher for the experimental (10.1) than comparison group (8.4) at the end of the TRIP implementation phase. At the end of the TRIP implementation phase, patients in the experimental group had a lower mean pain intensity rating than those in the comparison group (p<.0001). Conclusion The TRIP intervention improved quality of acute pain management of older adults hospitalized with a hip fracture. PMID:19146568

  20. Community Health Workers Versus Nurses as Counselors or Case Managers in a Self-Help Diabetes Management Program

    PubMed Central

    Kim, Kim B.; Kim, Miyong T.; Lee, Hochang B.; Nguyen, Tam; Bone, Lee R.; Levine, David

    2016-01-01

    Objectives To confirm the effectiveness of community health workers’ involvement as counselors or case managers in a self-help diabetes management program in 2009 to 2014. Methods Our open-label, randomized controlled trial determined the effectiveness of a self-help intervention among Korean Americans aged 35 to 80 years in the Baltimore-Washington metropolitan area with uncontrolled type 2 diabetes. We measured and analyzed physiological and psychobehavioral health outcomes of the community health worker–counseled (n = 54) and registered nurse (RN)–counseled (n = 51) intervention groups in comparison with the control group (n = 104). Results The community health workers’ performance was comparable to that of the RNs for both psychobehavioral outcomes (e.g., self-efficacy, quality of life) and physiological outcomes. The community health worker–counseled group showed hemoglobin A1C reductions from baseline (−1.2%, −1.5%, −1.3%, and −1.6%, at months 3, 6, 9, and 12, respectively), all of which were greater than reductions in the RN-counseled (−0.7%, −0.9%, −0.9%, and −1.0%) or the control (−0.5%, −0.5%, −0.6%, and −0.7%) groups. Conclusions Community health workers performed as well as or better than nurses as counselors or case managers in a self-help diabetes management program in a Korean American community. PMID:26985607

  1. Characteristics of effective self-management interventions in patients with COPD: individual patient data meta-analysis.

    PubMed

    Jonkman, Nini H; Westland, Heleen; Trappenburg, Jaap C A; Groenwold, Rolf H H; Bischoff, Erik W M A; Bourbeau, Jean; Bucknall, Christine E; Coultas, David; Effing, Tanja W; Epton, Michael; Gallefoss, Frode; Garcia-Aymerich, Judith; Lloyd, Suzanne M; Monninkhof, Evelyn M; Nguyen, Huong Q; van der Palen, Job; Rice, Kathryn L; Sedeno, Maria; Taylor, Stephanie J C; Troosters, Thierry; Zwar, Nicholas A; Hoes, Arno W; Schuurmans, Marieke J

    2016-07-01

    It is unknown whether heterogeneity in effects of self-management interventions in patients with chronic obstructive pulmonary disease (COPD) can be explained by differences in programme characteristics. This study aimed to identify which characteristics of COPD self-management interventions are most effective.Systematic search in electronic databases identified randomised trials on self-management interventions conducted between 1985 and 2013. Individual patient data were requested for meta-analysis by generalised mixed effects models.14 randomised trials were included (67% of eligible), representing 3282 patients (75% of eligible). Univariable analyses showed favourable effects on some outcomes for more planned contacts and longer duration of interventions, interventions with peer contact, without log keeping, without problem solving, and without support allocation. After adjusting for other programme characteristics in multivariable analyses, only the effects of duration on all-cause hospitalisation remained. Each month increase in intervention duration reduced risk of all-cause hospitalisation (time to event hazard ratios 0.98, 95% CI 0.97-0.99; risk ratio (RR) after 6 months follow-up 0.96, 95% CI 0.92-0.99; RR after 12 months follow-up 0.98, 95% CI 0.96-1.00).Our results showed that longer duration of self-management interventions conferred a reduction in all-cause hospitalisations in COPD patients. Other characteristics are not consistently associated with differential effects of self-management interventions across clinically relevant outcomes. PMID:27126694

  2. A pragmatic approach to measuring, monitoring and evaluating interventions for improved tuberculosis case detection

    PubMed Central

    Blok, Lucie; Creswell, Jacob; Stevens, Robert; Brouwer, Miranda; Ramis, Oriol; Weil, Olivier; Klatser, Paul; Sahu, Suvanand; Bakker, Mirjam I.

    2014-01-01

    The inability to detect all individuals with active tuberculosis has led to a growing interest in new approaches to improve case detection. Policy makers and program staff face important challenges measuring effectiveness of newly introduced interventions and reviewing feasibility of scaling-up successful approaches. While robust research will continue to be needed to document impact and influence policy, it may not always be feasible for all interventions and programmatic evidence is also critical to understand what can be expected in routine settings. The effects of interventions on early and improved tuberculosis detection can be documented through well-designed program evaluations. We present a pragmatic framework for evaluating and measuring the effect of improved case detection strategies using systematically collected intervention data in combination with routine tuberculosis notification data applying historical and contemporary controls. Standardized process evaluation and systematic documentation of program implementation design, cost and context will contribute to explaining observed levels of success and may help to identify conditions needed for success. Findings can then guide decisions on scale-up and replication in different target populations and settings. PMID:25100402

  3. Knowledge Management Analysis: A Case Study

    ERIC Educational Resources Information Center

    Mecha, Ezi I.; Desai, Mayur S.; Richards, Thomas C.

    2009-01-01

    It is imperative for businesses to manage knowledge and stay competitive in the marketplace. Knowledge management is critical and is a key to prevent organizations from duplicating their efforts with a subsequent improvement in their efficiency. This study focuses on overview of knowledge management, analyzes the current knowledge management in…

  4. Nonsurgical scar management of the face: does early versus late intervention affect outcome?

    PubMed

    Parry, Ingrid; Sen, Soman; Palmieri, Tina; Greenhalgh, David

    2013-01-01

    Special emphasis is placed on the clinical management of facial scarring because of the profound physical and psychological impact of facial burns. Noninvasive methods of facial scar management include pressure therapy, silicone, massage, and facial exercises. Early implementation of these scar management techniques after a burn injury is typically accepted as standard burn rehabilitation practice, however, little data exist to support this practice. This study evaluated the timing of common noninvasive scar management interventions after facial skin grafting in children and the impact on outcome, as measured by scar assessment and need for facial reconstructive surgery. A retrospective review of 138 patients who underwent excision and grafting of the face and subsequent noninvasive scar management during a 10-year time frame was conducted. Regression analyses were used to show that earlier application of silicone was significantly related to lower Modified Vancouver Scar Scale scores, specifically in the subscales of vascularity and pigmentation. Early use of pressure therapy and implementation of facial exercises were also related to lower Modified Vancouver Scar Scale vascularity scores. No relationship was found between timing of the interventions and facial reconstructive outcome. Early use of silicone, pressure therapy, and exercise may improve scar outcome and accelerate time to scar maturity. PMID:23816994

  5. Improving linkage with substance abuse treatment using brief case management and motivational interviewing

    PubMed Central

    Rapp, Richard C.; Otto, Amy L.; Lane, D. Timothy; Redko, Cristina; McGatha, Sue; Carlson, Robert G.

    2008-01-01

    Background Poor linkage with substance abuse treatment remains a problem, negating the benefits that can accrue to both substance abusers and the larger society. Numerous behavioral interventions have been tested to determine their potential role in improving linkage. Methods A randomized clinical trial of 678 substance abusers compared the linkage effect of two brief interventions with the referral standard of care (SOC) at a centralized intake unit (CIU). Interventions included five sessions of strengths-based case management (SBCM) or one session of motivational interviewing (MI). A priori hypotheses predicted that both interventions would be better than the standard of care in predicting linkage and that SBCM would be more effective than MI. We analyzed the effect of the two interventions on overall treatment linkage rates and by treatment modality. Logistic regression analysis examined predictors of treatment linkage for the sample and each group. Results Two hypotheses were confirmed in that SBCM (n = 222) was effective in improving linkage compared to the SOC (n = 230), 55.0% vs. 38.7% (p < .01). SBCM improved linkage more than MI (55.0% vs. 44.7%, p < .05). Motivational interviewing (n = 226) was not significantly more effective in improving linkage than the standard of care (44.7% vs. 38.7%; p > .05). The three trial groups differed only slightly on the client characteristics that predicted linkage with treatment. Conclusions The results of this study confirm a body of literature that supports the effectiveness of case management in improving linkage with treatment. The role of motivational interviewing in improving linkage was not supported. Results are discussed in the context of other case management and motivational interviewing linkage studies. PMID:18242883

  6. A Case of Telecommunications (Mis)Management; [and] A Case of Telecommunications (Mis)Management: Case Analysis.

    ERIC Educational Resources Information Center

    Fin, T. Andrew; Rogers, Priscilla S.; Taylor, James R.

    1999-01-01

    Presents a series of analyses of a case involving implementing a new voice-mail system, noting a newly appointed manager's failure to obtain feedback about the planned transition and evaluate user needs; successful introduction of any new technology is variable and suggests a degree of incrementalism; and four major issues arising in similar cases…

  7. A randomized controlled trial of a nurse-administered educational intervention for improving cancer pain management in ambulatory settings.

    PubMed

    Yates, Patsy; Edwards, Helen; Nash, Robyn; Aranda, Sanchia; Purdie, David; Najman, Jake; Skerman, Helen; Walsh, Anne

    2004-05-01

    The persistence of negative attitudes towards cancer pain and its treatment suggests there is scope for identifying more effective pain education strategies. This randomized controlled trial involving 189 ambulatory cancer patients evaluated an educational intervention that aimed to optimize patients' ability to manage pain. One week post-intervention, patients receiving the pain management intervention (PMI) had a significantly greater increase in self-reported pain knowledge, perceived control over pain, and number of pain treatments recommended. Intervention group patients also demonstrated a greater reduction in willingness to tolerate pain, concerns about addiction and side effects, being a "good" patient, and tolerance to pain relieving medication. The results suggest that targeted educational interventions that utilize individualized instructional techniques may alter cancer patient attitudes, which can potentially act as barriers to effective pain management. PMID:15140463

  8. Monitoring and evaluation of soil bioengineering interventions for watershed management, disaster mitigation and environmental restoration in Latin America

    NASA Astrophysics Data System (ADS)

    Petrone, Alessandro; Preti, Federico

    2013-04-01

    In recent decades the institutions responsible for land management and civil protection have showed a great interest in relation to the use of more environmentally friendly techniques to mitigate the risk of landslides and floods. Soil bioengineering has responded to this need and several research groups are carrying out experimentations using the techniques of this discipline in the countries in the developing world. The Deistaf from University of Florence has concentrated its activities in this area over the past decade promoting the use of the techniques of Soil bioengineering in Latin America through the implementation of training and experimentation programmes. Numerous works have been completed both in riverbanks and on slopes in Nicaragua, Guatemala, Ecuador and Colombia. It was decided to make a census of interventions in Latin America from different institutions that may be related to Soil bioengineering in order to obtain an overview of the state of the art in the specific context taking into account also environmental and socio-economic issues. Taking advantage of its network of contacts, DEISTAF has collected dozens of sheets that describe interventions. These sheets describe, among other fields focused on the environment in which the work has been carried out, the materials and techniques used, and the impact of the intervention. In the sheets we present also the monitoring that has been realized for some of these works in the months of October and November 2012; we include the identification of the current condition and functionality of the intervention and, in the case of the presence of some damages, the formulation of instructions to fix them as well as the economic quantification of the repairs to be carried out.

  9. The School Counselors' Ideas on Features, Determinant and Intervention on Child Negligence and Abuse Cases

    ERIC Educational Resources Information Center

    Usakli, Hakan

    2012-01-01

    It is sad to know that many of the child negligence and child abuse cases, which are being frequently encountered in the society today, still remains unknown. This perhaps is due to lack of information on the part of the administrators, school counselors and other related bodies in the management of such cases. In this study, 50 school counselors…

  10. Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases

    PubMed Central

    Okamoto, Kenichi W.; Gould, Fred; Lloyd, Alun L.

    2016-01-01

    Many vector-borne diseases lack effective vaccines and medications, and the limitations of traditional vector control have inspired novel approaches based on using genetic engineering to manipulate vector populations and thereby reduce transmission. Yet both the short- and long-term epidemiological effects of these transgenic strategies are highly uncertain. If neither vaccines, medications, nor transgenic strategies can by themselves suffice for managing vector-borne diseases, integrating these approaches becomes key. Here we develop a framework to evaluate how clinical interventions (i.e., vaccination and medication) can be integrated with transgenic vector manipulation strategies to prevent disease invasion and reduce disease incidence. We show that the ability of clinical interventions to accelerate disease suppression can depend on the nature of the transgenic manipulation deployed (e.g., whether vector population reduction or replacement is attempted). We find that making a specific, individual strategy highly effective may not be necessary for attaining public-health objectives, provided suitable combinations can be adopted. However, we show how combining only partially effective antimicrobial drugs or vaccination with transgenic vector manipulations that merely temporarily lower vector competence can amplify disease resurgence following transient suppression. Thus, transgenic vector manipulation that cannot be sustained can have adverse consequences—consequences which ineffective clinical interventions can at best only mitigate, and at worst temporarily exacerbate. This result, which arises from differences between the time scale on which the interventions affect disease dynamics and the time scale of host population dynamics, highlights the importance of accounting for the potential delay in the effects of deploying public health strategies on long-term disease incidence. We find that for systems at the disease-endemic equilibrium, even modest

  11. Design and Methods of a Synchronous Online Motivational Interviewing Intervention for Weight Management

    PubMed Central

    DiLillo, Vicki; Ingle, Krista; Harvey, Jean Ruth; West, Delia Smith

    2016-01-01

    Background While Internet-based weight management programs can facilitate access to and engagement in evidence-based lifestyle weight loss programs, the results have generally not been as effective as in-person programs. Furthermore, motivational interviewing (MI) has shown promise as a technique for enhancing weight loss outcomes within face-to-face programs. Objective This paper describes the design, intervention development, and analysis of a therapist-delivered online MI intervention for weight loss in the context of an online weight loss program. Methods The MI intervention is delivered within the context of a randomized controlled trial examining the efficacy of an 18-month, group-based, online behavioral weight control program plus individually administered, synchronous online MI sessions relative to the group-based program alone. Six individual 30-minute MI sessions are conducted in private chat rooms over 18 months by doctoral-level psychologists. Sessions use a semistructured interview format for content and session flow and incorporate core MI components (eg, collaborative agenda setting, open-ended questions, reflective listening and summary statements, objective data, and a focus on evoking and amplifying change talk). Results The project was funded in 2010 and enrollment was completed in 2012. Data analysis is currently under way and the first results are expected in 2016. Conclusions This is the first trial to test the efficacy of a synchronous online, one-on-one MI intervention designed to augment an online group behavioral weight loss program. If the addition of MI sessions proves to be successful, this intervention could be disseminated to enhance other distance-based weight loss interventions. Trial Registration Clinicaltrials.gov NCT01232699; https://clinicaltrials.gov/ct2/show/NCT01232699 PMID:27095604

  12. Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases.

    PubMed

    Okamoto, Kenichi W; Gould, Fred; Lloyd, Alun L

    2016-03-01

    Many vector-borne diseases lack effective vaccines and medications, and the limitations of traditional vector control have inspired novel approaches based on using genetic engineering to manipulate vector populations and thereby reduce transmission. Yet both the short- and long-term epidemiological effects of these transgenic strategies are highly uncertain. If neither vaccines, medications, nor transgenic strategies can by themselves suffice for managing vector-borne diseases, integrating these approaches becomes key. Here we develop a framework to evaluate how clinical interventions (i.e., vaccination and medication) can be integrated with transgenic vector manipulation strategies to prevent disease invasion and reduce disease incidence. We show that the ability of clinical interventions to accelerate disease suppression can depend on the nature of the transgenic manipulation deployed (e.g., whether vector population reduction or replacement is attempted). We find that making a specific, individual strategy highly effective may not be necessary for attaining public-health objectives, provided suitable combinations can be adopted. However, we show how combining only partially effective antimicrobial drugs or vaccination with transgenic vector manipulations that merely temporarily lower vector competence can amplify disease resurgence following transient suppression. Thus, transgenic vector manipulation that cannot be sustained can have adverse consequences-consequences which ineffective clinical interventions can at best only mitigate, and at worst temporarily exacerbate. This result, which arises from differences between the time scale on which the interventions affect disease dynamics and the time scale of host population dynamics, highlights the importance of accounting for the potential delay in the effects of deploying public health strategies on long-term disease incidence. We find that for systems at the disease-endemic equilibrium, even modest

  13. Training Corporate Managers to Adopt a More Autonomy-Supportive Motivating Style toward Employees: An Intervention Study

    ERIC Educational Resources Information Center

    Hardre, Patricia L.; Reeve, Johnmarshall

    2009-01-01

    Management style is treated in a variety of ways across the training and development literature. Yet few studies have tested the training-based malleability of management style in a for-profit, authentic work context. The present research tested whether or not training intervention would help managers adopt a more autonomy-supportive motivating…

  14. Effectiveness of a primary care based complex intervention to promote self-management in patients presenting psychiatric symptoms: study protocol of a cluster-randomized controlled trial

    PubMed Central

    2014-01-01

    Background Anxiety, Depression and Somatoform (ADSom) disorders are highly prevalent in primary care. Managing these disorders is time-consuming and requires strong commitment on behalf of the General Practitioners (GPs). Furthermore, the management of these patients is restricted by the high patient turnover rates in primary care practices, especially in the German health care system. In order to address this problem, we implement a complex, low-threshold intervention by an Advanced Practice Nurse (APN) using a mixture of case management and counseling techniques to promote self-management in these patients. Here we present the protocol of the “Self-Management Support for Anxiety, Depression and Somatoform Disorders in Primary Care” (SMADS)-Study. Methods/Design The study is designed as a cluster-randomized controlled trial, comparing an intervention and a control group of 10 primary care practices in each case. We will compare the effectiveness of the intervention applied by an APN with usual GP-care. A total of 340 participants will be enrolled in the study, 170 in either arm. We use the Patient Health Questionnaire-German version (PHQ-D) as a screening tool for psychiatric symptoms, including patients with a score above 5 on any of the three symptom scales. The primary outcome is self-efficacy, measured by the General Self-Efficacy Scale (GSE), here used as a proxy for self-management. As secondary outcomes we include the PHQ-D symptom load and questionnaires regarding coping with illness and health related quality of life. Outcome assessments will be applied 8 weeks and 12 months after the baseline assessment. Discussion The SMADS-study evaluates a complex, low threshold intervention for ambulatory patients presenting ADSom-symptoms, empowering them to better manage their condition, as well as improving their motivation to engage in self-help and health-seeking behaviour. The benefit of the intervention will be substantiated, when patients can enhance

  15. A cluster randomized trial of an organizational process improvement intervention for improving the assessment and case planning of offenders: a Study Protocol

    PubMed Central

    Shafer, Michael S; Prendergast, Michael; Melnick, Gerald; Stein, Lynda A; Welsh, Wayne N

    2014-01-01

    Background The Organizational Process Improvement Intervention (OPII), conducted by the NIDA-funded Criminal Justice Drug Abuse Treatment Studies consortium of nine research centers, examined an organizational intervention to improve the processes used in correctional settings to assess substance abusing offenders, develop case plans, transfer this information to community-based treatment agencies, and monitor the services provided by these community based treatment agencies. Methods/Design A multi-site cluster randomized design was used to evaluate an inter-agency organizational process improvement intervention among dyads of correctional agencies and community based treatment agencies. Linked correctional and community based agencies were clustered among nine (9) research centers and randomly assigned to an early or delayed intervention condition. Participants included administrators, managers, and line staff from the participating agencies; some participants served on interagency change teams while other participants performed agency tasks related to offender services. A manualized organizational intervention that includes the use of external organizational coaches was applied to create and support interagency change teams that proceeded through a four-step process over a planned intervention period of 12 months. The primary outcome of the process improvement intervention was to improve processes associated with the assessment, case planning, service referral and service provision processes within the linked organizations. Discussion Providing substance abuse offenders with coordinated treatment and access to community-based services is critical to reducing offender recidivism. Results from this study protocol will provide new and critical information on strategies and processes that improve the assessment and case planning for such offenders as they transition between correctional and community based systems and settings. Further, this study extends current

  16. Management of Rett syndrome in the controlled multisensory (Snoezelen) environment. A review with three case stories.

    PubMed

    Lotan, Meir

    2006-01-01

    Rett syndrome (RS) is a neurological disorder resulting from an X-linked dominant mutation. It is characterized by a variety of physical and perceptual disabilities, resulting in a need for continuous intervention programs to be administered on a regular basis throughout life. Many of these individuals with RS show fear of movement and, therefore, find it hard to accept external facilitation (so common in physical therapy intervention). In a search for novel intervention techniques that might improve their ability to cope with difficulties in daily situations, while also reducing their difficulty in handling motion inflicted by an external physical facilitator, we examined the use of the Snoezelen room. The Snoezelen, also known as the controlled multisensory environment, can provide a soothing atmosphere that appeals to the individual with RS, while at the same time it can improve physical, sensorial, and functional abilities. This article suggests various intervention goals that are appropriate for individuals with RS at different stages of the disorder. Since the management of young children with RS in the multisensory environment has been discussed at length in the past, this article will mainly describe intervention with adults with RS, focusing on three case stories. The present article reviews the available scientific materials on the topic of Snoezelen, incorporating clinical knowledge in the field of RS and suggesting this approach as an appropriate intervention method for this population. PMID:16830051

  17. Deriving Requirements for Pervasive Well-Being Technology From Work Stress and Intervention Theory: Framework and Case Study

    PubMed Central

    Koldijk, Saskia; Kraaij, Wessel

    2016-01-01

    Background Stress in office environments is a big concern, often leading to burn-out. New technologies are emerging, such as easily available sensors, contextual reasoning, and electronic coaching (e-coaching) apps. In the Smart Reasoning for Well-being at Home and at Work (SWELL) project, we explore the potential of using such new pervasive technologies to provide support for the self-management of well-being, with a focus on individuals' stress-coping. Ideally, these new pervasive systems should be grounded in existing work stress and intervention theory. However, there is a large diversity of theories and they hardly provide explicit directions for technology design. Objective The aim of this paper is to present a comprehensive and concise framework that can be used to design pervasive technologies that support knowledge workers to decrease stress. Methods Based on a literature study we identify concepts relevant to well-being at work and select different work stress models to find causes of work stress that can be addressed. From a technical perspective, we then describe how sensors can be used to infer stress and the context in which it appears, and use intervention theory to further specify interventions that can be provided by means of pervasive technology. Results The resulting general framework relates several relevant theories: we relate “engagement and burn-out” to “stress”, and describe how relevant aspects can be quantified by means of sensors. We also outline underlying causes of work stress and how these can be addressed with interventions, in particular utilizing new technologies integrating behavioral change theory. Based upon this framework we were able to derive requirements for our case study, the pervasive SWELL system, and we implemented two prototypes. Small-scale user studies proved the value of the derived technology-supported interventions. Conclusions The presented framework can be used to systematically develop theory

  18. Combined interventional and surgical treatment for a rare case of double patent ductus arteriosus

    PubMed Central

    SHANG, XIAO-KE; ZHANG, GANG-CHENG; ZHONG, LIANG; ZHOU, XIN; LIU, MEI; LU, RONG

    2016-01-01

    The present study describes the case of a 2.5-year-old girl with double patent ductus arteriosus (PDA) that was successfully treated following interventional and surgical treatment. Bilateral ductus arteriosus is a very rare condition, which is assumed to occur when the branchial-type arterial system transforms into the mammalian-type arterial system during the development of the aorta and its branches. This case was misdiagnosed as ordinary PDA by echocardiography prior to the first surgery and the surgery was not successful because of poor accessibility. Enhanced computed tomography subsequently showed situs solitus, atrial situs, levocardia, right-sided aortic arch with right-sided descending aorta, an isolated left subclavian artery and double PDA. Interventional treatment was performed and intraoperative aortic arch angiography showed that the descending aorta was the origin of the first funnel-type PDA (PDA-1). The left subclavian artery was not connected to the aorta but was connected to the pulmonary artery with a very narrow winding duct, which was PDA-2. Interventional treatment via PDA-2 also failed because passing a guidewire through the twisted PDA-2 was difficult. The child was immediately transferred to the surgical operation room for double PDA ligation and left subclavian artery reconstruction under median thoracotomy. The surgical procedure succeeded and the patient recovered quickly. The failure of the interventional treatment may be attributed to the difficulty in establishing a path. The soft tip of the hardened guidewire was relatively long. If the hardened part of the wire was sent to the appropriate place to support the pathway, the soft tip would be forced to enter the vertebrobasilar artery system. A similar problem was encountered when the left subclavian artery was selected for intervention. Shortening the length of the soft tip of the hardened guidewire may have enabled smooth completion of the establishment of the pathway. However

  19. Effect of a Consumer-Directed Voucher and a Disease-Management-Health-Promotion Nurse Intervention on Home Care Use

    ERIC Educational Resources Information Center

    Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R.; Mukamel, Dana; Eggert, Gerald M.

    2005-01-01

    Purpose: We describe the impact of two interventions, a consumer-directed voucher for in-home supportive services and a chronic disease self-management-health-promotion nurse intervention, on the probability of use of two types of home care-skilled home health care and personal assistance services-received by functionally impaired Medicare…

  20. Web-Based and Mobile Stress Management Intervention for Employees: A Randomized Controlled Trial

    PubMed Central

    Lehr, Dirk; Ebert, David Daniel; Berking, Matthias; Riper, Heleen

    2016-01-01

    Background Work-related stress is highly prevalent among employees and is associated with adverse mental health consequences. Web-based interventions offer the opportunity to deliver effective solutions on a large scale; however, the evidence is limited and the results conflicting. Objective This randomized controlled trial evaluated the efficacy of guided Web- and mobile-based stress management training for employees. Methods A total of 264 employees with elevated symptoms of stress (Perceived Stress Scale-10, PSS-10≥22) were recruited from the general working population and randomly assigned to an Internet-based stress management intervention (iSMI) or waitlist control group. The intervention (GET.ON Stress) was based on Lazarus’s transactional model of stress, consisted of seven sessions, and applied both well-established problem solving and more recently developed emotion regulation strategies. Participants also had the opportunity to request automatic text messages on their mobile phone along with the iSMI. Participants received written feedback on every completed session from an e-coach. The primary outcome was perceived stress (PSS-10). Web-based self-report assessments for both groups were scheduled at baseline, 7 weeks, and 6 months. At 12 months, an extended follow-up was carried out for the iSMI group only. Results An intention-to-treat analysis of covariance revealed significantly large effect differences between iSMI and waitlist control groups for perceived stress at posttest (F 1,261=58.08, P<.001; Cohen’s d=0.83) and at the 6-month follow-up (F 1,261=80.17, P<.001; Cohen’s d=1.02). The effects in the iSMI group were maintained at 12-month follow-up. Conclusions This Web- and mobile-based intervention has proven effective in reducing stress in employees in the long term. Internet-based stress management interventions should be further pursued as a valuable alternative to face-to-face interventions. Trial Registration German Clinical Trials

  1. Impact of comorbidity on fatigue management intervention outcomes among people with multiple sclerosis: an exploratory investigation.

    PubMed

    Finlayson, Marcia; Preissner, Katharine; Cho, Chi

    2013-01-01

    This exploratory secondary analysis examined whether the presence of six chronic health conditions moderated the effectiveness of a teleconference-delivered fatigue self-management education program for people with multiple sclerosis (MS). The longitudinal data used were from a randomized controlled trial involving 181 community-dwelling adults with MS. The primary outcome was fatigue impact, as measured by the Fatigue Impact Scale (FIS). Mixed-effects analysis of variance (ANOVA) models were used to determine the best-fitting model. Just under 65% (n = 112) of participants had at least one comorbid condition. Only diabetes and arthritis moderated all three FIS subscales over time. People with diabetes were slower to show improvement after intervention than people without diabetes. People with arthritis made much more dramatic initial gains compared with people without arthritis but had difficulty maintaining those gains over time. The results point to the need for greater attention to the impact of comorbidities on rehabilitation interventions. These exploratory findings suggest that fatigue self-management education protocols may need to be customized to people who are trying to incorporate MS fatigue self-management behaviors while simultaneously managing diabetes or arthritis. PMID:24453759

  2. Development of a Multisystemic Parent Management Training Intervention for Incarcerated Parents, Their Children and Families.

    PubMed

    Eddy, J Mark; Martinez, Charles R; Schiffmann, Tracy; Newton, Rex; Olin, Laura; Leve, Leslie; Foney, Dana M; Shortt, Joann Wu

    2008-11-01

    The majority of men and women prison inmates are parents. Many lived with children prior to incarceration, and most have at least some contact with their children and families while serving their sentences. As prison populations have increased in the United States, there has been a renewed interest in finding ways not only to reduce recidivism, but also to prevent incarceration in the first place, particularly amongst the children of incarcerated parents. Positive family interaction is related to both issues. The ongoing development of a multisystemic intervention designed to increase positive family interaction for parents and families involved in the criminal justice system is described. The intervention package currently includes a prison-based parent management training program called Parenting Inside Out (PIO); a prison-based therapeutic visitation program; and complimentary versions of PIO designed for jail and probation and parole settings. Work on other components designed for justice-involved parents, children and for caregivers during reunification from prison is ongoing. Program development has occurred within the context of strong support from the state department of corrections and other key governmental and non-profit sector groups, and support systems have been established to help maintain the interventions as well as to develop complimentary interventions, policies and procedures. PMID:19885365

  3. Process and outcome evaluation of an organizational-level stress management intervention in Switzerland.

    PubMed

    Jenny, Gregor J; Brauchli, Rebecca; Inauen, Alice; Füllemann, Désirée; Fridrich, Annemarie; Bauer, Georg F

    2015-09-01

    This field study evaluates the process and outcome of an organizational-level stress management intervention (SMI) in eight companies, taking into account the lessons learned from previous evaluation research. It utilizes the RE-AIM evaluation framework to capture the Reach and Adoption of the intervention in the companies, the appraisal of the Implementation process and the project's Effectiveness and Maintenance with a range of qualitative and quantitative methods. It applies an adapted research design in the context of a field study involving entire organizations, retrospectively assigning study participants to comparison groups. The results of a longitudinal analysis (n = 1400) showed that the SMI had a positive impact on the participants' job demands and resources, when controlled for baseline levels. Qualitative data analysis revealed that the companies had built capacities for ongoing health promotion and showed what issues must be borne in mind when implementing such projects. The study also showed that participation in such interventions alone does not suffice to achieve the desired impact, but that the individual participants' appraisal of the intervention and the collective involvement of the teams must be further researched to fully understand how change occurs. PMID:24395958

  4. Is there sufficient evidence to support intervention to manage shoulder arthritis?

    PubMed Central

    Tai Kie, Andrew; Hanusch, Birgit; Kulkarni, Rohit; Rees, Jonathan; Rangan, Amar

    2016-01-01

    Background We explore the nature, extent and validity of research studies concerning the management of shoulder arthritis to identify whether current management recommendations are adequate. Methods A full electronic search for relevant studies published between 2002 and 2012 was performed. The search focused on level 1 and level 2 studies. Full texts of selected articles were retrieved and assessed for quality against validated criteria. Results Four hundred and eleven studies were identified on the initial search and screened. Sixteen studies were selected for inclusion in the review. The studies identified were unable to provide a clear indication of best intervention for shoulder arthritis. The inclusion of a range of shoulder pathologies in some studies and the diversity in outcome measures used made it difficult for systematic reviews to effectively pool data. Better outcomes have been shown with total shoulder replacement over hemiarthroplasty for shoulder osteoarthritis; however, primary studies were often of limited quality. Sparse evidence is available for all other interventions, regardless of whether operative or non-operative. Conclusions The present review highlights the need for standardization of outcome assessment following treatment of shoulder arthritis. More rigorous and robust primary studies are needed to guide clinical practice on the best interventions for arthritis of the shoulder.

  5. Interventional pain management skills competency in pain medicine fellows: a method for development and assessment.

    PubMed

    McElroy, Kevin; Cuccurullo, Sara J; Perret-Karimi, Danielle; Hata, Justin; Ferrer, Steven M; Demesmin, Didier; Petagna, Ann Marie

    2014-08-01

    The purposes of this project were to propose an educational module to instruct pain medicine fellows in the appropriate performance of interventional pain management techniques and to verify procedural competency through objective evaluation methodology. Eight board-certified pain medicine physicians spanning two fellowship programs trained seven fellows using a standardized competency-based module. Assessment tools address the basic competencies outlined by the Accreditation Council for Graduate Medical Education (American Board of Anesthesiology Pain Medicine Content Outline). The seven fellows demonstrated proficiency in every segment of the evaluation module. Objective measures compared the fellows' performance on standardized procedure checklists administered 9 mos into training; fellows in the 2012-2013 academic year also received testing at the 3-mo mark. Support for the assessment module is demonstrated by appropriate performance of interventional procedures, with improvement noted from 3-mo to 9-mo testing, successful completion of chart-stimulated oral examinations, proper performance of relevant physical examination maneuvers, and completion of program-specific medical knowledge written tests. The fellows were evaluated via patient surveys and 360-degree global rating scales, maintained procedure logs, and completed two patient-care reports; these were reviewed by program directors to ensure adequate completion. The standardized educational module and evaluation methodology presented provide a potential framework for the definition of baseline competency in the clinical skill area of interventional pain management. PMID:25033098

  6. An educational intervention to promote self-management and professional socialization in graduate nurse anesthesia students

    NASA Astrophysics Data System (ADS)

    Maloy, Debra A.

    Traditionally, nurse anesthesia educators have utilized prior academic achievement to predict student success. However, research has indicated that prior academic achievement offers an inadequate assessment of student success in graduate healthcare programs with extensive clinical residencies. The educational literature has identified many non-cognitive factors, such as self-efficacy and locus of control, that may provide a more holistic prediction model of student success. An experimental study with pretest-posttest design and stratified random assignment was conducted to evaluate the effectiveness of an educational intervention to promote self-management, professional socialization, and academic achievement among first semester graduate nurse anesthesia students. Participants (N = 66) were demographically similar to the national graduate nurse anesthesia student body, though Hispanics and younger students were a little over-represented in the sample (56% female, 75.8% White, 15.2% Hispanic, 6% Other, 59% ≤ 30-years-old, 67% ≤ 3 years of ICU). The results showed that most graduate anesthesia students had strong self-management and professional socialization characteristics on admission. The results did not support the effectiveness of this educational intervention. Thus, ceiling effect may have accounted in part for statistically non-significant results regarding self-efficacy (p = .190, o2 = .03), locus of control (p = .137, o2 = .04), professional socialization (p = .819, o2 = .001), and academic achievement (p = .689, o2 = .003). Future researchers may need to expand the scope of the intervention, use a more powerful and sensitive instrument, and utilize a larger sample.

  7. Case management and self-management support for frequent users with chronic disease in primary care: a pragmatic randomized controlled trial

    PubMed Central

    2013-01-01

    Background Chronic diseases represent a major challenge for health care and social services. A number of people with chronic diseases require more services due to characteristics that increase their vulnerability. Given the burden of increasingly vulnerable patients on primary care, a pragmatic intervention in four Family Medicine Groups (primary care practices in Quebec, Canada) has been proposed for individuals with chronic diseases (diabetes, cardiovascular diseases, respiratory diseases, musculoskeletal diseases and/or chronic pain) who are frequent users of hospital services. The intervention combines case management by a nurse with group support meetings encouraging self-management based on the Stanford Chronic Disease Self-Management Program. The goals of this study are to: (1) analyze the implementation of the intervention in the participating practices in order to determine how the various contexts have influenced the implementation and the observed effects; (2) evaluate the proximal (self-efficacy, self-management, health habits, activation and psychological distress) and intermediate (empowerment, quality of life and health care use) effects of the intervention on patients; (3) conduct an economic analysis of the efficiency and cost-effectiveness of the intervention. Methods/Design The analysis of the implementation will be conducted using realistic evaluation and participatory approaches within four categories of stakeholders (Family Medicine Group and health centre management, Family Medicine Group practitioners, patients and their families, health centre or community partners). The data will be obtained through individual and group interviews, project documentation reviews and by documenting the intervention. Evaluation of the effects on patients will be based on a pragmatic randomized before-after experimental design with a delayed intervention control group (six months). Economic analysis will include cost-effectiveness and cost-benefit analysis

  8. Effective Case Study Methodologies in the Management of IT Courses.

    ERIC Educational Resources Information Center

    Buffington, James R.; Harper, Jeffrey S.

    Many Association to Advance Collegiate Schools of Business (AACSB) accredited schools require undergraduate Management Information Systems (MIS) majors to take a course in the management of information technology. Over half of these schools utilize case studies in the teaching of this course. Case studies are an important vehicle for teaching…

  9. Case Management: Effects of Improved Risk and Value Information

    ERIC Educational Resources Information Center

    Weissert, William G.; Hirth, Richard A.; Chernew, Michael E.; Diwan, Sadhna; Kim, Jinkyung

    2003-01-01

    Purpose: The purpose of this study was to determine the impact on resource use of providing case managers with information on the potential for patients to benefit from home care services. Design and Methods: Twenty-four case managers working in the Arizona Long Term Care System (ALTCS) were randomized into treatment and control groups. Members of…

  10. Identifying costs for capitation in psychiatric case management.

    PubMed

    Baker, J J; Chiverton, P; Hines, V

    1998-01-01

    This article presents an example of how one hospital identified costs for capitation in psychiatric case management. An 18-month postacute case management pilot project collected data on a nurse-specific and patient-specific basis. Costs were identified using activity-based costing methodology. PMID:9502055

  11. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168 Primary care case management services. (a)...

  12. 34 CFR 303.23 - Service coordination (case management).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., the system of payments for services in the State, and other pertinent information. (Authority: 20 U.S... 34 Education 2 2011-07-01 2010-07-01 true Service coordination (case management). 303.23 Section... Service coordination (case management). (a) General. (1) As used in this part, except in §...

  13. Comparison of a Mindful Eating Intervention to a Diabetes Self-Management Intervention among Adults with Type 2 Diabetes: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Miller, Carla K.; Kristeller, Jean L.; Headings, Amy; Nagaraja, Haikady

    2014-01-01

    Mindful eating may be an effective intervention for increasing awareness of hunger and satiety cues, improving eating regulation and dietary patterns, reducing symptoms of depression and anxiety, and promoting weight loss. Diabetes self-management education (DSME), which addresses knowledge, self-efficacy, and outcome expectations for improving…

  14. System dynamics-based evaluation of interventions to promote appropriate waste disposal behaviors in low-income urban areas: A Baltimore case study.

    PubMed

    Guo, Huaqing; Hobbs, Benjamin F; Lasater, Molly E; Parker, Cindy L; Winch, Peter J

    2016-10-01

    Inappropriate waste disposal is a serious issue in many urban neighborhoods, exacerbating environmental, rodent, and public health problems. Governments all over the world have been developing interventions to reduce inappropriate waste disposal. A system dynamics model is proposed to quantify the impacts of interventions on residential waste related behavior. In contrast to other models of municipal solid waste management, the structure of our model is based on sociological and economic studies on how incentives and social norms interactively affect waste disposal behavior, and its parameterization is informed by field work. A case study of low-income urban neighborhoods in Baltimore, MD, USA is presented. The simulation results show the effects of individual interventions, and also identify positive interactions among some potential interventions, especially information and incentive-based policies, as well as their limitations. The model can help policy analysts identify the most promising intervention packages, and then field test those few, rather than having to pilot test all combinations. Sensitivity analyses demonstrate large uncertainties about behavioral responses to some interventions, showing where information from survey research and social experiments would improve policy making. PMID:27260985

  15. Development of a primary care-based complex care management intervention for chronically ill patients at high risk for hospitalization: a study protocol

    PubMed Central

    2010-01-01

    Background Complex care management is seen as an approach to face the challenges of an ageing society with increasing numbers of patients with complex care needs. The Medical Research Council in the United Kingdom has proposed a framework for the development and evaluation of complex interventions that will be used to develop and evaluate a primary care-based complex care management program for chronically ill patients at high risk for future hospitalization in Germany. Methods and design We present a multi-method procedure to develop a complex care management program to implement interventions aimed at reducing potentially avoidable hospitalizations for primary care patients with type 2 diabetes mellitus, chronic obstructive pulmonary disease, or chronic heart failure and a high likelihood of hospitalization. The procedure will start with reflection about underlying precipitating factors of hospitalizations and how they may be targeted by the planned intervention (pre-clinical phase). An intervention model will then be developed (phase I) based on theory, literature, and exploratory studies (phase II). Exploratory studies are planned that entail the recruitment of 200 patients from 10 general practices. Eligible patients will be identified using two ways of 'case finding': software based predictive modelling and physicians' proposal of patients based on clinical experience. The resulting subpopulations will be compared regarding healthcare utilization, care needs and resources using insurance claims data, a patient survey, and chart review. Qualitative studies with healthcare professionals and patients will be undertaken to identify potential barriers and enablers for optimal performance of the complex care management program. Discussion This multi-method procedure will support the development of a primary care-based care management program enabling the implementation of interventions that will potentially reduce avoidable hospitalizations. PMID:20858242

  16. First-Birth Outcomes and Timing of Second Births: A Statewide Case Management Program for Adolescent Mothers

    ERIC Educational Resources Information Center

    Sangalang, Bernadette B.; Barth, Richard P.; Painter, John S.

    2006-01-01

    This study examines a case management intervention for first-time pregnant and parenting adolescents. It compares a sample of 1,260 first-time adolescent mothers in the Adolescent Parenting Program (APP) in North Carolina with 1,260 first-time adolescent mothers who did not participate in the program (non-APP). Using birth certificate data,…

  17. Integrating between-session interventions (homework) in therapy: the importance of the therapeutic relationship and cognitive case conceptualization.

    PubMed

    Cronin, Timothy J; Lawrence, Katherine A; Taylor, Kate; Norton, Peter J; Kazantzis, Nikolaos

    2015-05-01

    Between-session interventions, or homework, are crucial to a range of psychological therapies, including cognitive behavior therapy (CBT). Therapeutic interventions often involve experiencing emotions and situations, or examining strongly held views about their problems, that clients can find distressing. Hence, the clinician faces a particular challenge in collaborating with the client to carry out these interventions between sessions. In this article, we convey how this process in CBT requires not only a consideration of the theoretically meaningful determinants of adherence behavior but also a sophisticated cognitive case conceptualization. Using case material, we illustrate the interplay between in-session design, planning, and review of between-session interventions and the conceptualization. We also include a distinction between generic elements of the therapeutic relationship and CBT-specific elements. The case material also attends to the person of the therapist, and his or her own cognitive and emotional reactions occurring throughout the process of discussing between-session interventions. PMID:25809713

  18. Modification of pathological type A as worksite stress management and disease prevention intervention.

    PubMed

    Zonierczyk-Zreda, D

    2000-01-01

    The importance of helping an employee to better cope with occupational stress as the aim of stress management interventions is presented. It particularly concerns the employees who have the poorest temperamental and personality potential for effective coping and should be the target of primary stress intervention and prevention. According to evidence, Type A workers are at risk of occupational stress and disease, especially when some personality features of Type A are accompanied by high reactivity. The concept of pathological Type A is introduced. The already existing programs of modifying Type A and the framework of a program based on the elements that have been established to be the most therapeutic for pathological Type A are presented. PMID:10929150

  19. Laparoscopic management of recurrent pheochromocytoma: A case report.

    PubMed

    Garg, Harshit; Uppal, Manpreet; Sreedharan, Sreesanth Kelu; Aggarwal, Sandeep

    2016-01-01

    Recurrence of pheochromocytoma after a total adrenalectomy is uncommon. Such recurrent tumours are mostly managed by the open technique, with very few studies reporting laparoscopic management. We hereby report a case of successful laparoscopic management of a recurrent pheochromocytoma after total adrenalectomy for left adrenal pheochromocytoma. PMID:27279402

  20. Laparoscopic management of recurrent pheochromocytoma: A case report

    PubMed Central

    Garg, Harshit; Uppal, Manpreet; Sreedharan, Sreesanth Kelu; Aggarwal, Sandeep

    2016-01-01

    Recurrence of pheochromocytoma after a total adrenalectomy is uncommon. Such recurrent tumours are mostly managed by the open technique, with very few studies reporting laparoscopic management. We hereby report a case of successful laparoscopic management of a recurrent pheochromocytoma after total adrenalectomy for left adrenal pheochromocytoma. PMID:27279402

  1. 38 CFR 62.31 - Supportive service: Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... management services. 62.31 Section 62.31 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... management services. Grantees must provide case management services that include, at a minimum: (a... appointments for participants) to help participants obtain needed supportive services, such as medical,...

  2. Mycobacterium avium complex olecranon bursitis resolves without antimicrobials or surgical intervention: A case report and review of the literature

    PubMed Central

    Working, Selene; Tyser, Andrew; Levy, Dana

    2015-01-01

    Introduction Nontuberculous mycobacteria are an uncommon cause of septic olecranon bursitis, though cases have increasingly been described in both immunocompromised and immunocompetent hosts. Guidelines recommend a combination of surgical resection and antimicrobials for treatment. This case is the first reported case of nontuberculous mycobacterial olecranon bursitis that resolved without medical or surgical intervention. Case presentation A 67-year-old female developed a painless, fluctuant swelling of the olecranon bursa following blunt trauma to the elbow. Due to persistent bursal swelling, she underwent three separate therapeutic bursal aspirations, two involving intrabursal steroid injection. After the third aspiration, the bursa became erythematous and severely swollen, and bursal fluid grew Mycobacterium avium complex. Triple-drug antimycobacterial therapy was initiated, but discontinued abruptly due to a rash. Surgery was not performed. The patient was observed off antimicrobials, and gradually clinically improved with a compressive dressing. By 14 months after initial presentation, clinical exam revealed complete resolution of the previously erythematous bursal mass. Discussion This is the first reported case of nontuberculous mycobacterial olecranon bursitis managed successfully without surgery or antimicrobials. Musculoskeletal nontuberculous mycobacterial infections are challenging given the lack of clinical data about optimal duration and choice of antimicrobials or the role of surgery. Additionally, the potential toxicity and drug interactions of antimycobacterials are not insignificant and warrant close monitoring if treatment is pursued. Conclusion This case raises an important clinical question of whether close observation off antimicrobials is appropriate in select cases of immunocompetent patients with localized atypical mycobacterial disease of soft tissue and skeletal structures. PMID:26793457

  3. Managing Depression Among Homeless Mothers: Pilot Testing an Adapted Collaborative Care Intervention

    PubMed Central

    Weinreb, Linda; Upshur, Carole C.; Fletcher-Blake, Debbian; Reed, George; Frisard, Christine

    2016-01-01

    Objective Although depression is common among homeless mothers, little progress has been made in testing treatment strategies for this group. We describe pilot test results of an adapted collaborative care model for homeless mothers with depression. Method We conducted a pilot intervention study of mothers screening positive for depression in 2 randomly selected shelter-based primary care clinics in New York over 18 months in 2010–2012. Study participants completed a psychosocial, health, and mental health assessment at baseline, 3 months, and 6 months. Results One-third of women screened positive for depression (123 of 328 women). Sixty-seven women (63.2% of the eligible sample) enrolled in the intervention. At 6 months, compared to usual-care women, intervention group women were more likely to be receiving depression treatment (40.0% vs 5.9%, P = .01) and antidepressant medication (73.3% vs 5.9%, P = .001, respectively) and had more primary care physician and care manager visits at both 3 months (74.3% vs 53.3%, P = .009 and 91.4% vs 26.7%, P < .001, respectively) and 6 months (46.7% vs 23.5%, P = .003 and 70% vs 17.7%, P = .001, respectively). More women in the intervention group compared to usual-care women reported ≥ 50% improvement in depression symptoms at 6 months (30% vs 5.9%, P = .07). Conclusions This pilot study found that implementing an adapted collaborative care intervention was feasible in a shelter-based primary care clinic and had promising results that require further testing. Trial Registration ClinicalTrials.gov identifier: NCT02723058 PMID:27486545

  4. What is the role of a case manager in community aged care? A qualitative study in Australia.

    PubMed

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2016-07-01

    and ongoing development, as well as facilitate case managers to set professional boundaries in the delivery of case management interventions to their clients. PMID:25974261

  5. Using Design Thinking to Improve Psychological Interventions: The Case of the Growth Mindset during the Transition to High School

    ERIC Educational Resources Information Center

    Yeager, David S.; Romero, Carissa; Paunesku, Dave; Hulleman, Christopher S.; Schneider, Barbara; Hinojosa, Cintia; Lee, Hae Yeon; O'Brien, Joseph; Flint, Kate; Roberts, Alice; Trott, Jill; Greene, Daniel; Walton, Gregory M.; Dweck, Carol S.

    2016-01-01

    There are many promising psychological interventions on the horizon, but there is no clear methodology for preparing them to be scaled up. Drawing on design thinking, the present research formalizes a methodology for redesigning and tailoring initial interventions. We test the methodology using the case of fixed versus growth mindsets during the…

  6. Response to Intervention: Empirically Based Special Service Decisions From Single-Case Designs of Increasing and Decreasing Intensity

    ERIC Educational Resources Information Center

    Barnett, David W.; Daly, Edward, J.; Jones, Kevin M.; Lentz, Edward F.

    2004-01-01

    There have been several proposals to the effect that special service decisions could be based, at least in part, on the construct of response to intervention and not necessarily on traditional child measures. Single-case designs that focus on intervention response and intensity are reviewed as a potential evaluation framework for interdisciplinary…

  7. School nurse case management for children with chronic illness: health, academic, and quality of life outcomes.

    PubMed

    Keehner Engelke, Martha; Guttu, Martha; Warren, Michelle B; Swanson, Melvin

    2008-08-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with asthma, diabetes, severe allergies, seizures, or sickle-cell anemia in 5 different school districts who were provided case management by school nurses. The children ranged in age from 5 to 19 years. At the end of the school year, children experienced an improvement in quality of life and gained skills and knowledge to manage their illness more effectively. Classroom participation, grades, and participation in extracurricular activities also increased for many children. The study provides evidence of the positive impact school nurses have on children with chronic illness and suggests ways they can measure the outcomes of their interventions. PMID:18757353

  8. Diabetes Nurse Case Management and Motivational Interviewing for Change (DYNAMIC): Results of a 2-year Randomized Controlled Pragmatic Trial

    PubMed Central

    Gabbay, Robert A.; Añel-Tiangco, Raquel M.; Dellasega, Cheryl; Mauger, David T.; Adelman, Alan; Van Horn, Deborah H.A.

    2013-01-01

    Objective To determine if the addition of nurse case managers (NCMs) trained in motivational interviewing (MI) to usual care would result in improved outcomes in high risk type 2 diabetes patients. Methods A 2-year randomized controlled pragmatic trial randomized 545 patients to usual care control (n=313) or those who received the intervention (n= 232) with additional practice embedded NCM care, including MI-guided behavior change counseling. NCMs received intensive MI training with ongoing fidelity assessment. Results Systolic BP was better in the intervention group (131±15.9 vs. 135±18.2, p < 0.05). HbA1c, LDL, and diastolic BP improved in both groups: HbA1c (control group 9.1% to 8.0%, intervention group 8.8% to 7.8%), LDL (control group 127 to 100 mg/dL, intervention group 128 to 102 mg/dL), diastolic BP (control group 78 to 74 mm Hg, intervention group 80 to 74 mm Hg). Depression symptom scores were better in the intervention group. The reduction in diabetes-related distress approached statistical significance. Conclusions NCMs and MI improved systolic BP and complications screening. The large decrease in HbA1C and LDL in the control group may have obscured any further intervention effect. Although nurses prompted providers for medication titration, strategies to reduce provider clinical inertia might also be needed. Significant findings of the study In patients with type 2 diabetes, an intervention with nurse case management and motivational interviewing improves systolic blood pressure, depression, and screening for complications. What this study adds First study to look at the benefit of the addition of motivational interviewing to nurse case management in the care of the high-risk adult with type 2 diabetes. Particular attention was given to ensuring fidelity to the motivational interviewing approach. PMID:23368423

  9. Impact of a Script-based Communication Intervention on Patient Satisfaction with Pain Management.

    PubMed

    Alaloul, Fawwaz; Williams, Kimberly; Myers, John; Jones, Kayla Dlauren; Logsdon, M Cynthia

    2015-06-01

    Pain is a common complaint among hospitalized patients no matter the diagnosis. Pain has a negative effect on many aspects of a patient's life, including quality of life, sleep, and activities of daily living as well as increased health care expenses. The aim of this study was to evaluate the effectiveness of an intervention (script-based communication, use of white boards, and hourly rounding) related to pain management on patient satisfaction with nurses' management of pain. A prospective, quasi-experimental pretest-posttest design was used. Data were collected from two units that provided care for patients with a variety of medical-surgical diagnoses in a hospital located in an academic health sciences center in the southern United States. When nurses used clear and consistent communication with patients in pain, a positive effect was seen in patient satisfaction with pain management over time. This intervention was simple and effective. It could be replicated in a variety of health care organizations. PMID:25439123

  10. A case of small bowel mesenteric pneumatosis: A multidisciplinary approach to clinical interpretation and intervention

    PubMed Central

    Johnstone, Christopher; Salih, Tamir; Saha, Arin

    2016-01-01

    Introduction Pneumatosis of the small bowel mesentery is rare and the preserve of case reports. This case report describes the importance of a multi-disciplinary team (MDT) approach to rare pathologies. Case report A 78-year-old man presented to our unit with a two-day history of upper abdominal pain associated with nausea and intermittent vomiting. An urgent computed tomography (CT) scan was organised. The scan was grossly abnormal and difficult to interpret; it was reported as widespread intra-mural gas within the small bowel wall most likely secondary to extensive small bowel ischaemia. Although surgical intervention was very high risk (predicted P-possum mortality of over 60%) and there was a strong possibility that the patient would not recover from surgery, the disparity between clinical and radiological findings meant that a diagnostic laparoscopy was indicated. A diagnostic laparoscopy showed that the small bowel itself was normal but there was extensive gas within the mesentery, caused by a band adhesion which had eroded into the peritoneal layer of the small bowel mesentery. Discussion Pneumatosis of the small bowel mesentery is a pathological sign rather than a diagnosis and is characterised by gas within the mesenteric sleeves. It is likely associated with significant morbidity and therefore rarely observed as the majority with this sign would not be deemed suitable for surgical intervention. Conclusion The case highlights an unusual pathology, rare imaging findings, the importance of a multi-disciplinary approach and the value of clear communication and informed consent when considering major intervention or surgery. PMID:27082993

  11. Left ventricular-free wall rupture after successful coronary intervention: report of a case.

    PubMed

    Nakamura, Yoshinobu; Nishimura, Kengo; Harada, Shingo; Fujiwara, Yoshikazu; Shiraya, Suguru; Kamihira, Satoshi; Ishiguro, Shingo; Nishimura, Motonobu

    2008-01-01

    We experienced the case of a left ventricular-free wall rupture (LVFWR) following successful coronary intervention for acute myocardial infarction (AMI). A 73-year-old woman was hospitalized because of chest oppression that had been continuing for 8 days. She was diagnosed to have AMI, and percutaneous coronary intervention (PCI) was performed. PCI was successful. However, immediately following PCI, she developed electromechanical dissociation secondary to tamponade because of blow-out-type LVFWR. The perforation tear was initially closed by a direct suture, followed by reinforcement using bovine pericardium patches sealed with GRF glue. The patient died of irreversible brain damage on postoperative day 3, but no re-bleeding or aneurysmal dilatation was detected at autopsy. PMID:18368328

  12. Participatory ergonomic intervention for prevention of low back pain: assembly line redesign case.

    PubMed

    Bernardes, João Marcos; Wanderck, Claudia; Moro, Antônio Renato Pereira

    2012-01-01

    This paper gives an overview of a participatory ergonomic intervention aimed at reducing low back pain cases in the dispatch department of a catalogue and e-commerce retail company. Based on the findings of the ergonomic analysis and design committee, the company's own employees redesigned the assembly line's layout. As a result of these changes two job tasks that involved manual material handling of boxes, identified by the revised NIOSH equation as posing an increased risk for lifting-related low back pain, were totally eliminated, and the employees responsible for moving boxes from the end of the assembly line to pallets on the ground were given more control over their jobs, and these jobs were also enriched with a new, less heavy task. These results demonstrate that participatory ergonomic interventions are a viable and effective strategy to reduce the exposure to work-related physical and psychosocial risk factors for low back pain. PMID:22317739

  13. Enhancing generalisation in biofeedback intervention using the challenge point framework: A case study

    PubMed Central

    HITCHCOCK, ELAINE R.; BYUN, TARA McALLISTER

    2014-01-01

    Biofeedback intervention can help children achieve correct production of a treatment-resistant error sound, but generalisation is often limited. This case study suggests that generalisation can be enhanced when biofeedback intervention is structured in accordance with a “challenge point” framework for speech-motor learning. The participant was an 11-year-old with residual /r/ misarticulation who had previously attained correct /r/ production through a structured course of ultrasound biofeedback treatment but did not generalise these gains beyond the word level. Treatment difficulty was adjusted in an adaptive manner following predetermined criteria for advancing, maintaining, or moving back a level in a multidimensional hierarchy of functional task complexity. The participant achieved and maintained virtually 100% accuracy in producing /r/ at both word and sentence levels. These preliminary results support the efficacy of a semi-structured implementation of the challenge point framework as a means of achieving generalisation and maintenance of treatment gains. PMID:25216375

  14. Self-care Management Intervention to Improve Psychological Wellbeing for Jordanian Patients with Type Two Diabetes Mellitus.

    PubMed

    Albikawi, Zainab Fatehi; Petro-Nustas, Wasileh; Abuadas, Mohammad

    2016-03-01

    The purpose of the study is to evaluate the effectiveness of self-care management intervention on psychological wellbeing for Jordanian patients with type two diabetes mellitus. A quasi-experimental design was used. The study was conducted in a diabetes clinic of a specialized diabetes center in Amman. One hundred and forty-nine participants completed the three-month post-treatment assessments (76 in the intervention group and 73 in the control group). Both the control and intervention groups received a standard diabetic educational program. The intervention group received the following additional interventions: (1) Diabetes Self-care Management booklet, (2)DVD viewing, (3) counseling rehearsal session, and (4) a telephone follow-up. The main study instrument was an Arabic version 20 of the depression anxiety stress scales: To assess the group differences of dependent variable changes, repeated measure ANOVA was used. It was found that psychological wellbeing was not significant at 2-week post-intervention and significant change was observed at 3-month post-intervention. The findings from this study can guide the health providers to be trained to provide relevant diabetic interventions into their nursing interventions, education, and research. PMID:26962749

  15. Public Management of Science Case Studies.

    ERIC Educational Resources Information Center

    American Univ., Washington, DC. Coll. of Public Affairs.

    Presented are six papers pertaining to the management of science, research, and development by federal agencies. The papers were prepared by students in a management of science course offered at the American University, Washington, D.C. Federal agencies reviewed include: National Aeronautics and Space Administration (NASA); Department of…

  16. Privileged Emotion Managers: The Case of Actors

    ERIC Educational Resources Information Center

    Orzechowicz, David

    2008-01-01

    Theatre provides a unique set of conditions for the management of emotions. Drawing on participant observation from one repertory theater, three university productions, and interviews with stage actors, directors, and acting instructors, I conceptualize actors as privileged emotion managers. Actors access structural resources that enable their…

  17. Interdependency Management in Universities: A Case Study

    ERIC Educational Resources Information Center

    Braun, Dietmar; Benninghoff, Martin; Ramuz, Raphaël; Gorga, Adriana

    2015-01-01

    There remains uncertainty in scientific discussions regarding the governance of universities in new public management regimes in terms of who actually "rules" in the university. Apparently, a strengthened management leadership is confronted with continuing elements of academic self-regulation and professional autonomy in knowledge…

  18. Spontaneous Rectus Sheath Hematoma in the Elderly: An Unusual Case and Update on Proper Management

    PubMed Central

    Galyfos, George; Karantzikos, Georgios; Palogos, Konstantinos; Sianou, Argiri; Filis, Konstantinos; Kavouras, Nikolaos

    2014-01-01

    Spontaneous rectus sheath hematoma (SRSH) is an uncommon medical emergency in the elderly. We present a case of SRSH with an atypical clinical presentation and discuss literature regarding diagnosis and proper management. A 75-year-old female patient was transferred to the emergency department due to acute dyspnoea and confusion. Her medical history revealed a viral infection of the upper respiratory tract, and no coughing or use of anticoagulants. The clinical examination showed tenderness of the left lower abdomen, although palpation was misleading due to patient's obesity. Laboratory investigations showed light anaemia. Ultrasonography and computed tomography revealed a large rectus sheath hematoma of the left abdominal wall. Despite further deterioration of the patient, conservative management including bed rest, fluid replacement, blood products transfusion, and proper analgesia was successful. No surgical intervention was needed. Prompt diagnosis and management of SRSH plays significant role in the prognosis, especially in elder patients. Independently of size and severity, conservative management remains the first therapeutic choice. Only by failure of supportive management, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated. PMID:24839570

  19. Review of Medical Dispute Cases in the Pain Management in Korea: A Medical Malpractice Liability Insurance Database Study

    PubMed Central

    Moon, Hyun Seog

    2015-01-01

    Background Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur. PMID:26495080

  20. [Nursing intervention in a child diagnosed with ineffective airway clearance: a case report].

    PubMed

    Pereira-de-Melo, Renata; Arrais-Sampaio, Francisca Aline; de Oliveira-Lopes, Marcos Venícios

    2009-01-01

    The nursing diagnosis of inefficient airway clearance is prevalent in children. The present report describes the airway management intervention carried out over 5 consecutive days in a child admitted to a pediatric unit, using an instrument based on the indicators of respiratory rate, respiratory ease, respiratory rhythm, and adventitious breath sounds, included in the nursing outcome of "respiratory status: airway patency" of the Nursing Outcomes Classification. Monitoring was started after informed consent was obtained. The anonymity and confidentiality of the data were guaranteed. The monitoring started with a baseline evaluation of the child, followed by implementation of each activity in a pre-established order. On the following days, the nursing interventions implemented were evaluated once a day in the morning by the researcher. After implementing the selected activities, an improvement of 75% in health status was observed, generating an ascendant tendency line. The difference in means per follow-up day showed variations of 0.25 and 0.5. The final health status mean, i.e. the mean difference between the value of the last follow-up day and the initial status, showed a variation of 0.25. In conclusion, the intervention was satisfactory and hastened recovery, reduced length of hospital stay and the associated economic costs, and was painless and easy to perform. PMID:19467893

  1. Interventions for the treatment, management and rehabilitation of patients with chronic fatigue syndrome/myalgic encephalomyelitis: an updated systematic review

    PubMed Central

    Chambers, Duncan; Bagnall, Anne-Marie; Hempel, Susanne; Forbes, Carol

    2006-01-01

    Objectives To determine whether any particular intervention or combination of interventions is effective in the treatment, management and rehabilitation of adults and children with a diagnosis of chronic fatigue syndrome / myalgic encephalomyelitis (CFS/ME). Design Substantive update of a systematic review published in 2002. Randomized (RCTs) and non-randomized controlled trials of any intervention or combination of interventions were eligible for inclusion. Study participants could be adults or children with a diagnosis of CFS/ME based on any criteria. We searched eleven electronic databases, reference lists of articles and reviews, and textbooks on CFS/ME. Additional references were sought by contact with experts. Results Seventy studies met the inclusion criteria. Studies on behavioural, immunological, pharmacological and complementary therapies, nutritional supplements and miscellaneous other interventions were identified. Graded exercise therapy and cognitive behaviour therapy appeared to reduce symptoms and improve function based on evidence from RCTs. For most other interventions, evidence of effectiveness was inconclusive and some interventions were associated with significant adverse effects. Conclusions Over the last five years, there has been a marked increase in the size and quality of the evidence base on interventions for CFS/ME. Some behavioural interventions have shown promising results in reducing the symptoms of CFS/ME and improving physical functioning. There is a need for research to define the characteristics of patients who would benefit from specific interventions and to develop clinically relevant objective outcome measures. PMID:17021301

  2. Effects of resource-building group intervention on career management and mental health in work organizations: randomized controlled field trial.

    PubMed

    Vuori, Jukka; Toppinen-Tanner, Salla; Mutanen, Pertti

    2012-03-01

    A resource-building group intervention was developed to enhance career management, mental health, and job retention in work organizations. The in-company training program provided employees with better preparedness to manage their own careers. The program activities were universally implemented using an organization-level, 2-trainer model with trainers from the human resources management and occupational health services. The study was a within-organizations, randomly assigned field experimental study; it investigated the impacts of the intervention on immediate career management preparedness and later mental health and intentions to retire early. A total of 718 eligible individuals returned a questionnaire in 17 organizations and became voluntary participants. The respondents were randomly assigned to either an intervention (N = 369) or a comparison group (N = 349). Those in the intervention group were invited to group intervention workshops, whereas those in the comparison group received printed information about career and health-related issues. The 7-month follow-up results showed that the program significantly decreased depressive symptoms and intentions to retire early and increased mental resources among the group participants compared to the others. The mediation analyses demonstrated that the increase in career management preparedness as a proximal impact of the intervention mediated the longer term mental health effects. Those who benefited most from the intervention as regards their mental health were employees with elevated levels of depression or exhaustion and younger employees, implying additional benefits of a more targeted use of the intervention. The results demonstrated the benefits of the enhancement of individual-level career management and resilience resources as career and health promotion practice in work organizations. PMID:21942405

  3. A framework for good practice in interagency interventions with cases of self-neglect.

    PubMed

    Lauder, W; Anderson, I; Barclay, A

    2005-04-01

    Self-neglect is probably more common than has generally been thought and gives rise to a number of difficult conceptual, identification and intervention problems for health and social care workers. These patient management issues are compounded by the lack of any evidence-base for practice which nurses can draw on when faced with managing people who self-neglect. Nurses working with self-neglecters operate in an interdisciplinary context which includes professional groups, such as environmental health officers, who do not normally figure within health and social care teams. In the absence of such an evidence-base, a pragmatic solution in the form of a framework for interagency practice has been proposed. The background underpinning this framework, including a research study of housing in self-neglect and interagency responses, is briefly outlined in this paper. PMID:15788037

  4. The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016 Statement.

    PubMed

    Tate, Robyn L; Perdices, Michael; Rosenkoetter, Ulrike; Shadish, William; Vohra, Sunita; Barlow, David H; Horner, Robert; Kazdin, Alan; Kratochwill, Thomas; McDonald, Skye; Sampson, Margaret; Shamseer, Larissa; Togher, Leanne; Albin, Richard; Backman, Catherine; Douglas, Jacinta; Evans, Jonathan J; Gast, David; Manolov, Rumen; Mitchell, Geoffrey; Nickels, Lyndsey; Nikles, Jane; Ownsworth, Tamara; Rose, Miranda; Schmid, Christopher H; Wilson, Barbara

    2016-01-01

    Reporting guidelines, such as the Consolidated Standards of Reporting Trials (CONSORT) Statement, improve the reporting of research in the medical literature (Turner et al., 2012). Many such guidelines exist, and the CONSORT Extension to Nonpharmacological Trials (Boutron et al., 2008) provides suitable guidance for reporting between-groups intervention studies in the behavioral sciences. The CONSORT Extension for N-of-1 Trials (CENT 2015) was developed for multiple crossover trials with single individuals in the medical sciences (Shamseer et al., 2015; Vohra et al., 2015), but there is no reporting guideline in the CONSORT tradition for single-case research used in the behavioral sciences. We developed the Single-Case Reporting guideline In Behavioral interventions (SCRIBE) 2016 to meet this need. This Statement article describes the methodology of the development of the SCRIBE 2016, along with the outcome of 2 Delphi surveys and a consensus meeting of experts. We present the resulting 26-item SCRIBE 2016 checklist. The article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016) that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. PMID:27294998

  5. Sankofa pediatric HIV disclosure intervention cyber data management: building capacity in a resource-limited setting and ensuring data quality

    PubMed Central

    Catlin, Ann Christine; Fernando, Sumudinie; Gamage, Ruwan; Renner, Lorna; Antwi, Sampson; Tettey, Jonas Kusah; Amisah, Kofi Aikins; Kyriakides, Tassos; Cong, Xiangyu; Reynolds, Nancy R.; Paintsil, Elijah

    2015-01-01

    Prevalence of pediatric HIV disclosure is low in resource-limited settings. Innovative, culturally sensitive, and patient-centered disclosure approaches are needed. Conducting such studies in resource-limited settings is not trivial considering the challenges of capturing, cleaning, and storing clinical research data. To overcome some of these challenges, the Sankofa pediatric disclosure intervention adopted an interactive cyber infrastructure for data capture and analysis. The Sankofa Project database system is built on the HUBzero cyber infrastructure (https://hubzero.org), an open source software platform. The hub database components support: (1) data management – the “databases” component creates, configures, and manages database access, backup, repositories, applications, and access control; (2) data collection – the “forms” component is used to build customized web case report forms that incorporate common data elements and include tailored form submit processing to handle error checking, data validation, and data linkage as the data are stored to the database; and (3) data exploration – the “dataviewer” component provides powerful methods for users to view, search, sort, navigate, explore, map, graph, visualize, aggregate, drill-down, compute, and export data from the database. The Sankofa cyber data management tool supports a user-friendly, secure, and systematic collection of all data. We have screened more than 400 child–caregiver dyads and enrolled nearly 300 dyads, with tens of thousands of data elements. The dataviews have successfully supported all data exploration and analysis needs of the Sankofa Project. Moreover, the ability of the sites to query and view data summaries has proven to be an incentive for collecting complete and accurate data. The data system has all the desirable attributes of an electronic data capture tool. It also provides an added advantage of building data management capacity in resource-limited settings

  6. Sankofa pediatric HIV disclosure intervention cyber data management: building capacity in a resource-limited setting and ensuring data quality.

    PubMed

    Catlin, Ann Christine; Fernando, Sumudinie; Gamage, Ruwan; Renner, Lorna; Antwi, Sampson; Tettey, Jonas Kusah; Amisah, Kofi Aikins; Kyriakides, Tassos; Cong, Xiangyu; Reynolds, Nancy R; Paintsil, Elijah

    2015-01-01

    Prevalence of pediatric HIV disclosure is low in resource-limited settings. Innovative, culturally sensitive, and patient-centered disclosure approaches are needed. Conducting such studies in resource-limited settings is not trivial considering the challenges of capturing, cleaning, and storing clinical research data. To overcome some of these challenges, the Sankofa pediatric disclosure intervention adopted an interactive cyber infrastructure for data capture and analysis. The Sankofa Project database system is built on the HUBzero cyber infrastructure ( https://hubzero.org ), an open source software platform. The hub database components support: (1) data management - the "databases" component creates, configures, and manages database access, backup, repositories, applications, and access control; (2) data collection - the "forms" component is used to build customized web case report forms that incorporate common data elements and include tailored form submit processing to handle error checking, data validation, and data linkage as the data are stored to the database; and (3) data exploration - the "dataviewer" component provides powerful methods for users to view, search, sort, navigate, explore, map, graph, visualize, aggregate, drill-down, compute, and export data from the database. The Sankofa cyber data management tool supports a user-friendly, secure, and systematic collection of all data. We have screened more than 400 child-caregiver dyads and enrolled nearly 300 dyads, with tens of thousands of data elements. The dataviews have successfully supported all data exploration and analysis needs of the Sankofa Project. Moreover, the ability of the sites to query and view data summaries has proven to be an incentive for collecting complete and accurate data. The data system has all the desirable attributes of an electronic data capture tool. It also provides an added advantage of building data management capacity in resource-limited settings due to its

  7. Using student-managed interventions to increase homework completion and accuracy

    PubMed Central

    Olympia, Daniel E.; Sheridan, Susan M.; Jenson, William R.; Andrews, Debra

    1994-01-01

    We examined the effectiveness of self-managed individual and group contingency procedures in improving the completion and accuracy rates of daily mathematics homework assignments. A group of sixth-grade students having homework difficulties in mathematics were selected for the study. There was substantial improvement in the amount of homework completed over baseline for a majority of the students, whereas the results for accuracy were mixed. Students who participated in the self-management training made significant gains on standardized measures of academic achievement and curriculum-based measures of classroom performance. Parents also reported significantly fewer problems associated with homework completion following the intervention. Students who were allowed to select their own performance goals made superior improvements in the number of homework assignments returned compared to students who were given a specified goal by the classroom teacher. Parents, subjects, and the classroom teacher responded positively on consumer satisfaction measures following termination of the study. PMID:16795827

  8. Walking a tightrope: case management services and outpatient commitment.

    PubMed

    Sullivan, W Patrick; Carpenter, Jenneth; Floyd, Destinee F

    2014-01-01

    Effective case managers in community mental health are successful at forging a working alliance with recipients. This article explores one key aspect of case management practice, serving involuntary clients, specifically those on outpatient commitment orders. In 19 intensive interviews, a subset of a larger study, case managers shared their perceptions of the utility of outpatient commitment with a focus on how such orders impacted the professional relationship. We argue that the use of advance psychiatric directives and shared decision-making processes can reduce the need for coercive practice. PMID:25222837

  9. Embracing case management for computerization of care pathways.

    PubMed

    Mei, Jing; Li, Jing; Yu, Yiqin; Li, Xiang; Liu, Haifeng; Xie, Guotong

    2014-01-01

    The computerization of care pathways (CPs) has drawn considerable attention, for improving quality of health care and reducing costs. A well-known big challenge of implementing CPs is their flexibility and ad hoc variations in execution of clinical tasks. We observe that case management suits well to address this problem, and this paper proposes a CMMN-based CP model, where CMMN (Case Management Model and Notation) is becoming an industry standard. Via an experimental experience on modelling CHF (congestive heart failure) ambulatory CP, we illustrate that the usage of case management paves the way to popularize CPs, particularly for its quick deployment and execution in industrial products. PMID:25160134

  10. Media Management Education and the Case Method.

    ERIC Educational Resources Information Center

    Hoag, Anne; Brickley, Dale J.; Cawley, Joanne M.

    2001-01-01

    Traces the development and pedagogical theory of the case study method. Offers an overview of current discourse on its effectiveness. Presents results from a quasi-experiment. Finds that students exposed to the case method improved their problem solving skills measurably and significantly over a 15-week semester, outperforming the control group…

  11. Parent and Teacher Perceptions of the Impact of School Nurse Interventions on Children's Self-Management of Diabetes

    ERIC Educational Resources Information Center

    Peery, Annette I.; Engelke, Martha Keehner; Swanson, Melvin S.

    2012-01-01

    Diabetes is a common chronic illness among school-age children. The school nurse collaborates with the student, parents, and teachers to help the child manage their diabetes effectively. Very little is known about the relationship between school nurse interventions and parent/teacher perceptions of the child's self-management. We examined this…

  12. The Role of Teacher Behavior Management in the Development of Disruptive Behaviors: An Intervention Study with the Good Behavior Game

    ERIC Educational Resources Information Center

    Leflot, Geertje; van Lier, Pol A. C.; Onghena, Patrick; Colpin, Hilde

    2010-01-01

    The role of teacher behavior management for children's disruptive behavior development (hyperactive and oppositional behavior) was investigated using a universal classroom preventive intervention study. Five-hundred seventy children were followed from second to third grade of elementary school. Observations of teacher behavior management and…

  13. mHealth self-care interventions: managing symptoms following breast cancer treatment

    PubMed Central

    Fu, Mei R.; Axelrod, Deborah; Guth, Amber A.; Rampertaap, Kavita; El-Shammaa, Nardin; Hiotis, Karen; Scagliola, Joan; Yu, Gary; Wang, Yao

    2016-01-01

    Background Many women suffer from daily distressing symptoms related to lymphedema following breast cancer treatment. Lymphedema, an abnormal accumulation of lymph fluid in the ipsilateral body area or upper limb, remains an ongoing major health problem affecting more than 40% of 3.1 million breast cancer survivors in the United States. Patient-centered care related to lymphedema symptom management is often inadequately addressed in clinical research and practice. mHealth plays a significant role in improving self-care, patient-clinician communication, and access to health information. The-Optimal-Lymph-Flow health IT system (TOLF) is a patient-centered, web-and-mobile-based educational and behavioral mHealth interventions focusing on safe, innovative, and pragmatic electronic assessment and self-care strategies for lymphedema symptom management. The purpose of this paper is to describe the development and test of TOLF system. Methods The development of TOLF was guided by the Model of Self-Care for Lymphedema Symptom Management and designed based on principles fostering accessibility, convenience, and efficiency of mHealth system to enhance training and motivating assessment of and self-care for lymphedema symptoms. Test of TOLF was accomplished by conducting a psychometric study to evaluate reliability, validity, and efficiency of the electronic version of Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI), a usability testing and a pilot feasibility testing of mHealth self-care interventions. Results Findings from the psychometric study with 355 breast cancer survivors demonstrated high internal consistency of the electronic version of the instrument: a Cronbach’s alpha coefficient of 0.959 for the total scale, 0.919 for symptom occurrence, and 0.946 for symptom distress. Discriminant validity of the instrument was supported by a significant difference in symptom occurrence (z=−6.938, P<0.000), symptom distress (z=−5.894, P<0.000), and total

  14. Findings from a pilot Randomised trial of an Asthma Internet Self-management Intervention (RAISIN)

    PubMed Central

    Morrison, D; Wyke, S; Saunderson, K; McConnachie, A; Agur, K; Chaudhuri, R; Thomas, M; Thomson, N C; Yardley, L; Mair, F S

    2016-01-01

    Objective To evaluate the feasibility of a phase 3 randomised controlled trial (RCT) of a website (Living Well with Asthma) to support self-management. Design and setting Phase 2, parallel group, RCT, participants recruited from 20 general practices across Glasgow, UK. Randomisation through automated voice response, after baseline data collection, to website access for minimum 12 weeks or usual care. Participants Adults (age≥16 years) with physician diagnosed, symptomatic asthma (Asthma Control Questionnaire (ACQ) score ≥1). People with unstable asthma or other lung disease were excluded. Intervention ‘Living Well with Asthma’ is a desktop/laptop compatible interactive website designed with input from asthma/ behaviour change specialists, and adults with asthma. It aims to support optimal medication management, promote use of action plans, encourage attendance at asthma reviews and increase physical activity. Outcome measures Primary outcomes were recruitment/retention, website use, ACQ and mini-Asthma Quality of Life Questionnaire (AQLQ). Secondary outcomes included patient activation, prescribing, adherence, spirometry, lung inflammation and health service contacts after 12 weeks. Blinding postrandomisation was not possible. Results Recruitment target met. 51 participants randomised (25 intervention group). Age range 16–78 years; 75% female; 28% from most deprived quintile. 45/51 (88%; 20 intervention group) followed up. 19 (76% of the intervention group) used the website, for a mean of 18 min (range 0–49). 17 went beyond the 2 ‘core’ modules. Median number of logins was 1 (IQR 1–2, range 0–7). No significant difference in the prespecified primary efficacy measures of ACQ scores (−0.36; 95% CI −0.96 to 0.23; p=0.225), and mini-AQLQ scores (0.38; −0.13 to 0.89; p=0.136). No adverse events. Conclusions Recruitment and retention confirmed feasibility; trends to improved outcomes suggest use of Living Well with Asthma may improve

  15. Utility of Percutaneous Intervention in the Management of Tunneled Hemodialysis Catheters

    SciTech Connect

    Angle, John F.; Shilling, Alfred T.; Schenk, Worthington G.; Bissonette, Eric A.; Stadtlander, Kevin S.; Hagspiel, Klaus D.; Spinosa, David J.; Leung, Daniel A.; Matsumoto, Alan H.

    2003-02-15

    A variety of interventional techniques have been developed to restore function to dysfunctional tunneled hemodialysis catheters (THC). The relative efficacies of these techniques were evaluated retrospectively to determine which therapy might be most beneficial. The records of malfunctioning THCs referred to interventional radiology between November 1995 and December 1999 were retrospectively reviewed. Dysfunctional THCs were studied using DSA images obtained while injecting contrast through the lumens of the THCs. The interventions performed were categorized into 1 of 5 groups:no treatment or conservative measures such as vigorous flushing;advancing a guidewire through the THC to reposition the catheter tip or to dislodge a small thrombus; catheter exchange over a guidewire; fibrin stripping of the THC using a loop snare; or prolonged (4 or more hr) direct thrombolytic infusion. A Cox Proportional Hazards model was developed to compare the rate of failure among the procedures. There were 340 THC studies. The catheters were managed as follows: 93 patients received conservative management only, 15 had a guidewire advanced through the catheter, 147 underwent catheter exchange, 62 were treated with a fibrin stripping procedure, and 23 received athrombolytic infusion. Estimated 30-day patency rates for THCs were 38.2% for conservative management, 30.9% for guidewire manipulation of catheter tip, 53.6% for catheter exchange, 76.1% for fibrin stripping, and 69.8% for thrombolytic infusion. Differences among the treatments were observed (p < 0.01) and pairwise comparisons were made among the treatment groups. Failure rates were significantly higher in the catheter exchange(p <0.01) and guidewire manipulation at catheter tip (p <0.01) groups when compared with the fibrin stripping group. The catheter exchange and guidewire manipulation groups also experienced higher rates of failure when compared with the thrombolytic infusion group, although the differences were not

  16. Active Tuberculosis Case Finding Interventions Among Immigrants, Refugees and Asylum Seekers in Italy

    PubMed Central

    Schepisi, Monica Sañé; Gualano, Gina; Piselli, Pierluca; Mazza, Marta; D’Angelo, Donatella; Fasciani, Francesca; Barbieri, Alberto; Rocca, Giorgia; Gnolfo, Filippo; Olivani, Piefranco; Ferrarese, Maurizio; Codecasa, Luigi Ruffo; Palmieri, Fabrizio; Girardi, Enrico

    2016-01-01

    In Italy tuberculosis (TB) is largely concentrated in vulnerable groups such as migrants and in urban settings. We analyzed three TB case finding interventions conducted at primary centers and mobile clinics for regular/irregular immigrants and refugees/asylum seekers performed over a four-year period (November 2009-March 2014) at five different sites in Rome and one site in Milan, Italy. TB history and presence of symptoms suggestive of active TB were investigated by verbal screening through a structured questionnaire in migrants presenting for any medical condition to out-patient and mobile clinics. Individuals reporting TB history or symptoms were referred to a TB clinic for diagnostic workup. Among 6347 migrants enrolled, 891 (14.0%) reported TB history or symptoms suggestive of active TB and 546 (61.3%) were referred to the TB clinic. Of them, 254 (46.5%) did not present for diagnostic evaluation. TB was diagnosed in 11 individuals representing 0.17% of those screened and 3.76% of those evaluated. The overall yield of this intervention was in the range reported for other TB screening programs for migrants, although we recorded an unsatisfactory adherence to diagnostic workup. Possible advantages of this intervention include low cost and reduced burden of medical procedures for the screened population. PMID:27403270

  17. Adjustment Disorders Are Uniquely Suited for eHealth Interventions: Concept and Case Study

    PubMed Central

    Bachem, Rahel C; Lorenz, Louisa; Moser, Christian T; Berger, Thomas

    2015-01-01

    Background Adjustment disorders (also known as mental distress in response to a stressor) are among the most frequently diagnosed mental disorders in psychiatry and clinical psychology worldwide. They are also commonly diagnosed in clients engaging in deliberate self-harm and in those consulting general practitioners. However, their reputation in research-oriented mental health remains weak since they are largely underresearched. This may change when the International Statistical Classification of Diseases-11 (ICD-11) by the World Health Organization is introduced, including a new conceptualization of adjustment disorders as a stress-response disorder with positively defined core symptoms. Objective This paper provides an overview of evidence-based interventions for adjustment disorders. Methods We reviewed the new ICD-11 concept of adjustment disorder and discuss the the rationale and case study of an unguided self-help protocol for burglary victims with adjustment disorder, and its possible implementation as an eHealth intervention. Results Overall, the treatment with the self-help manual reduced symptoms of adjustment disorder, namely preoccupation and failure to adapt, as well as symptoms of depression, anxiety, and stress. Conclusions E-mental health options are considered uniquely suited for offering early intervention after the experiences of stressful life events that potentially trigger adjustment disorders. PMID:26543920

  18. Managing Parenting Stress through Life Skills Training: A Supportive Intervention for Mothers with Visually Impaired Children

    PubMed Central

    Khooshab, Elham; Jahanbin, Iran; Ghadakpour, Soraya; Keshavarzi, Sareh

    2016-01-01

    Background: Vision impairment in children is one of the most severe disabilities that cause stress in parents. Therefore, it seems necessary to establish and conduct interventions for controlling parenting stress and preventing its negative consequences. This study aimed to investigate the effect of life skills training (LST) program on parenting stress of mothers with blind children aged 7 to 12 years. Methods: This study was a non-blinded randomized controlled trial. 52 mothers with blind children studying at Shoorideh Shirazi educational complex, Shiraz, Iran in 2013 were enrolled, using census sampling method. Balanced block randomization method was used to allocate the participants to groups. The intervention group participated in an LST program consisting of 5 two-hour sessions per week for 5 consecutive weeks but the control group didn’t. Data were collected using a demographic questionnaire and Parenting Stress Index; they were completed three times by the participants of both groups before, immediately after, and one month after the intervention. Collected data were analyzed using Chi-square, independent t-test and repeated measures analysis of variances (ANOVA). Results: The LST program could decrease parenting stress in the intervention group mothers (P<0/001). This statistically significant reduction in the mean scores of parenting stress was observed in both children and parents. Conclusion: LST program could reduce parenting stress in mothers with blind children. Therefore, it can be used as an efficient, cost-effective and simple technique for managing parenting stress in such parents. Trial Registration Number: IRCT201405147531N6 PMID:27382593

  19. Intervention mapping protocol for developing a theory-based diabetes self-management education program.

    PubMed

    Song, Misoon; Choi, Suyoung; Kim, Se-An; Seo, Kyoungsan; Lee, Soo Jin

    2015-01-01

    Development of behavior theory-based health promotion programs is encouraged with the paradigm shift from contents to behavior outcomes. This article describes the development process of the diabetes self-management program for older Koreans (DSME-OK) using intervention mapping (IM) protocol. The IM protocol includes needs assessment, defining goals and objectives, identifying theory and determinants, developing a matrix to form change objectives, selecting strategies and methods, structuring the program, and planning for evaluation and pilot testing. The DSME-OK adopted seven behavior objectives developed by the American Association of Diabetes Educators as behavioral outcomes. The program applied an information-motivation-behavioral skills model, and interventions were targeted to 3 determinants to change health behaviors. Specific methods were selected to achieve each objective guided by IM protocol. As the final step, program evaluation was planned including a pilot test. The DSME-OK was structured as the 3 determinants of the IMB model were intervened to achieve behavior objectives in each session. The program has 12 weekly 90-min sessions tailored for older adults. Using the IM protocol in developing a theory-based self-management program was beneficial in terms of providing a systematic guide to developing theory-based and behavior outcome-focused health education programs. PMID:26062288

  20. A simulation-based intervention teaching seizure management to caregivers: A randomized controlled pilot study

    PubMed Central

    Sigalet, Elaine; Cheng, Adam; Donnon, Tyrone; Koot, Deanna; Chatfield, Jennifer; Robinson, Traci; Catena, Helen; Grant, Vincent J

    2014-01-01

    OBJECTIVES: To examine the effect of simulation-based seizure management teaching on improving caregiver competence and reported confidence with managing seizures. The authors hypothesized that simulation-based education would lead to a higher level of demonstrated competence and reported confidence in family members and caregivers. Simulation has not been previously studied in this context. METHODS: A two-group pre- and post-test experimental research design involving a total of 61 caregivers was used. The intervention was a simulation-based seizure curriculum delivered as a supplement to traditional seizure discharge teaching. Caregiver performance was analyzed using a seizure management checklist. Caregivers’ perception of self-efficacy was captured using a self-efficacy questionnaire. RESULTS: Caregivers in the experimental group achieved significantly higher postintervention performance scores than caregivers in the control group in both premedication and postmedication seizure management (P<0.01). Additionally, they achieved significantly higher scores on the self-efficacy questionnaire including items reflecting confidence managing the seizure at home (P<0.05). CONCLUSION: Caregivers receiving the supplemental simulation-based curriculum achieved significantly higher levels of competence and reported confidence, supporting a positive relationship between simulation-based seizure discharge education, and caregiver competence and confidence in managing seizures. Simulation sessions provided insight into caregiver knowledge but, more importantly, insight into the caregiver’s ability to apply knowledge under stressful conditions, allowing tailoring of curriculum to meet individual needs. These findings may have applications and relevance for management of other acute or chronic medical conditions. PMID:25332677

  1. Is your staffing ratio appropriate for your case management model?

    PubMed

    2015-03-01

    Case managers may be working longer hours and have more responsibilities to help their hospital comply with health care reform initiatives, but before rushing to the C-suite to ask for more staff, case management directors should take a hard look at the roles and responsibilities of the department, experts say. They recommend: Look at your staffing ratio and determine if it is appropriate for your case management model and if it is in line with staffing ratios at similar hospitals with similar models. Make a list of all the tasks that case managers are asked to do and break out those that don't affect outcomes or cost of care and those that don't require licensure. Get these assigned to other employees. Before you approach management to ask for more staff, do your homework and have hard data to back up your request. Consider hiring case management extenders to take over clerical tasks and free up case managers to work at the top of their licenses. PMID:25730955

  2. A Pilot Study of Self-Management-based Nutrition and Physical Activity Intervention in Cancer Survivors.

    PubMed

    Miller, Michelle; Zrim, Stephanie; Lawn, Sharon; Woodman, Richard; Leggett, Stephanie; Jones, Lynnette; Karapetis, Christos; Kichenadasse, Ganessan; Sukumaran, Shawgi; Roy, Amitesh C; Koczwara, Bogda

    2016-07-01

    Exercise and a healthy diet are beneficial after cancer, but are not uniformly adopted by cancer survivors. This study reports on the feasibility, acceptability, and effectiveness of a self-management-based nutrition and exercise intervention for Australian cancer survivors. Adult survivors (n  =  25) during curative chemotherapy (stratum 1[S1]; n  =  11) or post-treatment (stratum 2 [S2]; n  =  14) were recruited prospectively from a single center. The Flinders Living Well Self-Management Program™ (FLW Program) was utilized to establish patient-led nutrition and exercise goals and develop a tailored 12-wk intervention plan. Fortnightly reviews occurred with assessments at baseline, 6 and 12 wk. A recruitment and retention rate of 38% and 84% were observed. Both strata maintained total skeletal muscle mass. Small reductions in body mass index, hip circumference, and percentage body fat, and small increases in hand grip strength and exercise capacity among subjects in both strata were observed. No significant differences were observed between strata; however, significant increases in exercise capacity and global health status for S2 were observed from baseline to 12 wk. FLW Program is a feasible mode of delivering nutrition and exercise intervention to cancer survivors and it appears that there are no barriers to implementing this program early during chemotherapy. Hence, the additive effect of gains achieved over a longer duration is promising and this should be explored in randomized controlled trials adequately powered to observe clinically and statistically significant improvements in relevant outcomes. PMID:27176450

  3. A clinic-based pilot intervention to enhance diabetes management for elderly Hispanic patients

    PubMed Central

    Nguyen, Annie L.; Angulo, Marco; Haghi, Linda L.; Cruz, Maya; Nikroo, Nahal; Peraza, Sarah; Bennink, Justin; Duru, O. Kenrik; Moore, Alison A.; Mosqueda, Laura A.

    2016-01-01

    Background and objectives: Successful diabetes self-management requires behavioral and lifestyle changes. However, low-income patients may face challenges related to poverty that make it difficult to engage in lifestyle changes. We piloted an intervention designed to help older, low-income, Hispanic, patients with diabetes access free or low-cost community resources to enhance diabetes self-management. Results from this pilot intervention are reported. Design and Methods: Patients were recruited at baseline to complete surveys assessing diabetes self-care activities, diabetes self-efficacy, and general self-efficacy. Volunteers were trained by a clinic social worker to help patients identify needs and make referrals to local community resources (e.g., housing, transportation, food, clothing, dental and prescription services, employment, or family social services). Identical surveys were administered at 3-month follow-up. Results: 28 patients were recruited at baseline and 18 patients completed the follow-up assessment. No significant changes in diabetes care and self-efficacy were detected. All patients requested at least one referral to a community resource. The most common requests were for low-cost dental clinics, food assistance, and housing support. At follow-up, nine (50%) patients contacted their given referrals. Conclusions: The need for assistance with basic social services is high in this population. The rate of referral uptake (50%) is high for a relatively low intensity intervention. Since the completion of the pilot, the program has trained 21 volunteers and helped over 220 patients in a primary care clinic. Using a volunteer model and creating connections to existing community resources is a cost-conscious way to deliver needed services to patients. PMID:27110482

  4. A Case Study of a Failed Organization Development Intervention Rooted in the Employee Survey Process.

    ERIC Educational Resources Information Center

    Swanson, Richard A.; Zuber, John A.

    1996-01-01

    Presents results of a case study that illustrates problems of employee surveys as part of the organization development process and makes recommendations to practitioners for effectively managing a sound approach to performance improvement. Provides a look at an inexperienced consultant and the distractions that resulted in a failed organization…

  5. In Search of the Elusive "Hobbit": A Family Intervention Case with a Psychoeducational Focus.

    ERIC Educational Resources Information Center

    Erchul, William P.; Scott, Susan Smith

    This case study concerns an attempt to help a 15-year-old with the completion of written assignments and the development of time management and study skills. The document first presents the problem of the girl, Lisa, who could not complete longer written assignments due to an obsessive-compulsive anxiety disorder. The relevant history to the case…

  6. Effectiveness of multidisciplinary team case management: difference-in-differences analysis

    PubMed Central

    Kristensen, Søren Rud; Checkland, Kath; Bower, Peter

    2016-01-01

    Objectives To evaluate a multidisciplinary team (MDT) case management intervention, at the individual (direct effects of intervention) and practice levels (potential spillover effects). Design Difference-in-differences design with multiple intervention start dates, analysing hospital admissions data. In secondary analyses, we stratified individual-level results by risk score. Setting Single clinical commissioning group (CCG) in the UK's National Health Service (NHS). Participants At the individual level, we matched 2049 intervention patients using propensity scoring one-to-one with control patients. At the practice level, 30 practices were compared using a natural experiment through staged implementation. Intervention Practice Integrated Care Teams (PICTs), using MDT case management of high-risk patients together with a summary record of care versus usual care. Direct and indirect outcome measures Primary measures of intervention effects were accident and emergency (A&E) visits; inpatient non-elective stays, 30-day re-admissions; inpatient elective stays; outpatient visits; and admissions for ambulatory care sensitive conditions. Secondary measures included inpatient length of stay; total cost of secondary care services; and patient satisfaction (at the practice level only). Results At the individual level, we found slight, clinically trivial increases in inpatient non-elective admissions (+0.01 admissions per patient per month; 95% CI 0.00 to 0.01. Effect size (ES): 0.02) and 30-day re-admissions (+0.00; 0.00 to 0.01. ES: 0.03). We found no indication that highest risk patients benefitted more from the intervention. At the practice level, we found a small decrease in inpatient non-elective admissions (−0.63 admissions per 1000 patients per month; −1.17 to −0.09. ES: −0.24). However, this result did not withstand a robustness check; the estimate may have absorbed some differences in underlying practice trends. Conclusions The intervention does not meet its

  7. Human Error in Throat Pack Management: Report of Two Cases.

    PubMed

    Baranger, Violaine; Bon Mardion, Nicolas; Dureuil, Bertrand; Compère, Vincent

    2016-06-15

    Throat packs are frequently used after tracheal intubation during ear, nose, and throat surgery. We report 2 cases of complications related to throat packs retained at the end of surgery. Miscommunication between anesthesiology and surgery teams on throat pack management led to an upper gastrointestinal endoscopy examination under general anesthesia in the first case and to severe respiratory distress requiring tracheal reintubation in the second case. Our 2 case reports highlight the importance of good communication between anesthesiology and surgery teams and of standardized procedures and checklists for the management of throat packs to ensure patient safety. PMID:27301056

  8. Society of Vascular and Interventional Neurology (SVIN) Stroke Interventional Laboratory Consensus (SILC) Criteria: A 7M Management Approach to Developing a Stroke Interventional Laboratory in the Era of Stroke Thrombectomy for Large Vessel Occlusions

    PubMed Central

    Shams, Tanzila; Zaidat, Osama; Yavagal, Dileep; Xavier, Andrew; Jovin, Tudor; Janardhan, Vallabh

    2016-01-01

    Brain attack care is rapidly evolving with cutting-edge stroke interventions similar to the growth of heart attack care with cardiac interventions in the last two decades. As the field of stroke intervention is growing exponentially globally, there is clearly an unmet need to standardize stroke interventional laboratories for safe, effective, and timely stroke care. Towards this goal, the Society of Vascular and Interventional Neurology (SVIN) Writing Committee has developed the Stroke Interventional Laboratory Consensus (SILC) criteria using a 7M management approach for the development and standardization of each stroke interventional laboratory within stroke centers. The SILC criteria include: (1) manpower: personnel including roles of medical and administrative directors, attending physicians, fellows, physician extenders, and all the key stakeholders in the stroke chain of survival; (2) machines: resources needed in terms of physical facilities, and angiography equipment; (3) materials: medical device inventory, medications, and angiography supplies; (4) methods: standardized protocols for stroke workflow optimization; (5) metrics (volume): existing credentialing criteria for facilities and stroke interventionalists; (6) metrics (quality): benchmarks for quality assurance; (7) metrics (safety): radiation and procedural safety practices. PMID:27610118

  9. Society of Vascular and Interventional Neurology (SVIN) Stroke Interventional Laboratory Consensus (SILC) Criteria: A 7M Management Approach to Developing a Stroke Interventional Laboratory in the Era of Stroke Thrombectomy for Large Vessel Occlusions.

    PubMed

    Shams, Tanzila; Zaidat, Osama; Yavagal, Dileep; Xavier, Andrew; Jovin, Tudor; Janardhan, Vallabh

    2016-06-01

    Brain attack care is rapidly evolving with cutting-edge stroke interventions similar to the growth of heart attack care with cardiac interventions in the last two decades. As the field of stroke intervention is growing exponentially globally, there is clearly an unmet need to standardize stroke interventional laboratories for safe, effective, and timely stroke care. Towards this goal, the Society of Vascular and Interventional Neurology (SVIN) Writing Committee has developed the Stroke Interventional Laboratory Consensus (SILC) criteria using a 7M management approach for the development and standardization of each stroke interventional laboratory within stroke centers. The SILC criteria include: (1) manpower: personnel including roles of medical and administrative directors, attending physicians, fellows, physician extenders, and all the key stakeholders in the stroke chain of survival; (2) machines: resources needed in terms of physical facilities, and angiography equipment; (3) materials: medical device inventory, medications, and angiography supplies; (4) methods: standardized protocols for stroke workflow optimization; (5) metrics (volume): existing credentialing criteria for facilities and stroke interventionalists; (6) metrics (quality): benchmarks for quality assurance; (7) metrics (safety): radiation and procedural safety practices. PMID:27610118

  10. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program. PMID:9335724

  11. Case III: Managing Conflict--The Case of the Faculty Stuck in the Middle.

    ERIC Educational Resources Information Center

    Trombly, Robert M.; Comer, Robert W.; Villamil, Juanita E.

    2002-01-01

    Explores techniques of conflict management as well as the positive and negative factors that may exert progressive or detrimental influences. Presents a case scenario, drawn from a faculty development workshop, involving a dental school faculty member, and highlights central issues of the case and relevant management concepts. (EV)

  12. ED case managers save $4.5 million.

    PubMed

    2011-08-01

    Emergency department case managers at Lee Memorial Health System in Fort Myers, FL saved more than $4.5 million by ensuring that patients were in the right status and transferring patients who did not meet admission criteria to a more appropriate level of care. Case managers and social workers cover the emergency department at peak hours, seven days a week. Case managers screen patients for admission criteria and make sure admission orders are complete and correct. Case managers and social workers coordinate community services and placement for patients who don't meet admission criteria. Social workers intervene when there are concerns about abuse and neglect, and they facilitate placement to other acute care facilities. PMID:21789904

  13. Nurse's Breakout Session Injury/Illness Case Management

    NASA Technical Reports Server (NTRS)

    Hesselgesser, Connie

    2001-01-01

    An overview of the work related injury and illness case management model developed at the Johnson Space Center was presented. The major accomplishments and the challenges of implementation were discussed.

  14. The employer's case for health management.

    PubMed

    Coulter, Christopher H

    2006-01-01

    Employers' past solutions to rising health benefit costs--adopting managed care strategies, cost shifting to employees and reducing benefits-are no longer effectively controlling costs and are depressing the value of health benefits for employee recruitment and retention. An alternative strategy is to implement health management approaches that improve the health status of employees. These programs reduce medical costs and have a documented positive impact on workers' compensation, disability costs, absenteeism and productivity. Further, this approach is complementary to health care consumerism as a strategy for health improvement and benefit cost reduction and results in improved employee health, outlook and satisfaction. PMID:16792389

  15. The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016 Statement

    PubMed Central

    Tate, Robyn L.; Perdices, Michael; Rosenkoetter, Ulrike; Shadish, William; Vohra, Sunita; Barlow, David H.; Horner, Robert; Kazdin, Alan; Kratochwill, Thomas; McDonald, Skye; Sampson, Margaret; Shamseer, Larissa; Togher, Leanne; Albin, Richard; Backman, Catherine; Douglas, Jacinta; Evans, Jonathan J.; Gast, David; Manolov, Rumen; Mitchell, Geoffrey; Nickels, Lyndsey; Nikles, Jane; Ownsworth, Tamara; Rose, Miranda; Schmid, Christopher H.; Wilson, Barbara

    2016-01-01

    We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE) 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016) that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts. PMID:27279674

  16. Incorporating Prototyping and Iteration into Intervention Development: A Case Study of a Dining Hall-Based Intervention

    ERIC Educational Resources Information Center

    McClain, Arianna D.; Hekler, Eric B.; Gardner, Christopher D.

    2013-01-01

    Background: Previous research from the fields of computer science and engineering highlight the importance of an iterative design process (IDP) to create more creative and effective solutions. Objective: This study describes IDP as a new method for developing health behavior interventions and evaluates the effectiveness of a dining hall--based…

  17. Interventional radiology

    SciTech Connect

    Castaneda-Zuniga, W.R.

    1987-01-01

    This reference gives a step-by-step presentation of the elements of interventional radiology. CONTENTS: Introduction; Radiation protection; Embolotherapy; Interventional techniques in the management of gastrointestinal bleeding; Transluminal angioplasty; Thrombolytic therapy; Foreign body removal; Inferior vena cava filter placement; Percutaneous uroradiologic techniques; Interventional techniques in the biliary tract; Nonvascular gastrointestinal tract dilations; Percutaneous biopsy techniques; Drainage of abscess fluid collections in the abdomen.

  18. A Randomized Controlled Trial of an Individualized Preoperative Education Intervention for Symptom Management After Total Knee Arthroplasty.

    PubMed

    Wilson, Rosemary A; Watt-Watson, Judith; Hodnett, Ellen; Tranmer, Joan

    2016-01-01

    Pain and nausea limit recovery after total knee arthroplasty (TKA) patients. The aim of this study was to determine the effect of a preoperative educational intervention on postsurgical pain-related interference in activities, pain, and nausea. Participants (n = 143) were randomized to intervention or standard care. The standard care group received the usual teaching. The intervention group received the usual teaching, a booklet containing symptom management after TKA, an individual teaching session, and a follow-up support call. Outcome measures assessed pain, pain interference, and nausea. There were no differences between groups in patient outcomes. There were no group differences for pain at any time point. Respondents had severe postoperative pain and nausea and received inadequate doses of analgesia and antiemetics. Individualizing education content was insufficient to produce a change in symptoms for patients. Further research involving the modification of system factors affecting the provision of symptom management interventions is warranted. PMID:26814004

  19. Draugen HSE-case - occupational health risk management

    SciTech Connect

    Glas, J.J.P.; Kjaer, E.

    1996-12-31

    The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to work environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.

  20. Prevalence of illicit drug use in patients without controlled substance abuse in interventional pain management.

    PubMed

    Manchikanti, Laxmaiah; Pampati, Vidyasagar; Damron, Kim S; Beyer, Carla D; Barnhill, Renee C

    2003-04-01

    Drug abuse with illicit drugs and licit drugs has been increasing steadily over the past decade. A recent National Household Survey on Drug Abuse found statistically significant increases between 2000 and 2001 in the use of multiple drugs, including marijuana, cocaine, and non-medical use of pain relievers and tranquilizers. Prescription controlled substance abuse is a major issue in chronic pain management. Various means suggested to avoid or monitor abuse in patients in treatment include urine/serum drug screening whenever requested, along with other precautions including one prescribing physician and one designated pharmacy, etc. Based on the present evidence, physicians assume that patients adhering to controlled substance agreements and without obvious dependency behavior do not abuse either illicit or licit drugs. Thus, it is accepted that there is no necessity to perform routine urine/drug testing in this specific group of the patient population. One hundred patients undergoing interventional pain management and receiving controlled substances were randomly selected for evaluation of illicit drug abuse by urine drug testing. They were selected from a total of 250 patients who were identified as non-abusers of prescription drugs. Results showed that illicit drug abuse in patients without history of controlled substance abuse was seen in 16 patients. Thirteen of the 16 patients tested positive for marijuana and 3 patients tested positive for cocaine. Only one patient tested positive for a combined use of both marijuana and cocaine. This study showed that, in an interventional pain management setting, there is significant use of illicit drugs (16%) with 13% use of marijuana and 3% use of cocaine in patients who are considered as non-abusers of prescription controlled substances and those who are adherent to controlled substance agreements. However, if cocaine is considered as a hardcore drug in contrast to marijuana, abuse of hardcore illicit drugs is only 3

  1. Safety Events during an Automated Telephone Self-Management Support Intervention

    PubMed Central

    Lyles, Courtney R.; Schillinger, Dean; Lopez, Andrea; Handley, Margaret; Ratanawongsa, Neda; Sarkar, Urmimala

    2013-01-01

    Background Interactive health information technology (HIT) can support the complex self-management tasks for diabetes. However, less is known about between-visit interactions and patient safety among chronic illness patients treated in the outpatient setting. Methods We classified 13 categories for safety events and potential safety events within a larger trial evaluating a multilingual automated telephone self-management support system for diabetes using interactive voice response. Participants could trigger safety concerns by reporting hyperglycemia or hypoglycemia, inability to obtain medications, medication nonadherence and side effects, and needing appointments and/or supplies. We then examined these triggers across patient demographic and health characteristics to determine which patients were most likely to experience safety events. Results Overall, there were 360 safety triggers that occurred among 155 participants, which represented 53% of individuals and 7.6% of all automated calls over the 27-week intervention. The most common triggers were for pain or medication side effects (22%) and not checking blood sugars (13%). In adjusted models, race/ethnicity and language were related to safety triggers; Spanish-speaking participants were significantly (p = .02) more likely than English-speaking participants to experience a safety trigger, and black participants were marginally more likely (p =.09) than white participants to experience a safety trigger. Conclusion About half of patients enrolled in a self-management technology intervention triggered at least one potential safety event over the course of the trial, and this was more frequent among some patients. Systems implementing HIT strategies to improve self-care and remote monitoring should consider specific program design elements to address these potential safety events. PMID:23759391

  2. Feasibility and Efficacy of a Self-Management Intervention for Insomnia in Stable Heart Failure

    PubMed Central

    Redeker, Nancy S.; Jeon, Sangchoon; Andrews, Laura; Cline, John; Jacoby, Daniel; Mohsenin, Vahid

    2015-01-01

    Background: Chronic insomnia is common among patients with heart failure (HF) and may contribute to fatigue and poor function. However, to date there have been no randomized controlled trials focused on treatment of insomnia or daytime symptoms in this population. Objective: The purpose of this study was to examine the preliminary efficacy, feasibility, and acceptability of a self-management intervention (cognitive behavioral therapy [CBT-I]) for insomnia among patients with stable HF. Methods: We conducted a pilot randomized controlled trial (RCT) in which patients with stable Class I-III HF (n = 25/52.1% women; mean age = 59 ± 14.8 years) were randomized in groups to CBT-I (n = 29) or an attention control condition (HF self-management with sleep hygiene; n = 19). Participants completed 2 weeks of wrist actigraphy, the insomnia severity index, and measures of fatigue, depression, sleepiness, and functional performance at baseline and follow-up. We computed the size of the effects on the dependent variables and used MANOVA to evaluate the effects of CBT-I on insomnia and fatigue. Results: CBT-I was feasible and acceptable and had a statistically significant effect on insomnia and fatigue, while controlling for the effects of comorbidity and age. Conclusions: CBT-I has short-term efficacy as a treatment for chronic insomnia among patients with stable HF. Future studies are needed to address its sustained effects. Citation: Redeker NS, Jeon S, Andrews L, Cline J, Jacoby D, Mohsenin V. Feasibility and efficacy of a self-management intervention for insomnia in stable heart failure. J Clin Sleep Med 2015;11(10):1109–1119. PMID:25979100

  3. Managing Change: A Case Study in Evolving Strategic Management.

    ERIC Educational Resources Information Center

    Thor, Linda; Scarafiotti, Carol; Helminski, Laura

    1998-01-01

    Presents Rio Salado College as a case study of an institution that aligns itself with the needs of learners by altering its organizational values and practices. Emphasizes the need for institutions to embrace change and innovation to accommodate the needs of its learners. Contains 11 references. (YKH)

  4. Data management for genomic mapping applications: A case study

    SciTech Connect

    Markowitz, V.M.; Lewis, S.; McCarthy, J.; Olken, F.; Zorn, M.

    1992-05-01

    In this paper we describe a new approach to the construction of data management systems for genomic mapping applications in molecular biology, genetics, and plant breeding. We discuss the architecture of such systems and propose an incremental approach to the development of such systems. We illustrate the proposed approach and architecture with a case study of a prototype data management system for genomic maps.

  5. Essentials of Enrollment Management: Cases in the Field

    ERIC Educational Resources Information Center

    Black, Jim

    2004-01-01

    In AACRAO's new publication Essentials of Enrollment Management: Cases in the Field experts in enrollment management representing all types of institutions reveal the evolution of the enrollment strategies implemented at their institutions, the results, and the lessons learned. The introductory chapter provides an overview of themes and models…

  6. Tackling risky alcohol consumption in sport: a cluster randomised controlled trial of an alcohol management intervention with community football clubs

    PubMed Central

    Kingsland, Melanie; Wolfenden, Luke; Tindall, Jennifer; Rowland, Bosco C; Lecathelinais, Christophe; Gillham, Karen E; Dodds, Pennie; Sidey, Maree N; Rogerson, John C; McElduff, Patrick; Crundall, Ian; Wiggers, John H

    2015-01-01

    Background An increased prevalence of risky alcohol consumption and alcohol-related harm has been reported for members of sporting groups and at sporting venues compared with non-sporting populations. While sports clubs and venues represent opportune settings to implement strategies to reduce such risks, no controlled trials have been reported. The purpose of the study was to examine the effectiveness of an alcohol management intervention in reducing risky alcohol consumption and the risk of alcohol-related harm among community football club members. Method A cluster randomised controlled trial of an alcohol management intervention was undertaken with non-elite, community football clubs and their members in New South Wales, Australia. Risky alcohol consumption (5+ drinks) at the club and risk of alcohol-related harm using the Alcohol Use Disorders Identification Test (AUDIT) were measured at baseline and postintervention. Results Eighty-eight clubs participated in the trial (n=43, Intervention; n=45, Control) and separate cross-sectional samples of club members completed the baseline (N=1411) and postintervention (N=1143) surveys. Postintervention, a significantly lower proportion of intervention club members reported: risky alcohol consumption at the club (Intervention: 19%; Control: 24%; OR: 0.63 (95% CI 0.40 to 1.00); p=0.05); risk of alcohol-related harm (Intervention: 38%; Control: 45%; OR: 0.58 (95% CI 0.38 to 0.87); p<0.01); alcohol consumption risk (Intervention: 47%; Control: 55%; OR: 0.60 (95% CI 0.41 to 0.87); p<0.01) and possible alcohol dependence (Intervention: 1%; Control: 4%; OR: 0.20 (95% CI 0.06 to 0.65); p<0.01). Conclusions With large numbers of people worldwide playing, watching and sports officiating, enhancing club-based alcohol management interventions could make a substantial contribution to reducing the burden of alcohol misuse in communities. Trial registration number ACTRN12609000224224. PMID:26038252

  7. The importance of work or productive activity in life care planning and case management

    PubMed Central

    Reid, Christine; Riddick-Grisham, Susan

    2015-01-01

    Abstract INTRODUCTION: The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management. BACKGROUND: The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described. PURPOSE: The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities. CONCLUSION: Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities. PMID:26409330

  8. Pilot Test of a Culturally Sensitive Hypertension Management Intervention Protocol for Older Chinese Immigrants: Chinese Medicine as Longevity Modality.

    PubMed

    Li, Wen-Wen; Gomez, Cynthia A; Tam, Jocelyn Wing-Yin

    2015-11-01

    Hypertension control in older Chinese immigrants remains a significant health issue because of their unique cultural health practices to manage their hypertension. At present, there are limited culturally sensitive health education materials regarding hypertension management tailored for the older Chinese population available for and feasible to use. Because the San Francisco Bay Area has a large population of older Chinese immigrants, development of a culturally appropriate intervention is important to help this population achieve better blood pressure control. The focus of this study was to develop and test the feasibility of a culturally sensitive hypertension management intervention protocol, Chinese Medicine as Longevity Modality. This intervention protocol is implemented as a patient education health program delivered via video format in combination with an individual consultation provided by a nurse in the initial intervention, followed by four phone calls between the initial intervention and the second follow-up visit. The results of the study showed that the proposed intervention protocol was acceptable for the target population. PMID:26571335

  9. Managing cancer-related fatigue in men with prostate cancer: a systematic review of non-pharmacological interventions.

    PubMed

    Larkin, David; Lopez, Violeta; Aromataris, Edoardo

    2014-10-01

    The aim of this systematic review was to synthesize the best available evidence informing the effectiveness of non-pharmacological interventions for managing cancer-related fatigue in men treated for prostate cancer. This review considered experimental studies that included men with prostate cancer (regardless of staging, previous treatment or comorbidities), aged 18 years and over who were undergoing any treatment, or had completed any treatment for prostate cancer within the previous 12 months. Three interventions were identified for the management of cancer-related fatigue in men with prostate cancer. Evidence from five studies including 447 participants demonstrates the effectiveness of physical activity, both aerobic and resistance exercise, and from three studies including 153 participants suggesting the benefits of psychosocial interventions including education and cognitive behavioural therapy. Health professionals require knowledge of a range of effective interventions aimed at reducing cancer-related fatigue in men with prostate cancer and should incorporate those interventions into their patient management. Although physical activity appears to show the greatest benefit, other non-pharmacological interventions such as education and cognitive behavioural therapy have demonstrated benefit and should also be considered as a strategy in treating this debilitating side effect of cancer and its treatment. PMID:24237792

  10. A CASE STUDY OF ENVIRONMENTAL DATA MANAGEMENT

    EPA Science Inventory

    In order to support our ongoing research in watershed ecology and global climate change, we gather and analyze environmental data from several government agencies. This case study demonstrates a researcher’s approach to accessing, organizing, and using intersectoral data. T...

  11. Comparing Single Case Design Overlap-Based Effect Size Metrics from Studies Examining Speech Generating Device Interventions

    ERIC Educational Resources Information Center

    Chen, Mo; Hyppa-Martin, Jolene K.; Reichle, Joe E.; Symons, Frank J.

    2016-01-01

    Meaningfully synthesizing single case experimental data from intervention studies comprised of individuals with low incidence conditions and generating effect size estimates remains challenging. Seven effect size metrics were compared for single case design (SCD) data focused on teaching speech generating device use to individuals with…

  12. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Case management services. 441.18 Section 441.18 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES General Provisions § 441.18 Case...

  13. Covert Conditioning: Case Studies in Self-Management.

    ERIC Educational Resources Information Center

    Yager, Geoffrey G.

    The self-management of thoughts and mental images was used in a series of empirical case studies to influence behavior changes. The target behaviors in the cases reported were smoking, overeating, fingernail biting, thinking self-depreciative thoughts, and responding assertively. Self-monitoring, covert positive reinforcement, covert…

  14. Cost-Effectiveness of Case Management in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

    2006-01-01

    Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

  15. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management…

  16. CASE MANAGEMENT INSIDER. Re-Engineering Your Case Management Department: It's Simple, It's Just Not Easy, Part 1.

    PubMed

    Cesta, Toni

    2016-07-01

    This month, we have begun our discussion of the reasons why this is a very good time for hospitals to review and re-engineer their case management models and departments, including the Affordable Care Act and value-based purchasing, among others. Next time, we will discuss the elements you need to review when re-engineering your own case management department. PMID:27434941

  17. Conservative management of symptomatic Carpal Bossing in an elite hockey player: a case report

    PubMed Central

    Kissel, Peter

    2009-01-01

    Objective: To present the characteristics and create awareness of symptomatic carpal bossing and discuss potential etiologies and the role of conservative management through the presentation of an athlete with traumatic onset of symptomatic carpal bossing. Clinical features: This case report outlines the presentation and conservative management of an elite eighteen year old hockey player with symptomatic carpal bossing after a traumatic on ice collision. Carpal bossing is a bony, dorsal prominence in the quadrangular joint of the wrist that is inconsistently symptomatic. Intervention and outcome: A conservative treatment plan consisting of education, reassurance, avoidance of aggravation, and soft tissue therapy allowed return to play in two weeks without restrictions or need for surgical consultation. Conclusion: With inconsistent recurrence rates and surgical complications, the role of conservative management for symptomatic carpal bossing deserves further exploration. The conservative practitioner should be aware of the signs and symptoms of symptomatic carpal bossing to institute suitable treatment. PMID:20037693

  18. Community health workers assisting Latinos manage stress and diabetes (CALMS-D): rationale, intervention design, implementation, and process outcomes.

    PubMed

    Wagner, Julie; Bermudez-Millan, Angela; Damio, Grace; Segura-Perez, Sofia; Chhabra, Jyoti; Vergara, Cunegundo; Perez-Escamilla, Rafael

    2015-12-01

    Latinos have high rates of diabetes and mental distress, but lack appropriate services. A study was designed to compare enhanced standard diabetes care with enhanced standard care plus community health worker (CHW) delivered stress management for Latinos with type 2 diabetes. This paper reports intervention design and process outcomes. A formative process was used to develop and implement an eight-session, group stress management intervention. One hundred twenty-one participants completed baseline assessments; n = 107 attended diabetes education and were then randomized. Recruits reported high credibility and treatment expectancies. Treatment fidelity was high. Participants reported high treatment satisfaction and therapeutic alliance and their diabetes knowledge and affect improved over the short term. Retention and attendance at group sessions was challenging but successful relative to similar trials. This comprehensive and culturally sensitive stress management intervention, delivered by a well-trained CHW, was successfully implemented. PMID:26622914

  19. Self-management support interventions that are clinically linked and technology enabled: can they successfully prevent and treat diabetes?

    PubMed

    Kaufman, Neal D; Woodley, Paula D Patnoe

    2011-05-01

    Patients with diabetes need a complex set of services and supports. The challenge of integrating these services into the diabetes regimen can be successfully overcome through self-management support interventions that are clinically linked and technology enabled: self-management support because patients need help mastering the knowledge, attitudes, skills, and behaviors so necessary for good outcomes; interventions because comprehensive theory-based, evidence-proven, long-term, longitudinal interventions work better than direct-to-consumer or nonplanned health promotion approaches; clinically linked because patients are more likely to adopt new behaviors when the approach is in the context of a trusted therapeutic relationship and within an effective medical care system; and technology enabled because capitalizing on the amazing power of information technology leads to the delivery of cost-effective, scalable, engaging solutions that prevent and manage diabetes. PMID:21722596

  20. Recruiting Rural Participants for a Telehealth Intervention on Diabetes Self-Management

    PubMed Central

    Miyamoto, Sheridan; Henderson, Stuart; Young, Heather M.; Ward, Deborah; Santillan, Vanessa

    2012-01-01

    Purpose Recruiting rural and underserved participants in behavioral health interventions is challenging. Community-based recruitment approaches are effective, but they are not always feasible in multisite, diverse community interventions. This study evaluates the feasibility of a rapid, multisite approach that uses rural clinic site coordinators to recruit study participants. The approach allows for rural recruitment in areas where researchers may not have developed long-term collaborative relationships. Methods Adults with diabetes were recruited from rural Federally Qualified Health Center (FQHC) clinics. Recruitment feasibility was assessed by analyzing field notes by the project manager and health coaches, and 8 in-depth, semi-structured interviews with clinic site coordinators and champions, followed by thematic analysis of field notes and interviews. Findings Forty-seven rural sites were contacted to obtain the 6 sites that participated in the study. On average, sites took 14 days to commit to study participation. One hundred and twenty-one participants were acquired from letters mailed to eligible participants and, in some sites, by follow-up phone calls from site coordinators. Facilitators and deterrents affecting study recruitment fell into 4 broad categories—study design, site, site coordinator, and participant factors. Conclusion The rapid multi-site approach led to quick and efficient recruitment of clinic sites and participants. Recruitment success was achieved in some, but not all, rural sites. The study highlights the opportunities and challenges of recruiting rural clinics and rural, underserved participants in multisite research. Suggestions are provided for improving recruitment for future interventions. PMID:23289657

  1. A process evaluation of an adolescent weight management intervention: findings and recommendations.

    PubMed

    Nguyen, Binh; Shrewsbury, Vanessa A; O'Connor, Janice; Lau, Christine; Steinbeck, Katharine S; Hill, Andrew J; Baur, Louise A

    2015-06-01

    Process evaluation is valuable in guiding development of effective intervention programmes but rare in adolescent weight management. This paper presents a process evaluation of the Loozit(®) randomized controlled trial, a community-based behavioural lifestyle intervention for obese 13-16 year olds. Adolescents were randomized to receive the two-phase Loozit(®) group programme, with (n = 73) or without (n = 78), additional therapeutic contact (telephone coaching, short message service and/or emails) in Phase 2. Quantitative and qualitative process data were collected. Facilitators used a standardized evaluation form to document participant attendance, and comment on lesson adherence and process delivery. Adolescents and parents completed satisfaction questionnaires at 2-, 12- and 24-month follow-ups. Following the intervention, 14 adolescents who provided informed written consent were interviewed about their experience with additional therapeutic contact. Data were analysed using descriptive statistics, parametric and non-parametric tests to compare group means, and thematic analyses. Group attendance rates averaged 85 and 47% during Phases 1 (0-2 months) and 2 (3-24 months), respectively. Facilitators frequently noted that participants reported making healthy lifestyle changes. Elements enjoyed in the sessions included practical activities, fun active games, resistance training and forming new friendships. Adolescents struggled with setting specific, measurable, achievable, realistic and timely (SMART) goals. Overall, participants were satisfied with the help received including the telephone and electronic contact. More than 80% of participants found the programme changed adolescents' eating and physical activity habits, and 89% of parents reported changing parenting strategies. Future adolescent group-based programmes may enhance participant engagement and programme effectiveness by including more interactive and frequent telephone and electronic contact. PMID

  2. Minimal intervention dentistry for managing dental caries - a review: report of a FDI task group.

    PubMed

    Frencken, Jo E; Peters, Mathilde C; Manton, David J; Leal, Soraya C; Gordan, Valeria V; Eden, Ece

    2012-10-01

    This publication describes the history of minimal intervention dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the 'surgical' care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI's policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing. PMID:23106836

  3. Minimal Intervention Dentistry (MID) for managing dental caries – a review

    PubMed Central

    Frencken, Jo E.; Peters, Mathilde C.; Manton, David J.; Leal, Soraya C.; Gordan, Valeria V.; Eden, Ece

    2012-01-01

    This publication describes the history of Minimal Intervention Dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the ‘surgical’ care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI’s policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing. PMID:23106836

  4. Managing the failing heart: total circulatory assist--a case study.

    PubMed

    Allen, Yvonne; Collins, Rachel; Lester, Charnetta; Savage, Laura; Vijayan, Sajitha

    2009-03-01

    Congestive heart failure remains one of the leading causes of cardiac death and disability. As pharmacological therapies have advanced, patients are living longer and more productive lives. However, at some point, these interventions begin to fail. Circulatory assist devices have revolutionized the management of patients with end-stage heart disease. These devices successfully bridge patients to cardiac transplantation. The Syncardia Total Artificial Heart provides biventricular support for the failing heart. This case study illustrates the challenges of caring for patients with such a device. PMID:19341058

  5. Integration of case tools for software project management

    SciTech Connect

    Paul, R.; Shinagawa, Y.; Khan, M.F.

    1996-12-31

    Building and maintenance of high quality large software projects is a complex and difficult process. Tools employing software metrics are becoming an effective aid for management of such large projects. In this paper, we briefly trace the evolution of such tools from their beginnings up until the current trends of integrated CASE tools. We present a generic integrated CASE environment incorporating a formal set of software metrics with a suite of advanced analytic techniques. The proposed integrated CASE environment is an enhancement of currently used tools, and can enable more efficient and cost-effective management of large and complex software projects.

  6. Development of a Web-Based Self-management Intervention for Intermittent Urinary Catheter Users With Spinal Cord Injury.

    PubMed

    Wilde, Mary H; Fairbanks, Eileen; Parshall, Robert; Zhang, Feng; Miner, Sarah; Thayer, Deborah; Harrington, Brian; Brasch, Judith; McMAHON, James M

    2015-11-01

    While Web-based interventions have proliferated recently, information in the literature is often lacking about how the intervention was developed. In response to that gap, this is a report of the development of a Web-based self-management intervention for intermittent urinary catheter users and pretesting with four adults with spinal cord injury living in the community. Two Web sites were created, one for recruitment and the other for the intervention itself. The intervention involved developing new Web-based technology, including an interactive urinary diary (with fluid intake/urine output and a journal), extensive catheter products information, three intervention nurse phone call consultations, and user-community discussion forums. Study participants completed an online survey and were interviewed twice about the enrollment process and their perceptions of their involvement in the intervention. Suggestions from the pretesting participants were used to revise the Web site applications prior to the next stage of research (a feasibility study). Numerous recommendations and comments were received related to content, interactivity of components, and usability. This article provides a description of how the Web sites were developed (including the technology and software programs used), issues encountered and what was done to address them, and how the Web-based intervention was modified for improvements. PMID:26361267

  7. Effect of management interventions on the helminth parasites recovered from donkeys in South Africa.

    PubMed

    Matthee, Sonja; Krecek, Rosina C; Guthrie, Alan J

    2002-02-01

    The helminth burdens and biodiversity of 9 randomly selected donkeys (Equus asinus) were examined after necropsy. Prior to necropsy, 8 of the animals were subjected to 1 of 3 management interventions (monthly fecal removal, prewinter moxidectin treatment, and a combination of both treatments) or a control for a 16-mo period. The remaining animal was killed earlier in the study. Quantitative samples were collected from the gastrointestinal tract for helminth recovery. The intestinal walls were examined with transmural illumination and thereafter digested with a HCl-peptic method for identification of the mucosal larval stages of cyathostomes. In this study, 37 helminth species belonging to the Ascarididae, Atractidae, Dictyocaulidae. Habronematidae, Onchocercidae, Oxyuridae, Strongylidae, and Trichostrongylidae, 1 cestode species of the Anoplocephalidae, and 1 trematode species in the Paramphistomatidae were recovered. In addition, 1 species of oestrid fly of the Gasterophilidae was identified. The results obtained in the present study support the application of several intervention methods to reduce the helminth burdens in donkeys. PMID:12053959

  8. Improving the efficacy of appearance-based sun exposure interventions with the terror management health model.

    PubMed

    Morris, Kasey Lynn; Cooper, Douglas P; Goldenberg, Jamie L; Arndt, Jamie; Gibbons, Frederick X

    2014-01-01

    The terror management health model (TMHM) suggests that when thoughts of death are accessible people become increasingly motivated to bolster their self-esteem relative to their health, because doing so offers psychological protection against mortality concerns. Two studies examined sun protection intentions as a function of mortality reminders and an appearance-based intervention. In Study 1, participants given a sun protection message that primed mortality and shown a UV-filtered photo of their face reported greater intentions to use sun protection on their face, and took more sunscreen samples than participants shown a regular photo of their face. In Study 2, reminders of mortality increased participants' intentions to use facial sun protection when the UV photo was specifically framed as revealing appearance consequences of tanning, compared to when the photo was framed as revealing health consequences or when no photo was shown. These findings extend the TMHM, and provide preliminary evidence that appearance-based tanning interventions have a greater influence on sun protection intentions under conditions that prime thoughts of death. We discuss implications of the findings, and highlight the need for additional research examining the applicability to long-term tanning behaviour. PMID:24811049

  9. Interventional Radiology in the Diagnosis, Management, and Follow-Up of Pseudoaneurysms

    SciTech Connect

    Keeling, A. N.; McGrath, F. P.; Lee, M. J.

    2009-01-15

    Arterial wall disruption, as a consequence of inflammation/infection, trauma (penetrating or blunt), or iatrogenic causes, may result in pseudoaneurysm formation. Currently, iatrogenic causes are increasing as a result of the growth of endovascular intervention. The frequency of other causes also seems to be increasing, but this may simply be the result of increased diagnosis by better imaging techniques, such as multidetector contrast-enhanced computed tomography. Clinically, pseudoaneurysms may be silent, may present with local or systemic signs, or can rupture with catastrophic consequences. Open surgical repair, previously the mainstay of treatment, has largely been replaced by image-guided occlusion methods. On the basis of an experience of over 100 pseudoaneurysms, treatments at various anatomical sites, imaging modalities used for accurate diagnosis, current changing therapeutic options for pseudoaneurysm management, approved embolization agents, and clinical follow-up requirements to ensure adequate treatment will be discussed. Image-guided direct percutaneous and endovascular embolization of pseudoaneurysms are established treatment options with favorable success rates and minimal morbidity. The pendulum has now swung from invasive surgical repair of pseudoaneurysms to that of image-guided interventional radiology.

  10. Innovations in non-communicable diseases management in ASEAN: a case series

    PubMed Central

    Lim, Jeremy; Chan, Melissa M. H.; Alsagoff, Fatimah Z.; Ha, Duc

    2014-01-01

    Background Non-communicable diseases (NCDs) are reaching epidemic proportions worldwide and present an unprecedented challenge to economic and social development globally. In Southeast Asia, the challenges are exacerbated by vastly differing levels of health systems development and funding availability. In addressing the burden of NCDs, ASEAN nations need to fundamentally re-examine how health care services are structured and delivered and discover new models as undiscerning application of models from other geographies with different cultures and resources will be problematic. Objective We sought to examine cases of innovation and identify critical success factors in NCD management in ASEAN. Design A qualitative design, focusing on in-depth interviews and site visits to explore the meanings and perceptions of participants regarding innovations in NCD against the backdrop of the overall context of delivering health care within the country's context was adopted. Results In total 12 case studies in six ASEAN countries were analysed. Primary interventions accounted for five of the total cases, whereas secondary interventions comprised four, and tertiary interventions three. Five core themes contributing to successful innovation for NCD management were identified. They include: 1) encourage better outcomes through leadership and support, 2) strengthen inter-disciplinary partnership, 3) community ownership is key, 4) recognise the needs of the people and what appeals to them, and 5) raise awareness through capacity building and increasing health literacy. Conclusions Innovation is vital in enabling ASEAN nations to successfully address the growing crisis of NCDs. More of the same or wholesale transfers of developed world models will be ineffective and lead to financially unsustainable programmes or programmes lacking appropriate human capital. The case studies have demonstrated the transformative impact of innovation and identified key factors in successful

  11. Species Conservation and Management: Case Studies

    USGS Publications Warehouse

    Akcakaya, H.R.; Burgman, M.A.; Kindvall, O.; Wood, C.C.; Sjogren-Gulve, P.; Hatfield, J.S.; McCarthy, M.A.

    2004-01-01

    This edited volume is a collection of population and metapopulation models for a wide variety of species, including plants, invertebrates, fishes, amphibians, reptiles, birds, and mammals. Each chapter of the book describes the application of RAMAS GIS 4.0 to one species, with the aim of demonstrating how various life history characteristics of the species are incorporated into the model, and how the results of the model has been or can be used in conservation and management of the species. The book comes with a CD that includes a demo version of the program, and the data files for each species.

  12. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, G.; Greening, H.S.; Yates, K.K.

    2012-01-01

    Tampa Bay, Florida,USA, is a shallow,subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of sea grasses and other selected habitat types, to support estuarine-dependent faunal guilds.

  13. Clear Corneal Phacovitrectomy with Posterior Capsulorhexis and IOL Implantation in Management of Selective Vitreoretinal Cases

    PubMed Central

    Boiko, Ernest V.; Churashov, Sergey V.; Kulikov, Alexei N.; Maltsev, Dmitrii S.

    2015-01-01

    Purpose. To describe our technique, clear corneal phacovitrectomy with posterior capsulorhexis (CCPV), for the management of selected posterior segment intraocular foreign body (IOFB), posteriorly dislocated lens fragments (PDLF), and proliferative diabetic retinopathy (PDR) cases. Methods. This was a single-center retrospective interventional case series. In 21 patients (21 eyes) we performed phacovitrectomy through three clear corneal tunnel incisions (CCTI) and posterior capsulorhexis to remove IOFB (n = 8), PDLF from the vitreous cavity after complicated phacoemulsification (n = 6), and vitreous hemorrhage and epiretinal membranes in PDR (n = 7). The procedure was completed with implantation of a hydrophobic acrylic IOL through the CCTI. Results. The mean visual acuity (logMAR) was 0.90 preoperative and improved to 0.26 over a mean follow-up of 8.7 months (range, 6–12 months). The intraocular lens was implanted into the capsular bag (n = 12) or onto the anterior capsule (n = 9). One PDR patient experienced an intraprocedural complication, hemorrhage from isolated fibrovascular adhesions. One IOFB patient developed apparent anterior proliferative vitreoretinopathy and required a repeat intervention. Conclusion. Selected vitreoretinal IOFB, PDLF, and PDR cases can be successfully managed by a combined surgical approach involving clear corneal phacovitrectomy with posterior capsulorhexis and implantation of an IOL, with good visual outcome and a low complication rate. PMID:26587281

  14. Examining the effects of an interprofessional crew resource management training intervention on perceptions of patient safety.

    PubMed

    Wu, Wan-Ting; Wu, Yung-Lung; Hou, Shaw-Min; Kang, Chun-Mei; Huang, Chi-Hung; Huang, Yu-Ju; Wang, Victoria Yue An; Wang, Pa-Chun

    2016-07-01

    This article reports the results from a study that employed an interprofessional crew resource management (CRM) education programme in the emergency and critical care departments. The study aimed to investigate the effectiveness of this intervention of participants' satisfaction and safety attitude changes using a satisfaction questionnaire and the Human Factors Attitude Survey (HFAS). Overall, participants responded positively to the CRM training-93.4% were satisfied, 93.1% agreed that it enhanced patient safety and care quality, 85.7% agreed that it increased their confidence, 86.4% agreed that it reduced practice errors, and 90.8% agreed that it would change their behaviours. Overall, the participants reported positive changes in their attitudes regarding 22 of the 23 HFAS questions. PMID:27332501

  15. Sex effects in cocaine using methadone patients randomized to contingency management interventions

    PubMed Central

    Burch, Ashley E.; Rash, Carla J.; Petry, Nancy M.

    2015-01-01

    Contingency management (CM) is an effective treatment for promoting cocaine abstinence in patients receiving methadone maintenance. However, few studies have examined the effect of sex on treatment outcomes in this population. This study evaluated the impact of sex on longest duration of abstinence (LDA) and percent negative urine samples in 323 cocaine-using methadone patients from four randomized clinical trials comparing CM to standard methadone care. Overall, women had better treatment outcomes compared to men, demonstrated by an increase in both LDA and percentages of negative samples. Patients receiving CM also had significantly higher LDA and percentages of negative samples compared to patients receiving standard care, but sex by treatment condition effects were not significant. These data suggest that cocaine using methadone patients who are women have better substance use outcomes than men in interventions that regularly monitor cocaine use, and CM is equally efficacious regardless of sex. PMID:26237326

  16. Middle Managers' Experiences and Role in Implementing an Interactive Tailored Patient Assessment eHealth Intervention in Clinical Practice.

    PubMed

    Varsi, Cecilie; Ekstedt, Mirjam; Gammon, Deede; Børøsund, Elin; Ruland, Cornelia M

    2015-06-01

    The role of nurse and physician managers is considered crucial for implementing eHealth interventions in clinical practice, but few studies have explored this. The aim of the current study was to examine the perceptions of nurse and physician managers regarding facilitators, barriers, management role, responsibility, and action taken in the implementation of an eHealth intervention called Choice into clinical practice. Individual qualitative interviews were conducted with six nurses and three physicians in management positions at five hospital units. The findings revealed that nurse managers reported conscientiously supporting the implementation, but workloads prevented them from participating in the process as closely as they wanted. Physician managers reported less contribution. The implementation process was influenced by facilitating factors such as perceptions of benefits from Choice and use of implementation strategies, along with barriers such as physician resistance, contextual factors and difficulties for front-line providers in learning a new way of communicating with the patients. The findings suggest that role descriptions for both nurse and physician managers should include implementation knowledge and implementation skills. Managers could benefit from an implementation toolkit. Implementation management should be included in management education for healthcare managers to prepare them for the constant need for implementation and improvement in clinical practice. PMID:25988851

  17. The use of deception in public health behavioral intervention trials: a case study of three online alcohol trials.

    PubMed

    McCambridge, Jim; Kypri, Kypros; Bendtsen, Preben; Porter, John

    2013-01-01

    Some public health behavioral intervention research studies involve deception. A methodological imperative to minimize bias can be in conflict with the ethical principle of informed consent. As a case study, we examine the specific forms of deception used in three online randomized controlled trials evaluating brief alcohol interventions. We elaborate our own decision making about the use of deception in these trials, and present our ongoing findings and uncertainties. We discuss the value of the approach of pragmatism for examining these kinds of ethical issues that can arise in research on public health interventions. PMID:24161181

  18. The Use of Deception in Public Health Behavioral Intervention Trials: A Case Study of Three Online Alcohol Trials

    PubMed Central

    McCambridge, Jim; Kypri, Kypros; Bendtsen, Preben; Porter, John

    2013-01-01

    Some public health behavioral intervention research studies involve deception. A methodological imperative to minimize bias can be in conflict with the ethical principle of informed consent. As a case study, we examine the specific forms of deception used in three online randomized controlled trials evaluating brief alcohol interventions. We elaborate our own decision making about the use of deception in these trials, and present our ongoing findings and uncertainties. We discuss the value of the approach of pragmatism for examining these kinds of ethical issues that can arise in research on public health interventions. PMID:24161181

  19. Community pharmacy interventions for public health priorities: protocol for a systematic review of community pharmacy-delivered smoking, alcohol and weight management interventions

    PubMed Central

    2014-01-01

    Background Community pharmacists can deliver health care advice at an opportunistic level, related to prescription or non-prescription medicines and as part of focused services designed to reduce specific risks to health. Obesity, smoking and excessive alcohol intake are three of the most significant modifiable risk factors for morbidity and mortality in the UK, and interventions led by community pharmacists, aimed at these three risk factors, have been identified by the government as public health priorities. In 2008, the Department of Health for England stated that ‘a sound evidence base that demonstrates how pharmacy delivers effective, high quality and value for money services is needed’; this systematic review aims to respond to this requirement. Methods/design We will search the databases MEDLINE, Embase, CINAHL, PsycINFO, Social Sciences Citation Index, ASSIA, IBSS, Sociological Abstracts, Scopus and NHS Economic Evaluation Database for studies that have evaluated interventions based on community pharmacies that aim to target weight management, smoking cessation and alcohol misuse. We will include all randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after studies (CBAs) and interrupted time series (ITS) and repeated measures studies. Data from included studies will be extracted by two independent reviewers and will include study details methods, results, intervention implementation/costs and methodological quality. Meta-analysis will be conducted if appropriate; if not, the synthesis will be restricted to a narrative overview of individual studies looking at the same question. Discussion The review aims to summarise the evidence base on the effectiveness of community pharmacy interventions on health and health behaviours in relation to weight management, smoking cessation and alcohol misuse. It will also explore if, and how, socio-economic status, gender, ethnicity and age moderate the effect of the

  20. Functions of behavior change interventions when implementing multi-professional teamwork at an emergency department: a comparative case study

    PubMed Central

    2014-01-01

    Background While there is strong support for the benefits of working in multi-professional teams in health care, the implementation of multi-professional teamwork is reported to be complex and challenging. Implementation strategies combining multiple behavior change interventions are recommended, but the understanding of how and why the behavior change interventions influence staff behavior is limited. There is a lack of studies focusing on the functions of different behavior change interventions and the mechanisms driving behavior change. In this study, applied behavior analysis is used to analyze the function and impact of different behavior change interventions when implementing multi-professional teamwork. Methods A comparative case study design was applied. Two sections of an emergency department implemented multi-professional teamwork involving changes in work processes, aimed at increasing inter-professional collaboration. Behavior change interventions and staff behavior change were studied using observations, interviews and document analysis. Using a hybrid thematic analysis, the behavior change interventions were categorized according to the DCOM® model. The functions of the behavior change interventions were then analyzed using applied behavior analysis. Results The two sections used different behavior change interventions, resulting in a large difference in the degree of staff behavior change. The successful section enabled staff performance of teamwork behaviors with a strategy based on ongoing problem-solving and frequent clarification of directions. Managerial feedback initially played an important role in motivating teamwork behaviors. Gradually, as staff started to experience positive outcomes of the intervention, motivation for teamwork behaviors was replaced by positive task-generated feedback. Conclusions The functional perspective of applied behavior analysis offers insight into the behavioral mechanisms that describe how and why behavior