Psychosocial behaviour management programme for home-dwelling people with dementia: A cluster-randomized controlled trial.

PubMed

Nakanishi, Miharu; Endo, Kaori; Hirooka, Kayo; Granvik, Eva; Minthon, Lennart; Nägga, Katarina; Nishida, Atsushi

2018-03-01

Little is known about the effectiveness of a psychosocial behaviour management programme on home-dwelling people with dementia. We developed a Behaviour Analytics & Support Enhancement (BASE) programme for care managers and professional caregivers of home care services in Japan. We investigated the effects of BASE on challenging behaviour of home-dwelling people with dementia. A cluster-randomized controlled trial was conducted with home care providers from 3 different districts in Tokyo. Each provider recruited persons with dementia aged 65 years or older to receive home care in the BASE programme in August 2016. An online monitoring and assessment system was introduced to the intervention group for repeated measures of challenging behaviour with a total score of the Neuropsychiatric Inventory. Care professionals in both the intervention and control groups evaluated challenging behaviour of persons with dementia at baseline (September 2016) and follow-up (February 2017). A majority of persons with dementia had Alzheimer disease (59.3%). One-hundred and forty-one persons with dementia were included in the intervention group and 142 in the control group. Multilevel modelling revealed a significant reduction in challenging behaviour in the intervention group after 6 months (mean score, 18.3 to 11.2) compared with that of the control group (11.6 to 10.8; P < .05). The implementation of the BASE programme resulted in a reduction of challenging behaviour of home-dwelling people with dementia. Future research should examine the long-term effects of behaviour management programmes on behaviour, nursing home placement, and hospital admission of home-dwelling people with dementia. Copyright © 2017 John Wiley & Sons, Ltd.

Remote Control Laboratory Using EJS Applets and TwinCAT Programmable Logic Controllers

ERIC Educational Resources Information Center

Besada-Portas, E.; Lopez-Orozco, J. A.; de la Torre, L.; de la Cruz, J. M.

2013-01-01

This paper presents a new methodology to develop remote laboratories for systems engineering and automation control courses, based on the combined use of TwinCAT, a laboratory Java server application, and Easy Java Simulations (EJS). The TwinCAT system is used to close the control loop for the selected plants by means of programmable logic…

The effect of group-based exercise on cognitive performance and mood in seniors residing in intermediate care and self-care retirement facilities: a randomised controlled trial.

PubMed

Brown, A K; Liu-Ambrose, T; Tate, R; Lord, S R

2009-08-01

To determine the effect of a general group-based exercise programme on cognitive performance and mood among seniors without dementia living in retirement villages. Randomised controlled trial. Four intermediate care and four self-care retirement village sites in Sydney, Australia. 154 seniors (19 men, 135 women; age range 62 to 95 years), who were residents of intermediate care and self-care retirement facilities. Participants were randomised to one of three experimental groups: (1) a general group-based exercise (GE) programme composed of resistance training and balance training exercises; (2) a flexibility exercise and relaxation technique (FR) programme; or (3) no-exercise control (NEC). The intervention groups (GE and FR) participated in 1-hour exercise classes twice a week for a total period of 6 months. Using standard neuropsychological tests, we assessed cognitive performance at baseline and at 6-month re-test in three domains: (1) fluid intelligence; (2) visual, verbal and working memory; and (3) executive functioning. We also assessed mood using the Geriatric Depression Scale (GDS) and the Positive and Negative Affect Schedule (PANAS). The GE programme significantly improved cognitive performance of fluid intelligence compared with FR or NEC. There were also significant improvements in the positive PANAS scale within both the GE and FR groups and an indication that the two exercise programmes reduced depression in those with initially high GDS scores. Our GE programme significantly improved cognitive performance of fluid intelligence in seniors residing in retirement villages compared with our FR programme and the NEC group. Furthermore, both group-based exercise programmes were beneficial for certain aspects of mood within the 6-month intervention period.

A RCT of three training and support strategies to encourage implementation of screening and brief alcohol intervention by general practitioners.

PubMed

Kaner, E F; Lock, C A; McAvoy, B R; Heather, N; Gilvarry, E

1999-09-01

Providing doctors with new research findings or clinical guidelines is rarely sufficient to promote changes in clinical practice. An implementation strategy is required to provide clinicians with the skills and encouragement needed to alter established routines. To evaluate the effectiveness and cost-effectiveness of different training and support strategies in promoting implementation of screening and brief alcohol intervention (SBI) by general practitioners (GPs). Subjects were 128 GPs, one per practice, from the former Northern and Yorkshire Regional Health Authority, who agreed to use the 'Drink-Less' SBI programme in an earlier dissemination trial. GPs were stratified by previous marketing conditions and randomly allocated to three intensities of training and support: controls (n = 43) received the programme with written guidelines only, trained GPs (n = 43) received the programme plus practice-based training in programme usage, trained and supported GPs (n = 42) received the programme plus practice-based training and a support telephone call every two weeks. GPs were requested to use the programme for three months. Outcome measures included proportions of GPs implementing the programme and numbers of patients screened and intervened with. Seventy-three (57%) GPs implemented the programme and screened 11,007 patients for risk drinking. Trained and supported GPs were significantly more likely to implement the programme (71%) than controls (44%) or trained GPs (56%); they also screened, and intervened with, significantly more patients. Costs per patient screened were: trained and supported GPs, 1.05 Pounds; trained GPs, 1.08 Pounds; and controls, 1.47 Pounds. Costs per patient intervened with were: trained and supported GPs, 5.43 Pounds; trained GPs, 6.02 Pounds; and controls, 8.19 Pounds. Practice-based training plus support telephone calls was the most effective and cost-effective strategy to encourage implementation of SBI by GPs.

Cluster randomised controlled trial of 'whole school' child maltreatment prevention programme in primary schools in Northern Ireland: study protocol for Keeping Safe.

PubMed

McElearney, Aisling; Brennan-Wilson, Aoibheann; Murphy, Christina; Stephenson, Phyllis; Bunting, Brendan

2018-05-03

Child maltreatment has a pervasive, detrimental impact on children's wellbeing. Despite a growing focus on prevention through school based education, few programmes adopt a whole- school approach, are multi-component, seek to address all forms of maltreatment, or indeed have been robustly evaluated. This paper describes a cluster randomised controlled trial designed to evaluate a school based child maltreatment prevention programme: 'Keeping Safe' in primary schools in Northern Ireland. The intervention has been designed by a non-profit agency. Programme resources include 63 lessons taught incrementally to children between four and 11 years old, and is premised on three core themes: healthy relationships, my body, and being safe. There are programme resources to engage parents and to build the capacity and skills of school staff. A cluster Randomised Controlled Trial (RCT) will be conducted with children in 80 schools over a two-year period. The unit of randomisation is the school. Schools will be allocated to intervention or wait-list control groups using a computer-generated list. Data will be collected at three time points: baseline, end of year one, and end of year two of programme implementation. Primary outcomes will include: children's understanding of key programme concepts, self-efficacy to keep safe in situations of maltreatment, anxiety arising from programme participation, and disclosure of maltreatment. Secondary outcomes include teachers' comfort and confidence in teaching the programme and parents' confidence in talking to their children about programme concepts. This RCT will address gaps in current practice and evidence regarding school based child maltreatment prevention programmes. This includes the use of a whole- school approach and multi-component programme that addresses all maltreatment concepts, a two-year period of programme implementation, and the tracking of outcomes for children, parents, and teachers. Methodologically, it will extend our understanding and learning in: capturing sensitive outcome data from young children, adapting and using standardised measures with children of different ages, the use of school level administrative data on staff reports/children's disclosure of maltreatment as behavioural outcomes, and the conduct of complex trials within the busy school environment. ClinicalTrials.gov: NCT02961010 (Retrospectively registered 8 November 2016).

An Implementation Study of Two Evidence-Based Exercise and Health Education Programmes for Older Adults with Osteoarthritis of the Knee and Hip

ERIC Educational Resources Information Center

de Jong, O. R. W.; Hopman-Rock, M.; Tak, E. C. M. P.; Klazinga, N. S.

2004-01-01

Implementation studies are recommended to assess the feasibility and effectiveness in real-life of programmes which have been tested in randomized controlled trials (RCTs). We report on an implementation study of two evidence-based exercise and health education programmes for older adults with osteoarthritis (OA) of the knee or hip. Three types of…

Increased exposure to community-based education and 'below the line' social marketing results in increased fruit and vegetable consumption.

PubMed

Glasson, Colleen; Chapman, Kathy; Wilson, Tamara; Gander, Kristi; Hughes, Clare; Hudson, Nayerra; James, Erica

2013-11-01

To determine if localised programmes that are successful in engaging the community can add value to larger fruit and vegetable mass-media campaigns by evaluating the results of the Eat It To Beat It programme. The Eat It To Beat It programme is a multi-strategy intervention that uses community-based education and ‘below the line’ social marketing to increase fruit and vegetable consumption in parents. This programme was evaluated by a controlled before-and-after study with repeat cross-sectional data collected via computer-assisted telephone interviews with 1403 parents before the intervention (2008) and 1401 following intervention delivery (2011). The intervention area was the Hunter region and the control area was the New England region of New South Wales, Australia. Parents of primary school-aged children (Kindergarten to Year 6). The programme achieved improvements in knowledge of recommended intakes for fruit and vegetables and some positive changes in knowledge of serving size for vegetables. Exposure to the programme resulted in a net increase of 0.5 servings of fruit and vegetables daily for those who recalled the programme compared with those who did not (P = 0.004). Increased intake of fruit and vegetables was significantly associated with increasing exposure to programme strategies. The Eat It To Beat It programme demonstrates that an increase in consumption of fruit and vegetables can be achieved by programmes that build on the successes of larger mass-media and social-marketing campaigns.This suggests that funding for localised, community-based programmes should be increased.

Evaluating the Implementation of a School-Based Emotional Well-Being Programme: A Cluster Randomized Controlled Trial of Zippy's Friends for Children in Disadvantaged Primary Schools

ERIC Educational Resources Information Center

Clarke, Aleisha M.; Bunting, Brendan; Barry, Margaret M.

2014-01-01

Schools are recognized as one of the most important settings for promoting social and emotional well-being among children and adolescents. This clustered randomized controlled trial evaluated Zippy's Friends, an international school-based emotional well-being programme, with 766 children from designated disadvantaged schools. The purpose of this…

Upper secondary school students' compliance with two Internet-based self-help programmes: a randomised controlled trial.

PubMed

Antonson, Carl; Thorsén, Frida; Sundquist, Jan; Sundquist, Kristina

2018-02-01

Psychiatric symptoms and stress are on the increase among Swedish adolescents. We aimed to study the potential effect and feasibility of two Internet-based self-help programmes, one mindfulness based (iMBI) and the other music based in a randomised controlled trial that targeted adolescents. A total of 283 upper secondary school students in two Swedish schools were randomised to either a waiting list or one of the two programmes, on their own incentive, on schooltime. General psychiatric health (Symptoms Checklist 90), sleep quality (Pittsburgh Sleep Quality Index), and perceived stress (Perceived Stress Scale) were assessed before and after the interventions. In total, 202 participants answered the questionnaires. Less than 20 logged into each intervention and only 1 performed a full intervention (iMBI). No significant differences in any of the scales were found between those who logged in and those who did not. The potential effect of Internet-based self-help programmes was not possible to examine due to low compliance rates. Adolescents seem to have a very low compliance with Internet-based self-help programmes if left to their own incentive. There were no associations between the psychiatric and stress-related symptoms at baseline and compliance in any of the intervention groups, and no evidence for differences in compliance in relation to the type of programme. Additional studies are needed to examine how compliance rates can be increased in Internet-based self-help mindfulness programmes in adolescents, as the potentially positive effects of mindfulness are partly related to compliance rates.

Development and destruction of the first state funded anti-smoking campaign in the USA.

PubMed

Tsoukalas, T H; Glantz, S A

2003-06-01

Minnesota was the first state in the USA to implement a large state funded tobacco control programme (in 1985). Despite evidence of effectiveness, it was dismantled in 1993. To describe and analyse how and why these events transpired and identify lessons for tobacco control advocates facing similar challenges in the 21st century. Case study based on previously secret tobacco industry documents, news reports, research reports, official documents, and interviews with health advocates and state government officials. Unable to defeat funding for this campaign in 1985, the tobacco industry organised groups which eliminated it later. Despite the programme's documented effectiveness, it was dismantled based on claims of fiscal crisis. These claims were not true; the real debate was what to do with the state's surplus. Health advocates failed to challenge the claim of fiscal crisis or mobilise public support for the programme. Simply quoting evidence that a tobacco control programme is effective does not ensure its continuing survival. Claims of fiscal crisis are an effective cover for tobacco industry efforts to dismantle successful programmes, particularly if health advocates accept these claims and fail to mobilise political pressure to defend the programme.

Development and destruction of the first state funded anti-smoking campaign in the USA

PubMed Central

Tsoukalas, T; Glantz, S

2003-01-01

Background: Minnesota was the first state in the USA to implement a large state funded tobacco control programme (in 1985). Despite evidence of effectiveness, it was dismantled in 1993. Objective: To describe and analyse how and why these events transpired and identify lessons for tobacco control advocates facing similar challenges in the 21st century. Design: Case study based on previously secret tobacco industry documents, news reports, research reports, official documents, and interviews with health advocates and state government officials. Results: Unable to defeat funding for this campaign in 1985, the tobacco industry organised groups which eliminated it later. Despite the programme's documented effectiveness, it was dismantled based on claims of fiscal crisis. These claims were not true; the real debate was what to do with the state's surplus. Health advocates failed to challenge the claim of fiscal crisis or mobilise public support for the programme. Conclusions: Simply quoting evidence that a tobacco control programme is effective does not ensure its continuing survival. Claims of fiscal crisis are an effective cover for tobacco industry efforts to dismantle successful programmes, particularly if health advocates accept these claims and fail to mobilise political pressure to defend the programme. PMID:12773734

The effectiveness of an emotion-focused educational programme in reducing diabetes distress in adults with Type 2 diabetes mellitus (VEMOFIT): a cluster randomized controlled trial.

PubMed

Chew, B H; Vos, R C; Stellato, R K; Ismail, M; Rutten, G E H M

2018-06-01

To evaluate the effectiveness of a brief, value-based emotion-focused educational programme (VEMOFIT) in Malay adults with Type 2 diabetes mellitus compared with a programme of active listening to participants' emotional experiences, social support and their opinion on the health clinic diabetes care services (attention control). Malay adults with severe diabetes distress [Diabetes Distress Scale (DDS-17) mean score ≥ 3] were included. VEMOFIT consisted of four biweekly group sessions, a booster session after 3 months and a follow-up 6 months post intervention. The attention control programme consisted of three sessions over the same period. Outcomes included diabetes distress, depressive symptoms, self-efficacy and disease control. Required total sample size was 165. Participants (n = 124) were randomized to either VEMOFIT (n = 53) or the attention control programme (n = 71). Participants had a mean (sd) age of 55.7 (9.7) years, median diabetes duration of 7.0 (8.0) years and mean HbA 1c level of 82 mmol/mol (9.7%). The mean DDS-17 level decreased significantly in both the VEMOFIT and the attention control programmes (3.4 to 2.9 vs. 3.1 to 2.7, respectively). The adjusted between-group DDS-17 difference was not significant [-0.01, 95% confidence interval (CI) -0.38, 0.35]. The proportion of individuals with severe diabetes distress decreased in both groups, from 89% to 47% vs. 69% to 39% (odds ratio 0.88; 95% CI 0.26, 2.90). Other outcomes did not differ between groups. Both interventions decreased diabetes distress significantly. The theory-based VEMOFIT programme was not superior to the attention control programme. The latter approach is a simpler way to decrease severe diabetes distress (Trial registration: NCT02730078; NMRR-15-1144-24803). © 2018 Diabetes UK.

A randomized-controlled trial focusing on socio-economic status for promoting vegetable intake among adults using a web-based nutrition intervention programme: study protocol.

PubMed

Nakamura, Saki; Inayama, Takayo; Arao, Takashi

2017-01-13

Web-based nutritional education programmes appear to be comparable to those delivered face-to-face. However, no existing web-based nutrition education or similar programme has yet been evaluated with consideration of socio-economic status. The objective of a nutritional education programme of promoting vegetable intake designed a randomized controlled trial (RCT) is to evaluate the results of intervention and to determine how socio-economic status influences the programme effects. Participants will be randomly sampled individuals (aged 30-59) stratified according national population statistics for sex, age, and household income. Participants were consented to survey participation (n = 1500), and will be randomly divided into intervention and control groups. The intervention period is 5 weeks with one step of diet-related education per week. The main outcome of the programme is dietary behaviour as eating vegetable (350 g per day, five small bowl). To encourage behavioural changes, the programme contents are prepared using behavioural theories and techniques tailored to the assumed group stages of behavioural change. In the first step, we employ the health belief model to encourage a shift from the pre-contemplative to the contemplative phase; in the second and third steps, social cognitive theory is used to encourage transition to the preparatory phase; in the fourth step, social cognitive theory and strengthening social support are used to promote progression to the execution phase; finally, in the fifth step, strengthening social capital and social support are used to promote the shift to the maintenance phase. The baseline, post intervention and follow-up survey was assessed using a self-administered questionnaire. For process evaluation, we use five items relating to programme participation and satisfaction. A follow-up survey of participants will be carried out 3 months after intervention completion. The fact that this study is an RCT with an established control group is a strong advantage. Information and communications technology is not limited by time or place. If we could show this web-based nutrition education programmes has a positive effect, it may be an appropriate tool for reaching individuals in lower socio-economic state. Current Controlled Trials UMIN-ICDR UMIN 000019376 (Registered October 16, 2015).

What do community football players think about different exercise-training programmes? Implications for the delivery of lower limb injury prevention programmes

PubMed Central

Finch, Caroline F; Doyle, Tim LA; Dempsey, Alasdair R; Elliott, Bruce C; Twomey, Dara M; White, Peta E; Diamantopoulou, Kathy; Young, Warren; Lloyd, David G

2014-01-01

Background Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future. PMID:24047571

Effectiveness of a universal school-based programme for preventing depression in Chinese adolescents: a quasi-experimental pilot study.

PubMed

Wong, Paul W C; Fu, King-Wa; Chan, Kim Y K; Chan, Wincy S C; Liu, Patricia M Y; Law, Yik-Wa; Yip, Paul S F

2012-12-15

Evidence of the effectiveness, rather than efficacy, of universal school-based programmes for preventing depression among adolescents is limited. This study examined the effectiveness of a universal depression prevention programme, "The Little Prince is Depressed" (LPD), which adopted the cognitive-behavioural model and aimed to reduce depressive symptoms and enhance protective factors of depression among secondary school students in Hong Kong. A quasi-experimental design was adopted for this pilot study. Thirteen classes were assigned to the intervention or control conditions according to the deliberation of the programme administrator of the four participating schools. Implementation was carried out in two phases, with a professional-led first phase and teacher-led programme second phase. LPD consisted of a 12-week school-based face-to-face programme with psycho-educational lessons and homework assignments. Students completed the programme generally showed positive development in help-seeking attitudes and self-esteem. For students who had more depressive symptoms at pre-assessment, the programme was found to be significant in enhancing cognitive-restructuring skills and support-seeking behaviours. The programme was not, however, found to be statistically significant in reducing depressive symptoms of the participants over the study period. A small sample size, a high attrition rate, and a short follow-up time frame. The LPD programme was successful in building resilience of the students in general and enhancing the cognitive-behavioural skills of students with depressive symptoms. While we did not find sufficient evidence for concluding that the LPD was effective in reducing depressive symptoms, we believe that these results highlight the challenges of implementing evidence-based practices generated from highly controlled environments in real-life settings. Copyright © 2012 Elsevier B.V. All rights reserved.

Programmable calculator as a data system controller

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barth, A.W.; Strasburg, A.C.

Digital data techniques are in common use for analysis of analog information obtained in various tests, and systems have been developed which use a minicomputer as the central controller and data processor. Now, microprocessors allow new design approaches at considerably less cost. This report outlines an approach to system design based on the use of a programmable calculator as the data system controller. A block diagram of the calculator-controlled data system is shown. It was found that the programmable calculator provides a viable alternative to minicomputers or microprocessors for the development laboratory requiring digital data processing. 3 figures. (RWR)

Medical care of type 2 diabetes in German disease management programmes: a population-based evaluation.

PubMed

Stark, Reneé G; Schunk, Michaela V; Meisinger, Christine; Rathmann, Wolfgang; Leidl, Reiner; Holle, Rolf

2011-05-01

Type 2 diabetes disease management programmes (DDMPs) are offered by German social health insurance to promote healthcare consistent with evidence-based medical guidelines. The aim of this study was to compare healthcare quality and medical endpoints between diabetes management programme participants and patients receiving usual care designated as controls. All patients with type 2 diabetes (age range: 36-81) in a cross-sectional survey of a cohort study, performed by the Cooperative Health Research in the Region of Augsburg, received a self-administered questionnaire regarding their diabetes care. Physical examination and laboratory tests were also performed. The analysis only included patients with social health insurance and whose participation status in a diabetes disease management program was validated by the primary physician (n = 166). Regression analyses, adjusting for age, sex, education, diabetes duration, baseline waist circumference and clustering regarding primary physician were conducted. Evaluation of healthcare processes showed that those in diabetes disease management programmes (n = 89) reported medical examination of eyes and feet and medical advice regarding diet [odds ratio (OR): 2.39] and physical activity (OR: 2.87) more frequently, received anti-diabetic medications (OR: 3.77) and diabetes education more often (OR: 2.66) than controls. Both groups had satisfactory HbA(1c) control but poor low-density lipoprotein cholesterol control. Blood pressure goals (<140/90 mmHg) were achieved more frequently by patients in diabetes disease management programmes (OR: 2.21). German diabetes disease management programmes are associated with improved healthcare processes and blood pressure control. Low-density lipoprotein cholesterol control must be improved for all patients with diabetes. Further research will be required to assess the long-term effects of this diabetes disease management programme. Copyright © 2011 John Wiley & Sons, Ltd.

The use of a GIS-based malaria information system for malaria research and control in South Africa.

PubMed

Martin, Carrin; Curtis, Bronwyn; Fraser, Colleen; Sharp, Brian

2002-12-01

The paper aims to outline the innovative development and application of a Geographical Information System based Malaria Information System for malaria research and control in South Africa. This system is a product of collaboration between the Malaria Control Programmes and the Malaria Research Programme of the Medical Research Council of South Africa. The ability of such a system to process data timeously into a usable format is discussed, as well as its relevance to malaria research, appropriate malaria control measures, tourism, and social and economic development.

Mobile phone short message service messaging for behaviour modification in a community-based weight control programme in Korea.

PubMed

Joo, Nam-Seok; Kim, Bom-Taeck

2007-01-01

We conducted a community-based anti-obesity programme using mobile phone short message service (SMS) messaging. A total of 927 participants were recruited and visited a public health centre for initial assessment. Mobile phones were used to deliver short messages about diet, exercise and behaviour modification once a week. After a 12-week anti-obesity programme they visited the public health centre again. Four hundred and thirty-three subjects (47%) successfully completed their weight control programme. There were mean reductions of weight, waist circumference and body mass index of 1.6 kg (P < 0.001), 4.3 cm (P < 0.001) and 0.6 kg/m(2) (P < 0.001), respectively. Over two-thirds of the subjects had a reduction in waist circumference of 5-7.5 cm. A post-intervention survey showed that the majority of participants were satisfied with the weekly SMS messages and information brochures delivered by post. SMS messaging may be an effective method of behaviour modification in weight control and anti-obesity health education programmes when promoted by community health centres.

A control system based on field programmable gate array for papermaking sewage treatment

NASA Astrophysics Data System (ADS)

Zhang, Zi Sheng; Xie, Chang; Qing Xiong, Yan; Liu, Zhi Qiang; Li, Qing

2013-03-01

A sewage treatment control system is designed to improve the efficiency of papermaking wastewater treatment system. The automation control system is based on Field Programmable Gate Array (FPGA), coded with Very-High-Speed Integrate Circuit Hardware Description Language (VHDL), compiled and simulated with Quartus. In order to ensure the stability of the data used in FPGA, the data is collected through temperature sensors, water level sensor and online PH measurement system. The automatic control system is more sensitive, and both the treatment efficiency and processing power are increased. This work provides a new method for sewage treatment control.

Data from: Retrospective analysis of a classical biological control programme

USDA-ARS?s Scientific Manuscript database

This database contains the raw data for the publication entitled Naranjo, S.E. 2018. Retrospective analysis of a classical biological control programme. Journal of Applied Ecology https://doi.org/10.1111/1365-2664.13163. Specific data include field-based, partial life table data for immature stage...

Evaluation of a group based cognitive behavioural therapy programme for menstrual pain management in young women with intellectual disabilities: protocol for a mixed methods controlled clinical trial

PubMed Central

2014-01-01

Background Menstrual pain which is severe enough to impact on daily activities is very common amongst menstruating females. Research suggests that menstrual pain which impacts on daily functioning may be even more prevalent amongst those with intellectual disabilities. Despite this, little research attention has focused on pain management programmes for those with intellectual disabilities. The aims of this pilot study were to develop and evaluate a theory-based cognitive behavioural therapy (CBT) programme for menstrual pain management in young women with intellectual disabilities. Methods/Design The study utilised a mixed methods controlled clinical trial to evaluate elements from a CBT programme called Feeling Better (McGuire & McManus, 2010). The Feeling Better programme is a modular, manualised intervention designed for people with an intellectual disability and their carers. The programme was delivered to 36 young women aged 12 – 30 years who have a Mild - Moderate Intellectual Disability, split between two conditions. The treatment group received the Feeling Better intervention and the control group received treatment as usual. To evaluate the effectiveness of the programme, measures were taken of key pain variables including impact, knowledge, self-efficacy and coping. Process evaluation was conducted to examine which elements of the programme were most successful in promoting change. Discussion Participants in the intervention group were expected to report the use of a greater number of coping strategies and have greater knowledge of pain management strategies following participation in the intervention and at three month follow-up, when compared to control group participants. A significant advantage of the study was the use of mixed methods and inclusion of process evaluation to determine which elements of a cognitive behavioural therapy programme work best for individuals with intellectual disabilities. Trial registration Current Controlled Trials ISRCTN75567759 PMID:25201648

Efficacy of the Lexicon Pirate Strategy Therapy for Improving Lexical Learning in School-Age Children: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Motsch, Hans-Joachim; Marks, Dana-Kristin

2015-01-01

Lexicon Pirate was originally developed as a strategy intervention programme to treat lexical disorders of pre-school children. To evaluate the therapy's effectiveness for school-age students, a randomized controlled trial (RCT, N = 157) was conducted. Based on a pre--post-test design, the programme's impacts were compared with a control group…

Development of a group-based self-management programme for individuals with chronic fatigue syndrome: a pilot study.

PubMed

Pinxsterhuis, Irma; Hellum, Live Lange; Aannestad, Hilde Hassum; Sveen, Unni

2015-03-01

The aim of the study was to develop a group-based self-management programme for individuals with chronic fatigue syndrome (CFS) by using the participants' experiences with the initial version of the programme, which intends to promote coping with the illness in a primary healthcare setting. An initial programme was developed, based on self-efficacy theory and the concepts of client-centred practice and empowerment. Subsequently, the programme was tested and further developed by drawing on the participants' experiences with the programme. Focus-group interviews were applied. The interviews were analysed using thematic analysis. The initial programme was found to be feasible, although several modifications regarding the content and practical organization of the programme were proposed. In line with the participants' experiences, the final self-management programme was developed, which includes short presentations of eight topics, exchange of experiences among participants, goal-setting, construction of action plans, and relaxation exercises, in addition to a meeting for relatives. The programme will be provided in eight biweekly sessions and be led by juxtaposed peer counsellors and occupational therapists. The effects of the final programme will be evaluated in a randomized controlled trial.

Efficacy of 8- and 4-Session Mindfulness-Based Interventions in a Non-clinical Population: A Controlled Study.

PubMed

Demarzo, Marcelo; Montero-Marin, Jesus; Puebla-Guedea, Marta; Navarro-Gil, Mayte; Herrera-Mercadal, Paola; Moreno-González, Sergio; Calvo-Carrión, Sandra; Bafaluy-Franch, Laura; Garcia-Campayo, Javier

2017-01-01

Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted. Clinical Trials.gov Registration ID: NCT02643927.

Efficacy of 8- and 4-Session Mindfulness-Based Interventions in a Non-clinical Population: A Controlled Study

PubMed Central

Demarzo, Marcelo; Montero-Marin, Jesus; Puebla-Guedea, Marta; Navarro-Gil, Mayte; Herrera-Mercadal, Paola; Moreno-González, Sergio; Calvo-Carrión, Sandra; Bafaluy-Franch, Laura; Garcia-Campayo, Javier

2017-01-01

Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted. Clinical Trials.gov Registration ID: NCT02643927 PMID:28848465

'Football for Health'--a football-based health-promotion programme for children in South Africa: a parallel cohort study.

PubMed

Fuller, Colin W; Junge, Astrid; DeCelles, Jeff; Donald, James; Jankelowitz, Ryan; Dvorak, Jiri

2010-06-01

To develop, implement and assess an interactive, football-based health education programme for children in South Africa. Prospective cohort study with control group. Two schools in Khayelitsha township, South Africa. 370 children making up two intervention groups (Grade 6: 125; Grade 7: 131) and one control group (Grade 7: 114). Eleven 90 min sessions, each divided into two 45 min halves of Play Football (football skills) and Play Fair (health issues), each session focused on one specific health risk factor. Health knowledge using a 20-item questionnaire; coaches' attitudes towards their training programme using a 10-item questionnaire and children's attitudes towards the health education programme using a six-item questionnaire. Children in the Grade 7 intervention group showed significant (p<0.05) increases in the proportion of correct responses for nine of the 20 health knowledge questions postintervention, and these increases were maintained at 3 months postintervention. The Grade 6 intervention group showed significant increases in the proportion of correct responses for 15 of the 20 health knowledge questions postintervention. The Grade 7 control group showed a significant increase in the proportion of correct responses to one of the 20 health knowledge questions post-Play Football sessions and nine of 20 questions post-Play Fair sessions. Over 90% of the children provided positive attitude responses to the health-education programme. The programme demonstrated that it was possible to implement a football-based health-education programme for children in Africa that achieved significant increases in health knowledge and that was also well received by participants.

Evaluating the implementation of a school-based emotional well-being programme: a cluster randomized controlled trial of Zippy's Friends for children in disadvantaged primary schools.

PubMed

Clarke, Aleisha M; Bunting, Brendan; Barry, Margaret M

2014-10-01

Schools are recognized as one of the most important settings for promoting social and emotional well-being among children and adolescents. This clustered randomized controlled trial evaluated Zippy's Friends, an international school-based emotional well-being programme, with 766 children from designated disadvantaged schools. The purpose of this study was to evaluate the immediate and long term impact of the programme and to determine the impact of implementation fidelity on programme outcomes. Teachers reported emotional literacy outcomes using the Emotional Literacy Checklist, and emotional and behavioural outcomes using the Strengths and Difficulties Questionnaire. Controlling for the hierarchical structure of the data, path analysis using structural equation modelling revealed that the programme had a significant positive impact on the children's emotional literacy scores including significant improvements in the subscale scores of self-awareness (P < 0.001), self-regulation (P < 0.01), motivation (P < 0.001) and social skills (P < 0.001) at post-intervention. These results were maintained at 12-month follow-up (P < 0.01). The programme, however, did not have a significant impact on children's emotional and behavioural problems. Analysis of programme fidelity indicated that high fidelity was directly related to improved emotional literacy scores at post-intervention. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Integrated vector management for malaria control

PubMed Central

Beier, John C; Keating, Joseph; Githure, John I; Macdonald, Michael B; Impoinvil, Daniel E; Novak, Robert J

2008-01-01

Integrated vector management (IVM) is defined as "a rational decision-making process for the optimal use of resources for vector control" and includes five key elements: 1) evidence-based decision-making, 2) integrated approaches 3), collaboration within the health sector and with other sectors, 4) advocacy, social mobilization, and legislation, and 5) capacity-building. In 2004, the WHO adopted IVM globally for the control of all vector-borne diseases. Important recent progress has been made in developing and promoting IVM for national malaria control programmes in Africa at a time when successful malaria control programmes are scaling-up with insecticide-treated nets (ITN) and/or indoor residual spraying (IRS) coverage. While interventions using only ITNs and/or IRS successfully reduce transmission intensity and the burden of malaria in many situations, it is not clear if these interventions alone will achieve those critical low levels that result in malaria elimination. Despite the successful employment of comprehensive integrated malaria control programmes, further strengthening of vector control components through IVM is relevant, especially during the "end-game" where control is successful and further efforts are required to go from low transmission situations to sustained local and country-wide malaria elimination. To meet this need and to ensure sustainability of control efforts, malaria control programmes should strengthen their capacity to use data for decision-making with respect to evaluation of current vector control programmes, employment of additional vector control tools in conjunction with ITN/IRS tactics, case-detection and treatment strategies, and determine how much and what types of vector control and interdisciplinary input are required to achieve malaria elimination. Similarly, on a global scale, there is a need for continued research to identify and evaluate new tools for vector control that can be integrated with existing biomedical strategies within national malaria control programmes. This review provides an overview of how IVM programmes are being implemented, and provides recommendations for further development of IVM to meet the goals of national malaria control programmes in Africa. PMID:19091038

Effects of two physical education programmes on health- and skill-related physical fitness of Albanian children.

PubMed

Jarani, J; Grøntved, A; Muca, F; Spahi, A; Qefalia, D; Ushtelenca, K; Kasa, A; Caporossi, D; Gallotta, M C

2016-01-01

This study aims to evaluate the effectiveness of two school-based physical education (PE) programmes (exercise-based and games-based) compared with traditional PE, on health- and skill-related physical fitness components in children in Tirana, Albania. Participants were 378 first-grade (6.8 years) and 389 fourth-grade (9.8 years) children attending four randomly selected schools in Tirana. Twenty-four school classes within these schools were randomly selected (stratified by school and school grade) to participate as exercise group (EG), games group (GG) and control group (CG). Both EG and GG intervention programmes were taught by professional PE teachers using station/circuit teaching framework while CG referred to traditional PE school lessons by a general teacher. All programmes ran in parallel and lasted 5 months, having the same frequency (twice weekly) and duration (45 min). Heart rate (HR) monitoring showed that intensity during PE lessons was significantly higher in the intervention groups compared with control (P < 0.001). Both PE exercise- and games programmes significantly improved several health- and skill-related fitness indicators compared with traditional PE lessons (e.g. gross motor skill summary score: 9.4 (95% CI 7.9; 10.9) for exercise vs. control and 6.5 (95% CI 5.1; 8.1) for games vs. control, cardiorespiratory fitness: 2.0 ml O2 · min(-1) · kg(-1) (95% CI 1.5; 2.4) for exercise vs. control and 1.4 ml O2 · min(-1) · kg(-1) (95% CI 1.0; 1.8) for games vs. control). Furthermore, compared to games-based PE, exercise-based PE showed more positive changes in some gross motor coordination skills outcomes, coordination skills outcomes and cardiorespiratory fitness. The results from this study show that exercise- and games-based PE represents a useful strategy for improving health- and skill-related physical fitness in Albanian elementary school children. In addition, the study shows that exercise-based PE was more effective than games-based PE in improving gross motor function and cardiorespiratory fitness.

A Programmable System for Motion Control

NASA Technical Reports Server (NTRS)

Nowlin, Brent C.

2003-01-01

The need for improved flow measurements in the flow path of aeronautics testing facilities has led the NASA Glenn Research Center to develop a new motion control system. The new system is programmable, offering a flexibility unheard of in previous systems. The motion control system is PLC-based, which leads to highly accurate positioning ability, as well as reliability. The user interface is a software-based HMI package, which also adds flexibility to the overall system. The system also has the ability to create and execute motion profiles. This paper discusses the system's operation, control implementation, and experiences.

Effects of the Anger Coping Programme based on cognitive behavioural techniques on adolescents' anger, aggression and psychological symptoms.

PubMed

Avci, Dilek; Kelleci, Meral

2016-04-01

This study aimed to determine the effects of an Anger Coping Programme based on cognitive behavioural techniques on adolescents' anger, aggression and psychological symptoms. In this randomized controlled experimental study, 385 ninth-year high school students in Turkey were administered the State-Trait Anger Expression Inventory, the Aggression Scale and the Brief Symptom Inventory in 2011-2012. Of the 385 students, 62 who met the inclusion criteria were randomly assigned to experimental and control groups by gender and the scores they obtained from the scales. The students in the experimental group met 1 day a week for 1.5 h, and the study lasted 10 weeks. The scales were administered three times: before the programme was started, immediately after the programme was completed and 6 weeks later. The Anger Coping Programme was effective at reducing students' anger and aggression levels, and a range of psychological symptoms except for somatization. © 2015 John Wiley & Sons Australia, Ltd.

77 FR 33243 - Applications and Amendments to Facility Operating Licenses and Combined Licenses Involving...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

... Operations Management Tricon Programmable Logic Controller (PLC), Version 10, and the CS Innovations, LLC... process protection system that is based on the Invensys Operations Management Tricon Programmable Logic...

Programmable Electrochemical Rectifier Based on a Thin-Layer Cell.

PubMed

Park, Seungjin; Park, Jun Hui; Hwang, Seongpil; Kwak, Juhyoun

2017-06-21

A programmable electrochemical rectifier based on thin-layer electrochemistry is described here. Both the rectification ratio and the response time of the device are programmable by controlling the gap distance of the thin-layer electrochemical cell, which is easily controlled using commercially available beads. One of the electrodes was modified using a ferrocene-terminated self-assembled monolayer to offer unidirectional charge transfers via soluble redox species. The thin-layer configuration provided enhanced mass transport, which was determined by the gap thickness. The device with the smallest gap thickness (∼4 μm) showed an unprecedented, high rectification ratio (up to 160) with a fast response time in a two-terminal configuration using conventional electronics.

Past and Ongoing Tsetse and Animal Trypanosomiasis Control Operations in Five African Countries: A Systematic Review

PubMed Central

Holt, Hannah R.; Selby, Richard; Guitian, Javier

2016-01-01

Background Control operations targeting Animal African Trypanosomiasis and its primary vector, the tsetse, were covering approximately 128,000 km2 of Africa in 2001, which is a mere 1.3% of the tsetse infested area. Although extensive trypanosomiasis and tsetse (T&T) control operations have been running since the beginning of the 20th century, Animal African Trypanosomiasis is still a major constraint of livestock production in sub-Saharan Africa. Methodology/Principal Findings We performed a systematic review of the existing literature describing T&T control programmes conducted in a selection of five African countries, namely Burkina Faso, Cameroon, Ethiopia, Uganda and Zambia, between 1980 and 2015. Sixty-eight documents were eventually selected from those identified by the database search. This was supplemented with information gathered through semi-structured interviews conducted with twelve key informants recruited in the study countries and selected based on their experience and knowledge of T&T control. The combined information from these two sources was used to describe the inputs, processes and outcomes from 23 major T&T control programmes implemented in the study countries. Although there were some data gaps, involvement of the target communities and sustainability of the control activities were identified as the two main issues faced by these programmes. Further, there was a lack of evaluation of these control programmes, as well as a lack of a standardised methodology to conduct such evaluations. Conclusions/Significance Past experiences demonstrated that coordinated and sustained control activities require careful planning, and evidence of successes, failures and setbacks from past control programmes represent a mine of information. As there is a lack of evaluation of these programmes, these data have not been fully exploited for the design, analyses and justification of future control programmes. PMID:28027299

Can a school-based sleep education programme improve sleep knowledge, hygiene and behaviours using a randomised controlled trial.

PubMed

Rigney, Gabrielle; Blunden, Sarah; Maher, Carol; Dollman, James; Parvazian, Somayeh; Matricciani, Lisa; Olds, Timothy

2015-06-01

The present study investigated the effectiveness of a school-based sleep education programme in improving key sleep behaviours, sleep knowledge, and sleep hygiene. A cross-sectional cluster-randomised controlled trial with two groups (Intervention and Control) and three assessment time points [baseline, immediately post intervention (6 weeks post baseline) and follow-up (18 weeks post baseline)] was employed. A total of 296 students (mean age = 12.2 ± 0.6 years; 59% female) from 12 schools in Adelaide, South Australia, were recruited, with 149 participants in the Intervention group and 147 in the Control group. The intervention consisted of four classroom lessons delivered at weekly intervals, followed by a group project on sleep topics, which students presented at a parental information evening. Sleep patterns were assessed objectively (actigraphy, n = 175) and subjectively (time-use recall, n = 251) at three time points. Sleep knowledge and sleep hygiene (n = 296) were also measured. Generalised estimating equations were used to compare changes in the Intervention and Control groups. The programme increased time in bed by 10 min (p = 0.03) for the Intervention group relative to the Control group, due to a 10-min delay in wake time (p = 0.00). These changes were not sustained at follow-up. There was no impact on sleep knowledge or sleep hygiene. Investment in the sleep health of youth through sleep education is important but changes to sleep patterns are difficult to achieve. More intensive programmes, programmes with a different focus or programmes targeting different age groups may be more effective. Copyright © 2015 Elsevier B.V. All rights reserved.

‘Football for Health’—a football-based health-promotion programme for children in South Africa: a parallel cohort study

PubMed Central

Fuller, Colin W; Junge, Astrid; DeCelles, Jeff; Donald, James; Jankelowitz, Ryan; Dvorak, Jiri

2010-01-01

Objectives To develop, implement and assess an interactive, football-based health education programme for children in South Africa. Design Prospective cohort study with control group. Setting Two schools in Khayelitsha township, South Africa. Participants 370 children making up two intervention groups (Grade 6: 125; Grade 7: 131) and one control group (Grade 7: 114). Intervention Eleven 90 min sessions, each divided into two 45 min halves of Play Football (football skills) and Play Fair (health issues), each session focused on one specific health risk factor. Main outcome measures Health knowledge using a 20-item questionnaire; coaches' attitudes towards their training programme using a 10-item questionnaire and children's attitudes towards the health education programme using a six-item questionnaire. Results Children in the Grade 7 intervention group showed significant (p<0.05) increases in the proportion of correct responses for nine of the 20 health knowledge questions postintervention, and these increases were maintained at 3 months postintervention. The Grade 6 intervention group showed significant increases in the proportion of correct responses for 15 of the 20 health knowledge questions postintervention. The Grade 7 control group showed a significant increase in the proportion of correct responses to one of the 20 health knowledge questions post-Play Football sessions and nine of 20 questions post-Play Fair sessions. Over 90% of the children provided positive attitude responses to the health-education programme. Conclusions The programme demonstrated that it was possible to implement a football-based health-education programme for children in Africa that achieved significant increases in health knowledge and that was also well received by participants. PMID:20547667

Effect of a Universal Anxiety Prevention Programme (FRIENDS) on Children's Academic Performance: Results from a Randomised Controlled Trial

ERIC Educational Resources Information Center

Skryabina, Elena; Taylor, Gordon; Stallard, Paul

2016-01-01

Background: Evaluations of school-based anxiety prevention programmes have reported improvements in psychological functioning although little is known about their effect upon educational outcomes. Methods: One thousand three hundred and sixty-two children from 40 primary schools in England took part in the randomised controlled trial, Preventing…

Rational Emotive Behavior Based on Academic Procrastination Prevention: Training Programme of Effectiveness

ERIC Educational Resources Information Center

Düsmez, Ihsan; Barut, Yasar

2016-01-01

The research is an experimental study which has experimental and control groups, and based on pre-test, post-test, monitoring test model. Research group consists of second and third grade students of Primary School Education and Psychological Counseling undergraduate programmes in Giresun University Faculty of Educational Sciences. The research…

Effectiveness of the 'Home-but not Alone' mobile health application educational programme on parental outcomes: a randomized controlled trial, study protocol.

PubMed

Shorey, Shefaly; Ng, Yvonne Peng Mei; Danbjørg, Dorthe Boe; Dennis, Cindy-Lee; Morelius, Evalotte

2017-01-01

The aim of this study was to describe a study protocol that evaluates the effectiveness of the 'Home-but not Alone' educational programme delivered via a mobile health application in improving parenting outcomes. The development in mobile-based technology gives us the opportunity to develop an accessible educational programme that can be potentially beneficial to new parents. However, there is a scarcity of theory-based educational programmes that have incorporated technology such as a mobile health application in the early postpartum period. A randomized controlled trial with a two-group pre-test and post-test design. The data will be collected from 118 couples. Eligible parents will be randomly allocated to either a control group (receiving routine care) or an intervention group (routine care plus access to the 'Home-but not Alone' mobile health application. Outcome measures comprise of parenting self-efficacy, social support, parenting satisfaction and postnatal depression. Data will be collected at the baseline (on the day of discharge) and at four weeks postpartum. This will be an empirical study that evaluates a theory-based educational programme delivered via an innovative mobile health application on parental outcomes. Results from this study will enhance parenting self-efficacy, social support and parenting satisfaction, which may then reduce parental risks of postnatal depression. © 2016 John Wiley & Sons Ltd.

Programmable dispersion on a photonic integrated circuit for classical and quantum applications.

PubMed

Notaros, Jelena; Mower, Jacob; Heuck, Mikkel; Lupo, Cosmo; Harris, Nicholas C; Steinbrecher, Gregory R; Bunandar, Darius; Baehr-Jones, Tom; Hochberg, Michael; Lloyd, Seth; Englund, Dirk

2017-09-04

We demonstrate a large-scale tunable-coupling ring resonator array, suitable for high-dimensional classical and quantum transforms, in a CMOS-compatible silicon photonics platform. The device consists of a waveguide coupled to 15 ring-based dispersive elements with programmable linewidths and resonance frequencies. The ability to control both quality factor and frequency of each ring provides an unprecedented 30 degrees of freedom in dispersion control on a single spatial channel. This programmable dispersion control system has a range of applications, including mode-locked lasers, quantum key distribution, and photon-pair generation. We also propose a novel application enabled by this circuit - high-speed quantum communications using temporal-mode-based quantum data locking - and discuss the utility of the system for performing the high-dimensional unitary optical transformations necessary for a quantum data locking demonstration.

Do community-based rehabilitation programmes promote the participation of persons with disabilities? A case control study from Mandya District, in India.

PubMed

Biggeri, Mario; Deepak, Sunil; Mauro, Vincenzo; Trani, Jean-Francois; Kumar, Jayanth; Ramasamy, Parthipan

2014-01-01

In this paper, we measure the effectiveness of Community-Based Rehabilitation (CBR) programmes in promoting the well-being of people with disabilities and removing the barriers to their participation in family and community decision-making processes. To evaluate the impact of the CBR programme, we use data from a large-scale control study in Karnataka, India. Propensity score matching is used to evaluate the impacts on disabled persons after 2, 4 and 7 years of entering the CBR. The theoretical framework for the analysis is based on the CBR guidelines, which are combined with the International Classification of Functionings (ICF), the United Nations Convention on the Rights of People with Disabilities (UN CRPD) and Amartya Sen's capability approach. CBR has a positive impact on the well-being of persons with disabilities participating in the programme and particularly on their participation within the family and the society at large. CBR programmes have a multidimensional and positive impact on individual and collective capabilities; on individual, agency and social empowerment. Implications for Rehabilitation Community-Based Rehabilitation (CBR) can make a lasting difference in the life of persons with disabilities. CBR improves participation and inclusion of persons with disabilities in the family and in the community.

Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania.

PubMed

Chaki, Prosper P; Kannady, Khadija; Mtasiwa, Deo; Tanner, Marcel; Mshinda, Hassan; Kelly, Ann H; Killeen, Gerry F

2014-06-25

Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam's City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes.

Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania

PubMed Central

2014-01-01

Background Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. Case description The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. Discussion and evaluation The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. Conclusions The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam’s City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes. PMID:24964790

A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol.

PubMed

Nery, Susana Vaz; McCarthy, James S; Traub, Rebecca; Andrews, Ross M; Black, Jim; Gray, Darren; Weking, Edmund; Atkinson, Jo-An; Campbell, Suzy; Francis, Naomi; Vallely, Andrew; Williams, Gail; Clements, Archie

2015-12-30

There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes. This study is funded by a Partnership for Better Health--Project grant from the National Health and Research Council (NHMRC), Australia. ACTRN12614000680662; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol

PubMed Central

Nery, Susana Vaz; McCarthy, James S; Traub, Rebecca; Andrews, Ross M; Black, Jim; Gray, Darren; Weking, Edmund; Atkinson, Jo-An; Campbell, Suzy; Francis, Naomi; Vallely, Andrew; Williams, Gail; Clements, Archie

2015-01-01

Introduction There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. Methods and analysis WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. Ethics and dissemination Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes. This study is funded by a Partnership for Better Health—Project grant from the National Health and Research Council (NHMRC), Australia. Trial registration number ACTRN12614000680662; Pre-results PMID:26719316

The Applications of Model-Based Geostatistics in Helminth Epidemiology and Control

PubMed Central

Magalhães, Ricardo J. Soares; Clements, Archie C.A.; Patil, Anand P.; Gething, Peter W.; Brooker, Simon

2011-01-01

Funding agencies are dedicating substantial resources to tackle helminth infections. Reliable maps of the distribution of helminth infection can assist these efforts by targeting control resources to areas of greatest need. The ability to define the distribution of infection at regional, national and subnational levels has been enhanced greatly by the increased availability of good quality survey data and the use of model-based geostatistics (MBG), enabling spatial prediction in unsampled locations. A major advantage of MBG risk mapping approaches is that they provide a flexible statistical platform for handling and representing different sources of uncertainty, providing plausible and robust information on the spatial distribution of infections to inform the design and implementation of control programmes. Focussing on schistosomiasis and soil-transmitted helminthiasis, with additional examples for lymphatic filariasis and onchocerciasis, we review the progress made to date with the application of MBG tools in large-scale, real-world control programmes and propose a general framework for their application to inform integrative spatial planning of helminth disease control programmes. PMID:21295680

A dual-task home-based rehabilitation programme for improving balance control in patients with acquired brain injury: a single-blind, randomized controlled pilot study.

PubMed

Peirone, Eliana; Goria, Paolo Filiberto; Anselmino, Arianna

2014-04-01

To evaluate the safety, feasibility and effectiveness of a dual-task home-based rehabilitation programme on balance impairments among adult patients with acquired brain injury. Single-blind, randomized controlled pilot study. Single rehabilitation centre. Sixteen participants between 12 and 18 months post-acquired brain injury with balance impairments and a score <10 seconds on the One-Leg Stance Test (eyes open). All participants received 50-minutes individualised traditional physiotherapy sessions three times a week for seven weeks. In addition, the intervention group (N = 8) performed an individualised dual-task home-based programme six days a week for seven weeks. The primary outcome measure was the Balance Evaluation System Test; secondary measures were the Activities-specific Balance Confidence Scale and Goal Attainment Scaling. At the end of the pilot study, the intervention group showed significantly greater improvement in Balance Evaluation System Test scores (17.87, SD 6.05) vs. the control group (5.5, SD 3.53; P = 0.008, r = 0.63). There was no significant difference in improvement in Activities-specific Balance Confidence Scale scores between the intervention group (25.25, SD 25.51) and the control group (7.00, SD 14.73; P = 0.11, r = 0.63). There was no significant improvement in Goal Attainment Scaling scores in the intervention (19.37, SD 9.03) vs. the control group (16.28, SD 6.58; P = 0.093, r = 0.63). This pilot study shows the safety, feasibility and short-term benefit of a dual-task home-based rehabilitation programme to improve balance control in patients with acquired brain injury. A sample size of 26 participants is required for a definitive study.

FPGA-based multiprocessor system for injection molding control.

PubMed

Muñoz-Barron, Benigno; Morales-Velazquez, Luis; Romero-Troncoso, Rene J; Rodriguez-Donate, Carlos; Trejo-Hernandez, Miguel; Benitez-Rangel, Juan P; Osornio-Rios, Roque A

2012-10-18

The plastic industry is a very important manufacturing sector and injection molding is a widely used forming method in that industry. The contribution of this work is the development of a strategy to retrofit control of an injection molding machine based on an embedded system microprocessors sensor network on a field programmable gate array (FPGA) device. Six types of embedded processors are included in the system: a smart-sensor processor, a micro fuzzy logic controller, a programmable logic controller, a system manager, an IO processor and a communication processor. Temperature, pressure and position are controlled by the proposed system and experimentation results show its feasibility and robustness. As validation of the present work, a particular sample was successfully injected.

"Crazy? So what!": A School Programme to Promote Mental Health and Reduce Stigma--Results of a Pilot Study

ERIC Educational Resources Information Center

Conrad, Ines; Dietrich, Sandra; Heider, Dirk; Blume, Anne; Angermeyer, Matthias C.; Riedel-Heller, Steffi

2009-01-01

Purpose: The purpose of this paper is to evaluate the health-promoting and stigma-reducing effect of the German school-based programme "Crazy? So what!". Design/methodology/approach: A quasi-experimental longitudinal control-study was carried out with assessments one week prior to the school programme, immediately after it and three…

Exercise-based cardiac rehabilitation increases daily physical activity of patients following myocardial infarction: subanalysis of two randomised controlled trials.

PubMed

Ribeiro, F; Oliveira, N L; Silva, G; Campos, L; Miranda, F; Teixeira, M; Alves, A J; Oliveira, J

2017-03-01

To assess the effects of an exercise-based cardiac rehabilitation programme on daily physical activity levels of patients following myocardial infarction. Subanalysis of two randomised, prospective controlled trials. Outpatient clinic of a secondary hospital. Fifty consecutive patients randomised to the exercise group {n=25; 23 males; mean age 54 [standard deviation (SD) 9] years} or the control group [n=25; 20 males; mean age 58 (SD 9) years]. The exercise group participated in an 8-week aerobic exercise programme plus usual medical care and follow-up. The control group received usual medical care and follow-up. The primary outcome measure was change in time spent undertaking moderate-to-vigorous physical activity per day, assessed by accelerometer over 7 consecutive days. Secondary outcome measures were cardiorespiratory fitness, body mass, and resting blood pressure and heart rate. Moderate-to-vigorous physical activity levels increased significantly in the exercise group [43.2 (SD 36.3) to 53.5 (SD 31.9) minutes/day, P=0.030], and remained unchanged in the control group [40.8 (SD 26.2) to 36.8 (SD 26.5) minutes/day, P=0.241] from baseline to the end of the programme. Cardiorespiratory fitness increased significantly in the exercise group (mean difference 2.8; 95% of the difference 1.3 to 4.4ml/kg/minute, P=0.001) after the 8-week programme. In patients under optimal medication following myocardial infarction, participation in an 8-week exercise-based cardiac rehabilitation programme was found to improve physical activity levels consistent with health-related benefits. Future studies are needed to determine whether the increase in physical activity is maintained in the long term. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Preventing substance misuse: study protocol for a randomised controlled trial of the Strengthening Families Programme 10–14 UK (SFP 10–14 UK)

PubMed Central

2014-01-01

Background Prevention of alcohol, drug and tobacco misuse by young people is a key public health priority. There is a need to develop the evidence base through rigorous evaluations of innovative approaches to substance misuse prevention. The Strengthening Families Programme 10–14 is a universal family-based alcohol, drugs and tobacco prevention programme, which has achieved promising results in US trials, and which now requires cross-cultural assessment. This paper therefore describes the protocol for a randomised controlled trial of the UK version of the Strengthening Families Programme 10–14 (SFP 10–14 UK). Methods/Design The trial comprises a pragmatic cluster randomised controlled effectiveness trial with families as the unit of randomisation, with embedded process and economic evaluations. Participating families will be randomised to one of two treatment groups - usual care with full access to existing services (control group), or usual care plus SFP 10–14 UK (intervention group). The trial has two primary outcomes - the number of occasions that young people report having drunk alcohol in the last 30 days, and drunkenness during the last 30 days, both dichotomised as ‘never’ and ‘1-2 times or more’. The main follow-up is at 2 years past baseline, and short-term and intermediate outcomes are also measured at 9 and 15 months. Discussion The results from this trial will provide evidence on the effectiveness and cost-effectiveness of an innovative universal family-based substance misuse prevention programme in a UK context. Trial registration Current Controlled Trials ISRCTN63550893. PMID:24438460

Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial

PubMed Central

Chaplin, Emma; Hewitt, Stacey; Apps, Lindsay; Bankart, John; Pulikottil-Jacob, Ruth; Boyce, Sally; Morgan, Mike; Williams, Johanna; Singh, Sally

2017-01-01

Objectives The aim of this study was to determine if an interactive web-based pulmonary rehabilitation (PR) programme is a feasible alternative to conventional PR. Design Randomised controlled feasibility trial. Setting Participants with a diagnosis of chronic obstructive pulmonary disease were recruited from PR assessments, primary care and community rehabilitation programmes. Patients randomised to conventional rehabilitation started the programme according to the standard care at their referred site on the next available date. Participants 103 patients were recruited to the study and randomised: 52 to conventional rehabilitation (mean (±SD) age 66 (±8) years, Medical Research Council (MRC) 3 (IQR2–4)); 51 to the web arm (mean (±SD) age 66 (±10) years, MRC 3 (IQR2–4)). Participants had to be willing to participate in either arm of the trial, have internet access and be web literate. Interventions Patients randomised to the web-based programme worked through the website, exercising and recording their progress as well as reading educational material. Conventional PR consisted of twice weekly, 2 hourly sessions (an hour for exercise training and an hour for education). Outcome measures Recruitment rates, eligibility, patient preference and dropout and completion rates for both programmes were collected. Standard outcomes for a PR assessment including measures of exercise capacity and quality of life questionnaires were also evaluated. Results A statistically significant improvement (p≤0.01) was observed within each group in the endurance shuttle walk test (WEB: mean change 189±211.1; PR classes: mean change 184.5±247.4 s) and Chronic Respiratory disease Questionnaire-Dyspnoea (CRQ-D; WEB: mean change 0.7±1.2; PR classes: mean change 0.8±1.0). However, there were no significant differences between the groups in any outcome. Dropout rates were higher in the web-based programme (57% vs 23%). Conclusions An interactive web-based PR programme is feasible and acceptable when compared with conventional PR. Future trials maybe around choice-based PR programmes for select patients enabling stratification of patient care. Trial registration number ISRCTN03142263; Results. PMID:28363923

Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial.

PubMed

Chaplin, Emma; Hewitt, Stacey; Apps, Lindsay; Bankart, John; Pulikottil-Jacob, Ruth; Boyce, Sally; Morgan, Mike; Williams, Johanna; Singh, Sally

2017-03-31

The aim of this study was to determine if an interactive web-based pulmonary rehabilitation (PR) programme is a feasible alternative to conventional PR. Randomised controlled feasibility trial. Participants with a diagnosis of chronic obstructive pulmonary disease were recruited from PR assessments, primary care and community rehabilitation programmes. Patients randomised to conventional rehabilitation started the programme according to the standard care at their referred site on the next available date. 103 patients were recruited to the study and randomised: 52 to conventional rehabilitation (mean (±SD) age 66 (±8) years, Medical Research Council (MRC) 3 (IQR2-4)); 51 to the web arm (mean (±SD) age 66 (±10) years, MRC 3 (IQR2-4)). Participants had to be willing to participate in either arm of the trial, have internet access and be web literate. Patients randomised to the web-based programme worked through the website, exercising and recording their progress as well as reading educational material. Conventional PR consisted of twice weekly, 2 hourly sessions (an hour for exercise training and an hour for education). Recruitment rates, eligibility, patient preference and dropout and completion rates for both programmes were collected. Standard outcomes for a PR assessment including measures of exercise capacity and quality of life questionnaires were also evaluated. A statistically significant improvement (p≤0.01) was observed within each group in the endurance shuttle walk test (WEB: mean change 189±211.1; PR classes: mean change 184.5±247.4 s) and Chronic Respiratory disease Questionnaire-Dyspnoea (CRQ-D; WEB: mean change 0.7±1.2; PR classes: mean change 0.8±1.0). However, there were no significant differences between the groups in any outcome. Dropout rates were higher in the web-based programme (57% vs 23%). An interactive web-based PR programme is feasible and acceptable when compared with conventional PR. Future trials maybe around choice-based PR programmes for select patients enabling stratification of patient care. ISRCTN03142263; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Effects of Cluster-Based Mentoring Programme on Classroom Teaching Practices: Lessons from Pakistan

ERIC Educational Resources Information Center

Rizvi, Meher; Nagy, Philip

2016-01-01

This paper presents and evaluates a teacher training approach called the cluster-based mentoring programme (CBMP) for the professional development of government primary school teachers in Pakistan. The study sought to find differences in the teaching practices between districts where the CBMP was used (intervention) and control districts where it…

Multimedia Scenario Based Learning Programme for Enhancing the English Language Efficiency among Primary School Students

ERIC Educational Resources Information Center

Tupe, Navnath

2015-01-01

This research was undertaken with a view to assess the deficiencies in English language among Primary School Children and to develop Multimedia Scenario Based Learning Programme (MSBLP) for mastery of English language which required special attention and effective treatment. The experimental study with pre-test, post-test control group design was…

Punch Card Programmable Microfluidics

PubMed Central

Korir, George; Prakash, Manu

2015-01-01

Small volume fluid handling in single and multiphase microfluidics provides a promising strategy for efficient bio-chemical assays, low-cost point-of-care diagnostics and new approaches to scientific discoveries. However multiple barriers exist towards low-cost field deployment of programmable microfluidics. Incorporating multiple pumps, mixers and discrete valve based control of nanoliter fluids and droplets in an integrated, programmable manner without additional required external components has remained elusive. Combining the idea of punch card programming with arbitrary fluid control, here we describe a self-contained, hand-crank powered, multiplex and robust programmable microfluidic platform. A paper tape encodes information as a series of punched holes. A mechanical reader/actuator reads these paper tapes and correspondingly executes operations onto a microfluidic chip coupled to the platform in a plug-and-play fashion. Enabled by the complexity of codes that can be represented by a series of holes in punched paper tapes, we demonstrate independent control of 15 on-chip pumps with enhanced mixing, normally-closed valves and a novel on-demand impact-based droplet generator. We demonstrate robustness of operation by encoding a string of characters representing the word “PUNCHCARD MICROFLUIDICS” using the droplet generator. Multiplexing is demonstrated by implementing an example colorimetric water quality assays for pH, ammonia, nitrite and nitrate content in different water samples. With its portable and robust design, low cost and ease-of-use, we envision punch card programmable microfluidics will bring complex control of microfluidic chips into field-based applications in low-resource settings and in the hands of children around the world. PMID:25738834

Final Report A Multi-Language Environment For Programmable Code Optimization and Empirical Tuning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yi, Qing; Whaley, Richard Clint; Qasem, Apan

This report summarizes our effort and results of building an integrated optimization environment to effectively combine the programmable control and the empirical tuning of source-to-source compiler optimizations within the framework of multiple existing languages, specifically C, C++, and Fortran. The environment contains two main components: the ROSE analysis engine, which is based on the ROSE C/C++/Fortran2003 source-to-source compiler developed by Co-PI Dr.Quinlan et. al at DOE/LLNL, and the POET transformation engine, which is based on an interpreted program transformation language developed by Dr. Yi at University of Texas at San Antonio (UTSA). The ROSE analysis engine performs advanced compiler analysis,more » identifies profitable code transformations, and then produces output in POET, a language designed to provide programmable control of compiler optimizations to application developers and to support the parameterization of architecture-sensitive optimizations so that their configurations can be empirically tuned later. This POET output can then be ported to different machines together with the user application, where a POET-based search engine empirically reconfigures the parameterized optimizations until satisfactory performance is found. Computational specialists can write POET scripts to directly control the optimization of their code. Application developers can interact with ROSE to obtain optimization feedback as well as provide domain-specific knowledge and high-level optimization strategies. The optimization environment is expected to support different levels of automation and programmer intervention, from fully-automated tuning to semi-automated development and to manual programmable control.« less

Punch card programmable microfluidics.

PubMed

Korir, George; Prakash, Manu

2015-01-01

Small volume fluid handling in single and multiphase microfluidics provides a promising strategy for efficient bio-chemical assays, low-cost point-of-care diagnostics and new approaches to scientific discoveries. However multiple barriers exist towards low-cost field deployment of programmable microfluidics. Incorporating multiple pumps, mixers and discrete valve based control of nanoliter fluids and droplets in an integrated, programmable manner without additional required external components has remained elusive. Combining the idea of punch card programming with arbitrary fluid control, here we describe a self-contained, hand-crank powered, multiplex and robust programmable microfluidic platform. A paper tape encodes information as a series of punched holes. A mechanical reader/actuator reads these paper tapes and correspondingly executes operations onto a microfluidic chip coupled to the platform in a plug-and-play fashion. Enabled by the complexity of codes that can be represented by a series of holes in punched paper tapes, we demonstrate independent control of 15 on-chip pumps with enhanced mixing, normally-closed valves and a novel on-demand impact-based droplet generator. We demonstrate robustness of operation by encoding a string of characters representing the word "PUNCHCARD MICROFLUIDICS" using the droplet generator. Multiplexing is demonstrated by implementing an example colorimetric water quality assays for pH, ammonia, nitrite and nitrate content in different water samples. With its portable and robust design, low cost and ease-of-use, we envision punch card programmable microfluidics will bring complex control of microfluidic chips into field-based applications in low-resource settings and in the hands of children around the world.

The effects of a three-year smoking prevention programme in secondary schools in Helsinki.

PubMed

Vartiainen, Erkki; Pennanen, Marjaana; Haukkala, Ari; Dijk, Froukje; Lehtovuori, Riku; De Vries, Hein

2007-06-01

This study evaluates the effects of a 3-year smoking prevention programme in secondary schools in Helsinki. The study is part of the European Smoking prevention Framework Approach (ESFA), in which Denmark, Finland, the Netherlands, Portugal, Spain and the UK participated. A total of 27 secondary schools in Finland participated in the programme (n = 1821). Schools were randomised into experimental (13) and control groups (14). The programme included 14 information lessons about smoking and refusal skills training. The 3-year smoking prevention programme was also integrated into the standard curriculum. The community-element of the programme included parents, parish confirmation camps and dentists. The schools in the experimental group received the prevention programme and the schools in the control group received the standard health education curriculum. Among baseline never smokers (60.8%), the programme had a significant effect on the onset of weekly smoking in the experimental group [OR = 0.63 (0.45-0.90) P = 0.009] when compared with the control group. Being female, doing poorly at school, having parents and best friends who smoke and more pocket money to spend compared with others were associated with an increased likelihood of daily and weekly smoking onset. These predictors did not have an interaction effect with the experimental condition. This study shows that a school- and community-based smoking prevention programme can prevent smoking onset among adolescents.

Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial

PubMed Central

Hislop, Michael D; Stokes, Keith A; Williams, Sean; McKay, Carly D; England, Mike E; Kemp, Simon P T; Trewartha, Grant

2017-01-01

Background Injury risk in youth rugby has received much attention, highlighting the importance of establishing evidence-based injury reduction strategies. Aim To determine the efficacy of a movement control exercise programme in reducing injuries in youth rugby players and to investigate the effect of programme dose on injury measures. Methods In a cluster-randomised controlled trial, 40 independent schools (118 teams, 3188 players aged 14–18 years) were allocated to receive either the intervention or a reference programme, both of which were to be delivered by school coaches. The intervention comprised balance training, whole-body resistance training, plyometric training, and controlled rehearsal of landing and cutting manoeuvres. Time-loss (>24 hours) injuries arising from school rugby matches were recorded by coaches and medical staff. Results 441 time-loss match injuries (intervention, 233; control, 208) were reported across 15 938 match exposure-hours (intervention, 9083; control, 6855). Intention-to-treat results indicated unclear effects of trial arm on overall match injury incidence (rate ratio (RR)=0.85, 90% confidence limits 0.61 to 1.17), although clear reductions were evident in the intervention arm for concussion incidence (RR=0.71, 0.48 to 1.05). When trial arm comparisons were limited to teams who had completed three or more weekly programme sessions on average, clear reductions in overall match injury incidence (RR=0.28, 0.14 to 0.51) and concussion incidence (RR=0.41, 0.17 to 0.99) were noted in the intervention group. Conclusion A preventive movement control exercise programme can reduce match injury outcomes, including concussion, in schoolboy rugby players when compared with a standardised control exercise programme, although to realise the greatest effects players should complete the programme at least three times per week. PMID:28515056

Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial.

PubMed

Hislop, Michael D; Stokes, Keith A; Williams, Sean; McKay, Carly D; England, Mike E; Kemp, Simon P T; Trewartha, Grant

2017-08-01

Injury risk in youth rugby has received much attention, highlighting the importance of establishing evidence-based injury reduction strategies. To determine the efficacy of a movement control exercise programme in reducing injuries in youth rugby players and to investigate the effect of programme dose on injury measures. In a cluster-randomised controlled trial, 40 independent schools (118 teams, 3188 players aged 14-18 years) were allocated to receive either the intervention or a reference programme, both of which were to be delivered by school coaches. The intervention comprised balance training, whole-body resistance training, plyometric training, and controlled rehearsal of landing and cutting manoeuvres. Time-loss (>24 hours) injuries arising from school rugby matches were recorded by coaches and medical staff. 441 time-loss match injuries (intervention, 233; control, 208) were reported across 15 938 match exposure-hours (intervention, 9083; control, 6855). Intention-to-treat results indicated unclear effects of trial arm on overall match injury incidence (rate ratio (RR)=0.85, 90% confidence limits 0.61 to 1.17), although clear reductions were evident in the intervention arm for concussion incidence (RR=0.71, 0.48 to 1.05). When trial arm comparisons were limited to teams who had completed three or more weekly programme sessions on average, clear reductions in overall match injury incidence (RR=0.28, 0.14 to 0.51) and concussion incidence (RR=0.41, 0.17 to 0.99) were noted in the intervention group. A preventive movement control exercise programme can reduce match injury outcomes, including concussion, in schoolboy rugby players when compared with a standardised control exercise programme, although to realise the greatest effects players should complete the programme at least three times per week. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A framework for evaluating community-based physical activity promotion programmes in Latin America.

PubMed

Schmid, Thomas L; Librett, John; Neiman, Andrea; Pratt, Michael; Salmon, Art

2006-01-01

A growing interest in promoting physical activity through multi-sectoral community-based programmes has highlighted the need for effective programme evaluation. Meeting in Rio de Janeiro, an international workgroup of behavioural, medical, public health and other scientists and practitioners endorsed the principle of careful evaluation of all programmes and in a consensus process developed the Rio de Janeiro Recommendations for Evaluation of Physical Activity Interventions". Among these recommendations and principles were that when possible, evaluation should 'built into' the programme from the beginning. The workgroup also called for adequate funding for evaluation, setting a goal of about 10% of programme resources for evaluation. The group also determined that evaluations should be developed in conjunction with and the results shared with all appropriate stakeholders in the programme; evaluations should be guided by ethical standards such as those proposed by the American Evaluation Association and should assess programme processes as well as outcomes; evaluation outcomes should be used to revise and refine ongoing programmes and guide decisions about programme continuation or expansion. It was also recognised that additional training in programme evaluation is needed and the Centers for Disease Control and Prevention's Physical Activity Evaluation Handbook could be easily adapted for use in culturally diverse communities, especially in Latin America. This paper describes a 6-step evaluation process and provides the full set of recommendations from the Rio de Janeiro Workgroup. The handbook has been translated and additional case studies from Colombia and Brazil have been added. Spanish and Portuguese language editions of the Evaluation Handbook are available from the Centers for Disease Control and Prevention, Physical Activity and Health Branch.

Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised controlled trial in Western Australia.

PubMed

Brinkman, Sally A; Johnson, Sarah E; Codde, James P; Hart, Michael B; Straton, Judith A; Mittinty, Murthy N; Silburn, Sven R

2016-11-05

Infant simulator-based programmes, which aim to prevent teenage pregnancy, are used in high-income as well as low-income and middle-income countries but, despite growing popularity, no published evidence exists of their long-term effect. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) programme, on pregnancy outcomes of birth and induced abortion in Australia. In this school-based pragmatic cluster randomised controlled trial, eligible schools in Perth, Western Australia, were enrolled and randomised 1:1 to the intervention and control groups. Randomisation using a table of random numbers without blocking, stratification, or matching was done by a researcher who was masked to the identity of the schools. Between 2003 and 2006, the VIP programme was administered to girls aged 13-15 years in the intervention schools, while girls of the same age in the control schools received the standard health education curriculum. Participants were followed until they reached 20 years of age via data linkage to hospital medical and abortion clinic records. The primary endpoint was the occurrence of pregnancy during the teenage years. Binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups. This study is registered as an international randomised controlled trial, number ISRCTN24952438. 57 (86%) of 66 eligible schools were enrolled into the trial and randomly assigned 1:1 to the intervention (28 schools) or the control group (29 schools). Then, between Feb 1, 2003, and May 31, 2006, 1267 girls in the intervention schools received the VIP programme while 1567 girls in the control schools received the standard health education curriculum. Compared with girls in the control group, a higher proportion of girls in the intervention group recorded at least one birth (97 [8%] of 1267 in the intervention group vs 67 [4%] of 1567 in the control group) or at least one abortion as the first pregnancy event (113 [9%] vs 101 [6%]). After adjustment for potential confounders, the intervention group had a higher overall pregnancy risk than the control group (relative risk 1·36 [95% CI 1·10-1·67], p=0·003). Similar results were obtained with the use of proportional hazard models (hazard ratio 1·35 [95% CI 1·10-1·67], p=0·016). The infant simulator-based VIP programme did not achieve its aim of reducing teenage pregnancy. Girls in the intervention group were more likely to experience a birth or an induced abortion than those in the control group before they reached 20 years of age. Western Australian Health Promotion Foundation (Healthway), Lotteries WA, the Western Australian Department of Education and Training, and the Western Australian Department of Health. Copyright © 2016 Elsevier Ltd. All rights reserved.

Community-based youth tobacco control interventions: cost effectiveness of the Full Court Press project.

PubMed

Ross, Hana; Powell, Lisa M; Bauer, Joseph E; Levy, David T; Peck, Richard M; Lee, Hye-Ryeon

2006-01-01

We evaluated the impact of a community-based tobacco control project that was implemented in the city of Tucson, Arizona, USA, between 1996 and 2001. The project's goal was to reduce the prevalence of youth smoking through change in social norms at schools and in communities and workplaces. As is often the case, these community-based health promotion interventions were implemented in conjunction with other broader programmes, in this case implemented on the state level. Taking into account state level interventions as well as changes in sociodemographic and economic environment over the course of the project (e.g. increases in cigarette prices), we measure the net effect of the intervention in terms of the number of people who quit or did not initiate smoking and by the discounted life-years gained. To establish the value of investing into community-based intervention, we calculated the real discounted cost per quit and per life-year gained of 3789 US dollars and 3942 US dollars, respectively. These compare favourably with the real cost per quit of 4270 US dollars when implementing the 1996 US Clinical Practice Guideline for smoking cessation but exceed the real cost of 2923 US dollars per discounted life-year gained when following the guideline. A sensitivity analysis that assumed 5% programme persistence (i.e. 5% of the programme's impact would last forever in the absence of future funding for the programme), one-third would relapse and that one-third of those who quit may have quit smoking even without the programme, suggested a lower cost per discounted life-year saved of 3476 US dollars. The cost effectiveness of this project compares favourably with other tobacco control interventions. Despite its relatively small target group, this community-based intervention was cost effective.

Child, Teacher and Parent Perceptions of the FRIENDS Classroom-Based Universal Anxiety Prevention Programme: A Qualitative Study.

PubMed

Skryabina, Elena; Morris, Joanna; Byrne, Danielle; Harkin, Nicola; Rook, Sarah; Stallard, Paul

2016-01-01

School-based mental health prevention programmes can be effective but their adoption within schools will depend on their social acceptability. We report a qualitative evaluation summarising the views of children (115), parents (20) and school staff (47) about a universal school-based anxiety prevention programme FRIENDS. This study was conducted as part of a large scale randomised controlled trial ( n  = 1362) involving 40 schools in the UK providing primary education to children aged 7-11. Reported overall experience of the programme was very positive, with all three major components of the cognitive behaviour therapy programme (emotional, cognitive, and behavioural) being accepted well and understood by children. The programme was considered to be enjoyable and valuable in teaching children important skills, particularly emotional regulation and coping. Children provided examples of using the skills learned during FRIENDS to manage their emotions and solve problems. However, teachers were concerned that the programme overlapped with the current school curriculum, required additional time and almost half were unable to identify any tangible changes in the children's behaviour. Whilst this paper provides evidence to support the social validity of the FRIENDS anxiety prevention programme, the concerns raised by teachers question the longer-term sustainability of the programme.

A critical review of adolescent mindfulness-based programmes.

PubMed

Tan, Lucy B G

2016-04-01

Previous research has demonstrated that mindfulness-based programmes improve psychological functioning in a myriad of adult domains. These include health care, marketing and sports industries. The efficacy of mindfulness-based programmes in the adult population is well established. Indeed, compared to adult empirical literature, mindfulness programmes for adolescents are relatively developmental and less articulated until now. It may be argued that mindfulness-based programmes could and should begin early and be applicable to young people at a time that is critical in their development. Hence, this article analyses the characteristics, objectives and outcomes of mindfulness interventions for adolescents, focusing on the mindfulness programme adjustments and adaptations made to the content for this target group. A critique of the literature that included published articles of mindfulness-based interventions (both clinical and universal programmes) for adolescents were sourced and reviewed. Conference papers and unpublished dissertations were excluded. The review indicated that a majority of these were longitudinal and feasibility studies, with only one clinical randomised controlled trial study. Preliminary evidence for the use of mindfulness-based with adolescents continues to be nascent, with many of the studies using inappropriate or no mindfulness process measures at all. In addition, a majority of the studies did not provide specific details of the mindfulness programmes for adolescents, nor discuss what modifications were undertaken--all of which makes comparison difficult. However, with the availability of recent and age-appropriate mindfulness measures for adolescents, more rigorous and robust research looks promising. © The Author(s) 2015.

Effect of Sex Education Programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria.

PubMed

Esere, Mary Ogechi

2008-06-01

Adolescents display sexual behaviours and developmental characteristics that place them at risk for Sexually Transmitted Diseases (STDs). Because young people experiment sexually and because of the consequences of indiscriminate sexual activities on the youth, there is the need to mount sex education programmes that are geared towards enlightenment and appropriate education about sex and sexuality. To determine whether Sex Education Intervention Programme would reduce at-risk sexual behaviours of school-going adolescents. Pre-test, post-test control group quasi-experimental design. A randomly selected co-educational school in Ilorin Metropolis, Nigeria. 24 school-going adolescents aged 13-19 years. Sex Education Programme (treatment group) versus Control programme (placebo). Self-reported exposure to sexually transmitted diseases, multiple sex partners, anal sex, oral sex, non use of condom. When the treatment (intervention) group was compared with the control group in an intention to treat analysis, there were significant differences in at-risk sexual behaviours of the two groups. Those in the intervention group reported less at-risk sexual behaviours than their counterparts in the control group. The treatment group evaluated the intervention programme positively and their knowledge of sexual health improved. Lack of behavioural effect on the control group could be linked to differential quality of delivery of intervention. Compared with the control group, this specially designed intervention sex education programme reduced at-risk sexual behaviour in adolescents. Based on this finding, it was recommended that sex education be introduced into the curriculum of secondary school education in Nigeria.

The cost-effectiveness of weight management programmes in a postnatal population.

PubMed

Rawdin, A C; Duenas, A; Chilcott, J B

2014-09-01

The aim of the study was to estimate the cost-effectiveness of a weight management programme including elements of physical exercise and dietary restriction which are designed to help women lose excess weight gained during pregnancy in the vulnerable postnatal period and inhibit the development of behaviours which could lead to future excess weight gain and obesity. A mathematical model based on a regression equation predicting change in weight over a fifteen year postnatal period was developed. The model included programme effectiveness and resource data based on a randomized controlled trial of a weight management programme implemented in a postnatal population in the United States. Utility and mortality data based on body mass index categories were also included. The model adopted a National Health Service (NHS) and personal social services (PSS) perspective, a lifetime time horizon and estimated the cost effectiveness of a weight management programme against a no change comparator in terms of an incremental cost-effectiveness ratio (ICER). The baseline results show that the difference in weight between women who received the weight management programme and women who received the control intervention was 3.02 kg at six months and 3.53 kg at fifteen years following childbirth. This results in an ICER of £7355 per quality adjusted life year (QALY) for women who were married at childbirth. The estimated ICER would suggest that such a weight management programme is cost-effective at a NICE threshold of £20,000 per QALY. However significant structural and evidence based uncertainty is present in the analysis. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Access control mechanism of wireless gateway based on open flow

NASA Astrophysics Data System (ADS)

Peng, Rong; Ding, Lei

2017-08-01

In order to realize the access control of wireless gateway and improve the access control of wireless gateway devices, an access control mechanism of SDN architecture which is based on Open vSwitch is proposed. The mechanism utilizes the features of the controller--centralized control and programmable. Controller send access control flow table based on the business logic. Open vSwitch helps achieve a specific access control strategy based on the flow table.

Does hydrotherapy improve strength and physical function in patients with osteoarthritis--a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme.

PubMed

Foley, A; Halbert, J; Hewitt, T; Crotty, M

2003-12-01

To compare the effects of a hydrotherapy resistance exercise programme with a gym based resistance exercise programme on strength and function in the treatment of osteoarthritis (OA). Single blind, three arm, randomised controlled trial. 105 community living participants aged 50 years and over with clinical OA of the hip or knee. Participants were randomised into one of three groups: hydrotherapy (n = 35), gym (n = 35), or control (n = 35). The two exercising groups had three exercise sessions a week for six weeks. At six weeks an independent physiotherapist unaware of the treatment allocation performed all outcome assessments (muscle strength dynamometry, six minute walk test, WOMAC OA Index, total drugs, SF-12 quality of life, Adelaide Activities Profile, and the Arthritis Self-Efficacy Scale). In the gym group both left and right quadriceps significantly increased in strength compared with the control group, and right quadriceps strength was also significantly better than in the hydrotherapy group. The hydrotherapy group increased left quadriceps strength only at follow up, and this was significantly different from the control group. The hydrotherapy group was significantly different from the control group for distance walked and the physical component of the SF-12. The gym group was significantly different from the control group for walk speed and self efficacy satisfaction. Compliance rates were similar for both exercise groups, with 84% of hydrotherapy and 75% of gym sessions attended. There were no differences in drug use between groups over the study period. Functional gains were achieved with both exercise programmes compared with the control group.

Does hydrotherapy improve strength and physical function in patients with osteoarthritis—a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme

PubMed Central

Foley, A; Halbert, J; Hewitt, T; Crotty, M

2003-01-01

Objective: To compare the effects of a hydrotherapy resistance exercise programme with a gym based resistance exercise programme on strength and function in the treatment of osteoarthritis (OA). Design: Single blind, three arm, randomised controlled trial. Subjects: 105 community living participants aged 50 years and over with clinical OA of the hip or knee. Methods: Participants were randomised into one of three groups: hydrotherapy (n = 35), gym (n = 35), or control (n = 35). The two exercising groups had three exercise sessions a week for six weeks. At six weeks an independent physiotherapist unaware of the treatment allocation performed all outcome assessments (muscle strength dynamometry, six minute walk test, WOMAC OA Index, total drugs, SF-12 quality of life, Adelaide Activities Profile, and the Arthritis Self-Efficacy Scale). Results: In the gym group both left and right quadriceps significantly increased in strength compared with the control group, and right quadriceps strength was also significantly better than in the hydrotherapy group. The hydrotherapy group increased left quadriceps strength only at follow up, and this was significantly different from the control group. The hydrotherapy group was significantly different from the control group for distance walked and the physical component of the SF-12. The gym group was significantly different from the control group for walk speed and self efficacy satisfaction. Compliance rates were similar for both exercise groups, with 84% of hydrotherapy and 75% of gym sessions attended. There were no differences in drug use between groups over the study period. Conclusion: Functional gains were achieved with both exercise programmes compared with the control group. PMID:14644853

Toward integrated opisthorchiasis control in northeast Thailand: the Lawa project.

PubMed

Sripa, Banchob; Tangkawattana, Sirikachorn; Laha, Thewarach; Kaewkes, Sasithorn; Mallory, Frank F; Smith, John F; Wilcox, Bruce A

2015-01-01

Human liver fluke, Opisthorchis viverrini, a food-borne trematode is a significant public health problem in Southeast Asia, particularly in Thailand. Despite a long history of control programmes in Thailand and a nationwide reduction, O. viverrini infection prevalence remains high in the northeastern provinces. Therefore, a new strategy for controlling the liver fluke infection using the EcoHealth/One Health approach was introduced into the Lawa Lake area in Khon Kaen province where the liver fluke is endemic. A programme has been carried using anthelminthic treatment, novel intensive health education methods both in the communities and in schools, ecosystem monitoring and active community participation. As a result, the infection rate in the more than 10 villages surrounding the lake has declined to approximate one third of the average of 50% as estimated by a baseline survey. Strikingly, the Cyprinoid fish species in the lake, which are the intermediate host, now showed less than 1% prevalence compared to a maximum of 70% at baseline. This liver fluke control programme, named "Lawa model," is now recognised nationally and internationally, and being expanding to other parts of Thailand and neighbouring Mekong countries. Challenges to O. viverrini disease control, and lessons learned in developing an integrative control programme using a community-based, ecosystem approach, and scaling-up regionally based on Lawa as a model are described. Copyright © 2014 Elsevier B.V. All rights reserved.

The Effectiveness of a Universal School-Based Programme on Coping and Mental Health: A Randomised, Controlled Study of Zippy' Friends

ERIC Educational Resources Information Center

Holen, Solveig; Waaktaar, Trine; Lervag, Arne; Ystgaard, Mette

2012-01-01

The purpose of this study was to evaluate Zippy's Friends, a universal school programme that aims at strengthening children's coping skills. The sample consisted of 1483 children (aged 7-8 years) from 91 second-grade classes in 35 schools. The schools were matched and randomly assigned to intervention or control conditions. Coping was assessed by…

A programmable controller based on CAN field bus embedded microprocessor and FPGA

NASA Astrophysics Data System (ADS)

Cai, Qizhong; Guo, Yifeng; Chen, Wenhei; Wang, Mingtao

2008-10-01

One kind of new programmable controller(PLC) is introduced in this paper. The advanced embedded microprocessor and Field-Programmable Gate Array (FPGA) device are applied in the PLC system. The PLC system structure was presented in this paper. It includes 32 bits Advanced RISC Machines (ARM) embedded microprocessor as control core, FPGA as control arithmetic coprocessor and CAN bus as data communication criteria protocol connected the host controller and its various extension modules. It is detailed given that the circuits and working principle, IiO interface circuit between ARM and FPGA and interface circuit between ARM and FPGA coprocessor. Furthermore the interface circuit diagrams between various modules are written. In addition, it is introduced that ladder chart program how to control the transfer info of control arithmetic part in FPGA coprocessor. The PLC, through nearly two months of operation to meet the design of the basic requirements.

The paradox of control: An ethnographic analysis of opiate maintenance treatment in a Norwegian prison.

PubMed

Mjåland, Kristian

2015-08-01

Opiate maintenance treatment (OMT) is increasingly being offered in prisons throughout Europe. The benefits of OMT in prison have been found to be similar to those produced by OMT in community settings. However, prison-based OMT has been a controversial issue because of fear of the diversion of OMT medications and the development of black markets for prescription drugs such as buprenorphine and methadone. Prison-based OMT thus involves a delicate balance between the considerations of control and treatment. This article reports on an ethnographic study of a prison-based OMT programme in a closed Norwegian prison. The data include field notes from eight months of participant observation in the prison as well as qualitative interviews with 23 prisoners and 12 prison staff. Midway through the fieldwork, the prison authorities established a separate unit for OMT-enrolled prisoners to reduce the widespread diversion of buprenorphine. This "natural experiment" is explored in the analysis. The prison-based OMT programme was characterised by strict and repressive control to prevent the diversion of buprenorphine, and the control became even stricter after the establishment of the OMT unit. However, the diversion of buprenorphine increased rather than decreased after the establishment of the OMT unit. To understand this "paradox of control", the article engages with theories of legitimacy, power and resistance. The excessive and repressive control was perceived as illegitimate and unfair by the majority of study participants. In various ways, many prisoners protested, confronted and subverted the OMT programme. The increase in buprenorphine diversion is interpreted as a form of collective resistance towards the perceived unfairness of the OMT programme. The article demonstrates that an unbalanced and control-dominated approach to prison-based OMT may have the opposite effect of what is intended. Copyright © 2015 The Author. Published by Elsevier B.V. All rights reserved.

FPGA-Based Multiprocessor System for Injection Molding Control

PubMed Central

Muñoz-Barron, Benigno; Morales-Velazquez, Luis; Romero-Troncoso, Rene J.; Rodriguez-Donate, Carlos; Trejo-Hernandez, Miguel; Benitez-Rangel, Juan P.; Osornio-Rios, Roque A.

2012-01-01

The plastic industry is a very important manufacturing sector and injection molding is a widely used forming method in that industry. The contribution of this work is the development of a strategy to retrofit control of an injection molding machine based on an embedded system microprocessors sensor network on a field programmable gate array (FPGA) device. Six types of embedded processors are included in the system: a smart-sensor processor, a micro fuzzy logic controller, a programmable logic controller, a system manager, an IO processor and a communication processor. Temperature, pressure and position are controlled by the proposed system and experimentation results show its feasibility and robustness. As validation of the present work, a particular sample was successfully injected. PMID:23202036

Programmable Pulser

NASA Technical Reports Server (NTRS)

Baumann, Eric; Merolla, Anthony

1988-01-01

User controls number of clock pulses to prevent burnout. New digital programmable pulser circuit in three formats; freely running, counted, and single pulse. Operates at frequencies up to 5 MHz, with no special consideration given to layout of components or to terminations. Pulser based on sequential circuit with four states and binary counter with appropriate decoding logic. Number of programmable pulses increased beyond 127 by addition of another counter and decoding logic. For very large pulse counts and/or very high frequencies, use synchronous counters to avoid errors caused by propagation delays. Invaluable tool for initial verification or diagnosis of digital or digitally controlled circuity.

Programmable Analog Memory Resistors For Electronic Neural Networks

NASA Technical Reports Server (NTRS)

Ramesham, Rajeshuni; Thakoor, Sarita; Daud, Taher; Thakoor, Anilkumar P.

1990-01-01

Electrical resistance of new solid-state device altered repeatedly by suitable control signals, yet remains at steady value when control signal removed. Resistance set at low value ("on" state), high value ("off" state), or at any convenient intermediate value and left there until new value desired. Circuits of this type particularly useful in nonvolatile, associative electronic memories based on models of neural networks. Such programmable analog memory resistors ideally suited as synaptic interconnects in "self-learning" neural nets. Operation of device depends on electrochromic property of WO3, which when pure is insulator. Potential uses include nonvolatile, erasable, electronically programmable read-only memories.

Effectiveness of a physical activity programme based on the Pilates method in pregnancy and labour.

PubMed

Rodríguez-Díaz, Luciano; Ruiz-Frutos, Carlos; Vázquez-Lara, Juana María; Ramírez-Rodrigo, Jesús; Villaverde-Gutiérrez, Carmen; Torres-Luque, Gema

To assess the effectiveness and safety of a physical activity programme based on use of the Pilates method, over eight weeks in pregnant women, on functional parameters, such as weight, blood pressure, strength, flexibility and spinal curvature, and on labour parameters, such as, type of delivery, episiotomy, analgesia and newborn weight. A randomized clinical trial was carried out on pregnant women, applying a programme of physical activity using the Pilates method, designed specifically for this population. A sample consisting of a total of 105 pregnant women was divided into two groups: intervention group (n=50) (32.87±4.46 years old) and control group (n=55) (31.52±4.95 years old). The intervention group followed a physical activity programme based on the Pilates method, for 2 weekly sessions, whereas the control group did not follow the program. Significant improvements (p<0.05) in blood pressure, hand grip strength, hamstring flexibility and spinal curvature, in addition to improvements during labour, decreasing the number of Caesareans and obstructed labour, episiotomies, analgesia and the weight of the newborns were found at the end of the intervention. A physical activity programme of 8 weeks based on the Pilates method improves functional parameters in pregnant women and benefits delivery. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

The changing role and legitimate boundaries of epidemiology: community-based prevention programmes.

PubMed

Tuomilehto, J; Puska, P

1987-01-01

Epidemiology is the basic science of public health. It combines medical and social sciences, both of which are developing with new inventions. Therefore, the role of epidemiology and its boundaries are also changing over time. An important role of epidemiology is to develop and implement community-based control programmes for major diseases in the community. Such programmes are essential for large scale public health policy. It is necessary that epidemiological research can as freely as possible test new methods of disease prevention and health promotion. The first community-based control programme for cardiovascular diseases, the North Karelia Project is reviewed against this background. At present, it is still possible to define the boundaries of epidemiology geographically and culturally, but in the future, however, it will become more difficult. There is no doubt that epidemiology will remain as the basic science of public health but the scope of public health problems are growing much wider. These include the prevention of the final epidemic--the destruction of our planet by nuclear bombs. In the control of the existing epidemics and in the prevention of new ones the boundaries of epidemiology cannot stay rigid but they must be changing as new facts about the emerging public health problems are identified.

The applications of model-based geostatistics in helminth epidemiology and control.

PubMed

Magalhães, Ricardo J Soares; Clements, Archie C A; Patil, Anand P; Gething, Peter W; Brooker, Simon

2011-01-01

Funding agencies are dedicating substantial resources to tackle helminth infections. Reliable maps of the distribution of helminth infection can assist these efforts by targeting control resources to areas of greatest need. The ability to define the distribution of infection at regional, national and subnational levels has been enhanced greatly by the increased availability of good quality survey data and the use of model-based geostatistics (MBG), enabling spatial prediction in unsampled locations. A major advantage of MBG risk mapping approaches is that they provide a flexible statistical platform for handling and representing different sources of uncertainty, providing plausible and robust information on the spatial distribution of infections to inform the design and implementation of control programmes. Focussing on schistosomiasis and soil-transmitted helminthiasis, with additional examples for lymphatic filariasis and onchocerciasis, we review the progress made to date with the application of MBG tools in large-scale, real-world control programmes and propose a general framework for their application to inform integrative spatial planning of helminth disease control programmes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Perceived Effects of the Malaysian National Tobacco Control Programme on Adolescent Smoking Cessation: A Qualitative Study

PubMed Central

Hizlinda, Tohid; Noriah, Mohd Ishak; Noor Azimah, Muhammad; Farah Naaz, Momtaz Ahmad; Anis Ezdiana, Abdul Aziz; Khairani, Omar

2012-01-01

Background: The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined. Methods: Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed. Results: The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation. Conclusion: Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking. PMID:22973136

Perceived effects of the Malaysian National Tobacco Control Programme on adolescent smoking cessation: a qualitative study.

PubMed

Tohid, Hizlinda; Ishak, Noriah Mohd; Muhammad, Noor Azimah; Ahmad, Farah Naaz Momtaz; Aziz, Abdul Anis Ezdiana; Omar, Khairani

2012-04-01

The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined. Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed. The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation. Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking.

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care.

PubMed

Guiriguet, Carolina; Muñoz-Ortiz, Laura; Burón, Andrea; Rivero, Irene; Grau, Jaume; Vela-Vallespín, Carmen; Vilarrubí, Mercedes; Torres, Miquel; Hernández, Cristina; Méndez-Boo, Leonardo; Toràn, Pere; Caballeria, Llorenç; Macià, Francesc; Castells, Antoni

2016-07-01

Participation rates in colorectal cancer screening are below recommended European targets. To evaluate the effectiveness of an alert in primary care electronic medical records (EMRs) to increase individuals' participation in an organised, population-based colorectal cancer screening programme when compared with usual care. Cluster randomised controlled trial in primary care centres of Barcelona, Spain. Participants were males and females aged 50-69 years, who were invited to the first round of a screening programme based on the faecal immunochemical test (FIT) (n = 41 042), and their primary care professional. The randomisation unit was the physician cluster (n = 130) and patients were blinded to the study group. The control group followed usual care as per the colorectal cancer screening programme. In the intervention group, as well as usual care, an alert to health professionals (cluster level) to promote screening was introduced in the individual's primary care EMR for 1 year. The main outcome was colorectal cancer screening participation at individual participant level. In total, 67 physicians and 21 619 patients (intervention group) and 63 physicians and 19 423 patients (control group) were randomised. In the intention-to-treat analysis screening participation was 44.1% and 42.2% respectively (odds ratio 1.08, 95% confidence interval [CI] = 0.97 to 1.20, P = 0.146). However, in the per-protocol analysis screening uptake in the intervention group showed a statistically significant increase, after adjusting for potential confounders (OR, 1.11; 95% CI = 1.02 to 1.22; P = 0.018). The use of an alert in an individual's primary care EMR is associated with a statistically significant increased uptake of an organised, FIT-based colorectal cancer screening programme in patients attending primary care centres. © British Journal of General Practice 2016.

Evaluation of a web-based ECG-interpretation programme for undergraduate medical students.

PubMed

Nilsson, Mikael; Bolinder, Gunilla; Held, Claes; Johansson, Bo-Lennart; Fors, Uno; Ostergren, Jan

2008-04-23

Most clinicians and teachers agree that knowledge about ECG is of importance in the medical curriculum. Students at Karolinska Institute have asked for more training in ECG-interpretation during their undergraduate studies. Clinical tutors, however, have difficulties in meeting these demands due to shortage of time. Thus, alternative ways to learn and practice ECG-interpretation are needed. Education offered via the Internet is readily available, geographically independent and flexible. Furthermore, the quality of education may increase and become more effective through a superior educational approach, improved visualization and interactivity. A Web-based comprehensive ECG-interpretation programme has been evaluated. Medical students from the sixth semester were given an optional opportunity to access the programme from the start of their course. Usage logs and an initial evaluation survey were obtained from each student. A diagnostic test was performed in order to assess the effect on skills in ECG interpretation. Students from the corresponding course, at another teaching hospital and without access to the ECG-programme but with conventional teaching of ECG served as a control group. 20 of the 32 students in the intervention group had tested the programme after 2 months. On a five-graded scale (1- bad to 5 - very good) they ranked the utility of a web-based programme for this purpose as 4.1 and the quality of the programme software as 3.9. At the diagnostic test (maximal points 16) by the end of the 5-month course at the 6th semester the mean result for the students in the intervention group was 9.7 compared with 8.1 for the control group (p = 0.03). Students ranked the Web-based ECG-interpretation programme as a useful instrument to learn ECG. Furthermore, Internet-delivered education may be more effective than traditional teaching methods due to greater immediacy, improved visualisation and interactivity.

Improving reading comprehension in reading and listening settings: the effect of two training programmes focusing on metacognition and working memory.

PubMed

Carretti, Barbara; Caldarola, Nadia; Tencati, Chiara; Cornoldi, Cesare

2014-06-01

Metacognition and working memory (WM) have been found associated with success in reading comprehension, but no studies have examined their combined effect on the training of reading comprehension. Another open question concerns the role of listening comprehension: In particular, it is not clear whether training to improve reading comprehension must necessarily be based on processing written material or whether, as suggested in a recent study by Clarke et al. (2010, Psychol. Sci., 21, 1106), a programme based on verbal language could also be effective. The study examined the feasibility of improving text comprehension in school children by comparing the efficacy of two training programmes, both involving metacognition and WM, but one based on listening comprehension, the other on reading comprehension. The study involved a sample of 159 pupils attending eight classes in the fourth and fifth grades (age range 9-11 years). The listening and reading programmes focused on the same abilities/processes strictly related to text comprehension, and particularly metacognitive knowledge and control, WM (per se and in terms of integrating information in a text). The training programmes were implemented by school teachers as part of the class's normal school activities, under the supervision of experts. Their efficacy was compared with the results obtained in an active control group that completed standard text comprehension activities. Our results showed that both the training programmes focusing on specific text comprehension skills were effective in improving the children's achievement, but training in reading comprehension generated greater gains than the listening comprehension programme. Our study suggests that activities focusing specifically on metacognition and WM could foster text comprehension, but the potential benefit is influenced by the training modality, that is, the Reading group obtained greater and longer-lasting improvements than the Active control or Listening groups. © 2013 The British Psychological Society.

A pilot effectiveness study of the Enhancing Parenting Skills (EPaS) 2014 programme for parents of children with behaviour problems: study protocol for a randomised controlled trial.

PubMed

Williams, Margiad Elen; Hutchings, Judy

2015-05-20

The Enhancing Parenting Skills (EPaS) 2014 programme is a home-based, health visitor-delivered parenting support programme for parents of children with identified behaviour problems. This trial aims to evaluate the effectiveness of the EPaS 2014 programme compared to a waiting-list treatment as usual control group. This is a pragmatic, multicentre randomised controlled trial. Sixty health visitors will each be asked to identify two families that have a child scoring above the clinical cut-off for behaviour problems using the Eyberg Child Behaviour Inventory (ECBI). Families recruited to the trial will be randomised in a 1:1 ratio into an intervention or waiting-list control group. Randomisation will occur within health visitor to ensure that each health visitor has one intervention family and one control family. The primary outcome is change in child behaviour problems as measured by the parent-reported ECBI. Secondary outcomes include other measures of child behaviour, parent behaviour, and parental depression as measured by parent-reports and an independent observation of parent and child behaviour. Follow-up measures will be collected 6-months after the collection of baseline measures. This is the first rigorous evaluation of the EPaS 2014 programme. The trial will provide important information on the effectiveness of a one-to-one home-based intervention, delivered by health visitors, for pre-school children with behaviour problems. It will also examine potential mediating (improved parent behaviour and/or improved parental depression) and moderating (single parent, teenage parent, poverty, low education level) factors. Current Controlled Trials ISRCTN06867279 (18 June 2014).

Using mental visual imagery to improve autobiographical memory and episodic future thinking in relapsing-remitting multiple sclerosis patients: A randomised-controlled trial study.

PubMed

Ernst, Alexandra; Blanc, Frédéric; De Seze, Jérôme; Manning, Liliann

2015-01-01

The co-occurrence of autobiographical memory (AM) and episodic future thinking (EFT) impairment has been documented in relapsing-remitting multiple sclerosis (RR-MS) patients. On these bases, we aimed at probing the efficacy of a mental visual imagery (MVI)-based facilitation programme on AM and EFT functioning in the context of a randomised-controlled trial study in RR-MS patients. Using the Autobiographical Interview (AI), 40 patients presenting with an AM/EFT impairment were randomly assigned in three groups: (i) the experimental (n = 17), who followed the MVI programme, (ii) the verbal control (n = 10), who followed a sham verbal programme, and (iii) the stability groups (n = 13), who underwent the AM/EFT test twice, with no intervention in between. AI's second assessment scores showed a significant improvement of AM and EFT performance only for the experimental group, with a long-term robustness of treatment benefits. The control and stability groups' results ruled out nursing and test learning effects as explanations of AM/EFT improvement. These benefits were corroborated by the patients' comments, which indicated an effective MVI strategy transfer to daily life. Our results suggest that the MVI programme tackles a common cognitive process of scene construction present in AM and EFT.

Effectiveness of a community-based nutrition programme to improve child growth in rural Ethiopia: a cluster randomized trial.

PubMed

Kang, Yunhee; Kim, Sungtae; Sinamo, Sisay; Christian, Parul

2017-01-01

Few trials have shown that promoting complementary feeding among young children is effective in improving child linear growth in resource-challenged settings. We designed a community-based participatory nutrition promotion (CPNP) programme adapting a Positive Deviance/Hearth approach that engaged mothers in 2-week nutrition sessions using the principles of 'learning by doing' around child feeding. We aimed to test the effectiveness of the CPNP for improving child growth in rural Ethiopia. A cluster randomized trial was implemented by adding the CPNP to the existing government nutrition programmes (six clusters) vs. government programmes only (six clusters). A total of 1790 children aged 6 to 12 months (876 in the intervention and 914 in the control areas) were enrolled and assessed on anthropometry every 3 months for a year. Multi-level mixed-effect regression analysis of longitudinal outcome data (n = 1475) examined the programme impact on growth, adjusting for clustering and enrollment characteristics. Compared with children 6 to 24 months of age in the control area, those in the intervention area had a greater increase in z scores for length-for-age [difference (diff): 0.021 z score/month, 95% CI: 0.008, 0.034] and weight-for-length (diff: 0.042 z score/month, 95% CI: 0.024, 0.059). At the end of the 12-month follow-up, children in the intervention area showed an 8.1% (P = 0.02) and 6.3% (P = 0.046) lower prevalence of stunting and underweight, respectively, after controlling for differences in the prevalence at enrollment, compared with the control group. A novel CPNP programme was effective in improving child growth and reducing undernutrition in this setting. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

Living with diabetes: a group-based self-management support programme for T2DM patients in the early phases of illness and their partners, study protocol of a randomised controlled trial.

PubMed

van Puffelen, Anne L; Rijken, Mieke; Heijmans, Monique J W M; Nijpels, Giel; Rutten, Guy E H M; Schellevis, François G

2014-04-01

The present article presents the protocol for a randomised controlled trial to test the effectiveness of a group-based self-management support programme for recently diagnosed type 2 diabetes mellitus (T2DM) patients (one to three years post-diagnosis) and their partners. The course aims to support T2DM patients and their partners in successfully integrating diabetes care into their daily lives and hereby enhance self-management and diabetes-specific health-related quality of life. The content of the course is based on the Common-Sense Model of Self-Regulation (CSM). Furthermore, principles from the Social Cognitive Theory (SCT) and social support theories are integrated. We aim to recruit 160 recently diagnosed T2DM patients and their partners from general practices in six different regions in the Netherlands. Patients need to be diagnosed with T2DM for one to three years and have to experience some degree of diabetes-related difficulties, as measured with a three-item screener. Participating patients and their partners are randomly allocated to the intervention or control condition. Participants in the intervention condition receive three monthly group sessions and a booster session three months later. Participants in the control condition receive a single information meeting. Data will be collected at baseline (T0), directly after the programme (T1) and six months post-programme (T2), including: self-management, diabetes-specific health-related quality of life, illness perceptions, attitudes, social support and empowerment. A three-level multilevel model will be used to compare change-scores between the conditions (intervention/control) on each outcome. Our study will be the first to determine whether a group-based support programme based on the CSM is effective in enhancing self-management and diabetes-specific health-related quality of life in recently diagnosed T2DM patients. The important role of patients' partners in effective diabetes care is also acknowledged in the study. Netherlands National Trial Register (NTR) NTR3302.

The impact of inquiry-based learning on the critical thinking dispositions of pre-service science teachers

NASA Astrophysics Data System (ADS)

Arsal, Zeki

2017-07-01

In the study, the impact of inquiry-based learning on pre-service teachers' critical thinking dispositions was investigated. The sample of the study comprised of 56 pre-service teachers in the science education teacher education programme at the public university in the north of Turkey. In the study, quasi-experimental design with an experimental and a control group were applied to find out the impact of inquiry-based learning on the critical thinking dispositions of the pre-service teachers in the teacher education programme. The results showed that the pre-service teachers in the experimental group did not show statistically significant greater progress in terms of critical thinking dispositions than those in the control group. Teacher educators who are responsible for pedagogical courses in the teacher education programme should consider that the inquiry-based learning could not be effective method to improve pre-service teachers' critical thinking dispositions. The results are discussed in relation to potential impact on science teacher education and implications for future research.

Healthier food choices as a result of the revised healthy diet programme Krachtvoer for students of prevocational schools.

PubMed

Bessems, Kathelijne M H H; van Assema, Patricia; Martens, Marloes K; Paulussen, Theo G W M; Raaijmakers, Lieke G M; de Rooij, Mark; de Vries, Nanne K

2012-05-24

Krachtvoer is a Dutch healthy diet programme for prevocational schools, developed in 2001 and revised for a broader target group in 2007, based on the findings of an evaluation of the first version. The goal of this study was to report on the short- and longer-term total and subgroup effects of the revised programme on students' fruit, fruit juice, breakfast, and snack consumption. Schools were randomized to the experimental condition, teaching the Krachtvoer programme, or to the control condition teaching the regular nutrition lessons. Self-reported consumption of fruit, fruit juice, breakfast and snacks was measured at baseline directly before programme implementation, one to four weeks after finishing programme implementation, and after six months. Mixed linear and logistic regression analyses were conducted. In total 1117 students of 13 experimental schools and 758 students of 11 control schools participated in the study. Short- and longer-term favourable intervention effects were found on fruit consumption (mean difference between experimental and control group 0.15 servings at both posttests). Regarding fruit juice consumption, only short-term favourable effects were revealed (mean difference between experimental and control group 0.05 glasses). Intervention effects on breakfast intakes were limited. No changes in snack frequency were reported, but students made healthier snack choices as a result of the programme. Some favourable as well as unfavourable effects occurred in subgroups of students. The effects on fruit consumption and snack choices justify the current nationwide dissemination of the programme. Achieving changes in breakfast consumption may, however, require other strategies.

Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: a randomized controlled trial.

PubMed

Mikó, Ibolya; Szerb, Imre; Szerb, Anna; Poor, Gyula

2017-02-01

To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis. Randomized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment. A total of 100 osteoporotic women - at least with one osteoporotic fracture - aged 65 years old and above. Balance was assessed in static and dynamic posture both with performance-based measures of balance, such as the Berg Balance Scale and the Timed Up and Go Test, and with a stabilometric computerized platform. Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting, guided by physical therapists, three times a week, for 30 minutes. The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group ( p = 0.001 and p = 0.005, respectively). Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme. As a consequence, the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group. The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past.

Control of intestinal parasitic infections in Seychelles: a comprehensive and sustainable approach.

PubMed Central

Albonico, M.; Shamlaye, N.; Shamlaye, C.; Savioli, L.

1996-01-01

Intestinal parasitic infections have been perceived as a public health problem in Seychelles for decades. A comprehensive strategy to reduce morbidity and, in the long term, transmission of intestinal parasites has been implemented successfully since 1993. Management of the programme is integrated into the well established primary health care system, with control activities being undertaken through existing health facilities. The strategy is based on periodic chemotherapy of schoolchildren, intense health education and improvement of sanitation and safe water supply. The initial objectives of the control programme were met after 2 years of activities, with an overall reduction in prevalence of intestinal parasitic infections of 44%. The intensity of infection with Trichuris trichiura, the commonest parasite, was halved (from 780 to 370 eggs per g of faeces). The programme's integrated approach, in concert with political commitment and limited operational costs, is a warranty for the future sustainability of control activities. The programme can be seen as a model for other developing countries, even where health and socioeconomic conditions are different and the control of parasitic infections will need a much longer-term commitment. PMID:9060217

A programmable synthetic lineage-control network that differentiates human IPSCs into glucose-sensitive insulin-secreting beta-like cells

PubMed Central

Saxena, Pratik; Heng, Boon Chin; Bai, Peng; Folcher, Marc; Zulewski, Henryk; Fussenegger, Martin

2016-01-01

Synthetic biology has advanced the design of standardized transcription control devices that programme cellular behaviour. By coupling synthetic signalling cascade- and transcription factor-based gene switches with reverse and differential sensitivity to the licensed food additive vanillic acid, we designed a synthetic lineage-control network combining vanillic acid-triggered mutually exclusive expression switches for the transcription factors Ngn3 (neurogenin 3; OFF-ON-OFF) and Pdx1 (pancreatic and duodenal homeobox 1; ON-OFF-ON) with the concomitant induction of MafA (V-maf musculoaponeurotic fibrosarcoma oncogene homologue A; OFF-ON). This designer network consisting of different network topologies orchestrating the timely control of transgenic and genomic Ngn3, Pdx1 and MafA variants is able to programme human induced pluripotent stem cells (hIPSCs)-derived pancreatic progenitor cells into glucose-sensitive insulin-secreting beta-like cells, whose glucose-stimulated insulin-release dynamics are comparable to human pancreatic islets. Synthetic lineage-control networks may provide the missing link to genetically programme somatic cells into autologous cell phenotypes for regenerative medicine. PMID:27063289

Public-private partnerships in neglected tropical disease control: the role of nongovernmental organisations.

PubMed

Bush, S; Hopkins, A D

2011-09-01

Successful public-private partnerships for health control have usually included nongovernmental development organisations (NGDOs), and these have long been in the forefront of pinpointing particular social and health issues. The immensely successful control and elimination programmes for onchocerciasis are a case in point. NGDOs were the driving force in early advocacy for onchocerciasis control in West Africa, leading eventually to the remarkably effective and long lasting partnership of the Onchocerciasis Control Programme (OCP). With the donation of Mectizan(®), NGDOs were the driving force in developing onchocerciasis control in non-OCP countries, especially programmes for community based action. These were, further modified by the African Programme for Onchocerciasis Control (APOC) to become the successful Community Directed Interventions. NGDOs came together to coordinate activities in partnership with the World Health Organisation (WHO). Innovations by NGDOs led to integration of mass drug administration for Vitamin A deficiency and then for other parasitic diseases, leading to the current trend of preventive chemotherapy. The success of the NGDO Group for Onchocerciasis Control has led to the creation of similar groups for trachoma control and lymphatic filariasis elimination. These groups have now come together to form an NGDO Network for Neglected Tropical Disease control. Copyright © 2011 Elsevier B.V. All rights reserved.

Evaluating disease management programme effectiveness: an introduction to the regression discontinuity design.

PubMed

Linden, Ariel; Adams, John L; Roberts, Nancy

2006-04-01

Although disease management (DM) has been in existence for over a decade, there is still much uncertainty as to its effectiveness in improving health status and reducing medical cost. The main reason is that most programme evaluations typically follow weak observational study designs that are subject to bias, most notably selection bias and regression to the mean. The regression discontinuity (RD) design may be the best alternative to randomized studies for evaluating DM programme effectiveness. The most crucial element of the RD design is its use of a 'cut-off' score on a pre-test measure to determine assignment to intervention or control. A valuable feature of this technique is that the pre-test measure does not have to be the same as the outcome measure, thus maximizing the programme's ability to use research-based practice guidelines, survey instruments and other tools to identify those individuals in greatest need of the programme intervention. Similarly, the cut-off score can be based on clinical understanding of the disease process, empirically derived, or resource-based. In the RD design, programme effectiveness is determined by a change in the pre-post relationship at the cut-off point. While the RD design is uniquely suitable for DM programme evaluation, its success will depend, in large part, on fundamental changes being made in the way DM programmes identify and assign individuals to the programme intervention.

Effects of an exercise programme for chronically ill and mobility-restricted elderly with structured support by the general practitioner's practice (HOMEfit) - study protocol of a randomised controlled trial

PubMed Central

2011-01-01

Background Exercise programmes can be administered successfully as therapeutic agents to patients with a number of chronic diseases and help to improve physical functioning in older adults. Usually, such programmes target either healthy and mobile community-dwelling seniors or elderly individuals living in nursing institutions or special residences. Chronically ill or mobility-restricted individuals, however, are difficult to reach when they live in their own homes. A pilot study has shown good feasibility of a home-based exercise programme that is delivered to this target group through cooperation between general practitioners and exercise therapists. A logical next step involves evaluation of the effects of the programme. Methods/design The study is designed as a randomised controlled trial. We plan to recruit 210 patients (≥ 70 years) in about 15 general practices. The experimental intervention (duration 12 weeks)-a multidimensional home-based exercise programme-is delivered to the participant by an exercise therapist in counselling sessions at the general practitioner's practice and on the telephone. It is based on methods and strategies for facilitating behaviour change according to the Health Action Process Approach (HAPA). The control intervention-baseline physical activities-differs from the experimental intervention with regard to content of the counselling sessions as well as to content and frequency of the promoted activities. Primary outcome is functional lower body strength measured by the "chair-rise" test. Secondary outcomes are: physical function (battery of motor tests), physical activity (step count), health-related quality of life (SF-8), fall-related self-efficacy (FES-I), and exercise self-efficacy (SSA-Scale). The hypothesis that there will be differences between the two groups (experimental/control) with respect to post-interventional chair-rise time will be tested using an ANCOVA with chair-rise time at baseline, treatment group, and study centre effects as explanatory variables. Analysis of the data will be undertaken using the principle of intention-to-treat. Trial registration Current Controlled Trials ISRCTN17727272. PMID:22188781

A low power flash-FPGA based brain implant micro-system of PID control.

PubMed

Lijuan Xia; Fattah, Nabeel; Soltan, Ahmed; Jackson, Andrew; Chester, Graeme; Degenaar, Patrick

2017-07-01

In this paper, we demonstrate that a low power flash FPGA based micro-system can provide a low power programmable interface for closed-loop brain implant inter- faces. The proposed micro-system receives recording local field potential (LFP) signals from an implanted probe, performs closed-loop control using a first order control system, then converts the signal into an optogenetic control stimulus pattern. Stimulus can be implemented through optoelectronic probes. The long term target is for both fundamental neuroscience applications and for clinical use in treating epilepsy. Utilizing our device, closed-loop processing consumes only 14nJ of power per PID cycle compared to 1.52μJ per cycle for a micro-controller implementation. Compared to an application specific digital integrated circuit, flash FPGA's are inherently programmable.

Programmable logic controller implementation of an auto-tuned predictive control based on minimal plant information.

PubMed

Valencia-Palomo, G; Rossiter, J A

2011-01-01

This paper makes two key contributions. First, it tackles the issue of the availability of constrained predictive control for low-level control loops. Hence, it describes how the constrained control algorithm is embedded in an industrial programmable logic controller (PLC) using the IEC 61131-3 programming standard. Second, there is a definition and implementation of a novel auto-tuned predictive controller; the key novelty is that the modelling is based on relatively crude but pragmatic plant information. Laboratory experiment tests were carried out in two bench-scale laboratory systems to prove the effectiveness of the combined algorithm and hardware solution. For completeness, the results are compared with a commercial proportional-integral-derivative (PID) controller (also embedded in the PLC) using the most up to date auto-tuning rules. Copyright © 2010 ISA. Published by Elsevier Ltd. All rights reserved.

Highly active antiretroviral therapy and tuberculosis control in Africa: synergies and potential.

PubMed Central

Harries, Anthony D.; Hargreaves, Nicola J.; Chimzizi, Rehab; Salaniponi, Felix M.

2002-01-01

HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) and TB (tuberculosis) are two of the world's major pandemics, the brunt of which falls on sub-Saharan Africa. Efforts aimed at controlling HIV/AIDS have largely focused on prevention, little attention having been paid to care. Work on TB control has concentrated on case detection and treatment. HIV infection has complicated the control of tuberculosis. There is unlikely to be a decline in the number of cases of TB unless additional strategies are developed to control both this disease and HIV simultaneously. Such strategies would include active case-finding in situations where TB transmission is high, the provision of a package of care for HIV-related illness, and the application of highly active antiretroviral therapy. The latter is likely to have the greatest impact, but for this therapy to become more accessible in Africa the drugs would have to be made available through international support and a programme structure would have to be developed for its administration. It could be delivered by means of a structure based on the five-point strategy called DOTS, which has been adopted for TB control. However, it may be unrealistic to give TB control programmes the responsibility for running such a programme. A better approach might be to deliver highly active antiretroviral therapy within a comprehensive HIV/AIDS management strategy complementing the preventive work already being undertaken by AIDS control programmes. TB programmes could contribute towards the development and implementation of this strategy. PMID:12132003

Can coverage of schistosomiasis and soil transmitted helminthiasis control programmes targeting school-aged children be improved? New approaches.

PubMed

Massa, K; Olsen, A; Sheshe, A; Ntakamulenga, R; Ndawi, B; Magnussen, P

2009-11-01

Control programmes generally use a school-based strategy of mass drug administration to reduce morbidity of schistosomiasis and soil-transmitted helminthiasis (STH) in school-aged populations. The success of school-based programmes depends on treatment coverage. The community-directed treatment (ComDT) approach has been implemented in the control of onchocerciasis and lymphatic filariasis in Africa and improves treatment coverage. This study compared the treatment coverage between the ComDT approach and the school-based treatment approach, where non-enrolled school-aged children were invited for treatment, in the control of schistosomiasis and STH among enrolled and non-enrolled school-aged children. Coverage during the first treatment round among enrolled children was similar for the two approaches (ComDT: 80.3% versus school: 82.1%, P=0.072). However, for the non-enrolled children the ComDT approach achieved a significantly higher coverage than the school-based approach (80.0 versus 59.2%, P<0.001). Similar treatment coverage levels were attained at the second treatment round. Again, equal levels of treatment coverage were found between the two approaches for the enrolled school-aged children, while the ComDT approach achieved a significantly higher coverage in the non-enrolled children. The results of this study showed that the ComDT approach can obtain significantly higher treatment coverage among the non-enrolled school-aged children compared to the school-based treatment approach for the control of schistosomiasis and STH.

Designed cell consortia as fragrance-programmable analog-to-digital converters.

PubMed

Müller, Marius; Ausländer, Simon; Spinnler, Andrea; Ausländer, David; Sikorski, Julian; Folcher, Marc; Fussenegger, Martin

2017-03-01

Synthetic biology advances the rational engineering of mammalian cells to achieve cell-based therapy goals. Synthetic gene networks have nearly reached the complexity of digital electronic circuits and enable single cells to perform programmable arithmetic calculations or to provide dynamic remote control of transgenes through electromagnetic waves. We designed a synthetic multilayered gaseous-fragrance-programmable analog-to-digital converter (ADC) allowing for remote control of digital gene expression with 2-bit AND-, OR- and NOR-gate logic in synchronized cell consortia. The ADC consists of multiple sampling-and-quantization modules sensing analog gaseous fragrance inputs; a gas-to-liquid transducer converting fragrance intensity into diffusible cell-to-cell signaling compounds; a digitization unit with a genetic amplifier circuit to improve the signal-to-noise ratio; and recombinase-based digital expression switches enabling 2-bit processing of logic gates. Synthetic ADCs that can remotely control cellular activities with digital precision may enable the development of novel biosensors and may provide bioelectronic interfaces synchronizing analog metabolic pathways with digital electronics.

Description of extended pre-harvest pig Salmonella surveillance-and-control programme and its estimated effect on food safety related to pork.

PubMed

Alban, L; Barfod, K; Petersen, J V; Dahl, J; Ajufo, J C; Sandø, G; Krog, H H; Aabo, S

2010-11-01

Salmonella in pork can be combated during pre- or post-harvest. For large slaughterhouses, post-harvest measures like decontamination might be cost-effective while this is less likely with small-to-medium sized slaughterhouses. In this study, pre-harvest measures might be more relevant. We describe an extended surveillance-and-control programme for Salmonella in finisher pigs, which, to establish equivalence to the Swedish control programme, is intended for implementation on the Danish island, Bornholm. The effect of the programme on food safety was estimated by analysing Salmonella data from pig carcasses originating from herds that would have qualified for the programme during 2006-2008. Food safety was interpreted as prevalence of Salmonella on carcasses as well as the estimated number of human cases of salmonellosis related to pork produced within the programme. Data from the Danish Salmonella programme were obtained from Bornholm. We used a simulation model developed to estimate the number of human cases based on the prevalence of Salmonella on carcass swabs. Herds are only accepted in the programme if they have one or less seropositive sample within the previous 6 months. In this way, the Salmonella load is kept to a minimum. The programme is not yet in operation and pigs that qualify for the programme are currently mixed at slaughter with those that do not qualify. Therefore, we had to assess the impact on the carcass prevalence indirectly. The prevalence of Salmonella in carcass swabs among qualifying herds was 0.46% for the 3 years as a whole, with 2006 as the year with highest prevalence. According to the simulation the expected number of human cases relating to pork produced within the programme was below 10. When the programme is in operation, an extra effect of separating pigs within the programme from those outside is expected to lower the prevalence of Salmonella even further. © 2010 Blackwell Verlag GmbH.

A programmable and portable NMES device for drop foot correction and blood flow assist applications.

PubMed

Breen, Paul P; Corley, Gavin J; O'Keeffe, Derek T; Conway, Richard; Olaighin, Gearóid

2009-04-01

The Duo-STIM, a new, programmable and portable neuromuscular stimulation system for drop foot correction and blood flow assist applications is presented. The system consists of a programmer unit and a portable, programmable stimulator unit. The portable stimulator features fully programmable, sensor-controlled, constant-voltage, dual-channel stimulation and accommodates a range of customized stimulation profiles. Trapezoidal and free-form adaptive stimulation intensity envelope algorithms are provided for drop foot correction applications, while time dependent and activity dependent algorithms are provided for blood flow assist applications. A variety of sensor types can be used with the portable unit, including force sensitive resistor-based foot switches and MEMS-based accelerometer and gyroscope devices. The paper provides a detailed description of the hardware and block-level system design for both units. The programming and operating procedures for the system are also presented. Finally, functional bench test results for the system are presented.

A programmable and portable NMES device for drop foot correction and blood flow assist applications.

PubMed

Breen, Paul P; Corley, Gavin J; O'Keeffe, Derek T; Conway, Richard; OLaighin, Gearoid

2007-01-01

The Duo-STIM, a new, programmable and portable neuromuscular stimulation system for drop foot correction and blood flow assist applications is presented. The system consists of a programmer unit and a portable, programmable stimulator unit. The portable stimulator features fully programmable, sensor-controlled, constant-voltage, dual-channel stimulation and accommodates a range of customized stimulation profiles. Trapezoidal and free-form adaptive stimulation intensity envelope algorithms are provided for drop foot correction applications, while time dependent and activity dependent algorithms are provided for blood flow assist applications. A variety of sensor types can be used with the portable unit, including force sensitive resistor based foot switches and NMES based accelerometer and gyroscope devices. The paper provides a detailed description of the hardware and block-level system design for both units. The programming and operating procedures for the system are also presented. Finally, functional bench test results for the system are presented.

The impact of a multiple intelligences teaching approach drug education programme on drug refusal skills of Nigerian pupils.

PubMed

Nwagu, Evelyn N; Ezedum, Chuks E; Nwagu, Eric K N

2015-09-01

The rising incidence of drug abuse among youths in Nigeria is a source of concern for health educators. This study was carried out on primary six pupils to determine the effect of a Multiple Intelligences Teaching Approach Drug Education Programme (MITA-DEP) on pupils' acquisition of drug refusal skills. A programme of drug education based on the Multiple Intelligences Teaching Approach (MITA) was developed. An experimental group was taught using this programme while a control group was taught using the same programme but developed based on the Traditional Teaching Approach. Pupils taught with the MITA acquired more drug refusal skills than those taught with the Traditional Teaching Approach. Urban pupils taught with the MITA acquired more skills than rural pupils. There was no statistically significant difference in the mean refusal skills of male and female pupils taught with the MITA. © The Author(s) 2014.

Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial

PubMed Central

James, Janet; Thomas, Peter; Cavan, David; Kerr, David

2004-01-01

Objective To determine if a school based educational programme aimed at reducing consumption of carbonated drinks can prevent excessive weight gain in children. Design Cluster randomised controlled trial. Setting Six primary schools in southwest England. Participants 644 children aged 7-11 years. Intervention Focused educational programme on nutrition over one school year. Main outcome measures Drink consumption and number of overweight and obese children. Results Consumption of carbonated drinks over three days decreased by 0.6 glasses (average glass size 250 ml) in the intervention group but increased by 0.2 glasses in the control group (mean difference 0.7, 95% confidence interval 0.1 to 1.3). At 12 months the percentage of overweight and obese children increased in the control group by 7.5%, compared with a decrease in the intervention group of 0.2% (mean difference 7.7%, 2.2% to 13.1%). Conclusion A targeted, school based education programme produced a modest reduction in the number of carbonated drinks consumed, which was associated with a reduction in the number of overweight and obese children. PMID:15107313

Testing a Dutch web-based tailored lifestyle programme among adults: a study protocol.

PubMed

Schulz, Daniela N; Kremers, Stef Pj; van Osch, Liesbeth Adm; Schneider, Francine; van Adrichem, Mathieu Jg; de Vries, Hein

2011-02-16

Smoking, high alcohol consumption, unhealthy eating habits and physical inactivity often lead to (chronic) diseases, such as cardiovascular diseases and cancer. Tailored online interventions have been proven to be effective in changing health behaviours. The aim of this study is to test and compare the effectiveness of two different tailoring strategies for changing lifestyle compared to a control group using a multiple health behaviour web-based approach. In our Internet-based tailored programme, the five lifestyle behaviours of smoking, alcohol intake, fruit consumption, vegetable consumption, and physical activity are addressed. This randomized controlled trial, conducted among Dutch adults, includes two experimental groups (i.e., a sequential behaviour tailoring condition and a simultaneous behaviour tailoring condition) and a control group. People in the sequential behaviour tailoring condition obtain feedback on whether their lifestyle behaviours meet the Dutch recommendations. Using a step-by-step approach, they are stimulated to continue with a computer tailored module to change only one unhealthy behaviour first. In the course of the study, they can proceed to change a second behaviour. People in the simultaneous behaviour tailoring condition receive computer tailored feedback about all their unhealthy behaviours during their first visit as a stimulation to change all unhealthy behaviours. The experimental groups can re-visit the website and can then receive ipsative feedback (i.e., current scores are compared to previous scores in order to give feedback about potential changes). The (difference in) effectiveness of the different versions of the programme will be tested and compared to a control group, in which respondents only receive a short health risk appraisal. Programme evaluations will assess satisfaction with and appreciation and personal relevance of the intervention among the respondents. Finally, potential subgroup differences pertaining to gender, age and socioeconomic status regarding the behaviour effects and programme evaluation will be assessed. Research regarding multiple behaviour change is in its infancy. We study how to offer multiple behaviour change interventions optimally. Using these results could strengthen the effectiveness of web-based computer-tailoring lifestyle programmes. This study will yield new results about the need for differential lifestyle approaches using Internet-based expert systems and potential differences in subgroups concerning the effectiveness and appreciation. Dutch Trial Register NTR2168.

Randomised controlled trial of alternative messages to increase enrolment in a healthy food programme among individuals with diabetes

PubMed Central

Gopalan, A; Paramanund, J; Shaw, P A; Patel, D; Friedman, J; Brophy, C; Buttenheim, A M; Troxel, A B; Asch, D A; Volpp, K G

2016-01-01

Objectives We compared the effectiveness of diabetes-focused messaging strategies at increasing enrolment in a healthy food programme among adults with diabetes. Methods Vitality is a multifaceted wellness benefit available to members of Discovery Health, a South Africa-based health insurer. One of the largest Vitality programmes is HealthyFood (HF), an incentive-based programme designed to encourage healthier diets by providing up to 25% cashback on healthy food purchases. We randomised adults with type 2 diabetes to 1 of 5 arms: (1) control, (2) a diabetes-specific message, (3) a message with a recommendation of HF written from the perspective of a HF member with diabetes, (4) a message containing a physician's recommendation of HF, or (5) the diabetes-specific message from arm 2 paired with an ‘enhanced active choice’(EAC). In an EAC, readers are asked to make an immediate choice (in this case, to enrol or not enrol); the pros and cons associated with the preferred and non-preferred options are highlighted. HF enrolment was assessed 1 month following the first emailed message. Results We randomised 3906 members. After excluding those who enrolled in HF or departed from the Vitality programme before the first intervention email, 3665 (94%) were included in a modified intent-to-treat analysis. All 4 experimental arms had significantly higher HF enrolment rates compared with control (p<0.0001 for all comparisons). When comparing experimental arms, the diabetes-specific message with the EAC had a significantly higher enrolment rate (12.6%) than the diabetes-specific message alone (7.6%, p=0.0016). Conclusions Messages focused on diabetes were effective at increasing enrolment in a healthy food programme. The addition of a framed active choice to a message significantly raised enrolment rates in this population. These findings suggest that simple, low-cost interventions can enhance enrolment in health promoting programmes and also be pragmatically tested within those programmes. Trial registration number NCT02462057. PMID:27903559

The effectiveness of community-based rehabilitation programmes: an impact evaluation of a quasi-randomised trial.

PubMed

Mauro, Vincenzo; Biggeri, Mario; Deepak, Sunil; Trani, Jean-Francois

2014-11-01

Community-based rehabilitation (CBR) programmes have been described as highly effective means of promoting the rights and opportunities of persons with disabilities (PwD). Although CBR is often the main way in which PwD in low-income and middle-income countries access rehabilitation services, there is little literature providing rigorous evaluation of their impact on people's well-being. Data were collected in the Mandya and Ramanagar districts (Karnataka state, India), between December 2009 and May 2010. In total 2540 PwD were interviewed using stratified random sampling: 1919 CBR beneficiaries (who joined the programme between 1997 and 2009) and 621 persons who were living in villages not covered by the programme. We controlled for the systematic differences between people joining and not joining the programme using the propensity score matching method controlling for covariates at individual and village level. We evaluated the impact of the programme on the subgroups of PwD who are disadvantaged on the dimensions of interest: access to pensions, use of aid appliances, access to paid jobs and improvement in personal-practical autonomy after 4 and 7 years of joining the CBR. We observed a positive and significant impact of the programme on access to services, rights and opportunities of PwD. The results indicate that compared with the control group access to pensions and allowances, aid appliances, access to paid jobs and personal-practical autonomy increased by 29.7%, 9.4%, 12.3% and 36.2%, respectively, after 7 years. The CBR programme analysed has a positive impact on access to services and the well-being of PwD who are particularly deprived on outcomes of interest. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Maintaining evaluation designs in long term community based health promotion programmes: Heartbeat Wales case study.

PubMed Central

Nutbeam, D; Smith, C; Murphy, S; Catford, J

1993-01-01

STUDY OBJECTIVE--To examine the difficulties of developing and maintaining outcome evaluation designs in long term, community based health promotion programmes. DESIGN--Semistructured interviews of health promotion managers. SETTING--Wales and two reference health regions in England. PARTICIPANTS--Nine health promotion managers in Wales and 18 in England. MEASUREMENTS AND MAIN RESULTS--Information on selected heart health promotion activity undertaken or coordinated by health authorities from 1985-90 was collected. The Heartbeat Wales coronary heart disease prevention programme was set up in 1985, and a research and evaluation strategy was established to complement the intervention. A substantial increase in the budget occurred over the period. In the reference health regions in England this initiative was noted and rapidly taken up, thus compromising their use as control areas. CONCLUSION--Information on large scale, community based health promotion programmes can disseminate quickly and interfere with classic intervention/evaluation control designs through contamination. Alternative experimental designs for assessing the effectiveness of long term intervention programmes need to be considered. These should not rely solely on the use of reference populations, but should balance the measurement of outcome with an assessment of the process of change in communities. The development and use of intervention exposure measures together with well structured and comprehensive process evaluation in both the intervention and reference areas is recommended. PMID:8326270

Evaluation of Talking Parents, Healthy Teens, a new worksite based parenting programme to promote parent-adolescent communication about sexual health: randomised controlled trial

PubMed Central

Corona, Rosalie; Elliott, Marc N; Kanouse, David E; Eastman, Karen L; Zhou, Annie J; Klein, David J

2008-01-01

Objective To evaluate a worksite based parenting programme—Talking Parents, Healthy Teens—designed to help parents learn to address sexual health with their adolescent children. Design Randomised controlled trial (April 2002-December 2005). Setting 13 worksites in southern California. Participants 569 parents completed baseline surveys at work, gave permission for confidential surveys to be posted to their adolescent children, and were randomised to intervention or control groups. Parents and adolescents completed follow-up surveys at one week, three months, and nine months after the programme. Intervention Talking Parents, Healthy Teens consists of eight weekly one hour sessions at worksites for parents of adolescent children in 6th-10th grade (about ages 11-16 years). Main outcome measures Parent-adolescent communication about a list of sexual topics; whether parent taught adolescent how to use a condom; ability to communicate with parent/adolescent about sex; openness of parent-adolescent communication about sex. Results Differences between intervention and control groups were significant for the mean number of new sexual topics that parents and adolescents reported discussing between baseline and each follow-up (P<0.001 for each); intervention parents were less likely than controls to discuss no new topics (8% v 29%, 95% confidence interval for difference 16% to 24%) and more likely to discuss seven or more new topics (38% v 8%, 19% to 41%) at nine months. Some differences increased after completion of the programme: at one week after the programme, 18% of adolescents in the intervention group and 3% in the control group (6% to 30%) said that their parents had reviewed how to use a condom since baseline (P<0.001); this grew to 29% v 5% (13% to 36%) at nine months (P<0.001). Compared with controls at nine months, parents and adolescents in the intervention group reported greater ability to communicate with each other about sex (P<0.001) and more openness in communication about sex (P<0.001). Conclusions A worksite based programme can have substantial effects on communication between parents and adolescents about sexual health. Trial registration Clinical Trials NCT00465010. PMID:18617492

Improved cognitive performance in preadolescent Danish children after the school-based physical activity programme "FIFA 11 for Health" for Europe - A cluster-randomised controlled trial.

PubMed

Lind, Rune Rasmussen; Geertsen, Svend Sparre; Ørntoft, Christina; Madsen, Mads; Larsen, Malte Nejst; Dvorak, Jiri; Ritz, Christian; Krustrup, Peter

2018-02-01

Recent studies have shown promising effects of physical activity on cognitive function, but there is a need to investigate this link in real-life settings such as schools. Hence, the objective of the present pilot study was to investigate whether the school-based physical activity programme "FIFA 11 for Health" for Europe could improve cognitive performance in preadolescent Danish children. The pilot study used an 11-week cluster-randomised intervention study design. School classes were randomly assigned to either a control group (CG) (n = 93 children, age = 11.8, s = 0.2 years), which performed the obligatory daily school-based physical activity (5 × 45 minutes per week); or an intervention group (IG) (n = 838 children, age = 11.9, s = 0.4 years), which substituted 2 × 45 minutes per week of the daily school physical activity with the "FIFA 11 for Health" for Europe programme. The programme combines small-sided football games, drills and health education. Cognitive performance was evaluated at baseline and follow-up. The IG improved their cognitive performance compared to the CG for psychomotor function (56, s x -  = 22 ms, p < .001), attention (39, s x -  = 17 ms, p = .012) and working memory (79, s x -  = 35 ms, p = .020). This pilot study provides evidence that the school-based physical activity programme "FIFA 11 for Health" for Europe can improve cognitive performance in preadolescent Danish schoolchildren. Future studies should attempt to disentangle the effects of "FIFA 11 for Health" for Europe on cognitive performance by investigating the characteristics of the programme's physical activity.

Video-based training to improve perceptual-cognitive decision-making performance of Australian football umpires.

PubMed

Larkin, Paul; Mesagno, Christopher; Berry, Jason; Spittle, Michael; Harvey, Jack

2018-02-01

Decision-making is a central component of the in-game performance of Australian football umpires; however, current umpire training focuses largely on physiological development with decision-making skills development conducted via explicit lecture-style meetings with limited practice devoted to making actual decisions. Therefore, this study investigated the efficacy of a video-based training programme, aimed to provide a greater amount of contextualised visual experiences without explicit instruction, to improve decision-making skills of umpires. Australian football umpires (n = 52) were recruited from metropolitan and regional Division 1 competitions. Participants were randomly assigned to an intervention or control group and classified according to previous umpire game experience (i.e., experienced; less experienced). The intervention group completed a 12-week video-based decision-making training programme, with decision-making performance assessed at pre-training, and 1-week retention and 3-week retention periods. The control group did not complete any video-based training. Results indicated a significant Group (intervention; Control) × Test interaction (F(1, 100) = 3.98; P = 0.02, partial ῆ 2  = 0.074), with follow-up pairwise comparisons indicating significant within-group differences over time for the intervention group. In addition, decision-making performance of the less experienced umpires in the intervention group significantly improved (F(2, 40) = 5.03, P = 0.01, partial ῆ 2  = 0.201). Thus, video-based training programmes may be a viable adjunct to current training programmes to hasten decision-making development, especially for less experienced umpires.

An assessment of workplace programmes designed to control inhalation risks using respiratory protective equipment.

PubMed

Bell, Nikki; Vaughan, Nicholas P; Morris, Len; Griffin, Peter

2012-04-01

Few studies have assessed respiratory protective equipment (RPE) failures at the organizational level despite evidence to suggest that compliance with good practice may be low. The aim of this study was to develop an understanding of what current RPE programmes look like across industry and how this compares with good practice. Twenty cross-industry site visits were conducted with companies that had RPE programmes in place. Visits involved management interviews to explore current RPE systems and procedures and the decision making underpinning these. Observations of RPE operatives were included followed by short interviews to discuss the behaviours observed. Post-site assessments jointly undertaken by an RPE scientist and psychologist produced ratings for each site on six critical aspects of RPE programmes (knowledge/awareness, selection, use, training/information, supervision, and storage/cleaning/maintenance). Overall ratings for theoretical competence (i.e. management knowledge of RPE) and practical control (i.e. actual RPE practice on the shop floor) were also given. Qualitative analysis was performed on all interview data. The performance of RPE programmes varied across industry. Fewer than half the companies visited were considered to have an acceptable level of theoretical competence and practical control. Four distinct groups emerged from the 20 sites studied, ranging from Learners (low theoretical competence and practical control--four sites), Developers (acceptable theoretical competence and low practical control--five sites), and Fortuitous (low theoretical competence and acceptable practical control--two sites), to Proficient (acceptable theoretical competence and practical control--nine sites). None of the companies visited were achieving optimal control through the use of RPE. Widespread inadequacies were found with programme implementation, particularly training, supervision, and maintenance. Our taxonomy based on the four groups (Learners, Developers, Fortuitous, and Proficient) provided a useful expert-informed tool for explaining the variation in performance of RPE programmes across industry. Although further research and development are required, this taxonomy offers a useful starting point for the development of practical tools that may assist managers in making the much-needed improvements to all facets of programme implementation, particularly training, supervision, and maintenance.

Parents' perceptions of the value of the Webster-Stratton Parenting Programme: a qualitative study of a general practice based initiative.

PubMed

Patterson, J; Mockford, C; Stewart-Brown, S

2005-01-01

Parenting styles and parent-child relationships are a determinant of emotional and behavioural problems in children. Controlled trials of parenting programmes have been shown to be effective in helping parents of children with clinical levels of behaviour problems, but there is little research on the impact of such programmes in families where children's development falls in the 'normal' range. Also, such trials do not shed light on why or how programmes do, or do not, work, or how they might be improved. A qualitative study of the impact of the Webster-Stratton 'Parents and Children Series' programme on participants in a controlled trial of this programme, whose children's behaviour was below average, but, for the majority, in the normal range. Data were gathered in interviews, open-ended questions on a questionnaire and tape recordings of group leader supervision sessions. Parents reported increased confidence, better relationships with their children, successful use of new behaviour management techniques and improvements in their children's behaviour as a result of the programme. One parent found the programme unsuitable because she was already using the techniques that were taught, and another parent felt the programme was designed for parents of younger children. Many parents reported that additional sessions would have been useful to consolidate what they had learnt, and some parents felt the course would have been more effective if their partners had attended. The Webster-Stratton Parenting Programme is useful for parents of 'normal' children as well as for parents of children whose behaviour is in the clinical range. Follow-up sessions and attendance by both parents might increase effectiveness. The findings of this study suggest greater benefits to parents and children than were apparent in the controlled trial.

Healthcare Quality Improvement and 'work engagement'; concluding results from a national, longitudinal, cross-sectional study of the 'Productive Ward-Releasing Time to Care' Programme.

PubMed

White, Mark; Butterworth, Tony; Wells, John Sg

2017-08-01

Concerns about patient safety and reducing harm have led to a particular focus on initiatives that improve healthcare quality. However Quality Improvement (QI) initiatives have in the past typically faltered because they fail to fully engage healthcare professionals, resulting in apathy and resistance amongst this group of key stakeholders. Productive Ward: Releasing Time to Care (PW) is a ward-based QI programme created to help ward-based teams redesign and streamline the way that they work; leaving more time to care for patients. PW is designed to engage and empower ward-based teams to improve the safety, quality and delivery of care. The main objective of this study was to explore whether PW sustains the 'engagement' of ward-based teams by examining the longitudinal effect that the national QI programme had on the 'work-engagement' of ward-based teams in Ireland. Utilising the Utrecht Work Engagement Scale questionnaire (UWES-17), we surveyed nine PW (intervention) sites from typical acute Medical/Surgical, Rehabilitation and Elderly services (representing the entire cohort of a national phase of PW implementation in Ireland) and a cohort of matched control sites. The numbers surveyed from the PW group at T1 (up to 3 months after commencing the programme) totalled 253 ward-team members and 249 from the control group. At T2 (12 months later), the survey was repeated with 233 ward-team members from the PW sites and 236 from the control group. Overall findings demonstrated that those involved in the QI initiative had higher 'engagement' scores at T1 and T2 in comparison to the control group. Total 'engagement' score (TES), and its 3 dimensions, were all significantly higher in the PW group at T1, but only the Vigour dimension remained significantly higher at T2 (p = 0.006). Our results lend some support to the assertions of the PW initiative itself and suggest that when compared to a control group, ward-based teams involved in the QI programme are more likely to be 'engaged' by it and its associated improvement activities and that this is maintained over time. However, only the Vigour dimension of 'engagement' remained significantly higher in the PW over time.

A model to increase rehabilitation adherence to home exercise programmes in patients with varying levels of self-efficacy.

PubMed

Picha, Kelsey J; Howell, Dana M

2018-03-01

Patient adherence to rehabilitation programmes is frequently low - particularly adherence to home exercise programmes. Home exercise programmes have been identified as complementary to clinic-based physical therapy in an orthopaedic setting. Barriers to patient adherence have previously been identified within the literature. Low self-efficacy is a barrier to adherence that clinicians have the ability to have an impact on and improve. The theory of self-efficacy is defined as a person's confidence in their ability to perform a task. This theory examines the ability of a person to change through exerting control over inner processes of goal setting, self-monitoring, feedback, problem solving and self-evaluation. If clinicians are able to identify patients with low self-efficacy prior to the prescription of a home exercise programme, adjustments to individualized care can be implemented. Individualized care based on improving self-efficacy for home exercise programmes may improve patient adherence to these programmes. The purpose of this article was to use the theory of self-efficacy to direct clinicians in providing individualized programmes to patients with varying levels of self-efficacy. Copyright © 2017 John Wiley & Sons, Ltd.

Using an intervention mapping approach for planning, implementing and assessing a community-led project towards malaria elimination in the Eastern Province of Rwanda.

PubMed

Ingabire, Chantal Marie; Hakizimana, Emmanuel; Kateera, Fredrick; Rulisa, Alexis; Van Den Borne, Bart; Nieuwold, Ingmar; Muvunyi, Claude; Koenraadt, Constantianus J M; Van Vugt, Michele; Mutesa, Leon; Alaii, Jane

2016-12-16

Active community participation in malaria control is key to achieving malaria pre-elimination in Rwanda. This paper describes development, implementation and evaluation of a community-based malaria elimination project in Ruhuha sector, Bugesera district, Eastern province of Rwanda. Guided by an intervention mapping approach, a needs assessment was conducted using household and entomological surveys and focus group interviews. Data related to behavioural, epidemiological, entomological and economical aspects were collected. Desired behavioural and environmental outcomes were identified concurrently with behavioural and environmental determinants. Theoretical methods and their practical applications were enumerated to guide programme development and implementation. An operational plan including the scope and sequence as well as programme materials was developed. Two project components were subsequently implemented following community trainings: (1) community malaria action teams (CMATs) were initiated in mid-2014 as platforms to deliver malaria preventive messages at village level, and (2) a mosquito larval source control programme using biological substances was deployed for a duration of 6 months, implemented from January to July 2015. Process and outcome evaluation has been conducted for both programme components to inform future scale up. The project highlighted malaria patterns in the area and underpinned behavioural and environmental factors contributing to malaria transmission. Active involvement of the community in collaboration with CMATs contributed to health literacy, particularly increasing ability to make knowledgeable decisions in regards to malaria prevention and control. A follow up survey conducted six months following the establishment of CMATs reported a reduction of presumed malaria cases at the end of 2014. The changes were related to an increase in the acceptance and use of available preventive measures, such as indoor residual spraying and increase in community-based health insurance membership, also considered as a predictor of prompt and adequate care. The innovative larval source control intervention contributed to reduction in mosquito density and nuisance bites, increased knowledge and skills for malaria control as well as programme ownership. This community-based programme demonstrated the feasibility and effectiveness of active community participation in malaria control activities, which largely contributed to community empowerment and reduction of presumed malaria in the area. Further studies should explore how gains may be sustained to achieve the goal of malaria pre-elimination.

The value of theory in programmes to implement clinical guidelines: Insights from a retrospective mixed-methods evaluation of a programme to increase adherence to national guidelines for chronic disease in primary care

PubMed Central

Sheringham, Jessica; Solmi, Francesca; Ariti, Cono; Baim-Lance, Abigail; Morris, Steve; Fulop, Naomi J.

2017-01-01

Background Programmes have had limited success in improving guideline adherence for chronic disease. Use of theory is recommended but is often absent in programmes conducted in ‘real-world’ rather than research settings. Materials and methods This mixed-methods study tested a retrospective theory-based approach to evaluate a ‘real-world’ programme in primary care to improve adherence to national guidelines for chronic obstructive pulmonary disease (COPD). Qualitative data, comprising analysis of documents generated throughout the programme (n>300), in-depth interviews with planners (clinicians, managers and improvement experts involved in devising, planning, and implementing the programme, n = 14) and providers (practice clinicians, n = 14) were used to construct programme theories, experiences of implementation and contextual factors influencing care. Quantitative analyses comprised controlled before-and-after analyses to test ‘early’ and evolved’ programme theories with comparators grounded in each theory. ‘Early’ theory predicted the programme would reduce emergency hospital admissions (EHA). It was tested using national analysis of standardized borough-level EHA rates between programme and comparator boroughs. ‘Evolved’ theory predicted practices with higher programme participation would increase guideline adherence and reduce EHA and costs. It was tested using a difference-in-differences analysis with linked primary and secondary care data to compare changes in diagnosis, management, EHA and costs, over time and by programme participation. Results Contrary to programme planners’ predictions in ‘early’ and ‘evolved’ programme theories, admissions did not change following the programme. However, consistent with ‘evolved’ theory, higher guideline adoption occurred in practices with greater programme participation. Conclusions Retrospectively constructing theories based on the ideas of programme planners can enable evaluators to address some limitations encountered when evaluating programmes without a theoretical base. Prospectively articulating theory aided by existing models and mid-range implementation theories may strengthen guideline adoption efforts by prompting planners to scrutinise implementation methods. Benefits of deriving programme theory, with or without the aid of mid-range implementation theories, however, may be limited when the evidence underpinning guidelines is flawed. PMID:28328942

Cost-Effectiveness of a Community-Based Exercise Programme in COPD Self-Management.

PubMed

Zwerink, Marlies; Effing, Tanja; Kerstjens, Huib A M; van der Valk, Paul; Brusse-Keizer, Marjolein; Zielhuis, Gerhard; van der Palen, Job

2016-01-01

Information regarding cost-effectiveness of community-based exercise programmes in COPD is scarce. Therefore, we have investigated whether a community-based exercise programme is a cost-effective component of self-management for patients with COPD after 2 years of follow-up. All included COPD patients participated in four self-management sessions. Additionally, patients in the COPE-active group participated in an 11-month community-based exercise programme led by physiotherapists. Patients trained 3 times/week for 6 months and two times/week during the subsequent 5 months. In both periods, one of these weekly training sessions was home-based (unsupervised). No formal physiotherapy sessions were offered to COPE-active patients in the second year. A decision analytical model with a 24-month perspective was used to evaluate cost-effectiveness. Incremental cost-effectiveness ratios (ICER) were calculated and cost-effectiveness planes were created. Data of 77 patients participating in the exercise programme and 76 patients in the control group were analysed. The ICER for an additional patient prevented from deteriorating at least 47.5 meters on the ISWT was €6257. The ICER for an additional patient with a clinically relevant improvement (≥ 500 steps/day) in physical activity was €1564, and the ICER for an additional quality-adjusted life year (QALY) was €10 950. Due to a lack of maintenance of beneficial effects on our primary outcome exercise capacity after 2 years of follow-up and higher costs of the programme, the community-based exercise programme cannot be considered cost-effective compared to self-management programmes only. Nevertheless, the ICERs for the secondary outcomes physical activity and QALY are generally considered acceptable.

[Health behavior of medical students. Introduction of mental hygienic skills in the medical education in Hungary].

PubMed

Rosta, Eszter; Almási, Zsuzsanna; Karácsony, István; Konkolÿ Thege, Barna; Hegedűs, Katalin

2012-07-22

HuMania Training Programme is a voluntary peer training course. to measure the efficiency of HuMania Training Programme and to analyse social relations of medical students. WHO Well-being Index, Bergen Social Relationship Scale, Lazarus's Ways of Coping Questionnaire and the Maslach Burnout Inventory for undergraduate students were used. The results of HuMania Training Programme established in 2009 were compared with those obtained from controls and HuMania Training Programme of the forthcoming year. At the beginning, participants of the HuMania Training Programme had fewer well-being scores (p = 0.01), whereas their social anxiety (p = 0.01) and emotion-based coping (p = 0.05) were greater as compared to controls. After the HuMania Training Programme course, well-being showed an increasing tendency (p = 0.072), and burnout-level decreased (p = 0.040). Fifty percent of medical students had a minimum of three stressors, and 57% of them said that there was a person in their environment, who needed help, but they cannot provide it. Medical students display poor mental hygienic state. and HuMania Training Programme tries to fight this situation.

Perception of young adults with sickle cell disease or sickle cell trait about participation in the CHOICES randomized controlled trial.

PubMed

Hershberger, Patricia E; Gallo, Agatha M; Molokie, Robert; Thompson, Alexis A; Suarez, Marie L; Yao, Yingwei; Wilkie, Diana J

2016-06-01

To gain an in-depth understanding of the perceptions of young adults with sickle cell disease and sickle cell trait about parenthood and participating in the CHOICES randomized controlled trial that used computer-based, educational programmes. In the USA, there is insufficient education to assure that all young adults with sickle cell disease or sickle cell trait understand genetic inheritance risks and reproductive options to make informed reproductive decisions. To address this educational need, we developed a computer-based, multimedia program (CHOICES) and reformatted usual care into a computer-based (e-Book) program. We then conducted a two-year randomized controlled trial that included a qualitative component that would deepen understanding of young adults' perceptions of parenthood and use of computer-based, educational programmes. A qualitative descriptive approach completed after a randomized controlled trial. Sixty-eight men and women of childbearing age participated in semi-structured interviews at the completion of the randomized controlled trial from 2012-2013. Thematic content analysis guided the qualitative description. Three main themes were identified: (1) increasing knowledge and new ways of thinking and behaving; (2) rethinking parenting plans; and (3) appraising the program design and delivery. Most participants reported increased knowledge and rethinking of their parenting plans and were supportive of computer-based learning. Some participants expressed difficulty in determining individual transmission risks. Participants perceived the computer programs as beneficial to their learning. Future development of an Internet-based educational programme is warranted, with emphasis on providing tailored education or memory boosters about individual transmission risks. © 2015 John Wiley & Sons Ltd.

Coping successfully with dyslexia: an initial study of an inclusive school-based resilience programme.

PubMed

Firth, Nola; Frydenberg, Erica; Steeg, Charlotte; Bond, Lyndal

2013-05-01

A dyslexia coping programme entitled Success and Dyslexia was implemented in two primary schools within a whole-class coping programme and whole-school dyslexia professional development context. One hundred and two year 6 students, 23 of whom had dyslexia, undertook surveys pretest, post-test and at 1-year follow-up. Effectiveness of the coping programme and maintenance of effects for the students after transition to secondary school were investigated. Inclusion of contrast group data in the follow-up year suggested significant positive changes at first and second follow-ups in locus of control and nonproductive coping may also be associated with increase in age. Most trends were in the expected direction, especially for students with dyslexia. At follow-up, students with dyslexia reported similar perceived control and adaptive coping to students without dyslexia rather than a decrease in these areas as is usually the case. A larger sample and an ongoing control group are needed to confirm these results. Copyright © 2013 John Wiley & Sons, Ltd.

Trauma rehabilitation for war-affected persons in northern Uganda: a pilot evaluation of the EMPOWER programme.

PubMed

Sonderegger, Robi; Rombouts, Sacha; Ocen, Benson; McKeever, Reyelle Sarah

2011-09-01

OBJECTIVES. This study evaluated the impact of a culturally sensitive cognitive behaviour therapy (CBT)-based intervention (the EMPOWER programme) for war-affected persons in northern Uganda. DESIGN. The study conducted a pilot evaluation with a convenience sample of participants from internally displaced persons (IDPs) camps (i.e., a treatment camp and waitlist control camp). This was done to avoid treatment effects spreading from the intervention to control conditions. METHODS. A total of 202 participants (N= 90 treatment participants and N= 112 control participants) were included as a convenience sample. The Acholi Psychosocial Assessment Instrument (APAI), a culturally appropriate measure of psychosocial functioning, was administered to participants residing in two IDP camps at pre-treatment, post-treatment, and at 3-month follow-up. Participants in the treatment camp received the EMPOWER programme--a culturally sensitive CBT-based intervention teaching emotional resiliency and promoting forgiveness. RESULTS. Participants in the treatment condition reported (a) significantly lower scores on the depression-like syndromes and the anxiety-like syndrome and (b) significantly more prosocial behaviours, than participants in the control condition. CONCLUSIONS. The results of this study provide initial support for the application of structured CBT interventions in war-affected areas, illustrating that the EMPOWER programme could be utilized by humanitarian agencies to address the psychosocial needs of war-affected displaced persons. ©2010 The British Psychological Society.

A Randomised Controlled Trial of PEGASUS, a Psychoeducational Programme for Young People with High-Functioning Autism Spectrum Disorder

ERIC Educational Resources Information Center

Gordon, Kate; Murin, Marianna; Baykaner, Ozlem; Roughan, Laura; Livermore-Hardy, Vaan; Skuse, David; Mandy, Will

2015-01-01

Background: Psychoeducation is an essential component of postdiagnostic care for people with ASD (autism spectrum disorder), but there is currently no evidence base for clinical practice. We designed, manualised and evaluated PEGASUS (psychoeducation group for autism spectrum understanding and support), a group psychoeducational programme aiming…

A simple laser locking system based on a field-programmable gate array.

PubMed

Jørgensen, N B; Birkmose, D; Trelborg, K; Wacker, L; Winter, N; Hilliard, A J; Bason, M G; Arlt, J J

2016-07-01

Frequency stabilization of laser light is crucial in both scientific and industrial applications. Technological developments now allow analog laser stabilization systems to be replaced with digital electronics such as field-programmable gate arrays, which have recently been utilized to develop such locking systems. We have developed a frequency stabilization system based on a field-programmable gate array, with emphasis on hardware simplicity, which offers a user-friendly alternative to commercial and previous home-built solutions. Frequency modulation, lock-in detection, and a proportional-integral-derivative controller are programmed on the field-programmable gate array and only minimal additional components are required to frequency stabilize a laser. The locking system is administered from a host-computer which provides comprehensive, long-distance control through a versatile interface. Various measurements were performed to characterize the system. The linewidth of the locked laser was measured to be 0.7 ± 0.1 MHz with a settling time of 10 ms. The system can thus fully match laser systems currently in use for atom trapping and cooling applications.

A simple laser locking system based on a field-programmable gate array

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jørgensen, N. B.; Birkmose, D.; Trelborg, K.

Frequency stabilization of laser light is crucial in both scientific and industrial applications. Technological developments now allow analog laser stabilization systems to be replaced with digital electronics such as field-programmable gate arrays, which have recently been utilized to develop such locking systems. We have developed a frequency stabilization system based on a field-programmable gate array, with emphasis on hardware simplicity, which offers a user-friendly alternative to commercial and previous home-built solutions. Frequency modulation, lock-in detection, and a proportional-integral-derivative controller are programmed on the field-programmable gate array and only minimal additional components are required to frequency stabilize a laser. The lockingmore » system is administered from a host-computer which provides comprehensive, long-distance control through a versatile interface. Various measurements were performed to characterize the system. The linewidth of the locked laser was measured to be 0.7 ± 0.1 MHz with a settling time of 10 ms. The system can thus fully match laser systems currently in use for atom trapping and cooling applications.« less

A programmable positioning stepper-motor controller with a multibus/IEEE 796 compatible interface.

PubMed

Papoff, P; Ricci, D

1984-02-01

A programmable positioning stepper-motor controller, based on the Multibus/IEEE 796 standard interface, has been assembled by use of some intelligent and programmable integrated circuits. This controller, organized as a bus-slave unit, has been planned for local management of up to four stepper motors working simultaneously. The number of steps, the direction of rotation and the step-rate for the positioning of each motor are issued by the bus master microcomputer to the controller which handles all the required operations. Once each positioning has been performed, the controller informs the master by generating a proper bus-vectored interrupt. Displacements in up to 64,000 steps may be programmed with step-rates ranging from 0.1 to 6550 steps/sec. This device, for which only low-cost, high-performance components are required, can be successfully used in a wide range of applications and can be easily extended to control more than four stepper motors.

Effects of a Physical Education-Based Programme on Health-Related Physical Fitness and Its Maintenance in High School Students: A Cluster-Randomized Controlled Trial

ERIC Educational Resources Information Center

Mayorga-Vega, Daniel; Montoro-Escaño, Jorge; Merino-Marban, Rafael; Viciana, Jesús

2016-01-01

The purpose of this study was to examine the effects of a physical education-based development and maintenance programme on objective and perceived health-related physical fitness in high school students. A sample of 111 students aged 12-14 years old from six classes were cluster-randomly assigned to an experimental group (n = 54) or a control…

Programmable Oscillator

NASA Technical Reports Server (NTRS)

Quirk, Kevin J.; Patawaran, Ferze D.; Nguyen, Danh H.; Lee, Clement G.; Nguyen, Huy

2011-01-01

A programmable oscillator is a frequency synthesizer with an output phase that tracks an arbitrary function. An offset, phase-locked loop circuit is used in combination with an error control feedback loop to precisely control the output phase of the oscillator. To down-convert the received signal, several stages of mixing may be employed with the compensation for the time-base distortion of the carrier occurring at any one of those stages. In the Goldstone Solar System Radar (GSSR), the compensation occurs in the mixing from an intermediate frequency (IF), whose value is dependent on the station and band, to a common IF used in the final stage of down-conversion to baseband. The programmable oscillator (PO) is used in the final stage of down-conversion to generate the IF, along with a time-varying phase component that matches the time-base distortion of the carrier, thus removing it from the final down-converted signal.

Design of the iPlay study: systematic development of a physical activity injury prevention programme for primary school children.

PubMed

Collard, Dorine C M; Chinapaw, Mai J M; van Mechelen, Willem; Verhagen, Evert A L M

2009-01-01

Health benefits of physical activity in children are well known. However, a drawback is the risk of physical activity-related injuries. Children are at particular risk for these injuries, because of a high level of exposure. Because of the high prevalence of physical activity injuries and the negative short- and long-term consequences, prevention of these injuries in children is important. This article describes how we systematically developed a school-based physical activity injury prevention programme using the intervention mapping (IM) protocol. IM describes a process for developing theory- and evidence-based health promotion programmes. The development can be described in six steps: (i) perform a needs assessment; (ii) identify programme and performance objectives; (iii) select methods and strategies; (iv) develop programme; (v) adopt and implement; and (vi) evaluate. First, the results of the needs assessment showed the injury problem in children and the different risk factors for physical activity injuries. Based on the results of the needs assessment the main focus of the injury prevention programme was described. Second, the overall programme objective of the injury prevention programme was defined as reducing the incidence of lower extremity physical activity injuries. Third, theoretical methods and practical strategies were selected to accomplish a decrease in injury incidence. The theoretical methods used were active learning, providing cues and scenario-based risk information, and active processing of information. The practical strategy of the injury prevention programme was an 8-month course about injury prevention to be used in physical education classes in primary schools. Fourth, programme materials that were used in the injury prevention programme were developed, including newsletters for children and parents, posters, exercises to improve motor fitness, and an information website. Fifth, an implementation plan was designed in order to ensure that the prevention programme would be implemented, adopted and sustained over time. Finally, an evaluation plan was designed. The injury prevention programme is being evaluated in a cluster randomized controlled trial with more than 2200 children from 40 primary schools throughout the Netherlands. The IM process is a useful process for developing an injury prevention programme. Based on the steps of the IM we developed an 8-month injury prevention programme to be used in physical education classes of primary schools.

Stepped-care to prevent depression and anxiety in visually impaired older adults--design of a randomised controlled trial.

PubMed

van der Aa, Hilde P A; van Rens, Ger H M B; Comijs, Hannie C; Bosmans, Judith E; Margrain, Tom H; van Nispen, Ruth M A

2013-08-09

Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. A stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in The Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-)effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N = 230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI). Preventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step. Identifier: NTR3296.

The effect of a smartphone-based coronary heart disease prevention (SBCHDP) programme on awareness and knowledge of CHD, stress, and cardiac-related lifestyle behaviours among the working population in Singapore: a pilot randomised controlled trial.

PubMed

Zhang, Hui; Jiang, Ying; Nguyen, Hoang D; Poo, Danny Chiang Choon; Wang, Wenru

2017-03-14

Coronary heart disease (CHD) is the most prevalent type of cardiac disease among adults worldwide, including those in Singapore. Most of its risk factors, such as smoking, physical inactivity and high blood pressure, are preventable. mHealth has improved in the last decade, showing promising results in chronic disease prevention and health promotion worldwide. Our aim was to develop and examine the effect of a 4-week Smartphone-Based Coronary Heart Disease Prevention (SBCHDP) programme in improving awareness and knowledge of CHD, perceived stress as well as cardiac-related lifestyle behaviours in the working population of Singapore. The smartphone app "Care4Heart" was developed as the main component of the programme. App content was reviewed and validated by a panel of experts, including two cardiologists and two experienced cardiology-trained nurses. A pilot randomised controlled trial was conducted. Eighty working people were recruited and randomised to either the intervention group (n = 40) or the control group (n = 40). The intervention group underwent a 4-week SBCHDP programme, whereas the control group were offered health promotion websites only. The participants' CHD knowledge, perceived stress and behavioural risk factors were measured at baseline and on the 4th week using the Heart Disease Fact Questionnaire-2, Perceived Stress Scale, and Behavioural Risk Factor Surveillance System. After the SBCHDP programme, participants in the intervention group had a better awareness of CHD being the second leading cause of death in Singapore (X 2   = 6.486, p = 0.039), a better overall CHD knowledge level (t = 3.171, p = 0.002), and better behaviour concerning blood cholesterol control (X 2  = 4.54, p = 0.033) than participants in the control group. This pilot study partially confirmed the positive effects of the SBCHDP programme in improving awareness and knowledge of CHD among the working population. Due to the small sample size and short follow-up period, this study was underpowered to detect significant differences between groups. A full-scale longitudinal study is required in the future to confirm the effectiveness of the SBCHDP programme.

The Incredible Years Parent-Toddler Programme and parental language: a randomised controlled trial.

PubMed

Gridley, N; Hutchings, J; Baker-Henningham, H

2015-01-01

Parental language is associated with children's later language development. Parenting programmes, based on social learning theory, enhance a range of parenting behaviours, yet there is limited evidence for their effect on parental language. To assess the benefits of a behavioural-based parenting programme, which features components of language and communication, to enhance parental language. Parents of toddlers, aged 12 to 36 months, were recruited from eight Flying Start early intervention centres across Wales. Participants were randomised 2:1 either to a parenting programme (n = 60) or to a wait-list control group (n = 29). Researchers were blind to participant allocation throughout the trial. Fifteen-minute video-recorded observations of parents and children interacting during free-play, both at a pre-intervention and at 6-month follow-up, provided the data for the study. Five observed measures of parental language were assessed; quantity and variety, encouraging, critical, child-led and parent led interactions. The Incredible Years Parent-Toddler Programme (IYPTP) is a 12-week group-based behavioural intervention that teaches effective relationship and behavioural management skills including social, emotional and persistence coaching to enable parents to better support their children's development. Of 89 dyads that completed pre-intervention assessments 81 (54 intervention and 27 control) met the criteria for the current study. Intention to treat analysis indicated that child-led language interactions significantly benefited from the intervention [regression coefficient (B) = -1.44, 95% confidence intervals (CI) = -2.59 to -0.29, P = 0.015, effect size (ES) = 0.47] and a positive trend for encouraging language in favour of the intervention sample was evident. Per-protocol sample analysis replicated these findings with encouraging language reaching statistical significance (B = 1.07, 95% CI = 0.11 to 2.03, P = 0.03, ES = 0.52). No further benefits were evident. The IYPTP has limited evidence as an effective programme for enhancing some aspects of parental language. © 2014 John Wiley & Sons Ltd.

Adapted physical activity is beneficial on balance, functional mobility, quality of life and fall risk in community-dwelling older women: a randomized single-blinded controlled trial.

PubMed

Kovács, E; Prókai, L; Mészáros, L; Gondos, T

2013-06-01

Exercise programmes have important role in prevention of falls, but to date, we have little knowledge about the effects of Adapted Physical Activity programme on balance of older women. The aim of this study was to investigate the effects of an Adapted Physical Activity programme on balance, risk of falls and quality of life in community-dwelling older women. This was a randomized controlled study. Community, in a local sport centre. Older women aged over 60 years. Seventy-six women were randomised to an exercise group providing Adapted Physical Activity programme for 25 weeks or a control group (in which they did not participate in any exercise programme). The one-leg stance test, Timed Up and Go test, incidence of fall and the quality of life (SF-36V2) were measured at baseline and after 25 weeks. The one-leg stance test and the Timed Up and Go test in the exercise group was significantly better than in the control group after the intervention period (P=0.005; P=0.001, respectively). The Physical Functioning, Vitality and General Health subdomains of quality of life were also significantly better in the exercise group compared to the control group (P=0.004; P=0.005; P=0.038, respectively). Relative risk was 0.40 (90% CI 0.174 to 0.920) and the number needed to treat was 5 (95% CI 2.3 to 23.3). This 25-week Adapted Physical Activity programme improves static balance, functional mobility, as well as Physical Functioning, Vitality and General Health subdomains of quality of life. Based on our results, the Adapted Physical Activity programme may be a promising fall prevention exercise programme improving static balance and functional mobility for community-dwelling older women.

Effectiveness and safety of a home-based cardiac rehabilitation programme of mixed surveillance in patients with ischemic heart disease at moderate cardiovascular risk: A randomised, controlled clinical trial.

PubMed

Bravo-Escobar, Raquel; González-Represas, Alicia; Gómez-González, Adela María; Montiel-Trujillo, Angel; Aguilar-Jimenez, Rafael; Carrasco-Ruíz, Rosa; Salinas-Sánchez, Pablo

2017-02-20

Previous studies have documented the feasibility of home-based cardiac rehabilitation programmes in low-risk patients with ischemic heart disease, but a similar solution needs to be found for patients at moderate cardiovascular risk. The objective of this study was to analyse the effectiveness and safety of a home-based cardiac rehabilitation programme of mixed surveillance in patients with ischemic cardiopathology at moderate cardiovascular risk. A randomised, controlled clinical trial was designed wherein 28 patients with stable coronary artery disease at moderate cardiovascular risk, who met the selection criteria for this study, participated. Of these, 14 were assigned to the group undergoing traditional cardiac rehabilitation in hospital (control group) and 14 were assigned to the home-based mixed surveillance programme (experimental group). The patients in the experimental group went to the cardiac rehabilitation unit once a week and exercised at home, which was monitored with a remote electrocardiographic monitoring device (NUUBO®). The in-home exercises comprised of walking at 70% of heart rate reserve during the first month, and 80% during the second month, for 1 h per day at a frequency of 5 to 7 days per week. A two-way repeated measures analysis of variance (ANOVA) was performed to evaluate the effects of time (before and after intervention) and time-group interaction regarding exercise capacity, risk profile, cardiovascular complications, and quality of life. No significant differences were observed between the traditional cardiac rehabilitation group and the home-based with mixed surveillance group for exercise time and METS achieved during the exertion test, and the recovery rate in the first minute (which increased in both groups after the intervention). The only difference between the two groups was for quality of life scores (10.93 [IC95%: 17.251, 3.334, p = 0.007] vs -4.314 [IC95%: -11.414, 2.787; p = 0.206]). No serious heart-related complications were recorded during the cardiac rehabilitation programme. The home-based cardiac rehabilitation programme with mixed surveillance appears to be as effective and safe as the traditional model in patients with ischemic heart disease who are at moderate cardiovascular risk. However, the cardiac rehabilitation programmes carried out in hospital seems to have better results in improving the quality of life. Retrospectively registered NCT02796404 (May 23, 2016).

Sustenance and sustainability: maximizing the impact of school gardens on health outcomes.

PubMed

Davis, Jaimie N; Spaniol, Mackenzie R; Somerset, Shawn

2015-09-01

School garden programmes have become popular action-oriented learning environments in many countries, often driven by converging priorities of environmental sustainability and healthful diets. Many of these programmes have assessed the impact on dietary intake, specifically fruit and vegetable intake, and related dietary behaviours, such as knowledge, preference, motivation, intention and self-efficacy to eat and prepare fruit and vegetables. The objective of the present study was twofold: (i) to review published garden-based programmes conducted in schools targeting dietary intake and/or determinants of dietary behaviour in children; and (ii) to identify similar strategies and components employed by these garden-based programmes. The review included thirteen studies that have examined the impact of garden-based programmes conducted in school, either during school hours or in after-school settings, on dietary behaviours in children (kindergarten through 8th grade students). Three of the reviewed studies did not have a comparison or control group and simply evaluated within-group changes after a garden intervention. None of the reviewed studies were randomized, but were assigned based on school's interest and timing of new school gardens being built. Out of the eleven programmes that examined dietary intake, six found that the programme resulted in increased vegetable intake, whereas four showed no effect. Seven of the eight studies that measured preference found that the programmes resulted in increased preference for vegetables. Gardening programmes also resulted in improved attitudes towards, willingness to taste, identification of and self-efficacy to prepare/cook fruit and vegetables. Similar strategies/components employed by the majority of the programmes included: 'hands on' curriculum, incorporation of a cooking component, providing the instructors, parental and stakeholder support, food provision and using the garden as the focal point for media promotion. Some of the garden programmes resulted in increased vegetable intake, which has positive implications for both environment sustainability and health-related outcomes. Further, the majority resulted in some improvement in behaviour determinants more generally. However, more research is warranted to understand how to achieve long-term improvements in dietary behaviours and how to sustain the garden-based programmes in schools.

Effects of a community-based nutrition promotion programme on child feeding and hygiene practices among caregivers in rural Eastern Ethiopia.

PubMed

Kang, Yunhee; Suh, Youn Kyoung; Debele, Lemma; Juon, Hee-Soon; Christian, Parul

2017-06-01

To evaluate the effectiveness of a community-based participatory nutrition promotion (CPNP) programme involving a 2-week group nutrition session in improving child feeding and hygiene practices among caregivers. Cluster randomized trial. In the intervention area (six clusters), the CPNP programme was added to the context of government nutrition programmes; the control area (six clusters) received the government programme only. Child feeding practices were assessed every 3 months using a 24 h dietary recall questionnaire, and hand washing with soap was assessed every 6 months, over a period of 12 months. Feeding and hygiene measures at each visit were scored and the scores summed up for the entire follow-up period. Habro and Melka Bello districts, Ethiopia. Randomly selected mothers with a child aged 6-12 months (n 1790). A total of 1199 mothers, 629 in the control and 570 in the intervention areas, were assessed at all visits and included in the analysis. Mothers in the intervention area showed higher scores than those in the control area regarding meal frequency (difference: 1·04, 95 % CI 0·35, 1·73), composite feeding score_1 (difference: 1·25, 95 % CI 0·37, 2·13; a summing score of currently breast-feeding, meal frequency and dietary diversity) and composite feeding score_2 (difference: 1·40, 95 % CI 0·49, 2·32; a summing score of meal frequency and dietary diversity). However, there were no differences in the scores of breast-feeding, dietary diversity and hand washing between the two areas (all P>0·05). The CPNP programme was effective in improving some child feeding behaviours in rural Eastern Ethiopia.

The effectiveness of a preconditioning programme on preventing running-related injuries in novice runners: a randomised controlled trial.

PubMed

Bredeweg, Steef W; Zijlstra, Sjouke; Bessem, Bram; Buist, Ida

2012-09-01

There is no consensus on the aetiology and prevention of running-related injuries in runners. Preconditioning studies among different athlete populations show positive effects on the incidence of sports injuries. A 4-week preconditioning programme in novice runners will reduce the incidence of running-related injuries. Randomised controlled clinical trial; level of evidence, 1. Novice runners (N=432) prepared for a four-mile recreational running event. Participants were allocated to the 4-week preconditioning (PRECON) group (N=211) or the control group (N=221). The PRECON group started a 4-week training programme, prior to the running programme, with walking and hopping exercises. After the 4-week period both groups started a 9-week running programme. In both groups information was registered on running exposure and running-related injuries (RRIs) using an internet-based running log. Primary outcome measure was RRIs per 100 runners. An RRI was defined as any musculoskeletal complaint of the lower extremity or lower back causing restriction of running for at least a week. The incidence of RRIs was 15.2% in the PRECON group and 16.8% in the control group. The difference in RRIs between the groups was not significant (χ(2)=0.161, df=1, p=0.69). This prospective study demonstrated that a 4-week PRECON programme with walking and hopping exercises had no influence on the incidence of RRIs in novice runners.

Parenting for Autism, Language, And Communication Evaluation Study (PALACES): protocol for a pilot randomised controlled trial.

PubMed

Williams, Margiad Elen; Hastings, Richard; Charles, Joanna Mary; Evans, Sue; Hutchings, Judy

2017-02-16

Children with autistic spectrum disorder (ASD) often have associated behavioural difficulties that can present a challenge for parents and parenting. There are several effective social learning theory-based parenting programmes for dealing with behavioural difficulties, including the Incredible Years (IY) parent programmes. However, these programmes typically do not specifically target parents of children with ASD. Recently, a new addition to the IY suite of programmes known as the IY Autistic Spectrum and Language Delays (IY-ASLD) parent programme was developed. The main aims of the present study are to examine the feasibility of delivering this programme within child health services and to provide initial evidence for effectiveness and economic costs. The Parenting for Autism, Language, And Communication Evaluation Study (PALACES) trial is a pragmatic, multicentre, pilot randomised controlled trial comparing the IY-ASLD programme with a wait-list control condition. 72 parents of children with ASD (aged 3-8 years) will be randomly allocated to either the intervention or control condition. Data will be collected prior to randomisation and 6 months postrandomisation for all families. Families in the intervention condition only will also be followed up at 12 and 18 months postrandomisation. This study will provide initial evidence of effectiveness for the newly developed IY-ASLD parenting programme. It will also add to the limited economic evidence for an intervention targeting parents of children with ASD and provide longer term data, an important component for evaluations of parenting programmes. Approval for the study was granted by the Research Ethics Committee at the School of Psychology, Bangor University (reference number: 2016-15768) and the North Wales Research Ethics Committee, UK (reference number: 16/WA/0224). The findings will be disseminated through research conferences and peer-reviewed journals. ISRCTN57070414; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Parenting for Autism, Language, And Communication Evaluation Study (PALACES): protocol for a pilot randomised controlled trial

PubMed Central

Williams, Margiad Elen; Hastings, Richard; Charles, Joanna Mary; Evans, Sue; Hutchings, Judy

2017-01-01

Introduction Children with autistic spectrum disorder (ASD) often have associated behavioural difficulties that can present a challenge for parents and parenting. There are several effective social learning theory-based parenting programmes for dealing with behavioural difficulties, including the Incredible Years (IY) parent programmes. However, these programmes typically do not specifically target parents of children with ASD. Recently, a new addition to the IY suite of programmes known as the IY Autistic Spectrum and Language Delays (IY-ASLD) parent programme was developed. The main aims of the present study are to examine the feasibility of delivering this programme within child health services and to provide initial evidence for effectiveness and economic costs. Methods and analysis The Parenting for Autism, Language, And Communication Evaluation Study (PALACES) trial is a pragmatic, multicentre, pilot randomised controlled trial comparing the IY-ASLD programme with a wait-list control condition. 72 parents of children with ASD (aged 3–8 years) will be randomly allocated to either the intervention or control condition. Data will be collected prior to randomisation and 6 months postrandomisation for all families. Families in the intervention condition only will also be followed up at 12 and 18 months postrandomisation. This study will provide initial evidence of effectiveness for the newly developed IY-ASLD parenting programme. It will also add to the limited economic evidence for an intervention targeting parents of children with ASD and provide longer term data, an important component for evaluations of parenting programmes. Ethics and dissemination Approval for the study was granted by the Research Ethics Committee at the School of Psychology, Bangor University (reference number: 2016–15768) and the North Wales Research Ethics Committee, UK (reference number: 16/WA/0224). The findings will be disseminated through research conferences and peer-reviewed journals. Trial registration number ISRCTN57070414; Pre-results. PMID:28209607

FIFA 11+: an effective programme to prevent football injuries in various player groups worldwide—a narrative review

PubMed Central

Bizzini, Mario; Dvorak, Jiri

2015-01-01

In 2009, FIFA promoted and disseminated the FIFA 11+ injury prevention programme worldwide. Developed and studied by the FIFA Medical Assessment and Research Centre (F-MARC), the programme was based on a randomised controlled study and one countrywide campaign in amateur football that significantly reduced injuries and healthcare costs. Since the FIFA 11+ launch, key publications have confirmed the preventive effects of the programme and have evaluated its performance effects in female as well as male amateur football players. Furthermore, implementation strategies of this prevention programme have also been studied. The goal of this narrative review was to summarise the available scientific evidence about the FIFA 11+ programme. While FIFA continues to disseminate and implement FIFA 11+ among its Member Associations, adaptations of the injury prevention programme for children and referees have been developed and are currently being evaluated. PMID:25878073

A cluster randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of classroom-based cognitive-behavioural therapy (CBT) in reducing symptoms of depression in high-risk adolescents.

PubMed

Stallard, P; Phillips, R; Montgomery, A A; Spears, M; Anderson, R; Taylor, J; Araya, R; Lewis, G; Ukoumunne, O C; Millings, A; Georgiou, L; Cook, E; Sayal, K

2013-10-01

Depression in adolescents is a significant problem that impairs everyday functioning and increases the risk of severe mental health disorders in adulthood. Although this is a major problem, relatively few adolescents with, or at risk of developing, depression are identified and referred for treatment. This suggests the need to investigate alternative approaches whereby preventative interventions are made widely available in schools. To investigate the clinical effectiveness and cost-effectiveness of classroom-based cognitive-behavioural therapy (CBT) in reducing symptoms of depression in high-risk adolescents. Cluster randomised controlled trial. Year groups ( n = 28) randomly allocated on a 1 : 1 : 1 basis to one of three trial arms once all schools were recruited and balanced for number of classes, number of students, Personal, Social and Health Education (PSHE) lesson frequency, and scheduling of PSHE. Year groups 8 to 11 (ages 12-16 years) in mixed-sex secondary schools in the UK. Data were collected between 2009 and 2011. Young people who attended PSHE at participating schools were eligible ( n = 5503). Of the 5030 who agreed to participate, 1064 (21.2%) were classified as 'high risk': 392 in the classroom-based CBT arm, 374 in the attention control PSHE arm and 298 in the usual PSHE arm. Primary outcome data on the high-risk group at 12 months were available for classroom-based CBT ( n = 296), attention control PSHE ( n = 308) and usual PSHE ( n = 242). The Resourceful Adolescent Programme (RAP) is a focused CBT-based intervention adapted for the UK (RAP-UK) and delivered by two facilitators external to the school. Control groups were usual PSHE (usual school curriculum delivered by teachers) and attention control (usual school PSHE with additional support from two facilitators). Interventions were delivered universally to whole classes. Clinical effectiveness: symptoms of depression [Short Mood and Feelings Questionnaire (SMFQ)] in adolescents at high risk of depression 12 months from baseline. Cost-effectiveness: incremental cost-effectiveness ratios (ICERs) based on SMFQ score and quality-adjusted life-years (from European Quality of Life-5 Dimensions scores) between baseline and 12 months. Process evaluation: reach, attrition and qualitative feedback from service recipients and providers. SMFQ scores had decreased for high-risk adolescents in all trial arms at 12 months, but there was no difference between arms [classroom-based CBT vs. usual PSHE adjusted difference in means 0.97, 95% confidence interval (CI) -0.34 to 2.28; classroom-based CBT vs. attention control PSHE -0.63, 95% CI -1.99 to 0.73]. Costs of interventions per child were estimated at £41.96 for classroom-based CBT and £34.45 for attention control PSHE. Fieller's method was used to obtain a parametric estimate of the 95% CI for the ICERs and construct the cost-effectiveness acceptability curve, confirming that classroom-based CBT was not cost-effective relative to the controls. Reach of classroom-based CBT was good and attrition was low (median 80% attending ≥ 60% of sessions), but feedback indicated some difficulties with acceptability and sustainability. Classroom-based CBT, attention control PSHE and usual PSHE produced similar outcomes. Classroom-based CBT may result in increased self-awareness and reporting of depressive symptoms. Classroom-based CBT was not shown to be cost-effective. While schools are a convenient way of reaching a wide range of young people, implementing classroom-based CBT within schools is challenging, particularly with regard to fitting programmes into a busy timetable, the lack of value placed on PSHE, and difficulties engaging with teachers and young people. Wider use of classroom-based depression prevention programmes should not be undertaken without further research. If universal preventative approaches are to be pursued, their clinical effectiveness and cost-effectiveness with younger children (aged 10-11 years), before the incidence of depression increases, should be investigated. Alternatively, the clinical effectiveness of indicated school-based programmes targeting those already displaying symptoms of depression should be investigated. Current Controlled Trials ISRCTN19083628. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 17, No. 47. See the HTA programme website for further project information.

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care

PubMed Central

Guiriguet, Carolina; Muñoz-Ortiz, Laura; Burón, Andrea; Rivero, Irene; Grau, Jaume; Vela-Vallespín, Carmen; Vilarrubí, Mercedes; Torres, Miquel; Hernández, Cristina; Méndez-Boo, Leonardo; Toràn, Pere; Caballeria, Llorenç; Macià, Francesc; Castells, Antoni

2016-01-01

Background Participation rates in colorectal cancer screening are below recommended European targets. Aim To evaluate the effectiveness of an alert in primary care electronic medical records (EMRs) to increase individuals’ participation in an organised, population-based colorectal cancer screening programme when compared with usual care. Design and setting Cluster randomised controlled trial in primary care centres of Barcelona, Spain. Method Participants were males and females aged 50–69 years, who were invited to the first round of a screening programme based on the faecal immunochemical test (FIT) (n = 41 042), and their primary care professional. The randomisation unit was the physician cluster (n = 130) and patients were blinded to the study group. The control group followed usual care as per the colorectal cancer screening programme. In the intervention group, as well as usual care, an alert to health professionals (cluster level) to promote screening was introduced in the individual’s primary care EMR for 1 year. The main outcome was colorectal cancer screening participation at individual participant level. Results In total, 67 physicians and 21 619 patients (intervention group) and 63 physicians and 19 423 patients (control group) were randomised. In the intention-to-treat analysis screening participation was 44.1% and 42.2% respectively (odds ratio 1.08, 95% confidence interval [CI] = 0.97 to 1.20, P = 0.146). However, in the per-protocol analysis screening uptake in the intervention group showed a statistically significant increase, after adjusting for potential confounders (OR, 1.11; 95% CI = 1.02 to 1.22; P = 0.018). Conclusion The use of an alert in an individual’s primary care EMR is associated with a statistically significant increased uptake of an organised, FIT-based colorectal cancer screening programme in patients attending primary care centres. PMID:27266861

Improving child nutrition and development through community-based childcare centres in Malawi - The NEEP-IE study: study protocol for a randomised controlled trial.

PubMed

Gelli, Aulo; Margolies, Amy; Santacroce, Marco; Sproule, Katie; Theis, Sophie; Roschnik, Natalie; Twalibu, Aisha; Chidalengwa, George; Cooper, Amrik; Moorhead, Tyler; Gladstone, Melissa; Kariger, Patricia; Kutundu, Mangani

2017-06-19

The Nutrition Embedded Evaluation Programme Impact Evaluation (NEEP-IE) study is a cluster randomised controlled trial designed to evaluate the impact of a childcare centre-based integrated nutritional and agricultural intervention on the diets, nutrition and development of young children in Malawi. The intervention includes activities to improve nutritious food production and training/behaviour-change communication to improve food intake, care and hygiene practices. This paper presents the rationale and study design for this randomised control trial. Sixty community-based childcare centres (CBCCs) in rural communities around Zomba district, Malawi, were randomised to either (1) a control group where children were attending CBCCs supported by Save the Children's Early Childhood Health and Development (ECD) programme, or (2) an intervention group where nutritional and agricultural support activities were provided alongside the routine provision of the Save the Children's ECD programme. Primary outcomes at child level include dietary intake (measured through 24-h recall), whilst secondary outcomes include child development (Malawi Development Assessment Tool (MDAT)) and nutritional status (anthropometric measurements). At household level, primary outcomes include smallholder farmer production output and crop-mix (recall of last production season). Intermediate outcomes along theorised agricultural and nutritional pathways were measured. During this trial, we will follow a mixed-methods approach and undertake child-, household-, CBCC- and market-level surveys and assessments as well as in-depth interviews and focus group discussions with project stakeholders. Assessing the simultaneous impact of preschool meals on diets, nutrition, child development and agriculture is a complex undertaking. This study is the first to explicitly examine, from a food systems perspective, the impact of a preschool meals programme on dietary choices, alongside outcomes in the nutritional, child development and agricultural domains. The findings of this evaluation will provide evidence to support policymakers in the scale-up of national programmes. ISRCTN registry, ID: ISRCTN96497560 . Registered on 21 September 2016.

Group-based multimodal exercises integrated with cognitive-behavioural therapy improve disability, pain and quality of life of subjects with chronic neck pain: a randomized controlled trial with one-year follow-up.

PubMed

Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Cazzaniga, Daniele; Liquori, Valentina; Pedrocchi, Alessandra; Vernon, Howard

2017-06-01

To evaluate the effect of a group-based multidisciplinary rehabilitation programme on disability, pain and quality of life in subjects with chronic neck pain. Randomized controlled trial. Specialized rehabilitation centre. A total of 170 patients (mean age of 53 years (13); 121 females). The multidisciplinary group underwent a multidisciplinary rehabilitation programme combining multimodal exercises with psychologist-lead cognitive-behavioural therapy sessions. The general exercise group underwent general physiotherapy. Both groups followed group-based programmes once a week for ten weeks. Additionally, the multidisciplinary group met with the psychologist once a week for a 60-minute session. The Neck Disability Index (primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale and the Short-Form Health Survey. The participants were evaluated before, after training and after 12 months. A linear mixed model for repeated measures was used for each outcome measure. Significant effects ( p-value <0.001) were found over time and between groups for all outcome measures. After training, significant improvements were found for both groups for all outcome measures except kinesiophobia and catastrophizing, which did not change in the control group; however, the improvements were significantly greater for the multidisciplinary group. At 12-month follow-up a clinically meaningful between-group difference of 12.4 Neck Disability Index points was found for disability. A group-based multidisciplinary rehabilitation programme including cognitive-behavioural therapy was superior to group-based general physiotherapy in improving disability, pain and quality of life of subjects with chronic neck pain. The effects lasted for at least one year.

Status of infection control policies and organisation in European hospitals, 2001: the ARPAC study.

PubMed

Struelens, M J; Wagner, D; Bruce, J; MacKenzie, F M; Cookson, B D; Voss, A; van den Broek, P J; Gould, I M

2006-08-01

Patient safety in hospital care depends on effective infection control (IC) programmes. The Antimicrobial Resistance Prevention and Control (ARPAC) study assessed the organisation, components and human resources of IC programmes in European hospitals. A questionnaire survey of policies and procedures implemented in 2001 for the surveillance and control of nosocomial infection and antibiotic resistance was completed by 169 acute-care hospitals from 32 European countries, categorised by five geographical regions. A formal IC programme existed in 72% of hospitals, and a multidisciplinary IC committee was operational in 90%. Trained IC nurses (ICNs) were present in 80% of hospitals (ranging from 54% in south-east and central-eastern Europe, to 100% in northern Europe), whereas 74% had one or more trained IC doctors (ICDs) (ranging from 46% in south-east Europe to 84% in western Europe). Median staffing levels were 2.33 ICNs/1,000 beds and 0.94 ICDs/1,000 beds. The intensity of IC programmes scored higher in centres from northern and western Europe than from other European regions. Written guidelines promoted hand hygiene for healthcare workers in 89% of hospitals, education in 85%, and audit in 46%. Guidelines recommended use of alcohol-based solutions (70%) and/or medicated/antiseptic soap (43%) for decontamination of non-soiled hands. Use of alcohol-based solutions varied according to region, from 41% in southern Europe to 100% in northern Europe, compared with use of medicated soap from 77% in southern Europe to 11% in northern Europe (p < 0.01). These findings showed that IC programmes in European hospitals suffer from major deficiencies in human resources and policies. Staffing levels for ICNs were below recommended standards in the majority of hospitals. Education programmes were incomplete and often not supported by audit of performance. Hand hygiene procedures were sub-standard in one-third of centres. Strengthening of IC policies in European hospitals should be a public health priority.

Impact of parental weight status on a school-based weight management programme designed for Mexican-American children

USDA-ARS?s Scientific Manuscript database

While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impa...

Parental Participation and Retention in an Alcohol Preventive Family-Focused Programme

ERIC Educational Resources Information Center

Skarstrand, Eva; Branstrom, Richard; Sundell, Knut; Kallmen, Hakan; Andreassen, Sven

2009-01-01

Purpose: The purpose of this paper is to examine factors predicting parental participation and retention in a Swedish version of the Strengthening Families Programme (SFP). Design/methodology/approach: This study is based on data from a randomised controlled trial to evaluate the effects of the Swedish version of the SFP. The sample involves 441…

Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review

PubMed Central

Lussiana, Cristina

2016-01-01

The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. PMID:25862732

[Life support of the Mars exploration crew. Control of a zeolite system for carbon dioxide removal from space cabin air within a closed air regeneration cycle].

PubMed

Chekov, Iu F

2009-01-01

The author describes a zeolite system for carbon dioxide removal integrated into a closed air regeneration cycle aboard spacecraft. The continuous operation of a double-adsorbent regeneration system with pCO2-dependable productivity is maintained through programmable setting of adsorption (desorption) semicycle time. The optimal system regulation curve is presented within the space of statistical performance family obtained in quasi-steady operating modes with controlled parameters of the recurrent adsorption-desorption cycle. The automatically changing system productivity ensures continuous intake of concentrated CO2. Control of the adsorption-desorption process is based on calculation of the differential adsorption (desorption) heat from gradient of adsorbent and test inert substance temperatures. The adaptive algorithm of digital control is implemented through the standard spacecraft interface with the board computer system and programmable microprocessor-based controllers.

Community involvement in dengue vector control: cluster randomised trial.

PubMed

Vanlerberghe, V; Toledo, M E; Rodríguez, M; Gómez, D; Baly, A; Benítez, J R; Van der Stuyft, P

2010-01-01

To assess the effectiveness of an integrated community based environmental management strategy to control Aedes aegypti, the vector of dengue, compared with a routine strategy. Design Cluster randomised trial. Setting Guantanamo, Cuba. Participants 32 circumscriptions (around 2000 inhabitants each). Interventions The circumscriptions were randomly allocated to control clusters (n=16) comprising routine Aedes control programme (entomological surveillance, source reduction, selective adulticiding, and health education) and to intervention clusters (n=16) comprising the routine Aedes control programme combined with a community based environmental management approach. The primary outcome was levels of Aedes infestation: house index (number of houses positive for at least one container with immature stages of Ae aegypti per 100 inspected houses), Breteau index (number of containers positive for immature stages of Ae aegypti per 100 inspected houses), and the pupae per inhabitant statistic (number of Ae aegypti pupae per inhabitant). All clusters were subjected to the intended intervention; all completed the study protocol up to February 2006 and all were included in the analysis. At baseline the Aedes infestation levels were comparable between intervention and control clusters: house index 0.25% v 0.20%, pupae per inhabitant 0.44 x 10(-3) v 0.29 x 10(-3). At the end of the intervention these indices were significantly lower in the intervention clusters: rate ratio for house indices 0.49 (95% confidence interval 0.27 to 0.88) and rate ratio for pupae per inhabitant 0.27 (0.09 to 0.76). A community based environmental management embedded in a routine control programme was effective at reducing levels of Aedes infestation. Trial Registration Current Controlled Trials ISRCTN88405796.

Community involvement in dengue vector control: cluster randomised trial.

PubMed

Vanlerberghe, V; Toledo, M E; Rodríguez, M; Gomez, D; Baly, A; Benitez, J R; Van der Stuyft, P

2009-06-09

To assess the effectiveness of an integrated community based environmental management strategy to control Aedes aegypti, the vector of dengue, compared with a routine strategy. Cluster randomised trial. Guantanamo, Cuba. 32 circumscriptions (around 2000 inhabitants each). The circumscriptions were randomly allocated to control clusters (n=16) comprising routine Aedes control programme (entomological surveillance, source reduction, selective adulticiding, and health education) and to intervention clusters (n=16) comprising the routine Aedes control programme combined with a community based environmental management approach. The primary outcome was levels of Aedes infestation: house index (number of houses positive for at least one container with immature stages of Ae aegypti per 100 inspected houses), Breteau index (number of containers positive for immature stages of Ae aegypti per 100 inspected houses), and the pupae per inhabitant statistic (number of Ae aegypti pupae per inhabitant). All clusters were subjected to the intended intervention; all completed the study protocol up to February 2006 and all were included in the analysis. At baseline the Aedes infestation levels were comparable between intervention and control clusters: house index 0.25% v 0.20%, pupae per inhabitant 0.44x10(-3) v 0.29x10(-3). At the end of the intervention these indices were significantly lower in the intervention clusters: rate ratio for house indices 0.49 (95% confidence interval 0.27 to 0.88) and rate ratio for pupae per inhabitant 0.27 (0.09 to 0.76). A community based environmental management embedded in a routine control programme was effective at reducing levels of Aedes infestation. Current Controlled Trials ISRCTN88405796.

The impact of an arts-based programme on the affective and cognitive components of empathic development.

PubMed

Zazulak, Joyce; Halgren, Camilla; Tan, Megan; Grierson, Lawrence E M

2015-06-01

Medical education research demonstrates that empathic behaviour is amenable to positive change when targeted through educational programmes. This study evaluates the impact of an arts-based intervention designed to nurture learner empathy through the provision of facilitated visual literacy activities. Health Sciences students (N=19) were assigned to two learning groups: a group that participated in a visual literacy programme at the McMaster Museum of Art and a control group that participated in the normal Health Sciences curriculum. All participants completed an inter-reactivity index, which measures empathy on affective and cognitive levels, prior to and following the programme. Those individuals assigned to the visual literacy programme also completed open-ended questions concerning the programme's impact on their empathic development. The index scores were subjected to independent within-group, between-test analyses. There was no significant impact of the programme on the participants' overall empathic response. However, sub-component analyses revealed that the programme had a significant positive effect on cognitive aspects of empathy. This finding was substantiated by the narrative reports. The study concludes that the affective focus of humanities-based education needs to be enhanced and recommends that learners are educated on the different components that comprise the overall empathic response. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

An experimental study of a museum-based, science PD programme's impact on teachers and their students

NASA Astrophysics Data System (ADS)

Aaron Price, C.; Chiu, A.

2018-06-01

We present results of an experimental study of an urban, museum-based science teacher PD programme. A total of 125 teachers and 1676 of their students in grades 4-8 were tested at the beginning and end of the school year in which the PD programme took place. Teachers and students were assessed on subject content knowledge and attitudes towards science, along with teacher classroom behaviour. Subject content questions were mostly taken from standardised state tests and literature, with an 'Explain:' prompt added to some items. Teachers in the treatment group showed a 7% gain in subject content knowledge over the control group. Students of teachers in the treatment group showed a 4% gain in subject content knowledge over the control group on multiple-choice items and an 11% gain on the constructed response items. There was no overall change in science attitudes of teachers or students over the control groups but we did find differences in teachers' reported self-efficacy and teaching anxiety levels, plus PD teachers reported doing more student-centered science teaching activities than the control group. All teachers came into the PD with high initial excitement, perhaps reflecting its context within an informal learning environment.

Preparing for budget-based payment methodologies: global payment and episode-based payment.

PubMed

Hudson, Mark E

2015-10-01

Use of budget-based payment methodologies (capitation and episode-based bundled payment) has been demonstrated to drive value in healthcare delivery. With a focus on high-volume, high-cost surgical procedures, inclusion of anaesthesiology services in these methodologies is likely. This review provides a summary of budget-based payment methodologies and practical information necessary for anaesthesiologists to prepare for participation in these programmes. Although few examples of anaesthesiologists' participation in these models exist, an understanding of the structure of these programmes and opportunities for participation are available. Prospective preparation in developing anaesthesiology-specific bundled payment profiles and early participation in pathway development associated with selected episodes of care are essential for successful participation as a gainsharing partner. With significant opportunity to contribute to care coordination and cost management, anaesthesiology can play an important role in budget-based payment programmes and should expect to participate as full gainsharing partners. Precise costing methodologies and accurate economic modelling, along with identification of quality management and cost control opportunities, will help identify participation opportunities and appropriate payment and gainsharing agreements. Anaesthesiology-specific examples with budget-based payment models are needed to help guide increased participation in these programmes.

Nature-assisted rehabilitation for reactions to severe stress and/or depression in a rehabilitation garden: long-term follow-up including comparisons with a matched population-based reference cohort.

PubMed

Währborg, Peter; Petersson, Ingemar F; Grahn, Patrik

2014-03-01

To determine the effect of a nature-assisted rehabilitation programme in a group of patients with reactions to severe stress and/or mild to moderate depression. Changes in sick-leave status and healthcare consumption in these patients were compared with those in a matched population-based reference cohort (treatment as usual). Retrospective cohort study with a matched reference group from the general population. A total of 118 participants referred to a nature-assisted rehabilitation programme, and 678 controls recruited from the Skåne Health Care Register. For both groups, information on sick leave was extracted from the National Social Insurance Register and on healthcare consumption data from the Skåne Health Care Register. The interventional rehabilitation programme was designed as a multimodal programme involving professionals from horticulture and medicine. The programme was conducted in a rehabilitation garden, designed especially for this purpose. A significant reduction in healthcare consumption was noted among participants in the programme compared with the reference population. The main changes were a reduction in outpatient visits to primary healthcare and a reduction in inpatient psychiatric care. No significant difference in sick-leave status was found. A structured, nature-based rehabilitation programme for patients with reactions to severe stress and/or depression could be beneficial, as reflected in reduced healthcare consumption.

Outreach programmes to attract girls into computing: how the best laid plans can sometimes fail

NASA Astrophysics Data System (ADS)

Lang, Catherine; Fisher, Julie; Craig, Annemieke; Forgasz, Helen

2015-07-01

This article presents a reflective analysis of an outreach programme called the Digital Divas Club. This curriculum-based programme was delivered in Australian schools with the aim of stimulating junior and middle school girls' interest in computing courses and careers. We believed that we had developed a strong intervention programme based on previous literature and our collective knowledge and experiences. While it was coordinated by university academics, the programme content was jointly created and modified by practicing school teachers. After four years, when the final data were compiled, it showed that our programme produced significant change to student confidence in computing, but the ability to influence a desire to pursue a career path in computing did not fully eventuate. To gain a deeper insight in to why this may be the case, data collected from two of the schools are interrogated in more detail as described in this article. These schools were at the end of the expected programme outcomes. We found that despite designing a programme that delivered a multi-layered positive computing experience, factors beyond our control such as school culture and teacher technical self-efficacy help account for the unanticipated results. Despite our best laid plans, the expectations that this semester long programme would influence students' longer term career outcomes may have been aspirational at best.

Women's participation in rural credit programmes in Bangladesh and their demand for formal health care: is there a positive impact?

PubMed

Nanda, P

1999-08-01

Within the overall aim of poverty alleviation, development efforts have included credit and self-employment programmes. In Bangladesh, the major beneficiaries of such group-based credit programmes are rural women who use the loans to initiate small informal income-generating activities. This paper explores the benefits of women's participation in credit programmes on their own health seeking. Using data from a sample of 1798 households from rural Bangladesh, conducted in 1991-1992 through repeated random sampling of 87 districts covered by Grameen Bank, Bangladesh Rural Advancement Committee (BRAC) and Bangladesh Rural Development Board (BRDB), this paper addresses the question: does women's participation in credit programmes significantly affect their use of formal health care? A non-unitary household preference model is suggested to test the hypothesis that women's empowerment through participation in these programmes results in greater control of resources for their own demand for formal health care. The analysis controls for endogeneity due to self-selection and other unobserved village level factors through the use of a weighted two stage instrumental variable approach with village level fixed effects. The findings indicate a positive impact of women's participation in credit programmes on their demand for formal health care. The policy simulations on the results of this study highlight the importance of credit programmes as a health intervention in addition to being a mechanism for women's economic empowerment.

A Qualitative Process Evaluation of Classroom-Based Cognitive Behaviour Therapy to Reduce Adolescent Depression

PubMed Central

Taylor, John A.; Phillips, Rhiannon; Cook, Ellen; Georgiou, Lucy; Stallard, Paul; Sayal, Kapil

2014-01-01

Small scale trials indicate that classroom-based Cognitive Behaviour Therapy (CBT) for adolescents has good reach and can help prevent depression. However, under more diverse everyday conditions, such programmes tend not to show such positive effects. This study examined the process of implementing a classroom-based CBT depression prevention programme as part of a large (n = 5,030) randomised controlled trial across eight UK secondary schools which was not found to be effective (PROMISE, ISRCTN19083628). The views of young people (n = 42), teachers (n = 12) and facilitators (n = 16) involved in the Resourceful Adolescent Programme (RAP) were obtained via focus groups and interviews which were thematically analysed. The programme was considered to be well structured and contain useful content, particularly for younger pupils. However, challenges associated with implementation were its age appropriateness for all year groups, its perceived lack of flexibility, the consistency of quality of delivery, the competing demands for teacher time and a culture where academic targets were prioritised over personal, social and health education. Whilst schools are convenient locations for introducing such programmes and allow good reach, the culture around improving well-being of young people in schools, increasing engagement with teachers and young people and sustaining such programmes are issues that need addressing. PMID:24905241

Efficacy and acceptability of a home-based, family-inclusive intervention for veterans with TBI: A randomized controlled trial.

PubMed

Winter, Laraine; Moriarty, Helene J; Robinson, Keith; Piersol, Catherine V; Vause-Earland, Tracey; Newhart, Brian; Iacovone, Delores Blazer; Hodgson, Nancy; Gitlin, Laura N

2016-01-01

Traumatic brain injury (TBI) often undermines community re-integration, impairs functioning and produces other symptoms. This study tested an innovative programme for veterans with TBI, the Veterans' In-home Programme (VIP), delivered in veterans' homes, involving a family member and targeting the environment (social and physical) to promote community re-integration, mitigate difficulty with the most troubling TBI symptoms and facilitate daily functioning. Interviews and intervention sessions were conducted in homes or by telephone. Eighty-one veterans with TBI at a VA polytrauma programme and a key family member. This was a 2-group randomized controlled trial. Control-group participants received usual-care enhanced by two attention-control telephone calls. Follow-up interviews occurred up to 4 months after baseline interview. VIP's efficacy was evaluated using measures of community re-integration, target outcomes reflecting veterans' self-identified problems and self-rated functional competence. At follow-up, VIP participants had significantly higher community re-integration scores and less difficulty managing targeted outcomes, compared to controls. Self-rated functional competence did not differ between groups. In addition, VIP's acceptability was high. A home-based, family-inclusive service for veterans with TBI shows promise for improving meaningful outcomes and warrants further research and clinical application.

Programmable controlled mode-locked fiber laser using a digital micromirror device.

PubMed

Liu, Wu; Fan, Jintao; Xie, Chen; Song, Youjian; Gu, Chenlin; Chai, Lu; Wang, Chingyue; Hu, Minglie

2017-05-15

A digital micromirror device (DMD)-based arbitrary spectrum amplitude shaper is incorporated into a large-mode-area photonic crystal fiber laser cavity. The shaper acts as an in-cavity programmable filter and provides large tunable dispersion from normal to anomalous. As a result, mode-locking is achieved in different dispersion regimes with watt-level high output power. By programming different filter profiles on the DMD, the laser generates femtosecond pulse with a tunable central wavelength and controllable bandwidth. Under conditions of suitable cavity dispersion and pump power, design-shaped spectra are directly obtained by varying the amplitude transfer function of the filter. The results show the versatility of the DMD-based in-cavity filter for flexible control of the pulse dynamics in a mode-locked fiber laser.

[The methods within the evaluation of disease management programmes in control-group designs using the example of diabetes mellitus - a systematic literature review].

PubMed

Drabik, A; Sawicki, P T; Müller, D; Passon, A; Stock, S

2012-08-01

Disease management programmes (DMPs) were implemented in Germany in 2002. Their evaluation is required by law. Beyond the mandatory evaluation, a growing number of published studies evaluate the DMP for diabetes mellitus type 2 in a control-group design. As patients opt into the programme on a voluntary basis it is necessary to adjust the inherent selection bias between groups. The aim of this study is to review published studies which evaluate the diabetes DMP using a control-group design with respect to the methods used. A systematic literature review of electronic databases (PUBMED, Cochrane Library, EMBASE, MEDPILOT) and a hand search of reference lists of the relevant publications was conducted to identify studies evaluating the DMP diabetes mellitus in a control-group design. 8 studies were included in the systematic literature review. 4 studies gathered retrospective claims data from sickness funds, one from physician's records, one study used prospective data from ambulatory care, and 2 studies were based on one patient survey. Methods used for adjustment of selection bias included exact matching, matching using propensity score methods, age-adjusted and sex-separated analysis, and adjustment in a regression model/analysis of covariance. One study did not apply adjustment methods. The intervention period ranged from 1 day to 4 years. Considered outcomes of studies (surrogate parameter, diabetes complications, mortality, quality of life, and claim data) depended on the database. In the evaluation of the DMP diabetes mellitus based on a control-group design neither the database nor the methods used for selection bias adjustment were consistent in the available studies. Effectiveness of DMPs cannot be judged based on this review due to heterogeneity of study designs. To allow for a comprehensive programme evaluation standardised minimum requirements for the evaluation of DMPs in the control group design are required. © Georg Thieme Verlag KG Stuttgart · New York.

Randomised controlled trial of alternative messages to increase enrolment in a healthy food programme among individuals with diabetes.

PubMed

Gopalan, A; Paramanund, J; Shaw, P A; Patel, D; Friedman, J; Brophy, C; Buttenheim, A M; Troxel, A B; Asch, D A; Volpp, K G

2016-11-30

We compared the effectiveness of diabetes-focused messaging strategies at increasing enrolment in a healthy food programme among adults with diabetes. Vitality is a multifaceted wellness benefit available to members of Discovery Health, a South Africa-based health insurer. One of the largest Vitality programmes is HealthyFood (HF), an incentive-based programme designed to encourage healthier diets by providing up to 25% cashback on healthy food purchases. We randomised adults with type 2 diabetes to 1 of 5 arms: (1) control, (2) a diabetes-specific message, (3) a message with a recommendation of HF written from the perspective of a HF member with diabetes, (4) a message containing a physician's recommendation of HF, or (5) the diabetes-specific message from arm 2 paired with an 'enhanced active choice'(EAC). In an EAC, readers are asked to make an immediate choice (in this case, to enrol or not enrol); the pros and cons associated with the preferred and non-preferred options are highlighted. HF enrolment was assessed 1 month following the first emailed message. We randomised 3906 members. After excluding those who enrolled in HF or departed from the Vitality programme before the first intervention email, 3665 (94%) were included in a modified intent-to-treat analysis. All 4 experimental arms had significantly higher HF enrolment rates compared with control (p<0.0001 for all comparisons). When comparing experimental arms, the diabetes-specific message with the EAC had a significantly higher enrolment rate (12.6%) than the diabetes-specific message alone (7.6%, p=0.0016). Messages focused on diabetes were effective at increasing enrolment in a healthy food programme. The addition of a framed active choice to a message significantly raised enrolment rates in this population. These findings suggest that simple, low-cost interventions can enhance enrolment in health promoting programmes and also be pragmatically tested within those programmes. NCT02462057. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Voluntary Fasting to Control Post-Ramadan Weight Gain among Overweight and Obese Women

PubMed Central

Ismail, Suriani; Shamsuddin, Khadijah; Latiff, Khalib A.; Saad, Hazizi A.; Majid, Latifah A.; Othman, Fadlan M.

2015-01-01

Objectives: This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain. Methods: This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines (group B) and a faith-based programme promoting voluntary fasting in addition to the standard programme (group A). Participants’ dietary practices (i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day), body mass index (BMI), blood pressure, fasting blood high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC):HDL-C ratio were assessed before Ramadan and three months post-Ramadan. Results: Voluntary fasting practices increased only in group A (P <0.01). Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A (P <0.01, 0.05, 0.02 and <0.01, respectively). Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A (P = 0.03 and <0.01, respectively). Although changes in BMI between the groups was not significant (P = 0.08), BMI decrease among participants in group A was significant (P <0.01). Conclusion: Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients. PMID:25685394

Design of the Resistance and Endurance exercise After ChemoTherapy (REACT) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of exercise interventions after chemotherapy on physical fitness and fatigue.

PubMed

Kampshoff, Caroline S; Buffart, Laurien M; Schep, Goof; van Mechelen, Willem; Brug, Johannes; Chinapaw, Mai J M

2010-11-30

Preliminary studies suggest that physical exercise interventions can improve physical fitness, fatigue and quality of life in cancer patients after completion of chemotherapy. Additional research is needed to rigorously test the effects of exercise programmes among cancer patients and to determine optimal training intensity accordingly. The present paper presents the design of a randomized controlled trial evaluating the effectiveness and cost-effectiveness of a high intensity exercise programme compared to a low-to-moderate intensity exercise programme and a waiting list control group on physical fitness and fatigue as primary outcomes. After baseline measurements, cancer patients who completed chemotherapy are randomly assigned to either a 12-week high intensity exercise programme or a low-to-moderate intensity exercise programme. Next, patients from both groups are randomly assigned to immediate training or a waiting list (i.e. waiting list control group). After 12 weeks, patients of the waiting list control group start with the exercise programme they have been allocated to.Both interventions consist of equal bouts of resistance and endurance interval exercises with the same frequency and duration, but differ in training intensity. Additionally, patients of both exercise programmes are counselled to improve compliance and achieve and maintain an active lifestyle, tailored to their individual preferences and capabilities.Measurements will be performed at baseline (t = 0), 12 weeks after randomization (t = 1), and 64 weeks after randomization (t = 2). The primary outcome measures are cardiorespiratory fitness and muscle strength assessed by means of objective performance indicators, and self-reported fatigue. Secondary outcome measures include health-related quality of life, self-reported physical activity, daily functioning, body composition, mood and sleep disturbances, and return to work. In addition, compliance and satisfaction with the interventions will be evaluated. Potential moderation by pre- and post-illness lifestyle, health and exercise-related attitudes, beliefs and motivation will also be assessed. Finally, the cost-effectiveness of both exercise interventions will be evaluated. This randomized controlled trial will be a rigorous test of effects of exercise programmes for cancer patients after chemotherapy, aiming to contribute to evidence-based practice in cancer rehabilitation programmes. This study is registered at the Netherlands Trial Register (NTR2153).

Structured education programme for women with polycystic ovary syndrome: a randomised controlled trial.

PubMed

Mani, Hamidreza; Chudasama, Yogini; Hadjiconstantinou, Michelle; Bodicoat, Danielle H; Edwardson, Charlotte; Levy, Miles J; Gray, Laura J; Barnett, Janette; Daly, Heather; Howlett, Trevor A; Khunti, Kamlesh; Davies, Melanie J

2018-01-01

To evaluate the effectiveness of a structured education programmes in women with polycystic ovary syndrome (PCOS). Single-centre, randomised controlled trial, testing a single exposure to a group-based, face-to-face, structured education programme. Inclusion criteria were women with PCOS, aged 18-49 years inclusive and body mass index ≥23 kg/m 2 for black and minority ethnicities or ≥25 kg/m 2 for white Europeans. Primary outcome was step-count/day at 12 months. Secondary outcomes included indices of physical activity, cardiovascular risk factors, quality of life (QoL) and illness perception (IP). 161 women were included (78 control, 83 intervention); 69% white; mean age 33.4 (s.d. 7.6) years, of whom 100 (48 intervention; 52 control) attended their 12-month visit (38% attrition). 77% of the intervention arm attended the education programme. No significant change in step-count was observed at 12 months (mean difference: +351 steps/day (95% confidence interval -481, +1183); P  = 0.40). No differences were found in biochemical or anthropometric outcomes. The education programme improved participants' IP in 2 dimensions: understanding their PCOS ( P  < 0.001) and sense of control ( P  < 0.01) and improved QoL in 3 dimensions: emotions ( P  < 0.05), fertility ( P  < 0.05), weight ( P  < 0.01) and general mental well-being ( P  < 0.01). A single exposure to structured education programme did not increase physical activity or improve biochemical markers in overweight and obese women with PCOS. However, providing a structured education in parallel to routine medical treatment can be beneficial for participants' understanding of their condition, reducing their anxiety and improving their QoL. © 2018 The authors.

An exploratory trial of a health education programme to promote healthy lifestyles through social and emotional competence in young children: Study protocol.

PubMed

Bermejo-Martins, Elena; López-Dicastillo, Olga; Mujika, Agurtzane

2018-01-01

To implement and evaluate a health education programme based on the development of social and emotional competence in young children. Children's social and emotional skills play a key role in the adoption and maintenance of their lifestyles. Currently, a more comprehensive perspective dealing with these aspects is needed to promote healthy habits in children and develop effective health education programmes. An exploratory randomized controlled trial. A convenience sample of 30 children (5 and 6 years old) will be recruited from a public school in Spain, with 15 participants in the experimental group and 15 in the control group. Participants in the experimental group will receive the first unit of the programme, consisting of developing emotional knowledge skills around daily health habits (eating, hygiene, sleep and physical exercise) using different game-based dynamics and an emotional diary, while those in the control group will continue with their usual school routine. Outcome measures include emotional knowledge ability, basic social skills and children's health profile. The perceived impact of the intervention by parents, acceptability (by parents and children) and feasibility of the programme will be also assessed. Data will be collected at baseline, postintervention and at 7-month follow-up. This study offers an innovative intervention aimed at improving children's healthy lifestyles from a holistic perspective by addressing social and emotional competence as one of the most influential aspects of children's development. This exploratory trial is an essential step to explore crucial aspects of the full-scale clinical trial. © 2017 John Wiley & Sons Ltd.

Stepped-care to prevent depression and anxiety in visually impaired older adults – design of a randomised controlled trial

PubMed Central

2013-01-01

Background Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. Method/design A stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in the Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-)effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N = 230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI). Discussion Preventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step. Trial registration Identifier: NTR3296 PMID:23937975

ISIBINDI, creating circles of care for orphans and vulnerable children in South Africa: post-programme outcomes.

PubMed

Visser, Maretha; Zungu, Nompumelelo; Ndala-Magoro, Nkateko

2015-01-01

This paper presents the evaluation of post-programme outcomes of the ISIBINDI model, a community-based intervention to promote physical and psychosocial well-being of orphans and vulnerable children (OVC) in South Africa. A mixed methods quasi-experimental design was used to investigate the differences between former ISIBINDI participants (18 years and older) and a control group of similar background. ISIBINDI ex-participants at 12 sites (n=427) and a control group of non-participants (n=177) completed a questionnaire which explored level of education and employment, psychosocial well-being and HIV risk behaviour. Focus group discussions were conducted with various stakeholders. Ex-participants reported higher self-esteem and problem-solving abilities, family support and lower HIV risk behaviour than the control group. High levels of unemployment especially in rural areas resulted in unemployment of out-of-school OVC which creates new forms of vulnerability. The benefits of the programme may be compromised by the lack of community resources. An effective exit strategy is needed to contribute to financial independence of OVC after exiting the programme.

Effectiveness of a School-Based Early Intervention CBT Group Programme for Children with Anxiety Aged 5-7 Years

ERIC Educational Resources Information Center

Ruocco, Sylvia; Gordon, Jocelynne; McLean, Louise A.

2016-01-01

Early manifestations of anxiety in childhood confer significant distress and life interference. This study reports on the first controlled trial of the "Get Lost Mr. Scary" programme, a Cognitive Behavioural Therapy group intervention for children with anxiety aged 5-7 years. Participants were 134 children (65 males and 69 females) drawn…

Relay Protection and Automation Systems Based on Programmable Logic Integrated Circuits

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lashin, A. V., E-mail: LashinAV@lhp.ru; Kozyrev, A. V.

One of the most promising forms of developing the apparatus part of relay protection and automation devices is considered. The advantages of choosing programmable logic integrated circuits to obtain adaptive technological algorithms in power system protection and control systems are pointed out. The technical difficulties in the problems which today stand in the way of using relay protection and automation systems are indicated and a new technology for solving these problems is presented. Particular attention is devoted to the possibility of reconfiguring the logic of these devices, using programmable logic integrated circuits.

A versatile pulse programmer for pulsed nuclear magnetic resonance spectroscopy.

NASA Technical Reports Server (NTRS)

Tarr, C. E.; Nickerson, M. A.

1972-01-01

A digital pulse programmer producing the standard pulse sequences required for pulsed nuclear magnetic resonance spectroscopy is described. In addition, a 'saturation burst' sequence, useful in the measurement of long relaxation times in solids, is provided. Both positive and negative 4 V trigger pulses are produced that are fully synchronous with a crystal-controlled time base, and the pulse programmer may be phase-locked with a maximum pulse jitter of 3 ns to the oscillator of a coherent pulse spectrometer. Medium speed TTL integrated circuits are used throughout.

Effects of the culturally-sensitive comprehensive sex education programme among Thai secondary school students.

PubMed

Thato, R; Jenkins, R A; Dusitsin, N

2008-05-01

This paper reports on a study to evaluate the effectiveness of a culturally-sensitive comprehensive sex education programme among Thai secondary school students. Increasing number of adolescents in Thailand have been engaging in premarital sex. No theory-based, abstinence-oriented models of sex education have been evaluated in this population. A quasi-experimental study was conducted in 2006-2007. Outcome measures included sexual behaviour, condom use, intention to refuse sex, intention to use condoms, and knowledge regarding sexually transmitted infections/human immunodeficiency virus/acquired immunodeficiency syndrome and pregnancy. Students in the experimental group had lower levels of reported sexual intercourse at 3- and 6-month follow-ups, compared with those in control group (P < 0.01). Students participating in the programme had significantly greater intention to refuse sex in the future across time than controls (P < 0.05). Sexually active adolescents participating in the programme reported significantly lower frequencies of sexual intercourse across time than controls (P < 0.01). However, the programme did not influence consistent condom use (P > 0.05), although the intervention was associated with increased intention to use condoms (P < 0.01). Knowledge about sexually transmitted infections/human immunodeficiency virus/acquired immunodeficiency syndrome and pregnancy among students in the intervention group was significantly greater than that of the controls (P < 0.05). School nurses can play a major role by applying this kind of sex education programme. For nurse researchers, it would be useful to extend this research by considering alternative ways to foster condom use in the non-commercial partnerships that have become common among adolescents.

Striving for the impossible dream: a community-based multi-practice collaborative model of diabetes management.

PubMed

Distiller, L A; Brown, M A; Joffe, B I; Kramer, B D

2010-02-01

In 1994 the Centre for Diabetes and Endocrinology (CDE) based in Johannesburg, South Africa established a novel community-based capitation and risk-sharing model for diabetes management. We here describe the model and present a recent survey of the performance/outcomes of this unique diabetes care programme. Data on 17 043 patients managed by the CDE Diabetes Management Programme at its Centre and its 262 affiliated Centres were analysed from its national database. From this total cohort, 1520 Type 1 and 8026 Type 2 diabetes patients have been in the Programme for > 5 years. The 5-year outcome data on hospital admission rates, glycaemic control (HbA(1c)), and microvascular complication rates were assessed in this subgroup of patients. Major reductions in hospital admission rates for both acute metabolic emergencies and all causes (40% overall) were achieved in patients enrolled onto the Diabetes Management Programme. The mean HBA(1c) on enrolment was 9.2% for subjects with Type 1 and 8.8% for those with Type 2 diabetes. After 1 year, mean HbA(1c) fell to 7.6% and 7.3% for the Type 1 and Type 2 subjects, respectively. At 5 years the HbA(1c) remained similar at 7.7% for the Type 1 subjects and 7.4% for the Type 2 subjects, demonstrating sustained improvement. Progression of microvascular complications appears to have been delayed. This managed care model of diabetes care in the context of the South African Private Health Care System achieved long-term improvement in glycaemic control and all-cause hospital admission rates. This may be due to the cost-containment being in the hands of the treating doctor, supported by an annual training programme. This programme is based on an individualized and holistic approach encompassing intensive patient education to facilitate self-empowerment and including prompting for the management of risk factors.

Effectiveness and micro-costing of the KiVa school-based bullying prevention programme in Wales: study protocol for a pragmatic definitive parallel group cluster randomised controlled trial.

PubMed

Clarkson, Suzy; Axford, Nick; Berry, Vashti; Edwards, Rhiannon Tudor; Bjornstad, Gretchen; Wrigley, Zoe; Charles, Joanna; Hoare, Zoe; Ukoumunne, Obioha C; Matthews, Justin; Hutchings, Judy

2016-02-01

Bullying refers to verbal, physical or psychological aggression repeated over time that is intended to cause harm or distress to the victims who are unable to defend themselves. It is a key public health priority owing to its widespread prevalence in schools and harmful short- and long-term effects on victims' well-being. There is a need to strengthen the evidence base by testing innovative approaches to preventing bullying. KiVa is a school-based bullying prevention programme with universal and indicated elements and an emphasis on changing bystander behaviour. It achieved promising results in a large trial in Finland, and now requires testing in other countries. This paper describes the protocol for a cluster randomised controlled trial (RCT) of KiVa in Wales. The study uses a two-arm waitlist control pragmatic definitive parallel group cluster RCT design with an embedded process evaluation and calculation of unit cost. Participating schools will be randomised a using a 1:1 ratio to KiVa plus usual provision (intervention group) or usual provision only (control group). The trial has one primary outcome, child self-reported victimisation from bullying, dichotomised as 'victimised' (bullied at least twice a month in the last couple of months) versus 'not victimised'. Secondary outcomes are: bullying perpetration; aspects of child social and emotional well-being (including emotional problems, conduct, peer relations, prosocial behaviour); and school attendance. Follow-up is at 12 months post-baseline. Implementation fidelity is measured through teacher-completed lesson records and independent school-wide observation. A micro-costing analysis will determine the costs of implementing KiVa, including recurrent and non-recurrent unit costs. Factors related to the scalability of the programme will be examined in interviews with head teachers and focus groups with key stakeholders in the implementation of school-based bullying interventions. The results from this trial will provide evidence on whether the KiVa programme is transportable from Finland to Wales in terms of effectiveness and implementation. It will provide information about the costs of delivery and generate insights into factors related to the scalability of the programme. Current Controlled Trials ISRCTN23999021 Date 10-6-13.

Tuberculosis--triumph and tragedy.

PubMed

Singh, M M

2003-03-01

Tuberculosis has been making havoc worldwide with an 11.9 million cases to be involved by the year 2005. In India, about 2 million cases are infected every year. Regarding triumphs and tragedies in the control of tuberculosis some points as follows are discussed. (1) Tuberculosis Control Programmes from National Tuberculosis Programme (NTP) to Revised National Tuberculosis Control Programme (RNTCP) and Directly Observed Treatment, Short course (DOTS). (2) Problem of multidrug resistance (MDR) tuberculosis and (3) HIV and tuberculosis. DOTS being largely based on Indian research. It is now being applied worldwide. MDR is strictly a man made problem. Poor prescriptions, poor case management, lack of coordinated education and haphazard treatment research result in drug resistance. Treatment of MDR is difficult. The drug acceptability, tolerance and toxicity have to be considered. HIV and tuberculosis form a deadly duo. They mean more cases, more costs and more national losses.

Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial

PubMed Central

Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

2016-01-01

Background Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. Objective To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Methods Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Results Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). Conclusions These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. PMID:26399611

The art of medicine: arts-based training in observation and mindfulness for fostering the empathic response in medical residents.

PubMed

Zazulak, Joyce; Sanaee, May; Frolic, Andrea; Knibb, Nicole; Tesluk, Eve; Hughes, Edward; Grierson, Lawrence E M

2017-09-01

Empathy is an essential attribute for medical professionals. Yet, evidence indicates that medical learners' empathy levels decline dramatically during medical school. Training in evidence-based observation and mindfulness has the potential to bolster the acquisition and demonstration of empathic behaviours for medical learners. In this prospective cohort study, we explore the impact of a course in arts-based visual literacy and mindfulness practice ( Art of Seeing ) on the empathic response of medical residents engaged in obstetrics and gynaecology and family medicine training. Following this multifaceted arts-based programme that integrates the facilitated viewing of art and dance, art-making, and mindfulness-based practices into a practitioner-patient context, 15 resident trainees completed the previously validated Interpersonal Reactivity Index, Compassion, and Mindfulness Scales. Fourteen participants also participated in semistructured interviews that probed their perceived impacts of the programme on their empathic clinical practice. The results indicated that programme participants improved in the Mindfulness Scale domains related to self-confidence and communication relative to a group of control participants following the arts-based programme. However, the majority of the psychometric measures did not reveal differences between groups over the duration of the programme. Importantly, thematic qualitative analysis of the interview data revealed that the programme had a positive impact on the participants' perceived empathy towards colleagues and patients and on the perception of personal and professional well-being. The study concludes that a multifaceted arts-based curriculum focusing on evidence-based observation and mindfulness is a useful tool in bolstering the empathic response, improving communication, and fostering professional well-being among medical residents. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The National Action Plan for the Prevention and Control of Non-communicable Diseases and Health Promotion in Pakistan--Cardiovascular diseases.

PubMed

Nishtar, Sania; Faruqui, Azhar M A; Mattu, Mohamad A; Mohamud, Khalif Bile; Ahmed, Ashfaq

2004-12-01

The National Action Plan for Non-Communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD) incorporates prevention and control of cardiovascular diseases (CVD) as part of a comprehensive and integrated non-communicable Disease (NCD) prevention effort. In this programme, surveillance of cardiovascular risk factors is part of an integrated population-based NCD surveillance system. The population approach to CVD prevention is a priority area in this programme with a focus on broad policy measures and behavioural change communication. The former include revision of the current policy on diet and nutrition to expand its focus on under-nutrition; the development of a physical activity policy; strategies to limit the production of, and access to, ghee as a medium for cooking and agricultural and fiscal policies that increase the demand for, and make healthy food more accessible. The programme focuses attention on improving the quality of prevention programmes within primary and basic health sites and integrates concerted primary and secondary prevention programmes into health services as part of a comprehensive and sustainable, scientifically valid, and resource-sensitive programme for all categories of healthcare providers. It promotes screening for raised blood pressure at the population level and screening for dyslipidaemia and diabetes in high-risk groups only. It highlights the need to ensure the availability of aspirin, beta blockers, thiazides, ACE inhibitors, statins and penicillin at all levels of healthcare. The programme points out the need to conduct clinical end-point trials in the native Pakistani setting to define cost-effective therapeutic strategies for primary and secondary prevention of CVDs. Emphasis is laid on building capacity of health systems in support of CVD prevention and control and building a coalition or network of organizations to add momentum to CVD prevention and control efforts.

Effectiveness of a health promotion programme for farmers and fishermen with type-2 diabetes in Taiwan.

PubMed

Chen, Mei-Yen; Huang, Wei-Chao; Peng, Yun-Shing; Guo, Jing-Song; Chen, Chia-Pei; Jong, Ming-Chung; Lin, Hui-Chuan

2011-09-01

This paper is a report of a study examining the diabetes control and foot self-care capability in farmers and fishermen following introduction of a multi-stage, multi-disciplinary team and community-based small group health promotion programme. Improving the control of diabetes is a critical issue in Taiwan because mortality rates are increasing dramatically, particularly in rural populations. A quasi-experimental research design was deployed from January to December 2009. A total of 387 participants living in nine rural districts with previous diagnoses of type-2 diabetes were randomly selected. Three hundred and twenty-three completed the 3-stage programme, including health assessment, health promotion education and individually tailored telephone counselling and evaluation over a 1-year period. Most of the participants were fishermen or farmers who had <6 years of education (79%) and were elders (68·9 ± 9·5 years). Most of the physiological variables and foot self-care capabilities showed statistically significant improvement after the programme. Furthermore, 37 participants with severe high risk of diabetic foot accepted additional referral treatments, and their peripheral nerve and vascular functions improved. The research outcomes support the value of community-based health promotion programmes in rural areas, incorporating a multidisciplinary health team and culturally competent materials to help the elder rural inhabitants with diabetes enjoy better health and quality of life. © 2011 Blackwell Publishing Ltd.

Group-based parent training programmes for improving parental psychosocial health.

PubMed

Barlow, Jane; Smailagic, Nadja; Huband, Nick; Roloff, Verena; Bennett, Cathy

2014-05-17

Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing. To address whether group-based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence). We searched the following databases on 5 December 2011: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005. We included randomised controlled trials that compared a group-based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting-list, no treatment, treatment as usual or a placebo. At least two review authors extracted data independently and assessed the risk of bias in each study. We examined the studies for any information on adverse effects. We contacted authors where information was missing from trial reports. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation. We included 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, we found that group-based parenting programmes led to statistically significant short-term improvements in depression (standardised mean difference (SMD) -0.17, 95% confidence interval (CI) -0.28 to -0.07), anxiety (SMD -0.22, 95% CI -0.43 to -0.01), stress (SMD -0.29, 95% CI -0.42 to -0.15), anger (SMD -0.60, 95% CI -1.00 to -0.20), guilt (SMD -0.79, 95% CI -1.18 to -0.41), confidence (SMD -0.34, 95% CI -0.51 to -0.17) and satisfaction with the partner relationship (SMD -0.28, 95% CI -0.47 to -0.09). However, only stress and confidence continued to be statistically significant at six month follow-up, and none were significant at one year. There was no evidence of any effect on self-esteem (SMD -0.01, 95% CI -0.45 to 0.42). None of the trials reported on aggression or adverse effects.The limited data that explicitly focused on outcomes for fathers showed a statistically significant short-term improvement in paternal stress (SMD -0.43, 95% CI -0.79 to -0.06). We were unable to combine data for other outcomes and individual study results were inconclusive in terms of any effect on depressive symptoms, confidence or partner satisfaction. The findings of this review support the use of parenting programmes to improve the short-term psychosocial wellbeing of parents. Further input may be required to ensure that these results are maintained. More research is needed that explicitly addresses the benefits for fathers, and that examines the comparative effectiveness of different types of programme along with the mechanisms by which such programmes bring about improvements in parental psychosocial functioning.

Group-based parent training programmes for improving parental psychosocial health.

PubMed

Barlow, Jane; Smailagic, Nadja; Huband, Nick; Roloff, Verena; Bennett, Cathy

2012-06-13

Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing. To address whether group-based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence). We searched the following databases on 5 December 2012: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005. We included randomised controlled trials that compared a group-based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting-list, no treatment, treatment as usual or a placebo. At least two review authors extracted data independently and assessed the risk of bias in each study. We examined the studies for any information on adverse effects. We contacted authors where information was missing from trial reports. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation. We included 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, we found that group-based parenting programmes led to statistically significant short-term improvements in depression (standardised mean difference (SMD) -0.17, 95% confidence interval (CI) -0.28 to -0.07), anxiety (SMD -0.22, 95% CI -0.43 to -0.01), stress (SMD -0.29, 95% CI -0.42 to -0.15), anger (SMD -0.60, 95% CI -1.00 to -0.20), guilt (SMD -0.79, 95% CI -1.18 to -0.41), confidence (SMD -0.34, 95% CI -0.51 to -0.17) and satisfaction with the partner relationship (SMD -0.28, 95% CI -0.47 to -0.09). However, only stress and confidence continued to be statistically significant at six month follow-up, and none were significant at one year. There was no evidence of any effect on self-esteem (SMD -0.01, 95% CI -0.45 to 0.42). None of the trials reported on aggression or adverse effects.The limited data that explicitly focused on outcomes for fathers showed a statistically significant short-term improvement in paternal stress (SMD -0.43, 95% CI -0.79 to -0.06). We were unable to combine data for other outcomes and individual study results were inconclusive in terms of any effect on depressive symptoms, confidence or partner satisfaction. The findings of this review support the use of parenting programmes to improve the short-term psychosocial wellbeing of parents. Further input may be required to ensure that these results are maintained. More research is needed that explicitly addresses the benefits for fathers, and that examines the comparative effectiveness of different types of programme along with the mechanisms by which such programmes bring about improvements in parental psychosocial functioning.

A study protocol of a randomised controlled trial to investigate if a community based strength training programme improves work task performance in young adults with Down syndrome.

PubMed

Shields, Nora; Taylor, Nicholas F; Fernhall, Bo

2010-03-25

Muscle strength is important for young people with Down syndrome as they make the transition to adulthood, because their workplace activities typically emphasise physical rather than cognitive skills. Muscle strength is reduced up to 50% in people with Down syndrome compared to their peers without disability. Progressive resistance training improves muscle strength and endurance in people with Down syndrome. However, there is no evidence on whether it has an effect on work task performance or physical activity levels. The aim of this study is to investigate if a student-led community-based progressive resistance training programme can improve these outcomes in adolescents and young adults with Down syndrome. A randomised controlled trial will compare progressive resistance training with a control group undertaking a social programme. Seventy adolescents and young adults with Down syndrome aged 14-22 years and mild to moderate intellectual disability will be randomly allocated to the intervention or control group using a concealed method. The intervention group will complete a 10-week, twice a week, student-led progressive resistance training programme at a local community gymnasium. The student mentors will be undergraduate physiotherapy students. The control group will complete an arts/social programme with a student mentor once a week for 90 minutes also for 10 weeks to control for the social aspect of the intervention. Work task performance (box stacking, pail carry), muscle strength (1 repetition maximum for chest and leg press) and physical activity (frequency, duration, intensity over 7-days) will be assessed at baseline (Week 0), following the intervention (Week 11), and at 3 months post intervention (Week 24) by an assessor blind to group allocation. Data will be analysed using ANCOVA with baseline measures as covariates. This paper outlines the study protocol for a randomised controlled trial on the effects of progressive resistance training on work task performance and physical activity for adolescents and young adults with Down syndrome. The intervention addresses the impairment of muscle weakness which may improve work task performance and help to increase physical activity levels. Australian New Zealand Clinical Trials Registry ACTRN12609000938202.

Tailored telephone counselling to increase participation of underusers in a population-based colorectal cancer-screening programme with faecal occult blood test: A randomized controlled trial.

PubMed

Denis, B; Broc, G; Sauleau, E A; Gendre, I; Gana, K; Perrin, P

2017-02-01

Despite the involvement of general practitioners, the mailing of several recall letters and of the faecal occult blood test (FOBT) kit, the uptake remains insufficient in the French colorectal cancer-screening programme. Some studies have demonstrated a greater efficacy of tailored telephone counselling over usual care, untailored invitation mailing and FOBT kit mailing. We evaluated the feasibility and the effectiveness of telephone counselling on participation in the population-based FOBT colorectal cancer-screening programme implemented in Alsace (France). Underusers were randomized into a control group with untailored invitation and FOBT kit mailing (n=19,756) and two intervention groups for either a computer-assisted telephone interview (n=9367), system for tailored promotion of colorectal cancer screening, or a telephone-based motivational interview (n=9374). Only 5691 (19.9%) people were actually counseled, so that there was no difference in participation between the intervention groups taken together (13.9%, 95% confidence interval [CI] [13.5-14.4]) and the control group (13.9%, 95% CI [13.4-14.4]) (P=1.0) in intent-to-treat analysis. However, in per-protocol analysis, participation was significantly higher in the two intervention groups than in the control group (12.9%, 95% CI [12.6-13.2]) (P<0.01), with no difference between computer-assisted telephone interview (24.6%, 95% CI [22.7-26.4]) and motivational interview (23.6%, 95% CI [21.8-25.4]) (P=0.44). There was no difference of effectiveness between tailored telephone counselling and untailored invitation and FOBT kit mailing on participation of underusers in an organized population-based colorectal cancer screening programme. A greater efficacy of telephone counselling, around twice that of invitation and FOBT kit mailing, was observed only in people who could actually be counseled, without difference between computer-assisted telephone interview and motivational interview. However, technical failures hampered telephone counselling, so that there was no difference in intent-to-treat analysis. The rate of technical success of telephone interviews should be evaluated, and enhanced if insufficient, before implementation of telephone counselling in population-based cancer screening programmes. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial.

PubMed

Calner, T; Nordin, C; Eriksson, M K; Nyberg, L; Gard, G; Michaelson, P

2017-07-01

Web-based interventions for pain management are increasingly used with possible benefits, but never used in addition to multimodal rehabilitation (MMR). MMR is recommended treatment for persistent pain in Sweden. The aim was to evaluate the effects of a self-guided, web-based programme added to MMR for work ability, pain, disability and health-related quality of life. We included 99 participants with persistent musculoskeletal pain in a randomized study with two intervention arms: (1) MMR and web-based intervention, and (2) MMR. Data was collected at baseline, 4 and 12 months. Outcome measures were work ability, working percentage, average pain intensity, pain-related disability, and health-related quality of life. There were no significant effects of adding the web-based intervention to MMR regarding any of the outcome variables. This trial provides no support for adding a self-guided, web-based activity programme to MMR for patients with persistent musculoskeletal pain. The comprehensive self-guided, web-based programme for activity, Web-BCPA, added to multimodal treatment in primary health care had no effect on work ability, pain, disability or health-related quality of life. Future web-based interventions should be tailored to patients' individual needs and expectations. © 2017 European Pain Federation - EFIC®.

Effectiveness of a cognitive behavioural therapy-based anxiety prevention programme at an elementary school in Japan: a quasi-experimental study.

PubMed

Urao, Yuko; Yoshida, Michiko; Koshiba, Takako; Sato, Yasunori; Ishikawa, Shin-Ichi; Shimizu, Eiji

2018-01-01

The efficacy of cognitive behavioural therapy (CBT) for anxiety related problems in children is empirically supported. In addition, universal anxiety prevention programmes based on CBT have been demonstrated in recent years. The purpose of this study was to verify the effectiveness of a CBT based original programme 'Journey of the Brave,' aiming to prevent anxiety disorders and anxiety-related problems for Japanese children aged 10-12 years old. Intervention groups from two classes of 5th grade elementary students ( n  = 41) received ten 45-min programme sessions. The control group was drawn from one class of 5th grade children ( n  = 31) from a nearby school. All participants completed the Spence Children's Anxiety Scale (SCAS) at pre, post, and 3 months follow-up. Mixed-effects model for repeated measures analysis was conducted. The mean anxiety score on the SCAS for the intervention group was significantly reduced at both post intervention and 3 months follow-up compared with the control group. The group differences on the SCAS from baseline to post-test were - 5.321 (95% CI - 10.12 to - 0.523, p  = 0.030), and at the 3-month follow-up were - 7.104 (95% CI - 11.90 to - 2.306, p  = 0.004). The effectiveness of the anxiety prevention programme 'Journey of the Brave' was verified though this study using a quasi-experimental design on a small sample. Trial registration : UMIN000009021.

Preventing running-related injuries using evidence-based online advice: the design of a randomised-controlled trial

PubMed Central

de Vos, Robert-Jan; van Ochten, John M; Verhaar, Jan AN; Davis, Irene S; Bindels, Patrick JE; Bierma-Zeinstra, Sita MA; van Middelkoop, Marienke

2017-01-01

Introduction Running-related injuries (RRIs) are frequent and can lead to cessation of health promoting activities. Several risk factors for RRIs have been identified. However, no successful injury prevention programme has been developed so far. Therefore, the aim of the present study is to investigate the effect of an evidence-based online injury prevention programme on the number of RRIs. Methods and analysis The INSPIRE trial is a randomised-controlled trial with a 3-month follow-up. Both novice and more experienced runners, aged 18 years and older, who register for a running event (distances 5 km up to 42.195 km) will be asked to participate in this study. After completing the baseline questionnaire, participants will be randomised into either the intervention group or control group. Participants in the intervention group will get access to the online injury prevention programme. This prevention programme consists of information on evidence-based risk factors and advices to reduce the injury risk. The primary outcome measure is the number of self-reported RRIs in the time frame between registration for a running event and 1 month after the running event. Secondary outcome measures include the running days missed due to injuries, absence of work or school due to injuries, and the injury location. Ethics and dissemination An exemption for a comprehensive application is obtained by the Medical Ethical Committee of the Erasmus University Medical Centre Rotterdam, Netherlands. The results of the study will be published in peer-reviewed journals and presented on international congresses. Trial registration number NTR5998. Pre-results PMID:28761721

Variation in community intervention programmes and consequences for children and families: the example of Sure Start Local Programmes.

PubMed

Melhuish, Edward; Belsky, Jay; Anning, Angela; Ball, Mog; Barnes, Jacqueline; Romaniuk, Helena; Leyland, Alastair

2007-06-01

An area-based initiative, Sure Start Local Programmes (SSLPs), was established by the UK government to reduce social exclusion through improving the well-being of children aged 0-3 years and their families in disadvantaged communities; a true community intervention in that all children under four and their families in specified areas served as targets of universal services. A national evaluation examined the links between variation in programme implementation and effectiveness. Data gathered from multiple sources produced measures of implementation in terms of proficiency, services and staffing. Measures of programme impact on child/parenting outcomes derived from multilevel models, controlling for child, family and area characteristics, were identified to demonstrate programme effectiveness. Some modest linkage between programme implementation (e.g., proficiency, empowerment of parents and staff, identification of users) and effectiveness for child and parenting outcomes. Overall proficiency and specific aspects of implementation may influence effectiveness, which should guide the design of other child, family and community services.

Community involvement in dengue vector control: cluster randomised trial

PubMed Central

Toledo, M E; Rodríguez, M; Gomez, D; Baly, A; Benitez, J R; Van der Stuyft, P

2009-01-01

Objective To assess the effectiveness of an integrated community based environmental management strategy to control Aedes aegypti, the vector of dengue, compared with a routine strategy. Design Cluster randomised trial. Setting Guantanamo, Cuba. Participants 32 circumscriptions (around 2000 inhabitants each). Interventions The circumscriptions were randomly allocated to control clusters (n=16) comprising routine Aedes control programme (entomological surveillance, source reduction, selective adulticiding, and health education) and to intervention clusters (n=16) comprising the routine Aedes control programme combined with a community based environmental management approach. Main outcome measures The primary outcome was levels of Aedes infestation: house index (number of houses positive for at least one container with immature stages of Ae aegypti per 100 inspected houses), Breteau index (number of containers positive for immature stages of Ae aegypti per 100 inspected houses), and the pupae per inhabitant statistic (number of Ae aegypti pupae per inhabitant). Results All clusters were subjected to the intended intervention; all completed the study protocol up to February 2006 and all were included in the analysis. At baseline the Aedes infestation levels were comparable between intervention and control clusters: house index 0.25% v 0.20%, pupae per inhabitant 0.44×10−3 v 0.29×10−3. At the end of the intervention these indices were significantly lower in the intervention clusters: rate ratio for house indices 0.49 (95% confidence interval 0.27 to 0.88) and rate ratio for pupae per inhabitant 0.27 (0.09 to 0.76). Conclusion A community based environmental management embedded in a routine control programme was effective at reducing levels of Aedes infestation. Trial registration Current Controlled Trials ISRCTN88405796. PMID:19509031

Influence of a Non-formal Environmental Education Programme on Junior High-School Students' Environmental Literacy

NASA Astrophysics Data System (ADS)

Goldman, Daphne; Ben Zvi Assaraf, Orit; Shaharabani, Dina

2013-02-01

One of the solutions implemented by schools for conducting value-based environmental education (EE) is outsourcing: allocating external environmental organizations that develop and conduct EE programmes. This study addressed such a programme-the Green Council Programme (GCP)-developed and implemented in schools by the Israeli Society for Protection of Nature. A pre-test/post-test design was used to investigate the influence of participation in the GCP on components of junior high-school students' environmental literacy. Conceptualizations of 'environment', environmental attitudes and sense of ability to act on environmental issues were studied employing quantitative and qualitative tools. Contribution of the programme to the cognitive domain, in developing a systemic understanding of the environment, was limited. On the other hand, participating in this programme heightened students' sensitivity to human-environment interrelationships and developed a more ecological worldview. After the programme, students demonstrated greater perception of humans as part of the environment, an increased sensitivity to human impact on the environment and their value for non-human nature moved from an anthropocentric to a more ecocentric orientation. While students' internal locus-of-control increased, when environmental protection entailed personal economic trade-offs, their support was limited and remained unchanged. The article concludes with recommendations, based on the findings, regarding supplementing the school (science) curriculum with external EE enrichment programmes.

Strengthening the afferent limb of rapid response systems: an educational intervention using web-based learning for early recognition and responding to deteriorating patients.

PubMed

Liaw, Sok Ying; Wong, Lai Fun; Ang, Sophia Bee Leng; Ho, Jasmine Tze Yin; Siau, Chiang; Ang, Emily Neo Kim

2016-06-01

The timely recognition and response to patients with clinical deteriorations constitute the afferent limb failure of a rapid response system (RRS). This area is a persistent problem in acute healthcare settings worldwide. In this study, we evaluated the effect of an educational programme on improving the nurses' knowledge and performances in recognising and responding to clinical deterioration. The interactive web-based programme addressed three areas: (1) early detection of changes in vital signs; (2) performance of nursing assessment and interventions using airway, breathing, circulation, disability and expose/examine and (3) reporting clinical deterioration using identity, situation, background, assessment and recommendation. Sixty-seven registered nurses participated in the randomised control study. The experimental group underwent a 3 h programme while the control group received no intervention. Pretests and post-tests, a mannequin-based assessment and a multiple-choice knowledge questionnaire were conducted. We evaluated the participants' performances in assessing, managing and reporting the deterioration of a patient using a validated performance tool. A significantly higher number of nurses from the experimental group than the control group monitored respiratory rates (48.2% vs 25%, p<0.05) and pulse rates (74.3% vs 37.5%, p<0.01) in the simulated environment, after the intervention. The post-test mean scores of the experimental group was significantly higher than the control group for knowledge (21.29 vs 18.28, p<0.001), performance in assessing and managing clinical deterioration (25.83 vs 19.50, p<0.001) and reporting clinical deterioration (12.83 vs 10.97, p<0.001). A web-based educational programme developed for hospital nurses to strengthen the afferent limb of the RRS significantly increased their knowledge and performances in assessing, managing and reporting clinical deterioration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A community-based Falls Management Exercise Programme (FaME) improves balance, walking speed and reduced fear of falling.

PubMed

Yeung, Pui Yee; Chan, Wayne; Woo, Jean

2015-04-01

Although effective community falls prevention programmes for the older persons have been described, challenges remain in translating proven interventions into daily practice. To evaluate the efficacy, feasibility and acceptability of a falls prevention programme that can be integrated into daily activities in a group of community-dwelling older adults with risk of falling. A cohort study with intervention and comparison groups was designed to evaluate a 36-week group-based falls prevention exercise programme (FaME) in the community setting. Participants were aged 60 years or older, had fallen in the past 12 months, had fear of falling with avoidance of activities or had deficits in balance control. Primary outcome measures included assessment of balance control and mobility; secondary outcome measures included level of physical activity, assessment of fear of falling and health-related quality of life. There were 48 and 51 participants in the intervention and comparison groups, respectively. There were improvements in measurements of balance, walking speed and self-efficacy. The drop out rate was low (14.6% and 3.9% from the intervention and comparison groups, respectively). Overall compliance in the intervention group was 79%. Factors that motivated continued participation include the regular and long-term nature of the programme helping to reinforce their exercise habits, the simplicity of movements and friendliness of the group. The FaME programme improves balance, walking speed and reduces fear of falling. It could be widely promoted and integrated into regular health and social activities in community settings.

Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study.

PubMed

Bonete, Saray; Calero, María Dolores; Fernández-Parra, Antonio

2015-05-01

Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study describes preliminary data from a group format manual-based intervention, the Interpersonal Problem-Solving for Workplace Adaptation Programme, aimed at improving the cognitive and metacognitive process of social problem-solving skills focusing on typical social situations in the workplace based on mediation as the main strategy. A total of 50 adults with Asperger syndrome received the programme and were compared with a control group of typical development. The feasibility and effectiveness of the treatment were explored. Participants were assessed at pre-treatment and post-treatment on a task of social problem-solving skills and two secondary measures of socialisation and work profile using self- and caregiver-report. Using a variety of methods, the results showed that scores were significantly higher at post-treatment in the social problem-solving task and socialisation skills based on reports by parents. Differences in comparison to the control group had decreased after treatment. The treatment was acceptable to families and subject adherence was high. The Interpersonal Problem-Solving for Workplace Adaptation Programme appears to be a feasible training programme. © The Author(s) 2014.

Evaluation of a nationally funded state-based programme to reduce fatal occupational injuries

PubMed Central

Menendez, Cammie Chaumont; Castillo, Dawn; Rosenman, Kenneth; Harrison, Robert; Hendricks, Scott

2015-01-01

Background The Fatality Assessment and Control Evaluation (FACE) programme was established by the National Institute for Occupational Safety and Health to help prevent occupational traumatic fatalities by funding states to conduct targeted fatality investigations within cause-specific focus areas and associated prevention efforts. Purpose To investigate the impact of the state-based FACE programme on two previous focus areas. Methods A longitudinal time-series analysis spanning 22 years compared state fatality rates for occupational falls and electrocutions before and after FACE programme funding with states not receiving FACE programme funding. Lag periods were utilised to allow time for the programme to have an effect, and rates were adjusted for a variety of covariates. Separate analyses were conducted for each injury outcome. Results A reduction in fall fatality rates that was of borderline significance (1-year lag adjRR=0.92 (0.84 to 1.00)) and a non-significant reduction in electrocution fatality rates (3-year lag adjRR=0.92 (0.82 to 1.03)) were observed in states with FACE programme funding, Best-fit models presented two separate lag periods. Conclusions While it is challenging to quantitatively evaluate effectiveness of programmes such as FACE, the data suggest the FACE programme may be effective in preventing occupational injury deaths within its outcome focus areas throughout the state. It is important to look for ways to measure intermediate effects more precisely, as well as ways to maintain effects over time. PMID:22864251

Programmable Digital Controller

NASA Technical Reports Server (NTRS)

Wassick, Gregory J.

2012-01-01

An existing three-channel analog servo loop controller has been redesigned for piezoelectric-transducer-based (PZT-based) etalon control applications to a digital servo loop controller. This change offers several improvements over the previous analog controller, including software control over proportional-integral-derivative (PID) parameters, inclusion of other data of interest such as temperature and pressure in the control laws, improved ability to compensate for PZT hysteresis and mechanical mount fluctuations, ability to provide pre-programmed scanning and stepping routines, improved user interface, expanded data acquisition, and reduced size, weight, and power.

Distributed solid state programmable thermostat/power controller

NASA Technical Reports Server (NTRS)

Smith, Dennis A. (Inventor); Alexander, Jane C. (Inventor); Howard, David E. (Inventor)

2008-01-01

A self-contained power controller having a power driver switch, programmable controller, communication port, and environmental parameter measuring device coupled to a controllable device. The self-contained power controller needs only a single voltage source to power discrete devices, analog devices, and the controlled device. The programmable controller has a run mode which, when selected, upon the occurrence of a trigger event changes the state of a power driver switch and wherein the power driver switch is maintained by the programmable controller at the same state until the occurrence of a second event.

Enhancing Self-Regulation and Approaches to Learning in First-Year College Students: A Narrative-Based Programme Assessed in the Iberian Peninsula

ERIC Educational Resources Information Center

Rosario, Pedro; Nunez, Jose C.; Gonzalez-Pienda, Julio; Valle, Antonio; Trigo, Luisa; Guimaraes, Carina

2010-01-01

A programme to enhance first-year college students' self-regulated learning strategies is proposed and assessed in two samples, one from the University of Oviedo (Spain) and the other from the University of Minho (Portugal). Each sample was divided into two groups (experimental and control). The Spanish sample comprised 44 students in the…

Effectiveness of an implementation optimisation intervention aimed at increasing parent engagement in HENRY, a childhood obesity prevention programme - the Optimising Family Engagement in HENRY (OFTEN) trial: study protocol for a randomised controlled trial.

PubMed

Bryant, Maria; Burton, Wendy; Cundill, Bonnie; Farrin, Amanda J; Nixon, Jane; Stevens, June; Roberts, Kim; Foy, Robbie; Rutter, Harry; Hartley, Suzanne; Tubeuf, Sandy; Collinson, Michelle; Brown, Julia

2017-01-24

Family-based interventions to prevent childhood obesity depend upon parents' taking action to improve diet and other lifestyle behaviours in their families. Programmes that attract and retain high numbers of parents provide an enhanced opportunity to improve public health and are also likely to be more cost-effective than those that do not. We have developed a theory-informed optimisation intervention to promote parent engagement within an existing childhood obesity prevention group programme, HENRY (Health Exercise Nutrition for the Really Young). Here, we describe a proposal to evaluate the effectiveness of this optimisation intervention in regard to the engagement of parents and cost-effectiveness. The Optimising Family Engagement in HENRY (OFTEN) trial is a cluster randomised controlled trial being conducted across 24 local authorities (approximately 144 children's centres) which currently deliver HENRY programmes. The primary outcome will be parental enrolment and attendance at the HENRY programme, assessed using routinely collected process data. Cost-effectiveness will be presented in terms of primary outcomes using acceptability curves and through eliciting the willingness to pay for the optimisation from HENRY commissioners. Secondary outcomes include the longitudinal impact of the optimisation, parent-reported infant intake of fruits and vegetables (as a proxy to compliance) and other parent-reported family habits and lifestyle. This innovative trial will provide evidence on the implementation of a theory-informed optimisation intervention to promote parent engagement in HENRY, a community-based childhood obesity prevention programme. The findings will be generalisable to other interventions delivered to parents in other community-based environments. This research meets the expressed needs of commissioners, children's centres and parents to optimise the potential impact that HENRY has on obesity prevention. A subsequent cluster randomised controlled pilot trial is planned to determine the practicality of undertaking a definitive trial to robustly evaluate the effectiveness and cost-effectiveness of the optimised intervention on childhood obesity prevention. ClinicalTrials.gov identifier: NCT02675699 . Registered on 4 February 2016.

FPGA and USB based control board for quantum random number generator

NASA Astrophysics Data System (ADS)

Wang, Jian; Wan, Xu; Zhang, Hong-Fei; Gao, Yuan; Chen, Teng-Yun; Liang, Hao

2009-09-01

The design and implementation of FPGA-and-USB-based control board for quantum experiments are discussed. The usage of quantum true random number generator, control- logic in FPGA and communication with computer through USB protocol are proposed in this paper. Programmable controlled signal input and output ports are implemented. The error-detections of data frame header and frame length are designed. This board has been used in our decoy-state based quantum key distribution (QKD) system successfully.

PLC based automatic control of pasteurize mix in ice cream production

NASA Astrophysics Data System (ADS)

Yao, Xudong; Liang, Kai

2013-03-01

This paper describes the automatic control device of pasteurized mix in the ice cream production process.We design a scheme of control system using FBD program language and develop the programmer in the STEP 7-Micro/WIN software, check for any bugs before downloading into PLC .These developed devices will able to provide flexibility and accuracy to control the step of pasteurized mix. The operator just Input the duration and temperature of pasteurized mix through control panel. All the steps will finish automatically without any intervention in a preprogrammed sequence stored in programmable logic controller (PLC). With the help of this equipment we not only can control the quality of ice cream for various conditions, but also can simplify the production process. This control system is inexpensive and can be widely used in ice cream production industry.

Acceptability of the aquatic environment for exercise training by people with chronic obstructive pulmonary disease with physical comorbidities: Additional results from a randomised controlled trial.

PubMed

McNamara, Renae J; McKeough, Zoe J; McKenzie, David K; Alison, Jennifer A

2015-06-01

Water-based exercise training is a relatively new concept in the management of people with COPD. This study aimed to examine the acceptability of the aquatic environment as a medium for exercise training in people with COPD with physical comorbidities. Following a supervised eight week, three times a week, water-based exercise training programme conducted in a hospital hydrotherapy pool as part of a randomised controlled trial, participants completed a questionnaire about their experience with exercise training in the pool including adverse events, barriers and factors enabling exercise programme completion, satisfaction with the aquatic environment and their preference for an exercise training environment. All 18 participants (mean (SD) age 72 (10) years; FEV1% predicted 60 (10) %) who commenced the water-based exercise training programme completed the questionnaire. Three participants withdrew from training. High acceptability of the water and air temperature, shower and change-room facilities, staff assistance and modes of pool entry was reported (94% to 100%). Six factors were highly rated as enabling exercise programme adherence and completion: staff support (chosen by 93% of participants), enjoyment (80%), sense of achievement (80%), noticeable improvements (73%), personal motivation (73%) and participant support (53%). Eighty-nine percent of the participants indicated they would continue with water-based exercise. This study provides the first insight into the acceptability of the aquatic environment for exercise training in people with COPD and indicates water-based exercise and the aquatic environment is well accepted. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

National tuberculosis programme review: experience over the period 1990-95.

PubMed Central

Pio, A.; Luelmo, F.; Kumaresan, J.; Spinaci, S.

1997-01-01

Since 1990 the WHO Global Tuberculosis Programme (GTB) has promoted the revision of national tuberculosis programmes to strengthen the focus on directly observed treatment, short-course (DOTS) and close monitoring of treatment outcomes. GTB has encouraged in-depth evaluation of activities through a comprehensive programme review. Over the period 1990-95, WHO supported 12 such programme reviews. The criteria for selection were as follows: large population (Bangladesh, Brazil, China, Ethiopia, India, Indonesia, Mexico, and Thailand); good prospects of developing a model programme for a region (Nepal, Zimbabwe); or at advanced stage of implementation of a model programme for a region (Guinea, Peru). The estimated combined incidence of smear-positive pulmonary tuberculosis was 82 per 100,000 population, about 43% of the global incidence. The prevalence of infection with human immunodeficiency virus (HIV) was variable, being very high in Ethiopia and Zimbabwe, but negligible in Bangladesh, China, Nepal and Peru. The programme reviews were conducted by teams of 15-35 experts representing a wide range of national and external institutions. After a 2-3-month preparatory period, the conduct of the review usually lasted 2-3 weeks, including a first phase of meetings with authorities and review of documents, a second phase for field visits, and a third phase of discussion of findings and recommendations. The main lessons learned from the programme reviews were as follows: programme review is a useful tool to secure government commitment, reorient the tuberculosis control policies and replan the activities on solid grounds; the involvement of public health and academic institutions, cooperating agencies, and nongovernmental organizations secured a broad support to the new policies; programme success is linked to a centralized direction which supports a decentralized implementation through the primary health care services; monitoring and evaluation of case management functions well if it is based on the right classification of cases and quarterly reports on cohorts of patients; a comprehensive programme review should include teaching about tuberculosis in medical, nursing, and laboratory workers' schools; good quality diagnosis and treatment are the essential requirements for expanding a programme beyond the pilot testing; and control targets cannot be achieved if private and social security patients are left outside the programme scope. The methodology of comprehensive programme review should be recommended to all countries which require programme reorientation; it is also appropriate for carrying out evaluations at 4-5-year intervals in countries that are implementing the correct tuberculosis control policies. PMID:9509630

National tuberculosis programme review: experience over the period 1990-95.

PubMed

Pio, A; Luelmo, F; Kumaresan, J; Spinaci, S

1997-01-01

Since 1990 the WHO Global Tuberculosis Programme (GTB) has promoted the revision of national tuberculosis programmes to strengthen the focus on directly observed treatment, short-course (DOTS) and close monitoring of treatment outcomes. GTB has encouraged in-depth evaluation of activities through a comprehensive programme review. Over the period 1990-95, WHO supported 12 such programme reviews. The criteria for selection were as follows: large population (Bangladesh, Brazil, China, Ethiopia, India, Indonesia, Mexico, and Thailand); good prospects of developing a model programme for a region (Nepal, Zimbabwe); or at advanced stage of implementation of a model programme for a region (Guinea, Peru). The estimated combined incidence of smear-positive pulmonary tuberculosis was 82 per 100,000 population, about 43% of the global incidence. The prevalence of infection with human immunodeficiency virus (HIV) was variable, being very high in Ethiopia and Zimbabwe, but negligible in Bangladesh, China, Nepal and Peru. The programme reviews were conducted by teams of 15-35 experts representing a wide range of national and external institutions. After a 2-3-month preparatory period, the conduct of the review usually lasted 2-3 weeks, including a first phase of meetings with authorities and review of documents, a second phase for field visits, and a third phase of discussion of findings and recommendations. The main lessons learned from the programme reviews were as follows: programme review is a useful tool to secure government commitment, reorient the tuberculosis control policies and replan the activities on solid grounds; the involvement of public health and academic institutions, cooperating agencies, and nongovernmental organizations secured a broad support to the new policies; programme success is linked to a centralized direction which supports a decentralized implementation through the primary health care services; monitoring and evaluation of case management functions well if it is based on the right classification of cases and quarterly reports on cohorts of patients; a comprehensive programme review should include teaching about tuberculosis in medical, nursing, and laboratory workers' schools; good quality diagnosis and treatment are the essential requirements for expanding a programme beyond the pilot testing; and control targets cannot be achieved if private and social security patients are left outside the programme scope. The methodology of comprehensive programme review should be recommended to all countries which require programme reorientation; it is also appropriate for carrying out evaluations at 4-5-year intervals in countries that are implementing the correct tuberculosis control policies.

The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in Polio survivors: a randomised controlled trial.

PubMed

Murray, D; Hardiman, O; Campion, A; Vance, R; Horgan, F; Meldrum, D

2017-07-01

To investigate the effect of an eight-week home-based arm ergometry aerobic exercise programme on physical fitness, fatigue, activity and quality of life in Polio Survivors. An assessor blinded randomised controlled trial. Home-based exercise. Fifty-five Polio survivors randomised to exercise or control groups. Home-based arm ergometry at an intensity of 50%-70% maximum heart rate, compared with usual physiotherapy care. The Six-minute Arm Test, Fatigue Severity Scale, Physical Activity Scale for Individuals with Physical Disabilities and SF-36. Assessments were completed at baseline and at eight weeks. There was no significant difference in the primary outcome, exercising heart rate during the Six-minute Arm Test, between the groups at follow-up [97.6 (SD10.1) compared to 102.4 (SD13.7) beats per minute ( P=0.20)]. Blood pressure was significantly lower in the intervention group at follow-up [systolic blood pressure 132(18.6)mmHg compared to 144.1(14.6)mmHg ( P=0.002)]. There were no between group differences in the Fatigue Severity Scale ( P=0.25) or Physical Activity Scale for Individuals with Physical Disabilities ( P=0.49), with a small difference in SF-36 physical component score ( P=0.04). This home-based arm ergometry programme successfully facilitated aerobic exercise in Polio Survivors, but did not result in a significant change in physical fitness, measured by the Six-minute Arm Test.

Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits

PubMed Central

2013-01-01

Background The prevalence of obesity in men is rising, but they are less likely than women to engage in existing weight management programmes. The potential of professional sports club settings to engage men in health promotion activities is being increasingly recognised. This paper describes the development and optimization of the Football Fans in Training (FFIT) programme, which aims to help overweight men (many of them football supporters) lose weight through becoming more active and adopting healthier eating habits. Methods The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases. In Phase 1, a multidisciplinary working group developed the pilot programme (p-FFIT) and used a scoping review to summarize previous research and identify the target population. Phase 2 involved a process evaluation of p-FFIT in 11 Scottish Premier League (SPL) clubs. Participant and coach feedback, focus group discussions and interviews explored the utility/acceptability of programme components and suggestions for changes. Programme session observations identified examples of good practice and problems/issues with delivery. Together, these findings informed redevelopment of the optimized programme (FFIT), whose components were mapped onto specific behaviour change techniques using an evidence-based taxonomy. Results p-FFIT comprised 12, weekly, gender-sensitised, group-based weight management classroom and ‘pitch-side’ physical activity sessions. These in-stadia sessions were complemented by an incremental, pedometer-based walking programme. p-FFIT was targeted at men aged 35-65 years with body mass index ≥ 27 kg/m2. Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components, and valued the camaraderie and peer-support offered by the programme. Coaches appreciated the simplicity of the key healthy eating and physical activity messages. Suggestions for improvements that were incorporated into the optimized FFIT programme included: more varied in-stadia physical activity with football-related components; post-programme weight management support (emails and a reunion session); and additional training for coaches in SMART goal setting and the pedometer-based walking programme. Conclusions The Football Fans in Training programme is highly acceptable to participants and SPL coaches, and is appropriate for evaluation in a randomised controlled trial. PMID:23496915

Train the trainer? A randomized controlled trial of a multi-tiered oral health education programme in community-based residential services for adults with intellectual disability.

PubMed

Mac Giolla Phadraig, Caoimhin; Guerin, Suzanne; Nunn, June

2013-04-01

To assess the impact of a multi-tiered oral health education programme on care staff caring for people with intellectual disability (ID). Postal questionnaires were sent to all care staff of a community-based residential care service for adults, randomly assigned to control and intervention groups. A specifically developed training programme was delivered to residential staff nominees, who then trained all staff within the intervention group. The control group received no training. Post-test questionnaires were sent to both groups. Paired-samples t-test was used to compare oral health-related knowledge (K) and behaviour, attitude and self-efficacy (BAS) scores. Of the initial 219 respondents, 154 (response rate between 40% and 35.8%, with attrition rate of 29.7% from baseline to repeat) returned completed questionnaires at post-test (M=8.5 months, range=6.5-11 months). Control and intervention groups were comparable for general training, employment and demographic variables. In the intervention group, mean Knowledge Index score rose from K=7.2 to K=7.9 (P<0.001) and mean BAS scale score rose from BAS=4.7 to BAS=5.4 (P<0.001). There was no statistically significant increase in mean scores from test (K=7.0, BAS=4.7) to post-test (K=7.2, BAS=4.9) for the control group. Mean scores regarding knowledge, attitude, self-efficacy and reported behaviour increased significantly at 8.5 months in staff where training was provided. The results indicate that a multi-tiered training programme improved knowledge, attitude, self-efficacy and reported behaviour amongst staff caring for people with ID. © 2012 John Wiley & Sons A/S.

How balance task-specific training contributes to improving physical function in older subjects undergoing rehabilitation following hip fracture: a randomized controlled trial.

PubMed

Monticone, Marco; Ambrosini, Emilia; Brunati, Roberto; Capone, Antonio; Pagliari, Giulia; Secci, Claudio; Zatti, Giovanni; Ferrante, Simona

2018-03-01

To evaluate the efficacy of a rehabilitation programme including balance task-specific training in improving physical function, pain, activities of daily living (ADL), balance and quality of life in subjects after a hip fracture. Randomized controlled trial. A total of 52 older subjects selected for internal fixation due to extra-capsular hip fracture were randomized to be included in an experimental ( n = 26) and control group ( n = 26). The experimental group underwent a rehabilitation programme based on balance task-specific training. The control group underwent general physiotherapy, including open kinetic chain exercises and walking training. Both groups individually followed programmes of 90-minute sessions five times/week for three weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a Pain Numerical Rating Scale, the Berg Balance Scale, the Functional Independence Measure and the 36-item Short-Form Health Survey. The participants were evaluated before and after training, and after 12 months. Significant effects of time, group and time × group were found for all outcome measures in favour of the experimental group. A clinically important between-group difference of 25 points was achieved after training and at follow-up in terms of the primary outcome (WOMAC function before treatment, after treatment and at follow-up was 84.8 (3.7), 39.8 (4.9) and 35.7 (6.2) for the experimental group and 80.9 (5.7), 65.2 (7.1) and 61.0 (11.1) for the control group). An inpatient rehabilitation programme based on balance task-specific training is useful in improving physical function, pain, ADL and quality of life in older patients after hip fracture.

Are TB control programmes in South Asia ignoring children with disease? A situational analysis.

PubMed

Shakoor, Sadia; Qamar, Farah Naz; Mir, Fatima; Zaidi, Anita; Hasan, Rumina

2015-02-01

Paediatric tuberculosis (TB) has long been an evasive entity for public health practitioners striving to control the disease. Owing to difficulty in diagnosis of paediatric TB, incidence estimates based on current case detection fall short of actual rates. The four high-burden countries in South Asia (SA-HBC)-Afghanistan, Pakistan, India and Bangladesh-alone account for >75% of missed TB cases worldwide. It follows that these countries are also responsible for a large although unmeasured proportion of missed paediatric cases. In view of current Millennium Development Goals recommending a scale-up of paediatric TB detection and management globally, there is a dire need to improve paediatric TB programmes in these high-burden countries. Inherent problems with diagnosis of paediatric TB are compounded by programmatic and social barriers in SA-HBC. We have reviewed the current situation of TB control programmes in SA-HBC countries based on published statistics and performed a strengths, weaknesses, opportunities and threats situational analysis with a view towards identifying critical issues operant in the region posing barriers to improving paediatric TB control. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA.

PubMed

Wakefield, M; Chaloupka, F

2000-06-01

To describe the extent to which comprehensive statewide tobacco control programmes in the USA have made progress toward reducing teenage smoking. Literature search of Medline for reviews of effectiveness of programme and policy elements, plus journal articles and personal request for copies of publicly released reports and working papers from evaluation staff in each of the state programmes of California, Massachusetts, Arizona, Oregon, and Florida. All studies, reports, and commentaries that provided information on aspects of programme implementation and evaluation. Statewide comprehensive programmes show high levels of advertising recall and generally positive improvement in smoking related beliefs and attitudes among teenagers. More fully funded programmes lead to increased mass media campaign advertising and community initiatives; a greater capacity to implement school based smoking prevention programmes; and an increase in the passage of local ordinances that create smoke free indoor environments and reduce cigarette sales to youth. The combination of programme activity and increased tobacco tax reduce cigarette consumption more than expected as a result of price increases alone, and these effects seem to apply to adolescents as well as adults. Programmes are associated with a decline in adult smoking prevalence, with these effects observed to date in California, Massachusetts, and Oregon. Arizona and Florida have yet to examine change in adult prevalence associated with programme exposure. California and Massachusetts have demonstrated relative beneficial effects in teenage smoking prevalence, and Florida has reported promising indications of reduced prevalence. Arizona has yet to report follow up data, and Oregon has found no change in teenage smoking, but has only two years of follow up available. One of the most critical factors in programme success is the extent of programme funding, and consequent level of programme implementation, and the degree to which this is undermined by the tobacco industry and other competitors for funding. Despite the different strengths and combinations of programme messages and strategies used in these comprehensive programmes, there is evidence that they lead to change in factors that influence teenage smoking, and to reductions in teenage smoking.

Wireless Control of Miniaturized Mobile Vehicle for Indoor Surveillance

NASA Astrophysics Data System (ADS)

Taha Saquib, Syed M.; Hameed, Sarmad; Usman Ali, Syed M.; Jafri, Raza; Amin, Imran

2013-12-01

This work is based upon electronic automation and Smart Control techniques, which constitute the basis of Control Area Network (CAN) and Personal Area Network (PAN). Bluetooth technology has been interfaced with a programmable controller to provide multi-dimensional vehicle control. A network is proposed which contains a remote, mobile host controller and an android operating system based mobile set (Client). The client communicates with a host controller through a Bluetooth device. The system incorporates duplex communication after successful confirmation between the host and the client; the android based mobile unit controls the vehicle through the Bluetooth module.

A distributed control system for the lower-hybrid current drive system on the Tokamak de Varennes

NASA Astrophysics Data System (ADS)

Bagdoo, J.; Guay, J. M.; Chaudron, G.-A.; Decoste, R.; Demers, Y.; Hubbard, A.

1990-08-01

An rf current drive system with an output power of 1 MW at 3.7 GHz is under development for the Tokamak de Varennes. The control system is based on an Ethernet local-area network of programmable logic controllers as front end, personal computers as consoles, and CAMAC-based DSP processors. The DSP processors ensure the PID control of the phase and rf power of each klystron, and the fast protection of high-power rf hardware, all within a 40 μs loop. Slower control and protection, event sequencing and the run-time database are provided by the programmable logic controllers, which communicate, via the LAN, with the consoles. The latter run a commercial process-control console software. The LAN protocol respects the first four layers of the ISO/OSI 802.3 standard. Synchronization with the tokamak control system is provided by commercially available CAMAC timing modules which trigger shot-related events and reference waveform generators. A detailed description of each subsystem and a performance evaluation of the system will be presented.

Fast and robust control of nanopositioning systems: Performance limits enabled by field programmable analog arrays.

PubMed

Baranwal, Mayank; Gorugantu, Ram S; Salapaka, Srinivasa M

2015-08-01

This paper aims at control design and its implementation for robust high-bandwidth precision (nanoscale) positioning systems. Even though modern model-based control theoretic designs for robust broadband high-resolution positioning have enabled orders of magnitude improvement in performance over existing model independent designs, their scope is severely limited by the inefficacies of digital implementation of the control designs. High-order control laws that result from model-based designs typically have to be approximated with reduced-order systems to facilitate digital implementation. Digital systems, even those that have very high sampling frequencies, provide low effective control bandwidth when implementing high-order systems. In this context, field programmable analog arrays (FPAAs) provide a good alternative to the use of digital-logic based processors since they enable very high implementation speeds, moreover with cheaper resources. The superior flexibility of digital systems in terms of the implementable mathematical and logical functions does not give significant edge over FPAAs when implementing linear dynamic control laws. In this paper, we pose the control design objectives for positioning systems in different configurations as optimal control problems and demonstrate significant improvements in performance when the resulting control laws are applied using FPAAs as opposed to their digital counterparts. An improvement of over 200% in positioning bandwidth is achieved over an earlier digital signal processor (DSP) based implementation for the same system and same control design, even when for the DSP-based system, the sampling frequency is about 100 times the desired positioning bandwidth.

What limits the effectiveness of school-based anti-smoking programmes?

PubMed

Hrubá, Drahoslava; Zaloudíková, Iva

2012-03-01

It is generally accepted that living in families where there are smokers, children are stressed not only by the harmful physical exposure to second-hand and third-hand tobacco smoke, but also by the negative models of the adult relatives' behaviour, as relatives who smoke can inspire children to imitate this behaviour, influencing attitudes towards, and early experiments with smoking. In this paper, some of the most important results about influence of family smoking on the effects of the anti-smoking educational programme "Non-smoking Is Normal" are described. The school-based programme was created by medical and educational specialists and targets children at the first level of primary schools (aged from 6 to 11 years). The data about interesting outcomes of the programme (knowledge, attitudes, behaviour) were collected by anonymous questionnaire, administered twice in each school year: one month before the complex of 5 lectures (pre-tests) and 4-5 months after the last lecture (post-tests). The sample of participants (860-910) was divided into four groups, according to the intervention and family backrounds: (1) programme children from smoking families "P-S"; (2) control children from smoking families "C-S"; (3) programme children from non-smoking families "P-NS"; (4) control children from non-smoking families "C-NS". The differences in the frequency of children's answers were analysed using the tests in statistic Epi Info software, version 6.04a (chi-square, Mantel Haenszel, Yates, Fisher). In the programme group, the number of children with smoking relatives was significantly higher than in the control group (80.1% vs. 73.0%, p < 0.01) as well as of those who reported frequent/daily exposure to secondhand smoke at homes and/or in cars (49.5% vs. 40.0%, p < 0.01). Smoking families significantly influenced the children's seeking of smoking friends (40% vs. 17%, p < 0.01). The programme has significantly increased the amount of knowledge about health risks of smoking. Both in the programme and control groups of children from non-smoking families, the frequency of critics of adults smoking was significantly higher all the time of the study (p < 0.05 and 0.01 resp.); however, the programme influenced children's opinions about smoking (criticism) only partially. Children's actual intentions about their smoking in the future was fully influenced by their smoking household environment: the number of "future no-smokers" has decreased in time and was significantly less frequent among children from smoking families (p < 0.01). The frequency of those willing to smoke significantly increased within the period between 3rd and 5th grades, both in the programme and the control groups (p < 0.01). An almost linear increase of active experimentations with cigarette smoking in follow-up monitoring was seen, trends of smoking children were steeper in groups from smoking families. The number of experiments with smoking was significantly lower in programme children of non-smoking parents only at the end of the study (p < 0.05). Despite of the effort to initiate parental participation on the primary prevention of smoking, we have confirmed that smoking in families decreased the efficacy of anti-smoking intervention targeted on young children at school age.

Effect of a hospital outreach intervention programme on decreasing hospitalisations and medical costs in patients with chronic obstructive pulmonary disease in China: protocol of a randomised controlled trial.

PubMed

Yan, Jin; Wang, Lianhong; Liu, Chun; Yuan, Hong; Wang, Xiaowan; Yu, Baorong; Luo, Qian

2016-06-15

Patients with chronic obstructive pulmonary disease (COPD) often have multiple hospitalisations because of exacerbation. Evidence shows disease management programmes are one of the most cost-effective measures to prevent re-hospitalisation for COPD exacerbation, but lack implementation and economic appraisal in China. The aims of the proposed study are to determine whether a hospital outreach invention programme for disease management can decrease hospitalisations and medical costs in patients with COPD in China. Economic appraisal of the programme will also be carried out. A randomised single-blinded controlled trial will be conducted. 220 COPD patients with exacerbations will be recruited from the Third Xiangya Hospital, Central South University, China. After hospital discharge they will be randomly allocated into an intervention or a control group. Participants in the intervention group will attend a 3-month hospital-based pulmonary rehabilitation intervention and then receive a home-based programme. Both groups will receive identical usual discharge care before discharge from hospital. The primary outcomes will include rate of hospitalisation and medical cost, while secondary outcomes will include mortality, self-efficacy, self-management, health status, quality of life, exercise tolerance and pulmonary function, which will be evaluated at baseline and at 3, 12 and 24 months after the intervention. Cost-effectiveness analysis will be employed for economic appraisal. The study has been approved by the institutional review board (IRB) of the Third Xiangya Hospital, Central South University (IRB2014-S159). Findings will be shared widely through conference presentations and peer-reviewed publications. Furthermore, the results of the programme will be submitted to health authorities and policy reform will be recommended. Chi CTR-TRC-14005108; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effect of a hospital outreach intervention programme on decreasing hospitalisations and medical costs in patients with chronic obstructive pulmonary disease in China: protocol of a randomised controlled trial

PubMed Central

Yan, Jin; Wang, Lianhong; Liu, Chun; Yuan, Hong; Wang, Xiaowan; Yu, Baorong; Luo, Qian

2016-01-01

Introduction Patients with chronic obstructive pulmonary disease (COPD) often have multiple hospitalisations because of exacerbation. Evidence shows disease management programmes are one of the most cost-effective measures to prevent re-hospitalisation for COPD exacerbation, but lack implementation and economic appraisal in China. The aims of the proposed study are to determine whether a hospital outreach invention programme for disease management can decrease hospitalisations and medical costs in patients with COPD in China. Economic appraisal of the programme will also be carried out. Methods and analysis A randomised single-blinded controlled trial will be conducted. 220 COPD patients with exacerbations will be recruited from the Third Xiangya Hospital, Central South University, China. After hospital discharge they will be randomly allocated into an intervention or a control group. Participants in the intervention group will attend a 3-month hospital-based pulmonary rehabilitation intervention and then receive a home-based programme. Both groups will receive identical usual discharge care before discharge from hospital. The primary outcomes will include rate of hospitalisation and medical cost, while secondary outcomes will include mortality, self-efficacy, self-management, health status, quality of life, exercise tolerance and pulmonary function, which will be evaluated at baseline and at 3, 12 and 24 months after the intervention. Cost-effectiveness analysis will be employed for economic appraisal. Ethics and dissemination The study has been approved by the institutional review board (IRB) of the Third Xiangya Hospital, Central South University (IRB2014-S159). Findings will be shared widely through conference presentations and peer-reviewed publications. Furthermore, the results of the programme will be submitted to health authorities and policy reform will be recommended. Trial registration number Chi CTR-TRC-14005108; Pre-results. PMID:27311900

Associations of Community Water Fluoridation with Caries Prevalence and Oral Health Inequality in Children

PubMed Central

Kim, Han-Na; Kim, Jeong-Hee; Kim, Se-Yeon; Kim, Jin-Bom

2017-01-01

This study aimed to confirm the association between the community water fluoridation (CWF) programme and dental caries prevention on permanent teeth, comparing to a control area, neighbouring population without the programme, and verifying whether the programme can reduce the socio-economic inequality related to the oral health of children in Korea. Evaluation surveys were conducted among 6-, 8-, and 11-year-old children living in Okcheon (CWF) and neighbouring Yeongdong (non-CWF, control area) towns in South Korea. Data on monthly family income, caregiver educational level, and Family Affluence Scale scores were evaluated using questionnaires that were distributed to the parents. The effectiveness of CWF in caries reduction was calculated based on the differences in decayed, missing, and filled teeth and decayed, missing, and filled tooth surfaces indices between the two towns. The data were analysed using logistic regression and univariate analysis of variance. Both 8- and 11-year-old children living in the CWF area had lower dental caries prevalence than those living in the non-CWF community. Differences in dental caries prevalence based on educational level were found in the control area but not in the CWF area. Socio-economic factor-related inequality in oral health were observed in the non-CWF community. Additionally, 8- and 11-year-old children living in the CWF area displayed lower dental caries prevalence in the pit-and-fissure and smooth surfaces than those living in the non-CWF community. These results suggest that CWF programmes are effective in the prevention of caries on permanent teeth and can reduce oral health inequalities among children. The implementation of CWF programmes should be sustained to overcome oral health inequalities due to socio-economic factors and improve children’s overall oral health. PMID:28608827

Associations of Community Water Fluoridation with Caries Prevalence and Oral Health Inequality in Children.

PubMed

Kim, Han-Na; Kim, Jeong-Hee; Kim, Se-Yeon; Kim, Jin-Bom

2017-06-13

This study aimed to confirm the association between the community water fluoridation (CWF) programme and dental caries prevention on permanent teeth, comparing to a control area, neighbouring population without the programme, and verifying whether the programme can reduce the socio-economic inequality related to the oral health of children in Korea. Evaluation surveys were conducted among 6-, 8-, and 11-year-old children living in Okcheon (CWF) and neighbouring Yeongdong (non-CWF, control area) towns in South Korea. Data on monthly family income, caregiver educational level, and Family Affluence Scale scores were evaluated using questionnaires that were distributed to the parents. The effectiveness of CWF in caries reduction was calculated based on the differences in decayed, missing, and filled teeth and decayed, missing, and filled tooth surfaces indices between the two towns. The data were analysed using logistic regression and univariate analysis of variance. Both 8- and 11-year-old children living in the CWF area had lower dental caries prevalence than those living in the non-CWF community. Differences in dental caries prevalence based on educational level were found in the control area but not in the CWF area. Socio-economic factor-related inequality in oral health were observed in the non-CWF community. Additionally, 8- and 11-year-old children living in the CWF area displayed lower dental caries prevalence in the pit-and-fissure and smooth surfaces than those living in the non-CWF community. These results suggest that CWF programmes are effective in the prevention of caries on permanent teeth and can reduce oral health inequalities among children. The implementation of CWF programmes should be sustained to overcome oral health inequalities due to socio-economic factors and improve children's overall oral health.

A EUropean study on effectiveness and sustainability of current Cardiac Rehabilitation programmes in the Elderly: Design of the EU-CaRE randomised controlled trial.

PubMed

Prescott, Eva; Meindersma, Esther P; van der Velde, Astrid E; Gonzalez-Juanatey, Jose R; Iliou, Marie Christine; Ardissino, Diego; Zoccai, Giuseppe Biondi; Zeymer, Uwe; Prins, Leonie F; Van't Hof, Arnoud Wj; Wilhelm, Matthias; de Kluiver, Ed P

2016-10-01

Cardiac rehabilitation (CR) is an evidence-based intervention to increase survival and quality of life. Yet studies consistently show that elderly patients are less frequently referred to CR, show less uptake and more often drop out of CR programmes. The European study on effectiveness and sustainability of current cardiac rehabilitation programmes in the elderly (EU-CaRE) project consists of an observational study and an open prospective, investigator-initiated multicentre randomised controlled trial (RCT) involving mobile telemonitoring guided CR (mCR). The aim of EU-CaRE is to map the efficiency of current CR of the elderly in Europe, and to investigate whether mCR is an effective alternative in terms of efficacy, adherence and sustainability. The EU-CaRE study includes patients aged 65 years or older with ischaemic heart disease or who have undergone heart valve surgery. A total of 1760 patients participating in existing CR programmes in eight regions of Europe will be included. Of patients declining regular CR, 238 will be included in the RCT and randomised in two study arms. The experimental group (mCR) will receive a personalised home-based programme while the control group will receive no advice or coaching throughout the study period. Outcomes will be assessed after the end of CR and at 12 months follow-up. The primary outcome is VO 2peak and secondary outcomes include variables describing CR uptake, adherence, efficacy and sustainability. The study will provide important information to improve CR in the elderly. The EU-CaRE RCT is the first European multicentre study of mCR as an alternative for elderly patients not attending usual CR. © The European Society of Cardiology 2016.

HACCP-based quality risk management approach to udder health problems on dairy farms

PubMed Central

2009-01-01

Against the background of prevailing udder health problems on dairy farms, this paper discusses a new approach to mastitis control. Current udder health control programmes, such as the 'five-point plan', are highlighted and their drawbacks indicated. The concept and principles of hazard analysis critical control points (HACCP) are introduced. The eight core elements of this concept are dealt with by using the example of a dairy herd with a mastitis problem due to Staphylococcus aureus. The various steps to be taken in the development of a HACCP-based quality risk management programme are illustrated through the application of core elements. Finally, it is shown that the HACCP key words, structure, organisation, planning, communication and formalisation; which do not frequently appear in conventional herd health and production management programmes can contribute to better udder health. The role of the veterinarian can be paramount and of added value, if he/she is willing to invest in new knowledge and skills, such as the HACCP concept, farm economics, animal nutrition, and particularly the role of coach to the dairy farmer in the implementation of preventative measures in relation to udder health. PMID:22082372

HACCP-based quality risk management approach to udder health problems on dairy farms.

PubMed

Noordhuizen, Jptm; Cannas da Silva, J

2009-04-01

Against the background of prevailing udder health problems on dairy farms, this paper discusses a new approach to mastitis control. Current udder health control programmes, such as the 'five-point plan', are highlighted and their drawbacks indicated. The concept and principles of hazard analysis critical control points (HACCP) are introduced. The eight core elements of this concept are dealt with by using the example of a dairy herd with a mastitis problem due to Staphylococcus aureus. The various steps to be taken in the development of a HACCP-based quality risk management programme are illustrated through the application of core elements. Finally, it is shown that the HACCP key words, structure, organisation, planning, communication and formalisation; which do not frequently appear in conventional herd health and production management programmes can contribute to better udder health. The role of the veterinarian can be paramount and of added value, if he/she is willing to invest in new knowledge and skills, such as the HACCP concept, farm economics, animal nutrition, and particularly the role of coach to the dairy farmer in the implementation of preventative measures in relation to udder health.

The past matters: estimating intrinsic hookworm transmission intensity in areas with past mass drug administration to control lymphatic filariasis.

PubMed

Werkman, Marleen; Truscott, James E; Toor, Jaspreet; Wright, James E; Anderson, Roy M

2017-05-23

Current WHO guidelines for soil-transmitted helminth (STH) control focus on mass drug administration (MDA) targeting preschool-aged (pre-SAC) and school-aged children (SAC), with the goal of eliminating STH as a public health problem amongst children. Recently, attention and funding has turned towards the question whether MDA alone can result in the interruption of transmission for STH. The lymphatic filariasis (LF) elimination programme, have been successful in reaching whole communities. There is the possibility of building upon the infrastructure created for these LF-programmes to enhance the control of STH. Using hookworm as an example, we explore what further MDA coverage might be required to induce interruption of transmission for hookworm in the wake of a successful LF programme. Analyses based on the model of STH transmission and MDA impact predict the effects of previous LF control by MDA over five years, on a defined baseline prevalence of STH in an area with a defined transmission intensity (the basic reproductive number R 0 ). If the LF MDA programme achieved a high coverage (70, 70 and 60% for pre-SAC, SAC and adults, respectively) we expect that in communities with a hookworm prevalence of 15%, after 5 years of LF control, the intrinsic R 0 value in that setting is 2.47. By contrast, if lower LF coverages were achieved (40, 40 and 30% for pre-SAC, SAC and adults, respectively), with the same prevalence of 15% at baseline (after 5 years of LF MDA), the intrinsic hookworm R 0 value is predicted to be 1.67. The intrinsic R 0 value has a large effect on the expected successes of follow-up STH programmes post LF MDA. Consequently, the outcomes of identical programmes may differ between these communities. To design the optimal MDA intervention to eliminate STH infections, it is vital to have information on historical MDA programmes and baseline prevalence to estimate the intrinsic transmission intensity for the defined setting (R 0 ). The baseline prevalence alone is not sufficient to inform policy for the control of STH, post cessation of LF MDA, since this will be highly dependent on the intensity and effectiveness of past programmes and the intrinsic transmission intensity of the dominant STH species in any given setting.

A Field Programmable Gate Array-Based Reconfigurable Smart-Sensor Network for Wireless Monitoring of New Generation Computer Numerically Controlled Machines

PubMed Central

Moreno-Tapia, Sandra Veronica; Vera-Salas, Luis Alberto; Osornio-Rios, Roque Alfredo; Dominguez-Gonzalez, Aurelio; Stiharu, Ion; de Jesus Romero-Troncoso, Rene

2010-01-01

Computer numerically controlled (CNC) machines have evolved to adapt to increasing technological and industrial requirements. To cover these needs, new generation machines have to perform monitoring strategies by incorporating multiple sensors. Since in most of applications the online Processing of the variables is essential, the use of smart sensors is necessary. The contribution of this work is the development of a wireless network platform of reconfigurable smart sensors for CNC machine applications complying with the measurement requirements of new generation CNC machines. Four different smart sensors are put under test in the network and their corresponding signal processing techniques are implemented in a Field Programmable Gate Array (FPGA)-based sensor node. PMID:22163602

A field programmable gate array-based reconfigurable smart-sensor network for wireless monitoring of new generation computer numerically controlled machines.

PubMed

Moreno-Tapia, Sandra Veronica; Vera-Salas, Luis Alberto; Osornio-Rios, Roque Alfredo; Dominguez-Gonzalez, Aurelio; Stiharu, Ion; Romero-Troncoso, Rene de Jesus

2010-01-01

Computer numerically controlled (CNC) machines have evolved to adapt to increasing technological and industrial requirements. To cover these needs, new generation machines have to perform monitoring strategies by incorporating multiple sensors. Since in most of applications the online Processing of the variables is essential, the use of smart sensors is necessary. The contribution of this work is the development of a wireless network platform of reconfigurable smart sensors for CNC machine applications complying with the measurement requirements of new generation CNC machines. Four different smart sensors are put under test in the network and their corresponding signal processing techniques are implemented in a Field Programmable Gate Array (FPGA)-based sensor node.

Prevention of fall-related injuries in 7-year-old to 12-year-old children: a cluster randomised controlled trial.

PubMed

Nauta, Joske; Knol, Dirk L; Adriaensens, Lize; Klein Wolt, Karin; van Mechelen, Willem; Verhagen, Evert A L M

2013-09-01

To counteract the recently observed increase in forearm fractures in children worldwide, an educational programme to improve fall skills was developed. In this 8-week programme children learned basic martial arts falling techniques in their physical education classes. In this study, the effectiveness of this educational programme to improve fall skills was evaluated. A cluster randomised controlled trial was conducted in 33 primary schools. The intervention group received the educational programme to improve falling skills during their physical education (PE) classes whereas the control group received their regular PE curriculum. At baseline (October 2009) and follow-up (May 2010), a questionnaire was completed by the children about their physical activity behaviours. Furthermore, fall-related injuries were registered continuously during an entire school-year. A total of 36 incident injuries was reported in the intervention group, equalling an injury incidence density (IID) of 0.14 fall-related injuries per 1000 h of physical activity (95% CI 0.09 to 0.18). In contrast, 96 injuries were reported by the control group corresponding to an IID of 0.26 (95% CI 0.21 to 0.32). However, because intracluster correlation was high (ICC=0.46), differences in injury incidence were not statistically significant. When activity level was taken into account, a trend was shown suggesting that the 'falling is a sport' programme was effective in decreasing falling-related injury risk, but only in the least active children. Although results did not reach significance because of strong clustering effects, a trend was found suggesting that a school-based educational programme to improve falling skills may be more beneficial for the prevention of falling-related injuries in children with low levels of habitual physical activity.

Addressing policy needs for prevention and control of type 2 diabetes in India.

PubMed

Atre, Sachin

2015-09-01

India carries nearly one-fifth of the global burden of diabetes cases, the majority of which are of type 2 diabetes. Recognising the need for controlling diabetes, the Government of India has initiated a national level programme for prevention and control of diabetes along with other non-communicable diseases in 2008. Despite being piloted and implemented, there is hardly any published literature about the national level situation of diabetes and its control efforts. The present article is written with the aim to fill this gap to some extent and to provide a situational analysis of the diabetes problem in India in a holistic way, addressing policy needs for the national programme. It focuses on three main areas, namely, awareness of diabetes, costs of drugs for its treatment and healthcare-system related issues. It argues that poor coverage and weak implementation of the national level programme are major forces that push patients to seek help in the weakly regulated private sector. Approaching the private sector is likely to increase the cost of care, which in turn can lead to an increased financial burden for patients and their families due to factors such as patients' lack of awareness about diabetes, poor drug price regulation and prescriptions including combinations and/or patented products of medicines used for treating diabetes by the private sector. This article addresses several needs such as strengthening the national programme and increasing its reach to unreached districts, exerting drug price regulation and implementing community-based participatory programmes for prevention and management of type 2 diabetes. It also underscores a need for piloting and implementing a robust national level electronic reporting system for diabetes programmes. © Royal Society for Public Health 2015.

The effects of a mindfulness-based lifestyle programme for adults with Parkinson's disease: protocol for a mixed methods, randomised two-group control study.

PubMed

Advocat, Jenny; Russell, Grant; Enticott, Joanne; Hassed, Craig; Hester, Jennifer; Vandenberg, Brooke

2013-10-10

Parkinson's disease (PD) is the second most common neurodegenerative disorder in developed countries. There is an increasing interest in the use of mindfulness-related interventions in the management of patients with a chronic disease. In addition, interventions that promote personal control, stress-management and other lifestyle factors, such as diet and exercise, assist in reducing disability and improving quality of life in people with chronic illnesses. There has been little research in this area for people with PD. A prospective mixed-method randomised clinical trial involving community living adults with PD aged <76 years and with moderate disease severity (Hoehn and Yahr stage 2) PD. Participants will be randomised into the ESSENCE 6-week programme or a matched wait list control group. ESSENCE is a multifaceted, healthy lifestyle and mindfulness programme designed to improve quality of life. We aim to determine whether participation in a mindfulness and lifestyle programme could improve PD-related function and explore self-management related experiences and changing attitudes towards self-management. The outcome measures will include 5 self-administered questionnaires: PD function and well-being questionnaire (PDQ39), Health Behaviours, Mental health, Multidimensional locus of control, and Freiburg mindfulness inventory. An embedded qualitative protocol will include in-depth interviews with 12 participants before and after participation in the 6-week programme and a researcher will observe the programme and take notes. Repeated measures of Analysis of Variance (ANOVA) will examine the outcome measures for any significant effects from the group allocation, age, sex, adherence score and attendance. Qualitative data will be analysed thematically. We will outline the benefits of, and barriers to, the uptake of the intervention. This protocol has received ethics approval from the Monash University Human Research Ethics Committee project number CF11/2662-2011001553. This is the first research of its kind in Australia involving a comprehensive, lifestyle-based programme for people with PD and has the potential to involve a broader range of providers than standard care. The findings will be disseminated through peer reviewed journals, primary care conferences in Australia as well as abroad and through the Parkinson's community. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12612000440820.

The effects of a mindfulness-based lifestyle programme for adults with Parkinson’s disease: protocol for a mixed methods, randomised two-group control study

PubMed Central

Advocat, Jenny; Russell, Grant; Enticott, Joanne; Hassed, Craig; Hester, Jennifer; Vandenberg, Brooke

2013-01-01

Introduction Parkinson's disease (PD) is the second most common neurodegenerative disorder in developed countries. There is an increasing interest in the use of mindfulness-related interventions in the management of patients with a chronic disease. In addition, interventions that promote personal control, stress-management and other lifestyle factors, such as diet and exercise, assist in reducing disability and improving quality of life in people with chronic illnesses. There has been little research in this area for people with PD. Methods A prospective mixed-method randomised clinical trial involving community living adults with PD aged <76 years and with moderate disease severity (Hoehn and Yahr stage 2) PD. Participants will be randomised into the ESSENCE 6-week programme or a matched wait list control group. ESSENCE is a multifaceted, healthy lifestyle and mindfulness programme designed to improve quality of life. We aim to determine whether participation in a mindfulness and lifestyle programme could improve PD-related function and explore self-management related experiences and changing attitudes towards self-management. The outcome measures will include 5 self-administered questionnaires: PD function and well-being questionnaire (PDQ39), Health Behaviours, Mental health, Multidimensional locus of control, and Freiburg mindfulness inventory. An embedded qualitative protocol will include in-depth interviews with 12 participants before and after participation in the 6-week programme and a researcher will observe the programme and take notes. Analysis Repeated measures of Analysis of Variance (ANOVA) will examine the outcome measures for any significant effects from the group allocation, age, sex, adherence score and attendance. Qualitative data will be analysed thematically. We will outline the benefits of, and barriers to, the uptake of the intervention. Ethics This protocol has received ethics approval from the Monash University Human Research Ethics Committee project number CF11/2662–2011001553. Dissemination This is the first research of its kind in Australia involving a comprehensive, lifestyle-based programme for people with PD and has the potential to involve a broader range of providers than standard care. The findings will be disseminated through peer reviewed journals, primary care conferences in Australia as well as abroad and through the Parkinson's community. Registration details Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12612000440820. PMID:24114370

Electromechanical Devices and Controllers. Electronics Module 10. Instructor's Guide.

ERIC Educational Resources Information Center

Carter, Ed

This module is the tenth of 10 modules in the competency-based electronics series. Introductory materials include a listing of competencies addressed in the module, a parts/equipment list, and a cross-reference table of instructional materials. Six instructional units cover: electromechanical control devices; programmable logic controllers (PLC);…

A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial.

PubMed

Bjerk, Maria; Brovold, Therese; Skelton, Dawn A; Bergland, Astrid

2017-08-14

Falls and fall-related injuries in older adults are associated with great burdens, both for the individuals, the health care system and the society. Previous research has shown evidence for the efficiency of exercise as falls prevention. An understudied group are older adults receiving home help services, and the effect of a falls prevention programme on health-related quality of life is unclear. The primary aim of this randomised controlled trial is to examine the effect of a falls prevention programme on quality of life, physical function and falls efficacy in older adults receiving home help services. A secondary aim is to explore the mediating factors between falls prevention and health-related quality of life. The study is a single-blinded randomised controlled trial. Participants are older adults, aged 67 or older, receiving home help services, who are able to walk with or without walking aids, who have experienced at least one fall during the last 12 months and who have a Mini Mental State Examination of 23 or above. The intervention group receives a programme, based on the Otago Exercise Programme, lasting 12 weeks including home visits and motivational telephone calls. The control group receives usual care. The primary outcome is health-related quality of life (SF-36). Secondary outcomes are leg strength, balance, walking speed, walking habits, activities of daily living, nutritional status and falls efficacy. All measurements are performed at baseline, following intervention at 3 months and at 6 months' follow-up. Sample size, based on the primary outcome, is set to 150 participants randomised into the two arms, including an estimated 15-20% drop out. Participants are recruited from six municipalities in Norway. This trial will generate new knowledge on the effects of an exercise falls prevention programme among older fallers receiving home help services. This knowledge will be useful for clinicians, for health managers in the primary health care service and for policy makers. ClinicalTrials.gov . NCT02374307 . First registration, 16/02/2015.

Integrated programmable photonic filter on the silicon-on-insulator platform.

PubMed

Liao, Shasha; Ding, Yunhong; Peucheret, Christophe; Yang, Ting; Dong, Jianji; Zhang, Xinliang

2014-12-29

We propose and demonstrate a silicon-on-insulator (SOI) on-chip programmable filter based on a four-tap finite impulse response structure. The photonic filter is programmable thanks to amplitude and phase modulation of each tap controlled by thermal heaters. We further demonstrate the tunability of the filter central wavelength, bandwidth and variable passband shape. The tuning range of the central wavelength is at least 42% of the free spectral range. The bandwidth tuning range is at least half of the free spectral range. Our scheme has distinct advantages of compactness, capability for integrating with electronics.

[Evaluation of the Family-based Familien stärken-Program for Preventing Substance Abuse and Behavior Problems in Youth].

PubMed

Stappenbeck, J; Wendell, A; Thomasius, R

2015-09-01

The Strengthening Families Program was developed in the USA and is regarded as an effective family-based prevention programme for youth. The evaluation of an adapted German version was carried out as a randomised-controlled multicentre trial. 292 families were recruited, 150 followed the intervention, and 142 received a minimal intervention. Acceptance from families and programme facilitators was high. Results about the effectiveness will be reported as soon as follow-up assessments are completed. © Georg Thieme Verlag KG Stuttgart · New York.

Protocol for the Meningococcal Control Programme - Canadian Forces Base Cornwallis and Canadian Forces Base St. Jean 1980/81,

DTIC Science & Technology

1980-11-01

hours, then overnight in a refrigerator or cold room at 40C. Fol- lowing clot retraction , the serum may be decanted and spun, or the whole sample spun...Drogram. The SIMP programme may involve one or all of the following: collection of post nasal swabs, blood sera samples, air samples and surface samples...outlined in para 16. 16. Culturing of Swabs Swabs shall be placed on Columbia Blood Agar (4 or 5% sheep RBC’s) supplemented with IsoVitalex (Baltimore

Step-by-Step Design of an FPGA-Based Digital Compensator for DC/DC Converters Oriented to an Introductory Course

ERIC Educational Resources Information Center

Zumel, P.; Fernandez, C.; Sanz, M.; Lazaro, A.; Barrado, A.

2011-01-01

In this paper, a short introductory course to introduce field-programmable gate array (FPGA)-based digital control of dc/dc switching power converters is presented. Digital control based on specific hardware has been at the leading edge of low-medium power dc/dc switching converters in recent years. Besides industry's interest in this topic, from…

A factorial-design cluster randomised controlled trial investigating the cost-effectiveness of a nutrition supplement and an exercise programme on pneumonia incidence, walking capacity and body mass index in older people living in Santiago, Chile: the CENEX study protocol

PubMed Central

Dangour, Alan D; Albala, Cecilia; Aedo, Cristian; Elbourne, Diana; Grundy, Emily; Walker, Damian; Uauy, Ricardo

2007-01-01

Background Chile is currently undergoing a period of rapid demographic transition which has led to an increase in the proportion of older people in the population; the proportion aged 60 years and over, for example, increased from 8% of the population in 1980 to 12% in 2005. In an effort to promote healthy ageing and preserve function, the government of Chile has formulated a package of actions into the Programme of Complementary Feeding for the Older Population (PACAM) which has been providing a nutritional supplement to older people since 1998. PACAM distributes micronutrient fortified foods to individuals aged 70 years and over registered at Primary Health Centres and enrolled in the programme. The recommended serving size (50 g/day) of these supplements provides 50% of daily micronutrient requirements and 20% of daily energy requirements of older people. No information is currently available on the cost-effectiveness of the supplementation programme. Aim The aim of the CENEX cluster randomised controlled trial is to evaluate the cost-effectiveness of an ongoing nutrition supplementation programme, and a specially designed physical exercise intervention for older people of low to medium socio-economic status living in Santiago, Chile. Methods The study has been conceptualised as a public health programme effectiveness study and has been designed as a 24-month factorial cluster-randomised controlled trial conducted among 2800 individuals aged 65.0–67.9 years at baseline attending 28 health centres in Santiago. The main outcomes are incidence of pneumonia, walking capacity and change in body mass index over 24 months of intervention. Costing data (user and provider), collected at all levels, will enable the determination of the cost-effectiveness of the two interventions individually and in combination. The study is supported by the Ministry of Health in Chile, which is keen to expand and improve its national programme of nutrition for older people based on sound science-base and evidence for cost-effectiveness. Trial registration ISRCTN48153354 PMID:17615064

Internet cognitive behavioural therapy for mixed anxiety and depression: a randomized controlled trial and evidence of effectiveness in primary care.

PubMed

Newby, J M; Mackenzie, A; Williams, A D; McIntyre, K; Watts, S; Wong, N; Andrews, G

2013-12-01

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) have the highest co-morbidity rates within the internalizing disorders cluster, yet no Internet-based cognitive behavioural therapy (iCBT) programme exists for their combined treatment. We designed a six-lesson therapist-assisted iCBT programme for mixed anxiety and depression. Study 1 was a randomized controlled trial (RCT) comparing the iCBT programme (n = 46) versus wait-list control (WLC; n = 53) for patients diagnosed by structured clinical interview with MDD, GAD or co-morbid GAD/MDD. Primary outcome measures were the Patient Health Questionnaire nine-item scale (depression), Generalized Anxiety Disorder seven-item scale (generalized anxiety), Kessler 10-item Psychological Distress scale (distress) and 12-item World Health Organization Disability Assessment Schedule II (disability). The iCBT group was followed up at 3 months post-treatment. In study 2, we investigated the adherence to, and efficacy of the same programme in a primary care setting, where patients (n = 136) completed the programme under the supervision of primary care clinicians. The RCT showed that the iCBT programme was more effective than WLC, with large within- and between-groups effect sizes found (>0.8). Adherence was also high (89%), and gains were maintained at 3-month follow-up. In study 2 in primary care, adherence to the iCBT programme was low (41%), yet effect sizes were large (>0.8). Of the non-completers, 30% experienced benefit. Together, the results show that iCBT is effective and adherence is high in research settings, but there is a problem of adherence when translated into the 'real world'. Future efforts need to be placed on developing improved adherence to iCBT in primary care settings.

[Development and implementation of a state-wide "train the trainer" model of the school-based prevention programme "Join the Healthy Boat - Primary School"].

PubMed

Wartha, O; Koch, B; Kobel, S; Drenowatz, C; Kettner, S; Schreiber, A; Wirt, T; Kesztyüs, D; Steinacker, J M

2014-10-01

This paper shows how a state-wide health-promotion intervention at primary schools can be implemented by considering the example of the programme "Join the Healthy Boat - Primary School". Additionally, it is illustrated how quality control throughout the whole process can be incorporated. To operate long-term and target-group orientated in the whole state of Baden-Württemberg, the school-based prevention programme "Join the Healthy Boat" uses a "train the trainer" model. The trainers are teachers who were instructed by the project team. In the school year 2009/10, these trainers offered quadrinominal training courses for further teachers. Every urban and rural district is covered by 1 trainer. The trainers evaluated the 6 preparatory training courses they had been given using questionnaires. The following 4 training courses the trainers offered to the teachers were reviewed by the trainers as well as the teachers using questionnaires, too. Additionally, at the end of the school year 2009/10, the teachers completed a questionnaire about their satisfaction regarding the programme itself and the work with the trainer. During the school year 2009/10, 453 teachers were trained by 32 trainers. According to indications on the questionnaires about the preparatory training courses, all trainers felt themselves "very well" or "well" prepared for their task. The teachers evaluated the expertise of the respective trainer, the quality of the training courses and the satisfaction with the programme itself throughout highly. Based on the excellent results of the process evaluation and the programme's wide coverage, an adoption of a "train the trainer" model seems worthwhile for other school-based prevention programmes, as well. © Georg Thieme Verlag KG Stuttgart · New York.

Universal alcohol misuse prevention programmes for children and adolescents: Cochrane systematic reviews.

PubMed

Foxcroft, David R; Tsertsvadze, Alexander

2012-05-01

Alcohol misuse by young people causes significant health and social harm, including death and disability. Therefore, prevention of youth alcohol misuse is a policy aim in many countries. Our aim was to examine the effectiveness of (1) school-based, (2) family-based and (3) multi-component universal alcohol misuse prevention programmes in children and adolescents. Three Cochrane systematic reviews were performed: searches in MEDLINE, EMBASE, PsycINFO, Project CORK and the Cochrane Register of Controlled Trials up to July 2010, including randomised trials evaluating universal alcohol misuse prevention programmes in school, family or multiple settings in youths aged 18 years or younger. Two independent reviewers identified eligible studies and any discrepancies were resolved via discussion. A total of 85 trials were included in the reviews of school (n = 53), family (n = 12) and multi-component (n = 20) programmes. Meta-analysis was not performed due to study heterogeneity. Most studies were conducted in North America. Risk of bias assessment revealed problems related to inappropriate unit of analysis, moderate to high attrition, selective outcome reporting and potential confounding. Certain generic psychosocial and life skills school-based programmes were effective in reducing alcohol use in youth. Most family-based programmes were effective. There was insufficient evidence to conclude that multiple interventions provided additional benefit over single interventions. In these Cochrane reviews, some school, family or multi-component prevention programmes were shown to be effective in reducing alcohol misuse in youths. However, these results warrant a cautious interpretation, since bias and/or contextual factors may have affected the trial results. Further research should replicate the most promising studies identified in these reviews and pay particular attention to content and context factors through rigorous evaluation.

An evidence-based shared decision making programme on the prevention of myocardial infarction in type 2 diabetes: protocol of a randomised-controlled trial.

PubMed

Buhse, Susanne; Heller, Tabitha; Kasper, Jürgen; Mühlhauser, Ingrid; Müller, Ulrich Alfons; Lehmann, Thomas; Lenz, Matthias

2013-10-19

Lack of patient involvement in decision making has been suggested as one reason for limited treatment success. Concepts such as shared decision making may contribute to high quality healthcare by supporting patients to make informed decisions together with their physicians.A multi-component shared decision making programme on the prevention of heart attack in type 2 diabetes has been developed. It aims at improving the quality of decision-making by providing evidence-based patient information, enhancing patients' knowledge, and supporting them to actively participate in decision-making. In this study the efficacy of the programme is evaluated in the setting of a diabetes clinic. A single blinded randomised-controlled trial is conducted to compare the shared decision making programme with a control-intervention. The intervention consists of an evidence-based patient decision aid on the prevention of myocardial infarction and a corresponding counselling module provided by diabetes educators. Similar in duration and structure, the control-intervention targets nutrition, sports, and stress coping. A total of 154 patients between 40 and 69 years of age with type 2 diabetes and no previous diagnosis of ischaemic heart disease or stroke are enrolled and allocated either to the intervention or the control-intervention. Primary outcome measure is the patients' knowledge on benefits and harms of heart attack prevention captured by a standardised knowledge test. Key secondary outcome measure is the achievement of treatment goals prioritised by the individual patient. Treatment goals refer to statin taking, HbA1c-, blood pressure levels and smoking status. Outcomes are assessed directly after the counselling and at 6 months follow-up. Analyses will be carried out on intention-to-treat basis. Concurrent qualitative methods are used to explore intervention fidelity and to gain insight into implementation processes. Interventions to facilitate evidence-based shared decision making represent an innovative approach in diabetes care. The results of this study will provide information on the efficacy of such a concept in the setting of a diabetes clinic in Germany. ISRCTN84636255.

Application of multimedia-based exercise programmes focused on improvement of the schoolgirls' musculoskeletal system during breaks between classes

NASA Astrophysics Data System (ADS)

Bendíková, Elena

2017-11-01

This pilot study presents theoretical basis related to the purpose and methodology of the presented research the aim of which is to point to the importance of multimedia-based physical activity (exercise programme) done during breaks between classes. The purpose of this programme is to prevent occurrence of functional disorders of the musculoskeletal system among schoolchildren. The experimental and control groups were composed of the female students of the third grade at one secondary school in the town of L. Mikuláš. We obtained the data by means of standardized methods used for assessment of the musculoskeletal system in medical and physical education practice. The obtained qualitative and quantitative data were processed by means of the chi-squared test and the non-parametric Wilcoxon signed-rank test. The results significantly (p<0.01) proved a positive effect of the multimedia-based exercise programme on the experimental group (Mwwtest=8.639, p<0.01), especially the positive and significant (p<0.01, p<0.05) effect on the functional status of the muscular system.

Feasibility of a multidimensional home-based exercise programme for the elderly with structured support given by the general practitioner's surgery: Study protocol of a single arm trial preparing an RCT [ISRCTN58562962

PubMed Central

2009-01-01

Background Physical activity programmes can help to prevent functional decline in the elderly. Until now, such programmes use to target either on healthy community-dwelling seniors or on elderly living in special residences or care institutions. Sedentary or frail people, however, are difficult to reach when they live in their own homes. The general practitioner's (GP) practice offers a unique opportunity to acquire these people for participation in activity programmes. We conceptualised a multidimensional home-based exercise programme that shall be delivered to the target group through cooperation between GPs and exercise therapists. In order to prepare a randomised controlled trial (RCT), a feasibility study is being conducted. Methods The study is designed as a single arm interventional trial. We plan to recruit 90 patients aged 70 years and above through their GPs. The intervention lasts 12 weeks and consists of physical activity counselling, a home-exercise programme, and exercise consultations provided by an exercise therapist in the GP's practice and via telephone. The exercise programme consists of two main components: 1. a combination of home-exercises to improve strength, flexibility and balance, 2. walking for exercise to improve aerobic capacity. Primary outcome measures are: appraisal by GP, undesirable events, drop-outs, adherence. Secondary outcome measures are: effects (a. motor tests: timed-up-and-go, chair rising, grip strength, tandem stand, tandem walk, sit-and-reach; b. telephone interview: PRISCUS-Physical Activity Questionnaire, Short Form-8 Health Survey, three month recall of frequency of falls, Falls Efficacy Scale), appraisal by participant, exercise performance, focus group discussion. Data analyses will focus on: 1. decision-making concerning the conduction of a RCT, 2. estimation of the effects of the programme, detection of shortcomings and identification of subgroups with contrary results, 3. feedback to participants and to GPs. Conclusion A new cooperation between GPs and exercise therapists to approach community-dwelling seniors and to deliver a home-exercise programme is object of research with regard to feasibility and acceptance. In case of success, an RCT should examine the effects of the programme. A future implementation within primary medical care may take advantage from the flexibility of the programme. Trial registration Current Controlled Trials ISRCTN58562962. PMID:19686587

Evaluation of two educative models in a primary care hypertension programme.

PubMed

Martínez-Amenós, A; Fernández Ferré, M L; Mota Vidal, C; Alsina Rocasalbas, J

1990-08-01

This study was planned in the context of a regional high blood pressure programme, to compare the efficacy of two educative methods. The group of 722 hypertensive patients (58.8% women), mean age 61 years, was randomly selected from 19 primary care centres. Initial assessment was based on a patient interview including 22 questions on high blood pressure, its consequences and treatment. Patients agreeing to participate in an active education team programme were distributed into three groups: individual education, team education and a control group. Those who declined to participate formed two groups: individual education and controls. Team education consisted of two audiovisual sessions attended by groups of 8-12 patients and conducted by treating physicians and nurses. Individual education included comments related to the 22 questions. Follow-up assessment was made after two months. An increase in the level of hypertension control was observed only in the accepting group, in which educative action was followed by increased knowledge. Results were similarly favourable for both the individual and team education groups and suggested the need to consider educational factors together with those influencing patient attitude towards an active educational programme.

The effect of a sexuality education programme among out- of- school adolescents in Lagos, Nigeria.

PubMed

Odeyemi, K A; Onajole, A T; Ogunowo, B E; Olufunlayo, T; Segun, B

2014-06-01

This study was conducted to assess the effect of a community based sexuality education programme on the sexual health knowledge and practices of out of school female adolescents. This Intervention study was conducted in two markets within Lagos, Nigeria. Representative samples of adolescents were interviewed on their sexual health knowledge and practices. An Education- entertainment programme provided sexuality education to adolescents in Mushin market only (intervention group) followed by post intervention surveys in Mushin market and Sangrouse market (control group). The pre and post intervention surveys were compared 6 months post intervention to detect any changes. Sexual health knowledge and behaviour was similar among respondents in both markets pre intervention. Post intervention, the sexual health knowledge of the respondents in the intervention site improved significantly. (p<0.05) Fewer adolescents initiated sex in the intervention site than in the control site and contraceptive use increased. However among the sexually active, there was no significant change in their condom use and number of sexual partners. Community based health education programmes can be used to provide effective sexuality education for out of school adolescents. Provision should be made by government and non-governmental organisations during adolescent reproductive health programming for sexuality education targeted at out of school adolescents.

Effect of a school-based oral health education programme in Wuhan City, Peoples Republic of China.

PubMed

Petersen, Poul Erik; Peng, Bin; Tai, Baojun; Bian, Zhuan; Fan, Mingwen

2004-02-01

To assess oral health outcomes of a school-based oral health education (OHE) programme on children, mothers and schoolteachers in China, and to evaluate the methods applied and materials used. The WHO Health Promoting Schools Project applied to primary schoolchildren in 3 experimental and 3 control schools in Hongshan District, Wuhan City, Central China, with a 3-year follow-up. Data on dental caries, gingival bleeding and behaviour were collected. 803 children and their mothers, and 369 teachers were included at baseline in 1998. After three years, 666 children and their mothers (response rate 83%), and 347 teachers (response rate 94%) remained. DMFT/DMFS increments were comparable but the f/F components were higher among children in experimental schools than in control schools and the gingival bleeding score was, similarly, significantly lower. More children in experimental schools adopted regular oral health behaviour such as toothbrushing, recent dental visits, use of fluoride toothpaste, with less frequent consumption of cakes/biscuits compared to controls. In experimental schools, mothers showed significant beneficial oral health developments, while teachers showed higher oral health knowledge and more positive attitudes, also being satisfied with training workshops, methods applied, materials used and involvement with children in OHE. The programme had positive effects on gingival bleeding score and oral health behaviour of children, and on oral health knowledge and attitudes of mothers and teachers. No positive effect on dental caries incidence rate was demonstrated by the OHE programme.

School Area Road Safety Assessment and Improvements (SARSAI) programme reduces road traffic injuries among children in Tanzania.

PubMed

Poswayo, Ayikai; Kalolo, Simon; Rabonovitz, Katheryn; Witte, Jeffrey; Guerrero, Alejandro

2018-05-19

To determine the impact of a paediatric road traffic injury (RTI) prevention programme in urban Sub-Saharan Africa. Dares Salaam, Republic of Tanzania. Household surveys were conducted in catchment areas around 18 primary schools in Dar es Salaam, Republic of Tanzania; the catchment areas were divided into control and intervention groups. Collected data included basic demographic information on all school-aged household members and whether or not they had been involved in an RTI in the previous 12 months, and, if so, what the characteristics of that RTI were. Based on these findings, a separate road safety engineering site analysis and consultation with the communities and other stakeholders, an injury-prevention programme was developed and implemented, consisting of infrastructure enhancements and a site-specific educational programme. The programme was initially implemented at the intervention schools. After 1 year, data were collected in the same manner. The control group received the same intervention after follow-up data were collected. Data were collected on 12 957 school-aged children in the baseline period and 13 555 school-aged children in the post-intervention period, in both the control and intervention communities. There was a statistically significant reduction in RTIs in the intervention group and a non-significant increase in RTI in the control group. The greatest reduction was in motorcycle-pedestrian RTI, private vehicle-pedestrian RTI and morning RTI. The programme demonstrated a significant reduction in paediatric RTI after its implementation, in very specific ways. This study demonstrates that for a reasonable investment, scientifically driven injury-prevention programmes are feasible in resource-limited settings with high paediatric RTI rates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluation of the colorectal cancer screening Programme in the Basque Country (Spain) and its effectiveness based on the Miscan-colon model.

PubMed

Idigoras, I; Arrospide, A; Portillo, I; Arana-Arri, E; Martínez-Indart, L; Mar, J; de Koning, H J; Lastra, R; Soto-Gordoa, M; van der Meulen, M; Lansdorp-Vogelaar, I

2017-08-01

The population-based Basque Colorectal Cancer (CRC) Screening Programme started in 2009 with a biennial immunochemical quantitative test (FIT) biennial and colonoscopy under sedation in positive cases. The population target of 586,700 residents was from 50 to 69 years old and the total coverage was reached at the beginning of 2014. The aim of our study was to determine possible scenarios in terms of incidence, mortality and reduction of Life-years-Lost (L-y-L) in the medium and long term of CRC. Invitations were sent out by the Programme from 2009 to 2014, with combined organizational strategies. Simulation was done by MISCAN-colon (Microsimulation Screening Analysis) over 30 years comparing the results of screening vs no-screening, taking the population-based Cancer Registry into account. Lifetime population and real data from the Programme were used from 2008 to 2012. The model was run differentially for men and women. 924,416 invitations were sent out from 2009 to 2014. The average participation rate was 68.4%, CRC detection rate was 3.4% and the Advanced Adenoma detection rate was 24.0‰, with differences observed in sex and age. Future scenarios showed a higher decrease of incidence (17.2% vs 14.7%), mortality (28.1% vs 22.4%) and L-y-L (22.6% vs 18.4%) in men than women in 2030. The Basque Country CRC Programme results are aligned to its strategy and comparable to other programmes. MISCAN model was found to be a useful tool to predict the benefits of the programme in the future. The effectiveness of the Programme has not been formally established as case control studies are required to determine long term benefits from the screening strategy.

How well are malaria maps used to design and finance malaria control in Africa?

PubMed

Omumbo, Judy A; Noor, Abdisalan M; Fall, Ibrahima S; Snow, Robert W

2013-01-01

Rational decision making on malaria control depends on an understanding of the epidemiological risks and control measures. National Malaria Control Programmes across Africa have access to a range of state-of-the-art malaria risk mapping products that might serve their decision-making needs. The use of cartography in planning malaria control has never been methodically reviewed. An audit of the risk maps used by NMCPs in 47 malaria endemic countries in Africa was undertaken by examining the most recent national malaria strategies, monitoring and evaluation plans, malaria programme reviews and applications submitted to the Global Fund. The types of maps presented and how they have been used to define priorities for investment and control was investigated. 91% of endemic countries in Africa have defined malaria risk at sub-national levels using at least one risk map. The range of risk maps varies from maps based on suitability of climate for transmission; predicted malaria seasons and temperature/altitude limitations, to representations of clinical data and modelled parasite prevalence. The choice of maps is influenced by the source of the information. Maps developed using national data through in-country research partnerships have greater utility than more readily accessible web-based options developed without inputs from national control programmes. Although almost all countries have stratification maps, only a few use them to guide decisions on the selection of interventions allocation of resources for malaria control. The way information on the epidemiology of malaria is presented and used needs to be addressed to ensure evidence-based added value in planning control. The science on modelled impact of interventions must be integrated into new mapping products to allow a translation of risk into rational decision making for malaria control. As overseas and domestic funding diminishes, strategic planning will be necessary to guide appropriate financing for malaria control.

Programmable diagnostic devices made from paper and tape.

PubMed

Martinez, Andres W; Phillips, Scott T; Nie, Zhihong; Cheng, Chao-Min; Carrilho, Emanuel; Wiley, Benjamin J; Whitesides, George M

2010-10-07

This paper describes three-dimensional microfluidic paper-based analytical devices (3-D microPADs) that can be programmed (postfabrication) by the user to generate multiple patterns of flow through them. These devices are programmed by pressing single-use 'on' buttons, using a stylus or a ballpoint pen. Pressing a button closes a small space (gap) between two vertically aligned microfluidic channels, and allows fluids to wick from one channel to the other. These devices are simple to fabricate, and are made entirely out of paper and double-sided adhesive tape. Programmable devices expand the capabilities of microPADs and provide a simple method for controlling the movement of fluids in paper-based channels. They are the conceptual equivalent of field-programmable gate arrays (FPGAs) widely used in electronics.

Field Programmable Gate Array Control of Power Systems in Graduate Student Laboratories

DTIC Science & Technology

2008-03-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited FIELD PROGRAMMABLE...REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE Field Programmable Gate Array Control of Power Systems in Graduate Student...Electronics curriculum track is the development of a design center that explores Field Programmable Gate Array (FPGA) control of power electronics

Aptazyme-embedded guide RNAs enable ligand-responsive genome editing and transcriptional activation

PubMed Central

Tang, Weixin; Hu, Johnny H.; Liu, David R.

2017-01-01

Programmable sequence-specific genome editing agents such as CRISPR-Cas9 have greatly advanced our ability to manipulate the human genome. Although canonical forms of genome-editing agents and programmable transcriptional regulators are constitutively active, precise temporal and spatial control over genome editing and transcriptional regulation activities would enable the more selective and potentially safer use of these powerful technologies. Here, by incorporating ligand-responsive self-cleaving catalytic RNAs (aptazymes) into guide RNAs, we developed a set of aptazyme-embedded guide RNAs that enable small molecule-controlled nuclease-mediated genome editing and small molecule-controlled base editing, as well as small molecule-dependent transcriptional activation in mammalian cells. PMID:28656978

Dementia training programmes for staff working in general hospital settings - a systematic review of the literature.

PubMed

Scerri, Anthony; Innes, Anthea; Scerri, Charles

2017-08-01

Although literature describing and evaluating training programmes in hospital settings increased in recent years, there are no reviews that summarise these programmes. This review sought to address this, by collecting the current evidence on dementia training programmes directed to staff working in general hospitals. Literature from five databases were searched, based on a number of inclusion criteria. The selected studies were summarised and data was extracted and compared using narrative synthesis based on a set of pre-defined categories. Methodological quality was assessed. Fourteen peer-reviewed studies were identified with the majority being pre-test post-test investigations. No randomised controlled trials were found. Methodological quality was variable with selection bias being the major limitation. There was a great variability in the development and mode of delivery although, interdisciplinary ward based, tailor-made, short sessions using experiential and active learning were the most utilised. The majority of the studies mainly evaluated learning, with few studies evaluating changes in staff behaviour/practices and patients' outcomes. This review indicates that high quality studies are needed that especially evaluate staff behaviours and patient outcomes and their sustainability over time. It also highlights measures that could be used to develop and deliver training programmes in hospital settings.

A programmable Si-photonic node for SDN-enabled Bloom filter forwarding in disaggregated data centers

NASA Astrophysics Data System (ADS)

Moralis-Pegios, M.; Terzenidis, N.; Vagionas, C.; Pitris, S.; Chatzianagnostou, E.; Brimont, A.; Zanzi, A.; Sanchis, P.; Marti, J.; Kraft, J.; Rochracher, K.; Dorrestein, S.; Bogdan, M.; Tekin, T.; Syrivelis, D.; Tassiulas, L.; Miliou, A.; Pleros, N.; Vyrsokinos, K.

2017-02-01

Programmable switching nodes supporting Software-Defined Networking (SDN) over optical interconnecting technologies arise as a key enabling technology for future disaggregated Data Center (DC) environments. The SDNenabling roadmap of intra-DC optical solutions is already a reality for rack-to-rack interconnects, with recent research reporting on interesting applications of programmable silicon photonic switching fabrics addressing board-to-board and even on-board applications. In this perspective, simplified information addressing schemes like Bloom filter (BF)-based labels emerge as a highly promising solution for ensuring rapid switch reconfiguration, following quickly the changes enforced in network size, network topology or even in content location. The benefits of BF-based forwarding have been so far successfully demonstrated in the Information-Centric Network (ICN) paradigm, while theoretical studies have also revealed the energy consumption and speed advantages when applied in DCs. In this paper we present for the first time a programmable 4x4 Silicon Photonic switch that supports SDN through the use of BF-labeled router ports. Our scheme significantly simplifies packet forwarding as it negates the need for large forwarding tables, allowing for its remote control through modifications in the assigned BF labels. We demonstrate 1x4 switch operation controlling the Si-Pho switch by a Stratix V FPGA module, which is responsible for processing the packet ID and correlating its destination with the appropriate BF-labeled outgoing port. DAC- and amplifier-less control of the carrier-injection Si-Pho switches is demonstrated, revealing successful switching of 10Gb/s data packets with BF-based forwarding information changes taking place at a time-scale that equals the duration of four consecutive packets.

Developing a structured education reminiscence-based programme for staff in long-stay care facilities in Ireland.

PubMed

Cooney, Adeline; O'Shea, Eamon; Casey, Dympna; Murphy, Kathy; Dempsey, Laura; Smyth, Siobhan; Hunter, Andrew; Murphy, Edel; Devane, Declan; Jordan, Fionnuala

2013-07-01

This paper describes the steps used in developing and piloting a structured education programme - the Structured Education Reminiscence-based Programme for Staff (SERPS). The programme aimed to prepare nurses and care assistants to use reminiscence when caring for people with dementia living in long-term care. Reminiscence involves facilitating people to talk or think about their past. Structured education programmes are used widely as interventions in randomised controlled trials. However, the process of developing a structured education programme has received little attention relative to that given to evaluating the effectiveness of such programmes. This paper makes explicit the steps followed to develop the SERPS, thereby making a contribution to the methodology of designing and implementing effective structured education programmes. The approach to designing the SERPS was informed by the Van Meijel et al. (2004) model (Journal of Advanced Nursing 48, 84): (1) problem definition, (2) accumulation of building blocks for intervention design, (3) intervention design and (4) intervention validation. Grounded theory was used (1) to generate data to shape the 'building blocks' for the SERPS and (2) to explore residents, family and staff's experience of using/receiving reminiscence. Analysis of the pilot data indicated that the programme met its objective of preparing staff to use reminiscence with residents with dementia. Staff were positive both about the SERPS and the use of reminiscence with residents with dementia. This paper outlines a systematic approach to developing and validating a structured education programme. Participation in a structured education programme is more positive for staff if they are expected to actively implement what they have learnt. Ongoing support during the delivery of the programme is important for successful implementation. The incorporation of client and professional experience in the design phase is a key strength of this approach to programme design. © 2012 Blackwell Publishing Ltd.

Design of transient light signal simulator based on FPGA

NASA Astrophysics Data System (ADS)

Kang, Jing; Chen, Rong-li; Wang, Hong

2014-11-01

A design scheme of transient light signal simulator based on Field Programmable gate Array (FPGA) was proposed in this paper. Based on the characteristics of transient light signals and measured feature points of optical intensity signals, a fitted curve was created in MATLAB. And then the wave data was stored in a programmed memory chip AT29C1024 by using SUPERPRO programmer. The control logic was realized inside one EP3C16 FPGA chip. Data readout, data stream cache and a constant current buck regulator for powering high-brightness LEDs were all controlled by FPGA. A 12-Bit multiplying CMOS digital-to-analog converter (DAC) DAC7545 and an amplifier OPA277 were used to convert digital signals to voltage signals. A voltage-controlled current source constituted by a NPN transistor and an operational amplifier controlled LED array diming to achieve simulation of transient light signal. LM3405A, 1A Constant Current Buck Regulator for Powering LEDs, was used to simulate strong background signal in space. Experimental results showed that the scheme as a transient light signal simulator can satisfy the requests of the design stably.

The First-aid Advice and Safety Training (FAST) parents programme for the prevention of unintentional injuries in preschool children: a protocol.

PubMed

Mytton, Julie A; Towner, Elizabeth Ml; Kendrick, Denise; Stewart-Brown, Sarah; Emond, Alan; Ingram, Jenny; Blair, Peter S; Powell, Jane; Mulvaney, Caroline; Thomas, James; Deave, Toity; Potter, Barbara

2014-02-01

Unintentional injury is the leading cause of preventable death in children in the UK, and 0-4-year-olds frequently attend emergency departments following injuries in the home. Parenting programmes designed to support parents, promote behaviour change and enhance parent-child relationships have been shown to improve health outcomes in children. It is not known whether group-based parenting programmes have the potential to prevent unintentional injuries in preschool children. A study to develop a group-based parenting programme to prevent unintentional home injuries in preschool children, and assess the feasibility of evaluation through a cluster-randomised controlled trial. The intervention, designed for parents of children who have sustained a medically attended injury, will be developed with two voluntary sector organisations. The feasibility study will assess ability to recruit parents, deliver the programme and follow-up participants. Participants will complete questionnaires at baseline, 3 months and 6 months, and report injuries in their preschool children using a tool designed and validated for this study. Qualitative methods will assess user and deliverer perceptions of the programme. This study will develop the first group-based parenting programme to prevent injuries in preschool children, and design tools for parent-reported injury outcomes. A key challenge will be to recruit parents to participate in a manner that is non-stigmatising, and does not result in feelings of guilt or belief that they are perceived to be a bad parent. The findings will be used to prepare a trial to assess the effectiveness and cost-effectiveness of the intervention.

Field programmable chemistry: integrated chemical and electronic processing of informational molecules towards electronic chemical cells.

PubMed

Wagler, Patrick F; Tangen, Uwe; Maeke, Thomas; McCaskill, John S

2012-07-01

The topic addressed is that of combining self-constructing chemical systems with electronic computation to form unconventional embedded computation systems performing complex nano-scale chemical tasks autonomously. The hybrid route to complex programmable chemistry, and ultimately to artificial cells based on novel chemistry, requires a solution of the two-way massively parallel coupling problem between digital electronics and chemical systems. We present a chemical microprocessor technology and show how it can provide a generic programmable platform for complex molecular processing tasks in Field Programmable Chemistry, including steps towards the grand challenge of constructing the first electronic chemical cells. Field programmable chemistry employs a massively parallel field of electrodes, under the control of latched voltages, which are used to modulate chemical activity. We implement such a field programmable chemistry which links to chemistry in rather generic, two-phase microfluidic channel networks that are separated into weakly coupled domains. Electric fields, produced by the high-density array of electrodes embedded in the channel floors, are used to control the transport of chemicals across the hydrodynamic barriers separating domains. In the absence of electric fields, separate microfluidic domains are essentially independent with only slow diffusional interchange of chemicals. Electronic chemical cells, based on chemical microprocessors, exploit a spatially resolved sandwich structure in which the electronic and chemical systems are locally coupled through homogeneous fine-grained actuation and sensor networks and play symmetric and complementary roles. We describe how these systems are fabricated, experimentally test their basic functionality, simulate their potential (e.g. for feed forward digital electrophoretic (FFDE) separation) and outline the application to building electronic chemical cells. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Reduced severity of lumbo-pelvic-hip injuries in professional Rugby Union players following tailored preventative programmes.

PubMed

Evans, Kate L; Hughes, Jonathan; Williams, Morgan D

2018-03-01

The aim of this study was to tailor lumbo-pelvic-hip (LPH) injury reduction programmes in professional rugby union players based on screening data and examine its effectiveness. Prospective case controlled study. Twenty-eight professional rugby union players were screened pre- and immediately post- the YO-YO intermittent recovery level 1 test using six hip and groin strength tests (adductor squeeze at 0°, 60° and 90°, prone hip extension, abductor, adductor hand held dynamometry). The changes in hip and groin measures, were analysed using hierarchical cluster analysis. Three clusters emerged and a tailored LPH injury reduction programme was administered for each cluster. In addition, 22 players who were not involved in the initial testing received a generic LPH injury reduction programme and were used as the control. Seasonal information for LPH injury incidence, severity and prevalence were compared to the previous season. The same number of injuries were observed when the prospective injury surveillance data was compared to the previous season, however a reduced injury severity (936days vs 468days), average severity (78±126days vs 42±37days) and prevalence (21% vs 19%) were found. Moreover, LPH injury severity for players who were prescribed a tailored injury reduction programme (209days) were 50days less than players given a generic LPH injury reduction programme (259days). Our preliminary observations support the effectiveness of grouping players and tailoring intervention based on common group characteristics in reducing the severity of LPH injuries in professional Rugby Union. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Long-term effectiveness of a back education programme in elementary schoolchildren: an 8-year follow-up study.

PubMed

Dolphens, Mieke; Cagnie, Barbara; Danneels, Lieven; De Clercq, Dirk; De Bourdeaudhuij, Ilse; Cardon, Greet

2011-12-01

The purpose of this study was to investigate the long-term effectiveness of a spine care education programme conducted in 9- to 11-year-old schoolchildren. The study sample included 96 intervention subjects and 98 controls (9- to 11-year-olds at baseline). Intervention consisted of a 6-week school-based back education programme (predominantly biomechanically oriented) and was implemented by a physical therapist. Self-reported outcomes on back care knowledge, spinal care behaviour, self-efficacy towards favourable back care behaviour, prevalence of back and neck pain during the week and fear-avoidance beliefs were evaluated by the use of questionnaires. Post-tests were performed within 1 week after programme completion, after 1 year and after 8 years. Whereas the educational back care programme resulted in increased back care knowledge up to adulthood (P < 0.001), intervention did not change spinal care behaviour or self-efficacy. Pain prevalence figures increased less in the experimental group compared to the controls over the 8-year time span, yet statistical significance was not reached. Dropout analysis revealed spinal pain prevalence rates to be different in both groups throughout the study, including at baseline. Back education at young age did not reinforce fear-avoidance beliefs up to adulthood. Predominantly biomechanical oriented back education in elementary schoolchildren is effective in improving the cognitive aspect of back care up to adulthood, yet not in changing actual behaviour or self-efficacy. The current study does not provide evidence that educational back care programmes have any impact on spinal pain in adulthood. The true long-term impact of school-based spinal health interventions on clinically relevant outcome measures merits further attention.

Effectiveness of multifaceted educational programme to reduce antibiotic dispensing in primary care: practice based randomised controlled trial

PubMed Central

Simpson, Sharon A; Dunstan, Frank; Rollnick, Stephen; Cohen, David; Gillespie, David; Evans, Meirion R; health, senior lecturer in epidemiology and public; Alam, M Fasihul; Bekkers, Marie-Jet; Evans, John; Moore, Laurence; Howe, Robin; Hayes, Jamie; Hare, Monika; Hood, Kerenza

2012-01-01

Objective To evaluate the effectiveness and costs of a multifaceted flexible educational programme aimed at reducing antibiotic dispensing at the practice level in primary care. Design Randomised controlled trial with general practices as the unit of randomisation and analysis. Clinicians and researchers were blinded to group allocation until after randomisation. Setting 68 general practices with about 480 000 patients in Wales, United Kingdom. Participants 34 practices were randomised to receive the educational programme and 34 practices to be controls. 139 clinicians from the intervention practices and 124 from control practices had agreed to participate before randomisation. Practice level data covering all the clinicians in the 68 practices were analysed. Interventions Intervention practices followed the Stemming the Tide of Antibiotic Resistance (STAR) educational programme, which included a practice based seminar reflecting on the practices’ own dispensing and resistance data, online educational elements, and practising consulting skills in routine care. Control practices provided usual care. Main outcome measures Total numbers of oral antibiotic items dispensed for all causes per 1000 practice patients in the year after the intervention, adjusted for the previous year’s dispensing. Secondary outcomes included reconsultations, admissions to hospital for selected causes, and costs. Results The rate of oral antibiotic dispensing (items per 1000 registered patients) decreased by 14.1 in the intervention group but increased by 12.1 in the control group, a net difference of 26.1. After adjustment for baseline dispensing rate, this amounted to a 4.2% (95% confidence interval 0.6% to 7.7%) reduction in total oral antibiotic dispensing for the year in the intervention group relative to the control group (P=0.02). Reductions were found for all classes of antibiotics other than penicillinase-resistant penicillins but were largest and significant individually for phenoxymethylpenicillins (penicillin V) (7.3%, 0.4% to 13.7%) and macrolides (7.7%, 1.1% to 13.8%). There were no significant differences between intervention and control practices in the number of admissions to hospital or in reconsultations for a respiratory tract infection within seven days of an index consultation. The mean cost of the programme was £2923 (€3491, $4572) per practice (SD £1187). There was a 5.5% reduction in the cost of dispensed antibiotics in the intervention group compared with the control group (−0.4% to 11.4%), equivalent to a reduction of about £830 a year for an average intervention practice. Conclusion The STAR educational programme led to reductions in all cause oral antibiotic dispensing over the subsequent year with no significant change in admissions to hospital, reconsultations, or costs. Trial registration ISRCT No 63355948. PMID:22302780

A brucellosis disease control strategy for the Kakheti region of the country of Georgia: an agent-based model.

PubMed

Havas, K A; Boone, R B; Hill, A E; Salman, M D

2014-06-01

Brucellosis has been reported in livestock and humans in the country of Georgia with Brucella melitensis as the most common species causing disease. Georgia lacked sufficient data to assess effectiveness of the various potential control measures utilizing a reliable population-based simulation model of animal-to-human transmission of this infection. Therefore, an agent-based model was built using data from previous studies to evaluate the effect of an animal-level infection control programme on human incidence and sheep flock and cattle herd prevalence of brucellosis in the Kakheti region of Georgia. This model simulated the patterns of interaction of human-animal workers, sheep flocks and cattle herds with various infection control measures and returned population-based data. The model simulates the use of control measures needed for herd and flock prevalence to fall below 2%. As per the model output, shepherds had the greatest disease reduction as a result of the infection control programme. Cattle had the greatest influence on the incidence of human disease. Control strategies should include all susceptible animal species, sheep and cattle, identify the species of brucellosis present in the cattle population and should be conducted at the municipality level. This approach can be considered as a model to other countries and regions when assessment of control strategies is needed but data are scattered. © 2013 Blackwell Verlag GmbH.

Early home-based intervention in the Netherlands for children at familial risk of dyslexia.

PubMed

van Otterloo, Sandra G; van der Leij, Aryan; Henrichs, Lotte F

2009-08-01

Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n=23) received a specific training in phoneme awareness and letter knowledge. A control group (n=25) received a non-specific training in morphology, syntax, and vocabulary. Both interventions were designed to take 10 min a day, 5 days a week for 10 weeks. Most parents were sufficiently able to work with the programme properly. At post-test the experimental group had gained more on phoneme awareness than the control group. The control group gained more on one of the morphology measures. On average, these specific training results did not lead to significant group differences in first-grade reading and spelling measures. However, fewer experimental children scored below 10th percentile on word recognition. (c) 2008 John Wiley & Sons, Ltd.

PATHway I: design and rationale for the investigation of the feasibility, clinical effectiveness and cost-effectiveness of a technology-enabled cardiac rehabilitation platform.

PubMed

Claes, Jomme; Buys, Roselien; Woods, Catherine; Briggs, Andrew; Geue, Claudia; Aitken, Moira; Moyna, Niall; Moran, Kieran; McCaffrey, Noel; Chouvarda, Ioanna; Walsh, Deirdre; Budts, Werner; Filos, Dimitris; Triantafyllidis, Andreas; Maglaveras, Nicos; Cornelissen, Véronique A

2017-06-30

Exercise-based cardiac rehabilitation (CR) independently alters the clinical course of cardiovascular diseases resulting in a significant reduction in all-cause and cardiac mortality. However, only 15%-30% of all eligible patients participate in a phase 2 ambulatory programme. The uptake rate of community-based programmes following phase 2 CR and adherence to long-term exercise is extremely poor. Newer care models, involving telerehabilitation programmes that are delivered remotely, show considerable promise for increasing adherence. In this view, the PATHway (Physical Activity Towards Health) platform was developed and now needs to be evaluated in terms of its feasibility and clinical efficacy. In a multicentre randomised controlled pilot trial, 120 participants (m/f, age 40-80 years) completing a phase 2 ambulatory CR programme will be randomised on a 1:1 basis to PATHway or usual care. PATHway involves a comprehensive, internet-enabled, sensor-based home CR platform and provides individualised heart rate monitored exercise programmes (exerclasses and exergames) as the basis on which to provide a personalised lifestyle intervention programme. The control group will receive usual care. Study outcomes will be assessed at baseline, 3 months and 6 months after completion of phase 2 of the CR programme. The primary outcome is the change in active energy expenditure. Secondary outcomes include cardiopulmonary endurance capacity, muscle strength, body composition, cardiovascular risk factors, peripheral endothelial vascular function, patient satisfaction, health-related quality of life (HRQoL), well-being, mediators of behaviour change and safety. HRQoL and healthcare costs will be taken into account in cost-effectiveness evaluation. The study will be conducted in accordance with the Declaration of Helsinki. This protocol has been approved by the director and clinical director of the PATHway study and by the ethical committee of each participating site. Results will be disseminated via peer-reviewed scientific journals and presentations at congresses and events. NCT02717806. This trial is currently in the pre-results stage. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Assessment of vaccination coverage, vaccination scar rates, and smallpox scarring in five areas of West Africa.

PubMed

Henderson, R H; Davis, H; Eddins, D L; Foege, W H

1973-01-01

In 1966, nineteen countries of West and Central Africa began a regional smallpox eradication and measles control programme in cooperation with the World Health Organization. This paper summarizes sample survey data collected to assess the results of the programme in Northern Nigeria (Sokoto and Katsina Provinces), Western Nigeria, Niger, Dahomey, and Togo. These data indicate that the programme, which used mass vaccination campaigns based on a collecting-point strategy, was generally successful in reaching a high proportion of the population. Analysis of vaccination coverage and vaccination scar rates by age underlined the importance to the programme of newborn children who accumulate rapidly following the mass campaign. Of all persons without vaccination scars at the time of the surveys, 34.4% were under 5 years of age; in the absence of a maintenance programme, this figure would rise to 40% after 1 year.

Effect of a universal anxiety prevention programme (FRIENDS) on children's academic performance: results from a randomised controlled trial.

PubMed

Skryabina, Elena; Taylor, Gordon; Stallard, Paul

2016-11-01

Evaluations of school-based anxiety prevention programmes have reported improvements in psychological functioning although little is known about their effect upon educational outcomes. One thousand three hundred and sixty-two children from 40 primary schools in England took part in the randomised controlled trial, Preventing Anxiety in Children through Education in Schools. The trial investigated the effectiveness of a universal school-based cognitive behaviour therapy prevention programme, FRIENDS, delivered by health care staff or school staff compared with usual personal, social, health and education (PSHE) lessons. Self-report psychological outcomes and educational attainment on national standardised attainment tests in reading, writing and maths were collected 12 months postintervention. Analysis was performed at individual level using multivariable mixed effect models controlling for gender, type of intervention and school effect. Registered trial: ISRCTN: 23563048. At 12 months, anxiety reduced in the health-led FRIENDS group compared to school-led FRIENDS and PSHE. There were no between-group differences in academic performance regardless of gender, deprivation, ethnicity and additional educational needs. School-based mental health interventions should assess psychological and educational outcomes. Further research should directly compare the effects of interventions led by health and school staff. © 2016 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

A Nurse-Led School-Based Sun Protection Programme in Turkey.

PubMed

Erkin, Özüm; Temel, Ayla Bayık

2017-12-01

The aim of this study was to determine the effects of a nurse-led school-based sun protection programme in Turkey. A randomized controlled trial was performed at two public schools between February and October 2014. Children with written consent from their parents were screened by nurses for skin type, and 80 children at moderate to high risk for skin cancer were included in the study. The sample was randomized by age, gender and skin type. Stratified and block randomizations were used. The participants were separated into an intervention group (n=40) and control group (n=40). Data were collected using a personal information form and two scales for sun protection behaviour and self-efficacy. In the intervention group, the pretest mean score for sun protection behaviour was 19.25±5.44 and increased significantly in the posttest assessment (33.05±4.23, p<0.001). Self-efficacy scores also increased significantly after the intervention (pretest 20.50±6.68, post-test 35.85±4.70, p<0.001). However, there were no significant increases in mean sun protection behaviour or self-efficacy scores in the control group (p>0.05). A nurse-led school-based sun protection programme effectively promoted children's self-efficacy and sun protection behaviour. Copyright© by the National Institute of Public Health, Prague 2017

Home- or community-based programmes for treating malaria.

PubMed

Okwundu, Charles I; Nagpal, Sukrti; Musekiwa, Alfred; Sinclair, David

2013-05-31

Malaria is an important cause of morbidity and mortality, in particular among children and pregnant women in sub-Saharan Africa. Prompt access to diagnosis and treatment with effective antimalarial drugs is a central component of the World Health Organization's (WHO) strategy for malaria control. Home- or community-based programmes for managing malaria are one strategy that has been proposed to overcome the geographical barrier to malaria treatment.  To evaluate home- and community-based management strategies for treating malaria. We searched the Cochrane Central Register of Controlled Trials published in The Cochrane Library; MEDLINE; EMBASE; Science Citation Index; PsycINFO/LIT; CINAHL; WHO clinical trial registry platform; and the metaRegister of Controlled Trials up to September 2012. Randomized controlled trials (RCTs) and non-RCTs that evaluated the effects of a home- or community-based programme for treating malaria in a malaria endemic setting. Two authors independently screened and selected studies, extracted data, and assessed the risk of bias. Where possible the effects of interventions are compared using risk ratios (RR), and presented with 95% confidence intervals (CI). The quality of the evidence was assessed using the GRADE approach. We identified 10 trials that met the inclusion criteria. The interventions involved brief training of basic-level health workers or mothers, and most provided the antimalarial for free or at a highly subsidized cost. In eight of the studies, fevers were treated presumptively without parasitological confirmation with microscopy or a rapid diagnostic test (RDT). Two studies trained community health workers to use RDTs as a component of community management of fever.Home- or community-based strategies probably increase the number of people with fever who receive an appropriate antimalarial within 24 hours (RR 2.27, 95% CI 1.79 to 2.88 in one trial; RR 9.79, 95% CI 6.87 to 13.95 in a second trial; 3099 participants, moderate quality evidence). They may also reduce all-cause mortality, but to date this has only been demonstrated in rural Ethiopia (RR 0.58, 95% CI 0.44 to 0.77, one trial, 13,677 participants, moderate quality evidence).Hospital admissions in children were reported in one small trial from urban Uganda, with no effect detected (437 participants, very low quality evidence). No studies reported on severe malaria. For parasitaemia prevalence, the study from urban Uganda demonstrated a reduction in community parasite prevalence (RR 0.22, 95% CI 0.08 to 0.64, 365 participants), but a second study in rural Burkina Faso did not (1006 participants). Home- or community-based programmes may have little or no effect on the prevalence of anaemia (three trials, 3612 participants, low quality evidence). None of the included studies reported on adverse effects of using home- or community-based programmes for treating malaria.In two studies which trained community health workers to only prescribe antimalarials after a positive RDT, prescriptions of antimalarials were reduced compared to the control group where community health workers used clinical diagnosis (RR 0.39, 95% CI 0.18 to 0.84, two trials, 5944 participants, moderate quality evidence). In these two studies, mortality and hospitalizations remained very low in both groups despite the lower use of antimalarials (two trials, 5977 participants, low quality evidence). Home- or community-based interventions which provide antimalarial drugs free of charge probably improve prompt access to antimalarials, and there is moderate quality evidence from rural Ethiopia that they may impact on childhood mortality when implemented in appropriate settings.Programmes which treat all fevers presumptively with antimalarials lead to overuse antimalarials, and potentially undertreat other causes of fever such as pneumonia. Incorporating RDT diagnosis into home- or community-based programmes for malaria may help to reduce this overuse of antimalarials, and has been shown to be safe under trial conditions.

Field-programmable beam reconfiguring based on digitally-controlled coding metasurface

NASA Astrophysics Data System (ADS)

Wan, Xiang; Qi, Mei Qing; Chen, Tian Yi; Cui, Tie Jun

2016-02-01

Digital phase shifters have been applied in traditional phased array antennas to realize beam steering. However, the phase shifter deals with the phase of the induced current; hence, it has to be in the path of each element of the antenna array, making the phased array antennas very expensive. Metamaterials and/or metasurfaces enable the direct modulation of electromagnetic waves by designing subwavelength structures, which opens a new way to control the beam scanning. Here, we present a direct digital mechanism to control the scattered electromagnetic waves using coding metasurface, in which each unit cell loads a pin diode to produce binary coding states of “1” and “0”. Through data lines, the instant communications are established between the coding metasurface and the internal memory of field-programmable gate arrays (FPGA). Thus, we realize the digital modulation of electromagnetic waves, from which we present the field-programmable reflective antenna with good measurement performance. The proposed mechanism and functional device have great application potential in new-concept radar and communication systems.

Effect of an Education Programme for South Asians with Asthma and Their Clinicians: A Cluster Randomised Controlled Trial (OEDIPUS)

PubMed Central

Griffiths, Chris; Bremner, Stephen; Islam, Kamrul; Sohanpal, Ratna; Vidal, Debi-Lee; Dawson, Carolyn; Foster, Gillian; Ramsay, Jean; Feder, Gene; Taylor, Stephanie; Barnes, Neil; Choudhury, Aklak; Packe, Geoff; Bayliss, Elizabeth; Trathen, Duncan; Moss, Philip; Cook, Viv; Livingstone, Anna Eleri; Eldridge, Sandra

2016-01-01

Background People with asthma from ethnic minority groups experience significant morbidity. Culturally-specific interventions to reduce asthma morbidity are rare. We tested the hypothesis that a culturally-specific education programme, adapted from promising theory-based interventions developed in the USA, would reduce unscheduled care for South Asians with asthma in the UK. Methods A cluster randomised controlled trial, set in two east London boroughs. 105 of 107 eligible general practices were randomised to usual care or the education programme. Participants were south Asians with asthma aged 3 years and older with recent unscheduled care. The programme had two components: the Physician Asthma Care Education (PACE) programme and the Chronic Disease Self Management Programme (CDSMP), targeted at clinicians and patients with asthma respectively. Both were culturally adapted for south Asians with asthma. Specialist nurses, and primary care teams from intervention practices were trained using the PACE programme. South Asian participants attended an outpatient appointment; those registered with intervention practices received self-management training from PACE-trained specialist nurses, a follow-up appointment with PACE-trained primary care practices, and an invitation to attend the CDSMP. Patients from control practices received usual care. Primary outcome was unscheduled care. Findings 375 south Asians with asthma from 84 general practices took part, 183 registered with intervention practices and 192 with control practices. Primary outcome data were available for 358/375 (95.5%) of participants. The intervention had no effect on time to first unscheduled attendance for asthma (Adjusted Hazard Ratio AHR = 1.19 95% CI 0.92 to 1.53). Time to first review in primary care was reduced (AHR = 2.22, (1.67 to 2.95). Asthma-related quality of life and self-efficacy were improved at 3 months (adjusted mean difference -2.56, (-3.89 to -1.24); 0.44, (0.05 to 0.82) respectively. Conclusions A multi-component education programme adapted for south Asians with asthma did not reduce unscheduled care but did improve follow-up in primary care, self-efficacy and quality of life. More effective interventions are needed for south Asians with asthma. PMID:28030569

Parental depression and child conduct problems: evaluation of parental service use and associated costs after attending the Incredible Years Basic Parenting Programme

PubMed Central

2013-01-01

Background There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children’s health and social care service use, but little is known about the programme’s impact on parental service use. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme. Methods This is a secondary analysis of a subsample (N = 119) from the first U.K. community-based randomised controlled trial of the 12-week IY Basic Programme (N = 153). Parents with children at risk of developing conduct disorder were randomised to receive the programme or to a waiting-list control group. BDI II total and BDI II clinical depression cut-off scores were compared to frequencies and costs of parents’ service use, at baseline, six, twelve and eighteen months post-baseline for the intervention group and at baseline and six months post-baseline for the control group. Results Intervention group parents who scored above the clinical cut-off on the BDI II at baseline used more health and social care services than those who scored below at baseline, six and eighteen months. Significant reductions in service use frequencies were found for the intervention group only. Conclusion Parents with higher levels or depression used more health and social care service and parenting programmes have been shown to reduce parental depression and also health and social service use. However, further exploration of depressed parents’ service use and the cost implications for publically funded health and social care services is needed. Trial registration Registration of the original RCT of the IY Basic Parenting Programme - Current Controlled Trials ISRCTN46984318 PMID:24350571

Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review.

PubMed

Lussiana, Cristina

2016-09-01

The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Planning and implementing a nationwide football-based health-education programme.

PubMed

Dvorak, Jiri; Fuller, Colin W; Junge, Astrid

2012-01-01

Communicable and non-communicable diseases place enormous social and economic burdens on developed and developing countries. Health education leading to changes in people's attitudes and behaviours remains the best approach for reducing the problem of communicable diseases while there is evidence that programmes providing regular physical exercise and advocating a controlled diet can reduce the prevalence of many non-communicable diseases. Hence, the delivery of health education and physical activity within a single coherent programme offers great potential for simultaneously addressing both health issues. Since 2006, FIFA has developed and tested a novel football-based health-education programme for children entitled '11 for Health', which is aimed at increasing children's levels of physical activity while also delivering 11 simple health messages. When new interventions of this type are published in the scientific literature, it is often not possible to describe important background information about the project that could assist other researchers in developing and implementing similar programmes. This paper attempts to bridge this gap by describing the aims and objectives, organisation, planning, implementation and monitoring requirements needed to deliver FIFA's '11 for Health' programme, first as a pilot project and subsequently as a nationwide project, through a tripartite arrangement between FIFA, the national Football Association and the Government Ministries in Mauritius.

Planning and implementing a nationwide football-based health-education programme

PubMed Central

Dvorak, Jiri; Fuller, Colin W; Junge, Astrid

2012-01-01

Communicable and non-communicable diseases place enormous social and economic burdens on developed and developing countries. Health education leading to changes in people's attitudes and behaviours remains the best approach for reducing the problem of communicable diseases while there is evidence that programmes providing regular physical exercise and advocating a controlled diet can reduce the prevalence of many non-communicable diseases. Hence, the delivery of health education and physical activity within a single coherent programme offers great potential for simultaneously addressing both health issues. Since 2006, FIFA has developed and tested a novel football-based health-education programme for children entitled ‘11 for Health’, which is aimed at increasing children's levels of physical activity while also delivering 11 simple health messages. When new interventions of this type are published in the scientific literature, it is often not possible to describe important background information about the project that could assist other researchers in developing and implementing similar programmes. This paper attempts to bridge this gap by describing the aims and objectives, organisation, planning, implementation and monitoring requirements needed to deliver FIFA's ‘11 for Health’ programme, first as a pilot project and subsequently as a nationwide project, through a tripartite arrangement between FIFA, the national Football Association and the Government Ministries in Mauritius. PMID:22144002

Humans, 'things' and space: costing hospital infection control interventions.

PubMed

Page, K; Graves, N; Halton, K; Barnett, A G

2013-07-01

Previous attempts at costing infection control programmes have tended to focus on accounting costs rather than economic costs. For studies using economic costs, estimates tend to be quite crude and probably underestimate the true cost. One of the largest costs of any intervention is staff time, but this cost is difficult to quantify and has been largely ignored in previous attempts. To design and evaluate the costs of hospital-based infection control interventions or programmes. This article also discusses several issues to consider when costing interventions, and suggests strategies for overcoming these issues. Previous literature and techniques in both health economics and psychology are reviewed and synthesized. This article provides a set of generic, transferable costing guidelines. Key principles such as definition of study scope and focus on large costs, as well as pitfalls (e.g. overconfidence and uncertainty), are discussed. These new guidelines can be used by hospital staff and other researchers to cost their infection control programmes and interventions more accurately. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial.

PubMed

Finch, Caroline F; Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

2016-04-01

Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Household perceptions and subjective valuations of indoor residual spraying programmes to control malaria in northern Uganda.

PubMed

Brown, Zachary S; Kramer, Randall A; Ocan, David; Oryema, Christine

2016-10-06

Insecticide-based tools remain critical for controlling vector-borne diseases in Uganda. Securing public support from targeted populations for such tools is an important component in sustaining their long-run effectiveness. Yet little quantitative evidence is available on the perceived benefits and costs of vector control programmes among targeted households. A survey was administered to a clustered random sample of 612 households in Gulu and Oyam districts of northern Uganda during a period of very high malaria transmission and following a pilot indoor residual spray (IRS) programme. A discrete choice experiment was conducted within the survey, in which respondents indicated their preferences for different IRS programmes relative to money compensation in a series of experimentally controlled, hypothetical choice sets. The data were analysed using conditional logit regression models to estimate respondents' willingness to accept (WTA) some amount of money compensation in lieu of foregone malaria risk reductions. Latent class models were used to analyse whether respondent characteristics predicted WTA. Average WTA is estimated at $8.94 annually for a 10 % reduction in malaria risk, and additional co-benefits of IRS were estimated to be worth on average $54-$56 (depending on insecticide type) per round of IRS. Significant heterogeneity is observed: Four in five household heads in northern Uganda have high valuations for IRS programmes, while the remaining 20 % experience costly side effects of IRS (valued at between $2 and $3 per round). Statistically significant predictors of belonging to the high-value group include respondent gender, mean age of household members, participation in previous IRS, basic knowledge of mosquito reproduction, and the number of mosquito nets owned. Proxies for household income and wealth are not found to be statistically significant predictors of WTA. This study suggests that the majority of people in areas of high malaria transmission like northern Uganda place a high value on vector control programmes using IRS. However, there is significant heterogeneity in terms of the perceived side effects (positive and negative). This has implications for sustaining public support for these programmes in the long-term.

Parental depression and child conduct problems: evaluation of parental service use and associated costs after attending the Incredible Years Basic Parenting Programme.

PubMed

Charles, Joanna M; Bywater, Tracey J; Edwards, Rhiannon Tudor; Hutchings, Judy; Zou, Lu

2013-12-18

There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children's health and social care service use, but little is known about the programme's impact on parental service use. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme. This is a secondary analysis of a subsample (N = 119) from the first U.K. community-based randomised controlled trial of the 12-week IY Basic Programme (N = 153). Parents with children at risk of developing conduct disorder were randomised to receive the programme or to a waiting-list control group. BDI II total and BDI II clinical depression cut-off scores were compared to frequencies and costs of parents' service use, at baseline, six, twelve and eighteen months post-baseline for the intervention group and at baseline and six months post-baseline for the control group. Intervention group parents who scored above the clinical cut-off on the BDI II at baseline used more health and social care services than those who scored below at baseline, six and eighteen months. Significant reductions in service use frequencies were found for the intervention group only. Parents with higher levels or depression used more health and social care service and parenting programmes have been shown to reduce parental depression and also health and social service use. However, further exploration of depressed parents' service use and the cost implications for publically funded health and social care services is needed.

A tool box for operational mosquito larval control: preliminary results and early lessons from the Urban Malaria Control Programme in Dar es Salaam, Tanzania

PubMed Central

Fillinger, Ulrike; Kannady, Khadija; William, George; Vanek, Michael J; Dongus, Stefan; Nyika, Dickson; Geissbühler, Yvonne; Chaki, Prosper P; Govella, Nico J; Mathenge, Evan M; Singer, Burton H; Mshinda, Hassan; Lindsay, Steven W; Tanner, Marcel; Mtasiwa, Deo; de Castro, Marcia C; Killeen, Gerry F

2008-01-01

Background As the population of Africa rapidly urbanizes, large populations could be protected from malaria by controlling aquatic stages of mosquitoes if cost-effective and scalable implementation systems can be designed. Methods A recently initiated Urban Malaria Control Programme in Dar es Salaam delegates responsibility for routine mosquito control and surveillance to modestly-paid community members, known as Community-Owned Resource Persons (CORPs). New vector surveillance, larviciding and management systems were designed and evaluated in 15 city wards to allow timely collection, interpretation and reaction to entomologic monitoring data using practical procedures that rely on minimal technology. After one year of baseline data collection, operational larviciding with Bacillus thuringiensis var. israelensis commenced in March 2006 in three selected wards. Results The procedures and staff management systems described greatly improved standards of larval surveillance relative to that reported at the outset of this programme. In the first year of the programme, over 65,000 potential Anopheles habitats were surveyed by 90 CORPs on a weekly basis. Reaction times to vector surveillance at observations were one day, week and month at ward, municipal and city levels, respectively. One year of community-based larviciding reduced transmission by the primary malaria vector, Anopheles gambiae s.l., by 31% (95% C.I. = 21.6–37.6%; p = 0.04). Conclusion This novel management, monitoring and evaluation system for implementing routine larviciding of malaria vectors in African cities has shown considerable potential for sustained, rapidly responsive, data-driven and affordable application. Nevertheless, the true programmatic value of larviciding in urban Africa can only be established through longer-term programmes which are stably financed and allow the operational teams and management infrastructures to mature by learning from experience. PMID:18218148

A combined drama-based and CBT approach to working with self-reported anger aggression.

PubMed

Blacker, Janine; Watson, Andy; Beech, Anthony R

2008-01-01

A drama-based programme, called 'Insult to Injury', was designed to explore the processes of anger, aggression and violence. The aim of the programme was to enable offenders to identify and generate strategies and skills for dealing with potentially volatile situations, and to provide a safe and supportive environment in which to practice and evaluate these strategies. AIMS An active drama-based approach combined with cognitive-behavioural techniques was used to explore issues such as masculinity, power and control, pride and shame and victim awareness. Reductions in anger were hypothesized. METHOD A single group pre/post design assessed the levels of anger before and after the course. RESULTS Sixty-two adult male offenders from six prison establishments in the UK took part in the nine-day course. As hypothesised, significant reductions in anger were found in pre- to post-course assessment. These results suggest that a drama-based approach may be a promising adjunct to traditional anger management programmes for violent offenders.

Thermal monitoring, measurement, and control system for a Volatile Condensable Materials (VCM) test apparatus

NASA Technical Reports Server (NTRS)

Ives, R. E.

1982-01-01

A thermal monitoring and control concept is described for a volatile condensable materials (VCM) test apparatus where electric resistance heaters are employed. The technique is computer based, but requires only proportioning ON/OFF relay control signals supplied through a programmable scanner and simple quadrac power controllers. System uniqueness is derived from automatic temperature measurements and the averaging of these measurements in discrete overlapping temperature zones. Overall control tolerance proves to be better than + or - 0.5 C from room ambient temperature to 150 C. Using precisely calibrated thermocouples, the method provides excellent temperature control of a small copper VCM heating plate at 125 + or - 0.2 C over a 24 hr test period. For purposes of unattended operation, the programmable computer/controller provides a continual data printout of system operation. Real time operator command is also provided for, as is automatic shutdown of the system and operator alarm in the event of malfunction.

Randomised controlled trial of a web-based programme in sustaining best practice alcohol management practices at community sports clubs: a study protocol

PubMed Central

McFadyen, Tameka; Kingsland, Melanie; Tindall, Jennifer; Rowland, Bosco; Sherker, Shauna; Gillham, Karen; Heaton, Rachael; Clinton-McHarg, Tara; Lecathelinais, Christophe; Brooke, Daisy; Wiggers, John

2018-01-01

Introduction Community-based interventions have been found to effectively increase the implementation of alcohol management practices and reduce excessive alcohol use and alcohol-related harm at sports clubs. However, once implementation support ceases there may be a reduction in such intervention effects. Thus, ongoing contribution to improving the health of the community is diminished; sustaining practice implementation is a key determinant to address this. One possible solution to the strategic and logistical challenges of sustainability involves the use of the web. The primary aim of this study is to assess the effectiveness of a web-based programme in sustaining the implementation of alcohol management practices by community football clubs. The secondary aim is to assess the effectiveness of the programme in preventing excessive alcohol consumption and alcohol-related harm among members of community football clubs. Methods and analysis The study will employ a repeat randomised controlled trial design and be conducted in regional and metropolitan areas within two states of Australia. Community level football clubs who are currently accredited with an existing alcohol management programme (‘Good Sports’) and implementing at least 10 of the 13 core alcohol management practices (eg, not serving alcohol to <18-year-olds) required by the programme will be recruited and randomised to either a web-based sustainability programme or a ‘minimal contact’ programme. The primary outcome measures are the proportion of football clubs implementing ≥10 of the 13 required alcohol management practices and the mean number of those practices being implemented at 3-year follow-up. Secondary outcomes include: the proportion of club members who report risky drinking at their club, the Alcohol Use Disorder Identification Test (AUDIT) score and mean AUDIT score of club members. Outcome data will be collected via observation at the club during a 1-day visit to a home game, conducted by trained research assistants at baseline and follow-up. Ethics and dissemination The study was approved by The University of Newcastle Human Research Ethics Committee (reference: H-2013-0429). Study findings will be disseminated widely through peer-reviewed publications and conference presentations. Trial registration number ACTRN12614000746639; Pre-results. PMID:29362250

Two-year effects of a school-based prevention programme on adolescent cigarette smoking in Guangzhou, China: a cluster randomized trial

PubMed Central

Wen, Xiaozhong; Chen, Weiqing; Gans, Kim M; Colby, Suzanne M; Lu, Ciyong; Liang, Caihua; Ling, Wenhua

2010-01-01

Background The prevalence of adolescent smoking has been increasing rapidly in China. Theory-based smoking prevention programmes in schools may be an effective approach in preventing smoking among Chinese adolescents. Methods A school-level cluster randomized controlled trial was conducted among 7th and 8th grade students (N = 2343) in four junior high schools in southern China during 2004–06. The theory-based, multi-level intervention was compared with the standard health curriculum. Outcome measures comprised changes in students’ smoking-related knowledge, attitudes and behaviour. Results The mean knowledge scores from baseline to the 1- and 2-year follow-ups increased more in the intervention group than in the control group, whereas there was little change in attitude scores. At the 1-year follow-up (the total sample), the interventions reduced the probability of baseline experimental smokers’ escalating to regular smoker [7.9 vs 18.3%; adjusted odds ratio (OR) 0.34, 95% confidence interval (CI) 0.12–0.97, P = 0.043], but did not reduce the probability of baseline non-smokers’ initiating smoking (7.9 vs 10.6%; adjusted OR 0.86, 95% CI 0.54–1.38, P = 0.538). At the 2-year follow-up (only 7th grade students), similar proportions of baseline non-smokers initiated smoking in the intervention group and the control group (13.5 vs 13.1%), while a possibly lower proportion of baseline experimental smokers escalated to regular smoking in the intervention group than the control group (22.6 vs 40.0%; adjusted OR 0.43, 95% CI 0.12–1.57, P = 0.199). Conclusions This multi-level intervention programme had a moderate effect on inhibiting the escalation from experimental to regular smoking among Chinese adolescents, but had little effect on the initiation of smoking. The programme improved adolescents’ smoking-related knowledge, but did not change their attitudes towards smoking. PMID:20236984

Effect of a Physical Education-Based Stretching Programme on Sit-and-Reach Score and Its Posterior Reduction in Elementary Schoolchildren

ERIC Educational Resources Information Center

Merino-Marban, Rafael; Mayorga-Vega, Daniel; Fernandez-Rodriguez, Emilio; Estrada, Francisco Vera; Viciana, Jesús

2015-01-01

The purpose of this study was to examine the effects of a 1-minute stretching programme and 5 weeks of detraining on sit-and-reach score among schoolchildren aged 5-6 years in a physical education setting. Forty-five schoolchildren 5-6 years old from two classes were clustered randomly assigned to an experimental group (n = 23) or a control group…

Rapid case-based mapping of seasonal malaria transmission risk for strategic elimination planning in Swaziland

PubMed Central

2013-01-01

Background As successful malaria control programmes move towards elimination, they must identify residual transmission foci, target vector control to high-risk areas, focus on both asymptomatic and symptomatic infections, and manage importation risk. High spatial and temporal resolution maps of malaria risk can support all of these activities, but commonly available malaria maps are based on parasite rate, a poor metric for measuring malaria at extremely low prevalence. New approaches are required to provide case-based risk maps to countries seeking to identify remaining hotspots of transmission while managing the risk of transmission from imported cases. Methods Household locations and travel histories of confirmed malaria patients during 2011 were recorded through routine surveillance by the Swaziland National Malaria Control Programme for the higher transmission months of January to April and the lower transmission months of May to December. Household locations for patients with no travel history to endemic areas were compared against a random set of background points sampled proportionate to population density with respect to a set of variables related to environment, population density, vector control, and distance to the locations of identified imported cases. Comparisons were made separately for the high and low transmission seasons. The Random Forests regression tree classification approach was used to generate maps predicting the probability of a locally acquired case at 100 m resolution across Swaziland for each season. Results Results indicated that case households during the high transmission season tended to be located in areas of lower elevation, closer to bodies of water, in more sparsely populated areas, with lower rainfall and warmer temperatures, and closer to imported cases than random background points (all p < 0.001). Similar differences were evident during the low transmission season. Maps from the fit models suggested better predictive ability during the high season. Both models proved useful at predicting the locations of local cases identified in 2012. Conclusions The high-resolution mapping approaches described here can help elimination programmes understand the epidemiology of a disappearing disease. Generating case-based risk maps at high spatial and temporal resolution will allow control programmes to direct interventions proactively according to evidence-based measures of risk and ensure that the impact of limited resources is maximized to achieve and maintain malaria elimination. PMID:23398628

Rapid case-based mapping of seasonal malaria transmission risk for strategic elimination planning in Swaziland.

PubMed

Cohen, Justin M; Dlamini, Sabelo; Novotny, Joseph M; Kandula, Deepika; Kunene, Simon; Tatem, Andrew J

2013-02-11

As successful malaria control programmes move towards elimination, they must identify residual transmission foci, target vector control to high-risk areas, focus on both asymptomatic and symptomatic infections, and manage importation risk. High spatial and temporal resolution maps of malaria risk can support all of these activities, but commonly available malaria maps are based on parasite rate, a poor metric for measuring malaria at extremely low prevalence. New approaches are required to provide case-based risk maps to countries seeking to identify remaining hotspots of transmission while managing the risk of transmission from imported cases. Household locations and travel histories of confirmed malaria patients during 2011 were recorded through routine surveillance by the Swaziland National Malaria Control Programme for the higher transmission months of January to April and the lower transmission months of May to December. Household locations for patients with no travel history to endemic areas were compared against a random set of background points sampled proportionate to population density with respect to a set of variables related to environment, population density, vector control, and distance to the locations of identified imported cases. Comparisons were made separately for the high and low transmission seasons. The Random Forests regression tree classification approach was used to generate maps predicting the probability of a locally acquired case at 100 m resolution across Swaziland for each season. Results indicated that case households during the high transmission season tended to be located in areas of lower elevation, closer to bodies of water, in more sparsely populated areas, with lower rainfall and warmer temperatures, and closer to imported cases than random background points (all p < 0.001). Similar differences were evident during the low transmission season. Maps from the fit models suggested better predictive ability during the high season. Both models proved useful at predicting the locations of local cases identified in 2012. The high-resolution mapping approaches described here can help elimination programmes understand the epidemiology of a disappearing disease. Generating case-based risk maps at high spatial and temporal resolution will allow control programmes to direct interventions proactively according to evidence-based measures of risk and ensure that the impact of limited resources is maximized to achieve and maintain malaria elimination.

Increasing leadership capacity for HIV/AIDS programmes by strengthening public health epidemiology and management training in Zimbabwe

PubMed Central

Jones, Donna S; Tshimanga, Mufuta; Woelk, Godfrey; Nsubuga, Peter; Sunderland, Nadine L; Hader, Shannon L; St Louis, Michael E

2009-01-01

Background Increased funding for global human immunodeficiency virus prevention and control in developing countries has created both a challenge and an opportunity for achieving long-term global health goals. This paper describes a programme in Zimbabwe aimed at responding more effectively to the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public health leaders. Methods The programme used new HIV/AIDS programme-specific funds to build on the assets of a local education institution to strengthen and expand the general public health leadership capacity in Zimbabwe, simultaneously ensuring that they were trained in HIV interventions. Results The programme increased both numbers of graduates and retention of faculty. The expanded HIV/AIDS curriculum was associated with a substantial increase in trainee projects related to HIV. The increased number of public health professionals has led to a number of practically trained persons working in public health leadership positions in the ministry, including in HIV/AIDS programmes. Conclusion Investment of a modest proportion of new HIV/AIDS resources in targeted public health leadership training programmes can assist in building capacity to lead and manage national HIV and other public health programmes. PMID:19664268

The REFANI Pakistan study--a cluster randomised controlled trial of the effectiveness and cost-effectiveness of cash-based transfer programmes on child nutrition status: study protocol.

PubMed

Fenn, Bridget; Sangrasi, Ghulam Murtaza; Puett, Chloe; Trenouth, Lani; Pietzsch, Silke

2015-10-12

Cash-based transfer programmes are an emerging strategy in the prevention of wasting in children, especially targeted at vulnerable households during periods of food insecurity or during emergencies. However, the evidence surrounding the use of either cash or voucher transfer programmes in the humanitarian context and on nutritional outcomes is elusive. More evidence is needed not only to inform the global community of practice on best practices in humanitarian settings, but also to help strengthen national mitigation responses. The Research for Food Assistance on Nutrition Impact Pakistan study (REFANI-P) sets out to evaluate the impact of three cash-based interventions on nutritional outcomes in children aged less than five years from poor and very poor households in Dadu District. This four-arm parallel cluster randomised controlled trial is set among Action Against Hunger (ACF) programme villages in Dadu District, Sindh Province. Mothers are the target recipients of either seasonal unconditional cash transfers or fresh food vouchers. A comparison group receives 'standard care' provided by the ACF programme to which all groups have the same access. The primary outcomes are prevalence of wasting and mean weight-for-height Z-score (WHZ) in children. Impact will be assessed at 6 months and at 1 year from baseline. Using a theory-based approach we will determine 'how' the different interventions work by looking at the processes involved and the impact pathways following the theory of change developed for this context. Quantitative and qualitative data are collected on morbidity, health seeking, hygiene and nutrition behaviours, dietary diversity, haemoglobin concentration, women's empowerment, household food security and expenditures and social capital. The direct and indirect costs of each intervention borne by the implementing organisation and their partners as well as by beneficiaries and their communities are also assessed. The results of this trial will provide robust evidence to help increase knowledge about the predictability of how different modalities of cash-based transfer work best to reduce the risk of child wasting during a season where food insecurity is at its highest. Evidence on costing and cost-effectiveness will further aid decisions on choice of modality in terms of effectiveness and sustainability. Current Controlled Trials ISRCTN10761532 . Registered 26 March 2015.

Policy Innovation and Policy Pathways: Tuberculosis Control in Sri Lanka, 1948-1990.

PubMed

Jones, Margaret

2016-10-01

This paper, based on World Health Organization and Sri Lankan sources, examines the attempts to control tuberculosis in Sri Lanka from independence in 1948. It focuses particularly on the attempt in 1966 to implement a World Health Organization model of community-orientated tuberculosis control that sought to establish a horizontally structured programme through the integration of control into the general health services. The objective was to create a cost- effective method of control that relied on a simple bacteriological test for case finding and for treatment at the nearest health facility that would take case detection and treatment to the rural periphery where specialist services were lacking. In the late 1940s and early 1950s, Sri Lanka had already established a specialist control programme composed of chest clinics, mass X-ray, inpatient and domiciliary treatment, and social assistance for sufferers. This programme had both reduced mortality and enhanced awareness of the disease. This paper exposes the obstacles presented in trying to impose the World Health Organization's internationally devised model onto the existing structure of tuberculosis control already operating in Sri Lanka. One significant hindrance to the WHO approach was lack of resources but, equally important, was the existing medical culture that militated against its acceptance.

Policy Innovation and Policy Pathways: Tuberculosis Control in Sri Lanka, 1948–1990

PubMed Central

Jones, Margaret

2016-01-01

This paper, based on World Health Organization and Sri Lankan sources, examines the attempts to control tuberculosis in Sri Lanka from independence in 1948. It focuses particularly on the attempt in 1966 to implement a World Health Organization model of community-orientated tuberculosis control that sought to establish a horizontally structured programme through the integration of control into the general health services. The objective was to create a cost- effective method of control that relied on a simple bacteriological test for case finding and for treatment at the nearest health facility that would take case detection and treatment to the rural periphery where specialist services were lacking. In the late 1940s and early 1950s, Sri Lanka had already established a specialist control programme composed of chest clinics, mass X-ray, inpatient and domiciliary treatment, and social assistance for sufferers. This programme had both reduced mortality and enhanced awareness of the disease. This paper exposes the obstacles presented in trying to impose the World Health Organization’s internationally devised model onto the existing structure of tuberculosis control already operating in Sri Lanka. One significant hindrance to the WHO approach was lack of resources but, equally important, was the existing medical culture that militated against its acceptance. PMID:27628860

47 CFR 95.1209 - Permissible communications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... to which the MedRadio implant or body-worn transmitter is used. (c) MedRadio programmer/control...Radio programmer/control transmitters may transmit only non-voice data containing operational... shall transmit except in response to a transmission from a MedRadio programmer/control transmitter or in...

Programmable Logic Controllers.

ERIC Educational Resources Information Center

Insolia, Gerard; Anderson, Kathleen

This document contains a 40-hour course in programmable logic controllers (PLC), developed for a business-industry technology resource center for firms in eastern Pennsylvania by Northampton Community College. The 10 units of the course cover the following: (1) introduction to programmable logic controllers; (2) DOS primer; (3) prerequisite…

Social control and coercion in addiction treatment: towards evidence-based policy and practice.

PubMed

Wild, T Cameron

2006-01-01

Social pressures are often an integral part of the process of seeking addiction treatment. However, scientists have not developed conclusive evidence on the processes, benefits and limitations of using legal, formal and informal social control tactics to inform policy makers, service providers and the public. This paper characterizes barriers to a robust interdisciplinary analysis of social control and coercion in addiction treatment and provides directions for future research. Conceptual analysis and review of key studies and trends in the area are used to describe eight implicit assumptions underlying policy, practice and scholarship on this topic. Many policies, programmes and researchers are guided by a simplistic behaviourist and health-service perspective on social controls that (a) overemphasizes the use of criminal justice systems to compel individuals into treatment and (b) fails to take into account provider, patient and public views. Policies and programmes that expand addiction treatment options deserve support. However, drawing a firm distinction between social controls (objective use of social pressure) and coercion (client perceptions and decision-making processes) supports a parallel position that rejects treatment policies, programmes, and associated practices that create client perceptions of coercion.

Farmer attitudes to vaccination and culling of badgers in controlling bovine tuberculosis.

PubMed

Warren, M; Lobley, M; Winter, M

2013-07-13

Controversy persists in England, Wales and Northern Ireland concerning methods of controlling the transmission of bovine tuberculosis (bTB) between badgers and cattle. The National Trust, a major land-owning heritage organisation, in 2011, began a programme of vaccinating badgers against bTB on its Killerton Estate in Devon. Most of the estate is farmed by 18 tenant farmers, who thus have a strong interest in the Trust's approach, particularly as all have felt the effects of the disease. This article reports on a study of the attitudes to vaccination of badgers and to the alternative of a culling programme, using face-to-face interviews with 14 of the tenants. The results indicated first that the views of the respondents were more nuanced than the contemporary public debate about badger control would suggest. Secondly, the attitude of the interviewees to vaccination of badgers against bTB was generally one of resigned acceptance. Thirdly, most respondents would prefer a combination of an effective vaccination programme with an effective culling programme, the latter reducing population of density sufficiently (and preferably targeting the badgers most likely to be diseased) for vaccination to have a reasonable chance of success. While based on a small sample, these results will contribute to the vigorous debate concerning contrasting policy approaches to bTB control in England, Wales and Northern Ireland.

A controlled clinical evaluation of the Parents Plus Children's Programme for parents of children aged 6-12 with mild intellectual disability in a school setting.

PubMed

Hand, Ailish; Raghallaigh, Ciara Ní; Cuppage, Jennifer; Coyle, Sadhbh; Sharry, John

2013-10-01

The aim of this study was to evaluate the effectiveness of the parent training, Parents Plus Children's Programme (PPCP) as an intervention for parents of children with mild intellectual disabilities. Participants were parents of children, aged six to 12, attending a special school for children with mild general learning disability (n = 29). Minor programme adaptations were made. Pre and post-assessment included the Strengths and Difficulties Questionnaire, the Parenting Stress Index, the Kansas Parent Satisfaction Scale and parent identified personal and child-related goals. A significant reduction in clinical range scores for treatment group participants (n = 16) was observed. Conversely, clinical range scores for control group participants (n = 13) increased, or remained elevated. These preliminary results suggest that PPCP may be successfully delivered as a routine community-based intervention and aid to prevent and reduce behavioural problems, reduce parent stress and increase parent confidence and satisfaction. Further investigation of programme effectiveness for parents of children with developmental disability is warranted.

Visuospatial training improves elementary students' mathematics performance.

PubMed

Lowrie, Tom; Logan, Tracy; Ramful, Ajay

2017-06-01

Although spatial ability and mathematics performance are highly correlated, there is scant research on the extent to which spatial ability training can improve mathematics performance. This study evaluated the efficacy of a visuospatial intervention programme within classrooms to determine the effect on students' (1) spatial reasoning and (2) mathematics performance as a result of the intervention. The study involved grade six students (ages 10-12) in eight classes. There were five intervention classes (n = 120) and three non-intervention control classes (n = 66). A specifically designed 10-week spatial reasoning programme was developed collaboratively with the participating teachers, with the intervention replacing the standard mathematics curriculum. The five classroom teachers in the intervention programme presented 20 hr of activities aimed at enhancing students' spatial visualization, mental rotation, and spatial orientation skills. The spatial reasoning programme led to improvements in both spatial ability and mathematics performance relative to the control group who received standard mathematics instruction. Our study is the first to show that a classroom-based spatial reasoning intervention improves elementary school students' mathematics performance. © 2017 The British Psychological Society.

School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents.

PubMed

Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl

2016-11-08

School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs). To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov and the World Health Organization's (WHO) International Clinical Trials Registry Platform for prospective trials; AIDS Educaton and Global Information System (AEGIS) and National Library of Medicine (NLM) gateway for conference presentations; and the Centers for Disease Control and Prevention (CDC), UNAIDS, the WHO and the National Health Service (NHS) centre for Reviews and Dissemination (CRD) websites from 1990 to 7 April 2016. We handsearched the reference lists of all relevant papers. We included randomized controlled trials (RCTs), both individually randomized and cluster-randomized, that evaluated school-based programmes aimed at improving the sexual and reproductive health of adolescents. Two review authors independently assessed trials for inclusion, evaluated risk of bias, and extracted data. When appropriate, we obtained summary measures of treatment effect through a random-effects meta-analysis and we reported them using risk ratios (RR) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. We included eight cluster-RCTs that enrolled 55,157 participants. Five trials were conducted in sub-Saharan Africa (Malawi, South Africa, Tanzania, Zimbabwe, and Kenya), one in Latin America (Chile), and two in Europe (England and Scotland). Sexual and reproductive health educational programmesSix trials evaluated school-based educational interventions.In these trials, the educational programmes evaluated had no demonstrable effect on the prevalence of HIV (RR 1.03, 95% CI 0.80 to 1.32, three trials; 14,163 participants; low certainty evidence), or other STIs (herpes simplex virus prevalence: RR 1.04, 95% CI 0.94 to 1.15; three trials, 17,445 participants; moderate certainty evidence; syphilis prevalence: RR 0.81, 95% CI 0.47 to 1.39; one trial, 6977 participants; low certainty evidence). There was also no apparent effect on the number of young women who were pregnant at the end of the trial (RR 0.99, 95% CI 0.84 to 1.16; three trials, 8280 participants; moderate certainty evidence). Material or monetary incentive-based programmes to promote school attendanceTwo trials evaluated incentive-based programmes to promote school attendance.In these two trials, the incentives used had no demonstrable effect on HIV prevalence (RR 1.23, 95% CI 0.51 to 2.96; two trials, 3805 participants; low certainty evidence). Compared to controls, the prevalence of herpes simplex virus infection was lower in young women receiving a monthly cash incentive to stay in school (RR 0.30, 95% CI 0.11 to 0.85), but not in young people given free school uniforms (Data not pooled, two trials, 7229 participants; very low certainty evidence). One trial evaluated the effects on syphilis and the prevalence was too low to detect or exclude effects confidently (RR 0.41, 95% CI 0.05 to 3.27; one trial, 1291 participants; very low certainty evidence). However, the number of young women who were pregnant at the end of the trial was lower among those who received incentives (RR 0.76, 95% CI 0.58 to 0.99; two trials, 4200 participants; low certainty evidence). Combined educational and incentive-based programmesThe single trial that evaluated free school uniforms also included a trial arm in which participants received both uniforms and a programme of sexual and reproductive education. In this trial arm herpes simplex virus infection was reduced (RR 0.82, 95% CI 0.68 to 0.99; one trial, 5899 participants; low certainty evidence), predominantly in young women, but no effect was detected for HIV or pregnancy (low certainty evidence). There is a continued need to provide health services to adolescents that include contraceptive choices and condoms and that involve them in the design of services. Schools may be a good place in which to provide these services. There is little evidence that educational curriculum-based programmes alone are effective in improving sexual and reproductive health outcomes for adolescents. Incentive-based interventions that focus on keeping young people in secondary school may reduce adolescent pregnancy but further trials are needed to confirm this.

A general approach to DNA-programmable atom equivalents.

PubMed

Zhang, Chuan; Macfarlane, Robert J; Young, Kaylie L; Choi, Chung Hang J; Hao, Liangliang; Auyeung, Evelyn; Liu, Guoliang; Zhou, Xiaozhu; Mirkin, Chad A

2013-08-01

Nanoparticles can be combined with nucleic acids to programme the formation of three-dimensional colloidal crystals where the particles' size, shape, composition and position can be independently controlled. However, the diversity of the types of material that can be used is limited by the lack of a general method for preparing the basic DNA-functionalized building blocks needed to bond nanoparticles of different chemical compositions into lattices in a controllable manner. Here we show that by coating nanoparticles protected with aliphatic ligands with an azide-bearing amphiphilic polymer, followed by the coupling of DNA to the polymer using strain-promoted azide-alkyne cycloaddition (also known as copper-free azide-alkyne click chemistry), nanoparticles bearing a high-density shell of nucleic acids can be created regardless of nanoparticle composition. This method provides a route to a virtually endless class of programmable atom equivalents for DNA-based colloidal crystallization.

Evaluating factors influencing the delivery and outcomes of an incentive-based behaviour change strategy targeting child obesity: protocol for a qualitative process and impact evaluation.

PubMed

Enright, Gemma; Gyani, Alex; Raadsma, Simon; Allman-Farinelli, Margaret; Rissel, Chris; Innes-Hughes, Christine; Lukeis, Sarah; Rodgers, Anthony; Redfern, Julie

2016-12-16

Community-based weight management programmes are important in addressing childhood obesity. However, the mechanisms that lead to behaviour change within the programmes are rarely studied within the context of the programmes themselves once they have been implemented. This means that further potential gains in the effectiveness of the programme are often not made and any potential losses of efficacy are often not noticed. Qualitative research alongside randomised controlled trials (RCTs) can tell us the context in which these programmes are implemented and elucidate potential mediators or modifiers of the programmes' effectiveness. The aim of this evaluation is to determine the barriers and enablers to the delivery and impact of an incentive-based behaviour change strategy targeting child obesity to inform future translation. Qualitative analysis, including stakeholder and family interviews, focus groups and a survey, will be used. The research will be conducted in collaboration with policymakers, researchers and community health professionals. Participants will be selected from programme providers, and parents/carers and children participating in an Australian community weight management programme during an RCT examining the effectiveness of incentives for improving behaviour change. A maximum variation sampling method based on participant demographics and group characteristics will be used. Thematic analysis will be carried out inductively based on emergent themes, using NVivo V.9. This research is approved by the South West Sydney Human Ethics Committee review body (HREC/14/LPOOL/480). The evaluation will provide information about the contextual and influencing factors related to the outcomes of the RCT. The results will assist researchers, community health practitioners and policymakers regarding the development, implementation and translation of behaviour change strategies in community initiatives for obese children. Insights gained may be applicable to a range of chronic conditions where similar preventive intervention approaches are indicated. ACTRN12615000558527, Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A pilot study to evaluate the efficacy of adding a structured home visiting intervention to improve outcomes for high-risk families attending the Incredible Years Parent Programme: study protocol for a randomised controlled trial.

PubMed

Lees, Dianne G; Fergusson, David M; Frampton, Christopher M; Merry, Sally N

2014-02-25

Antisocial behaviour and adult criminality often have their origins in childhood and are best addressed early in the child's life using evidence-based treatments such as the 'Incredible Years Parent Programme'. However, families with additional risk factors who are at highest risk for poor outcomes do not always make sufficient change while attending such programmes. Additional support to address barriers and improve implementation of positive parenting strategies while these families attend the Incredible Years Programme may improve overall outcomes.The study aims to evaluate the efficacy of adding a structured home visiting intervention (Home Parent Support) to improve outcomes in families most at risk of poor treatment response from the Incredible Years intervention. This study will inform the design of a larger prospective randomised controlled trial. A pilot single-blind, parallel, superiority, randomised controlled trial. Randomisation will be undertaken using a computer-generated sequence in a 1:1 ratio to the two treatments arranged in permuted blocks with stratification by age, sex, and ethnicity. One hundred and twenty six participants enrolled in the Incredible Years Parent Programme who meet the high-risk criteria will be randomly allocated to receive either Incredible Years Parent Programme and Home Parent Support, or the Incredible Years Parent Programme alone. The Home Parent Support is a 10-session structured home visiting intervention provided by a trained therapist, alongside the usual Incredible Years Parent Programme, to enhance the adoption of key parenting skills. The primary outcome is the change in child behaviour from baseline to post-intervention in parent reported Eyberg Child Behavior Inventory Problem Scale. This is the first formal evaluation of adding Home Parent Support alongside Incredible Years Parent Programme for families with risk factors who typically have poorer treatment outcomes. We anticipate that the intervention will help vulnerable families stay engaged, strengthen the adoption of effective parenting strategies, and improve outcomes for both the children and families. Australian New Zealand Clinical Trials Registry ACTRN12612000878875.

Integrating DNA strand-displacement circuitry with DNA tile self-assembly

PubMed Central

Zhang, David Yu; Hariadi, Rizal F.; Choi, Harry M.T.; Winfree, Erik

2013-01-01

DNA nanotechnology has emerged as a reliable and programmable way of controlling matter at the nanoscale through the specificity of Watson–Crick base pairing, allowing both complex self-assembled structures with nanometer precision and complex reaction networks implementing digital and analog behaviors. Here we show how two well-developed frameworks, DNA tile self-assembly and DNA strand-displacement circuits, can be systematically integrated to provide programmable kinetic control of self-assembly. We demonstrate the triggered and catalytic isothermal self-assembly of DNA nanotubes over 10 μm long from precursor DNA double-crossover tiles activated by an upstream DNA catalyst network. Integrating more sophisticated control circuits and tile systems could enable precise spatial and temporal organization of dynamic molecular structures. PMID:23756381

The 'Walking for Wellbeing in the West' randomised controlled trial of a pedometer-based walking programme in combination with physical activity consultation with 12 month follow-up: rationale and study design

PubMed Central

Fitzsimons, Claire F; Baker, Graham; Wright, Annemarie; Nimmo, Myra A; Ward Thompson, Catharine; Lowry, Ruth; Millington, Catherine; Shaw, Rebecca; Fenwick, Elisabeth; Ogilvie, David; Inchley, Joanna; Foster, Charlie E; Mutrie, Nanette

2008-01-01

Background Scotland has a policy aimed at increasing physical activity levels in the population, but evidence on how to achieve this is still developing. Studies that focus on encouraging real world participants to start physical activity in their settings are needed. The Walking for Well-being in the West study was designed to assess the effectiveness of a pedometer-based walking programme in combination with physical activity consultation. The study was multi-disciplinary and based in the community. Walking for Well-being in the West investigated whether Scottish men and women, who were not achieving the current physical activity recommendation, increased and maintained walking behaviour over a 12 month period. This paper outlines the rationale and design of this innovative and pragmatic study. Methods Participants were randomised into two groups: Group 1: Intervention (pedometer-based walking programme combined with a series of physical activity consultations); Group 2: Waiting list control for 12 weeks (followed by minimal pedometer-based intervention). Physical activity (primary outcome) was measured using pedometer step counts (7 day) and the International Physical Activity Questionnaire (long version). Psychological processes were measured using questionnaires relating to the Transtheoretical Model of Behaviour Change, mood (Positive and Negative Affect Schedule) and quality of life (Euroqol EQ-5D instrument). Physiological measures included anthropometric and metabolic outcomes. Environmental influences were assessed subjectively (Neighbourhood Quality of Life Survey) and objectively (neighbourhood audit tool and GIS mapping). The qualitative evaluation employed observation, semi-structured interviews and focus groups. A supplementary study undertook an economic evaluation. Discussion Data analysis is on-going. Walking for Well-being in the West will demonstrate if a pedometer based walking programme, in combination with physical activity consultation results in a sustainable increase in walking behaviour in this sample of Scottish adults over a 12 month period. The study will examine the complex relationships between behavioural change, health consequences and the role of the environment, in conjunction with the cost effectiveness of this approach and a detailed insight into the participants' experiences of the intervention. Trial registration Current Controlled Trials ISRCTN88907382 PMID:18655723

Effectiveness of community-based exercise intervention programme in obese adults with metabolic syndrome.

PubMed

Chang, Shu-Hung; Chen, Miao-Chuan; Chien, Nai-Hui; Lin, Hsih-Fong

2016-09-01

The objective of this study was to change the anthropometric, clinical, biochemical indicators and the rate of metabolic syndrome among obese adults in community. Obesity is an indicator of metabolic syndrome and cardiometabolic diseases. Obesity increases national health care expenditure in Taiwan. The high prevalence of obesity is not only a public health issue but also an economic problem. Changes in lifestyle can help to prevent metabolic syndrome for individuals with obesity. A randomised controlled trial was applied. In this randomised controlled trial by location, 136 metabolically abnormal obese individuals were included. The related indicators with metabolic syndrome were measured at baseline and after six months. The experimental group participated in a six-month community-based programme including provided exercise environments, exercise skills and volunteers' reminding. The control group was only provided environment and skills. One hundred and thirty-one participants completed this trail. In comparison with the baseline, the intervention group showed a significant increase in high-density lipoprotein cholesterol (2·34 mg/dl), and decrease in body weight (1·09 kg), waist circumference (3·63 cm), systolic blood pressure (10·52 mmHg), diastolic blood pressure (5·21 mmHg), fasting blood glucose (5·84 mg/dl) and body mass index (0·74 kg/m(2) ). In the control group, significant decrease in body mass index and waist circumference were discovered. Compared to the changes between the two groups, the results showed there were significant differences in waist circumference, systolic blood pressure, diastolic blood pressure and high-density lipoprotein cholesterol. The community-based intervention could help to improve high-density lipoprotein cholesterol, reduce body weight, body mass index, waist circumference, blood pressure and fasting blood glucose in metabolically abnormal obese. This community-based programme helped metabolically abnormal obese individuals become metabolically healthy. In the future, community nurses will work with village heads and volunteers. They can encourage residents in the communities to have healthy lifestyle. As a result, the goal of this programme will be successfully achieved with less time and effort. © 2016 John Wiley & Sons Ltd.

School-based interventions for preventing Hiv, sexually transmitted infections, and pregnancy in adolescents

PubMed Central

Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl

2016-01-01

Background School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs). Objectives To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents. Search methods We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov and the World Health Organization's (WHO) International Clinical Trials Registry Platform for prospective trials; AIDS Educaton and Global Information System (AEGIS) and National Library of Medicine (NLM) gateway for conference presentations; and the Centers for Disease Control and Prevention (CDC), UNAIDS, the WHO and the National Health Service (NHS) centre for Reviews and Dissemination (CRD) websites from 1990 to 7 April 2016. We handsearched the reference lists of all relevant papers. Selection criteria We included randomized controlled trials (RCTs), both individually randomized and cluster-randomized, that evaluated school-based programmes aimed at improving the sexual and reproductive health of adolescents. Data collection and analysis Two review authors independently assessed trials for inclusion, evaluated risk of bias, and extracted data. When appropriate, we obtained summary measures of treatment effect through a random-effects meta-analysis and we reported them using risk ratios (RR) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. Main results We included eight cluster-RCTs that enrolled 55,157 participants. Five trials were conducted in sub-Saharan Africa (Malawi, South Africa, Tanzania, Zimbabwe, and Kenya), one in Latin America (Chile), and two in Europe (England and Scotland). Sexual and reproductive health educational programmes Six trials evaluated school-based educational interventions. In these trials, the educational programmes evaluated had no demonstrable effect on the prevalence of HIV (RR 1.03, 95% CI 0.80 to 1.32, three trials; 14,163 participants; low certainty evidence), or other STIs (herpes simplex virus prevalence: RR 1.04, 95% CI 0.94 to 1.15; three trials, 17,445 participants; moderate certainty evidence; syphilis prevalence: RR 0.81, 95% CI 0.47 to 1.39; one trial, 6977 participants; low certainty evidence). There was also no apparent effect on the number of young women who were pregnant at the end of the trial (RR 0.99, 95% CI 0.84 to 1.16; three trials, 8280 participants; moderate certainty evidence). Material or monetary incentive-based programmes to promote school attendance Two trials evaluated incentive-based programmes to promote school attendance. In these two trials, the incentives used had no demonstrable effect on HIV prevalence (RR 1.23, 95% CI 0.51 to 2.96; two trials, 3805 participants; low certainty evidence). Compared to controls, the prevalence of herpes simplex virus infection was lower in young women receiving a monthly cash incentive to stay in school (RR 0.30, 95% CI 0.11 to 0.85), but not in young people given free school uniforms (Data not pooled, two trials, 7229 participants; very low certainty evidence). One trial evaluated the effects on syphilis and the prevalence was too low to detect or exclude effects confidently (RR 0.41, 95% CI 0.05 to 3.27; one trial, 1291 participants; very low certainty evidence). However, the number of young women who were pregnant at the end of the trial was lower among those who received incentives (RR 0.76, 95% CI 0.58 to 0.99; two trials, 4200 participants; low certainty evidence). Combined educational and incentive-based programmes The single trial that evaluated free school uniforms also included a trial arm in which participants received both uniforms and a programme of sexual and reproductive education. In this trial arm herpes simplex virus infection was reduced (RR 0.82, 95% CI 0.68 to 0.99; one trial, 5899 participants; low certainty evidence), predominantly in young women, but no effect was detected for HIV or pregnancy (low certainty evidence). Authors' conclusions There is a continued need to provide health services to adolescents that include contraceptive choices and condoms and that involve them in the design of services. Schools may be a good place in which to provide these services. There is little evidence that educational curriculum-based programmes alone are effective in improving sexual and reproductive health outcomes for adolescents. Incentive-based interventions that focus on keeping young people in secondary school may reduce adolescent pregnancy but further trials are needed to confirm this. School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents Cochrane researchers conducted a review of the effects of school-based interventions for reducing HIV, sexually transmitted infections (STIs), and pregnancy in adolescents. After searching for relevant trials up to 7 April 2016, they included eight trials that had enrolled 55,157 adolescents. Why is this important and how might school-based programmes work? Sexually active adolescents, particularly young women, are at high risk in many countries of contracting HIV and other STIs. Early unintended pregnancy can also have a detrimental impact on young people's lives. The school environment plays an important role in the development of children and young people, and curriculum-based sexuality education programmes have become popular in many regions of the world. While there is some evidence that these programmes improve knowledge and reduce self-reported risk taking, this review evaluated whether they have any impact on the number of young people that contracted STIs or on the number of adolescent pregnancies. What the research says Sexual and reproductive health education programmes As they are currently configured, educational programmes alone probably have no effect on the number of young people infected with HIV during adolescence (low certainty evidence). They also probably have no effect on the number of young people infected with other STIs (herpes simplex virus: moderate certainty evidence; syphilis: low certainty evidence), or the number of adolescent pregnancies (moderate certainty evidence). Material or monetary incentive-based programmes to promote school attendance Giving monthly cash, or free school uniforms, to encourage students to stay in school may have no effect on the number of young people infected with HIV during adolescence (low certainty evidence). We do not currently know whether monthly cash or free school uniforms will reduce the number of young people infected with other STIs (very low certainty evidence). However, incentives to promote school attendance may reduce the number of adolescent pregnancies (low certainty evidence). Combined educational and incentive-based programmes Based on a single included trial, giving an incentive such as a free school uniform combined with a programme of sexual and reproductive health education may reduce STIs (herpes simplex virus; low certainty evidence) in young women, but no effect was detected for HIV or pregnancy (low certainty evidence). Authors' conclusions There is currently little evidence that educational programmes alone are effective at reducing STIs or adolescent pregnancy. Incentive-based interventions that focus on keeping young people, especially girls, in secondary school may reduce adolescent pregnancy but further high quality trials are needed to confirm this. PMID:27824221

Patient education in gastro-oesophageal reflux disease: a randomized controlled trial.

PubMed

Urnes, Jorgen; Farup, Per G; Lydersen, Stian; Petersen, Hermod

2007-12-01

Gastro-oesophageal reflux disease (GORD) is chronic, affects 8-20% of the population, impairs quality of life (QoL) and generates substantial health-related costs. Patient education is intended to improve patients' disease-related competency, potentially enabling them to deal more efficiently with their disease, eventually improving QoL and reducing healthcare cost. This study aimed to investigate the effects of a group-based education programme for patients with mild GORD. Patients with GORD were randomly allocated to education (n=102) or control (n=109). The education programme was designed as a structured dialogue conveying medical information about the pathophysiology and prognosis, pharmacological and nonpharmacological treatment of GORD, patients' rights and use of healthcare. Outcomes were measured using general QoL [General Health Questionnaire-30 (GHQ-30)], disease-specific QoL [Digestive Symptoms and Impact Questionnaire (DSIQ)], global QoL and healthcare use at 2 and 12 months after the educational programme. No statistically significant differences were found in GHQ-30, DSIQ or global QoL at 2 or 12 months' follow-up between the GORD-education group and controls. In the GORD-education group, patients who had completed primary school education only showed improved QoL at 12 months on both GHQ and DSIQ, whereas patients who had completed advanced schooling showed no change. No difference was found between the groups in their use of healthcare. A group-based education programme for patients with mild GORD showed no effect on QoL or use of healthcare. Subgroup analyses showed improved QoL only in patients with primary school education, who had been allocated to GORD education.

A blended-learning programme regarding professional ethics in physiotherapy students.

PubMed

Aguilar-Rodríguez, Marta; Marques-Sule, Elena; Serra-Añó, Pilar; Espí-López, Gemma Victoria; Dueñas-Moscardó, Lirios; Pérez-Alenda, Sofía

2018-01-01

In the university context, assessing students' attitude, knowledge and opinions when applying an innovative methodological approach to teach professional ethics becomes fundamental to know if the used approach is enough motivating for students. To assess the effect of a blended-learning model, based on professional ethics and related to clinical practices, on physiotherapy students' attitude, knowledge and opinions towards learning professional ethics. Research design and participants: A simple-blind clinical trial was performed (NLM identifier NCT03241693) (control group, n = 64; experimental group, n = 65). Both groups followed clinical practices for 8 months. Control group performed a public exposition of a clinical case about professional ethics. By contrast, an 8-month blended-learning programme regarding professional ethics was worked out for experimental group. An online syllabus and online activities were elaborated, while face-to-face active participation techniques were performed to discuss ethical issues. Students' attitudes, knowledge and opinions towards learning professional ethics were assessed. Ethical considerations: The study was approved by the University Ethic Committee of Human Research and followed the ethical principles according to the Declaration of Helsinki. After the programme, attitudes and knowledge towards learning professional ethics of experimental group students significantly improved, while no differences were observed in control group. Moreover, opinions reported an adequate extension of themes and temporization, importance of clinical practices and interest of topics. Case study method and role playing were considered as the most helpful techniques. The blended-learning programme proposed, based on professional ethics and related to clinical practices, improves physiotherapy students' attitudes, knowledge and opinions towards learning professional ethics.

Efficacy of a smoking prevention programme in Catalan secondary schools: a cluster-randomized controlled trial in Spain.

PubMed

Valdivieso López, Empar; Rey-Reñones, Cristina; Rodriguez-Blanco, Teresa; Ferre Grau, Carmen; Arija, Victoria; Barrera Uriarte, Maria Luisa; Granado-Font, Esther; Flores-Mateo, Gemma

2015-05-01

To evaluate the efficacy of a school-based educational programme in reducing the incidence and prevalence of smoking in secondary school students (compulsory secondary education: CSE) in Catalonia (Spain). Cluster-randomized controlled trial. Schools in the Tarragona Health Care Region of Spain. All students enrolled in the first year of CSE during the 2007-08 school year in the 29 participating schools (n = 2245); 1583 students completed the follow-up over the 4-year study period (804 and 779 in the control and intervention groups, respectively). Self-reported questionnaires were administered during the first quarter of the 2007, 2008, 2009 and 2010 school years. A smoker was defined as 'smoking cigarettes daily or occasionally within the past 30 days'. Multi-level logistic regression analysis was conducted to analyse the prevalence and incidence of smoking between the intervention and control groups. A school-based educational programme comprising seven modules, each with a different approach to smoking habits. Each module included activities, work-shops and/or class sessions. The initial prevalence of smokers in the control and intervention groups who completed the follow-up was 3.9% and 4.2%, respectively. At the end of the study, the prevalence of smokers was 24.4% in the control group and 19.9% in the intervention group. The accumulated incidence of new smokers was 230.57/1000 in the control group and 183.65/1000 in the intervention group. The adjusted odds ratio (OR) comparing the intervention group with the control group was 0.75 [95% confidence interval (CI) = 0.49, 1.15] for smoking prevalence, and 0.74 (95% CI = 0.48, 1.14) for smoking incidence. A school-based educational intervention for secondary school students in Catalonia, Spain was not found to lead to a statistically significant reduction of smoking prevalence and incidence. © 2015 Society for the Study of Addiction.

V&V Plan for FPGA-based ESF-CCS Using System Engineering Approach.

NASA Astrophysics Data System (ADS)

Maerani, Restu; Mayaka, Joyce; El Akrat, Mohamed; Cheon, Jung Jae

2018-02-01

Instrumentation and Control (I&C) systems play an important role in maintaining the safety of Nuclear Power Plant (NPP) operation. However, most current I&C safety systems are based on Programmable Logic Controller (PLC) hardware, which is difficult to verify and validate, and is susceptible to software common cause failure. Therefore, a plan for the replacement of the PLC-based safety systems, such as the Engineered Safety Feature - Component Control System (ESF-CCS), with Field Programmable Gate Arrays (FPGA) is needed. By using a systems engineering approach, which ensures traceability in every phase of the life cycle, from system requirements, design implementation to verification and validation, the system development is guaranteed to be in line with the regulatory requirements. The Verification process will ensure that the customer and stakeholder’s needs are satisfied in a high quality, trustworthy, cost efficient and schedule compliant manner throughout a system’s entire life cycle. The benefit of the V&V plan is to ensure that the FPGA based ESF-CCS is correctly built, and to ensure that the measurement of performance indicators has positive feedback that “do we do the right thing” during the re-engineering process of the FPGA based ESF-CCS.

Project-Based Learning in Programmable Logic Controller

NASA Astrophysics Data System (ADS)

Seke, F. R.; Sumilat, J. M.; Kembuan, D. R. E.; Kewas, J. C.; Muchtar, H.; Ibrahim, N.

2018-02-01

Project-based learning is a learning method that uses project activities as the core of learning and requires student creativity in completing the project. The aims of this study is to investigate the influence of project-based learning methods on students with a high level of creativity in learning the Programmable Logic Controller (PLC). This study used experimental methods with experimental class and control class consisting of 24 students, with 12 students of high creativity and 12 students of low creativity. The application of project-based learning methods into the PLC courses combined with the level of student creativity enables the students to be directly involved in the work of the PLC project which gives them experience in utilizing PLCs for the benefit of the industry. Therefore, it’s concluded that project-based learning method is one of the superior learning methods to apply on highly creative students to PLC courses. This method can be used as an effort to improve student learning outcomes and student creativity as well as to educate prospective teachers to become reliable educators in theory and practice which will be tasked to create qualified human resources candidates in order to meet future industry needs.

Synchronized operation by field programmable gate array based signal controller for the Thomson scattering diagnostic system in KSTAR.

PubMed

Lee, W R; Kim, H S; Park, M K; Lee, J H; Kim, K H

2012-09-01

The Thomson scattering diagnostic system is successfully installed in the Korea Superconducting Tokamak Advanced Research (KSTAR) facility. We got the electron temperature and electron density data for the first time in 2011, 4th campaign using a field programmable gate array (FPGA) based signal control board. It operates as a signal generator, a detector, a controller, and a time measuring device. This board produces two configurable trigger pulses to operate Nd:YAG laser system and receives a laser beam detection signal from a photodiode detector. It allows a trigger pulse to be delivered to a time delay module to make a scattered signal measurement, measuring an asynchronous time value between the KSTAR timing board and the laser system injection signal. All functions are controlled by the embedded processor running on operating system within a single FPGA. It provides Ethernet communication interface and is configured with standard middleware to integrate with KSTAR. This controller has operated for two experimental campaigns including commissioning and performed the reconfiguration of logic designs to accommodate varying experimental situation without hardware rebuilding.

Programmable Logic Controllers. Teacher Edition.

ERIC Educational Resources Information Center

Rauh, Bob; Kaltwasser, Stan

These materials were developed for a seven-unit secondary or postsecondary education course on programmable logic controllers (PLCs) that treats most of the skills needed to work effectively with PLCs as programming skills. The seven units of the course cover the following topics: fundamentals of programmable logic controllers; contracts, timers,…

School-based programmes for preventing smoking.

PubMed

Thomas, R

2002-01-01

Smoking rates in adolescents are rising. Helping young people to avoid starting smoking is a widely endorsed goal of public health, but there is uncertainty about how to do this. Schools provide a route for communicating with a large proportion of young people, and school-based programmes for smoking prevention have been widely developed and evaluated. To review all randomised controlled trials of behavioural interventions in schools to prevent children (aged 5 to12) and adolescents (aged 13 to18) starting smoking. We searched The Cochrane Controlled Trials and Tobacco Review group registers, MEDLINE, EMBASE, Psyclnfo, ERIC, CINAHL, Health Star, Dissertation Abstracts and studies identified in the bibliographies of articles. Individual MEDLINE searches were made for 133 authors who had undertaken randomised controlled trials in this area. Types of studies: those in which individual students, classes, schools, or school districts were randomised to the intervention or control groups and followed for at least six months. Children (aged 5 to12) or adolescents (aged 13 to18) in school settings. Types of interventions: Classroom programmes or curricula, including those with associated family and community interventions, intended to deter use of tobacco. We included programmes or curricula that provided information, those that used social influences approaches, those that taught generic social competence, and those that included interventions beyond the school into the community. We included programmes with a drug or alcohol focus if outcomes for tobacco use were reported. Types of outcome measures: Prevalence of non-smoking at follow-up among those not smoking at baseline. We did not require biochemical validation of self-reported tobacco use for study inclusion. We assessed whether identified citations were randomised controlled trials. We assessed the quality of design and execution, and abstracted outcome data. Because of the marked heterogeneity of design and outcomes, we did not perform a meta-analysis. We synthesised the data using narrative systematic review. We grouped studies by intervention method (information; social competence; social influences; combined social influences/social competence and multi-modal programmes). Within each category, we placed them into three groups according to validity using quality criteria for reported study design. Of the 76 randomised controlled trials identified, we classified 16 as category one (most valid). There were no category one studies of information giving alone. There were fifteen category one studies of social influences interventions. Of these, eight showed some positive effect of intervention on smoking prevalence, and seven failed to detect an effect on smoking prevalence. The largest and most rigorous study, the Hutchinson Smoking Prevention Project, found no long-term effect of an intensive 8-year programme on smoking behaviour. There was a lack of high quality evidence about the effectiveness of combinations of social influences and social competence approaches. There was limited evidence about the effectiveness of multi-modal approaches including community initiatives. There is no rigorous test of the effects of information giving about smoking. There are well-conducted randomised controlled trials to test the effects of social influences interventions: in half of the group of best quality studies those in the intervention group smoke less than those in the control, but many studies showed no effect of the intervention. There is a lack of high-quality evidence about the effectiveness of combinations of social influences and social competence interventions, and of multi-modal programmes that include community interventions.

Evaluation of a school-based intervention programme for South African children of divorce.

PubMed

Botha, Cornelius J; Wild, Lauren G

2013-01-01

Parental divorce affects approximately 30 000 South African children annually. This pilot study aimed to evaluate the effectiveness of the Children of Divorce Intervention Programme (CODIP) at two South African schools. CODIP is a preventively oriented group programme which was developed to foster resilience by helping children cope more effectively with possible academic, behavioural, and emotional problems brought about by their parents' divorce. Twenty-five 10- to 14-year-old boys from two primary schools were randomly assigned to 2 experimental groups and 1 delayed intervention control group. The experimental groups attended 12 one-hour weekly sessions; the control group received no intervention until after the study was completed. Children's understanding of divorce related events and social, emotional and behavioural adjustment was assessed one week before the intervention and three months thereafter using a battery of self-rated, teacher-rated and parent-rated questionnaires. One-way ANOVAs indicated no statistically significant decline in children's self-reported problematic beliefs about divorce or total difficulties. However, teachers' and parents' ratings indicated that compared to the control group, the combined experimental groups showed significant improvement in their general behavioural, emotional and social adjustment after programme participation. The results suggest that South African children who experience parental divorce may benefit from participation in CODIP.

Security mechanism based on Hospital Authentication Server for secure application of implantable medical devices.

PubMed

Park, Chang-Seop

2014-01-01

After two recent security attacks against implantable medical devices (IMDs) have been reported, the privacy and security risks of IMDs have been widely recognized in the medical device market and research community, since the malfunctioning of IMDs might endanger the patient's life. During the last few years, a lot of researches have been carried out to address the security-related issues of IMDs, including privacy, safety, and accessibility issues. A physician accesses IMD through an external device called a programmer, for diagnosis and treatment. Hence, cryptographic key management between IMD and programmer is important to enforce a strict access control. In this paper, a new security architecture for the security of IMDs is proposed, based on a 3-Tier security model, where the programmer interacts with a Hospital Authentication Server, to get permissions to access IMDs. The proposed security architecture greatly simplifies the key management between IMDs and programmers. Also proposed is a security mechanism to guarantee the authenticity of the patient data collected from IMD and the nonrepudiation of the physician's treatment based on it. The proposed architecture and mechanism are analyzed and compared with several previous works, in terms of security and performance.

Security Mechanism Based on Hospital Authentication Server for Secure Application of Implantable Medical Devices

PubMed Central

2014-01-01

After two recent security attacks against implantable medical devices (IMDs) have been reported, the privacy and security risks of IMDs have been widely recognized in the medical device market and research community, since the malfunctioning of IMDs might endanger the patient's life. During the last few years, a lot of researches have been carried out to address the security-related issues of IMDs, including privacy, safety, and accessibility issues. A physician accesses IMD through an external device called a programmer, for diagnosis and treatment. Hence, cryptographic key management between IMD and programmer is important to enforce a strict access control. In this paper, a new security architecture for the security of IMDs is proposed, based on a 3-Tier security model, where the programmer interacts with a Hospital Authentication Server, to get permissions to access IMDs. The proposed security architecture greatly simplifies the key management between IMDs and programmers. Also proposed is a security mechanism to guarantee the authenticity of the patient data collected from IMD and the nonrepudiation of the physician's treatment based on it. The proposed architecture and mechanism are analyzed and compared with several previous works, in terms of security and performance. PMID:25276797

'Fit for school' - a school-based water, sanitation and hygiene programme to improve child health: Results from a longitudinal study in Cambodia, Indonesia and Lao PDR.

PubMed

Duijster, Denise; Monse, Bella; Dimaisip-Nabuab, Jed; Djuharnoko, Pantjawidi; Heinrich-Weltzien, Roswitha; Hobdell, Martin; Kromeyer-Hauschild, Katrin; Kunthearith, Yung; Mijares-Majini, Maria Carmela; Siegmund, Nicole; Soukhanouvong, Panith; Benzian, Habib

2017-04-05

The Fit for School (FIT) programme integrates school health and Water, Sanitation and Hygiene interventions, which are implemented by the Ministries of Education in four Southeast Asian countries. This paper describes the findings of a Health Outcome Study, which aimed to assess the two-year effect of the FIT programme on the parasitological, weight, and oral health status of children attending schools implementing the programme in Cambodia, Indonesia and Lao PDR. The study was a non-randomized clustered controlled trial with a follow-up period of two years. The intervention group consisted of children attending public elementary schools implementing the FIT programme, including daily group handwashing with soap and toothbrushing with fluoride toothpaste, biannual school-based deworming; as well as construction of group handwashing facilities. Control schools implemented the regular government health education curriculum and biannual deworming. Per school, a random selection of six to seven-year-old grade-one students was drawn. Data on parasitological infections, anthropometric measurements, dental caries, odontogenic infections and sociodemographic characteristics were collected at baseline and at follow-up (24 months later). Data were analysed using the χ 2 -test, Mann Whitney U-test and multilevel logistic and linear regression. A total of 1847 children (mean age = 6.7 years, range 6.0-8.0 years) participated in the baseline survey. Of these, 1499 children were available for follow-up examination - 478, 486 and 535 children in Cambodia, Indonesia and Lao PDR, respectively. In all three countries, children in intervention schools had a lower increment in the number of decayed, missing and filled permanent teeth between baseline and follow-up, in comparison to children in controls schools. The preventive fraction was 24% at average. The prevalence of soil-transmitted helminth infection (which was unexpectedly low at baseline), the prevalence of thinness and the prevalence of odontogenic infections did not significantly differ between baseline and follow-up, nor between intervention and control schools. The study found that the FIT programme significantly contributed to the prevention of dental caries in children. This study describes the challenges, learnings and, moreover, the importance of conducting real-life implementation research to evaluate health programmes to transform school settings into healthy learning environments for children. The study is retrospectively registered with the German Clinical Trials Register, University of Freiburg (Trial registration number: DRKS00004485, date of registration: 26th of February, 2013).

Research of vibration controlling based on programmable logic controller for electrostatic precipitator

NASA Astrophysics Data System (ADS)

Zhang, Zisheng; Li, Yanhu; Li, Jiaojiao; Liu, Zhiqiang; Li, Qing

2013-03-01

In order to improve the reliability, stability and automation of electrostatic precipitator, circuits of vibration motor for ESP and vibration control ladder diagram program are investigated using Schneider PLC with high performance and programming software of Twidosoft. Operational results show that after adopting PLC, vibration motor can run automatically; compared with traditional control system of vibration based on single-chip microcomputer, it has higher reliability, better stability and higher dust removal rate, when dust emission concentrations <= 50 mg m-3, providing a new method for vibration controlling of ESP.

Processes of change in a school-based mindfulness programme: cognitive reactivity and self-coldness as mediators.

PubMed

Van der Gucht, Katleen; Takano, Keisuke; Raes, Filip; Kuppens, Peter

2018-05-01

The underlying mechanisms of the effectiveness of mindfulness-based interventions for emotional well-being remain poorly understood. Here, we examined the potential mediating effects of cognitive reactivity and self-compassion on symptoms of depression, anxiety and stress using data from an earlier randomised controlled school trial. A moderated time-lagged mediation model based on multilevel modelling was used to analyse the data. The findings showed that post-treatment changes in cognitive reactivity and self-coldness, an aspect of self-compassion, mediated subsequent changes in symptoms of depression, anxiety and stress. These results suggest that cognitive reactivity and self-coldness may be considered as transdiagnostic mechanisms of change of a mindfulness-based intervention programme for youth.

42. Upper level, electronic racks, left to rightguidance and control ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

42. Upper level, electronic racks, left to right--guidance and control coupler rack, programmer group, status command message processing group, UHF radio - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

How tobacco companies ensure prime placement of their advertising and products in stores: interviews with retailers about tobacco company incentive programmes

PubMed Central

Feighery, E; Ribisl, K; Clark, P; Haladjian, H

2003-01-01

Background: About 81% of cigarette manufacturers' marketing expenditures in the USA is spent to promote cigarette sales in stores. Relatively little is known about how these expenditures help the manufacturers achieve their marketing goals in stores. A better understanding of how tobacco companies influence the retail environment would help researchers and tobacco control activists to monitor industry presence in stores. Objective: To describe the types of tobacco company incentive programmes offered to retailers, how these programmes impact the store environments, and possible visual indicators of retailer participation in incentive programmes. Study design: In-depth qualitative interviews with a convenience sample of 29 tobacco retailers were conducted in 2001. Setting: USA. Main outcome measures: The types and requirements of retailer incentive programmes provided by tobacco companies, and how participation in a programme alters their stores. Results: The retailers provided insights into how tobacco companies convey promotional allowances and special offers to them and how these incentives shape the retail environment. Retailers noted that tobacco companies exert substantial control over their stores by requiring placement of products in the most visible locations, and of specific amounts and types of advertising in prime locations in the store. Retailers also described how tobacco companies reduce prices by offering them volume based discounts, "buy two, get one free" specials, and "buying down" the price of existing product. Conclusions: Tobacco companies are concentrating their marketing dollars at the point-of-sale to the extent that the store is their primary communication channel with customers. As a result, all shoppers regardless of age or smoking status are exposed to pro-smoking messages. Given the financial resources spent by tobacco companies in stores, this venue warrants closer scrutiny by researchers and tobacco control advocates. PMID:12773729

How tobacco companies ensure prime placement of their advertising and products in stores: interviews with retailers about tobacco company incentive programmes.

PubMed

Feighery, E C; Ribisl, K M; Clark, P I; Haladjian, H H

2003-06-01

About 81% of cigarette manufacturers' marketing expenditures in the USA is spent to promote cigarette sales in stores. Relatively little is known about how these expenditures help the manufacturers achieve their marketing goals in stores. A better understanding of how tobacco companies influence the retail environment would help researchers and tobacco control activists to monitor industry presence in stores. To describe the types of tobacco company incentive programmes offered to retailers, how these programmes impact the store environments, and possible visual indicators of retailer participation in incentive programmes. In-depth qualitative interviews with a convenience sample of 29 tobacco retailers were conducted in 2001. USA. The types and requirements of retailer incentive programmes provided by tobacco companies, and how participation in a programme alters their stores. The retailers provided insights into how tobacco companies convey promotional allowances and special offers to them and how these incentives shape the retail environment. Retailers noted that tobacco companies exert substantial control over their stores by requiring placement of products in the most visible locations, and of specific amounts and types of advertising in prime locations in the store. Retailers also described how tobacco companies reduce prices by offering them volume based discounts, "buy two, get one free" specials, and "buying down" the price of existing product. Tobacco companies are concentrating their marketing dollars at the point-of-sale to the extent that the store is their primary communication channel with customers. As a result, all shoppers regardless of age or smoking status are exposed to pro-smoking messages. Given the financial resources spent by tobacco companies in stores, this venue warrants closer scrutiny by researchers and tobacco control advocates.

State variation in retail promotions and advertising for Marlboro cigarettes

PubMed Central

Slater, S.; Chaloupka, F.; Wakefield, M.

2001-01-01

BACKGROUND—There is some evidence that tobacco companies marketing efforts undermine the effects of comprehensive tobacco control programmes.
OBJECTIVE—To determine whether point-of-purchase advertising and promotions are more pervasive in states where comprehensive tobacco control programmes are underway.
DESIGN—Cross sectional survey using 1996 data, with merged records of the existence of local tobacco advertising restrictions.
PARTICIPANTS AND SETTING—581 tobacco retail stores located in close proximity to high schools in mainland USA.
MAIN OUTCOME MEASURES—Existence of gift-with-purchase, number of interior advertisements, and exterior store advertisements for Marlboro cigarettes.
RESULTS—After controlling for store type and existence of advertising restrictions, offer of a gift-with-purchase for Marlboro cigarettes was significantly more likely in states with comprehensive tobacco control programmes than those without programmes (odds ratio 2.59, 95% confidence interval 1.57 to 4.26). Although not significant, results show an increase in the number of interior and exterior store advertisements for stores located in states with a comprehensive tobacco control programme than those in other states.
CONCLUSION—Results suggest some point-of-purchase tobacco promotions and advertising are more pervasive in states with comprehensive tobacco control programmes. These efforts are likely to act against the objectives of programmes and need to be accounted for in programme evaluations.


Keywords: advertising; public policy; value added promotions PMID:11740024

The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system -a multiple case study.

PubMed

Keugoung, Basile; Macq, Jean; Buve, Anne; Meli, Jean; Criel, Bart

2013-03-22

Tuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level. We used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs. The NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers. Well-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human resources, HIS and technical capacity of DHs indicates that the NTCP supports, rather than strengthens, the local health system. Moreover, there is potential for this support to be enhanced. Positive synergies between the NTCP and district health systems can be achieved if opportunities to strengthen the district health system are seized. The question remains, however, of why managers do not take advantage of the opportunities to strengthen the health system.

The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system –a multiple case study

PubMed Central

2013-01-01

Background Tuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level. Methods We used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs. Results The NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers. Conclusion Well-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human resources, HIS and technical capacity of DHs indicates that the NTCP supports, rather than strengthens, the local health system. Moreover, there is potential for this support to be enhanced. Positive synergies between the NTCP and district health systems can be achieved if opportunities to strengthen the district health system are seized. The question remains, however, of why managers do not take advantage of the opportunities to strengthen the health system. PMID:23521866

A school-based intervention incorporating smartphone technology to improve health-related fitness among adolescents: rationale and study protocol for the NEAT and ATLAS 2.0 cluster randomised controlled trial and dissemination study

PubMed Central

Lubans, David R; Smith, Jordan J; Peralta, Louisa R; Plotnikoff, Ronald C; Okely, Anthony D; Salmon, Jo; Eather, Narelle; Dewar, Deborah L; Kennedy, Sarah; Lonsdale, Chris; Hilland, Toni A; Estabrooks, Paul; Finn, Tara L; Pollock, Emma; Morgan, Philip J

2016-01-01

Introduction Physical inactivity has been described as a global pandemic. Interventions aimed at developing skills in lifelong physical activities may provide the foundation for an active lifestyle into adulthood. In general, school-based physical activity interventions targeting adolescents have produced modest results and few have been designed to be ‘scaled-up’ and disseminated. This study aims to: (1) assess the effectiveness of two physical activity promotion programmes (ie, NEAT and ATLAS) that have been modified for scalability; and (2) evaluate the dissemination of these programmes throughout government funded secondary schools. Methods and analysis The study will be conducted in two phases. In the first phase (cluster randomised controlled trial), 16 schools will be randomly allocated to the intervention or a usual care control condition. In the second phase, the Reach, Effectiveness, Adoption, Implementation and Maintenance (Re-AIM) framework will be used to guide the design and evaluation of programme dissemination throughout New South Wales (NSW), Australia. In both phases, teachers will be trained to deliver the NEAT and ATLAS programmes, which will include: (1) interactive student seminars; (2) structured physical activity programmes; (3) lunch-time fitness sessions; and (4) web-based smartphone apps. In the cluster RCT, study outcomes will be assessed at baseline, 6 months (primary end point) and 12-months. Muscular fitness will be the primary outcome and secondary outcomes will include: objectively measured body composition, cardiorespiratory fitness, flexibility, resistance training skill competency, physical activity, self-reported recreational screen-time, sleep, sugar-sweetened beverage and junk food snack consumption, self-esteem and well-being. Ethics and dissemination This study has received approval from the University of Newcastle (H-2014-0312) and the NSW Department of Education (SERAP: 2012121) human research ethics committees. This study is funded by the Australian Research Council (FT140100399) and the NSW Department of Education. Trial registration number ACTRN12615000360516; Pre-results. PMID:27354070

A school-based intervention incorporating smartphone technology to improve health-related fitness among adolescents: rationale and study protocol for the NEAT and ATLAS 2.0 cluster randomised controlled trial and dissemination study.

PubMed

Lubans, David R; Smith, Jordan J; Peralta, Louisa R; Plotnikoff, Ronald C; Okely, Anthony D; Salmon, Jo; Eather, Narelle; Dewar, Deborah L; Kennedy, Sarah; Lonsdale, Chris; Hilland, Toni A; Estabrooks, Paul; Finn, Tara L; Pollock, Emma; Morgan, Philip J

2016-06-27

Physical inactivity has been described as a global pandemic. Interventions aimed at developing skills in lifelong physical activities may provide the foundation for an active lifestyle into adulthood. In general, school-based physical activity interventions targeting adolescents have produced modest results and few have been designed to be 'scaled-up' and disseminated. This study aims to: (1) assess the effectiveness of two physical activity promotion programmes (ie, NEAT and ATLAS) that have been modified for scalability; and (2) evaluate the dissemination of these programmes throughout government funded secondary schools. The study will be conducted in two phases. In the first phase (cluster randomised controlled trial), 16 schools will be randomly allocated to the intervention or a usual care control condition. In the second phase, the Reach, Effectiveness, Adoption, Implementation and Maintenance (Re-AIM) framework will be used to guide the design and evaluation of programme dissemination throughout New South Wales (NSW), Australia. In both phases, teachers will be trained to deliver the NEAT and ATLAS programmes, which will include: (1) interactive student seminars; (2) structured physical activity programmes; (3) lunch-time fitness sessions; and (4) web-based smartphone apps. In the cluster RCT, study outcomes will be assessed at baseline, 6 months (primary end point) and 12-months. Muscular fitness will be the primary outcome and secondary outcomes will include: objectively measured body composition, cardiorespiratory fitness, flexibility, resistance training skill competency, physical activity, self-reported recreational screen-time, sleep, sugar-sweetened beverage and junk food snack consumption, self-esteem and well-being. This study has received approval from the University of Newcastle (H-2014-0312) and the NSW Department of Education (SERAP: 2012121) human research ethics committees. This study is funded by the Australian Research Council (FT140100399) and the NSW Department of Education. ACTRN12615000360516; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Inclusion of persons with disabilities in systems of social protection: a population-based survey and case–control study in Peru

PubMed Central

Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vasquez, Alberto; Kuper, Hannah; Walsham, Matthew; Blanchet, Karl

2016-01-01

Objective This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. Design Population based-survey with a nested case–control study. Setting Morropon, a semiurban district located in Piura, northern Peru. Participants For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case–control study, only one participant, case or control, per household was included in the study. Primary and secondary outcome measures Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconomic status, education, health and rehabilitation and social protection participation. Results The survey included 3684 participants, 1848 (50.1%) females, mean age: 36.4 (SD: 21.7). A total of 290 participants (7.9%; 95% CI 7.0% to 8.7%) were classified as having disability. Adults with disabilities were more likely to be single (OR=3.40; 95% CI 1.54 to 7.51) and not to be working (OR=4.36; 95% CI 2.26 to 8.40), while those who did work were less likely to receive the national minimum wage (ie, 750 PEN or about US$265; p=0.007). People with disabilities were more likely to experience health problems. There was no difference between those enrolled in any social protection programme among participants with and without disabilities. Conclusions People with disabilities were found to have higher needs for social protection, but were not more likely to be enrolled in social protection programmes. The Peruvian social protection system should consider adding disability status to selection criteria in their cash transfer programmes as well as implementing disability-specific interventions. PMID:27566630

Evaluation of a manual-based programme for the promotion of social and emotional skills in elementary school children: results from a 4-year study in Portugal.

PubMed

Moreira, Paulo; Crusellas, Lorena; Sá, Isabel; Gomes, Paulo; Matias, Carla

2010-09-01

The promotion of socio-emotional skills in educational contexts is highly beneficial to individuals' global adjustment and development. Evaluation research suggests that interventions for the promotion of socio-emotional skills are effective. However, most of this work has been carried out in the USA and there is now a pressing need to evaluate interventions at the cross-cultural level. This 4-year study evaluated the effectiveness of a teacher manual-based intervention for the promotion of social and emotional skills in Portuguese elementary school children. Using a quasi-experimental design, teachers taught manual-based strategies to children in the experimental group, focusing on specific social and emotional skills. These strategies were integrated as part of the curricular activities. Results showed statistically significant differences between the experimental group and the control group on the evaluated outcomes (self-control, emotional differentiation, emotional regulation, social skills, and self-esteem). For each of the dimensions studied, effect sizes were large (above 0.80). Findings are similar to those reported by international research evaluating the effectiveness of programmes for the promotion of social and emotional skills in school-age children. This study is an important contribution in the establishment of evidence-based socio-emotional skills programmes at the cross-cultural level.

Effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of older adults living alone.

PubMed

Ahn, Jeong-Ah; Park, JeeWon; Kim, Chun-Ja

2017-09-07

The effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of 71 older adults living alone were examined. Although a regular dietary meal plan is recommended for improving nutritional status of older adults living alone, little research is done in this field in Korea. A pre- and post-test controlled quasi-experimental design was used at public health centres. The intervention group participated in an intensive nutritional education and support programme once a week for 8 weeks with dietary menus provided by home visiting nurses/dieticians; control group received usual care. Dietary habits and nutritional knowledge were assessed using structured questionnaires; nutritional intake status was analysed using Computer Aided Nutritional Analysis Program 5.0. The mean age of participants was 77.6 years, and 81.7% of the participants were women. At 8 weeks, there were significant interactions of group by time for dietary habits, nutritional knowledge and selected nutritional status of protein, iron and vitamins of B 2 and C. Changes over time in the mean score of dietary habits and nutritional knowledge were significantly improved in the intervention group compared to the control group. The percentages of normal nutrition intake of protein, iron and vitamins A and C in the intervention group were significantly higher than the control group at 8 weeks. Nutritional education and support programme positively impacted dietary habits, nutritional knowledge and selected nutritional status in older adults living alone, and we highlight the need for community-based nutritional education and counselling programmes. Older adults living alone in a community have relatively poor nutritional status and thus require tailored nutritional intervention according to objective nutritional analysis. It is necessary to link visiting nurses with dieticians in the community to manage effective nutritional programme continuously. © 2017 John Wiley & Sons Ltd.

NATIONAL POLICIES TO MEET THE CHALLENGE OF SUBSTANCE ABUSE : PROGRAMMES AND IMPLEMENTATION

PubMed Central

Malhotra, Anil; Mohan, Ashwin

2000-01-01

Drug abuse has become a growing issue of concern to humanity. India has a large consumer base of drug and alcohol abusers. This has serious repercussions in terms of morbidity & mortality. Hence the need for a national policy. In India, the Narcotic Drugs and Psychotropic Substances Act. 1985 (NDPS) provides the framework for drug abuse control in the country. A large number of measures have been undertaken as part of demand reduction activities. These include framing policies and programmes, setting up of centres, developing pilot projects, etc. However, the implementation still needs a lot to be desired. The efforts have not yet been streamlined and no revision of policies has taken place based on experience. This paper critically reviews the initiatives taken thus far to control drug abuse in our country. PMID:21407973

Smart house-based optimal operation of thermal unit commitment for a smart grid considering transmission constraints

NASA Astrophysics Data System (ADS)

Howlader, Harun Or Rashid; Matayoshi, Hidehito; Noorzad, Ahmad Samim; Muarapaz, Cirio Celestino; Senjyu, Tomonobu

2018-05-01

This paper presents a smart house-based power system for thermal unit commitment programme. The proposed power system consists of smart houses, renewable energy plants and conventional thermal units. The transmission constraints are considered for the proposed system. The generated power of the large capacity renewable energy plant leads to the violated transmission constraints in the thermal unit commitment programme, therefore, the transmission constraint should be considered. This paper focuses on the optimal operation of the thermal units incorporated with controllable loads such as Electrical Vehicle and Heat Pump water heater of the smart houses. The proposed method is compared with the power flow in thermal units operation without controllable loads and the optimal operation without the transmission constraints. Simulation results show the validation of the proposed method.

Methodology for a randomised controlled trial of preschool vision screening. A new approach with the 'ALSPAC' project.

PubMed

Williams, C; Harrad, R A; Harvey, I; Frankel, S; Golding, J

1996-06-01

We present the methodology of a population-based Randomised Controlled Trial, comparing an intensive programme of primary preschool vision screening by orthoptists with the usual non-specialist screening. The aims of the trial are to compare the effectiveness and costs of intensive orthoptic screening with non-specialist measures. The orthoptic screening programme will be evaluated both as a composite package and in terms of the screening value of the individual tests at specific ages. This trial is nested within a large population-based longitudinal study. Additional demographic and developmental data on the children in the trial are therefore available. The results of the trial will be used to help clarify which methods of preschool ophthalmic population screening are best in terms of disease detection and cost efficiency.

The effect of a healthy lifestyle programme on 8-9 year olds from social disadvantage.

PubMed

Breslin, Gavin; Brennan, Deirdre; Rafferty, Ruth; Gallagher, Alison M; Hanna, Donncha

2012-07-01

This study assessed the efficacy of a school-based healthy lifestyle intervention (Sport for LIFE) for increasing physical activity, decreasing sedentary behaviour, reducing screen time behaviour, encouraging healthy attitudes and behaviour to nutrition, and reducing body mass index (BMI) in 8-9-year-old primary school children from lower socioeconomic backgrounds in Northern Ireland. A non-randomised controlled trial of 416 children from 24 schools took part. Schools were randomly assigned to one of two groups, an intervention or control group with 12 schools in each group. The intervention group received a 12-week school-based programme based on social cognitive theory. At baseline and follow-up, groups completed questionnaires assessing physical activity, screen time behaviour and dietary patterns. On each occasion anthropometric assessments of height and weight were taken. Physical activity and sedentary behaviour were measured by accelerometry. Significant effects were observed for vigorous, moderate and light activity for the intervention group at follow-up. Sedentary behaviour was significantly reduced for the intervention group but not for the control group. No significant effects of the intervention on BMI, screen time behaviour or attitudes to nutrition, with the exception of non-core foods, were shown. The programme was effective in increasing physical activity and reducing sedentary behaviour, however no significant changes in screen time behaviour and attitude to nutrition, with the exception of non-core foods, were observed. Future research ideas are offered for tackling low levels of physical activity in children.

The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization - a cluster-randomised controlled trial

PubMed Central

2013-01-01

Background The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. Methods The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. Results The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Conclusions Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Trial registration Clinicaltrials.gov identifier: NCT01228708. PMID:24090189

The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization--a cluster-randomised controlled trial.

PubMed

Smidth, Margrethe; Christensen, Morten Bondo; Fenger-Grøn, Morten; Olesen, Frede; Vedsted, Peter

2013-10-03

The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Clinicaltrials.gov identifier: NCT01228708.

A new evidence-based model for weight management in primary care: the Counterweight Programme.

PubMed

Laws, Rachel

2004-06-01

Obesity has become a global epidemic, and a major preventable cause of morbidity and mortality. Management strategies and treatment protocols are however poorly developed and evaluated. The aim of the Counterweight Programme is to develop an evidence-based model for the management of obesity in primary care. The Counterweight Programme is based on the theoretical model of Evidence-Based Quality Assessment aimed at improving the management of obese adults (18-75 years) in primary care. The model consists of four phases: (1) practice audit and needs assessment, (2) practice support and training, (3) practice nurse-led patient intervention, and (4) evaluation. Patient intervention consisted of screening and treatment pathways incorporating evidence-based approaches, including patient-centred goal setting, prescribed eating plans, a group programme, physical activity and behavioural approaches, anti-obesity medication and weight maintenance strategies. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation. Eighty practices were recruited of which 18 practices were randomized to act as controls and receive deferred intervention 2 years after the initial audit. By February 2004, 58 of the 62 (93.5%) intervention practices had been trained to run the intervention programme, 47 (75.8%) practices were active in implementing the model and 1256 patients had been recruited (74% female, 26% male, mean age 50.6 years, SD 14). At baseline, 75% of patients had at one or more co-morbidity, and the mean body mass index (BMI) was 36.9 kg/m(2) (SD 5.4). Of the 1256 patients recruited, 91% received one of the core lifestyle interventions in the first 12 months. For all patients followed up at 12 months, 34% achieved a clinical meaningful weight loss of 5% or more. A total of 51% of patients were classed as compliant in that they attended the required level of appointments in 3, 6, and 12 months. For fully compliant patients, weight loss improved with 43% achieving a weight loss of 5% or more at 12 months. The Counterweight Programme is an evidence-based weight management model which is feasible to implement in primary care.

Promoting the health of Aboriginal Australians through empowerment: eliciting the components of the family well-being empowerment and leadership programme.

PubMed

Laliberté, Arlene; Haswell, Melissa; Tsey, Komla

2012-12-01

Most policies addressing Aboriginal health in Australia promote initiatives that are based on empowerment principles. Articulated programme components are necessary to support personal and group empowerment and to assist individuals in gaining the sense of control and purposefulness needed to exert their political and personal power in the face of the severe stress and powerlessness faced by the Australian Aboriginal people. This paper aims to provide a detailed description of the mechanisms underpinning a 'bottom-up' empowerment initiative, the Family well-being empowerment and leadership programme (FWB), and to analyze how the programme supports empowerment. The five stages of FWB were described and the validity of this model was assessed through the combination of participatory observation, documentation analysis, literature review, semi-structured interviews and iterative feedback with different analytical perspectives. Our study results articulated four distinct programme components: the setting plus inter-relational, educational and experiential actions. FWB is an example of the promotion of both outcome and process pathways towards empowerment. Potential applications of the programme are discussed.

Description and student self-evaluation of a pilot integrated small group learning and simulation programme for medical students in the first clinical year.

PubMed

Levinson, Michele; Kelly, Diane; Zahariou, Krisoula; Johnson, Matthew; Jackman, Christine; Mackenzie, Sara

2017-02-01

Contemporary education for medical students should be student-centred, integrated and contextualised. Small group learning promotes clinical reasoning and skills for lifelong learning. Simulation can provide experiential learning in a safe and controlled environment. We developed a weekly integrated problem-based learning and simulation programme (IPS) over two semesters in the first clinical year to augment clinical placement experience and contextualise theory into work-relevant practice. To evaluate the new programme at Kirkpatrick level 1. An anonymous survey of participating students. The programme was well liked. Students found the programme relevant and that they had a better understanding of patient safety and the assessment of the deteriorating patient. They felt it contributed to integration of theory and practice, clinical reasoning and the acquisition of non-technical skills, particularly affective and communication elements. This IPS programme in the first clinical year can deliver a student-centred curriculum to complement clinical placement that delivers the important requirements of contemporary medical student education. © 2016 Royal Australasian College of Physicians.

The impact of a home-based walking programme on falls in older people: the Easy Steps randomised controlled trial.

PubMed

Voukelatos, Alexander; Merom, Dafna; Sherrington, Catherine; Rissel, Chris; Cumming, Robert G; Lord, Stephen R

2015-05-01

walking is the most popular form of exercise in older people but the impact of walking on falls is unclear. This study investigated the impact of a 48-week walking programme on falls in older people. three hundred and eighty-six physically inactive people aged 65+ years living in the community were randomised into an intervention or control group. The intervention group received a self-paced, 48-week walking programme that involved three mailed printed manuals and telephone coaching. Coinciding with the walking programme manual control group participants received health information unrelated to falls. Monthly falls calendars were used to monitor falls (primary outcome) over 48 weeks. Secondary outcomes were self-reported quality of life, falls efficacy, exercise and walking levels. Mobility, leg strength and choice stepping reaction time were measured in a sub-sample (n = 178) of participants. there was no difference in fall rates between the intervention and control groups in the follow-up period (IRR = 0.88, 95% CI: 0.60-1.29). By the end of the study, intervention group participants spent significantly more time exercising in general, and specifically walking for exercise (median 1.69 versus 0.75 h/week, P < 0.001). our finding that a walking programme is ineffective in preventing falls supports previous research and questions the suitability of recommending walking as a fall prevention strategy for older people. Walking, however, increases physical activity levels in previously inactive older people. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Infection prevention and control strategies in the era of limited resources and quality improvement: a perspective paper.

PubMed

Vandijck, Dominique; Cleemput, Irina; Hellings, Johan; Vogelaers, Dirk

2013-11-01

This paper aims to describe, using an evidence-based approach, the importance of and the resources necessary for implementing effective infection prevention and control (IPC) programmes. The intrinsic and explicit values of such strategies are presented from a clinical, health-economic and patient safety perspective. Policy makers and hospital managers are committed to providing comprehensive, accessible, and affordable healthcare of high quality. Changes in the healthcare system over time accompanied with variations in demographics and case-mix have considerably affected the availability, quality and ultimately the safety of healthcare. The main goal of an IPC programme is to prevent and control healthcare-associated infections (HAI). Many patient-, healthcare provider-, and organizational factors are associated with an increased risk for acquiring HAIs and may impact both the quality and outcome of patient care. Evidence has been published in support of having an effective IPC programme. It has been estimated that about one-third of HAIs could be prevented if key elements of the evidence-based recommendations for IPC are adequately introduced and followed. However, several healthcare agencies from over the world have reported deficits in the essential resources and components of current IPC programmes. To meet its main goal, staffing, training, and infrastructure requirements are needed. Nevertheless, and given the economic crisis, policy makers and hospital managers may be tempted to not increase or even to reduce the budget as it consumes resources and does not generate sufficient visible revenue. IPC is a critical issue in patient safety, as HAIs are by far the most common complication affecting admitted patients. The significant clinical and health-economic burden HAIs place on the healthcare system speak to the importance of getting introduced effective IPC programmes. Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Land-based versus aquatic resistance therapeutic exercises for older women with sarcopenic obesity: study protocol for a randomised controlled trial

PubMed Central

2013-01-01

Background Sarcopenic obesity is a health condition that combines excess adipose tissue and loss of muscle mass and strength. Sarcopenic obesity predisposes to more functional disabilities than obesity or sarcopenia alone. Progressive resistance exercises are recommended for older people as a potential treatment for sarcopenia and also for obesity. However, there is a lack of evidence indicating which programmes are best applied to older people, and no studies have investigated their effects on sarcopenic obese people. The aims of this protocol study are to investigate and compare the efficacy of land-based and aquatic resistance exercise programmes on improving muscle performance, functional capacity and quality of life of older women with sarcopenic obesity. Methods/Design This is a protocol study for a parallel randomised controlled clinical trial. Eligible participants are older women (≥65 years) with a body mass index ≥30 kg/m 2 and hand grip strength ≤21 kg force. A total sample of 36 participants will be randomly allocated to one of the intervention groups in blocks of three: land-based, aquatic or control. Each intervention group will undergo 2-week sessions of a 10-week therapeutic exercise programme for strength, power and endurance training of the lower-limb muscles. Participants in the control group will not participate in any strengthening activity for lower limbs and will receive telephone calls once a week. Baseline and final evaluation of outcomes will encompass muscle performance of the lower limbs assessed by an isokinetic dynamometer; functional tests of usual walking speed, maximal walking speed (shuttle walking test), stair speed and the Short Physical Performance Battery; and health-related quality of life (Medical Outcomes Study Short Form Questionnaire – SF-36). Data collectors will be blinded to randomisation and will not be in touch with participants during the interventions. Discussion This study is the first randomised controlled trial designed to evaluate resistance exercises in older patients with sarcopenic obesity. If our hypothesis proves correct, both intervention programmes will be effective, with the land-based exercises conferring better results in muscle performance. Trial registration Registro Brasileiro de Ensaios Clínicos: RBR-9p5q67 PMID:24041219

Community participation in disease control.

PubMed

Bermejo, A; Bekui, A

1993-05-01

The main determinants of community participation in disease control programmes are identified and a framework with eleven variables is developed. Attention is drawn to the political background, community characteristics, the managerial capacity of the provider and the epidemiology of the disease. The framework is designed to guide health professionals in the systematic assessment and monitoring of participation in disease control programmes. Analysis of the Ghanaian Guinea Worm Eradication Programme and the Nicaraguan Tuberculosis Control Programme are presented as case studies. They show that political support does not guarantee community participation in disease control programmes and stress the importance of other determinants such as commitment to PHC, intersectoral coordination, the project approach and human resources. The relevance of the epidemiology of the disease in determining what degree of community participation will be most effective is highlighted by the case studies.

Uniaxial three-dimensional shape measurement with multioperation modes for different modulation algorithms

NASA Astrophysics Data System (ADS)

Jing, Hailong; Su, Xianyu; You, Zhisheng

2017-03-01

A uniaxial three-dimensional shape measurement system with multioperation modes for different modulation algorithms is proposed. To provide a general measurement platform that satisfies the specific measurement requirements in different application scenarios, a measuring system with multioperation modes based on modulation measuring profilometry (MMP) is presented. Unlike the previous solutions, vertical scanning by focusing control of an electronic focus (EF) lens is implemented. The projection of a grating pattern is based on a digital micromirror device, which means fast phase-shifting with high precision. A field programmable gate array-based master control center board acts as the coordinator of the MMP system; it harmonizes the workflows, such as grating projection, focusing control of the EF lens, and fringe pattern capture. Fourier transform, phase-shifting technique, and temporary Fourier transform are used for modulation analysis in different operation modes. The proposed system features focusing control, speed, programmability, compactness, and availability. This paper details the principle of MMP for multioperation modes and the design of the proposed system. The performances of different operation modes are analyzed and compared, and a work piece with steep holes is measured to verify this multimode MMP system.

Can the Onset of Type 2 Diabetes Be Delayed by a Group-Based Lifestyle Intervention in Women with Prediabetes following Gestational Diabetes Mellitus (GDM)? Findings from a Randomized Control Mixed Methods Trial.

PubMed

O'Dea, Angela; Tierney, Marie; McGuire, Brian E; Newell, John; Glynn, Liam G; Gibson, Irene; Noctor, Eoin; Danyliv, Andrii; Connolly, Susan B; Dunne, Fidelma P

2015-01-01

To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM). A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n = 24) or wait control (n = 26) and postintervention qualitative interviews with participants. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG) from study entry to one-year follow-up. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

Functional and structural cerebral changes in key brain regions after a facilitation programme for episodic future thought in relapsing-remitting multiple sclerosis patients.

PubMed

Ernst, Alexandra; Sourty, Marion; Roquet, Daniel; Noblet, Vincent; Gounot, Daniel; Blanc, Frédéric; De Seze, Jérôme; Manning, Liliann

2016-06-01

Increasingly studied, episodic future thought (EFT) impairment negatively affects patients' daily life. Along these lines, working with relapsing-remitting multiple sclerosis (RR-MS) patients, we documented the clinical effectiveness of a mental visual imagery (MVI)-based facilitation programme on EFT impairment related to executive function difficulties. We aimed at improving the characterisation of the cognitive and neural underpinnings of RR-MS patients' EFT amelioration, by exploring the structural and functional brain changes following the MVI programme. Seventeen non-depressed RR-MS patients were recruited and randomly assigned in the (i) experimental group (n=10), who followed the MVI programme or in the control group (n=7), who followed a verbal control programme. Using an adapted version of the Autobiographical Interview to assess EFT, after facilitation, significant improvement was observed in the experimental group only. This was accompanied by increased activation in the prefrontal region during the generation of future events and was positively correlated with grey matter volume increase in this same brain area. Increased activations in the parahippocampal and the middle temporal gyri were also observed in the experimental group in post-facilitation. Likewise, functional connectivity changes were observed in the posterior brain regions after facilitation. Only minor cerebral changes were observed in the control group, likely reflecting practice effects. Our study showed that EFT improvement following the MVI programme led to functional and structural changes in brain regions sustaining contextual processing, visual imagery, the integration and maintenance of multimodal information. Taken together, these findings suggest that a cognitive intervention focusing on scene construction can be efficient to alleviate EFT impairment related to executive dysfunction. As such, this study opens the way to the development of tailor-made rehabilitation programmes using the different cognitive mechanisms involved in EFT. Copyright © 2016 Elsevier Inc. All rights reserved.

Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity: walk well cluster-randomised controlled trial.

PubMed

Melville, Craig A; Mitchell, Fiona; Stalker, Kirsten; Matthews, Lynsay; McConnachie, Alex; Murray, Heather M; Melling, Chris; Mutrie, Nanette

2015-09-29

Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups. The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities. We used a cluster randomised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations. Assessments were carried out blind to allocation. Clusters of participants were randomly allocated to the Walk Well program or a 12-week waiting list control. Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques, written resources for participants and carers, and an individualised, structured walking programme. The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks. Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity (MVPA), body mass index (BMI), and subjective well being. One hundred two participants in 50 clusters were randomised. 82 (80.4%) participants completed the primary outcome. 66.7% of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation. At baseline, participants walked 4780 (standard deviation 2432) steps per day, spent 65.5% (standard deviation 10.9) of time sedentary and 59% percent had a body mass in the obesity range. After the walking programme, the difference between mean counts of the Walk Well and control group was 69.5 steps per day [95% confidence interval (CI) -1054 to 1193.3]. There were no significant between group differences in percentage time sedentary 1.6% (95% CI -2.984 to 6.102), percentage time in MVPA 0.3% (95% CI -0.7 to 1.3), BMI -0.2 kg/m(2) (95% CI -0.8 to 0.4) or subjective well-being 0.3 (95% CI -0.9 to 1.5). This is the first published trial of a walking program for adults with intellectual disabilities. Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities. Since participants spent the majority of their time sedentary, home-based programmes to reduce sitting time may be a viable health improvement approach. Current Controlled Trials ISRCTN50494254.

Study protocol of a cluster randomized controlled trial evaluating the efficacy of a comprehensive pressure ulcer prevention programme for private for-profit nursing homes.

PubMed

Kwong, Enid Wai-yung; Lee, Paul Hong; Yeung, Kwan-mo

2016-01-18

Because the demand for government-subsidized nursing homes in Hong Kong outstrips the supply, the number of for-profit private nursing homes has been increasing rapidly. However, the standard of care in such homes is always criticized. Pressure ulcers are a major long-term care issue that is closely associated with the quality of care delivered in nursing home settings. The aim of this study is to evaluate the effectiveness of a pressure ulcer prevention programme for residents in private for-profit nursing homes. This is a two-arm cluster randomized controlled trial with an estimated sample size of 1088 residents and 74 care staff from eight for-profit private nursing homes. Eligible nursing homes will be those classified as category A2 homes in the Enhanced Bought Place Scheme (EBPS), having a capacity of around 130-150 beds, and no structured PU prevention protocol and/or programmes in place. Care staff will be health workers, personal care workers, and nurses who are front-line staff providing direct care to residents. Eight nursing homes will be randomly assigned to either an experimental or control group. The experimental group will be provided with an intensive training programme and will be involved in the implementation of a 16-week pressure ulcer prevention protocol, while the control group will deliver the usual pressure ulcer prevention care. The study outcomes are the pressure ulcer prevention knowledge and skills of the care staff and the prevalence and incidence of pressure ulcers. Data on the knowledge and skills of care staff, and prevalence of pressure ulcer will be collected at the base line, and then at the 8(th) week and at completion of the implementation of the protocol. The assessment of the incidence of pressures will start from before the commencement of the intensive training course to the end of the implementation of the protocol. In view of the negative impact of pressure ulcers, it is important to have an effective and evidence-based pressure ulcer prevention programme to improve preventive care in private for-profit nursing homes. The programme will potentially improve the knowledge and skills of care staff on the prevention of pressure ulcers and also lead to a reduction in the development of pressure ulcers in nursing homes. The Current Controlled Trial is NCT02270385, 18 October 2014.

Programmable multi-node quantum network design and simulation

NASA Astrophysics Data System (ADS)

Dasari, Venkat R.; Sadlier, Ronald J.; Prout, Ryan; Williams, Brian P.; Humble, Travis S.

2016-05-01

Software-defined networking offers a device-agnostic programmable framework to encode new network functions. Externally centralized control plane intelligence allows programmers to write network applications and to build functional network designs. OpenFlow is a key protocol widely adopted to build programmable networks because of its programmability, flexibility and ability to interconnect heterogeneous network devices. We simulate the functional topology of a multi-node quantum network that uses programmable network principles to manage quantum metadata for protocols such as teleportation, superdense coding, and quantum key distribution. We first show how the OpenFlow protocol can manage the quantum metadata needed to control the quantum channel. We then use numerical simulation to demonstrate robust programmability of a quantum switch via the OpenFlow network controller while executing an application of superdense coding. We describe the software framework implemented to carry out these simulations and we discuss near-term efforts to realize these applications.

Control of Aedes aegypti larvae in household water containers by Chinese cat fish.

PubMed

Wu, N; Wang, S S; Han, G X; Xu, R M; Tang, G K; Qian, C

1987-01-01

In 1980-81 an outbreak of dengue fever occurred in Guangdong province and in Guangxi-Zhuang autonomous region in the central-southern part of China. Subsequently, a nationwide survey indicated that the vector of the disease, Aedes aegypti, was confined to the coastal strip of Guangdong and Guangxi-Zhuang. Since the first case in the outbreak occurred in Guangxi-Zhuang, a community-based programme to control A. aegypti was set up in eight fishing villages of this region where the mosquito was breeding in household water containers. The principal method of control was use of the indigenous edible fish Clarias fuscus (Chinese cat fish), which is highly larvivorous and tolerant of harsh environmental conditions. Each container was stocked with a young fish, which could survive there for periods of up to a year. A team of primary medical personnel (barefoot doctors) made sure that the programme was correctly implemented. The programme was monitored from 1981 to 1985 in three of the villages, and the results indicated that the Breteau index remained at a low level throughout this period.

Control of Aedes aegypti larvae in household water containers by Chinese cat fish

PubMed Central

Neng, Wu; Shusen, Wang; Guangxin, Han; Rongman, Xu; Guangkun, Tang; Chen, Qian

1987-01-01

In 1980-81 an outbreak of dengue fever occurred in Guangdong province and in Guangxi-Zhuang autonomous region in the central-southern part of China. Subsequently, a nationwide survey indicated that the vector of the disease, Aedes aegypti, was confined to the coastal strip of Guangdong and Guangxi-Zhuang. Since the first case in the outbreak occurred in Guangxi-Zhuang, a community-based programme to control A. aegypti was set up in eight fishing villages of this region where the mosquito was breeding in household water containers. The principal method of control was use of the indigenous edible fish Clarias fuscus (Chinese cat fish), which is highly larvivorous and tolerant of harsh environmental conditions. Each container was stocked with a young fish, which could survive there for periods of up to a year. A team of primary medical personnel (barefoot doctors) made sure that the programme was correctly implemented. The programme was monitored from 1981 to 1985 in three of the villages, and the results indicated that the Breteau index remained at a low level throughout this period. PMID:3500803

Optically-programmable nonlinear photonic component for dielectric-loaded plasmonic circuitry.

PubMed

Krasavin, Alexey V; Randhawa, Sukanya; Bouillard, Jean-Sebastien; Renger, Jan; Quidant, Romain; Zayats, Anatoly V

2011-12-05

We demonstrate both experimentally and numerically a compact and efficient, optically tuneable plasmonic component utilizing a surface plasmon polariton ring resonator with nonlinearity based on trans-cis isomerization in a polymer material. We observe more than 3-fold change between high and low transmission states of the device at milliwatt control powers (∼100 W/cm² by intensity), with the performance limited by switching speed of the material. Such plasmonic components can be employed in optically programmable and reconfigurable integrated photonic circuitry.

Synthetic biology in mammalian cells: Next generation research tools and therapeutics

PubMed Central

Lienert, Florian; Lohmueller, Jason J; Garg, Abhishek; Silver, Pamela A

2014-01-01

Recent progress in DNA manipulation and gene circuit engineering has greatly improved our ability to programme and probe mammalian cell behaviour. These advances have led to a new generation of synthetic biology research tools and potential therapeutic applications. Programmable DNA-binding domains and RNA regulators are leading to unprecedented control of gene expression and elucidation of gene function. Rebuilding complex biological circuits such as T cell receptor signalling in isolation from their natural context has deepened our understanding of network motifs and signalling pathways. Synthetic biology is also leading to innovative therapeutic interventions based on cell-based therapies, protein drugs, vaccines and gene therapies. PMID:24434884

School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial.

PubMed

Wasserman, Danuta; Hoven, Christina W; Wasserman, Camilla; Wall, Melanie; Eisenberg, Ruth; Hadlaczky, Gergö; Kelleher, Ian; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Guillemin, Francis; Haring, Christian; Iosue, Miriam; Kaess, Michael; Kahn, Jean-Pierre; Keeley, Helen; Musa, George J; Nemes, Bogdan; Postuvan, Vita; Saiz, Pilar; Reiter-Theil, Stella; Varnik, Airi; Varnik, Peeter; Carli, Vladimir

2015-04-18

Suicidal behaviours in adolescents are a major public health problem and evidence-based prevention programmes are greatly needed. We aimed to investigate the efficacy of school-based preventive interventions of suicidal behaviours. The Saving and Empowering Young Lives in Europe (SEYLE) study is a multicentre, cluster-randomised controlled trial. The SEYLE sample consisted of 11,110 adolescent pupils, median age 15 years (IQR 14-15), recruited from 168 schools in ten European Union countries. We randomly assigned the schools to one of three interventions or a control group. The interventions were: (1) Question, Persuade, and Refer (QPR), a gatekeeper training module targeting teachers and other school personnel, (2) the Youth Aware of Mental Health Programme (YAM) targeting pupils, and (3) screening by professionals (ProfScreen) with referral of at-risk pupils. Each school was randomly assigned by random number generator to participate in one intervention (or control) group only and was unaware of the interventions undertaken in the other three trial groups. The primary outcome measure was the number of suicide attempt(s) made by 3 month and 12 month follow-up. Analysis included all pupils with data available at each timepoint, excluding those who had ever attempted suicide or who had shown severe suicidal ideation during the 2 weeks before baseline. This study is registered with the German Clinical Trials Registry, number DRKS00000214. Between Nov 1, 2009, and Dec 14, 2010, 168 schools (11,110 pupils) were randomly assigned to interventions (40 schools [2692 pupils] to QPR, 45 [2721] YAM, 43 [2764] ProfScreen, and 40 [2933] control). No significant differences between intervention groups and the control group were recorded at the 3 month follow-up. At the 12 month follow-up, YAM was associated with a significant reduction of incident suicide attempts (odds ratios [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and severe suicidal ideation (0·50, 0·27-0·92; p=0·025), compared with the control group. 14 pupils (0·70%) reported incident suicide attempts at the 12 month follow-up in the YAM versus 34 (1·51%) in the control group, and 15 pupils (0·75%) reported incident severe suicidal ideation in the YAM group versus 31 (1·37%) in the control group. No participants completed suicide during the study period. YAM was effective in reducing the number of suicide attempts and severe suicidal ideation in school-based adolescents. These findings underline the benefit of this universal suicide preventive intervention in schools. Coordination Theme 1 (Health) of the European Union Seventh Framework Programme. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Incredible Years Therapeutic Dinosaur Programme to build social and emotional competence in Welsh primary schools: study protocol for a randomised controlled trial.

PubMed

Bywater, Tracey; Hutchings, Judy; Whitaker, Christopher; Evans, Ceri; Parry, Laura

2011-02-11

School interventions such as the Incredible Years Classroom Dinosaur Programme targets pupil behaviour across whole classrooms, yet for some children a more intense approach is needed. The Incredible Years Therapeutic Dinosaur Programme is effective for clinically referred children by enhancing social, problem-solving skills, and peer relationship-building skills when delivered in a clinical setting in small groups. The aim of this trial is to evaluate the effectiveness of the Therapeutic Programme, delivered with small groups of children at high-risk of developing conduct disorder, delivered in schools already implementing the Classroom Programme. This is a pragmatic, parallel, randomised controlled trial.Two hundred and forty children (aged 4-8 years) rated by their teacher as above the 'borderline cut-off' for concern on the Strengths and Difficulties Questionnaire, and their parents, will be recruited. Randomisation is by individual within blocks (schools); 1:1 ratio, intervention to waiting list control. Twenty schools will participate in two phases. Two teachers per school will deliver the programme to six intervention children for 2-hours/week for 18 weeks between baseline and first follow-up. The control children will receive the intervention after first follow up. Phase 1 comprises three data collection points - baseline and two follow-ups eight months apart. Phase 2 includes baseline and first follow-up.The Therapeutic Programme includes elements on; Learning school rules; understanding, identifying, and articulating feelings; problem solving; anger management; how to be friendly; how to do your best in school. Primary outcomes are; change in child social, emotional and behavioural difficulties. Secondary outcomes are; teacher and parent mental wellbeing, child academic attainment, child and teacher school attendance. Intervention delivery will be assessed for fidelity. Intention to treat analyses will be conducted. ANCOVA, effect sizes, mediator and moderator analyses will be applied to establish differences between conditions, and for whom the intervention works best for and why. This trial will provide information on the delivery and effectiveness of a child centred, school-based intervention delivered in small groups of children, at risk of developing more severe conduct problems. The effects on child behaviour in school and home environments, academic attainment, peer interactions, parent and teacher mental health will be assessed. UK Clinical Research Network UKCRNID8615. Current Controlled Trials ISRCTN96803379.

'It's like a personal motivator that you carried around wi' you': utilising self-determination theory to understand men's experiences of using pedometers to increase physical activity in a weight management programme.

PubMed

Donnachie, Craig; Wyke, Sally; Mutrie, Nanette; Hunt, Kate

2017-05-05

Self-monitoring using pedometers is an effective behaviour change technique to support increased physical activity (PA). However, the ways in which pedometers operate as motivational tools in adoption and maintenance of PA is not well understood. This paper investigates men's experiences of pedometers as motivational tools both during and after their participation in a 12-week group-based, weight management programme for overweight/obese men, Football Fans in Training (FFIT). Semi-structured telephone interviews were conducted with 28 men, purposively sampled to include men who did and did not achieve 5% weight loss during the programme. Data were analysed thematically utilising the framework approach, using Self-Determination Theory (SDT) - namely concepts of behavioural regulation and the basic needs of relatedness, competence and autonomy - as an analytical lens. During the programme, FFIT's context and fellow participants supported relatedness and encouraged use of the pedometer. The pedometer was seen to provide tangible proof of progress, thus increasing competence for change, whilst the ability to monitor one's own progress and take remedial action supported autonomy; these men portrayed the pedometer as an 'ally'. However, a minority found the pedometer 'dispiriting' or controlling when it evidenced their inability to meet their PA targets. After the programme, some men no longer used the device as they had fully internalised their motivations for increased PA. In contrast, others continued to use pedometers or progressed to other self-monitoring technologies because it was enjoyable and facilitated maintenance of their increased PA. However, the minority of men who experienced the pedometer as controlling no longer used it. They were less successful in achieving 5% weight loss and appeared reliant on external factors, including support from coach and group members, to maintain motivation. These findings show how self-monitoring using pedometers and associated goal setting supported the development of autonomous motivation for PA, during and after participation in a group-based programme. They also suggest that programmes could focus on early identification of participants who remain motivated by extrinsic factors or express negative experiences of self-monitoring tools, to offer greater support to identify the benefits of PA based on a person's own values.

The costs and benefits of technology-enabled, home-based cardiac rehabilitation measured in a randomised controlled trial.

PubMed

Whittaker, Frank; Wade, Victoria

2014-10-01

We conducted a cost benefit analysis of a home telehealth-based cardiac rehabilitation programme compared to the standard hospital-based programme. A total of 120 participants were enrolled in a trial, with 60 randomised to the telehealth group and 60 randomised to usual care. Participants in the telehealth group received a mobile phone, Wellness Diary and a Wellness web portal, with daily text messaging. Participants in the usual care group received the standard 6-week hospital-based outpatient cardiac rehabilitation programme, including gym sessions. The cost of delivery by telehealth was slightly lower than for patients attending a rehabilitation service in person. From the provider's perspective, the telehealth intervention could be delivered for $1633 per patient, compared to $1845 for the usual care group. From the participant's perspective, patient travel costs for home rehabilitation were substantially less than for hospital attendance ($80 vs $400). Cardiac rehabilitation by telehealth offers obvious advantages and the option should be available to all patients who are eligible for cardiac rehabilitation. © The Author(s) 2014 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

Performance points. The reform club.

PubMed

Edwards, Nick

2004-03-18

The improvement Partnership for Hospitals programme is the vanguard of Modernization Agency work. It is based on statistical process control to eliminate variations in performance, especially in elective service. All starred trusts will join IPH by next April.

Evaluation of a nurse-led social rehabilitation programme for neurological patients and carers: an action research study.

PubMed

Portillo, Mari Carmen; Corchón, Silvia; López-Dicastillo, Olga; Cowley, Sarah

2009-02-01

Very few neurological rehabilitation programmes have successfully dealt with patients' and relatives' social needs. Furthermore, the nurses' contribution in those programmes is poor or unclear. To determine the rationale, effectiveness and adequacy of a nurse-led social rehabilitation programme implemented with neurological patients and their carers. In this action research study Hart and Bond's experimental and professionalizing typologies were applied through Lewinian cycles. A social rehabilitation programme was planned, based on the results of an in-depth baseline assessment of the context and individual needs. The programme focused on increasing the level of acceptance/adaptation of the disease through verbal and written education, easing the discharge planning, and offering social choices based on the social assessment of individual needs and possibilities at home. Two neurological wards of a hospital in Spain. The programme evaluation included 27 nurses, and two groups of patients and relatives (control group=18 patients and 19 relatives, intervention group=17 patients and 16 relatives). The two groups of patients and relatives were compared before and after discharge to determine the effectiveness of the programme. Socio-demographic forms, semi-structured interviews, participant observations, and validated scales to measure activities of daily living and social life were used, and data were analysed using content (QSR Nudist Vivo, v.2.0) and statistical (SPSS v. 13.0) analyses. The new programme resulted in social care being integrated in daily practice and developed knowledge about social rehabilitation. This had a positive impact on nurses' attitudes. Patients and relatives had more realistic expectations and positive attitudes towards social life, and developed a wider variety of choices for social changes. Better adaptation, and more coping skills and satisfaction were achieved. This rehabilitation programme was feasible and effective. Patients and relatives benefited from better understanding of the socialisation process, as a result of advancing nurses' knowledge, experience and role in psychosocial care.

Internet-based intervention programme for obese adolescents and their families (Next.Step): research protocol of a controlled trial.

PubMed

Sousa, Pedro; Fonseca, Helena; Gaspar, Pedro; Gaspar, Filomena

2014-04-01

This paper describes the design and rationale of a controlled trial that aims to determine the effectiveness of an intervention programme in which the internet is used. Adolescent obesity is a major health problem, there being urgency to find effective interventions that induce behavioural change. The inclusion of the internet in the intervention may improve adolescents' adherence to the weight management programme and lead to adoption of healthier lifestyles. A clinical trial with a control group (non-randomized). Participants are adolescents with appointments at a paediatric obesity clinic (Portugal). Sample size was calculated according to the power analysis. The experimental group will follow the standard treatment protocol and receive free access to the e-therapeutic platform. The control group will follow the standard treatment protocol and join a waiting list. Intervention length will be 36 weeks (24 weeks of direct intervention with a follow-up for 12 weeks). This study was approved by the Ethical Committee for Health (Lisbon, Portugal) in January 2012 and funded by the Foundation for Science and Technology (Portugal) in December 2012. The results of this research will promote reflection on new approaches directed to treat adolescent obesity and on the promotion of healthy behaviours. We expect to gather empirical evidence of the intervention programme effectiveness. The expectations lie on the population health gains, empowerment in decision-making and adoption of healthier lifestyles. © 2013 John Wiley & Sons Ltd.

Malaria community health workers in Myanmar: a cost analysis.

PubMed

Kyaw, Shwe Sin; Drake, Tom; Thi, Aung; Kyaw, Myat Phone; Hlaing, Thaung; Smithuis, Frank M; White, Lisa J; Lubell, Yoel

2016-01-25

Myanmar has the highest malaria incidence and attributed mortality in South East Asia with limited healthcare infrastructure to manage this burden. Establishing malaria Community Health Worker (CHW) programmes is one possible strategy to improve access to malaria diagnosis and treatment, particularly in remote areas. Despite considerable donor support for implementing CHW programmes in Myanmar, the cost implications are not well understood. An ingredients based micro-costing approach was used to develop a model of the annual implementation cost of malaria CHWs in Myanmar. A cost model was constructed based on activity centres comprising of training, patient malaria services, monitoring and supervision, programme management, overheads and incentives. The model takes a provider perspective. Financial data on CHWs programmes were obtained from the 2013 financial reports of the Three Millennium Development Goal fund implementing partners that have been working on malaria control and elimination in Myanmar. Sensitivity and scenario analyses were undertaken to outline parameter uncertainty and explore changes to programme cost for key assumptions. The range of total annual costs for the support of one CHW was US$ 966-2486. The largest driver of CHW cost was monitoring and supervision (31-60% of annual CHW cost). Other important determinants of cost included programme management (15-28% of annual CHW cost) and patient services (6-12% of annual CHW cost). Within patient services, malaria rapid diagnostic tests are the major contributor to cost (64% of patient service costs). The annual cost of a malaria CHW in Myanmar varies considerably depending on the context and the design of the programme, in particular remoteness and the approach to monitoring and evaluation. The estimates provide information to policy makers and CHW programme planners in Myanmar as well as supporting economic evaluations of their cost-effectiveness.

A home-based rehabilitation intervention for people living with HIV and disability in a resource-poor community, KwaZulu-Natal: study protocol for a randomised controlled trial.

PubMed

Cobbing, Saul; Hanass-Hancock, Jill; Myezwa, Hellen

2015-11-02

In the era of highly active antiretroviral therapy HIV is now viewed as a chronic disease. Although people living with HIV are living longer lives, they are prone to a number of disabilities. Home-based rehabilitation has been shown to be an effective means of improving quality of life and function for people with a wide range of chronic diseases. There is a dearth of evidence, however, related to home-based rehabilitation interventions for people living with HIV, particularly in sub-Saharan Africa - the region with the highest global prevalence of HIV. A randomised controlled trial design will be employed. Adults living with HIV who have been on antiretroviral therapy for at least six months and with defined limited mobility will be randomly allocated to either an intervention group or the control group. Pre and post-intervention testing will be conducted at a public hospital in KwaZulu-Natal, South Africa in order to assess the participants' quality of life, perceived level of disability, functional ability and endurance. Individuals randomly allocated to the intervention group will participate in a four-month home-based rehabilitation programme, conducted once a week in their homes. This programme will be implemented by community workers who will be trained and supervised by a qualified physiotherapist. The participants in the control group will continue with the standard clinic management offered to them. On completion of the intervention, all participants will be re-assessed using the same outcome measures. Analysis of results will be carried out on intention-to-treat basis in order to identify any changes between intervention and control groups. The researchers aim to employ a novel task shifting approach to implement a needs-based home-based rehabilitation programme for people living with HIV in order to improve their quality of life and functional ability. It is hoped that this study will provide rehabilitation professionals and researchers with evidence that can be utilised to improve existing rehabilitation interventions for people living with HIV. South African National Clinical Trials Register: NHREC#4094 (Date of registration: 21 July 2015).

CARE CR-Cardiovascular and cardiorespiratory Adaptations to Routine Exercise-based Cardiac Rehabilitation: a study protocol for a community-based controlled study with criterion methods.

PubMed

Nichols, Simon; Nation, Fiona; Goodman, Toni; Clark, Andrew L; Carroll, Sean; Ingle, Lee

2018-01-27

Cardiac rehabilitation (CR) reduces all-cause and cardiovascular mortality in patients with coronary heart disease (CHD). Much of this improvement has been attributed to the beneficial effects of structured exercise training. However, UK-based studies have not confirmed this. Improvements in survival and cardiovascular health are associated with concurrent improvements in cardiorespiratory fitness (CRF). It is therefore concerning that estimated CRF improvements resulting from UK-based CR are approximately one-third of those reported in international literature. Modest improvements in CRF suggest that UK CR exercise training programmes may require optimisation if long-term survival is to be improved. However, contemporary UK studies lack control data or use estimates of CRF change. Cardiovascular and cardiorespiratory Adaptations to Routine Exercise-based CR is a longitudinal, observational, controlled study designed to assess the short-term and long-term effect of CR on CRF, as well cardiovascular and cardiometabolic health. Patients will be recruited following referral to their local CR programme and will either participate in a routine, low-to-moderate intensity, 8-week (16 sessions) exercise-based CR programme or freely abstain from supervised exercise. Initial assessment will be conducted prior to exercise training, or approximately 2 weeks after referral to CR if exercise training is declined. Reassessment will coincide with completion of exercise training or 10 weeks after initial assessment for control participants. Participants will receive a final follow-up 12 months after recruitment. The primary outcome will be peak oxygen consumption determined using maximal cardiopulmonary exercise testing. Secondary outcomes will include changes in subclinical atherosclerosis (carotid intima-media thickness and plaque characteristics), body composition (dual X-ray absorptiometry) and cardiometabolic biomarkers. Ethical approval for this non-randomised controlled study has been obtained from the Humber Bridge NHS Research Ethics Committee-Yorkshire and the Humber on the 27th September 2013, (12/YH/0278). Results will be presented at national conferences and published in peer-reviewed journals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Programmable Control in Extracellular Matrix-mimicking Polymer Hydrogels.

PubMed

Hof, Kevin S; Bastings, Maartje M C

2017-06-28

The extracellular matrix (ECM) and cells have a reciprocal relationship, one shapes the other and vice versa. One of the main challenges of synthetic material systems for developmental cell culturing, organoid and stem cell work includes the implementation of this reciprocal nature. The largest hurdle to achieve true cell-instructive materials in biomaterials engineering is a lack of spatial and temporal control over material properties and the display of bioactive signals compared to the natural cell environment. ECM-mimicking hydrogels have been developed using a wide range of polymers, assembly and cross-linking strategies. While our synthetic toolbox is larger than nature, often our systems underperform when compared to ECM systems with natural components like Matrigel. Material properties and three-dimensional structure ill-represent the three-dimensional ECM reciprocal nature and ligand presentation is an oversimplified version of the complexity found in nature. We hypothesize that the lack of programmable control in properties and ligand presentation forms the basis of this mismatch in performance and analyze the presence of control in current state of the art ECM-mimicking systems based on covalent, supramolecular and recombinant polymers. We conclude that through combining the dynamics of supramolecular materials, robustness from covalent systems and the programmable spatial control of bio-activation in recombinant ECM materials, the optimal synthetic artificial ECM could be assembled.

A Research Agenda for Helminth Diseases of Humans: Diagnostics for Control and Elimination Programmes

PubMed Central

McCarthy, James S.; Lustigman, Sara; Yang, Guo-Jing; Barakat, Rashida M.; García, Héctor H.; Sripa, Banchob; Willingham, Arve Lee; Prichard, Roger K.; Basáñez, María-Gloria

2012-01-01

Diagnostic tools appropriate for undertaking interventions to control helminth infections are key to their success. Many diagnostic tests for helminth infection have unsatisfactory performance characteristics and are not well suited for use in the parasite control programmes that are being increasingly implemented. Although the application of modern laboratory research techniques to improve diagnostics for helminth infection has resulted in some technical advances, uptake has not been uniform. Frequently, pilot or proof of concept studies of promising diagnostic technologies have not been followed by much needed product development, and in many settings diagnosis continues to rely on insensitive and unsatisfactory parasitological or serodiagnostic techniques. In contrast, PCR-based xenomonitoring of arthropod vectors, and use of parasite recombinant proteins as reagents for serodiagnostic tests, have resulted in critical advances in the control of specific helminth parasites. The Disease Reference Group on Helminths Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR) was given the mandate to review helminthiases research and identify research priorities and gaps. In this review, the diagnostic technologies relevant to control of helminth infections, either available or in development, are reviewed. Critical gaps are identified and opportunities to improve needed technologies are discussed. PMID:22545166

European Guidelines for Quality Assurance in Cervical Cancer Screening. Second edition--summary document.

PubMed

Arbyn, M; Anttila, A; Jordan, J; Ronco, G; Schenck, U; Segnan, N; Wiener, H; Herbert, A; von Karsa, L

2010-03-01

European Guidelines for Quality Assurance in Cervical Cancer Screening have been initiated in the Europe Against Cancer Programme. The first edition established the principles of organised population-based screening and stimulated numerous pilot projects. The second multidisciplinary edition was published in 2008 and comprises approximately 250 pages divided into seven chapters prepared by 48 authors and contributors. Considerable attention has been devoted to organised, population-based programme policies which minimise adverse effects and maximise benefits of screening. It is hoped that this expanded guidelines edition will have a greater impact on countries in which screening programmes are still lacking and in which opportunistic screening has been preferred in the past. Other methodological aspects such as future prospects of human papillomavirus testing and vaccination in cervical cancer control have also been examined in the second edition; recommendations for integration of the latter technologies into European guidelines are currently under development in a related project supported by the European Union Health Programme. An overview of the fundamental points and principles that should support any quality-assured screening programme and key performance indicators are presented here in a summary document of the second guidelines edition in order to make these principles and standards known to a wider scientific community.

Significant reduction in vancomycin-resistant enterococcus colonization and bacteraemia after introduction of a bleach-based cleaning-disinfection programme.

PubMed

Grabsch, E A; Mahony, A A; Cameron, D R M; Martin, R D; Heland, M; Davey, P; Petty, M; Xie, S; Grayson, M L

2012-12-01

Vancomycin-resistant enterococcus (VRE) colonization and infection have increased at our hospital, despite adherence to standard VRE control guidelines. We implemented a multi-modal, hospital-wide improvement programme including a bleach-based cleaning-disinfection programme ('Bleach-Clean'). VRE colonization, infection and environmental contamination were compared pre and post implementation. The programme included a new product (sodium hypochlorite 1000 ppm + detergent), standardized cleaning-disinfection practices, employment of cleaning supervisors, and modified protocols to rely on alcohol-based hand hygiene and sleeveless aprons instead of long-sleeved gowns and gloves. VRE was isolated using chromogenic agar and/or routine laboratory methods. Outcomes were assessed during the 6 months pre and 12 months post implementation, including proportions (per 100 patients screened) of VRE colonization in high-risk wards (HRWs: intensive care, liver transplant, renal, haematology/oncology); proportions of environmental contamination; and episodes of VRE bacteraemia throughout the entire hospital. Significant reductions in newly recognized VRE colonizations (208/1948 patients screened vs 324/4035, a 24.8% reduction, P = 0.001) and environmental contamination (66.4% reduction, P = 0.012) were observed, but the proportion of patients colonized on admission was stable. The total burden of inpatients with VRE in the HRWs also declined (median percentage of colonized inpatients per week, 19.4% vs 17.3%, P = 0.016). Hospital-wide VRE bacteraemia declined from 14/2935 patients investigated to 5/6194 (83.1% reduction; P < 0.001), but there was no change in vancomycin-susceptible enterococcal bacteraemia (P = 0.54). The Bleach-Clean programme was associated with marked reductions in new VRE colonizations in high-risk patients, and VRE bacteraemia across the entire hospital. These findings have important implications for VRE control in endemic healthcare settings. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial

PubMed Central

Fiatarone Singh, Maria A; Bundy, Anita; Cumming, Robert G; Manollaras, Kate; O’Loughlin, Patricia; Black, Deborah

2012-01-01

Objectives To determine whether a lifestyle integrated approach to balance and strength training is effective in reducing the rate of falls in older, high risk people living at home. Design Three arm, randomised parallel trial; assessments at baseline and after six and 12 months. Randomisation done by computer generated random blocks, stratified by sex and fall history and concealed by an independent secure website. Setting Residents in metropolitan Sydney, Australia. Participants Participants aged 70 years or older who had two or more falls or one injurious fall in past 12 months, recruited from Veteran’s Affairs databases and general practice databases. Exclusion criteria were moderate to severe cognitive problems, inability to ambulate independently, neurological conditions that severely influenced gait and mobility, resident in a nursing home or hostel, or any unstable or terminal illness that would affect ability to do exercises. Interventions Three home based interventions: Lifestyle integrated Functional Exercise (LiFE) approach (n=107; taught principles of balance and strength training and integrated selected activities into everyday routines), structured programme (n=105; exercises for balance and lower limb strength, done three times a week), sham control programme (n=105; gentle exercise). LiFE and structured groups received five sessions with two booster visits and two phone calls; controls received three home visits and six phone calls. Assessments made at baseline and after six and 12 months. Main outcome measures Primary measure: rate of falls over 12 months, collected by self report. Secondary measures: static and dynamic balance; ankle, knee and hip strength; balance self efficacy; daily living activities; participation; habitual physical activity; quality of life; energy expenditure; body mass index; and fat free mass. Results After 12 months’ follow-up, we recorded 172, 193, and 224 falls in the LiFE, structured exercise, and control groups, respectively. The overall incidence of falls in the LiFE programme was 1.66 per person years, compared with 1.90 in the structured programme and 2.28 in the control group. We saw a significant reduction of 31% in the rate of falls for the LiFE programme compared with controls (incidence rate ratio 0.69 (95% confidence interval 0.48 to 0.99)); the corresponding difference between the structured group and controls was non-significant (0.81 (0.56 to 1.17)). Static balance on an eight level hierarchy scale, ankle strength, function, and participation were significantly better in the LiFE group than in controls. LiFE and structured groups had a significant and moderate improvement in dynamic balance, compared with controls. Conclusions The LiFE programme provides an alternative to traditional exercise to consider for fall prevention. Functional based exercise should be a focus for interventions to protect older, high risk people from falling and to improve and maintain functional capacity. Trial registration Australia and New Zealand Clinical Trials Registry 12606000025538. PMID:22872695

Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial.

PubMed

Clemson, Lindy; Fiatarone Singh, Maria A; Bundy, Anita; Cumming, Robert G; Manollaras, Kate; O'Loughlin, Patricia; Black, Deborah

2012-08-07

To determine whether a lifestyle integrated approach to balance and strength training is effective in reducing the rate of falls in older, high risk people living at home. Three arm, randomised parallel trial; assessments at baseline and after six and 12 months. Randomisation done by computer generated random blocks, stratified by sex and fall history and concealed by an independent secure website. Residents in metropolitan Sydney, Australia. Participants aged 70 years or older who had two or more falls or one injurious fall in past 12 months, recruited from Veteran's Affairs databases and general practice databases. Exclusion criteria were moderate to severe cognitive problems, inability to ambulate independently, neurological conditions that severely influenced gait and mobility, resident in a nursing home or hostel, or any unstable or terminal illness that would affect ability to do exercises. Three home based interventions: Lifestyle integrated Functional Exercise (LiFE) approach (n=107; taught principles of balance and strength training and integrated selected activities into everyday routines), structured programme (n=105; exercises for balance and lower limb strength, done three times a week), sham control programme (n=105; gentle exercise). LiFE and structured groups received five sessions with two booster visits and two phone calls; controls received three home visits and six phone calls. Assessments made at baseline and after six and 12 months. Primary measure: rate of falls over 12 months, collected by self report. Secondary measures: static and dynamic balance; ankle, knee and hip strength; balance self efficacy; daily living activities; participation; habitual physical activity; quality of life; energy expenditure; body mass index; and fat free mass. After 12 months' follow-up, we recorded 172, 193, and 224 falls in the LiFE, structured exercise, and control groups, respectively. The overall incidence of falls in the LiFE programme was 1.66 per person years, compared with 1.90 in the structured programme and 2.28 in the control group. We saw a significant reduction of 31% in the rate of falls for the LiFE programme compared with controls (incidence rate ratio 0.69 (95% confidence interval 0.48 to 0.99)); the corresponding difference between the structured group and controls was non-significant (0.81 (0.56 to 1.17)). Static balance on an eight level hierarchy scale, ankle strength, function, and participation were significantly better in the LiFE group than in controls. LiFE and structured groups had a significant and moderate improvement in dynamic balance, compared with controls. The LiFE programme provides an alternative to traditional exercise to consider for fall prevention. Functional based exercise should be a focus for interventions to protect older, high risk people from falling and to improve and maintain functional capacity. Australia and New Zealand Clinical Trials Registry 12606000025538.

A mixed-method systematic review of the effectiveness and acceptability of preoperative psychological preparation programmes to reduce paediatric preoperative anxiety in elective surgery.

PubMed

Dai, Ying; Livesley, Joan

2018-05-13

To explore the effectiveness of preoperative psychological preparation programmes aimed to reduce paediatric preoperative anxiety and the potential factors that could have an impact on parent and children's acceptance of such interventions. Various preoperative psychological preparation programmes are available to address paediatric preoperative anxiety. No mixed-method review has been conducted to explore the effectiveness and acceptability of these programmes. A mixed-method systematic review. Seven bibliographic databases were searched from inception to September 2016, complemented by hand searching of key journals, the reference lists of relevant reviews, search for grey literature and the contacting of associated experts. The review process was conducted based on the framework developed by the Evidence for Policy and Practice Information and Co-ordinating Centre. A narrative summary and a thematic synthesis were developed to synthesise the quantitative and qualitative data respectively, followed by a third synthesis to combine the previous syntheses. Nineteen controlled trials and eleven qualitative studies were included for data synthesis. The controlled trials reveal that educational multimedia applications and web-based programmes may reduce paediatric preoperative anxiety, while the effectiveness of therapeutic play and books remains uncertain. Qualitative studies showed parent-child dyads seek different levels of information. Providing matched information provision to each parent and child, actively involving children and their parents and teaching them coping skills, may be the essential hallmarks of a successful preoperative psychological preparation. Further research is necessary to confirm the effectiveness of therapeutic play and books. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Outcomes and process evaluation of a programme integrating physical activity into the primary school mathematics curriculum: The EASY Minds pilot randomised controlled trial.

PubMed

Riley, Nicholas; Lubans, David R; Morgan, Philip J; Young, Myles

2015-11-01

This study evaluated the feasibility of the 'Encouraging Activity to Stimulate Young (EASY) Minds' programme, a school-based intervention for integrating physical activity (PA) into mathematics lessons. Randomised controlled trial. Two classes from a single school (n = 54) were randomised to receive either the 6-week EASY Minds intervention (n = 27) or follow their usual school programme (n = 27). The intervention involved the embedding of PA across the pre-existing mathematics programme for 3 × 60 min sessions per week. Changes in PA were measured using accelerometers and 'on task' behaviour was measured using momentary time sampling observation. Using intention-to-treat analysis, significant intervention effects were found for MVPA (9.7%, 95%CI = 7.6, 11.8, p ≤ 0.001) and sedentary time (-22.4%, CI = -24.9, -12.2, p ≤ 0.001) for the intervention group during Mathematics lessons (9.30 am-10.30 am). Significant intervention effects were also shown for MVPA 8.7% (95% CI = 5.8, 11.6, p ≤ 0.001 and sedentary time -18.6% (95% CI = -24.9, -12.2, p ≤ 0.001) across the whole school day. Furthermore, children displayed significantly greater 'on-task' behaviour across the intervention period with a 19.9% (95%CI = 2.4, 37.4, p ≤ 0.03) mean difference between groups. The EASY Minds programme demonstrated that integrating movement across the primary mathematics syllabus is feasible and efficacious in enhancing school based-PA and improving on-task behaviour in mathematics lessons. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

A training programme to build cancer research capacity in low- and middle-income countries: findings from Guatemala.

PubMed

Arnold, Lauren D; Barnoya, Joaquin; Gharzouzi, Eduardo N; Benson, Peter; Colditz, Graham A

2014-04-01

Guatemala is experiencing an increasing burden of cancer but lacks capacity for cancer prevention, control and research. In partnership with a medical school in the United States of America, a multidisciplinary Cancer Control Research Training Institute was developed at the Instituto de Cancerología (INCAN) in Guatemala City. This institute provided a year-long training programme for clinicians that focused on research methods in population health and sociocultural anthropology. The programme included didactic experiences in Guatemala and the United States as well as applied training in which participants developed research protocols responsive to Guatemala's cancer needs. Although INCAN is the point of referral and service for Guatemala's cancer patients, the institute's administration is also interested in increasing cancer research - with a focus on population health. INCAN is thus a resource for capacity building within the context of cancer prevention and control. Trainees increased their self-efficacy for the design and conduct of research. Value-added benefits included establishment of an annual cancer seminar and workshops in cancer pathology and qualitative analysis. INCAN has recently incorporated some of the programme's components into its residency training and established a research department. A training programme for clinicians can build cancer research capacity in low- and middle-income countries. Training in population-based research methods will enable countries such as Guatemala to gather country-specific data. Once collected, such data can be used to assess the burden of cancer-related disease, guide policy for reducing it and identify priority areas for cancer prevention and treatment.

Advanced Map For Real-Time Process Control

NASA Astrophysics Data System (ADS)

Shiobara, Yasuhisa; Matsudaira, Takayuki; Sashida, Yoshio; Chikuma, Makoto

1987-10-01

MAP, a communications protocol for factory automation proposed by General Motors [1], has been accepted by users throughout the world and is rapidly becoming a user standard. In fact, it is now a LAN standard for factory automation. MAP is intended to interconnect different devices, such as computers and programmable devices, made by different manufacturers, enabling them to exchange information. It is based on the OSI intercomputer com-munications protocol standard under development by the ISO. With progress and standardization, MAP is being investigated for application to process control fields other than factory automation [2]. The transmission response time of the network system and centralized management of data exchanged with various devices for distributed control are import-ant in the case of a real-time process control with programmable controllers, computers, and instruments connected to a LAN system. MAP/EPA and MINI MAP aim at reduced overhead in protocol processing and enhanced transmission response. If applied to real-time process control, a protocol based on point-to-point and request-response transactions limits throughput and transmission response. This paper describes an advanced MAP LAN system applied to real-time process control by adding a new data transmission control that performs multicasting communication voluntarily and periodically in the priority order of data to be exchanged.

Participant experiences of two successful habit-based weight-loss interventions in Australia: a qualitative study

PubMed Central

2018-01-01

Objectives Habit-based weight-loss interventions have shown clinically important weight loss and weight-loss maintenance. Understanding why habit-based interventions work is therefore of great value, but there is little qualitative evidence about the experiences of participants in such programmes. We explored the perspectives of individuals who completed two habit-based weight-management programmes, Ten Top Tips and Do Something Different. Design One-on-one, face-to-face, semistructured interviews were conducted and analysed thematically. Setting Participants from the community were interviewed at Bond University, Australia. Participants Using a maximum variation design, we recruited 15 participants (eight men, seven women) aged 39–69 years (mean 53.3 years, SD 10.3) with a range of education levels (no high school to university degree) and percentage weight change on the programmes (+4.0% to −10.4%). Main outcome measures (1) The general experience of participants who completed the Ten Top Tips or Do Something Different intervention, (2) whether and how the interventions affected the participants’ lifestyle postintervention, and (3) participants’ views regarding the acceptability and practical application of Ten Top Tips and Do Something Different. Results Participants reported positive experiences of the two programmes, both during and after the interventions. Participants particularly enjoyed the novelty of the interventions as they shifted focus from diet and exercise, to practical everyday habit changes. They also reported indirect health benefits such as increased energy levels, increased confidence and improved self-awareness. Accountability throughout the programmes and convenience of the interventions were identified as key themes and facilitators for weight-loss success. Conclusions This study offers insight into how and why habit-based interventions might work. Overall, Ten Top Tips and Do Something Different are practical and convenient to implement, and are viewed favourably by participants when compared with conventional lifestyle programmes for weight control. Trial registration number ACTRN12615000114549. PMID:29858412

Method and infrastructure for cycle-reproducible simulation on large scale digital circuits on a coordinated set of field-programmable gate arrays (FPGAs)

DOEpatents

Asaad, Sameh W; Bellofatto, Ralph E; Brezzo, Bernard; Haymes, Charles L; Kapur, Mohit; Parker, Benjamin D; Roewer, Thomas; Tierno, Jose A

2014-01-28

A plurality of target field programmable gate arrays are interconnected in accordance with a connection topology and map portions of a target system. A control module is coupled to the plurality of target field programmable gate arrays. A balanced clock distribution network is configured to distribute a reference clock signal, and a balanced reset distribution network is coupled to the control module and configured to distribute a reset signal to the plurality of target field programmable gate arrays. The control module and the balanced reset distribution network are cooperatively configured to initiate and control a simulation of the target system with the plurality of target field programmable gate arrays. A plurality of local clock control state machines reside in the target field programmable gate arrays. The local clock state machines are configured to generate a set of synchronized free-running and stoppable clocks to maintain cycle-accurate and cycle-reproducible execution of the simulation of the target system. A method is also provided.

Peer-led diabetes self-management programme for community-dwelling older people in China: study protocol for a quasi-experimental design.

PubMed

Shen, Huixia; Edwards, Helen; Courtney, Mary; McDowell, Jan; Wu, Ming

2012-12-01

A protocol for a new peer-led self-management programme for community-dwelling older people with diabetes in Shanghai, China. The increasing prevalence of type 2 diabetes poses major public health challenges. Appropriate education programmes could help people with diabetes to achieve self-management and better health outcomes. Providing education programmes to the fast growing number of people with diabetes present a real challenge to Chinese healthcare system, which is strained for personnel and funding shortages. Empirical literature and expert opinions suggest that peer education programmes are promising. Quasi-experimental. This study is a non-equivalent control group design (protocol approved in January, 2008). A total of 190 people, with 95 participants in each group, will be recruited from two different, but similar, communities. The programme, based on Social Cognitive Theory, will consist of basic diabetes instruction and social support and self-efficacy enhancing group activities. Basic diabetes instruction sessions will be delivered by health professionals, whereas social support and self-efficacy enhancing group activities will be led by peer leaders. Outcome variables include: self-efficacy, social support, self-management behaviours, depressive status, quality of life and healthcare utilization, which will be measured at baseline, 4 and 12 weeks. This theory-based programme tailored to Chinese patients has potential for improving diabetes self-management and subsequent health outcomes. In addition, the delivery mode, through involvement of peer leaders and existing community networks, is especially promising considering healthcare resource shortage in China. © 2012 Blackwell Publishing Ltd.

Methodology and results of integrated WNV surveillance programmes in Serbia

PubMed Central

Šekler, Milanko; Petrić, Dušan; Lazić, Sava; Debeljak, Zoran; Vidanović, Dejan; Ignjatović Ćupina, Aleksandra; Lazić, Gospava; Lupulović, Diana; Kolarević, Mišo; Plavšić, Budimir

2018-01-01

Studies conducted during the past few years have confirmed active West Nile virus (WNV) circulation in Serbia. Based on these studies and the epidemiological situation, the Veterinary Directorate of the Ministry of Agriculture and Environmental Protection launched national WNV surveillance programmes in 2014 and 2015. The programmes encompassed the territory of Serbia and were conducted by the veterinary service in collaboration with entomologists and ornithologists. The objective of the programmes was early detection of WNV and timely reporting to the public health service and local authorities to increase both clinical and mosquito control preparedness. The WNV surveillance programmes were based on direct and indirect surveillance of the presence of WNV by the serological testing of initially seronegative sentinel horses and chickens as well as through viral detection in pooled mosquito and wild bird samples. The most intense WNV circulation was observed in all seven districts of Vojvodina Province (northern Serbia) and Belgrade City, where most of the positive samples were detected among sentinel animals, mosquitoes and wild birds. The West Nile virus surveillance programmes in 2014 and 2015 showed satisfactory results in their capacity to indicate the spatial distribution of the risk for humans and their sensitivity to early detect viral circulation at the enzootic level. Most of the human cases were preceded by the detection of WNV circulation as part of the surveillance programmes. According to the existing data, it can be reasonably assumed that WNV infection, now an endemic infection in Serbia, will continue to present a significant problem for the veterinary service and public health. PMID:29624622

Increasing engagement with, and effectiveness of, an online CBT-based stress management intervention for employees through the use of an online facilitated bulletin board: study protocol for a pilot randomised controlled trial.

PubMed

Carolan, Stephany; Harris, Peter R; Greenwood, Kathryn; Cavanagh, Kate

2016-12-15

The evidence for the benefits of online cognitive behaviour therapy (CBT)-based programmes delivered in a clinical context is clear, but this evidence does not translate to online CBT-based stress management programmes delivered within a workplace context. One of the challenges to the delivery of online interventions is programme engagement; this challenge is even more acute for interventions delivered in real-world settings such as the workplace. The purpose of this pilot study is to explore the effect of an online facilitated discussion group on engagement, and to estimate the potential effectiveness of an online CBT-based stress management programme. This study is a three-arm randomised controlled trial (RCT) comparing a minimally guided, online, CBT-based stress management intervention delivered with and without an online facilitated bulletin board, and a wait list control group. Up to 90 employees from six UK-based organisations will be recruited to the study. Inclusion criteria will include age 18 years or over, elevated levels of stress (as measured on the PSS-10 scale), access to a computer or a tablet and the Internet. The primary outcome measure will be engagement, as defined by the number of logins to the site; secondary outcome measures will include further measures of engagement (the number of pages visited, the number of modules completed and self-report engagement) and measures of effectiveness (psychological distress and subjective wellbeing). Possible moderators will include measures of intervention quality (satisfaction, acceptability, credibility, system usability), time pressure, goal conflict, levels of distress at baseline and job autonomy. Measures will be taken at baseline, 2 weeks (credibility and expectancy measures only), 8 weeks (completion of intervention) and 16 weeks (follow-up). Primary analysis will be conducted on intention-to-treat principles. To our knowledge this is the first study to explore the effect of an online discussion group on the engagement and effectiveness of an online CBT-based stress management intervention. This study could provide a solution to the growing problem of poor employee psychological health and begin to address the challenge of increasing engagement with Internet-delivered health interventions. ClinicalTrials.gov Identifier: NCT02729987 . Registered on 18 Mar 2016.

Effect of comprehensive cardiac telerehabilitation on one-year cardiovascular rehospitalization rate, medical costs and quality of life: A cost-effectiveness analysis.

PubMed

Frederix, Ines; Hansen, Dominique; Coninx, Karin; Vandervoort, Pieter; Vandijck, Dominique; Hens, Niel; Van Craenenbroeck, Emeline; Van Driessche, Niels; Dendale, Paul

2016-05-01

Notwithstanding the cardiovascular disease epidemic, current budgetary constraints do not allow for budget expansion of conventional cardiac rehabilitation programmes. Consequently, there is an increasing need for cost-effectiveness studies of alternative strategies such as telerehabilitation. The present study evaluated the cost-effectiveness of a comprehensive cardiac telerehabilitation programme. This multi-centre randomized controlled trial comprised 140 cardiac rehabilitation patients, randomized (1:1) to a 24-week telerehabilitation programme in addition to conventional cardiac rehabilitation (intervention group) or to conventional cardiac rehabilitation alone (control group). The incremental cost-effectiveness ratio was calculated based on intervention and health care costs (incremental cost), and the differential incremental quality adjusted life years (QALYs) gained. The total average cost per patient was significantly lower in the intervention group (€2156 ± €126) than in the control group (€2720 ± €276) (p = 0.01) with an overall incremental cost of €-564.40. Dividing this incremental cost by the baseline adjusted differential incremental QALYs (0.026 QALYs) yielded an incremental cost-effectiveness ratio of €-21,707/QALY. The number of days lost due to cardiovascular rehospitalizations in the intervention group (0.33 ± 0.15) was significantly lower than in the control group (0.79 ± 0.20) (p = 0.037). This paper shows the addition of cardiac telerehabilitation to conventional centre-based cardiac rehabilitation to be more effective and efficient than centre-based cardiac rehabilitation alone. These results are useful for policy makers charged with deciding how limited health care resources should best be allocated in the era of exploding need. © The European Society of Cardiology 2015.

Novel Television-Based Cognitive Training Improves Working Memory and Executive Function

PubMed Central

Shatil, Evelyn; Mikulecká, Jaroslava; Bellotti, Francesco; Bureš, Vladimír

2014-01-01

The main study objective was to investigate the effect of interactive television-based cognitive training on cognitive performance of 119 healthy older adults, aged 60–87 years. Participants were randomly allocated to a cognitive training group or to an active control group in a single-blind controlled two-group design. Before and after training interactive television cognitive performance was assessed on well validated tests of fluid, higher-order ability, and system usability was evaluated. The participants in the cognitive training group completed a television-based cognitive training programme, while the participants in the active control group completed a TV-based programme of personally benefiting activities. Significant improvements were observed in well validated working memory and executive function tasks in the cognitive training but not in the control group. None of the groups showed statistically significant improvement in life satisfaction score. Participants' reports of “adequate” to “high” system usability testify to the successful development and implementation of the interactive television-based system and compliant cognitive training contents. The study demonstrates that cognitive training delivered by means of an interactive television system can generate genuine cognitive benefits in users and these are measurable using well-validated cognitive tests. Thus, older adults who cannot use or afford a computer can easily use digital interactive television to benefit from advanced software applications designed to train cognition. PMID:24992187

A programmable metasurface with dynamic polarization, scattering and focusing control

NASA Astrophysics Data System (ADS)

Yang, Huanhuan; Cao, Xiangyu; Yang, Fan; Gao, Jun; Xu, Shenheng; Li, Maokun; Chen, Xibi; Zhao, Yi; Zheng, Yuejun; Li, Sijia

2016-10-01

Diverse electromagnetic (EM) responses of a programmable metasurface with a relatively large scale have been investigated, where multiple functionalities are obtained on the same surface. The unit cell in the metasurface is integrated with one PIN diode, and thus a binary coded phase is realized for a single polarization. Exploiting this anisotropic characteristic, reconfigurable polarization conversion is presented first. Then the dynamic scattering performance for two kinds of sources, i.e. a plane wave and a point source, is carefully elaborated. To tailor the scattering properties, genetic algorithm, normally based on binary coding, is coupled with the scattering pattern analysis to optimize the coding matrix. Besides, inverse fast Fourier transform (IFFT) technique is also introduced to expedite the optimization process of a large metasurface. Since the coding control of each unit cell allows a local and direct modulation of EM wave, various EM phenomena including anomalous reflection, diffusion, beam steering and beam forming are successfully demonstrated by both simulations and experiments. It is worthwhile to point out that a real-time switch among these functionalities is also achieved by using a field-programmable gate array (FPGA). All the results suggest that the proposed programmable metasurface has great potentials for future applications.

A programmable metasurface with dynamic polarization, scattering and focusing control

PubMed Central

Yang, Huanhuan; Cao, Xiangyu; Yang, Fan; Gao, Jun; Xu, Shenheng; Li, Maokun; Chen, Xibi; Zhao, Yi; Zheng, Yuejun; Li, Sijia

2016-01-01

Diverse electromagnetic (EM) responses of a programmable metasurface with a relatively large scale have been investigated, where multiple functionalities are obtained on the same surface. The unit cell in the metasurface is integrated with one PIN diode, and thus a binary coded phase is realized for a single polarization. Exploiting this anisotropic characteristic, reconfigurable polarization conversion is presented first. Then the dynamic scattering performance for two kinds of sources, i.e. a plane wave and a point source, is carefully elaborated. To tailor the scattering properties, genetic algorithm, normally based on binary coding, is coupled with the scattering pattern analysis to optimize the coding matrix. Besides, inverse fast Fourier transform (IFFT) technique is also introduced to expedite the optimization process of a large metasurface. Since the coding control of each unit cell allows a local and direct modulation of EM wave, various EM phenomena including anomalous reflection, diffusion, beam steering and beam forming are successfully demonstrated by both simulations and experiments. It is worthwhile to point out that a real-time switch among these functionalities is also achieved by using a field-programmable gate array (FPGA). All the results suggest that the proposed programmable metasurface has great potentials for future applications. PMID:27774997

A programmable metasurface with dynamic polarization, scattering and focusing control.

PubMed

Yang, Huanhuan; Cao, Xiangyu; Yang, Fan; Gao, Jun; Xu, Shenheng; Li, Maokun; Chen, Xibi; Zhao, Yi; Zheng, Yuejun; Li, Sijia

2016-10-24

Diverse electromagnetic (EM) responses of a programmable metasurface with a relatively large scale have been investigated, where multiple functionalities are obtained on the same surface. The unit cell in the metasurface is integrated with one PIN diode, and thus a binary coded phase is realized for a single polarization. Exploiting this anisotropic characteristic, reconfigurable polarization conversion is presented first. Then the dynamic scattering performance for two kinds of sources, i.e. a plane wave and a point source, is carefully elaborated. To tailor the scattering properties, genetic algorithm, normally based on binary coding, is coupled with the scattering pattern analysis to optimize the coding matrix. Besides, inverse fast Fourier transform (IFFT) technique is also introduced to expedite the optimization process of a large metasurface. Since the coding control of each unit cell allows a local and direct modulation of EM wave, various EM phenomena including anomalous reflection, diffusion, beam steering and beam forming are successfully demonstrated by both simulations and experiments. It is worthwhile to point out that a real-time switch among these functionalities is also achieved by using a field-programmable gate array (FPGA). All the results suggest that the proposed programmable metasurface has great potentials for future applications.

Time--temperature indicator for perishable products based on kinetically programmable Ag overgrowth on Au nanorods.

PubMed

Zhang, Chao; Yin, An-Xiang; Jiang, Ruibin; Rong, Jie; Dong, Lu; Zhao, Tian; Sun, Ling-Dong; Wang, Jianfang; Chen, Xing; Yan, Chun-Hua

2013-05-28

Food safety is a constant concern for humans. Besides adulteration and contamination, another major threat comes from the spontaneous spoilage of perishable products, which is basically inevitable and highly dependent on the temperature history during the custody chain. For advanced quality control and assessment, time-temperature indicators (TTIs) can be deployed to document the temperature history. However, the use of TTIs is currently limited by either relatively high cost or poor programmability. Here we describe a general, kinetically programmable, and cost-efficient TTI protocol constructed from plasmonic nanocrystals. We present proof-of-principle demonstrations that our TTI can be specifically tailored and thus used to track perishables, dynamically mimic the deteriorative processes therein, and indicate product quality through sharp-contrast multicolor changes. The flexible programmability of our TTI, combined with its substantially low cost and low toxicity, promises a general applicability to each single packaged item of a plethora of perishable products.

Considerations on BVD eradication for the Irish livestock industry

PubMed Central

2011-01-01

Animal Health Ireland has produced clear guidelines for the control of Bovine Viral Diarrhoea (BVD) infection in Irish cattle herds. In the course of developing these guidelines it was clear that a framework for regional and/or national BVD control would be required to increase the uptake of BVD control at farm level and reduce the overall prevalence of the disease. This paper assessed the economic impact of BVD, epidemiological aspects of the disease to its control, models of BVD control, international experiences of BVD control programmes. The technical knowledge and test technology exists to eradicate BVD. Indeed, many countries have successfully and others are embarking on control of the disease. The identification and prompt elimination of PI cattle will form the basis of any control programme. The trade of such animals must be curtailed. Pregnant and potentially pregnant carrying PI foetuses pose a significant threat. International experience indicates systematic, well coordinated programmes have the most success, while voluntary programmes can make good initial progress but ultimately fail. The farming community must buy into any proposed programme, and without their support, failure is likely. To buy into the programme and create such a demand for BVD control, farmers must first be well informed. It is likely that stemming economic loss and improving productivity will be the primary motivator at individual farm level. PMID:21967764

Comparison between exclusively school teacher-based and mixed school teacher and healthcare provider-based programme on basic cardiopulmonary resuscitation for secondary schools.

PubMed

Jiménez-Fábrega, X; Escalada-Roig, X; Miró, O; Sanclemente, G; Díaz, N; Gómez, X; Villena, O; Rodríguez, E; Gaspar, A; Molina, J E; Salvador, J; Sánchez, M

2009-09-01

To compare two teaching methodologies for PROCES (a basic cardiopulmonary resuscitation (b-CPR) programme for secondary school students): one exclusively performed by school teachers (study group) and another by a mixed team of school teachers and healthcare providers (control group). According to their preferences, teachers chose either method and students were consequently assigned to the control or study group. All participants took a 10 multiple-choice question exam regarding b-CPR skills twice: immediately after PROCES and one year later. Eight or more correct answers was considered satisfactory learning. Results between groups were compared. Associations between satisfactory learning and some student characteristics were analysed. Immediately after PROCES, 442 students (219 in the study group and 223 in the control group) took the exam. The percentage of satisfactory learning was not different: 67.1% in the study group and 64.6% in the control group. Immediate satisfactory learning was related to the absence of pending subjects in the control (odds ratio (OR) 2.31, 95% CI 1.16 to 4.64) and study (OR 5.87, 95% CI 1.22 to 28.20) groups. One year later, a greater percentage of retention of b-CRP skills was detected in the study group (57.1% vs 40.6%; p = 0.01). The absence of any pending subject (OR 6.86, 95% CI 1.83 to 25.66) was independently associated with better retention in the study group, but not the control group. Secondary school teachers, previously trained in b-CPR, can teach these skills effectively to 14-16-year-old students using PROCES. The retention of b-CPR skills is greater with this methodology compared with a more standardised programme.

Cost of microbial larviciding for malaria control in rural Tanzania.

PubMed

Rahman, Rifat; Lesser, Adriane; Mboera, Leonard; Kramer, Randall

2016-11-01

Microbial larviciding may be a potential supplement to conventional malaria vector control measures, but scant information on its relative implementation costs and effectiveness, especially in rural areas, is an impediment to expanding its uptake. We perform a costing analysis of a seasonal microbial larviciding programme in rural Tanzania. We evaluated the financial and economic costs from the perspective of the public provider of a 3-month, community-based larviciding intervention implemented in twelve villages in the Mvomero District of Tanzania in 2012-2013. Cost data were collected from financial reports and invoices and through discussion with programme administrators. Sensitivity analysis explored the robustness of our results to varying key parameters. Over the 2-year study period, approximately 6873 breeding sites were treated with larvicide. The average annual economic costs of the larviciding intervention in rural Tanzania are estimated at 2014 US$ 1.44 per person protected per year (pppy), US$ 6.18 per household and US$ 4481.88 per village, with the larvicide and staffing accounting for 14% and 58% of total costs, respectively. We found the costs pppy of implementing a seasonal larviciding programme in rural Tanzania to be comparable to the costs of other larviciding programmes in urban Tanzania and rural Kenya. Further research should evaluate the cost-effectiveness of larviciding relative to, and in combination with, other vector control strategies in rural settings. © 2016 John Wiley & Sons Ltd.

Improving immunization of programmable logic controllers using weighted median filters.

PubMed

Paredes, José L; Díaz, Dhionel

2005-04-01

This paper addresses the problem of improving immunization of programmable logic controllers (PLC's) to electromagnetic interference with impulsive characteristics. A filtering structure, based on weighted median filters, that does not require additional hardware and can be implemented in legacy PLC's is proposed. The filtering operation is implemented in the binary domain and removes the impulsive noise presented in the discrete input adding thus robustness to PLC's. By modifying the sampling clock structure, two variants of the filter are obtained. Both structures exploit the cyclic nature of the PLC to form an N-sample observation window of the discrete input, hence a status change on it is determined by the filter output taking into account all the N samples avoiding thus that a single impulse affects the PLC functionality. A comparative study, based on a statistical analysis, of the different filters' performances is presented.

A DNA-based molecular motor that can navigate a network of tracks

NASA Astrophysics Data System (ADS)

Wickham, Shelley F. J.; Bath, Jonathan; Katsuda, Yousuke; Endo, Masayuki; Hidaka, Kumi; Sugiyama, Hiroshi; Turberfield, Andrew J.

2012-03-01

Synthetic molecular motors can be fuelled by the hydrolysis or hybridization of DNA. Such motors can move autonomously and programmably, and long-range transport has been observed on linear tracks. It has also been shown that DNA systems can compute. Here, we report a synthetic DNA-based system that integrates long-range transport and information processing. We show that the path of a motor through a network of tracks containing four possible routes can be programmed using instructions that are added externally or carried by the motor itself. When external control is used we find that 87% of the motors follow the correct path, and when internal control is used 71% of the motors follow the correct path. Programmable motion will allow the development of computing networks, molecular systems that can sort and process cargoes according to instructions that they carry, and assembly lines that can be reconfigured dynamically in response to changing demands.

A programmable droplet-based microfluidic device applied to multiparameter analysis of single microbes and microbial communities

PubMed Central

Leung, Kaston; Zahn, Hans; Leaver, Timothy; Konwar, Kishori M.; Hanson, Niels W.; Pagé, Antoine P.; Lo, Chien-Chi; Chain, Patrick S.; Hallam, Steven J.; Hansen, Carl L.

2012-01-01

We present a programmable droplet-based microfluidic device that combines the reconfigurable flow-routing capabilities of integrated microvalve technology with the sample compartmentalization and dispersion-free transport that is inherent to droplets. The device allows for the execution of user-defined multistep reaction protocols in 95 individually addressable nanoliter-volume storage chambers by consecutively merging programmable sequences of picoliter-volume droplets containing reagents or cells. This functionality is enabled by “flow-controlled wetting,” a droplet docking and merging mechanism that exploits the physics of droplet flow through a channel to control the precise location of droplet wetting. The device also allows for automated cross-contamination-free recovery of reaction products from individual chambers into standard microfuge tubes for downstream analysis. The combined features of programmability, addressability, and selective recovery provide a general hardware platform that can be reprogrammed for multiple applications. We demonstrate this versatility by implementing multiple single-cell experiment types with this device: bacterial cell sorting and cultivation, taxonomic gene identification, and high-throughput single-cell whole genome amplification and sequencing using common laboratory strains. Finally, we apply the device to genome analysis of single cells and microbial consortia from diverse environmental samples including a marine enrichment culture, deep-sea sediments, and the human oral cavity. The resulting datasets capture genotypic properties of individual cells and illuminate known and potentially unique partnerships between microbial community members. PMID:22547789

A digital optical phase-locked loop for diode lasers based on field programmable gate array.

PubMed

Xu, Zhouxiang; Zhang, Xian; Huang, Kaikai; Lu, Xuanhui

2012-09-01

We have designed and implemented a highly digital optical phase-locked loop (OPLL) for diode lasers in atom interferometry. The three parts of controlling circuit in this OPLL, including phase and frequency detector (PFD), loop filter and proportional integral derivative (PID) controller, are implemented in a single field programmable gate array chip. A structure type compatible with the model MAX9382∕MCH12140 is chosen for PFD and pipeline and parallelism technology have been adapted in PID controller. Especially, high speed clock and twisted ring counter have been integrated in the most crucial part, the loop filter. This OPLL has the narrow beat note line width below 1 Hz, residual mean-square phase error of 0.14 rad(2) and transition time of 100 μs under 10 MHz frequency step. A main innovation of this design is the completely digitalization of the whole controlling circuit in OPLL for diode lasers.

A digital optical phase-locked loop for diode lasers based on field programmable gate array

NASA Astrophysics Data System (ADS)

Xu, Zhouxiang; Zhang, Xian; Huang, Kaikai; Lu, Xuanhui

2012-09-01

We have designed and implemented a highly digital optical phase-locked loop (OPLL) for diode lasers in atom interferometry. The three parts of controlling circuit in this OPLL, including phase and frequency detector (PFD), loop filter and proportional integral derivative (PID) controller, are implemented in a single field programmable gate array chip. A structure type compatible with the model MAX9382/MCH12140 is chosen for PFD and pipeline and parallelism technology have been adapted in PID controller. Especially, high speed clock and twisted ring counter have been integrated in the most crucial part, the loop filter. This OPLL has the narrow beat note line width below 1 Hz, residual mean-square phase error of 0.14 rad2 and transition time of 100 μs under 10 MHz frequency step. A main innovation of this design is the completely digitalization of the whole controlling circuit in OPLL for diode lasers.

Programmable immersive peripheral environmental system (PIPES): a prototype control system for environmental feedback devices

NASA Astrophysics Data System (ADS)

Frend, Chauncey; Boyles, Michael

2015-03-01

This paper describes an environmental feedback device (EFD) control system aimed at simplifying the VR development cycle. Programmable Immersive Peripheral Environmental System (PIPES) affords VR developers a custom approach to programming and controlling EFD behaviors while relaxing the required knowledge and expertise of electronic systems. PIPES has been implemented for the Unity engine and features EFD control using the Arduino integrated development environment. PIPES was installed and tested on two VR systems, a large format CAVE system and an Oculus Rift HMD system. A photocell based end-to-end latency experiment was conducted to measure latency within the system. This work extends previously unpublished prototypes of a similar design. Development and experiments described in this paper are part of the VR community goal to understand and apply environment effects to VEs that ultimately add to users' perceived presence.

Global policy and programme guidance on maternal nutrition: what exists, the mechanisms for providing it, and how to improve them?

PubMed

Shrimpton, Roger

2012-07-01

Undernutrition in one form or another affects the majority of women of reproductive age in most developing countries. However, there are few or no effective programmes trying to solve maternal undernutrition problems. The purpose of the paper is to examine global policy and programme guidance mechanisms for nutrition, what their content is with regard to maternal nutrition in particular, as well as how these might be improved. Almost all countries have committed themselves politically to ensuring the right of pregnant and lactating women to good nutrition through the Convention on the Elimination of all Forms of Discrimination Against Women. Despite this, the World Health Organization (WHO) has not endorsed any policy commitments with regard to maternal nutrition. The only policy guidance coming from the various technical departments of WHO relates to the control of maternal anaemia. There is no policy or programme guidance concerning issues of maternal thinness, weight gain during pregnancy and/or low birthweight prevention. Few if any countries have maternal nutrition programmes beyond those for maternal anaemia, and most of those are not effective. The lack of importance given to maternal nutrition is related in part to a weakness of evidence, related to the difficulty of getting ethical clearance, as well as a generalised tendency to downplay the importance of those interventions found to be efficacious. No priority has been given to implementing existing policy and programme guidance for the control of maternal anaemia largely because of a lack of any dedicated funding, linked to a lack of Millennium Development Goals indicator status. This is partly due to the poor evidence base, as well as to the common belief that maternal anaemia programmes were not effective, even if efficacious. The process of providing evidence-based policy and programme guidance to member states is currently being revamped and strengthened by the Department of Nutrition for Health and Development of WHO through the Nutrition Guidance Expert Advisory Group processes. How and if programme guidance, as well as policy commitment for improved maternal nutrition, will be strengthened through the Nutrition Guidance Expert Advisory Group process is as yet unclear. The global movement to increase investment in programmes aimed at maternal and child undernutrition called Scaling Up Nutrition offers an opportunity to build developing country experience with efforts to improve nutrition during pregnancy and lactation. All member states are being encouraged by the World Health Assembly to scale-up efforts to improve maternal infant and young child nutrition. Hopefully Ministries of Health in countries most affected by maternal and child undernutrition will take leadership in the development of such plans, and ensure that the control of anaemia during pregnancy is given a great priority among these actions, as well as building programme experience with improved nutrition during pregnancy and lactation. For this to happen it is essential that donor support is assured, even if only to spearhead a few flagship countries. © 2012 Blackwell Publishing Ltd.

Internet treatment for social phobia reduces comorbidity.

PubMed

Titov, Nickolai; Gibson, Matthew; Andrews, Gavin; McEvoy, Peter

2009-08-01

Social phobia can be treated by brief Internet-based cognitive behaviour therapy (CBT). Most people with social phobia, however, meet criteria for another mental disorder; this comorbidity is associated with significant disability, and cases of comorbidity may be more difficult to treat. The present study examined the impact of the Shyness programme, an Internet-based treatment programme for social phobia, on comorbid symptoms of depression and generalized anxiety disorder. Data from three randomized controlled trials using the Shyness programme to treat social phobia were reanalysed. The 211 subjects, all of whom met DSM-IV criteria for social phobia, were divided into four groups: (i) social phobia only; (ii) social phobia with elevated symptoms of depression; (iii) social phobia with elevated symptoms of generalized anxiety; and (iv) social phobia with elevated symptoms of both generalized anxiety and depression. The improvement in social phobia, depression and anxiety following Internet-based treatment for social phobia was measured. Improvement in social phobia was seen in all groups, whether comorbid or not. Significant improvements in comorbid symptoms of depression and generalized anxiety occurred even though the treatment was focused on the social phobia. Brief Internet-based CBT can reduce both the target disorder as well as comorbid symptoms. These findings are consistent with evidence that unified or transdiagnostic programmes may reduce the severity of comorbid disorders and symptoms, indicating an important direction for future research.

Psychological effects of a cosmetic education programme in patients with breast cancer.

PubMed

Park, H Y; Kim, J H; Choi, S; Kang, E; Oh, S; Kim, J Y; Kim, S W

2015-07-01

Treatments for breast cancer often include interventions related to psychosocial issues such as negative body image, loss of femininity, and low self-esteem. We identified the psychological effects of a cosmetics education programme in patients with breast cancer. Cosmetic programme is a specific care designed to help patients handle appearance-related side effects. Thirty-one women with breast cancer at a university hospital in South Korea who received a cosmetics education programme were compared with 29 subjects in a control group who received the treatment as usual. Psychological factors including distress, self-esteem, and sexual functioning were assessed three times (before and after the programme, and at the 1-month follow-up). After the programme, patients in the treatment group were significantly less likely than those in the control group to rely on distress (P = 0.038) and avoidance coping (P < 0.001) but not on self-esteem. The mean scores in the treatment group for sexual functioning were higher than those in the control group after the treatment. Our results suggest the potential usefulness of a brief cosmetics education programme for reducing distress and reliance on negative coping strategies. Implementing a cosmetics programme for patients with breast cancer may encourage patients to control negative psychological factors. © 2015 John Wiley & Sons Ltd.

Physiotherapy for sleep disturbance in chronic low back pain: a feasibility randomised controlled trial

PubMed Central

2010-01-01

Background Sleep disturbance is becoming increasingly recognised as a clinically important symptom in people with chronic low back pain (CLBP, low back pain >12 weeks), associated with physical inactivity and depression. Current research and international clinical guidelines recommend people with CLBP assume a physically active role in their recovery to prevent chronicity, but the high prevalence of sleep disturbance in this population may be unknowingly limiting their ability to participate in exercise-based rehabilitation programmes and contributing to poor outcomes. There is currently no knowledge concerning the effectiveness of physiotherapy on sleep disturbance in people with chronic low back pain and no evidence of the feasibility of conducting randomized controlled trials that comprehensively evaluate sleep as an outcome measure in this population. Methods/Design This study will evaluate the feasibility of a randomised controlled trial (RCT), exploring the effects of three forms of physiotherapy (supervised general exercise programme, individualized walking programme and usual physiotherapy, which will serve as the control group) on sleep quality in people with chronic low back pain. A presenting sample of 60 consenting patients will be recruited in the physiotherapy department of Beaumont Hospital, Dublin, Ireland, and randomly allocated to one of the three groups in a concealed manner. The main outcomes will be sleep quality (self-report and objective measurement), and self-reported functional disability, pain, quality of life, fear avoidance, anxiety and depression, physical activity, and patient satisfaction. Outcome will be evaluated at baseline, 3 months and 6 months. Qualitative telephone interviews will be embedded in the research design to obtain feedback from a sample of participants' about their experiences of sleep monitoring, trial participation and interventions, and to inform the design of a fully powered future RCT. Planned analysis will explore trends in the data, effect sizes and clinically important effects (quantitative data), and thematic analysis (qualitative data). Discussion This study will evaluate the feasibility of a randomised controlled trial exploring the effects of three forms of physiotherapy (supervised general exercise programme, individualized walking programme and usual physiotherapy, which will serve as the control group) on sleep quality in people with chronic low back pain. Trial Registration Current controlled trial ISRCTN54009836 PMID:20398349

Use of physiological knowledge to control the invasive sea lamprey (Petromyzon marinus) in the Laurentian Great Lakes.

PubMed

Siefkes, Michael J

2017-01-01

Sea lamprey ( Petromyzon marinus ) control in the Laurentian Great Lakes of North America is an example of using physiological knowledge to successfully control an invasive species and rehabilitate an ecosystem and valuable fishery. The parasitic sea lamprey contributed to the devastating collapse of native fish communities after invading the Great Lakes during the 1800s and early 1900s. Economic tragedy ensued with the loss of the fishery and severe impacts to property values and tourism resulting from sea lamprey-induced ecological changes. To control the sea lamprey and rehabilitate the once vibrant Great Lakes ecosystem and economy, the Great Lakes Fishery Commission (Commission) was formed by treaty between Canada and the United States in 1955. The Commission has developed a sea lamprey control programme based on their physiological vulnerabilities, which includes (i) the application of selective pesticides (lampricides), which successfully kill sedentary sea lamprey larvae in their natal streams; (ii) barriers to spawning migrations and associated traps to prevent infestations of upstream habitats and remove adult sea lamprey before they reproduce; and (iii) the release of sterilized males to reduce the reproductive potential of spawning populations in select streams. Since 1958, the application of the sea lamprey control programme has suppressed sea lamprey populations by ~90% from peak abundance. Great Lakes fish populations have rebounded and the economy is now thriving. In hopes of further enhancing the efficacy and selectivity of the sea lamprey control programme, the Commission is exploring the use of (i) sea lamprey chemosensory cues (pheromones and alarm cues) to manipulate behaviours and physiologies, and (ii) genetics to identify and manipulate genes associated with key physiological functions, for control purposes. Overall, the Commission capitalizes on the unique physiology of the sea lamprey and strives to develop a diverse integrated programme to successfully control a once devastating invasive species.

Use of physiological knowledge to control the invasive sea lamprey (Petromyzon marinus) in the Laurentian Great Lakes

PubMed Central

2017-01-01

Abstract Sea lamprey (Petromyzon marinus) control in the Laurentian Great Lakes of North America is an example of using physiological knowledge to successfully control an invasive species and rehabilitate an ecosystem and valuable fishery. The parasitic sea lamprey contributed to the devastating collapse of native fish communities after invading the Great Lakes during the 1800s and early 1900s. Economic tragedy ensued with the loss of the fishery and severe impacts to property values and tourism resulting from sea lamprey-induced ecological changes. To control the sea lamprey and rehabilitate the once vibrant Great Lakes ecosystem and economy, the Great Lakes Fishery Commission (Commission) was formed by treaty between Canada and the United States in 1955. The Commission has developed a sea lamprey control programme based on their physiological vulnerabilities, which includes (i) the application of selective pesticides (lampricides), which successfully kill sedentary sea lamprey larvae in their natal streams; (ii) barriers to spawning migrations and associated traps to prevent infestations of upstream habitats and remove adult sea lamprey before they reproduce; and (iii) the release of sterilized males to reduce the reproductive potential of spawning populations in select streams. Since 1958, the application of the sea lamprey control programme has suppressed sea lamprey populations by ~90% from peak abundance. Great Lakes fish populations have rebounded and the economy is now thriving. In hopes of further enhancing the efficacy and selectivity of the sea lamprey control programme, the Commission is exploring the use of (i) sea lamprey chemosensory cues (pheromones and alarm cues) to manipulate behaviours and physiologies, and (ii) genetics to identify and manipulate genes associated with key physiological functions, for control purposes. Overall, the Commission capitalizes on the unique physiology of the sea lamprey and strives to develop a diverse integrated programme to successfully control a once devastating invasive species. PMID:28580146

Distributed Autonomous Control Action Based on Sensor and Mission Fusion

DTIC Science & Technology

2005-09-01

programmable control algorithm driven by the readings of two pressure switch sensors located on either side of the valve unit. Thus, a micro-controller...and Characterization The process of leak detection and characterization must be accomplished with a set of pressure switch sensors. This sensor...economically supplementing existing widely used pressure switch type sensors which are characterized by prohibitively long inertial lag responses

Operational studies on the control of Taenia solium taeniasis/cysticercosis in Ecuador.

PubMed

Cruz, M; Davis, A; Dixon, H; Pawlowski, Z S; Proano, J

1989-01-01

A large-scale study in Loja and El Oro Provinces, Ecuador, demonstrated that population-based treatment of human taeniasis with a low dose of praziquantel is feasible and effective for the short-term control of transmission of Taenia solium in hyperendemic areas. Chemotherapeutic intervention also effectively promoted local preventive measures and contributed greatly to the elaboration of a long-term control programme.

Building capacity for sustainable research programmes for cancer in Africa.

PubMed

Adewole, Isaac; Martin, Damali N; Williams, Makeda J; Adebamowo, Clement; Bhatia, Kishor; Berling, Christine; Casper, Corey; Elshamy, Karima; Elzawawy, Ahmed; Lawlor, Rita T; Legood, Rosa; Mbulaiteye, Sam M; Odedina, Folakemi T; Olopade, Olufunmilayo I; Olopade, Christopher O; Parkin, Donald M; Rebbeck, Timothy R; Ross, Hana; Santini, Luiz A; Torode, Julie; Trimble, Edward L; Wild, Christopher P; Young, Annie M; Kerr, David J

2014-05-01

Cancer research in Africa will have a pivotal role in cancer control planning in this continent. However, environments (such as those in academic or clinical settings) with limited research infrastructure (laboratories, biorespositories, databases) coupled with inadequate funding and other resources have hampered African scientists from carrying out rigorous research. In September 2012, over 100 scientists with expertise in cancer research in Africa met in London to discuss the challenges in performing high-quality research, and to formulate the next steps for building sustainable, comprehensive and multi-disciplinary programmes relevant to Africa. This was the first meeting among five major organizations: the African Organisation for Research and Training in Africa (AORTIC), the Africa Oxford Cancer Foundation (AfrOx), and the National Cancer Institutes (NCI) of Brazil, France and the USA. This article summarizes the discussions and recommendations of this meeting, including the next steps required to create sustainable and impactful research programmes that will enable evidenced-based cancer control approaches and planning at the local, regional and national levels.

Building capacity for sustainable research programmes for cancer in Africa

PubMed Central

Adewole, Isaac; Martin, Damali N.; Williams, Makeda J.; Adebamowo, Clement; Bhatia, Kishor; Berling, Christine; Casper, Corey; Elshamy, Karima; Elzawawy, Ahmed; Lawlor, Rita T.; Legood, Rosa; Mbulaiteye, Sam M.; Odedina, Folakemi T.; Olopade, Olufunmilayo I.; Olopade, Christopher O.; Parkin, Donald M.; Rebbeck, Timothy R.; Ross, Hana; Santini, Luiz A.; Torode, Julie; Trimble, Edward L.; Wild, Christopher P.; Young, Annie M.; Kerr, David J.

2015-01-01

Cancer research in Africa will have a pivotal role in cancer control planning in this continent. However, environments (such as those in academic or clinical settings) with limited research infrastructure (laboratories, biorespositories, databases) coupled with inadequate funding and other resources have hampered African scientists from carrying out rigorous research. In September 2012, over 100 scientists with expertise in cancer research in Africa met in London to discuss the challenges in performing high-quality research, and to formulate the next steps for building sustainable, comprehensive and multi-disciplinary programmes relevant to Africa. This was the first meeting among five major organizations: the African Organisation for Research and Training in Africa (AORTIC), the Africa Oxford Cancer Foundation (AfrOx), and the National Cancer Institutes (NCI) of Brazil, France and the USA. This article summarizes the discussions and recommendations of this meeting, including the next steps required to create sustainable and impactful research programmes that will enable evidenced-based cancer control approaches and planning at the local, regional and national levels. PMID:24614139

Peer-led versus teacher-led AIDS education for female high-school students in Yazd, Islamic Republic of Iran.

PubMed

Baghianimoghadam, M H; Forghani, H; Zolghadr, R; Rahaei, Z; Khani, P

2012-04-01

Peer-led programmes on AIDS prevention have shown a good level of effectiveness when tested among high-risk populations. This study compared peer-led and teacher-led methods of education about HIV/AIDS among female high-school students in Yazd city, Islamic Republic of Iran. In 2009 students in 3 high schools were trained by their classmates (peer-led), by the research team (teacher-led) or had no education (controls); 180 students completed a specially designed questionnaire based on the health belief model, before and after the intervention. Post-intervention mean knowledge scores increased 2-fold in the peer-led group, and this was significantly higher than the increase in the teacher-led group scores (1.5-fold). Control group scores were unchanged. In the peer-led programme all of the components of the model were significantly improved whereas in the teacher-led programme, only perceived severity and perceived barriers scored significantly higher after the intervention.

Programmable Pulse Generator for Aditya Gas Puffing System

NASA Astrophysics Data System (ADS)

Patel, Narendra; Chavda, Chhaya; Bhatt, S. B.; Chattopadhyay, Prabal; Saxena, Y. C.

2012-11-01

In the Aditya Tokamak, one of primary requirement for plasma generation is to feed the required quantity of the fuel gas prior to plasma shot. Gas feed system mainly consists of piezoelectric gas leak valve and gas reservoir. The Hydrogen gas is prior to 300ms loop voltage for the duration of 4 msec to 7 msec. Gas is puffed during the shot for required plasma parameters and to increase plasma density using the same system. The valve is controlled by either continuous voltage or pulses of different width, amplitude and delay with respect to loop voltage. These voltage pulses are normally applied through standard pulse generator. The standard pulse generator is replaced by micro controller based in housed developed programmable pulse generator system consists of in built power supply, BNC input for external trigger, BNC output and serial interface. This programmable pulse generator is successfully tested and is in operation for gas puffing during ADITYA Tokamak experiments. The paper discusses the design and development aspect of the system.

A Self-Management Programme of Activity Coping and Education - SPACE for COPD(C) - in primary care: The protocol for a pragmatic trial.

PubMed

Bourne, Claire LA; Kanabar, Pratiksha; Mitchell, Katy; Schreder, Sally; Houchen-Wolloff, Linzy; Bankart, M John G; Apps, Lindsay; Hewitt, Stacey; Harvey-Dunstan, Theresa; Singh, Sally J

2017-07-10

National guidance for chronic obstructive pulmonary disease (COPD) suggests that self-management support be provided for patients. Our institution has developed a standardised, manual-based, supported self-management programme: Self-Management Programme of Activity Coping and Education (SPACE for COPD(C)). SPACE was previously piloted on a 1-2-1 basis, delivered by researchers, to individuals with COPD. Discussions with stakeholders highlighted considerable interest in delivering the SPACE for COPD(C) intervention as a group-based self-management programme facilitated by healthcare professionals (HCPs) in primary care settings. The study aims are to explore the feasibility, acceptability and efficacy for the intervention to be delivered and supported by HCPs and to examine whether group-based delivery of SPACE for COPD(C), with sustained support, improves patient outcomes following the SPACE for COPD(C) intervention. A prospective, multi-site, single-blinded randomised controlled trial (RCT) will be conducted, with follow-up at 6 and 9 months. Participants will be randomly assigned to either the control group (usual care) or intervention group (a six-session, group-based SPACE for COPD(C)self-management programme delivered over 5 months). The primary outcome is change in COPD assessment test at 6 months.A discussion session will be conducted with HCPs who deliver the intervention to discuss and gain insight into any potential facilitators/barriers to implementing the intervention in practice. Furthermore, we will conduct semi-structured focus groups with intervention participants to understand feasibility and acceptability. All qualitative data will be analysed thematically. The project has received a favourable opinion from South Hampshire B Research Ethics Committee, REC reference: 14/SC/1169 and full R&D approval from the University Hospitals of Leicester NHS Trust: 152408.Study results will be disseminated through appropriate peer-reviewed journals, national and international respiratory/physiotherapy conferences, via the Collaboration and Leadership in Applied Health Research and Care and through social media. ISRCTN17942821; pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Coverage and beliefs about temephos application for control of dengue vectors and impact of a community-based prevention intervention: secondary analysis from the Camino Verde trial in Mexico.

PubMed

Legorreta-Soberanis, José; Paredes-Solís, Sergio; Morales-Pérez, Arcadio; Nava-Aguilera, Elizabeth; de Los Santos, Felipé René Serrano; Sánchez-Gervacio, Belén Madeline; Ledogar, Robert J; Cockcroft, Anne; Andersson, Neil

2017-05-30

Temephos in domestic water containers remains a mainstay of Latin American government programmes for control of Aedes aegypti and associated illnesses, including dengue. There is little published evidence about coverage of routine temephos programmes. A cluster randomised controlled trial of community mobilisation in Mexico and Nicaragua reduced vector indices, dengue infection, and clinical dengue cases. Secondary analysis from the Mexican arm of the trial examined temephos coverage and beliefs, and the impact of the trial on these outcomes. The trial impact survey in December 2012, in 10,491 households in 45 intervention and 45 control clusters, asked about visits from the temephos programme, retention of applied temephos, and views about temephos and mosquito control. Fieldworkers noted if temephos was present in water containers. Some 42.4% of rural and 20.7% of urban households reported no temephos programme visits within the last 12 months. Overall, 42.0% reported they had temephos placed in their water containers less than 3 months previously. Fieldworkers observed temephos in at least one container in 21.1% of households. Recent temephos application and observed temephos were both significantly more common in urban households, when other household variables were taken into account; in rural areas, smaller households were more likely to have temephos present. Most households (74.4%) did not think bathing with water containing temephos carried any health risk. Half (51%) believed drinking or cooking with such water could be harmful and 17.6% were unsure. Significantly fewer households in intervention sites (16.5%) than in control sites (26.0%) (Risk Difference - 0.095, 95% confidence interval - 0.182 to -0.009) had temephos observed in their water; more households in intervention clusters (41.8%) than in control clusters (31.6%) removed the applied temephos quickly. Although fewer households in intervention sites (82.7%) compared with control sites (86.7%) (RD -0.04, 95% CI -0.067 to -0.013) agreed temephos and fumigation was the best way to avoid mosquitoes, the proportion believing this remained very high. Coverage with the government temephos programme was low, especially in rural areas. Despite an intervention encouraging non-chemical mosquito control, most households continued to believe that chemicals are the best control method. ISRCTN: 27581154 .

Poor uptake of an online intervention in a cluster randomised controlled trial of online diabetes education for rural general practitioners.

PubMed

Paul, Christine L; Piterman, Leon; Shaw, Jonathan E; Kirby, Catherine; Forshaw, Kristy L; Robinson, Jennifer; Thepwongsa, Isaraporn; Sanson-Fisher, Robert W

2017-03-23

In Australia, rural and remote communities have high rates of diabetes-related death and hospitalisation. General practitioners (GPs) play a major role in diabetes detection and management. Education of GPs could optimise diabetes management and improve patient outcomes at a population level. The study aimed to describe the uptake of a continuing medical education intervention for rural GPs and its impact on the viability of a cluster randomised controlled trial of the effects of continuing medical education on whole-town diabetes monitoring and control. Trial design: the cluster randomised controlled trial involved towns as the unit of allocation and analysis with outcomes assessed by de-identified pathology data (not reported here). The intervention programme consisted of an online active learning module, direct electronic access to specialist advice and performance feedback. Multiple rounds of invitation were used to engage GPs with the online intervention content. Evidence-based strategies (e.g. pre-notification, rewards, incentives) were incorporated into the invitations to enrol in the programme. Recruitment to the programme was electronically monitored through the hosting software package during the study intervention period. Eleven matched pairs of towns were included in the study. There were 146 GPs in the 11 intervention towns, of whom 34 (23.3%) enrolled in the programme, and 8 (5.5%) completed the online learning module. No town had more than 10% of the resident GPs complete the learning module. There were no contacts made by GPs regarding requests for specialist advice. Consequently, the trial was discontinued. There is an ongoing need to engage primary care physicians in improving diabetes monitoring and management in rural areas. Online training options, while notionally attractive and accessible, are not likely to have high levels of uptake, even when evidence-based recruitment strategies are implemented. Australian New Zealand Clinical Trials Registry, identifier: ACTRN12611000553976 . Retrospectively registered on 31 May 2011.

An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: A randomised controlled trial.

PubMed

Gouveia, Bruna Raquel; Gonçalves Jardim, Helena; Martins, Maria Manuela; Gouveia, Élvio Rúbio; de Freitas, Duarte Luís; Maia, José António; Rose, Debra J

2016-04-01

This study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal. Single-blind, randomised controlled trial. University laboratory. Community-dwelling older people, aged 65-85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n=27) or a wait-list control group (CG; n=25). A rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period. Balance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). Changes in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and -1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were -1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F (2, 42)=27.89, p<0.001, Partial Eta Squared=0.57) and a main effect for time (F (2, 43)=3.76, p=0.03, Partial Eta Squared=0.15), with both groups showing changes in the mean FAB scale scores across the three time periods. A significant main effect comparing the two groups (F (1, 43)=21.90, p<0.001, Partial Eta Squared=0.34) confirmed a clear positive effect of the intervention when compared to the control. This study demonstrated that the rehabilitation nursing programme was effective in improving balance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention. ACTRN12612000301864. Copyright © 2015 Elsevier Ltd. All rights reserved.

Schistosomiasis and soil-transmitted helminth control in Niger: cost effectiveness of school based and community distributed mass drug administration [corrected].

PubMed

Leslie, Jacqueline; Garba, Amadou; Oliva, Elisa Bosque; Barkire, Arouna; Tinni, Amadou Aboubacar; Djibo, Ali; Mounkaila, Idrissa; Fenwick, Alan

2011-10-01

In 2004 Niger established a large scale schistosomiasis and soil-transmitted helminths control programme targeting children aged 5-14 years and adults. In two years 4.3 million treatments were delivered in 40 districts using school based and community distribution. Four districts were surveyed in 2006 to estimate the economic cost per district, per treatment and per schistosomiasis infection averted. The study compares the costs of treatment at start up and in a subsequent year, identifies the allocation of costs by activity, input and organisation, and assesses the cost of treatment. The cost of delivery provided by teachers is compared to cost of delivery by community distributers (CDD). The total economic cost of the programme including programmatic, national and local government costs and international support in four study districts, over two years, was US$ 456,718; an economic cost/treatment of $0.58. The full economic delivery cost of school based treatment in 2005/06 was $0.76, and for community distribution was $0.46. Including only the programme costs the figures are $0.47 and $0.41 respectively. Differences at sub-district are more marked. This is partly explained by the fact that a CDD treats 5.8 people for every one treated in school. The range in cost effectiveness for both direct and direct and indirect treatments is quantified and the need to develop and refine such estimates is emphasised. The relative cost effectiveness of school and community delivery differs by country according to the composition of the population treated, the numbers targeted and treated at school and in the community, the cost and frequency of training teachers and CDDs. Options analysis of technical and implementation alternatives including a financial analysis should form part of the programme design process.

Effect of School Based Treatment on the Prevalence of Schistosomiasis in Endemic Area in Yemen

PubMed Central

Abdulrab, A; Salem, A; Algobati, F; Saleh, S; Shibani, K; Albuthigi, R

2013-01-01

Background Schistosomiasis and soil transmitted infection is a major health problem of children from rural areas of developing countries including Yemen. In an attempt to reduce this burden, the Ministry of Public Health and Population in Yemen established in 2002 a programme for Schistosomal, soil transmitted infection control that aimed to reduce morbidity and prevalence rates of Schistosomiasis, and Soil transmitted helminthes to less than 5% by 2015. The study was conducted to assess the current prevalence and intensity of schistosomal infection among schoolchildren in rural areas of the Taiz governorate after 6 years of running National Control Programme. Methods Grade 3 schoolchildren from Shara'b Al-Raona district of Taiz Governorate were examined for infections with Schistosoma mansoni using Modified Kato–Katz method and S. haematobium applying filtration method in 1998/1999, comparing the prevalence and intensity of infection with base line study, which was done 6 years ago. Results The S. mansoni prevalence in the study population was 31%, while the prevalence of S. haematobium was 18.6%. This result considerably is similar to the prevalence of base line study. The intensity of mild, moderate and severe infection for S. mansoni reached to 15.9%, 60.6% & 23.5% respectively. The severity of S. haematobium infection was 68.4%. It was exceptionally found that the prevalence of S. haematobium is increased. Conclusion The high prevalence of schistosomiasis and low effectiveness of control programme against schistosomal infection in the study area demands consideration of alternative treatment approaches. PMID:23914234

Programmable prostate palpation simulator using property-changing pneumatic bladder.

PubMed

Talhan, Aishwari; Jeon, Seokhee

2018-05-01

The currently available prostate palpation simulators are based on either a physical mock-up or pure virtual simulation. Both cases have their inherent limitations. The former lacks flexibility in presenting abnormalities and scenarios because of the static nature of the mock-up and has usability issues because the prostate model must be replaced in different scenarios. The latter has realism issues, particularly in haptic feedback, because of the very limited performance of haptic hardware and inaccurate haptic simulation. This paper presents a highly flexible and programmable simulator with high haptic fidelity. Our new approach is based on a pneumatic-driven, property-changing, silicone prostate mock-up that can be embedded in a human torso mannequin. The mock-up has seven pneumatically controlled, multi-layered bladder cells to mimic the stiffness, size, and location changes of nodules in the prostate. The size is controlled by inflating the bladder with positive pressure in the chamber, and a hard nodule can be generated using the particle jamming technique; the fine sand in the bladder becomes stiff when it is vacuumed. The programmable valves and system identification process enable us to precisely control the size and stiffness, which results in a simulator that can realistically generate many different diseases without replacing anything. The three most common abnormalities in a prostate are selected for demonstration, and multiple progressive stages of each abnormality are carefully designed based on medical data. A human perception experiment is performed by actual medical professionals and confirms that our simulator exhibits higher realism and usability than do the conventional simulators. Copyright © 2018 Elsevier Ltd. All rights reserved.

Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life.

PubMed

Lambeek, Ludeke C; van Mechelen, Willem; Knol, Dirk L; Loisel, Patrick; Anema, Johannes R

2010-03-16

To evaluate the effectiveness of an integrated care programme, combining a patient directed and a workplace directed intervention, for patients with chronic low back pain. Population based randomised controlled trial. Primary care (10 physiotherapy practices, one occupational health service, one occupational therapy practice) and secondary care (five hospitals). 134 adults aged 18-65 sick listed for at least 12 weeks owing to low back pain. Patients were randomly assigned to usual care (n=68) or integrated care (n=66). Integrated care consisted of a workplace intervention based on participatory ergonomics, involving a supervisor, and a graded activity programme based on cognitive behavioural principles. The primary outcome was the duration of time off work (work disability) due to low back pain until full sustainable return to work. Secondary outcome measures were intensity of pain and functional status. The median duration until sustainable return to work was 88 days in the integrated care group compared with 208 days in the usual care group (P=0.003). Integrated care was effective on return to work (hazard ratio 1.9, 95% confidence interval 1.2 to 2.8, P=0.004). After 12 months, patients in the integrated care group improved significantly more on functional status compared with patients in the usual care group (P=0.01). Improvement of pain between the groups did not differ significantly. The integrated care programme substantially reduced disability due to chronic low back pain in private and working life. Trial registration Current Controlled Trials ISRCTN28478651.

[A study of the effectiveness of a group-based cognitive-behavioral parent training program].

PubMed

Konstadinidis, L; Goga, P; Simos, G; Mavreas, V

2012-01-01

The role of the family in the development of the child as well as the quality of the parent-child relationship and its effect in the social, mental and cognitive development of the child has been the focus of attention of many sciences and scientists and it has been discovered that many parents are not well prepared to do their best for their children. The parent training programmes are willing to partly give a solution to this with their preventive role. In recent years, the effectiveness of the parent training programmes, which are offered to "high risk" parents, has been the focus of a big amount of research, meta-analyses and reviews. A smaller amount concerns the effectiveness of the universal programmes which are offered to the parents of the general population. The effectiveness of a ten-meeting structured group parent training programme of cognitive-behavioral approach, which had been offered to mothers of the general population, was researched in the present study. It aimed to research the effectiveness of the specific programme in the children's behavior and the subjective perception of the functionality of the family of the mothers who chose to participate in and completed the programme (n=56, experimental group/participants), compared to those who chose not to (n=113, control group/non participants). The mothers of the two groups were mothers with children aged between 2 and 12 and filled in the Family Adaptation and Cohesion Scales, FACES-III and the Questionnaire of Inter-personal and Cross-personal Adaptation, before (Phases A) and after (Phases B) the programme. The two groups were fully matched and did not present any significant difference regarding their demographic characteristics. During both Phases A and B of the training programme participants and non-participants expressed a high degree of satisfaction by the functionality of their family and did not differentiate significantly in the evaluation of the existent family cohesion and adaptability, the type of the family based on the cohesion and adaptability and the general type of family based on the functionality. In addition, while the children of the participants were, before the start of the programme, in a significantly disadvantaged position compared to the children of the non-participants, after the end of the programme, they were significantly improved, decreasing the negative symptoms and behaviors. This particular parent training programme of cognitive-behavioral approach, as well as other programmes which belong to the same theoretical direction, could contribute to the prevention of the behavior problems and the promotion of the mental health.

The impact of a school dental service on the periodontal health and oral hygiene status of 6-year-old Sowetan learners.

PubMed

Maraj, E; Kroon, J

2004-10-01

The public oral health sector offers essentially two types of services to learners viz, (i) clinical services, where curative and restorative treatment, and prophylactic care is provided, and (ii) school-based services which focus on a primary preventive approach to oral health that consists of health promotion and specific protection initiatives e.g. brushing programmes. Learners may be exposed to a combination of clinical and school-based services or to school-based services only. The objective of this study was to compare the impact of services delivered by the public oral health sector on periodontal health and oral hygiene status of 6-year-old Sowetan learners to a control group who were not exposed to any organised oral health programme. Follow-up visits were conducted every 6 months from baseline for a period of 18 months. A significant decrease in the percentage of learners with healthy periodontal tissues and a significant increase in the percentage of learners with gingival bleeding was observed for all three cohorts. Oral hygiene performance, assessed according to the Patient Hygiene Performance (PHP) index, demonstrated no improvement after 18 months, although the mean scores remained within the 'fair' interval. No significant benefit could be demonstrated in providing a clinical services component in combination with school-based services. No significant positive impact of the brushing programme on oral hygiene and periodontal health status of learners was observed after 18 months when compared to a control group.

Computer Controlled Portable Greenhouse Climate Control System for Enhanced Energy Efficiency

NASA Astrophysics Data System (ADS)

Datsenko, Anthony; Myer, Steve; Petties, Albert; Hustek, Ryan; Thompson, Mark

2010-04-01

This paper discusses a student project at Kettering University focusing on the design and construction of an energy efficient greenhouse climate control system. In order to maintain acceptable temperatures and stabilize temperature fluctuations in a portable plastic greenhouse economically, a computer controlled climate control system was developed to capture and store thermal energy incident on the structure during daylight periods and release the stored thermal energy during dark periods. The thermal storage mass for the greenhouse system consisted of a water filled base unit. The heat exchanger consisted of a system of PVC tubing. The control system used a programmable LabView computer interface to meet functional specifications that minimized temperature fluctuations and recorded data during operation. The greenhouse was a portable sized unit with a 5' x 5' footprint. Control input sensors were temperature, water level, and humidity sensors and output control devices were fan actuating relays and water fill solenoid valves. A Graphical User Interface was developed to monitor the system, set control parameters, and to provide programmable data recording times and intervals.

Reducing deaths from diarrhoea through oral rehydration therapy.

PubMed Central

Victora, C. G.; Bryce, J.; Fontaine, O.; Monasch, R.

2000-01-01

In 1980, diarrhoea was the leading cause of child mortality, accounting for 4.6 million deaths annually. Efforts to control diarrhoea over the past decade have been based on multiple, potentially powerful interventions implemented more or less simultaneously. Oral rehydration therapy (ORT) was introduced in 1979 and rapidly became the cornerstone of programmes for the control of diarrhoeal diseases. We report on the strategy for controlling diarrhoea through case management, with special reference to ORT, and on the relationship between its implementation and reduced mortality. Population-based data on the coverage and quality of facility-based use of ORT are scarce, despite its potential importance in reducing mortality, especially for severe cases. ORT use rates during the 1980s are available for only a few countries. An improvement in the availability of data occurred in the mid-1990s. The study of time trends is hampered by the use of several different definitions of ORT. Nevertheless, the data show positive trends in diarrhoea management in most parts of the world. ORT is now given to the majority of children with diarrhoea. The annual number of deaths attributable to diarrhoea among children aged under 5 years fell from the estimated 4.6 million in 1980 to about 1.5 million today. Case studies in Brazil, Egypt, Mexico, and the Philippines confirm increases in the use of ORT which are concomitant with marked falls in mortality. In some countries, possible alternative explanations for the observed decline in mortality have been fairly confidently ruled out. Experience with ORT can provide useful guidance for child survival programmes. With adequate political will and financial support, cost-effective interventions other than that of immunization can be successfully delivered by national programmes. Furthermore, there are important lessons for evaluators. The population-based data needed to establish trends in health service delivery, outcomes and impact are not available in respect of diarrhoea, as is true for malaria, pneumonia and other major childhood conditions. Standard indicators and measurement methods should be established. Efforts to change existing global indicators should be firmly resisted. Support should be given for the continuing evaluation and documentation activities needed to guide future public health policies and programmes. PMID:11100619

A closed-loop control-loading system

NASA Technical Reports Server (NTRS)

Ashworth, B. R.; Parrish, R. V.

1979-01-01

Langley Differential Maneuvering Simulator (DMS) realistically simulates two aircraft operating in differential mode. It consists of two identical fixed-base cockpits and dome projection systems. Each projection system consists of sky/Earth projector and target-image generator and projector. Although programmable control forces are small part of overall system, they play large role in providing pilot with kinesthetic cues.

A Validity-Based Approach to Quality Control and Assurance of Automated Scoring

ERIC Educational Resources Information Center

Bejar, Isaac I.

2011-01-01

Automated scoring of constructed responses is already operational in several testing programmes. However, as the methodology matures and the demand for the utilisation of constructed responses increases, the volume of automated scoring is likely to increase at a fast pace. Quality assurance and control of the scoring process will likely be more…

Students' Emotions for Achievement and Technology Use in Synchronous Hybrid Graduate Programmes: A Control-Value Approach

ERIC Educational Resources Information Center

Butz, Nikolaus T.; Stupnisky, Robert H.; Pekrun, Reinhard

2015-01-01

Synchronous hybrid delivery (simultaneously teaching on-campus and online students using web conferencing) is becoming more common; however, little is known about how students experience emotions in this learning environment. Based on Pekrun's (2006) control-value theory of emotions, the dual purpose of this study was first to compare synchronous…

Political Barriers to Evidence-Based Tobacco Control Policy: Cronyism and Cognitive Dissonance, a Tasmanian Case Study

ERIC Educational Resources Information Center

Barnsley, Kathryn; Walters, E. Haydn; Wood-Baker, Richard

2017-01-01

Tasmania led in several areas of tobacco control legislation reform in the period 1997 to 2010. Despite this, Tasmania lagged in other crucial areas, particularly the allocation of resources for community education, mass media campaigns and cessation programmes. Key impediments were crony capitalism; the conservative ideology of "white…

Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study.

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, L Kay; Schlief, Angelique; Oostendorp, Rob A B; de Vries, Nanne K

2013-05-25

Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim of the study was to pilot test the multilevel QUIP programme's effectiveness and the fidelity, acceptability and feasibility of its implementation. A one-group, pre-test, post-test pilot study (N = 8 practices; N = 32 PTs, 8 of whom were also PQMs) done between September and December 2009. Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines' main recommendations. Determinants of adherence were measured using quantitative methods (questionnaires). Delivery of the programme and management changes were assessed using qualitative methods (observations, group interviews, and document analyses). Changes in adherence and determinants were tested in the paired samples T-tests and expressed in effect sizes (Cohen's d). Overall adherence did not change (3.1%; p = .138). Adherence to three quality indicators improved (8%, 24%, 43%; .000 ≤ p ≤ .023). Adherence to one quality indicator decreased (-15.7%; p = .004). Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed. Improvements were associated with the programme's multilevel approach, collective goal setting, and the application of self-regulation; unfavourable findings with programme deficits. The one-group pre-test post-test design limits the internal validity of the study, the self-selected sample its external validity. The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence. To assess its value, the programme needs to be tested in a randomized controlled trial.

The Impact of Lymphatic Filariasis Mass Drug Administration Scaling Down on Soil-Transmitted Helminth Control in School-Age Children. Present Situation and Expected Impact from 2016 to 2020.

PubMed

Mupfasoni, Denise; Montresor, Antonio; Mikhailov, Alexei; King, Jonathan

2016-12-01

Lymphatic filariasis (LF) and soil-transmitted-helminths (STH) are co-endemic in 58 countries which are mostly in Africa and Asia. Worldwide, 486 million school-age children are considered at risk of both diseases. In 2000, the World Health Organization (WHO) established the global programme to eliminate LF by 2020. Since then, the LF elimination programme has distributed ivermectin or diethylcarbamazine citrate (DEC) in combination with albendazole, thereby also treating STH. Consequently, many school-age children have been treated for STH through the LF programme. As treatment targets towards the 2020 LF elimination goal are achieved, many countries are implementing the transmission assessment survey (TAS) and, if the LF prevalence is estimated to be less than 1%, scaling down mass drug administration (MDA). We analysed the 2014 data on preventive chemotherapy (PC) reported from LF STH co-endemic countries and projected the year and location of TAS expected to be conducted between 2016 and 2020 to assess the impact of this scaling down on STH PC. Eighty percent of all co-endemic countries that have already stopped LF MDA nationally were able to establish STH PC through schools. It is estimated that 14% of the total number of children presently covered by the LF programme is at risk of not continuing to receive PC for STH. In order to achieve and maintain the WHO 2020 goal for STH control, there is an urgent need to establish and reinforce school-based deworming programmes in countries scaling-down national LF elimination programmes.

Improving access to psychological therapies (IAPT) and treatment outcomes: epistemological assumptions and controversies.

PubMed

Williams, C H J

2015-06-01

Cognitive behaviour therapy (CBT) is recommended as a primary treatment choice in England, for anxiety and depression, by the National Institute for Health and Care Excellence (NICE). It has been argued that CBT has enjoyed political and cultural dominance and this has arguably led to maintained government investment in England for the cognitive and behavioural treatment of mental health problems. The government programme 'Improving Access to Psychological Therapies' (IAPT) aims to improve the availability of CBT. The criticism of the NICE evidence-based guidelines supporting the IAPT programme, has been the dominance of the gold standard randomized controlled trial methodology, with a focus on numerical outcome data, rather than a focus on a recovery narrative. RCT-based research is influenced by a philosophical paradigm called positivism. The IAPT culture is arguably influenced by one research paradigm and such an influence can skew services only towards numerical outcome data as the only truth of 'recovery'. An interpretative paradigm could assist in shaping service-based cultures, alter how services are evaluated and improve the richness of CBT research. This paper explores the theory of knowledge (epistemology) that underpins the evidence-based perspective of CBT and how this influences service delivery. The paper argues that the inclusion of service user narrative (qualitative data) can assist the evaluation of CBT from the user's perspective and can understand the context in which people live and how they access services. A qualitative perspective is discussed as a research strategy, capturing the lived experience of under-represented groups, such as sexual, gender and ethnic minorities. Cognitive behaviour therapy (CBT) has enjoyed political and cultural dominance within mental healthcare, with renewed government investment in England for the'Improving Access to Psychological Therapies' (IAPT) programme. The criticism of the evidence-based guidelines, published by the National Institute for Health and Care Excellence (NICE), which supports the IAPT programme has been the dominance of the gold standard randomized controlled trial methodology. The definition of 'recovery' used by IAPT is based on a positivist position, with a focus on numerical outcome data garnered through psychometric measures. An interpretative perspective of recovery, which would include a subjective individual patient/service user narrative and would include a collaborative qualitative dialogue, is arguably absent from the IAPT programme. The challenge inherent in the IAPT programme is the high demand/high turnover culture, and psychometric measures are quick to administer; however, this culture is driven from one research paradigm. An interpretative paradigm may assist in shaping service-based cultures, alter how services are evaluated, and improve the richness of CBT research. © 2015 John Wiley & Sons Ltd.

Programmable data communications controller requirements

NASA Technical Reports Server (NTRS)

1977-01-01

The design requirements for a Programmable Data Communications Controller (PDCC) that reduces the difficulties in attaching data terminal equipment to a computer are presented. The PDCC is an interface between the computer I/O channel and the bit serial communication lines. Each communication line is supported by a communication port that handles all line control functions and performs most terminal control functions. The port is fabricated on a printed circuit board that plugs into a card chassis, mating with a connector that is joined to all other card stations by a data bus. Ports are individually programmable; each includes a microprocessor, a programmable read-only memory for instruction storage, and a random access memory for data storage.

A web-based computer-tailored smoking prevention programme for primary school children: intervention design and study protocol

PubMed Central

2012-01-01

Background Although the number of smokers has declined in the last decade, smoking is still a major health problem among youngsters and adolescents. For this reason, there is a need for effective smoking prevention programmes targeting primary school children. A web-based computer-tailored feedback programme may be an effective intervention to stimulate youngsters not to start smoking, and increase their knowledge about the adverse effects of smoking and their attitudes and self-efficacy regarding non-smoking. Methods & design This paper describes the development and evaluation protocol of a web-based out-of-school smoking prevention programme for primary school children (age 10-13 years) entitled ‘Fun without Smokes’. It is a transformation of a postal mailed intervention to a web-based intervention. Besides this transformation the effects of prompts will be examined. This web-based intervention will be evaluated in a 2-year cluster randomised controlled trial (c-RCT) with three study arms. An intervention and intervention + prompt condition will be evaluated for effects on smoking behaviour, compared with a no information control condition. Information about pupils’ smoking status and other factors related to smoking will be obtained using a web-based questionnaire. After completing the questionnaire pupils in both intervention conditions will receive three computer-tailored feedback letters in their personal e-mail box. Attitudes, social influences and self-efficacy expectations will be the content of these personalised feedback letters. Pupils in the intervention + prompt condition will - in addition to the personalised feedback letters - receive e-mail and SMS messages prompting them to revisit the ‘Fun without Smokes’ website. The main outcome measures will be ever smoking and the utilisation of the ‘Fun without Smokes’ website. Measurements will be carried out at baseline, 12 months and 24 months of follow-up. Discussion The present study protocol describes the purpose, intervention design and study protocol of ‘Fun without Smokes’. Expectations are that pupils receiving tailored advice will be less likely to smoke after 24 months in contrast to pupils in the control condition. Furthermore, tailored feedback letters and prompting is expected to be more effective than providing tailored feedback letters only. Trial registration Dutch Trial Register NTR3116 PMID:22490110

Implementation of Adolescent Family-Based Substance Use Prevention Programmes in Health Care Settings: Comparisons across Conditions and Programmes

ERIC Educational Resources Information Center

Aalborg, Annette E.; Miller, Brenda A.; Husson, Gail; Byrnes, Hilary F.; Bauman, Karl E.; Spoth, Richard L.

2012-01-01

Objective: To examine factors that influence the effectiveness and quality of implementation of evidence-based family-focused adolescent substance use prevention programmes delivered in health care settings and to assess the effects of programme choice versus programme assignment on programme delivery. Design: Strengthening Families Program: For…

Effectiveness of a structured education reminiscence-based programme for staff on the quality of life of residents with dementia in long-stay units: a study protocol for a cluster randomised trial.

PubMed

O'Shea, Eamon; Devane, Declan; Murphy, Kathy; Cooney, Adeline; Casey, Dympna; Jordan, Fionnuala; Hunter, Andrew; Murphy, Edel

2011-02-14

Current projections indicate that there will be a significant increase in the number of people with dementia in Ireland, from approximately 40,000 at present to 100,000 by 2036. Psychosocial interventions, such as reminiscence, have the potential to improve the quality of life of people with dementia. However, while reminiscence is used widely in dementia care, its impact on the quality of life of people with dementia remains largely undocumented and there is a need for a robust and fair assessment of its overall effectiveness. The DementiA education programme incorporating REminiscence for Staff study will evaluate the effectiveness of a structured reminiscence-based education programme for care staff on the quality of life of residents with dementia in long-stay units. The study is a two-group, single-blind cluster randomised trial conducted in public and private long-stay residential settings in Ireland. Randomisation to control and intervention is at the level of the long-stay residential unit. Sample size calculations suggest that 18 residential units each containing 17 people with dementia are required for randomisation to control and intervention groups to achieve power of at least 80% with alpha levels of 0.05. Each resident in the intervention group is linked with a nurse and care assistant who have taken the structured reminiscence-based education programme. Participants in the control group will receive usual care. The primary outcome is quality of life of residents as measured by the Quality of Life-AD instrument. Secondary outcomes include agitation, depression and carer burden. Blinded outcome assessment is undertaken at baseline and at 18-22 weeks post-randomisation. Trials on reminiscence-based interventions for people with dementia have been scarce and the quality of the information arising from those that have been done has been undermined by methodological problems, particularly in relation to scale and scope. This trial is powered to deliver more credible and durable results. The trial may also convey process utility to a long-stay system in Ireland that has not been geared for education and training, especially in relation to dementia. The results of this trial are applicable to long-stay residential units in Ireland and internationally. Current Controlled Trials ISRCTN99651465.

Teaching nutrition to medical students: a community-based problem-solving approach.

PubMed

Bhattacharji, S; Joseph, A; Abraham, S; Muliyil, J; John, K R; Ethirajan, N

1990-01-01

This paper presents a community-based problem-solving educational programme which aims at teaching medical and other health science students the importance of nutrition and its application. Through community surveys students assess the nutritional status of children under five using different anthropometric methods. They understand the cultural beliefs and customs related to food fads and the reasons for them. They also acquire the skill to educate the community using the information gathered. They use epidemiological methods such as case control study to find associations between malnutrition and other causative factors. Feedback from students has been positive and evaluation of students' knowledge before and after the programme has shown significant improvement.

Programmable Low-Power Low-Noise Capacitance to Voltage Converter for MEMS Accelerometers

PubMed Central

Royo, Guillermo; Sánchez-Azqueta, Carlos; Gimeno, Cecilia; Aldea, Concepción; Celma, Santiago

2016-01-01

In this work, we present a capacitance-to-voltage converter (CVC) for capacitive accelerometers based on microelectromechanical systems (MEMS). Based on a fully-differential transimpedance amplifier (TIA), it features a 34-dB transimpedance gain control and over one decade programmable bandwidth, from 75 kHz to 1.2 MHz. The TIA is aimed for low-cost low-power capacitive sensor applications. It has been designed in a standard 0.18-μm CMOS technology and its power consumption is only 54 μW. At the maximum transimpedance configuration, the TIA shows an equivalent input noise of 42 fA/Hz at 50 kHz, which corresponds to 100 μg/Hz. PMID:28042830

Programmable Low-Power Low-Noise Capacitance to Voltage Converter for MEMS Accelerometers.

PubMed

Royo, Guillermo; Sánchez-Azqueta, Carlos; Gimeno, Cecilia; Aldea, Concepción; Celma, Santiago

2016-12-30

In this work, we present a capacitance-to-voltage converter (CVC) for capacitive accelerometers based on microelectromechanical systems (MEMS). Based on a fully-differential transimpedance amplifier (TIA), it features a 34-dB transimpedance gain control and over one decade programmable bandwidth, from 75 kHz to 1.2 MHz. The TIA is aimed for low-cost low-power capacitive sensor applications. It has been designed in a standard 0.18-μm CMOS technology and its power consumption is only 54 μW. At the maximum transimpedance configuration, the TIA shows an equivalent input noise of 42 fA/ Hz at 50 kHz, which corresponds to 100 μg/ Hz .

Efficacy of the FIFA 11+ Warm-Up Programme in Male Youth Football: A Cluster Randomised Controlled Trial

PubMed Central

Owoeye, Oluwatoyosi B. A.; Akinbo, Sunday R. A.; Tella, Bosede A.; Olawale, Olajide A.

2014-01-01

The FIFA 11+ is a structured warm-up programme specially designed to prevent injuries among football players from age 14 years and above. However, studies to prove its efficacy are generally few and it is yet to be tested in male youth footballers and among African players. The purpose of the study was to examine the efficacy of the FIFA 11+ programme in reducing the risk of injuries among male youth football players of the Lagos Junior League. A cluster randomised controlled trial was conducted. All the 20 teams (414 players aged 14 -19 years) in the Premier League division were block-randomised into either an intervention (INT) or a control (CON) group. The INT group performed the FIFA 11+ exercises as warm-up during training sessions and the CON group performed usual warm-up. Participating teams were prospectively followed through an entire league season of 6 months in which they were visited every week to assess injured players for time-loss injuries in both groups. The primary outcomes were any injury to the players, injuries by type of exposure and injuries specific to the lower extremities. The secondary outcomes were injuries reported by body location, aetiology, mechanism and severity. In total, 130 injuries were recorded affecting 104 (25%) of the 416 players. Team and player compliance with the INT was 60% and 74% respectively. Based on the primary outcome measures of the study, the FIFA 11+ programme significantly reduced the overall rate of injury in the INT group by 41% [RR = 0.59 (95% CI: 0.40 – 0.86; p = 0.006)] and all lower extremity injuries by 48% [RR = 0.52 (95% CI: 0.34 – 0.82; p = 0.004)]. However, the rate of injury reduction based on secondary outcomes mostly did not reach the level of statistical significance. The FIFA 11+ programme is effective in reducing the rates of injuries in male youth football players. Key points The FIFA 11+ has only been tested in randomised controlled trials conducted on female youth football players; this study reports its efficacy in male youth football for the first time The FIFA 11+ programme significantly reduced the overall rate of injuries and lower extremity injuries in male youth football players Youth football administrators in Africa and other parts of the world should pursue the implementation of the FIFA 11+ in order to minimize the incidence of injuries among players PMID:24790486

Perceptions of symptoms of severe childhood malaria among Mijikenda and Luo residents of coastal Kenya.

PubMed

Mwenesi, H A; Harpham, T; Marsh, K; Snow, R W

1995-04-01

Effective community based malaria control programmes require an understanding of current perceptions of malaria as a disease and its severe manifestations. Quantitative and qualitative surveys of mothers on the Kenyan Coast suggest that fever is conceptualised in biomedical terms whereas the aetiology of severe malaria is perceived to be of more complex cultural origin. This is reflected in the treatments sought for convulsions. The results are discussed in the context of ethnographic factors. To be effective, future health information programmes must take cultural beliefs into account.

ANOPP programmer's reference manual for the executive System. [aircraft noise prediction program

NASA Technical Reports Server (NTRS)

Gillian, R. E.; Brown, C. G.; Bartlett, R. W.; Baucom, P. H.

1977-01-01

Documentation for the Aircraft Noise Prediction Program as of release level 01/00/00 is presented in a manual designed for programmers having a need for understanding the internal design and logical concepts of the executive system software. Emphasis is placed on providing sufficient information to modify the system for enhancements or error correction. The ANOPP executive system includes software related to operating system interface, executive control, and data base management for the Aircraft Noise Prediction Program. It is written in Fortran IV for use on CDC Cyber series of computers.

A 6-week warm-up injury prevention programme results in minimal biomechanical changes during jump landings: a randomized controlled trial.

PubMed

Taylor, Jeffrey B; Ford, Kevin R; Schmitz, Randy J; Ross, Scott E; Ackerman, Terry A; Shultz, Sandra J

2018-01-16

To examine the extent to which an ACL injury prevention programme modifies lower extremity biomechanics during single- and double-leg landing tasks in both the sagittal and frontal plane. It was hypothesized that the training programme would elicit improvements in lower extremity biomechanics, but that these improvements would be greater during a double-leg sagittal plane landing task than tasks performed on a single leg or in the frontal plane. Ninety-seven competitive multi-directional sport athletes that competed at the middle- or high-school level were cluster randomized into intervention (n = 48, age = 15.4 ± 1.0 years, height = 1.7 ± 0.07 m, mass = 59.9 ± 11.0 kg) and control (n = 49, age = 15.7 ± 1.6 years, height = 1.7 ± 0.06 m, mass = 60.4 ± 7.7 kg) groups. The intervention group participated in an established 6-week warm-up-based ACL injury prevention programme. Three-dimensional biomechanical analyses of a double- (SAG-DL) and single-leg (SAG-SL) sagittal, and double- (FRONT-DL) and single-leg (FRONT-SL) frontal plane jump landing tasks were tested before and after the intervention. Peak angles, excursions, and external joint moments were analysed for group differences using 2 (group) × 4 (task) repeated measures MANOVA models of delta scores (post-pre-test value) (α < 0.05). Relative to the control group, no significant biomechanical changes were identified in the intervention group for any of the tasks (n.s.). However, a group by task interaction was identified for knee abduction (λ = 0.80, p = 0.02), such that participants in the intervention group showed relative decreases in knee abduction moments during the SAG-DL compared to the SAG-SL (p = 0.005; d = 0.45, CI = 0.04-0.85) task. A 6-week warm-up-based ACL injury prevention programme resulted in no significant biomechanical changes during a variety of multi-directional jump landings. Clinically, future prevention programmes should provide a greater training stimulus (intensity, volume), more specificity to tasks associated with the mechanism of ACL injury (single-leg, non-sagittal plane jump landings), and longer programme duration (> 6 weeks) to elicit meaningful biomechanical changes. I.

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

PubMed

Jolly, Kate; Duda, Joan L; Daley, Amanda; Eves, Frank F; Mutrie, Nanette; Ntoumanis, Nikos; Rouse, Peter C; Lodhia, Rekha; Williams, Geoffrey C

2009-06-08

The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation. An exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT) exercise on prescription intervention. 347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n = 7) or to the SDT-based intervention (n = 6).Outcomes measured at 3 and 6-months: Minutes of moderate or vigorous physical activity per week assessed using the 7-day Physical Activity Recall; physical health: blood pressure and weight; health status measured using the Dartmouth CO-OP charts; anxiety and depression measured by the Hospital Anxiety and Depression Scale and vitality measured by the subjective vitality score; motivation and processes of change: perceptions of autonomy support from the advisor, satisfaction of the needs for competence, autonomy, and relatedness via physical activity, and motivational regulations for exercise. This trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model (perceived autonomy support, need satisfaction, motivation regulations, outcomes) via structural equation modelling. The trial is registered as Current Controlled trials ISRCTN07682833.

Industrial Control System Process-Oriented Intrusion Detection (iPoid) Algorithm

DTIC Science & Technology

2016-08-01

inspection rules using an intrusion-detection system (IDS) sensor, a simulated Programmable Logic Controller (PLC), and a Modbus client operating...operating system PLC Programmable Logic Controller SCADA supervisory control and data acquisition SIGHUP signal hangup SPAN Switched Port Analyzer

Design and realization of the real-time spectrograph controller for LAMOST based on FPGA

NASA Astrophysics Data System (ADS)

Wang, Jianing; Wu, Liyan; Zeng, Yizhong; Dai, Songxin; Hu, Zhongwen; Zhu, Yongtian; Wang, Lei; Wu, Zhen; Chen, Yi

2008-08-01

A large Schmitt reflector telescope, Large Sky Area Multi-Object Fiber Spectroscopic Telescope(LAMOST), is being built in China, which has effective aperture of 4 meters and can observe the spectra of as many as 4000 objects simultaneously. To fit such a large amount of observational objects, the dispersion part is composed of a set of 16 multipurpose fiber-fed double-beam Schmidt spectrographs, of which each has about ten of moveable components realtimely accommodated and manipulated by a controller. An industrial Ethernet network connects those 16 spectrograph controllers. The light from stars is fed to the entrance slits of the spectrographs with optical fibers. In this paper, we mainly introduce the design and realization of our real-time controller for the spectrograph, our design using the technique of System On Programmable Chip (SOPC) based on Field Programmable Gate Array (FPGA) and then realizing the control of the spectrographs through NIOSII Soft Core Embedded Processor. We seal the stepper motor controller as intellectual property (IP) cores and reuse it, greatly simplifying the design process and then shortening the development time. Under the embedded operating system μC/OS-II, a multi-tasks control program has been well written to realize the real-time control of the moveable parts of the spectrographs. At present, a number of such controllers have been applied in the spectrograph of LAMOST.

Effects of self reflection on engagement in a 12-step addiction treatment programme: a linguistic analysis of diary entries.

PubMed

Stephenson, Geoffrey M; Zygouris, Nikolaos

2007-02-01

Thirty clients receiving Twelve-Step Facilitation Therapy in a rehabilitation setting formed the intervention group. They were asked to complete in third person a weekly evaluation of progress based on reading personal "Feelings" diaries they had written on a daily basis over a period of one week, starting 3weeks previously. The diaries of the clients and of a further 60 clients in two matched control groups were compared. One control group consisted of clients receiving treatment before the intervention was introduced, and clients in the second control group received treatment after the intervention was terminated. Clients in the control groups were matched to the intervention group according to presenting disorder (alcohol, drugs or food), gender and age. Analysis of the number of words written and diaries produced suggested that the experimental group's productivity was enhanced. Linguistic and cluster analyses indicated that the clients in the Intervention group referred more frequently to key elements of the programme (steps and spirituality) and responded in a more integrated way to the major aspects of their treatment regime. The study supported the expectation that by promoting self-reflection on progress in therapeutic settings, an increase in programme engagement can be expected.

Introducing new diagnostics into STI control programmes: the importance of programme science.

PubMed

Peeling, Rosanna W; Mabey, David; Ballard, Ronald C

2013-03-01

Many innovative diagnostic technologies will become commercially available over the next 5-10 years. These tests can potentially transform the diagnosis of sexually transmitted infections but their introduction into control programmes can be hampered by health system constraints, and political, cultural, socioeconomic and behavioural factors. We used the introduction of syphilis rapid tests to illustrate the importance of programme science to address the gap between accruing evidence of acceptable test performance and the complexity of programme design, implementation and evaluation of test deployment to address public health needs and improve patient-important outcomes.

Research support for effective state and community tobacco control programme response to electronic nicotine delivery systems

PubMed Central

Schmitt, Carol L; Lee, Youn Ok; Curry, Laurel E; Farrelly, Matthew C; Rogers, Todd

2014-01-01

Objective To identify unmet research needs of state and community tobacco control practitioners pertaining to electronic nicotine delivery systems (ENDS or e-cigarettes) that would inform policy and practice efforts at the state and community levels, and to describe ENDS-related research and dissemination activities of the National Cancer Institute-funded State and Community Tobacco Control Research Initiative. Methods To determine specific research gaps relevant to state and community tobacco control practice, we analysed survey data collected from tobacco control programmes (TCPs) in all 50 US states and the District of Columbia (N=51). Survey items covered a range of ENDS issues: direct harm to users, harm of secondhand vapour, cessation, flavours, constituents and youth access. Results There is no ENDS topic on which a majority of state TCP managers feel very informed. They feel least informed about harms of secondhand vapour while also reporting that this information is among the most important for their programme. A majority (N=31) of respondents indicated needs for research on the implications of ENDS products for existing policies. Conclusions TCP managers report that ENDS research is highly important for practice and need research-based information to inform decision making around the inclusion of ENDS in existing tobacco control policies. For optimal relevance to state and community TCPs, research on ENDS should prioritise study of the health effects of ENDS use and secondhand exposure to ENDS vapour in the context of existing tobacco control policies. PMID:24935899

Oral language skills intervention in pre-school-a cautionary tale.

PubMed

Haley, Allyson; Hulme, Charles; Bowyer-Crane, Claudine; Snowling, Margaret J; Fricke, Silke

2017-01-01

While practitioners are increasingly asked to be mindful of the evidence base of intervention programmes, evidence from rigorous trials for the effectiveness of interventions that promote oral language abilities in the early years is sparse. To evaluate the effectiveness of a language intervention programme for children identified as having poor oral language skills in preschool classes. A randomized controlled trial was carried out in 13 UK nursery schools. In each nursery, eight children (N = 104, mean age = 3 years 11 months) with the poorest performance on standardized language measures were selected to take part. All but one child were randomly allocated to either an intervention (N = 52) or a waiting control group (N = 51). The intervention group received a 15-week oral language programme in addition to their standard nursery curriculum. The programme was delivered by trained teaching assistants and aimed to foster vocabulary knowledge, narrative and listening skills. Initial results revealed significant differences between the intervention and control group on measures of taught vocabulary. No group differences were found on any standardized language measure; however, there were gains of moderate effect size in listening comprehension. The study suggests that an intervention, of moderate duration and intensity, for small groups of preschool children successfully builds vocabulary knowledge, but does not generalize to non-taught areas of language. The findings strike a note of caution about implementing language interventions of moderate duration in preschool settings. The findings also highlight the importance of including a control group in intervention studies. © 2016 Royal College of Speech and Language Therapists.

Effects of a lifestyle programme on ambulatory blood pressure and drug dosage in treated hypertensive patients: a randomized controlled trial.

PubMed

Burke, Valerie; Beilin, Lawrie J; Cutt, Hayley E; Mansour, Jacqueline; Wilson, Amy; Mori, Trevor A

2005-06-01

To assess effects of multifactorial lifestyle modification on antihypertensive drug needs in treated hypertensive individuals. Randomized controlled trial. Research studies unit. Overweight hypertensive patients, receiving one or two antihypertensive drugs, were recruited by advertising, and allocated randomly to a usual care group (controls; n = 118) or a lifestyle modification group (programme group; n = 123). A 4-month programme of weight loss, a low-sodium 'Dietary Approaches to Stop Hypertension'-type diet with added fish, physical activity and moderation of alcohol intake. After 4 months, if mean 24-h ambulatory blood pressure (ABP) was less than 135/85 mmHg, antihypertensive drugs were withdrawn over 4 weeks and long-term home blood pressure monitoring was begun. Antihypertensive drug requirements, ABP, weight, waist girth at 4 months and 1-year follow-up. Ninety control group and 102 programme group participants completed the study. Mean 24-h ABP changed after 4 months by -1.0/-0.3 +/- 0.5/0.4 mmHg in controls and -4.1/-2.1 +/- 0.7/0.5 mmHg with the lifestyle programme (P < 0.01). At follow-up, changes in the two groups were not significantly different (4.1/1.3 +/- 1.1/1.0 mmHg in controls; 2.5/-0.1 +/- 1.1/0.8 mmHg in the programme group; P = 0.73). At 4 months, drug withdrawal differed significantly between the groups (P = 0.038) in men (control 44%; programme 66%) but not in women (65 and 64%, respectively; P = 0.964). At follow-up, sex-related differences were not significant, and 41% in the control group and 43% in the programme group maintained drug-withdrawal status. With the programme, net weight loss was 3.3 kg (P < 0.001) at 4 months and 3.0 kg (P < 0.001) at follow-up; respective net decreases in waist girth were 3.3 cm (P < 0.001) and 3.5 cm (P < 0.001). A 4-month multifactorial lifestyle modification in patients with treated hypertension reduced blood pressure in the short-term. Decreased central obesity persisted 1 year later and could reduce overall cardiovascular risk.

Evaluation of a regional disease management programme for patients with asthma or chronic obstructive pulmonary disease.

PubMed

Steuten, Lotte; Vrijhoef, Bert; Van Merode, Frits; Wesseling, Geert-Jan; Spreeuwenberg, Cor

2006-12-01

To assess the impact of a population-based disease management programme for adult patients with asthma or chronic obstructive pulmonary disease (COPD) on process measures, intermediate outcomes, and endpoints of care. Quasi-experimental design with 12-month follow-up. Region of Maastricht (the Netherlands) including university hospital and 16 general practices. Nine hundred and seventy-five patients of whom 658 have asthma and 317 COPD. Disease management programme. Endpoints of care are respiratory health, health utility, patient satisfaction, and total health care costs related to asthma or COPD. Quality aspects of care, disease control, self-care behaviour, smoking status, disease-specific knowledge, and patients' satisfaction improved after implementation of the programme. Lung function was not affected by implementation of the programme. For COPD patients, a significant improvement in health utility was found. For patients with asthma, significant cost savings were measured. Organizing health care according to principles of disease management for adults with asthma or COPD is associated with significant improvements in several processes and outcomes of care, while costs of care do not exceed the existing budget.

The World Starts With Me: using intervention mapping for the systematic adaptation and transfer of school-based sexuality education from Uganda to Indonesia.

PubMed

Leerlooijer, Joanne N; Ruiter, Robert A C; Reinders, Jo; Darwisyah, Wati; Kok, Gerjo; Bartholomew, L Kay

2011-06-01

Evidence-based health promotion programmes, including HIV/AIDS prevention and sexuality education programmes, are often transferred to other cultures, priority groups and implementation settings. Challenges in this process include the identification of retaining core elements that relate to the programme's effectiveness while making changes that enhances acceptance in the new context and for the new priority group. This paper describes the use of a systematic approach to programme adaptation using a case study as an example. Intervention Mapping, a protocol for the development of evidence-based behaviour change interventions, was used to adapt the comprehensive school-based sexuality education programme 'The World Starts With Me'. The programme was developed for a priority population in Uganda and adapted to a programme for Indonesian secondary school students. The approach helped to systematically address the complexity and challenges of programme adaptation and to find a balance between preservation of essential programme elements (i.e. logic models) that may be crucial to the programme's effectiveness, including key objectives and theoretical behaviour change methods, and the adaptation of the programme to be acceptable to the new priority group and the programme implementers.

Effectiveness of a web-based self-help smoking cessation intervention: protocol of a randomised controlled trial.

PubMed

Kramer, Jeannet Jam; Willemsen, Marc C; Conijn, Barbara; van Emst, Andrée J; Brunsting, Suzanne; Riper, Heleen

2009-01-22

Cigarette smoking is a major risk factor for many chronic and fatal illnesses. Stopping smoking directly reduces those risks. The aim of this study is to investigate the effectiveness of a web-based interactive self-help programme for smoking cessation, known as the StopSite, by comparing it to an online self-help guide. Both interventions were based on cognitive-behavioural and self-control principles, but the former provided exercises, feedback and interactive features such as one-to-one chatrooms and a user forum, which facilitated mutual support and experience sharing. We conducted a randomised controlled trial to compare the interactive intervention with the self-help guide. The primary outcome measure was prolonged abstinence from smoking. Secondary outcomes were point-prevalence abstinence, number of cigarettes smoked, and incidence of quit attempts reported at follow-up assessments. Follow-up assessments took place three and six months after a one-month grace period for starting the intervention after baseline. Analyses were based on intention-to-treat principles using a conservative imputation method for missing data, whereby non-responders were classified as smokers. The trial should add to the body of knowledge on the effectiveness of web-based self-help smoking cessation interventions. Effective web-based programmes can potentially help large numbers of smokers to quit, thus having a major public health impact. ISRCTN74423766.

Evaluation of an occupational health intervention programme on whole‐body vibration in forklift truck drivers: a controlled trial

PubMed Central

Hulshof, C T J; Verbeek, J H A M; Braam, I T J; Bovenzi, M; van Dijk, F J H

2006-01-01

Objectives To evaluate process and outcome of a multifaceted occupational health intervention programme on whole‐body vibration (WBV) in forklift truck drivers. Methods An experimental pretest/post‐test control group study design. The authors trained occupational health services (OHS) in the experimental group in the use of the programme. OHS in the control group were asked to deliver care as usual. In total, 15 OHS, 32 OHS professionals, 26 companies, and 260 forklift drivers were involved. Post‐test measurements were carried out one year after the start of the programme. Results Baseline data before the start of the programme showed no difference between experimental and control group. Results of the outcome evaluation indicate a slight, although not statistically significant, reduction of WBV exposure in the experimental group (p = 0.06). Process evaluation revealed a positive influence on company policy toward WBV, attitude and intended behaviour of forklift drivers, and a trend towards an increase in knowledge of OHS professionals and company managers. The number of observed control measures with a major impact (levelling of surface and reduction of speed) was rather low. In those cases where control measures had been taken, there was a significant reduction in WBV exposure. This limited effect of the programme might be caused by the short period of follow up and the dropout of participants. The feasibility and the usefulness of the programme within the OHS setting were rated good by the participants. Conclusions This programme to decrease WBV exposure was partially effective. Significant effects on intermediate objectives were observed. More research on the effectiveness of intervention in the field of WBV is needed. PMID:16551762

Bioassay selection, experimental design and quality control/assurance for use in effluent assessment and control.

PubMed

Johnson, Ian; Hutchings, Matt; Benstead, Rachel; Thain, John; Whitehouse, Paul

2004-07-01

In the UK Direct Toxicity Assessment Programme, carried out in 1998-2000, a series of internationally recognised short-term toxicity test methods for algae, invertebrates and fishes, and rapid methods (ECLOX and Microtox) were used extensively. Abbreviated versions of conventional tests (algal growth inhibition tests, Daphnia magna immobilisation test and the oyster embryo-larval development test) were valuable for toxicity screening of effluent discharges and the identification of causes and sources of toxicity. Rapid methods based on chemiluminescence and bioluminescence were not generally useful in this programme, but may have a role where the rapid test has been shown to be an acceptable surrogate for a standardised test method. A range of quality assurance and control measures were identified. Requirements for quality control/assurance are most stringent when deriving data for characterising the toxic hazards of effluents and monitoring compliance against a toxicity reduction target. Lower quality control/assurance requirements can be applied to discharge screening and the identification of causes and sources of toxicity.

Operational studies on the control of Taenia solium taeniasis/cysticercosis in Ecuador.

PubMed Central

Cruz, M.; Davis, A.; Dixon, H.; Pawlowski, Z. S.; Proano, J.

1989-01-01

A large-scale study in Loja and El Oro Provinces, Ecuador, demonstrated that population-based treatment of human taeniasis with a low dose of praziquantel is feasible and effective for the short-term control of transmission of Taenia solium in hyperendemic areas. Chemotherapeutic intervention also effectively promoted local preventive measures and contributed greatly to the elaboration of a long-term control programme. PMID:2805217

The Norwegian healthy body image programme: study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students.

PubMed

Sundgot-Borgen, Christine; Bratland-Sanda, Solfrid; Engen, Kethe M E; Pettersen, Gunn; Friborg, Oddgeir; Torstveit, Monica Klungland; Kolle, Elin; Piran, Niva; Sundgot-Borgen, Jorunn; Rosenvinge, Jan H

2018-03-06

Body dissatisfaction and disordered eating raise the risk for eating disorders. In the prevention of eating disorders, many programmes have proved partly successful in using cognitive techniques to combat such risk factors. However, specific strategies to actively promote a positive body image are rarely used. The present paper outlines a protocol for a programme integrating the promotion of a positive body image and the prevention of disordered eating. Using a cluster randomized controlled mixed methods design, 30 high schools and 2481 12th grade students were allocated to the Healthy Body Image programme or to a control condition. The intervention comprised three workshops, each of 90 min with the main themes body image, media literacy, and lifestyle. The intervention was interactive in nature, and were led by trained scientists. The outcome measures include standardized instruments administered pre-post intervention, and at 3 and 12 months follow-ups, respectively. Survey data cover feasibility and implementation issues. Qualitative interviews covers experiential data about students' benefits and satisfaction with the programme. The present study is one of the first in the body image and disordered eating literature that integrates a health promotion and a disease prevention approach, as well as integrating standardized outcome measures and experiential findings. Along with mediator and moderator analyses it is expected that the Healthy Body Image programme may prove its efficacy. If so, plans are made with respect to further dissemination as well as communicating the findings to regional and national decision makers in the education and health care services. The study was registered and released at ClinicalTrials.gov 21th August 2016 with the Clinical Trial.gov ID: PRSNCT02901457 . In addition, the study is approved by the Regional Committee for Medical and Health Research Ethics.

Disease Control in Wildlife: Evaluating a Test and Cull Programme for Bovine Tuberculosis in African Buffalo.

PubMed

le Roex, N; Cooper, D; van Helden, P D; Hoal, E G; Jolles, A E

2016-12-01

Providing an evidence base for wildlife population management is difficult, due to limited opportunities for experimentation and study replication at the population level. We utilized an opportunity to assess the outcome of a test and cull programme aimed at limiting the spread of Mycobacterium bovis in African buffalo. Buffalo act as reservoirs of M. bovis, the causative agent of bovine tuberculosis (BTB), which can have major economic, ecological and public health impacts through the risk of infection to other wildlife species, livestock and surrounding communities. BTB prevalence data were collected in conjunction with disease control operations in Hluhluwe-iMfolozi Park, South Africa, from 1999 to 2006. A total of 4733 buffalo (250-950 per year) were tested for BTB using the single comparative intradermal tuberculin (SCIT) test, with BTB-positive animals culled, and negative animals released. BTB prevalence was spatially and temporally variable, ranging from 2.3% to 54.7%. Geographic area was a strong predictor of BTB transmission in HiP, owing to relatively stable herds and home ranges. Herds experiencing more intensive and frequent captures showed reduced per capita disease transmission risk and less increase in herd prevalence over time. Disease hot spots did not expand spatially over time, and BTB prevalence in all but the hot spot areas was maintained between 10% and 15% throughout the study period. Our data suggest that HiP's test and cull programme was effective at reducing BTB transmission in buffalo, with capture effort and interval found to be the crucial components of the programme. The programme was thus successful with respect to the original goals; however, there are additional factors that should be considered in future cost/benefit analyses and decision-making. These findings may be utilized and expanded in future collaborative work between wildlife managers, veterinarians and scientists, to optimize wildlife disease control programmes and mitigate conflict at the interface of conservation, agricultural and urban areas. © 2015 Blackwell Verlag GmbH.

[CRISPR/Cas system for genome editing in pluripotent stem cells].

PubMed

Vasil'eva, E A; Melino, D; Barlev, N A

2015-01-01

Genome editing systems based on site-specific nucleases became very popular for genome editing in modern bioengineering. Human pluripotent stem cells provide a unique platform for genes function study, disease modeling, and drugs testing. Consequently, technology for fast, accurate and well controlled genome manipulation is required. CRISPR/Cas (clustered regularly interspaced short palindromic repeat/CRISPR-associated) system could be employed for these purposes. This system is based on site-specific programmable nuclease Cas9. Numerous advantages of the CRISPR/Cas system and its successful application to human stem cells provide wide opportunities for genome therapy and regeneration medicine. In this publication, we describe and compare the main genome editing systems based on site-specific programmable nucleases and discuss opportunities and perspectives of the CRISPR/Cas system for application to pluripotent stem cells.

A Scoping Review of Economic Evaluations Alongside Randomised Controlled Trials of Home Monitoring in Chronic Disease Management.

PubMed

Kidholm, Kristian; Kristensen, Mie Borch Dahl

2018-04-01

Many countries have considered telemedicine and home monitoring of patients as a solution to the demographic challenges that health-care systems face. However, reviews of economic evaluations of telemedicine have identified methodological problems in many studies as they do not comply with guidelines. The aim of this study was to examine economic evaluations alongside randomised controlled trials of home monitoring in chronic disease management and hereby to explore the resources included in the programme costs, the types of health-care utilisation that change as a result of home monitoring and discuss the value of economic evaluation alongside randomised controlled trials of home monitoring on the basis of the studies identified. A scoping review of economic evaluations of home monitoring of patients with chronic disease based on randomised controlled trials and including information on the programme costs and the costs of equipment was carried out based on a Medline (PubMed) search. Nine studies met the inclusion criteria. All studies include both costs of equipment and use of staff, but there is large variation in the types of equipment and types of tasks for the staff included in the costs. Equipment costs constituted 16-73% of the total programme costs. In six of the nine studies, home monitoring resulted in a reduction in primary care or emergency contacts. However, in total, home monitoring resulted in increased average costs per patient in six studies and reduced costs in three of the nine studies. The review is limited by the small number of studies found and the restriction to randomised controlled trials, which can be problematic in this area due to lack of blinding of patients and healthcare professionals and the difficulty of implementing organisational changes in hospital departments for the limited period of a trial. Furthermore, our results may be based on assessments of older telemedicine interventions.

Positive health-care effects of an alcohol ignition interlock programme among driving while impaired (DWI) offenders.

PubMed

Bjerre, Bo; Kostela, Johan; Selén, Jan

2007-11-01

To compare the costs of hospital care and sick leave/disability pensions between two groups of driving while impaired (DWI) offenders: participants in an alcohol ignition interlock programme (AIIP) and controls with revoked licences, but with no comparable opportunity to participate in an AIIP. As an alternative to licence revocation DWI offenders can participate in a voluntary 2-year AIIP permitting the offender to drive under strict regulations entailing regular medical check-ups. The participants are forced to alter their alcohol habits and those who cannot demonstrate sobriety are dismissed from the programme. Participants are liable for all costs themselves. Quasi-experimental, with a non-equivalent control group used for comparison; intent-to-treat design. Based on the number of occasions/days in hospital and on sick leave/disability pension, the health-care costs for public insurance have been calculated. Average total health-care costs were 25% lower among AIIP participants (1156 individuals) than among controls (815 individuals) during the 2-year treatment period. This corresponds to over 1000 euros (SEK9610) less annual costs per average participant. For those who complete the 2-year programme the cost reduction was more pronounced; 37% during the treatment and 20% during the post-treatment period. The positive health-care effects were due apparently to reduced alcohol consumption. The social benefit of being allowed to drive while in the AIIP may also have contributed. The reduction in health-care costs was significant only during the 2-year treatment period, but among those who completed the entire AIIP sustained effects were also observed in the post-treatment period. The effects were comparable to those of regular alcoholism treatment programmes.

The effect of functional insulin therapy on glycaemic parameters in children with diabetes mellitus type 1.

PubMed

Štimjanin-Koldžo, Diana; Alajbegović, Salem; Štimjanin, Ena; Mehinagić, Jasmina

2017-08-01

Aim The aim of the study is to evaluate the effect of a prospectively conducted interactive 5-day education programme based on Düsseldorf model on glycated haemoglobin (A1C), and total daily dose of insulin in type 1 diabetes patients. Methods A total of 67 type 1 diabetes patients was analysed; mean age of 11±0.68 years, 43 females and 24 males. The programme was led by a trained team of diabetes specialist doctors and nurses. All subjects and their parents completed a knowledge test about diabetes at beginning, and at the end of education, and after 12 months (30 questions). Subjects were evaluated for total daily insulin, and HbA1c at baseline, as well as 3, 6, 9 and 12 months after the end of the education programme. Results Results of the knowledge test after the education have shown higher knowledge at baseline. At the end of the education programme an average of total daily insulin dose was significantly lower. There was a 3.17% reduction in HbA1c values over 9 months, and 1.8% over 12 months in the comparison to the baseline values (p<0.001). Conclusions Structured education programme of functional insulin therapy was associated with improved glycaemic control in type 1 diabetes patients and their parents. It motivated patients and parents to improve glycaemic control. One year after the follow up, glycaemic control was worsening, due to lack of patients' motivation, therefore, there is a need for yearly re-education. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

pH-programmable self-assembly of plasmonic nanoparticles: hydrophobic interaction versus electrostatic repulsion.

PubMed

Li, Weikun; Kanyo, Istvan; Kuo, Chung-Hao; Thanneeru, Srinivas; He, Jie

2015-01-21

We report a general strategy to conceptualize a new design for the pH-programmable self-assembly of plasmonic gold nanoparticles (AuNPs) tethered by random copolymers of poly(styrene-co-acrylic acid) (P(St-co-AA)). It is based on using pH as an external stimulus to reversibly change the surface charge of polymer tethers and to control the delicate balance of interparticle attractive and repulsive interactions. By incorporating -COOH moieties locally within PSt hydrophobic segments, the change in the ionization degree of -COOH moieties can dramatically disrupt the hydrophobic attraction within a close distance. pH acts as a key parameter to control the deprotonation of -COOH moieties and "programs" the assembled nanostructures of plasmonic nanoparticles in a stepwise manner. At a higher solution pH where -COOH groups of polymer tethers became highly deprotonated, electrostatic repulsion dominated the self-assembly and favored the formation of end-to-end, anisotropic assemblies, e.g. 1-D single-line chains. At a lower pH, the less deprotonated -COOH groups led to the decrease of electrostatic repulsion and the side-to-side aggregates, e.g. clusters and multi-line chains of AuNPs, became favorable. The pH-programmable self-assembly allowed us to engineer a "manual" program for a sequential self-assembly by changing the pH of the solution. We demonstrated that the two-step pH-programmable assembly could generate more sophisticated "multi-block" chains using two differently sized AuNPs. Our strategy offers a general means for the programmable design of plasmonic nanoparticles into the specific pre-ordained nanostructures that are potentially useful for the precise control over their plasmon coupling.

The politics of tuberculosis and HIV service integration in Ghana.

PubMed

Amo-Adjei, Joshua; Kumi-Kyereme, Akwasi; Fosuah Amo, Hannah; Awusabo-Asare, Kofi

2014-09-01

The need to integrate TB/HIV control programmes has become critical due to the comorbidity regarding these diseases and the need to optimise the use of resources. In developing countries such as Ghana, where public health interventions depend on donor funds, the integration of the two programmes has become more urgent. This paper explores stakeholders' views on the integration of TB/HIV control programmes in Ghana within the remits of contingency theory. With 31 purposively selected informants from four regions, semi-structured interviews and observations were conducted between March and May 2012, and the data collected were analysed using the inductive approach. The results showed both support for and opposition to integration, as well as some of the avoidable challenges inherent in combining TB/HIV control. While those who supported integration based their arguments on clinical synergies and the need to promote the efficient use of resources, those who opposed integration cited the potential increase in workload, the clinical complications associated with joint management, the potential for a leadership crisis, and the "smaller the better" propositions to support their stance. Although a policy on TB/HIV integration exists, inadequate 'political will' from the top management of both programmes has trickled down to lower levels, which has stifled progress towards the comprehensive management of TB/HIV and particularly leading to weak data collection and management structures and unsatisfactory administration of co-trimoxazole for co-infected patients. It is our view that the leadership of both programmes show an increased commitment to protocols involving the integration of TB/HIV, followed by a commitment to addressing the 'fears' of frontline service providers to encourage confidence in the process of service integration. Copyright © 2014 Elsevier Ltd. All rights reserved.

Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study.

PubMed

Hsu, Ming Hung; Flowerdew, Rosamund; Parker, Michael; Fachner, Jörg; Odell-Miller, Helen

2015-07-18

Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia. Music therapy has shown potential effects, but it is not clear how this intervention can be programmed to involve care staff within the delivery of patients' care. This study reports initial feasibility and outcomes from a five month music therapy programme including weekly individual active music therapy for people with dementia and weekly post-therapy video presentations for their carers in care homes. 17 care home residents and 10 care staff were randomised to the music therapy intervention group or standard care control group. The cluster randomised, controlled trial included baseline, 3-month, 5-month and post-intervention 7-month measures of residents' symptoms and well-being. Carer-resident interactions were also assessed. Feasibility was based on carers' feedback through semi-structured interviews, programme evaluations and track records of the study. The music therapy programme appeared to be a practicable and acceptable intervention for care home residents and staff in managing dementia symptoms. Recruitment and retention data indicated feasibility but also challenges. Preliminary outcomes indicated differences in symptoms (13.42, 95 % CI: [4.78 to 22.07; p = 0.006]) and in levels of wellbeing (-0.74, 95 % CI: [-1.15 to -0.33; p = 0.003]) between the two groups, indicating that residents receiving music therapy improved. Staff in the intervention group reported enhanced caregiving techniques as a result of the programme. The data supports the value of developing a music therapy programme involving weekly active individual music therapy sessions and music therapist-carer communication. The intervention is feasible with modifications in a more rigorous evaluation of a larger sample size. Clinicaltrials.gov, number NCT01744600.

"Not easy at all but I am trying": barriers and facilitators to physical activity in a South African cohort of people living with HIV participating in a home-based pedometer walking programme.

PubMed

Roos, Ronel; Myezwa, Hellen; van Aswegen, Helena

2015-01-01

The promotion of physical activity is encouraged in people living with HIV and AIDS (PLWHA) as a means of promoting wellness and health. Adherence to programmes that promote exercise is often reduced, and home-based programmes are suggested to improve adherence. This study investigated the personal and environmental factors that cause barriers and facilitators of physical activity in a home-based pedometer walking programme as a means of highlighting adherence challenges. An observational study nested in a randomised controlled trial was conducted in a cohort of South African PLWHA on antiretroviral therapy over a six-month period. Descriptive analysis and qualitative content analysis of 42 participants who underwent physical activity modification assisted with data review. The mean age of the sample was 38.7 (±8.9) years, consisted mostly of women (n = 35; 83.3%) who were employed (n = 19; 45.2%) but earning very little (less than R500 per month) and often single or widowed (n = 23; 54.8%). Barriers to physical activity identified included physical complaints, e.g., low-energy levels; psychological complaints, e.g., stress levels; family responsibility, e.g., being primary caregivers; the physical environment, e.g., adverse weather conditions; social environment, e.g., domestic abuse and crime; and workplace, e.g., being in a sedentary job. Facilitators of physical activity included support and encouragement from friends and family, religious practices during worship and community environment, e.g., having access to parks and sport fields. The study is of benefit as it highlights personal and environmental factors that need to be considered when developing or implementing a home-based walking programme in PLWHA.

Independent evaluation of a canine Echinococcosis Control Programme in Hobukesar County, Xinjiang, China

PubMed Central

van Kesteren, Freya; Qi, Xinwei; Tao, Jiang; Feng, Xiaohui; Mastin, Alexander; Craig, Philip S.; Vuitton, Dominique A.; Duan, Xinyu; Chu, Xiangdong; Zhu, Jinlong; Wen, Hao

2015-01-01

The Xinjiang Uyghur Autonomous Region in northwest China is one of the world's most important foci for cystic echinococcosis. Domestic dogs are the main source for human infection, and previous studies in Xinjiang have found a canine Echinococcus spp. coproELISA prevalence of between 36% and 41%. In 2010 the Chinese National Echinococcosis Control Programme was implemented in Xinjiang, and includes regular dosing of domestic dogs with praziquantel. Six communities in Hobukesar County, northwest Xinjiang were assessed in relation to the impact of this control programme through dog necropsies, dog Echinococcus spp. coproantigen surveys based on Lot Quality Assurance Sampling (LQAS) and dog owner questionnaires. We found that 42.1% of necropsied dogs were infected with Echinococcus granulosus, and coproELISA prevalences were between 15% and 70% in the communities. Although approximately half of all dog owners reported dosing their dogs within the 12 months prior to sampling, coproELISA prevalence remained high. Regular praziquantel dosing of owned dogs in remote and semi-nomadic communities such as those in Hobukesar County is logistically very difficult and additional measures should be considered to reduce canine echinococcosis. PMID:25661801

Independent evaluation of a canine Echinococcosis Control Programme in Hobukesar County, Xinjiang, China.

PubMed

van Kesteren, Freya; Qi, Xinwei; Tao, Jiang; Feng, Xiaohui; Mastin, Alexander; Craig, Philip S; Vuitton, Dominique A; Duan, Xinyu; Chu, Xiangdong; Zhu, Jinlong; Wen, Hao

2015-05-01

The Xinjiang Uyghur Autonomous Region in northwest China is one of the world's most important foci for cystic echinococcosis. Domestic dogs are the main source for human infection, and previous studies in Xinjiang have found a canine Echinococcus spp. coproELISA prevalence of between 36% and 41%. In 2010 the Chinese National Echinococcosis Control Programme was implemented in Xinjiang, and includes regular dosing of domestic dogs with praziquantel. Six communities in Hobukesar County, northwest Xinjiang were assessed in relation to the impact of this control programme through dog necropsies, dog Echinococcus spp. coproantigen surveys based on Lot Quality Assurance Sampling (LQAS) and dog owner questionnaires. We found that 42.1% of necropsied dogs were infected with Echinococcus granulosus, and coproELISA prevalences were between 15% and 70% in the communities. Although approximately half of all dog owners reported dosing their dogs within the 12 months prior to sampling, coproELISA prevalence remained high. Regular praziquantel dosing of owned dogs in remote and semi-nomadic communities such as those in Hobukesar County is logistically very difficult and additional measures should be considered to reduce canine echinococcosis. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Exercise interventions for smoking cessation.

PubMed

Ussher, Michael H; Taylor, Adrian; Faulkner, Guy

2008-10-08

Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. To determine whether exercise-based interventions alone or combined with a smoking cessation programme are more effective than a smoking cessation intervention alone. In July 2008, we searched the Cochrane Tobacco Addiction Group Specialized Register for studies including the terms 'exercise' or 'physical activity'. We also searched MEDLINE, EMBASE, PsycINFO, Dissertation Abstracts and CINAHL. We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme, recruiting smokers or recent quitters, and with a follow up of six months or more. We extracted data on study characteristics and smoking outcomes. Because of differences in studies we summarized the results narratively, making no attempt at meta-analysis. We identified 13 trials, six of which had fewer than 25 people in each treatment arm. They varied in the timing and intensity of the smoking cessation and exercise programmes. Three studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow up and a benefit for exercise of borderline significance (P = 0.05) at the 12-month follow up. One study showed significantly higher abstinence rates for the exercise group versus a control group at the three-month follow up but not at the end of treatment or 12-month follow up. The other studies showed no significant effect for exercise on abstinence. Only one of the 13 trials offered evidence for exercise aiding smoking cessation at a 12-month follow up. All the other trials were too small to exclude reliably an effect of intervention, or included an exercise intervention which was insufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions, equal contact control conditions, measures of exercise adherence and change in physical activity in both exercise and comparison groups.

Exercise interventions for smoking cessation.

PubMed

Ussher, Michael H; Taylor, Adrian; Faulkner, Guy

2012-01-18

Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone. In July 2011, we searched the Cochrane Tobacco Addiction Group Specialized Register for studies including the terms 'exercise' or 'physical activity'. We also searched MEDLINE, EMBASE, PsycINFO, Dissertation Abstracts and CINAHL using the terms 'exercise' or 'physical activity' and 'smoking cessation'. We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme, recruiting smokers or recent quitters, and with a follow up of six months or more. We extracted data on study characteristics and smoking outcomes. Because of differences in studies we summarized the results narratively, making no attempt at meta-analysis. We identified 15 trials, seven of which had fewer than 25 people in each treatment arm. They varied in the timing and intensity of the smoking cessation and exercise programmes. Three studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow up and a benefit for exercise of borderline significance (p = 0.05) at the 12-month follow up. One study showed significantly higher abstinence rates for the exercise group versus a control group at the three-month follow up but not at the end of treatment or 12-month follow up. The other studies showed no significant effect for exercise on abstinence. Only one of the 15 trials offered evidence for exercise aiding smoking cessation at a 12-month follow up. All the other trials were too small to reliably exclude an effect of intervention, or included an exercise intervention which was insufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions, equal contact control conditions, and measures of exercise adherence and change in physical activity in both exercise and comparison groups.

Real-time plasma control based on the ISTTOK tomography diagnostica)

NASA Astrophysics Data System (ADS)

Carvalho, P. J.; Carvalho, B. B.; Neto, A.; Coelho, R.; Fernandes, H.; Sousa, J.; Varandas, C.; Chávez-Alarcón, E.; Herrera-Velázquez, J. J. E.

2008-10-01

The presently available processing power in generic processing units (GPUs) combined with state-of-the-art programmable logic devices benefits the implementation of complex, real-time driven, data processing algorithms for plasma diagnostics. A tomographic reconstruction diagnostic has been developed for the ISTTOK tokamak, based on three linear pinhole cameras each with ten lines of sight. The plasma emissivity in a poloidal cross section is computed locally on a submillisecond time scale, using a Fourier-Bessel algorithm, allowing the use of the output signals for active plasma position control. The data acquisition and reconstruction (DAR) system is based on ATCA technology and consists of one acquisition board with integrated field programmable gate array (FPGA) capabilities and a dual-core Pentium module running real-time application interface (RTAI) Linux. In this paper, the DAR real-time firmware/software implementation is presented, based on (i) front-end digital processing in the FPGA; (ii) a device driver specially developed for the board which enables streaming data acquisition to the host GPU; and (iii) a fast reconstruction algorithm running in Linux RTAI. This system behaves as a module of the central ISTTOK control and data acquisition system (FIRESIGNAL). Preliminary results of the above experimental setup are presented and a performance benchmarking against the magnetic coil diagnostic is shown.

Filling the observational void: Scientific value and quantitative validation of hydrometeorological data from a community-based monitoring programme

NASA Astrophysics Data System (ADS)

Walker, David; Forsythe, Nathan; Parkin, Geoff; Gowing, John

2016-07-01

This study shows how community-based hydrometeorological monitoring programmes can provide reliable high-quality measurements comparable to formal observations. Time series of daily rainfall, river stage and groundwater levels obtained by a local community in Dangila woreda, northwest Ethiopia, have passed accepted quality control standards and have been statistically validated against formal sources. In a region of low-density and declining formal hydrometeorological monitoring networks, a situation shared by much of the developing world, community-based monitoring can fill the observational void providing improved spatial and temporal characterisation of rainfall, river flow and groundwater levels. Such time series data are invaluable in water resource assessment and management, particularly where, as shown here, gridded rainfall datasets provide gross under or over estimations of rainfall and where groundwater level data are non-existent. Discussions with the local community during workshops held at the setup of the monitoring programme and since have demonstrated that the community have become engaged in the project and have benefited from a greater hydrological knowledge and sense of ownership of their resources. This increased understanding and empowerment is at the relevant scale required for effective community-based participatory management of shallow groundwater and river catchments.

Inclusion of persons with disabilities in systems of social protection: a population-based survey and case-control study in Peru.

PubMed

Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vasquez, Alberto; Kuper, Hannah; Walsham, Matthew; Blanchet, Karl

2016-08-26

This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. Population based-survey with a nested case-control study. Morropon, a semiurban district located in Piura, northern Peru. For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case-control study, only one participant, case or control, per household was included in the study. Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconomic status, education, health and rehabilitation and social protection participation. The survey included 3684 participants, 1848 (50.1%) females, mean age: 36.4 (SD: 21.7). A total of 290 participants (7.9%; 95% CI 7.0% to 8.7%) were classified as having disability. Adults with disabilities were more likely to be single (OR=3.40; 95% CI 1.54 to 7.51) and not to be working (OR=4.36; 95% CI 2.26 to 8.40), while those who did work were less likely to receive the national minimum wage (ie, 750 PEN or about US$265; p=0.007). People with disabilities were more likely to experience health problems. There was no difference between those enrolled in any social protection programme among participants with and without disabilities. People with disabilities were found to have higher needs for social protection, but were not more likely to be enrolled in social protection programmes. The Peruvian social protection system should consider adding disability status to selection criteria in their cash transfer programmes as well as implementing disability-specific interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Impact of vectorborne parasitic neglected tropical diseases on child health.

PubMed

Barry, Meagan A; Murray, Kristy O; Hotez, Peter J; Jones, Kathryn M

2016-07-01

Chagas disease, leishmaniasis, onchocerciasis and lymphatic filariasis are all vectorborne neglected tropical diseases (NTDs) that are responsible for significant disease burden in impoverished children and adults worldwide. As vectorborne parasitic diseases, they can all be targeted for elimination through vector control strategies. Examples of successful vector control programmes for these diseases over the past two decades have included the Southern Cone Initiative against Chagas disease, the Kala-azar Control Scheme against leishmaniasis, the Onchocerciasis Control Programme and the lymphatic filariasis control programme in The Gambia. A common vector control component in all of these programmes is the use of adulticides including dichlorodiphenyltrichloroethane and newer synthetic pyrethroid insecticides against the insect vectors of disease. Household spraying has been used against Chagas disease and leishmaniasis, and insecticide-treated bed nets have helped prevent leishmaniasis and lymphatic filariasis. Recent trends in vector control focus on collaborations between programmes and sectors to achieve integrated vector management that addresses the holistic vector control needs of a community rather than approaching it on a disease-by-disease basis, with the goals of increased efficacy, sustainability and cost-effectiveness. As evidence of vector resistance to currently used insecticide regimens emerges, research to develop new and improved insecticides and novel control strategies will be critical in reducing disease burden. In the quest to eliminate these vectorborne NTDs, efforts need to be made to continue existing control programmes, further implement integrated vector control strategies and stimulate research into new insecticides and control methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Ranking of healthcare programmes based on health outcome, health costs and safe delivery of care in hospital pharmacy practice.

PubMed

Brisseau, Lionel; Bussières, Jean-François; Bois, Denis; Vallée, Marc; Racine, Marie-Claude; Bonnici, André

2013-02-01

To establish a consensual and coherent ranking of healthcare programmes that involve the presence of ward-based and clinic-based clinical pharmacists, based on health outcome, health costs and safe delivery of care. This descriptive study was derived from a structured dialogue (Delphi technique) among directors of pharmacy department. We established a quantitative profile of healthcare programmes at five sites that involved the provision of ward-based and clinic-based pharmaceutical care. A summary table of evidence established a unique quality rating per inpatient (clinic-based) or outpatient (ward-based) healthcare programme. Each director rated the perceived impact of pharmaceutical care per inpatient or outpatient healthcare programme on three fields: health outcome, health costs and safe delivery of care. They agreed by consensus on the final ranking of healthcare programmes. A ranking was assigned for each of the 18 healthcare programmes for outpatient care and the 17 healthcare programmes for inpatient care involving the presence of pharmacists, based on health outcome, health costs and safe delivery of care. There was a good correlation between ranking based on data from a 2007-2008 Canadian report on hospital pharmacy practice and the ranking proposed by directors of pharmacy department. Given the often limited human and financial resources, managers should consider the best evidence available on a profession's impact to plan healthcare services within an organization. Data are few on ranking healthcare programmes in order to prioritize which healthcare programme would mostly benefit from the delivery of pharmaceutical care by ward-based and clinic-based pharmacists. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

Evaluation of alternative school feeding models on nutrition, education, agriculture and other social outcomes in Ghana: rationale, randomised design and baseline data.

PubMed

Gelli, Aulo; Masset, Edoardo; Folson, Gloria; Kusi, Anthoni; Arhinful, Daniel K; Asante, Felix; Ayi, Irene; Bosompem, Kwabena M; Watkins, Kristie; Abdul-Rahman, Lutuf; Agble, Rosanna; Ananse-Baden, Getrude; Mumuni, Daniel; Aurino, Elisabetta; Fernandes, Meena; Drake, Lesley

2016-01-20

'Home-grown' school feeding programmes are complex interventions with the potential to link the increased demand for school feeding goods and services to community-based stakeholders, including smallholder farmers and women's groups. There is limited rigorous evidence, however, that this is the case in practice. This evaluation will examine explicitly, and from a holistic perspective, the simultaneous impact of a national school meals programme on micronutrient status, alongside outcomes in nutrition, education and agriculture domains. The 3-year study involves a cluster-randomised control trial designed around the scale-up of the national school feeding programme, including 116 primary schools in 58 districts in Ghana. The randomly assigned interventions are: 1) a school feeding programme group, including schools and communities where the standard government programme is implemented; 2) 'home-grown' school feeding, including schools and communities where the standard programme is implemented alongside an innovative pilot project aimed at enhancing nutrition and agriculture; and 3) a control group, including schools and households from communities where the intervention will be delayed by at least 3 years, preferably without informing schools and households. Primary outcomes include child health and nutritional status, school participation and learning, and smallholder farmer income. Intermediate outcomes along the agriculture and nutrition pathways will also be measured. The evaluation will follow a mixed-method approach, including child-, household-, school- and community-level surveys as well as focus group discussions with project stakeholders. The baseline survey was completed in August 2013 and the endline survey is planned for November 2015. The tests of balance show significant differences in the means of a number of outcome and control variables across the intervention groups. Important differences across groups include marketed surplus, livestock income, per capita food consumption and intake, school attendance, and anthropometric status in the 2-5 and 5-15 years age groups. In addition, approximately 19 % of children in the target age group received some form of free school meals at baseline. Designing and implementing the evaluation of complex interventions is in itself a complex undertaking, involving a multi-disciplinary research team working in close collaboration with programme- and policy-level stakeholders. Managing the complexity from an analytical and operational perspective is an important challenge. The analysis of the baseline data indicates that the random allocation process did not achieve statistically comparable treatment groups. Differences in outcomes and control variables across groups will be controlled for when estimating treatment effects. ISRCTN66918874 (registered on 5 March 2015).

Evaluation of a computerized cognitive behavioural therapy programme, MindWise (2.0), for adults with mild-to-moderate depression and anxiety.

PubMed

Collins, Sarah; Byrne, Michael; Hawe, James; O'Reilly, Gary

2018-06-01

To investigate the acceptability and utility of a newly developed computerized cognitive behavioural therapy (cCBT) programme, MindWise (2.0), for adults attending Irish primary care psychology services. Adult primary care psychology service users across four rural locations in Ireland were invited to participate in this study. A total of 60 service users participated in the MindWise (2.0) treatment group and compared to 22 people in a comparison waiting list control group. Participants completed pre- and post-intervention outcome measures of anxiety, depression, and work/social functioning. At post-intervention, 25 of 60 people in the MindWise (2.0) condition had fully completed the programme and 19 of 22 people in the waiting list condition provided time 2 data. Relative to those in the control group, the MindWise (2.0) participants reported significantly reduced symptoms of anxiety and no change in depression or work/social functioning. The newly developed cCBT programme, MindWise (2.0), resulted in significant improvements on a measure of anxiety and may address some barriers to accessing more traditional face-to-face mental health services for adults in a primary care setting. Further programme development and related research appears both warranted and needed to lower programme drop-out, establish if gains in anxiety management are maintained over time, and support people in a primary care context with depression. There is a growing evidence base that computerized self-help programmes can assist in a stepped-care approach to adult mental health service provision. These programmes require further development to address issues such as high dropout, the development of equally effective transdiagnostic content, and greater effectiveness in the country of origin. This study evaluated the acceptability and utility of a brief online CBT programme for adults referred due to anxiety or low mood to primary care psychology services in the national health service in Ireland. Results indicate that 42% of people completed the programme and experienced a significant reduction in anxiety but not depression and no improvement in work or social adjustment compared to similar adults on a waiting list for services. This study suggests the programme warrants further development and research and may in time become a useful and suitable intervention within the national health service in Ireland. © 2017 The British Psychological Society.

Study protocol for a randomized controlled trial comparing the efficacy of a specialist and a generic parenting programme for the treatment of preschool ADHD.

PubMed

McCann, Donna C; Thompson, Margaret; Daley, David; Barton, Joanne; Laver-Bradbury, Cathy; Hutchings, Judy; Coghill, David; Stanton, Louise; Maishman, Tom; Dixon, Liz; Caddy, Josh; Chorozoglou, Maria; Raftery, James; Sonuga-Barke, Edmund

2014-04-25

The New Forest Parenting Programme (NFPP) is a home-delivered, evidence-based parenting programme to target symptoms of attention-deficit/hyperactivity disorder (ADHD) in preschool children. It has been adapted for use with 'hard-to-reach' or 'difficult-to-treat' children. This trial will compare the adapted-NFPP with a generic parenting group-based programme, Incredible Years (IY), which has been recommended for children with preschool-type ADHD symptoms. This multicentre randomized controlled trial comprises three arms: adapted-NFPP, IY and treatment as usual (TAU). A sample of 329 parents of preschool-aged children with a research diagnosis of ADHD enriched for hard-to-reach and potentially treatment-resistant children will be allocated to the arms in the ratio 3:3:1. Participants in the adapted-NFPP and IY arms receive an induction visit followed by 12 weekly parenting sessions of 1½ hours (adapted-NFPP) or 2½ hours (IY) over 2.5 years. Adapted-NFPP will be delivered as a one-to-one home-based intervention; IY, as a group-based intervention. TAU participants are offered a parenting programme at the end of the study. The primary objective is to test whether the adapted-NFPP produces beneficial effects in terms of core ADHD symptoms. Secondary objectives include examination of the treatment impact on secondary outcomes, a study of cost-effectiveness and examination of the mediating role of treatment-induced changes in parenting behaviour and neuropsychological function. The primary outcome is change in ADHD symptoms, as measured by the parent-completed version of the SNAP-IV questionnaire, adjusted for pretreatment SNAP-IV score. Secondary outcome measures are: a validated index of behaviour during child's solo play; teacher-reported SNAP-IV (ADHD scale); teacher and parent SNAP-IV (ODD) Scale; Eyberg Child Behaviour Inventory - Oppositional Defiant Disorder scale; Revised Client Service Receipt Inventory - Health Economics Costs measure and EuroQol (EQ5D) health-related quality-of-life measure. Follow-up measures will be collected 6 months after treatment for participants allocated to adapted-NFPP and IY. This trial will provide evidence as to whether the adapted-NFPP is more effective and cost-effective than the recommended treatment and TAU. It will also provide information about mediating factors (improved parenting and neuropsychological function) and moderating factors (parent and child genetic factors) in any increased benefit. Current Controlled Trials, ISRCTN39288126.

Study protocol for a randomized controlled trial comparing the efficacy of a specialist and a generic parenting programme for the treatment of preschool ADHD

PubMed Central

2014-01-01

Background The New Forest Parenting Programme (NFPP) is a home-delivered, evidence-based parenting programme to target symptoms of attention-deficit/hyperactivity disorder (ADHD) in preschool children. It has been adapted for use with ‘hard-to-reach’ or ‘difficult-to-treat’ children. This trial will compare the adapted-NFPP with a generic parenting group-based programme, Incredible Years (IY), which has been recommended for children with preschool-type ADHD symptoms. Methods/design This multicentre randomized controlled trial comprises three arms: adapted-NFPP, IY and treatment as usual (TAU). A sample of 329 parents of preschool-aged children with a research diagnosis of ADHD enriched for hard-to-reach and potentially treatment-resistant children will be allocated to the arms in the ratio 3:3:1. Participants in the adapted-NFPP and IY arms receive an induction visit followed by 12 weekly parenting sessions of 1½ hours (adapted-NFPP) or 2½ hours (IY) over 2.5 years. Adapted-NFPP will be delivered as a one-to-one home-based intervention; IY, as a group-based intervention. TAU participants are offered a parenting programme at the end of the study. The primary objective is to test whether the adapted-NFPP produces beneficial effects in terms of core ADHD symptoms. Secondary objectives include examination of the treatment impact on secondary outcomes, a study of cost-effectiveness and examination of the mediating role of treatment-induced changes in parenting behaviour and neuropsychological function. The primary outcome is change in ADHD symptoms, as measured by the parent-completed version of the SNAP-IV questionnaire, adjusted for pretreatment SNAP-IV score. Secondary outcome measures are: a validated index of behaviour during child’s solo play; teacher-reported SNAP-IV (ADHD scale); teacher and parent SNAP-IV (ODD) Scale; Eyberg Child Behaviour Inventory - Oppositional Defiant Disorder scale; Revised Client Service Receipt Inventory - Health Economics Costs measure and EuroQol (EQ5D) health-related quality-of-life measure. Follow-up measures will be collected 6 months after treatment for participants allocated to adapted-NFPP and IY. Discussion This trial will provide evidence as to whether the adapted-NFPP is more effective and cost-effective than the recommended treatment and TAU. It will also provide information about mediating factors (improved parenting and neuropsychological function) and moderating factors (parent and child genetic factors) in any increased benefit. Trial registration Current Controlled Trials, ISRCTN39288126. PMID:24767423

WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial.

PubMed

Hamdani, S U; Akhtar, P; Zill-E-Huma; Nazir, H; Minhas, F A; Sikander, S; Wang, D; Servilli, C; Rahman, A

2017-01-01

Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan. The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by 'family volunteers' to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule - child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894). This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings. Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.

Surveillance and Control of Aedes albopictus in the Swiss-Italian Border Region: Differences in Egg Densities between Intervention and Non-intervention Areas

PubMed Central

Suter, Tobias T.; Flacio, Eleonora; Feijoó Fariña, Begoña; Engeler, Lukas; Tonolla, Mauro; Regis, Lêda N.; de Melo Santos, Maria A. V.; Müller, Pie

2016-01-01

Background Aedes albopictus, the Asian tiger mosquito, originates from the tropical and subtropical regions of Southeast Asia. Over the recent decades it has been passively spread across the globe, primarily through the used tyre trade and passive transportation along major traffic routes. A. albopictus is a proven vector for many arboviruses, most notably chikungunya and dengue, with recent outbreaks also in continental Europe. In southern Switzerland, in the Canton of Ticino A. albopictus was spotted for the first time in 2003. Since then the local authorities have implemented a control programme based on larval source reduction. Despite these efforts, mosquito densities have increased over the last decade, casting doubts on the effectiveness of such larval control programmes. Methodology/Principal Findings The Italian communities just across the Swiss-Italian border lack a control programme. This motivated us to compare the intervention and the non-intervention areas side by side in an attempt to find evidence for, or against, the effectiveness of larval A. albopictus control. Using ovitraps and a randomised sampling scheme, we examined the seasonal and spatial abundance of A. albopictus in sylvatic and urban environments across the Swiss-Italian border in 2012 and 2013. In the urban environments of the non-intervention area, egg densities were 2.26 times higher as compared to the intervention area. In the sylvatic environments, as compared to the urban environments, egg densities were 36% in the intervention area and 18% in the non-intervention area. Conclusions/Significance Though alternative explanations are also valid, the results support the hypothesis that the Ticino intervention programme does have an impact. At the same time the data also suggest that current larval interventions fall short in gaining full control over the mosquito, calling for the evaluation of additional, or alternative, approaches. Ideally, these should also consider inclusion of the neighbouring Italian communities in the surveillance and control efforts. PMID:26734946

Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study

PubMed Central

Banks, Lena Morgon; Kuper, Hannah; Murthy, G. V. S.; Sagar, Jayanthi; Oye, Joseph; Polack, Sarah

2018-01-01

Proven links between disability and poverty suggest that development programmes and policies that are not disability-inclusive will leave persons with disabilities behind. Despite this, there is limited quantitative evidence on livelihood opportunities amongst adults with disabilities in Low and Middle Income Countries. This study adds to the limited evidence base, contributing data from one African and one Asian Setting. We undertook a population-based case–control study of adults (18+) with and without disabilities in North-West Cameroon and in Telangana State, India. We found that adults with disabilities were five times less likely to be working compared to age-sex matched controls in both settings. Amongst adults with disabilities, current age, marital status and disability type were key predictors of working. Inclusive programmes are therefore needed to provide adequate opportunities to participate in livelihood prospects for adults with disabilities in Cameroon and India, on an equal basis as others. These findings are of crucial importance at this stage of the Sustainable Development Agenda, to ensure that the mandate of inclusive development is achieved. PMID:29630606

Defining a global research and policy agenda for betel quid and areca nut.

PubMed

Mehrtash, Hedieh; Duncan, Kalina; Parascandola, Mark; David, Annette; Gritz, Ellen R; Gupta, Prakash C; Mehrotra, Ravi; Amer Nordin, Amer Siddiq; Pearlman, Paul C; Warnakulasuriya, Saman; Wen, Chi-Pang; Zain, Rosnah Binti; Trimble, Edward L

2017-12-01

Betel quid and areca nut are known risk factors for many oral and oesophageal cancers, and their use is highly prevalent in the Asia-Pacific region. Additionally, betel quid and areca nut are associated with health effects on the cardiovascular, nervous, gastrointestinal, metabolic, respiratory, and reproductive systems. Unlike tobacco, for which the WHO Framework Convention on Tobacco Control provides evidence-based policies for reducing tobacco use, no global policy exists for the control of betel quid and areca nut use. Multidisciplinary research is needed to address this neglected global public health emergency and to mobilise efforts to control betel quid and areca nut use. In addition, future research is needed to advance our understanding of the basic biology, mechanisms, and epidemiology of betel quid and areca nut use, to advance possible prevention and cessation programmes for betel quid and areca nut users, and to design evidence-based screening and early diagnosis programmes to address the growing burden of cancers that are associated with use. Copyright © 2017 Elsevier Ltd. All rights reserved.

Customizable 3D Printed ‘Plug and Play’ Millifluidic Devices for Programmable Fluidics

PubMed Central

Tsuda, Soichiro; Jaffery, Hussain; Doran, David; Hezwani, Mohammad; Robbins, Phillip J.; Yoshida, Mari; Cronin, Leroy

2015-01-01

Three dimensional (3D) printing is actively sought after in recent years as a promising novel technology to construct complex objects, which scope spans from nano- to over millimeter scale. Previously we utilized Fused deposition modeling (FDM)-based 3D printer to construct complex 3D chemical fluidic systems, and here we demonstrate the construction of 3D milli-fluidic structures for programmable liquid handling and control of biological samples. Basic fluidic operation devices, such as water-in-oil (W/O) droplet generators for producing compartmentalized mono-disperse droplets, sensor-integrated chamber for online monitoring of cellular growth, are presented. In addition, chemical surface treatment techniques are used to construct valve-based flow selector for liquid flow control and inter-connectable modular devices for networking fluidic parts. As such this work paves the way for complex operations, such as mixing, flow control, and monitoring of reaction / cell culture progress can be carried out by constructing both passive and active components in 3D printed structures, which designs can be shared online so that anyone with 3D printers can reproduce them by themselves. PMID:26558389

[Effectiveness of a programme based on a virtual reality game for cognitive enhancement in schizophrenia].

PubMed

López-Martín, Olga; Segura Fragoso, Antonio; Rodríguez Hernández, Marta; Dimbwadyo Terrer, Iris; Polonio-López, Begoña

2016-01-01

To evaluate the effectiveness of a programme based on a virtual reality game to improve cognitive domains in patients with schizophrenia. A randomized controlled trial was conducted in 40 patients with schizophrenia, 20 in the experimental group and 20 in the control group. The experimental group received 10 sessions with Nintendo Wii(®) for 5 weeks, 50 minutes/session, 2 days/week in addition to conventional treatment. The control group received conventional treatment only. Statistically significant differences in the T-Score were found in 5 of the 6 cognitive domains assessed: processing speed (F=12.04, p=0.001), attention/vigilance (F=12.75, p=0.001), working memory (F=18.86, p <0.01), verbal learning (F=7.6, p=0.009), visual learning (F=3.6, p=0.064), and reasoning and problem solving (F=11.08, p=0.002). Participation in virtual reality interventions aimed at cognitive training have great potential for significant gains in different cognitive domains assessed in patients with schizophrenia. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of patient acceptability.

PubMed

Burkow, Tatjana M; Vognild, Lars K; Østengen, Geir; Johnsen, Elin; Risberg, Marijke Jongsma; Bratvold, Astrid; Hagen, Tord; Brattvoll, Morten; Krogstad, Trine; Hjalmarsen, Audhild

2013-03-05

The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers.This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user's own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home. The digital health diary was used as background information in the individual consultations and by some participants as a self-management tool. Participant retention was high, with no dropouts. None of the participants reported that the six-week duration of the home programmes was too long. The Internet-enabled programmes for home-based groups in pulmonary rehabilitation and diabetes education were generally well accepted by the participants. Our findings indicate that conventional programmes have the potential to be delivered in socially supportive group settings at home.

Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of patient acceptability

PubMed Central

2013-01-01

Background The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers. This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. Methods We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user’s own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Results Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home. The digital health diary was used as background information in the individual consultations and by some participants as a self-management tool. Participant retention was high, with no dropouts. None of the participants reported that the six-week duration of the home programmes was too long. Conclusions The Internet-enabled programmes for home-based groups in pulmonary rehabilitation and diabetes education were generally well accepted by the participants. Our findings indicate that conventional programmes have the potential to be delivered in socially supportive group settings at home. PMID:23496829