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Sample records for intervention increases n-3

  1. Reducing dietary intake of linoleic acid of mouse dams during lactation increases offspring brain n-3 LCPUFA content.

    PubMed

    Schipper, L; Oosting, A; Scheurink, A J W; van Dijk, G; van der Beek, E M

    2016-07-01

    Omega (n-)3 and n-6 long chain polyunsaturated fatty acids (LCPUFA) accumulation in the infant brain after birth is strongly driven by dietary supply of n-3 and n-6 LCPUFAs and their C18 precursors through breast milk or infant formula. n-3 LCPUFA accretion is associated with positive effects on neurodevelopmental outcome whereas high n-6 LCPUFA accumulation is considered disadvantageous. Maternal diet is crucial for breast milk fatty acid composition. Unfortunately, global increases in linoleic acid (C18:2n-6; LA) intake have dramatically increased n-6 LCPUFA and reduced n-3 LCPUFA availability for breastfed infants. We investigated the effects of reducing maternal dietary LA, or increasing n-3 LCPUFA, during lactation on milk and offspring brain fatty acids in mice. Offspring brain n-3 LCPUFA was higher following both interventions, although effects were mediated by different mechanisms. Because of competitive interactions between n-3 and n-6 fatty acids, lowering maternal LA intake may support neurodevelopment in breastfed infants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Test meals rich in marine long-chain n-3 polyunsaturated fatty acids increase postprandial chylomicron response.

    PubMed

    Griffo, E; Di Marino, L; Patti, L; Bozzetto, L; Annuzzi, G; Cipriano, P; Mangione, A; Della Pepa, G; Cocozza, S; Riccardi, G; Rivellese, A A

    2014-08-01

    Postprandial lipid abnormalities are considered an independent cardiovascular risk factor. Hence, it is important to find nutritional strategies that are able to positively influence these abnormalities. Since the effect of n-3 polyunsaturated fatty acids (PUFA) and polyphenols on postprandial lipids in humans is still under debate, we evaluated the acute response of triglyceride-rich lipoproteins to test meals that are naturally rich in polyphenols and/or marine long-chain (LC) n-3 PUFAs. We hypothesized that LC n-3 PUFA would have a different effect on chylomicron and very low density lipoproteins when compared with polyphenols or their combination. We randomly assigned 78 individuals who were at high cardiometabolic risk to 4 isoenergetic diets. These diets only differed in amount of LC n-3 PUFA and/or polyphenols. Prior to starting the intervention, each subject underwent a test meal similar to the type of diet assigned: low in LC n-3 PUFA and polyphenols (control), rich in LC n-3 PUFA and low in polyphenols, rich in polyphenols and low in LC n-3 PUFA, or rich in both. Blood samples were taken before and up to 6 hours after the test meal in order to evaluate cholesterol and triglycerides (plasma and triglyceride-rich lipoprotein), apolipoprotein B-48 (large very low density lipoprotein), glucagon-like peptide-1, and free fatty acid plasma levels. The levels of chylomicron cholesterol and triglyceride in response to the test meal rich in LC n-3 PUFA were significantly higher than after the control meal (P = .037 and P = .018); there was no difference in the other variables. In conclusion, this study indicates that acute administration of marine LC n-3 PUFA increases postprandial chylomicron response in contrast with their lowering chronic effects. These differences underline the importance of understanding the acute and chronic effects of nutritional, as well as of other types of, interventions.

  3. Cheek cell fatty acids reflect n-3 PUFA in blood fractions during linseed oil supplementation: a controlled human intervention study

    PubMed Central

    2013-01-01

    Background Adequate biomarkers for the dietary supply of fatty acids (FA) are FA of adipose tissue and blood fractions. In human studies, invasive sample collection is unpleasant for subjects. In contrast, cheek cell sampling can be considered as a non-invasive alternative to investigate FA status. The aim of this study was to analyze whether cheek cell FA composition reflect the supplementation of alpha-linolenic acid (ALA) using a linseed oil mixture compared to olive oil supplementation. Additionally, it was investigated if cheek cell FA composition correlates with the FA composition of plasma, red blood cells (RBC) and peripheral blood mononuclear cells (PBMC) before and during both interventions. Methods During a 10-week randomized, controlled, double-blind human intervention study, 38 subjects provided cheek cell and blood samples. After a two-week run-in period, the test group (n = 23) received 17 g/d of an ALA-rich linseed oil mixture, while the control group (n = 15) received 17 g/d of an omega-3 (n-3) polyunsaturated FA (PUFA)-free olive oil. Cheek cells and blood were collected on days 0, 7 and 56 of the 8-week intervention period. Results Compared to olive oil, the linseed oil intervention increased ALA and also the endogenously converted long-chain n-3 metabolites eicosatetraenoic-, eicosapentaenoic- and docosapentaenoic acid in cheek cells (P ≤ 0.05). Docosahexaenoic acid remained unchanged. Reflecting the treatment, the n-6/n-3 ratio decreased in the test group. In general, cheek cell FA reflected the changes of FA in blood fractions. Independent of treatment, significant correlations (P ≤ 0.05) of n-6 PUFA and n-3 PUFA between cheek cells and plasma, RBC and PBMC were found, except for linoleic acid and ALA. Conclusions The changes in FA composition of cheek cells confirmed that ALA from linseed oil increased endogenously derived n-3 PUFA in cheek cell lipids. These changes in cheek cells and their correlation to the respective

  4. Cheek cell fatty acids reflect n-3 PUFA in blood fractions during linseed oil supplementation: a controlled human intervention study.

    PubMed

    Grindel, Annemarie; Staps, Frank; Kuhnt, Katrin

    2013-11-14

    Adequate biomarkers for the dietary supply of fatty acids (FA) are FA of adipose tissue and blood fractions. In human studies, invasive sample collection is unpleasant for subjects. In contrast, cheek cell sampling can be considered as a non-invasive alternative to investigate FA status.The aim of this study was to analyze whether cheek cell FA composition reflect the supplementation of alpha-linolenic acid (ALA) using a linseed oil mixture compared to olive oil supplementation. Additionally, it was investigated if cheek cell FA composition correlates with the FA composition of plasma, red blood cells (RBC) and peripheral blood mononuclear cells (PBMC) before and during both interventions. During a 10-week randomized, controlled, double-blind human intervention study, 38 subjects provided cheek cell and blood samples. After a two-week run-in period, the test group (n = 23) received 17 g/d of an ALA-rich linseed oil mixture, while the control group (n = 15) received 17 g/d of an omega-3 (n-3) polyunsaturated FA (PUFA)-free olive oil. Cheek cells and blood were collected on days 0, 7 and 56 of the 8-week intervention period. Compared to olive oil, the linseed oil intervention increased ALA and also the endogenously converted long-chain n-3 metabolites eicosatetraenoic-, eicosapentaenoic- and docosapentaenoic acid in cheek cells (P ≤ 0.05). Docosahexaenoic acid remained unchanged. Reflecting the treatment, the n-6/n-3 ratio decreased in the test group. In general, cheek cell FA reflected the changes of FA in blood fractions. Independent of treatment, significant correlations (P ≤ 0.05) of n-6 PUFA and n-3 PUFA between cheek cells and plasma, RBC and PBMC were found, except for linoleic acid and ALA. The changes in FA composition of cheek cells confirmed that ALA from linseed oil increased endogenously derived n-3 PUFA in cheek cell lipids. These changes in cheek cells and their correlation to the respective FA in blood fractions indicate the cheek

  5. Red meat from animals offered a grass diet increases plasma and platelet n-3 PUFA in healthy consumers.

    PubMed

    McAfee, A J; McSorley, E M; Cuskelly, G J; Fearon, A M; Moss, B W; Beattie, J A M; Wallace, J M W; Bonham, M P; Strain, J J

    2011-01-01

    Red meat from grass-fed animals, compared with concentrate-fed animals, contains increased concentrations of long-chain (LC) n-3 PUFA. However, the effects of red meat consumption from grass-fed animals on consumer blood concentrations of LC n-3 PUFA are unknown. The aim of the present study was to compare the effects on plasma and platelet LC n-3 PUFA status of consuming red meat produced from either grass-fed animals or concentrate-fed animals. A randomised, double-blinded, dietary intervention study was carried out for 4 weeks on healthy subjects who replaced their habitual red meat intake with three portions per week of red meat (beef and lamb) from animals offered a finishing diet of either grass or concentrate (n 20 consumers). Plasma and platelet fatty acid composition, dietary intake, blood pressure, and serum lipids and lipoproteins were analysed at baseline and post-intervention. Dietary intakes of total n-3 PUFA, as well as plasma and platelet concentrations of LC n-3 PUFA, were significantly higher in those subjects who consumed red meat from grass-fed animals compared with those who consumed red meat from concentrate-fed animals (P < 0·05). No significant differences in concentrations of serum cholesterol, TAG or blood pressure were observed between groups. Consuming red meat from grass-fed animals compared with concentrate-fed animals as part of the habitual diet can significantly increase consumer plasma and platelet LC n-3 PUFA status. As a result, red meat from grass-fed animals may contribute to dietary intakes of LC n-3 PUFA in populations where red meat is habitually consumed.

  6. Folate administration increases n-3 polyunsaturated fatty acids in rat plasma and tissue lipids.

    PubMed

    Pita, M L; Delgado, M J

    2000-09-01

    It has been shown that folic acid deficiency can modify polyunsaturated fatty acid (PUFA) metabolism and thus could contribute to the development of cardiovascular diseases. We have studied the effect of folate administration on fatty acid composition of plasma, platelet, erythrocyte, intestinal and liver lipids. Two groups of rats were daily injected with either saline solution (control group) or 5-methyl-tetrahydrofolate (MTHF) solution (MTHF group) for 15 days. Changes induced by folate treatment on n-6 PUFA were not very significant. Linoleic acid only decreased in liver and intestinal phospholipids of MTHF rats whereas arachidonic acid was unaffected by folate administration. However, n-3 PUFA significantly increased in plasma lipid fractions and in platelet, erythrocyte and intestinal phospholipids. It is well known that n-3 PUFA show antithrombotic properties. Thus, the increase of n-3 PUFA observed after MTHF administration might contribute to the prevention of vascular disorders.

  7. Mechanisms increasing n-3 highly unsaturated fatty acids in the heart.

    PubMed

    Glück, Tobias; Rupp, Heinz; Alter, Peter

    2016-03-01

    Due to ambiguous findings on cardiovascular benefits of systemic omega-3 fatty acid therapy, endogenous mechanisms contributing to local organ-specific concentrations of highly unsaturated fatty acids (HUFA) were examined. Using gas chromatography, 43 fatty acids were analyzed in atrial and ventricular myocardium and in pericardial fluid of male Wistar rats. To examine the endogenous fatty acid metabolism, precursors were administered into the pericardial sac. Pro- and anti-inflammatory actions were induced by talc or fenofibrate, respectively. Physical exercise and a sedentary obese state were used for increased beta-oxidation. DHA (22:6n-3) was increased in ventricular when compared with atrial myocardium (9.0 ± 2.1% vs. 4.7 ± 1.0%, p < 0.001). Intrapericardial EPA (20:5n-3) application lead to an increase of the succeeding tetracosapentaenoic acid (24:5n-3) in atrial myocardium, which is a key precursor of DHA. In contrast, proinflammatory stimulation of the n-6 HUFA pathway did not influence the n-3 metabolism. Exercise- and obesity-induced increased beta-oxidation, the finalizing step of DHA synthesis, was associated with increased ventricular DHA concentrations (6.7 ± 1.0% vs. 8.4 ± 1.2%, p < 0.01). It is concluded that the endogenous metabolism contributes markedly to myocardial HUFA concentrations. The findings are supposed to influence the efficacy of oral HUFA treatment and provide a rationale for divergent findings of previous trials on omega-3 therapy.

  8. Significance of Increasing n-3 PUFA Content in Pork on Human Health.

    PubMed

    Ma, Xianyong; Jiang, Zongyong; Lai, Chaoqiang

    2016-01-01

    Evidence for the health-promoting effects of food rich in n-3 polyunsaturated fatty acids (n-3 PUFA) is reviewed. Pork is an important meat source for humans. According to a report by the US Department of Agriculture ( http://www.ers.usda.gov/topics ), the pork consumption worldwide in 2011 was about 79.3 million tons, much higher than that of beef (48.2 million tons). Pork also contains high levels of unsaturated fatty acids relative to ruminant meats (Enser, M., Hallett, K., Hewett, B., Fursey, G. A. J. and Wood, J. D. (1996) . Fatty acid content and composition of English beef, lamb, and pork at retail. Meat Sci. 44:443-458). The available literature indicates that the levels of eicosatetraenoic and docosahexaenoic in pork may be increased by fish-derived or linseed products, the extent of which being dependent on the nature of the supplementation. Transgenic pigs and plants show promise with high content of n-3 PUFA and low ratio of n-6/n-3 fatty acids in their tissues. The approaches mentioned for decreasing n-6/n-3 ratios have both advantages and disadvantages. Selected articles are critically reviewed and summarized.

  9. Dietary flavonoids increase plasma very long-chain (n-3) fatty acids in rats.

    PubMed

    Toufektsian, Marie-Claire; Salen, Patricia; Laporte, François; Tonelli, Chiara; de Lorgeril, Michel

    2011-01-01

    Flavonoids probably contribute to the health benefits associated with the consumption of fruit and vegetables. However, the mechanisms by which they exert their effects are not fully elucidated. PUFA of the (n-3) series also have health benefits. Epidemiological and clinical studies have suggested that wine flavonoids may interact with the metabolism of (n-3) PUFA and increase their blood and cell levels. The present studies in rats were designed to assess whether flavonoids actually increase plasma levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the main very long-chain (n-3) PUFA. Rats were fed a corn-derived anthocyanin (ACN)-rich (ACN-rich) or ACN-free diet with constant intakes of plant and marine (n-3) PUFA for 8 wk (Expt. 1). Plasma fatty acids were measured by GC. The ACN-rich diet contained ~0.24 ± 0.01 mg of ACN/g pellets. There were no significant differences between groups in the main saturated, monounsaturated, and (n-6) fatty acids. In contrast, plasma EPA and DHA were greater in the ACN-rich diet group than in the ACN-free diet group (P < 0.05). We obtained similar results in 2 subsequent experiments in which rats were administered palm oil (80 μL/d) and consumed the ACN-rich or ACN-free diet (Expt. 2) or were supplemented with fish oil (60 mg/d, providing 35 mg DHA and 12 mg EPA) and consumed the ACN-rich or ACN-free diet (Expt. 3). In both experiments, plasma EPA and DHA were significantly greater in the ACN-rich diet group. These studies demonstrate that the consumption of flavonoids increases plasma very long-chain (n-3) PUFA levels. These data confirm previous clinical and epidemiological studies and provide new insights into the health benefits of flavonoids.

  10. Twice-weekly consumption of farmed Atlantic salmon increases plasma content of phospholipid n-3 fatty acids

    USDA-ARS?s Scientific Manuscript database

    Elevated intake of the n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is related to risk reduction of cardiovascular and other diseases. Increased consumption of seafood such as farmed Atlantic salmon is an effective way to consume n-3 but there is a paucity of data as ...

  11. Dietary n-3 polyunsaturated fatty acids increase oxidative stress in rats with intracerebral hemorrhagic stroke.

    PubMed

    Park, Yongsoon; Nam, Somyoung; Yi, Hyeong-Joong; Hong, Hyun-Jong; Lee, Myoungsook

    2009-11-01

    Intake of n-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has been suggested to associate with an increased risk of hemorrhagic stroke. The present study was designed to investigate the hypothesis that EPA and DHA increase oxidative stress and hemorrhage volume in rats with intracerebral hemorrhagic (ICH) stroke. Thirty-five-week-old male rats were fed an American Institute of Nutrition-93M diet containing 0% (n = 27), 0.5% (n = 15), or 1% EPA + DHA of total energy for 5 weeks. Of 5 rats fed 1% EPA + DHA (41%), 5 died because of excessive bleeding within 12 hours after ICH surgery. Behavior test score and hemorrhage volume were significantly (P < .05) greater in the 1% EPA + DHA-fed rats than in other rats. Magnetic resonance imaging consistently showed that edema and bleeding were visible in only the rats fed 1% EPA + DHA. Levels of superoxide dismutase and glutathione were significantly (P < .05) lower in rats fed 0.5% and 1% EPA + DHA than those fed 0% EPA + DHA. Thiobarbituric acid-reactive substance content was significantly (P < .05) higher in 1% EPA + DHA-fed rats than in 0% and 0.5% EPA + DHA-fed rats. The level of 8-hydroxydeoxyguanosine was significantly (P < .05) higher in ICH rats with all diets than in sham surgery rats. Brain levels of EPA and DHA were highest in rats fed 1% EPA + DHA than in rats fed 0% and 0.5% EPA + DHA. These results suggested that intake of 1% EPA + DHA of total energy could lead to oxidative damage to the brain and thus increase the risk of intracerebral hemorrhagic stroke in this rat model.

  12. A low omega-6 polyunsaturated fatty acid (n-6 PUFA) diet increases omega-3 (n-3) long chain PUFA status in plasma phospholipids in humans.

    PubMed

    Wood, K E; Lau, A; Mantzioris, E; Gibson, R A; Ramsden, C E; Muhlhausler, B S

    2014-04-01

    This study aimed to determine the effect of reducing the dietary linoleic acid (LA) intake from ~5% to <2.5% energy (%E) on n-3 long chain PUFA (LCPUFA) status in humans. Thirty-six participants followed a <2.5%E LA diet for 4 weeks. Nutrient intakes were estimated from diet diaries and blood samples were collected for assessment of fatty acid composition in plasma and erythrocyte phospholipids. LA intakes were reduced from 4.6%E to 2%E during the low LA intervention (P<0.001) while n-3 LCPUFA intakes were unchanged. LA and total n-6 PUFA content of plasma and erythrocyte phospholipids were significantly reduced after the low LA diet phase (P<0.001). The n-3 LCPUFA content of plasma phospholipids was significantly increased after the low LA diet compared to baseline (6.22% vs. 5.53%, P<0.001). These data demonstrate that reducing LA intake for 4 weeks increases n-3 LCPUFA status in humans in the absence of increased n-3 LCPUFA intake.

  13. Dose-dependent consumption of farmed Atlantic salmon (salmo salar) increases plasma phospholipid n-3 fatty acids differentially

    USDA-ARS?s Scientific Manuscript database

    ABSTRACT Background: Enhanced n-3 intake benefit CVD risk reduction. Increasing consumption at a population level will be better addressed by dietary modification than through supplementation. However, limited data are available on the effect of increasing doses of fish intake on circulating level...

  14. Chronic dietary n-3 PUFA intervention improves dyslipidaemia and subsequent cardiovascular complications in the JCR:LA- cp rat model of the metabolic syndrome.

    PubMed

    Lu, Jing; Borthwick, Faye; Hassanali, Zahra; Wang, Ye; Mangat, Rabban; Ruth, Megan; Shi, Danni; Jaeschke, Anja; Russell, James C; Field, Catherine J; Proctor, Spencer D; Vine, Donna F

    2011-06-01

    There is increasing interest in the potential chronic beneficial effects of dietary n-3 PUFA on the metabolic syndrome (MetS) and associated cardiovascular complications. We have recently established that increased dietary n-3 PUFA has a profound acute benefit on fasting lipids and the postprandial pro-inflammatory response in the JCR:LA-cp rat, a model of the MetS. However, it is unclear to what extent chronic dietary n-3 PUFA intervention can modulate the progression of end-stage metabolic and vascular complications. The present study aimed to determine the chronic effects of dietary n-3 PUFA supplementation on fasting and non-fasting dyslipidaemia, insulin resistance and vascular complications in the JCR:LA-cp rodent model. JCR:LA-cp rats were fed an isoenergetic lipid-balanced diet supplemented with 5 % n-3 PUFA (w/w) of the total fat (fish oil-derived EPA/DHA) for 16 weeks. Fasting and non-fasting (postprandial) plasma lipid profile was assessed. Hepatic and adipose tissue was probed for the expression of lipogenic proteins (acyl-CoA carboxylase (ACC), fatty acid synthase (FAS) and sterol regulatory element-binding protein-1 (SREBP-1)), while the activity of Jun N-terminal kinase (JNK) was assessed via Western blot to target phosphorylated JNK protein in primary enterocytes. The frequency of myocardial lesions was assessed by haematoxylin and eosin staining. Increased dietary n-3 PUFA improved both the fasting and postprandial lipid profiles (TAG, cholesterol and apoB48) in the JCR:LA-cp rat, potentially via the down-regulation of the hepatic or adipose tissue expression of lipogenic enzymes (ACC, FAS and SREBP-1). Rats fed the 5 % n-3 PUFA diet had lower (58·2 %; P < 0·01) enterocytic phosphorylated JNK protein and secreted less cholesterol (30 %; P < 0·05) into mesenteric lymph compared with the control. The chronic metabolic benefits of dietary n-3 PUFA may underlie the potential to reduce vascular complications during the MetS, including the observed

  15. Long-chain n-3 PUFA against breast and prostate cancer: Which are the appropriate doses for intervention studies in animals and humans?

    PubMed

    Fasano, Elena; Serini, Simona; Cittadini, Achille; Calviello, Gabriella

    2017-07-24

    The potential antineoplastic effect of the long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) remains a highly controversial issue. Numerous animal studies have supported the anticancer role of these dietary fatty acids, whereas conflicting results have been obtained in population studies, and only a few intervention human trials have been so far performed. In view of the possibility that the anticancer effects may be maximally observed within a defined range of EPA and DHA doses, herein we critically review the results and doses used in both animal studies and human clinical trials focusing on the possible n-3 PUFA protective effects against breast and prostate cancer. Our main aim is to identify the EPA and/or DHA ranges of doses needed to obtain clear anticancer effects. This may be of great help in designing future animal studies, and also in understanding the most appropriate dose for further human intervention studies. Moreover, since the healthy effects of these fatty acids have been strictly related to their increased incorporation in plasma and tissue lipids, we also examine and discuss the incorporation changes following the administration of the effective anticancer EPA and/or DHA doses in animals and humans.

  16. Camelina meal increases egg n-3 fatty acid content without altering quality or production in laying hens.

    PubMed

    Kakani, Radhika; Fowler, Justin; Haq, Akram-Ul; Murphy, Eric J; Rosenberger, Thad A; Berhow, Mark; Bailey, Christopher A

    2012-05-01

    Camelina sativa is an oilseed plant rich in n-3 and n-6 fatty acids and extruding the seeds results in high protein meal (*40%) containing high levels of n-3 fatty acids. In this study, we examined the effects of feeding extruded defatted camelina meal to commercial laying hens, measuring egg production, quality, and fatty acid composition. Lohmann White Leghorn hens (29 weeks old) were randomly allocated to three dietary treatment groups (n = 25 per group) and data was collected over a 12 week production period. All the treatment groups were fed a corn soy based experimental diet containing 0% (control), 5, or 10% extruded camelina meal. We found no significant differences in percent hen-day egg production and feed consumed per dozen eggs. Egg shell strength was significantly higher in both camelina groups compared to the controls. Egg total n-3 fatty acid content increased 1.9- and 2.7-fold in 5 and 10% camelina groups respectively relative to the control. A similar increase in DHA content also occurred. Further camelina meal did not alter glucosinolate levels and no detectable glucosinolates or metabolic product isothiocyanates were found in the eggs from either the 5 or 10% camelina groups. These results indicate that camelina meal is a viable dietary source of n-3 fatty acids for poultry and its dietary inclusion results in eggs enriched with n-3 fatty acids.

  17. Short-term n-3 fatty acid supplementation but not aspirin increases plasma proresolving mediators of inflammation[S

    PubMed Central

    Barden, Anne; Mas, Emilie; Croft, Kevin D.; Phillips, Michael; Mori, Trevor A.

    2014-01-01

    Resolution of inflammation is an active process involving specialized proresolving mediators (SPM) formed from the n-3 fatty acids. This study examined the effect of n-3 fatty acid supplementation and aspirin on plasma SPMs in healthy humans. Healthy volunteers (n = 21) were supplemented with n-3 fatty acids (2.4g/day) for 7 days with random assignment to take aspirin (300 mg/day) or placebo from day 5 to day 7. Blood was collected at baseline (day 0), day 5, and day 7. Plasma 18R/S-HEPE, E-series resolvins, 17R/S-HDHA, D-series resolvins, 14R/S-HDHA, and MaR-1 were measured by LC/MS/MS. At baseline concentrations of E- and D- series resolvins and the upstream precursors 18R/S-HEPE, 17R/S-HDHA ranged from 0.1nM to 0.2nM. 14R/S-HDHA was 3-fold higher than the other SPMs at baseline but MaR-1 was below the limit of detection. Supplementation with n-3 fatty acids significantly increased RvE1, 18R/S-HEPE, 17R/S-HDHA, and 14R/S-HDHA but not other SPMs. The addition of aspirin after 5 days of n-3 fatty acids did not affect concentrations of any SPM. N-3 fatty acid supplementation for 5 days results in concentrations of SPMs that are biologically active in healthy humans. Aspirin administered after n-3 fatty acids did not offer any additional benefit in elevating the levels of SPMs. PMID:25187667

  18. Effect of n-3 Polyunsaturated Fatty Acids on Regression of Coronary Atherosclerosis in Statin Treated Patients Undergoing Percutaneous Coronary Intervention

    PubMed Central

    Ahn, Jinhee; Park, Seo Kwang; Park, Tae Sik; Kim, Jin Hee; Yun, Eunyoung; Kim, Sang-Pil; Lee, Hye Won; Oh, Jun-Hyok; Choi, Jung Hyun; Cha, Kwang Soo; Hong, Taek Jong; Lee, Sang Yeoup

    2016-01-01

    Background and Objectives Statins remain the mainstay of secondary coronary artery disease (CAD) prevention, but n-3 polyunsaturated fatty acids (ω-3 PUFA) display biological effects that may also reduce the risk of atherosclerosis and CAD. However, data on the possible antiatherosclerotic benefits of adding ω-3 PUFA to statin therapy are limited. This study aimed to investigate the potential additive effects of ω-3 PUFA on regression of atherosclerosis in CAD patients receiving statin therapy and stent implantation. Subjects and Methods Seventy-four CAD patients undergoing percutaneous coronary intervention (PCI) with stent implantation were enrolled, prescribed statins, and randomly assigned to two groups: n-3 group (ω-3 PUFA 3 g/day, n=38) or placebo group (placebo, n=36). All patients completed the study follow-up consisting of an intravascular ultrasound at baseline and at 12 months. Results There was no difference in the baseline characteristics and distribution of other medications. No significant differences were observed in primary endpoints, including changes in atheroma volume index (−12.65% vs. −8.51%, p=0.768) and percent atheroma volume (−4.36% vs. −9.98%, p=0.526), and in secondary endpoints including a change in neointimal volume index (7.84 vs. 4.94 mm3/mm, p=0.087). Conclusion ω-3 PUFA had no definite additional effect on the regression of coronary atherosclerosis when added to statin in CAD patients undergoing PCI. PMID:27482256

  19. Red Blood Cell Docosapentaenoic Acid (DPA n-3) is Inversely Associated with Triglycerides and C-reactive Protein (CRP) in Healthy Adults and Dose-Dependently Increases Following n-3 Fatty Acid Supplementation

    PubMed Central

    Skulas-Ray, Ann C.; Flock, Michael R.; Richter, Chesney K.; Harris, William S.; West, Sheila G.; Kris-Etherton, Penny M.

    2015-01-01

    The role of the long-chain omega-3 (n-3) fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in lipid metabolism and inflammation has been extensively studied; however, little is known about the relationship between docosapentaenoic acid (DPA, 22:5 n-3) and inflammation and triglycerides (TG). We evaluated whether n-3 DPA content of red blood cells (RBC) was associated with markers of inflammation (interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and C-reactive protein (CRP) and fasting TG prior to n-3 supplementation in two studies (Study 1: n = 115, aged 20–44 years, body mass index (BMI) 20–30 kg/m2, TG = 34–176 mg/dL; Study 2: n = 28, aged 22–65 years, BMI 24–37 kg/m2, TG = 141–339 mg/dL). We also characterized the dose-response effects of n-3 fatty acid supplementation on RBC n-3 DPA after five months of supplementation with fish oil (Study 1: 0, 300, 600, 900, and 1800 mg/day EPA + DHA) and eight weeks of prescription n-3 ethyl esters (Study 2: 0, 850, and 3400 mg/day EPA + DHA). In Study 1, RBC n-3 DPA was inversely correlated with CRP (R2 = 36%, p < 0.001) and with fasting TG (r = −0.30, p = 0.001). The latter finding was replicated in Study 2 (r = −0.33, p = 0.04). In both studies, n-3 supplementation significantly increased RBC n-3 DPA dose-dependently. Relative increases were greater for Study 1, with increases of 29%–61% vs. 14%–26% for Study 2. The associations between RBC n-3 DPA, CRP, and fasting TG may have important implications for the prevention of atherosclerosis and chronic inflammatory diseases and warrant further study. PMID:26247967

  20. Fish oil-derived n-3 PUFA therapy increases muscle mass and function in healthy older adults.

    PubMed

    Smith, Gordon I; Julliand, Sophie; Reeds, Dominic N; Sinacore, David R; Klein, Samuel; Mittendorfer, Bettina

    2015-07-01

    Age-associated declines in muscle mass and function are major risk factors for an impaired ability to carry out activities of daily living, falls, prolonged recovery time after hospitalization, and mortality in older adults. New strategies that can slow the age-related loss of muscle mass and function are needed to help older adults maintain adequate performance status to reduce these risks and maintain independence. We evaluated the efficacy of fish oil-derived n-3 (ω-3) PUFA therapy to slow the age-associated loss of muscle mass and function. Sixty healthy 60-85-y-old men and women were randomly assigned to receive n-3 PUFA (n = 40) or corn oil (n = 20) therapy for 6 mo. Thigh muscle volume, handgrip strength, one-repetition maximum (1-RM) lower- and upper-body strength, and average power during isokinetic leg exercises were evaluated before and after treatment. Forty-four subjects completed the study [29 subjects (73%) in the n-3 PUFA group; 15 subjects (75%) in the control group]. Compared with the control group, 6 mo of n-3 PUFA therapy increased thigh muscle volume (3.6%; 95% CI: 0.2%, 7.0%), handgrip strength (2.3 kg; 95% CI: 0.8, 3.7 kg), and 1-RM muscle strength (4.0%; 95% CI: 0.8%, 7.3%) (all P < 0.05) and tended to increase average isokinetic power (5.6%; 95% CI: -0.6%, 11.7%; P = 0.075). Fish oil-derived n-3 PUFA therapy slows the normal decline in muscle mass and function in older adults and should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults. This study was registered at clinicaltrials.gov as NCT01308957. © 2015 American Society for Nutrition.

  1. Effects of n-3 polyunsaturated fatty acids high fat diet intervention on the synthesis of hepatic high-density lipoprotein cholesterol in obesity-insulin resistance rats.

    PubMed

    Xie, Xianxing; Zhang, Tao; Zhao, Shuang; Li, Wei; Ma, Lanzhi; Ding, Ming; Liu, Yuan

    2016-04-22

    n-3 polyunsaturated fatty acids (PUFA) have previously been demonstrated in association with a reduced risk of chronic diseases, including insulin resistance, cancer and cardiovascular disease. In the present study, we analyzed the effects of n-3 PUFA-rich perilla oil (PO) and fish oil (FO) high fat diet intervention against the synthesis of hepatic high-density lipoprotein cholesterol (HDL-c) in obesity-insulin resistance model rats. In the modeling period, the male SD rats were randomly divided into 2 groups. The rats in the high fat (HF) group were given a high fat pure diet containing 20.62% lard. In the intervention period, the model rats were intervened with purified high-fat diets rich in PO or FO, containing same energy content with high fat pure diet in HF. After the intervention, the protein and mRNA expressions status of the key genes involved in synthesis of hepatic HDL-c were measured for further analytic comparison. The obesity-insulin resistance model rats were characterized by surprisingly high levels of serum triglyceride (TG) and increased body weight (P < 0.05, each). After the intervention, there were no apparent changes in the serum HDL-c and total cholesterol (TCH). In addition, the FO could up-regulate the hepatic adenosine triphosphate (ATP) binding cassette transporter A1 (ABCA1) mRNA (P < 0.01) and protein expressions, as well as increase the level of serum apolipoprotein A-1 (apoA-1) (P < 0.0001), and elevate the hepatic apoA-1mRNA expression (P < 0.01). Different from FO, the PO specifically elevated the hepatic ABCA1mRNA expression (P < 0.01). The FO high fat diets promoted the synthesis of HDL-c in the obesity-insulin resistance rats.

  2. N-3 fatty acids reduced trans fatty acids retention and increased docosahexaenoic acid levels in the brain.

    PubMed

    Lavandera, Jimena Verónica; Saín, Juliana; Fariña, Ana Clara; Bernal, Claudio Adrián; González, Marcela Aída

    2017-09-01

    The levels of docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6) are critical for the normal structure and function of the brain. Trans fatty acids (TFA) and the source of the dietary fatty acids (FA) interfere with long-chain polyunsaturated fatty acids (LC-PUFA) biosynthesis. The aim of this study was to investigate the effect of TFA supplementation in diets containing different proportions of n-9, n-6, and n-3 FA on the brain FA profile, including the retention of TFA, LC-PUFA levels, and n-6/n-3 PUFA ratios. These parameters were also investigated in the liver, considering that LC-PUFA are mainly bioconverted from their dietary precursors in this tissue and transported by serum to the brain. Also, stearoyl-CoA desaturase-1 (SCD1) and sterol regulatory element-binding protein-1c (SREBP-1c) gene expressions were evaluated. Male CF1 mice were fed (16 weeks) diets containing different oils (olive, corn, and rapeseed) with distinct proportions of n-9, n-6, and n-3 FA (55.2/17.2/0.7, 32.0/51.3/0.9, and 61.1/18.4/8.6), respectively, substituted or not with 0.75% of TFA. FA composition of the brain, liver, and serum was assessed by gas chromatography. TFA were incorporated into, and therefore retained in the brain, liver, and serum. However, the magnitude of retention was dependent on the tissue and type of isomer. In the brain, total TFA retention was lower than 1% in all diets. Dietary n-3 PUFA decreased TFA retention and increased DHA accretion in the brain. The results underscore the importance of the type of dietary FA on the retention of TFA in the brain and also on the changes of the FA profile.

  3. Motivating Intervention Strategies to Increase Homework Completion

    ERIC Educational Resources Information Center

    Amerine, Melissa; Pender, Lisa; Schuler, Kristin

    2009-01-01

    The purpose of this action research project was to increase homework completion through the use of motivating strategies. There were approximately 75 students, 100 parents, and three teacher researchers involved in this study. The three intervention strategies used were 15 minutes of class time, extrinsic rewards, and assignment notebook checks.…

  4. Randomized placebo-controlled intervention with n-3 LC-PUFA-supplemented yoghurt: effects on circulating eicosanoids and cardiovascular risk factors.

    PubMed

    Dawczynski, Christine; Massey, Karen A; Ness, Christina; Kiehntopf, Michael; Stepanow, Stefanie; Platzer, Matthias; Grün, Michael; Nicolaou, Anna; Jahreis, Gerhard

    2013-10-01

    The study examined the value of n-3 LC-PUFA-enriched yogurt as means of improving cardiovascular health. Fifty three mildly hypertriacylglycerolemic subjects (TAG ≥ 1.7 mmol/L) participated in a randomized, placebo-controlled, double-blind, parallel designed study. The subjects consumed 1) control yoghurt; 2) yoghurt enriched with 0.8 g n-3 LC-PUFA/d; or 3) yoghurt enriched with 3 g n-3 LC-PUFA/d for a period of 10 wks. Blood samples were taken at the beginning and the end of the study period. Following daily intake of 3 g n-3 LC-PUFA for 10 weeks, n-3 LC-PUFA levels increased significantly in plasma and red blood cells (RBC) with concomitant increase in the EPA-derived mediators (PGE₃, 12-, 15-, 18-HEPE) in plasma whilst cardiovascular risk factors such as HDL, TAG, AA/EPA ratio, and n-3 index were improved (P < 0.05); the decrease of TAG and increase in HDL were associated with the CD36 genotype. The observed increase of n-3 LC-PUFA in RBC and plasma lipids due to intake of n-3 LC-PUFA enriched yoghurt resulted in a reduction of cardiovascular risk factors and inflammatory mediators showing that daily consumption of n-3 PUFA enriched yoghurt can be an effective way of supplementing the daily diet and improving cardiovascular health. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  5. Workplace pedometer interventions for increasing physical activity.

    PubMed

    Freak-Poli, Rosanne L A; Cumpston, Miranda; Peeters, Anna; Clemes, Stacy A

    2013-04-30

    The World Health Organization and the World Economic Forum have recommended further research to strengthen current knowledge of workplace health programmes, particularly on effectiveness and using simple instruments. A pedometer is one such simple instrument that can be incorporated in workplace interventions. To assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving subsequent health outcomes. Electronic searches of the Cochrane Central Register of Controlled Trials (671 potential papers), MEDLINE (1001), Embase (965), CINAHL (1262), OSH UPDATE databases (75) and Web of Science (1154) from the earliest record to between 30th January and 6th February 2012 yielded 3248 unique records. Reference lists of articles yielded an additional 34 papers. Contact with individuals and organisations did not produce any further records. We included individual and cluster-randomised controlled trials of workplace health promotion interventions with a pedometer component in employed adults. The primary outcome was physical activity and was part of the eligibility criteria. We considered subsequent health outcomes, including adverse effects, as secondary outcomes. Two review authors undertook the screening of titles and abstracts and the full-text papers independently. Two review authors (RFP and MC) independently completed data extraction and risk of bias assessment. We contacted authors to obtain additional data and clarification. We found four relevant studies providing data for 1809 employees, 60% of whom were allocated to the intervention group. All studies assessed outcomes immediately after the intervention had finished and the intervention duration varied between three to six months. All studies had usual treatment control conditions; however one study's usual treatment was an alternative physical activity programme while the other three had minimally active controls. In general, there was high risk of bias mainly

  6. Community wide interventions for increasing physical activity.

    PubMed

    Baker, Philip R A; Francis, Daniel P; Soares, Jesus; Weightman, Alison L; Foster, Charles

    2015-01-05

    Multi-strategic community wide interventions for physical activity are increasingly popular but their ability to achieve population level improvements is unknown. To evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity. We searched the Cochrane Public Health Group Segment of the Cochrane Register of Studies,The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, LILACS, PsycINFO, ASSIA, the British Nursing Index, Chinese CNKI databases, EPPI Centre (DoPHER, TRoPHI), ERIC, HMIC, Sociological Abstracts, SPORT Discus, Transport Database and Web of Science (Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index). We also scanned websites of the EU Platform on Diet, Physical Activity and Health; Health-Evidence.org; the International Union for Health Promotion and Education; the NIHR Coordinating Centre for Health Technology (NCCHTA); the US Centre for Disease Control and Prevention (CDC) and NICE and SIGN guidelines. Reference lists of all relevant systematic reviews, guidelines and primary studies were searched and we contacted experts in the field. The searches were updated to 16 January 2014, unrestricted by language or publication status. Cluster randomised controlled trials, randomised controlled trials, quasi-experimental designs which used a control population for comparison, interrupted time-series studies, and prospective controlled cohort studies were included. Only studies with a minimum six-month follow up from the start of the intervention to measurement of outcomes were included. Community wide interventions had to comprise at least two broad strategies aimed at physical activity for the whole population. Studies which randomised individuals from the same community were excluded. At least two review authors independently extracted the data and assessed the risk of bias. Each study was assessed for the setting, the number of included components

  7. Camelina meal increases egg n-3 fatty acid content without altering egg quality or production in laying hens

    USDA-ARS?s Scientific Manuscript database

    Camelina sativa is an oilseed plant rich in n-3 and n-6-fatty acids and extruding defatted seed meal results in high protein meal (~40%) containing residual n-3 fatty acids. We examined the effects of feeding extruded defatted camelina seed meal to commercial laying hens on egg production, quality, ...

  8. n-3 PUFA fortification of high n-6 PUFA farmed tilapia with linseed could significantly increase dietary contribution and support nutritional expectations of fish.

    PubMed

    Shapira, Niva; Weill, Pierre; Sharon, Ossie; Loewenbach, Rachel; Berzak, Ofer

    2009-03-25

    Farmed fish high in n-6 PUFA may undermine fish nutritional expectations and intake recommendations for n-3 PUFA requirements and exacerbate rather than improve already high n-6/n-3 PUFA diets. Dietary contribution of fish fortification by linseed-based n-3 PUFA was evaluated. Mango tilapia (12 months old) with high n-6 PUFA (21.8 FA%, n-6/n-3 ratio 4.6:1) were fed standard/control (T(C)) or linseed-supplemented (5%, T(5%); 7%, T(7%)) feed for 61 days regular-growth and 120 days stock-growth (to 650 g). Compared to T(C), n-3 PUFA increased in T(5%) 46% and T(7%) 58%; ALA in T(5%) increased 100% and T(7%) 167%; EPA+DHA in T(5%) increased 14% and T(7%) 23% (p < 0.05); n-6 PUFA/LCPUFA were unchanged. T(7%) EPA+DHA 168 mg/100 g of raw fillet is comparable to current American intake and Dietary Reference Intakes; controlled cooking preserved approximately 90% EPA+DHA. n-6/n-3 ratios decreased 16-38% in total PUFA to 2.3:1 and in LCPUFA to 0.61:1. Linseed supplementation could improve tilapia n-3 PUFA/LCPUFA, ameliorating n-3 PUFA scarcity and unexpectedly high fish n-6 PUFA content, potentially making a significant nutritional contribution.

  9. Community wide interventions for increasing physical activity.

    PubMed

    Baker, Philip Ra; Francis, Daniel P; Soares, Jesus; Weightman, Alison L; Foster, Charles

    2011-04-13

    Multi-strategic community wide interventions for physical activity are increasingly popular but their ability to achieve population level improvements is unknown. To evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity. We searched the Cochrane Public Health Group Specialised Register, The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, LILACS, PsycINFO, ASSIA, The British Nursing Index, Chinese CNKI databases, EPPI Centre (DoPHER, TRoPHI), ERIC, HMIC, Sociological Abstracts, SPORTDiscus, Transport Database and Web of Science (Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index). We also scanned websites of the EU Platform on Diet, Physical Activity and Health; Health-Evidence.ca; the International Union for Health Promotion and Education; the NIHR Coordinating Centre for Health Technology (NCCHTA) and NICE and SIGN guidelines. Reference lists of all relevant systematic reviews, guidelines and primary studies were followed up. We contacted experts in the field from the National Obesity Observatory Oxford, Oxford University; Queensland Health, Queensland University of Technology, the University of Central Queensland; the University of Tennessee and Washington University; and handsearched six relevant journals. The searches were last updated to the end of November 2009 and were not restricted by language or publication status. Cluster randomised controlled trials, randomised controlled trials (RCT), quasi-experimental designs which used a control population for comparison, interrupted time-series (ITS) studies, and prospective controlled cohort studies (PCCS) were included. Only studies with a minimum six-month follow up from the start of the intervention to measurement of outcomes were included. Community wide interventions had to comprise at least two broad strategies aimed at physical activity for the whole population. Studies which randomised

  10. Immune dysfunction and increased oxidative stress state in diet-induced obese mice are reverted by nutritional supplementation with monounsaturated and n-3 polyunsaturated fatty acids.

    PubMed

    Hunsche, Caroline; Hernandez, Oskarina; Gheorghe, Alina; Díaz, Ligia Esperanza; Marcos, Ascensión; De la Fuente, Mónica

    2017-02-23

    Obesity is associated with impaired immune defences and chronic low levels of inflammation and oxidation. In addition, this condition may lead to premature aging. The aim of the study was to evaluate the effects of a nutritional supplementation with monounsaturated and n-3 polyunsaturated fatty acids on several functions and oxidative stress parameters in peritoneal immune cells of obese mice, as well as on the life span of these animals. Obesity was induced in adult female ICR/CD1 by the administration of a high-fat diet (HFD) for 14 weeks. During the last 6 weeks of HFD feeding, one group of obese mice received the same HFD, supplemented with 1500 mg of 2-hydroxyoleic acid (2-OHOA) and another with 3000 mg of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Several functions and oxidative stress parameters of peritoneal leukocytes were evaluated. The groups of obese mice treated with 2-OHOA or with EPA and DHA showed a significant improvement in several functions such as chemotaxis, phagocytosis, digestion capacity, Natural killer activity and lymphoproliferation in response to mitogens. All of these functions, which were decreased in obese mice, increased reaching similar levels to those found in non-obese controls. Both treatments also improved oxidative stress parameters such as xanthine oxidase activity, which decreased, catalase activity and glutathione levels, which increased. These data suggest that dietary supplementation with monounsaturated and n-3 polyunsaturated fatty acids could be an effective nutritional intervention to restore the immune response and oxidative stress state, which are impaired in obese mice.

  11. Fifteen weeks of dietary n-3 polyunsaturated fatty acid deprivation increases turnover of n-6 docosapentaenoic acid in rat-brain phospholipids

    PubMed Central

    Igarashi, Miki; Kim, Hyung-Wook; Gao, Fei; Chang, Lisa; Ma, Kaizong; Rapoport, Stanley I.

    2012-01-01

    Docosapentaenoic acid (DPAn-6, 22:5n-6) is an n-6 polyunsaturated fatty acid (PUFA) whose brain concentration can be increased in rodents by dietary n-3 PUFA deficiency, which may contribute to their behavioral dysfunction. We used our in vivo intravenous infusion method to see if brain DPAn-6 turnover and metabolism also were altered with deprivation. We studied male rats that had been fed for 15 weeks post-weaning an n-3 PUFA adequate diet containing 4.6% alpha-linolenic acid (α-LNA, 18:3n-3) or a deficient diet (0.2% α-LNA), each lacking docosahexaenoic acid (22:6n-3) and arachidonic acid (AA, 20:4n-6). [1-14C]DPAn-6 was infused intravenously for 5 min in unanesthetized rats, after which the brain underwent high-energy microwaving, and then was analyzed. The n-3 PUFA deficient compared with adequate diet increased DPAn-6 and decreased DHA concentrations in plasma and brain, while minimally changing brain AA concentration. Incorporation rates of unesterified DPAn-6 from plasma into individual brain phospholipids were increased 5.2–7.7 fold, while turnover rates were increased 2.1–4.7 fold. The observations suggest that increased metabolism and brain concentrations of DPAn-6 and its metabolites, together with a reduced brain DHA concentration, contribute to behavioral and functional abnormalities reported with dietary n-3 PUFA deprivation in rodents. PMID:22142872

  12. Dietary n-3 polyunsaturated fatty acids revert renal responses induced by a combination of 2 protocols that increase the amounts of advanced glycation end product in rats.

    PubMed

    de Assis, Adriano M; Rech, Anderson; Longoni, Aline; da Silva Morrone, Maurílio; de Bittencourt Pasquali, Matheus A; Perry, Marcos L S; Souza, Diogo O; Moreira, José C F

    2015-06-01

    Renal dysfunction is a severe complication that is caused by diabetes mellitus. Many factors associate the progression of this complication with high levels of proinflammatory and pro-oxidant substances, such as advanced glycation end products (AGEs), which form a heterogeneous group of compounds that can accumulate in tissues such as retinas, joints, and kidneys. The hypothesis of this study is that n-3 polyunsaturated fatty acids (n-3 PUFAs) have a nephroprotective effect on rats after exposing them to a combination of 2 protocols that increase the AGE amounts: a high-fat diet enriched with AGEs and a diabetes rat model. Adult Wistar rats were divided into 6 groups that received the following diets for 4 weeks: (1) control group; 2) HAGE: high AGE fat-containing diet group; (3) HAGE + n-3: high AGE fat-containing diet plus n-3 PUFAs group; (4) diabetic group; (5) Db + HAGE: high AGE fat-containing diet diabetic group; and (6) Db + HAGE + n-3: high AGE fat-containing diet plus n-3 PUFAs diabetic group. Diabetes mellitus was induced by an intraperitoneal injection of alloxan (150 mg kg(-1)). In diabetic and nondiabetic rats, the high HAGE fat-containing diet increased the serum creatinine, tumor necrosis factor-α, thiobarbituric acid reactive substances, and reactive oxygen species levels, as well as the superoxide dismutase/catalase + glutathione peroxidase ratio and the superoxide dismutase 2 and receptor for advanced glycation end products immunocontent of the kidneys. n-3 Polyunsaturated fatty acids attenuated these alterations and influenced the receptor for advanced glycation end products/oxidative stress/tumor necrosis factor-α axis. In summary, this study showed that the extrinsic AGE pathway (HAGE diet) had a greater effect on renal metabolism than the intrinsic AGE pathway (diabetes induction) and that n-3 PUFAs appear to prevent renal dysfunction via antioxidant and anti-inflammatory pathways.

  13. Dietary n-6 PUFA deprivation for 15 weeks reduces arachidonic acid concentrations while increasing n-3 PUFA concentrations in organs of post-weaning male rats

    PubMed Central

    Igarashi, Miki; Gao, Fei; Kim, Hyung-Wook; Ma, Kaizong; Bell, Jane M.; Rapoport, Stanley I.

    2009-01-01

    Few studies have examined effects of feeding animals a diet deficient in n-6 polyunsaturated fatty acids (PUFAs) but with an adequate amount of n-3 PUFAs. To do this, we fed post-weaning male rats a control n-6 and n-3 PUFA adequate diet and an n-6 deficient diet for 15 weeks, and measured stable lipid and fatty acid concentrations in different organs. The deficient diet contained nutritionally essential linoleic acid (LA,18:2n-6) as 2.3% of total fatty acids (10% of the recommended minimum LA requirement for rodents) but no arachidonic acid (AA, 20:4n-6), and an adequate amount (4.8% of total fatty acids) of α-linolenic acid (18:3n-3). The deficient compared with adequate diet did not significantly affect body weight, but decreased testis weight by 10%. AA concentration was decreased significantly in serum (−86%), brain (−27%), liver (−68%), heart (−39%), testis (−25%), and epididymal adipose tissue (−77%). Eicosapentaenoic (20:5n-3) and docosahexaenoic acid (22:6n-3) concentrations were increased in all but adipose tissue, and the total monounsaturated fatty acid concentration was increased in all organs. The concentration of 20:3n-9, a marker of LA deficiency, was increased by the deficient diet, and serum concentrations of triacylglycerol, total cholesterol and total phospholipid were reduced. In summary, 15 weeks of dietary n-6 PUFA deficiency with n-3 PUFA adequacy significantly reduced n-6 PUFA concentrations in different organs of male rats, while increasing n-3 PUFA and monounsaturated fatty acid concentrations. This rat model could be used to study metabolic, functional and behavioral effects of dietary n-6 PUFA deficiency. PMID:19073280

  14. Treatment of flaxseed to reduce biohydrogenation of a-linolenic acid by ruminal microbes in sheep and cattle and increase n-3 fatty acid concentrations in red meat

    USDA-ARS?s Scientific Manuscript database

    Our study determined if flaxseed treated with a formaldehyde-free process increased n-3 fatty acid (FA) levels in ruminant muscle. Twenty-four lambs (initial BW 43.8 ± 4.4 kg) were randomly divided into 4 groups for a 90-d trial. One treatment group (FLX) was fed 136 g/d of non-treated ground flaxse...

  15. Interventions to increase adherence to acne treatment

    PubMed Central

    Moradi Tuchayi, Sara; Alexander, Tiffany M; Nadkarni, Anish; Feldman, Steven R

    2016-01-01

    Background Adherence to acne medication is poor and is a major reason why treatment plans are ineffective. Recognizing solutions to nonadherence is critical. Objective The purpose of this study is to describe the hurdles associated with acne nonadherence and to provide mechanisms on how to ameliorate them. Methods PubMed database was searched. Of the 419 search results, 29 articles were reviewed to identify hurdles to adherence and corresponding solutions. Results Hurdles to primary nonadherence where the medication is not even started, include lack of knowledge, confusion about usage, weak physician–patient relationship, fear of adverse reactions, and cost. Secondary nonadherence hurdles where the medication is started but is not taken as directed include lack of results, complex regimens, side effects, busy lifestyle, forgetfulness, inconvenience, and psychiatric comorbidity. Solutions to these hurdles include treatment simplification, technology, and dynamic education. Limitations Adherence is affected by numerous factors, but available literature analyzing acne adherence and interventions to improve adherence to treatment is limited. Conclusion There are several hurdles in adhering to acne treatment. Recognition of these hurdles and finding appropriate solutions may be as important to treatment outcomes as choosing the right medication to prescribe. PMID:27784999

  16. High feeding intensity increases the severity of fatty liver in the American mink (Neovison vison) with potential ameliorating role for long-chain n-3 polyunsaturated fatty acids

    PubMed Central

    2014-01-01

    Background Rapid body fat mobilization, obesity, and an inadequate supply of n-3 polyunsaturated fatty acids (PUFA) have been suggested to play roles in the etiology of fatty liver in the American mink (Neovison vison). This study examined the effects of feeding intensity and dietary fat source on fatty liver induced by fasting. In a multi-factorial design, 3 different fat sources (herring oil, rich in n-3 PUFA, soya oil, rich in n-6 PUFA, and canola oil, rich in n-9 monounsaturated fatty acids) were fed to mink at a low and high feeding intensity for 10 weeks, followed by an overnight or a 5-day fasting treatment to induce fatty liver. Results Fasting led to the development of fatty liver with increased severity in the mink fed at the high feeding intensity. The herring oil diet, high in long-chain n-3 PUFA, was found to decrease the severity of fatty liver in the mink at the high feeding intensity. Conclusion Preventing excessive weight gain and increasing dietary intake of n-3 long-chain PUFA may help prevent excessive lipid accumulation during prolonged periods of fasting or inappetence by promoting hepatic fatty acid oxidation. PMID:24438337

  17. High feeding intensity increases the severity of fatty liver in the American mink (Neovison vison) with potential ameliorating role for long-chain n-3 polyunsaturated fatty acids.

    PubMed

    Dick, Morag F; Hurford, Jennifer; Lei, Sha; Mustonen, Anne-Mari; Nieminen, Petteri; Rouvinen-Watt, Kirsti

    2014-01-16

    Rapid body fat mobilization, obesity, and an inadequate supply of n-3 polyunsaturated fatty acids (PUFA) have been suggested to play roles in the etiology of fatty liver in the American mink (Neovison vison). This study examined the effects of feeding intensity and dietary fat source on fatty liver induced by fasting. In a multi-factorial design, 3 different fat sources (herring oil, rich in n-3 PUFA, soya oil, rich in n-6 PUFA, and canola oil, rich in n-9 monounsaturated fatty acids) were fed to mink at a low and high feeding intensity for 10 weeks, followed by an overnight or a 5-day fasting treatment to induce fatty liver. Fasting led to the development of fatty liver with increased severity in the mink fed at the high feeding intensity. The herring oil diet, high in long-chain n-3 PUFA, was found to decrease the severity of fatty liver in the mink at the high feeding intensity. Preventing excessive weight gain and increasing dietary intake of n-3 long-chain PUFA may help prevent excessive lipid accumulation during prolonged periods of fasting or inappetence by promoting hepatic fatty acid oxidation.

  18. Interventions to increase HPV vaccination coverage: A systematic review

    PubMed Central

    Smulian, Elizabeth A.; Mitchell, Krista R.; Stokley, Shannon

    2016-01-01

    ABSTRACT We reviewed intervention studies designed to increase human papillomavirus (HPV) vaccination coverage to further understand the impact interventions can have on HPV vaccination coverage. We searched 5 databases for intervention studies published from June 2006 to May 2015. Studies were included if they quantitatively measured HPV vaccination coverage as an outcome and were conducted in the United States. We abstracted outcomes, methods, and results from each study and classified by type of intervention conducted. Findings from 34 studies suggest many types of intervention strategies can increase HPV vaccination coverage in different settings, and with modest cost. Interventions were effective especially when implemented in combination at both provider and community levels. However, not all interventions showed significant effects on coverage. More research is needed to identify the best methods for widespread implementation of effective strategies. PMID:26838959

  19. Is it possible to increase n-3 fatty acid content of meat without affecting its technological and/or sensory quality and the growing performance of chickens?

    PubMed

    Baeza, E; Chartrin, P; Lessire, M; Meteau, K; Chesneau, G; Guillevic, M; Mourot, J

    2015-01-01

    The aim of this study was to increase the content of n-3 fatty acids (FA) of meat without affecting its sensory and/or technological properties or the growth performance of chickens reared under standard conditions. Male chickens, Ross 308, were distributed into 5 groups corresponding to 5 different diets for the growing and finishing periods: control (T), containing extruded linseeds exhibiting high concentration of fibre (ELHF), extruded linseeds exhibiting low concentration of fibre (ELLF), microalgae, or an association of 75% ELLF and 25% MA (ELLF+MA). The diet containing microalgae induced a decrease in feed consumption without affecting growth rate. Chickens exhibited a lower feed conversion ratio than the other groups for the growing and finishing periods but also the whole rearing period. The use of linseeds in diets had no effect on the growth performance of chickens in comparison to the control group. The dietary enrichment with n-3 FA had few effects on carcass composition or the ultimate pH and colour of breast meat. The microalgae increased the meat susceptibility to oxidation. The lipid content of breast meat was not affected by the diets. The breast meat of chickens fed on diets containing linseeds and/or microalgae had greater n-3 FA content (2.4 to 3.9 times higher than group T). The linseeds and microalgae mainly increased the contents in linolenic acid and long chain n-3 FA, respectively. Dietary enrichment with n-3 FA had no effect on the sensory quality of fillets whereas the thighs of the MA group exhibited the lowest score for the flavour "chicken" and the greatest score for the flavour "abnormal" corresponding to a fish flavour.

  20. Interventions to Increase Free School Meal Take-Up

    ERIC Educational Resources Information Center

    Woodward, Jenny; Sahota, Pinki; Pike, Jo; Molinari, Rosie

    2015-01-01

    Purpose: The purpose of this paper is to design and implement interventions to increase free school meal (FSM) uptake in pilot schools. This paper describes the interventions, reports on acceptability (as perceived by school working parties) and explores the process of implementing change. Design/Methodology/Approach: The research consisted of two…

  1. Interventions to Increase Free School Meal Take-Up

    ERIC Educational Resources Information Center

    Woodward, Jenny; Sahota, Pinki; Pike, Jo; Molinari, Rosie

    2015-01-01

    Purpose: The purpose of this paper is to design and implement interventions to increase free school meal (FSM) uptake in pilot schools. This paper describes the interventions, reports on acceptability (as perceived by school working parties) and explores the process of implementing change. Design/Methodology/Approach: The research consisted of two…

  2. Enhanced increase of omega-3 index in healthy individuals with response to 4-week n-3 fatty acid supplementation from krill oil versus fish oil

    PubMed Central

    2013-01-01

    Background Due to structural differences, bioavailability of krill oil, a phospholipid based oil, could be higher than fish oil, a triglyceride-based oil, conferring properties that render it more effective than fish oil in increasing omega-3 index and thereby, reducing cardiovascular disease (CVD) risk. Objective The objective was to assess the effects of krill oil compared with fish oil or a placebo control on plasma and red blood cell (RBC) fatty acid profile in healthy volunteers. Participants and methods Twenty four healthy volunteers were recruited for a double blinded, randomized, placebo-controlled, crossover trial. The study consisted of three treatment phases including krill or fish oil each providing 600 mg of n-3 polyunsaturated fatty acids (PUFA) or placebo control, corn oil in capsule form. Each treatment lasted 4 wk and was separated by 8 wk washout phases. Results Krill oil consumption increased plasma (p = 0.0043) and RBC (p = 0.0011) n-3 PUFA concentrations, including EPA and DHA, and reduced n-6:n-3 PUFA ratios (plasma: p = 0.0043, RBC: p = 0.0143) compared with fish oil consumption. Sum of EPA and DHA concentrations in RBC, the omega-3 index, was increased following krill oil supplementation compared with fish oil (p = 0.0143) and control (p < 0.0001). Serum triglycerides and HDL cholesterol concentrations did not change with any of the treatments. However, total and LDL cholesterol concentrations were increased following krill (TC: p = 0.0067, LDL: p = 0.0143) and fish oil supplementation (TC: p = 0.0028, LDL: p = 0.0143) compared with control. Conclusions Consumption of krill oil was well tolerated with no adverse events. Results indicate that krill oil could be more effective than fish oil in increasing n-3 PUFA, reducing n-6:n-3 PUFA ratio, and improving the omega-3 index. Trial registration ClinicalTrials.gov, NCT01323036 PMID:24304605

  3. N-3 fatty acid enriched eggs and production of egg yolk powders: an increased risk of lipid oxidation?

    PubMed

    Meynier, A; Leborgne, C; Viau, M; Schuck, P; Guichardant, M; Rannou, C; Anton, M

    2014-06-15

    Lipid oxidation is generally favoured by thermal processing and long-term storage. Oxidised lipids can alter nutritional and sensorial properties of foods. As eggs are widely used in food industries in dried powder form, our aim was to determine whether compositional or processing parameters have an impact on lipid oxidation from the shell eggs up to the dried powders and subsequent storage. Two batches of shell eggs were processed: one issued from hens fed with a standard diet and another receiving a diet enriched in extruded linseed, rich in linolenic acid. The extent of lipid oxidation was evaluated by quantification of conjugated dienes (CD) and malondialdehyde (MDA), but also by assessment of tocopherols, lutein and zeaxanthin losses. Results highlighted the remarkable oxidative stability of control and enriched yolk powders as revealed by a moderate increase of the quantities of CD and MDA, the lack of oxidised cholesterol and small loss of α-tocopherol. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. What interventions increase commuter cycling? A systematic review

    PubMed Central

    Stewart, Glenn; Anokye, Nana Kwame; Pokhrel, Subhash

    2015-01-01

    Objective To identify interventions that will increase commuter cycling. Setting All settings where commuter cycling might take place. Participants Adults (aged 18+) in any country. Interventions Individual, group or environmental interventions including policies and infrastructure. Primary and secondary outcome measures A wide range of ‘changes in commuter cycling’ indicators, including frequency of cycling, change in workforce commuting mode, change in commuting population transport mode, use of infrastructure by defined populations and population modal shift. Results 12 studies from 6 countries (6 from the UK, 2 from Australia, 1 each from Sweden, Ireland, New Zealand and the USA) met the inclusion criteria. Of those, 2 studies were randomised control trials and the remainder preintervention and postintervention studies. The majority of studies (n=7) evaluated individual-based or group-based interventions and the rest environmental interventions. Individual-based or group-based interventions in 6/7 studies were found to increase commuter cycling of which the effect was significant in only 3/6 studies. Environmental interventions, however, had small but positive effects in much larger but more difficult to define populations. Almost all studies had substantial loss to follow-up. Conclusions Despite commuter cycling prevalence varying widely between countries, robust evidence of what interventions will increase commuter cycling in low cycling prevalence nations is sparse. Wider environmental interventions that make cycling conducive appear to reach out to hard to define but larger populations. This could mean that environmental interventions, despite their small positive effects, have greater public health significance than individual-based or group-based measures because those interventions encourage a larger number of people to integrate physical activity into their everyday lives. PMID:26275902

  5. Hempseed Products Fed to Hens Effectively Increased n-3 Polyunsaturated Fatty Acids in Total Lipids, Triacylglycerol and Phospholipid of Egg Yolk.

    PubMed

    Neijat, M; Suh, M; Neufeld, J; House, J D

    2016-05-01

    Hempseed products represent potential alternative feed ingredients for poultry. However, their usage is not currently approved due to a lack of data to support their safety and efficacy. In this regard, the current study was conducted to assess the impact of dietary concentration of hempseed (HS) products and duration of their feeding to hens on the polyunsaturated fatty acid (PUFA) composition of egg yolk lipids. In the current study, 48 Lohmann LSL-Classic hens were individually housed in metabolism cages, in a completely randomized design, and provided one of six diets (wheat-barley-soybean-based) containing either HS (10, 20 and 30 %), hempseed oil (HO; 4.5 and 9.0 %) or no hempseed product (control) over 12 weeks. Increasing alpha-linolenic acid (ALA) intake via increasing dietary hempseed product inclusion, significantly (p < 0.0001) increased the n-3 PUFA contents of yolk total lipid. The values of ALA increased by 12-fold (152 ± 3.56 and 156 ± 2.42 mg/yolk) and docosahexaenoic acid (DHA) by twofold to threefold (41.3 ± 1.57 and 43.6 ± 1.61 mg/yolk) over the control, for the highest levels of HS and HO inclusion, respectively. Increasing levels of hemp products in laying hen diets proved effective in manipulating the fatty acid profile of the total lipid, triacylglycerol (TAG) and total phospholipid (PL) fractions of yolks, enhancing the n-3 fatty acids and reducing the n-6/n-3 ratio. The latter benefit was achieved within 4 weeks of feeding hens either HS- or HO-containing diets.

  6. Educational interventions to increase HPV vaccination acceptance: A systematic review

    PubMed Central

    Fu, Linda Y.; Bonhomme, Lize-Anne; Cooper, Spring Chenoa; Joseph, Jill G.; Zimet, Gregory D.

    2014-01-01

    Background The Human papillomavirus (HPV) vaccine has been available for protection against HPV-associated cervical cancer and genital warts since 2006. Nonetheless, uptake has varied among countries and populations within countries. Studies have found that individuals’ knowledge and attitudes toward the vaccine are associated with immunization uptake. The purpose of the current review is to summarize and evaluate the evidence for educational interventions to increase HPV vaccination acceptance. Methods We searched the databases of PubMed and Web of Science for English-language articles describing educational interventions designed to improve HPV vaccination uptake, intention or attitude. Results We identified 33 studies of HPV vaccination educational interventions: 7 tested the effectiveness of interventions with parents, 8 with adolescents or young adults, and 18 compared the effectiveness of different message frames in an educational intervention among adolescents, young adults or their parents. Most studies involved populations with higher educational attainment and most interventions required participants to be literate. The minority of studies used the outcome of HPV vaccine uptake. Well-designed studies adequately powered to detect change in vaccine uptake were rare and generally did not demonstrate effectiveness of the tested intervention. Conclusions There is not strong evidence to recommend any specific educational intervention for wide-spread implementation. Future studies are required to determine the effectiveness of culturally-competent interventions reaching diverse populations. PMID:24530401

  7. Newborn Parent Based Intervention to Increase Child Safety Seat Use

    PubMed Central

    Liu, Xiangxiang; Yang, Jingzhen; Cheng, Fuyuan; Li, Liping

    2016-01-01

    This paper intends to assess the effect of a maternity department intervention on improvement of knowledge and use of child safety seats (CSS) among newborn parents. An intervention study included three groups (one education plus free CSS intervention group, one education only group, and one control group). The participants were parents of newborns in the maternity department of two hospitals. Both of the intervention groups received a folded pamphlet of child passenger safety, a height chart and standardized safety education during their hospital stay after giving birth. The education plus free CSS intervention group received an additional free CSS and professional installation training at hospital discharge. The control group received a pamphlet with educational information about nutrition and food safety. Three months after enrollment, a telephone follow-up was conducted among participants in the three groups. Data on child passenger safety knowledge, risky driving behaviors, and use of CSS were evaluated before and after the intervention. A total of 132 newborn parents were enrolled in the study; of those, 52 (39.4%) were assigned into the education plus free CSS intervention group, 44 (33.3%) were in the education intervention only group, and 36 (27.3%) were in the control group. No significant differences existed in demographics among the three groups. There was a significant difference in newborn parents’ child passenger safety knowledge and behaviors in the three groups before and after the intervention. In addition, the CSS use increased significantly in the education plus free CSS group after the intervention compared to parents in the education only or control groups. Education on safety, combined with a free CSS and professional installation training, were effective at increasing newborn parents’ knowledge and use of CSS. Future studies with larger sample sizes and longer follow-up are needed to determine a long-term effect of the intervention. PMID

  8. Newborn Parent Based Intervention to Increase Child Safety Seat Use.

    PubMed

    Liu, Xiangxiang; Yang, Jingzhen; Cheng, Fuyuan; Li, Liping

    2016-08-02

    This paper intends to assess the effect of a maternity department intervention on improvement of knowledge and use of child safety seats (CSS) among newborn parents. An intervention study included three groups (one education plus free CSS intervention group, one education only group, and one control group). The participants were parents of newborns in the maternity department of two hospitals. Both of the intervention groups received a folded pamphlet of child passenger safety, a height chart and standardized safety education during their hospital stay after giving birth. The education plus free CSS intervention group received an additional free CSS and professional installation training at hospital discharge. The control group received a pamphlet with educational information about nutrition and food safety. Three months after enrollment, a telephone follow-up was conducted among participants in the three groups. Data on child passenger safety knowledge, risky driving behaviors, and use of CSS were evaluated before and after the intervention. A total of 132 newborn parents were enrolled in the study; of those, 52 (39.4%) were assigned into the education plus free CSS intervention group, 44 (33.3%) were in the education intervention only group, and 36 (27.3%) were in the control group. No significant differences existed in demographics among the three groups. There was a significant difference in newborn parents' child passenger safety knowledge and behaviors in the three groups before and after the intervention. In addition, the CSS use increased significantly in the education plus free CSS group after the intervention compared to parents in the education only or control groups. Education on safety, combined with a free CSS and professional installation training, were effective at increasing newborn parents' knowledge and use of CSS. Future studies with larger sample sizes and longer follow-up are needed to determine a long-term effect of the intervention.

  9. Increasing vegetable intakes: rationale and systematic review of published interventions.

    PubMed

    Appleton, Katherine M; Hemingway, Ann; Saulais, Laure; Dinnella, Caterina; Monteleone, Erminio; Depezay, Laurence; Morizet, David; Armando Perez-Cueto, F J; Bevan, Ann; Hartwell, Heather

    2016-04-01

    While the health benefits of a high fruit and vegetable consumption are well known and considerable work has attempted to improve intakes, increasing evidence also recognises a distinction between fruit and vegetables, both in their impacts on health and in consumption patterns. Increasing work suggests health benefits from a high consumption specifically of vegetables, yet intakes remain low, and barriers to increasing intakes are prevalent making intervention difficult. A systematic review was undertaken to identify from the published literature all studies reporting an intervention to increase intakes of vegetables as a distinct food group. Databases-PubMed, PsychInfo and Medline-were searched over all years of records until April 2015 using pre-specified terms. Our searches identified 77 studies, detailing 140 interventions, of which 133 (81 %) interventions were conducted in children. Interventions aimed to use or change hedonic factors, such as taste, liking and familiarity (n = 72), use or change environmental factors (n = 39), use or change cognitive factors (n = 19), or a combination of strategies (n = 10). Increased vegetable acceptance, selection and/or consumption were reported to some degree in 116 (83 %) interventions, but the majority of effects seem small and inconsistent. Greater percent success is currently found from environmental, educational and multi-component interventions, but publication bias is likely, and long-term effects and cost-effectiveness are rarely considered. A focus on long-term benefits and sustained behaviour change is required. Certain population groups are also noticeably absent from the current list of tried interventions.

  10. Dietary echium oil increases long-chain n-3 PUFAs, including docosapentaenoic acid, in blood fractions and alters biochemical markers for cardiovascular disease independently of age, sex, and metabolic syndrome.

    PubMed

    Kuhnt, Katrin; Fuhrmann, Claudia; Köhler, Melanie; Kiehntopf, Michael; Jahreis, Gerhard

    2014-04-01

    Dietary supplementation with echium oil (EO) containing stearidonic acid (SDA) is a plant-based strategy to improve long-chain (LC) n-3 (ω-3) polyunsaturated fatty acid (PUFA) status in humans. We investigated the effect of EO on LC n-3 PUFA accumulation in blood and biochemical markers with respect to age, sex, and metabolic syndrome. This double-blind, parallel-arm, randomized controlled study started with a 2-wk run-in period, during which participants (n = 80) were administered 17 g/d run-in oil. Normal-weight individuals from 2 age groups (20-35 and 49-69 y) were allotted to EO or fish oil (FO; control) groups. During the 8-wk intervention, participants were administered either 17 g/d EO (2 g SDA; n = 59) or FO [1.9 g eicosapentaenoic acid (EPA); n = 19]. Overweight individuals with metabolic syndrome (n = 19) were recruited for EO treatment only. During the 10-wk study, the participants followed a dietary n-3 PUFA restriction, e.g., no fish. After the 8-wk EO treatment, increases in the LC n-3 metabolites EPA (168% and 79%) and docosapentaenoic acid [DPA (68% and 39%)] were observed, whereas docosahexaenoic acid (DHA) decreased (-5% and -23%) in plasma and peripheral blood mononuclear cells, respectively. Compared with FO, the efficacy of EO to increase EPA and DPA in blood was significantly lower (∼25% and ∼50%, respectively). A higher body mass index (BMI) was associated with lower relative and net increases in EPA and DPA. Compared with baseline, EO significantly reduced serum cholesterol, LDL cholesterol, oxidized LDL, and triglyceride (TG), but also HDL cholesterol, regardless of age and BMI. In the FO group, only TG decreased. Overall, daily intake of 15-20 g EO increased EPA and DPA in blood but had no influence on DHA. EO lowered cardiovascular risk markers, e.g., serum TG, which is particularly relevant for individuals with metabolic syndrome. Natural EO could be a noteworthy source of n-3 PUFA in human nutrition.

  11. Intervention to Increase Mammography Utilization in a Public Hospital

    PubMed Central

    Davis, Terry C; Berkel, Hans J; Arnold, Connie L; Nandy, Indrani; Jackson, Robert H; Murphy, Peggy W

    1998-01-01

    OBJECTIVE To study the effects of three approaches to increasing utilization of screening mammography in a public hospital setting in Northwest Louisiana. DESIGN Randomized intervention study. POPULATION Four hundred forty-five women aged 40 years and over, predominantly low-income and with low literacy skills, who had not had a mammogram in the preceding year. INTERVENTION All interventions were chosen to motivate women to get a mammogram. Group 1 received a personal recommendation from one of the investigators. Group 2 received the recommendation plus an easy-to-read National Cancer Institute (NCI) brochure. Group 3 received the recommendation, the brochure, and a 12-minute interactive educational and motivational program, including a soap-opera-style video, developed in collaboration with women from the target population. MEASUREMENTS AND MAIN RESULTS Mammography utilization was determined at 6 months and 2 years after intervention. A significant increase (p = .05) in mammography utilization was observed after the intervention designed in collaboration with patients (29%) as compared with recommendation alone (21%) or recommendation with brochure (18%) at 6 months. However, at 2 years the difference favoring the custom-made intervention was no longer significant. CONCLUSIONS At 6 months there was at least a 30% increase in the mammography utilization rate in the group receiving the intervention designed in collaboration with patients as compared with those receiving the recommendation alone or recommendation with brochure. Giving patients an easy-to-read NCI brochure and a personal recommendation was no more effective than giving them a recommendation alone, suggesting that simply providing women in a public hospital with a low-literacy-level, culturally appropriate brochure is not sufficient to increase screening mammography rates. In a multivariate analysis, the only significant predictor of mammography use at 6 months was the custom-made intervention. PMID

  12. Intervention to increase mammography utilization in a public hospital.

    PubMed

    Davis, T C; Berkel, H J; Arnold, C L; Nandy, I; Jackson, R H; Murphy, P W

    1998-04-01

    To study the effects of three approaches to increasing utilization of screening mammography in a public hospital setting in Northwest Louisiana. Randomized intervention study. Four hundred forty-five women aged 40 years and over, predominantly low-income and with low literacy skills, who had not had a mammogram in the preceding year. All interventions were chosen to motivate women to get a mammogram. Group 1 received a personal recommendation from one of the investigators. Group 2 received the recommendation plus an easy-to-read National Cancer Institute (NCI) brochure. Group 3 received the recommendation, the brochure, and a 12-minute interactive educational and motivational program, including a soap-opera-style video, developed in collaboration with women from the target population. Mammography utilization was determined at 6 months and 2 years after intervention. A significant increase (p = .05) in mammography utilization was observed after the intervention designed in collaboration with patients (29%) as compared with recommendation alone (21%) or recommendation with brochure (18%) at 6 months. However, at 2 years the difference favoring the custom-made intervention was no longer significant. At 6 months there was at least a 30% increase in the mammography utilization rate in the group receiving the intervention designed in collaboration with patients as compared with those receiving the recommendation alone or recommendation with brochure. Giving patients an easy-to-read NCI brochure and a personal recommendation was no more effective than giving them a recommendation alone, suggesting that simply providing women in a public hospital with a low-literacy-level, culturally appropriate brochure is not sufficient to increase screening mammography rates. In a multivariate analysis, the only significant predictor of mammography use at 6 months was the custom-made intervention.

  13. n-3 PUFA status in school children is associated with beneficial lipid profile, reduced physical activity and increased blood pressure in boys.

    PubMed

    Damsgaard, Camilla T; Stark, Ken D; Hjorth, Mads F; Biltoft-Jensen, Anja; Astrup, Arne; Michaelsen, Kim F; Lauritzen, Lotte

    2013-10-01

    Dietary n-3 long-chain PUFA (LC-PUFA) improve dyslipidaemia and hypertension and may affect insulin resistance and adiposity. Increasing numbers of children show signs of the metabolic syndrome (MetS), but few studies have investigated the association with n-3 LC-PUFA status. We examined the relationship between fasting whole-blood EPA or DHA (w/w% of the total fatty acids, FA%) and markers of the MetS (anthropometry, blood pressure, plasma lipids and glucose homeostasis) cross-sectionally in seventy-three 8-11-year-old Danish children from the OPUS School Meal Pilot Study (OPUS is an acronym of the project 'Optimal well-being, development and health for Danish children through a healthy New Nordic Diet' and is supported by a grant from the Nordea Foundation). Also, we explored the potential mediating effects of physical activity and energy intake. Girls had higher body fat percentage (BF%), diastolic blood pressure, heart rate,plasma TAG, insulin, homeostasis model assessment-insulin resistance and glycosylated Hb than boys. Sexes did not differ in fish or macro nutrient intake or whole-blood fatty acids. After adjustment for sex, age and total whole-blood fatty acid concentration, BF% and HDL:TAG increased with whole-blood EPA (beta > 0·25, P<0·05), and HDL increased 0·35 (SEM 0·13) mmol/l per FA% EPA increase (beta = 0·30, P=0·008). Unexpectedly, DHA was positively associated with mean arterial pressure in boys (6·3 (SEM 1·7) mmHg/FA% DHA increase,b ¼ 0·62, P=0·001) and reduced physical activity in both sexes (244 (SEM 19) counts/min per FA%, beta = -0·22, P=0.24). The associations with blood pressure and HDL remained after adjustment for physical activity, BF% and energy intake. The present study confirmed the beneficial association between n-3 LC-PUFA status and lipid profile seen in adults, but showed unexpected relationships with physical activity, BF% and blood pressure. This is the third time we have observed such tendencies in Danish children.

  14. Increase of O6-methylguanine-DNA-methyltransferase and N3-methyladenine glycosylase RNA transcripts in rat hepatoma cells treated with DNA-damaging agents

    SciTech Connect

    Laval, F. )

    1991-05-15

    A variety of DNA-damaging agents increase the O6-methylguanine-DNA-methyltransferase (transferase) and the N3-methyladenine (3-meAde)-DNA-glycosylase activities in a rat hepatoma cell line (H4 cells). Using two cDNA expressing either the rat 3-meAde-DNA-glycosylase or the transferase, the level of mRNA transcripts was measured by hybridization in H4 cells treated with three different inducing agents, gamma-rays, cis-dichlorodiammine platinum II or N-methyl-9-hydroxy ellipticinium. The two mRNA increased 24 hours after the cell treatments but this enhanced transcription was a transient phenomenon, as it was no longer observed after 96 hours. No significant DNA amplification was detectable in the treated cells.

  15. Increasing physical activity through mobile device interventions: A systematic review.

    PubMed

    Muntaner, Adrià; Vidal-Conti, Josep; Palou, Pere

    2016-09-01

    Physical inactivity is a health problem that affects people worldwide and has been identified as the fourth largest risk factor for overall mortality (contributing to 6% of deaths globally). Many researchers have tried to increase physical activity levels through traditional methods without much success. Thus, many researchers are turning to mobile technology as an emerging method for changing health behaviours. This systematic review sought to summarise and update the existing scientific literature on increasing physical activity through mobile device interventions, taking into account the methodological quality of the studies. The articles were identified by searching the PubMed, SCOPUS and SPORTDiscus databases for studies published between January 2003 and December 2013. Studies investigating efforts to increase physical activity through mobile phone or even personal digital assistant interventions were included. The search results allowed the inclusion of 11 studies that gave rise to 12 publications. Six of the articles included in this review reported significant increases in physical activity levels. The number of studies using mobile devices for interventions has increased exponentially in the last few years, but future investigations with better methodological quality are needed to draw stronger conclusions regarding how to increase physical activity through mobile device interventions. © The Author(s) 2015.

  16. Increasing the Odds: Applying Emergentist Theory in Language Intervention

    PubMed Central

    Poll, Gerard H.

    2011-01-01

    Purpose This review introduces a leading theory of language development, emergentism, the view that language ability is the product of interactions between the language environment and the learning capabilities of the child. It suggests ways in which emergentism provides a theoretical rationale for interventions designed to address developmental language delays in young children. Method A review of selected literature on emergentist theory and research is presented, with a focus on the acquisition of early morphology and syntax. A significant method for developing and testing emergentist theory, connectionist modeling, is described. Key themes from both connectionist and behavioral studies are summarized and applied with specific examples to language intervention techniques. A case study is presented to integrate elements of emergentism with language intervention. Conclusions Evaluating the theoretical foundation for language interventions is an important step in evidence-based practice. This article introduces three themes in the emergentist literature that have implications for language intervention: sufficiency of language input, active engagement of the child with the input, and the introduction of factors that increase the odds for correctly mapping language form to meaning. Evidence supporting the importance of these factors in effective language intervention is presented, along with limitations in that evidence. PMID:21616988

  17. Incremental amounts of ground flaxseed decrease milk yield but increase n-3 fatty acids and conjugated linoleic acids in dairy cows fed high-forage diets(1).

    PubMed

    Resende, T L; Kraft, J; Soder, K J; Pereira, A B D; Woitschach, D E; Reis, R B; Brito, A F

    2015-07-01

    decreased linearly with GFX supplementation. Milk trans-11 18:1, α-linolenic acid, cis-9,trans-11 18:2, and the sum of n-3 FA all increased linearly and quadratically, whereas the milk ratio of n-6 to n-3 decreased linearly in cows fed GFX. Overall, compared with the control diet (0% GFX), the diet with 15% GFX supplementation resulted in the lowest milk yield but highest milk proportions and yields (data not shown) of cis-9,trans-11 18:2 and n-3 FA.

  18. A dietary planning intervention increases fruit consumption in Iranian women.

    PubMed

    Gholami, Maryam; Lange, Daniela; Luszczynska, Aleksandra; Knoll, Nina; Schwarzer, Ralf

    2013-04-01

    The study examined whether a dietary planning intervention would help increase fruit consumption among Iranian women focusing on self-regulatory mechanisms in behavior change. We conducted a randomized controlled trial to compare a planning intervention with a control condition in 165 Iranian women (aged 17-48years). Dependent variable was fruit intake, and dietary planning served as the mediator. After baseline assessment (T1) the intervention group received a leaflet on fruit consumption with a planning sheet. Changes were assessed at 3-weeks (T2) and at 3-months follow-ups (T3). Findings showed that the dietary planning intervention led to an increase in fruit intake. Age moderated this mediation. Changes in dietary planning mediated between intervention and fruit consumption in middle aged women. Dietary planning seems to play a role in the mechanism that facilitates fruit intake among Iranian women. This mediation by planning was found in middle aged women (30-48 years old), but not in young adult women (17-29 years old). Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. An Intervention to Increase Physical Activity in Children

    PubMed Central

    Pate, Russell R.; Brown, William H.; Pfeiffer, Karin A.; Howie, Erin K.; Saunders, Ruth P.; Addy, Cheryl L.; Dowda, Marsha

    2016-01-01

    Introduction A majority of preschool-aged children spend a significant portion of every weekday in a preschool or child care setting, where they typically participate in limited physical activity. This study determined if an ecologic physical activity intervention in preschools increases children’s moderate-to-vigorous intensity physical activity (MVPA). Design RCT, with preschool as the unit of randomization and analysis. Child physical activity was measured by accelerometry. Mixed model analysis of covariance with preschool as a random variable was used to test the effects of the intervention on physical activity in the total group and in sex-specific subgroups. Data were collected in 2008–2010 and analyzed in 2012–2014. Setting/participants Children in 4-year-old classrooms in 16 preschools, pair matched and assigned to intervention or control groups. Intervention The intervention focused on increasing children’s physical activity by changing instructional practices. Researchers trained preschool teachers to engage children in physical activity during: (1) structured, teacher-led physical activity opportunities in the classroom; (2) structured and unstructured physical activity opportunities at recess; and (3) physical activity integrated into pre-academic lessons. Research staff encouraged teachers to adapt the intervention to their classrooms. Main outcome measures Minutes/hour of MVPA during the preschool day. Results In an analytic sample of 379 children (188 intervention, 191 control), those in the intervention schools engaged in significantly more MVPA than children in control schools (7.4 and 6.6 minutes/hour, respectively). This difference remained significant after adjusting for parent education and length of the school day (half versus full day), In the sex-specific analyses, the difference was significant for girls (6.8 vs 6.1 minutes/hour of MVPA, respectively) but not for boys (7.9 vs 7.2 minutes/hour, respectively). Conclusions A flexible

  20. (n-3) Long chain PUFA dose-dependently increase oxygen utilization efficiency and inhibit arrhythmias after saturated fat feeding in rats.

    PubMed

    Pepe, Salvatore; McLennan, Peter L

    2007-11-01

    Fish oil (FO) modifies cardiac membrane phospholipid fatty acid composition to confer increased efficiency of oxygen utilization and antiarrhythmic effects. We tested the capacity of low-dose increments of FO, rich in (n-3) PUFA, to reverse the detrimental pro-arrhythmic and inefficient oxygen usage effects of dietary saturated fat (SAT) [including high ratio of (n-6) PUFA:(n-3) PUFA] during ischemia and reperfusion. Wistar rats were fed an SAT-enriched diet (15.3% fat, including 12% SAT, added by weight) for 6 wk and were then divided into 4 groups (n = 10/group) fed that diet or a 12% fat diet containing 3, 6, or 12% FO in place of SAT for 6 wk. Paced (300/min), erythrocyte-perfused isolated working hearts were subjected to low coronary flow ischemia (15 min) and were then reperfused. At normoxic baseline, external work capacity increased marginally at 6 and 12% FO; however, marked dose-related reductions in oxygen consumption were evident due to FO-dependent reduction in oxygen-energy utilization efficiency and associated reductions in coronary flow and oxygen extraction. Postischemic recovery resulted in lower oxygen consumption, greater oxygen-energy utilization efficiency, reduced coronary release of creatine kinase, and reduced incidence of arrhythmias in all FO groups compared with the SAT group. FO at a dose as low as 3% of total fat dietary supplement effectively reversed the high oxygen requirements and pro-arrhythmic effects of a SAT-rich diet even with continued consumption of SAT (9%) in this ex vivo animal model.

  1. What implementation interventions increase cancer screening rates? a systematic review

    PubMed Central

    2011-01-01

    Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC) screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP) change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic reviews. This review served as

  2. Interventions to increase adherence to medications for tobacco dependence.

    PubMed

    Hollands, Gareth J; McDermott, Máirtín S; Lindson-Hawley, Nicola; Vogt, Florian; Farley, Amanda; Aveyard, Paul

    2015-02-23

    Pharmacological treatments for tobacco dependence, such as nicotine replacement therapy (NRT), have been shown to be safe and effective interventions for smoking cessation. Higher levels of adherence to these medications increase the likelihood of sustained smoking cessation, but many smokers use them at a lower dose and for less time than is optimal. It is therefore important to determine the effectiveness of interventions designed specifically to increase medication adherence. Such interventions may include further educating individuals about the value of taking medications and providing additional support to overcome problems with maintaining adherence. The primary objective of this review was to assess the effectiveness of interventions to increase adherence to medications for smoking cessation, such as NRT, bupropion, nortriptyline and varenicline (and combination regimens). This was considered in comparison to a control group, typically representing standard care. Secondary objectives were to i) assess which intervention approaches are most effective; ii) determine the impact of interventions on potential precursors of adherence, such as understanding of the treatment and efficacy perceptions; and iii) evaluate key outcomes influenced by prior adherence, principally smoking cessation. We searched the following databases using keywords and medical subject headings: Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE (OVID SP) (1946 to July Week 3 2014), EMBASE (OVID SP) (1980 to Week 29 2014), and PsycINFO (OVID SP) (1806 to July Week 4 2014). The Cochrane Tobacco Addiction Group Specialized Register was searched on 9th July 2014. We conducted forward and backward citation searches. Randomised, cluster-randomised or quasi-randomised studies in which participants using active pharmacological treatment for smoking cessation are allocated to an intervention arm or a control arm. Eligible participants were adult (18+) smokers

  3. Worksite interventions to increase stair climbing; reasons for caution.

    PubMed

    Eves, Frank F; Webb, Oliver J

    2006-07-01

    Point-of-choice prompts to use the stairs rather than the escalator consistently increase physical activity at public access staircases such as those in shopping malls. More recently, exercise promoters have targeted stair climbing in the worksite. A review of interventions in worksites reveals little hard evidence of successful increases in stair climbing, though the increases in stair usage are encouraging. The contrast between the worksites and public access staircases, however, is not simply one of location. In a worksite, the choice is between the stairs and an elevator rather than an escalator. We reason that the availability of the elevator or the stairwell may be the major immediate determinant of stair climbing in worksites and dilute any possible effects of an intervention.

  4. A brief simulation intervention increasing basic science and clinical knowledge.

    PubMed

    Sheakley, Maria L; Gilbert, Gregory E; Leighton, Kim; Hall, Maureen; Callender, Diana; Pederson, David

    2016-01-01

    The United States Medical Licensing Examination (USMLE) is increasing clinical content on the Step 1 exam; thus, inclusion of clinical applications within the basic science curriculum is crucial. Including simulation activities during basic science years bridges the knowledge gap between basic science content and clinical application. To evaluate the effects of a one-off, 1-hour cardiovascular simulation intervention on a summative assessment after adjusting for relevant demographic and academic predictors. This study was a non-randomized study using historical controls to evaluate curricular change. The control group received lecture (n l=515) and the intervention group received lecture plus a simulation exercise (n l+s=1,066). Assessment included summative exam questions (n=4) that were scored as pass/fail (≥75%). USMLE-style assessment questions were identical for both cohorts. Descriptive statistics for variables are presented and odds of passage calculated using logistic regression. Undergraduate grade point ratio, MCAT-BS, MCAT-PS, age, attendance at an academic review program, and gender were significant predictors of summative exam passage. Students receiving the intervention were significantly more likely to pass the summative exam than students receiving lecture only (P=0.0003). Simulation plus lecture increases short-term understanding as tested by a written exam. A longitudinal study is needed to assess the effect of a brief simulation intervention on long-term retention of clinical concepts in a basic science curriculum.

  5. A brief simulation intervention increasing basic science and clinical knowledge.

    PubMed

    Sheakley, Maria L; Gilbert, Gregory E; Leighton, Kim; Hall, Maureen; Callender, Diana; Pederson, David

    2016-01-01

    Background The United States Medical Licensing Examination (USMLE) is increasing clinical content on the Step 1 exam; thus, inclusion of clinical applications within the basic science curriculum is crucial. Including simulation activities during basic science years bridges the knowledge gap between basic science content and clinical application. Purpose To evaluate the effects of a one-off, 1-hour cardiovascular simulation intervention on a summative assessment after adjusting for relevant demographic and academic predictors. Methods This study was a non-randomized study using historical controls to evaluate curricular change. The control group received lecture (n l=515) and the intervention group received lecture plus a simulation exercise (n l+s=1,066). Assessment included summative exam questions (n=4) that were scored as pass/fail (≥75%). USMLE-style assessment questions were identical for both cohorts. Descriptive statistics for variables are presented and odds of passage calculated using logistic regression. Results Undergraduate grade point ratio, MCAT-BS, MCAT-PS, age, attendance at an academic review program, and gender were significant predictors of summative exam passage. Students receiving the intervention were significantly more likely to pass the summative exam than students receiving lecture only (P=0.0003). Discussion Simulation plus lecture increases short-term understanding as tested by a written exam. A longitudinal study is needed to assess the effect of a brief simulation intervention on long-term retention of clinical concepts in a basic science curriculum.

  6. A brief simulation intervention increasing basic science and clinical knowledge

    PubMed Central

    Sheakley, Maria L.; Gilbert, Gregory E.; Leighton, Kim; Hall, Maureen; Callender, Diana; Pederson, David

    2016-01-01

    Background The United States Medical Licensing Examination (USMLE) is increasing clinical content on the Step 1 exam; thus, inclusion of clinical applications within the basic science curriculum is crucial. Including simulation activities during basic science years bridges the knowledge gap between basic science content and clinical application. Purpose To evaluate the effects of a one-off, 1-hour cardiovascular simulation intervention on a summative assessment after adjusting for relevant demographic and academic predictors. Methods This study was a non-randomized study using historical controls to evaluate curricular change. The control group received lecture (nl=515) and the intervention group received lecture plus a simulation exercise (nl+s=1,066). Assessment included summative exam questions (n=4) that were scored as pass/fail (≥75%). USMLE-style assessment questions were identical for both cohorts. Descriptive statistics for variables are presented and odds of passage calculated using logistic regression. Results Undergraduate grade point ratio, MCAT-BS, MCAT-PS, age, attendance at an academic review program, and gender were significant predictors of summative exam passage. Students receiving the intervention were significantly more likely to pass the summative exam than students receiving lecture only (P=0.0003). Discussion Simulation plus lecture increases short-term understanding as tested by a written exam. A longitudinal study is needed to assess the effect of a brief simulation intervention on long-term retention of clinical concepts in a basic science curriculum. PMID:27060102

  7. Increasing face validity of a vascular interventional training system.

    PubMed

    Winder, John; Zheng, Huiru; Hughes, Simon; Kelly, Barry; Wilson, Carol; Gallagher, Anthony

    2004-01-01

    Many aspects of medical training take place on real patients in a live environment thus incurring risk. Apart from the obvious risks to patients there is the issue of X-ray exposure to both staff and trainees. Image quality used during interventional procedures is low to ensure minimum X-ray radiation dose. A virtual interventional system may be used to simulate the interventional cardiology training environment therefore reducing overall risk. The purpose of this project was to determine the appropriate image quality settings on a virtual training system to accurately simulate interventional cardiology and increase the face validity of the overall system. Real image data was obtained from patients undergoing diagnostic interventional cardiology examinations in the Royal Victoria Hospital, Belfast. The images were obtained during catheter placement and contrast enhancement around the region of the heart. The diagnostic views were left anterior oblique, right anterior oblique, left lateral, caudal and the spider view. These five views were simulated on a virtual interventional training system (VIST, Mentice Medical Simulation AB, Sweden) by adjusting x-ray tube and table position at 20 different image quality settings. Signal to noise ratio and image contrast were measured for each of these views using soft tissue and vertebra. The results from the real image data and the VIST image data were compared. Calibration curves were compiled to determine the appropriate VIST image quality setting for each procedure. Average SNR ranged from 2.94 to 74.0 and IC ranged from 0.009 to 0.61 on the real image data. This indicates the very wide range of image quality encountered in interventional cardiology. Calibration curves for each view with the corresponding range of real patient image quality were produced. These calibration curves enabled the appropriate VIST image quality setting to be determined and therefore simulate the real examination image quality as closely as

  8. N-3 Polyunsaturated Fatty Acids Improve Liver Lipid Oxidation-Related Enzyme Levels and Increased the Peroxisome Proliferator-Activated Receptor α Expression Level in Mice Subjected to Hemorrhagic Shock/Resuscitation.

    PubMed

    Zhang, Li; Tian, Feng; Gao, Xuejin; Wang, Xinying; Wu, Chao; Li, Ning; Li, Jieshou

    2016-04-22

    Appropriate metabolic interventions after hemorrhagic shock/resuscitation injury have not yet been identified. We aimed to examine the effects of fish oil on lipid metabolic intervention after hemorrhagic shock/resuscitation. Firstly, 48 C57BL/6 mice were assigned to six groups (n = 8 per group). The sham group did not undergo surgery, while mice in the remaining groups were sacrificed 1-5 days after hemorrhagic shock/resuscitation. In the second part, mice were treated with saline or fish oil (n = 8 per group) five days after injury. We determined serum triglyceride levels and liver tissues were collected and prepared for qRT-PCR or Western blot analysis. We found that triglyceride levels were increased five days after hemorrhagic shock/resuscitation, but decreased after addition of fish oil. After injury, the protein and gene expression of carnitine palmitoyltransferase 1A, fatty acid transport protein 1, and peroxisome proliferator-activated receptor-α decreased significantly in liver tissue. In contrast, after treatment with fish oil, the expression levels of these targets increased compared with those in the saline group. The present results suggest n-3 polyunsaturated fatty acids could improve lipid oxidation-related enzymes in liver subjected to hemorrhagic shock/resuscitation. This function is possibly accomplished through activating the peroxisome proliferator-activated receptor-α pathway.

  9. Total Worker Health Intervention Increases Activity of Sedentary Workers.

    PubMed

    Carr, Lucas J; Leonhard, Christoph; Tucker, Sharon; Fethke, Nathan; Benzo, Roberto; Gerr, Fred

    2016-01-01

    Office employees are exposed to hazardous levels of sedentary work. Interventions that integrate health promotion and health protection elements are needed to advance the health of sedentary workers. This study tested an integrated intervention on occupational sedentary/physical activity behaviors, cardiometabolic disease biomarkers, musculoskeletal discomfort, and work productivity. Two-group, RCT. Data were collected between January and August 2014. Overweight/obese adults working in sedentary desk jobs were randomized to: (1) a health protection-only group (HPO, n=27); or (2) an integrated health protection/health promotion group (HP/HP, n=27). HPO participants received an ergonomic workstation optimization intervention and three e-mails/week promoting rest breaks and posture variation. HP/HP participants received the HPO intervention plus access to a seated activity permissive workstation. Occupational sedentary and physical activity behaviors (primary outcomes), cardiometabolic health outcomes, musculoskeletal discomfort, and work productivity (secondary outcomes) were measured at baseline and post-intervention (16 weeks). The HP/HP group increased occupational light intensity physical activity over the HPO group and used the activity permissive workstations 50 minutes/work day. Significant associations were observed between activity permissive workstation adherence and improvements in several cardiometabolic biomarkers (weight, total fat mass, resting heart rate, body fat percentage) and work productivity outcomes (concentration at work, days missed because of health problems). The HP/HP group increased occupational physical activity and greater activity permissive workstation adherence was associated with improved health and work productivity outcomes. These findings are important for employers interested in advancing the well-being of sedentary office workers. This study is registered at www.clinicaltrials.gov NCT02071420. Copyright © 2016 American Journal

  10. 2,4,6-Trimethyl-N-[3-(trifluoromethyl)phenyl]benzenesulfonamide increases calcium influx in lipopolisaccharide-pre-treated arteries

    PubMed Central

    Grześk, Elżbieta; Szadujkis-Szadurska, Katarzyna; Bloch-Bogusławska, Elżbieta; Wiciński, Michał; Malinowski, Bartosz; KołTan, Sylwia; Tejza, Barbara; Pujanek, Maciej; GrześK, Grzegorz

    2017-01-01

    It has been demonstrated that 2,4,6-trimethyl-N-[3-(trifluoromethyl)phenyl]benzenesulfonamide (m-3M3FBS) activates phospholipase C (PLC) and stimulates apoptosis in smooth muscle cells, which may increase vascular reactivity. The primary aim of the present study was to evaluate the physiological effects of the direct stimulation of PLC by m-3M3FBS on vascular smooth muscle reactivity in arteries pre-treated with lipopolysaccharides (LPS) as a model of septic shock. Experiments were performed on isolated and perfused tail arteries of Wistar rats. The contraction force in the model was measured by assessing increases in perfusion pressure at a constant flow. Parameters describing the concentration-response curves (CRCs) obtained for phenylephrine and arginine-vasopressin in the presence of LPS confirmed a decrease in vessels reactivity. In comparison with the controls, m-3M3FBS treatment caused a significant increase in LPS-untreated as well as pre-treated arteries. Furthermore, in the presence of m-3M3FBS, calcium influx from intra- as well as extracellular calcium stores was significantly higher for LPS-untreated and pre-treated arteries. The results of the present study suggested that m-3M3FBS significantly increased the reactivity of vascular smooth muscle cells pre-treated with LPS by increasing the calcium influx from intra- and extracellular calcium stores. Further studies investigating this mechanism are required to evaluate whether this pathway may be a potential therapeutic strategy to treat sepsis. PMID:28352364

  11. Shopper marketing nutrition interventions: Social norms on grocery carts increase produce spending without increasing shopper budgets☆

    PubMed Central

    Payne, Collin R.; Niculescu, Mihai; Just, David R.; Kelly, Michael P.

    2015-01-01

    Objectives We assessed the efficacy of an easy-to-implement shopper marketing nutrition intervention in a pilot and two additional studies to increase produce demand without decreasing store profitability or increasing shopper budgets. Methods We created grocery cart placards that detailed the number of produce items purchased (i.e., descriptive norm) at particular stores (i.e., provincial norm). The effect of these placards on produce spending was assessed across 971,706 individual person grocery store transactions aggregated by day. The pilot study designated a baseline period (in both control and intervention store) followed by installation of grocery cart placards (in the intervention store) for two weeks. The pilot study was conducted in Texas in 2012. In two additional stores, we designated baseline periods followed by 28 days of the same grocery cart placard intervention as in the pilot. Additional interventions were conducted in New Mexico in 2013. Results The pilot study resulted in a significant difference between average produce spending per day per person across treatment periods (i.e., intervention versus same time period in control) (16%) and the difference between average produce spending per day per person across stores in the control periods (4%); Furthermore, the same intervention in two additional stores resulted in significant produce spending increases of 12.4% and 7.5% per day per person respectively. In all stores, total spending did not change. Conclusions Descriptive and provincial social norm messages (i.e., on grocery cart placards) may be an overlooked tool to increase produce demand without decreasing store profitability and increasing shopper budgets. PMID:26844084

  12. Exposure to a comprehensive school intervention increases vegetable consumption.

    PubMed

    Wang, May C; Rauzon, Suzanne; Studer, Natalie; Martin, Anna C; Craig, Launa; Merlo, Caitlin; Fung, Kelly; Kursunoglu, Deniz; Shannguan, Muyun; Crawford, Patricia

    2010-07-01

    The current epidemic of childhood overweight has launched a variety of school-based efforts to address the issue. This study reports on the first 2 years of a 3-year evaluation of one school district's comprehensive intervention to transform school foodservices and dining experiences, offer cooking and gardening programs, and integrate nutrition and food systems concepts into the academic curriculum. This 3-year prospective study enrolled 327 4th and 5th graders in a mid-sized school district in California, and followed them into middle school. Intervention exposure was determined through interviews with school staff and student surveys. Student knowledge and attitudes were assessed annually by questionnaire, and student behavior was assessed annually by 3-day food diary. Household information was gathered by parent questionnaire. Changes in knowledge, attitudes, and behavior were compared by level of intervention exposure using analysis of covariance; pairwise differences were evaluated using Bonferroni's test at a procedure-wise error rate of 5%. After controlling for family sociodemographic background, students most exposed to the intervention increased their consumption of fruits and vegetables by nearly 0.5 cups (one standard serving), whereas students least exposed decreased their consumption by 0.3 cups (p < .05). Students most exposed to the programming also showed a significantly greater increase in preference for fruit and green leafy vegetables, compared to students least exposed to the programming (p < .05). Future research is needed to better understand the relative importance of the different components of such a program, and their cost-benefits as well as health impacts. Copyright (c) 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. n-3 fatty acids effectively improve the reference memory-related learning ability associated with increased brain docosahexaenoic acid-derived docosanoids in aged rats.

    PubMed

    Hashimoto, Michio; Katakura, Masanori; Tanabe, Yoko; Al Mamun, Abdullah; Inoue, Takayuki; Hossain, Shahdat; Arita, Makoto; Shido, Osamu

    2015-02-01

    We investigated whether a highly purified eicosapentaenoic acid (EPA) and a concentrated n-3 fatty acid formulation (prescription TAK-085) containing EPA and docosahexaenoic acid (DHA) ethyl ester could improve the learning ability of aged rats and whether this specific outcome had any relation with the brain levels of EPA-derived eicosanoids and DHA-derived docosanoids. The rats were tested for reference memory errors (RMEs) and working memory errors (WMEs) in an eight-arm radial maze. Fatty acid compositions were analyzed by GC, whereas brain eicosanoid/docosanoids were measured by LC-ESI-MS-MS-based analysis. The levels of lipid peroxides (LPOs) were measured by thiobarbituric acid reactive substances. The administration of TAK-085 at 300 mg·kg⁻¹day⁻¹ for 17 weeks reduced the number of RMEs in aged rats compared with that in the control rats. Both TAK-085 and EPA administration increased plasma EPA and DHA levels in aged rats, with concurrent increases in DHA and decreases in arachidonic acid in the corticohippocampal brain tissues. TAK-085 administration significantly increased the formation of EPA-derived 5-HETE and DHA-derived 7-, 10-, and 17-HDoHE, PD1, RvD1, and RvD2. ARA-derived PGE2, PGD2, and PGF2α significantly decreased in TAK-085-treated rats. DHA-derived mediators demonstrated a significantly negative correlation with the number of RMEs, whereas EPA-derived mediators did not exhibit any relationship. Furthermore, compared with the control rats, the levels of LPO in the plasma, cerebral cortex, and hippocampus were significantly reduced in TAK-085-treated rats. The findings of the present study suggest that long-term EPA+DHA administration may be a possible preventative strategy against age-related cognitive decline.

  14. Transgenic increase in N-3/n-6 Fatty Acid ratio reduces maternal obesity-associated inflammation and limits adverse developmental programming in mice.

    PubMed

    Heerwagen, Margaret J R; Stewart, Michael S; de la Houssaye, Becky A; Janssen, Rachel C; Friedman, Jacob E

    2013-01-01

    Maternal and pediatric obesity has risen dramatically over recent years, and is a known predictor of adverse long-term metabolic outcomes in offspring. However, which particular aspects of obese pregnancy promote such outcomes is less clear. While maternal obesity increases both maternal and placental inflammation, it is still unknown whether this is a dominant mechanism in fetal metabolic programming. In this study, we utilized the Fat-1 transgenic mouse to test whether increasing the maternal n-3/n-6 tissue fatty acid ratio could reduce the consequences of maternal obesity-associated inflammation and thereby mitigate downstream developmental programming. Eight-week-old WT or hemizygous Fat-1 C57BL/6J female mice were placed on a high-fat diet (HFD) or control diet (CD) for 8 weeks prior to mating with WT chow-fed males. Only WT offspring from Fat-1 mothers were analyzed. WT-HFD mothers demonstrated increased markers of infiltrating adipose tissue macrophages (P<0.02), and a striking increase in 12 serum pro-inflammatory cytokines (P<0.05), while Fat1-HFD mothers remained similar to WT-CD mothers, despite equal weight gain. E18.5 Fetuses from WT-HFD mothers had larger placentas (P<0.02), as well as increased placenta and fetal liver TG deposition (P<0.01 and P<0.02, respectively) and increased placental LPL TG-hydrolase activity (P<0.02), which correlated with degree of maternal insulin resistance (r = 0.59, P<0.02). The placentas and fetal livers from Fat1-HFD mothers were protected from this excess placental growth and fetal-placental lipid deposition. Importantly, maternal protection from excess inflammation corresponded with improved metabolic outcomes in adult WT offspring. While the offspring from WT-HFD mothers weaned onto CD demonstrated increased weight gain (P<0.05), body and liver fat (P<0.05 and P<0.001, respectively), and whole body insulin resistance (P<0.05), these were prevented in WT offspring from Fat1-HFD mothers. Our results suggest that

  15. Transgenic Increase in N-3/N-6 Fatty Acid Ratio Reduces Maternal Obesity-Associated Inflammation and Limits Adverse Developmental Programming in Mice

    PubMed Central

    Heerwagen, Margaret J. R.; Stewart, Michael S.; de la Houssaye, Becky A.; Janssen, Rachel C.; Friedman, Jacob E.

    2013-01-01

    Maternal and pediatric obesity has risen dramatically over recent years, and is a known predictor of adverse long-term metabolic outcomes in offspring. However, which particular aspects of obese pregnancy promote such outcomes is less clear. While maternal obesity increases both maternal and placental inflammation, it is still unknown whether this is a dominant mechanism in fetal metabolic programming. In this study, we utilized the Fat-1 transgenic mouse to test whether increasing the maternal n-3/n-6 tissue fatty acid ratio could reduce the consequences of maternal obesity-associated inflammation and thereby mitigate downstream developmental programming. Eight-week-old WT or hemizygous Fat-1 C57BL/6J female mice were placed on a high-fat diet (HFD) or control diet (CD) for 8 weeks prior to mating with WT chow-fed males. Only WT offspring from Fat-1 mothers were analyzed. WT-HFD mothers demonstrated increased markers of infiltrating adipose tissue macrophages (P<0.02), and a striking increase in 12 serum pro-inflammatory cytokines (P<0.05), while Fat1-HFD mothers remained similar to WT-CD mothers, despite equal weight gain. E18.5 Fetuses from WT-HFD mothers had larger placentas (P<0.02), as well as increased placenta and fetal liver TG deposition (P<0.01 and P<0.02, respectively) and increased placental LPL TG-hydrolase activity (P<0.02), which correlated with degree of maternal insulin resistance (r = 0.59, P<0.02). The placentas and fetal livers from Fat1-HFD mothers were protected from this excess placental growth and fetal-placental lipid deposition. Importantly, maternal protection from excess inflammation corresponded with improved metabolic outcomes in adult WT offspring. While the offspring from WT-HFD mothers weaned onto CD demonstrated increased weight gain (P<0.05), body and liver fat (P<0.05 and P<0.001, respectively), and whole body insulin resistance (P<0.05), these were prevented in WT offspring from Fat1-HFD mothers. Our results suggest that

  16. Increased Plasma Levels of Chemoresistance-Inducing Fatty Acid 16:4(n-3) After Consumption of Fish and Fish Oil.

    PubMed

    Daenen, Laura G M; Cirkel, Geert A; Houthuijzen, Julia M; Gerrits, Johan; Oosterom, Ilse; Roodhart, Jeanine M L; van Tinteren, Harm; Ishihara, Kenji; Huitema, Alwin D R; Verhoeven-Duif, Nanda M; Voest, Emile E

    2015-06-01

    Our research group previously identified specific endogenous platinum-induced fatty acids (PIFAs) that, in picomolar quantities, activate splenic macrophages leading to resistance to chemotherapy in mouse models. Fish oil was shown to contain the PIFA 16:4(n-3) (hexadeca-4,7,10,13-tetraenoic acid) and when administered to mice neutralized chemotherapy activity. Because patients with cancer frequently use fish oil supplements, we set out to determine exposure to 16:4(n-3) after intake of fish or fish oil. (1) In November 2011, 400 patients with cancer undergoing treatment at the University Medical Center Utrecht were surveyed to determine their use of fish oil supplements; 118 patients responded to the questionnaire (30%); (2) pharmacokinetic analysis of the 16:4(n-3) content of 6 fish oils and 4 fishes was carried out; (3) from April through November 2012, a healthy volunteer study was performed to determine 16:4(n-3) plasma levels after intake of 3 different brands of fish oil or 4 different fish species. Thirty healthy volunteers were randomly selected for the fish oil study; 20 were randomly selected for the fish study. These studies were supported by preclinical tumor experiments in mice to determine chemoresistance conducted between September 2011 and December 2012. (1) Rate of use of fish oil supplements among patients undergoing cancer treatment at our institution; (2) levels of 16:4(n-3) present in 3 brands of fish oil and 4 species of fish; and (3) plasma levels of 16:4(n-3) present in healthy volunteers after consuming fish oil or fish. Eleven percent of respondents reported using omega-3 supplements. All fish oils tested contained relevant amounts of 16:4(n-3), from 0.2 to 5.7 µM. Mouse experiments showed that addition of 1 µL of fish oil to cisplatin was sufficient to induce chemoresistance, treatment having no impact on the growth rate of tumors compared with vehicle-treated controls (estimated tumor volume difference, 44.1 mm3; P > .99). When

  17. Undergraduate-driven interventions to increase representation in science classrooms

    NASA Astrophysics Data System (ADS)

    Freilich, M.; Aluthge, D.; Bryant, R. M.; Knox, B.; McAdams, J.; Plummer, A.; Schlottman, N.; Stanley, Z.; Suglia, E.; Watson-Daniels, J.

    2014-12-01

    Recognizing that racial, ethnic, and gender underrepresentation in science classrooms persists despite intervention programs and institutional commitments to diversity, a group of undergraduates from a variety of backgrounds and academic disciplines came together for a group independent study to (a) study the theoretical foundations of the current practice of science and of programs meant to increase diversity, (b) utilize the experiences of course participants and our peers to better understand the drivers of underrepresentation, and (c) design and implement interventions at Brown University. We will present on individual and small group projects designed by course members in collaboration with faculty. The projects emerged from an exploration of literature in history, philosophy, and sociology of science, as well as an examination of anthropological and psychological studies. We also evaluated the effectiveness of top-down and bottom-up approaches that have already been attempted in developing our projects. They focus on the specific problems faced by underrepresented minorities, women, LGBTQ+ people, and well-represented minorities. We will share experiences of faculty-student collaboration and engaged scholarship focused on representation in science and discuss student-designed interventions.

  18. Chemical intervention in plant sugar signalling increases yield and resilience

    NASA Astrophysics Data System (ADS)

    Griffiths, Cara A.; Sagar, Ram; Geng, Yiqun; Primavesi, Lucia F.; Patel, Mitul K.; Passarelli, Melissa K.; Gilmore, Ian S.; Steven, Rory T.; Bunch, Josephine; Paul, Matthew J.; Davis, Benjamin G.

    2016-12-01

    The pressing global issue of food insecurity due to population growth, diminishing land and variable climate can only be addressed in agriculture by improving both maximum crop yield potential and resilience. Genetic modification is one potential solution, but has yet to achieve worldwide acceptance, particularly for crops such as wheat. Trehalose-6-phosphate (T6P), a central sugar signal in plants, regulates sucrose use and allocation, underpinning crop growth and development. Here we show that application of a chemical intervention strategy directly modulates T6P levels in planta. Plant-permeable analogues of T6P were designed and constructed based on a ‘signalling-precursor’ concept for permeability, ready uptake and sunlight-triggered release of T6P in planta. We show that chemical intervention in a potent sugar signal increases grain yield, whereas application to vegetative tissue improves recovery and resurrection from drought. This technology offers a means to combine increases in yield with crop stress resilience. Given the generality of the T6P pathway in plants and other small-molecule signals in biology, these studies suggest that suitable synthetic exogenous small-molecule signal precursors can be used to directly enhance plant performance and perhaps other organism function.

  19. Effects of N-3 Polyunsaturated Fatty Acids on Dementia

    PubMed Central

    Yanai, Hidekatsu

    2017-01-01

    N-3 polyunsaturated fatty acids (PUFAs) including α-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have anti-inflammatory effects and neuronal protective functions and may benefit prevention of dementia; however, the epidemiological evidence is very limited. Therefore, the literature about the association between n-3 PUFA and dementia was searched, by using Pubmed. In the analyses of observational studies, n-3 PUFA has been reported to be beneficially associated with dementia in 17 studies; however, the beneficial association between n-3 PUFA and dementia was denied by three studies. In the analyses of intervention studies, n-3 PUFA supplementation was beneficially associated with dementia in eight studies; however, five studies reported the negligible effect of n-3 PUFA for dementia. N-3 PUFA may improve Alzheimer’s disease by increasing clearance of amyloid-β peptide, neurotrophic and neuroprotective factors, and by anti-inflammatory effects. In conclusion, patients with mild memory and/or cognitive impairment can be treated by a long-term and higher intake of n-3 PUFA. PMID:27924168

  20. Effects of N-3 Polyunsaturated Fatty Acids on Dementia.

    PubMed

    Yanai, Hidekatsu

    2017-01-01

    N-3 polyunsaturated fatty acids (PUFAs) including α-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have anti-inflammatory effects and neuronal protective functions and may benefit prevention of dementia; however, the epidemiological evidence is very limited. Therefore, the literature about the association between n-3 PUFA and dementia was searched, by using Pubmed. In the analyses of observational studies, n-3 PUFA has been reported to be beneficially associated with dementia in 17 studies; however, the beneficial association between n-3 PUFA and dementia was denied by three studies. In the analyses of intervention studies, n-3 PUFA supplementation was beneficially associated with dementia in eight studies; however, five studies reported the negligible effect of n-3 PUFA for dementia. N-3 PUFA may improve Alzheimer's disease by increasing clearance of amyloid-β peptide, neurotrophic and neuroprotective factors, and by anti-inflammatory effects. In conclusion, patients with mild memory and/or cognitive impairment can be treated by a long-term and higher intake of n-3 PUFA.

  1. Microencapsulated krill and tuna oil blend raises plasma long-chain n-3 polyunsaturated fatty acid levels compared to tuna oil with similar increases in ileal contractility in rats.

    PubMed

    Patten, Glen S; Sanguansri, Luz; Augustin, Mary Ann; Abeywardena, Mahinda Y; Bird, Anthony R; Patch, Craig S; Belobrajdic, Damien P

    2017-03-01

    Long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) may be more bioavailable from krill oil compared to fish oil due to their phospholipid structure. We tested whether a microencapsulated krill and tuna oil blend (ME-TOKO) provided greater LC n-3 PUFA bioavailability, improved blood lipid profiles and increased intestinal contractility compared to microencapsulated tuna oil (ME-TO). Rats were divided into three groups to receive isocaloric diets containing ME-TO, ME-TOKO and microencapsulated olive oil (ME-OO) at 0.3 or 2 g/100 g for 4 weeks. Final body and organ weights, feed intake and waste output were similar. ME-TOKO rats had higher plasma total LC n-3 PUFA levels compared to ME-TO, but liver LC n-3 PUFA levels and plasma triglyceride and cholesterol levels were similar in non-fasted rats. Diets containing 2% ME-TO and ME-TOKO also showed similar increases in ileal contractility. In summary, ME-TO bioavailability of LC n-3 PUFA was similar to ME-TOKO.

  2. Consumption of Buglossoides arvensis seed oil is safe and increases tissue long-chain n-3 fatty acid content more than flax seed oil - results of a phase I randomised clinical trial.

    PubMed

    Lefort, Natalie; LeBlanc, Rémi; Giroux, Marie-Andrée; Surette, Marc E

    2016-01-01

    Enrichment of tissues with ≥20-carbon n-3 PUFA like EPA is associated with positive cardiovascular outcomes. Stearidonic acid (SDA; 18 : 4n-3) and α-linolenic acid (ALA; 18 : 3n-3) are plant-derived dietary n-3 PUFA; however, direct comparisons of their impact on tissue n-3 PUFA content are lacking. Ahiflower(®) oil extracted from Buglossoides arvensis seeds is the richest known non-genetically modified source of dietary SDA. To investigate the safety and efficacy of dietary Ahiflower oil, a parallel-group, randomised, double-blind, comparator-controlled phase I clinical trial was performed. Diets of healthy subjects (n 40) were supplemented for 28 d with 9·1 g/d of Ahiflower (46 % ALA, 20 % SDA) or flax seed oil (59 % ALA). Blood and urine chemistries, blood lipid profiles, hepatic and renal function tests and haematology were measured as safety parameters. The fatty acid composition of fasting plasma, erythrocytes, polymorphonuclear cells and mononuclear cells were measured at baseline and after 14 and 28 d of supplementation. No clinically significant changes in safety parameters were measured in either group. Tissue ALA and EPA content increased in both groups compared with baseline, but EPA accrual in plasma and in all cell types was greater in the Ahiflower group (time × treatment interactions, P ≤ 0·01). Plasma and mononuclear cell eicosatetraenoic acid (20 : 4n-3) and docosapentaenoic acid (22 : 5n-3) content also increased significantly in the Ahiflower group compared with the flax group. In conclusion, the consumption of Ahiflower oil is safe and is more effective for the enrichment of tissues with 20- and 22-carbon n-3 PUFA than flax seed oil.

  3. Increases in Network Ties Are Associated With Increased Cohesion Among Intervention Participants.

    PubMed

    Gesell, Sabina B; Barkin, Shari L; Sommer, Evan C; Thompson, Jessica R; Valente, Thomas W

    2016-04-01

    Many behavior change programs are delivered in group settings to manage implementation costs and to foster support and interactions among group members in order to facilitate behavior change. Understanding the group dynamics that evolve in group settings (e.g., weight management, Alcoholics Anonymous) is important, yet rarely measured. This article examined the relationship between social network ties and group cohesion in a group-based intervention to prevent obesity in children. The data reported are process measures from an ongoing community-based randomized controlled trial. A total of 305 parents with a child (3-6 years) at risk of developing obesity were assigned to an intervention that taught parents healthy lifestyles. Parents met weekly for 12 weeks in small consistent groups. Two measures were collected at Weeks 3 and 6: a social network survey (people in the group with whom one discusses healthy lifestyles) and the validated Perceived Cohesion Scale. We used lagged random and fixed effects regression models to analyze the data. Cohesion increased from 6.51 to 6.71 (t= 4.4,p< .01). Network nominations tended to increase over the 3-week period in each network. In the combined discussion and advice network, the number of nominations increased from 1.76 to 1.95 (z= 2.59,p< .01). Cohesion at Week 3 was the strongest predictor of cohesion at Week 6 (b= 0.55,p< .01). Number of new network nominations at Week 6 was positively related to cohesion at Week 6 (b= 0.06,p< .01). In sum, being able to name new network contacts was associated with feelings of cohesion. This is the first study to demonstrate how network changes affect perceived group cohesion within a behavioral intervention. Given that many behavioral interventions occur in group settings, intentionally building new social networks could be promising to augment desired outcomes. © 2015 Society for Public Health Education.

  4. Increases in New Social Network Ties are Associated with Increased Cohesion among Intervention Participants

    PubMed Central

    Gesell, Sabina B.; Barkin, Shari L.; Sommer, Evan C.; Thompson, Jessica R.; Valente, Thomas W.

    2016-01-01

    Objective Many behavior change programs are delivered in group settings to manage implementation costs and to foster support and interactions among group members to facilitate behavior change. Understanding the group dynamics that evolve in group settings (e.g., weight management, Alcoholics Anonymous) is important, yet rarely measured. This paper examined the relationship between social network ties and group cohesion in a group-based intervention to prevent obesity in children. Method The data reported are process measures from an ongoing community-based randomized controlled trial. 305 parents with a child (3-6 years) at risk of developing obesity were assigned to an intervention that taught parents healthy lifestyles. Parents met weekly for 12 weeks in small consistent groups. Two measures were collected at weeks 3 and 6: a social network survey (people in the group with whom one discusses healthy lifestyles); and the validated Perceived Cohesion Scale (Bollen & Hoyle, 1990). We used lagged random and fixed effects regression models to analyze the data. Results Cohesion increased from 6.51 to 6.71 (t=4.4, p<0.01). Network nominations tended to increase over the 3-week period in each network. In the combined discussion and advice network, the number of nominations increased from 1.76 to 1.95 (z=2.59, p<0.01). Cohesion at week 3 was the strongest predictor of cohesion at week 6 (b=0.55, p<0.01). Number of new network nominations at week 6 was positively related to cohesion at week 6 (b=0.06, p<.01). In sum, being able to name new network contacts was associated with feelings of cohesion. Conclusion This is the first study to demonstrate how network changes affect perceived group cohesion within a behavioral intervention. Given that many behavioral interventions occur in group settings, intentionally building new social networks could be promising to augment desired outcomes. PMID:26286298

  5. Plasma fatty acid changes following consumption of dietary oils containing n-3, n-6, and n-9 fatty acids at different proportions: preliminary findings of the Canola Oil Multicenter Intervention Trial (COMIT)

    PubMed Central

    2014-01-01

    Background The Canola Oil Multicenter Intervention Trial (COMIT) was a randomized controlled crossover study designed to evaluate the effects of five diets that provided different oils and/or oil blends on cardiovascular disease (CVD) risk factors in individuals with abdominal obesity. The present objective is to report preliminary findings on plasma fatty acid profiles in volunteers with abdominal obesity, following the consumption of diets enriched with n-3, n-6 and n-9 fatty acids. Methods COMIT was conducted at three clinical sites, Winnipeg, Manitoba, Canada, Québec City, Québec, Canada and University Park, Pennsylvania, United States. Inclusion criteria were at least one of the followings: waist circumference (≥90 cm for males and ≥84 cm for females), and at least one other criterion: triglycerides ≥1.7 mmol/L, high density lipoprotein cholesterol <1 mmol/L (males) or <1.3 mmol/L (females), blood pressure ≥130 mmHg (systolic) and/or ≥85 mmHg (diastolic), and glucose ≥5.5 mmol/L. Weight-maintaining diets that included shakes with one of the dietary oil blends were provided during each of the five 30-day dietary phases. Dietary phases were separated by four-week washout periods. Treatment oils were canola oil, high oleic canola oil, high oleic canola oil enriched with docosahexaenoic acid (DHA), flax oil and safflower oil blend, and corn oil and safflower oil blend. A per protocol approach with a mixed model analysis was decided to be appropriate for data analysis. Results One hundred and seventy volunteers were randomized and 130 completed the study with a dropout rate of 23.5%. The mean plasma total DHA concentrations, which were analyzed among all participants as a measure of adherence, increased by more than 100% in the DHA-enriched phase, compared to other phases, demonstrating excellent dietary adherence. Conclusions Recruitment and retention strategies were effective in achieving a sufficient number of participants who completed the study

  6. Dietary Buglossoides Arvensis Oil Increases Circulating n-3 Polyunsaturated Fatty Acids in a Dose-Dependent Manner and Enhances Lipopolysaccharide-Stimulated Whole Blood Interleukin-10—A Randomized Placebo-Controlled Trial

    PubMed Central

    Lefort, Natalie; LeBlanc, Rémi; Surette, Marc E.

    2017-01-01

    Buglossoides arvensis (Ahiflower) oil is a dietary oil rich in stearidonic acid (20% SDA; 18:4 n-3). The present randomized, double blind, placebo-controlled clinical trial investigated the effects of three Ahiflower oil dosages on omega-3 polyunsaturated fatty acid (PUFA) content of plasma and mononuclear cells (MCs) and of the highest Ahiflower dosage on stimulated cytokine production in blood. Healthy subjects (n = 88) consumed 9.7 mL per day for 28 days of 100% high oleic sunflower oil (HOSO); 30% Ahiflower oil (Ahi) + 70% HOSO; 60% Ahi + 40% HOSO; and 100% Ahi. No clinically significant changes in blood and urine chemistries, blood lipid profiles, hepatic and renal function tests nor hematology were measured. Linear mixed models (repeated measures design) probed for differences in time, and time × treatment interactions. Amongst significant changes, plasma and MC eicosapentaenoic acid (EPA, 20:5 n-3) levels increased from baseline at day 28 in all Ahiflower groups (p < 0.05) and the increase was greater in all Ahiflower groups compared to the HOSO control (time × treatment interactions; p < 0.05). Similar results were obtained for α-linolenic acid (ALA, 18:3 n-3), eicosatetraenoic acid (ETA, 20:4 n-3), and docosapentaenoic acid (DPA, 22:5 n-3) content; but not docosahexaenoic acid (DHA, 22:6 n-3). Production of interleukin-10 (IL-10) was increased in the 100% Ahiflower oil group compared to 100% HOSO group (p < 0.05). IL-10 production was also increased in lipopolysaccharide (LPS)-stimulated M2-differentiated THP-1 macrophage-like cells in the presence of 20:4 n-3 or EPA (p < 0.05). Overall; this indicates that the consumption of Ahiflower oil is associated with an anti-inflammatory phenotype in healthy subjects. PMID:28287415

  7. Dietary Buglossoides Arvensis Oil Increases Circulating n-3 Polyunsaturated Fatty Acids in a Dose-Dependent Manner and Enhances Lipopolysaccharide-Stimulated Whole Blood Interleukin-10-A Randomized Placebo-Controlled Trial.

    PubMed

    Lefort, Natalie; LeBlanc, Rémi; Surette, Marc E

    2017-03-10

    Buglossoides arvensis (Ahiflower) oil is a dietary oil rich in stearidonic acid (20% SDA; 18:4 n-3). The present randomized, double blind, placebo-controlled clinical trial investigated the effects of three Ahiflower oil dosages on omega-3 polyunsaturated fatty acid (PUFA) content of plasma and mononuclear cells (MCs) and of the highest Ahiflower dosage on stimulated cytokine production in blood. Healthy subjects (n = 88) consumed 9.7 mL per day for 28 days of 100% high oleic sunflower oil (HOSO); 30% Ahiflower oil (Ahi) + 70% HOSO; 60% Ahi + 40% HOSO; and 100% Ahi. No clinically significant changes in blood and urine chemistries, blood lipid profiles, hepatic and renal function tests nor hematology were measured. Linear mixed models (repeated measures design) probed for differences in time, and time × treatment interactions. Amongst significant changes, plasma and MC eicosapentaenoic acid (EPA, 20:5 n-3) levels increased from baseline at day 28 in all Ahiflower groups (p < 0.05) and the increase was greater in all Ahiflower groups compared to the HOSO control (time × treatment interactions; p < 0.05). Similar results were obtained for α-linolenic acid (ALA, 18:3 n-3), eicosatetraenoic acid (ETA, 20:4 n-3), and docosapentaenoic acid (DPA, 22:5 n-3) content; but not docosahexaenoic acid (DHA, 22:6 n-3). Production of interleukin-10 (IL-10) was increased in the 100% Ahiflower oil group compared to 100% HOSO group (p < 0.05). IL-10 production was also increased in lipopolysaccharide (LPS)-stimulated M2-differentiated THP-1 macrophage-like cells in the presence of 20:4 n-3 or EPA (p < 0.05). Overall; this indicates that the consumption of Ahiflower oil is associated with an anti-inflammatory phenotype in healthy subjects.

  8. Role of intervention programs to increase influenza vaccination in Israel

    PubMed Central

    2014-01-01

    Background Influenza vaccination is the most efficient and cost-effective method to prevent influenza. To increase vaccination coverage, health authorities use various intervention programs (IPs), such as cost subsidies or placing vaccination centers in malls to make vaccination more accessible. Nevertheless, vaccination coverage has been sub-optimal in most developed countries, including in Israel. Methods To determine possible drivers of individual vaccination uptake and to examine the effectiveness of different IPs in increasing vaccination, we analyzed a telephone survey of a representative sample of the Israeli population conducted in March 2011 (n = 470), and paper questionnaires at the work place and at homes during April-July 2011 to several sub-populations : soldiers (n = 81), medical staff (n = 107), ultra-orthodox Jews (n = 72), Israeli Arabs (n = 87) and students (n = 85). Results The population can be stratified into three sub-groups: Acceptors, who receive vaccination regardless of IPs (22%), Conditional Acceptors, who are only vaccinated because of IP implementation (44%) and Non-Acceptors, who are not vaccinated despite IP implementation (34%). Our analysis shows that the risk perception towards influenza relative to vaccination is higher in the Acceptors than in the Conditional Acceptors, with the Non-Acceptors showing the lowest risk perception (P < 0.01). For Conditional Acceptors, physician recommendation is the most effective IP, regardless of the sub-population tested (P = 0.04). Students and low-income participants were more prone than any others to be persuaded to receive vaccination following IPs. In addition, financial incentives were more effective for ultra-religious orthodox Jews and students; vaccinations in more accessible areas were more effective for the ultra-religious orthodox, soldiers, and medical personnel; and TV and radio advertisements were more effective for people above 50 relative to other

  9. Dietary fish oil supplements increase tissue n-3 fatty acid composition and expression of delta-6 desaturase and elongase-2 in Jade Tiger hybrid abalone.

    PubMed

    Mateos, Hintsa T; Lewandowski, Paul A; Su, Xiao Q

    2011-08-01

    This study was conducted to investigate the effects of fish oil (FO) supplements on fatty acid composition and the expression of ∆6 desaturase and elongase 2 genes in Jade Tiger abalone. Five test diets were formulated to contain 0.5, 1.0, 1.5, 2.0 and 2.5% of FO respectively, and the control diet was the normal commercial abalone diet with no additional FO supplement. The muscle, gonad and digestive glands (DG) of abalone fed with all of the five test diets showed significantly high levels of total n-3 polyunsaturated fatty acid (PUFA), eicosapentaenoic acid (EPA), docosapentaenoic acid n-3 (DPAn-3), and docosahexaenoic acid (DHA) than the control group. In all three types of tissue, abalone fed diet supplemented with 1.5% FO showed the highest level of these fatty acids (P < 0.05). For DPAn-3 the higher level was also found in muscle and gonad of abalone fed diet supplemented with 2% FO (P < 0.05). Elongase 2 expression was markedly higher in the muscle of abalone fed diet supplemented with 1.5% FO (P < 0.05), followed by the diet containing 2% FO supplement. For ∆6 desaturase, significantly higher expression was observed in muscle of abalone fed with diet containing 0.5% FO supplement (P < 0.05). Supplementation with FO in the normal commercial diet can significantly improve long chain n-3 PUFA level in cultured abalone, with 1.5% being the most effective supplementation level.

  10. Increasing the Effectiveness of In-Home Behavior Intervention.

    ERIC Educational Resources Information Center

    Williams, Bruce W.

    This report summarizes in-home behavioral interventions carried out with 18 individuals (ages 3 to 43) with developmental disabilities in the San Diego and North Los Angeles County Regional Centers during 1990-1991. The report focuses on client characteristics, problems that were addressed, intervention procedures used, and results. The paper…

  11. Test Driving Interventions to Increase Treatment Integrity and Student Outcomes

    ERIC Educational Resources Information Center

    Dart, Evan H.; Cook, Clayton R.; Collins, Tai A.; Gresham, Frank M.; Chenier, Jeffrey S.

    2012-01-01

    Behavioral consultation has been shown to be an effective way for school psychologists to work with teachers in implementing interventions for student problem behavior. Some teachers are resistant to the behavioral consultation process and thereby fail to implement agreed upon interventions with integrity, which is problematic considering the…

  12. Short communication: Feeding linseed oil to dairy goats with competent reticular groove reflex greatly increases n-3 fatty acids in milk fat.

    PubMed

    Martínez Marín, A L; Gómez-Cortés, P; Carrión Pardo, D; Núñez Sánchez, N; Gómez Castro, G; Juárez, M; Pérez Alba, L; Pérez Hernández, M; de la Fuente, M A

    2013-01-01

    A crossover experiment was designed to compare the effects of 2 ways of feeding linseed oil on milk fat fatty acid (FA) composition. Ten lactating goats, trained to keep competent their inborn reticular groove reflex, received a daily dose of linseed oil (38 g/d) either with their solid (concentrate) feed (CON) or emulsified in skim milk and bottle-fed (BOT). Two groups of 5 goats received alternative and successively each of the treatments in two 15-d periods. α-Linolenic acid in milk fat rose up to 13.7% in the BOT versus 1.34% in the CON treatment. The n-6 to n-3 FA ratio was significantly reduced in goats receiving bottle-fed linseed oil (1.49 vs. 0.49). Contents of rumen biohydrogenation intermediates of dietary unsaturated FA were high in milk fat of goats under the CON treatment but low in those in the BOT treatment. These results point to a clear rumen bypass of the bottle-fed linseed oil. This strategy allows obtaining milk fat naturally very rich in n-3 FA and very low in trans FA. Translating this approach into practical farm conditions could enable farmers to produce milk enriched in specific FA. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  13. Effects of supplementing n-3 fatty acid enriched eggs and walnuts on cardiovascular disease risk markers in healthy free-living lacto-ovo-vegetarians: a randomized, crossover, free-living intervention study.

    PubMed

    Burns-Whitmore, Bonny; Haddad, Ella; Sabaté, Joan; Rajaram, Sujatha

    2014-03-27

    Plant and marine n-3 fatty acids (FA) may favorably modify select markers of cardiovascular disease risk. Whether supplementing the habitual diet of lacto-ovo-vegetarians (LOV) with walnuts (containing α-linolenic acid, ALA) and n-3 FA enriched eggs (containing primarily docosahexaenoic acid, DHA and ALA) would have equivalent effects on CVD risk factors is explored in this study. In this study, 20 healthy free-living LOVs following their habitual diet were randomly assigned in a crossover design to receive one of three supplements: n-3 FA enriched egg (6/week), walnuts (28.4 g, 6/week) or a standard egg, 6/week (control) for 8 weeks each with 4-wk washout between treatments. Erythrocyte membrane fatty acids, serum lipids and inflammatory markers were measured at the end of each treatment. Dietary compliance was observed by an expected increase in erythrocyte membrane ALA following the walnut treatment and in DHA following the n-3 FA enriched egg treatment. Walnut treatment lowered serum triacylglycerol, total cholesterol and Apo B (p < 0.05) compared to the standard egg but not the n-3 FA enriched egg treatment. However, walnut treatment significantly reduced total: HDL cholesterol ratio compared to both egg treatments. There were no differences between treatments for any of the inflammatory markers. For LOV, a direct source of DHA such as n-3 FA enriched eggs seems necessary to increase membrane levels of DHA. However for producing an overall favorable blood lipid profile, daily consumption of a handful of walnuts rich in ALA may be a preferred option for lacto-ovo vegetarian.

  14. Effects of supplementing n-3 fatty acid enriched eggs and walnuts on cardiovascular disease risk markers in healthy free-living lacto-ovo-vegetarians: a randomized, crossover, free-living intervention study

    PubMed Central

    2014-01-01

    Background Plant and marine n-3 fatty acids (FA) may favorably modify select markers of cardiovascular disease risk. Whether supplementing the habitual diet of lacto-ovo-vegetarians (LOV) with walnuts (containing α-linolenic acid, ALA) and n-3 FA enriched eggs (containing primarily docosahexaenoic acid, DHA and ALA) would have equivalent effects on CVD risk factors is explored in this study. Methods In this study, 20 healthy free-living LOVs following their habitual diet were randomly assigned in a crossover design to receive one of three supplements: n-3 FA enriched egg (6/week), walnuts (28.4 g, 6/week) or a standard egg, 6/week (control) for 8 weeks each with 4-wk washout between treatments. Erythrocyte membrane fatty acids, serum lipids and inflammatory markers were measured at the end of each treatment. Results Dietary compliance was observed by an expected increase in erythrocyte membrane ALA following the walnut treatment and in DHA following the n-3 FA enriched egg treatment. Walnut treatment lowered serum triacylglycerol, total cholesterol and Apo B (p < 0.05) compared to the standard egg but not the n-3 FA enriched egg treatment. However, walnut treatment significantly reduced total: HDL cholesterol ratio compared to both egg treatments. There were no differences between treatments for any of the inflammatory markers. Conclusions For LOV, a direct source of DHA such as n-3 FA enriched eggs seems necessary to increase membrane levels of DHA. However for producing an overall favorable blood lipid profile, daily consumption of a handful of walnuts rich in ALA may be a preferred option for lacto-ovo vegetarian. PMID:24673793

  15. A multifaceted hospital-wide intervention increases hand hygiene compliance.

    PubMed

    Patel, B; Engelbrecht, H; McDonald, H; Morris, V; Smythe, W

    2016-03-07

    Hand hygiene is an important and basic practice that should be used by all healthcare staff to protect both themselves and their patients against infection. Unfortunately hand hygiene compliance remains poor. To show an improvement in hand hygiene compliance using a multifaceted approach. This was a quasiexperimental pre-post intervention study design with a number of standardised interventions to promote hand hygiene. The World Health Organization hand hygiene multimodal (five-step) intervention approach was used. The study ran from June 2015 to August 2015 in 11 selected wards of a 975-bed tertiary and quaternary care public hospital (Groote Schuur Hospital, Cape Town, South Africa). The outcome was to assess improvement in hand hygiene compliance monthly over the 3 months, compared with non-intervention wards and compared with the wards' own performance measured in 2014. The study included both descriptive and analytical components. Post intervention, hand hygiene compliance showed a statistically significant improvement for before patient contact from 34% in 2014 to 76% in 2015 (p<0.05) and for after patient contact from 47% in 2014 to 82% in 2015 (p<0.05). The intervention improved hand hygiene compliance and can easily be replicated in other wards, resulting in sustaining a culture of hand hygiene improvement and behavioural change throughout the hospital.

  16. Prescription n-3 fatty acids, but not eicosapentaenoic acid alone, improve reference memory-related learning ability by increasing brain-derived neurotrophic factor levels in SHR.Cg-Lepr(cp)/NDmcr rats, a metabolic syndrome model.

    PubMed

    Hashimoto, Michio; Inoue, Takayuki; Katakura, Masanori; Tanabe, Yoko; Hossain, Shahdat; Tsuchikura, Satoru; Shido, Osamu

    2013-10-01

    Metabolic syndrome is implicated in the decline of cognitive ability. We investigated whether the prescription n-3 fatty acid administration improves cognitive learning ability in SHR.Cg-Lepr(cp)/NDmcr (SHR-cp) rats, a metabolic syndrome model, in comparison with administration of eicosapentaenoic acid (EPA, C20:5, n-3) alone. Administration of TAK-085 [highly purified and concentrated n-3 fatty acid formulation containing EPA ethyl ester and docosahexaenoic acid (DHA, C22:6, n-3) ethyl ester] at 300 mg/kg body weight per day for 13 weeks reduced the number of reference memory-related errors in SHR-cp rats, but EPA alone had no effect, suggesting that long-term TAK-085 administration improves cognitive learning ability in a rat model of metabolic syndrome. However, the working memory-related errors were not affected in either of the rat groups. TAK-085 and EPA administration increased plasma EPA and DHA levels of SHR-cp rats, associating with an increase in EPA and DHA in the cerebral cortex. The TAK-085 administration decreased the lipid peroxide levels and reactive oxygen species in the cerebral cortex and hippocampus of SHR-cp rats, suggesting that TAK-085 increases antioxidative defenses. Its administration also increased the brain-derived neurotrophic factor levels in the cortical and hippocampal tissues of TAK-085-administered rats. The present study suggests that long-term TAK-085 administration is a possible therapeutic strategy for protecting against metabolic syndrome-induced learning decline.

  17. Yeast Biodiversity in Vineyard Environments Is Increased by Human Intervention

    PubMed Central

    Drumonde-Neves, João; Lima, Teresa; Schuller, Dorit; Pais, Célia

    2016-01-01

    One hundred and five grape samples were collected during two consecutive years from 33 locations on seven oceanic islands of the Azores Archipelago. Grape samples were obtained from vineyards that were either abandoned or under regular cultivation involving common viticultural interventions, to evaluate the impact of regular human intervention on grape yeast biota diversity in vineyards. A total of 3150 yeast isolates were obtained and 23 yeast species were identified. The predominant species were Hanseniaspora uvarum, Pichia terricola, Starmerella bacillaris and Issatchenkia hanoiensis. The species Barnettozyma californica, Candida azymoides and Pichia cecembensis were reported in grapes or wine-associated environments for the first time. A higher biodiversity was found in active vineyards where regular human intervention takes place (Shannon index: 1.89 and 1.53 in the first and second years, respectively) when compared to the abandoned ones (Shannon index: 0.76 and 0.31). This finding goes against the assumptions that human intervention can destroy biodiversity and lead to homogeneity in the environment. Biodiversity indices were considerably lower in the year with the heaviest rainfall. This study is the first to report on the grape yeast communities from several abandoned vineyards that have undergone no human intervention. PMID:27500638

  18. Yeast Biodiversity in Vineyard Environments Is Increased by Human Intervention.

    PubMed

    Drumonde-Neves, João; Franco-Duarte, Ricardo; Lima, Teresa; Schuller, Dorit; Pais, Célia

    2016-01-01

    One hundred and five grape samples were collected during two consecutive years from 33 locations on seven oceanic islands of the Azores Archipelago. Grape samples were obtained from vineyards that were either abandoned or under regular cultivation involving common viticultural interventions, to evaluate the impact of regular human intervention on grape yeast biota diversity in vineyards. A total of 3150 yeast isolates were obtained and 23 yeast species were identified. The predominant species were Hanseniaspora uvarum, Pichia terricola, Starmerella bacillaris and Issatchenkia hanoiensis. The species Barnettozyma californica, Candida azymoides and Pichia cecembensis were reported in grapes or wine-associated environments for the first time. A higher biodiversity was found in active vineyards where regular human intervention takes place (Shannon index: 1.89 and 1.53 in the first and second years, respectively) when compared to the abandoned ones (Shannon index: 0.76 and 0.31). This finding goes against the assumptions that human intervention can destroy biodiversity and lead to homogeneity in the environment. Biodiversity indices were considerably lower in the year with the heaviest rainfall. This study is the first to report on the grape yeast communities from several abandoned vineyards that have undergone no human intervention.

  19. Technical interventions to increase adenoma detection rate in colonoscopy.

    PubMed

    Rondonotti, Emanuele; Andrealli, Alida; Amato, Arnaldo; Paggi, Silvia; Conti, Clara Benedetta; Spinzi, Giancarlo; Radaelli, Franco

    2016-12-01

    Adenoma detection rate (ADR) is the most robust colonoscopy quality metric and clinical studies have adopted it as the ideal method to assess the impact of technical interventions. Areas covered: We reviewed papers focusing on the impact of colonoscopy technical issues on ADR, including withdrawal time and technique, second evaluation of the right colon, patient positional changes, gastrointestinal assistant participation during colonoscopy, water-aided technique, optimization of bowel preparation and antispasmodic administration. Expert commentary: Overall, technical interventions are inexpensive, available worldwide and easy to implement. Some of them, such as the adoption of split dose regimen and slow scope withdrawal to allow a careful inspection, have been demonstrated to significantly improve ADR. Emerging data support the use of water-exchange colonoscopy. According to published studies, other technical interventions seem to provide only marginal benefit to ADR. Unfortunately, the available evidence has methodological limitations, such as small sample sizes, the inclusion of expert endoscopists only and the evaluation of single technical interventions. Additionally, larger studies are needed to clarify whether these interventions might have a higher benefit on low adenoma detectors and whether the implementation of a bundle of them, instead of a single technical maneuver, might have a greater impact on ADR.

  20. Private health care coverage and increased risk of obstetric intervention

    PubMed Central

    2014-01-01

    Background When clinically indicated, common obstetric interventions can greatly improve maternal and neonatal outcomes. However, variation in intervention rates suggests that obstetric practice may not be solely driven by case criteria. Methods Differences in obstetric intervention rates by private and public status in Ireland were examined using nationally representative hospital discharge data. A retrospective cohort study was performed on childbirth hospitalisations occurring between 2005 and 2010. Multivariate logistic regression analysis with correction for the relative risk was conducted to determine the risk of obstetric intervention (caesarean delivery, operative vaginal delivery, induction of labour or episiotomy) by private or public status while adjusting for obstetric risk factors. Results 403,642 childbirth hospitalisations were reviewed; approximately one-third of maternities (30.2%) were booked privately. After controlling for relevant obstetric risk factors, women with private coverage were more likely to have an elective caesarean delivery (RR: 1.48; 95% CI: 1.45-1.51), an emergency caesarean delivery (RR: 1.13; 95% CI: 1.12-1.16) and an operative vaginal delivery (RR: 1.25; 95% CI: 1.22-1.27). Compared to women with public coverage who had a vaginal delivery, women with private coverage were 40% more likely to have an episiotomy (RR: 1.40; 95% CI: 1.38-1.43). Conclusions Irrespective of obstetric risk factors, women who opted for private maternity care were significantly more likely to have an obstetric intervention. To better understand both clinical and non-clinical dynamics, future studies of examining health care coverage status and obstetric intervention would ideally apply mixed-method techniques. PMID:24418254

  1. Private health care coverage and increased risk of obstetric intervention.

    PubMed

    Lutomski, Jennifer E; Murphy, Michael; Devane, Declan; Meaney, Sarah; Greene, Richard A

    2014-01-13

    When clinically indicated, common obstetric interventions can greatly improve maternal and neonatal outcomes. However, variation in intervention rates suggests that obstetric practice may not be solely driven by case criteria. Differences in obstetric intervention rates by private and public status in Ireland were examined using nationally representative hospital discharge data. A retrospective cohort study was performed on childbirth hospitalisations occurring between 2005 and 2010. Multivariate logistic regression analysis with correction for the relative risk was conducted to determine the risk of obstetric intervention (caesarean delivery, operative vaginal delivery, induction of labour or episiotomy) by private or public status while adjusting for obstetric risk factors. 403,642 childbirth hospitalisations were reviewed; approximately one-third of maternities (30.2%) were booked privately. After controlling for relevant obstetric risk factors, women with private coverage were more likely to have an elective caesarean delivery (RR: 1.48; 95% CI: 1.45-1.51), an emergency caesarean delivery (RR: 1.13; 95% CI: 1.12-1.16) and an operative vaginal delivery (RR: 1.25; 95% CI: 1.22-1.27). Compared to women with public coverage who had a vaginal delivery, women with private coverage were 40% more likely to have an episiotomy (RR: 1.40; 95% CI: 1.38-1.43). Irrespective of obstetric risk factors, women who opted for private maternity care were significantly more likely to have an obstetric intervention. To better understand both clinical and non-clinical dynamics, future studies of examining health care coverage status and obstetric intervention would ideally apply mixed-method techniques.

  2. Alpha linolenic acid (ALA) from Rosa canina, sacha inchi and chia oils may increase ALA accretion and its conversion into n-3 LCPUFA in diverse tissues of the rat.

    PubMed

    Valenzuela B, Rodrigo; Barrera R, Cynthia; González-Astorga, Marcela; Sanhueza C, Julio; Valenzuela B, Alfonso

    2014-07-25

    Alpha-linolenic acid (ALA) is an essential n-3 PUFA; its n-3 LCPUFA derivatives EPA and DHA, which have diverse beneficial effects, are scarce in the human diet. In recent years nontraditional vegetable oils rich in ALA (up to 45%) have been developed as new alternatives to increase ALA consumption. This work evaluated the accretion of ALA, EPA and DHA into the phospholipids extracted from erythrocytes, liver, kidney, small intestine, heart, quadriceps and the brain in rats fed sunflower (SFO), canola (CO), Rosa canina (RCO), sacha inchi (Plukenetia volubilis, SIO) and chia (Salvia hispánica, ChO) oils. Five experimental groups (n = 12 per group) were fed for 21 days with SFO (1% ALA), CO (10% ALA), RCO (33% ALA), SIO (49% ALA), and ChO (64% ALA). SIO and ChO allowed higher ALA accretion in all tissues, except the brain, and a reduction in the content of arachidonic acid in all tissues except the brain. EPA was increased in erythrocytes, liver, kidney, small intestine, heart and quadriceps, but not in the brain. DHA was increased in the liver, small intestine and brain tissues. Our results demonstrate that ALA, when provided in significant amounts, can be converted into n-3 LCPUFA, mostly DHA in the liver and brain. It is suggested that oils rich in ALA, such as SIO and ChO, are good sources for obtaining higher tissue levels of ALA, also allowing its selective conversion into n-3 LCPUFA in some tissues of the rat.

  3. The Infant Fish Oil Supplementation Study (IFOS): design and research protocol of a double-blind, randomised controlled n--3 LCPUFA intervention trial in term infants.

    PubMed

    Meldrum, S J; D'Vaz, N; Dunstan, J; Mori, T A; Prescott, S L

    2011-09-01

    The Infant Fish Oil Supplementation Study is a double-blind randomised controlled trial investigating whether the incidence of allergic disease can be reduced and developmental outcomes enhanced through supplementation with omega-3 fatty acids. Infants at high risk of developing allergic disease will be randomised to receive either fish oil or olive oil supplements until 6 months of age and followed up at six postnatal clinic visits to assess allergy outcomes and infant neurodevelopment. Study groups to consist of a treatment group allocated to receive 650 mg of fish oil daily (250-280 mg docosahexaenoic acid and at least 60 mg eicosapentaenoic acid and a placebo group (olive oil) from birth to 6 months of age. Allergy outcomes will be assessed by clinical history, clinical assessments and allergen skin prick tests at the 12, 30 and 60 month visits. Neurodevelopmental assessments to be conducted at 18 months, and language questionnaires at 12, 18 and 30 months. Samples will be collected from mothers antenatally, from infants at birth, and at clinic visits from 6 months onwards for immunological assessments. Fatty acid composition to be measured in erythrocytes and plasma (at birth and after the supplementation period) to assess the effect of the intervention on fatty acid status. Information on medical history, diet and other lifestyle factors at an antenatal clinic visit and postnatal clinic visits will also be collected. This study is designed to examine clinically relevant effects of a novel, non-invasive and potentially low cost approach to reduce the incidence of allergic disease and facilitate neurodevelopment during early childhood. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Increasing Children's Self-Control through Cognitive Interventions.

    ERIC Educational Resources Information Center

    Pressley, Michael

    1979-01-01

    Research is reviewed on cognitive interventions which affect children's self-control. Five types of effective manipulations are discussed: self-verbalization; external verbalization; affect manipulation; cognitive transformation; and manipulation of attention. Self-control behaviors include modification of impulsive behaviors; delay of…

  5. Increasing Fathers' Participation in Therapeutic Intervention Programs for Exceptional Children.

    ERIC Educational Resources Information Center

    Revelj, Elizabeth O.

    In response to a research review indicating that few programs address the father's role in early intervention and preschool programs for the young exceptional child, a three-month practicum was designed which included fathers in physical therapy sessions and in daily home exercise programming for their developmentally disabled children. Practicum…

  6. Increasing Children's ASL Classifier Production: A Multicomponent Intervention

    ERIC Educational Resources Information Center

    Beal-Alvarez, Jennifer S.; Easterbrooks, Susan R.

    2013-01-01

    The Authors examined classifier production during narrative retells by 10 deaf and hard of hearing students in grades 2-4 at a day school for the deaf following a 6-week intervention of repeated viewings of stories in American Sign Language (ASL) paired with scripted teacher mediation. Classifier production, documented through a…

  7. Interventions to Increase Enrollments of Older Adults at a University.

    ERIC Educational Resources Information Center

    Baum, Joanne; And Others

    In 1973 The Board of Regents of The University of Wisconsin system created the Guest Student Program. In effect, the program opened the doors of the University to all Wisconsin residents aged 62 and over. There were 52 men and 47 women in the final sample, with a mean age of 74.89. The following types of interventions were initiated to aid Guest…

  8. Increasing Children's ASL Classifier Production: A Multicomponent Intervention

    ERIC Educational Resources Information Center

    Beal-Alvarez, Jennifer S.; Easterbrooks, Susan R.

    2013-01-01

    The Authors examined classifier production during narrative retells by 10 deaf and hard of hearing students in grades 2-4 at a day school for the deaf following a 6-week intervention of repeated viewings of stories in American Sign Language (ASL) paired with scripted teacher mediation. Classifier production, documented through a…

  9. Curricular intervention increases adolescents' knowledge about asthma: a randomized trial.

    PubMed

    Coelho, Ana Carla C; Souza-Machado, Carolina de; Oliveira, Thiara S de; Santos, Tássia Natalie N Dos; Cruz, Álvaro A; Souza-Machado, Adelmir

    2017-09-06

    To evaluate the impact of a curricular intervention concerning the knowledge about asthma among adolescents from a public school. This was a randomized, controlled trial study on a curricular intervention in asthma, carried out with asthmatic and non-asthmatic adolescents. The study participants were divided into a curricular intervention group for asthma (IG), and a control group with traditional curriculum (CG). Topics related to asthma were included in the curriculum, such as the disease concept, triggering factors, treatment, symptoms, action plan, and beliefs in popular myths about the disease. These topics were evaluated through a questionnaire with scores ranging from 0 to 20 points, expressed by the mean score. The acquisition of knowledge was evaluated 90 days and 540 days after the start of the intervention (baseline), by applying the mixed linear model for analysis of associations. 181 students participated in the study (IG=101 and CG=80). As shown by their scores before the intervention; the students were unaware about asthma (IG: x¯=10.7±2.9vs. CG: x¯=11.5±2.7 points), its treatment (IG: x¯=1.6±0.9vs. CG: x¯=1.6±0.8 points), and reported beliefs in popular myths about the disease (IG: x¯=1.5±1.1vs. CG: x¯=1.7±1.1 points). After the intervention, the IG showed higher overall knowledge (GI: x¯=15.5±3.1 points), as well as knowledge about the treatment (GI: x¯=2.5±1.0 points), and two times more knowledge in the field "beliefs in popular myths about the disease" when compared to the CG. A greater probability of achieving satisfactory knowledge about asthma was noted in the IG (RR=3.5), with NTT=2.0. The inclusion of the asthma topic in the curriculum improved knowledge about the disease in a subgroup of students. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  10. Increasing the treatment of hypertension through primary intervention

    SciTech Connect

    Fair, M.D.

    1994-12-31

    South Carolina is one of the leading states in stroke mortality. Hypertension is one of the major risk factors that lead to strokes. Unfortunately, many people who are hypertensive do not treat their disease properly due to lack of medical education. The specific objectives of this project are to access geographic areas to determine the level of medical representation available; to identify areas of medical needs based on race, income and health status; and, to structure an intervention plan to target areas that are in the highest hypertension at-risk category. The methods used are to identify medical coverage by geographic areas. Health in poor areas is identified and mapped. Implementation of intervention strategies is prioritized based on areas of need.

  11. Process Evaluation of an Intervention to Increase Provision of Adolescent Vaccines at School Health Centers

    ERIC Educational Resources Information Center

    Golden, Shelley D.; Moracco, Kathryn E.; Feld, Ashley L.; Turner, Kea L.; DeFrank, Jessica T.; Brewer, Noel T.

    2014-01-01

    Background: Vaccination programs in school health centers (SHCs) may improve adolescent vaccine coverage. We conducted a process evaluation of an intervention to increase SHC-located vaccination to better understand the feasibility and challenges of such interventions. Method: Four SHCs participated in an intervention to increase provision of…

  12. Process Evaluation of an Intervention to Increase Provision of Adolescent Vaccines at School Health Centers

    ERIC Educational Resources Information Center

    Golden, Shelley D.; Moracco, Kathryn E.; Feld, Ashley L.; Turner, Kea L.; DeFrank, Jessica T.; Brewer, Noel T.

    2014-01-01

    Background: Vaccination programs in school health centers (SHCs) may improve adolescent vaccine coverage. We conducted a process evaluation of an intervention to increase SHC-located vaccination to better understand the feasibility and challenges of such interventions. Method: Four SHCs participated in an intervention to increase provision of…

  13. Increasing Bicycle Helmet Use in Michigan: A School-Based Intervention Pilot Program. Evaluation Report.

    ERIC Educational Resources Information Center

    Smith, Patricia K.

    In Michigan, a school-based bicycle helmet intervention program has been developed to increase the prevalence of helmet use among middle/junior high school students. The intervention involved approximately 3,100 students and their parents. The school-based intervention component of the project is the focus of this report. A two-tier intervention…

  14. Does n-3 LCPUFA supplementation during pregnancy increase the IQ of children at school age? Follow-up of a randomised controlled trial

    PubMed Central

    Gould, Jacqueline F; Treyvaud, Karli; Yelland, Lisa N; Anderson, Peter J; Smithers, Lisa G; Gibson, Robert A; McPhee, Andrew J; Makrides, Maria

    2016-01-01

    Introduction Despite recommendations that pregnant women increase their docosahexaenoic acid (DHA) intake to support fetal brain development, a recent systematic review found a lack of high-quality data to support the long-term effects of DHA supplementation on children's neurodevelopment. Methods and analysis We will assess child neurodevelopment at 7 years of age in follow-up of a multicentre double-blind randomised controlled trial of DHA supplementation in pregnancy. In 2010–2012, n=2399 Australian women with a singleton pregnancy <21 weeks’ gestation were randomised to receive 3 capsules daily containing a total dose of 800 mg DHA/day or a vegetable oil placebo until birth. N=726 children from Adelaide (all n=97 born preterm, random sample of n=630 born at term) were selected for neurodevelopmental follow-up and n=638 (preterm n=85) are still enrolled at 7 years of age. At the 7-year follow-up, a psychologist will assess the primary outcome, IQ, with the Wechsler Abbreviated Scale of Intelligence, Second Edition. Specific measures of executive functioning (Fruit Stroop and the Rey Complex Figure), attention (Test of Everyday Attention for Children), memory and learning (Rey Auditory Verbal Learning Test), language (Clinical Evaluation of Language Fundamentals, Fourth Edition) and basic educational skills (Wide Range Achievement Test, Fourth Edition) will also be administered. Caregivers will be asked to complete questionnaires measuring behaviour and executive functioning. Families, clinicians and research personnel are blinded to group assignment with the exception of families who requested unblinding prior to the follow-up. All analyses will be conducted according to the intention-to-treat principal. Ethics and dissemination All procedures will be approved by the relevant institutional ethics committees prior to start of the study. The results of this study will be disseminated in peer-reviewed journal publications and academic presentations

  15. Does n-3 LCPUFA supplementation during pregnancy increase the IQ of children at school age? Follow-up of a randomised controlled trial.

    PubMed

    Gould, Jacqueline F; Treyvaud, Karli; Yelland, Lisa N; Anderson, Peter J; Smithers, Lisa G; Gibson, Robert A; McPhee, Andrew J; Makrides, Maria

    2016-05-17

    Despite recommendations that pregnant women increase their docosahexaenoic acid (DHA) intake to support fetal brain development, a recent systematic review found a lack of high-quality data to support the long-term effects of DHA supplementation on children's neurodevelopment. We will assess child neurodevelopment at 7 years of age in follow-up of a multicentre double-blind randomised controlled trial of DHA supplementation in pregnancy. In 2010-2012, n=2399 Australian women with a singleton pregnancy <21 weeks' gestation were randomised to receive 3 capsules daily containing a total dose of 800 mg DHA/day or a vegetable oil placebo until birth. N=726 children from Adelaide (all n=97 born preterm, random sample of n=630 born at term) were selected for neurodevelopmental follow-up and n=638 (preterm n=85) are still enrolled at 7 years of age. At the 7-year follow-up, a psychologist will assess the primary outcome, IQ, with the Wechsler Abbreviated Scale of Intelligence, Second Edition. Specific measures of executive functioning (Fruit Stroop and the Rey Complex Figure), attention (Test of Everyday Attention for Children), memory and learning (Rey Auditory Verbal Learning Test), language (Clinical Evaluation of Language Fundamentals, Fourth Edition) and basic educational skills (Wide Range Achievement Test, Fourth Edition) will also be administered. Caregivers will be asked to complete questionnaires measuring behaviour and executive functioning. Families, clinicians and research personnel are blinded to group assignment with the exception of families who requested unblinding prior to the follow-up. All analyses will be conducted according to the intention-to-treat principal. All procedures will be approved by the relevant institutional ethics committees prior to start of the study. The results of this study will be disseminated in peer-reviewed journal publications and academic presentations. ACTRN12605000569606 and ACTRN12614000770662. Published by the BMJ

  16. Structure Strategy Interventions: Increasing Reading Comprehension of Expository Text

    ERIC Educational Resources Information Center

    Meyer, Bonnie J. F.; Ray, Melissa N.

    2011-01-01

    In this review of the literature we examine empirical studies designed to teach the structure strategy to increase reading comprehension of expository texts. First, we review the research that has served as a foundation for many of the studies examining the effects of text structure instruction. Text structures generally can be grouped into six…

  17. An evaluation of evidence-based interventions to increase compliance among children with autism.

    PubMed

    Fischetti, Anthony T; Wilder, David A; Myers, Kristin; Leon-Enriquez, Yanerys; Sinn, Stephanie; Rodriguez, Rebecka

    2012-01-01

    We evaluated 4 evidence-based interventions to increase compliance. Three children with autism who exhibited noncompliance when asked to relinquish a preferred toy were exposed sequentially to interventions that included a reduction in response effort, differential reinforcement, and guided compliance. Results indicated that effort reduction alone was ineffective and that each participant's compliance improved after exposure to a different intervention; these results highlight the need to individualize treatments for compliance.

  18. Effectiveness of interventions to increase screening for gastric and colorectal cancer in Korea.

    PubMed

    Hong, Nam Soo; Kam, Sin

    2014-01-01

    Public health centers in Korea play an important role at the community level in encouraging residents to participate in cancer screening, usually by sending reminders in the mail and by making phone calls. However, there have not been any studies on the effectiveness of these interventions by public health centers in Korea. The purpose of this study was to evaluate this question. The study was limited to male subjects aged 50-59 years living in one district of Daegu, Korea. A total of 923 subjects were selected for the study among the target population for gastric and colorectal cancer screening as part of the National Cancer Screening Program in 2012. The subjects were randomly assigned to one of four groups: control, postal intervention, telephone intervention, and telephone and postal intervention. Three months after the interventions, the results were confirmed by the National Health Insurance Corporation. Logistic regression analyses were performed to find differences in participation rates in cancer screening for each group. Men who received telephone and postal intervention were most likely (40.5%) to undergo gastric cancer screening, in comparison to the men who received telephone intervention only (31.7%), postal intervention only (22.2%) and those in the control group (17.9%). Also, men who received telephone and postal intervention were most likely (27.8%) to participate in colorectal cancer screening, followed by the men who received telephone intervention only (24.3%), postal intervention only (16.5%), and men in the control group (13.5%). Combined telephone and postal intervention and telephone only intervention as well produced significantly increased rates of participation in cancer screening in comparison to the control group. There was no significant difference, however, between the postal intervention only and control groups for either colorectal or gastric cancer screening.

  19. Now Hiring! Empirically Testing a Three-Step Intervention to Increase Faculty Gender Diversity in STEM.

    PubMed

    Smith, Jessi L; Handley, Ian M; Zale, Alexander V; Rushing, Sara; Potvin, Martha A

    2015-11-01

    Workforce homogeneity limits creativity, discovery, and job satisfaction; nonetheless, the vast majority of university faculty in science, technology, engineering, and mathematics (STEM) fields are men. We conducted a randomized and controlled three-step faculty search intervention based in self-determination theory aimed at increasing the number of women faculty in STEM at one US university where increasing diversity had historically proved elusive. Results show that the numbers of women candidates considered for and offered tenure-track positions were significantly higher in the intervention groups compared with those in controls. Searches in the intervention were 6.3 times more likely to make an offer to a woman candidate, and women who were made an offer were 5.8 times more likely to accept the offer from an intervention search. Although the focus was on increasing women faculty within STEM, the intervention can be adapted to other scientific and academic communities to advance diversity along any dimension.

  20. Now Hiring! Empirically Testing a Three-Step Intervention to Increase Faculty Gender Diversity in STEM

    PubMed Central

    Smith, Jessi L.; Handley, Ian M.; Zale, Alexander V.; Rushing, Sara; Potvin, Martha A.

    2015-01-01

    Workforce homogeneity limits creativity, discovery, and job satisfaction; nonetheless, the vast majority of university faculty in science, technology, engineering, and mathematics (STEM) fields are men. We conducted a randomized and controlled three-step faculty search intervention based in self-determination theory aimed at increasing the number of women faculty in STEM at one US university where increasing diversity had historically proved elusive. Results show that the numbers of women candidates considered for and offered tenure-track positions were significantly higher in the intervention groups compared with those in controls. Searches in the intervention were 6.3 times more likely to make an offer to a woman candidate, and women who were made an offer were 5.8 times more likely to accept the offer from an intervention search. Although the focus was on increasing women faculty within STEM, the intervention can be adapted to other scientific and academic communities to advance diversity along any dimension. PMID:26955075

  1. Increasing the Screening and Counseling of Adolescents for Risky Health Behaviors: A Primary Care Intervention

    ERIC Educational Resources Information Center

    Ozer, Elizabeth M.; Adams, Sally H.; Lustig, Julie L.; Gee, Scott; Garber, Andrea K.; Gardner, Linda Rieder; Rehbein, Michael; Addison, Louise; Irwin, Charles E., Jr.

    2005-01-01

    Objective: To determine whether a systems intervention for primary care providers resulted in increased preventive screening and counseling of adolescent patients, compared with the usual standard of care. Methods: The intervention was conducted in 2 out-patient pediatric clinics; 2 other pediatric clinics in the same health maintenance…

  2. Increasing the Screening and Counseling of Adolescents for Risky Health Behaviors: A Primary Care Intervention

    ERIC Educational Resources Information Center

    Ozer, Elizabeth M.; Adams, Sally H.; Lustig, Julie L.; Gee, Scott; Garber, Andrea K.; Gardner, Linda Rieder; Rehbein, Michael; Addison, Louise; Irwin, Charles E., Jr.

    2005-01-01

    Objective: To determine whether a systems intervention for primary care providers resulted in increased preventive screening and counseling of adolescent patients, compared with the usual standard of care. Methods: The intervention was conducted in 2 out-patient pediatric clinics; 2 other pediatric clinics in the same health maintenance…

  3. An Evaluation of Evidence-Based Interventions to Increase Compliance among Children with Autism

    ERIC Educational Resources Information Center

    Fischetti, Anthony T.; Wilder, David A.; Myers, Kristin; Leon-Enriquez, Yanerys; Sinn, Stephanie; Rodriguez, Rebecka

    2012-01-01

    We evaluated 4 evidence-based interventions to increase compliance. Three children with autism who exhibited noncompliance when asked to relinquish a preferred toy were exposed sequentially to interventions that included a reduction in response effort, differential reinforcement, and guided compliance. Results indicated that effort reduction alone…

  4. An Emergency Department Intervention to Increase Parent-Child Tobacco Communication: A Pilot Study

    ERIC Educational Resources Information Center

    Mahabee-Gittens, E. Melinda; Huang, Bin; Slap, Gail B.; Gordon, Judith S.

    2008-01-01

    We conducted a randomized trial of parents and their 9- to 16-year-old children to pilot test an emergency department (ED)-based intervention designed to increase parent-child tobacco communication. Intervention group (IG) parents received verbal/written instructions on how to relay anti-tobacco messages to their children; control group (CG)…

  5. Increasing breast examinations among arab women using a tailored culture-based intervention.

    PubMed

    Cohen, Miri; Azaiza, Faisal

    2010-01-01

    This study aimed to assess outcomes of a culture-specific intervention devised to reduce barriers to breast cancer screening among Arab women in Israel. Women in intervention (n = 42) and control (n = 24) groups answered breast examination performance and Arab culture-specific barriers and health beliefs questionnaires at pre- and postintervention. Women in the study group received tailored telephone intervention between the 2 interviews. Although the study and control groups did not differ in rate of attending clinical examinations and mammography at pre-intervention, at post-intervention, almost 48% of the intervention group and 12.5% of the control group scheduled or attended a clinical examination, and 38.5% of women in the intervention group and 21.4% of the control group attended or scheduled a mammography. Of the cultural barriers, a significant group x time effect was found for the cultural barriers of exposure, social barriers, and self-uneasiness with body, with a higher decrease in the intervention group. Of the health beliefs, a group x time effect was found for perceived vulnerability and perceived barriers to clinical examination and mammography, which significantly decreased in the intervention group, but not in the control group. The preliminary results showed that the culture-based intervention was effective in reducing barriers and increasing the rate of breast cancer examinations.

  6. Knowledge of human papillomavirus among high school students can be increased by an educational intervention.

    PubMed

    Gottvall, M; Tydén, T; Höglund, A T; Larsson, M

    2010-08-01

    The aim of this study was to evaluate the effect of an educational intervention concerning human papillomavirus (HPV) directed at Swedish first year high school students. The intervention consisted of a class room lesson, a website and a folder. Outcome variables were knowledge of HPV and attitudes to preventive methods such as HPV vaccination, condom use and Pap smear testing. An intervention group (n = 92) was matched with two comparison groups (n = 184). At baseline, the median score for HPV knowledge was one out of 10 in both groups. At follow-up, the median knowledge score had increased to six in the intervention group, but was still one in the comparison group (P < 0.001). Attitudes to HPV vaccination, condom use and Pap smear testing remained the same (P > 0.05). In conclusion, a short school-based intervention can greatly increase the students' knowledge about HPV, but attitudes and behaviours are less easy to influence.

  7. Effectiveness of a primary care practice intervention for increasing colorectal cancer screening in Appalachian Kentucky.

    PubMed

    Dignan, Mark; Shelton, Brent; Slone, Stacey A; Tolle, Cheri; Mohammad, Sohail; Schoenberg, Nancy; Pearce, Kevin; Van Meter, Emily; Ely, Gretchen

    2014-01-01

    This report describes findings from a randomized controlled trial of an intervention to increase colorectal cancer (CRC) screening in primary care practices in Appalachian Kentucky. Sixty-six primary care practices were randomized to early or delayed intervention groups. The intervention was provided at practices using academic detailing, a method of education where providers receive information on a specific topic through personal contact. Data were collected in cross-sectional surveys of medical records at baseline and six months post-intervention. A total of 3844 medical records were reviewed at baseline and 3751 at the six-month follow-up. At baselines, colonoscopy was recommended more frequently (43.4%) than any other screening modality, followed by fecal occult blood testing (18.0%), flexible sigmoidoscopy (0.4%), and double-contrast barium enema (0.3%). Rates of documented screening results were higher for all practices at the six-month follow-up for colonoscopy (31.8% vs 29.6%) and fecal occult blood testing (12.2% vs 11.2%). For early intervention practices that recommended screening, colonoscopy rates increased by 15.7% at six months compared to an increase of 2.4% in the delayed intervention practices (p=.01). Using academic detailing to reach rural primary care providers with a CRC screening intervention was associated with an increase in colonoscopy. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Are dietary interventions effective at increasing fruit and vegetable consumption among overweight children? A systematic review.

    PubMed

    Bourke, Michael; Whittaker, Paula J; Verma, Arpana

    2014-05-01

    Childhood obesity is now a global epidemic and the incidence continues to increase. Dietary interventions and nutritional education are possible options to manage childhood obesity. However, restrictive diets can result in negative outcomes, and therefore it may be more apt to encourage children to consume more fruit and vegetables and thereby develop a healthier positive attitude towards food. A systematic review of literature of interventions to increase fruit and/or vegetable consumption in overweight or obese children and adolescents was conducted, applying a free-text strategy with a set of search terms. A total of five studies describing seven interventions published in international peer-reviewed journals and meeting the review's eligibility criteria were identified. All five studies examined family-focused interventions to increase daily fruit and vegetable consumption measured either by child self-report or parent report. Only one intervention reported a lasting statistically significant increased consumption of fruit and vegetables. This review highlights that in order to tackle obesity narrow interventions focusing on single aspects of behaviour are unlikely to achieve long-term change. Successful public health interventions tackling childhood obesity will need to take a holistic approach and target behaviour change in multiple aspects of children's lifestyles and their surroundings, including nutritional education, parental support and physical activity.

  9. A family-based intervention to increase fruit and vegetable consumption in adolescents: a pilot study.

    PubMed

    Pearson, Natalie; Atkin, Andrew J; Biddle, Stuart J H; Gorely, Trish

    2010-06-01

    To evaluate the feasibility and effectiveness of a pilot family-based newsletter intervention to increase fruit and vegetable (FV) consumption among adolescents. Family-based, two-group randomised control trial with baseline, post-intervention and follow-up measures. The intervention group received two FV newsletter packs over a 1 month period by postal mail. Social cognitive and behavioural choice theories provide the theoretical framework for the design and development of intervention materials. Control families were provided with all intervention materials at the end of the study. Adolescent FV consumption was assessed by an FFQ. Adolescent-reported barriers to eating FV, FV habits and preferences were the secondary outcomes, along with parent FV consumption, and parents reported knowledge, encouragement, home availability and accessibility of FV. Repeated-measures ANOVA was used to detect differences in behavioural and psychosocial outcomes between groups, time and group-by-time. East Midlands, UK. Forty-nine parents and adolescents aged 12-14 years. Process evaluation indicated high reach, dose acceptability and fidelity of the intervention. At post-intervention and 6 weeks later at follow-up, adolescents in the intervention group had significantly higher fruit: (P < 0.01) and vegetable (P < 0.05) consumption and higher preferences for vegetables (P < 0.01), compared with the control group. At post-intervention and follow-up, parents in the intervention group had significantly higher fruit (P < 0.001) and vegetable (P < 0.01) consumption and reported higher accessibility of fruit and vegetables (P < 0.001), compared with those in the control group. Family-based, newsletter interventions promoting FV consumption to adolescents appear to be feasible and effective at increasing FV consumption.

  10. A community intervention by firefighters to increase 911 calls and aspirin use for chest pain.

    PubMed

    Meischke, Hendrika; Diehr, Paula; Rowe, Sharon; Cagle, Anthony; Eisenberg, Mickey

    2006-04-01

    To test the effectiveness of an intervention, delivered face-to-face by local firefighters, designed to increase utilization of 911 and self-administration of aspirin for seniors experiencing chest pain. King County, Washington was divided into 126 geographically distinct areas that were randomized to intervention and control areas. A mailing list identified households of seniors within these areas. More than 20,000 homes in the intervention areas were contacted by local firefighters. Data on all 911 calls for chest pain and self-administration of aspirin were collected from the medical incident report form (MIRF). The unit of analysis was the area. Firefighters delivered a heart attack survival kit (that included an aspirin) and counseled participants on the importance of aspirin and 911 use for chest pain. Main outcome measures were 911 calls for chest pain and aspirin ingestion for a chest pain event, obtained from the MIRFs that are collected by emergency medical services personnel for 2 years after the intervention. There were significantly more calls (16%) among seniors on the mailing list in the intervention than control areas in the first year after the intervention. Among the seniors who were not on the mailing list, there was little difference in the intervention and control areas. The results were somewhat sensitive to the analytical model used and to an outlier in the treatment group. A community-based firefighter intervention can be effective in increasing appropriate response to symptoms of a heart attack among elders.

  11. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

    PubMed Central

    2012-01-01

    Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening

  12. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women.

    PubMed

    Lu, Mingshan; Moritz, Sabina; Lorenzetti, Diane; Sykes, Lindsay; Straus, Sharon; Quan, Hude

    2012-06-07

    The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening uptake. Intervention

  13. Evidence-Based Interventions for Increasing Work Participation for Persons With Various Disabilities.

    PubMed

    Smith, Diane L; Atmatzidis, Katie; Capogreco, Marisa; Lloyd-Randolfi, Dominic; Seman, Victoria

    2017-04-01

    Title I of the Americans With Disabilities Act prohibits discrimination in employment; however, 26 years later, employment rates for persons with disabilities hover at 34%. This systematic review investigates the effectiveness of evidence-based interventions to increase employment for people with various disabilities. Forty-six articles met the inclusion criteria for evidence-based interventions. The majority of studies assessed interventions for persons with mental health disabilities. Strong evidence was found for ongoing support and work-related social skills training prior to and during competitive employment for persons with mental health disabilities. Moderate evidence supported simulation and use of assistive technology, especially apps for cueing and peer support to increase work participation for persons with intellectual disabilities, neurological/cognitive disabilities, and autism spectrum disorder. Many of the strategies to increase work participation were appropriate for occupational therapy intervention. Suggestions were made for research, specifically looking at more rigorous evaluation of strategies in the long term.

  14. Evaluating an Intervention to Increase Cancer Knowledge in Racially Diverse Communities in South Carolina

    PubMed Central

    Ford, Marvella; Wahlquist, Amy E.; Ridgeway, Celina; Streets, June; Mitchum, Katie A.; Harper, Reverend Remus; Hamilton, Ian; Etheredge, Jim; Sweat, Melanie; Varner, Heidi; Campbell, Katora; Garrett-Mayer, Elizabeth

    2014-01-01

    Objective To conduct a cancer education intervention with racially diverse communities in South Carolina. Methods The study was conducted at eight different sites in six counties in SC. The intervention included a 3-hour general cancer knowledge and 30-minute prostate cancer knowledge component. Pre- and post-intervention surveys were administered. Maximum scores were 31, 10 and 5 for the general cancer knowledge, prostate cancer knowledge and perceived self-efficacy in patient-physician interaction instruments, respectively. Analyses were completed using SPSS 16.0, SAS 9.1.3, and R v2.6.1. Results The study sample consisted of 164 predominantly African American participants. Most of the participants who reported age were 50+ years (62.5%). Among those who reported income, 46.1% had an annual household income < $40,000. The mean general cancer knowledge pre-test score was 26.2 (standard deviation (SD) 3.7) with a mean post-intervention increase of 2.15 points (p<0.01). The mean pre-test prostate cancer knowledge score was 7.3 (SD 2.0) with a post-intervention increase of 0.48 points (p<0.01). Perceived self-efficacy in patient-physician interaction scores had a ceiling effect. Conclusions General cancer knowledge and prostate cancer knowledge scores increased following the intervention. Practice Implications The intervention was successful in the short-term. It could be continued by community members. PMID:20674239

  15. Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women

    PubMed Central

    Highfield, Linda; Hartman, Marieke A.; Mullen, Patricia Dolan; Rodriguez, Serena A.; Fernandez, Maria E.; Bartholomew, L. Kay

    2015-01-01

    This paper describes and demonstrates the use of the systematic planning process, Intervention Mapping, to adapt an evidence-based public health intervention (EBI). We used a simplified version of Intervention Mapping (IM Adapt) to increase an intervention's fit with a new setting and population. IM Adapt guides researchers and practitioners in selecting an EBI, making decisions about whether and what to adapt, and executing the adaptation while guarding the EBI's essential elements (those responsible for effectiveness). We present a case study of a project in which we used IM Adapt to find, adapt, implement, and evaluate an EBI to improve mammography adherence for African American women in a new practice setting in Houston, Texas. IM Adapt includes the following (1) assess needs and organizational capacity; (2) find EBIs; (3) plan adaptations based on fit assessments; (4) make adaptations; (5) plan for implementation; and (6) plan for evaluation of the adapted EBI. The case study shows an example of how public health researchers and practitioners can use the tool to make it easier to find and use EBIs, thus encouraging greater uptake. IM Adapt adds to existing dissemination and adaptation models by providing detailed guidance on how to decide on effective adaptation, while maintaining the essential elements of the EBI. PMID:26587531

  16. Altering Instructional Delivery Options to Improve Intervention Outcomes: Does Increased Instructional Intensity Also Increase Instructional Effectiveness?

    ERIC Educational Resources Information Center

    Begeny, John C.; Hawkins, Amy Lynn; Krouse, Hailey E.; Laugle, Kelly M.

    2011-01-01

    With limited educational resources and numerous other variables that complicate effective teaching, educators need to think prudently about how to allocate resources. In essence, teachers must allocate resources in ways that will best maximize student learning. However, minimal research has systematically evaluated whether increased instructional…

  17. Increasing pro-environmental behaviors by increasing self-concordance: Testing an intervention.

    PubMed

    Unsworth, Kerrie L; McNeill, Ilona M

    2017-01-01

    Globally, there is a clear need to change our behavior to mitigate climate change. Many people, however, will not find the need for mitigation important enough to make their behavior more environmentally sustainable. Three studies supported the hypothesis that it is possible to overcome this issue by connecting these behaviors to goals that are important to people, even if such goals are unrelated to climate change or the environment in general. Study 1 (N = 305 working adults) showed that stronger self-concordance of behavior related to energy sustainability was related to a greater chance of signing a petition for increasing renewable energy sources. Next, 2 experimental studies (Study 2: N = 412 working and nonworking adults, and Study 3: N = 300 working adults) showed that increasing self-concordance of environmentally sustainable behaviors by asking people to cognitively connect either sustainable energy use (Study 2) or commuting behaviors (Study 3) to their personal goals increased intentions to engage in these behaviors compared to a control condition (Study 2 and Study 3) and compared to persuasion attempts based on climate change mitigation (Study 3). These findings occurred even after controlling for political orientation and environmental concerns. This research has significant practical implications for workplaces, particularly for those in which employees or managers place a low priority on environmental and climate change considerations. (PsycINFO Database Record

  18. Effectiveness of Parent-Focused Interventions to Increase Teen Driver Safety: A Critical Review.

    PubMed

    Curry, Allison E; Peek-Asa, Corinne; Hamann, Cara J; Mirman, Jessica H

    2015-07-01

    We critically reviewed recent parent-directed teen driving interventions to summarize their success in meeting stated goals; identify promising intervention components and knowledge gaps; aid in the selection, adaptation, and dissemination of effective interventions; and guide future research efforts. We focused on interventions that included a direct parent component, explicitly stated outcomes related to the teen and/or their parents, were evaluated for parent or teen outcomes, targeted drivers younger than the age of 21 years, and had at least one evaluation study published since 1990 and in English. We conducted a comprehensive systematic search of 26 online databases between November 2013 and January 2014 and identified 34 articles representing 18 interventions. Several interventions-in particular, those that had an active engagement component, incorporated an in-vehicle data recorder system, and had a strong conceptual approach-show promise in improving parental supervisory behaviors during the learner and early independent phases, increasing teen driver skill acquisition, and reducing teens' risky driving behaviors. We identify essential characteristics of effective parent-involved teen driving interventions and their evaluation studies, propose a comprehensive and multitiered approach to intervention, and discuss several research areas and overarching issues for consideration. Copyright © 2015 Society for Adolescent Health and Medicine. All rights reserved.

  19. Practice- and Community-Based Interventions to Increase Human Papillomavirus Vaccine Coverage

    PubMed Central

    Niccolai, Linda M.; Hansen, Caitlin E.

    2016-01-01

    IMPORTANCE Vaccines against human papillomavirus (HPV) are recommended for routine use in adolescents aged 11 to 12 years in the United States, but uptake remains suboptimal. Educational interventions focused on parents and patients to increase coverage have not generally demonstrated effectiveness. OBJECTIVE To systematically review the literature on effectiveness of interventions conducted at the practice or community level to increase uptake of HPV vaccines in the United States. EVIDENCE REVIEW Keyword searches of the PubMed, Web of Science, and MEDLINE databases identified studies of adolescents that included the outcome of HPV vaccination published through July 2014. References of identified articles were also reviewed. A total of 366 records were screened, 38 full-text articles were reviewed, and 14 published studies were included. Results were summarized by different intervention approaches. FINDINGS Practice- and community-based intervention approaches included reminder and recall (n = 7), physician-focused interventions (eg, audit and feedback) (n = 6), school-based programs (n = 2), and social marketing (n = 2) (2 interventions tested multiple approaches). Seven studies used a randomized design, and 8 used quasiexperimental approaches (one used both). Thirteen studies included girls, and 2 studies included boys. Studies were conducted in a variety of populations and geographic locations. Twelve studies reported significant increases in at least one HPV vaccination outcome, one reported a nonsignificant increase, and one reported mixed effects. CONCLUSIONS AND RELEVANCE Most practice- and community-based interventions significantly increased HPV vaccination rates using varied approaches across diverse populations. This finding is in stark contrast to a recent review that did not find effects to warrant widespread implementation for any educational intervention. To address the current suboptimal rates of HPV vaccination in the United States, future efforts

  20. Step It UP: a multicomponent intervention to increase stair use in a university residence building.

    PubMed

    Howie, Erin Kaye; Young, Deborah Rohm

    2011-01-01

    Examine the effects of a multicomponent intervention on stair usage. Nonrandomized controlled intervention. Two multistory university dormitories. Total of 5711 direct observations of university dormitory residents. The 2-week "Step It UP" intervention used poster prompts and fun/competitive challenges with incentives to encourage residents to take the stairs instead of the elevators. Ascending stair and elevator use was directly observed and coded for gender at high traffic times in intervention and control dormitories for 14 nonconsecutive hours over 1 week each at baseline, midintervention, and 1 week postintervention. The proportions of ascending stair and elevator users were compared using χ(2) analyses. Baseline stair use was equal between intervention and control dormitories (24.9% and 27.8%, respectively; χ(2)[1, N  =  1849]  =  .08; p  =  .77). Stair use significantly increased from baseline in the intervention dormitory to 33.24% (χ(2)[1, N  =  2192]  =  18.44; p < .001) compared with no change in the control. Stair use returned to baseline in the intervention dormitory at postintervention (25.4%; χ(2)[1, N  =  2297]  =  .08; p  =  .78). There were no significant differences between genders. This multicomponent, short-duration intervention significantly increased stair usage in a university dormitory relative to the control but was unable to sustain the increase when prompts were removed. Campaigns to sustain stair use are needed. Formative assessment is required to determine what combinations of components may yield the most cost-effective approach for future interventions.

  1. Maintenance of Increased Childhood Influenza Vaccination Rates 1 Year After an Intervention in Primary Care Practices.

    PubMed

    Nowalk, Mary Patricia; Zimmerman, Richard K; Lin, Chyongchiou Jeng; Reis, Evelyn Cohen; Huang, Hsin-Hui; Moehling, Krissy K; Hannibal, Kristin M; Matambanadzo, Annamore; Shenouda, Emeil M; Allred, Norma J

    2016-01-01

    Influenza vaccination rates among some groups of children remain below the Healthy People 2020 goal of 70%. Multistrategy interventions to increase childhood influenza vaccination have not been evaluated recently. Twenty pediatric and family medicine practices were randomly assigned to receive the intervention in either year 1 or year 2. This study focuses on influenza vaccine uptake in the 10 year 1 intervention sites during intervention and the following maintenance year. The intervention included the 4 Pillars Immunization Toolkit-a practice improvement toolkit, early delivery of donated vaccine for disadvantaged children, staff education, and feedback on progress. During the maintenance year, practices were not assisted or contacted, except to complete follow-up surveys. Student's t tests assessed vaccine uptake of children aged 6 months to 18 years, and multilevel regression modeling in repeated measures determined variables related to the likelihood of vaccination. Influenza vaccine uptake increased 12.4 percentage points (PP; P < .01) during active intervention and uptake was sustained (+0.4 PP; P > .05) during maintenance, for an average change of 12.7 PP over all sites, increasing from 42.2% at baseline to 54.9% (P < .001) during maintenance. In regression modeling that controlled for age, race, and insurance, likelihood of vaccination was greater during intervention than baseline (odds ratio 1.47; 95% confidence interval 1.44-1.50; P < .001) and greater during maintenance than baseline (odds ratio 1.50; 95% confidence interval 1.47-1.54; P < .001). In primary care practices, a multistrategy intervention that included the 4 Pillars Immunization Toolkit, early delivery of vaccine, and feedback was associated with significant improvements in childhood influenza vaccination rates that were maintained 1 year after active intervention. Copyright © 2016 Academic Pediatric Association. All rights reserved.

  2. Effectiveness of iterative interventions to increase research productivity in one residency program

    PubMed Central

    Alweis, Richard; Wenderoth, Suzanne; Donato, Anthony

    2015-01-01

    Background The Accreditation Council for Graduate Medical Education requires residency programs to expose residents to research opportunities. Objective The purpose of this study was to assess the impact of a series of iterative interventions to increase scholarly activity in one internal medicine residency. Methods Retrospective analysis of the effectiveness of a series of interventions to increase resident and faculty scholarly productivity over a 14-year period was performed using quality improvement methodology. Outcomes measured were accepted regional and national abstracts and PubMed indexed manuscripts of residents and faculty. Results Initially, regional meeting abstracts increased and then were supplanted by national meeting abstracts. Sustained gains in manuscript productivity occurred in the eighth year of interventions, increasing from a baseline of 0.01 publications/FTE/year to 1.57 publications/FTE/year in the final year measured. Run chart analysis indicated special cause variation associated with the interventions performed. Conclusions Programs attempting to stimulate research production among faculty and residents can choose among many interventions cited in the literature. Since success of any group of interventions is likely additive and may take years to show benefit, measuring outcomes using quality improvement methodology may be an effective way to determine success. PMID:26653689

  3. Evaluation of a brief intervention for increasing seat belt use on a college campus.

    PubMed

    Pastò, L; Baker, A G

    2001-07-01

    The authors evaluated a brief intervention for increasing seat belt use among the front seat occupants of cars at a junior college, in a jurisdiction with a mandatory belt use law. The intervention included public posting of performance feedback and distribution of an informational flyer to cars in target parking lot. Feedback was the display of the proportion of drivers observed wearing seat belts on the previous observation day. Seat belt use among drivers increased from 64% during the baseline phase to 71% during the intervention phase. Seat belt use among front passengers increased from 49% during the baseline phase to 67% during the intervention phase. In both cases, seat belt use at follow-up was comparable to seat belt use during the intervention phase, although a trend toward decreasing belt use was noted. Also found was higher seat belt use among females as compared with males irrespective of their front seat occupant status (driver or passenger). Effects of the intervention are discussed in the context of increasing seat belt use in a hardcore nonuser population of predominantly young adults.

  4. Interventions to Increase Physical Activity in Children Aged 2-5 Years: A Systematic Review.

    PubMed

    Ling, Jiying; Robbins, Lorraine B; Wen, Fujun; Peng, Wei

    2015-08-01

    Comprehensive evaluation of prior interventions designed to increase preschoolers' physical activity is lacking. This systematic review aimed to examine the effect of interventions on objectively measured physical activity in children aged 2-5 years. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. In May 2014, we searched PubMed, CINAHL, PsycINFO, ERIC, SPORTDiscus, Cochrane, and Embase. Two reviewers independently identified and appraised the studies. Twenty-four articles describing 23 independent studies and 20 unique interventions met inclusion criteria. Of the 8 interventions resulting in a significant effect in objectively measured physical activity, all were center-based and included a structured physical activity component, 6 included multiple components, 5 integrated theories or models, and 4 actively involved parents. Seven of the 8 were randomized controlled trials. Due to the heterogeneity of the study designs, physical activity measures, and interventions, drawing definitive conclusions was difficult. Although the overall intervention effect was less than optimal, the review indicated that theory-driven, multicomponent interventions including a structured physical activity component and targeting both parents and their children may be a promising approach for increasing preschoolers' physical activity and warrant continued investigation using rigorous designs to identify those that are most effective.

  5. A Culturally-Specific Dance Intervention to Increase Functional Capacity in African American Women

    PubMed Central

    Murrock, Carolyn J.; Gary, Faye A.

    2013-01-01

    This study examined a culturally-specific dance intervention on functional capacity in African American women at three time points. The intervention was two times per week for 8 weeks using two African American churches randomly assigned to either the experimental or comparison group, had 126 participants, ages 36–82 years. Analysis of covariance revealed that both groups improved over time and the only significant difference between groups was at 18 weeks. The increase at 18 weeks in the experimental group remained when controlling for baseline covariates. This study supported culturally-specific dance as an intervention to improve functional capacity in African American women. PMID:19202718

  6. A culturally-specific dance intervention to increase functional capacity in African American women.

    PubMed

    Murrock, Carolyn J; Gary, Faye A

    2008-01-01

    This study examined a culturally-specific dance intervention on functional capacity in African American women at three time points. The intervention was two times per week for 8 weeks using two African American churches randomly assigned to either the experimental or comparison group, had 126 participants, ages 36-82 years. Analysis of covariance revealed that both groups improved over time and the only significant difference between groups was at 18 weeks. The increase at 18 weeks in the experimental group remained when controlling for baseline covariates. This study supported culturally-specific dance as an intervention to improve functional capacity in African American women.

  7. Increasing Access to an ASD Imitation Intervention Via a Telehealth Parent Training Program.

    PubMed

    Wainer, Allison L; Ingersoll, Brooke R

    2015-12-01

    Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed internet-based instruction with remote coaching, was created to introduce parents of children with ASD to an imitation intervention. A single-subject multiple-baseline design study evaluated the effect of the program on changes in parent and child behavior. Parents improved in their use of the intervention techniques and their children demonstrated concurrent increases in spontaneous imitation skills. Parents also indicated that the intervention and telehealth service delivery model were acceptable, useable, and effective. Results suggest that this hybrid telehealth program has the potential to increase access to ASD services.

  8. Community-based interventions to promote increased physical activity: a primer.

    PubMed

    Bopp, Melissa; Fallon, Elizabeth

    2008-01-01

    Current recommendations, based on an abundance of empirical data documenting the impact of physical activity (PA) on preventing morbidity and mortality associated with common chronic diseases, indicate that adults should accumulate 30 minutes of moderate-intensity PA > or =5 days per week. However, worldwide rates of PA remain low, indicating a great need for large-scale implementation of evidence-based PA interventions. We briefly present practical aspects of intervention planning, implementation and evaluation within common community settings. The first stage of intervention planning is formative research, which allows for a better understanding of the elements needed for a successful intervention. Partnering with community settings (schools, worksites, faith-based organizations and healthcare organizations) offers many benefits and the opportunity to reach specific populations. Setting-based approaches allow for multilevel strategies, ranging from individual-based programmes and educational initiatives to physical and social environmental changes. Various settings such as healthcare, worksite, and school- and community-based settings are discussed. Intervention delivery methods and strategies can range, depending on the population and setting targeted, from small-group approaches to mediated methods (e.g. print, telephone, electronic). The final phase of intervention planning and implementation is evaluation. Several objective and subjective methods of PA assessment are available to determine the effectiveness of the intervention. We have highlighted the need for process evaluation of intervention implementation to provide valuable information for the dissemination and sustainability of successful interventions. Although there are numerous considerations for the design, implementation, assessment and evaluation of PA interventions, the potential for positive impact on the overall health of the public indicates the necessity for programmes designed to increase PA.

  9. Factors affecting acceptability of an email-based intervention to increase fruit and vegetable consumption.

    PubMed

    Kothe, Emily J; Mullan, Barbara A

    2014-09-30

    Fresh Facts is a 30-day email-delivered intervention designed to increase the fruit and vegetable consumption of Australian young adults. This study investigated the extent to which the program was acceptable to members of the target audience and examined the relationships between participant and intervention characteristics, attrition, effectiveness, and acceptability ratings. Young adults were randomised to two levels of message frequency: high-frequency (n = 102), low-frequency (n = 173). Individuals in the high-frequency group received daily emails while individuals in the low-frequency group received an email every 3 days. Individuals in the high-frequency group were more likely to indicate that they received too many emails than individuals in the low-frequency group. No other differences in acceptability were observed. Baseline beliefs about fruit and vegetables were an important predictor of intervention acceptability. In turn, acceptability was associated with a number of indicators of intervention success, including change in fruit and vegetable consumption. The findings highlight the importance of considering the relationship between these intervention and participant factors and acceptability in intervention design and evaluation. Results support the ongoing use of email-based interventions to target fruit and vegetable consumption within young adults. However, the relationships between beliefs about fruit and vegetable consumption and acceptability suggest that this intervention may be differentially effective depending on individual's existing beliefs about fruit and vegetable consumption. As such, there is a pressing need to consider these factors in future research in order to minimize attrition and maximize intervention effectiveness when interventions are implemented outside of a research context.

  10. Interventions to increase physician efficiency and comfort with an electronic health record system.

    PubMed

    Jalota, L; Aryal, M R; Mahmood, M; Wasser, T; Donato, A

    2015-01-01

    To determine comfort when using the Electronic Health Record (EHR) and increase in documentation efficiency after an educational intervention for physicians to improve their transition to a new EHR. This study was a single-center randomized, parallel, non-blinded controlled trial of real-time, focused educational interventions by physician peers in addition to usual training in the intervention arm compared with usual training in the control arm. Participants were 44 internal medicine physicians and residents stratified to groups using a survey of comfort with electronic media during rollout of a system-wide EHR and order entry system. Outcomes were median time to complete a progress note, notes completed after shift, and comfort with EHR at 20 and 40 shifts. In the intervention group, 73 education sessions averaging 14.4 (SD: 7.7) minutes were completed with intervention group participants, who received an average of 3.47 (SD: 2.1) interventions. Intervention group participants decreased their time to complete a progress note more quickly than controls over 30 shifts (p < 0.001) and recorded significantly fewer progress notes after scheduled duty hours (77 versus 292, p < 0.001). Comfort with EHRs increased significantly in both groups from baseline but did not differ significantly by group. Intervention group participants felt that the intervention was more helpful than their standard training (3.47 versus 1.95 on 4-point scale). Physicians teaching physicians during clinical work improved physician efficiency but not comfort with EHRs. More study is needed to determine best methods to assist those most challenged with new EHR rollouts.

  11. Promising school-based strategies and intervention guidelines to increase physical activity of adolescents.

    PubMed

    Murillo Pardo, Berta; García Bengoechea, Enrique; Generelo Lanaspa, Eduardo; Bush, Paula L; Zaragoza Casterad, Javier; Julián Clemente, José A; García González, Luis

    2013-06-01

    This narrative review describes the available scientific evidence regarding promising school-based strategies to increase physical activity of adolescents. We conducted a literature search for studies published up to 2011, regarding adolescent physical activity intervention studies that resulted in increased physical activity (regardless of measurement) and reviewed 52 intervention articles and 21 review articles. We identified several promising strategies and grouped into five broad intervention guidelines. These guidelines are as follows: (i) design multi-component interventions that foster the empowerment of members of the school community; (ii) develop improvements to Physical Education curricula as a strategy to promote physical activity to adolescents; (iii) design and implement non-curricular programmes and activities to promote physical activity; (iv) include computer-tailored interventions during the implementation and monitoring of physical activity promotion programmes and (v) design and implement specific strategies that respond to the interests and needs of girls. On the basis of our review of the adolescent physical activity promotion literature, we suggest that these five guidelines should be taken into account in school-based interventions geared towards achieving an increase in adolescent physical activity.

  12. Regular consumption of n-3 fatty acid-enriched pork modifies cardiovascular risk factors.

    PubMed

    Coates, Alison M; Sioutis, Stelios; Buckley, Jonathan D; Howe, Peter R C

    2009-02-01

    The long-chain (LC) n-3 PUFA content of pork, particularly DHA, can be increased by including 15% PorcOmega (a fortified tuna fishmeal product) in pig finisher diets. The aim of the present study was to see whether this enriched pork could deliver cardiovascular health benefits to consumers. In a double-blind intervention trial, thirty-three healthy adult volunteers (sixteen female and seventeen male) were randomised to consume either n-3-enriched or regular (control) pork (a selection of five fresh cuts totalling 1000 g/week) for 12 weeks. Fasting blood samples were collected every 4 weeks and analysed for serum lipids, maximally stimulated thromboxane production and erythrocyte fatty acid composition. The n-3-enriched pork provided subjects with 1.3 g LC n-3 PUFA per week. Erythrocyte DHA levels rose 15% in the n-3 group and fell 5% in the control group over 12 weeks (P=0.001). Compared with the control group, serum TAG decreased to a greater extent in the n-3 group (P=0.02) and serum thromboxane production increased to a lesser extent (P=0.004). Changes in the latter were inversely associated with changes in incorporation of DHA into erythrocytes (r -0.54; P<0.05). Thus the modest increases in LC n-3 PUFA intake resulting from regular consumption of enriched pork can improve cardiovascular risk factors.

  13. Packaging interventions to increase medication adherence: systematic review and meta-analysis.

    PubMed

    Conn, Vicki S; Ruppar, Todd M; Chan, Keith C; Dunbar-Jacob, Jacqueline; Pepper, Ginette A; De Geest, Sabina

    2015-01-01

    Inadequate medication adherence is a widespread problem that contributes to increased chronic disease complications and health care expenditures. Packaging interventions using pill boxes and blister packs have been widely recommended to address the medication adherence issue. This meta-analysis review determined the overall effect of packaging interventions on medication adherence and health outcomes. In addition, we tested whether effects vary depending on intervention, sample, and design characteristics. Extensive literature search strategies included examination of 13 computerized databases and 19 research registries, hand searches of 57 journals, and author and ancestry searches. Eligible studies included either pill boxes or blister packaging interventions to increase medication adherence. Primary study characteristics and outcomes were reliably coded. Random-effects analyses were used to calculate overall effect sizes and conduct moderator analyses. Data were synthesized across 22,858 subjects from 52 reports. The overall mean weighted standardized difference effect size for two-group comparisons was 0.593 (favoring treatment over control), which is consistent with the mean of 71% adherence for treatment subjects compared to 63% among control subjects. We found using moderator analyses that interventions were most effective when they used blister packs and were delivered in pharmacies, while interventions were less effective when studies included older subjects and those with cognitive impairment. Methodological moderator analyses revealed significantly larger effect sizes in studies reporting continuous data outcomes instead of dichotomous results and in studies using pharmacy refill medication adherence measures compared with studies with self-report measures. Overall, meta-analysis findings support the use of packaging interventions to effectively increase medication adherence. Limitations of the study include the exclusion of packaging interventions other

  14. Packaging interventions to increase medication adherence: systematic review and meta-analysis

    PubMed Central

    Conn, Vicki S.; Ruppar, Todd M.; Chan, Keith C.; Dunbar-Jacob, Jacqueline; Pepper, Ginette A.; De Geest, Sabina

    2015-01-01

    Objective Inadequate medication adherence is a widespread problem that contributes to increase chronic disease complications and health care expenditures. Packaging interventions using pill boxes and blister packs have been widely recommended to address the medication adherence issue. This meta-analysis review determined the overall effect of packaging interventions on medication adherence and health outcomes. In addition, we tested whether effects vary depending on intervention, sample, and design characteristics. Research design and methods Extensive literature search strategies included examination of 13 computerized databases and 19 research registries, hand searches of 57 journal, and author and ancestry searches. Eligible studies included either pill-boxes or blister packaging interventions to increase medication adherence. Primary study characteristics and outcomes were reliably coded. Random-effects analyses were used to calculate overall effect sizes and conduct moderator analyses. Results Data were synthesized across 22,858 subjects from 52 reports. The overall mean weighted standardized difference effect size for two-group comparisons was 0.593 (favoring treatment over control), which is consistent with the mean of 71% adherence for treatment subjects compared to 63% among control subjects. We found using moderator analyses that interventions were most effective when they used blister packs and were delivered in pharmacies, while interventions were less effective when studies included older subjects and those with cognitive impairment. Methodological moderator analyses revealed significantly larger effect sizes in studies reporting continuous data outcomes instead of dichotomous results and in studies using pharmacy refill medication adherence measures as compared to studies with self-report measures. Conclusions Overall, meta-analysis findings support the use of packaging interventions to effectively increase medication adherence. Limitations of the

  15. Effectiveness of Parent-Focused Interventions to Increase Teen Driver Safety:A Critical Review

    PubMed Central

    Curry, Allison E.; Peek-Asa, Corinne; Hamann, Cara J.; Mirman, Jessica H.

    2015-01-01

    Purpose We critically reviewed recent parent-directed teen driving interventions in order to summarize their success in meeting stated goals; identify promising intervention components and knowledge gaps; aid in the selection, adaptation, and dissemination of effective interventions; and guide future research efforts. Methods We focused on interventions that included a direct parent component, explicitly stated outcomes related to the teen and/or their parents, were evaluated for parent or teen outcomes, targeted drivers under age 21, and had at least one evaluation study published since 1990 and in English. We conducted a comprehensive systematic search of 26 online databases between November 2013 and January 2014 and identified 34 papers representing 18 interventions. Results Several interventions—in particular those that had an active engagement component, incorporated an in-vehicle data recorder system, and had a strong conceptual approach—show promise in improving parental supervisory behaviors during the learner and early independent phases, increasing teen driver skill acquisition, and reducing teens' risky driving behaviors. Conclusions We identify essential characteristics of effective parent-involved teen driving interventions and their evaluation studies, propose a comprehensive and multi-tiered approach to intervention, and discuss several research areas and overarching issues for consideration. PMID:26112737

  16. Promising School-Based Strategies and Intervention Guidelines to Increase Physical Activity of Adolescents

    ERIC Educational Resources Information Center

    Pardo, Berta Murillo; Bengoechea, Enrique Garcia; Lanaspa, Eduardo Generelo; Bush, Paula L.; Casterad, Javier Zaragoza; Clemente, Jose A. Julian; Gonzalez, Luis Garcia

    2013-01-01

    This narrative review describes the available scientific evidence regarding promising school-based strategies to increase physical activity of adolescents. We conducted a literature search for studies published up to 2011, regarding adolescent physical activity intervention studies that resulted in increased physical activity (regardless of…

  17. Interventions That Increase Enrolment of Women in Higher Education: The University of Dar es Salaam, Tanzania

    ERIC Educational Resources Information Center

    Kilango, Nasero Charles; Qin, Yu Hai; Nyoni, Watende Pius; Senguo, Richard Allen

    2017-01-01

    Gender equality and equity has long been a focus area in Tanzanian government, encouraging the increased recruitment of female students in to higher education. This article investigates the effectiveness of affirmative action policy interventions that introduced and designed to increase female students' enrolment at the University of Dar es…

  18. Promising School-Based Strategies and Intervention Guidelines to Increase Physical Activity of Adolescents

    ERIC Educational Resources Information Center

    Pardo, Berta Murillo; Bengoechea, Enrique Garcia; Lanaspa, Eduardo Generelo; Bush, Paula L.; Casterad, Javier Zaragoza; Clemente, Jose A. Julian; Gonzalez, Luis Garcia

    2013-01-01

    This narrative review describes the available scientific evidence regarding promising school-based strategies to increase physical activity of adolescents. We conducted a literature search for studies published up to 2011, regarding adolescent physical activity intervention studies that resulted in increased physical activity (regardless of…

  19. Modulation of atherosclerosis by N-3 polyunsaturated fatty acids

    USDA-ARS?s Scientific Manuscript database

    We have reviewed literature regarding the effects of n-3 polyunsaturated fatty acids (PUFA) on risk factors for atherosclerosis in human subjects. Dietary intervention with long chain n-3 PUFA decreased some risk factor (s) for atherosclerosis in most human studies reviewed. These benefits resulted ...

  20. Therapeutic Interventions for Increasing Ankle Dorsiflexion After Ankle Sprain: A Systematic Review

    PubMed Central

    Terada, Masafumi; Pietrosimone, Brian G.; Gribble, Phillip A.

    2013-01-01

    Context: Clinicians perform therapeutic interventions, such as stretching, manual therapy, electrotherapy, ultrasound, and exercises, to increase ankle dorsiflexion. However, authors of previous studies have not determined which intervention or combination of interventions is most effective. Objective: To determine the magnitude of therapeutic intervention effects on and the most effective therapeutic interventions for restoring normal ankle dorsiflexion after ankle sprain. Data Sources: We performed a comprehensive literature search in Web of Science and EBSCO HOST from 1965 to May 29, 2011, with 19 search terms related to ankle sprain, dorsiflexion, and intervention and by cross-referencing pertinent articles. Study Selection: Eligible studies had to be written in English and include the means and standard deviations of both pretreatment and posttreatment in patients with acute, subacute, or chronic ankle sprains. Outcomes of interest included various joint mobilizations, stretching, local vibration, hyperbaric oxygen therapy, electrical stimulation, and mental-relaxation interventions. Data Extraction: We extracted data on dorsiflexion improvements among various therapeutic applications by calculating Cohen d effect sizes with associated 95% confidence intervals (CIs) and evaluated the methodologic quality using the Physiotherapy Evidence Database (PEDro) scale. Data Synthesis: In total, 9 studies (PEDro score = 5.22 ± 1.92) met the inclusion criteria. Static-stretching interventions with a home exercise program had the strongest effects on increasing dorsiflexion in patients 2 weeks after acute ankle sprains (Cohen d = 1.06; 95% CI = 0.12, 2.42). The range of effect sizes for movement with mobilization on ankle dorsiflexion among individuals with recurrent ankle sprains was small (Cohen d range = 0.14 to 0.39). Conclusions: Static-stretching intervention as a part of standardized care yielded the strongest effects on dorsiflexion after acute ankle sprains. The

  1. Interventions to increase physical activity and healthy eating among overweight and obese children in Mexico.

    PubMed

    Eisenberg, Christina M; Sánchez-Romero, Luz María; Rivera-Dommarco, Juan A; Holub, Christina K; Arredondo, Elva M; Elder, John P; Barquera, Simón

    2013-01-01

    The purpose of the present study was to conduct a systematic literature review of obesity interventions that focused on increasing physical activity and healthy eating among overweight and obese children in Mexico. Data was taken from a larger literature review focused on obesity interventions for Latinos in Latin America and the United States. Study design suitability, quality of execution, and effect size were assessed for a subset of these articles. There were six intervention studies included in the present review. Five studies showed reductions in obesity-related outcomes, while one study reported gains in body mass index (BMI). Physical activity and healthy eating remain constant components in obesity treatment interventions, which highlights the importance of understanding evidence-based strategies to guide future research to reduce childhood obesity in Mexico.

  2. A practice-centered intervention to increase screening for domestic violence in primary care practices.

    PubMed

    Bonds, Denise E; Ellis, Shellie D; Weeks, Erin; Palla, Shana L; Lichstein, Peter

    2006-10-25

    Interventions to change practice patterns among health care professionals have had mixed success. We tested the effectiveness of a practice centered intervention to increase screening for domestic violence in primary care practices. A multifaceted intervention was conducted among primary care practice in North Carolina. All practices designated two individuals to serve as domestic violence resources persons, underwent initial training on screening for domestic violence, and participated in 3 lunch and learn sessions. Within this framework, practices selected the screening instrument, patient educational material, and content best suited for their environment. Effectiveness was evaluated using a pre/post cross-sectional telephone survey of a random selection of female patients from each practice. Seventeen practices were recruited and fifteen completed the study. Baseline screening for domestic violence was 16% with a range of 2% to 49%. An absolute increase in screening of 10% was achieved (range of increase 0 to 22%). After controlling for clustering by practice and other patient characteristics, female patients were 79% more likely to have been screened after the intervention (OR 1.79, 95% CI 1.43-2.23). An intervention that allowed practices to tailor certain aspects to fit their needs increased screening for domestic violence. Further studies testing this technique using other outcomes are needed.

  3. Evaluation of a 3year intervention to increase adoption of safer nursery crop production practices.

    PubMed

    Chapman, Larry J; Newenhouse, Astrid C; Karsh, Ben-Tzion

    2010-01-01

    We conducted a 3year intervention to increase awareness and adoption of eight more profitable nursery crop production practices that reduced certain traumatic and musculoskeletal injury hazards. We disseminated information to nursery managers across seven states using information channels they were known to rely on (e.g. trade publications, public events, university Extension, other managers). We evaluated rolling, independent, probability samples (n=1200) with mail questionnaires before the intervention and after each of 3 intervention years. We also evaluated samples (n=250) from a comparison group of New Zealand nursery managers. The intervention was associated with increased awareness of four of the eight practices among US managers after year 3 compared to their baseline: zippers (20 vs. 32%, pincreased for hoes after year 2 compared to their baseline (35 vs. 52%, pintervention was associated with increased awareness, but not adoption.

  4. Interventions to Increase Treatment Adherence in Pediatric Atopic Dermatitis: A Systematic Review

    PubMed Central

    Bass, Alexandria M.; Anderson, Kathryn L.; Feldman, Steven R.

    2015-01-01

    Poor adherence to treatment is a major factor limiting treatment outcomes in patients with atopic dermatitis. The purpose of our systematic review is to identify techniques that have been tested to increase treatment adherence in atopic dermatitis. A MEDLINE search was performed for clinical trials focusing on interventions used to increase adherence in atopic dermatitis. Four articles were retrieved. References of these studies were analyzed yielding three more trials. The seven results were evaluated by comparing the intervention used to improve adherence, how adherence was assessed, and the outcome of the intervention tested. Different approaches to increase adherence such as written eczema action plans, educational workshops, extra office visits, and use of an atopic dermatitis educator were evaluated. All interventions increased adherence rates or decreased severity in patients, except for two. The MEDLINE search yielded limited results due to a lack of studies conducted specifically for atopic dermatitis and adherence was measured using different methods making the studies difficult to compare. Interventions including patient education, eczema action plans, and a quick return for a follow-up visit improve adherence, but based on the lack of clinical trials, developing new techniques to improve adherence could be as valuable as developing new treatments. PMID:26239125

  5. Dietary intervention with Okinawan vegetables increased circulating endothelial progenitor cells in healthy young women.

    PubMed

    Mano, Rieko; Ishida, Akio; Ohya, Yusuke; Todoriki, Hidemi; Takishita, Shuichi

    2009-06-01

    Circulating endothelial progenitor cells (EPCs) play a critical role in maintaining the integrity of vascular vessels. The number of EPCs inversely correlates with the number of atherosclerotic risk factors. Although nonpharmacological treatment represents the first approach to the primary prevention of atherosclerotic diseases, little is known about the effects of diet on EPCs. We investigated the effect of a dietary intervention with vegetables that are commonly eaten in Okinawa on the number of EPCs. Forty-five healthy young women were employed and randomized to a dietary intervention group (n=24) or a control group (n=21). Subjects in the intervention group received typical Okinawan vegetables through home-parcel delivery for 2 weeks. After the dietary intervention, urinary potassium and magnesium excretion increased only in the intervention group and changes were greater than in the control group (p=0.007, 0.010, respectively). The consumption of total vegetables correlated with changes in both urinary potassium and magnesium excretion. Serum folic acid increased and plasma homocysteine decreased in both groups but the change was significant only in the intervention group. The EPCs number significantly increased in the intervention group but did not in the control group. An inverse correlation was observed between EPC number and plasma homocysteine level (r=-0.272, p=0.016). Changes in the EPC number inversely correlated with changes in both serum total cholesterol and low-density lipoprotein cholesterol level (r=-0.555, p=0.0002; r=-0.626, p<0.0001, respectively). The consumption of vegetables increased the number of circulating EPCs; this change might be associated with a homocysteine-lowering effect.

  6. Meta-analysis of internet-delivered interventions to increase physical activity levels

    PubMed Central

    2012-01-01

    Many internet-delivered physical activity behaviour change programs have been developed and evaluated. However, further evidence is required to ascertain the overall effectiveness of such interventions. The objective of the present review was to evaluate the effectiveness of internet-delivered interventions to increase physical activity, whilst also examining the effect of intervention moderators. A systematic search strategy identified relevant studies published in the English-language from Pubmed, Proquest, Scopus, PsychINFO, CINHAL, and Sport Discuss (January 1990 – June 2011). Eligible studies were required to include an internet-delivered intervention, target an adult population, measure and target physical activity as an outcome variable, and include a comparison group that did not receive internet-delivered materials. Studies were coded independently by two investigators. Overall effect sizes were combined based on the fixed effect model. Homogeneity and subsequent exploratory moderator analysis was undertaken. A total of 34 articles were identified for inclusion. The overall mean effect of internet-delivered interventions on physical activity was d = 0.14 (p = 0.00). Fixed-effect analysis revealed significant heterogeneity across studies (Q = 73.75; p = 0.00). Moderating variables such as larger sample size, screening for baseline physical activity levels and the inclusion of educational components significantly increased intervention effectiveness. Results of the meta-analysis support the delivery of internet-delivered interventions in producing positive changes in physical activity, however effect sizes were small. The ability of internet-delivered interventions to produce meaningful change in long-term physical activity remains unclear. PMID:22546283

  7. Interventions to increase the uptake of seasonal influenza vaccination among pregnant women: A systematic review.

    PubMed

    Wong, Valerie W Y; Lok, Kris Y W; Tarrant, Marie

    2016-01-02

    Pregnant women and their infants under 6 months of age infected with influenza have a high risk of serious morbidity and mortality. Influenza vaccine during pregnancy offers 3-for-1 benefits to pregnant women, fetuses and newborn infants. Current vaccination uptake rates during pregnancy, however, are often lower than other high-risk groups and the general population. We systematically reviewed evidence on the effectiveness of interventions to improve influenza vaccination coverage in pregnant women. Risk differences (RDs) were calculated from the included studies. Eleven studies were included in the review, of which four were randomized controlled trials (RCTs). Three cohort studies assessed provider-focused interventions while four RCTs and one cohort study evaluated pregnant women-focused interventions. Two cohort studies and a prospective intervention study assessed the effectiveness of bundled interventions. No study solely assessed the effectiveness of interventions to enhance access to influenza vaccination. One moderate quality RCT showed that an influenza pamphlet, with or without a verbalized benefit statement, improved the vaccination rate (RD=0.26; RD=0.39). The other reviewed RCTs showed discordant results, with RDs ranging from -0.15 to 0.03. Although all observational studies significantly improved vaccination rates (RDs ranged from 0.03 to 0.44), the quality of the evidence varied. There is a lack of effective interventions to increase the influenza vaccination rate in pregnant women. Based on the existing research, we recommend that clinicians provide influenza pamphlets to pregnant women with a verbalized statement about the benefits of influenza vaccine to newborns. Further high-quality RCTs are needed to develop successful maternal influenza vaccination programs. Increased clarity in reporting the content of interventions would help to improve the comparability and generalizability of the published studies. Copyright © 2015 Elsevier Ltd. All

  8. Administrative interventions associated with increased initiation on antiretroviral therapy in Irkutsk, Siberia.

    PubMed

    Ogarkov, O B; Ebers, A; Zhdanova, S; Moiseeva, E; Koshcheyev, M E; Zorkaltseva, E; Shugaeva, S; Vitko, S; Lyles, G; Houpt, E R; Heysell, S K

    2016-12-21

    A bundle of initiatives to integrate human immunodeficiency virus (HIV) and tuberculosis (TB) services was assessed for the impact on antiretroviral therapy (ART) initiation at a TB referral hospital in Irkutsk, Russian Federation, from February 2014 to December 2015. The ART initiation rates in 166 ART-naïve patients undergoing anti-tuberculosis treatment (34.1% with multidrug or extensively drug-resistant TB) increased significantly from 14 (17%) pre-intervention to 44 (54%) post-intervention (P < 0.001). A survey of TB hospital staff identified administrative prioritisation as the most important initiative for increasing ART initiation.

  9. Administrative interventions associated with increased initiation on antiretroviral therapy in Irkutsk, Siberia

    PubMed Central

    Ogarkov, O. B.; Ebers, A.; Zhdanova, S.; Moiseeva, E.; Koshcheyev, M. E.; Zorkaltseva, E.; Shugaeva, S.; Vitko, S.; Lyles, G.; Houpt, E. R.

    2016-01-01

    A bundle of initiatives to integrate human immunodeficiency virus (HIV) and tuberculosis (TB) services was assessed for the impact on antiretroviral therapy (ART) initiation at a TB referral hospital in Irkutsk, Russian Federation, from February 2014 to December 2015. The ART initiation rates in 166 ART-naïve patients undergoing anti-tuberculosis treatment (34.1% with multidrug or extensively drug-resistant TB) increased significantly from 14 (17%) pre-intervention to 44 (54%) post-intervention (P < 0.001). A survey of TB hospital staff identified administrative prioritisation as the most important initiative for increasing ART initiation. PMID:28123963

  10. Health promotion interventions for increasing stroke awareness in ethnic minorities: a systematic review of the literature

    PubMed Central

    2014-01-01

    Background Stroke places a significant burden to all affected individuals, but it is perhaps more significant amongst members of black, minority and ethnic communities, who may experience poorer awareness of stroke symptoms than the general population. Recently, several initiatives tried to improve public awareness that symptoms of stroke need to be treated as a medical emergency. However, ethnic communities present cultural barriers, requiring tailored health promotion interventions, whose effectiveness remains uncertain. Our systematic review aimed to identify relevant published evidence, synthesize the main study components and identify evidence of the effectiveness of the interventions. Methods MEDLINE, EMBASE, CINAHL, and PsycInfo were searched for journal articles on health promotion interventions for increasing stroke awareness in ethnic minorities, published in English between 1995 and 2012. Search results were collaboratively assessed by the authors; included studies were analysed to identify their main characteristics, and a thematic analysis of their content was conducted. No meta-analysis was performed, due to the heterogeneity of results. Results Eighteen studies were included, reporting 15 interventions conducted in the US, for African-Americans or Hispanics; populations sizes differed between interventions. Interventions were mostly carried out in community settings with different educational techniques, focussing on experiential methods. Health professionals usually organized the programs, delivered by nurses, other health professionals or volunteers. The few theory-based interventions focussed on individual-level behavioural change. Practical cultural adaptation strategies were not linked to specific theoretical frameworks. Interventions widely differed as for target populations, settings, delivery methods, contents and professional roles involved. All study designs were quantitative, and the emerging evidence of effectiveness was inconclusive

  11. Outcomes of a Multi-faceted Educational Intervention to Increase Student Scholarship

    PubMed Central

    Nelson, Melissa; Slack, Marion; Warholak, Terri

    2015-01-01

    Objective. To increase the percentage of state, national, or international student presentations and publications. Design. A multi-faceted intervention to increase student scholarly output was developed that included: (1) a 120-minute lecture on publication of quality improvement or independent study research findings; (2) abstract workshops; (3) poster workshops; and (4) a reminder at an advanced pharmacy practice experience (APPE) meeting encouraging students to publish or present posters. The intervention effect was measured as the percent of students who presented at meetings and the number of student projects published. Assessment. A significant increase occurred in the percent of students who presented posters or published manuscripts after the intervention (64% vs 81%). Total student productivity increased from 84 to 147 posters, publications, and presentations. The number of projects presented or published increased from 50 to 77 in one year. Conclusion. This high-impact, low-cost intervention increased scholarly output and may help students stand out in a competitive job market. PMID:26430267

  12. A social communication intervention to increase validating comments by children with language impairment.

    PubMed

    Fujiki, Martin; Brinton, Bonnie; McCleave, Chelsea P; Anderson, Valyne W; Chamberlain, Janet P

    2013-01-01

    Four children identified with language impairment (LI) participated in a social communication intervention to increase the production of validating comments, including making positive statements, sharing information, and asking peers questions about themselves. A case study design was used. Baseline measures were collected from 3 cooperative learning sessions for each participant. The intervention lasted 10 weeks, with 40 (15-min) sessions for 3 of the children and 20 (30-min) sessions for the remaining child. Each week, participants took part in sessions of group instruction, novel peer play, and review with the clinician. Data monitoring the production of validating comments were taken from the novel peer play interactions. One child produced a notable increase in validating comments during intervention, and 2 other participants produced more modest improvement. All 3 maintained these gains in the follow-up sessions. The remaining participant produced little change from baseline during the intervention. With respect to social outcomes, changes were not noted in peer acceptance and friendship. Teachers reported notable improvement in the sociable behavior of 2 of the children. The 4 participants showed varied increases in the production of validating comments. Possible factors influencing the successful application of the intervention are discussed.

  13. Discounts on fruit and vegetables combined with a space management intervention increased sales in supermarkets.

    PubMed

    Toft, U; Winkler, L L; Mikkelsen, B E; Bloch, P; Glümer, C

    2017-04-01

    To examine the effects of two interventions on consumer purchases of fruits and vegetables (F&V) on the Danish island of Bornholm: a 20% discount on F&V combined with improved shelf-space allocation, and improved shelf-space allocation alone. A space management intervention to promote F&V sales was performed in two large discount supermarkets on Bornholm in Denmark for 3 months (September-November 2012). In addition, a 20% discount on F&V was introduced for 3 months in one of the supermarkets ('space + price'). The effect was evaluated using sales data from the two intervention supermarkets and three control supermarkets from the same supermarket chain but in Odsherred, Denmark (control area). Both the effect on sales of fresh F&V and potential unhealthy substitution effects were evaluated using multi-level regression analyses. During the price intervention period, the index number for sales of fresh vegetables increased by 22.2% (P=0.001) in the 'space + price' intervention supermarket compared with the control supermarkets. Furthermore, the index number for the sale of organic fresh fruit and vegetables increased by 12.1% (P=0.04) and the sale of the total amount of fruit and vegetables (fresh, frozen, dried and canned) increased by 15.3% (P=0.01) compared with the control supermarkets. In the 'space only' intervention supermarket no significant increase in the sale of fruit and vegetables was found. No unhealthy substitution effects were found. In conclusion, a 20% price reduction on F&V significantly increased sales of F&V. The effect was most pronounced on vegetables and no negative/unhealthy substitution effects were found.

  14. How can self-efficacy be increased? Meta-analysis of dietary interventions.

    PubMed

    Prestwich, Andrew; Kellar, Ian; Parker, Richard; MacRae, Siobhan; Learmonth, Matthew; Sykes, Bianca; Taylor, Natalie; Castle, Holly

    2014-01-01

    Targeting individuals' beliefs that they are able to eat healthily can improve dietary-related behaviours. However, the most effective behaviour change techniques (BCTs) to promote dietary self-efficacy have not been systematically reviewed. This research addressed this gap. Studies testing the effect of interventions on healthy eating and underlying dietary-related self-efficacy, within randomised controlled trials, were systematically reviewed in MEDLINE, EMBASE and PSYCINFO. Two reviewers independently coded intervention content in both intervention and comparison groups. Data pertaining to study quality were also extracted. Random effects meta-analysis was used to calculate an overall effect size on dietary self-efficacy for each study. The associations between 26 BCTs and self-efficacy effects were calculated using meta-regression. In some of the analyses, interventions that incorporated self-monitoring (tracking one's own food-related behaviour), provided feedback on performance, prompted review of behavioural goals, provided contingent rewards (rewarding diet success), or planned for social support/social change increased dietary self-efficacy significantly more than interventions that did not. Stress management was consistently associated with self-efficacy effects across all analyses. There was strong evidence for stress management and weaker evidence for a number of other BCTs. The findings can be used to develop more effective, theory- and evidence-based behavioural interventions.

  15. Do brief online planning interventions increase physical activity amongst university students? A randomised controlled trial.

    PubMed

    Skår, Silje; Sniehotta, Falko F; Molloy, Gerard J; Prestwich, Andrew; Araújo-Soares, Vera

    2011-04-01

    Brief planning interventions, usually delivered within paper and pencil questionnaires, have been found to be effective in changing health behaviours. Using a double-blind randomised controlled trial, this study examined the efficacy of two types of planning interventions (action plans and coping plans) in increasing physical activity levels when they are delivered via the internet. Following the completion of self-reported physical activity (primary outcome) and theory of planned behaviour (TPB) measures at baseline, students (N = 1273) were randomised into one of four conditions on the basis of a 2 (received instructions to form action plans or not) × 2 (received instructions to form coping plans or not) factorial design. Physical activity (primary outcome) and TPB measures were completed again at two-month follow-up. An objective measure (attendance at the university's sports facilities) was employed 6 weeks after a follow-up for a duration of 13 weeks (secondary outcome). The interventions did not change self-reported physical activity, attendance at campus sports facilities or TPB measures. This might be due to low adherence to the intervention protocol (ranging from 58.8 to 76.7%). The results of this study suggest that the planning interventions under investigation are ineffective in changing behaviour when delivered online to a sample of participants unaware of the allocation to different conditions. Possible moderators of the effectiveness of planning interventions in changing health behaviours are discussed.

  16. Can a school-based intervention increase children's fruit and vegetable consumption in the home setting?

    PubMed

    Taylor, Charlotte; Darby, Helena; Upton, Penney; Upton, Dominic

    2013-11-01

    Although previous research has shown the Food Dudes programme increases children's fruit and vegetable consumption at school, the evidence for the effectiveness in the home setting is more equivocal. The school environment is identified as a logical setting for targeting children's fruit and vegetable consumption; however, to produce sustainable changes in behaviour, it is equally important that interventions target consumption in the home setting. This study aimed to establish whether the Food Dudes intervention can influence home consumption of fruit and vegetables and the extent to which any changes in eating behaviour following the intervention were maintained in the long term. A total of 34 children aged 4-11 years from eight primary schools (four intervention and four control groups) in the West Midlands, United Kingdom, completed a 7-day photographic food diary at baseline (prior to the intervention), a 3-month follow-up (post-intervention) and a 12-month follow-up. The Food Dudes programme did not influence either short- or long-term changes in children's consumption of fruit and vegetables at home during weekdays or at the weekend. The Food Dudes programme had no effect on changing children's fruit and vegetable consumption in the home environment. Further development of the programme could consider how parental and home environmental factors may be combined with the principles of the Food Dudes programme to influence children's fruit and vegetable consumption in this setting.

  17. Multiple behavior interventions to prevent substance abuse and increase energy balance behaviors in middle school students.

    PubMed

    Velicer, Wayne F; Redding, Colleen A; Paiva, Andrea L; Mauriello, Leanne M; Blissmer, Bryan; Oatley, Karin; Meier, Kathryn S; Babbin, Steven F; McGee, Heather; Prochaska, James O; Burditt, Caitlin; Fernandez, Anne C

    2013-03-01

    This study examined the effectiveness of two transtheoretical model-tailored, computer-delivered interventions designed to impact multiple substance use or energy balance behaviors in a middle school population recruited in schools. Twenty middle schools in Rhode Island including sixth grade students (N=4,158) were stratified and randomly assigned by school to either a substance use prevention (decreasing smoking and alcohol) or an energy balance (increasing physical activity, fruit and vegetable consumption, and limiting TV time) intervention group in 2007. Each intervention involved five in-class contacts over a 3-year period with assessments at 12, 24, and 36 months. Main outcomes were analyzed using random effects modeling. In the full energy balance group and in subsamples at risk and not at risk at baseline, strong effects were found for physical activity, healthy diet, and reducing TV time, for both categorical and continuous outcomes. Despite no direct treatment, the energy balance group also showed significantly lower smoking and alcohol use over time than the substance use prevention group. The energy balance intervention demonstrated strong effects across all behaviors over 3 years among middle school students. The substance use prevention intervention was less effective than the energy balance intervention in preventing both smoking and alcohol use over 3 years in middle school students. The lack of a true control group and unrepresented secular trends suggest the need for further study.

  18. Interventions that increase the intention to seek voluntary HIV testing in young people: a review.

    PubMed

    Bumgarner, Kelly Feist; Pharr, Jennifer; Buttner, Mark; Ezeanolue, Echezona

    2017-03-01

    Young people 15-24 years old represent 39% of new HIV infections globally. However, they are the least likely age demographic to seek HIV testing and the most likely to be unaware of their HIV status. The purpose of this systematic literature review was to identify interventions that increase either rates of HIV testing or intentions to seek HIV testing in young people 10-24 years old. In total, 1601 manuscripts were systematically examined and five manuscripts were included in the final review. Two common themes identified in the interventions were education and test delivery methods. Educational programs were found to be effective when delivered in classroom or entertainment-based formats. Health providers offering testing and home testing increased the rate of testing. Additional research is needed on programs aimed at young people not enrolled in schools, interventions that measure testing rates, and educating healthcare providers about offering HIV tests to young people.

  19. Increasing Cervical Cancer Awareness and Screening in Jamaica: Effectiveness of a Theory-Based Educational Intervention

    PubMed Central

    Coronado Interis, Evelyn; Anakwenze, Chidinma P.; Aung, Maug; Jolly, Pauline E.

    2015-01-01

    Despite declines in cervical cancer mortality in developed countries, cervical cancer incidence and mortality rates remain high in Jamaica due to low levels of screening. Effective interventions are needed to decrease barriers to preventive behaviors and increase adoption of behaviors and services to improve prospects of survival. We enrolled 225 women attending health facilities in an intervention consisting of a pre-test, educational presentation and post-test. The questionnaires assessed attitudes, knowledge, risk factors, and symptoms of cervical cancer among women. Changes in knowledge and intention to screen were assessed using paired t-tests and tests for correlated proportions. Participants were followed approximately six months post-intervention to determine cervical cancer screening rates. We found statistically significant increases from pre-test to post-test in the percentage of questions correctly answered and in participants’ intention to screen for cervical cancer. The greatest improvements were observed in responses to questions on knowledge, symptoms and prevention, with some items increasing up to 62% from pre-test to post-test. Of the 123 women reached for follow-up, 50 (40.7%) screened for cervical cancer. This theory-based education intervention significantly increased knowledge of and intention to screen for cervical cancer, and may be replicated in similar settings to promote awareness and increase screening rates. PMID:26703641

  20. Increasing Cervical Cancer Awareness and Screening in Jamaica: Effectiveness of a Theory-Based Educational Intervention.

    PubMed

    Coronado Interis, Evelyn; Anakwenze, Chidinma P; Aung, Maug; Jolly, Pauline E

    2015-12-22

    Despite declines in cervical cancer mortality in developed countries, cervical cancer incidence and mortality rates remain high in Jamaica due to low levels of screening. Effective interventions are needed to decrease barriers to preventive behaviors and increase adoption of behaviors and services to improve prospects of survival. We enrolled 225 women attending health facilities in an intervention consisting of a pre-test, educational presentation and post-test. The questionnaires assessed attitudes, knowledge, risk factors, and symptoms of cervical cancer among women. Changes in knowledge and intention to screen were assessed using paired t-tests and tests for correlated proportions. Participants were followed approximately six months post-intervention to determine cervical cancer screening rates. We found statistically significant increases from pre-test to post-test in the percentage of questions correctly answered and in participants' intention to screen for cervical cancer. The greatest improvements were observed in responses to questions on knowledge, symptoms and prevention, with some items increasing up to 62% from pre-test to post-test. Of the 123 women reached for follow-up, 50 (40.7%) screened for cervical cancer. This theory-based education intervention significantly increased knowledge of and intention to screen for cervical cancer, and may be replicated in similar settings to promote awareness and increase screening rates.

  1. Student Content Knowledge Increases After Participation in a Hands-on Biotechnology Intervention

    NASA Astrophysics Data System (ADS)

    Bigler, Amber M.; Hanegan, Nikki L.

    2011-06-01

    Implementing biotechnology education through hands-on teaching methods should be considered by secondary biology teachers. This study is an experimental research design to examine increased student content knowledge in biotechnology after a hands-on biotechnology intervention. The teachers from both school groups participated in, Project Crawfish, a biotechnology professional development program. Students from both schools completed a pre and post assessment. The classroom was the unit of analysis. When the assessment was analyzed, each school had statistically significant increases in student content knowledge ( p < 0.0001 for the intervention school and p = 0.0481 for the control school). When the schools were compared to each other, a p-value of 0.0543 provided a suggestive relationship that the biotechnology intervention school had a larger increase in student content knowledge overall. When the assessment was divided into the five components, the intervention school showed significant increases in all five components. The control school had significant increases in student content knowledge in the PCR and DNA sequencing components ( p = 0.0459, p = 0.0043, respectively).

  2. An audit and feedback intervention study increased adherence to antibiotic prescribing guidelines at a Norwegian hospital.

    PubMed

    Høgli, June Utnes; Garcia, Beate Hennie; Skjold, Frode; Skogen, Vegard; Småbrekke, Lars

    2016-02-27

    Appropriate antibiotic prescribing is associated with favourable levels of antimicrobial resistance (AMR) and clinical outcomes. Most intervention studies on antibiotic prescribing originate from settings with high level of AMR. In a Norwegian hospital setting with low level of AMR, the literature on interventions for promoting guideline-recommended antibiotic prescribing in hospital is scarce and requested. Preliminary studies have shown improvement potentials regarding antibiotic prescribing according to guidelines. We aimed to promote appropriate antibiotic prescribing in patients with community-acquired pneumonia (CAP) and acute exacerbations of chronic obstructive pulmonary disease (AECOPD) at a respiratory medicine department in a Norwegian University hospital. Our specific objectives were to increase prescribing of appropriate empirical antibiotics, reduce high-dose benzylpenicillin and reduce total treatment duration. We performed an audit and feedback intervention study, combined with distribution of a recently published pocket version of the national clinical practice guideline. We included patients discharged with CAP or AECOPD and prescribed antibiotics during hospital stay, and excluded those presenting with aspiration, nosocomial infection and co-infections. The pre- and post-intervention period was 9 and 6 months, respectively. Feedback was provided orally to the department physicians at an internal-educational meeting. To explore the effect of the intervention on appropriate empirical antibiotics and mean total treatment duration we applied before-after analysis (Student's t-test) and interrupted time series (ITS). We used Pearson's χ2 to compare dose changes. In the pre-and post-intervention period we included 253 and 155 patients, respectively. Following the intervention, overall mean prescribing of appropriate empirical antibiotics increased from 61.7 to 83.8 % (P < 0.001), overall mean total treatment duration decreased from 11.2 to 10.4 days

  3. Behavioural intervention to increase physical activity in adults with coronary heart disease in Jordan.

    PubMed

    Alsaleh, Eman; Windle, Richard; Blake, Holly

    2016-07-26

    Patients with coronary heart disease often do not follow prescribed physical activity recommendations. The aim of this study was to assess the efficacy of a behavioural intervention to increase physical activity in patients with coronary heart disease not attending structured cardiac rehabilitation programmes. Parallel randomised controlled trial comparing 6-month multi-component behavioural change intervention (n = 71) with usual care (n = 85) was conducted in two hospitals in Jordan, Middle East. Intervention included one face-to-face individualised consultation, 6 telephone support calls (for goal-setting, feedback and self-monitoring) and 18 reminder text messages. Patients were randomly allocated to the two groups by opening opaque sealed sequence envelopes. The patients and the researcher who provided the intervention and assessed the outcomes were not blinded. Outcomes were assessed at baseline and 6 months. Primary outcome was physical activity level, secondary outcomes were blood pressure, body mass index, exercise self-efficacy for exercise and health-related quality of life. Intervention and control groups were comparable at baseline. Moderate physical activity significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 0.23 (0.87) days/week versus -.06 (0.40); duration: 15.53 (90.15) minutes/week versus -3.67 (22.60) minutes/week; intensity: 31.05 (105.98) Metabolic equivalents (METs) versus 14.68 (90.40) METs). Effect size was 0.03 for moderate PA frequency, 0.02 for moderate PA duration and 0.01 for moderate PA intensity. Walking significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 3.15 (2.75) days/week versus 0.37 (1.83) days/week; duration: 150.90 (124.47) minutes/week versus 24.05 (195.93) minutes/week; intensity: 495.12 (413.74) METs versus14.62 (265.06) METs). Effect size was 0.36 for walking frequency, 0.05 for walking duration, 0

  4. Bootstrapping N}=3 superconformal theories

    NASA Astrophysics Data System (ADS)

    Lemos, Madalena; Liendo, Pedro; Meneghelli, Carlo; Mitev, Vladimir

    2017-04-01

    We initiate the bootstrap program for N=3 superconformal field theories (SCFTs) in four dimensions. The problem is considered from two fronts: the protected subsector described by a 2 d chiral algebra, and crossing symmetry for half-BPS operators whose superconformal primaries parametrize the Coulomb branch of N=3 theories. With the goal of describing a protected subsector of a family of N=3 SCFTs, we propose a new 2 d chiral algebra with super Virasoro symmetry that depends on an arbitrary parameter, identified with the central charge of the theory. Turning to the crossing equations, we work out the superconformal block expansion and apply standard numerical bootstrap techniques in order to constrain the CFT data. We obtain bounds valid for any theory but also, thanks to input from the chiral algebra results, we are able to exclude solutions with N=4 supersymmetry,allowingustozoominonaspecific N=3 SCFT.

  5. A controlled trial of an intervention to increase resident choice in long-term care

    PubMed Central

    Schnelle, John F.; Rahman, Annie; Durkin, Daniel W.; Beuscher, Linda; Choi, Leena; Simmons, Sandra F.

    2013-01-01

    Objective The purpose of this study was to evaluate an intervention to improve staff offers of choice to nursing home (NH) residents during morning care. Design A controlled trial with a delayed intervention design. Setting Four community, for-profit nursing homes. Participants A total of 169 long-stay NH residents who required staff assistance with morning care and were able to express their care preferences. Intervention Research staff held weekly training sessions with nurse aides (NAs) for 12 consecutive weeks focused on how to offer choice during four targeted morning care areas: when to get out of bed, when to get dressed/what to wear, incontinence care (changing and/or toileting), and where to dine. Training sessions consisted of brief video vignettes illustrating staff-resident interactions followed by weekly feedback about how often choice was being provided based on standardized observations of care conducted weekly by research staff. Measurements Research staff conducted standardized observations during a minimum of 4 consecutive morning hours per participant per week for 12-weeks of baseline and 12-weeks of intervention. Results There was a significant increase in the frequency that choice was offered for three of the four targeted morning care areas from baseline to intervention: (1) out of bed, 21% to 33% (p< .001); dressing, 20% to 32% (p< .001); incontinence care, 18% to 23%, (p< .014). Dining location (8% to 13%) was not significant. There was also a significant increase in the amount of NA staff time to provide care from baseline to intervention (8.01 ± 9.0 to 9.68 ± 9.9 minutes per person, p< .001). Conclusion A staff training intervention improved the frequency with which NAs offered choice during morning care but also required more time. Despite significant improvements, choice was still offered one-third or less of the time during morning care. PMID:23294967

  6. The effectiveness of interventions to increase physical activity. A systematic review.

    PubMed

    Kahn, Emily B; Ramsey, Leigh T; Brownson, Ross C; Heath, Gregory W; Howze, Elizabeth H; Powell, Kenneth E; Stone, Elaine J; Rajab, Mummy W; Corso, Phaedra

    2002-05-01

    The Guide to Community Preventive Service's methods for systematic reviews were used to evaluate the effectiveness of various approaches to increasing physical activity: informational, behavioral and social, and environmental and policy approaches. Changes in physical activity behavior and aerobic capacity were used to assess effectiveness. Two informational interventions ("point-of-decision" prompts to encourage stair use and community-wide campaigns) were effective, as were three behavioral and social interventions (school-based physical education, social support in community settings, and individually-adapted health behavior change) and one environmental and policy intervention (creation of or enhanced access to places for physical activity combined with informational outreach activities). Additional information about applicability, other effects, and barriers to implementation are provided for these interventions. Evidence is insufficient to assess a number of interventions: classroom-based health education focused on information provision, and family-based social support (because of inconsistent findings); mass media campaigns and college-based health education and physical education (because of an insufficient number of studies); and classroom-based health education focused on reducing television viewing and video game playing (because of insufficient evidence of an increase in physical activity). These recommendations should serve the needs of researchers, planners, and other public health decision makers.

  7. A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals.

    PubMed

    Colquhoun, Heather L; Lamontagne, Marie-Eve; Duncan, Edward As; Fiander, Michelle; Champagne, Catherine; Grimshaw, Jeremy M

    2017-03-01

    To determine the types and effectiveness of interventions to increase the knowledge about, attitudes towards, and use of standardized outcome measures in rehabilitation professionals. An electronic search using Medline, EMBASE, PsycINFO, CINAHL, Ergonomics Abstracts, Sports Discus. The search is current to February 2016. All study designs testing interventions were included as were all provider and patient types. Two reviewers independently conducted a title and abstract review, followed by a full-text review. Two reviewers independently extracted a priori variables and used consensus for disagreements. Quality assessment was conducted using the Assessment of Quantitative Studies published by the Effective Public Health Practice Group. We identified 11 studies involving at least 1200 providers. Nine of the studies showed improvements in outcome measure use rates but only three of these studies used an experimental or quasi-experimental design. Eight of the studies used an educational approach in the intervention and three used audit and feedback. Poor intervention description and quality of studies limited recommendations. Increased attention to testing interventions focused on known barriers, matched to behavior change techniques, and with stronger designs is warranted.

  8. Low-n-6 and low-n-6 plus high-n-3 diets for use in clinical research

    PubMed Central

    MacIntosh, Beth A.; Ramsden, Christopher E.; Faurot, Keturah R.; Zamora, Daisy; Mangan, Margaret; Hibbeln, Joseph R.; Mann, J. Douglas

    2014-01-01

    Few trials have evaluated the metabolic effects and health outcomes of lowering dietary n-6 PUFA. The objectives of the present paper were (1) to report the methods employed to lower dietary n-6 PUFA, while either increasing or maintaining n-3 PUFA intake and (2) to validate our methods with 24 h recalls and erythrocyte fatty acid analyses. A total of sixty-seven subjects were randomised to either (1) an average-n-3 PUFA, low-n-6 PUFA (L6) intervention designed to lower linoleic acid (LA; ≤2·5 % of energy (en%)) and arachidonic acid (≤60 mg/d), while maintaining an average US intake of n-3 PUFA or (2) a high-n-3 PUFA, low-n-6 PUFA (H3-L6) intervention designed to lower n-6 LA, while increasing the n-3 PUFA α-linolenic acid (ALA; ≥1·5 en%) and EPA + DHA (≥1000 mg/d). Pre- and intra-intervention nutrient intakes were estimated with six 24 h dietary recalls per subject. Both groups achieved the targeted reductions in dietary LA to ≤2·5 en% (median LA 2·45 (2·1, 3·1); P<0·001). Intakes of n-3 PUFA did not change for the L6 group. Target increases in n-3 ALA (median 1·6 en%, (1·3, 2·0), P<0·001) and EPA + DHA (1482 mg, (374, 2558), P<0·001) were achieved in the H3-L6 group. Dietary changes were validated by corresponding changes in erythrocyte n-6 and n-3 fatty acid composition. Dietary LA can be lowered to ≤2·5 en%, with or without concurrent increases in dietary n-3 PUFA, in an outpatient clinical trial setting using this integrated diet method. PMID:23328113

  9. Do Reinforcement and Induction Increase Prosocial Behavior? Results of a Teacher-Based Intervention in Preschools

    ERIC Educational Resources Information Center

    Ramaswamy, Vidya; Bergin, Christi

    2009-01-01

    Teachers were trained to use reinforcement and induction to increase prosocial behavior in a sample of 98 children in Head Start-affiliated preschools, using a peer coaching model. There was one control group and three intervention groups: reinforcement-only, induction-only, and reinforcement-and-induction. Results indicated that the intervention…

  10. Positive Psychology Intervention to Alleviate Child Depression and Increase Life Satisfaction: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Kwok, Sylvia Y. C. L.; Gu, Minmin; Kit, Katrina Tong Kai

    2016-01-01

    Purpose: The study aims to examine the effectiveness of a positive psychology group-based intervention program, incorporating elements of hope and gratitude, in decreasing depression and increasing life satisfaction among primary school students in Hong Kong. Method: A total of 68 children, with the Depression score of Chinese Hospital Anxiety and…

  11. Positive Psychology Intervention to Alleviate Child Depression and Increase Life Satisfaction: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Kwok, Sylvia Y. C. L.; Gu, Minmin; Kit, Katrina Tong Kai

    2016-01-01

    Purpose: The study aims to examine the effectiveness of a positive psychology group-based intervention program, incorporating elements of hope and gratitude, in decreasing depression and increasing life satisfaction among primary school students in Hong Kong. Method: A total of 68 children, with the Depression score of Chinese Hospital Anxiety and…

  12. A Brief Instructional Intervention to Increase Students' Motivation on the First Day of Class

    ERIC Educational Resources Information Center

    McGinley, Jared J.; Jones, Brett D.

    2014-01-01

    What an instructor does on the first day of a course can impact students' motivation in the course. To build upon these prior research findings, we implemented a first-day intervention to influence students' motivation by increasing their perceptions of course interest, course usefulness, and instructor caring. The participants were undergraduate…

  13. Student Content Knowledge Increases after Participation in a Hands-on Biotechnology Intervention

    ERIC Educational Resources Information Center

    Bigler, Amber M.; Hanegan, Nikki L.

    2011-01-01

    Implementing biotechnology education through hands-on teaching methods should be considered by secondary biology teachers. This study is an experimental research design to examine increased student content knowledge in biotechnology after a hands-on biotechnology intervention. The teachers from both school groups participated in, Project Crawfish,…

  14. Student Content Knowledge Increases after Participation in a Hands-on Biotechnology Intervention

    ERIC Educational Resources Information Center

    Bigler, Amber M.; Hanegan, Nikki L.

    2011-01-01

    Implementing biotechnology education through hands-on teaching methods should be considered by secondary biology teachers. This study is an experimental research design to examine increased student content knowledge in biotechnology after a hands-on biotechnology intervention. The teachers from both school groups participated in, Project Crawfish,…

  15. Increasing Independence in Autism Spectrum Disorders: A Review of Three Focused Interventions

    ERIC Educational Resources Information Center

    Hume, Kara; Loftin, Rachel; Lantz, Johanna

    2009-01-01

    The features of autism that inhibit the independent demonstration of skills, as well as three effective interventions for increasing independence, are explored in this review article. Independent performance may prove difficult for individuals with autism spectrum disorders (ASD) due to the core deficits of the disability, as well as executive…

  16. A Systematic Review and Meta-Analysis of Indicated Interventions to Increase School Attendance

    ERIC Educational Resources Information Center

    Maynard, Brandy R.; Tyson-McCrea, Katherine; Pigott, Therese; Kelly, Michael

    2011-01-01

    The main objective of this systematic review and meta-analysis was to examine the effects of intervention programs on school attendance behaviors of elementary and secondary school students to inform policy and practice. The specific questions guiding this study were: (1) Do indicated programs with a goal of increasing student attendance affect…

  17. An Analysis of Naturalistic Interventions for Increasing Spontaneous Expressive Language in Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Lane, Justin D.; Lieberman-Betz, Rebecca; Gast, David L.

    2016-01-01

    The purpose of this review was to identify naturalistic language interventions for increasing spontaneous expressive language (defined in this review as absence of verbal prompt or other verbalization from adults or peers) in young children with autism spectrum disorder. Also, the methodological rigor and effectiveness of each study were evaluated…

  18. An Intervention to Increase the Use of Asthma Action Plans in Schools: A MASNRN Study

    ERIC Educational Resources Information Center

    Pulcini, Joyce; DeSisto, Marie C.; McIntyre, C. Lynne

    2007-01-01

    School nurses, in collaboration with primary care providers (PCPs), can work to better manage asthma by using the Asthma Action Plan (AAP) with peak flow monitoring. The aim of this pilot study was to determine the effectiveness of an intervention to increase the number of AAPs in schools for students with asthma by having school nurses provide…

  19. A Strategy Intervention to Increase the Reading Comprehension of Junior High School Students with Reading Disabilities

    ERIC Educational Resources Information Center

    Mothus, Trudy G.; Lapadat, Judith C.

    2006-01-01

    A challenge facing educators is to find ways to arrest and reverse the cumulative deficit in reading experienced by many students with learning disabilities. In this study, we evaluated the effect of a strategy intervention to increase the reading comprehension of eighth grade students with reading disabilities in intact junior high school classes…

  20. Increasing colorectal cancer screening among individuals in the carpentry trade: test of risk communication interventions.

    PubMed

    Lipkus, Isaac M; Skinner, Celette Sugg; Dement, John; Pompeii, Lisa; Moser, Barry; Samsa, Gregory P; Ransohoff, David

    2005-05-01

    Individuals in the carpentry trade, due to lifestyle habits and occupational exposures, may be at above-average risk for colorectal cancer (CRC). Based on the literature which suggests that increasing perceived risk motivates behavior change, we report on the effectiveness of four risk-communication interventions targeted to increase initial, yearly and repeat fecal occult screening (FOBT) among carpenters (N = 860) over a 3-year period. Our 2 x 2 factorial design intervention study varied two dimensions of providing CRC risk factor information: (1) type of risk factor-one set of interventions emphasized three basic risk factors (age, family history and polyps); the other set emphasized a comprehensive set of risk factors including basic, lifestyle, and occupational factors, and (2) tailoring/not tailoring risk factor information. Participants were provided FOBTs. Outcomes were the proportion of returned FOBTs. Varying the amount and intensity of delivering CRC risk factors information affected neither risk perceptions nor initial, yearly, or repeat screening. However, yearly and repeat screening rates were greater among participants who received interventions addressing comprehensive set of risk factors, especially with increasing age. Tailoring on several CRC risk factors appears insufficient to increase and sustain elevated perceptions of CRC risks to promote screening.

  1. The Classroom Password: A Class-Wide Intervention to Increase Academic Engagement

    ERIC Educational Resources Information Center

    Dart, Evan H.; Radley, Keith C.; Battaglia, Allison A.; Dadakhodjaeva, Komila; Bates, Kayla E.; Wright, Sarah J.

    2016-01-01

    The present study investigated the effectiveness of a novel class-wide intervention, the Classroom Password, for increasing the academic engaged behavior of middle school students. The effectiveness of an independent group contingency was evaluated using a concurrent multiple baseline design across three seventh- and eighth-grade classrooms.…

  2. Do Reinforcement and Induction Increase Prosocial Behavior? Results of a Teacher-Based Intervention in Preschools

    ERIC Educational Resources Information Center

    Ramaswamy, Vidya; Bergin, Christi

    2009-01-01

    Teachers were trained to use reinforcement and induction to increase prosocial behavior in a sample of 98 children in Head Start-affiliated preschools, using a peer coaching model. There was one control group and three intervention groups: reinforcement-only, induction-only, and reinforcement-and-induction. Results indicated that the intervention…

  3. An Intervention to Increase the Use of Asthma Action Plans in Schools: A MASNRN Study

    ERIC Educational Resources Information Center

    Pulcini, Joyce; DeSisto, Marie C.; McIntyre, C. Lynne

    2007-01-01

    School nurses, in collaboration with primary care providers (PCPs), can work to better manage asthma by using the Asthma Action Plan (AAP) with peak flow monitoring. The aim of this pilot study was to determine the effectiveness of an intervention to increase the number of AAPs in schools for students with asthma by having school nurses provide…

  4. A Program Evaluation of a Policy Intervention to Increase Racial Diversity in the Sciences and Engineering

    ERIC Educational Resources Information Center

    Gomez Yepes, Ricardo Leon

    2013-01-01

    This dissertation is an evaluation of an intervention designed to (a) increase the number of minority students who pursue graduate degrees in Science, Technology, Engineering, and Mathematics (STEM) disciplines, and (b) to develop a cadre of qualified individuals from minority backgrounds who, upon finishing their training, are ready to take…

  5. A Program Evaluation of a Policy Intervention to Increase Racial Diversity in the Sciences and Engineering

    ERIC Educational Resources Information Center

    Gomez Yepes, Ricardo Leon

    2013-01-01

    This dissertation is an evaluation of an intervention designed to (a) increase the number of minority students who pursue graduate degrees in Science, Technology, Engineering, and Mathematics (STEM) disciplines, and (b) to develop a cadre of qualified individuals from minority backgrounds who, upon finishing their training, are ready to take…

  6. The Classroom Password: A Class-Wide Intervention to Increase Academic Engagement

    ERIC Educational Resources Information Center

    Dart, Evan H.; Radley, Keith C.; Battaglia, Allison A.; Dadakhodjaeva, Komila; Bates, Kayla E.; Wright, Sarah J.

    2016-01-01

    The present study investigated the effectiveness of a novel class-wide intervention, the Classroom Password, for increasing the academic engaged behavior of middle school students. The effectiveness of an independent group contingency was evaluated using a concurrent multiple baseline design across three seventh- and eighth-grade classrooms.…

  7. Utility-value intervention with parents increases students' STEM preparation and career pursuit.

    PubMed

    Rozek, Christopher S; Svoboda, Ryan C; Harackiewicz, Judith M; Hulleman, Chris S; Hyde, Janet S

    2017-01-31

    During high school, developing competence in science, technology, engineering, and mathematics (STEM) is critically important as preparation to pursue STEM careers, yet students in the United States lag behind other countries, ranking 35th in mathematics and 27th in science achievement internationally. Given the importance of STEM careers as drivers of modern economies, this deficiency in preparation for STEM careers threatens the United States' continued economic progress. In the present study, we evaluated the long-term effects of a theory-based intervention designed to help parents convey the importance of mathematics and science courses to their high-school-aged children. A prior report on this intervention showed that it promoted STEM course-taking in high school; in the current follow-up study, we found that the intervention improved mathematics and science standardized test scores on a college preparatory examination (ACT) for adolescents by 12 percentile points. Greater high-school STEM preparation (STEM course-taking and ACT scores) was associated with increased STEM career pursuit (i.e., STEM career interest, the number of college STEM courses, and students' attitudes toward STEM) 5 y after the intervention. These results suggest that the intervention can affect STEM career pursuit indirectly by increasing high-school STEM preparation. This finding underscores the importance of targeting high-school STEM preparation to increase STEM career pursuit. Overall, these findings demonstrate that a motivational intervention with parents can have important effects on STEM preparation in high school, as well as downstream effects on STEM career pursuit 5 y later.

  8. Utility-value intervention with parents increases students’ STEM preparation and career pursuit

    PubMed Central

    Rozek, Christopher S.; Svoboda, Ryan C.; Harackiewicz, Judith M.; Hulleman, Chris S.; Hyde, Janet S.

    2017-01-01

    During high school, developing competence in science, technology, engineering, and mathematics (STEM) is critically important as preparation to pursue STEM careers, yet students in the United States lag behind other countries, ranking 35th in mathematics and 27th in science achievement internationally. Given the importance of STEM careers as drivers of modern economies, this deficiency in preparation for STEM careers threatens the United States’ continued economic progress. In the present study, we evaluated the long-term effects of a theory-based intervention designed to help parents convey the importance of mathematics and science courses to their high-school–aged children. A prior report on this intervention showed that it promoted STEM course-taking in high school; in the current follow-up study, we found that the intervention improved mathematics and science standardized test scores on a college preparatory examination (ACT) for adolescents by 12 percentile points. Greater high-school STEM preparation (STEM course-taking and ACT scores) was associated with increased STEM career pursuit (i.e., STEM career interest, the number of college STEM courses, and students’ attitudes toward STEM) 5 y after the intervention. These results suggest that the intervention can affect STEM career pursuit indirectly by increasing high-school STEM preparation. This finding underscores the importance of targeting high-school STEM preparation to increase STEM career pursuit. Overall, these findings demonstrate that a motivational intervention with parents can have important effects on STEM preparation in high school, as well as downstream effects on STEM career pursuit 5 y later. PMID:28096393

  9. Echium oil increased the expression of a Δ4 Fads2 fatty acyl desaturase and the deposition of n-3 long-chain polyunsaturated fatty acid in comparison with linseed oil in striped snakehead (Channa striata) muscle.

    PubMed

    Jaya-Ram, Annette; Shu-Chien, Alexander Chong; Kuah, Meng-Kiat

    2016-08-01

    Despite the potential of vegetable oils as aquafeed ingredients, a major drawback associated with their utilization is the inferior level of beneficial n-3 long-chain polyunsaturated fatty acids (LC-PUFA). Echium oil (EO), which is rich in stearidonic acid (SDA, 18:4n-3), could potentially improve the deposition of n-3 LC-PUFA as the biosynthesis of LC-PUFA is enhanced through bypassing the rate-limiting ∆6 desaturation step. We report for the first time an attempt to investigate whether the presence of a desaturase (Fads2) capable of ∆4 desaturation activities and an elongase (Elovl5) will leverage the provision of dietary SDA to produce a higher rate of LC-PUFA bioconversion. Experimental diets were designed containing fish oil (FO), EO or linseed oil (LO) (100FO, 100EO, 100LO), and diets which comprised equal mixtures of the designated oils (50EOFO and 50EOLO) were evaluated in a 12-week feeding trial involving striped snakeheads (Channa striata). There was no significant difference in growth and feed conversion efficiency. The hepatic fatty acid composition and higher expression of fads2 and elovl5 genes in fish fed EO-based diets indicate the utilization of dietary SDA for LC-PUFA biosynthesis. Collectively, this resulted in a higher deposition of muscle eicosapentaenoic acid (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3) compared to LO-based diets. Dietary EO improved the ratio of n-3 LC-PUFA to n-6 LC-PUFA in fish muscle, which is desirable for human populations with excessive consumption of n-6 PUFA. This study validates the contribution of SDA in improving the content of n-3 LC-PUFA and the ratio of EPA to arachidonic acid (ARA, 20:4n-6) in a freshwater carnivorous species.

  10. Increasing the use of nicotine replacement therapy by a simple intervention: an exploratory trial.

    PubMed

    Raupach, Tobias; Shahab, Lion; Eimer, Stefanie; Puls, Miriam; Hasenfuss, Gerd; Andreas, Stefan

    2010-02-01

    This historical cohort study conducted in a University Hospital between 2004 and 2006 included 322 smokers willing to quit and assessed whether adding a teaching session on nicotine addiction to a smoking cessation program could increase the proportion of participants using pharmacotherapy. The control cohort received the standard course while two short talks were added to the course for a consecutive intervention cohort. These talks used the metaphor of a pizza delivery service to explain neural mechanisms underlying nicotine addiction. Medication use was significantly more common in the intervention than control cohort (82.1% vs. 51.2%; adjusted odds ratio 4.0; 2.34-6.83).

  11. Piloting a mobile health intervention to increase physical activity for adolescents with ADHD.

    PubMed

    Schoenfelder, Erin; Moreno, Megan; Wilner, Molly; Whitlock, Kathryn B; Mendoza, Jason A

    2017-06-01

    Physical activity (PA) reduces symptoms of Attention Deficit Hyperactivity Disorder (ADHD); interventions to increase PA may improve functioning and health for adolescents with ADHD. Mobile health (mHealth) technology and social media constitute promising interactive modalities for engaging adolescents-who are at highest risk for ADHD treatment drop-out-in interventions to increase PA. The current pilot study evaluated feasibility and acceptability of an innovative intervention incorporating an mHealth-linked wearable activity tracker (Fitbit Flex) and a Facebook group to increase PA among adolescents with ADHD. 11 adolescents diagnosed with ADHD (age 14-18, m = 15.5; 54% female) participated in a 4-week trial utilizing the Fitbit Flex in conjunction with (1) weekly personalized step count goals (2) social support through a Facebook group and (3) daily text messages about PA. The study took place in the greater Seattle, Washington area in the fall of 2015. Adolescents completed online surveys twice per week to rate their ADHD symptoms and positive and negative mood states, and parents rated adolescent ADHD symptoms weekly. Participants were adherent to the study protocol and acceptability of the intervention was high. Linear mixed models indicated that participants significantly increased their average weekly steps over the course of the study and demonstrated improvements in both adolescent and parent-reported ADHD Inattentive symptoms. Results indicate that this mHealth intervention is engaging and promising for increasing PA among adolescents with ADHD, and warrant further study. Implications for improving ADHD symptoms and overall functioning for this undertreated population are discussed.

  12. Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels: the ToyBox-study.

    PubMed

    De Craemer, M; De Decker, E; De Bourdeaudhuij, I; Verloigne, M; Duvinage, K; Koletzko, B; Ibrügger, S; Kreichauf, S; Grammatikaki, E; Moreno, L; Iotova, V; Socha, P; Szott, K; Manios, Y; Cardon, G

    2014-08-01

    Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers. © 2014 World Obesity.

  13. Comparison of three interventions to increase mammography screening in low income African American women.

    PubMed

    Champion, Victoria L; Springston, Jeffrey K; Zollinger, Terry W; Saywell, Robert M; Monahan, Patrick O; Zhao, Qianqian; Russell, Kathleen M

    2006-01-01

    Low-income African American women are more likely to die of breast cancer than their Caucasian counterparts, and at least part of the difference in mortality results from differential screening adherence. The purpose of this study was to identify more efficacious methods of promoting routine mammography screening in underserved populations. A prospective randomized intervention study of 344 low income African American women compared the impact of three interventions on mammography adherence and stage of readiness: (1) pamphlet only; (2) culturally appropriate video; and (3) interactive computer-assisted instruction program. The interactive computer intervention program produced the greatest level of adherence to mammography (40.0%) compared to the video group (24.6%) and the pamphlet group (32.1%). When subjects in the pamphlet and video groups were combined to form a non-interactive group, this group had a significantly lower adherence than the group who received the interactive computer intervention (27.0% versus 40.0%). There was also significantly more forward movement in mammography stage of readiness among participants in the computer group (52.0%) compared to those in the pamphlet group (46.4%) or the video group (31.3%). When combining the non-interactive technology (pamphlet and video) there was also more forward movement in mammography stage of readiness for those in the interactive intervention group (52.0% moved 1 or 2 stages) compared to those in the non-interactive group (36.2%). These data indicate that tailored approaches are more effective than targeted messages either in print or video format. Another finding of this study is that interactive interventions are more effective than non-interactive interventions in increasing adherence and moving African American women forward in their mammogram stage of readiness.

  14. A cluster randomised feasibility study of an adolescent incentive intervention to increase uptake of HPV vaccination.

    PubMed

    Forster, Alice S; Cornelius, Victoria; Rockliffe, Lauren; Marlow, Laura Av; Bedford, Helen; Waller, Jo

    2017-08-22

    Uptake of human papillomavirus (HPV) vaccination is suboptimal among some groups. We aimed to determine the feasibility of undertaking a cluster randomised controlled trial (RCT) of incentives to improve HPV vaccination uptake by increasing consent form return. An equal-allocation, two-arm cluster RCT design was used. We invited 60 London schools to participate. Those agreeing were randomised to either a standard invitation or incentive intervention arm, in which Year 8 girls had the chance to win a £50 shopping voucher if they returned a vaccination consent form, regardless of whether consent was provided. We collected data on school and parent participation rates and questionnaire response rates. Analyses were descriptive. Six schools completed the trial and only 3% of parents opted out. The response rate was 70% for the girls' questionnaire and 17% for the parents'. In the intervention arm, 87% of girls returned a consent form compared with 67% in the standard invitation arm. The proportion of girls whose parents gave consent for vaccination was higher in the intervention arm (76%) than the standard invitation arm (61%). An RCT of an incentive intervention is feasible. The intervention may improve vaccination uptake but a fully powered RCT is needed.British Journal of Cancer advance online publication: 22 August 2017; doi:10.1038/bjc.2017.284 www.bjcancer.com.

  15. Implementation of a school environment intervention to increase physical activity in high school girls.

    PubMed

    Ward, D S; Saunders, R; Felton, G M; Williams, E; Epping, J N; Pate, R R

    2006-12-01

    Physical activity levels begin to decline in childhood and continue falling throughout adolescence, with girls being at greatest risk for inactivity. Schools are ideal settings for helping girls develop and maintain a physically active lifestyle. This paper describes the design and implementation of 'Lifestyle Education for Activity Program', or LEAP. LEAP used a health team approach with participatory strategies to provide training and support, instructional capacity building and opportunities to adapt school instructional program and environmental supports to local needs. The social-ecological model, based on social cognitive theory, served as the organizing framework for the LEAP intervention and elements of the coordinated school health program model as intervention channels. For the 12 intervention schools, LEAP staff documented 191 visits and interactions with 850 individuals over the 2-year period. Teachers reported successful implementation of most components of the intervention and demonstrated optimism for sustainability. These results indicate that a facilitative approach to intervention implementation can be used successfully to engage school personnel, and to change instructional programs and school environments to increase the physical activity level of high school girls.

  16. Development of an Intervention to Increase Sexual Health Service Uptake by Young People.

    PubMed

    Newby, Katie V; Brown, Katherine E; Bayley, Julie; Kehal, Isher; Caley, Mike; Danahay, Amy; Hunt, Jonny; Critchley, George

    2017-05-01

    This study aimed to develop and implement an intervention, delivered via a website and Web app, to increase the uptake of sexual health services by young people. The intervention was co-designed with a group of 10 young people. Intervention mapping was used to guide development. To identify barriers and facilitators of access to sexual health services, three focus groups with 24 young people aged 13 to 19 years, and interviews with 12 professionals recruited from across a range of health and social services, were conducted. Data were analyzed using content analysis. Evidence was supplemented through a literature review. Barriers and facilitators were categorized as theoretical determinants and then suitable behavior change techniques (BCTs) for targeting them were selected. Targeted determinants were attitude, subjective norm, perceived behavioral control, and knowledge. Selected BCTs included "information about others' approval," "framing/reframing," and "credible source." The website/app enable users to search for services, access key information about them, watch videos about what to expect, and have key concerns removed/addressed. This is the first known digital evidence-based intervention to target this behavior described in the literature. A clear and full description of intervention development and content, including of theorized causal pathways, is provided to aid interpretation of future outcome evaluations.

  17. Case Series of a Knowledge Translation Intervention to Increase Upper Limb Exercise in Stroke Rehabilitation.

    PubMed

    Connell, Louise A; McMahon, Naoimh E; Tyson, Sarah F; Watkins, Caroline L; Eng, Janice J

    2016-12-01

    Current approaches to upper limb rehabilitation are not sufficient to drive neural reorganization and maximize recovery after stroke. To address this evidence-practice gap, a knowledge translation intervention using the Behaviour Change Wheel was developed. The intervention involves collaboratively working with stroke therapy teams to change their practice and increase therapy intensity by therapists prescribing supplementary self-directed arm exercise. The purposes of this case series are: (1) to provide an illustrative example of how a research-informed process changed clinical practice and (2) to report on staff members' and patients' perceptions of the utility of the developed intervention. A participatory action research approach was used in 3 stroke rehabilitation units in the United Kingdom. The intervention aimed to change 4 therapist-level behaviors: (1) screening patients for suitability for supplementary self-directed arm exercise, (2) provision of exercises, (3) involving family and caregivers in assisting with exercises, and (4) monitoring and progressing exercises. Data on changes in practice were collected by therapy teams using a bespoke audit tool. Utility of the intervention was explored in qualitative interviews with patients and staff. Components of the intervention were successfully embedded in 2 of the 3 stroke units. At these sites, almost all admitted patients were screened for suitability for supplementary self-directed exercise. Exercises were provided to 77%, 70%, and 88% of suitable patients across the 3 sites. Involving family and caregivers and monitoring and progressing exercises were not performed consistently. This case series is an example of how a rigorous research-informed knowledge translation process resulted in practice change. Research is needed to demonstrate that these changes can translate into increased intensity of upper limb exercise and affect patient outcomes. © 2016 American Physical Therapy Association.

  18. Limited Progress in Increasing Coverage of Neonatal and Child-health Interventions in Africa and Asia

    PubMed Central

    Boschi-Pinto, Cynthia; Martines, José

    2009-01-01

    The study was conducted to analyze recent trends in the coverage of selected child-survival interventions. A systematic analysis of the coverage of six key child-health interventions in 29 African and Asian countries that had two recent demographic and health surveys—the latest one carried out in 2001 onwards and the immediately preceding survey conducted after 1990—was undertaken. A regression model was used for examining the relationship between the changes in the coverage of interventions and the changes in rates of mortality among children aged less than five years (under-five mortality). A limited increase in the coverage of key child-health interventions occurred in the past 5–10 years in these 29 countries in sub-Saharan Africa and Asia. More than half of the countries had no significant improvement or a significant reduction in the coverage of oral rehydration therapy (ORT) for diarrhoea (17/29) and care-seeking for acute respiratory infection (ARI) (16/29). Results of multivariate analysis revealed that increases in the coverage of early initiation of breastfeeding, ORT for diarrhoea, and care-seeking for ARI were significantly associated with reductions in under-five mortality. The results of this analysis should serve as a wake-up call for policy-makers and programme managers in countries, donors, and international agencies to accelerate efforts to increase the coverage of key child-survival interventions. The following three main actions are proposed: setting of the clear target; mobilization of resources for increasing skilled birth attendants and health workers trained in integrated management of childhood illness; and implementation of community-based approaches. PMID:20099759

  19. Is there an incremental rise in the risk of obstetric intervention with increasing maternal age?

    PubMed

    Rosenthal, A N; Paterson-Brown, S

    1998-10-01

    To determine whether increasing maternal age increases the risk of operative delivery and to investigate whether such a trend is due to fetal or maternal factors. DESIGN ANALYSIS: of prospectively collected data on a maternity unit database. A postgraduate teaching hospital. 6410 nulliparous women with singleton cephalic pregnancies delivering at term (3742 weeks of gestation) between 1 January 92 and 31 December 95. Mode of delivery, rates of prelabour caesarean section, induction of labour and epidural usage. There was a positive, highly significant association between increasing maternal age and obstetric intervention. Prelabour (P < 0.001) and emergency (P < 0.001) caesarean section, instrumental vaginal delivery (spontaneous labour P < 0001; induced labour P = 0.001), induction of labour (P < 0.001) and epidural usage in spontaneous labour (P = 0.005) all increased with increasing age. In the second stage of labour fetal distress and failure to advance, requiring instrumental delivery, were both more likely with increasing maternal age (in both P < 0.001). Epidural usage in induced labour and the incidence of small for gestational age newborns did not increase with increasing maternal age (P = 0.68 and P = 0.50, respectively). This study demonstrates that increasing maternal age is associated with an incremental increase in obstetric intervention. Previous studies have demonstrated a significant effect in women older than 35 years of age, but these data show changes on a continuum from teenage years. This finding may reflect a progressive, age-related deterioration in myometrial function.

  20. An environmental intervention to increase fruit and salad purchases in a cafeteria.

    PubMed

    Jeffery, R W; French, S A; Raether, C; Baxter, J E

    1994-11-01

    This study explored the hypothesis that consumption of fruit and salad in a cafeteria setting would increase if the variety of offerings was increased and their price reduced. Food purchases in a cafeteria setting were observed during 3 weeks of baseline observation, 3 weeks of intervention, and 3 weeks of return to baseline conditions. Intervention consisted of doubling the number of fruit choices, increasing salad ingredient selections by three, and reducing the price of both fruit and salad by 50%. The primary outcome measures in the study were daily sales of fruit and salad as assessed by cash register receipts. Fruit and salad purchases increased threefold in the intervention period compared to those in the nonintervention periods. Women and those trying to control their weight were most likely to make these nutritious food choices. Results of this study support the argument that increasing the number of nutritious food choices and making them more attractive economically may be important to changing food choice behavior. Further exploration of the practical application of the concept is recommended.

  1. How to Increase Reach and Adherence of Web-Based Interventions: A Design Research Viewpoint.

    PubMed

    Ludden, Geke D S; van Rompay, Thomas J L; Kelders, Saskia M; van Gemert-Pijnen, Julia E W C

    2015-07-10

    Nowadays, technology is increasingly used to increase people's well-being. For example, many mobile and Web-based apps have been developed that can support people to become mentally fit or to manage their daily diet. However, analyses of current Web-based interventions show that many systems are only used by a specific group of users (eg, women, highly educated), and that even they often do not persist and drop out as the intervention unfolds. In this paper, we assess the impact of design features of Web-based interventions on reach and adherence and conclude that the power that design can have has not been used to its full potential. We propose looking at design research as a source of inspiration for new (to the field) design approaches. The paper goes on to specify and discuss three of these approaches: personalization, ambient information, and use of metaphors. Central to our viewpoint is the role of positive affect triggered by well-designed persuasive features to boost adherence and well-being. Finally, we discuss the future of persuasive eHealth interventions and suggest avenues for follow-up research.

  2. How to Increase Reach and Adherence of Web-Based Interventions: A Design Research Viewpoint

    PubMed Central

    2015-01-01

    Nowadays, technology is increasingly used to increase people’s well-being. For example, many mobile and Web-based apps have been developed that can support people to become mentally fit or to manage their daily diet. However, analyses of current Web-based interventions show that many systems are only used by a specific group of users (eg, women, highly educated), and that even they often do not persist and drop out as the intervention unfolds. In this paper, we assess the impact of design features of Web-based interventions on reach and adherence and conclude that the power that design can have has not been used to its full potential. We propose looking at design research as a source of inspiration for new (to the field) design approaches. The paper goes on to specify and discuss three of these approaches: personalization, ambient information, and use of metaphors. Central to our viewpoint is the role of positive affect triggered by well-designed persuasive features to boost adherence and well-being. Finally, we discuss the future of persuasive eHealth interventions and suggest avenues for follow-up research. PMID:26163456

  3. The KinFact intervention - a randomized controlled trial to increase family communication about cancer history.

    PubMed

    Bodurtha, Joann N; McClish, Donna; Gyure, Maria; Corona, Rosalie; Krist, Alexander H; Rodríguez, Vivian M; Maibauer, Alisa M; Borzelleca, Joseph; Bowen, Deborah J; Quillin, John M

    2014-10-01

    Knowing family history is important for understanding cancer risk, yet communication within families is suboptimal. Providing strategies to enhance communication may be useful. Four hundred ninety women were recruited from urban, safety-net, hospital-based primary care women's health clinics. Participants were randomized to receive the KinFact intervention or the control handout on lowering risks for breast/colon cancer and screening recommendations. Cancer family history was reviewed with all participants. The 20-minute KinFact intervention, based in communication and behavior theory, included reviewing individualized breast/colon cancer risks and an interactive presentation about cancer and communication. Study outcomes included whether participants reported collecting family history, shared cancer risk information with relatives, and the frequency of communication with relatives. Data were collected at baseline, 1, 6, and 14 months. Overall, intervention participants were significantly more likely to gather family cancer information at follow-up (odds ratio [OR]: 2.73; 95% confidence interval [CI]: 2.01, 3.71) and to share familial cancer information with relatives (OR: 1.85; 95% CI: 1.37, 2.48). Communication frequency (1=not at all; 4=a lot) was significantly increased at follow-up (1.67 vs. 1.54). Differences were not modified by age, race, education, or family history. However, effects were modified by pregnancy status and genetic literacy. Intervention effects for information gathering and frequency were observed for nonpregnant women but not for pregnant women. Additionally, intervention effects were observed for information gathering in women with high genetic literacy, but not in women with low genetic literacy. The KinFact intervention successfully promoted family communication about cancer risk. Educating women to enhance their communication skills surrounding family history may allow them to partner more effectively with their families and ultimately

  4. Effects of an Intervention to Increase Bed Alarm Use to Prevent Falls in Hospitalized Patients

    PubMed Central

    Shorr, Ronald I.; Chandler, A. Michelle; Mion, Lorraine C.; Waters, Teresa M.; Liu, Minzhao; Daniels, Michael J.; Kessler, Lori A.; Miller, Stephen T.

    2013-01-01

    Background Bed alarm systems intended to prevent hospital falls have not been formally evaluated. Objective To investigate whether an intervention aimed at increasing bed alarm use decreases hospital falls and related events. Design Pair-matched, cluster randomized trial over 18 months. Nursing units were allocated by computer-generated randomization on the basis of baseline fall rates. Patients and outcome assessors were blinded to unit assignment; outcome assessors may have become unblinded. (ClinicalTrials.gov registration number: NCT00183053) Setting 16 nursing units in an urban community hospital. Patients 27 672 inpatients in general medical, surgical, and specialty units. Intervention Education, training, and technical support to promote use of a standard bed alarm system (intervention units); bed alarms available but not formally promoted or supported (control units). Measurements Pre–post difference in change in falls per 1000 patient-days (primary end point); number of patients who fell, fall-related injuries, and number of patients restrained (secondary end points). Results Prevalence of alarm use was 64.41 days per 1000 patient-days on intervention units and 1.79 days per 1000 patient-days on control units (P = 0.004). There was no difference in change in fall rates per 1000 patient-days (risk ratio, 1.09 [95% CI, 0.85 to 1.53]; difference, 0.41 [CI, −1.05 to 2.47], which corresponds to a greater difference in falls in control vs. intervention units) or in the number of patients who fell, injurious fall rates, or the number of patients physically restrained on intervention units compared with control units. Limitation The study was conducted at a single site and was slightly underpowered compared with the initial design. Conclusion An intervention designed to increase bed alarm use in an urban hospital increased alarm use but had no statistically or clinically significant effect on fall-related events or physical restraint use. Primary Funding

  5. Process Evaluation of an Intervention to Increase Child Activity Levels in Afterschool Programs

    PubMed Central

    Weaver, R. Glenn; Saunders, Ruth; Webster, Collin; Beets, Michael W.

    2014-01-01

    Background Identifying effective strategies in Afterschool programs (ASPs) to increase children's moderate-to-vigorous physical activity (MVPA) in the ASP setting is crucial. This study describes the process evaluation outcomes from an intervention to reduce child sedentary time and increase MVPA in ASPs. Methods Four ASPs participated in a quasi-experimental single-group pre-post study targeting child sedentary time and MVPA. The strategies implemented to help ASPs meet Physical Activity Standards consisted of detailed schedules, professional development trainings, on-site booster sessions, and technical assistance. Process evaluation related to staff behaviors was collected via systematic observation to identify the interventions impact on the physical and social environment of the ASP. Random-effects regression models examined the impact of the intervention on boys/girls observed sedentary behavior, MVPA, and changes in staff behaviors. Results Increases in MVPA and reductions in sedentary behavior were observed during enrichment, academics, organized and free-play physical activities (PA). Corresponding changes in staff behaviors were observed during these ASP contexts. For example, staff reduced child idle-time during organized PA (38.9%-1.8%) and provided energizers more often during enrichment (0.2%-11.5%). Conclusions This study identified changes in staff behavior during ASP contexts that led to increases in child MVPA and decreases in child sedentary behavior. PMID:24836999

  6. The influence of n-3 PUFA supplements and n-3 PUFA enriched foods on the n-3 LC PUFA intake of Flemish women.

    PubMed

    Sioen, Isabelle; Devroe, Jolien; Inghels, David; Terwecoren, Ruth; De Henauw, Stefaan

    2010-04-01

    Food consumption data of Flemish women of reproductive age collected in 2002 showed a large deficit for ALA and n-3 LC PUFA compared to the recommendations (mean ALA and EPA + DHA intake 1.4 g/day and 209 mg/day, respectively) and indicated a need to tackle the problem of low n-3 PUFA intake. Another recent Belgian study demonstrated that enrichment of commonly eaten food items with n-3 PUFA provides the opportunity to increase the n-3 PUFA intake up to 6.5 g/day and decrease the n-6/n-3 ratio. Since a large supply of n-3 PUFA supplements and n-3 PUFA enriched foods exists on the Belgian market, this study aimed at assessing the influence of these products on the n-3 LC PUFA intake for Flemish women of reproductive age. It was found that n-3 supplements are consumed by 5% of the Flemish women. Of all the n-3 PUFA enriched foods on the Flemish market, margarines and cooking fat are most frequently consumed by young women. The results indicated that a big gap remains between the EPA&DHA intake (mean = 276 mg/day) and the recommendation. Seafood remains the most important source of EPA&DHA. Only 11.6% of the population sample reached an intake level of 500 mg EPA&DHA per day. The study showed that other strategies will be needed to increase the EPA&DHA intake in the long term.

  7. A trial assessing N-3 as treatment for injury-induced cachexia (ATLANTIC trial): does a moderate dose fish oil intervention improve outcomes in older adults recovering from hip fracture?

    PubMed Central

    2010-01-01

    Background Proximal femoral fractures are associated with increased morbidity and mortality. Pre-existing malnutrition and weight loss amongst this patient group is of primary concern, with conventional nutrition support being largely ineffective. The inflammatory response post proximal femoral fracture surgery and the subsequent risk of cachexia may explain the inability of conventional high energy high protein management to produce an anabolic response amongst these patients. Omega-3 fatty acids derived from fish oils have been extensively studied for their anti-inflammatory benefits. Due to their anti-inflammatory properties, the benefit of fish oil combined with individualized nutrition support amongst proximal femoral fracture patients post surgery is an attractive potential therapeutic strategy. The aim of the ATLANTIC trial is to assess the potential benefits of an anti-inflammatory dose of fish oil within the context of a 12 week individualised nutrition program, commencing seven days post proximal femoral fracture surgery. Methods/Design This randomized controlled, double blinded trial, will recruit 150 community dwelling elderly patients aged ≥65 years, within seven days of surgery for proximal femoral fracture. Participants will be randomly allocated to receive either a 12 week individualized nutrition support program complemented with 20 ml/day anti-inflammatory dose fish oil (~3.6 g eicosapentaenoic acid, ~2.4 g docosahexanoic acid; intervention), or, a 12 week individualized nutrition support program complemented with 20 ml/day low dose fish oil (~0.36 g eicosapentaenoic acid, ~0.24 g docosahexanoic acid; control). Discussion The ATLANTIC trial is the first of its kind to provide fish oil combined with individualized nutrition therapy as an intervention to address the inflammatory response experienced post proximal femoral fracture surgery amongst elderly patients. The final outcomes of this trial will assist clinicians in the development of

  8. A trial assessing N-3 as treatment for injury-induced cachexia (ATLANTIC trial): does a moderate dose fish oil intervention improve outcomes in older adults recovering from hip fracture?

    PubMed

    Miller, Michelle D; Yaxley, Alison; Villani, Anthony; Cobiac, Lynne; Fraser, Robert; Cleland, Leslie; James, Michael; Crotty, Maria

    2010-10-22

    Proximal femoral fractures are associated with increased morbidity and mortality. Pre-existing malnutrition and weight loss amongst this patient group is of primary concern, with conventional nutrition support being largely ineffective. The inflammatory response post proximal femoral fracture surgery and the subsequent risk of cachexia may explain the inability of conventional high energy high protein management to produce an anabolic response amongst these patients. Omega-3 fatty acids derived from fish oils have been extensively studied for their anti-inflammatory benefits. Due to their anti-inflammatory properties, the benefit of fish oil combined with individualized nutrition support amongst proximal femoral fracture patients post surgery is an attractive potential therapeutic strategy. The aim of the ATLANTIC trial is to assess the potential benefits of an anti-inflammatory dose of fish oil within the context of a 12 week individualised nutrition program, commencing seven days post proximal femoral fracture surgery. This randomized controlled, double blinded trial, will recruit 150 community dwelling elderly patients aged ≥65 years, within seven days of surgery for proximal femoral fracture. Participants will be randomly allocated to receive either a 12 week individualized nutrition support program complemented with 20 ml/day anti-inflammatory dose fish oil (~3.6 g eicosapentaenoic acid, ~2.4 g docosahexanoic acid; intervention), or, a 12 week individualized nutrition support program complemented with 20 ml/day low dose fish oil (~0.36 g eicosapentaenoic acid, ~0.24 g docosahexanoic acid; control). The ATLANTIC trial is the first of its kind to provide fish oil combined with individualized nutrition therapy as an intervention to address the inflammatory response experienced post proximal femoral fracture surgery amongst elderly patients. The final outcomes of this trial will assist clinicians in the development of effective and alternative treatment methods

  9. Interventions for increasing fruit and vegetable consumption in children aged 5 years and under

    PubMed Central

    Wolfenden, Luke; Wyse, Rebecca J; Britton, Ben I; Campbell, Karen J; Hodder, Rebecca K; Stacey, Fiona G; McElduff, Patrick; James, Erica L

    2014-01-01

    Background Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases including cardiovascular disease. Objectives To assess the effectiveness, cost-effectiveness and associated adverse events of interventions designed to increase the consumption of fruit and/or vegetables amongst children aged five years and under. Search methods The Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library Issue 2, 2010, MEDLINE (1950 to 2010 April week 4), EMBASE (1947 to 2010 week 18), CINAHL (up to 12 May 2010), PsycINFO (up to 12 May 2010) and Proquest Dissertations and Theses (up to February 2011) were searched to identify eligible trials, as well as electronic trial registers (also up to February 2011). The reference lists of included trials were reviewed and handsearches of three international nutrition journals were also performed. Authors of all included trials were contacted in order to identify further potentially relevant trials. Selection criteria We included randomised controlled trials (RCTs), including cluster-randomised controlled trials, of any intervention primarily targeting fruit and/or vegetable consumption among children aged five years and under and incorporating a biochemical or dietary assessment of fruit and/or vegetable consumption. Two review authors independently screened the titles and abstracts of identified papers. A third review author with expertise in review methodology resolved any disagreements regarding study eligibility. Data collection and analysis Two review authors independently extracted data and assessed the risk of bias of the included studies. A third reviewer resolved disagreements between review authors. Fixed-effect models were used to perform meta-analysis for the primary review outcomes where a sufficient number of trials with suitable data and homogeneity were identified. Main results Five trials, with 13 trial arms and 3967 participants were included in

  10. Increasing independence in autism spectrum disorders: a review of three focused interventions.

    PubMed

    Hume, Kara; Loftin, Rachel; Lantz, Johanna

    2009-09-01

    The features of autism that inhibit the independent demonstration of skills, as well as three effective interventions for increasing independence, are explored in this review article. Independent performance may prove difficult for individuals with autism spectrum disorders (ASD) due to the core deficits of the disability, as well as executive function deficits that impact initiation and generalization. These difficulties, coupled with intervention strategies that encourage over-reliance on adult support, contribute to poor long term outcomes for adults with ASD in employment, housing, and relationship development. Self-monitoring, video modeling, and individual work systems each emphasize a shift in stimulus control from continuous adult management to an alternative stimulus and have proven successful in addressing executive function deficits and increasing independence.

  11. Randomized controlled trial of a brief intervention for increasing participation in parent management training.

    PubMed

    Nock, Matthew K; Kazdin, Alan E

    2005-10-01

    Evidence-based treatments exist for a range of child and adolescent behavior problems; however, effects are often limited by poor treatment attendance and adherence. The authors developed and evaluated the efficacy of a brief (5 to 45 min) intervention designed to increase treatment attendance and adherence in a sample of 76 parents referred for treatment of their child's oppositional, aggressive, and antisocial behavior. The results of this randomized controlled trial showed that parents who received this brief intervention had greater treatment motivation, attended significantly more treatment sessions, and had greater adherence to treatment according to both parent and therapist report. This study provides researchers and clinicians with a brief and efficacious method of increasing motivation, attendance, and adherence for treatment. ((c) 2005 APA, all rights reserved).

  12. Ironic effects of antiprejudice messages: how motivational interventions can reduce (but also increase) prejudice.

    PubMed

    Legault, Lisa; Gutsell, Jennifer N; Inzlicht, Michael

    2011-12-01

    Although prejudice-reduction policies and interventions abound, is it possible that some of them result in the precise opposite of their intended effect--an increase in prejudice? We examined this question by exploring the impact of motivation-based prejudice-reduction interventions and assessing whether certain popular practices might in fact increase prejudice. In two experiments, participants received detailed information on, or were primed with, the goal of prejudice reduction; the information and primes either encouraged autonomous motivation to regulate prejudice or emphasized the societal requirement to control prejudice. Ironically, motivating people to reduce prejudice by emphasizing external control produced more explicit and implicit prejudice than did not intervening at all. Conversely, participants in whom autonomous motivation to regulate prejudice was induced displayed less explicit and implicit prejudice compared with no-treatment control participants. We outline strategies for effectively reducing prejudice and discuss the detrimental consequences of enforcing antiprejudice standards.

  13. Development of a universal approach to increase physical activity among adolescents: the GoActive intervention

    PubMed Central

    Corder, Kirsten; Schiff, Annie; Kesten, Joanna M; van Sluijs, Esther M F

    2015-01-01

    Objectives To develop a physical activity (PA) promotion intervention for adolescents using a process addressing gaps in the literature while considering participant engagement. We describe the initial development stages; (1) existing evidence, (2) large scale opinion gathering and (3) developmental qualitative work, aiming (A) to gain insight into how to increase PA among the whole of year 9 (13–14 years-old) by identifying elements for intervention inclusion (B) to improve participant engagement and (C) to develop and refine programme design. Methods Relevant systematic reviews and longitudinal analyses of change were examined. An intervention was developed iteratively with older adolescents (17.3±0.5 years) and teachers, using the following process: (1) focus groups with (A) adolescents (n=26) and (B) teachers (n=4); (2) individual interviews (n=5) with inactive and shy adolescents focusing on engagement and programme acceptability. Qualitative data were analysed thematically. Results Limitations of the existing literature include lack of evidence on whole population approaches, limited adolescent involvement in intervention development, and poor participant engagement. Qualitative work suggested six themes which may encourage adolescents to do more PA; choice, novelty, mentorship, competition, rewards and flexibility. Teachers discussed time pressures as a barrier to encouraging adolescent PA and suggested between-class competition as a strategy. GoActive aims to increase PA through increased peer support, self-efficacy, group cohesion, self-esteem and friendship quality, and is implemented in tutor groups using a student-led tiered-leadership system. Conclusions We have followed an evidence-based iterative approach to translate existing evidence into an adolescent PA promotion intervention. Qualitative work with adolescents and teachers supported intervention design and addressed lack of engagement with health promotion programmes within this age group

  14. An Integrated Intervention for Increasing Clinical Nurses' Knowledge of HIV/AIDS-Related Occupational Safety.

    PubMed

    He, Liping; Lu, Zhiyan; Huang, Jing; Zhou, Yiping; Huang, Jian; Bi, Yongyi; Li, Jun

    2016-11-07

    Background: Approximately 35 new HIV (Human Immunodeficiency Virus, HIV) cases and at least 1000 serious infections are transmitted annually to health care workers. In China, HIV prevalence is increasing and nursing personnel are encountering these individuals more than in the past. Contaminated needle-stick injuries represent a significant occupational burden for nurses. Evidence suggests that nurses in China may not fully understand HIV/AIDS (Acquired immunodeficiency syndrome, AIDS) and HIV-related occupational safety. At this time, universal protection precautions are not strictly implemented in Chinese hospitals. Lack of training may place nurses at risk for occupational exposure to blood-borne pathogens. Objectives: To assess the effectiveness of integrated interventions on nurses' knowledge improvement about reducing the risk of occupationally acquired HIV infection. Methods: We audited integrated interventions using 300 questionnaires collected from nurses at the Affiliated Hospital of Xiangnan University, a public polyclinic in Hunan Province. The intervention studied was multifaceted and included appropriate and targeted training content for hospital, department and individual levels. After three months of occupational safety integrated interventions, 234 participants who completed the program were assessed. Results: Of the subjects studied, 94.3% (283/300) were injured one or more times by medical sharp instruments or splashed by body fluids in the last year and 95.3% considered their risk of occupational exposure high or very high. After the intervention, awareness of HIV/AIDS-related knowledge improved significantly (χ² = 86.34, p = 0.00), and correct answers increased from 67.9% to 82.34%. Correct answers regarding risk perception were significantly different between pre-test (54.4%) and post-test (66.6%) (χ² = 73.2, p = 0.00). When coming into contact with patient body fluids and blood only 24.0% of subjects used gloves regularly. The pre

  15. An intervention to increase compliance with a tobacco-free university policy.

    PubMed

    Fallin, Amanda; Johnson, Andrew O; Riker, Carol; Cohen, Elisia; Rayens, Mary Kay; Hahn, Ellen J

    2013-01-01

    To test the effects of a population-based self-efficacy message card campaign on compliance with a tobacco-free campus policy. This study was conducted at a large public university in the South. Three hundred twelve observational periods at 39 campus sites. The message card campaign, based on the Theory of Planned Behavior, consisted of distributing approximately 6000 efficacy-enhancing cards over 3 days. The intent of the cards was to increase awareness of the policy and resources available to help individuals stop smoking or remain comfortable while on campus. Policy compliance was measured using the Tobacco-Free Compliance Assessment Tool. Field notes were used to assess campaign reaction. Mann-Whitney U-test was conducted to compare number of cigarette butts in hot spot areas before and after the intervention. A rate ratio was also calculated using Geographic Information System (GIS) mapping software to compare cigarette butts collected per day before and after the intervention at each of the study sites. The median number of cigarette butts per day after the intervention was significantly lower than before the intervention (1.9 vs. 4.7, χ(2): 8.1, p  =  .004). Eighteen sites (66.6%) had a post-pre ratio of .11 to .75, indicating a decrease in cigarette butts per day. An efficacy-enhancing message card campaign shows promise in improving compliance with tobacco-free campus policies.

  16. Beauty salon health intervention increases fruit and vegetable consumption in African-American women.

    PubMed

    Johnson, Latasha T; Ralston, Penny A; Jones, Ethel

    2010-06-01

    African Americans, especially women, have low fruit and vegetable consumption, which is related to higher rates of obesity, morbidity, and mortality in comparison to whites. Community-based approaches are recommended to address this problem, including beauty salons, which are conducive environments for health information dissemination. The purpose of this pilot study, conducted in 2007, was to determine the effectiveness of a 6-week beauty salon-based health intervention, Steps for a New You, in improving diet, physical activity, and water consumption behaviors in African-American women using a quasiexperimental design. A random sample of 20 African-American women was selected from a list of regular clients at two beauty salons (n=10 each for treatment and comparison salons) located in a Southern rural community. The intervention included scripted motivational sessions between the cosmetologist and clients, information packets, and a starter kit of sample items. Data were collected using pre- and posttest questionnaires. The results showed that mean intake of fruit and vegetables was significantly higher at posttest for the treatment group but not for the comparison group. These findings suggest that the intervention may have had a positive effect on fruit and vegetable consumption by treatment group participants. However, further work is needed to refine the methodology, especially strengthening the intervention to increase physical activity and water consumption.

  17. Public Awareness of Colorectal Cancer Screening: Knowledge, Attitudes, and Interventions for Increasing Screening Uptake

    PubMed Central

    Gimeno Garcia, Antonio Z.; Hernandez Alvarez Buylla, Noemi; Nicolas-Perez, David; Quintero, Enrique

    2014-01-01

    Colorectal cancer ranks as one of the most incidental and death malignancies worldwide. Colorectal cancer screening has proven its benefit in terms of incidence and mortality reduction in randomized controlled trials. In fact, it has been recommended by medical organizations either in average-risk or family-risk populations. Success of a screening campaign highly depends on how compliant the target population is. Several factors influence colorectal cancer screening uptake including sociodemographics, provider and healthcare system factors, and psychosocial factors. Awareness of the target population of colorectal cancer and screening is crucial in order to increase screening participation rates. Knowledge about this disease and its prevention has been used across studies as a measurement of public awareness. Some studies found a positive relationship between knowledge about colorectal cancer, risk perception, and attitudes (perceived benefits and barriers against screening) and willingness to participate in a colorectal cancer screening campaign. The mentioned factors are modifiable and therefore susceptible of intervention. In fact, interventional studies focused on average-risk population have tried to increase colorectal cancer screening uptake by improving public knowledge and modifying attitudes. In the present paper, we reviewed the factors impacting adherence to colorectal cancer screening and interventions targeting participants for increasing screening uptake. PMID:24729896

  18. A self-regulation-based intervention to increase physical activity in cancer patients.

    PubMed

    Ungar, Nadine; Sieverding, Monika; Weidner, Gerdi; Ulrich, Cornelia M; Wiskemann, Joachim

    2016-01-01

    The study examined whether a behavior-change intervention focusing on self-regulatory strategies and emphasizing role model support increases physical activity (PA) among insufficiently active (not meeting PA guidelines of 150 min/week) cancer patients. Ambulatory cancer patients [N = 72; 54% female; M = 56 years, SD = 12.34; most with breast or colon cancer (34, 15%)] were enrolled in the MOTIVACTION-study, a 4-week intervention (1-hr counseling, followed by weekly phone calls), with pretest (T1), posttest (T2) and a 10-week follow-up (T3). Participants were randomized to either an exercise or to a stress management intervention (active control). The exercise intervention emphasized self-regulatory strategies (e.g. action- and coping planning and self-monitoring); patients were also encouraged to contact a physically active same-sex role model as a potential exercise partner. The active control condition consisted of coping and relaxation techniques. Sixty-seven patients remained in the study and completed the SQUASH assessment of PA and a measure of perceived stress. PA was validated by Actigraph accelerometry. At T2, 46% of the patients in the exercise group and 19% of stress management patients increased their activity levels to meet PA guidelines (>150 min/week; χ(2)(1) = 5.51, p = .019). At T3, participants in the exercise intervention maintained their exercise level (46%), but also 31% of the stress management patients met the guidelines. All patients reported reductions in perceived stress. Additional analyses comparing patients in the exercise group by role model contact (63% realized contact) revealed that those who had contact with their role model were significantly more likely to adhere to the recommended guidelines (T2:50%; T3:64%) compared to those who did not have contact with a role model (T2:39%; T3:15%), suggesting the potential of mobilizing role model support to facilitate PA. In sum, cancer patients may not only benefit from an exercise

  19. Do Interventions that Promote Awareness of Rights Increase Use of Maternity Care Services? A Systematic Review.

    PubMed

    George, Asha S; Branchini, Casey; Portela, Anayda

    2015-01-01

    Twenty years after the rights of women to go through pregnancy and childbirth safely were recognized by governments, we assessed the effects of interventions that promote awareness of these rights to increase use of maternity care services. Using inclusion and exclusion criteria defined in a peer-reviewed protocol, we searched published and grey literature from one database of studies on maternal health, two search engines, an internet search and contact with experts. From the 707 unique documents found, 219 made reference to rights, with 22 detailing interventions promoting awareness of rights for maternal and newborn health. Only four of these evaluated effects on health outcomes. While all four interventions promoted awareness of rights, they did so in different ways. Interventions included highly-scripted dissemination meetings with educational materials and other visual aids, participatory approaches that combined raising awareness of rights with improving accountability of services, and broader multi-stakeholder efforts to improve maternal health. Study quality ranged from weak to strong. Measured health outcomes included increased antenatal care and facility birth. Improvements in human rights outcomes such as availability, acceptability, accessibility, quality of care, as well as the capacity of rights holders and duty bearers were also reported to varying extents. Very little information on costs and almost no information on harms or risks were described. Despite searching multiple sources of information, while some studies did report on activities to raise awareness of rights, few detailed how they did so and very few measured effects on health outcomes. Promoting awareness of rights is one element of increasing demand for and use of quality maternity care services for women during pregnancy, birth and after birth. To date efforts have not been well documented in the literature and the program theories, processes and costs, let alone health effects have

  20. Do Interventions that Promote Awareness of Rights Increase Use of Maternity Care Services? A Systematic Review

    PubMed Central

    George, Asha S.; Branchini, Casey; Portela, Anayda

    2015-01-01

    Twenty years after the rights of women to go through pregnancy and childbirth safely were recognized by governments, we assessed the effects of interventions that promote awareness of these rights to increase use of maternity care services. Using inclusion and exclusion criteria defined in a peer-reviewed protocol, we searched published and grey literature from one database of studies on maternal health, two search engines, an internet search and contact with experts. From the 707 unique documents found, 219 made reference to rights, with 22 detailing interventions promoting awareness of rights for maternal and newborn health. Only four of these evaluated effects on health outcomes. While all four interventions promoted awareness of rights, they did so in different ways. Interventions included highly-scripted dissemination meetings with educational materials and other visual aids, participatory approaches that combined raising awareness of rights with improving accountability of services, and broader multi-stakeholder efforts to improve maternal health. Study quality ranged from weak to strong. Measured health outcomes included increased antenatal care and facility birth. Improvements in human rights outcomes such as availability, acceptability, accessibility, quality of care, as well as the capacity of rights holders and duty bearers were also reported to varying extents. Very little information on costs and almost no information on harms or risks were described. Despite searching multiple sources of information, while some studies did report on activities to raise awareness of rights, few detailed how they did so and very few measured effects on health outcomes. Promoting awareness of rights is one element of increasing demand for and use of quality maternity care services for women during pregnancy, birth and after birth. To date efforts have not been well documented in the literature and the program theories, processes and costs, let alone health effects have

  1. Impact of a theory based intervention to increase bicycle helmet use in low income children

    PubMed Central

    Hendrickson, S. G.; Becker, H.

    1998-01-01

    Objective—While community interventions to increase bicycle helmet use have increased markedly, few of these studies are theoretically based. The purpose of this study was to determine relationships among PRECEDE model predictors and self reported helmet use among 407 fourth graders from nine low income, non-urban schools. Setting—Low income schools, with high minority populations in eight non-metropolitan Central Texas counties were chosen. Methods—Schools were randomly assigned in a repeated measures design to either classroom only, parent-child, or control groups. School nurses were educated by the researchers to present a head injury prevention program in all but the experimental schools. Researchers made contact by phone with the parents of children in the parent-child group. Results and conclusions—Participation in either of the educational interventions, followed by belief that helmets protect your head (a predisposing factor), and participation in the parent intervention condition, added significant unique variance to the prediction of helmet use after helmet ownership is accounted. These four variables, taken together, account for 72% of the variance in predicting bicycle helmet use. PMID:9666367

  2. n-3 Fatty Acid Supplementation and Leukocyte Telomere Length in Patients with Chronic Kidney Disease.

    PubMed

    Barden, Anne; O'Callaghan, Nathan; Burke, Valerie; Mas, Emile; Beilin, Lawrence J; Fenech, Michael; Irish, Ashley B; Watts, Gerald F; Puddey, Ian B; Huang, Rae-Chi; Mori, Trevor A

    2016-03-19

    DNA telomere shortening associates with the age-related increase cardiovascular disease (CVD) risk. Reducing oxidative stress, could modify telomere erosion during cell replication, and CVD risk in patients with chronic kidney disease (CKD). The effect of n-3 fatty acids and coenzyme Q10 (CoQ) on telomere length was studied in a double-blind placebo-controlled trial in CKD. Eighty-five CKD patients were randomized to: n-3 fatty acids (4 g); CoQ (200 mg); both supplements; or control (4 g olive oil), daily for 8 weeks. Telomere length was measured in neutrophils and peripheral blood mononuclear cells (PBMC) at baseline and 8 weeks, with and without correction for cell counts. Main and interactive effects of n-3 fatty acids and CoQ on telomere length were assessed adjusting for baseline values. F₂-isoprostanes were measured as markers of oxidative stress. There was no effect of n-3 fatty acids or CoQ on neutrophil or PBMC telomere length. However, telomere length corrected for neutrophil count was increased after n-3 fatty acids (p = 0.015). Post-intervention plasma F₂-isoprostanes were negative predictors of post-intervention telomere length corrected for neutrophil count (p = 0.025).The effect of n-3 fatty acids to increased telomere length corrected for neutrophil count may relate to reduced oxidative stress and increased clearance of neutrophils with shorter telomeres from the circulation. This may be a novel mechanism of modifying CVD risk in CKD patients.

  3. n-3 Fatty Acid Supplementation and Leukocyte Telomere Length in Patients with Chronic Kidney Disease

    PubMed Central

    Barden, Anne; O’Callaghan, Nathan; Burke, Valerie; Mas, Emile; Beilin, Lawrence J.; Fenech, Michael; Irish, Ashley B.; Watts, Gerald F.; Puddey, Ian B.; Huang, Rae-Chi; Mori, Trevor A.

    2016-01-01

    DNA telomere shortening associates with the age-related increase cardiovascular disease (CVD) risk. Reducing oxidative stress, could modify telomere erosion during cell replication, and CVD risk in patients with chronic kidney disease (CKD). The effect of n-3 fatty acids and coenzyme Q10 (CoQ) on telomere length was studied in a double-blind placebo-controlled trial in CKD. Eighty-five CKD patients were randomized to: n-3 fatty acids (4 g); CoQ (200 mg); both supplements; or control (4 g olive oil), daily for 8 weeks. Telomere length was measured in neutrophils and peripheral blood mononuclear cells (PBMC) at baseline and 8 weeks, with and without correction for cell counts. Main and interactive effects of n-3 fatty acids and CoQ on telomere length were assessed adjusting for baseline values. F2-isoprostanes were measured as markers of oxidative stress. There was no effect of n-3 fatty acids or CoQ on neutrophil or PBMC telomere length. However, telomere length corrected for neutrophil count was increased after n-3 fatty acids (p = 0.015). Post-intervention plasma F2-isoprostanes were negative predictors of post-intervention telomere length corrected for neutrophil count (p = 0.025).The effect of n-3 fatty acids to increased telomere length corrected for neutrophil count may relate to reduced oxidative stress and increased clearance of neutrophils with shorter telomeres from the circulation. This may be a novel mechanism of modifying CVD risk in CKD patients. PMID:27007392

  4. Iterative development of Vegethon: a theory-based mobile app intervention to increase vegetable consumption.

    PubMed

    Mummah, Sarah A; King, Abby C; Gardner, Christopher D; Sutton, Stephen

    2016-08-08

    Mobile technology may serve as a cost-effective and scalable tool for delivering behavioral nutrition interventions. This research sought to iteratively develop a theory-driven mobile app, Vegethon, to increase vegetable consumption. Development of Vegethon followed phases outlined by the IDEAS framework: 1) empathize with users (qualitative interviews, n = 18); 2) specify target behavior; 3) ground in behavioral theory; 4) ideate implementation strategies; 5) prototype potential products; 6) gather user feedback (qualitative interviews, n = 14; questionnaire, n = 41); 7) build minimum viable product; and 8) pilot potential efficacy and usability (pilot RCT, n = 17). Findings from each phase informed subsequent phases. The target population that informed intervention development was 18-50 years of age, had BMIs of 28-40 kg/m(2), and lived in the geographical area surrounding Stanford University. A full description of the final version of Vegethon is included in the paper. Qualitative findings that shaped initial intervention conception were: participants' interests in accountability without judgment; their desire for simple and efficient dietary self-monitoring; and the importance of planning meals in advance. Qualitative findings identified during intervention refinement were the need for a focus on vegetable self-monitoring; inclusion of vegetable challenges; simplification of features; advice and inspiration for eating vegetables; reminder notifications; and peer comparison. Pilot RCT findings suggested the initial efficacy, acceptance, and feasibility of the intervention. The final version of Vegethon enabled easy self-monitoring of vegetable consumption and included a range of features designed to engage the user (e.g., surprise challenges; leaderboard; weekly reports). Vegethon was coded for its inclusion of 18 behavior change techniques (BCTs) (e.g., goal setting; feedback; social comparison; prompts/cues; framing/reframing; identity

  5. Evaluation of an intervention to increase screening colonoscopy in an urban public hospital setting.

    PubMed

    Nash, Denis; Azeez, Sulaiman; Vlahov, David; Schori, Melissa

    2006-03-01

    Only 50% of New Yorkers aged 50 and over reported ever being screened for colorectal cancer by any modality according to a recent household survey. The objective of this investigation was to assess the impact of a hospital-based intervention aimed at eliminating health care system barriers to timely colorectal cancer screening at Lincoln Medical Center, a large, urban public hospital in one of the nation's poorest census tracts. We conducted a retrospective analysis of all colonoscopies performed over an 11-month period, during which a multi-pronged intervention to increase the number of screening colonoscopies took place. Two "patient navigators" were hired during the study period to provide continuity for colonoscopy patients. A Direct Endoscopic Referral System (DERS) was also implemented. Enhancements to the gastrointestinal (GI) suite were also made to improve operational efficiency. Immediately following the introduction of the patient navigators, there was a dramatic and sustained decline in the broken appointment rates for both screening and diagnostic colonoscopy (from 67% in May of 2003 to 5% in June of 2003). The likelihood of keeping the appointment for colonoscopy after the patient navigator intervention increased by nearly 3-fold (relative risk = 2.6, 95% CI 2.2-3.0). The rate of screening colonoscopies increased from 56.8 per month to 119 per month. The screening colonoscopy coverage provided by this facility among persons aged 50 and over in surrounding Zip codes increased from 5.2 to 15.6% (RR 3.0, 95% CI 1.9-4.7). Efforts to increase the number of screening colonoscopies were highly successful, due in large part to the influence of patient navigators, a streamlined referral system, and GI suite enhancements. These findings suggest that there are significant health-care system barriers to colonoscopy that, when addressed, could have a significant impact on screening colonoscopy rates in the general population.

  6. Incorporation of marine lipids into mitochondrial membranes increases susceptibility to damage by calcium and reactive oxygen species: evidence for enhanced activation of phospholipase A2 in mitochondria enriched with n-3 fatty acids.

    PubMed Central

    Malis, C D; Weber, P C; Leaf, A; Bonventre, J V

    1990-01-01

    Experiments were designed to evaluate the susceptibility of mitochondrial membranes enriched with n-3 fatty acids to damage by Ca2+ and reactive oxygen species. Fatty acid content and respiratory function were assessed in renal cortical mitochondria isolated from fish-oil- and beef-tallow-fed rats. Dietary fish oils were readily incorporated into mitochondrial membranes. After exposure to Ca2+ and reactive oxygen species, mitochondria enriched in n-3 fatty acids, and using pyruvate and malate as substrates, had significantly greater changes in state 3 and uncoupled respirations, when compared with mitochondria from rats fed beef tallow. Mitochondrial site 1 (NADH coenzyme Q reductase) activity was reduced to 45 and 85% of control values in fish-oil- and beef-tallow-fed groups, respectively. Exposure to Ca2+ and reactive oxygen species enhance the release of polyunsaturated fatty acids enriched at the sn-2 position of phospholipids from mitochondria of fish-oil-fed rats when compared with similarly treated mitochondria of beef-tallow-fed rats. This release of fatty acids was partially inhibited by dibucaine, the phospholipase A2 inhibitor, which we have previously shown to protect mitochondria against damage associated with Ca2+ and reactive oxygen species. The results indicate that phospholipase A2 is activated in mitochondria exposed to Ca2+ and reactive oxygen species and is responsible, at least in part, for the impairment of respiratory function. Phospholipase A2 activity and mitochondrial damage are enhanced when mitochondrial membranes are enriched with n-3 fatty acids. PMID:2123344

  7. Adipose tissue RNASeq reveals novel gene-nutrient interactions following n-3 PUFA supplementation and evoked inflammation in humans.

    PubMed

    Ferguson, Jane F; Xue, Chenyi; Hu, Yu; Li, Mingyao; Reilly, Muredach P

    2016-04-01

    Dietary consumption of long-chain omega-3 polyunsaturated fatty acids (n-3 PUFA) may protect against cardiometabolic disease through modulation of systemic and adipose inflammation. However, it is often difficult to detect the subtle effects of n-3 PUFA on inflammatory biomarkers in traditional intervention studies. We aimed to identify novel n-3 PUFA modulated gene expression using unbiased adipose transcriptomics during evoked endotoxemia in a clinical trial of n-3 PUFA supplementation. We analyzed adipose gene expression using RNA sequencing in the fenofibrate and omega-3 fatty acid modulation of endotoxemia (FFAME) trial of healthy individuals at three timepoints: before and after n-3 PUFA supplementation (n=8; 3600mg/day EPA/DHA) for 6weeks compared with placebo (n=6), as well as during a subsequent evoked inflammatory challenge (lipopolysaccharide 0.6ng/kg i.v.). As expected, supplementation with n-3 PUFA vs. placebo alone had only modest effects on adipose tissue gene expression, e.g., increased expression of immediate early response IER2. In contrast, the transcriptomic response to evoked endotoxemia was significantly modified by n-3 PUFA supplementation, with several genes demonstrating significant n-3 PUFA gene-nutrient interactions, e.g., enhanced transcriptional responses in specific immune genes IER5L, HES1, IL1RN, CCL18, IL1RN, IL7R, IL8, CCL3 and others. These data highlight potential mechanisms whereby n-3 PUFA consumption may enhance the immune response to an inflammatory challenge. In conclusion, unbiased transcriptomics during evoked inflammation reveals novel immune modulating functions of n-3 PUFA nutritional intervention in a dynamic pathophysiological setting. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review.

    PubMed

    Lundgren, Ingela; Smith, Valerie; Nilsson, Christina; Vehvilainen-Julkunen, Katri; Nicoletti, Jane; Devane, Declan; Bernloehr, Annette; van Limbeek, Evelien; Lalor, Joan; Begley, Cecily

    2015-02-05

    The number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC. The bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, 'Effective Public Health Practice Project'. The primary outcome measure was VBAC rates. 238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates. This systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that the included studies were

  9. Increasing condom use: evaluation of a theory-based intervention to prevent sexually transmitted diseases in young women.

    PubMed

    Bryan, A D; Aiken, L S; West, S G

    1996-09-01

    A multicomponent intervention to increase condom use in sexually active young women was designed, implemented, and evaluated in a randomized experiment. Participants were 198 unmarried female college students (mean age = 18.6 years) who received a 1-session condom promotion intervention or a control (stress management) intervention. The condom promotion intervention led to increased self-reported condom use up to 6 months following intervention as well as positive changes in perceived benefits of condom use, affective attitudes toward condom use and condom users, perceived acceptance of sexuality, control over the sexual encounter, perceived self-efficacy for condom use, and intentions to use condoms. Mediational analysis illustrated the mechanisms of the condom promotion intervention effects, linking psychological constructs affected by the intervention (perceived benefits, acceptance of sexuality, control over the sexual encounter, attitudes toward condoms, and self-efficacy for condom use) to condom use intentions.

  10. A quality improvement intervention to increase access to pediatric subspecialty practice.

    PubMed

    Heptulla, Rubina A; Choi, Steven J; Belamarich, Peter F

    2013-02-01

    To improve access to new pediatric endocrinology appointments in an urban academic hospital faculty-based practice. Three strategies were implemented to increase the number of appointment slots: new patient appointments were protected from conversion to follow-up appointments; all physicians, including senior faculty, were scheduled to see 3 to 4 new patients per session; and sessions devoted exclusively to follow-up appointments were added based on demand. The main outcomes for this quality improvement activity were waiting times for new and follow-up appointments, monthly visit volume, the per-provider visit volume, differences in the proportion of new visits, and clinic arrival rates pre- and postintervention. Thirteen months after the intervention, average wait for a new patient appointment decreased from 11.4 to 1.7 weeks (P < .001) and follow-up appointment wait time decreased from 8.2 to 2.9 weeks (P < .001). Mean monthly total visit volume increased from 284 to 366 patient visits (P < .01) and mean monthly visit volume per provider increased from 36.8 to 41.0 patients (P = .08). New patients were 27% of the visit volume and 35% after the intervention. Access to our pediatric specialty care clinic was improved without increasing the number of providers by improved scheduling.

  11. Increased adolescent overweight and obesity documentation through a simple electronic medical record intervention.

    PubMed

    Bode, David V; Roberts, Timothy A; Johnson, Christine

    2013-01-01

    The purpose of this project was to improve provider documentation of adolescent overweight and obesity through body mass index percentile (BMI%) documentation in the military's electronic medical record (EMR). Using the FOCUS-PDCA (Find-Organize-Clarify-Understand-Select-Plan-Do-Check-Act) model, we developed an intervention to improve rates of diagnosis of overweight/obesity in our adolescent medicine clinic. Medical technicians documented the patient's BMI% and growth chart in the EMR. Pre- and postintervention chart reviews of approximately 300 consecutive patient encounters compared the rates of overweight/obesity with provider-documented diagnosis. A total of 333 pre- and 328 postintervention clinic encounters were reviewed. The rate of obesity calculated was similar between pre- and postintervention groups (30% vs. 31%). Correct diagnosis increased from 40% to 64% after the intervention. Females and patients seen by resident physicians were less likely to receive a correct diagnosis at baseline, but these differences were mitigated in the postintervention group. In multivariate analyses, only the intervention and provider type were predictive of an improvement in correct diagnosis. BMI% documentation in our EMR was an effective way to improve documentation of overweight/obese adolescent patients and may be particularly helpful for resident physicians.

  12. Formative evaluation of an intervention to increase compliance to HIV therapies: the ALP project.

    PubMed

    Fourney, Andrew M; Williams, Mark L

    2003-04-01

    Non-adherence to highly effective antiretroviral medications can lead to treatment failure and the development of drug-resistant strains of HIV, and may result in an epidemic of treatment resistant HIV. This article describes a theory-based intervention (ALP) that was developed to increase adherence to HIV therapies among low-literacy populations of HIV positive African American women. The ALP intervention consists of a cartoon book and a cassette tape suitable for individuals with less than a 3rd-grade reading level. Qualitative data were collected through focus groups and expert panel interviews to conduct a formative evaluation. The results indicated that constructs of the Health Belief Model and Social Cognitive Theory were recognizable by behavioral scientists and that the materials would be used as intended by the target population to achieve the desired behavior change. This type of evaluation is a cost-effective method that can be used to develop effective interventions and obtain community buy-in.

  13. Strategies for increasing adherence to an online smoking cessation intervention for college students.

    PubMed

    An, Lawrence C; Perry, Cheryl L; Lein, Emily B; Klatt, Colleen; Farley, Dana M; Bliss, Robin L; Hennrikus, Deborah J; Pallonen, Unto E; Lando, Harry A; Ahluwalia, Jasjit S; Ehlinger, Edward P

    2006-12-01

    High rates of Internet use among young adults make online intervention with this population particularly attractive. However, low adherence rates limit the exposure to and the potential effectiveness of these programs. This study identifies strategies for increasing adherence by examining the rates of participation for a 5-week beta (pilot) version and final version of the RealU Web site, an online intervention for college smokers. Three modifications from the beta to the RealU Web site were (a) changing format from a smoking cessation Web site to an online college life magazine, (b) providing proactive peer e-mail support, and (c) adopting a more linear site structure. Participants were recruited via Internet health screening and received US$10 for completing weekly study activities. Enrollment among eligible smokers was higher for the beta compared with the RealU intervention (47/69, 68.1% vs. 517/1618, 32.0%, p<.001), but participants did not differ in terms of age, gender, or past 30-day cigarette or alcohol use. Participation fell sharply during the beta test (53% in week 1 to 26% by week 5) compared with the RealU average of 95% (range 89% to 98%). Participation during each study's final week was much higher in the RealU (93% week 20) compared with the beta (26% week 5, p<.001). After 5 weeks, self-reported 30-day abstinence was higher for RealU intervention participants (16.0%) compared with the beta participants (4.3%, p=.03). The modifications from the beta to RealU Web site described above resulted in high rates of sustained participation over 20 weeks.

  14. Strategies used to increase lifestyle physical activity in a pedometer-based intervention.

    PubMed

    Croteau, Karen A

    2004-01-01

    The purpose of this study was to determine the self-selected strategies participants used to increase physical activity during an 8-week, pedometer-based lifestyle intervention. Participants were 34 employees of a small northeastern private college, with a mean age of 44.3 (+/- 9.3) years. The intervention consisted of a counseling session (goal setting, strategy selection), daily pedometer usage, and self-monitoring. Measures included height, weight, and pedometer-assessed ambulatory activity. Participants were placed in body mass index (BMI) and weekly physical activity improvement tertiles. BMI categories included normal weight (BMI 18.6-24.9), overweight (BMI 25-29.9), and obese (BMI > or =30). Weekly physical activity improvement categories included small/no improvement (<1%/wk), moderate improvement (1-5%/wk), and large improvement (>5%/wk). Data analysis consisted of descriptive and nonparametric inferential statistics (chi2). Participants in this study used 11 primary strategies on a regular basis to increase daily physical activity. The percentage of participants who used these strategies was as follows: walked to a meeting or work-related errand (64.7%), after work (50.0%), before work (35.3%), at lunch (47.1%), on the weekend (32.4%), while traveling (32.4%), with the dog (32.4%), or to a destination (work/store) (29.4%). Additionally, participants parked farther away (50%), used the stairs rather than an elevator (23.5%), and performed other cardiovascular activity (52.9%). Differences among BMI groups were found for the parking further strategy (p < 0.05), with obese participants using this strategy significantly more than overweight participants. No significant differences were found among weekly physical activity improvement groups. This study indicates that participants in a pedometer-based lifestyle physical activity intervention used a variety of strategies to increase daily physical activity.

  15. Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects

    PubMed Central

    Johannesson, Elisabet; Ringström, Gisela; Abrahamsson, Hasse; Sadik, Riadh

    2015-01-01

    AIM: To assess the long-term effects of physical activity on irritable bowel syndrome (IBS) symptoms and on quality of life, fatigue, depression and anxiety. METHODS: Seventy-six patients from a previous randomized controlled interventional study on increased physical activity in IBS were asked to participate in this long-term follow-up study. The included patients attended one visit in which they filled out questionnaires and they underwent a submaximal cycle ergometer test. The primary end point was the change in the IBS Severity Scoring System (IBS-SSS) at baseline, i.e., before the intervention and at follow-up. The secondary endpoints were changes in quality of life, fatigue, depression and anxiety. RESULTS: A total of 39 [32 women, median age 45 (28-61) years] patients were included in this follow-up. Median follow-up time was 5.2 (range: 3.8-6.2) years. The IBS symptoms were improved compared with baseline [IBS-SSS: 276 (169-360) vs 218 (82-328), P = 0.001]. This was also true for the majority of the dimensions of psychological symptoms such as disease specific quality of life, fatigue, depression and anxiety. The reported time of physical activity during the week before the visit had increased from 3.2 (0.0-10.0) h at baseline to 5.2 (0.0-15.0) h at follow-up, P = 0.019. The most common activities reported were walking, aerobics and cycling. There was no significant difference in the oxygen uptake 31.8 (19.7-45.8) mL per min per kg at baseline vs 34.6 (19.0-54.6) mL/min per kg at follow-up. CONCLUSION: An intervention to increase physical activity has positive long-term effects on IBS symptoms and psychological symptoms. PMID:25593485

  16. Intervention to induce short-term increases in moderate-to-vigorous physical activity in the Lower Mississippi Delta

    USDA-ARS?s Scientific Manuscript database

    Our objective was to determine if a short-term pedometer-based educational intervention results in short-term increases in time spent in moderate-to-vigorous physical activity (MVPA) compared to an education-only intervention, and whether increases in the number of steps taken per day correlate with...

  17. Patient-specific prescriber feedback can increase the rate of osteoporosis screening and treatment: results from two national interventions.

    PubMed

    Kalisch Ellett, Lisa M; Pratt, N L; Sluggett, J K; Ramsay, E N; Kerr, M; LeBlanc, V T; Barratt, J D; Roughead, E E

    2017-12-01

    Osteoporosis interventions targeting older Australians and clinicians were conducted in 2008 and 2011 as part of a national quality improvement program underpinned by behavioural theory and stakeholder engagement. Uptake of bone mineral density (BMD) tests among targeted men and women increased after both interventions and sustained increases in osteoporosis treatment were observed among men targeted in 2008.

  18. An educational intervention designed to increase women's leadership self-efficacy.

    PubMed

    Isaac, Carol; Kaatz, Anna; Lee, Barbara; Carnes, Molly

    2012-01-01

    Women are sparsely represented in leadership in academic science, technology, engineering, mathematics, and medicine (STEMM). Cultural stereotypes about men, women, and leaders influence the attitudes, judgments, and decisions that others make about women and the choices women make for themselves. Multilevel interventions are needed to counteract the impact of these pervasive and easily activated stereotypes, which conspire in multiple ways to constrain women's entry, persistence, and advancement in academic STEMM. We describe an individual-level educational intervention. Using the transtheoretical model of behavioral change as a framework, we assessed the success of a semester course on increasing women's leadership self-efficacy for the first three cohorts of course participants (n = 30). Pre/post questionnaires showed gains in leadership self-efficacy, personal mastery, and self-esteem, and decreases in perceived constraints. Qualitative text analysis of weekly journals indicated increasing leadership self-efficacy as course participants applied course information and integrated strategies to mitigate the impact of societal stereotypes into their own leadership practices. Follow-up queries of the first two cohorts supported the enduring value of course participation. We conclude that providing strategies to recognize and mitigate the impact of gender stereotypes is effective in increasing leadership self-efficacy in women at early stages of academic STEMM careers.

  19. An Educational Intervention Designed to Increase Women's Leadership Self-Efficacy

    PubMed Central

    Isaac, Carol; Kaatz, Anna; Lee, Barbara; Carnes, Molly

    2012-01-01

    Women are sparsely represented in leadership in academic science, technology, engineering, mathematics, and medicine (STEMM). Cultural stereotypes about men, women, and leaders influence the attitudes, judgments, and decisions that others make about women and the choices women make for themselves. Multilevel interventions are needed to counteract the impact of these pervasive and easily activated stereotypes, which conspire in multiple ways to constrain women's entry, persistence, and advancement in academic STEMM. We describe an individual-level educational intervention. Using the transtheoretical model of behavioral change as a framework, we assessed the success of a semester course on increasing women's leadership self-efficacy for the first three cohorts of course participants (n = 30). Pre/post questionnaires showed gains in leadership self-efficacy, personal mastery, and self-esteem, and decreases in perceived constraints. Qualitative text analysis of weekly journals indicated increasing leadership self-efficacy as course participants applied course information and integrated strategies to mitigate the impact of societal stereotypes into their own leadership practices. Follow-up queries of the first two cohorts supported the enduring value of course participation. We conclude that providing strategies to recognize and mitigate the impact of gender stereotypes is effective in increasing leadership self-efficacy in women at early stages of academic STEMM careers. PMID:22949427

  20. Parent-Targeted Mobile Phone Intervention to Increase Physical Activity in Sedentary Children: Randomized Pilot Trial

    PubMed Central

    Marker, Arwen M; Allen, H Raymond; Machtmes, Ryan; Han, Hongmei; Johnson, William D; Schuna Jr, John M; Broyles, Stephanie T; Tudor-Locke, Catrine; Church, Timothy S

    2014-01-01

    Background Low levels of moderate-to-vigorous physical activity are associated with adverse health consequences. Objective The intent of the study was to determine the feasibility and efficacy of a 12-week physical activity promotion program targeting children, which was delivered to parents through mobile phones. Methods Potential participants were recruited through advertisements placed in the newspaper, local hospitals and schools, and an email listserv. Sedentary children aged 6-10 years were randomly assigned to a minimal (MIG) or intensive (IIG) intervention group. Parents in the MIG were given a goal to increase (within 1 month) and maintain their child’s activity at 6000 pedometer steps/day above their baseline levels and to monitor their child’s steps daily. Parents in the IIG were given the same steps/day and monitoring goals, in addition to text messages and articles containing additional behavioral strategies (based on the Social Cognitive Theory) designed to promote their child’s physical activity. The intervention components were delivered via mobile phone. Anthropometrics, body composition, and questionnaires were administered in a clinic. Children wore a New Lifestyles pedometer (NL-1000) each day throughout the intervention and parents were to monitor their child’s step counts daily. Results Out of 59 children who screened for the study, a total of 27 children (mean age 8.7, SD 1.4 years; 56%, 15/27 female; 59%, 16/27 African American) were enrolled and completed the study. Overall, 97.90% (2220/2268; 98.20%, 1072/1092 for MIG; 97.60%, 1148/1176 for IIG) of expected step data were successfully entered by the parent or study coordinator. Parents in the MIG and IIG were sent approximately 7 and 13 text messages per week, respectively, averaged over the course of the study. IIG parents accessed an average of 6.1 (SD 4.4) articles over the course of the intervention and accessed a fewer number of articles in the last month compared to the first

  1. Effectiveness of worksite interventions to increase influenza vaccination rates among employees and families.

    PubMed

    Ofstead, Cori L; Sherman, Bruce W; Wetzler, Harry P; Dirlam Langlay, Alexandra M; Mueller, Natalie J; Ward, Jeremy M; Ritter, Daniel R; Poland, Gregory A

    2013-02-01

    To increase influenza vaccination rates among industrial employees and their families through a campaign at a large corporation. This prospective, multisite study used employee surveys and claims data to evaluate an evidence-based worksite vaccination program. Vaccination rates among insured employees and dependents (N = 13,520) increased significantly after the intervention (P < 0.001). More than 90% of vaccinated employees received vaccine at employer-sponsored events. There was a strong association between employee and family vaccination status. Primary reasons for receiving the vaccine were economic (free 84%; convenient 80%; avoid absenteeism 82%), rather than health-related. Knowledge was associated with vaccination, but customized education did not change beliefs. Worksite programs can demonstrably increase vaccination rates among industrial employees and families. Consideration should be given to repositioning vaccination from medical treatment to community initiatives offered with other worksite health promotion programs.

  2. Increasing nurse staffing levels in Belgian cardiac surgery centres: a cost-effective patient safety intervention?

    PubMed

    Van den Heede, Koen; Simoens, Steven; Diya, Luwis; Lesaffre, Emmanuel; Vleugels, Arthur; Sermeus, Walter

    2010-06-01

    This paper is a report of a cost-effectiveness analysis from a hospital perspective of increased nurse staffing levels (to the level of the 75th percentile) in Belgian general cardiac postoperative nursing units. A previous study indicated that increasing nurse staffing levels in Belgian general cardiac postoperative nursing units was associated with lower mortality rates. Research is needed to compare the costs of increased nurse staffing levels with benefits of reducing mortality rates. Two types of average national costs were compared. A first calculation included the simulation of an increase in the number of nursing hours per patient day to the 75th percentile for nursing units staffed below that level. For the second calculation (the comparator) we used a 'do nothing' alternative. The most recent available data sources were used for the analysis. Results were expressed in the form of the additional costs per avoided death and the additional costs per life-year gained. The analysis used 2007 costing data. The costs of increasing nurse staffing levels to the 75th percentile in Belgian general cardiac postoperative nursing units amounted to euro1,211,022. Such nurse staffing levels would avoid an estimated number of 45.9 (95% confidence interval: 22.0-69.4) patient deaths per year and generate 458.86 (95% confidence interval: 219.93-693.79) life-years gained annually. This corresponds with incremental cost-effectiveness ratios of euro26,372 per avoided death and euro2639 per life-year gained. Increasing nurse staffing levels appears to be a cost-effective intervention as compared with other cardiovascular interventions.

  3. The role of evidence and context for implementing a multimodal intervention to increase HIV testing.

    PubMed

    Bokhour, Barbara G; Saifu, Hemen; Goetz, Matthew Bidwell; Fix, Gemmae M; Burgess, Jane; Fletcher, Michael D; Knapp, Herschel; Asch, Steven M

    2015-02-13

    Increasing the use of routine preventive care such as HIV testing is important, yet implementation of such evidence-based clinical care is complex. The Promoting Action on Research Implementation in Health Services (PARiHS) model for implementation posits that implementation will be most successful when the evidence, context, and facilitation strategies are strong for the clinical practice. We evaluated the relative importance of perceived evidence, context, and facilitation of HIV testing during the implementation of a multimodal intervention in US Department of Veterans Affairs primary care clinics. A multimodal intervention including clinical reminders (CRs), academic detailing--providing education sessions for providers--and social marketing to improve HIV testing was implemented in 15 VA primary care clinics in three regions. We conducted qualitative formative and process evaluations using semi-structured interviews with HIV lead clinicians, primary care lead clinicians, nurse managers, and social workers. Interviews were analyzed thematically to identify barriers and facilitators to implementation of HIV testing and how these were addressed by the intervention. Sites were then rated high, medium, or low on the dimensions of perceived evidence and the context for testing. We then assessed the relationship of these ratings to improvements in HIV testing rates found in earlier quantitative analyses. Sites that showed greatest improvements in HIV testing rates also rated high on evidence and context. Conversely, sites that demonstrated the poorest improvements in testing rates rated low on both dimensions. Perceptions of evidence and several contextual aspects resulted in both barriers and facilitators to implementing testing. Evidence barriers included provider perceptions of evidence for routine testing as irrelevant to their population. Contextual barriers included clinical reminder overload, insufficient resources, onerous consent processes, stigma, provider

  4. Repeated exposure in a natural setting: a preschool intervention to increase vegetable consumption.

    PubMed

    O'Connell, Meghan L; Henderson, Kathryn E; Luedicke, Joerg; Schwartz, Marlene B

    2012-02-01

    Laboratory and home-based research suggest that repeated exposure to vegetables may increase consumption among children. Effectiveness of repeated exposure to vegetables has not been tested in a community-based preschool setting. This randomized controlled trial tested the hypotheses that children who are served unfamiliar vegetables repeatedly in the preschool lunch setting will increase consumption of them, and that consumption will be influenced by peer eating behaviors and parental feeding behaviors. Data were collected in two private preschools in a small northeastern city in 2007. Ninety-six children (aged 3 to 6 years) participated. Schools were randomly assigned to condition. During the first 6 weeks, Preschool A served three vegetables at lunch on 10 separate occasions (ie, 30 days of exposure), while Preschool B continued routine practice. In the 7th week, schools reversed conditions and Preschool B served the vegetables for the next 6 weeks. Consumption data were collected daily in the intervention school and at baseline and post-intervention meals in the control school. PRIMARY OUTCOMES/STATISTICAL ANALYSES: Analysis of variance was used to examine the effect of vegetable exposure on vegetable intake; multilevel models were used to examine the effect of peer eating behaviors and parental feeding practices on vegetable intake. Repeated exposure did not increase vegetable consumption. Greater consumption by tablemates was a significant predictor of greater vegetable consumption; across the three vegetables, 1 g of peer intake was associated with roughly a 1/5-g intake increase among the subjects. Overall, children demonstrated wide fluctuation in vegetable consumption from day to day, creating as much variability within subjects as between them. Further research should explore the conditions necessary for repeated exposure to increase vegetable consumption in preschool settings. Creating opportunities for young children to serve as peer models has promise

  5. A randomized trial of two print interventions to increase colon cancer screening among first-degree relatives.

    PubMed

    Rawl, Susan M; Champion, Victoria L; Scott, Linda L; Zhou, Honghong; Monahan, Patrick; Ding, Yan; Loehrer, Patrick; Skinner, Celette Sugg

    2008-05-01

    First-degree relatives (FDRs) of people diagnosed with colorectal cancer (CRC) have a two- to threefold increased risk of developing the same disease. Tailored print interventions based on behavior change theories have demonstrated considerable promise in facilitating health-promoting behaviors. This study compared the impact of two mailed print interventions on CRC screening outcomes among FDRs. This randomized trial compared effects of two mailed print interventions--one tailored and one nontailored--on participation in CRC screening among FDRs of CRC survivors. Data collected via phone interviews from 140 FDRs at baseline, 1 week post-intervention, and 3 months post-intervention. At 3 months, both the tailored and nontailored interventions yielded modest but statistically insignificant increases in adherence to any CRC screening test (14% vs. 21%, respectively; p=0.30). While there were no main effects for tailored versus nontailored interventions, there were significant interactions that showed that the tailored print intervention had significantly greater effects on forward stage movement for CRC screening depending on stage of adoption at baseline, race, and objective CRC risk. Receipt of the tailored intervention was 2.5 times more likely to move baseline precontemplators and contemplators forward in stage of adoption for colonoscopy (95% CI: 1.10-5.68) and was three times more likely to move Caucasians forward in stage of adoption for FOBT (95% CI: 1.00-9.07). In addition, the tailored intervention was 7.7 times more likely to move people at average risk forward in stage of adoption for colonoscopy (95% CI: 1.25-47.75). The tailored print intervention was more effective at moving Caucasians, those in precontemplation and contemplation at baseline, and those at average risk forward in their stage of adoption for CRC screening. Both tailored and nontailored print interventions showed moderate effects for increasing CRC screening participation. Tailored print

  6. A community-based intervention designed to increase preventive health care seeking among adolescents: the Gonorrhea Community Action Project.

    PubMed

    VanDevanter, Nancy L; Messeri, Peter; Middlestadt, Susan E; Bleakley, Amy; Merzel, Cheryl R; Hogben, Matthew; Ledsky, Rebecca; Malotte, C Kevin; Cohall, Renee M; Gift, Thomas L; St Lawrence, Janet S

    2005-02-01

    We evaluated the effectiveness of an intervention designed to increase preventive health care seeking among adolescents. Adolescents and young adults aged 12 to 21 years, recruited from community-based organizations in 2 different communities, were randomized into either a 3-session intervention or a control condition. We estimated outcomes from 3-month follow-up data using logistic and ordinary least squares regression. Female intervention participants were significantly more likely than female control participants to have scheduled a health care appointment (odds ratio [OR]=3.04), undergone a checkup (OR=2.87), and discussed with friends or family members the importance of undergoing a checkup (OR=4.5). There were no differences between male intervention and male control participants in terms of outcomes. This theory-driven, community-based group intervention significantly increased preventive health care seeking among female adolescents. Further research is needed, however, to identify interventions that will produce successful outcomes among male adolescents.

  7. Developing the intervention material to increase physical activity levels of European preschool children: the ToyBox-study.

    PubMed

    Duvinage, K; Ibrügger, S; Kreichauf, S; Wildgruber, A; De Craemer, M; De Decker, E; Androutsos, O; Lateva, M; Iotova, V; Socha, P; Zych, K; Mouratidou, T; Mesana Graffe, M I; Manios, Y; Koletzko, B

    2014-08-01

    Early childhood is an important period for adopting positive health-related behaviours. More than 95% of European preschool children attend kindergartens, making these settings ideal for the implementation of health promotion interventions. The ToyBox-intervention addressed preschool children, their parents/caregivers and teachers. The aim of the intervention was to improve four energy balance-related behaviours (i.e. healthy snacking, water consumption, physical activity and sedentary behaviour) by implementing a kindergarten-based, family-involved intervention in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). The intervention material was developed following the intervention mapping protocol, taking into account local and cultural differences among the intervention countries. The present paper focuses on the development of the physical activity component of the intervention. Parental involvement was addressed by providing parents/caregivers with two newsletters, two tip cards and a poster. Teachers received a handbook with guidance on environmental changes in the classroom, 26 physical education sessions and suggestions for fun, interactive classroom activities aiming at total class participation to increase preschoolers' physical activity levels. The ToyBox-intervention material was distributed according to a standard time frame. Teachers received their material prior to the start of the intervention and parents/caregivers received their material during the intervention when each energy balance-related behaviour was implemented.

  8. Watch Me Grow: A garden-based pilot intervention to increase vegetable and fruit intake in preschoolers

    PubMed Central

    2013-01-01

    Background Americans, including children, consume fewer fruit and vegetable servings than is recommended. Given that young children spend large amounts of time in child care centers, this may be an ideal venue for increasing consumption of and enthusiasm for fruits and vegetables. This pilot study aimed to assess the feasibility of a gardening intervention to promote vegetable and fruit intake among preschoolers. Methods We enrolled two intervention centers and two control centers. The intervention included a fruit and vegetable garden, monthly curriculum, gardening support, and technical assistance. We measured mean (SD) servings of fruits and vegetables served to and consumed by three children per center before and after the intervention. Results Post intervention, intervention and control centers served fewer vegetables (mean (standard deviation) difference of -0.18 (0.63) in intervention, -0.37 (0.36) in control), but intervention children consumed more than control children (+0.25 (1.11) vs. -0.18 (0.52). The number of fruits served decreased in all centers (intervention -0.62 (0.58) vs. control -0.10 (0.52)) but consumption was higher in controls (intervention -0.32 (0.58) vs. control 0.15 (0.26)). Conclusions The garden-based feasibility study shows promise, but additional testing is needed to assess its ability to increase vegetable and fruit intake in children. PMID:23597235

  9. Evaluating a tailored intervention to increase screening mammography in an urban area.

    PubMed Central

    Allen, Bruce; Bazargan-Hejazi, Shahrzad

    2005-01-01

    METHOD: The study was conducted over a four-year period, 1996 and 2000. Participants were recruited using Computer Assisted Telephone Interviewing (CATI) software and random-digit dialing (RDD). Study eligibility criteria included living in the King/Drew Medical Center service area in Los Angeles, having an operable telephone, being female > or = 40 years old and not having had a screening mammogram in the past year. Four-hundred-thirty respondents were randomly assigned to the intervention and comparison groups. English and Spanish focus-group-tested tailored interventions were administered telephonically by trained interviewers. African Americans and Latinas constituted 83.0% of the sample at assignment and 83.8% at six-month follow-up, which is representative of the study area. RESULTS: The main outcome variable of interest in this study was having a screening mammogram during the time interval between baseline and the six-month follow-up assessment. Multiple logistic regressions that revealed factors predicting the outcome variable included: 1) age (p < or = 0.05, OR=2.22, CI 0.98-5.0); 2) study group (p < or = 0.05, OR=1.76, CI 1.06-2.92); 3) prior mammograms (p < or = 0.05, O0R=2.51, 1.39-4.56); and 4) and knowledge of the age when a woman should begin getting mammograms on a regular basis (p < or = 0.05, OR=0.55, 0.33-0.92). CONCLUSION: Tailored telephone counseling increased the instances of screening mammograms by nearly 8% in the intervention group at follow-up. The results of this study confirm previous findings regarding the impact of structural and behavioral factors related to screening mammography. PMID:16353657

  10. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Background Ankle joint equinus, or restricted dorsiflexion range of motion (ROM), has been linked to a range of pathologies of relevance to clinical practitioners. This systematic review and meta-analysis investigated the effects of conservative interventions on ankle joint ROM in healthy individuals and athletic populations. Methods Keyword searches of Embase, Medline, Cochrane and CINAHL databases were performed with the final search being run in August 2013. Studies were eligible for inclusion if they assessed the effect of a non-surgical intervention on ankle joint dorsiflexion in healthy populations. Studies were quality rated using a standard quality assessment scale. Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and results were pooled where study methods were homogenous. Results Twenty-three studies met eligibility criteria, with a total of 734 study participants. Results suggest that there is some evidence to support the efficacy of static stretching alone (SMDs: range 0.70 to 1.69) and static stretching in combination with ultrasound (SMDs: range 0.91 to 0.95), diathermy (SMD 1.12), diathermy and ice (SMD 1.16), heel raise exercises (SMDs: range 0.70 to 0.77), superficial moist heat (SMDs: range 0.65 to 0.84) and warm up (SMD 0.87) in improving ankle joint dorsiflexion ROM. Conclusions Some evidence exists to support the efficacy of stretching alone and stretching in combination with other therapies in increasing ankle joint ROM in healthy individuals. There is a paucity of quality evidence to support the efficacy of other non-surgical interventions, thus further research in this area is warranted. PMID:24225348

  11. Immediate increases in quadriceps corticomotor excitability during an electromyography biofeedback intervention.

    PubMed

    Pietrosimone, Brian; McLeod, Michelle M; Florea, David; Gribble, Phillip A; Tevald, Michael A

    2015-04-01

    The purpose of the study was to determine the effects of EMG-BF on vastus lateralis corticomotor excitability, measured via motor evoked potential (MEP) amplitudes elicited using Transcranial Magnetic Stimulation (TMS) during a maximal voluntary isometric contraction (MVIC). We also determined the effect of EMG-BF on isometric knee extensor strength. Fifteen healthy participants volunteered for this crossover study with two sessions held one-week apart. Participants were randomly assigned to condition order, during which five intervention MVICs were performed with or without EMG-BF. MEP amplitudes were collected with TMS during five knee extension contractions (5% of MVIC) at baseline and again during intervention MVICs within each session. During the control condition, participants were instructed to perform the same number of MVICs without any EMG-BF. Percent change scores were used to calculate the change in peak-to-peak MEP amplitudes that occurred during EMG-BF and Control MVICs compared to the baseline MEPs. Peak knee extension torque was recorded during MVICs prior to TMS for each condition. EMG-BF produced significantly increased MEP change scores and significantly greater torque than the control condition. The results of the current study suggest that EMG-BF may be a viable clinical method for targeting corticomotor excitability. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. On-farm feeding interventions to increase milk production in lactating dairy cows.

    PubMed

    Wanapat, Metha; Foiklang, Suban; Phesatcha, Kampanat; Paoinn, Chainarong; Ampapon, Thiwakorn; Norrapoke, Thitima; Kang, Sungchhang

    2017-04-01

    The objective of this study was to investigate the effect of tropical legume (Phaseolus calcaratus) mixed with ruzi grass feeding on the performance of lactating dairy cows. Eighty-eight lactating dairy cows from 22 smallholder dairy farms northeast of Thailand were assigned to respective dietary treatments according to a Randomized Completely Block Design (RCBD). Four cows were selected from each farm and were allocated into two different feeding groups as follows: ruzi grass and P. calcaratus mixed with ruzi grass (1:1 ratio), respectively. All cows were fed with roughage ad libitum with 1:2 ratio of concentrate diet to milk yield. The results revealed that total dry matter intake, ruminal volatile fatty acids, and ammonia nitrogen concentration were enhanced when cows were fed with P. calcaratus mixed with ruzi grass (P < 0.05). Moreover, feeding tropical legume mixed with ruzi grass could increase milk production and milk protein in this study. Importantly, an economical assessment showed that milk income and the profit from milk sale were significantly greater in cows fed the mixture of roughage than those from the non-mixed group. This study concluded that high-quality roughage as tropical legume mixed with ruzi grass at the ratio of 1:1 brought out the remarkable and practical implementation for smallholder dairy farms, and the intervention was practical and deserving of more on-farm intervention.

  13. Use of Theory in Behavior Change Interventions: An Analysis of Programs to Increase Physical Activity in Posttreatment Breast Cancer Survivors

    PubMed Central

    Bluethmann, Shirley M.; Bartholomew, L. Kay; Murphy, Caitlin C.; Vernon, Sally W.

    2017-01-01

    Objective Theory use may enhance effectiveness of behavioral interventions, yet critics question whether theory-based interventions have been sufficiently scrutinized. This study applied a framework to evaluate theory use in physical activity interventions for breast cancer survivors. The aims were to (1) evaluate theory application intensity and (2) assess the association between extensiveness of theory use and intervention effectiveness. Methods Studies were previously identified through a systematic search, including only randomized controlled trials published from 2005 to 2013, that addressed physical activity behavior change and studied survivors who were <5 years posttreatment. Eight theory items from Michie and Prestwich’s coding framework were selected to calculate theory intensity scores. Studies were classified into three subgroups based on extensiveness of theory use (Level 1 = sparse; Level 2 = moderate; and Level 3 = extensive). Results Fourteen randomized controlled trials met search criteria. Most trials used the transtheoretical model (n = 5) or social cognitive theory (n = 3). For extensiveness of theory use, 5 studies were classified as Level 1, 4 as Level 2, and 5 as Level 3. Studies in the extensive group (Level 3) had the largest overall effect size (g = 0.76). Effects were more modest in Level 1 and 2 groups with overall effect sizes of g = 0.28 and g = 0.36, respectively. Conclusions Theory use is often viewed as essential to behavior change, but theory application varies widely. In this study, there was some evidence to suggest that extensiveness of theory use enhanced intervention effectiveness. However, there is more to learn about how theory can improve interventions for breast cancer survivors. PMID:27226430

  14. A Randomized Intervention Study to Evaluate Whether Electronic Messaging Can Increase Human Papillomavirus Vaccine Completion and Knowledge among College Students

    ERIC Educational Resources Information Center

    Richman, Alice R.; Maddy, LaDonna; Torres, Essie; Goldberg, Ellen J.

    2016-01-01

    Objective: To evaluate an intervention aimed at increasing human papillomavirus (HPV) vaccine completion of the 3-dose series and knowledge. Participants: Two hundred sixty-four male and female US college students 18-26 years old who were receiving HPV vaccine dose 1. Methods: Students were randomly assigned to the intervention or control group.…

  15. A Preliminary Investigation of Evidence-Based Interventions to Increase Oral Reading Fluency in Children with Autism

    ERIC Educational Resources Information Center

    Reisener, Carmen D.; Lancaster, Amity Lewis; McMullin, W. Arrel; Ho, Tuan

    2014-01-01

    At present, the incidence rates of children identified with autism spectrum disorders are on the rise, leading to an increased number of school-aged children needing specialized services in public schools. Most intervention efforts in the school setting focus on behavioral interventions and/or communication and social skills remediation services…

  16. Safer Sex in a Digital World: A Web-Based Motivational Enhancement Intervention to Increase Condom Use among College Women

    ERIC Educational Resources Information Center

    Starosta, Amy J.; Cranston, Emma; Earleywine, Mitch

    2016-01-01

    Objective: This study is a randomized trial of a Web-based intervention to increase condom use among college women. Participants: From October 2012 to March 2013, N = 422 completed baseline questionnaires and intervention procedures. n = 216 completed 3-month follow-up. Methods: Participants completed a decisional balance exercise examining their…

  17. A Randomized Intervention Study to Evaluate Whether Electronic Messaging Can Increase Human Papillomavirus Vaccine Completion and Knowledge among College Students

    ERIC Educational Resources Information Center

    Richman, Alice R.; Maddy, LaDonna; Torres, Essie; Goldberg, Ellen J.

    2016-01-01

    Objective: To evaluate an intervention aimed at increasing human papillomavirus (HPV) vaccine completion of the 3-dose series and knowledge. Participants: Two hundred sixty-four male and female US college students 18-26 years old who were receiving HPV vaccine dose 1. Methods: Students were randomly assigned to the intervention or control group.…

  18. Peer 2 Peer: Efficacy of a Course-Based Peer Education Intervention to Increase Physical Activity among College Students

    ERIC Educational Resources Information Center

    Boyle, Jennifer; Mattern, Craig O.; Lassiter, Jill W.; Ritzler, Julia A.

    2011-01-01

    There are few physical activity (PA) interventions in higher education, and they have been only minimally effective. Objective: To determine if a course-based, peer education intervention was associated with increases in PA and physical fitness. Participants: Participants were 178 students enrolled in a personal health class during the 2007-2008…

  19. Peer 2 Peer: Efficacy of a Course-Based Peer Education Intervention to Increase Physical Activity among College Students

    ERIC Educational Resources Information Center

    Boyle, Jennifer; Mattern, Craig O.; Lassiter, Jill W.; Ritzler, Julia A.

    2011-01-01

    There are few physical activity (PA) interventions in higher education, and they have been only minimally effective. Objective: To determine if a course-based, peer education intervention was associated with increases in PA and physical fitness. Participants: Participants were 178 students enrolled in a personal health class during the 2007-2008…

  20. Development of a Multilevel Intervention to Increase HIV Clinical Trial Participation among Rural Minorities

    ERIC Educational Resources Information Center

    Corbie-Smith, Giselle; Odeneye, Ebun; Banks, Bahby; Shandor Miles, Margaret; Roman Isler, Malika

    2013-01-01

    Minorities are disproportionately affected by HIV/AIDS in the rural Southeast; therefore, it is important to develop targeted, culturally appropriate interventions to support rural minority participation in HIV/AIDS research. Using intervention mapping, we developed a comprehensive multilevel intervention for service providers (SPs) and people…

  1. A group-based intervention to increase condom use among HIV serodiscordant couples in India, Thailand, and Uganda.

    PubMed

    Mcgrath, J W; Celentano, D D; Chard, S E; Fullem, A; Kamya, M; Gangakhedar, R R; Khamboonruang, C; Joglekar, N; Malhotra-Kohli, R; Kiwanuka, A; Sirirojn, B

    2007-03-01

    This study assessed the feasibility of a group-based couples intervention to increase condom use in HIV serodiscordant couples in three countries (India, Thailand and Uganda). The intervention focused on communication, problem solving, and negotiation skills. Forty-three couples enrolled in the intervention (15 in India, 14 in Thailand, and 14 in Uganda) and 40 couples completed all study activities. Participants were interviewed at baseline and at one and three months post- intervention. The intervention consisted of two same sex sessions and two couples sessions with 'homework' to practice skills between sessions. The same intervention modules were used at each site, tailored for local appropriateness. Participants at each site were enthusiastic about the intervention, citing information about HIV serodiscordancy and the opportunity to meet couples 'like us' as important features. Participants reported increased comfort discussing sex and condoms with their partner, although some participants remain concerned about situations when condoms might not be used (e.g. when drunk). At three-month follow up 90% of the participants reported having been able to use the skills from the intervention with their partner. Our results highlight the feasibility of this couples group-based intervention and the need for ongoing support for discordant couples.

  2. The Effect of Couples Intervention to Increase Breast Cancer Screening Among Korean Americans

    PubMed Central

    Lee, Eunice; Menon, Usha; Nandy, Karabi; Szalacha, Laura; Kviz, Frederick; Cho, Young; Miller, Arlene; Park, Hanjong

    2014-01-01

    Purpose/Objectives To assess the efficacy of Korean Immigrants and Mammography—Culture-Specific Health Intervention (KIM-CHI), an educational program for Korean American (KA) couples designed to improve mammography uptake among KA women. Design A two-group cluster randomized, longitudinal, controlled design. Setting 50 KA religious organizations in the Chicago area. Sample 428 married KA women 40 years of age or older who had not had a mammogram in the past year. The women and their husbands were recruited from 50 KA religious organizations. Methods Couples were randomly assigned to intervention or attention control groups. Those in the KIM-CHI program (n = 211 couples) were compared to an attention control group (n = 217 couples) at baseline, as well as at 6 and 15 months postintervention on mammogram uptake. Main Research Variables Sociodemographic variables and mammography uptake were measured. Level of acculturation was measured using the Suinn-Lew Asian Self-Identity Acculturation Scale. Researchers asked questions about healthcare resources and use, health insurance status, usual source of care, physical examinations in the past two years, family history of breast cancer, and history of mammography. Findings The KIM-CHI group showed statistically significant increases in mammography uptake compared to the attention control group at 6 months and 15 months postintervention. Conclusions The culturally targeted KIM-CHI program was effective in increasing mammogram uptake among nonadherent KA women. Implications for Nursing Nurses and healthcare providers should consider specific health beliefs as well as inclusion of husbands or significant others. They also should target education to be culturally relevant for KA women to effectively improve frequency of breast cancer screening. PMID:24769601

  3. Media interventions to increase cervical screening uptake in South Africa: an evaluation study of effectiveness.

    PubMed

    Risi, L; Bindman, J P; Campbell, O M R; Imrie, J; Everett, K; Bradley, J; Denny, L

    2004-08-01

    Successful cervical cancer prevention depends on reaching, screening and treating women with pre-invasive disease. We aimed to evaluate the effectiveness of two media interventions-a photo-comic and a radio-drama-in increasing cervical screening uptake. A randomized controlled trial compared a photo-comic on cervical cancer screening with a placebo comic. One month after the comics were distributed a radio-drama paralleling the photo-comic was broadcast on the community radio station and a retrospective evaluation was carried out. The trial was set in Khayelitsha, a peri-urban squatter community near Cape Town, South Africa. A random sample consisted of 658 women between the ages of 35 and 65 years, from a stratified sample of census areas. The main outcome measure was self-reported cervical screening uptake 6 months after distribution of the comics. Seven percent (18 of 269) of women who received the intervention photo-comic reported cervical screening during the 6 months follow-up, compared with 6% (25 of 389) of controls (P = 0.89). Women who recalled hearing the radio-drama were more likely to report attending screening (nine of 53, 17%) than those who did not (19 of 429, 4%; P < 0.001). We conclude that the photo-comic was ineffective in increasing cervical screening uptake in this population. The radio-drama may have had more impact, but only a minority of women recalled being exposed to it. Future research must concentrate not only on achieving high level of exposure to health messages, but also on investigating the links between exposure and action.

  4. Motor imagery during action observation increases eccentric hamstring force: an acute non-physical intervention.

    PubMed

    Scott, Matthew; Taylor, Stephen; Chesterton, Paul; Vogt, Stefan; Eaves, Daniel Lloyd

    2017-03-21

    Rehabilitation professionals typically use motor imagery (MI) or action observation (AO) to increase physical strength for injury prevention and recovery. Here we compared hamstring force gains for MI during AO (AO + MI) against two pure MI training groups. Over a 3-week intervention physically fit adults imagined Nordic hamstring exercises in both legs and synchronized this with a demonstration of the same action (AO + MI), or they purely imagined this action (pure MI), or imagined upper-limb actions (pure MI-control). Eccentric hamstring strength gains were assessed using ANOVAs, and magnitude-based inference (MBI) analyses determined the likelihood of clinical/practical benefits for the interventions. Hamstring strength only increased significantly following AO + MI training. This effect was lateralized to the right leg, potentially reflecting a left-hemispheric dominance in motor simulation. MBIs: The right leg within-group treatment effect size for AO + MI was moderate and likely beneficial (d = 0.36), and only small and possibly beneficial for pure MI (0.23). Relative to pure MI-control, effects were possibly beneficial and moderate for AO + MI (0.72), although small for pure MI (0.39). Since hamstring strength predicts injury prevalence, our findings point to the advantage of combined AO + MI interventions, over and above pure MI, for injury prevention and rehabilitation. Implications for rehabilitation While hamstring strains are the most common injury across the many sports involving sprinting and jumping, Nordic hamstring exercises are among the most effective methods for building eccentric hamstring strength, for injury prevention and rehabilitation. In the acute injury phase it is crucial not to overload damaged soft tissues, and so non-physical rehabilitation techniques are well suited to this phase. Rehabilitation professionals typically use either motor imagery or action observation techniques to safely improve physical

  5. The Influence of Neighborhood Crime on Increases in Physical Activity during a Pilot Physical Activity Intervention in Children.

    PubMed

    Broyles, Stephanie T; Myers, Candice A; Drazba, Kathryn T; Marker, Arwen M; Church, Timothy S; Newton, Robert L

    2016-04-01

    The purpose of this study was to examine whether neighborhood crime moderated the response (increases in steps) to a pilot intervention to increase physical activity in children. Twenty-seven insufficiently active children aged 6-10 years (mean age = 8.7 years; 56 % female; 59 % African American) were randomly assigned to an intensive intervention group (IIG) or minimal intervention group (MIG). Change in average daily number of steps from baseline was regressed against an index of neighborhood crime in a multilevel repeated-measures model that included a propensity score to reduce confounding. Safer neighborhoods were associated with higher increases in steps during the pilot intervention (interaction p = 0.008). Children in the IIG living in low-crime neighborhoods significantly increased their physical activity (5275 ± 1040 steps/day) while those living in high-crime neighborhoods did not (1118 ± 1007) (p for difference = 0.046). In the IIG, the increase in daily steps was highly correlated with neighborhood crime (r = 0.58, p = 0.04). These findings suggest the need for physical activity interventions to account for participants' environments in their design and/or delivery. To promote healthy behaviors in less-supportive environments, future studies should seek to understand how environments modify intervention response and to identify mediators of the relationship between environment and intervention.

  6. How to inform: comparing written and video education interventions to increase human papillomavirus knowledge and vaccination intentions in young adults.

    PubMed

    Krawczyk, Andrea; Lau, Elsa; Perez, Samara; Delisle, Vanessa; Amsel, Rhonda; Rosberger, Zeev

    2012-01-01

    To compare the efficacy of 2 human papillomavirus (HPV) educational interventions on increasing HPV knowledge and vaccination intentions in college students. Male (n = 60) and female (n = 140) undergraduates (M (age) = 20.4, SD = 2.3) recruited from a university in Montreal, Quebec, Canada, from October 2009 to March 2010. Using theory-based interventions, participants were randomly assigned to either a written HPV pamphlet, an HPV video, or a control. HPV knowledge and vaccination intentions were assessed pre and postintervention. Low baseline knowledge and intentions were found across groups. Postintervention, participants in the written and video interventions had significantly higher knowledge and intentions than the control. No differences were found between written and video interventions on knowledge or intentions. This study, a first in comparing HPV educational formats, suggests that both written and video interventions are equally effective in educating about HPV and increasing young adults' vaccination intentions.

  7. The "buddy-in-jail" technique-a novel method for increasing support during percutaneous coronary intervention.

    PubMed

    Bagnall, Alan J; Spratt, James C

    2009-10-01

    The "buddy-in-jail" technique is a novel method for increasing support during percutaneous coronary intervention. We report two case-based examples of successful coronary stent delivery using the jailed buddy wire technique.

  8. Randomized trial of a brief dietary intervention to decrease consumption of fat and increase consumption of fruits and vegetables.

    PubMed

    Stevens, Victor J; Glasgow, Russell E; Toobert, Deborah J; Karanja, Njeri; Smith, K Sabina

    2002-01-01

    This study tested the efficacy of a computer-assisted counseling intervention to reduce diet-related cancer risk. Randomized controlled trial. Healthy women HMO members (n = 616) aged 40 to 70. Participants were randomly assigned to nutrition intervention or an attention-control intervention unrelated to diet. Intervention consisted of two 45-minute counseling sessions plus two 5- to 10-minute follow-up telephone contacts. Counseling sessions included a 20-minute, interactive, computer-based intervention using a touchscreen format. Intervention goals were reducing dietary fat and increasing consumption of fruit, vegetables, and whole grains. Twenty-four hour diet recalls and the Fat and Fiber Behavior Questionnaire (FFB). Four-month follow-up data were collected from 94% of the intervention participants and 91% of the controls. Testing with a multivariate general linear models analysis showed improvements on all dietary outcome variables. Compared to the control, intervention participants reported significantly less fat consumption (2.35 percentage points less for percentage of energy from fat), significantly greater consumption of fruit and vegetables combined (1.04 servings per day), and a significant reduction in a behavioral measure of fat consumption (.24 point change in the FFB). These 4-month results are comparable to several other moderate-intensity studies showing that, in the appropriate circumstances, moderate-intensity dietary interventions can be efficacious. Study limitations include the short follow-up period and the use of self-reported outcome measures.

  9. Effectiveness of culturally focused interventions in increasing the satisfaction of hospitalized Asian patients: a systematic review.

    PubMed

    Alfred, Millicent; Ubogaya, Karolina; Chen, Xing; Wint, Diana; Worral, Priscilla Sandford

    2016-08-01

    Patient satisfaction is a driving force for healthcare organizations to enhance patient services. As the Asian population in the United States is increasing at a significant rate, it is important to understand the needs of this population to implement culturally focused services that will lead to increased Asian in-patient satisfaction. The objective of the systematic review was to identify the best available evidence on the effectiveness of culturally focused interventions in increasing satisfaction of hospitalized adult Asian patients. This review considered studies that included Asian adults, 18 years of age and older, who were admitted to acute-care hospitals in countries where Asians are a minority culture. This review considered studies that included any intervention or sets of interventions implemented by hospitals for the purpose of making the hospital experience consistent with the cultural preferences of adult Asian in-patients. Satisfaction of adult Asian hospitalized patients as measured by self-report satisfaction scales or tools considered by accrediting and/or governing bodies to be acceptable sources of evidence of patients' perceptions of their care. This review first considered randomized controlled trials (RCTs), non-RCTs and quasi-experimental studies. As no RCTs or quasi-experimental studies were found, the reviewers also considered before and after studies, cohort studies and case-control studies for inclusion. This review also considered for inclusion descriptive study designs including case series, individual case reports and descriptive cross-sectional studies related to the adult Asian population in acute-care hospital settings. Three descriptive studies were selected in the review. The search strategy aimed to find both published and unpublished studies in English and Chinese (Mandarin and Cantonese) languages. A search of MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Educational Research

  10. Increasing physical activity efficiently: an experimental pilot study of a website and mobile phone intervention.

    PubMed

    Thorsteinsen, Kjærsti; Vittersø, Joar; Svendsen, Gunnvald Bendix

    2014-01-01

    The main objective of this pilot study was to test the effectiveness of an online, interactive physical activity intervention that also incorporated gaming components. The intervention design included an activity planner, progress monitoring, and gamification components and used SMS text as a secondary delivery channel and feedback to improve engagement in the intervention content. Healthy adults (n = 21) recruited through ads in local newspapers (age 35-73) were randomized to the intervention or the control condition. Both groups reported physical activity using daily report forms in four registration weeks during the three-month study: only the experiment condition received access to the intervention. Analyses showed that the intervention group had significantly more minutes of physical activity in weeks five and nine. We also found a difference in the intensity of exercise in week five. Although the intervention group reported more minutes of physical activity at higher intensity levels, we were not able to find a significant effect at the end of the study period. In conclusion, this study adds to the research on the effectiveness of using the Internet and SMS text messages for delivering physical activity interventions and supports gamification as a viable intervention tool.

  11. The concept of scalability: increasing the scale and potential adoption of health promotion interventions into policy and practice.

    PubMed

    Milat, Andrew John; King, Lesley; Bauman, Adrian E; Redman, Sally

    2013-09-01

    Increased focus on prevention presents health promoters with new opportunities and challenges. In this context, the study of factors influencing policy-maker decisions to scale up health promotion interventions from small projects or controlled trials to wider state, national or international roll-out is increasingly important. This study aimed to: (i) examine the perspectives of senior researchers and policy-makers regarding concepts of 'scaling up' and 'scalability'; (ii) generate an agreed definition of 'scalability' and (iii) identify intervention and research design factors perceived to increase the potential for interventions to be implemented on a more widespread basis or 'scaled up'. A two-stage Delphi process with an expert panel of senior Australian public health intervention researchers (n = 7) and policy-makers (n = 7) and a review of relevant literature were conducted. Through this process 'scalability' was defined as: the ability of a health intervention shown to be efficacious on a small scale and or under controlled conditions to be expanded under real world conditions to reach a greater proportion of the eligible population, while retaining effectiveness. Results showed that in health promotion research insufficient attention is given to issues of effectiveness, reach and adoption; human, technical and organizational resources; costs; intervention delivery; contextual factors and appropriate evaluation approaches. If these issues were addressed in the funding, design and reporting of intervention research, it would advance the quality and usability of research for policy-makers and by doing so improve uptake and expansion of promising programs into practice.

  12. Effectiveness of a multi-level asthma intervention in increasing controller medication use: a randomized control trial.

    PubMed

    Canino, Glorisa; Shrout, Patrick E; Vila, Doryliz; Ramírez, Rafael; Rand, Cynthia

    2016-01-01

    Poor self-management by families is an important factor in explaining high rates of asthma morbidity in Puerto Rico, and for this reason we previously tested a family intervention called CALMA that was found effective in improving most asthma outcomes, but not effective in increasing the use of controller medications. CALMA-plus was developed to address this issue by adding to CALMA, components of provider training and screening for asthma in clinics. Study participants were selected from claims Medicaid data in San Juan, Puerto Rico. After screening, 404 children in eight clinics were selected after forming pairs of clinics and randomizing the clinics) to CALMA-only or CALMA-plus. For all three primary outcomes at 12 months, the mean differences between treatment arms were small but in the predicted direction. However, after adjusting for clinic variation, the study failed to demonstrate that the CALMA-plus intervention was more efficacious than the CALMA-only intervention for increasing controller medication use, or decreasing asthma symptoms. Both groups had lower rates of asthma symptoms and service utilization, consistent with previous results of the CALMA-only intervention. Compliance of providers with the intervention and training, small number of clinics available and the multiple barriers experienced by providers for medicating may have been related to the lack of difference observed between the groups. Future interventions should respond to the limitations of the present study design and provide more resources to providers that will increase provider participation in training and implementation of the intervention.

  13. Increasing HIV serostatus disclosure in low- and middle-income countries: a systematic review of intervention evaluations

    PubMed Central

    Kennedy, Caitlin E.; Fonner, Virginia A.; Armstrong, Kevin A.; O'reilly, Kevin R.; Sweat, Michael D.

    2017-01-01

    Objective To review the effectiveness of interventions to increase HIV serostatus disclosure in low- and middle-income countries. Design Systematic review of peer-reviewed articles providing pre-post or multi-arm evaluations of disclosure interventions, defined broadly as any intervention with the goal of increasing rates of voluntary disclosure of HIV serostatus through self-disclosure or partner notification. Methods Articles were included if they reported post-intervention evaluation results and were published between January 1, 1990 and August 1, 2014. Searching was conducted through 5 electronic databases, secondary searching of four journals, and hand searching reference lists of included articles. Systematic methods were used for screening and data abstraction, which was conducted in duplicate. Study quality (rigor) was assessed with eight items. Results Fourteen articles evaluating 13 interventions met the inclusion criteria, all from sub-Saharan Africa. Most interventions focused on people living with HIV and used cognitive-behavioral group sessions or peer/community health worker support to encourage disclosure to sexual partners, family members, or friends. One focused on maternal disclosure to HIV-uninfected children, while two examined voluntary partner notification interventions. Several studies had limitations due to weak designs, small sample sizes, or high attrition. Findings on disclosure were mixed, with most effect sizes being relatively small and some, more rigorous studies showing no effect. Partner notification interventions had the strongest evidence of impact. Conclusion The existing evidence base for interventions to increase disclosure is limited and shows variable results. Further research is needed to determine whether current approaches to increasing disclosure are effective or whether new approaches should be considered. PMID:26049541

  14. Implementing Interventions with Families in Schools to Increase Youth School Engagement: The Family Check-Up Model

    PubMed Central

    Fosco, Gregory M.; Dishion, Thomas J.

    2010-01-01

    This study examined outcomes associated with the Family Check-Up (FCU), an adaptive, tailored, family-centered intervention to enhance positive adjustment of middle school youth and prevent problem behavior. The FCU intervention model was delivered to families in 3 public middle schools. The study sample comprised 377 families, and participants were randomly assigned to receive either the intervention or school as usual. Participation in the intervention was relatively high, with 38% of the families receiving the FCU. Participation in the intervention improved youth self-regulation over the 3 years of the study. Self-regulation skills, defined as effortful control, predicted both decreased depression and increased school engagement in high school, with small to medium effect sizes. The results have implications for the delivery of mental health services in schools that specifically target family involvement and parenting skills. PMID:20495673

  15. Selecting Effective Interventions to Increase Math Computation Fluency via Brief Experimental Analyses

    ERIC Educational Resources Information Center

    Reisener, Carmen D.; Dufrene, Brad A.; Clark, Chelsi R.; Olmi, D. Joe; Tingstrom, Daniel H.

    2016-01-01

    In a response to intervention RtI paradigm, the use of brief experimental analyses (BEAs) for identifying effective interventions for elementary and middle school students struggling with math is a relatively new area of research. This investigation includes two studies, both of which employed a brief multielement design and an extended analysis…

  16. Behavioral Intervention Planning: Increasing Appropriate Behavior of a Socially Withdrawn Student

    ERIC Educational Resources Information Center

    Christensen, Lynnette; Young, K. Richard; Marchant, Michelle

    2007-01-01

    This study examined the effects of an assessment-based intervention plan on the appropriate classroom behavior of a socially withdrawn, Hispanic, learning disabled, third grade student. The study focused on (1) the effects of peer mediation as part of a behavioral intervention package of empirically validated components, (2) the effects of…

  17. Selecting Effective Interventions to Increase Math Computation Fluency via Brief Experimental Analyses

    ERIC Educational Resources Information Center

    Reisener, Carmen D.; Dufrene, Brad A.; Clark, Chelsi R.; Olmi, D. Joe; Tingstrom, Daniel H.

    2016-01-01

    In a response to intervention RtI paradigm, the use of brief experimental analyses (BEAs) for identifying effective interventions for elementary and middle school students struggling with math is a relatively new area of research. This investigation includes two studies, both of which employed a brief multielement design and an extended analysis…

  18. A Function-Based Intervention to Decrease Disruptive Behavior and Increase Academic Engagement

    ERIC Educational Resources Information Center

    Lane, Kathleen Lynne; Smither, Rachel; Huseman, Rachel; Guffey, Jennifer; Fox, James

    2007-01-01

    A range of interventions exist to prevent and respond to disruptive classroom behavior. This study documents the efficacy of a function-based intervention conducted using a multiple baseline across settings design. Despite moderately variable levels of treatment fidelity, results suggest a functional relation between the introduction of a package…

  19. Increasing Teachers' Use of Praise with a Response-to-Intervention Approach

    ERIC Educational Resources Information Center

    Myers, Diane M.; Simonsen, Brandi; Sugai, George

    2011-01-01

    A multiple baseline design across teachers was used to evaluate the effects of a systematic, response-to-intervention (RTI) approach on rates of desired teacher behavior. Specifically, teachers whose rates of specific, contingent praise were nonresponsive to typical schoolwide positive behavior support training (primary intervention tier) were…

  20. Increasing Walking in College Students Using a Pedometer Intervention: Differences According to Body Mass Index

    ERIC Educational Resources Information Center

    Jackson, Erica M.; Howton, Amy

    2008-01-01

    Objective: The researchers assessed the effectiveness of a pedometer intervention and differences in walking behaviors according to body mass index (BMI). Participants: Two hundred ninety college students completed the intervention from January to February 2005. Methods: Participants wore pedometers 5 days per week for 12 weeks and completed…

  1. Development of the REFOCUS intervention to increase mental health team support for personal recovery.

    PubMed

    Slade, Mike; Bird, Victoria; Le Boutillier, Clair; Farkas, Marianne; Grey, Barbara; Larsen, John; Leamy, Mary; Oades, Lindsay; Williams, Julie

    2015-12-01

    There is an emerging evidence base about best practice in supporting recovery. This is usually framed in relation to general principles, and specific pro-recovery interventions are lacking. To develop a theoretically based and empirically defensible new pro-recovery manualised intervention--called the REFOCUS intervention. Seven systematic and two narrative reviews were undertaken. Identified evidence gaps were addressed in three qualitative studies. The findings were synthesised to produce the REFOCUS intervention, manual and model. The REFOCUS intervention comprises two components: recovery-promoting relationships and working practices. Approaches to supporting relationships comprise coaching skills training for staff, developing a shared team understanding of recovery, exploring staff values, a Partnership Project with people who use the service and raising patient expectations. Working practices comprise the following: understanding values and treatment preferences; assessing strengths; and supporting goal-striving. The REFOCUS model describes the causal pathway from the REFOCUS intervention to improved recovery. The REFOCUS intervention is an empirically supported pro-recovery intervention for use in mental health services. It will be evaluated in a multisite cluster randomised controlled trial (ISRCTN02507940). © The Royal College of Psychiatrists 2015.

  2. Using Narrative Language Intervention as a Tool To Increase Communicative Competence in Spanish-Speaking Children.

    ERIC Educational Resources Information Center

    Schoenbrodt, Lisa; Kerins, Marie; Gesell, Jacqueline

    2003-01-01

    Twelve Spanish-speaking school-aged children participated in an 8-week pretest/posttest design investigation targeting improvement of their communicative competence through a narrative intervention program. Also examined the efficacy of providing an intervention in the children's native language. Findings revealed that use of a narrative…

  3. A Review of Interventions To Increase Driving Safety among Teenage Drivers.

    ERIC Educational Resources Information Center

    Mattox, John R., II

    Young drivers across the United States represent a persistent traffic safety problem. Many interventions have been imposed on these drivers but few studies have evaluated the impact of these interventions on risky behaviors or traffic safety measures. To fill this gap, a review was undertaken to examine the most rigorous methodological evaluations…

  4. The Taped Problems Intervention: Increasing the Math Fact Fluency of a Student with an Intellectual Disability

    ERIC Educational Resources Information Center

    McCallum, Elizabeth; Schmitt, Ara J.

    2011-01-01

    The Taped Problems intervention is an evidence-based practice that involves a self-monitored, audio-recording procedure in which students follow along with automated recordings of math facts and their solutions. A multiple-probes-across-tasks design was used to evaluate the effectiveness of the Taped Problems intervention on the division-fact…

  5. Increasing the Social Skills of a Student with Autism through a Literacy-Based Behavioral Intervention

    ERIC Educational Resources Information Center

    Francis, Grace L.; McMullen, Victoria B.; Blue-Banning, Martha; Haines, Shana

    2013-01-01

    Social skills instruction is as important for many students with disabilities as instruction in core academic subjects. Frequently, students with autism require individualized social skills instruction to experience success in general education settings. Literacy-based behavioral Interventions (LBBIs) are an effective intervention that instructors…

  6. Randomized Controlled Trial of Social Media: Effect of Increased Intensity of the Intervention.

    PubMed

    Fox, Caroline S; Gurary, Ellen B; Ryan, John; Bonaca, Marc; Barry, Karen; Loscalzo, Joseph; Massaro, Joseph

    2016-04-27

    A prior randomized controlled trial of social media exposure at Circulation determined that social media did not increase 30-day page views. Whether insufficient social media intensity contributed to these results is uncertain. Original article manuscripts were randomized to social media exposure compared with no social media exposure (control) at Circulation beginning in January 2015. Social media exposure consisted of Facebook and Twitter posts on the journal's accounts. To increase social media intensity, a larger base of followers was built using advertising and organic growth, and posts were presented in triplicate and boosted on Facebook and retweeted on Twitter. The primary outcome was 30-day page views. Stopping rules were established at the point that 50% of the manuscripts were randomized and had 30-day follow-up to compare groups on 30-day page views. The trial was stopped for futility on September 26, 2015. Overall, 74 manuscripts were randomized to receive social media exposure, and 78 manuscripts were randomized to the control arm. The intervention and control arms were similar based on article type (P=0.85), geographic location of the corresponding author (P=0.33), and whether the manuscript had an editorial (P=0.80). Median number of 30-day page views was 499.5 in the social media arm and 450.5 in the control arm; there was no evidence of a treatment effect (P=0.38). There were no statistically significant interactions of treatment by manuscript type (P=0.86), by corresponding author (P=0.35), by trimester of publication date (P=0.34), or by editorial status (P=0.79). A more intensive social media strategy did not result in increased 30-day page views of original research. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  7. Synthesis and characterization of the SO(2)N(3)(-), (SO(2))(2)N(3)(-), and SO(3)N(3)(-) anions.

    PubMed

    Christe, Karl O; Boatz, Jerry A; Gerken, Michael; Haiges, Ralf; Schneider, Stefan; Schroer, Thorsten; Tham, Fook S; Vij, Ashwani; Vij, Vandana; Wagner, Ross I; Wilson, William W

    2002-08-12

    SO(2) solutions of azide anions are bright yellow, and their Raman spectra indicate the presence of covalently bound azide. Removal of the solvent at -64 degrees C from CsN(3) or N(CH(3))(4)N(3) solutions produces yellow (SO(2))(2)N(3)(-) salts. Above -64 degrees C, these salts lose 1 mol of SO(2), resulting in white SO(2)N(3)(-) salts that are marginally stable at room temperature and thermally decompose to the corresponding azides and SO(2). These anions were characterized by vibrational and (14)N NMR spectroscopy and theoretical calculations. Slow loss of the solvent by diffusion through the walls of a sealed Teflon tube containing a sample of CsSO(2)N(3) in SO(2) resulted in white and yellowish single crystals that were identified by X-ray diffraction as CsSO(2)N(3).CsSO(3)N(3) with a = 9.542(2) A, b = 6.2189(14) A, c = 10.342(2) A, and beta = 114.958(4) degrees in the monoclinic space group P2(1)/m, Z = 2, and Cs(2)S(2)O(5).Cs(2)S(2)O(7).SO(2), respectively. Pure CsSO(3)N(3) was also prepared and characterized by vibrational spectroscopy. The S-N bond in SO(2)N(3)(-) is much weaker than that in SO(3)N(3)(-), resulting in decreased thermal stability, an increase in the S-N bond distance by 0.23 A, and an increased tendency to undergo rotational disorder. This marked difference is due to SO(3) being a much stronger Lewis acid (pF(-) value of 7.83) than SO(2) (pF(-) value of 3.99), thus forming a stronger S-N bond with the Lewis base N(3)(-). The geometry of the free gaseous SO(2)N(3)(-) anion was calculated at the RHF, MP2, B3LYP, and CCSD(T) levels. The results show that only the correlated methods correctly reproduce the experimentally observed orientation of the SO(2) group.

  8. Effects of a peer modelling and rewards-based intervention to increase fruit and vegetable consumption in children.

    PubMed

    Lowe, C F; Horne, P J; Tapper, K; Bowdery, M; Egerton, C

    2004-03-01

    To measure children's consumption of, and liking for, fruit and vegetables and how these are altered by a peer modelling and rewards-based intervention. In this initial evaluation of the programme, children's consumption of fruit and vegetables were compared within and across baseline and intervention phases. Three primary schools in England and Wales. In total, 402 children, aged from 4 to 11 y. Over 16 days, children watched six video adventures featuring heroic peers (the Food Dudes) who enjoy eating fruit and vegetables, and received small rewards for eating these foods themselves. Fruit and vegetable consumption was measured (i) in school at lunchtime and snacktime using a five-point observation scale, with inter-rated reliability and weighed validation tests; and (ii) at home using parental recall. A questionnaire measured children's liking for fruit and vegetables before and after the intervention. Consumption during the intervention was significantly higher than during baseline at lunchtime and at snacktime (P<0.001 in all instances). Consumption outside school was significantly higher during the intervention on weekdays (P<0.05) but not weekend days. Following the intervention, children's liking for fruit and vegetables also showed a significant increase (P<0.001). The peer modelling and rewards-based intervention was shown to be effective in bringing about substantial increases in children's consumption of, and expressed liking for, fruit and vegetables. : Horticultural Development Council, Fresh Produce Consortium, ASDA, Co-operative Group, Safeway, Sainsbury, Somerfield, Tesco and Birds Eye Wall's.

  9. Eat Smart, Live Strong intervention increases fruit and vegetable consumption among low-income older adults.

    PubMed

    Hersey, James C; Cates, Sheryl C; Blitstein, Jonathan L; Kosa, Katherine M; Santiago Rivera, Olga J; Contreras, Dawn A; Long, Valerie A; Singh, Anita; Berman, Danielle A

    2015-01-01

    This study evaluated the impact of a four-session interactive nutrition education program-Eat Smart, Live Strong (ESLS)-on the consumption of fruit and vegetables by low-income older adults. A pre-post quasi-experimental design study was conducted with a longitudinal sample of 614 low-income Supplemental Nutrition Assistance Program (SNAP) participants and those eligible for SNAP, aged 60 to 80 years, in 17 intervention and 16 comparison senior centers in Michigan. The study compared participants' self-reports of their consumption of fruit and vegetables using a modified version of the University of California Cooperative Extension Food Behavior Checklist. ESLS increased participants' average daily consumption of fruit by 0.2 cups (P < 0.05) and vegetables by 0.31 cups (P < 0.01). ESLS, a four-session, cognitive-behavioral nutrition education program is an effective curriculum for helping low-income older adults eat more fruit and vegetables.

  10. Increased risk of coronary perforation during percutaneous intervention of myocardial bridge: What histopathology says.

    PubMed

    Pourhoseini, Somayeh; Bakhtiari, Mohammad; Babaee, Abdolreza; Ostovan, Mohammad Ali; Eftekhar-Vaghefi, Seyed Hassan; Ostovan, Nikan; Dehghani, Pooyan

    2017-01-01

    Introduction: Myocardial bridge (MB) is a segment of a major epicardial coronary artery that goes intramurally under a bridge of overlying myocardium. Complications have been reported during or after stent implantation particularly coronary perforation. The aim of this study was to determine histological differences between proximal left anterior descending artery (LAD) and the tunneled segment that may have a possible role in increased risk of coronary artery perforation during percutaneous coronary intervention. Methods: Twenty specimens of MB were obtained from dissection of 45 cadavers. Sections were stained using hematoxylin and eosin (H&E), and trichrome methods. The proximal section and the tunneled artery were compared with a normal sample in terms of the characteristics of a muscle artery. Results: The findings of this study showed an MB prevalence of 51%, as 23 out of the 45 examined cadavers were discovered to be afflicted by the MB. The intima layer in the suffering artery had gone through significant hypertrophy, while it had remained thin in the tunneled artery section. The epithelial cells under the bridge were spindle-shaped, while they were polygonal in the proximal section. In the myocardium the nuclei of the muscle fibers in the MB section were smaller than the normal section. Adventitial layer was almost normal. Conclusion: The histopathological differences between MB and proximal part of vessel combined with small vessel diameter in the tunneled segment can explain the high incidence of the LAD rupture and perforation in the section under the bridge.

  11. Increase urban resilience by planning the public spaces uses for humanitarian interventions.

    NASA Astrophysics Data System (ADS)

    Delaitre, Maxime; Barroca, Bruno; Vargas, Jorge; Cornejo, Christian; Sierra, Alexis

    2017-04-01

    Challenges in post-disaster crisis of natural origin seem to have a strong relation with territory characteristics (location, habitat, propagation, etc.). Moreover, they determine those requirements needed for humanitarian interventions. Decision-making at response and recuperation stages are supported or limited depending on the availability of public spaces to be used for victims' accommodation, field hospitals and rubble deposits. In the case of Lima and Callao (Peru), the presence and superposition of multiple governmental levels - national, regional (1), provincial (2) and district (50) - result in a highly-complex local Disaster Risk Management system for response coordination. The diversity of actors, their responsibilities and individual initiative suggest competition for the resources available in an emergency situation. Resource location determines if humanitarian operations can be run in an effective and efficient way. In this context, public space is a fundamental resource; if it is well-selected, it will provide access to accumulated resources such as water, electricity and telecommunications for the affected population. To increase urban resilience, it requires previous planning and coordination for emergency response, where institutional and territorial configurations are decisive factors for the recuperation and rehabilitation processes performance. This communication will present the institutional and territorial dimensions of the Peruvian capital which condition emergency management performances to consider the crisis management opportunities, offered by territorial analysis and estimations of actors' needs. It would be a starting point for decision-making on emergence activities locations and for establishing coordination frameworks concerning territorial issues and challenges.

  12. Video-feedback intervention increases sensitive parenting in ethnic minority mothers: a randomized control trial.

    PubMed

    Yagmur, Sengul; Mesman, Judi; Malda, Maike; Bakermans-Kranenburg, Marian J; Ekmekci, Hatice

    2014-01-01

    Using a randomized control trial design we tested the effectiveness of a culturally sensitive adaptation of the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) in a sample of 76 Turkish minority families in the Netherlands. The VIPP-SD was adapted based on a pilot with feedback of the target mothers, resulting in the VIPP-TM (VIPP-Turkish Minorities). The sample included families with 20-47-month-old children with high levels of externalizing problems. Maternal sensitivity, nonintrusiveness, and discipline strategies were observed during pretest and posttest home visits. The VIPP-TM was effective in increasing maternal sensitivity and nonintrusiveness, but not in enhancing discipline strategies. Applying newly learned sensitivity skills in discipline situations may take more time, especially in a cultural context that favors more authoritarian strategies. We conclude that the VIPP-SD program and its video-feedback approach can be successfully applied in immigrant families with a non-Western cultural background, with demonstrated effects on parenting sensitivity and nonintrusiveness.

  13. Increased adolescent knowledge and behavior following a one-time educational intervention about tuberculosis.

    PubMed

    Hatzenbuehler, Lindsay A; Starke, Jeffrey R; Smith, E O'Brian; Turner, Teri L; Balmer, Doreen F; Arif, Zainab; Guzman, Francisco; Cruz, Andrea T

    2017-05-01

    To evaluate the impact of a tuberculosis (TB) educational intervention (EI) on change in adolescent student knowledge and participation in a TB prevention program. From 2/2013-5/2015, students from 2 high schools in Houston, TX participated. The 25-min EI discussed TB bacteriology, epidemiology, symptoms, and indications for TB testing/treatment. Students completed pre- and post-quizzes. Immediately after the EI, students were invited to participate in voluntary TB risk-factor screening, testing and treatment. At 6 months, focus groups were conducted. 895 students attended the EI. 827 students (92%) completed the EI quizzes. Knowledge improved by 12% (pre: 70%; post: 82%, p<0.001); 78% shared their TB knowledge. Following the EI, 671/827 (81%) enrolled in a TB prevention program. Focus groups indicated that the EI stimulated student learning about TB and increased their willingness to participate. A brief, one-time, TB EI is an effective method to encourage adolescents to learn about TB and motivate their uptake of TB risk-factor screening, testing and treatment. Similar EIs should accompany TB prevention programs targeting adolescents. The study's procedures could be considered for incorporation into school-based TB prevention programs to improve the identification, testing and treatment of adolescents at risk for TB. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Insulin Resistance Increases the Risk of Contrast-Induced Nephropathy in Patients Undergoing Elective Coronary Intervention.

    PubMed

    Li, Yueping; Liu, Yuyang; Shi, Dongmei; Yang, Lixia; Liang, Jing; Zhou, Yujie

    2016-02-01

    We assessed the influence of insulin resistance (IR) on the development of contrast-induced nephropathy (CIN) in patients (n = 719) undergoing elective percutaneous coronary intervention (PCI). Patients were divided into diabetes mellitus (DM = 242), nondiabetic IR (IR = 120), and nondiabetic insulin sensitivity (IS = 357) groups according to medical history and homeostasis model assessment insulin resistance index. Serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were measured before and 72 hours after PCI. There were no differences in SCr and eGFR among the groups before PCI; SCr increased and eGFR decreased significantly in the DM and IR groups post-PCI (P < .001). The incidence of CIN in the IR group was as high as in the DM group and were both significantly higher than in the IS group (6.7% vs 8.7% vs 2.2%, P < .05). Multivariate logistic regression analysis showed DM (odds ratio [OR] = 1.19, 95%CI = 1.08-1.510, P < .001), HOMA-IR (OR = 1.39, 95%CI = 1.23-1.58, P < 0.001), and eGFR (OR = 0.88, 95%CI = 0.84-0.92, P < .001) were independent risk factors in predicting CIN. Screening IR patients and taking appropriate prophylactic strategy before PCI may reduce the incidence of CIN.

  15. Dual Intervention to Increase Chlamydia Retesting: A Randomized Controlled Trial in Three Populations.

    PubMed

    Smith, Kirsty S; Hocking, Jane S; Chen, Marcus Y; Fairley, Christopher K; McNulty, Anna M; Read, Phillip; Bradshaw, Catriona S; Tabrizi, Sepehr N; Wand, Handan; Saville, Marion; Rawlinson, William; Garland, Suzanne M; Donovan, Basil; Kaldor, John M; Guy, Rebecca J

    2015-07-01

    Chlamydia retesting 3 months after treatment is recommended to detect reinfections, but retesting rates are typically low. The purpose of this study is to determine if the addition of a postal home collection kit to a short message service (SMS) reminder at 3 months increases the percentage of patients retested for chlamydia at 1-4 months, compared to SMS alone. In this unblinded randomized controlled trial, participants were randomized 1:1 to intervention (home arm) or control (clinic arm) status. Participants included 200 each of women, heterosexual men, and men who have sex with men diagnosed and treated for chlamydia at sexual health services. Three months after chlamydia diagnosis, home arm participants received an SMS reminder and postal home collection kit (women, vaginal swab; heterosexual men, Copan UriSwab; men who have sex with men, UriSwab and rectal swab). The main outcome measures were the percentage of participants retested at 1-4 months after chlamydia diagnosis and the percentage in each arm with repeat positive tests, by risk group and overall, analyzed by intention to treat. Data were collected from 2011 to 2013 and analyzed in 2014. The percentage retested within 1-4 months of chlamydia diagnosis was significantly higher in home versus clinic arm participants among women (64% [66/103] vs 39% [38/97], p<0.001); heterosexual men (56% [57/101] vs 34% [34/99], p=0.002); men who have sex with men (62% [61/98] vs 44% [45/102], p=0.010); and overall (61% [184/302] vs 39% [117/298], p<0.001). The percentage in the home versus clinic arm with repeat positive tests was significantly higher among men who have sex with men (16% [16/98] vs 5% [5/102], p=0.021) and overall (10% [31/302] vs 4% [12/298], p=0.006). The addition of a postal home collection kit to routine SMS reminders resulted in substantial improvements in chlamydia retesting rates in all three risk groups and detection of more repeat positive tests, compared with SMS alone. Extending the

  16. Increasing Antiretroviral Adherence for HIV-Positive African Americans (Project Rise): A Treatment Education Intervention Protocol

    PubMed Central

    Bogart, Laura M; Mutchler, Matt G; McDavitt, Bryce; Mutepfa, Kieta D; Risley, Brian

    2016-01-01

    Background HIV-positive African Americans have been shown to have lower adherence to antiretroviral therapy (ART) than those of other races/ethnicities, yet adherence interventions have rarely been tailored to the needs of this population. Objective We developed and will evaluate a treatment education adherence intervention (called Rise) that was culturally adapted to address the needs of African Americans living with HIV. Methods This randomized controlled trial will examine the effects of the Rise intervention on ART adherence and HIV viral load. African Americans on ART who report adherence problems will be recruited from the community and randomly assigned to receive the intervention or usual care for 6 months. The intervention consists of 6-10 individual counseling sessions, with more sessions provided to those who demonstrate lower adherence. Primary outcomes include adherence as monitored continuously with Medication Event Monitoring Systems (MEMS) caps, and viral load data received from the participant’s medical provider. Survey assessments will be administered at baseline and month 6. Results The trial is ongoing. Conclusions If effective, the Rise intervention will provide community-based organizations with an intervention tailored to address the needs of African Americans for promoting optimal ART adherence and HIV clinical outcomes. Trial Registration Clinicaltrials.gov NCT01350544; https://clinicaltrials.gov/ct2/show/NCT01350544 (Archived by WebCite at http://www.webcitation.org/6fjqqnmn0). PMID:27025399

  17. Fasting lipoprotein and postprandial triacylglycerol responses to a low-carbohydrate diet supplemented with n-3 fatty acids.

    PubMed

    Volek, J S; Gómez, A L; Kraemer, W J

    2000-06-01

    The effects of a prolonged low-carbohydrate diet rich in n-3 fatty acids on blood lipid profiles have not been addressed in the scientific literature. This study examined the effects of an eight-week ketogenic diet rich in n-3 fatty acids on fasting serum lipoproteins and postprandial triacylglycerol (TG) responses. Ten men consumed a low-carbohydrate diet rich in monounsaturated fat (MUFA) and supplemented with n-3 fatty acids for eight weeks. Fasting blood samples were collected before and after one week of habitual diet and on two consecutive days after 2, 4, 6 and 8 weeks of the intervention diet. Postprandial TG responses to a fat-rich test meal were measured prior to and after the intervention diet. Compared to the habitual diet, subjects consumed significantly (p < or = 0.05) greater quantities of protein, fat, MUFA and n-3 fatty acids and significantly less total energy, carbohydrate and dietary fiber. Body weight significantly declined over the experimental period (-4.2+/-2.7 kg). Compared to baseline, fasting total cholesterol, LDL cholesterol and HDL cholesterol were not significantly different after the intervention diet (+1.5%, +9.7% and +10.0%, respectively). Fasting TG were significantly reduced after the intervention diet (-55%). There was a significant reduction in peak postprandial TG (-42%) and TG area under the curve (-48%) after the intervention diet. A hypocaloric low-carbohydrate diet rich in MUFA and supplemented with n-3 fatty acids significantly reduced postabsorptive and postprandial TG in men that were not hypertriglyceridemic as a group before the diet. This may be viewed as a clinically significant positive adaptation in terms of cardiovascular risk status. However, transient increases in total cholesterol and LDL cholesterol were also evident and should be examined further in regard to which particular subfractions are elevated.

  18. Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

    PubMed

    Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

    2017-02-01

    The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

  19. An organizational climate intervention associated with increased handwashing and decreased nosocomial infections.

    PubMed

    Larson, E L; Early, E; Cloonan, P; Sugrue, S; Parides, M

    2000-01-01

    Handwashing practices are persistently suboptimal among healthcare professionals and are also stubbornly resistant to change. The purpose of this quasi-experimental intervention trial was to assess the impact of an intervention to change organizational culture on frequency of staff handwashing (as measured by counting devices inserted into soap dispensers on four critical care units) and nosocomial infections associated with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). All staff in one of two hospitals in the mid-Atlantic region received an intervention with multiple components designed to change organizational culture; the second hospital served as a comparison. Over a period of 8 months, 860,567 soap dispensings were recorded, with significant improvements in the study hospital after 6 months of follow-up. Rates of MRSA were not significantly different between the two hospitals, but rates of VRE were significantly reduced in the intervention hospital during implementation.

  20. Defragmenting care: testing an intervention to increase the effectiveness of interdisciplinary health care teams.

    PubMed

    Kilgore, Rachel V; Langford, Rae W

    2010-06-01

    Few studies in the literature have examined the outcomes of health care interdisciplinary teams. Most existing studies have measured attributes of health care teams; however, none have implemented and examined outcomes of a team development intervention. This study was conducted to determine whether a development intervention used with an existing interdisciplinary team would reduce the length of stay for patients in an acute care setting. A quasi-experimental single-subject time series design was conducted with multiple measures of length of stay collected across baseline, intervention, and reversal phases of the study. Bronstein's Model for Interdisciplinary Collaboration provided the framework for this study. The components of this model were used to guide a team development intervention comprised of 4 consecutive weeks of classroom development sessions and 4 consecutive weeks of booster messaging. Length of stay (LOS) data were collected for each of the study phases to examine preintervention LOS and compare these data with LOS during the intervention and reversal phases. The results of this study revealed that the interdisciplinary team development intervention had no positive effect on the length of stay data. Baseline mean LOS across 12 baseline months was 4.83 days (SD=0.65) with monthly means ranging from 4.1 to 6.3 days. The mean LOS was 5.1 and 4.6 days for the intervention months of May and June and 6.0, 6.5, 5.7, and 5.4 days for the reversal months of July to October, respectively. All means in the intervention and reversal phases were higher than comparable months in the baseline phase. The pattern of the graphed trend was closely aligned with the seasonal variations seen during the baseline months. Although these results showed that the team development intervention provided for this interdisciplinary team had no positive effect on the LOS, there are many factors that may have influenced the results and may provide insights useful for future

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

    PubMed Central

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

    1994-01-01

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

  2. An educational intervention to increase "speaking-up" behaviors in nurses and improve patient safety.

    PubMed

    Sayre, Michelle M; McNeese-Smith, Donna; Leach, Linda Searle; Phillips, Linda R

    2012-01-01

    "Speaking up" is a critical component in improving patient safety. Studies indicate, though, that most registered nurses prefer using behaviors of avoidance or accommodation in conflict situations. The purpose of this quasi-experimental study was to determine whether an educational intervention using scenarios, personal reflection, and peer support in small groups could improve speaking-up behaviors in registered nurses. Results showed a significant difference in speaking-up behaviors and scores in the intervention group (P < .001).

  3. Obesity increase among low SES Australian schoolchildren between 2000 and 2006: time for preventive interventions to target children from low income schools?

    PubMed

    O'Dea, Jennifer A; Dibley, Michael J

    2010-06-01

    To examine change from 2000 to 2006 in obesity and overweight by gender, school year and school socioeconomic status (SES) in a national sample of students from Australia. Survey of students aged 6-18 years from the same 32 schools in 2000 (N = 3,819) and 2006 (N = 5,524) with measured height and weight. All analyses were adjusted for the cluster survey design. Main outcome measures were height, weight, Z-score distribution of BMI, overweight and obesity [International Obesity Task Force (IOTF) cut-offs], school SES. Obesity and overweight were similar to previous Australian findings with 5.2% and 6.1% obese in 2000 and 2006, respectively, and 16.3 and 19.0% overweight. Significant increase in obesity was observed in students from low SES schools which increased from 5.8 to 8.6% (P < 0.05) compared to 5.5 to 6.3% (P = 0.32) in middle SES and 3.3 to 4.2% (P = 0.92) in high SES schools. Obesity increased significantly among children in low SES schools and preventive efforts should urgently and carefully target preventive efforts to assist schools, families and communities which are socially and economically, disadvantaged using culturally appropriate physical activity and nutrition promotion interventions.

  4. Efficacy of technology-based interventions to increase the use of hearing protections among adolescent farmworkers.

    PubMed

    Khan, Khalid M; Evans, Sydney S; Bielko, Sylvanna L; Rohlman, Diane S

    2017-09-18

    Adolescent farmworkers are exposed to loud noise during farm activities. We present a prospective study that evaluated the efficacy of low-cost, technology-based intervention approaches in high schools to enhance the use of hearing protection among adolescent farmworkers. Six high schools in Iowa that agreed to participate in the study were divided into three equal groups through cluster-randomisation with each group receiving one of the three formats of hearing protection intervention: (a) classroom training, (b) classroom training coupled with smartphone app training and (c) computer training. Participants completed baseline (pre-training) and six-week post-intervention surveys for assessing hearing protection knowledge, attitudes and behaviour. Seventy participants from six schools were initially enrolled but 50 completed both pre- and post-intervention surveys. In most cases, all three groups showed significant improvement in hearing protection knowledge, attitude and frequency of use from pre- to post-intervention. However, changes between groups were statistically non-significant. Although all three formats led to improvements on hearing protection knowledge, attitude and behaviour, the findings of the study, perhaps due to the small sample size, did not allow us to detect whether technology-based hearing protection interventions were more effective than the traditional face-to-face training for adolescent farmworkers.

  5. Development of a Multilevel Intervention to Increase HIV Clinical Trial Participation among Rural Minorities

    PubMed Central

    Corbie-Smith, Giselle; Odeneye, Ebun; Banks, Bahby; Miles, Margaret Shandor; Isler, Malika Roman

    2013-01-01

    Minorities are disproportionately affected by HIV/AIDS in the rural Southeast; therefore, it is important to develop targeted, culturally appropriate interventions to support rural minority participation in HIV/AIDS research. Using Intervention Mapping, we developed a comprehensive multilevel intervention for service providers (SPs) and people living with HIV/AIDS (PLWHA). We collected data from both groups through 11 focus groups and 35 individual interviews. Resultant data were used to develop matrices of behavioral outcomes, performance objectives and learning objectives. Each performance objective was mapped with changeable, theory-based determinants to inform components of the intervention. Behavioral outcomes for the intervention included: (a) Eligible PLWHA will enroll in clinical trials; and (b) SPs will refer eligible PLWHA to clinical trials. The ensuing intervention consists of four SPs and six PLWHA educational sessions. Its contents, methods and strategies were grounded in the theory of reasoned action, social cognitive theory, and the concept of social support. All materials were pretested and refined for content appropriateness and effectiveness. PMID:22991051

  6. Mobilizing men as partners: the results of an intervention to increase dual protection among Nigerian men

    PubMed Central

    Exner, Theresa M.; Mantell, J. E.; Adeokun, L. A.; Udoh, I. A.; Ladipo, O. A.; Delano, G. E.; Faleye, J.; Akinpelu, K.

    2009-01-01

    This quasi-experimental, proof-of-concept study evaluated the effects of an intervention designed to help Nigerian men decrease risk for HIV/sexually transmitted infections and unintended pregnancy. The intervention was delivered in groups during two 5-hour workshops, with a monthly 2-hour check-in session. A comparison condition consisted of a group-based half-day didactic workshop. Based on recruitment area, 149 men were assigned to the intervention and 132 to the comparison. Men were evaluated at baseline and 3-month post-intervention. At follow-up, men assigned to the intervention were almost four times more likely than comparison men to report condom use at last intercourse (P < 0.001) and to report fewer unprotected vaginal sex occasions, greater self-efficacy for negotiation, a more egalitarian power dynamic in their primary relationship, more positive expectations for condom use and greater intention for future consistent condom use (all P values < 0.05). Findings suggest that this intervention is both feasible and effective. PMID:19359352

  7. A Self-Regulation eHealth Intervention to Increase Healthy Behavior Through General Practice: Protocol and Systematic Development

    PubMed Central

    De Bourdeaudhuij, Ilse; Verloigne, Maite; Oenema, Anke; Crombez, Geert

    2015-01-01

    Background Chronic diseases are the principal cause of morbidity and mortality worldwide. An increased consumption of vegetables and fruit reduces the risk of hypertension, coronary heart disease, stroke, and cancer. An increased fruit and vegetable (FV) intake may also prevent body weight gain, and therefore indirectly affect type 2 diabetes mellitus. Insufficient physical activity (PA) has been identified as the fourth leading risk factor for global mortality. Consequently, effective interventions that promote PA and FV intake in a large number of people are required. Objective To describe the systematic development of an eHealth intervention, MyPlan 1.0, for increasing FV intake and PA. Methods The intervention was developed following the six steps of the intervention mapping (IM) protocol. Decisions during steps were based upon available literature, focus group interviews, and pilot studies. Results Based on needs assessment (Step 1), it was decided to focus on fruit and vegetable intake and physical activity levels of adults. Based on self-regulation and the health action process approach model, motivational (eg, risk awareness) and volitional (eg, action planning) determinants were selected and crossed with performance objectives into a matrix with change objectives (Step 2). Behavioral change strategies (eg, goal setting, problem solving, and implementation intentions) were selected (Step 3). Tablet computers were chosen for delivery of the eHealth program in general practice (Step 4). To facilitate implementation of the intervention in general practice, GPs were involved in focus group interviews (Step 5). Finally, the planning of the evaluation of the intervention (Step 6) is briefly described. Conclusions Using the IM protocol ensures that a theory- and evidence-based intervention protocol is developed. If the intervention is found to be effective, a dynamic eHealth program for the promotion of healthy lifestyles could be available for use in general

  8. Dietary intervention in acne: Attenuation of increased mTORC1 signaling promoted by Western diet.

    PubMed

    Melnik, Bodo

    2012-01-01

    The purpose of this paper is to highlight the endocrine signaling of Western diet, a fundamental environmental factor involved in the pathogenesis of epidemic acne. Western nutrition is characterized by high calorie uptake, high glycemic load, high fat and meat intake, as well as increased consumption of insulin- and IGF-1-level elevating dairy proteins. Metabolic signals of Western diet are sensed by the nutrient-sensitive kinase, mammalian target of rapamycin complex 1 (mTORC1), which integrates signals of cellular energy, growth factors (insulin, IGF-1) and protein-derived signals, predominantly leucine, provided in high amounts by milk proteins and meat. mTORC1 activates SREBP, the master transcription factor of lipogenesis. Leucine stimulates mTORC1-SREBP signaling and leucine is directly converted by sebocytes into fatty acids and sterols for sebaceous lipid synthesis. Over-activated mTORC1 increases androgen hormone secretion and most likely amplifies androgen-driven mTORC1 signaling of sebaceous follicles. Testosterone directly activates mTORC1. Future research should investigate the effects of isotretinoin on sebocyte mTORC1 activity. It is conceivable that isotretinoin may downregulate mTORC1 in sebocytes by upregulation of nuclear levels of FoxO1. The role of Western diet in acne can only be fully appreciated when all stimulatory inputs for maximal mTORC1 activation, i.e., glucose, insulin, IGF-1 and leucine, are adequately considered. Epidemic acne has to be recognized as an mTORC1-driven disease of civilization like obesity, type 2 diabetes, cancer and neurodegenerative diseases. These new insights into Western diet-mediated mTORC1-hyperactivity provide a rational basis for dietary intervention in acne by attenuating mTORC1 signaling by reducing (1) total energy intake, (2) hyperglycemic carbohydrates, (3) insulinotropic dairy proteins and (4) leucine-rich meat and dairy proteins. The necessary dietary changes are opposed to the evolution of

  9. Choice architecture interventions for increased vegetable intake and behaviour change in a school setting: a systematic review.

    PubMed

    Nørnberg, Trine Riebeling; Houlby, Louise; Skov, Laurits Rohden; Peréz-Cueto, Federico Jose Armando

    2016-05-01

    The primary objective of this review is to assess the prevalence and quality of published studies on the effect of choice architectural nudge interventions promoting vegetable consumption among adolescents. Additionally, this review aims to identify studies estimating adolescents' attitude towards choice architectural nudge interventions. Web of Science, Scopus and PubMed were searched systematically for experimental studies with a predefined search strategy in the period November-December 2013. Publications were included following predetermined inclusion criteria. Studies were evaluated as of high, moderate or weak quality. Finally, studies were grouped by the type of intervention and underwent a narrative synthesis. The search showed that only very few studies investigated the effects of choice architectural nudging interventions on vegetable consumption, and none of them had attitude towards behavioural interventions as an outcome measure. Twelve studies met the inclusion criteria. The results of the 12 studies were inconclusive, and the majority of studies were of weak or moderate quality. This review uncovers a gap in knowledge on the effect of choice architectural nudge interventions aiming to promote the intake of vegetables among adolescents in a school context. It also highlights that no previous studies have considered the attitudes towards choice architectural nudge interventions as a potential factor for their success - or lack thereof - in achieving the desired goal of increased vegetable consumption. © Royal Society for Public Health 2015.

  10. Effects of a Bug-in-the-Ear Intervention to Increase Physical Activity Prompting and Level during Preschool Recess

    ERIC Educational Resources Information Center

    Kahan, David; Nicaise, Virginie; Reuben, Karen

    2016-01-01

    Teacher prompting is a means to increase preschool children's physical activity. Twelve 4- and 5-year-olds at one preschool in the southwest U.S. participated in an ABA prompting intervention that utilized a bug-in-the-ear device to signal teachers to prompt sedentary children to increase physical activity level during unstructured recess.…

  11. Heparins crossover in percutaneous coronary interventions: a real issue with increasing rate of transradial procedures?

    PubMed

    Sciahbasi, Alessandro; Rigattieri, Stefano; Calcagno, Simone; Mancone, Massimo; Pendenza, Gianluca; Cera, Maria; Danza, Aurora Ilaria; Di Russo, Cristian; Bruno, Pasqualina; Fedele, Silvio; Pugliese, Francesco Rocco; Sardella, Gennaro

    2015-07-01

    Current guidelines give a class III recommendation to the intraprocedural use of unfractionated heparin (UFH) in patients pretreated with enoxaparin. The aim of our study was to evaluate bleeding complications in patients who underwent percutaneous coronary interventions (PCIs) performed using intraprocedural crossover of heparin therapy. We retrospectively evaluated all PCIs performed at two Italian hospitals since January 2011 to December 2013. After a propensity-matched analysis, patients were divided into two groups (with a ratio 1 : 2) according to intraprocedural crossover of heparins (from enoxaparin to UFH) (Group 1) or intraprocedural UFH alone (Group 2). The primary end-point was a haemoglobin drop of at least 3 g/dl within 48 h after the procedure. During the 3 years analysed, 3224 patients underwent PCI, and after the propensity analysis, 309 patients were considered eligible for our study: 104 patients in Group 1 (69 ± 12 years, 78% men) and 205 patients in Group 2 (69 ± 13 years, 80% men, P = NS). There were no significant differences between the two groups for BMI, periprocedural use of antiplatelet therapy, baseline haemoglobin haematocrit or platelets levels. The primary end-point did not differ between the two groups (2.9% in Group 1 and 3.4% in Group 2, P = 0.550). Also, nadir of haematocrit or haemoglobin levels did not differ between the two groups. Finally, in hospital, major adverse cardio-cerebrovascular events did not differ between the two groups (1.9% in Group 1 and 3.9% in Group 2, P = 0.50). In this retrospective analysis of a large PCI database, the 'heparins crossover' during PCI was not associated with increased bleeding risk.

  12. A behavioral economics intervention to increase pertussis vaccination among infant caregivers: A randomized feasibility trial.

    PubMed

    Buttenheim, Alison M; Fiks, Alexander G; Burson, Randall C; Wang, Eileen; Coffin, Susan E; Metlay, Joshua P; Feemster, Kristen A

    2016-02-03

    The incidence of pertussis has tripled in the past five years. Infants can be protected by "cocooning," or vaccinating household contacts with the Tdap vaccine. However, Tdap coverage for adult caregivers of infants is low. This study evaluated the feasibility and impact of interventions informed by behavioral economics (retail pharmacy vouchers for Tdap vaccines and a celebrity public service announcement) to increase Tdap vaccination among caregivers of young infants. We conducted a randomized controlled feasibility trial among adults attending newborn well-child visits at an urban Philadelphia pediatric primary care clinic who were not previously vaccinated with Tdap. Participants were randomized to one of four conditions: ($5-off Tdap voucher vs. free voucher)×(watching a 1min video public service announcement (PSA) about Tdap vaccination vs. no PSA). Tdap vaccination was assessed by tracking voucher redemption and following up with participants by phone. Ninety-five adult caregivers of 74 infants were enrolled in the study (mean age 29.3 years; 61% male; relationship to newborn: 54% father, 33% mother, 13% grandparent or other; caregiver insurance status: 35% Medicaid, 34% private insurance, 32% uninsured). Only 1 subject redeemed the retail pharmacy Tdap voucher. Follow-up interviews suggest that, even with the voucher, significant barriers to vaccination remained including: delaying planned vaccination, perceived inconvenient pharmacy locations, and beliefs about pertussis risk and severity. Despite leveraging existing infrastructure for adult vaccination, results suggest that retail pharmacy vouchers delivered during a newborn visit are not an effective strategy for promoting Tdap. Alternate approaches are needed that prioritize convenience and provide an immediate opportunity to vaccinate when motivation is high. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Trials in adult critical care that show increased mortality of the new intervention: Inevitable or preventable mishaps?

    PubMed

    Russell, James A; Williams, Mark D

    2016-12-01

    Several promising therapies assessed in the adult critically ill in large, multicenter randomized controlled trials (RCTs) were associated with significantly increased mortality in the intervention arms. Our hypothesis was that there would be wide ranges in sponsorship (industry or not), type(s) of intervention(s), use of DSMBs, presence of interim analyses and early stopping rules, absolute risk increase (ARI), and whether or not adequate prior proof-of-principle Phase II studies were done of RCTs that found increased mortality rates of the intervention compared to control groups. We reviewed RCTs that showed a statistically significant increased mortality rate in the intervention compared to control group(s). We recorded source of sponsorship, sample sizes, types of interventions, mortality rates, ARI (as well as odds ratios, relative risks and number needed to harm), whether there were pre-specified interim analyses and early stopping rules, and whether or not there were prior proof-of-principle (also known as Phase II) RCTs. Ten RCTs (four industry sponsored) of many interventions (high oxygen delivery, diaspirin cross-linked hemoglobin, growth hormone, methylprednisolone, hetastarch, high-frequency oscillation ventilation, intensive insulin, NOS inhibition, and beta-2 adrenergic agonist, TNF-α receptor) included 19,126 patients and were associated with wide ranges of intervention versus control group mortality rates (25.7-59 %, mean 29.9 vs 17-49 %, mean 25 %, respectively) yielding ARIs of 2.6-29 % (mean 5 %). All but two RCTs had pre-specified interim analyses, and seven RCTs were stopped early. All RCTs were preceded by published proof-of-principle RCT(s), two by the same group. Seven interventions (except diaspirin cross-linked hemoglobin and the NOS inhibitor) were available for use clinically at the time of the pivotal RCT. Common, clinically available interventions used in the critically ill were associated with increased mortality in large

  14. Targeted alteration of dietary n-3 and n-6 fatty acids for the treatment of chronic headaches: a randomized trial.

    PubMed

    Ramsden, Christopher E; Faurot, Keturah R; Zamora, Daisy; Suchindran, Chirayath M; Macintosh, Beth A; Gaylord, Susan; Ringel, Amit; Hibbeln, Joseph R; Feldstein, Ariel E; Mori, Trevor A; Barden, Anne; Lynch, Chanee; Coble, Rebecca; Mas, Emilie; Palsson, Olafur; Barrow, David A; Mann, J Douglas

    2013-11-01

    Omega-3 and n-6 fatty acids are biosynthetic precursors to lipid mediators with antinociceptive and pronociceptive properties. We conducted a randomized, single-blinded, parallel-group clinical trial to assess clinical and biochemical effects of targeted alteration in dietary n-3 and n-6 fatty acids for treatment of chronic headaches. After a 4-week preintervention phase, ambulatory patients with chronic daily headache undergoing usual care were randomized to 1 of 2 intensive, food-based 12-week dietary interventions: a high n-3 plus low n-6 (H3-L6) intervention, or a low n-6 (L6) intervention. Clinical outcomes included the Headache Impact Test (HIT-6, primary clinical outcome), Headache Days per month, and Headache Hours per day. Biochemical outcomes included the erythrocyte n-6 in highly unsaturated fatty acids (HUFA) score (primary biochemical outcome) and bioactive n-3 and n-6 derivatives. Fifty-six of 67 patients completed the intervention. Both groups achieved targeted intakes of n-3 and n-6 fatty acids. In intention-to-treat analysis, the H3-L6 intervention produced significantly greater improvement in the HIT-6 score (-7.5 vs -2.1; P<0.001) and the number of Headache Days per month (-8.8 vs -4.0; P=0.02), compared to the L6 group. The H3-L6 intervention also produced significantly greater reductions in Headache Hours per day (-4.6 vs -1.2; P=0.01) and the n-6 in HUFA score (-21.0 vs -4.0%; P<0.001), and greater increases in antinociceptive n-3 pathway markers 18-hydroxy-eicosapentaenoic acid (+118.4 vs +61.1%; P<0.001) and 17-hydroxy-docosahexaenoic acid (+170.2 vs +27.2; P<0.001). A dietary intervention increasing n-3 and reducing n-6 fatty acids reduced headache pain, altered antinociceptive lipid mediators, and improved quality-of-life in this population.

  15. Beyond the Most Willing Audiences: A Meta-Intervention to Increase Exposure to HIV-Prevention Programs by Vulnerable Populations

    PubMed Central

    Albarracín, Dolores; Durantini, Marta R.; Earl, Allison; Gunnoe, Joanne B.; Leeper, Josh

    2013-01-01

    Objective Enrollment in HIV-prevention interventions is more likely when the audience has safer rather than riskier HIV-relevant behavior. Thus, a meta-intervention was designed to increase participation by an audience of infrequent condom users in Florida. Design Participants (N = 400) were randomly assigned to 1 of 4 conditions varying the introduction to a counseling program. In the experimental condition, participants were told that the intervention gave participants options but might not change their behavior. In a standard-introduction condition, participants were told that the program was highly effective at changing participants’ behaviors. There was also an information-control group containing a description of the program, and a no-information-control group solely containing an invitation. Main outcome measures The outcome measure was actual participation in the offered counseling. Results Findings indicated that the experimental introduction was the most successful at yielding participation in the counseling program when the audience had low intentions to use condoms in the future. Conclusion Intervention introductions countering participants’ resistance to change increase participation in HIV-prevention counseling among reluctant clients. Other meta-interventions may be explored to systematically augment the effectiveness of evidence-based health-promotion interventions. PMID:18823190

  16. A randomized intervention study to evaluate whether electronic messaging can increase human papillomavirus vaccine completion and knowledge among college students.

    PubMed

    Richman, Alice R; Maddy, LaDonna; Torres, Essie; Goldberg, Ellen J

    2016-01-01

    To evaluate an intervention aimed at increasing human papillomavirus (HPV) vaccine completion of the 3-dose series and knowledge. Two hundred sixty-four male and female US college students 18-26 years old who were receiving HPV vaccine dose 1. Students were randomly assigned to the intervention or control group. Intervention participants received the electronic intervention (text/e-mail appointment reminders and education messages) and controls received standard-of-care. Baseline/follow-up survey data were collected. Main outcome measures included vaccine completion and knowledge. HPV vaccine completion across groups were not significantly different for HPV dose 2 (53% vs 52%) and dose 3 (34% vs 32%). Mean knowledge score at follow-up for intervention group was significantly higher (p = .01) than at baseline. No significant differences in knowledge were found for the control group. The biggest predictor of HPV vaccine completion was female gender. The intervention increased knowledge but not vaccine completion. More research with catch-up age populations is needed.

  17. A Community-Based Intervention Designed to Increase Preventive Health Care Seeking Among Adolescents: The Gonorrhea Community Action Project

    PubMed Central

    VanDevanter, Nancy L.; Messeri, Peter; Middlestadt, Susan E.; Bleakley, Amy; Merzel, Cheryl R.; Hogben, Matthew; Ledsky, Rebecca; Malotte, C. Kevin; Cohall, Renee M.; Gift, Thomas L.; St. Lawrence, Janet S.

    2005-01-01

    Objectives. We evaluated the effectiveness of an intervention designed to increase preventive health care seeking among adolescents. Methods. Adolescents and young adults aged 12 to 21 years, recruited from community-based organizations in 2 different communities, were randomized into either a 3-session intervention or a control condition. We estimated outcomes from 3-month follow-up data using logistic and ordinary least squares regression. Results. Female intervention participants were significantly more likely than female control participants to have scheduled a health care appointment (odds ratio [OR]=3.04), undergone a checkup (OR=2.87), and discussed with friends or family members the importance of undergoing a checkup (OR=4.5). There were no differences between male intervention and male control participants in terms of outcomes. Conclusions. This theory-driven, community-based group intervention significantly increased preventive health care seeking among female adolescents. Further research is needed, however, to identify interventions that will produce successful outcomes among male adolescents. PMID:15671472

  18. Playful Interventions Increase Knowledge about Healthy Habits and Cardiovascular Risk Factors in Children: The CARDIOKIDS Randomized Study

    PubMed Central

    Cecchetto, Fátima H.; Pena, Daniela B.; Pellanda, Lucia C.

    2017-01-01

    Background Childhood obesity is an important health problem worldwide. In this context, there is a need for the development and evaluation of innovative educational interventions targeting prevention and formation of health habits. Objectives To ascertain the impact of ludic workshops on children’s knowledge, self-care, and body weight. Methods This was a randomized, clinical study with 79 students aged 7-11 years, conducted from March to November 2012. Anthropometric measurements were collected and two questionnaires (Typical Day of Physical Activities and Food Intake, in Portuguese, and the CARDIOKIDS, a questionnaire of knowledge about cardiovascular risk factors) were applied at baseline, at the end of intervention, and three months thereafter. The intervention consisted of eight playful workshops, which involved the presentation of a play. Results Seventy-nine students were randomized to the intervention (n = 40) or the control group (n = 39). Mean age was 10.0 ± 1.1 years. After eight weeks, the intervention group showed significant improvement in the knowledge score (p < 0.001). There was an increase in physical activity scores in both groups, but with no difference between the groups at the end of intervention (p = 0.209). A reduction in the BMI percentile was observed in the intervention group, but there was no significant statistical difference between the two groups after the intervention. Conclusions Playful interventions may improve knowledge and physical activity levels in children and, when combined with other strategies, may be beneficial to prevent child obesity and improve self-care. PMID:28746521

  19. Effectiveness of interventions to increase the participation rate of gastric cancer screening in the Republic of Korea: a pilot study.

    PubMed

    Lee, Myung Ha; Lee, Yoon Young; Jung, Da Won; Park, Boyoung; Yun, E Hwa; Lee, Hoo-Yeon; Jun, Jae Kwan; Choi, Kui Son

    2012-01-01

    This study assessed the effectiveness of three intervention strategies to improve the participation rate of gastric cancer screening among people who had never undergone such screening, and those who had been screened for the disease, but not recently. It was conducted in the Ilsandong-gu District of Goyang City, Korea. The population for the current study was restricted to male residents, aged 40-65 years, who received an invitation letter to undergo gastric cancer screening from the National Health Insurance (NHI) Corporation at the beginning of 2010. The subjects were divided into two categories according to their screening history: never-screened, and ever-screened. A total of 2,065 men were eligible: 803 never-screened and 1,262 ever-screened. In each screening category they were randomly assigned to one of three intervention groups: 1) tailored telephone counseling; 2) tailored postcard reminder after tailored telephone counseling;and 3) tailored telephone counseling after tailored postcard reminder. At 3 months post-intervention, never- screened men with any intervention were more likely to undergo gastric cancer screening (OR=2.75, 95% CI: 1.22-6.18) compared to those in the reference group (no intervention). However, there was no statistically significant intervention effect in ever-screened men (OR=1.21, 95% CI: 0.65-2.27). Examination of the intervention effects by intervention group among never-screened men showed that those in the postcard reminder after telephone counseling group to be statistically significantly more likely to undergo gastric cancer screening (OR=4.49, 95% CI: 1.79-11.29) than the reference group (no intervention). Our results highlight that use of tailored postcard reminders after tailored telephone counseling is an effective method to increase participation in gastric cancer screening among men who had never been screened.

  20. Laser ablation of NaN3 and CsN3

    NASA Astrophysics Data System (ADS)

    Belau, Leonid; Gorodetsky, Jonathan; Haas, Yehuda

    2005-06-01

    Solid sodium azide and cesium azide crystals were irradiated by high power laser pulses; the ablation products were rapidly cooled by a supersonic expansion of helium and detected by a time of flight mass spectrometer. Neutral and positively charged species were separately recorded and analyzed using N15 isotopomers to help in their assignment. Cluster series of the sequences Na(NaN3)n [or Cs(CsN3)n] were observed, as well as clusters containing NaOH and NaCN; the origin of the C, H, and O atoms appears to be water and CO2 occluded in the salt. Addition of D2O increased the intensity of large clusters and added deuterated ones, whereas addition of chloroform leads to formation of clusters of a Na atom with (NaCl)n clusters. Possible mechanisms for the formation of these clusters are discussed.

  1. A cluster randomized controlled trial of a telephone-based parent intervention to increase preschoolers’ fruit and vegetable consumption123

    PubMed Central

    Wolfenden, Luke; Campbell, Elizabeth; Campbell, Karen J; Wiggers, John; Brennan, Leah; Fletcher, Amanda; Bowman, Jenny; Heard, Todd R

    2012-01-01

    Background: Inadequate fruit and vegetable consumption is associated with increased chronic disease risk and represents a considerable global health burden. Despite evidence that dietary habits track from early childhood, there are few published trials of interventions attempting to increase preschoolers’ fruit and vegetable consumption. Objective: The Healthy Habits trial aimed to assess the efficacy of a telephone-based intervention for parents to increase the fruit and vegetable consumption in their 3–5-y-old children. Design: A cluster randomized controlled trial was conducted involving 394 parents of children aged 3–5 y recruited through local preschools. Parents allocated to the intervention received printed resources plus four 30-min telephone calls targeting aspects of the home food environment associated with children's fruit and vegetable consumption. Parents allocated to the control group received generic printed nutrition information. Children's fruit and vegetable consumption was assessed by using the Fruit and Vegetable Subscale of the Children's Dietary Questionnaire, which was administered via telephone interview at baseline and 2 and 6 mo later. Results: Analysis of all available data showed that children's fruit and vegetable scores were significantly higher in the intervention group than in the control group at 2 mo (P < 0.001) and at 6 mo (P = 0.021). Sensitivity analysis using baseline observation carried forward showed an intervention effect at 2 mo (P = 0.008) but not at 6 mo (P = 0.069). Conclusions: Telephone-delivered parent interventions may be an effective way of increasing children's fruit and vegetable consumption in the short term. Further investigation to determine whether the intervention effect is maintained in the longer term is recommended. This trial was registered at http://www.anzctr.org.au as ACTRN12609000820202. PMID:22623749

  2. A School-Based Intervention to Increase Lyme Disease Preventive Measures Among Elementary School-Aged Children

    PubMed Central

    Zibit, Melanie J.; Nardone, Elizabeth; DeMaria, Alfred; Iannaccone, Christine K.; Cui, Jing

    2016-01-01

    Abstract Purpose: Educational interventions to reduce Lyme disease (LD) among at-risk school children have had little study. The purpose of this study was to evaluate whether a short in-class LD education program based on social learning theory and the Health Belief Model (HBM) impacted a child's knowledge, attitude, and preventive behavior. Methods: Students in grades 2–5 in 19 elementary schools were selected in an area that was highly endemic for LD. The children received an educational intervention or were on a wait list as controls. Their knowledge, attitudes, and self-reported preventive behaviors were surveyed before implementing the program and 1 year later. General linear regression analyses adjusting for age, gender, and baseline variables were used to measure the impact of the intervention. Results: There were 3570 participants in the study: 1562 received the intervention, and 2008 were controls. The mean age for both groups was 9.1 years, with 53% women in the intervention group and 50% women in the control group. The children in the intervention group increased their overall knowledge of LD more than the children in the control group (overall knowledge score improvement, mean difference (SD) 1.38 (1.3) vs. 0.36 (1.3) p < 0.0001). All children in classes receiving the intervention reported an increase in precautionary behavior, positive attitude toward taking precautions, and self-efficacy compared with the wait list controls. Two LD cases were confirmed during the follow-up period, one in the intervention group and one in the controls. Conclusions: These findings demonstrate that a short in-class educational program that includes elements of the HBM, including: (1) awareness and knowledge about the disease, (2) benefits of preventive behavior, and (3) confidence in ability to perform preventive behaviors can improve knowledge, attitude, and self-reported precautionary behavior among at-risk children. www.clinicaltrials.gov: NCT00594997 PMID

  3. A School-Based Intervention to Increase Lyme Disease Preventive Measures Among Elementary School-Aged Children.

    PubMed

    Shadick, Nancy A; Zibit, Melanie J; Nardone, Elizabeth; DeMaria, Alfred; Iannaccone, Christine K; Cui, Jing

    2016-08-01

    Educational interventions to reduce Lyme disease (LD) among at-risk school children have had little study. The purpose of this study was to evaluate whether a short in-class LD education program based on social learning theory and the Health Belief Model (HBM) impacted a child's knowledge, attitude, and preventive behavior. Students in grades 2-5 in 19 elementary schools were selected in an area that was highly endemic for LD. The children received an educational intervention or were on a wait list as controls. Their knowledge, attitudes, and self-reported preventive behaviors were surveyed before implementing the program and 1 year later. General linear regression analyses adjusting for age, gender, and baseline variables were used to measure the impact of the intervention. There were 3570 participants in the study: 1562 received the intervention, and 2008 were controls. The mean age for both groups was 9.1 years, with 53% women in the intervention group and 50% women in the control group. The children in the intervention group increased their overall knowledge of LD more than the children in the control group (overall knowledge score improvement, mean difference (SD) 1.38 (1.3) vs. 0.36 (1.3) p < 0.0001). All children in classes receiving the intervention reported an increase in precautionary behavior, positive attitude toward taking precautions, and self-efficacy compared with the wait list controls. Two LD cases were confirmed during the follow-up period, one in the intervention group and one in the controls. These findings demonstrate that a short in-class educational program that includes elements of the HBM, including: (1) awareness and knowledge about the disease, (2) benefits of preventive behavior, and (3) confidence in ability to perform preventive behaviors can improve knowledge, attitude, and self-reported precautionary behavior among at-risk children. www.clinicaltrials.gov : NCT00594997.

  4. Bari-Active: A randomized controlled trial of a preoperative intervention to increase physical activity in bariatric surgery patients

    PubMed Central

    Bond, Dale S.; Vithiananthan, Sivamainthan; Thomas, J. Graham; Trautvetter, Jennifer; Unick, Jessica L.; Jakicic, John M.; Pohl, Dieter; Ryder, Beth A.; Roye, G. Dean; Sax, Harry C.; Wing, Rena R.

    2014-01-01

    Background: Habitual physical activity (PA) may help to optimize bariatric surgery outcomes; however objective PA measures show that most patients have low PA preoperatively and make only modest PA changes postoperatively. Patients require additional support to adopt habitual PA. Objectives: Test the efficacy of a preoperative PA intervention (PAI) versus standard pre-surgical care (SC) for increasing daily moderate-to-vigorous PA (MVPA) in bariatric surgery patients. Setting: University Hospital, United States. Methods: Outcomes analysis included 75 participants (86.7% women; 46.0±8.9 years; Body Mass Index [BMI]=45.0±6.5 kg/m2) who were randomly assigned preoperatively to 6 weeks of PAI (n=40) or SC (n=35). PAI received weekly individual face-to-face sessions with tailored instruction in behavioral strategies (e.g., self-monitoring, goal-setting) to increase home-based walking exercise. The primary outcome, pre- to post-intervention change in daily bout-related (≥10-min bouts) and total (≥1-minute bouts) MVPA minutes, was assessed objectively via a multi-sensor monitor worn for 7 days at baseline- and post-intervention. Results: Retention was 84% at the post-intervention primary end point. In intent-to-treat analyses with baseline value carried forward for missing data and adjusted for baseline MVPA, PAI achieved a mean increase of 16.6±20.6 minutes/day in bout-related MVPA (baseline: 4.4±5.5 to post-intervention: 21.0±21.4 minutes/day) compared to no change (−0.3±12.7 minutes/day; baseline: 7.9±16.6 to post-intervention: 7.6±11.5 minutes/day) for SC (p=0.001). Similarly, PAI achieved a mean increase of 21.0±26.9 minutes/day in total MVPA (baseline: 30.9±21.2 to post-intervention: 51.9±30.0 minutes/day), whereas SC demonstrated no change (− 0.1±16.3 minutes/day; baseline: 33.7±33.2 to post-intervention: 33.6±28.5 minutes/day) (p=0.001). Conclusions: With behavioral intervention, patients can significantly increase MVPA before bariatric

  5. Effect of an intervention to increase statin use in medicare members who qualified for a medication therapy management program.

    PubMed

    Stockl, Karen M; Tjioe, Daniel; Gong, Sherry; Stroup, Jenni; Harada, Ann S M; Lew, Heidi C

    2008-01-01

    The cardiovascular (CV) benefits of lipid-lowering therapy in older adults with hypercholesterolemia and underlying risk factors for coronary artery disease (CAD) have been well documented. Significant reductions in the risk of myocardial infarction (MI) and coronary death have been demonstrated with statin therapy, benefits that are of particular relevance in patients with diabetes. Managed care interventions with prescribers have increased the use of selected drugs such as statins. To (1) measure the increase in new users of statins associated with the implementation of a statin initiation intervention aimed at prescribers for Medicare Part D Medication Therapy Management Program (MTMP) members with diabetes or CAD and (2) estimate the potential cost savings associated with the projected reduction in CV events based on published controlled trials. Medicare Advantage Prescription Drug (MA-PD) and prescription drug plan (PDP) members of a pharmacy benefits manager (PBM) were identified for the intervention who (1) met the criteria for MTMP (expected to incur at least dollars 4,000 in annual pharmacy expenditures for Part D-covered medications, filled at least 10 distinct Part D-covered medications, and had at least 3 of 5 chronic diseases of interest); (2) were identified as having diabetes or CAD (patients with a history of MI were considered to have CAD); and (3) had no pharmacy claims for a statin between January and June 2006. In August 2006, the primary prescribers for antidiabetic or CV medications of 1,144 identified members were sent educational materials and a report listing their patients with diabetes or CAD who were not receiving statin therapy. A comparison group of MA-PD members (N = 700) with diabetes or CAD was identified who did not receive the intervention but who met all of the MTMP criteria except the presence of at least 3 of 5 chronic diseases of interest. Logistic regression was conducted to evaluate the intervention effectiveness after

  6. Familias Sanas: an Intervention Designed to Increase rates of Postpartum Visits among Latinas

    PubMed Central

    Marsiglia, Flavio F.; Bermudez-Parsai, Monica; Coonrod, Dean

    2010-01-01

    Familias Sanas (Healthy Families) is an educational intervention implemented and tested with low-income, immigrant Latina mothers. The program was designed to reduce existing health disadvantages of Latinas by empowering them to take active part in the management of their health and by encouraging them to advocate for themselves. Familias Sanas was implemented at a prenatal clinic located at a major urban hospital in the southwestern U.S. The efficacy of the intervention was evaluated through a randomized control trial measuring the participants’ rate of postpartum visits and other relevant well-being measures. Initial findings show a significant effect of the intervention, with participants in the experimental group returning for their postpartum clinic visit at a higher rate in comparison with the control group. The results are discussed from a culturally specific perspective. Practice, policy, and research implications and recommendations are provided. PMID:20675950

  7. Educational Intervention Increased Referrals to Allopathic Care by Traditional Healers in Three High HIV-Prevalence Rural Districts in Mozambique

    PubMed Central

    Audet, Carolyn M.; Salato, José; Blevins, Meridith; Amsalem, David; Vermund, Sten H.; Gaspar, Felisbela

    2013-01-01

    Introduction Delayed uptake of clinical services impedes favorable clinical outcomes in Mozambique. Care is delayed among patients who initiate care with traditional healers; patients with conditions like human immunodeficiency virus (HIV) or tuberculosis are rarely referred to the health system in a timely fashion. Methods We conducted a pre-post educational intervention with traditional healers, assessing healer referral rates and HIV knowledge in three rural districts in Zambézia Province. Results The median monthly referral rate prior to the intervention was 0.25 patients (interquartile range [IQR]: 0–0.54) compared with a post-intervention rate of 0.34 patients (IQR: 0–0.71), a 35% increase (p = 0.046). A median HIV knowledge score of 67% (IQR: 59–78) was noted 4-months pre-intervention and a median score of 81% (IQR: 74–89) was recorded 2½ months post-intervention (p<0.001). One hundred and eleven healers referred 127 adults, 36 pregnant women, and 188 children to health facilities. Referred patients were most likely to be diagnosed with bronchopneumonia (20% adults; 13% children) and/or malaria (15% adults; 37% children). Of 315 non-pregnant persons referred, 3.5% were tested for HIV and 2.5% were tested for tuberculosis. Discussion We engaged traditional healers with some success; referral rates were low, but increased post-intervention. Once seen in the clinics, patients were rarely tested for HIV or tuberculosis, though symptoms suggested screening was indicated. We found increased referral rates through an inexpensive intervention with traditional healers, a viable, cost-effective method of directing patients to health facilities. However, quality improvement within the clinics is necessary before a substantial impact can be expected. PMID:23936407

  8. Fruit and vegetable intake and knowledge increased following a community-based intervention in older adults in Georgia senior centers.

    PubMed

    Hendrix, Sara J; Fischer, Joan G; Reddy, R D Sudha; Lommel, Tiffany Sellers; Speer, Elizabeth M; Stephens, Heather; Park, Sohyun; Johnson, Mary Ann

    2008-01-01

    Our purpose was to evaluate a community-based fruit and vegetable intervention conducted in rural and urban areas of Georgia. Participants were a convenience sample from Georgia senior centers that completed a pre-test, the intervention, and a post-test (N = 558, mean age = 75, 83% female, 47% white, 53% black). The 4-month intervention had eight sessions focused on practical ways to increase intake of fruits and vegetables at meals and snacks and included physical activity. Pre- and post-tests examined self-reported intakes of fruits and vegetables at breakfast, lunch, the evening meal, and snacks, knowledge of recommended intakes, and barriers to intake. Following the intervention, the number of participants reporting consumption of at least 7 servings of fruits and vegetables daily increased by 21-percentage points (P < or = 0.001), knowledge that 7 to 10 servings of fruits and vegetables are recommended daily (for 1,600 to 2,200 calories) increased from 7% to 57% (P < or = 0.001), and three barriers to fruit and vegetable intake decreased (P < or = 0.05): "difficulties with digestion," "too many are recommended," and "too much trouble." Regression analyses indicated that increased intake following the intervention was independently associated with living in more urban rather than rural areas, improved knowledge of intake recommendations, decrease in perception of cost as a barrier, and increase in digestive problems as a barrier (P < or = 0.05). These results provide an evidence base for the effectiveness of this community intervention for improving knowledge and intake and decreasing barriers to fruit and vegetable intake in older adults.

  9. Comparing Two Classwide Interventions: Implications of Using Technology for Increasing Multiplication Fact Fluency

    ERIC Educational Resources Information Center

    Musti-Rao, Shobana; Plati, Erin

    2015-01-01

    An adapted alternating treatments design with initial baseline and final best treatment phase was used to evaluate and compare the effects of two classwide interventions, detect--practice--repair (DPR), and self-mediated iPad instruction, on the multiplication math facts fluency in an inclusive third-grade classroom. Twelve students participated…

  10. A Systematic Review of Interventions to Increase Peer Interactions for Students with Complex Communication Challenges

    ERIC Educational Resources Information Center

    Chung, Yun-Ching; Carter, Erik W.; Sisco, Lynn G.

    2012-01-01

    Although positive peer relationships can facilitate the academic learning, skill development, and emotional well-being of students with complex communication challenges, few peer interactions are likely to take place in school settings apart from intentional intervention and support efforts. We conducted a systematic review to identify and examine…

  11. Announcement: Community Preventive Services Task Force Recommendation for Built Environment Interventions to Increase Physical Activity.

    PubMed

    2017-05-05

    The Community Preventive Services Task Force recently posted new information on its website: "Physical Activity: Built Environment Approaches Combining Transportation System Interventions with Land Use and Environmental Design." This information is available at https://www.thecommunityguide.org/findings/physical-activity-built-environment-approaches.

  12. The effectiveness of Squire's Quest II game intervention to increase home availability of fruit and vegetables

    USDA-ARS?s Scientific Manuscript database

    Children's dietary behavior is strongly influenced by their family environment, e.g. by home availability of healthy food. Direct parental involvement, via active involvement in activities, or requiring children to engage their parents, in interventions to change children's dietary behavior is there...

  13. Reading for Success: The Effectiveness of Literacy Interventions for Increasing Student Achievement in Core Academic Classes

    ERIC Educational Resources Information Center

    Harrell, Margaret A.

    2014-01-01

    The purpose of this action research study was to utilize quantitative and qualitative data to measure the effects of Tier 2 and Tier 3 literacy interventions as they affect student achievement in the secondary school setting. The research questions addressed performance of students who were enrolled in Reading for Success as compared to a cohort…

  14. A Study of Effective Practices in Reading Intervention that Increase Student Achievement

    ERIC Educational Resources Information Center

    Avila, Ray

    2010-01-01

    The purpose of this study was to evaluate a reading intervention program designed to narrow the achievement gap between students who are proficient in reading language arts as measured by the California Standards Test in comparison to students who are performing below the targeted proficiency level. State, district, and local school data show that…

  15. Professional Development to Increase Problem-Solving Skills in a Response to Intervention Framework

    ERIC Educational Resources Information Center

    Albritton, Kizzy; Truscott, Stephen

    2014-01-01

    With the latest re-authorization of the Individuals with Disabilities Education Improvement Act (IDEA, 2004), states are allowed to use a Response to Intervention (RtI) framework to determine whether students qualify for special education services. Although RtI has promise and has been implemented well with documented results, further research is…

  16. Intervention After Grade 1: Serving Increased Numbers of Struggling Readers Effectively

    ERIC Educational Resources Information Center

    Brown, Kathleen J.; Morris, Darrell; Fields, Matthew

    2005-01-01

    The present study replicated the original evaluation of the Howard Street tutoring model (Morris, Shaw, & Perney, Perney, 1990), an intervention for struggling readers in second and third grade. It also evaluated the effectiveness of supervised paraprofessionals (Title I aides) in delivering that tutorial. For an entire school year, teachers or…

  17. Comparing Two Classwide Interventions: Implications of Using Technology for Increasing Multiplication Fact Fluency

    ERIC Educational Resources Information Center

    Musti-Rao, Shobana; Plati, Erin

    2015-01-01

    An adapted alternating treatments design with initial baseline and final best treatment phase was used to evaluate and compare the effects of two classwide interventions, detect--practice--repair (DPR), and self-mediated iPad instruction, on the multiplication math facts fluency in an inclusive third-grade classroom. Twelve students participated…

  18. An Educational Intervention Designed to Increase Women's Leadership Self-Efficacy

    ERIC Educational Resources Information Center

    Isaac, Carol; Kaatz, Anna; Lee, Barbara; Carnes, Molly

    2012-01-01

    Women are sparsely represented in leadership in academic science, technology, engineering, mathematics, and medicine (STEMM). Cultural stereotypes about men, women, and leaders influence the attitudes, judgments, and decisions that others make about women and the choices women make for themselves. Multilevel interventions are needed to counteract…

  19. An Educational Intervention Designed to Increase Women's Leadership Self-Efficacy

    ERIC Educational Resources Information Center

    Isaac, Carol; Kaatz, Anna; Lee, Barbara; Carnes, Molly

    2012-01-01

    Women are sparsely represented in leadership in academic science, technology, engineering, mathematics, and medicine (STEMM). Cultural stereotypes about men, women, and leaders influence the attitudes, judgments, and decisions that others make about women and the choices women make for themselves. Multilevel interventions are needed to counteract…

  20. Increasing Access to an ASD Imitation Intervention via a Telehealth Parent Training Program

    ERIC Educational Resources Information Center

    Wainer, Allison L.; Ingersoll, Brooke R.

    2015-01-01

    Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed…

  1. Teaching Story Grammar Components to Increase Oral Narrative Ability: A Group Intervention Study

    ERIC Educational Resources Information Center

    Green, Laura B.; Klecan-Aker, Joni S.

    2012-01-01

    This pilot study investigated the impact of an oral narrative intervention program implemented with 24 children who attended a College of Education on campus laboratory school for children with specific language learning difficulties. Oral narratives were elicited before and after treatment and underwent T-unit and story grammar component…

  2. Increasing Reading Comprehension of Elementary Students through Fluency-Based Interventions

    ERIC Educational Resources Information Center

    Neumann, Veda S.; Ross, Dorothy K.; Slaboch, Anita F.

    2008-01-01

    The authors of this action research project report implemented oral reading fluency-based interventions for the purpose of improving students' reading comprehension. Six students in grade three, six students in grade five and six students in grade six participated in the study from Monday, August 27 through Friday, December 7, 2007. Researchers…

  3. Teaching Story Grammar Components to Increase Oral Narrative Ability: A Group Intervention Study

    ERIC Educational Resources Information Center

    Green, Laura B.; Klecan-Aker, Joni S.

    2012-01-01

    This pilot study investigated the impact of an oral narrative intervention program implemented with 24 children who attended a College of Education on campus laboratory school for children with specific language learning difficulties. Oral narratives were elicited before and after treatment and underwent T-unit and story grammar component…

  4. Do Exam Wrappers Increase Metacognition and Performance? A Single Course Intervention

    ERIC Educational Resources Information Center

    Soicher, Raechel N.; Gurung, Regan A. R.

    2017-01-01

    Previous research has indicated that an intervention called "exam wrappers" can improve students' metacognition when they are using wrappers in more than one course per academic term. In this study, we tested if exam wrappers would improve students' metacognition and academic performance when used in only one course per academic term. A…

  5. Increasing Access to an ASD Imitation Intervention via a Telehealth Parent Training Program

    ERIC Educational Resources Information Center

    Wainer, Allison L.; Ingersoll, Brooke R.

    2015-01-01

    Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed…

  6. Effectiveness and implementation of interventions to increase commuter cycling to school: a quasi-experimental study.

    PubMed

    Østergaard, Lars; Støckel, Jan Toftegaard; Andersen, Lars Bo

    2015-11-30

    Active transportation to school has been positively associated with various health parameters whereas only sparse evidence exists on risk of injury while commuting to school. This study investigated the overall effectiveness of cycling promotion combined with structural changes on cycling to school. Interventions at public schools in three different regions in Denmark were based on planned infrastructural changes near schools (e.g. road surface and traffic regulation) and school-motivation for promoting commuter cycling. Participants were pupils from control schools (n = 12) or intervention schools (n = 13). All children (n = 2415) from the 4(th) and 5(th) grade were measured at baseline during spring 2010 and at follow-up one year later. No significant differences in commuter cycling were detected in the adjusted analyses comparing the intervention with the control group neither when assessed as changes in short term (beta: 0.15 trips/week, p = 0.463) nor when assessed as changes in long term school cycling (beta: -0.02 units, p = 0.485). No differences were observed neither in the incidence of traffic injuries nor in the characteristics of injuries when comparing the control group and the intervention group. Approximately 50 % of all traffic injuries occurred during school transport with most injuries categorized as solo injuries. The only significant predictor of future traffic injuries was previous school transport injuries. This multifaceted school cycling promotion programme did not affect school cycling behaviour or the health parameters assessed. Implementation issues relevant in the planning of future school cycling interventions are discussed in the article. The one year incidence of being involved in a traffic injury was approximately 25 % with almost 50 % of all traffic injuries occurred during school transport. Previous school transport injury predicted future school traffic injuries.

  7. A randomized controlled trial comparing Circle of Security Intervention and treatment as usual as interventions to increase attachment security in infants of mentally ill mothers: Study Protocol

    PubMed Central

    2014-01-01

    Background Psychopathology in women after childbirth represents a significant risk factor for parenting and infant mental health. Regarding child development, these infants are at increased risk for developing unfavorable attachment strategies to their mothers and for subsequent behavioral, emotional and cognitive impairments throughout childhood. To date, the specific efficacy of an early attachment-based parenting group intervention under standard clinical outpatient conditions, and the moderators and mediators that promote attachment security in infants of mentally ill mothers, have been poorly evaluated. Methods/Design This randomized controlled clinical trial tests whether promoting attachment security in infancy with the Circle of Security (COS) Intervention will result in a higher rate of securely attached children compared to treatment as usual (TAU). Furthermore, we will determine whether the distributions of securely attached children are moderated or mediated by variations in maternal sensitivity, mentalizing, attachment representations, and psychopathology obtained at baseline and at follow-up. We plan to recruit 80 mother-infant dyads when infants are aged 4-9 months with 40 dyads being randomized to each treatment arm. Infants and mothers will be reassessed when the children are 16-18 months of age. Methodological aspects of the study are systematic recruitment and randomization, explicit inclusion and exclusion criteria, research assessors and coders blinded to treatment allocation, advanced statistical analysis, manualized treatment protocols and assessments of treatment adherence and integrity. Discussion The aim of this clinical trial is to determine whether there are specific effects of an attachment-based intervention that promotes attachment security in infants. Additionally, we anticipate being able to utilize data on maternal and child outcome measures to obtain preliminary indications about potential moderators of the intervention and

  8. Interventions to Increase Male Attendance and Testing for Sexually Transmitted Infections at Publicly-Funded Family Planning Clinics.

    PubMed

    Fine, David; Warner, Lee; Salomon, Sarah; Johnson, David M

    2017-07-01

    We assessed the impact of staff, clinic, and community interventions on male and female family planning client visit volume and sexually transmitted infection testing at a multisite community-based health care agency. Staff training, clinic environmental changes, in-reach/outreach, and efficiency assessments were implemented in two Family Health Center (San Diego, CA) family planning clinics during 2010-2012; five Family Health Center family planning programs were identified as comparison clinics. Client visit records were compared between preintervention (2007-2009) and postintervention (2010-2012) for both sets of clinics. Of 7,826 male client visits during the time before intervention, most were for clients who were aged <30 years (50%), Hispanic (64%), and uninsured (81%). From preintervention to postintervention, intervention clinics significantly increased the number of male visits (4,004 to 8,385; Δ = +109%); for comparison clinics, male visits increased modestly (3,822 to 4,500; Δ = +18%). The proportion of male clinic visits where chlamydia testing was performed increased in intervention clinics (35% to 42%; p < .001) but decreased in comparison clinics (37% to 33%; p < .001). Subgroup analyses conducted among adolescent and young adult males yielded similar findings for male client volume and chlamydia testing. The number of female visits declined nearly 40% in both comparison (21,800 to 13,202; -39%) and intervention clinics (30,830 to 19,971; -35%) between preintervention and postintervention periods. Multilevel interventions designed to increase male client volume and sexually transmitted infection testing services in family planning clinics succeeded without affecting female client volume or services. Copyright © 2017 Society for Adolescent Health and Medicine. All rights reserved.

  9. Take Five, a nutrition education intervention to increase fruit and vegetable intakes: impact on consumer choice and nutrient intakes.

    PubMed

    Cox, D N; Anderson, A S; Reynolds, J; McKellar, S; Lean, M E; Mela, D J

    1998-08-01

    This study reports results from a randomized controlled intervention trial, focusing on: (1) the identification of successful consumer strategies for increasing fruit and vegetable intakes to the recommended levels of more than five (80 g) portions per day and (2) impact on overall diet and nutrient intakes. Adult men and women (n 170) fulfilling the main recruitment criterion of eating less than five fruit and vegetable portions per day but contemplating increasing intakes were recruited. Complete valid dietary data was provided by 101 intervention (fifty-nine estimated fruit and vegetable intakes, and forty-two simultaneous weighted total dietary and estimated fruit and vegetable intakes) and twenty-four control subjects (weighed total dietary intakes). Intervention advice included the specific association of high fruit and vegetable intake with reduced risk of disease, practicalities, and portion definition with a target intake of greater than five 80 g fruit and vegetable portions per day for 8 weeks. There were significant effects (P < 0.001) on weighed intakes of fruit and vegetables in the intervention group, rising from 324 (SE 25) to 557 (SE 31) g/d and reflected by validated portion measures at 8 weeks intervention. Successful strategies chosen by 'achievers' of the target intake (65% of subjects) were conventional (fruit as a snack, vegetables with main meals etc.) and favoured fruit. There were significant increases in percentage energy from carbohydrate (from sugars not starch), vitamin C, carotenes and NSP and there was a significant decrease in percentage energy from fat for subjects who had high fat intakes (> 35% energy) at baseline. Follow-up self-reported measures at 6 and 12 months indicated mean intakes of 4.5 and 4.6 defined portions/d respectively, suggesting some sustainable effect. In conclusion, the intervention led to significant increases in fruit and vegetable intakes largely via conventional eating habits, with some desirable effects

  10. A systematic review of interventions aimed at increasing physical activity in adults with chronic musculoskeletal pain—protocol

    PubMed Central

    2014-01-01

    Background Chronic musculoskeletal pain is highly prevalent, affecting around one in five people across Europe. Osteoarthritis, low back pain, neck pain and other musculoskeletal disorders are leading causes of disability worldwide and the most common source of chronic pain. Exercise and/or physical activity interventions have the potential to address not only the pain and disability associated with chronic pain but also the increased risk of morbidity and mortality seen in this population. Although exercise and/or physical activity is widely recommended, there is currently a paucity of research that offers an evidence base upon which the development or optimisation of interventions can be based. This systematic review will investigate the components of interventions associated with changes in physical activity levels in adults with chronic musculoskeletal pain. Methods/Design This systematic review will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidance. Randomised and quasi-randomised controlled trials of interventions aimed at increasing physical activity in adults with chronic musculoskeletal pain will be included. Articles will be identified through a comprehensive search of the following databases: CENTRAL in the Cochrane Library, the Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Embase, CINAHL, PsycINFO and AMED. Two review authors will independently screen articles retrieved from the search for eligibility, extract relevant data on methodological issues and code interventions according to the behaviour change technique taxonomy (v1) of 93 hierarchically clustered techniques. As complex healthcare interventions can be modified by a wide variety of factors, data will be summarised statistically when the data are available, are sufficiently similar and are of sufficient quality. A narrative synthesis will be completed if there is insufficient data to permit a formal meta

  11. Behavioural intervention to increase physical activity among patients with coronary heart disease: protocol for a randomised controlled trial.

    PubMed

    Alsaleh, Eman; Blake, Holly; Windle, Richard

    2012-12-01

    Although physical activity has significant health benefits in the treatment of patients with coronary heart disease, patients often do not follow prescribed physical activity recommendations. Behavioural strategies have been shown to be efficacious in increasing physical activity among those patients with coronary heart disease who are attending structured cardiac rehabilitation programmes. Research has also shown that tailoring consultation according to patients' needs and sending motivational reminders are successful ways of motivating patients to be physically active. However, there is a lack of evidence for the efficacy of behavioural interventions based on individualised consultation in promoting physical activity among those patients with coronary heart disease who are not attending structured physical activity programmes. This paper outlines the study protocol for a trial which is currently underway, to examine the effect of a behavioural change intervention delivered through individualised consultation calls and motivational reminder text messages on the level of physical activity among patients with coronary heart disease. Two large hospitals in Jordan. Eligible patients aged between 18 and 70 years, who are clinically stable, are able to perform physical activity and who have access to a mobile telephone have been randomly allocated to control or intervention group. Two-group randomised controlled trial. Behavioural intervention will be compared with usual care in increasing physical activity levels among patients with coronary heart disease. The control group (n=85) will receive advice from their doctors about physical activity as they would in usual practice. The intervention group (n=71) will receive the same advice, but will also receive behavioural change intervention (goal-setting, feed-back, self-monitoring) that will be delivered over a period of six months. Intervention will be delivered through individually tailored face-to-face and telephone

  12. The Effect of Career Interventions Designed to Increase Self-Knowledge on the Self-Concepts of Adolescents

    ERIC Educational Resources Information Center

    Portnoi, Lisette; Guichard, Jean; Lallemand, Noelle

    2004-01-01

    This paper reports a study that used a quasi-experimental design to examine if a career intervention designed to increase self-knowledge enabled self-discovery or self-construction, determined by the structure of the personality inventory used. This study, situated within the theoretical model of Markus's research in self-schemata (1977), used…

  13. Increasing the Use of Group Interventions in a Pediatric Rehabilitation Program: Perceptions of Administrators, Therapists, and Parents

    ERIC Educational Resources Information Center

    Camden, Chantal; Tetreault, Sylvie; Swaine, Bonnie

    2012-01-01

    Objectives: To explore perceptions related to increased utilization of group interventions as a part of the service reorganization within a pediatric rehabilitation program. Methods: Individual interviews with program administrators (n = 13) and focus groups with therapists (n = 19) and parents of children with disabilities (n = 5) were conducted.…

  14. Interventions to Increase Smoking Cessation at the Population Level: How Much Progress Has Been Made in the Last Two Decades?

    PubMed Central

    Zhu, Shu-Hong; Lee, Madeleine; Zhuang, Yue-Lin; Gamst, Anthony; Wolfson, Tanya

    2012-01-01

    This paper reviews the literature on smoking cessation interventions, with a focus on the last twenty years (1991 to 2010). These two decades witnessed major development in a wide range of cessation interventions, from pharmacotherapy to tobacco price increases. It was expected that these interventions would work conjointly to increase the cessation rate on the population level. This paper examines population data from the U.S., from 1991 to 2010, using the National Health Interview Surveys. Results indicate there is no consistent trend of increase in the population cessation rate over the last two decades. Various explanations are presented for this lack of improvement, and the key concept of Impact = Effectiveness × Reach is critically examined. Finally, it suggests that the field of cessation has focused so much on developing and promoting interventions to improve smokers’ odds of success that it has largely neglected to investigate how to get more smokers to try to quit and to try more frequently. Future research should examine whether increasing the rate of quit attempts would be key to improving the population cessation rate. PMID:22345233

  15. How to Inform: Comparing Written and Video Education Interventions to Increase Human Papillomavirus Knowledge and Vaccination Intentions in Young Adults

    ERIC Educational Resources Information Center

    Krawczyk, Andrea; Lau, Elsa; Perez, Samara; Delisle, Vanessa; Amsel, Rhonda; Rosberger, Zeev

    2012-01-01

    Objective: To compare the efficacy of 2 human papillomavirus (HPV) educational interventions on increasing HPV knowledge and vaccination intentions in college students. Participants: Male (n = 60) and female (n = 140) undergraduates (M[subscript age] = 20.4, SD = 2.3) recruited from a university in Montreal, Quebec, Canada, from October 2009 to…

  16. Disseminating a Successful Dietary Intervention to Faith Communities: Feasibility of Using Staff Contact and Encouragement to Increase Uptake

    ERIC Educational Resources Information Center

    Hannon, Peggy A.; Bowen, Deborah J.; Christensen, Catherine L.; Kuniyuki, Alan

    2008-01-01

    Objective: To test the feasibility of a dissemination strategy to increase faith communities' (FCs) adoption and implementation of a tested dietary intervention. Design: The study was a randomized, controlled trial that took place over a 9-month period. Setting: Seattle, Washington, metropolitan area. Participants: Seven FCs assigned to an…

  17. How to Inform: Comparing Written and Video Education Interventions to Increase Human Papillomavirus Knowledge and Vaccination Intentions in Young Adults

    ERIC Educational Resources Information Center

    Krawczyk, Andrea; Lau, Elsa; Perez, Samara; Delisle, Vanessa; Amsel, Rhonda; Rosberger, Zeev

    2012-01-01

    Objective: To compare the efficacy of 2 human papillomavirus (HPV) educational interventions on increasing HPV knowledge and vaccination intentions in college students. Participants: Male (n = 60) and female (n = 140) undergraduates (M[subscript age] = 20.4, SD = 2.3) recruited from a university in Montreal, Quebec, Canada, from October 2009 to…

  18. Understanding the behavioral linkages needed for designing effective interventions to increase fruit and vegetable intake in diverse populations

    USDA-ARS?s Scientific Manuscript database

    The design of interventions to increase fruit and vegetable consumption in a population (e.g. all men, all elementary school students) requires an underlying model that organizes the relevant literatures and provides an audience. The mediating-moderating variable model is a statistical analysis tech...

  19. The Effect of Career Interventions Designed to Increase Self-Knowledge on the Self-Concepts of Adolescents

    ERIC Educational Resources Information Center

    Portnoi, Lisette; Guichard, Jean; Lallemand, Noelle

    2004-01-01

    This paper reports a study that used a quasi-experimental design to examine if a career intervention designed to increase self-knowledge enabled self-discovery or self-construction, determined by the structure of the personality inventory used. This study, situated within the theoretical model of Markus's research in self-schemata (1977), used…

  20. Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial.

    PubMed

    Shorr, Ronald I; Chandler, A Michelle; Mion, Lorraine C; Waters, Teresa M; Liu, Minzhao; Daniels, Michael J; Kessler, Lori A; Miller, Stephen T

    2012-11-20

    Bed alarm systems intended to prevent hospital falls have not been formally evaluated. To investigate whether an intervention aimed at increasing bed alarm use decreases hospital falls and related events. Pair-matched, cluster randomized trial over 18 months. Nursing units were allocated by computer-generated randomization on the basis of baseline fall rates. Patients and outcome assessors were blinded to unit assignment; outcome assessors may have become unblinded. (ClinicalTrials.gov registration number: NCT00183053) 16 nursing units in an urban community hospital. 27 672 inpatients in general medical, surgical, and specialty units. Education, training, and technical support to promote use of a standard bed alarm system (intervention units); bed alarms available but not formally promoted or supported (control units). Pre-post difference in change in falls per 1000 patient-days (primary end point); number of patients who fell, fall-related injuries, and number of patients restrained (secondary end points). Prevalence of alarm use was 64.41 days per 1000 patient-days on intervention units and 1.79 days per 1000 patient-days on control units (P = 0.004). There was no difference in change in fall rates per 1000 patient-days (risk ratio, 1.09 [95% CI, 0.85 to 1.53]; difference, 0.41 [CI, -1.05 to 2.47], which corresponds to a greater difference in falls in control vs. intervention units) or in the number of patients who fell, injurious fall rates, or the number of patients physically restrained on intervention units compared with control units. The study was conducted at a single site and was slightly underpowered compared with the initial design. An intervention designed to increase bed alarm use in an urban hospital increased alarm use but had no statistically or clinically significant effect on fall-related events or physical restraint use. National Institute on Aging.

  1. A Comparison of Interventional Approaches for Increasing Power Take-off Shielding on New York Farms.

    PubMed

    Sorensen, Julie A; Tinc, Pamela J; Dalton, Deb; Scott, Erika E; Jenkins, Paul L

    2017-01-01

    Power take-off (PTO) driveline entanglements are a primary source of injury on US farms. As with many farm injury concerns, hazard control technology is widely available for mitigating the risk of these entanglements. Despite the availability of hazard control technology, PTO shields are damaged or missing on approximately 57% of PTO driveline implements in New York. Given the catastrophic nature of entanglements and the ready access to safety technology, a better understanding of what motivates farmers to install or replace PTO shields is warranted. To examine this question, agricultural health and safety researchers in New York State conducted an initial comparison of PTO shield sales on farms receiving one of three different interventional approaches. These included PTO shield audits, a social marketing campaign, and on-farm safety services. PTO shield purchases were tracked from January 2011 through June 2016 on farms receiving these interventions and on other farms that were not exposed to interventional strategies. Results indicate that a significantly higher number of PTO shields were purchased on farms that requested and received on-farm safety services versus farms that were exposed to PTO shield audits, the social marketing campaign, or the control group. PTO shield sales were slightly elevated on farms receiving driveline audits, as compared with control farms (although these differences were not significant). No marked differences in sales were noted between control farms and farms exposed to the social marketing campaign. Only one of the three interventional strategies (on-farm safety services) approached the number of PTO shield sales necessary to prevent an entanglement.

  2. Prevention of diabetes-promoted colorectal cancer by (n-3) polyunsaturated fatty acids and (n-3) PUFA mimetic

    PubMed Central

    Hertz, Rachel; Peri, Irena; Bar-Tana, Jacob; Schwartz, Betty

    2014-01-01

    The global obesity / diabetes epidemic has resulted in robust increase in the incidence of colorectal cancer (CRC). Epidemiological, animal and human studies have indicated efficacy of (n-3) PUFA in chemoprevention of sporadic and genetic-driven CRC. However, diabetes-promoted CRC presents a treatment challenge that surpasses that of sporadic CRC. This report analyzes the efficacy of (n-3) PUFA generated by the fat-1 transgene that encodes an (n-6) to (n-3) PUFA desaturase, and of synthetic (n-3) PUFA mimetic (MEDICA analog), to suppress CRC development in carcinogen-induced diabetes-promoted animal model. Carcinogen-induced CRC is shown here to be promoted by the diabetes context, in terms of increased aberrant crypt foci (ACF) load, cell proliferation and epithelial dedifferentiation, being accompanied by increase in the expression of HNF4α, β-catenin, and β-catenin-responsive genes. Incorporating the fat-1 transgene in the diabetes context, or oral MEDICA treatment, resulted in ameliorating the diabetic phenotype and in abrogating CRC, with decrease in ACF load, cell proliferation and the expression of HNF-4α, β-catenin, and β-catenin-responsive genes. The specificity of (n-3) PUFA in abrogating CRC development, as contrasted with enhancing CRC by (n-6) PUFA, was similarly verified in CRC cell lines. These findings may indicate prospective therapeutic potential of (n-3) PUFA or MEDICA in the management of CRC, in particular diabetes-promoted CRC. PMID:25375205

  3. Prevention of diabetes-promoted colorectal cancer by (n-3) polyunsaturated fatty acids and (n-3) PUFA mimetic.

    PubMed

    Algamas-Dimantov, Anna; Yehuda-Shnaidman, Einav; Hertz, Rachel; Peri, Irena; Bar-Tana, Jacob; Schwartz, Betty

    2014-10-30

    The global obesity / diabetes epidemic has resulted in robust increase in the incidence of colorectal cancer (CRC). Epidemiological, animal and human studies have indicated efficacy of (n-3) PUFA in chemoprevention of sporadic and genetic-driven CRC. However, diabetes-promoted CRC presents a treatment challenge that surpasses that of sporadic CRC. This report analyzes the efficacy of (n-3) PUFA generated by the fat-1 transgene that encodes an (n-6) to (n-3) PUFA desaturase, and of synthetic (n-3) PUFA mimetic (MEDICA analog), to suppress CRC development in carcinogen-induced diabetes-promoted animal model. Carcinogen-induced CRC is shown here to be promoted by the diabetes context, in terms of increased aberrant crypt foci (ACF) load, cell proliferation and epithelial dedifferentiation, being accompanied by increase in the expression of HNF4α, β-catenin, and β-catenin-responsive genes. Incorporating the fat-1 transgene in the diabetes context, or oral MEDICA treatment, resulted in ameliorating the diabetic phenotype and in abrogating CRC, with decrease in ACF load, cell proliferation and the expression of HNF-4α, β-catenin, and β-catenin-responsive genes. The specificity of (n-3) PUFA in abrogating CRC development, as contrasted with enhancing CRC by (n-6) PUFA, was similarly verified in CRC cell lines. These findings may indicate prospective therapeutic potential of (n-3) PUFA or MEDICA in the management of CRC, in particular diabetes-promoted CRC.

  4. A web-based intervention to support increased physical activity among at-risk adults.

    PubMed

    Massoudi, Barbara L; Olmsted, Murrey G; Zhang, Yuying; Carpenter, Ruth Ann; Barlow, Carolyn E; Huber, Rachel

    2010-10-01

    Physical inactivity is an important contributor to the development of numerous chronic conditions and alone is an independent risk factor for diabetes, cardiovascular disease, and depression and yet, most Americans consistently fail to achieve the recommended amount of physical activity. As part of Project HealthDesign, we designed and prototyped a personal health record application (PHA) that delivers and supports a highly individualized, behaviorally based lifestyle physical activity intervention for sedentary adults. Through a user centered design approach, we engaged consumers, health care providers, and personal trainers for multiple facilitated group discussions and structured interviews to determine their needs and wants related to an activity PHA. The PHA was developed to include elements of evidence-based approaches which help participants adopt cognitive and behavioral skills such as goal-setting, self-monitoring, accepting social support, cognitive restructuring, contingency management, decisional balance, and relapse prevention. This PHA demonstrated the potential for research-based behavioral interventions to be delivered via a web portal. This finding is important for both consumers and their providers who have the desire to implement physical activity recommendations, but lack the tools to facilitate or undertake such interventions.

  5. Impact evaluation of a pilot web-based intervention to increase physical activity.

    PubMed

    Grim, Melissa; Hortz, Brian; Petosa, Rick

    2011-01-01

    The purpose of this pilot study was to conduct an impact evaluation of a 10-week Web-based physical activity intervention. Quasi-experimental, three-group pretest, posttest design. Large Midwestern university. Participants (N = 233) included college students registered for three courses. The study employed a convenience sample consisting of a Web-based group (n = 108), a physical activity group (n = 64), and a general health group (n = 61). The Web-based group received a Social Cognitive Theory behavioral skill-building intervention and exercised 3 days per week in their leisure time. The physical activity group received exercise instruction and was required to attend three physical activity labs per week. The comparison group received health instruction. Outcome variables included moderate and vigorous physical activity, self-regulation, social support, self-efficacy, and outcome expectations and expectancies. Differences between groups were assessed at pretest and posttest using multiple analyses of variance. Vigorous physical activity, self-regulation, and outcome expectancy value changed significantly in the Web-based and physical activity course groups (p < .01). Even with consideration of limitations such as small sample size and lack of randomization, the Web-based and traditional physical activity lecture and activity lab interventions were superior in eliciting changes in vigorous physical activity, self-regulation, and outcome expectancy value than a traditional health course.

  6. Brief Telephone Intervention Increases Soy Intake in Peri- and Postmenopausal US Women: the Herbal Alternatives (HALT) Trial

    PubMed Central

    Beasley, Jeannette M.; Schenk, Jeannette M.; Ludman, Evette; Lampe, Johanna W.; Reed, Susan; Grothaus, Lou; Newton, Katherine M.

    2010-01-01

    Background Effective dietary intervention strategies that can be widely disseminated and have the potential for sustainable dietary modifications are needed. Objective To describe and evaluate the effectiveness of a telephone-based soy intervention. Design A randomized controlled trial comparing self-reported and serum measures of soy intake during a 1-year dietary soy (Soy) to fruit and vegetable (Placebo) intervention conducted in two of five arms from the Herbal Alternatives Trial between May 2001-September 2004. Subjects/setting 163 peri- and postmenopausal women (mean age 52 y) consuming self-selected diets; Pacific Northwest, US. Intervention Five telephone contacts with a dietitian during a 12-month intervention with the goal to increase soy food consumption to two servings daily. Main outcome measures Change from baseline in self-reported soy servings and serum isoflavone (daidzein and genistein) concentrations were estimated using analysis of variance and generalized estimating equations. Proportion of participants achieving the intervention goal was compared using Chi-squared tests. Results Ninety-four percent (n=74) of participants in the Soy arm and 89% (n=75) in the Placebo arm completed the trial, and just over 1/3 (n=27) received 5 phone contacts. Mean(±SD) intake of soy was similar for the Soy and Placebo arms at baseline (0.6±1.0 versus 0.4±0.8 servings/day, P>0.05). At the 12-month follow-up visit, mean±SD servings of soy per day were 1.6±1.4 for the Soy intervention compared to 0.5±0.9 within the Placebo arm (P<0.001). There were concomitant increases in serum isoflavones at 3 and 6 months from baseline in the Soy arm only, with approximately 2-fold increases in both daidzein (mean 66.4 nmol/L, 95% CI 39.0 to 93.9) and genistein (mean 100.4 nmol/L, 95% CI 60.9 to 139.9) concentrations. Mean weight changed by less than 1 kg over the 12-month period in each group and physical activity remained stable, suggesting participants incorporated soy

  7. Image gently, step lightly: increasing radiation dose awareness in pediatric interventions through an international social marketing campaign.

    PubMed

    Sidhu, Manrita K; Goske, Marilyn J; Coley, Brian J; Connolly, Bairbre; Racadio, John; Yoshizumi, Terry T; Utley, Tara; Strauss, Keith J

    2009-09-01

    In the past several decades, advances in imaging and interventional techniques have been accompanied by an increase in medical radiation dose to the public. Radiation exposure is even more important in children, who are more sensitive to radiation and have a longer lifespan during which effects may manifest. To address radiation safety in pediatric computed tomography, in 2008 the Alliance for Radiation Safety in Pediatric Imaging launched an international social marketing campaign entitled Image Gently. This article describes the next phase of the Image Gently campaign, entitled Step Lightly, which focuses on radiation safety in pediatric interventional radiology.

  8. Environmental Intervention in Carryout Restaurants Increases Sales of Healthy Menu Items in a Low-Income Urban Setting.

    PubMed

    Lee-Kwan, Seung Hee; Bleich, Sara N; Kim, Hyunju; Colantuoni, Elizabeth; Gittelsohn, Joel

    2015-01-01

    To investigate how a pilot environmental intervention changed food sales patterns in carryout restaurants. Quasi-experimental. Low-income neighborhoods of Baltimore, Maryland. Seven carryouts (three intervention, four comparison). Phase 1, menu board revision and healthy menu labeling; phase 2, increase of healthy sides and beverages; and phase 3, promotion of cheaper and healthier combination meals. Weekly handwritten menu orders collected to assess changes in the proportion of units sold and revenue of healthy items (entrée, sides and beverages, and combined). Logistic and Poisson regression models with generalized estimating equations. In the intervention group, odds for healthy entrée units and odds for healthy side and beverage units sold significantly increased in phases 2 and 3; odds for healthy entrée revenue significantly increased in phase 1 (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.08-1.26), phase 2 (OR 1.32, 95% CI 1.25-1.41), and phase 3 (OR 1.39, 95% CI 1.14-1.70); and odds for healthy side and beverage revenues increased significantly in phase 2 (OR 1.62, 95% CI 1.33-1.97) and phase 3 (OR 2.73, 95% CI 2.15-3.47) compared to baseline. Total revenue in the intervention group was significantly higher in all phases than in the comparison group (p < .05). Environmental intervention changes such as menu revision, menu labeling, improved healthy food selection, and competitive pricing can increase availability and sales of healthy items in carryouts.

  9. Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: a qualitative study.

    PubMed

    Cleland, Claire L; Hunter, Ruth F; Tully, Mark A; Scott, David; Kee, Frank; Donnelly, Michael; Prior, Lindsay; Cupples, Margaret E

    2014-05-23

    There is an urgent need to increase population levels of physical activity, particularly amongst those who are socio-economically disadvantaged. Multiple factors influence physical activity behaviour but the generalisability of current evidence to such 'hard-to-reach' population subgroups is limited by difficulties in recruiting them into studies. Also, rigorous qualitative studies of lay perceptions and perceptions of community leaders about public health efforts to increase physical activity are sparse. We sought to explore, within a socio-economically disadvantaged community, residents' and community leaders' perceptions of physical activity (PA) interventions and issues regarding their implementation, in order to improve understanding of needs, expectations, and social/environmental factors relevant to future interventions. Within an ongoing regeneration project (Connswater Community Greenway), in a socio-economically disadvantaged community in Belfast, we collaborated with a Community Development Agency to purposively sample leaders from public- and voluntary-sector community groups and residents. Individual semi-structured interviews were conducted with 12 leaders. Residents (n = 113), of both genders and a range of ages (14 to 86 years) participated in focus groups (n = 14) in local facilities. Interviews and focus groups were recorded, transcribed verbatim and analysed using a thematic framework. Three main themes were identified: awareness of PA interventions; factors contributing to intervention effectiveness; and barriers to participation in PA interventions. Participants reported awareness only of interventions in which they were involved directly, highlighting a need for better communications, both inter- and intra-sectoral, and with residents. Meaningful engagement of residents in planning/organisation, tailoring to local context, supporting volunteers, providing relevant resources and an 'exit strategy' were perceived as important factors

  10. Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: a qualitative study

    PubMed Central

    2014-01-01

    Background There is an urgent need to increase population levels of physical activity, particularly amongst those who are socio-economically disadvantaged. Multiple factors influence physical activity behaviour but the generalisability of current evidence to such ‘hard-to-reach’ population subgroups is limited by difficulties in recruiting them into studies. Also, rigorous qualitative studies of lay perceptions and perceptions of community leaders about public health efforts to increase physical activity are sparse. We sought to explore, within a socio-economically disadvantaged community, residents’ and community leaders’ perceptions of physical activity (PA) interventions and issues regarding their implementation, in order to improve understanding of needs, expectations, and social/environmental factors relevant to future interventions. Methods Within an ongoing regeneration project (Connswater Community Greenway), in a socio-economically disadvantaged community in Belfast, we collaborated with a Community Development Agency to purposively sample leaders from public- and voluntary-sector community groups and residents. Individual semi-structured interviews were conducted with 12 leaders. Residents (n = 113), of both genders and a range of ages (14 to 86 years) participated in focus groups (n = 14) in local facilities. Interviews and focus groups were recorded, transcribed verbatim and analysed using a thematic framework. Results Three main themes were identified: awareness of PA interventions; factors contributing to intervention effectiveness; and barriers to participation in PA interventions. Participants reported awareness only of interventions in which they were involved directly, highlighting a need for better communications, both inter- and intra-sectoral, and with residents. Meaningful engagement of residents in planning/organisation, tailoring to local context, supporting volunteers, providing relevant resources and an ‘exit strategy

  11. A community-based intervention increases physical activity and reduces obesity in school-age children in North Carolina.

    PubMed

    Benjamin Neelon, Sara E; Namenek Brouwer, Rebecca J; Østbye, Truls; Evenson, Kelly R; Neelon, Brian; Martinie, Annie; Bennett, Gary

    2015-06-01

    Community-based interventions are promising approaches to obesity prevention, but few studies have prospectively evaluated them. The aim of this study was to evaluate a natural experiment—a community intervention designed to promote active living and decrease obesity within a small southern town. In 2011, community leaders implemented the Mebane on the Move intervention—a community-wide effort to promote physical activity (PA) and decrease obesity among residents of Mebane, North Carolina. We measured child PA and BMI before and after the intervention, using a nearby town not implementing an intervention as the comparison. In total, we assessed 64 children from Mebane and 40 from the comparison community 6 months before, as well as 34 and 18 children 6 months after the intervention. We assessed PA with accelerometers worn for 7 days and calculated BMI z-scores using children's height and weight. We conducted multivariable linear regressions examining pre- to postintervention change in minutes of PA and BMI z-score, adjusting for confounders. At follow-up, children in Mebane modestly increased their moderate-to-vigorous PA (1.3 minutes per hour; 95% confidence interval (CI): 0.2, 2.3; p=0.03) and vigorous activity (0.8 minutes per hour; 95% CI: 0.1, 1.5; p=0.04) more than comparison children. In intervention children, BMI z-scores decreased 0.5 units (kg/m(2); 95% CI: -0.9, -0.02; p=0.045), compared to children in the comparison community. We observed positive effects on PA level and weight status of children in Mebane, despite high rates of attrition, suggesting that the community-based intervention may have been successful.

  12. A Community-Based Intervention Increases Physical Activity and Reduces Obesity in School-Age Children in North Carolina

    PubMed Central

    Namenek Brouwer, Rebecca J.; Østbye, Truls; Evenson, Kelly R.; Neelon, Brian; Martinie, Annie; Bennett, Gary

    2015-01-01

    Abstract Background: Community-based interventions are promising approaches to obesity prevention, but few studies have prospectively evaluated them. The aim of this study was to evaluate a natural experiment—a community intervention designed to promote active living and decrease obesity within a small southern town. Methods: In 2011, community leaders implemented the Mebane on the Move intervention—a community-wide effort to promote physical activity (PA) and decrease obesity among residents of Mebane, North Carolina. We measured child PA and BMI before and after the intervention, using a nearby town not implementing an intervention as the comparison. In total, we assessed 64 children from Mebane and 40 from the comparison community 6 months before, as well as 34 and 18 children 6 months after the intervention. We assessed PA with accelerometers worn for 7 days and calculated BMI z-scores using children's height and weight. We conducted multivariable linear regressions examining pre- to postintervention change in minutes of PA and BMI z-score, adjusting for confounders. Results: At follow-up, children in Mebane modestly increased their moderate-to-vigorous PA (1.3 minutes per hour; 95% confidence interval (CI): 0.2, 2.3; p=0.03) and vigorous activity (0.8 minutes per hour; 95% CI: 0.1, 1.5; p=0.04) more than comparison children. In intervention children, BMI z-scores decreased 0.5 units (kg/m2; 95% CI: −0.9, −0.02; p=0.045), compared to children in the comparison community. Conclusions: We observed positive effects on PA level and weight status of children in Mebane, despite high rates of attrition, suggesting that the community-based intervention may have been successful. PMID:25938983

  13. A multilevel intervention to increase community hospital use of alteplase for acute stroke (INSTINCT): a cluster-randomised controlled trial

    PubMed Central

    Scott, Phillip A; Meurer, William J; Frederiksen, Shirley M; Kalbfleisch, John D; Xu, Zhenzhen; Haan, Mary N; Silbergleit, Robert; Morgenstern, Lewis B

    2013-01-01

    Summary Background Use of alteplase improves outcome in some patients with stroke. Several types of barrier frequently prevent its use. We assessed whether a standardised, barrier-assessment, multicomponent intervention could increase alteplase use in community hospitals in Michigan, USA. Methods In a cluster-randomised controlled trial, we selected adult, non-specialty, acute-care community hospitals in the Lower Peninsula of Michigan, USA. Eligible hospitals discharged at least 100 patients who had had a stroke per year, had less than 100 000 visits to the emergency department per year, and were not academic comprehensive stroke centres. Using a computer-generated randomisation sequence, we selected 12 matched pairs of eligible hospitals. Within pairs, the hospitals were allocated to intervention or control groups with restricted randomisation in January, 2007. Between January, 2007, and December, 2007, intervention hospitals implemented a multicomponent intervention that included qualitative and quantitative assessment of barriers to alteplase use and ways to address the findings, and provided additional support. The primary outcome was change in alteplase use in patients with stroke in emergency departments between the pre-intervention period (January, 2005, to December, 2006) and the post-intervention period (January, 2008, to January, 2010). Physicians in participating hospitals and the coordinating centre could not be masked to group assignment, but were masked to progress made in paired control hospitals. External medical reviewers who were masked to group assignment assessed outcomes. We did intention-to-treat (ITT) and target-population (without one pair that was excluded after randomisation) analyses. This trial is registered at ClinicalTrials.gov, number NCT00349479. Findings All 24 hospitals completed the study. Overall, 745 of 40 823 patients with stroke received intravenous alteplase treatment. In the ITT analysis, the proportion of patients with

  14. Youth Action Research for Prevention: a multi-level intervention designed to increase efficacy and empowerment among urban youth.

    PubMed

    Berg, Marlene; Coman, Emil; Schensul, Jean J

    2009-06-01

    Youth Action Research for Prevention (YARP), a federally funded research and demonstration intervention, utilizes youth empowerment as the cornerstone of a multi-level intervention designed to reduce and/or delay onset of drug and sex risk, while increasing individual and collective efficacy and educational expectations. The intervention, located in Hartford Connecticut, served 114 African-Caribbean and Latino high school youth in a community education setting and a matched comparison group of 202 youth from 2001 to 2004. The strategy used in YARP begins with individuals, forges group identity and cohesion, trains youth as a group to use research to understand their community better (formative community ethnography), and then engages them in using the research for social action at multiple levels in community settings (policy, school-based, parental etc.) Engagement in community activism has, in turn, an effect on individual and collective efficacy and individual behavioral change. This approach is unique insofar as it differs from multilevel interventions that create approaches to attack multiple levels simultaneously. We describe the YARP intervention and employ qualitative and quantitative data from the quasi-experimental evaluation study design to assess the way in which the YARP approach empowered individual youth and groups of youth (youth networks) to engage in social action in their schools, communities and at the policy level, which in turn affected their attitudes and behaviors.

  15. A Teacher-Focused Intervention to Decrease PE Students' Amotivation by Increasing Need Satisfaction and Decreasing Need Frustration.

    PubMed

    Cheon, Sung Hyeon; Reeve, Johnmarshall; Song, Yong-Gwan

    2016-06-01

    Intervention-induced gains in need satisfaction decrease PE students' amotivation. The present study adopted a dual-process model to test whether an intervention could also decrease need frustration and hence provide a second supplemental source to further decrease students' PE amotivation. Using an experimental, longitudinal research design, 19 experienced PE teachers (9 experimental, 10 control) and their 1,017 students participated in an intervention program to help teachers become both more autonomy supportive and less controlling. Multilevel repeated measures analyses showed that students of teachers in the experimental group reported greater T2, T3, and T4 perceived autonomy support, need satisfaction, and engagement and lesser T2, T3, and T4 perceived teacher control, need frustration, and amotivation than did students of teachers in the control group. Multilevel structural equation modeling analyses confirmed the hypothesized dual-process model in which both intervention-induced increases in need satisfaction and intervention-induced decreases need frustration decreased students' end-of-semester amotivation. We discuss the theoretical and practical implications of this new finding on the dual antecedents of diminished amotivation.

  16. Brief online interventions targeting risk and protective factors for increased and problematic alcohol use among American college students studying abroad.

    PubMed

    Pedersen, Eric R; Neighbors, Clayton; Atkins, David C; Lee, Christine M; Larimer, Mary E

    2017-03-01

    Research documents increased and problematic alcohol use during study abroad experiences for college students yet no research documents effective preventive programs with these students. The present randomized controlled trial was designed to prevent increased and problematic alcohol use abroad by correcting misperceptions of peer drinking norms abroad and by promoting positive and healthy adjustment into the host culture (i.e., sojourner adjustment) through brief online personalized feedback interventions. A sample of 343 study abroad college students was randomly assigned to 1 of 4 conditions including a personalized normative feedback intervention (PNF), a sojourner adjustment feedback intervention (SAF), a combined PNF + SAF intervention, and an assessment-only control condition. Generalized estimated equation analyses accounting for baseline drinking and consequences revealed an intervention effect for PNF that was mitigated by baseline drinking level, such that PNF was best for those with lighter baseline drinking, but heavier baseline drinkers receiving PNF alone or PNF + SAF drank comparatively similar or more heavily abroad to those in the control condition. However, PNF + SAF condition participants with greater baseline levels of consequences reported comparatively less consequences abroad than their control participants. Thus, PNF alone may be helpful for lighter drinkers at predeparture and the addition of SAF to PNF may help prevent consequences abroad for those reporting more consequences prior to departure abroad. This research represents an important first step in designing and implementing efficacious interventions with at-risk study abroad college students, for which no current empirically based programs exist. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  17. Feasibility Study of Increasing Social Support to Enhance a Healthy Lifestyle Intervention for Individuals with Serious Mental Illness.

    PubMed

    Aschbrenner, Kelly A; Mueser, Kim T; Naslund, John A; Gorin, Amy A; Kinney, Allison; Daniels, Lucas; Bartels, Stephen J

    2016-01-01

    Healthy lifestyle interventions addressing obesity in people with serious mental illness (SMI) lead to modest weight losses that tend not to be sustained over time. By augmenting lifestyle interventions with family and peer support targeting health behavior change, greater weight loss might be obtained and sustained in this population. The purpose of this study was to assess the feasibility of increasing support from family and friends to enhance a healthy lifestyle intervention (In SHAPE) adapted for individuals with SMI. A sample of 7 dyads (14 total participants) participated in this small-scale open-feasibility trial of social support strategies to enhance health promotion. Weekly 1-hour health coaching sessions were augmented by sessions designed to increase support for healthy eating and exercise through active learning and didactic instruction. Feasibility was assessed by program participation and by examining participants' satisfaction and exploring suggestions for improving the model post-intervention. The majority of participants (57%) nominated a friend, followed by adult child-parent pairs (28%) and sibling pairs (14%) to participate as support partners in the study. All participant-partner dyads (100%) completed 12 sessions within 16 weeks. Participants reported high satisfaction and perceived benefits from the program. Recommend modifications by the dyads included more interactive sessions, a combination of group and dyadic sessions, and hands-on cooking classes. This formative research showed that the study design is feasible and that the intervention can facilitate social support for health behavior change in people with SMI. Further research is needed to evaluate the effectiveness of this intervention.

  18. Increasing Physical Activity in Parks: Results of a Randomized Controlled Intervention Trial Using Community-Based Participatory Research

    PubMed Central

    Cohen, Deborah A.; Han, Bing; Derose, Kathryn Pitkin; Williamson, Stephanie; Marsh, Terry; McKenzie, Thomas L.

    2013-01-01

    Background Physical inactivity is an important health risk factor that could be addressed at the community level. Purpose To determine whether using a community-based participatory approach with park directors and park advisory boards (PABs) could increase physical activity in local parks. We also tested whether involving PABs would be more effective than working with park directors alone. Design Randomized controlled intervention trial from 10/2007-4/2012 with partial blinding of observers to the condition. Setting/Participants Of 183 eligible parks in the City of Los Angeles, 50 neighborhood park/recreation centers serving diverse populations participated. Parks were randomized to three study arms, 1) Park-director intervention (PD-only), 2) Park Advisory Board intervention (PAB/PD), and 3) a control arm. We systematically observed physical activity in each park and interviewed park users and residents living within one mile of the park. Intervention(s) The intervention including assessing park use, obtaining feedback from park users and community residents, offering training on outreach and marketing, and giving each intervention park $4000 to increase park-based physical activity. The PAB/PD arm required participation and concurrence on all purchases by the PAB. Main Outcome Measure(s) Change in the number of park users and change in the level of physical activity, expressed as MET-hours. Results Relative to control parks where physical activity declined, in both the PD-only and PAB/PD parks physical activity increased, generating an estimated average of 600 more person visits/week/park, and 1830 MET-hours more physical activity/week/park. Both residents and park users reported increased frequency of exercise. No differences were noted between the PD-only and PAB/PD study arms. Conclusions Overall, providing feedback on park use and community perspectives and offering park directors training on outreach and marketing with modest discretionary funding increased

  19. Increased prevalence of preeclampsia among women undergoing procedural intervention for renal artery fibromuscular dysplasia.

    PubMed

    Vance, Chardonnay J; Taylor, Robert N; Craven, Timothy E; Edwards, Matthew S; Corriere, Matthew A

    2015-08-01

    Renal artery fibromuscular dysplasia (RA-FMD) has a higher prevalence among women and a presumed hormonal etiology. Although preeclampsia has a clinical presentation similar to symptomatic RA-FMD and occurs exclusively in women, associations between these 2 diseases have not been characterized. To explore epidemiologic associations between RA-FMD and preeclampsia, we administered a validated screening instrument for preeclampsia to a cohort of women with a history of pregnancy who had previously been treated with procedural intervention for symptomatic RA stenosis. Women with a history of pregnancy who had previously undergone procedural intervention (including angioplasty and/or bypass) for symptomatic RA stenosis were identified from a prospectively maintained operative registry and screened for remote history of preeclampsia using a validated survey instrument. Univariable associations between RA-FMD and preeclampsia among participants with a history of pregnancy were evaluated using t-tests for continuous factors and chi-squared tests for dichotomous factors. Multivariable associations were evaluated using logistic regression models. A total of 144 women were identified who met the study inclusion criteria, including 94 with atherosclerotic RA stenosis and 50 with RA-FMD. Sixty-nine patients were contacted, 59 consented to participate, and 52 had a history of pregnancy (and therefore were at risk for preeclampsia). Participants completed the survey instrument at a mean of 7.1 ± 3.1 vs. 6.9 ± 3.6 years after RA procedural intervention, respectively. Survey responses indicated a history of preeclampsia in 19/52 (36.5%) of participants overall, including 14/27 (51.9%) with RA-FMD versus 5/20 (20.0%) with RA atherosclerosis (P = 0.02). Preeclampsia remained associated with FMD in a multivariable model adjusting for smoking status, age at time of surgery, and estimated glomerular filtration rate (odds ratio [OR] 9.51, 95% confidence interval [CI] 1.49-60.6, P = 0

  20. Do school-based physical activity interventions increase or reduce inequalities in health?

    PubMed

    Vander Ploeg, Kerry A; Maximova, Katerina; McGavock, Jonathan; Davis, Wendy; Veugelers, Paul

    2014-07-01

    Little is known about the effectiveness of school-based health promotion on physical activity inequalities among children from low-income areas. This study compared the two-year change in physical activity among 10-11 year-old children attending schools with and without health promotion programs by activity level, body weight status, and socioeconomic backgrounds to assess whether health promotion programs reduce or exacerbate health inequalities. This was a quasi-experimental trial of a Comprehensive School Health (CSH) program implemented in schools located in socioeconomically disadvantaged neighbourhoods in Edmonton, Alberta, Canada. In the spring of 2009 and 2011, pedometer (7 full days) and demographic data were collected from cross-sectional samples of grade five children from 10 intervention and 20 comparison schools. Socioeconomic status was determined from parent self-report. Low-active, active, and high-active children were defined according to step-count tertiles. Multilevel linear regression methods adjusted for potential confounders were used to assess the relative inequity in physical activity and were compared between groups and over-time. In 2009, a greater proportion of students in the intervention schools were overweight (38% vs. 31% p = 0.03) and were less active (10,827 vs. 12,265 steps/day p < 0.001). Two years later, the relative difference in step-counts between intervention and comparison schools reduced from -15.5% to 0% among low-active students, from -13.4% to 0% among active students, and from -15.1% to -2.7% among high-active students. The relative difference between intervention and comparison schools reduced from -11.1% to -1.6% among normal weight students, from -16.8% to -1.4% among overweight students, and was balanced across socioeconomic subgroups. These findings demonstrate that CSH programs implemented in socioeconomically disadvantaged neighbourhoods reduced inequalities in physical activity. Investments in school

  1. Checking In: A Pilot of a Physician-Delivered Intervention to Increase Parent-Adolescent Communication About Blood Glucose Monitoring.

    PubMed

    Monaghan, Maureen; Clary, Lauren; Mehta, Priya; Stern, Alexa; Sharkey, Christina; Cogen, Fran R; Vaidyanathan, Priya; Streisand, Randi

    2015-12-01

    Low-cost, translatable interventions to promote adherence in adolescents with type 1 diabetes are needed. This study evaluated a brief physician-delivered intervention designed to increase parent-adolescent communication about blood glucose monitoring. Thirty adolescent-parent dyads completed baseline questionnaires and received the physician-delivered intervention. Participants completed follow-up questionnaires at 12 weeks; HbA1c and glucometer data were abstracted from medical charts. Parent-reported conflict surrounding diabetes management decreased from pre- to postintervention. Participants who reported adhering to the intervention plan (n = 15) demonstrated an increase in blood glucose monitoring frequency and trends in improved HbA1c and parental diabetes collaboration from pre- to postintervention. Participants and physicians reported overall satisfaction with the program. Results demonstrate initial feasibility as well as a trend toward improvement in diabetes-specific health indicators for parent-adolescent dyads who adhered to program components. Frequent joint review of glucometer data can be a useful strategy to improve type 1 diabetes-related health outcomes and parent-adolescent communication. © The Author(s) 2015.

  2. Increasing resource allocation and research into tobacco control activities: a comprehensive approach including primary prevention, treatment and brief intervention.

    PubMed

    Richmond, R

    1993-01-01

    The range of tobacco control activities should be viewed as essential parts of a complex multi-component puzzle. Intervention strategies designed to address tobacco control should be comprehensive and include both primary and secondary prevention activities and be multi-faceted and capable of bringing about change at both the individual and broader social and cultural levels. In this paper I argue for a mutually inclusive framework in which the various components contribute in important and different ways. I examine the prevalence of smoking and identify the high risk groups, then I examine the range of available strategies and present the evidence for their success. I discuss the primary prevention approaches such as warning labels, taxes, price increases, workplace bans, education in schools, mass media and self-help materials, as well as brief interventions and treatment strategies which are conducted at the worksite, general practice and specialized cessation clinics. The areas for future research are delineated for increased resource allocation and include: the best ways to disseminate brief interventions to smokers, methods to motivate smokers; training of health professionals to deliver brief interventions; enhancing quitting and access to existing treatment resources among specific disadvantaged minority groups, e.g. migrants, unemployed youth, the effect on smoking prevalence of warning labels on cigarette packets and price rises on cigarettes.

  3. Network meta-analysis to evaluate the effectiveness of interventions to increase the uptake of smoke alarms.

    PubMed

    Cooper, Nicola J; Kendrick, Denise; Achana, Felix; Dhiman, Paula; He, Zhimin; Wynn, Persephone; Le Cozannet, Elodie; Saramago, Pedro; Sutton, Alex J

    2012-01-01

    This study is the first known to use network meta-analysis to simultaneously evaluate the effectiveness of interventions to increase the prevalence of functioning smoke alarms in households with children. The authors identified 24 primary studies from a systematic review of reviews and of more recently published primary studies, of which 23 (17 randomized controlled trials and 6 nonrandomized comparative studies) were included in 1 of the following 2 network meta-analyses: 1) possession of a functioning alarm: interventions that were more "intensive" (i.e., included components providing equipment (with or without fitting), home inspection, or both, in addition to education) generally were more effective. The intervention containing all of the aforementioned components was identified as being the most likely to be the most effective (probability (best) = 0.66), with an odds ratio versus usual care of 7.15 (95% credible interval: 2.40, 22.73); 2) type of battery-powered alarms: ionization alarms with lithium batteries were most likely to be the best type for increasing functioning possession (probability (best) = 0.69). Smoke alarm promotion programs should ensure they provide the combination of interventions most likely to be effective.

  4. A systematic review of interventions to increase awareness, knowledge, and folic acid consumption before and during pregnancy.

    PubMed

    Chivu, Corina Mihaela; Tulchinsky, Theodore H; Soares-Weiser, Karla; Braunstein, Rony; Brezis, Mayer

    2008-01-01

    We conducted a systematic review of studies designed to increase awareness of knowledge about, and consumption of folic acid before and during pregnancy. Studies were identified from Cochrane Library, Medline, and the references of primary studies and reviews. Studies included randomized controlled trials, quasi-experimental interrupted time series studies, follow-up studies, case-control studies, and before-and-after studies, all of which were conducted between 1992 and 2005 on women ages 15 to 49 years and/or health professionals, evaluating awareness and/or knowledge and/or consumption of folic acid both before and after intervention. Studies were excluded if data were not presented both before and after intervention or were other outcomes than those mentioned here. Data were extracted in relation to characteristics of studies, participants, interventions, and outcomes. Because of heterogeneity, we performed a narrative synthesis describing the direction and the size of effects. On average, women's awareness increased from 60% to 72%, knowledge from 21% to 45%, and consumption from 14% to 23%. Interventions had a positive effect on folic acid intakes before and during pregnancy, although the average usage reached less than 25%.

  5. Increasing delivery of an outdoor journey intervention to people with stroke: A feasibility study involving five community rehabilitation teams

    PubMed Central

    2010-01-01

    Background Contrary to recommendations in a national clinical guideline, baseline audits from five community-based stroke rehabilitation teams demonstrated an evidence-practice gap; only 17% of eligible people with stroke were receiving targeted rehabilitation by occupational therapists and physiotherapists to increase outdoor journeys. The primary aim of this feasibility study was to design, test, and evaluate the impact of an implementation program intended to change the behaviour of community rehabilitation teams. A secondary aim was to measure the impact of this change on client outcomes. Methods A before-and-after study design was used. The primary data collection method was a medical record audit. Five community rehabilitation teams and a total of 12 professionals were recruited, including occupational therapists, physiotherapists, and a therapy assistant. A medical record audit was conducted twice over 12 months (total of 77 records pre-intervention, 53 records post-intervention) against a guideline recommendation about delivering outdoor journey sessions to people with stroke. A behavioural intervention (the 'Out-and-About Implementation Program') was used to help change team practice. Active components of the intervention included feedback about the audit, barrier identification, and tailored education to target known barriers. The primary outcome measure was the proportion of medical records containing evidence of multiple outdoor journey sessions. Other outcomes of interest included the proportion of medical records that contained evidence of screening for outdoor journeys and driving by team members, and changes in patient outcomes. A small sample of community-dwelling people with stroke (n = 23) provided pre-post outcome data over three months. Data were analysed using descriptive statistics and t-tests. Results Medical record audits found that teams were delivering six or more outdoor journeys to 17% of people with stroke pre-intervention, rising to

  6. An intervention to increase fruit and vegetable consumption using audio communications: in-store public service announcements and audiotapes.

    PubMed

    Connell, D; Goldberg, J P; Folta, S C

    2001-01-01

    Consumers make an estimated 70% of their food purchase decisions as they shop. Effective presentation of information about healthier food selections at the point-of-purchase should have an impact on their decisions. This study was designed to evaluate the effectiveness of two audio formats on knowledge, attitudes, and beliefs about fruits and vegetables and on intake of these foods. Participants identified as "regular shoppers" (n = 374) in three intervention stores were recruited as they entered. They provided baseline demographic data, answered questions about their knowledge and beliefs about fruits and vegetables, and completed a checklist to assess fruit and vegetable intake. They were given two one-hour audiotapes and asked to play them within the next four weeks. In-store public service announcements (PSAs) with information about fruits and vegetables were rotated every 30 minutes for four weeks. A control group (n = 378), recruited in three other stores matched by demographic characteristics, provided the same information. They received an audiotape with stress reduction information. At posttest, the original series of questionnaires were readministered in telephone interviews with 87.7% of the original intervention group and 93.7% of the original control group. Knowledge scores in the intervention group increased significantly over baseline and as compared with the control group. Self-reported fruit and vegetable intake increased significantly in both groups, perhaps in part because of a seasonal effect. The increase from baseline was significantly higher in the intervention group and compared with controls. These findings support the further exploration of the use of audiotapes in nutrition education interventions.

  7. Increasing Fruit and Vegetable Intake among Children and Youth through Gardening-Based Interventions: A Systematic Review.

    PubMed

    Savoie-Roskos, Mateja R; Wengreen, Heidi; Durward, Carrie

    2017-02-01

    Although there are numerous health benefits associated with eating fruit and vegetables (F/V), few children are consuming recommended amounts. Gardening interventions have been implemented in various settings in an effort to increase children's F/V consumption by expanding knowledge, exposure, and preferences for a variety of F/V. The purpose of this review was to identify the effectiveness of gardening interventions that have been implemented to increase F/V consumption among children. A systematic review was conducted using four electronic databases: Web of Science, PubMed, Scopus, and the Cumulative Index to Nursing and Allied Health Literature. English language studies conducted in developed countries between January 2005 and October 2015 were included in this review. Included studies measured F/V consumption among children aged 2 to 15 years before and after implementation of a gardening intervention in a school, community, or afterschool setting. All study designs were included in this review. A total of 891 articles were identified through database searching and cross-referencing. After removing duplicates, 650 articles remained and were screened using inclusion and exclusion criteria. Twenty-seven full-text articles were analyzed and 14 articles were included in this review. Of the 14 articles reviewed, 10 articles found statistically significant increases in fruit or vegetable consumption among participants after implementation of a gardening intervention. However, many studies were limited by the use of convenience samples, small sample sizes, and self-reported measurements of F/V consumption. Although the evidence is mixed and fraught with limitations, most studies suggest a small but positive influence of gardening interventions on children's F/V intake. Future studies that include control groups, randomized designs, and assessments of F/V consumption over at least 1 year are needed to advance the literature on this topic.

  8. Train-the-trainer intervention to increase nursing teamwork and decrease missed nursing care in acute care patient units.

    PubMed

    Kalisch, Beatrice J; Xie, Boqin; Ronis, David L

    2013-01-01

    Teamwork is essential for patient safety and results in less missed nursing care. The aim of this study was to test the impact of a train-the-trainer intervention on the level of satisfaction with nursing teamwork and the amount of missed nursing care. This study used a quasiexperimental design with repeated measures taken at pretest, posttest, and 2 months after completion of the intervention. The sample for this study was the nursing staff on three medical-surgical units in three separate acute care hospitals (one unit in each hospital). Three nurses from each unit underwent a training program and then taught the skills and knowledge they acquired to the staff members on their units in three-hour-long sessions. The training involved staff role-playing scenarios based on teamwork problems that occur regularly on inpatient units in acute care hospitals followed by debriefing, which focused on teamwork behaviors (e.g., leadership, team orientation, backup, performance monitoring) and missed nursing care. Four measures were used to test the efficacy of this intervention: The Nursing Teamwork Survey, the MISSCARE Survey, and questions about the knowledge of and satisfaction with teamwork. Return rates for the surveys ranged from 73% to 84%. Follow-up tests individually comparing pretest, posttest, and delayed posttest were conducted within the mixed model and used the Bonferroni correction for multiple comparisons. Teamwork increased (F = 6.91, df = 259.01, p = .001) and missed care decreased (F = 3.59, df = 251.29, p = .03) over time. Nursing staff also reported a higher level of satisfaction with teamwork and an increase of teamwork knowledge after the intervention. The intervention tested in this study shows promise of being an effective and efficient approach to increase nursing teamwork and decrease missed nursing care.

  9. An e-health intervention designed to increase workday energy expenditure by reducing prolonged occupational sitting habits.

    PubMed

    Pedersen, Scott J; Cooley, Paul D; Mainsbridge, Casey

    2014-01-01

    Desk-based employees face multiple workplace health hazards such as insufficient physical activity and prolonged sitting. The objective of this study was to increase workday energy expenditure by interrupting prolonged occupational sitting time and introducing short-bursts of physical activity to employees' daily work habits. Over a 13-week period participants (n=17) in the intervention group were regularly exposed to a passive prompt delivered through their desktop computer that required them to stand up and engage in a short-burst of physical activity, while the control group (n=17) was not exposed to this intervention. Instead, the control group continued with their normal work routine. All participants completed a pre- and post- intervention survey to estimate workplace daily energy expenditure (calories). There was a significant 2 (Group) × 2 (Test) interaction, F (1, 32)=9.26, p < 0.05. The intervention group increased the calories expended during the workday from pre-test (M=866.29 ± 151.40) to post-test (M=1054.10 ± 393.24), whereas the control group decreased calories expended during the workday from pre-test (M=982.55 ± 315.66) to post-test (M=892.21 ± 255.36). An e-health intervention using a passive prompt was an effective mechanism for increasing employee work-related energy expenditure. Engaging employees in regular short-bursts of physical activity during the workday resulted in reduced sitting time, which may have long-term effects on the improvement of employee health.

  10. Increased Pre-operative Pulse Pressure Predicts Procedural Complications and Mortality in Patients Undergoing Tibial Interventions for Critical Limb Ischemia

    PubMed Central

    Darling, Jeremy D.; Lee, Vanessa; Schermerhorn, Marc L.; Guzman, Raul J.

    2015-01-01

    Introduction Pulse pressure is a non-invasive measure of arterial stiffness. Elevated pulse pressure is associated with an increased risk of cardiovascular events and death. The effects of pulse pressure on outcomes after endovascular interventions for critical limb ischemia (CLI), however, are unknown. We thus evaluated whether increased pre-operative pulse pressure was associated with adverse outcomes and mortality in patients undergoing endovascular tibial artery intervention. Methods All patients undergoing endovascular tibial intervention for CLI at a single institution from 2004 to 2014 were included in this study. Pre-operative pulse pressure was derived from measurements obtained in the holding area prior to the procedure. Patients were divided into 2 groups based on pulse pressure, < 80 or ≥ 80. Patient demographics and co-morbidities were documented, and outcomes including procedural complications, repeat intervention, amputation, and mortality were recorded. Multivariable logistic regression was utilized to account for patient demographics and comorbidities. Results Of 371 patients, 186 patients had a pre-operative pulse pressure <80 and 185 had a pre-operative pulse pressure ≥80. No significant differences in patient demographics or comorbidities were identified; however there was a trend toward older age in patients with elevated pulse pressure (70 vs. 72, P = 0.07). On univariate analysis, procedural complications (21% vs. 13%, P = 0.02), reinterventions (26% vs. 17%, P < 0.01), and restenosis (32% vs. 23%, P = 0.03) were more common among patients with pulse pressure ≥ 80. Procedural complications remained significant on multivariate analysis (OR 1.8, 95% CI 1.0-3.1, P = 0.04). There was no difference in 30-day mortality; however increased mortality was seen at 5 years of follow-up (OR: 1.6, 95% CI: 1.0-2.5, P = 0.04) following multivariable analysis. Conclusions Increased pre-operative pulse pressure is associated with procedural complications

  11. The KinFact Intervention – A Randomized Controlled Trial to Increase Family Communication About Cancer History

    PubMed Central

    McClish, Donna; Gyure, Maria; Corona, Rosalie; Krist, Alexander H.; Rodríguez, Vivian M.; Maibauer, Alisa M.; Borzelleca, Joseph; Bowen, Deborah J.; Quillin, John M.

    2014-01-01

    Abstract Background: Knowing family history is important for understanding cancer risk, yet communication within families is suboptimal. Providing strategies to enhance communication may be useful. Methods: Four hundred ninety women were recruited from urban, safety-net, hospital-based primary care women's health clinics. Participants were randomized to receive the KinFact intervention or the control handout on lowering risks for breast/colon cancer and screening recommendations. Cancer family history was reviewed with all participants. The 20-minute KinFact intervention, based in communication and behavior theory, included reviewing individualized breast/colon cancer risks and an interactive presentation about cancer and communication. Study outcomes included whether participants reported collecting family history, shared cancer risk information with relatives, and the frequency of communication with relatives. Data were collected at baseline, 1, 6, and 14 months. Results: Overall, intervention participants were significantly more likely to gather family cancer information at follow-up (odds ratio [OR]: 2.73; 95% confidence interval [CI]: 2.01, 3.71) and to share familial cancer information with relatives (OR: 1.85; 95% CI: 1.37, 2.48). Communication frequency (1=not at all; 4=a lot) was significantly increased at follow-up (1.67 vs. 1.54). Differences were not modified by age, race, education, or family history. However, effects were modified by pregnancy status and genetic literacy. Intervention effects for information gathering and frequency were observed for nonpregnant women but not for pregnant women. Additionally, intervention effects were observed for information gathering in women with high genetic literacy, but not in women with low genetic literacy. Conclusions: The KinFact intervention successfully promoted family communication about cancer risk. Educating women to enhance their communication skills surrounding family history may allow them to partner

  12. Increased adherence to prenatal group B streptococcal screening guidelines through a paired electronic reminder and education intervention.

    PubMed

    Maclaughlin, Kathy L; Garrison, Gregory M; Matthews, Marc R; O'Brien, Marcia L; Westby, Elizabeth; Targonski, Paul V

    2014-01-01

    The 2010 Centers for Disease Control and Prevention (CDC) update on perinatal group B streptococcal (GBS) prevention advises universal vaginal-rectal GBS screening of pregnant women in the 35th through 37th week of gestation. Because GBS colonization is transient, a test performed more than 5 weeks before delivery may not have sufficient negative predictive value to be clinically useful. Our objective was to increase rates of quality-improved, CDC-adherent GBS screening and decrease repeat screening. A reminder for maternal vaginal-rectal GBS testing was added to the physicians' electronic ordering screen, and family medicine physicians and residents were educated about screening guidelines through standardized, in-person presentations. Retrospective chart review was performed before and after these interventions. Univariate or bivariate analysis was performed for demographic factors, timing of first screen, rates of CDC-adherent screening (the newly defined quality-improved screen and the usual screen), and rates of repeat and unnecessary screens. Multivariate analysis was performed with quality-improved and usual screening as dependent variables. Bivariate analysis showed that post-intervention rates of quality-improved screening increased from 30 to 62 % (P < .001), usual screening increased from 69 to 84 % (P = .005), and repeat GBS screening decreased from 20 to 8 % (P = .007). Multivariate analysis showed increased post-intervention odds of quality-improved screening [odds ratio (OR) 3.59; 95 % CI 2.07-6.34] and usual screening (OR 2.67; 95 % CI 1.40-5.25). Low-cost, reproducible quality improvement interventions (electronic order reminder, educational sessions) have the potential to increase guideline adherence for GBS screening in pregnant women and decrease repeat screening.

  13. Does a pre-intervention functional assessment increase intervention effectiveness? A meta-analysis of within-subject interrupted time-series studies.

    PubMed

    Hurl, Kylee; Wightman, Jade; Haynes, Stephen N; Virues-Ortega, Javier

    2016-07-01

    This study examined the relative effectiveness of interventions based on a pre-intervention functional behavioral assessment (FBA), compared to interventions not based on a pre-intervention FBA. We examined 19 studies that included a direct comparison between the effects of FBA- and non-FBA-based interventions with the same participants. A random effects meta-analysis of effect sizes indicated that FBA-based interventions were associated with large reductions in problem behaviors when using non-FBA-based interventions as a reference intervention (Effect size=0.85, 95% CI [0.42, 1.27], p<0.001). In addition, non-FBA based interventions had no effect on problem behavior when compared to no intervention (0.06, 95% CI [-0.21, 0.33], p=0.664). Interestingly, both FBA-based and non-FBA-based interventions had significant effects on appropriate behavior relative to no intervention, albeit the overall effect size was much larger for FBA-based interventions (FBA-based: 1.27, 95% CI [0.89, 1.66], p<0.001 vs. non-FBA-based: 0.35, 95% CI [0.14, 0.56], p=0.001). In spite of the evidence in favor of FBA-based interventions, the limited number of comparative studies with high methodological standards underlines the need for further comparisons of FBA-based versus non-FBA-based interventions.

  14. Family-based interventions to increase physical activity in children: a meta-analysis and realist synthesis protocol.

    PubMed

    Brown, Helen Elizabeth; Atkin, Andrew J; Panter, Jenna; Corder, Kirsten; Wong, Geoff; Chinapaw, Mai J M; van Sluijs, Esther

    2014-08-06

    Despite the established relationship between physical activity and health, data suggest that many children are insufficiently active, and that levels decline into adolescence. Engaging the family in interventions may increase and maintain children's physical activity levels at the critical juncture before secondary school. Synthesis of existing evidence will inform future studies, but the heterogeneity in target populations recruited, behaviour change techniques and intervention strategies employed, and measurement conducted, may require a multifaceted review method. The primary objective of this work will therefore be to synthesis evidence from intervention studies that explicitly engage the family unit to increase children's physical activity using an innovative dual meta-analysis and realist approach. Peer-reviewed studies will be independently screened by two authors for inclusion based on (1) including 'healthy' participants aged 5-12 years; (2) having a substantive intervention aim of increasing physical activity, by engaging the family and (3) reporting on physical activity. Duplicate data extraction and quality assessment will be conducted using a specially designed proforma and the Effective Public Health Practice Project Quality Assessment Tool respectively. STATA software will be used to compute effect sizes for meta-analyses, with subgroup analyses conducted to identify moderating characteristics. Realist syntheses will be conducted according to RAMESES quality and publication guidelines, including development of a programme theory and evidence mapping. This review will be the first to use the framework of a traditional review to conduct a dual meta-analysis and realist synthesis, examining interventions that engage the family to increase physical activity in children. The results will be disseminated through peer-reviewed publications, conferences, formal presentations to policy makers and practitioners and informal meetings. Evidence generated from

  15. Can technology and the media help reduce dysfunctional parenting and increase engagement with preventative parenting interventions?

    PubMed

    Calam, Rachel; Sanders, Matthew R; Miller, Chloe; Sadhnani, Vaneeta; Carmont, Sue-Ann

    2008-11-01

    In an evaluation of the television series "Driving Mum and Dad Mad," 723 families participated and were randomly assigned to either a standard or technology enhanced viewing condition (included additional Web-support). Parents in both conditions reported significant improvements from pre- to postintervention in their child's behavior, dysfunctional parenting, parental anger, depression, and self-efficacy. Short-term improvements were maintained at 6-months follow-up. Regressions identified predictors of program outcomes and level of involvement. Parents who watched the entire series had more severe problems at preintervention and high sociodemographic risk than parents who did not watch the entire series. Few sociodemographic, child, or parent variables assessed at preintervention predicted program outcomes or program engagement, suggesting that a wide range of parents from diverse socioeconomic status benefited from the program. Media interventions depicting evidence-based parenting programs may be a useful means of reaching hard to engage families in population-level child maltreatment prevention programs.

  16. Behavioral intervention to increase compliance with electroencephalographic procedures in children with developmental disabilities

    PubMed Central

    Slifer, Keith J.; Avis, Kristin T.; Frutchey, Robin A.

    2010-01-01

    The EEG, or electroencephalogram, is a neurophysiological technique used to detect and record electrical activity in the brain. It is critical to the diagnosis and management of seizure disorders, such as epilepsy, as well as other neurological conditions. The EEG procedure is often not well tolerated by children with developmental disabilities because of anxiety about unfamiliar equipment, difficulty inhibiting motion, and tactile defensiveness. The inability of children with developmental disabilities to tolerate an EEG procedure is especially problematic because the incidence of epilepsy is considerably higher in children with disabilities. This clinical outcome study sought to determine the efficacy of using behavioral intervention to teach children with developmental disorders to cooperate with an EEG procedure. The behavioral training employed modeling, counterconditioning, escape extinction, and differential reinforcement-based shaping procedures. Results indicated that behavioral training is successful in promoting EEG compliance without restraint, anesthesia, or sedation. PMID:18348911

  17. Rapid intervention and treatment zone: redesigning nursing services to meet increasing emergency department demand.

    PubMed

    Considine, Julie; Lucas, Elspeth; Martin, Roslyn; Stergiou, Helen E; Kropman, Matthew; Chiu, Herman

    2012-02-01

    The impact of emergency nursing roles in demand management systems is poorly understood. The aim of this study was to evaluate emergency nurses' role in a specific emergency department (ED) demand management system: rapid intervention and treatment zone (RITZ). A descriptive exploratory approach was used. Data were collected from audit of 193 randomly selected patient records and 12 h of clinical practice observation. The median age of participants was 31 years, 51.8% were males and 99.5% were discharged home. Nurse qualifications or seniority had no significant effect on waiting time or length of stay (LOS). There were disparities between documented and observed nursing practice. The designation and qualifications of RITZ nurses made little difference to waiting times and ED LOS. Specific documentation and communication systems for areas of the ED that manage large numbers of low complexity patients warrant further research.

  18. Comparing the Effectiveness of Two Dance Game Interventions for Increasing Physical Movement and Intensity

    ERIC Educational Resources Information Center

    Tarbay, Joshua J.

    2011-01-01

    The problem addressed in this study was the increasing number of overweight and obese children and the increased demand for cost-effective methods of combating this epidemic. One method used to promote weight loss and to increase movement levels and cardiovascular endurance among school-aged children, is the Konami [R] brand dancing game, Dance…

  19. Comparing the Effectiveness of Two Dance Game Interventions for Increasing Physical Movement and Intensity

    ERIC Educational Resources Information Center

    Tarbay, Joshua J.

    2011-01-01

    The problem addressed in this study was the increasing number of overweight and obese children and the increased demand for cost-effective methods of combating this epidemic. One method used to promote weight loss and to increase movement levels and cardiovascular endurance among school-aged children, is the Konami [R] brand dancing game, Dance…

  20. Chemoprotective epigenetic mechanisms in a colorectal cancer model: Modulation by n-3 PUFA in combination with fermentable fiber

    PubMed Central

    Triff, Karen; Kim, Eunjoo; Chapkin, Robert S.

    2015-01-01

    Colorectal cancer is the third major cause of cancer-related mortality in both men and women worldwide. The beneficial role of n-3 polyunsaturated fatty acids (PUFA) in preventing colon cancer is substantiated by experimental, epidemiological, and clinical data. From a mechanistic perspective, n-3 PUFA are pleiotropic and multifaceted with respect to their molecular mechanisms of action. For example, this class of dietary lipid uniquely modulates membrane and nuclear receptors, sensors/ion channels, and membrane structure/cytoskeletal function, thereby regulating signaling processes that influence patterns of gene expression and cell phenotype. In addition, n-3 PUFA can synergize with other potential chemoprotective agents known to reprogram the chromatin landscape, such as the fermentable fiber product, butyrate. Nutri-epigenomics is an emerging field of research that is focused on the interaction between nutrition and epigenetics. Epigenetics refers to a group of heterogeneous processes that regulate transcription without changing the DNA coding sequence, ranging from DNA methylation, to histone tail modifications and transcription factor activity. One implication of the nutri-epigenome is that it may be possible to reprogram epigenetic marks that are associated with increased disease risk by nutritional or lifestyle interventions. This review will focus on the nutri-epigenomic role of n-3 PUFA, particularly DHA, as well as the combinatorial effects of n-3 PUFA and fermentable fiber in relation to colon cancer. PMID:25938013

  1. Randomized trial of a lay health advisor and computer intervention to increase mammography screening in African American women.

    PubMed

    Russell, Kathleen M; Champion, Victoria L; Monahan, Patrick O; Millon-Underwood, Sandra; Zhao, Qianqian; Spacey, Nicole; Rush, Nathan L; Paskett, Electra D

    2010-01-01

    Low-income African American women face numerous barriers to mammography screening. We tested the efficacy of a combined interactive computer program and lay health advisor intervention to increase mammography screening. In this randomized, single blind study, participants were 181 African American female health center patients of ages 41 to 75 years, at < or =250% of poverty level, with no breast cancer history, and with no screening mammogram in the past 15 months. They were assigned to either (a) a low-dose comparison group consisting of a culturally appropriate mammography screening pamphlet or (b) interactive, tailored computer instruction at baseline and four monthly lay health advisor counseling sessions. Self-reported screening data were collected at baseline and 6 months and verified by medical record. For intent-to-treat analysis of primary outcome (medical record-verified mammography screening, available on all but two participants), the intervention group had increased screening to 51% (45 of 89) compared with 18% (16 of 90) for the comparison group at 6 months. When adjusted for employment status, disability, first-degree relatives with breast cancer, health insurance, and previous breast biopsies, the intervention group was three times more likely (adjusted relative risk, 2.7; 95% confidence interval, 1.8-3.7; P < 0.0001) to get screened than the low-dose comparison group. Similar results were found for self-reported mammography stage of screening adoption. The combined intervention was efficacious in improving mammography screening in low-income African American women, with an unadjusted effect size (relative risk, 2.84) significantly higher (P < 0.05) than that in previous studies of each intervention alone.

  2. Interactive Sections of an Internet-Based Intervention Increase Empowerment of Chronic Back Pain Patients: Randomized Controlled Trial

    PubMed Central

    Camerini, Anne-Linda; Allam, Ahmed; Schulz, Peter J

    2014-01-01

    Background Chronic back pain (CBP) represents a significant public health problem. As one of the most common causes of disability and sick leave, there is a need to develop cost-effective ways, such as Internet-based interventions, to help empower patients to manage their disease. Research has provided evidence for the effectiveness of Internet-based interventions in many fields, but it has paid little attention to the reasons why they are effective. Objective This study aims to assess the impact of interactive sections of an Internet-based self-management intervention on patient empowerment, their management of the disease, and, ultimately, health outcomes. Methods A total of 51 patients were recruited through their health care providers and randomly assigned to either an experimental group with full access to the Internet-based intervention or a control group that was denied access to the interactive sections and knew nothing thereof. The intervention took 8 weeks. A baseline, a mid-term after 4 weeks, and a final assessment after 8 weeks measured patient empowerment, physical exercise, medication misuse, and pain burden. Results All patients completed the study. Overall, the intervention had a moderate effect (F 1.52=2.83, P=.03, η2=0.30, d=0.55). Compared to the control group, the availability of interactive sections significantly increased patient empowerment (midterm assessment: mean difference=+1.2, P=.03, d=0.63; final assessment: mean difference=+0.8, P=.09, d=0.44) and reduced medication misuse (midterm assessment: mean difference=−1.5, P=.04, d=0.28; final assessment: mean difference=−1.6, P=.03, d=−0.55) in the intervention group. Both the frequency of physical exercise and pain burden decreased, but to equal measures in both groups. Conclusions Results suggest that interactive sections as part of Internet-based interventions can positively alter patients’ feelings of empowerment and help prevent medication misuse. Detrimental effects were not

  3. Interactive sections of an Internet-based intervention increase empowerment of chronic back pain patients: randomized controlled trial.

    PubMed

    Riva, Silvia; Camerini, Anne-Linda; Allam, Ahmed; Schulz, Peter J

    2014-08-13

    Chronic back pain (CBP) represents a significant public health problem. As one of the most common causes of disability and sick leave, there is a need to develop cost-effective ways, such as Internet-based interventions, to help empower patients to manage their disease. Research has provided evidence for the effectiveness of Internet-based interventions in many fields, but it has paid little attention to the reasons why they are effective. This study aims to assess the impact of interactive sections of an Internet-based self-management intervention on patient empowerment, their management of the disease, and, ultimately, health outcomes. A total of 51 patients were recruited through their health care providers and randomly assigned to either an experimental group with full access to the Internet-based intervention or a control group that was denied access to the interactive sections and knew nothing thereof. The intervention took 8 weeks. A baseline, a mid-term after 4 weeks, and a final assessment after 8 weeks measured patient empowerment, physical exercise, medication misuse, and pain burden. All patients completed the study. Overall, the intervention had a moderate effect (F1.52=2.83, P=.03, η(2)=0.30, d=0.55). Compared to the control group, the availability of interactive sections significantly increased patient empowerment (midterm assessment: mean difference=+1.2, P=.03, d=0.63; final assessment: mean difference=+0.8, P=.09, d=0.44) and reduced medication misuse (midterm assessment: mean difference=-1.5, P=.04, d=0.28; final assessment: mean difference=-1.6, P=.03, d=-0.55) in the intervention group. Both the frequency of physical exercise and pain burden decreased, but to equal measures in both groups. Results suggest that interactive sections as part of Internet-based interventions can positively alter patients' feelings of empowerment and help prevent medication misuse. Detrimental effects were not observed. ClinicalTrials.gov: NCT02114788; http

  4. Evaluation of a complex healthcare intervention to increase smoking cessation in pregnant women: interrupted time series analysis with economic evaluation.

    PubMed

    Bell, Ruth; Glinianaia, Svetlana V; Waal, Zelda van der; Close, Andrew; Moloney, Eoin; Jones, Susan; Araújo-Soares, Vera; Hamilton, Sharon; Milne, Eugene Mg; Shucksmith, Janet; Vale, Luke; Willmore, Martyn; White, Martin; Rushton, Steven

    2017-02-15

    To evaluate the effectiveness of a complex intervention to improve referral and treatment of pregnant smokers in routine practice, and to assess the incremental costs to the National Health Service (NHS) per additional woman quitting smoking. Interrupted time series analysis of routine data before and after introducing the intervention, within-study economic evaluation. Eight acute NHS hospital trusts and 12 local authority areas in North East England. 37 726 records of singleton delivery including 10 594 to mothers classified as smoking during pregnancy. A package of measures implemented in trusts and smoking cessation services, aimed at increasing the proportion of pregnant smokers quitting during pregnancy, comprising skills training for healthcare and smoking cessation staff; universal carbon monoxide monitoring with routine opt-out referral for smoking cessation support; provision of carbon monoxide monitors and supporting materials; and an explicit referral pathway and follow-up protocol. Referrals to smoking cessation services; probability of quitting smoking during pregnancy; additional costs to health services; incremental cost per additional woman quitting. After introduction of the intervention, the referral rate increased more than twofold (incidence rate ratio=2.47, 95% CI 2.16 to 2.81) and the probability of quitting by delivery increased (adjusted OR=1.81, 95% CI 1.54 to 2.12). The additional cost per delivery was £31 and the incremental cost per additional quit was £952; 31 pregnant women needed to be treated for each additional quitter. The implementation of a system-wide complex healthcare intervention was associated with significant increase in rates of quitting by delivery. © 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.

  5. n-3 fatty acids from vegetable oils.

    PubMed

    Hunter, J E

    1990-05-01

    Principal food sources of the n-3 fatty acid alpha-linolenic acid are salad and cooking oil, salad dressing, shortening, margarine, and food-service fat and oil products made from canola oil or soybean oil. Using food production data provided by US trade associations and by Statistics Canada, I estimated the per capita availability of alpha-linolenic acid from vegetable-oil products in the United States to be approximately 1.2 g/d and in Canada, approximately 2 g/d. The higher alpha-linolenic acid availability in Canada is largely accounted for by widespread use of canola oil there. Considering also contributions to dietary alpha-linolenic acid of other foods such as nuts, dairy products, and vegetables, it would appear that total intake of alpha-linolenic acid in US and Canadian diets adequately exceeds the reported nutritional requirement. Emerging research has suggested possible health benefits associated with modest increases in dietary alpha-linolenic acid, including reduced blood-clotting tendency and reduced blood pressure.

  6. Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial.

    PubMed

    O'Dwyer, Tom; Monaghan, Ann; Moran, Jonathan; O'Shea, Finbar; Wilson, Fiona

    2017-01-01

    Does a 3-month behaviour change intervention targeting physical activity (PA) increase habitual physical activity in adults with ankylosing spondylitis (AS)? Does the intervention improve health-related physical fitness, AS-related features, and attitude to exercise? Are any gains maintained over a 3-month follow-up? Parallel-group, randomised, controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. Forty adults with a diagnosis of AS, on stable medication, and without PA-limiting comorbidities. Over a 3-month period, the experimental group engaged in individually-tailored, semi-structured consultations aiming to motivate and support individuals in participating in PA. The control group continued with usual care. The primary outcome was PA measured by accelerometry over 1 week. Secondary outcomes included clinical questionnaires and measures of health-related physical fitness. Measures were taken at baseline, post-intervention, and after a 3-month follow-up period. Baseline characteristics were similar across groups, except age and body composition. There were statistically significant, moderate-to-large time-by-group effects in health-enhancing PA (mixed-design ANOVA for overall effect F(2, 76)=14.826, p<0.001), spinal mobility (F(2, 76)=5.691, p<0.005) and quality of life (χ(2)(2)=8.400, p<0.015) favouring the intervention group; post-intervention improvements were sustained 3 months later. No significant effects were seen in other physical fitness outcomes or on clinical questionnaires. No adverse effects were reported during the study. Health-enhancing PA, spinal mobility and quality of life were significantly improved after the intervention, and improvements were maintained at 3-month follow-up. NCT02374502. [O'Dwyer T, Monaghan A, Moran J, O'Shea F, Wilson F (2016) Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial

  7. Increasing social responsiveness in a child with autism. A comparison of music and non-music interventions.

    PubMed

    Finnigan, Emily; Starr, Elizabeth

    2010-07-01

    This study sought to determine the effects of using music and non-music interventions on the social responsive and avoidant behaviours of a preschool child with autism. A single-subject alternating treatment design was used in which two interventions were presented in a similar fashion except for the addition of music during the music condition. Four phases took place: baseline (Phase A), alternating treatments (Phase B), a second treatment phase (Phase C) using the condition that proved to be more effective in Phase B, and follow-up (Phase D). Data were collected over a total of 12 treatment sessions for various social responsive and avoidant behaviours. Results indicated that the music intervention was more effective than the non-music intervention in increasing all three social responsive behaviours in both Phases B and C. Furthermore, no avoidant behaviours were observed during the music condition. It is suggested that the music condition was more motivating for the participant than the non-music condition, resulting in more social responsive behaviours.

  8. Increased HIV disclosure three months after an online video intervention for men who have sex with men (MSM).

    PubMed

    Chiasson, Mary Ann; Shaw, Francine Shuchat; Humberstone, Mike; Hirshfield, Sabina; Hartel, Diana

    2009-09-01

    A behavioral intervention for men who have sex with men (MSM) was created for online delivery. The nine-minute video drama "The Morning After" (www.hivbigdeal.org) was designed to promote critical thinking about HIV risk. MSM were recruited for the evaluation through banner ads on a subscription-based gay sexual meeting web site. Participants viewed the intervention online and completed online behavioral questionnaires at enrollment and three month follow-up. Each participant served as his own control. No participant incentives were provided. Follow-up was completed by 522 (54%) of 971 eligible men. Men completing follow-up were similar to those who did not by age and prevalence of unprotected anal intercourse (UAI) but reported more lifetime sex partners. They also differed somewhat by race, education, and HIV testing. In the three months after the intervention, men were significantly more likely to disclose HIV status to partners (odds ratio [OR] = 3.37, p<0.001) and less likely to report a casual partner or UAI in their most recent sexual encounter than at baseline. Of 120 men HIV tested during follow-up, 17 (14%) reported being HIV seropositive. These findings show that MSM at high risk for HIV will participate in a brief online video intervention designed to engage critical thinking and that significant, self-reported increases in HIV disclosure and decreases in risk behavior occurred three months after MSM viewed the video.

  9. Closing the digital divide in HIV/AIDS care: development of a theory-based intervention to increase Internet access.

    PubMed

    Kalichman, S C; Weinhardt, L; Benotsch, E; Cherry, C

    2002-08-01

    Advances in information technology are revolutionizing medical patient education and the Internet is becoming a major source of information for people with chronic medical conditions, including HIV/AIDS. However, many AIDS patients do not have equal access to the Internet and are therefore at an information disadvantage, particularly minorities, persons of low-income levels and individuals with limited education. This paper describes the development and pilot testing of a workshop-style intervention designed to close the digital divide in AIDS care. Grounded in the Information-Motivation-Behavioral Skills (IMB) model of health behaviour change, we developed an intervention for persons with no prior history of using the Internet. The intervention included instruction in using hardware and search engines, motivational enhancement to increase interest and perceived relevance of the Internet, and skills for critically evaluating and using health information accessed via the Internet. Participants were also introduced to communication and support functions of the Internet including e-mail, newsgroups and chat groups. Pilot testing demonstrated feasibility, acceptability and promise for closing the digital divide in HIV/AIDS care using a relatively brief and intensive theory-based intervention that could be implemented in community settings.

  10. Client-directed interventions to increase community demand for breast, cervical, and colorectal cancer screening a systematic review.

    PubMed

    Baron, Roy C; Rimer, Barbara K; Breslow, Rosalind A; Coates, Ralph J; Kerner, Jon; Melillo, Stephanie; Habarta, Nancy; Kalra, Geetika P; Chattopadhyay, Sajal; Wilson, Katherine M; Lee, Nancy C; Mullen, Patricia Dolan; Coughlin, Steven S; Briss, Peter A

    2008-07-01

    Most major medical organizations recommend routine screening for breast, cervical, and colorectal cancers. Screening can lead to early detection of these cancers, resulting in reduced mortality. Yet not all people who should be screened are screened, either regularly or, in some cases, ever. This report presents the results of systematic reviews of effectiveness, applicability, economic efficiency, barriers to implementation, and other harms or benefits of interventions designed to increase screening for breast, cervical, and colorectal cancers by increasing community demand for these services. Evidence from these reviews indicates that screening for breast cancer (mammography) and cervical cancer (Pap test) has been effectively increased by use of client reminders, small media, and one-on-one education. Screening for colorectal cancer by fecal occult blood test has been increased effectively by use of client reminders and small media. Additional research is needed to determine whether client incentives, group education, and mass media are effective in increasing use of any of the three screening tests; whether one-on-one education increases screening for colorectal cancer; and whether any demand-enhancing interventions are effective in increasing the use of other colorectal cancer screening procedures (i.e., flexible sigmoidoscopy, colonoscopy, double contrast barium enema). Specific areas for further research are also suggested in this report.

  11. Client-directed interventions to increase community access to breast, cervical, and colorectal cancer screening a systematic review.

    PubMed

    Baron, Roy C; Rimer, Barbara K; Coates, Ralph J; Kerner, Jon; Kalra, Geetika P; Melillo, Stephanie; Habarta, Nancy; Wilson, Katherine M; Chattopadhyay, Sajal; Leeks, Kimberly

    2008-07-01

    Most major medical organizations recommend routine screening for breast, cervical, and colorectal cancers. Screening can lead to early detection of these cancers, resulting in reduced mortality. Yet not all people who should be screened are screened, either regularly or, in some cases, ever. This report presents the results of systematic reviews of effectiveness, applicability, economic efficiency, barriers to implementation, and other harms or benefits of interventions designed to increase screening for breast, cervical, and colorectal cancers by increasing community access to these services. Evidence from these reviews indicates that screening for breast cancer (by mammography) has been increased effectively by reducing structural barriers and by reducing out-of pocket client costs, and that screening for colorectal cancer (by fecal occult blood test) has been increased effectively by reducing structural barriers. Additional research is needed to determine whether screening for cervical cancer (by Pap test) can be increased by reducing structural barriers and by reducing out-of-pocket costs, whether screening for colorectal cancer (fecal occult blood test) can be increased by reducing out-of-pocket costs, and whether these interventions are effective in increasing the use of other colorectal cancer screening procedures (i.e., flexible sigmoidoscopy, colonoscopy, double contrast barium enema). Specific areas for further research are also suggested in this report.

  12. Pilot testing of a mindfulness- and acceptance-based intervention for increasing cardiorespiratory fitness in sedentary adults: A feasibility study.

    PubMed

    Martin, E C; Galloway-Williams, N; Cox, M G; Winett, R A

    2015-10-01

    Vigorous physical activity (PA) has been promoted for improving cardiorespiratory fitness (CRF). However, therapeutic techniques designed to engage participants in vigorous PA have fallen short; one reason for this may be the unpleasant physical sensations associated with vigorous exercise (e.g., temporary shortness of breath and mild muscle soreness). Mindfulness and acceptance-based therapies such as Acceptance and Commitment Therapy (ACT) may be helpful at improving adherence to vigorous PA levels. In this open clinical trial, we sought to demonstrate the feasibility and acceptability of a mindfulness- and acceptance-based intervention for increasing CRF in sedentary adults and to generate initial outcomes data. Participants (N=24) engaged in a 10-week fitness walking program while attending regular group sessions based on ACT. The feasibility and acceptability of the intervention were demonstrated through high levels of walking adherence (89.30%) and group session attendance (85.50%). A large significant decrease in total 1-mile walk test time [t(18)=4.61, p=.0002, d=.64] and a moderate significant increase in estimated VO2max [t(18)=-4.05, p=.0007, d=-.43] were observed. Analyses indicated a large significant increase in exercise-related experiential acceptance [t(18)=-9.19, p <.0001, d=-2.09]. This study demonstrates the feasibility and acceptability of an ACT-based intervention for supporting participation in vigorous PA in sedentary individuals.

  13. Increasing Energy Access in Sub-Saharan Africa: Exploring Public-Private Models for Intervention

    SciTech Connect

    Bazilian, Morgan; Pless, Jacquelyn

    2014-01-16

    This report, by Morgan Bazilian and Jacquelyn Pless, examines ways that Energy+ could make a large impact in providing energy access to the poor, focusing on four promising models. While there remains a focus on a technology (PV), and a region (SSA) in this report, the models the authors explore are amenable to other specifications as well. Thus, the models presented provide an opportunity for stakeholders and the international community to collaborate and leverage capacities, resources, and networks. Of course, these models are only a few of the very wide range of possible mechanisms. They also are somewhat focused on engaging the private sector. The report does not provide a full context for the complex landscape of energy access and energy poverty. Rather, the paper is focused around the specifics of the interventions. It remains the case that the fundamental building blocks of capacity building, good governance and planning, and the ability to find funding for 'upfront' due diligence and analysis remain critical. Those items are, however, largely outside the scope of this short report.

  14. A randomized prospective trial of a worksite intervention program to increase physical activity.

    PubMed

    Gazmararian, Julie A; Elon, Lisa; Newsome, Kimberly; Schild, Laura; Jacobson, Kara L

    2013-01-01

    To evaluate the effectiveness of addressing multiple barriers to physical activity (PA) using interventions at the workplace. The Physical Activity and Lifestyle Study used a randomized controlled trial in which 60 university departments were randomized into five groups. Large Southeastern university. Physically inactive nonfaculty employees in the participating departments (n = 410) were interviewed five times over 9 months, with 82% completing all surveys. Departments were randomly assigned to (1) control, (2) gym membership, (3) gym + PA education, (4) gym + time during the workday, and (5) gym + education + time. PA intensity and quantity were measured using the 7-day Physical Activity Recall instrument, with PA then classified as the number of days meeting Centers for Disease Control and Prevention guidelines. The outcome was modeled with generalized linear mixed model methodology. There was no significant improvement when a group received gym alone compared to the control (Rate Ratio [RR]) 1.22 [.90, 1.67]). However, gym + education, gym + time, and gym + education + time were significantly better than the control (RR 1.51 [1.15, 1.98], RR 1.46 [1.13, 1.88], RR 1.28 [1.01, 1.62]), with improvements sustained over the 9 months. Among sedentary adults who had access to indoor exercise facilities, addressing environmental and cognitive barriers simultaneously (i.e., time and education) did not encourage more activity than addressing either barrier alone.

  15. Coral population trajectories, increased disturbance and management intervention: a sensitivity analysis

    PubMed Central

    Riegl, Bernhard; Berumen, Michael; Bruckner, Andrew

    2013-01-01

    Coral reefs distant from human population were sampled in the Red Sea and one-third showed degradation by predator outbreaks (crown-of-thorns-starfish = COTS observed in all regions in all years) or bleaching (1998, 2010). Models were built to assess future trajectories. They assumed variable coral types (slow/fast growing), disturbance frequencies (5,10,20 years), mortality (equal or not), and connectivity (un/connected to un/disturbed community). Known disturbances were used to parameterize models. Present and future disturbances were estimated from remote-sensing chlorophyll and temperature data. Simulations and sensitivity analysis suggest community resilience at >20-year disturbance frequency, but degradation at higher frequency. Trajectories move from fast-grower to slow-grower dominance at intermediate disturbance frequency, then again to fast-grower dominance. A similar succession was observed in the field: Acropora to Porites to Stylophora/Pocillopora dominance on shallow reefs, and a transition from large poritids to small faviids on deep reefs. Synthesis and application: Even distant reefs are impacted by global changes. COTS impacts and bleaching were key driver of coral degradation, coral population decline could be reduced if these outbreaks and bleaching susceptibility were managed by maintaining water quality and by other interventions. Just leaving reefs alone, seems no longer a satisfactory option. PMID:23610643

  16. Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial.

    PubMed

    Free, Caroline; McCarthy, Ona; French, Rebecca S; Wellings, Kaye; Michie, Susan; Roberts, Ian; Devries, Karen; Rathod, Sujit; Bailey, Julia; Syred, Jonathan; Edwards, Phil; Hart, Graham; Palmer, Melissa; Baraitser, Paula

    2016-07-01

    Younger people bear the heaviest burden of sexually transmitted infections (STIs). Partner notification, condom use and STI testing can reduce infection but many young people lack the knowledge, skills and confidence needed to carry out these behaviours. Text messages can provide effective behavioural support. The acceptability and feasibility of a randomised controlled trial of safer sex support delivered by text message are not known. To assess the acceptability and feasibility of a randomised controlled trial of a safer sex intervention delivered by text message for young people aged 16-24 years. (1) Intervention development; (2) follow-up procedure development; (3) a pilot, parallel-arm randomised controlled trial with allocation via remote automated randomisation (ratio of 1 : 1) (participants were unmasked, whereas researchers analysing samples and data were masked); and (4) qualitative interviews. Participants were recruited from sexual health services in the UK. Young people aged 16-24 years diagnosed with chlamydia or reporting unprotected sex with more than one partner in the last year. A theory- and evidence-based safer sex intervention designed, with young people's input, to reduce the incidence of STIs by increasing the correct treatment of STIs, partner notification, condom use and STI testing before unprotected sex with a new partner. The intervention was delivered via automated mobile phone messaging over 12 months. The comparator was a monthly text message checking contact details. (1) Development of the intervention based on theory, evidence and expert and user views; (2) follow-up procedures; (3) pilot trial primary outcomes: full recruitment within 3 months and follow-up rate for the proposed primary outcomes for the main trial; and (4) participants' views and experiences regarding the acceptability of the intervention. In total, 200 participants were randomised in the pilot trial, of whom 99 were allocated to the intervention and 101 were

  17. Using an Implementation Research Framework to Identify Potential Facilitators and Barriers of an Intervention to Increase HPV Vaccine Uptake.

    PubMed

    Selove, Rebecca; Foster, Maya; Mack, Raquel; Sanderson, Maureen; Hull, Pamela C

    Although the incidence of cervical cancer has been decreasing in the United States over the last decade, Hispanic and African American women have substantially higher rates than Caucasian women. The human papillomavirus (HPV) is a necessary, although insufficient, cause of cervical cancer. In the United States in 2013, only 37.6% of girls 13 to 17 years of age received the recommended 3 doses of a vaccine that is almost 100% efficacious for preventing infection with viruses that are responsible for 70% of cervical cancers. Implementation research has been underutilized in interventions for increasing vaccine uptake. The Consolidated Framework for Implementation Research (CFIR), an approach for designing effective implementation strategies, integrates 5 domains that may include barriers and facilitators of HPV vaccination. These include the innovative practice (Intervention), communities where youth and parents live (Outer Setting), agencies offering vaccination (Inner Setting), health care staff (Providers), and planned execution and evaluation of intervention delivery (Implementation Process). Secondary qualitative analysis of transcripts of interviews with 30 community health care providers was conducted using the CFIR to code potential barriers and facilitators of HPV vaccination implementation. All CFIR domains except Implementation Process were well represented in providers' statements about challenges and supports for HPV vaccination. A comprehensive implementation framework for promoting HPV vaccination may increase vaccination rates in ethnically diverse communities. This study suggests that the CFIR can be used to guide clinicians in planning implementation of new approaches to increasing HPV vaccine uptake in their settings. Further research is needed to determine whether identifying implementation barriers and facilitators in all 5 CFIR domains as part of developing an intervention contributes to improved HPV vaccination rates.

  18. Potassium excretion in healthy Japanese women was increased by a dietary intervention utilizing home-parcel delivery of Okinawan vegetables.

    PubMed

    Tuekpe, Mallet K-N; Todoriki, Hidemi; Sasaki, Satoshi; Zheng, Kui-Cheng; Ariizumi, Makoto

    2006-06-01

    Potassium, which is abundant in vegetables, is inversely related to blood pressure. Although the situation has changed somewhat in recent years, the Okinawan diet has generally included a large amount of vegetables, and until recently Okinawans had the lowest rates of mortality due to stroke and coronary heart disease in Japan. Based on the hypothesis that these low mortality rates are partly attributable to increased potassium intake resulting from the high vegetable consumption, this study examined whether increasing the consumption of typical yellow-green Okinawan vegetables increases potassium intake. The purpose of this investigation was to determine whether increased consumption of these vegetables should be one of the dietary modifications recommended in public health promotion programs for Okinawans. The study employed 56 healthy, normotensive, free-living Japanese women aged 18-38 years living in Okinawa. They were randomized to a dietary intervention group (n=27) or a control group (n=29). Members of the dietary intervention group received an average weight of 371.4 g/day of a combination of the following vegetables twice weekly through an express home parcel deliver service for a period of 14 days: Goya (Momordica charantia), green papaya (Carica papaya), Handama (Gynura bicolor), Karashina (Brassica juncea), Njana (Crepidiastrum lanceolatium), Fuchiba (Artemisia vulgaris) and Fudanso (Beta vulgaris); and they consumed an average of 144.9 g/day, resulting in a 20.5% increase in their urinary potassium excretion over the baseline (p=0.045). The members of the control group were asked to avoid these vegetables, and the change in potassium excretion in this group was not significant (p=0.595). Urinary sodium and magnesium excretions, systolic and diastolic blood pressures, folic acid, triglycerides and serum high density lipoprotein cholesterol, low density lipoprotein cholesterol and total cholesterols changed non-significantly in both groups. Also, post-intervention

  19. From observation to intervention: development of a psychoeducational intervention to increase uptake of BRCA genetic counseling among high-risk breast cancer survivors.

    PubMed

    Vadaparampil, Susan T; Malo, Teri L; Nam, Kelli M; Nelson, Alison; de la Cruz, Cara Z; Quinn, Gwendolyn P

    2014-12-01

    We describe the development of a psychoeducational intervention (PEI) to increase uptake of genetic counseling targeted to high-risk breast cancer survivors. Based on previous research, scientific literature, and a review of cancer education websites, we identified potential PEI content. We then assessed the initial acceptability and preference of two booklets of identical content but different layouts, by presenting the booklets to individuals with a personal or family history of breast cancer (n = 57). The preferred booklet was evaluated by two focus groups of ten breast cancer patients who had not attended genetic counseling. The booklet was refined based on participants' feedback at each stage. Focus group participants generally found the booklet visually appealing, informative, and helpful, but some thought that it was too long. Final changes were made based on learner verification principles of attraction, comprehension, cultural acceptability, and persuasion. This project produced an interventional tool to present key constructs that may facilitate decision making about risk-appropriate genetic counseling uptake among high-risk breast cancer survivors. The process described for creating, testing, and adapting materials from a patient perspective can be used for developing other PEIs. This newly developed, unique PEI can be used in many clinical settings.

  20. From Observation to Intervention: Development of a Psychoeducational Intervention to Increase Uptake of BRCA Genetic Counseling Among High-Risk Breast Cancer Survivors

    PubMed Central

    Malo, Teri L.; Nam, Kelli M.; Nelson, Alison; de la Cruz, Cara Z.; Quinn, Gwendolyn P.

    2015-01-01

    We describe the development of a psychoeducational intervention (PEI) to increase uptake of genetic counseling targeted to high-risk breast cancer survivors. Based on previous research, scientific literature, and a review of cancer education websites, we identified potential PEI content. We then assessed the initial acceptability and preference of two booklets of identical content but different layouts, by presenting the booklets to individuals with a personal or family history of breast cancer (n=57). The preferred booklet was evaluated by two focus groups of ten breast cancer patients who had not attended genetic counseling. The booklet was refined based on participants' feedback at each stage. Focus group participants generally found the booklet visually appealing, informative, and helpful, but some thought that it was too long. Final changes were made based on learner verification principles of attraction, comprehension, cultural acceptability, and persuasion. This project produced an interventional tool to present key constructs that may facilitate decision making about risk-appropriate genetic counseling uptake among high-risk breast cancer survivors. The process described for creating, testing, and adapting materials from a patient perspective can be used for developing other PEIs. This newly developed, unique PEI can be used in many clinical settings. PMID:24706196

  1. Provider-Focused Intervention Increases Adherence-Related Dialogue, But Does Not Improve Antiretroviral Therapy Adherence in Persons with HIV

    PubMed Central

    Wilson, Ira B.; Laws, M. Barton; Safren, Steven A.; Lee, Yoojin; Lu, Minyi; Coady, William; Skolnik, Paul R.; Rogers, William H.

    2010-01-01

    Background Physicians' limited knowledge of patients' antiretroviral adherence may reduce their ability to perform effective adherence counseling. Methods We conducted a randomized, cross-over study of an intervention to improve physicians' knowledge of patients' antiretroviral adherence. The intervention was a report given to the physician prior to a routine office visit that included data on: MEMS and self-reported data on antiretroviral adherence, patients' beliefs about antiretroviral therapy, reasons for missed doses, alcohol and drug use, and depression. We audio-recorded one intervention and one control visit for each patient to analyze differences in adherence related dialogue. Results 156 patients were randomized, and 106 completed all 5 study visits. Paired audio-recorded visits were available for 58 patients. Using a linear regression model that adjusted for site and baseline MEMS adherence, adherence following intervention visits did not differ significantly from control visits (2.0% higher, p=0.31, 95% CI -1.95% – 5.9%). There was a trend toward more total adherence-related utterances (median of 76 vs. 49.5, p=0.07) and a significant increase in utterances about the current regimen (median of 51.5 vs. 32.5, p=0.0002) in intervention compared with control visits. However less than 10% of adherence-related utterances were classified as “problem solving” in content, and one third of physicians' problem solving utterances were directive in nature. Conclusions Receipt of a detailed report prior to clinic visits containing data about adherence and other factors did not improve patients' antiretroviral adherence. Analyses of patient-provide dialogue suggests that providers who care for persons with HIV may benefit from training in adherence counseling techniques. PMID:20048680

  2. Dietary supplementation with n-3-fatty acids in patients with pancreatic cancer and cachexia: marine phospholipids versus fish oil - a randomized controlled double-blind trial.

    PubMed

    Werner, Kristin; Küllenberg de Gaudry, Daniela; Taylor, Lenka A; Keck, Tobias; Unger, Clemens; Hopt, Ulrich T; Massing, Ulrich

    2017-06-02

    Like many other cancer patients, most pancreatic carcinoma patients suffer from severe weight loss. As shown in numerous studies with fish oil (FO) supplementation, a minimum daily intake of 1.5 g n-3-fatty acids (n-3-FA) contributes to weight stabilization and improvement of quality of life (QoL) of cancer patients. Given n-3-FA not as triglycerides (FO), but mainly bound to marine phospholipids (MPL), weight stabilization and improvement of QoL has already been seen at much lower doses of n-3-FA (0,3 g), and MPL were much better tolerated. The objective of this double-blind randomized controlled trial was to compare low dose MPL and FO formulations, which had the same n-3-FA amount and composition, on weight and appetite stabilization, global health enhancement (QoL), and plasma FA-profiles in patients suffering from pancreatic cancer. Sixty pancreatic cancer patients were included into the study and randomized to take either FO- or MPL supplementation. Patients were treated with 0.3 g of n-3-fatty acids per day over six weeks. Since the n-3-FA content of FO is usually higher than that of MPL, FO was diluted with 40% of medium chain triglycerides (MCT) to achieve the same capsule size in both intervention groups and therefore assure blinding. Routine blood parameters, lipid profiles, body weight, and appetite were measured before and after intervention. Patient compliance was assessed through a patient diary. Quality of life and nutritional habits were assessed with validated questionnaires (EORTC-QLQ-C30, PAN26). Thirty one patients finalized the study protocol and were analyzed (per-protocol-analysis). Intervention with low dose n-3-FAs, either as FO or MPL supplementation, resulted in similar and promising weight and appetite stabilization in pancreatic cancer patients. MPL capsules were slightly better tolerated and showed fewer side effects, when compared to FO supplementation. The similar effects between both interventions were unexpected but reliable

  3. Costs and cost-effectiveness of a clinical intervention to increase mammography utilization in an inner city public health hospital.

    PubMed

    Thompson, Beti; Thompson, L Anne; Andersen, M Robyn; Hager, Shelly; Taylor, Victoria; Urban, Nicole

    2002-07-01

    Studies have demonstrated the cost-effectiveness of screening women for breast cancer; however, the cost-effectiveness of strategies to motivate women to receive breast cancer screening has been less well studied. A total of 196 women, aged 50 to 74, who were enrolled in a public health hospital clinic, were noncompliant with mammography screening, and had at least one routine clinic appointment during the study period (15 months) were entered into a randomized, controlled trial of a motivational intervention to increase mammography rates. Costs were captured via a modified Delphi technique, accounting records, sampling of staff time logs, and an estimation of miscellaneous and overhead costs. Summary costs were calculated using Excel spread sheets. Overall, 49% of women who received the intervention had a mammogram within 8 weeks of an index visit compared with 22% of control women. Calculation of the cost-effectiveness of the project showed an additional cost of $151 (1996 U.S.$) for each woman receiving the intervention and $559 for each additional woman motivated to receive a mammogram. Cost tracking and cost-effectiveness analysis can be done when intervening in a clinical setting, thereby allowing clinics to make informed decisions about implementing programs to increase motivation of their patients to receive screening.

  4. Improving social norms interventions: Rank-framing increases excessive alcohol drinkers' information-seeking.

    PubMed

    Taylor, Michael J; Vlaev, Ivo; Maltby, John; Brown, Gordon D A; Wood, Alex M

    2015-12-01

    Two types of social norm message