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  1. Developing Targeted Health Service Interventions Using the PRECEDE-PROCEED Model: Two Australian Case Studies.

    PubMed

    Phillips, Jane L; Rolley, John X; Davidson, Patricia M

    2012-01-01

    Aims and Objectives. This paper provides an overview of the applicability of the PRECEDE-PROCEED Model to the development of targeted nursing led chronic illness interventions. Background. Changing health care practice is a complex and dynamic process that requires consideration of social, political, economic, and organisational factors. An understanding of the characteristics of the target population, health professionals, and organizations plus identification of the determinants for change are also required. Synthesizing this data to guide the development of an effective intervention is a challenging process. The PRECEDE-PROCEED Model has been used in global health care settings to guide the identification, planning, implementation, and evaluation of various health improvement initiatives. Design. Using a reflective case study approach, this paper examines the applicability of the PRECEDE-PROCEED Model to the development of targeted chronic care improvement interventions for two distinct Australian populations: a rapidly expanding and aging rural population with unmet palliative care needs and a disadvantaged urban community at higher risk of cardiovascular disease. Results. The PRECEDE-PROCEED Model approach demonstrated utility across diverse health settings in a systematic planning process. In environments characterized by increasing health care needs, limited resources, and growing community expectations, adopting planning tools such as PRECEDE-PROCEED Model at a local level can facilitate the development of the most effective interventions. Relevance to Clinical Practice. The PRECEDE-PROCEED Model is a strong theoretical model that guides the development of realistic nursing led interventions with the best chance of being successful in existing health care environments.

  2. Outcome of a Targeted Nutritional Intervention Among Older Adults With Early-Stage Alzheimer's Disease: The Nutrition Intervention Study.

    PubMed

    Shatenstein, Bryna; Kergoat, Marie-Jeanne; Reid, Isabelle

    2016-02-01

    A 6-month dietary intervention program was designed for community-dwelling older adults with Alzheimer's disease. Sixty-seven persons aged 70 years and above were recruited with their caregivers from six hospital memory and geriatric outpatient clinics, and allocated to intervention (n = 34 dyads) or control group (n = 33 dyads). Usual diet was assessed by a validated food frequency questionnaire and current diet by two nonconsecutive diet recalls or records corroborated by caregivers, at recruitment (T1) and exit from the study (T2). Intervention participants received targeted dietary recommendations; control participants received Canada's Food Guide leaflets. The program was assessed using paired and independent t tests and nonparametric statistics. Fat intakes increased at T2 within intervention participants (54 ± 16 vs. 67 ± 23 g, p = .013), and there was a tendency for higher energy, protein, and calcium intakes at T2 within this group. Proportions with adequate protein intakes almost doubled from T1 to T2 in intervention group women (p = .028) but decreased in female controls (p = .030). Longer follow-up is necessary to determine persistence of benefits.

  3. Generating political priority for regulatory interventions targeting obesity prevention: an Australian case study.

    PubMed

    Baker, Phillip; Gill, Timothy; Friel, Sharon; Carey, Gemma; Kay, Adrian

    2017-03-01

    Effective obesity prevention requires a synergistic mix of population-level interventions including a strong role for government and the regulation of the marketing, labelling, content and pricing of energy-dense foods and beverages. In this paper we adopt the agenda of the Australian Federal Government (AFG) as a case study to understand the factors generating or hindering political priority for such 'regulatory interventions' between 1990 and 2011. Using a theoretically-guided process tracing method we undertook documentary analysis and conducted 27 interviews with a diversity of actors involved in obesity politics. The analysis was structured by a theoretical framework comprising four dimensions: the power of actors involved; the ideas the actors deploy to interpret and portray the issue; the institutional and political context; and issue characteristics. Despite two periods of sustained political attention, political priority for regulatory interventions did not emerge and was hindered by factors from all four dimensions. Within the public health community, limited cohesion among experts and advocacy groups hampered technical responses and collective action efforts. An initial focus on children (child obesity), framing the determinants of obesity as 'obesogenic environments', and the deployment of 'protecting kids', 'industry demonization' and 'economic costs' frames generated political attention. Institutional norms within government effectively selected out regulatory interventions from consideration. The 'productive power' and activities of the food and advertising industries presented formidable barriers, buttressed by a libertarian/neolibertarian rhetoric emphasizing individual responsibility, a negative view of freedom (as free from 'nanny-state' intervention) and the idea that regulation imposes an unacceptable cost on business. Issue complexity, the absence of a supportive evidence base and a strict 'evidence-based' policy-making approach were used as

  4. Adherence to the obesity-related lifestyle intervention targets in the IDEFICS study.

    PubMed

    Kovács, E; Siani, A; Konstabel, K; Hadjigeorgiou, C; de Bourdeaudhuij, I; Eiben, G; Lissner, L; Gwozdz, W; Reisch, L; Pala, V; Moreno, L A; Pigeot, I; Pohlabeln, H; Ahrens, W; Molnár, D

    2014-09-01

    To address behaviours associated with childhood obesity, certain target values are recommended that should be met to improve children's health. In the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and infantS) study such lifestyle recommendations were conveyed as six key messages. Here, we investigate the adherence of European children to these messages. The IDEFICS intervention was based on the intervention mapping approach with the following six targets: increase water consumption (to replace sugar-containing beverages), increase fruit/vegetable consumption, reduce daily screen time, increase daily physical activity, improve the quality of family life and ensure adequate sleep duration. Internationally recommended target values were applied to determine the prevalence of children meeting these targets. In a cohort of 18,745 children participating in the IDEFICS baseline survey or newly recruited during follow-up, data on the above lifestyle behaviours were collected for a varying number of 8302 to 17,212 children. Information on all six behaviours was available for 5140 children. Although 52.5% of the cohort was classified in the highest category of water consumption, only 8.8% met the target of an intake of fruits/vegetables five times a day. The prevalence of children adhering to the recommendation regarding total screen time-below 1 h for pre-school children and 2 h for school children-was 51.1%. The recommended amount of at least 60 min of moderate-to-vigorous physical activity per day was fulfilled by 15.2%. Family life of the child measured by various indicators was considered as satisfactory in 22.8%. Nocturnal sleep duration of 11 (10) hours or more in pre-school (school) children was achieved by 37.9%. In general, children in northern countries and younger children showed better adherence to the recommendations. Only 1.1% of the children adhered to at least five of these recommendations. Current

  5. Adherence to the obesity-related lifestyle intervention targets in the IDEFICS study

    PubMed Central

    Kovács, E; Siani, A; Konstabel, K; Hadjigeorgiou, C; de Bourdeaudhuij, I; Eiben, G; Lissner, L; Gwozdz, W; Reisch, L; Pala, V; Moreno, L A; Pigeot, I; Pohlabeln, H; Ahrens, W; Molnár, D

    2014-01-01

    Background/objectives: To address behaviours associated with childhood obesity, certain target values are recommended that should be met to improve children's health. In the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and infantS) study such lifestyle recommendations were conveyed as six key messages. Here, we investigate the adherence of European children to these messages. Methods: The IDEFICS intervention was based on the intervention mapping approach with the following six targets: increase water consumption (to replace sugar-containing beverages), increase fruit/vegetable consumption, reduce daily screen time, increase daily physical activity, improve the quality of family life and ensure adequate sleep duration. Internationally recommended target values were applied to determine the prevalence of children meeting these targets. Results: In a cohort of 18 745 children participating in the IDEFICS baseline survey or newly recruited during follow-up, data on the above lifestyle behaviours were collected for a varying number of 8302 to 17 212 children. Information on all six behaviours was available for 5140 children. Although 52.5% of the cohort was classified in the highest category of water consumption, only 8.8% met the target of an intake of fruits/vegetables five times a day. The prevalence of children adhering to the recommendation regarding total screen time—below 1 h for pre-school children and 2 h for school children—was 51.1%. The recommended amount of at least 60 min of moderate-to-vigorous physical activity per day was fulfilled by 15.2%. Family life of the child measured by various indicators was considered as satisfactory in 22.8%. Nocturnal sleep duration of 11 (10) hours or more in pre-school (school) children was achieved by 37.9%. In general, children in northern countries and younger children showed better adherence to the recommendations. Only 1.1% of the children adhered

  6. The impact of hotspot-targeted interventions on malaria transmission: study protocol for a cluster-randomized controlled trial

    PubMed Central

    2013-01-01

    Background Malaria transmission is highly heterogeneous in most settings, resulting in the formation of recognizable malaria hotspots. Targeting these hotspots might represent a highly efficacious way of controlling or eliminating malaria if the hotspots fuel malaria transmission to the wider community. Methods/design Hotspots of malaria will be determined based on spatial patterns in age-adjusted prevalence and density of antibodies against malaria antigens apical membrane antigen-1 and merozoite surface protein-1. The community effect of interventions targeted at these hotspots will be determined. The intervention will comprise larviciding, focal screening and treatment of the human population, distribution of long-lasting insecticide-treated nets and indoor residual spraying. The impact of the intervention will be determined inside and up to 500 m outside the targeted hotspots by PCR-based parasite prevalence in cross-sectional surveys, malaria morbidity by passive case detection in selected facilities and entomological monitoring of larval and adult Anopheles populations. Discussion This study aims to provide direct evidence for a community effect of hotspot-targeted interventions. The trial is powered to detect large effects on malaria transmission in the context of ongoing malaria interventions. Follow-up studies will be needed to determine the effect of individual components of the interventions and the cost-effectiveness of a hotspot-targeted approach, where savings made by reducing the number of compounds that need to receive interventions should outweigh the costs of hotspot-detection. Trial registration NCT01575613. The protocol was registered online on 20 March 2012; the first community was randomized on 26 March 2012. PMID:23374910

  7. Head-and-Neck Target Delineation Among Radiation Oncology Residents After a Teaching Intervention: A Prospective, Blinded Pilot Study

    SciTech Connect

    Bekelman, Justin E. Wolden, Suzanne; Lee, Nancy

    2009-02-01

    Purpose: We conducted this study to determine the feasibility of incorporating a teaching intervention on target delineation into the educational curriculum of a radiation oncology residency program and to assess the short-term effects on resident skills. Methods and Materials: The study schema consisted of a baseline evaluation, the teaching intervention, and a follow-up evaluation. At the baseline evaluation, the participants contoured three clinical tumor volumes (CTVs) (70 Gy, 59.4 Gy, and 54 Gy) on six contrast-enhanced axial computed tomography images of a de-identified patient with Stage T2N2bM0 squamous cell carcinoma of the right base of the tongue. The participants attended a series of head-and-neck oncology and anatomy seminars. The teaching intervention consisted of a didactic lecture and an interactive hands-on practical session designed to improve the knowledge and skills for target delineation in the head and neck. At the follow-up evaluation, the residents again contoured the CTVs. Results: Of the 14 eligible residents, 11 (79%) actually participated in the study. For all participants, but especially for those who had not had previous experience with head-and-neck target delineation, the teaching intervention was associated with improvement in the delineation of the node-negative neck (CTV 54 Gy contour). Regardless of clinical experience, participants had difficulty determining what should be included in the CTV 59.4 Gy contour to ensure adequate coverage of potential microscopic disease. Conclusion: Incorporating a teaching intervention into the education curriculum of a radiation oncology residency program is feasible and was associated with short-term improvements in target delineation skills. Subsequent interventions will require content refinement, additional validation, longer term follow-up, and multi-institutional collaboration.

  8. A Pilot Study of an Alcohol Education Intervention Targeting the Frequently Binge-Drinking College Student.

    ERIC Educational Resources Information Center

    Maney, Dolores W.; Theodorou, Elena; Vasey, Joseph J.

    This paper describes a study that tested the effects of an educational intervention on the alcohol-related knowledge, normative beliefs, attitudes, and psychosocial skills of high-risk drinking college students. Knowledge items measured cognitive awareness of alcohol risks. Normative beliefs and attitude measures reflected misperceptions of…

  9. A Pilot Study of an Alcohol Education Intervention Targeting the Frequently Binge-Drinking College Student.

    ERIC Educational Resources Information Center

    Maney, Dolores W.; Theodorou, Elena; Vasey, Joseph J.

    This paper describes a study that tested the effects of an educational intervention on the alcohol-related knowledge, normative beliefs, attitudes, and psychosocial skills of high-risk drinking college students. Knowledge items measured cognitive awareness of alcohol risks. Normative beliefs and attitude measures reflected misperceptions of…

  10. An intervention study targeting energy and nutrient intake in worksite cafeterias.

    PubMed

    Lowe, Michael R; Tappe, Karyn A; Butryn, Meghan L; Annunziato, Rachel A; Coletta, Maria C; Ochner, Christopher N; Rolls, Barbara J

    2010-08-01

    Modifying the food environment is a promising strategy for promoting healthier eating behavior. This study aimed to evaluate nutritional and weight changes in a program that used worksite cafeterias to reduce employees' calorie content of purchased foods and improve their macronutrient intake. Participants were randomly assigned to one of two conditions: 1) only environmental change (i.e., the introduction of 10 new low-energy-density (ED) foods and provision of labels for all foods sold at lunch, which listed ED, calories, and macronutrient content) or 2) the environmental change plus pricing incentives for purchasing low-ED foods and education about low-ED eating delivered in four, 1-hour group sessions. Participant lunch choices were monitored electronically at the point of purchase for 3 months before the intervention was instituted (i.e., the baseline period) and for 3 months afterward (i.e., intervention period). Participants were adults (n=96, BMI=29.7+/-6.0 kg/m(2)) who regularly ate lunch at their workplace cafeteria. There was no difference between groups in total energy intake over the study period. Across groups, energy and percent of energy from fat decreased and percent of energy from carbohydrate increased from baseline to the intervention period (all p<.01). Follow-up analyses, conducted by averaging Baseline Months 1 and 2 and comparing them to Intervention Month 3 as a conservative estimate of overall impact of the intervention, indicated that change in energy, carbohydrate, and fat intake remained significant (p<.001). Providing nutrition labels and reducing the ED of selected foods was associated with improved dietary intake. 2010 Elsevier Ltd. All rights reserved.

  11. Impact of a medication therapy management intervention targeting medications associated with falling: Results of a pilot study

    PubMed Central

    Mott, David A.; Martin, Beth; Breslow, Robert; Michaels, Barb; Kirchner, Jeff; Mahoney, Jane; Margolis, Amanda

    2016-01-01

    BACKGROUND The use of fall risk–increasing drugs (FRIDs) by older adults is one factor associated with falling, and FRID use is common among older adults. A targeted medication therapy management intervention focused on FRID use that included prescription and over-the-counter (OTC) medications, along with follow-up telephone calls was designed. OBJECTIVE The purpose of this pilot study was to examine preliminary effects of a medication therapy management (MTM) intervention focused on FRIDs provided by a community pharmacist to older adults. DESIGN Randomized, controlled trial. SETTING One community pharmacy. PARTICIPANTS Eighty older adults who completed a fall prevention workshop. MAIN OUTCOME MEASURES The main outcome measures were the rate of discontinuing FRIDs, the proportion of older adults falling, and the number of falls. A secondary outcome was the acceptance rate of medication recommendations by patients and prescribers. RESULTS Thirty-eight older adults received the targeted MTM intervention. Of the 31 older adults using a FRID, a larger proportion in the intervention group had FRID use modified relative to controls (77% and 28%, respectively; P < 0.05). There were no significant changes between the study groups in the risk and rate of falling. Medication recommendations in the intervention group had a 75% acceptance rate by patients and prescribers. CONCLUSION A targeted MTM intervention provided by a community pharmacist and focused on FRID use among older adults was effective in modifying FRID use. This result supports the preliminary conclusion that community pharmacists can play an important role in modifying FRID use among older adults. PMID:26802916

  12. Process and Effects Evaluation of a Digital Mental Health Intervention Targeted at Improving Occupational Well-Being: Lessons From an Intervention Study With Failed Adoption

    PubMed Central

    Ermes, Miikka

    2016-01-01

    use experienced many benefits such as relief in stressful situations. The app was perceived as a toolkit for personal well-being that gives concrete instructions on how mindfulness can be practiced. However, many barriers to participate in the intervention were identified at the individual level, such as lack of time, lack of perceived need, and lack of perceived benefits. Conclusions The findings suggest that neither the setting nor the approach used in this study were successful in adopting new digital interventions at the target organizations. Barriers were faced at both the organizational as well as the individual level. At the organizational level, top management needs to be involved in the intervention planning for fitting into the organization policies, the existing technology infrastructure, and also targeting the organizational goals. At the individual level, concretizing the benefits of the preventive intervention and arranging time for app use at the workplace are likely to increase adoption. PMID:27170553

  13. Process and Effects Evaluation of a Digital Mental Health Intervention Targeted at Improving Occupational Well-Being: Lessons From an Intervention Study With Failed Adoption.

    PubMed

    Muuraiskangas, Salla; Harjumaa, Marja; Kaipainen, Kirsikka; Ermes, Miikka

    2016-05-11

    relief in stressful situations. The app was perceived as a toolkit for personal well-being that gives concrete instructions on how mindfulness can be practiced. However, many barriers to participate in the intervention were identified at the individual level, such as lack of time, lack of perceived need, and lack of perceived benefits. The findings suggest that neither the setting nor the approach used in this study were successful in adopting new digital interventions at the target organizations. Barriers were faced at both the organizational as well as the individual level. At the organizational level, top management needs to be involved in the intervention planning for fitting into the organization policies, the existing technology infrastructure, and also targeting the organizational goals. At the individual level, concretizing the benefits of the preventive intervention and arranging time for app use at the workplace are likely to increase adoption.

  14. Short message service (SMS)-based intervention targeting alcohol consumption among university students: study protocol of a randomized controlled trial.

    PubMed

    Thomas, Kristin; Bendtsen, Marcus; Linderoth, Catharina; Karlsson, Nadine; Bendtsen, Preben; Müssener, Ulrika

    2017-04-04

    Despite significant health risks, heavy drinking of alcohol among university students is a widespread problem; excessive drinking is part of the social norm. A growing number of studies indicate that short message service (SMS)-based interventions are cost-effective, accessible, require limited effort by users, and can enable continuous, real-time, brief support in real-world settings. Although there is emerging evidence for the effect of SMS-based interventions in reducing alcohol consumption, more research is needed. This study aims to test the effectiveness of a newly developed SMS-based intervention targeting excessive alcohol consumption among university and college students in Sweden. The study is a two-arm randomized controlled trial with an intervention (SMS programme) and a control (treatment as usual) group. Outcome measures will be investigated at baseline and at 3-month follow up. The primary outcome is total weekly alcohol consumption. Secondary outcomes are frequency of heavy episodic drinking, highest estimated blood alcohol concentration and number of negative consequences due to excessive drinking. This study contributes knowledge on the effect of automatized SMS support to reduce excessive drinking among students compared with existing support such as Student Health Centres. ISRCTN.com, ISRCTN95054707 . Registered on 31 August 2016.

  15. Screen-time Weight-loss Intervention Targeting Children at Home (SWITCH): A randomized controlled trial study protocol

    PubMed Central

    2011-01-01

    Background Approximately one third of New Zealand children and young people are overweight or obese. A similar proportion (33%) do not meet recommendations for physical activity, and 70% do not meet recommendations for screen time. Increased time being sedentary is positively associated with being overweight. There are few family-based interventions aimed at reducing sedentary behavior in children. The aim of this trial is to determine the effects of a 24 week home-based, family oriented intervention to reduce sedentary screen time on children's body composition, sedentary behavior, physical activity, and diet. Methods/Design The study design is a pragmatic two-arm parallel randomized controlled trial. Two hundred and seventy overweight children aged 9-12 years and primary caregivers are being recruited. Participants are randomized to intervention (family-based screen time intervention) or control (no change). At the end of the study, the control group is offered the intervention content. Data collection is undertaken at baseline and 24 weeks. The primary trial outcome is child body mass index (BMI) and standardized body mass index (zBMI). Secondary outcomes are change from baseline to 24 weeks in child percentage body fat; waist circumference; self-reported average daily time spent in physical and sedentary activities; dietary intake; and enjoyment of physical activity and sedentary behavior. Secondary outcomes for the primary caregiver include change in BMI and self-reported physical activity. Discussion This study provides an excellent example of a theory-based, pragmatic, community-based trial targeting sedentary behavior in overweight children. The study has been specifically designed to allow for estimation of the consistency of effects on body composition for Māori (indigenous), Pacific and non-Māori/non-Pacific ethnic groups. If effective, this intervention is imminently scalable and could be integrated within existing weight management programs. Trial

  16. Neuro-Intensive Treatment Targeting Intracranial Hypertension Improves Outcome in Severe Bacterial Meningitis: An Intervention-Control Study

    PubMed Central

    Glimåker, Martin; Johansson, Bibi; Halldorsdottir, Halla; Wanecek, Michael; Elmi-Terander, Adrian; Ghatan, Per Hamid; Lindquist, Lars; Bellander, Bo Michael

    2014-01-01

    Objective To evaluate the efficacy of early intracranial pressure (ICP)-targeted treatment, compared to standard intensive care, in adults with community acquired acute bacterial meningitis (ABM) and severely impaired consciousness. Design A prospectively designed intervention-control comparison study of adult cases from September 2004 to January 2012. Patients Included patients were confirmed ABM-cases, aged 16–75 years, with severely impaired mental status on admission. Fifty-two patients, given ICP-targeted treatment at the neuro-intensive care unit, and 53 control cases, treated with conventional intensive care, were included. All the patients received intensive care with mechanical ventilation, sedation, antibiotics and corticosteroids according to current guidelines. Additional ICP-treatment in the intervention group included cerebrospinal fluid drainage using external ventricular catheters (n = 48), osmotherapy (n = 21), hyperventilation (n = 13), external cooling (n = 9), gram-doses of methylprednisolone (n = 3) and deep barbiturate sedation (n = 2) aiming at ICP <20 mmHg and a cerebral perfusion pressure of >50 mmHg. Measurements The primary endpoint was mortality at two months and secondary endpoint was Glasgow outcome score and hearing ability at follow-up at 2–6 months. Outcomes The mortality was significantly lower in the intervention group compared to controls, 5/52 (10%) versus 16/53 (30%; relative risk reduction 68%; p<0.05). Furthermore, only 17 patients (32%) in the control group fully recovered compared to 28 (54%) in the intervention group (relative risk reduction 40%; p<0.05). Conclusions Early neuro-intensive care using ICP-targeted therapy, mainly cerebrospinal fluid drainage, reduces mortality and improves the overall outcome in adult patients with ABM and severely impaired mental status on admission. PMID:24667767

  17. Hip Hop HEALS: Pilot Study of a Culturally Targeted Calorie Label Intervention to Improve Food Purchases of Children

    ERIC Educational Resources Information Center

    Williams, Olajide; DeSorbo, Alexandra; Sawyer, Vanessa; Apakama, Donald; Shaffer, Michele; Gerin, William; Noble, James

    2016-01-01

    Objectives: We explored the effect of a culturally targeted calorie label intervention on food purchasing behavior of elementary school students. Method: We used a quasi-experimental design with two intervention schools and one control school to assess food purchases of third through fifth graders at standardized school food sales before and after…

  18. Hip Hop HEALS: Pilot Study of a Culturally Targeted Calorie Label Intervention to Improve Food Purchases of Children

    ERIC Educational Resources Information Center

    Williams, Olajide; DeSorbo, Alexandra; Sawyer, Vanessa; Apakama, Donald; Shaffer, Michele; Gerin, William; Noble, James

    2016-01-01

    Objectives: We explored the effect of a culturally targeted calorie label intervention on food purchasing behavior of elementary school students. Method: We used a quasi-experimental design with two intervention schools and one control school to assess food purchases of third through fifth graders at standardized school food sales before and after…

  19. Targeted intervention reduces refracture rates in patients with incident non-vertebral osteoporotic fractures: a 4-year prospective controlled study.

    PubMed

    Lih, A; Nandapalan, H; Kim, M; Yap, C; Lee, P; Ganda, K; Seibel, M J

    2011-03-01

    In the present prospective controlled observational study, we investigated the effect of a coordinated intervention program on 4-year refracture rates in patients with recent osteoporotic fractures. Compared to standard care, targeted identification, and management significantly reduced the risk of refracture by more than 80%. The risk of refracture following an incident osteoporotic fracture is high. Despite the availability of treatments that reduce refracture and mortality rates, most patients with minimal trauma fracture (MTF) are not managed appropriately. The present prospective controlled observational study investigated the effect of a coordinated intervention program on 4-year refracture rates and time to refracture in patients with recent osteoporotic fractures. Patients presenting with a non-vertebral MTF were actively identified and offered referral to a dedicated intervention program. Patients attending the clinic underwent a standardized set of investigations, were treated as indicated and reviewed at 12-monthly intervals ('MTF group'). Patients who elected to follow-up with their primary care physician were assigned to the concurrent control group. Groups were balanced for baseline anthropometric, socio-economic, and clinical risk factors. Over 4 years, 10 out of 246 patients (4.1%) in the MTF group and 31 of 157 patients (19.7%) in the control group suffered a new fracture, with a median time to refracture of 26 and 16 months, respectively (p < 0.01). Compared to the intervention group, the risk of refracture was increased by 5.3-fold in the control group (95% CI: 2.8-12.2, p < 0.01), and remained elevated (HR 5.63, 95%CI 2.73-11.6, p < 0.01) after adjustment for other significant predictors of refracture such as age and body weight. In patients presenting with a minimal trauma non-vertebral fracture, active identification and management significantly reduces the risk of refracture (Australian New Zealand Clinical Trials Registry ACTRN

  20. Hip Hop HEALS: Pilot Study of a Culturally Targeted Calorie Label Intervention to Improve Food Purchases of Children.

    PubMed

    Williams, Olajide; DeSorbo, Alexandra; Sawyer, Vanessa; Apakama, Donald; Shaffer, Michele; Gerin, William; Noble, James

    2016-02-01

    We explored the effect of a culturally targeted calorie label intervention on food purchasing behavior of elementary school students. We used a quasi-experimental design with two intervention schools and one control school to assess food purchases of third through fifth graders at standardized school food sales before and after the intervention (immediate and delayed) in schools. The intervention comprised three 1-hour assembly-style hip-hop-themed multimedia classes. A mean total of 225 children participated in two baseline preintervention sales with and without calorie labels; 149 children participated in immediate postintervention food sales, while 133 children participated in the delayed sales. No significant change in purchased calories was observed in response to labels alone before the intervention. However, a mean decline in purchased calories of 20% (p < .01) and unhealthy foods (p < .01) was seen in immediately following the intervention compared to baseline purchases, and this persisted without significant decay after 7 days and 12 days. A 3-hour culturally targeted calorie label intervention may improve food-purchasing behavior of children. © 2015 Society for Public Health Education.

  1. A Pilot Study of a Culturally Targeted Video Intervention to Increase Participation of African American Patients in Cancer Clinical Trials

    PubMed Central

    Libin, Alexander V.; Wang, Hong; Swain, Sandra M.

    2012-01-01

    Purpose. Barriers to clinical trial participation among African American cancer patients are well characterized in the literature. Attitudinal barriers encompassing fear, distrust, and concerns about ethical misconduct are also well documented. To increase trial accrual, these attitudes must be adequately addressed, yet there remains a lack of targeted interventions toward this end. We developed a 15-minute culturally targeted video designed to impact six specific attitudes of African American cancer patients toward therapeutic trials. We conducted a pilot study to test in the first such intervention to increase intention to enroll. Patients and Methods. The primary study outcome was self-reported likelihood to participate in a therapeutic trial. Using a mixed methods approach, we developed the Attitudes and Intention to Enroll in Therapeutic Clinical Trials (AIET) instrument, a 30-item questionnaire measuring six attitudinal barriers to African American trial participation. We enrolled 108 eligible active treatment patients at a large urban cancer institute. McNemar's test for matched pairs was used to assess changes in attitudes and likelihood to enroll in a clinical trial at baseline and immediately after the video. Pre- and post-video AIET summative scores were analyzed by paired t-test for each attitudinal barrier. Results. Patients' likelihood of enrolling in a clinical trial significantly increased post-video with 36% of the sample showing positive changes in intention [McNemar's χ2 = 33.39, p < .001]. Paired t-tests showed significant changes in all six attitudinal barriers measured via AIET summative scores from pre- to post-video. Conclusion. These data suggest utility of our video for increasing African American participation in clinical trials. PMID:22639112

  2. Text Message-Based Intervention Targeting Alcohol Consumption Among University Students: Findings From a Formative Development Study

    PubMed Central

    Linderoth, Catharina; Bendtsen, Marcus; Bendtsen, Preben; Müssener, Ulrika

    2016-01-01

    Background Drinking of alcohol among university students is a global phenomenon; heavy episodic drinking is accepted despite several potential negative consequences. There is emerging evidence that short message service (SMS) text messaging interventions are effective to promote behavior change among students. However, it is still unclear how effectiveness can be optimized through intervention design or how user interest and adherence can be maximized. Objective The objective of this study was to develop an SMS text message-based intervention targeting alcohol drinking among university students using formative research. Methods A formative research design was used including an iterative revision process based on input from end users and experts. Data were collected via seven focus groups with students and a panel evaluation involving students (n=15) and experts (n=5). Student participants were recruited from five universities in Sweden. A semistructured interview guide was used in the focus groups and included questions on alcohol culture, message content, and intervention format. The panel evaluation asked participants to rate to what degree preliminary messages were understandable, usable, and had a good tone on a scale from 1 (very low degree) to 4 (very high degree). Participants could also write their own comments for each message. Qualitative data were analyzed using qualitative descriptive analysis. Quantitative data were analyzed using descriptive statistics. The SMS text messages and the intervention format were revised continuously in parallel with data collection. A behavior change technique (BCT) analysis was conducted on the final version of the program. Results Overall, students were positive toward the SMS text message intervention. Messages that were neutral, motivated, clear, and tangible engaged students. Students expressed that they preferred short, concise messages and confirmed that a 6-week intervention was an appropriate duration. However

  3. Joint marketing as a framework for targeting men who have sex with men in China: a pilot intervention study.

    PubMed

    Tan, Jingguang; Cai, Rui; Lu, Zuxun; Cheng, Jinquan; de Vlas, Sake J; Richardus, Jan Hendrik

    2013-04-01

    To apply the joint marketing principle as a new intervention approach for targeting men who have sex with men (MSM) who are often difficult to reach in societies with discrimination towards homosexuality and HIV/AIDS. A pilot intervention according to the principles of joint marketing was carried out by the CDC in Shenzhen, China, in MSM social venues. A self-designed questionnaire of HIV knowledge, condom use, and access to HIV-related services was used before and after the pilot intervention to evaluate its effectiveness. The CDC supported gatekeepers of MSM social venues in running their business and thereby increasing their respectability and income. In return, the gatekeepers cooperated with the CDC in reaching the MSM at the venues with health promotion messages and materials. Thus a win-win situation was created, bringing together two noncompetitive parties in reaching out to a shared customer, the MSM. The pilot intervention succeeded in demonstrating acceptability and feasibility of the joint marketing approach targeting MSM. HIV knowledge, the rate of condom use, and access to HIV-related services of participants in the pilot intervention increased significantly. The joint marketing intervention is an innovative way to create synergies between the gatekeepers of MSM social venues and public health officials for reaching and potentially changing HIV high-risk behaviors among MSM.

  4. A family-based intervention targeting parents of preschool children with overweight and obesity: conceptual framework and study design of LOOPS- Lund overweight and obesity preschool study.

    PubMed

    Önnerfält, Jenny; Erlandsson, Lena-Karin; Orban, Kristina; Broberg, Malin; Helgason, Christina; Thorngren-Jerneck, Kristina

    2012-10-17

    As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS) is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that preschool children with overweight and obesity, whose parents participate in a one-year intervention, both at completion of the one-year intervention and at long term follow up (2-, 3- and 5-years) will have reduced their BMI-for-age z-score. The study is a randomized controlled trial, including overweight (n=160) and obese (n=80) children 4-6-years-old. The intervention is targeting the parents, who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes, both in the short and long term. To evaluate the effect of various supports, the parents are randomized to different interventions with the main focus of: 1) supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2) influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle. The primary outcome variable, child BMI-for-age z-score will be measured at referral, inclusion, after 6 months, at the end of intervention and at 2-, 3- and 5-years post intervention. Secondary outcome variables, measured at inclusion and at the end of intervention, are child activity pattern, eating habits and biochemical markers as well as parent BMI, exercise habits, perception of health, experience of parenthood and level of parental stress. The LOOPS project will provide

  5. Molecular Targeted Intervention for Pancreatic Cancer

    PubMed Central

    Mohammed, Altaf; Janakiram, Naveena B.; Pant, Shubham; Rao, Chinthalapally V.

    2015-01-01

    Pancreatic cancer (PC) remains one of the worst cancers, with almost uniform lethality. PC risk is associated with westernized diet, tobacco, alcohol, obesity, chronic pancreatitis, and family history of pancreatic cancer. New targeted agents and the use of various therapeutic combinations have yet to provide adequate treatments for patients with advanced cancer. To design better preventive and/or treatment strategies against PC, knowledge of PC pathogenesis at the molecular level is vital. With the advent of genetically modified animals, significant advances have been made in understanding the molecular biology and pathogenesis of PC. Currently, several clinical trials and preclinical evaluations are underway to investigate novel agents that target signaling defects in PC. An important consideration in evaluating novel drugs is determining whether an agent can reach the target in concentrations effective to treat the disease. Recently, we have reported evidence for chemoprevention of PC. Here, we provide a comprehensive review of current updates on molecularly targeted interventions, as well as dietary, phytochemical, immunoregulatory, and microenvironment-based approaches for the development of novel therapeutic and preventive regimens. Special attention is given to prevention and treatment in preclinical genetically engineered mouse studies and human clinical studies. PMID:26266422

  6. Targeted intervention research studies on sexually transmitted diseases (STD): methodology, selected findings and implications for STD service delivery and communications.

    PubMed

    Field, M L; Price, J; Niang, C; N'tcha, J; Zwane, I T; Lurie, M; Nxumalo, M; Dialmy, A; Manhart, L; Gebre, A; Saidel, T; Dallabetta, G

    1998-01-01

    Targeted intervention research (TIR) studies were performed in five African countries (Senegal, Ethiopia, Benin, Morocco, and Swaziland) to improve the utilization of a community perspective in sexually transmitted disease (STD) programs. TIR, conducted by program managers with the aid of a multidisciplinary technical advisory group, examines factors at five levels of analysis (individual, social network, organization, community, and policy) through a variety of qualitative methods. The TIR studies indicated that patients' conceptions of normal versus abnormal health are fundamental to the process of interpreting symptoms and subsequently seeking care. The interpretation of STD symptoms varied across settings (e.g., vaginal lesions and discharge were considered signs of healing in Morocco and Benin), but increasing pain and discomfort were key triggers to seeking treatment. The concept of sexual transmission was blended with other causes such as violation of religious or moral codes, consumption of certain foods, and supernatural forces. Care-seeking tended to reflect an ordered yet loosely constructed process of elimination in pursuit of symptom relief, beginning with alternative regimens. Barriers to biomedical STD care included the need for husband's permission, costs, confidentiality concerns, long waits in public clinics, and fear of judgmental health provider attitudes. Overall, the findings highlight the importance of location-specific strategies aimed at increasing prompt care-seeking at qualified biomedical facilities.

  7. Targeting communication interventions to decrease caregiver burden.

    PubMed

    Wittenberg-Lyles, Elaine; Goldsmith, Joy; Oliver, Debra Parker; Demiris, George; Rankin, Anna

    2012-11-01

    To describe family communication patterns that give shape to four types of family caregivers: Manager, Carrier, Partner, and Loner. Case studies of oncology family caregivers and hospice patients selected from data collected as part of a larger, randomized controlled trial aimed at assessing family participation in interdisciplinary team meetings. Each caregiver type demonstrates essential communication traits with nurses and team members; an ability to recognize these caregiver types will facilitate targeted interventions to decrease family oncology caregiver burden. By becoming familiar with caregiver types, oncology nurses will be better able to address family oncology caregiver burden and the conflicts arising from family communication challenges. With an understanding of family communication patterns and its impact on caregiver burden, nurses can aid the patient, family, and team to best optimize all quality-of-life domains for patient and family caregiver. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. The SPORTSMART study: a pilot randomised controlled trial of sexually transmitted infection screening interventions targeting men in football club settings

    PubMed Central

    Fuller, Sebastian S; Mercer, Catherine H; Copas, Andrew J; Saunders, John; Sutcliffe, Lorna J; Cassell, Jackie A; Hart, Graham; Johnson, Anne M; Roberts, Tracy E; Jackson, Louise J; Muniina, Pamela; Estcourt, Claudia S

    2015-01-01

    Background Uptake of chlamydia screening by men in England has been substantially lower than by women. Non-traditional settings such as sports clubs offer opportunities to widen access. Involving people who are not medically trained to promote screening could optimise acceptability. Methods We developed two interventions to explore the acceptability and feasibility of urine-based sexually transmitted infection (STI) screening interventions targeting men in football clubs. We tested these interventions in a pilot cluster randomised control trial. Six clubs were randomly allocated, two to each of three trial arms: team captain-led and poster STI screening promotion; sexual health adviser-led and poster STI screening promotion; and poster-only STI screening promotion (control/comparator). Primary outcome was test uptake. Results Across the three arms, 153 men participated in the trial and 90 accepted the offer of screening (59%, 95% CI 35% to 79%). Acceptance rates were broadly comparable across the arms: captain-led: 28/56 (50%); health professional-led: 31/46 (67%); and control: 31/51 (61%). However, rates varied appreciably by club, precluding formal comparison of arms. No infections were identified. Process evaluation confirmed that interventions were delivered in a standardised way but the control arm was unintentionally ‘enhanced’ by some team captains actively publicising screening events. Conclusions Compared with other UK-based community screening models, uptake was high but gaining access to clubs was not always easy. Use of sexual health advisers and team captains to promote screening did not appear to confer additional benefit over a poster-promoted approach. Although the interventions show potential, the broader implications of this strategy for UK male STI screening policy require further investigation. PMID:25512674

  9. The SPORTSMART study: a pilot randomised controlled trial of sexually transmitted infection screening interventions targeting men in football club settings.

    PubMed

    Fuller, Sebastian S; Mercer, Catherine H; Copas, Andrew J; Saunders, John; Sutcliffe, Lorna J; Cassell, Jackie A; Hart, Graham; Johnson, Anne M; Roberts, Tracy E; Jackson, Louise J; Muniina, Pamela; Estcourt, Claudia S

    2015-03-01

    Uptake of chlamydia screening by men in England has been substantially lower than by women. Non-traditional settings such as sports clubs offer opportunities to widen access. Involving people who are not medically trained to promote screening could optimise acceptability. We developed two interventions to explore the acceptability and feasibility of urine-based sexually transmitted infection (STI) screening interventions targeting men in football clubs. We tested these interventions in a pilot cluster randomised control trial. Six clubs were randomly allocated, two to each of three trial arms: team captain-led and poster STI screening promotion; sexual health adviser-led and poster STI screening promotion; and poster-only STI screening promotion (control/comparator). Primary outcome was test uptake. Across the three arms, 153 men participated in the trial and 90 accepted the offer of screening (59%, 95% CI 35% to 79%). Acceptance rates were broadly comparable across the arms: captain-led: 28/56 (50%); health professional-led: 31/46 (67%); and control: 31/51 (61%). However, rates varied appreciably by club, precluding formal comparison of arms. No infections were identified. Process evaluation confirmed that interventions were delivered in a standardised way but the control arm was unintentionally 'enhanced' by some team captains actively publicising screening events. Compared with other UK-based community screening models, uptake was high but gaining access to clubs was not always easy. Use of sexual health advisers and team captains to promote screening did not appear to confer additional benefit over a poster-promoted approach. Although the interventions show potential, the broader implications of this strategy for UK male STI screening policy require further investigation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Intervention Targets for Youth with Disabilities in Foster Care

    ERIC Educational Resources Information Center

    Harwick, Robin; Tyre, Ashli; Beisse, Kay; Thomas, Cathy

    2015-01-01

    This article will focus on students with disabilities in foster care to help school psychologists identify effective school-based interventions for these students. We will report our findings from three independent studies and then apply the findings to suggest targeted interventions for these students that are intended to improve educational and…

  11. 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).

  12. Who to target in sudden unexpected death in epilepsy prevention and how? Risk factors, biomarkers, and intervention study designs.

    PubMed

    Tomson, Torbjörn; Surges, Rainer; Delamont, Robert; Haywood, Serena; Hesdorffer, Dale C

    2016-01-01

    The risk of dying suddenly and unexpectedly is increased 24- to 28-fold among young people with epilepsy compared to the general population, but the incidence of sudden unexpected death in epilepsy (SUDEP) varies markedly depending on the epilepsy population. This article first reviews risk factors and biomarkers for SUDEP with the overall aim of enabling identification of epilepsy populations with different risk levels as a background for a discussion of possible intervention strategies. The by far most important clinical risk factor is frequency of generalized tonic-clonic seizures (GTCS), but nocturnal seizures, early age at onset, and long duration of epilepsy have been identified as additional risk factors. Lack of antiepileptic drug (AED) treatment or, in the context of clinical trials, adjunctive placebo versus active treatment is associated with increased risks. Despite considerable research, reliable electrophysiologic (electrocardiography [ECG] or electroencephalography [EEG]) biomarkers of SUDEP risk remain to be established. This is an important limitation for prevention strategies and intervention studies. There is a lack of biomarkers for SUDEP, and until validated biomarkers are found, the endpoint of interventions to prevent SUDEP must be SUDEP itself. These interventions, be they pharmacologic, seizure-detection devices, or nocturnal supervision, require large numbers. Possible methods for assessing prevention measures include public health community interventions, self-management, and more traditional (and much more expensive) randomized clinical trials.

  13. Engaging stakeholders and target groups in prioritising a public health intervention: the Creating Active School Environments (CASE) online Delphi study

    PubMed Central

    Morton, Katie L; Atkin, Andrew J; Corder, Kirsten; Suhrcke, Marc; Turner, David; van Sluijs, Esther M F

    2017-01-01

    Objectives Stakeholder engagement and public involvement are considered as integral to developing effective public health interventions and is encouraged across all phases of the research cycle. However, limited guidelines and appropriate tools exist to facilitate stakeholder engagement—especially during the intervention prioritisation phase. We present the findings of an online ‘Delphi’ study that engaged stakeholders (including young people) in the process of prioritising secondary school environment-focused interventions that aim to increase physical activity. Setting Web-based data collection using an online Delphi tool enabling participation of geographically diverse stakeholders. Participants 37 stakeholders participated, including young people (age 13–16 years), parents, teachers, public health practitioners, academics and commissioners; 33 participants completed both rounds. Primary and secondary outcome measures Participants were asked to prioritise a (short-listed) selection of school environment-focused interventions (eg, standing desks, outdoor design changes) based on the criteria of ‘reach’, ‘equality’, ‘acceptability’, ‘feasibility’, ‘effectiveness’ and ‘cost’. Participants were also asked to rank the criteria and the effectiveness outcomes (eg, physical activity, academic achievement, school enjoyment) from most to least important. Following feedback along with any new information provided, participants completed round 2 4 weeks later. Results The intervention prioritisation process was feasible to conduct and comments from participants indicated satisfaction with the process. Consensus regarding intervention strategies was achieved among the varied groups of stakeholders, with ‘active lessons’ being the favoured approach. Participants ranked ‘mental health and well-being’ as the most important outcome followed by ‘enjoyment of school’. The most important criteria was ‘effectiveness’, followed by

  14. A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: a study protocol of a quasi-experimental design.

    PubMed

    Borglin, Gunilla; Gustafsson, Markus; Krona, Hans

    2011-09-23

    Pain is one of the most frequent problems among patients diagnosed with cancer. Despite the availability of effective pharmacological treatments, this group of patients often receives less than optimal treatment. Research into nurses' pain management highlights certain factors, such as lack of knowledge and attitudes and inadequate procedures for systematic pain assessment, as common barriers to effective pain management. However, educational interventions targeting nurses' pain management have shown promise. As cancer-related pain is also known to have a negative effect on vital aspects of the patient's life, as well as being commonly associated with problems such as sleep, fatigue, depression and anxiety, further development of knowledge within this area is warranted. A quasi-experimental study design will be used to investigate whether the implementation of guidelines for systematic daily pain assessments following a theory-based educational intervention will result in an improvement in knowledge and attitude among nurses. A further aim is to investigate whether the intervention that targets nurses' behaviour will improve hospital patients' perception of pain. Data regarding nurses' knowledge and attitudes to pain (primary outcome), patient perception regarding pain (secondary outcome), together with socio-demographic variables, will be collected at baseline and at four weeks and 12 weeks following the intervention. Nursing care is nowadays acknowledged as an increasingly complicated activity and "nursing complexity is such that it can be seen as the quintessential complex intervention." To be able to change and improve clinical practice thus requires multiple points of attack appropriate to meet complex challenges. Consequently, we expect the theory-based intervention used in our quasi-experimental study to improve care as well as quality of life for this group of patients and we also envisage that evidence-based guidelines targeting this patient group's pain

  15. The Effectiveness of a Technologically Facilitated Classroom-Based Early Reading Intervention: The Targeted Reading Intervention

    ERIC Educational Resources Information Center

    Amendum, Steven J.; Vernon-Feagans, Lynne; Ginsberg, Marnie C.

    2011-01-01

    The purpose of this study was to evaluate the efficacy of a classroom-teacher-delivered reading intervention for struggling readers called the Targeted Reading Intervention (TRI), designed particularly for kindergarten and first-grade teachers and their struggling students in rural, low-wealth communities. The TRI was delivered via an innovative…

  16. Target for improvement: a cluster randomised trial of public involvement in quality-indicator prioritisation (intervention development and study protocol)

    PubMed Central

    2011-01-01

    Background Public priorities for improvement often differ from those of clinicians and managers. Public involvement has been proposed as a way to bridge the gap between professional and public clinical care priorities but has not been studied in the context of quality-indicator choice. Our objective is to assess the feasibility and impact of public involvement on quality-indicator choice and agreement with public priorities. Methods We will conduct a cluster randomised controlled trial comparing quality-indicator prioritisation with and without public involvement. In preparation for the trial, we developed a 'menu' of quality indicators, based on a systematic review of existing validated indicator sets. Participants (public representatives, clinicians, and managers) will be recruited from six participating sites. In intervention sites, public representatives will be involved through direct participation (public representatives, clinicians, and managers will deliberate together to agree on quality-indicator choice and use) and consultation (individual public recommendations for improvement will be collected and presented to decision makers). In control sites, only clinicians and managers will take part in the prioritisation process. Data on quality-indicator choice and intended use will be collected. Our primary outcome will compare quality-indicator choice and agreement with public priorities between intervention and control groups. A process evaluation based on direct observation, videorecording, and participants' assessment will be conducted to help explain the study's results. The marginal cost of public involvement will also be assessed. Discussion We identified 801 quality indicators that met our inclusion criteria. An expert panel agreed on a final set of 37 items containing validated quality indicators relevant for chronic disease prevention and management in primary care. We pilot tested our public-involvement intervention with 27 participants (11 public

  17. Genetic and intervention studies implicating complement C3 as a major target for the treatment of periodontitis1

    PubMed Central

    Maekawa, Tomoki; Abe, Toshiharu; Hajishengallis, Evlambia; Hosur, Kavita B.; DeAngelis, Robert A.; Ricklin, Daniel; Lambris, John D.; Hajishengallis, George

    2014-01-01

    Chronic periodontitis is induced by a dysbiotic microbiota and leads to inflammatory destruction of tooth-supporting connective tissue and bone. The third component of complement, C3, is a point of convergence of distinct complement activation mechanisms but its involvement in periodontitis was not previously addressed. We investigated this question using two animal species models, namely, C3-deficient or wild-type mice and non-human primates (NHP) locally treated with a potent C3 inhibitor (the compstatin analog Cp40) or an inactive peptide control. In mice, C3 was required for maximal periodontal inflammation and bone loss and for the sustenance of the dysbiotic microbiota. The effect of C3 on the microbiota was therefore different from that reported for the C5a receptor, which is required for the initial induction of dysbiosis. C3-dependent bone loss was demonstrated in distinct models, including Porphyromonas gingivalis-induced periodontitis, ligature-induced periodontitis, and aging-associated periodontitis. Importantly, local treatment of NHP with Cp40 inhibited ligature-induced periodontal inflammation and bone loss, which correlated with lower gingival crevicular fluid levels of proinflammatory mediators (e.g., IL-17 and RANKL) and decreased osteoclastogenesis in bone biopsy specimens, as compared to control treatment. This is the first time, for any disease, that complement inhibition in NHP was shown to inhibit inflammatory processes that lead to osteoclastogenesis and bone loss. These data strongly support the feasibility of C3-targeted intervention for the treatment of human periodontitis. PMID:24808362

  18. An Exploratory Study of the Effects of Mind-Body Interventions Targeting Sleep on Salivary Oxytocin Levels in Cancer Survivors.

    PubMed

    Lipschitz, David L; Kuhn, Renee; Kinney, Anita Y; Grewen, Karen; Donaldson, Gary W; Nakamura, Yoshio

    2015-07-01

    Cancer survivors experience high levels of distress, associated with a host of negative psychological states, including anxiety, depression, and fear of recurrence, which often lead to sleep problems and reduction in quality of life (QOL) and well-being. As a neuropeptide hormone associated with affiliation, calmness, and well-being, oxytocin may be a useful biological measure of changes in health outcomes in cancer survivors. In this exploratory study, which comprised a subset of participants from a larger study, we evaluated (a) the feasibility and reliability of salivary oxytocin (sOT) levels in cancer survivors and (b) the effects of 2 sleep-focused mind-body interventions, mind-body bridging (MBB) and mindfulness meditation (MM), compared with a sleep hygiene education (SHE) control, on changes in sOT levels in 30 cancer survivors with self-reported sleep disturbance. Interventions were conducted in 3 sessions, once per week for 3 weeks. Saliva samples were collected at baseline, postintervention (~1 week after the last session), and at the 2-month follow-up. In this cancer survivor group, we found that intra-individual sOT levels were fairly stable across the 3 time points, of about 3 months' duration, and mean baseline sOT levels did not differ between females and males and were not correlated with age. Correlations between baseline sOT and self-report measures were weak; however, several of these relationships were in the predicted direction, in which sOT levels were negatively associated with sleep problems and depression and positively associated with cancer-related QOL and well-being. Regarding intervention effects on sOT, baseline-subtracted sOT levels were significantly larger at postintervention in the MBB group as compared with those in SHE. In this sample of cancer survivors assessed for sOT, at postintervention, greater reductions in sleep problems were noted for MBB and MM compared with that of SHE, and increases in mindfulness and self

  19. Spatial targeting of interventions against malaria.

    PubMed Central

    Carter, R.; Mendis, K. N.; Roberts, D.

    2000-01-01

    Malaria transmission is strongly associated with location. This association has two main features. First, the disease is focused around specific mosquito breeding sites and can normally be transmitted only within certain distances from them: in Africa these are typically between a few hundred metres and a kilometre and rarely exceed 2-3 kilometres. Second, there is a marked clustering of persons with malaria parasites and clinical symptoms at particular sites, usually households. In localities of low endemicity the level of malaria risk or case incidence may vary widely between households because the specific characteristics of houses and their locations affect contact between humans and vectors. Where endemicity is high, differences in human/vector contact rates between different households may have less effect on malaria case incidences. This is because superinfection and exposure-acquired immunity blur the proportional relationship between inoculation rates and case incidences. Accurate information on the distribution of malaria on the ground permits interventions to be targeted towards the foci of transmission and the locations and households of high malaria risk within them. Such targeting greatly increases the effectiveness of control measures. On the other hand, the inadvertent exclusion of these locations causes potentially effective control measures to fail. The computerized mapping and management of location data in geographical information systems should greatly assist the targeting of interventions against malaria at the focal and household levels, leading to improved effectiveness and cost-effectiveness of control. PMID:11196487

  20. Will interventions targeting conscientiousness improve aging outcomes?

    PubMed

    English, Tammy; Carstensen, Laura L

    2014-05-01

    The articles appearing in this special section discuss the role that conscientiousness may play in healthy aging. Growing evidence suggests that conscientious individuals live longer and healthier lives. However, the question remains whether this personality trait can be leveraged to improve long-term health outcomes. We argue that even though it may be possible to design therapeutic interventions that increase conscientiousness, there may be more effective and efficient ways to improve population health. We ask for evidence that a focus on conscientiousness improves behavior change efforts that target specific health-related behaviors or large-scale environmental modification.

  1. Targeting the specific vocabulary needs of at-risk preschoolers: a randomized study of the effectiveness of an educator-implemented intervention.

    PubMed

    Vuattoux, Delphine; Japel, Christa; Dion, Eric; Dupéré, Véronique

    2014-04-01

    This randomized study examined the effectiveness of a preschool stimulation program created to teach words that had been selected by considering the needs of the target population of children. Twenty-two educators and their group of at-risk preschoolers (N = 222, M age = 4.27 years) were assigned to one of two conditions: control or intervention. In the latter condition, educators had to read specifically developed storybooks to their group and conduct stimulation activities. Despite the training and support they received, educators implemented the intervention with varying degrees of fidelity. Nonetheless, intent-to-treat comparison of the two conditions indicates that children in the intervention condition learned the meaning of a much greater number of words than their peers in the control condition. In addition, efficacy subset analyses that took into account fidelity of implementation show that the greatest gains were made by children who had an educator who had implemented the intervention reliably. Strategies for scaling up the intervention and optimizing its implementation are discussed.

  2. Mobile Interventions Targeting Risky Drinking Among University Students: A Review.

    PubMed

    Berman, Anne H; Gajecki, Mikael; Sinadinovic, Kristina; Andersson, Claes

    Mobile interventions based on text messages, automated telephone programs (interactive voice response (IVR)), and smartphone apps offer a new approach targeting hazardous alcohol use in university students. This review covers seven recent studies involving college or university students that evaluated intervention efficacy in comparison to controls: four using text messages, one using IVR, and two smartphone apps. Only the study evaluating IVR reported positive results for the primary outcome. Two of the text message studies reported positive results on secondary outcomes, while the other two reported no differences in comparison to control groups. For smartphone apps, one study reported positive results on secondary outcomes, while the other showed no differences in comparison to controls for a web-based app and negative results for a native app. Further development of mobile interventions is needed for this at-risk population, both in terms of intervention content and use of robust research designs.

  3. Targeting educational interventions to clinician's stage of change.

    PubMed

    Yu, Catherine H Y; Batty, Helen P

    2010-09-01

    This before-after mixed-method study assessed the effect of a diabetes education and self-efficacy training workshop on clinician knowledge, intention and self-efficacy. This workshop demonstrated and narrowed a knowledge gap but did not change intention or self-efficacy. Neither the intervention nor the measured outcomes were targeted to clinicians' stage of change.

  4. Interventions targeting social isolation in older people: a systematic review

    PubMed Central

    2011-01-01

    Background Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. Methods Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL) were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. Results Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87% reported beneficial effects across

  5. The effect of interventions targeting screen time reduction

    PubMed Central

    Wu, Lei; Sun, Samio; He, Yao; Jiang, Bin

    2016-01-01

    Abstract Previous studies have evaluated the effectiveness of interventions aimed at screen time reduction, but the results have been inconsistent. We therefore conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to summarize the accumulating evidence of the impact of interventions targeting screen time reduction on body mass index (BMI) reduction and screen time reduction. The PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for RCTs on the effect of interventions targeting screen time reduction. The primary and secondary outcomes were the mean difference between the treatment and control groups in the changes in BMI and changes in screen viewing time. A random effects model was used to calculate the pooled mean differences. Fourteen trials including 2238 participants were assessed. The pooled analysis suggested that interventions targeting screen time reduction had a significant effect on BMI reduction (−0.15 kg/m2, P < 0.001, I2 = 0) and on screen time reduction (−4.63 h/w, P = 0.003, I2 = 94.6%). Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention was <7 months and that the types of interventions in those studies were health promotion curricula or counseling. Interventions for screen time reduction might be effective in reducing screen time and preventing excess weight. Further rigorous investigations with larger samples and longer follow-up periods are still needed to evaluate the efficacy of screen time reduction both in children and in adults. PMID:27399085

  6. The Targeted Reading Intervention (TRI): A Classroom Teacher Tier 2 Intervention to Help Struggling Readers in Early Elementary School

    ERIC Educational Resources Information Center

    Vernon-Feagans, Lynne; Amendum, Steve; Kainz, Kirsten; Ginsburg, Marnie

    2009-01-01

    The two studies presented in this report were designed to test the effectiveness of a new diagnostic-based reading intervention for classroom teachers, called the Targeted Reading Intervention (TRI). This TRI Tier 2 intervention stressed diagnostic teaching as the key to helping struggling readers make rapid progress in reading in the regular…

  7. Effectiveness of two web-based cognitive bias modification interventions targeting approach and attentional bias in gambling problems: study protocol for a pilot randomised controlled trial.

    PubMed

    Boffo, Marilisa; Willemen, Ronny; Pronk, Thomas; Wiers, Reinout W; Dom, Geert

    2017-10-03

    Disordered gamblers have phenotypical and pathological similarities to those with substance use disorders (SUD), including exaggerated automatic cognitive processing of motivationally salient gambling cues in the environment (i.e., attentional and approach bias). Cognitive bias modification (CBM) is a family of computerised interventions that have proved effective in successfully re-training these automatic cognitive biases in SUD. CBM interventions can, in principle, be administered online, thus showing potential of being a low-cost, low-threshold addition to conventional treatments. This paper presents the design of a pilot randomised controlled trial exploring the effectiveness of two web-based CBM interventions targeting attentional and approach bias towards gambling cues in a sample of Dutch and Belgian problematic and pathological gamblers. Participants (N = 182) are community-recruited adults experiencing gambling problems, who have gambled at least twice in the past 6 months and are motivated to change their gambling behaviour. After a baseline assessment session, participants are randomly assigned to one of four experimental conditions (attentional or approach bias training, or the placebo version of the two trainings) and complete six sessions of training. At baseline and before each training session, participants receive automated personalised feedback on their gambling motives and reasons to quit or reduce gambling. The post-intervention, 1-month, and 3-month follow-up assessments will examine changes in gambling behaviour, with frequency and expenditure as primary outcomes, and depressive symptoms and gambling-related attentional and approach biases as secondary outcomes. Secondary analyses will explore possible moderators (interference control capacity and trait impulsivity) and mediators (change in cognitive bias) of training effects on the primary outcomes. This study is the first to explore the effectiveness of an online CBM intervention for

  8. Foodservice employees benefit from interventions targeting barriers to food safety.

    PubMed

    York, Valerie K; Brannon, Laura A; Shanklin, Carol W; Roberts, Kevin R; Howells, Amber D; Barrett, Elizabeth B

    2009-09-01

    The number of foodborne illnesses traced to improper food handling in restaurants indicates a need for research to improve food safety in these establishments. Therefore, this 2-year longitudinal study investigated the effectiveness of traditional ServSafe (National Restaurant Association Educational Foundation, Chicago, IL) food-safety training and a Theory of Planned Behavior intervention program targeting employees' perceived barriers and attitudes toward important food-safety behaviors. The effectiveness of the training and intervention was measured by knowledge scores and observed behavioral compliance rates related to food-safety practices. Employees were observed for handwashing, thermometer usage, and proper handling of work surfaces at baseline, after receiving ServSafe training, and again after exposure to the intervention targeting barriers and negative attitudes about food-safety practices. Repeated-measures analyses of variance indicated training improved handwashing knowledge, but the intervention was necessary to improve overall behavioral compliance and handwashing compliance. Results suggest that registered dietitians; dietetic technicians, registered; and foodservice managers should implement a combination of training and intervention to improve knowledge and compliance with food-safety behaviors, rather than relying on training alone. Challenges encountered while conducting this research are discussed, and recommendations are provided for researchers interested in conducting this type of research in the future.

  9. Issues to consider when setting intervention targets with limited data for low-moisture food commodities: a peanut case study.

    PubMed

    Schaffner, Donald W; Buchanan, Robert L; Calhoun, Stephen; Danyluk, Michelle D; Harris, Linda J; Djordjevic, Darinka; Whiting, Richard C; Kottapalli, Bala; Wiedmann, Martin

    2013-02-01

    Peanuts and peanut-containing products have been linked to at least seven salmonellosis outbreaks worldwide in the past two decades. In response, the Technical Committee on Food Microbiology of the North American Branch of the International Life Sciences Institute collaborated with the American Peanut Council to convene a workshop to develop a framework for managing risk in low-moisture food commodities where large data sets are unavailable (using peanuts as the example). Workshop attendees were charged with answering questions regarding the appropriate statistical and scientific methods for setting log reduction targets with limited pathogen prevalence and concentration data, suitable quantities of data needed for determining appropriate log reduction targets, whether the requirement of a 5-log reduction in the absence of data to establish a target log reduction is appropriate, and what targeted log reduction would protect public health. This report concludes that the judgment about sufficient data is not solely scientific, but is instead a science-informed policy decision that must weigh additional societal issues. The participants noted that modeling efforts should proceed with sampling efforts, allowing one to compare various assumptions about prevalence and concentration and how they are combined. The discussions made clear that data and risk models developed for other low-moisture foods like almonds and pistachios may be applicable to peanuts. Workshop participants were comfortable with the use of a 5-log reduction for controlling risk in products like peanuts when the level of contamination of the raw ingredients is low (<1 CFU/g) and the process well controlled, even when limited data are available. The relevant stakeholders from the food safety community may eventually conclude that as additional data, assumptions, and models are developed, alternatives to a 5-log reduction might also result in the desired level of protection for peanuts and peanut

  10. "Act on Threes" Paradigm for Treatment Intensification of Type 2 Diabetes in Managed Care: Results of a Randomized Controlled Study with an Educational Intervention Targeting Improved Glycemic Control.

    PubMed

    Bieszk, Nella; Reynolds, Shannon L; Wei, Wenhui; Davis, Cralen; Kamble, Pravin; Uribe, Claudia

    2016-09-01

    Clinical inertia, which has been defined as the recognition of a problem with a patient's management but failing to act, is a concern in type 2 diabetes (T2D) because it places the patient at risk of diabetes-related complications. Despite managed care organizations making significant investment in this area, little is known about the impact of educational programs aimed at aligning patients and their physicians with diabetes guidelines and thus overcoming clinical inertia. To assess the impact of an educational intervention specifically designed to align patients and their physicians with 2012 American Diabetes Association (ADA) guidelines on glycated hemoglobin (A1c) testing frequency and insulin initiation. The "Act on Threes" educational intervention was a 12-month, randomized controlled prospective study that included Medicare Advantage patients aged 18-85 years with T2D, who received ≥ 3 oral antidiabetes drugs (OADs) and/or had A1c not at goal and/or had no recent A1c evaluation over 12 months, as identified through the analysis of administrative claims data (May 1, 2011-April 30, 2013) from the Humana database. Identified patients were randomized 3:1 to receive the Act on Threes educational intervention in conjunction with standard care (intervention group) or standard care alone (control group). For the educational intervention, patients and physicians were simultaneously mailed general and targeted information aimed at aligning them to 3 vital aspects of A1c control: timely measurement of A1c every 3 months; timely treatment intensification to meet A1c goals with treatment intensification every 3 months if A1c is not at goal; and insulin initiation when appropriate, including patients receiving ≥ 3 OADs with A1c not at goal. Control patients were only enrolled if the treating physician was not involved in the care of any patients in the intervention group. The primary outcome measures were A1c testing frequency based on the ADA standard for compliance

  11. Innovative public–private partnership to target subsidised antimalarials: a study protocol for a cluster randomised controlled trial to evaluate a community intervention in Western Kenya

    PubMed Central

    Laktabai, Jeremiah; Lesser, Adriane; Platt, Alyssa; Maffioli, Elisa; Mohanan, Manoj; Menya, Diana; Prudhomme O'Meara, Wendy; Turner, Elizabeth L

    2017-01-01

    Introduction There are concerns of inappropriate use of subsidised antimalarials due to the large number of fevers treated in the informal sector with minimal access to diagnostic testing. Targeting antimalarial subsidies to confirmed malaria cases can lead to appropriate, effective therapy. There is evidence that community health volunteers (CHVs) can be trained to safely and correctly use rapid diagnostic tests (RDTs). This study seeks to evaluate the public health impact of targeted antimalarial subsidies delivered through a partnership between CHVs and the private retail sector. Methods and analysis We are conducting a stratified cluster-randomised controlled trial in Western Kenya where 32 community units were randomly assigned to the intervention or control (usual care) arm. In the intervention arm, CHVs offer free RDT testing to febrile individuals and, conditional on a positive test result, a voucher to purchase a WHO-qualified artemisinin combination therapy (ACT) at a reduced fixed price in the retail sector. Study outcomes in individuals with a febrile illness in the previous 4 weeks will be ascertained through population-based cross-sectional household surveys at four time points: baseline, 6, 12 and 18 months postbaseline. The primary outcome is the proportion of fevers that receives a malaria test from any source (CHV or health facility). The main secondary outcome is the proportion of ACTs used by people with a malaria-positive test. Other secondary outcomes include: the proportion of ACTs used by people without a test and adherence to test results. Ethics and dissemination The protocol has been approved by the National Institutes of Health, the Moi University School of Medicine Institutional Research and Ethics Committee and the Duke University Medical Center Institutional Review Board. Findings will be reported on clinicalstrials.gov, in peer-reviewed publications and through stakeholder meetings including those with the Kenyan Ministry of

  12. Strategic targeting of advance care planning interventions: the Goldilocks phenomenon.

    PubMed

    Billings, J Andrew; Bernacki, Rachelle

    2014-04-01

    Strategically selecting patients for discussions and documentation about limiting life-sustaining treatments-choosing the right time along the end-of-life trajectory for such an intervention and identifying patients at high risk of facing end-of-life decisions-can have a profound impact on the value of advance care planning (ACP) efforts. Timing is important because the completion of an advance directive (AD) too far from or too close to the time of death can lead to end-of-life decisions that do not optimally reflect the patient's values, goals, and preferences: a poorly chosen target patient population that is unlikely to need an AD in the near future may lead to patients making unrealistic, hypothetical choices, while assessing preferences in the emergency department or hospital in the face of a calamity is notoriously inadequate. Because much of the currently studied ACP efforts have led to a disappointingly small proportion of patients eventually benefitting from an AD, careful targeting of the intervention should also improve the efficacy of such projects. A key to optimal timing and strategic selection of target patients for an ACP program is prognostication, and we briefly highlight prognostication tools and studies that may point us toward high-value AD interventions.

  13. Cancer caregiver quality of life: need for targeted intervention.

    PubMed

    Lapid, Maria I; Atherton, Pamela J; Kung, Simon; Sloan, Jeff A; Shahi, Varun; Clark, Matthew M; Rummans, Teresa A

    2016-12-01

    Caregiving can negatively impact well-being. Cancer caregivers face unique challenges given the intense nature of cancer and treatment, which increases their risk for burden, poor quality of life (QOL), and burnout. Studies to reduce caregiver burden demonstrate QOL improvement and distress reduction in the short term. However, few studies exist to address long-term benefits. We assessed changes in various QOL domains after participation in a QOL intervention for caregivers of patients having newly diagnosed advanced cancer. Our institutional review board-approved study randomized patient-caregiver dyads to either usual care or an in-person group intervention composed of six 90-min sessions of structured multidisciplinary QOL components delivered over 4 weeks, with 10 follow-up phone calls within 20 weeks. Caregivers attended four of the six sessions attended by patients. Sessions included physical therapy, coping and communication strategies, mental health education, spirituality, and social needs. Caregiver QOL (Caregiver Quality of Life Index-Cancer Scale [CQOLC] and Linear Analogue Self-Assessment [LASA]) and mood (Profile of Mood States-Brief [POMS-B]) were measured at baseline and 4, 27, and 52 weeks. Wilcoxon tests and effect sizes were used to compare the caregiver groups. Of the 131 caregivers (65 intervention and 66 usual care), 116 completed the study. Caregivers post-intervention (at 4 weeks) had improved scores on LASA Spiritual Well-being; POMS-B total score, Vigor/Activity, and Fatigue/Inertia; and CQOLC Adaptation. At long term (at 27 weeks), caregivers retained improvement in POMS-B Fatigue/Inertia and gained improvements in CQOLC Disruptiveness and Financial Concerns. Caregivers who received the intervention had higher QOL ratings for specific QOL domains but not for overall QOL. Although a comprehensive intervention was helpful, more specific, targeted interventions tailored for individual needs are recommended. Copyright © 2015 John Wiley

  14. Targeting Energy Metabolic Pathways as Therapeutic Intervention for Breast Cancer

    DTIC Science & Technology

    2012-10-01

    Intervention for Breast Cancer PRINCIPAL INVESTIGATOR: Yan Cheng, Ph.D. CONTRACTING ORGANIZATION: Pennsylvania State University...Targeting Energy Metabolic Pathways as Therapeutic Intervention for Breast Cancer 5b. GRANT NUMBER W81XWH-11-1-0649 5c. PROGRAM ELEMENT NUMBER...causes of cancer mortality in women. Current therapies for breast cancer mainly target molecular signaling pathways that promote tumor cell

  15. Are there three main subgroups within the patellofemoral pain population? A detailed characterisation study of 127 patients to help develop targeted intervention (TIPPs)

    PubMed Central

    Selfe, James; Janssen, Jessie; Callaghan, Michael; Witvrouw, Erik; Sutton, Chris; Richards, Jim; Stokes, Maria; Martin, Denis; Dixon, John; Hogarth, Russell; Baltzopoulos, Vasilios; Ritchie, Elizabeth; Arden, Nigel; Dey, Paola

    2016-01-01

    Background Current multimodal approaches for the management of non-specific patellofemoral pain are not optimal, however, targeted intervention for subgroups could improve patient outcomes. This study explores whether subgrouping of non-specific patellofemoral pain patients, using a series of low cost simple clinical tests, is possible. Method The exclusivity and clinical importance of potential subgroups was assessed by applying à priori test thresholds (1 SD) from seven clinical tests in a sample of adult patients with non-specific patellofemoral pain. Hierarchical clustering and latent profile analysis, were used to gain additional insights into subgroups using data from the same clinical tests. Results 130 participants were recruited, 127 had complete data: 84 (66%) female, mean age 26 years (SD 5.7) and mean body mass index 25.4 (SD 5.83), median (IQR) time between onset of pain and assessment was 24 (7–60) months. Potential subgroups defined by the à priori test thresholds were not mutually exclusive and patients frequently fell into multiple subgroups. Using hierarchical clustering and latent profile analysis three subgroups were identified using 6 of the 7 clinical tests. These subgroups were given the following nomenclature: (1) ‘strong’, (2) ‘weak and tighter’ and (3) ‘weak and pronated foot’. Conclusions We conclude that three subgroups of patellofemoral patients may exist based on the results of six clinical tests which are feasible to perform in routine clinical practice. Further research is needed to validate these findings in other data sets and, if supported by external validation, to see if targeted interventions for these subgroups improve patient outcomes. PMID:26834185

  16. Harvest for Healthy Kids Pilot Study: Associations between Exposure to a Farm-to-Preschool Intervention and Willingness to Try and Liking of Target Fruits and Vegetables among Low-Income Children in Head Start.

    PubMed

    Izumi, Betty T; Eckhardt, Cara L; Hallman, Jennifer A; Herro, Katherine; Barberis, Dawn A

    2015-12-01

    Most US children do not meet recommendations for daily fruit and vegetable intake. Our aim was to evaluate the hypothesis that at post-intervention, children exposed to the Harvest for Healthy Kids pilot study will have greater willingness to try and liking of target foods vs children in the comparison group, controlling for baseline differences. We conducted a quasi-experimental pilot study with comparison, low-intervention, and high-intervention groups. Pre- and post-intervention survey data were collected. The intervention period was October 2012 to May 2013. The analysis sample was 226 children within the higher-level unit sample of five participating Head Start centers (Portland, OR); 231 children dropped out of or enrolled in Head Start mid-year, were absent during or refused to participate in the assessments, or were missing covariates. The comparison group received no intervention components; the low-intervention group received foodservice modifications; the high-intervention group received foodservice modifications and nutrition education. Willingness to try and liking of target foods were tested and analyzed as binary variables. McNemar's tests were used to assess differences between pre- and post-intervention scores by intervention group. Fixed slope, random intercept multilevel logistic models were used to assess associations between intervention group and post-intervention scores controlling for covariates, adjusting for baseline values, and accounting for center level clustering. The difference between pre- and post-intervention willingness to try and liking of target foods was statistically significant for a variety of foods; for example, 44.2% of children liked rutabaga pre-intervention compared with 78.1% post-intervention (P=0.004). Multilevel modeling indicated similar associations. The Harvest for Healthy Kids pilot study suggests a positive association between the intervention and willingness to try and liking for target foods among study

  17. A home-visiting intervention targeting determinants of infant mental health: the study protocol for the CAPEDP randomized controlled trial in France

    PubMed Central

    2012-01-01

    Background Several studies suggest that the number of risk factors rather than their nature is key to mental health disorders in childhood. Method and design The objective of this multicentre randomized controlled parallel trial (PROBE methodology) is to assess the impact in a multi-risk French urban sample of a home-visiting program targeting child mental health and its major determinants. This paper describes the protocol of this study. In the study, pregnant women were eligible if they were: living in the intervention area; able to speak French, less than 26 years old; having their first child; less than 27 weeks of amenorrhea; and if at least one of the following criteria were true: less than twelve years of education, intending to bring up their child without the presence of the child’s father, and 3) low income. Participants were randomized into either the intervention or the control group. All had access to usual care in mother-child centres and community mental health services free of charge in every neighbourhood. Psychologists conducted all home visits, which were planned on a weekly basis from the 7th month of pregnancy and progressively decreasing in frequency until the child’s second birthday. Principle outcome measures included child mental health at 24 months and two major mediating variables for infant mental health: postnatal maternal depression and the quality of the caring environment. A total of 440 families were recruited, of which a subsample of 120 families received specific attachment and caregiver behaviour assessment. Assessment was conducted by an independent assessment team during home visits and, for the attachment study, in a specifically created Attachment Assessment laboratory. Discussion The CAPEDP study is the first large-scale randomised, controlled infant mental health promotion programme to take place in France. A major specificity of the program was that all home visits were conducted by specifically trained

  18. Exercise training amount and intensity effects on metabolic syndrome (from Studies of a Targeted Risk Reduction Intervention through Defined Exercise).

    PubMed

    Johnson, Johanna L; Slentz, Cris A; Houmard, Joseph A; Samsa, Gregory P; Duscha, Brian D; Aiken, Lori B; McCartney, Jennifer S; Tanner, Charles J; Kraus, William E

    2007-12-15

    Although exercise improves individual risk factors for metabolic syndrome (MS), there is little research on the effect of exercise on MS as a whole. The objective of this study was to determine how much exercise is recommended to decrease the prevalence of MS. Of 334 subjects randomly assigned, 227 finished and 171 (80 women, 91 men) had complete data for all 5 Adult Treatment Panel III-defined MS risk factors and were included in this analysis. Subjects were randomly assigned to a 6-month control or 1 of 3 eight-month exercise training groups of (1) low amount/moderate intensity (equivalent to walking approximately 19 km/week), (2) low amount/vigorous intensity (equivalent to jogging approximately 19 km/week), or (3) high amount/vigorous intensity (equivalent to jogging approximately 32 km/week). The low-amount/moderate-intensity exercise prescription improved MS relative to inactive controls (p <0.05). However, the same amount of exercise at vigorous intensity was not significantly better than inactive controls, suggesting that lower-intensity exercise may be more effective in improving MS. The high-amount/vigorous-intensity group improved MS relative to controls (p <0.0001), the low-amount/vigorous-intensity group (p = 0.001), and the moderate-intensity group (p = 0.07), suggesting an exercise-dose effect. In conclusion, a modest amount of moderate-intensity exercise in the absence of dietary changes significantly improved MS and thus supported the recommendation that adults get 30 minutes of moderate-intensity exercise every day. A higher amount of vigorous exercise had greater and more widespread benefits. Finally, there was an indication that moderate-intensity may be better than vigorous-intensity exercise for improving MS.

  19. Targeting the nucleolus for cancer intervention.

    PubMed

    Quin, Jaclyn E; Devlin, Jennifer R; Cameron, Donald; Hannan, Kate M; Pearson, Richard B; Hannan, Ross D

    2014-06-01

    The contribution of the nucleolus to cancer is well established with respect to its traditional role in facilitating ribosome biogenesis and proliferative capacity. More contemporary studies however, infer that nucleoli contribute a much broader role in malignant transformation. Specifically, extra-ribosomal functions of the nucleolus position it as a central integrator of cellular proliferation and stress signaling, and are emerging as important mechanisms for modulating how oncogenes and tumor suppressors operate in normal and malignant cells. The dependence of certain tumor cells to co-opt nucleolar processes to maintain their cancer phenotypes has now clearly been demonstrated by the application of small molecule inhibitors of RNA Polymerase I to block ribosomal DNA transcription and disrupt nucleolar function (Bywater et al., 2012 [1]). These drugs, which selectively kill tumor cells in vivo while sparing normal cells, have now progressed to clinical trials. It is likely that we have only just begun to scratch the surface of the potential of the nucleolus as a new target for cancer therapy, with "suppression of nucleolar stress" representing an emerging "hallmark" of cancer. This article is part of a Special Issue entitled: Role of the Nucleolus in Human Disease.

  20. Targeted Reading Intervention: A Coaching Model to Help Classroom Teachers with Struggling Readers

    ERIC Educational Resources Information Center

    Vernon-Feagans, Lynne; Kainz, Kirsten; Amendum, Steve; Ginsberg, Marnie; Wood, Tim; Bock, Amanda

    2012-01-01

    This study examined the effectiveness of a classroom teacher intervention, the Targeted Reading Intervention (TRI), in helping struggling readers in kindergarten and first grade. This intervention used biweekly literacy coaching in the general education classroom to help classroom teachers use diagnostic strategies with struggling readers in…

  1. Investigating maternal risk factors as potential targets of intervention to reduce socioeconomic inequality in small for gestational age: a population-based study.

    PubMed

    Hayward, Irene; Malcoe, Lorraine Halinka; Cleathero, Lesley A; Janssen, Patricia A; Lanphear, Bruce P; Hayes, Michael V; Mattman, Andre; Pampalon, Robert; Venners, Scott A

    2012-06-13

    The major aim of this study was to investigate whether maternal risk factors associated with socioeconomic status and small for gestational age (SGA) might be viable targets of interventions to reduce differential risk of SGA by socioeconomic status (socioeconomic SGA inequality) in the metropolitan area of Vancouver, Canada. This study included 59,039 live, singleton births in the Vancouver Census Metropolitan Area (Vancouver) from January 1, 2006 to September 17, 2009. To identify an indicator of socioeconomic SGA inequality, we used hierarchical logistic regression to model SGA by area-level variables from the Canadian census. We then modelled SGA by area-level average income plus established maternal risk factors for SGA and calculated population attributable SGA risk percentages (PAR%) for each variable. Associations of maternal risk factors for SGA with average income were investigated to identify those that might contribute to SGA inequality. Finally, we estimated crude reductions in the percentage and absolute differences in SGA risks between highest and lowest average income quintiles that would result if interventions on maternal risk factors successfully equalized them across income levels or eliminated them altogether. Average income produced the most linear and statistically significant indicator of socioeconomic SGA inequality with 8.9% prevalence of SGA in the lowest income quintile compared to 5.6% in the highest. The adjusted PAR% of SGA for variables were: bottom four quintiles of height (51%), first birth (32%), bottom four quintiles of average income (14%), oligohydramnios (7%), underweight or hypertension, (6% each), smoking (3%) and placental disorder (1%). Shorter height, underweight and smoking during pregnancy had higher prevalence in lower income groups. Crude models assuming equalization of risk factors across income levels or elimination altogether indicated little potential change in relative socioeconomic SGA inequality and reduction

  2. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    PubMed Central

    Piotrowicz, Karolina; Rewiuk, Krzysztof; Halicka, Monika; Kalwak, Weronika; Rybak, Paulina

    2017-01-01

    Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards). Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization), received standard care. Outcome Measures. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males) participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward. PMID:28164113

  3. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study.

    PubMed

    Gorski, Stanislaw; Piotrowicz, Karolina; Rewiuk, Krzysztof; Halicka, Monika; Kalwak, Weronika; Rybak, Paulina; Grodzicki, Tomasz

    2017-01-01

    Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards). Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization), received standard care. Outcome Measures. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males) participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.

  4. HIV behavioural interventions targeted towards older adults: a systematic review

    PubMed Central

    2014-01-01

    Background The increasing number of people living with HIV aged 50 years and older has been recognised around the world yet non-pharmacologic HIV behavioural and cognitive interventions specifically targeted to older adults are limited. Evidence is needed to guide the response to this affected group. Methods We conducted a systematic review of the available published literature in MEDLINE, Embase and the Education Resources Information Center. A search strategy was defined with high sensitivity but low specificity to identify behavioural interventions with outcomes in the areas of treatment adherence, HIV testing uptake, increased HIV knowledge and uptake of prevention measures. Data from relevant articles were extracted into excel. Results Twelve articles were identified all of which originated from the Americas. Eight of the interventions were conducted among older adults living with HIV and four for HIV-negative older adults. Five studies included control groups. Of the included studies, four focused on general knowledge of HIV, three emphasised mental health and coping, two focused on reduced sexual risk behaviour, two on physical status and one on referral for care. Only four of the studies were randomised controlled trials and seven – including all of the studies among HIV-negative older adults – did not include controls at all. A few of the studies conducted statistical testing on small samples of 16 or 11 older adults making inference based on the results difficult. The most relevant study demonstrated that using telephone-based interventions can reduce risky sexual behaviour among older adults with control reporting 3.24 times (95% CI 1.79-5.85) as many occasions of unprotected sex at follow-up as participants. Overall however, few of the articles are sufficiently rigorous to suggest broad replication or to be considered representative and applicable in other settings. Conclusions More evidence is needed on what interventions work among older adults to

  5. Integrating intervention targets offered by homeostatic theory

    PubMed Central

    Annunziato, Rachel A; Grossman, Stephanie L

    2016-01-01

    Marks presents “homeostatic theory” which proposes that weight gain is fostered by a “Circle of Discontent” consisting of body dissatisfaction, negative affect, and overconsumption. This innovative framework offers potential intervention approaches, including victim-blaming, stigma, and discrimination, as well as devalorizing the thin-ideal. Our article discusses possible ways that clinical health psychologists based in university settings may be uniquely positioned to consider and implement large-scale programs that have shown great promise for addressing these core issues. PMID:28070390

  6. A multimodal approach to investigate biomarkers for psychosis in a clinical setting: the integrative neuroimaging studies in schizophrenia targeting for early intervention and prevention (IN-STEP) project.

    PubMed

    Koike, Shinsuke; Takano, Yosuke; Iwashiro, Norichika; Satomura, Yoshihiro; Suga, Motomu; Nagai, Tatsuya; Natsubori, Tatsunobu; Tada, Mariko; Nishimura, Yukika; Yamasaki, Syudo; Takizawa, Ryu; Yahata, Noriaki; Araki, Tsuyoshi; Yamasue, Hidenori; Kasai, Kiyoto

    2013-01-01

    Longitudinal clinical investigations and biological measurements have determined not only progressive brain volumetric and functional changes especially around the onset of psychosis but also the abnormality of developmental pathways based on gene-environment interaction model. However, these studies have contributed little to clinical decisions on their diagnosis and therapeutic choices because of subtle differences between patients and healthy controls. A multi-modal approach may resolve this limitation and is favorable to explore the pathophysiology of psychosis. The integrative neuroimaging studies for schizophrenia targeting early intervention and prevention (IN-STEP) is a research project aimed at exploring the pathophysiological features of the onset of psychosis and investigating possible predictive biomarkers for the clinical treatment of psychosis. Since 2008, we have adopted blood sampling, neurocognitive batteries, neurophysiological assessment, structural imaging, and functional imaging longitudinally for help-seeking ultra-high-risk (UHR) individuals and patients with first-episode psychosis (FEP). Here, we intend to introduce the IN-STEP research study protocol and present preliminary clinical findings. Thirty-seven UHR individuals and 30 patients with FEP participated in this study. Six months later, there was no difference in objective and subjective scores between the groups, which suggests that young people having symptoms and functional deficits should be cared for regardless of their history of psychosis according to their clinical stages. The rate of transition to psychosis was 7.1%, 8.0%, and 35.3% (at 6, 12, and 24months, respectively). Through this research project, we expect to clarify the pathophysiological features around the onset of psychosis and improve the prognosis of psychosis through clinical application.

  7. Using Sensation Seeking to Target Adolescents for Substance Use Interventions

    PubMed Central

    Sargent, James D.; Tanski, Susanne; Stoolmiller, Mike; Hanewinkel, Reiner

    2009-01-01

    Aims This study examines the predictive validity of sensation seeking as a predictor of adolescent substance use, in order to optimize targeting for substance use prevention programmes. Design Longitudinal study. Setting Random digit dial telephone survey. Participants 6522 U.S. adolescents aged 10–14 years at baseline, resurveyed at 8-month intervals for 3 subsequent waves. Measurements Two outcomes were assessed--onset of binge drinking (more than 5 drinks in a short time) and established smoking (>100 cigarettes lifetime). Sensation seeking level was assessed at baseline. Logistic regression was used to predict onset of substance use at any follow-up wave as a function of sensation seeking. The receiver operating characteristic curve was used to illustrate how well sensation seeking predicted substance use as a function of different cut-off points for defining high sensation seeking, and area under the receiver operating characteristic curve (AROC) was the metric of predictive validity. Findings Of 5854 participants with one or more follow up assessments, 5634 reported no binge drinking and 5802 were not established smokers at baseline, of whom 717 (12.7% of 5634) reported binge drinking and 144 (2.5% of 5802) reported established smoking at one or more follow up interviews. Sensation seeking predicted binge drinking moderately well (AROC = 0.71 [95% CI 0.69, 0.73]) and was a significantly better predictor of established smoking onset (AROC = 0.80 [0.76, 0.83)). For binge drinking, predictive validity was significantly lower in Blacks; for established smoking it was significantly higher for Hispanics. Implications for two targeting interventions are discussed. Conclusions Sensation seeking works moderately well at identifying adolescents at risk for onset of binge drinking and established smoking. This study offers a guide for determining the appropriate targeting cut-off value, based on intervention efficacy, costs and risks. PMID:20402995

  8. The Gut Microbiome, Kidney Disease, and Targeted Interventions

    PubMed Central

    Ramezani, Ali

    2014-01-01

    The human gut harbors >100 trillion microbial cells, which influence the nutrition, metabolism, physiology, and immune function of the host. Here, we review the quantitative and qualitative changes in gut microbiota of patients with CKD that lead to disturbance of this symbiotic relationship, how this may contribute to the progression of CKD, and targeted interventions to re-establish symbiosis. Endotoxin derived from gut bacteria incites a powerful inflammatory response in the host organism. Furthermore, protein fermentation by gut microbiota generates myriad toxic metabolites, including p-cresol and indoxyl sulfate. Disruption of gut barrier function in CKD allows translocation of endotoxin and bacterial metabolites to the systemic circulation, which contributes to uremic toxicity, inflammation, progression of CKD, and associated cardiovascular disease. Several targeted interventions that aim to re-establish intestinal symbiosis, neutralize bacterial endotoxins, or adsorb gut-derived uremic toxins have been developed. Indeed, animal and human studies suggest that prebiotics and probiotics may have therapeutic roles in maintaining a metabolically-balanced gut microbiota and reducing progression of CKD and uremia-associated complications. We propose that further research should focus on using this highly efficient metabolic machinery to alleviate uremic symptoms. PMID:24231662

  9. The gut microbiome, kidney disease, and targeted interventions.

    PubMed

    Ramezani, Ali; Raj, Dominic S

    2014-04-01

    The human gut harbors >100 trillion microbial cells, which influence the nutrition, metabolism, physiology, and immune function of the host. Here, we review the quantitative and qualitative changes in gut microbiota of patients with CKD that lead to disturbance of this symbiotic relationship, how this may contribute to the progression of CKD, and targeted interventions to re-establish symbiosis. Endotoxin derived from gut bacteria incites a powerful inflammatory response in the host organism. Furthermore, protein fermentation by gut microbiota generates myriad toxic metabolites, including p-cresol and indoxyl sulfate. Disruption of gut barrier function in CKD allows translocation of endotoxin and bacterial metabolites to the systemic circulation, which contributes to uremic toxicity, inflammation, progression of CKD, and associated cardiovascular disease. Several targeted interventions that aim to re-establish intestinal symbiosis, neutralize bacterial endotoxins, or adsorb gut-derived uremic toxins have been developed. Indeed, animal and human studies suggest that prebiotics and probiotics may have therapeutic roles in maintaining a metabolically-balanced gut microbiota and reducing progression of CKD and uremia-associated complications. We propose that further research should focus on using this highly efficient metabolic machinery to alleviate uremic symptoms.

  10. Potential targets for intervention in radiation-induced heart disease.

    PubMed

    Boerma, M; Hauer-Jensen, M

    2010-11-01

    Radiotherapy of thoracic and chest wall tumors, if all or part of the heart was included in the radiation field, can lead to radiation-induced heart disease (RIHD), a late and potentially severe side effect. RIHD presents clinically several years after irradiation and manifestations include accelerated atherosclerosis, pericardial and myocardial fibrosis, conduction abnormalities, and injury to cardiac valves. The pathogenesis of RIHD is largely unknown, and a treatment is not available. Hence, ongoing pre-clinical studies aim to elucidate molecular and cellular mechanisms of RIHD. Here, an overview of recent pre-clinical studies is given, and based on the results of these studies, potential targets for intervention in RIHD are discussed.

  11. Melanoma Perception in People of Color: A Targeted Educational Intervention.

    PubMed

    Chao, Lucy X; Patterson, Stavonnie S L; Rademaker, Alfred W; Liu, Dachao; Kundu, Roopal V

    2017-06-01

    Although melanoma is more common in non-Hispanic Whites, ethnic minorities face a greater risk of melanoma-related mortality, which may be partially attributed to presentation at atypical sites and a lack of awareness. Our objective was to assess the effectiveness of a melanoma educational intervention targeted towards people of color. Participants received one of two scripted melanoma educational interventions in the summer of 2015. They completed surveys before the intervention, immediately post-intervention, and 2 months post-intervention. Dermatology clinic at an academic hospital. A consecutive sample of 100 participants who self-identified as African American, Asian, or Hispanic were recruited following their dermatology visit. In total, 70 participants completed the 2-month follow-up questionnaire. The comparison intervention group received an educational intervention using a conventional pamphlet on the 'ABCDEs' (Asymmetry, Borders, Color, Diameter, Evolution) of melanoma. The targeted intervention group received a modified pamphlet that included a skin of color section, the nomenclature "melanoma skin cancer", and an image of an individual performing a skin self-examination with the help of a friend. Melanoma knowledge, perceived risk for developing melanoma, and skin self-examination practices were assessed through self-reported questionnaires. Among the 100 participants, 78% self-identified as African American, 11% as Asian, and 11% as Hispanic. Both groups experienced a similar increase in melanoma knowledge that was retained at 2 months. Perceived personal risk for developing melanoma increased more in the targeted intervention group immediately post-intervention (p = 0.015), but this difference no longer existed between the groups at the 2-month follow-up. The targeted intervention group also demonstrated a greater increase in skin self-examinations (p = 0.048) and knowledge of warning signs to look for when examining the skin (p = 0.002) at

  12. Translating Genetic Research into Preventive Intervention: The Baseline Target Moderated Mediator Design.

    PubMed

    Howe, George W; Beach, Steven R H; Brody, Gene H; Wyman, Peter A

    2015-01-01

    In this paper we present and discuss a novel research approach, the baseline target moderated mediation (BTMM) design, that holds substantial promise for advancing our understanding of how genetic research can inform prevention research. We first discuss how genetically informed research on developmental psychopathology can be used to identify potential intervention targets. We then describe the BTMM design, which employs moderated mediation within a longitudinal study to test whether baseline levels of intervention targets moderate the impact of the intervention on change in that target, and whether change in those targets mediates causal impact of preventive or treatment interventions on distal health outcomes. We next discuss how genetically informed BTMM designs can be applied to both microtrials and full-scale prevention trials. We use simulated data to illustrate a BTMM, and end with a discussion of some of the advantages and limitations of this approach.

  13. Translating Genetic Research into Preventive Intervention: The Baseline Target Moderated Mediator Design

    PubMed Central

    Howe, George W.; Beach, Steven R. H.; Brody, Gene H.; Wyman, Peter A.

    2016-01-01

    In this paper we present and discuss a novel research approach, the baseline target moderated mediation (BTMM) design, that holds substantial promise for advancing our understanding of how genetic research can inform prevention research. We first discuss how genetically informed research on developmental psychopathology can be used to identify potential intervention targets. We then describe the BTMM design, which employs moderated mediation within a longitudinal study to test whether baseline levels of intervention targets moderate the impact of the intervention on change in that target, and whether change in those targets mediates causal impact of preventive or treatment interventions on distal health outcomes. We next discuss how genetically informed BTMM designs can be applied to both microtrials and full-scale prevention trials. We use simulated data to illustrate a BTMM, and end with a discussion of some of the advantages and limitations of this approach. PMID:26779062

  14. The Health Education for Lupus Patients Study: A Randomized Controlled Cognitive-Behavioral Intervention Targeting Psychosocial Adjustment and Quality of Life in Adolescent Females with Systemic Lupus Erythematosus

    PubMed Central

    Brown, Ronald T.; Shaftman, Stephanie R.; Tilley, Barbara C.; Anthony, Kelly K.; Kral, Mary C.; Maxson, Bonnie; Mee, Laura; Bonner, Melanie J.; Vogler, Larry B.; Schanberg, Laura E.; Connelly, Mark A.; Wagner, Janelle L.; Silver, Richard M.; Nietert, Paul J.

    2012-01-01

    Objective Examine in a randomize controlled feasibility clinical trial the efficacy of a cognitive-behavioral intervention designed to manage pain, enhance disease adjustment and adaptation, and improve quality of life among female adolescents with systemic lupus erythematosus (SLE). Methods Female adolescents (N = 53) ranging in age from 12 to 18 years were randomized to one of three groups including a cognitive-behavioral intervention, an education-only arm, and a no-contact control group. Participants were assessed at baseline, post-intervention, and at three-and six-month intervals following completion of the intervention. Results No significant differences were revealed among the three treatment arms for any of the dependent measures at any of the assessment points. For the mediator variables, a post-hoc secondary analysis did reveal increases in coping skills from baseline to post-intervention among the participants in the cognitive-behavioral intervention group compared to both the no-contact control group and the education-only group. Conclusion Although no differences were detected in the primary outcome, a possible effect on female SLE adolescent coping was detected in this feasibility study. Whether the impact of training in the area of coping was of sufficient magnitude to generalize to other areas of functioning, such as adjustment and adaptation, is unclear. Future Phase III randomized trials will be needed to assess additional coping models, and to evaluate the dose of training and its influence on pain management, adjustment, and health-related quality of life. PMID:22996139

  15. Cervical cancer screening in Malaysia: Are targeted interventions necessary?

    PubMed

    Dunn, Richard A; Tan, Andrew K G

    2010-09-01

    This study examines the determinants of Papanicolaou Smear Test (PST) screening for cervical cancer among women in Malaysia. Attention is focused on the reasons different population subgroups give for non-screening. We find that Indian women are the least likely to have had a PST and also the least likely to know the reasons why one is screened. Malay women are less likely than Chinese women to have received a PST and are more likely to report embarrassment as the reason for not being tested. Urban women are less likely than rural women to have been tested and more likely to state lack of time as the reason. These results suggest targeted interventions may be necessary to increase screening rates in Malaysia.

  16. Targeting communication interventions to decrease oncology family caregiver burden

    PubMed Central

    Wittenberg-Lyles, Elaine; Goldsmith, Joy; Oliver, Debra Parker; Demiris, George; Rankin, Anna

    2012-01-01

    Objectives The goal of this paper was to articulate and describe family communication patterns that give shape to four types of family caregivers: Manager, Carrier, Partner, and Loner. Data Sources Case studies of oncology family caregivers and hospice patients were selected from data collected as part of a larger, randomized controlled trial aimed at assessing family participation in interdisciplinary team meetings. Conclusion Each caregiver type demonstrates essential communication traits with nurses and team members; an ability to recognize these caregiver types will facilitate targeted interventions to decrease family oncology caregiver burden. Implications for Nursing Practice By becoming familiar with caregiver types, oncology nurses will be better able to address family oncology caregiver burden and the conflicts arising from family communication challenges. With an understanding of family communication patterns and its impact on caregiver burden, nurses can aid patient, family, and team to best optimize all quality of life domains for patient as well as the lead family caregiver. PMID:23107184

  17. A SYSTEMATIC REVIEW OF INTERVENTIONS TARGETING PATERNAL MENTAL HEALTH IN THE PERINATAL PERIOD.

    PubMed

    Rominov, Holly; Pilkington, Pamela D; Giallo, Rebecca; Whelan, Thomas A

    2016-05-01

    Interventions targeting parents' mental health in the perinatal period are critical due to potential consequences of perinatal mental illness for the parent, the infant, and their family. To date, most programs have targeted mothers. This systematic review explores the current status and evidence for intervention programs aiming to prevent or treat paternal mental illness in the perinatal period. Electronic databases were systematically searched to identify peer-reviewed studies that described an intervention targeting fathers' mental health in the perinatal period. Mental health outcomes included depression, anxiety, and stress as well as more general measures of psychological functioning. Eleven studies were identified. Three of five psychosocial interventions and three massage-technique interventions reported significant effects. None of the couple-based interventions reported significant effects. A number of methodological limitations were identified, including inadequate reporting of study designs, and issues with the timing of interventions. The variability in outcomes measures across the studies made it difficult to evaluate the overall effectiveness of the interventions. Father-focused interventions aimed at preventing perinatal mood problems will be improved if future studies utilize more rigorous research strategies.

  18. Targeted hepatitis C antibody testing interventions: a systematic review and meta-analysis.

    PubMed

    Aspinall, Esther Jane; Doyle, Joseph Samuel; Corson, Stephen; Hellard, Margaret Elena; Hunt, David; Goldberg, David; Nguyen, Tim; Falck-Ytter, Yngve; Morgan, Rebecca Lynn; Smith, Bryce; Stoove, Mark; Wiktor, Stefan Zbyszko; Hutchinson, Sharon

    2015-02-01

    Testing for hepatitis C virus (HCV) infection may reduce the risk of liver-related morbidity, by facilitating earlier access to treatment and care. This review investigated the effectiveness of targeted testing interventions on HCV case detection, treatment uptake, and prevention of liver-related morbidity. A literature search identified studies published up to 2013 that compared a targeted HCV testing intervention (targeting individuals or groups at increased risk of HCV) with no targeted intervention, and results were synthesised using meta-analysis. Exposure to a targeted testing intervention, compared to no targeted intervention, was associated with increased cases detected [number of studies (n) = 14; pooled relative risk (RR) 1.7, 95% CI 1.3, 2.2] and patients commencing therapy (n = 4; RR 3.3, 95% CI 1.1, 10.0). Practitioner-based interventions increased test uptake and cases detected (n = 12; RR 3.5, 95% CI 2.5, 4.8; and n = 10; RR 2.2, 95% CI 1.4, 3.5, respectively), whereas media/information-based interventions were less effective (n = 4; RR 1.5, 95% CI 0.7, 3.0; and n = 4; RR 1.3, 95% CI 1.0, 1.6, respectively). This meta-analysis provides for the first time a quantitative assessment of targeted HCV testing interventions, demonstrating that these strategies were effective in diagnosing cases and increasing treatment uptake. Strategies involving practitioner-based interventions yielded the most favourable outcomes. It is recommended that testing should be targeted at and offered to individuals who are part of a population with high HCV prevalence, or who have a history of HCV risk behaviour.

  19. Emotionally Intelligent Leadership: An Analysis of Targeted Interventions for Aspiring School Leaders in Texas

    ERIC Educational Resources Information Center

    Kearney, W. Sean; Kelsey, Cheryl; Sinkfield, Carolin

    2014-01-01

    This study measures the impact of targeted interventions on the emotional intelligence of aspiring principals. The interventions utilized were designed by Nelson and Low (2011) to increase emotionally intelligent leadership skills in the following six areas: social awareness/active listening; anxiety management; decision making; appropriate use of…

  20. Using the Instructional Level as a Criterion to Target Reading Interventions

    ERIC Educational Resources Information Center

    Parker, David C.; Burns, Matthew K.

    2014-01-01

    The instructional hierarchy offers a useful framework for targeting academic interventions. Within this framework, the accuracy with which a student reads might function as an indicator that the student should receive an intervention that focuses either on accuracy or on fluency. The current study examined whether the instructional level for…

  1. Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections

    PubMed Central

    van der Velden, Alike W; Pijpers, Eefje J; Kuyvenhoven, Marijke M; Tonkin-Crine, Sarah KG; Little, Paul; Verheij, Theo JM

    2012-01-01

    Background Antibiotic use and concomitant resistance are increasing. Literature reviews do not unambiguously indicate which interventions are most effective in improving antibiotic prescribing practice. Aim To assess the effectiveness of physician-targeted interventions aiming to improve antibiotic prescribing for respiratory tract infections (RTIs) in primary care, and to identify intervention features mostly contributing to intervention success. Design and setting Analysis of a set of physician-targeted interventions in primary care. Method A literature search (1990–2009) for studies describing the effectiveness of interventions aiming to optimise antibiotic prescription for RTIs by primary care physicians. Intervention features were extracted and effectiveness sizes were calculated. Association between intervention features and intervention success was analysed in multivariate regression analysis. Results This study included 58 studies, describing 87 interventions of which 60% significantly improved antibiotic prescribing; interventions aiming to decrease overall antibiotic prescription were more frequently effective than interventions aiming to increase first choice prescription. On average, antibiotic prescription was reduced by 11.6%, and first choice prescription increased by 9.6%. Multiple interventions containing at least ‘educational material for the physician’ were most often effective. No significant added value was found for interventions containing patient-directed elements. Communication skills training and near-patient testing sorted the largest intervention effects. Conclusion This review emphasises the importance of physician education in optimising antibiotic use. Further research should focus on how to provide physicians with the relevant knowledge and tools, and when to supplement education with additional intervention elements. Feasibility should be included in this process. PMID:23211259

  2. Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care

    PubMed Central

    2014-01-01

    Background Physical activity (PA) and nutrition are the cornerstones of diabetes management. Several reviews and meta-analyses report that PA independently produces clinically important improvements in glucose control in people with Type 2 diabetes. However, it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care. Methods This study will determine whether an evidence-informed multifaceted behaviour change intervention (Movement as Medicine for Type 2 Diabetes) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting. An open pilot study conducted in two primary care practices (phase one) will assess acceptability, feasibility and fidelity. Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures. A two-arm parallel group clustered pilot randomised controlled trial with patients from participating primary care practices in North East England will assess acceptability, feasibility, and fidelity of the intervention (versus usual clinical care) and trial processes over a 12-month period. Consultation behaviour involving fidelity of intervention delivery, diabetes and PA related knowledge, attitudes/beliefs, intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals. We will rehearse the collection of outcome data (with the focus on data yield and quality) for a future definitive trial, through outcome assessment at baseline, one, six and twelve months. An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and

  3. Is a national time target for emergency department stay associated with changes in the quality of care for acute asthma? A multicentre pre-intervention post-intervention study.

    PubMed

    Jones, Peter; Wells, Susan; Harper, Alana; LeFevre, James; Stewart, Joanna; Curtis, Elana; Reid, Papaarangi; Ameratunga, Shanthi

    2016-02-01

    There is debate whether targets for ED length of stay introduced to reduce ED overcrowding are helpful or harmful, as focus on a process target may divert attention from clinical care. Our objective was to investigate the effect of a national ED target in Aotearoa New Zealand on the recommended care for acute asthma as this is known to suffer in overcrowded departments. We conducted a retrospective chart review study across four sites from 2006 to 2012 (target introduced mid 2009). The primary outcome was time to steroids in the ED. The secondary outcomes were other aspects of asthma care in ED. We used general linear models or logistic regression as appropriate to assess care before and after the target. Among the 570 (of 1270 randomly selected cases) eligible for analysis, no difference was demonstrated in time to steroids: least square mean (95% CI) = 58.1 (49-67.5) min before and 50.4 (42.9-55.8) min after the target (P = 0.15). More patients received steroids in ED after the target, OR (95% CI) = 2.1 (1.2-4.3). No differences were demonstrated in those receiving steroid prescriptions or re-presentations: OR (95% CI) = 1.3 (0.9-1.96) and 1.1 (0.5-2.3), respectively. Changes in pre-target and post-target ED and hospital length of stay varied between hospitals. Introduction of the target was not associated with a change in times to steroids in ED, although more patients received steroids in ED indicating closer adherence to recommended practice. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  4. Protein kinases as targets for interventive biogerontology: overview and perspectives.

    PubMed

    Lai, Wing-Fu

    2012-04-01

    Protein kinases are enzymes that catalyze the transfer of γ phosphate from adenosine triphosphate to substrate proteins, and are important signal transduction mediators in a diversity of biological processes, ranging from apoptosis to energy metabolism. In this article, we will take this prominent class of proteins as an example to illustrate the involvement of proteins in modulation of aging and to highlight the prospects and challenges of protein-targeted interventions for anti-aging purposes. It is hoped that through this article, more empirical work on interventive gerontology will follow, and with collaborative endeavors among researchers, hurdles in anti-aging intervention development can be overcome in the near future. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Intervention Integrity in the Low Countries: Interventions Targeting Social-Emotional Behaviors in the School

    ERIC Educational Resources Information Center

    Taal, Margot; Ekels, Elles; van der Valk, Cindel; van der Molen, Maurits

    2017-01-01

    The current study presents a review of intervention studies conducted in the Low Countries (i.e., The Netherlands and Flanders) focusing on social-emotional behaviors in the school. The primary purpose of this review was to assess whether studies included an operational definition of the intervention under study and reported data on the…

  6. Intervention Integrity in the Low Countries: Interventions Targeting Social-Emotional Behaviors in the School

    ERIC Educational Resources Information Center

    Taal, Margot; Ekels, Elles; van der Valk, Cindel; van der Molen, Maurits

    2017-01-01

    The current study presents a review of intervention studies conducted in the Low Countries (i.e., The Netherlands and Flanders) focusing on social-emotional behaviors in the school. The primary purpose of this review was to assess whether studies included an operational definition of the intervention under study and reported data on the…

  7. Culturally tailored interventions of chronic disease targeting Korean Americans: a systematic review

    PubMed Central

    Heo, Hyun-Hee; Braun, Kathryn L.

    2017-01-01

    Objective Because little is known about promising interventions to prevent and control chronic disease in Korean Americans, we conducted a systematic literature review to investigate: (1) theoretical frameworks and strategies employed by interventions targeting Korean Americans; (2) cultural factors considered by these interventions; and (3) the extent of their success in engaging Korean participants and improving their health. Design Following the PRISMA guidelines, PubMed, PsycInfo, and Web of Science were searched to identify primary research articles evaluating interventions to prevent or control chronic disease, tailored to Korean Americans, and published from 1980 through 2011. Of 238 articles identified, 21 articles describing16 unique intervention tests met inclusion criteria. These interventions targeted cancer (10), hypertension (2), diabetes (1), mental health (1), tobacco cessation (1), and general health (1). Results All included studies were published since 2000, reflecting the relatively recent establishment of intervention research with Korean Americans. All 16 programs delivered linguistically appropriate messages and education. The 11 programs that realized significant intervention effects also provided or coordinated social support from culturally relevant and well-trained lay health workers, nurses, or family members during an intervention and/or follow-up period. Conclusions Culturally matched and linguistically appropriate messages and education may not be enough to prevent or control chronic disease among immigrant Korean Americans. Culturally sensitive and committed social support should be provided to catalyze behavioral changes and sustain the effect of the interventions. PMID:24261698

  8. Online parent-targeted cognitive-behavioural therapy intervention to improve quality of life in families of young cancer survivors: study protocol for a randomised controlled trial.

    PubMed

    Wakefield, Claire E; Sansom-Daly, Ursula M; McGill, Brittany C; McCarthy, Maria; Girgis, Afaf; Grootenhuis, Martha; Barton, Belinda; Patterson, Pandora; Osborn, Michael; Lowe, Cherie; Anazodo, Antoinette; Miles, Gordon; Cohn, Richard J

    2015-04-11

    Due to advances in multimodal therapies, most children survive cancer. In addition to the stresses of diagnosis and treatment, many families are now navigating the challenges of survivorship. Without sufficient support, the ongoing distress that parents experience after their child's cancer treatment can negatively impact the quality of life and psychological wellbeing of all family members. The 'Cascade' (Cope, Adapt, Survive: Life after C AncEr) study is a three-arm randomised controlled trial to evaluate the feasibility and efficacy of a new intervention to improve the quality of life of parents of young cancer survivors. Cascade will be compared to a peer-support group control and a 6-month waitlist control. Parents (n = 120) whose child (under 16 years of age) has completed cancer treatment in the past 1 to 12 months will be recruited from hospitals across Australia. Those randomised to receive Cascade will participate in four, weekly, 90-minute online group sessions led live by a psychologist. Cascade involves peer discussion on cognitive-behavioural coping skills, including behavioural activation, thought challenging, mindfulness and acceptance, communication and assertiveness skills training, problem-solving and goal-setting. Participants randomised to peer support will receive four, weekly, 90-minute, live, sessions of non-directive peer support. Participants will complete measures at baseline, directly post-intervention, one month post-intervention, and 6 months post-intervention. The primary outcome will be parents' quality of life. Secondary outcomes include parent depression, anxiety, parenting self-agency, and the quality of life of children in the family. The child cancer survivor and all siblings aged 7 to 15 years will be invited to complete self-report quality of life measures covering physical, emotional, social and school-related domains. This article reviews the empirical rationale for group-based, online cognitive-behavioural therapy in

  9. A Review of Culturally Targeted/Tailored Tobacco Prevention and Cessation Interventions for Minority Adolescents

    PubMed Central

    Singh, Nisha; Krishnan-Sarin, Suchitra

    2012-01-01

    Aim: Emerging racial/ethnic disparities in tobacco use behaviors and resulting long-term health outcomes highlight the importance of developing culturally tailored/targeted tobacco prevention and cessation interventions. This manuscript describes the efficacy and the components of prevention and cessation interventions developed for minority adolescents. Methods: Thirteen studies focused on culturally tailoring and targeting tobacco prevention/cessation interventions were selected and information on intervention design (type, number of sessions), setting (school or community), theoretical constructs, culture-specific components (surface/deep structures), and treatment outcomes were extracted. Results: Of the 13 studies, 5 focused on prevention, 4 on cessation, and 4 combined prevention and cessation, and most of the studies were primarily school-based, while a few used community locations. Although diverse minority groups were targeted, a majority of the studies (n = 6) worked with Hispanic adolescents. The most common theoretical construct examined was the Social Influence Model (n = 5). The overall findings indicated that culturally tailoring cessation interventions did not appear to improve tobacco quit rates among minority adolescents, but culturally tailored prevention interventions appeared to produce lower tobacco initiation rates among minority adolescents than control conditions. Conclusions: The results of review suggest that there is a critical need to develop better interventions to reduce tobacco use among minority adolescents and that developing a better understanding of cultural issues related to both cessation and initiation of tobacco use among minority populations is a key component of this endeavor. PMID:22614548

  10. An assessment of interventions that target risk factors for elder abuse.

    PubMed

    Day, Andrew; Boni, Nadia; Evert, Helen; Knight, Tess

    2017-09-01

    Although there is increasing concern about both the prevalence of, and harms associated with the abuse of older adults, progress in the development of interventions to prevent its occurrence has been slow. This paper reports the findings of a systematic review of the published literature that identified studies in which the outcomes of preventative interventions are described. A total of eight different intervention trials, published since 2004, are described across the primary, secondary and tertiary levels of prevention and in terms of the types of risk factor that they target. The current evidence to support the effectiveness of these interventions is not only limited by the small number of outcome studies but also the poor quality of evaluation designs and the focus of many interventions on single risk factors. It is concluded that work is needed to strengthen the evidence base that supports the delivery of interventions to prevent elder abuse. © 2016 John Wiley & Sons Ltd.

  11. Implementation of targeted medication adherence interventions within a community chain pharmacy practice: The Pennsylvania Project.

    PubMed

    Bacci, Jennifer L; McGrath, Stephanie Harriman; Pringle, Janice L; Maguire, Michelle A; McGivney, Melissa Somma

    2014-01-01

    To identify facilitators and barriers to implementing targeted medication adherence interventions in community chain pharmacies, and describe adaptations of the targeted intervention and organizational structure within each individual pharmacy practice. Qualitative study. Central and western Pennsylvania from February to April 2012. Rite Aid pharmacists staffed at the 118 Pennsylvania Project intervention sites. Qualitative analysis of pharmacists' perceptions of facilitators and barriers experienced, targeted intervention and organizational structure adaptations implemented, and training and preparation prior to implementation. A total of 15 key informant interviews were conducted from February to April 2012. Ten pharmacists from "early adopter" practices and five pharmacists from "traditionalist" practices were interviewed. Five themes emerged regarding the implementation of targeted interventions, including all pharmacists' need to understand the relationship of patient care programs to their corporation's vision; providing individualized, continual support and mentoring to pharmacists; anticipating barriers before implementation of patient care programs; encouraging active patient engagement; and establishing best practices regarding implementation of patient care services. This qualitative analysis revealed that there are a series of key steps that can be taken before the execution of targeted interventions that may promote successful implementation of medication therapy management in community chain pharmacies.

  12. Improving Student Outcomes in Higher Education: The Science of Targeted Intervention.

    PubMed

    Harackiewicz, Judith M; Priniski, Stacy J

    2017-09-20

    Many theoretically based interventions have been developed over the past two decades to improve educational outcomes in higher education. Based in social-psychological and motivation theories, well-crafted interventions have proven remarkably effective because they target specific educational problems and the processes that underlie them. In this review, we evaluate the current state of the literature on targeted interventions in higher education with an eye to emerging theoretical and conceptual questions about intervention science. We review three types of interventions, which focus on the value students perceive in academic tasks, their framing of academic challenges, and their personal values, respectively. We consider interventions that (a) target academic outcomes (e.g., grades, major or career plans, course taking, retention) in higher education, as well as the pipeline to college, and (b) have been evaluated in at least two studies. Finally, we discuss implications for intervention science moving forward. Expected final online publication date for the Annual Review of Psychology Volume 69 is January 4, 2018. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

  13. Qualitative methods to ensure acceptability of behavioral and social interventions to the target population

    PubMed Central

    Ayala, Guadalupe X.; Elder, John P.

    2013-01-01

    This paper introduces qualitative methods for assessing the acceptability of an intervention. Acceptability refers to determining how well an intervention will be received by the target population and the extent to which the new intervention or its components might meet the needs of the target population and organizational setting. In this paper, we focus on two common qualitative methods for conducting acceptability research and their advantages and disadvantages: focus groups and interviews. We provide examples from our own research and other studies to demonstrate the use of these methods for conducting acceptability research and how one might adapt this approach for oral health research. Finally, we present emerging methods for conducting acceptability research, including the use of community-based participatory research, as well as the utility of conducting acceptability research for assessing the appropriateness of measures in intervention research. PMID:21656958

  14. Identifying early intervention targets for children with autism in inclusive school settings.

    PubMed

    Koegel, L K; Koegel, R L; Frea, W D; Fredeen, R M

    2001-10-01

    This study assessed play and social behavior of young children with autism in inclusive school settings to identify important targets for intervention. Data were collected for five children with autism and for typically developing peers. All children with autism received intervention in one-on-one settings but did not have individual education plan goals that provided systematic intervention for developing play and social skills in their school settings. Results indicated the children with autism and their typically developing peers played with a comparable number of stimulus items (e.g., toys), but the children with autism engaged in these activities for shorter durations. Both children with autism and their typically developing peers engaged in similar levels of social interaction with adults. However, the children with autism rarely or never engaged in social interactions with their peers, whereas the typically developing peers frequently engaged in social interactions with other children. The results suggest important targets for intervention.

  15. Longitudinal Follow-Up of Children with Autism Receiving Targeted Interventions on Joint Attention and Play

    ERIC Educational Resources Information Center

    Kasari, Connie; Gulsrud, Amanda; Freeman, Stephanny; Paparella, Tanya; Hellemann, Gerhard

    2012-01-01

    Objective: This study examines the cognitive and language outcomes of children with an autism spectrum disorder (ASD) over a 5-year period after receiving targeted early interventions that focused on joint attention and play skills. Method: Forty children from the original study (n = 58) had complete data at the 5-year follow-up. Results: In all,…

  16. Longitudinal Follow-Up of Children with Autism Receiving Targeted Interventions on Joint Attention and Play

    ERIC Educational Resources Information Center

    Kasari, Connie; Gulsrud, Amanda; Freeman, Stephanny; Paparella, Tanya; Hellemann, Gerhard

    2012-01-01

    Objective: This study examines the cognitive and language outcomes of children with an autism spectrum disorder (ASD) over a 5-year period after receiving targeted early interventions that focused on joint attention and play skills. Method: Forty children from the original study (n = 58) had complete data at the 5-year follow-up. Results: In all,…

  17. The effectiveness of interventions targeting the stigma of mental illness at the workplace: a systematic review.

    PubMed

    Hanisch, Sabine E; Twomey, Conal D; Szeto, Andrew C H; Birner, Ulrich W; Nowak, Dennis; Sabariego, Carla

    2016-01-06

    The majority of people experiencing mental-health problems do not seek help, and the stigma of mental illness is considered a major barrier to seeking appropriate treatment. More targeted interventions (e.g. at the workplace) seem to be a promising and necessary supplement to public campaigns, but little is known about their effectiveness. The aim of this systematic review is to provide an overview of the evidence on the effectiveness of interventions targeting the stigma of mental illness at the workplace. Sixteen studies were included after the literature review. The effectiveness of anti-stigma interventions at the workplace was assessed by examining changes in: (1) knowledge of mental disorders and their treatment and recognition of signs/symptoms of mental illness, (2) attitudes towards people with mental-health problems, and (3) supportive behavior. The results indicate that anti-stigma interventions at the workplace can lead to improved employee knowledge and supportive behavior towards people with mental-health problems. The effects of interventions on employees' attitudes were mixed, but generally positive. The quality of evidence varied across studies. This highlights the need for more rigorous, higher-quality evaluations conducted with more diverse samples of the working population. Future research should explore to what extent changes in employees' knowledge, attitudes, and supportive behavior lead to affected individuals seeking help earlier. Such investigations are likely to inform important stakeholders about the potential benefits of current workplace anti-stigma interventions and provide guidance for the development and implementation of effective future interventions.

  18. Characteristics of interventions targeting multiple lifestyle risk behaviours in adult populations: a systematic scoping review.

    PubMed

    King, Kristel; Meader, Nick; Wright, Kath; Graham, Hilary; Power, Christine; Petticrew, Mark; White, Martin; Sowden, Amanda J

    2015-01-01

    Modifiable lifestyle risk behaviours such as smoking, unhealthy diet, physical inactivity and alcohol misuse are the leading causes of major, non-communicable diseases worldwide. It is increasingly being recognised that interventions which target more than one risk behaviour may be an effective and efficient way of improving people's lifestyles. To date, there has been no attempt to summarise the global evidence base for interventions targeting multiple risk behaviours. To identify and map the characteristics of studies evaluating multiple risk behaviour change interventions targeted at adult populations in any country. Seven bibliographic databases were searched between January, 1990, and January/ May, 2013. Authors of protocols, conference abstracts, and other relevant articles were contacted. Study characteristics were extracted and inputted into Eppi-Reviewer 4. In total, 220 studies were included in the scoping review. Most were randomised controlled trials (62%) conducted in the United States (49%), and targeted diet and physical activity (56%) in people from general populations (14%) or subgroups of general populations (45%). Very few studies had been conducted in the Middle East (2%), Africa (0.5%), or South America (0.5%). There was also a scarcity of studies conducted among young adults (1%), or racial and minority ethnic populations (4%) worldwide. Research is required to investigate the interrelationships of lifestyle risk behaviours in varying cultural contexts around the world. Cross-cultural development and evaluation of multiple risk behaviour change interventions is also needed, particularly in populations of young adults and racial and minority ethnic populations.

  19. A Behavioral Intervention to Reduce Child Exposure to Indoor Air Pollution: Identifying Possible Target Behaviors

    ERIC Educational Resources Information Center

    Barnes, Brendon R.; Mathee, Angela; Shafritz, Lonna B.; Krieger, Laurie; Zimicki, Susan

    2004-01-01

    Indoor air pollution has been causally linked to acute lower respiratory infections in children younger than 5. The aim of this study was to identify target behaviors for a behavioral intervention to reduce child exposure to indoor air pollution by attempting to answer two research questions: Which behaviors are protective of child respiratory…

  20. Personality-Targeted Interventions Delay the Growth of Adolescent Drinking and Binge Drinking

    ERIC Educational Resources Information Center

    Conrod, Patricia J.; Castellanos, Natalie; Mackie, Clare

    2008-01-01

    Background: Personality factors are implicated in the vulnerability to adolescent alcohol misuse. This study examined whether providing personality-targeted interventions in early adolescence can delay drinking and binge drinking in high-risk youth. Methods: A randomised control trial was carried out with 368 adolescents recruited from years 9 and…

  1. A Behavioral Intervention to Reduce Child Exposure to Indoor Air Pollution: Identifying Possible Target Behaviors

    ERIC Educational Resources Information Center

    Barnes, Brendon R.; Mathee, Angela; Shafritz, Lonna B.; Krieger, Laurie; Zimicki, Susan

    2004-01-01

    Indoor air pollution has been causally linked to acute lower respiratory infections in children younger than 5. The aim of this study was to identify target behaviors for a behavioral intervention to reduce child exposure to indoor air pollution by attempting to answer two research questions: Which behaviors are protective of child respiratory…

  2. Personality-Targeted Interventions Delay the Growth of Adolescent Drinking and Binge Drinking

    ERIC Educational Resources Information Center

    Conrod, Patricia J.; Castellanos, Natalie; Mackie, Clare

    2008-01-01

    Background: Personality factors are implicated in the vulnerability to adolescent alcohol misuse. This study examined whether providing personality-targeted interventions in early adolescence can delay drinking and binge drinking in high-risk youth. Methods: A randomised control trial was carried out with 368 adolescents recruited from years 9 and…

  3. Targeting young drinkers online: the effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among college students: study protocol of a two-arm parallel group randomized controlled trial.

    PubMed

    Voogt, Carmen V; Poelen, Evelien A P; Kleinjan, Marloes; Lemmers, Lex A C J; Engels, Rutger C M E

    2011-04-14

    The prevalence of heavy drinking among college students and its associated health related consequences highlights an urgent need for alcohol prevention programs targeting 18 to 24 year olds. Nevertheless, current alcohol prevention programs in the Netherlands pay surprisingly little attention to the drinking patterns of this specific age group. The study described in this protocol will test the effectiveness of a web-based brief alcohol intervention that is aimed at reducing alcohol use among heavy drinking college students aged 18 to 24 years old. The effectiveness of the What Do You Drink web-based brief alcohol intervention will be tested among 908 heavy drinking college students in a two-arm parallel group randomized controlled trial. Participants will be allocated at random to either the experimental (N=454: web-based brief alcohol intervention) or control condition (N=454: no intervention). The primary outcome measure will be the percentage of participants who drink within the normative limits of the Dutch National Health Council for low-risk drinking. These limits specify that, for heavy alcohol use, the mean consumption cannot exceed 14 or 21 glasses of standard alcohol units per week for females and males, respectively, while for binge drinking, the consumption cannot exceed five or more glasses of standard alcohol units on one drinking occasion at least once per week within one month and six months after the intervention. Reductions in mean weekly alcohol consumption and frequency of binge drinking are also primary outcome measures. Weekly Ecological Momentary Assessment will measure alcohol-related cognitions, that is, attitudes, self-efficacy, subjective norms and alcohol expectancies, which will be included as the secondary outcome measures. This study protocol describes the two-arm parallel group randomized controlled trial developed to evaluate the effectiveness of a web-based brief alcohol intervention. We expect a reduction of mean weekly alcohol

  4. Medication Adherence Interventions That Target Subjects with Adherence Problems: Systematic Review and Meta-analysis

    PubMed Central

    Conn, Vicki S.; Ruppar, Todd M.; Enriquez, Maithe; Cooper, Pam

    2015-01-01

    Background Inadequate medication adherence is a pervasive, under-recognized cause of poor health outcomes. Many intervention trials designed to improve medication adherence have targeted adults with adherence problems. No previous reviews have synthesized the effectiveness of medication adherence interventions focused on subjects with medication adherence difficulties. Objective This systematic review and meta-analysis synthesized findings from medication adherence intervention studies conducted among adults with medication adherence difficulties. Methods Primary research studies were eligible for inclusion if they tested an intervention designed to increase medication adherence among adults with documented adherence difficulties and reported medication adherence behavior outcomes. Comprehensive search strategies of 13 computerized databases, author and ancestry searches, and hand searches of 57 journals were used to locate eligible primary research. Participant demographics, intervention characteristics, and methodological features were reliably coded from reports along with medication adherence outcomes. Effect sizes for outcomes were calculated as standardized mean differences, and random effects models were used to estimate overall mean effects. Exploratory dichotomous and continuous variable moderator analyses were employed to examine potential associations between medication adherence effect size and sample, intervention, and methodological characteristics. Results Data were extracted from 53 reports of studies involving 8,243 individual primary study participants. The overall standardized mean difference effect size for treatment vs. control subjects was 0.301. For treatment pre- vs. post-intervention comparisons, the overall effect size was 0.533. Significantly larger effect sizes were associated with interventions incorporating prompts to take medications than interventions lacking medication prompts (0.497 vs. 0.234). Larger effect sizes were also found

  5. Efficacy of rosuvastatin in achieving target HDL, LDL, triglycerides and total cholesterol levels in type 2 diabetes mellitus (T2DM) with newly diagnosed dyslipidaemia: an open label, nonrandomised, non-interventional and observational study in India.

    PubMed

    Shah, Siddharth N; Arneja, Jaspal

    2013-10-01

    Asian Indians with dyslipidaemia should be treated as aggressively as if they had a CHD risk equivalent-similar to the treatment of patients with diabetes or heart disease. To evaluate efficacy of Rosuvastatin in achieving target HDL, LDL, triglycerides and total cholesterol levels in type 2 diabetes mellitus (T2DM) patients with newly diagnosed dyslipidaemia, but without known coronary artery disease. The study was an open label, nonrandomised, non-interventional, observational study in India involving T2DM patients who require statin therapy to control dyslipidaemia. Data were collected at baseline, interim (8 weeks) and subsequently at 16 weeks of Rosuvastatin (10 and 20 mg) therapy. Efficacy of the treatment was assessed by evaluating whether subjects reached target LDL and total cholesterol levels according to NCEP ATP III guidelines. Four thousand three hundred and sixty-nine patients completed the study. Out of 4369, 1115 (25.52%) have achieved a target LDL level of < 100 mg/dL and 2930 (67.06%) falls under HDL level of 40-60 mg/dL.The mean change in HDL levels was 5.56 mg/dL in females and 4.59 mg/dL in males. Overall 63.95% of patients had achieved the total cholesterol target and 50.06% achieved triglyceride target. The adverse events reported were generally mild. On the basis of the above results, it can be concluded that Rosuvastatin safely and beneficially alters the entire spectrum of lipoproteins in Indian patients.

  6. Family-Based Interventions Targeting Childhood Obesity: A Meta-Analysis

    PubMed Central

    Everts, Jessie C.

    2011-01-01

    Abstract Background: With the rising prevalence of childhood obesity over the last several decades, and the call for more family-based intervention research to combat childhood obesity, it is important to examine the extant research on family-based interventions in order to make recommendations and improve future research. Objective: To conduct a meta-analysis of family-based interventions targeting childhood obesity in the last decade in order to inform the research in the next decade. Methods: A literature review was conducted between December 2009-April 2010. Studies published between the years 2000–2009 that used family-based interventions to treat childhood obesity were included. A total of 20 studies met inclusionary criteria. Results: Although results varied by study design, the majority of studies had a moderate to large effect size for change in the target child's BMI (BMI percentile, zBMI, percent overweight) after participating in a family-based intervention. Long-term change varied by study, but the majority of studies produced sustainable change in child BMI, although smaller effect sizes. Change in secondary variables (dietary intake, sugar-sweetened beverage intake, physical activity) were substantially different between studies and are reported as trends. Conclusion: To date, there is preliminary evidence suggesting that family-based interventions targeting childhood obesity are successful in producing weight loss in the short and long-term. Including families in weight loss treatment of obese children warrants further implementation and study. Limitations with the research, recommendations for future research, and implications for practitioners working with overweight/obese children are discussed. PMID:26182126

  7. Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: a systematic review

    PubMed Central

    BAUER, ISABELLE E.; GÁLVEZ, JUAN F.; HAMILTON, JANE E.; BALANZÁ-MARTÍNEZ, VICENT; ZUNTA-SOARES, GIOVANA; SOARES, JAIR C.; MEYER, THOMAS D.

    2015-01-01

    Background Bipolar disorder (BD) is a serious mental illness associated with a high risk of medical comorbidities, long-term disability and premature death. This systematic review examined the current literature on therapeutic interventions targeting nutrition and physical activity in BD and collecting health-related measures such as mood and course of illness. Methods Scopus (all databases), Pubmed and Ovid Medline were systematically searched with no language or year restrictions, up to June 2015, for studies focusing on lifestyle interventions in BD. Search terms were related to bipolar disorder, nutrition, physical activity, wellbeing, psychosocial interventions and course of illness. We hand searched content pages of Bipolar Disorders and Journal of Affective Disorders and checked references of relevant reviews and dissertations to identify additional papers. Results After applying inclusion and exclusion criteria to identified hits, this literature search retrieved six papers. Overall findings point towards a beneficial role of lifestyle interventions on mood, weight, blood pressure, lipid profile, physical activity and overall wellbeing. Methodological limitations include small sample size, gender ratio imbalance, inconsistencies in terms of laboratory measures, and lack of randomized control trials and absence of follow-up and longitudinal studies to determine the benefits of these factors on clinical and functional outcomes over time Conclusions Lifestyle interventions in BD targeting nutrition, exercise, wellbeing alongside beliefs, coping strategies and attitudes towards health show promise in reducing the risk of comorbid ailments in BD. There is still a strong need for studies a) developing interventions which are informed by the patient’s input and b) examining the effectiveness of such interventions targeting general wellness using well-controlled trials. PMID:26724541

  8. The effect of interventions targeting screen time reduction: A systematic review and meta-analysis.

    PubMed

    Wu, Lei; Sun, Samio; He, Yao; Jiang, Bin

    2016-07-01

    Previous studies have evaluated the effectiveness of interventions aimed at screen time reduction, but the results have been inconsistent. We therefore conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to summarize the accumulating evidence of the impact of interventions targeting screen time reduction on body mass index (BMI) reduction and screen time reduction. The PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for RCTs on the effect of interventions targeting screen time reduction. The primary and secondary outcomes were the mean difference between the treatment and control groups in the changes in BMI and changes in screen viewing time. A random effects model was used to calculate the pooled mean differences. Fourteen trials including 2238 participants were assessed. The pooled analysis suggested that interventions targeting screen time reduction had a significant effect on BMI reduction (-0.15 kg/m, P < 0.001, I = 0) and on screen time reduction (-4.63 h/w, P = 0.003, I = 94.6%). Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention was <7 months and that the types of interventions in those studies were health promotion curricula or counseling. Interventions for screen time reduction might be effective in reducing screen time and preventing excess weight. Further rigorous investigations with larger samples and longer follow-up periods are still needed to evaluate the efficacy of screen time reduction both in children and in adults.

  9. Evaluation design for a complex intervention program targeting loneliness in non-institutionalized elderly Dutch people

    PubMed Central

    2010-01-01

    Background The aim of this paper is to provide the rationale for an evaluation design for a complex intervention program targeting loneliness among non-institutionalized elderly people in a Dutch community. Complex public health interventions characteristically use the combined approach of intervening on the individual and on the environmental level. It is assumed that the components of a complex intervention interact with and reinforce each other. Furthermore, implementation is highly context-specific and its impact is influenced by external factors. Although the entire community is exposed to the intervention components, each individual is exposed to different components with a different intensity. Methods/Design A logic model of change is used to develop the evaluation design. The model describes what outcomes may logically be expected at different points in time at the individual level. In order to address the complexity of a real-life setting, the evaluation design of the loneliness intervention comprises two types of evaluation studies. The first uses a quasi-experimental pre-test post-test design to evaluate the effectiveness of the overall intervention. A control community comparable to the intervention community was selected, with baseline measurements in 2008 and follow-up measurements scheduled for 2010. This study focuses on changes in the prevalence of loneliness and in the determinants of loneliness within individuals in the general elderly population. Complementarily, the second study is designed to evaluate the individual intervention components and focuses on delivery, reach, acceptance, and short-term outcomes. Different means of project records and surveys among participants are used to collect these data. Discussion Combining these two evaluation strategies has the potential to assess the effectiveness of the overall complex intervention and the contribution of the individual intervention components thereto. PMID:20836840

  10. The quality and effectiveness of interventions that target multiple risk factors among young people: a systematic review

    PubMed Central

    Shakeshaft, Anthony; Havard, Alys; Maple, Myfanwy; Foley, Catherine; Shakeshaft, Bernie

    2016-01-01

    Abstract Objective: To identify evaluations of interventions that target multiple risk factors in high‐risk young people, describe their characteristics, critique their methodological quality and summarise their effectiveness. Methods: A search of the literature published between 2009 and 2014 identified 13 evaluations of interventions that targeted multiple risk factors, compared to 95 evaluations that targeted single risk factors. The methodological adequacy of the 13 evaluation studies was analysed using the Quality Assessment Tool for Quantitative Studies and information regarding characteristics and intervention effectiveness was extracted and summarised. Results: There were very few outcome evaluation studies of interventions that targeted multiple risk factors, relative to single risk factors, among high‐risk young people. Of the identified studies, half were methodologically weak. Interventions delivered in community settings targeted a greater number of risk factors, while those delivered in a school or health setting reported a higher proportion of statistically significant outcomes. No economic analyses were conducted. Conclusions and Implications for Public Health: More methodologically rigorous evaluations of interventions targeting multiple risk factors among high‐risk young people are required, especially for those delivered in community settings. Four key areas for improvement are: i) more precisely defining the risk factors experienced by high‐risk young people; ii) achieving greater consistency across interventions; iii) standardising outcome measures; and iv) conducting economic analyses. PMID:27624886

  11. The quality and effectiveness of interventions that target multiple risk factors among young people: a systematic review.

    PubMed

    Knight, Alice; Shakeshaft, Anthony; Havard, Alys; Maple, Myfanwy; Foley, Catherine; Shakeshaft, Bernie

    2017-02-01

    To identify evaluations of interventions that target multiple risk factors in high-risk young people, describe their characteristics, critique their methodological quality and summarise their effectiveness. A search of the literature published between 2009 and 2014 identified 13 evaluations of interventions that targeted multiple risk factors, compared to 95 evaluations that targeted single risk factors. The methodological adequacy of the 13 evaluation studies was analysed using the Quality Assessment Tool for Quantitative Studies and information regarding characteristics and intervention effectiveness was extracted and summarised. There were very few outcome evaluation studies of interventions that targeted multiple risk factors, relative to single risk factors, among high-risk young people. Of the identified studies, half were methodologically weak. Interventions delivered in community settings targeted a greater number of risk factors, while those delivered in a school or health setting reported a higher proportion of statistically significant outcomes. No economic analyses were conducted. Conclusions and Implications for Public Health: More methodologically rigorous evaluations of interventions targeting multiple risk factors among high-risk young people are required, especially for those delivered in community settings. Four key areas for improvement are: i) more precisely defining the risk factors experienced by high-risk young people; ii) achieving greater consistency across interventions; iii) standardising outcome measures; and iv) conducting economic analyses. © 2016 The Authors.

  12. Cost-effectiveness of targeted versus tailored interventions to promote mammography screening among women military veterans in the United States.

    PubMed

    Lairson, David R; Chan, Wen; Chang, Yu-Chia; del Junco, Deborah J; Vernon, Sally W

    2011-05-01

    We conducted an economic evaluation of mammography promotion interventions in a population-based, nationally representative sample of 5500 women veterans. Women 52 years and older were randomly selected from the National Registry of Women Veterans and randomly assigned to a survey-only control group and two intervention groups that varied in the extent of personalization (tailored vs. targeted). Effectiveness measures were the prevalence of at least one self-reported post-intervention mammogram and two post-intervention mammograms 6-15 months apart. Incremental cost-effectiveness ratios (ICERs) were the incremental cost per additional person screened. Uncertainty was examined with sensitivity analysis and bootstrap simulation. The targeted intervention cost $25 per person compared to $52 per person for the tailored intervention. About 27% of the cost was incurred in identifying and recruiting the eligible population. The percent of women reporting at least one mammogram were .447 in the control group, .469 in the targeted group, and .460 in the tailored group. The ICER was $1116 comparing the targeted group to the control group (95% confidence interval (CI)=$493 to dominated). The tailored intervention was dominated (more costly and less effective) by the targeted intervention. Decision-makers should consider effectiveness evidence and the full recruitment and patient time costs associated with the implementation of screening interventions when making investments in mammography screening promotion programs. Identification and recruitment of eligible participants add substantial costs to outreach screening promotion interventions. Tailoring adds substantial cost to the targeted mammography promotion strategy without a commensurate increase in effectiveness. Although cost-effectiveness has been reported to be higher for some in-reach screening promotion interventions, a recent meta-analysis revealed significant heterogeneity in the effect sizes of published health

  13. Cost-Effectiveness of Targeted vs. Tailored Interventions to Promote Mammography Screening Among Women Military Veterans in the United States

    PubMed Central

    Lairson, David R.; Chan, Wen; Chang, Yu-Chia; del Junco, Deborah J.; Vernon, Sally W.

    2010-01-01

    Objective We conducted an economic evaluation of mammography promotion interventions in a population-based, nationally representative sample of 5,500 women veterans. Methods Women 52 years and older were randomly selected from the National Registry of Women Veterans and randomly assigned to a survey-only control group and two intervention groups that varied in the extent of personalization (tailored vs. targeted). Effectiveness measures were the prevalence of at least one self-reported post-intervention mammogram and two post-intervention mammograms 6-15 months apart. Incremental cost effectiveness ratios (ICERs) were the incremental cost per additional person screened. Uncertainty was examined with sensitivity analysis and bootstrap simulation. Results The targeted intervention cost $25 per person compared to $52 per person for the tailored intervention. About 27 percent of the cost was incurred in identifying and recruiting the eligible population. The percent of women reporting at least one mammogram were .447 in the control group, .469 in the targeted group, and .460 in the tailored group. The ICER was $1,116 comparing the targeted group to the control group (95% confidence interval (CI) = $493 to dominated). The tailored intervention was dominated (more costly and less effective) by the targeted intervention. Conclusion Decision-makers should consider effectiveness evidence and the full recruitment and patient time costs associated with the implementation of screening interventions when making investments in mammography screening promotion programs. Identification and recruitment of eligible participants add substantial costs to out-reach screening promotion interventions. Tailoring adds substantial cost to the targeted mammography promotion strategy without a commensurate increase in effectiveness. Although cost-effectiveness has been reported to be higher for some in-reach screening promotion interventions, a recent meta-analysis revealed significant

  14. Decreasing antibiotic use through a joint intervention targeting physicians and pharmacists.

    PubMed

    Roque, Fátima; Teixeira-Rodrigues, António; Breitenfeld, Luiza; Piñeiro-Lamas, Maria; Figueiras, Adolfo; Herdeiro, Maria Teresa

    2016-07-01

    To decrease population antibiotic use through an educational intervention targeting primary care physicians' and community pharmacists' attitudes and knowledge. We designed a pragmatic cluster-randomized trial covering all National Health System primary care physicians and all community pharmacists' in a region in the north of Portugal. The study protocol was registered on ClinicalTrials.gov (identifier: NCT02173509). After adjustment for baseline values and comparison with the control group, the intervention was associated with a significant reduction in overall antibiotic use in the year following the intervention. The effect was most marked for tetracyclines, macrolides and cephalosporins. No statistically significant differences were observed for fluoroquinolone consumption. Multifaceted interventions involving physicians, pharmacists and general public proved effective in reducing antibiotic consumption in the population.

  15. A trial of an iPad™ intervention targeting social communication skills in children with autism.

    PubMed

    Fletcher-Watson, Sue; Petrou, Alexandra; Scott-Barrett, Juliet; Dicks, Pamela; Graham, Catherine; O'Hare, Anne; Pain, Helen; McConachie, Helen

    2016-10-01

    This study evaluated a technology-based early intervention for social communication skills in pre-schoolers in a randomised controlled trial. Participants were 54 children aged under 6 years with a diagnosis of autism, assigned to either intervention or control conditions. The app engaged children, who played consistently, regardless of developmental level, and was rated highly by parents. There were no significant group differences in parent-report measures post-intervention, nor in a measure of parent-child play at follow-up. Therefore, this intervention did not have an observable impact on real-world social communication skills and caution is recommended about the potential usefulness of iPad(™) apps for amelioration of difficulties in interaction. However, positive attitudes among participants, lack of harms and the potential of apps to deliver therapeutic content at low economic cost suggest this approach is worth pursuing further, perhaps targeting other skill domains. © The Author(s) 2015.

  16. Design of aging intervention studies: the NIA interventions testing program

    PubMed Central

    Strong, R.; Miller, R. A.; Nelson, J.; Javors, M.; Sharp, Z. D.; Peralba, J. M.; Harrison, D. E.

    2008-01-01

    The field of biogerontology has made great strides towards understanding the biological processes underlying aging, and the time is ripe to look towards applying this knowledge to the pursuit of aging interventions. Identification of safe, inexpensive, and non-invasive interventions that slow the aging process and promote healthy aging could have a significant impact on quality of life and health care expenditures for the aged. While there is a plethora of supplements and interventions on the market that purport to slow aging, the evidence to validate such claims is generally lacking. Here we describe the development of an aging interventions testing program funded by the National Institute on Aging (NIA) to test candidate interventions in a model system. The development of this program highlights the challenges of long-term intervention studies and provides approaches to cope with the stringent requirements of a multi-site testing program. PMID:19424842

  17. Design of aging intervention studies: the NIA interventions testing program.

    PubMed

    Nadon, N L; Strong, R; Miller, R A; Nelson, J; Javors, M; Sharp, Z D; Peralba, J M; Harrison, D E

    2008-12-01

    The field of biogerontology has made great strides towards understanding the biological processes underlying aging, and the time is ripe to look towards applying this knowledge to the pursuit of aging interventions. Identification of safe, inexpensive, and non-invasive interventions that slow the aging process and promote healthy aging could have a significant impact on quality of life and health care expenditures for the aged. While there is a plethora of supplements and interventions on the market that purport to slow aging, the evidence to validate such claims is generally lacking. Here we describe the development of an aging interventions testing program funded by the National Institute on Aging (NIA) to test candidate interventions in a model system. The development of this program highlights the challenges of long-term intervention studies and provides approaches to cope with the stringent requirements of a multi-site testing program.

  18. Targeting adolescent mothers with depressive symptoms for early intervention.

    PubMed

    Field, T; Pickens, J; Prodromidis, M; Malphurs, J; Fox, N; Bendell, D; Yando, R; Schanberg, S; Kuhn, C

    2000-01-01

    Infants of mothers with depressive symptoms show developmental delays if symptoms persist over the first 6 months of the infant's life, thus highlighting the importance of identifying those mothers for early intervention. In Study 1, mothers with depressive symptoms (n = 160) and mothers without depressive symptoms (n = 100) and their infants were monitored to identify variables from the first 3 months that predict which mothers would still be symptomatic at 6 months. A "dysregulation" profile was noted for the infants of depressed mothers, including lower Brazelton scores, more indeterminate sleep, and elevated norepinephrine, epinephrine, and dopamine levels at the neonatal period, and greater right frontal EEG activation, lower vagal tone, and negative interactions at the 3- and 6-month periods. A group of maternal variables from the neonatal and 3-month assessments accounted for 51% of the variance in the mothers' continuing depressive symptoms. These variables included greater right frontal EEG activation, lower vagal tone, and less positive interactions at 3 months, and elevated norepinephrine, serotonin, and cortisol levels at the neonatal stage. In Study 2, a similar sample of mothers with depressive symptoms (n = 160) and without depressive symptoms (n = 100) was recruited and followed to 3 months. Those symptomatic mothers who had values above (or below) the median (depending on the negative direction) on the predictor variables identified in Study 1 (taken from the first 3 months) were then randomly assigned to an intervention or a control group at 3 months. These groups were then compared with each other, as well as with the group without depressive symptoms, at 6 and 12 months. The intervention, conducted from 3 to 6 months, consisted of free day care for the infants and a rehab program (social, educational, and vocational) plus several mood induction interventions for the mothers, including relaxation therapy, music mood induction, massage therapy

  19. Testing a mobile mindful eating intervention targeting craving-related eating: feasibility and proof of concept.

    PubMed

    Mason, Ashley E; Jhaveri, Kinnari; Cohn, Michael; Brewer, Judson A

    2017-09-16

    Theoretically driven smartphone-delivered behavioral interventions that target mechanisms underlying eating behavior are lacking. In this study, we administered a 28-day self-paced smartphone-delivered intervention rooted in an operant conditioning theoretical framework that targets craving-related eating using mindful eating practices. At pre-intervention and 1-month post-intervention, we assessed food cravings among adult overweight or obese women (N = 104; M age = 46.2 ± 14.1 years; M BMI = 31.5 ± 4.5) using ecological momentary assessment via text message (SMS), self-reported eating behavior (e.g., trait food craving), and in-person weight. Seventy-eight participants (75.0%) completed the intervention within 7 months ('all completers'), and of these, 64 completed the intervention within 3 months ('timely completers'). Participants experienced significant reductions in craving-related eating (40.21% reduction; p < .001) and self-reported overeating behavior (trait food craving, p < .001; other measures ps < .01). Reductions in trait food craving were significantly correlated with weight loss for timely completers (r = .30, p = .020), this pattern of results was also evident in all completers (r = .22, p = .065). Taken together, results suggest that smartphone-delivered mindful eating training targeting craving-related eating may (1) target behavior that impacts a relative metabolic pathway, and (2) represent a low-burden and highly disseminable method to reduce problematic overeating among overweight individuals. ClinicalTrials.gov registration: NCT02694731.

  20. [Improving health care practices and organization: methodology for intervention studies].

    PubMed

    Zaugg, Vincent; Savoldelli, Virginie; Sabatier, Brigitte; Durieux, Pierre

    2014-01-01

    Interventions designed to improve professional practices and healthcare organization are regularly implemented in all health systems. Their effectiveness on quality of care should be properly evaluated prior to their widespread implementation. Intervention studies can be conducted for this purpose according to a rigorous methodology in order to provide results with a good level of evidence. This article describes the main phases of an intervention study, including definition of the intervention, choice of study design, outcomes assessment, and writing of the report. It also addresses methodological issues of intervention studies designed to improve quality of care, such as cluster-randomization or the use of quasi-experimental designs. One of the specific features of these studies is that professionals are the targets, while patients are the beneficiaries of the intervention. A good knowledge of the specific features of studies designed to improve quality of care is essential to conduct research, or to evaluate the quality of the evidence from published studies.

  1. Targeting macrophage necroptosis for therapeutic and diagnostic interventions in atherosclerosis

    PubMed Central

    Karunakaran, Denuja; Geoffrion, Michele; Wei, Lihui; Gan, Wei; Richards, Laura; Shangari, Prakriti; DeKemp, Ella M.; Beanlands, Rachelle A.; Perisic, Ljubica; Maegdefessel, Lars; Hedin, Ulf; Sad, Subash; Guo, Liang; Kolodgie, Frank D.; Virmani, Renu; Ruddy, Terrence; Rayner, Katey J.

    2016-01-01

    Atherosclerosis results from maladaptive inflammation driven primarily by macrophages, whose recruitment and proliferation drive plaque progression. In advanced plaques, macrophage death contributes centrally to the formation of plaque necrosis, which underlies the instability that promotes plaque rupture and myocardial infarction. Hence, targeting macrophage cell death pathways may offer promise for the stabilization of vulnerable plaques. Necroptosis is a recently discovered pathway of programmed cell necrosis regulated by RIP3 and MLKL kinases that, in contrast to apoptosis, induces a proinflammatory state. We show herein that necroptotic cell death is activated in human advanced atherosclerotic plaques and can be targeted in experimental atherosclerosis for both therapeutic and diagnostic interventions. In humans with unstable carotid atherosclerosis, expression of RIP3 and MLKL is increased, and MLKL phosphorylation, a key step in the commitment to necroptosis, is detected in advanced atheromas. Investigation of the molecular mechanisms underlying necroptosis showed that atherogenic forms of low-density lipoprotein increase RIP3 and MLKL transcription and phosphorylation—two critical steps in the execution of necroptosis. Using a radiotracer developed with the necroptosis inhibitor necrostatin-1 (Nec-1), we show that 123I-Nec-1 localizes specifically to atherosclerotic plaques in Apoe−/− mice, and its uptake is tightly correlated to lesion areas by ex vivo nuclear imaging. Furthermore, treatment of Apoe−/− mice with established atherosclerosis with Nec-1 reduced lesion size and markers of plaque instability, including necrotic core formation. Collectively, our findings offer molecular insight into the mechanisms of macrophage cell death that drive necrotic core formation in atherosclerosis and suggest that this pathway can be used as both a diagnostic and therapeutic tool for the treatment of unstable atherosclerosis. PMID:27532042

  2. Endocannabinoid signaling and energy metabolism: a target for dietary intervention.

    PubMed

    Kim, Jeffrey; Li, Yong; Watkins, Bruce A

    2011-06-01

    The endocannabinoid (EC) signaling (ECS) system involves the activation of receptors targeted by endogenously produced ligands called endocannabinoids that trigger specific physiologic events in various organs and tissues throughout the body. ECs are lipid mediators that bind to specific receptors and elicit cell signaling. The focus of this review is to discuss the responses that direct pathways of systemic energy metabolism. Recent findings have indicated that an imbalance of the ECS contributes to visceral fat accumulation and disrupts energy homeostasis, which are characteristics of the metabolic syndrome. Constant activation of ECS has been linked to metabolic processes that are associated with the hypothalamus and peripheral tissues of obese patients. In contrast, inhibition of ECS results in weight loss in animal and human subjects. Despite these findings, the mechanism involved in the dysregulation of ECS is unclear. Interestingly, the level of endogenous ligands, derived from arachidonic acid, can be directly manipulated by nutrient intervention, in that a diet rich in long-chain ω-3 polyunsaturated fatty acids will decrease the production of ligands to modulate the activation of target receptors. In contrast, a diet that is high in ω-6 polyunsaturated fatty acids will cause an increase in ECS activation and stimulate tissue specific activities that decrease insulin sensitivity in muscle and promote fat accumulation in the adipose tissue. The purpose of this review is to explain the components of ECS, its role in adipose and muscle energy metabolism, and how nutritional approaches with dietary ω-3 polyunsaturated fatty acids may reverse the dysregulation of this system to improve insulin sensitivity and control body fat.

  3. Lifestyle Interventions Targeting Body Weight Changes during the Menopause Transition: A Systematic Review

    PubMed Central

    Jull, Janet; Stacey, Dawn; Beach, Sarah; Dumas, Alex; Strychar, Irene; Ufholz, Lee-Anne; Prince, Stephanie; Abdulnour, Joseph; Prud'homme, Denis

    2014-01-01

    Objective. To determine the effectiveness of exercise and/or nutrition interventions and to address body weight changes during the menopause transition. Methods. A systematic review of the literature was conducted using electronic databases, grey literature, and hand searching. Two independent researchers screened for studies using experimental designs to evaluate the impact of exercise and/or nutrition interventions on body weight and/or central weight gain performed during the menopausal transition. Studies were quality appraised using Cochrane risk of bias. Included studies were analyzed descriptively. Results. Of 3,564 unique citations screened, 3 studies were eligible (2 randomized controlled trials, and 1 pre/post study). Study quality ranged from low to high risk of bias. One randomized controlled trial with lower risk of bias concluded that participation in an exercise program combined with dietary interventions might mitigate body adiposity increases, which is normally observed during the menopause transition. The other two studies with higher risk of bias suggested that exercise might attenuate weight loss or weight gain and change abdominal adiposity patterns. Conclusions. High quality studies evaluating the effectiveness of interventions targeting body weight changes in women during their menopause transition are needed. Evidence from one higher quality study indicates an effective multifaceted intervention for women to minimize changes in body adiposity. PMID:24971172

  4. Targeting Metabolic Reprogramming by Influenza Infection for Therapeutic Intervention

    DOE PAGES

    Smallwood, Heather S.; Duan, Susu; Morfouace, Marie; ...

    2017-05-23

    Influenza is a worldwide health and financial burden posing a significant risk to the immune-compromised, obese, diabetic, elderly, and pediatric populations. We identified increases in glucose metabolism in the lungs of pediatric patients infected with respiratory pathogens. Using quantitative mass spectrometry, we found metabolic changes occurring after influenza infection in primary human respiratory cells and validated infection-associated increases in c-Myc, glycolysis, and glutaminolysis. We confirmed these findings with a metabolic drug screen that identified the PI3K/mTOR inhibitor BEZ235 as a regulator of infectious virus production. BEZ235 treatment ablated the transient induction of c-Myc, restored PI3K/mTOR pathway homeostasis measured by 4E-BP1more » and p85 phosphorylation, and reversed infection-induced changes in metabolism. Importantly, BEZ235 reduced infectious progeny but had no effect on the early stages of viral replication. BEZ235 significantly increased survival in mice, while reducing viral titer. We show metabolic reprogramming of host cells by influenza virus exposes targets for therapeutic intervention.« less

  5. Targeting Metabolic Reprogramming by Influenza Infection for Therapeutic Intervention.

    PubMed

    Smallwood, Heather S; Duan, Susu; Morfouace, Marie; Rezinciuc, Svetlana; Shulkin, Barry L; Shelat, Anang; Zink, Erika E; Milasta, Sandra; Bajracharya, Resha; Oluwaseum, Ajayi J; Roussel, Martine F; Green, Douglas R; Pasa-Tolic, Ljiljana; Thomas, Paul G

    2017-05-23

    Influenza is a worldwide health and financial burden posing a significant risk to the immune-compromised, obese, diabetic, elderly, and pediatric populations. We identified increases in glucose metabolism in the lungs of pediatric patients infected with respiratory pathogens. Using quantitative mass spectrometry, we found metabolic changes occurring after influenza infection in primary human respiratory cells and validated infection-associated increases in c-Myc, glycolysis, and glutaminolysis. We confirmed these findings with a metabolic drug screen that identified the PI3K/mTOR inhibitor BEZ235 as a regulator of infectious virus production. BEZ235 treatment ablated the transient induction of c-Myc, restored PI3K/mTOR pathway homeostasis measured by 4E-BP1 and p85 phosphorylation, and reversed infection-induced changes in metabolism. Importantly, BEZ235 reduced infectious progeny but had no effect on the early stages of viral replication. BEZ235 significantly increased survival in mice, while reducing viral titer. We show metabolic reprogramming of host cells by influenza virus exposes targets for therapeutic intervention. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  6. Parental Factors Associated with Child Post-traumatic Stress Following Injury: A Consideration of Intervention Targets

    PubMed Central

    Wise, Anna E.; Delahanty, Douglas L.

    2017-01-01

    Post-traumatic stress disorder (PTSD) symptoms are relatively common following pediatric traumatic injury and are related to poor long-term child outcomes. However, due to concerns regarding the efficacy of early child preventive interventions, and difficulty intervening with injured and medicated children soon after the event, it is not feasible to provide early psychological interventions to children exposed to traumatic injury. Parental PTSD symptoms and reactions to the child’s traumatic injury impact child outcomes and provide potential targets for early intervention to reduce child symptom development without involving the child. The authors conducted a review of the literature using Psycinfo and Pubmed research databases (publication years = 1990–2017) and identified 65 published studies relevant to the topic of the review. The present review considers parent factors [parenting styles, parental post-traumatic pathology (PTS), adaptive and maladaptive coping strategies, and communication regarding the traumatic injury] and their impact on child PTS. We focus specifically on factors amenable to intervention. We further review moderators of these relationships (e.g., child age and gender, parent gender) and conclude that it is unlikely that a one-size-fits-all approach to treatment will be successful. Rather, it is necessary to consider the age and gender of parent child dyads in designing and providing targeted interventions to families following the traumatic injury of a child. PMID:28878711

  7. Systematic review of public-targeted communication interventions to improve antibiotic use.

    PubMed

    Cross, Elizabeth Louise Anne; Tolfree, Robert; Kipping, Ruth

    2017-04-01

    Excessive use of antibiotics accelerates the acquisition/spread of antimicrobial resistance. A systematic review was conducted to identify the components of successful communication interventions targeted at the general public to improve antibiotic use. The databases MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library were searched. Search terms were related to the population (public, community), intervention (campaign, mass media) and outcomes (antibiotic, antimicrobial resistance). References were screened for inclusion by one author with a random subset of 10% screened by a second author. No date restrictions were applied and only articles in the English language were considered. Studies had to have a control group or be an interrupted time-series. Outcomes had to measure change in antibiotic-related prescribing/consumption and/or the public's knowledge, attitudes or behaviour. Two reviewers assessed the quality of studies. Narrative synthesis was performed. Fourteen studies were included with an estimated 74-75 million participants. Most studies were conducted in the United States or Europe and targeted both the general public and clinicians. Twelve of the studies measured changes in antibiotic prescribing. There was quite strong ( P  < 0·05 to ≥ 0·01) to very strong ( P  < 0·001) evidence that interventions that targeted prescribing for RTIs were associated with decreases in antibiotic prescribing; the majority of these studies reported reductions of greater than -14% with the largest effect size reaching -30%. Multi-faceted communication interventions that target both the general public and clinicians can reduce antibiotic prescribing in high-income countries but the sustainability of reductions in antibiotic prescribing is unclear.

  8. Systematic review of family and home-based interventions targeting paediatric overweight and obesity.

    PubMed

    Knowlden, A P; Sharma, M

    2012-06-01

    The family and home environment is a highly influential psychosocial antecedent of paediatric obesity. The purpose of this investigation was to systematically analyze family and home-based randomized control trials aimed at treating overweight and obesity in children ages 2-7 years. In gathering materials for this review, a search of Cumulative Index to Nursing and Allied Health, MEDLINE, Education Resources Information Center, Psychology and Behavioural Sciences Collection and CENTRAL databases was conducted for the time frame of January 2001 to August 2011. The data extraction spanned three phases resulting in a total of nine interventions that met the specified inclusion criteria. Among the identified studies, eight produced significant outcomes. The majority of the programmes incorporated educational sessions targeting parents as the primary modality for intervention delivery. Less than one-quarter of the interventions included home visitations; however, all of the interventions included home-based activities to reinforce behaviour modification. Only three of the interventions applied social and behavioural theory, and only two interventions employed process evaluation. Additional research is needed to gauge the efficacy of the home and family milieu for treating paediatric obesity. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.

  9. Mechanisms of personality-targeted intervention effects on adolescent alcohol misuse, internalizing and externalizing symptoms.

    PubMed

    O'Leary-Barrett, Maeve; Castellanos-Ryan, Natalie; Pihl, Robert O; Conrod, Patricia J

    2016-05-01

    This study aims to explore the mechanisms of personality-targeted intervention effects on problematic drinking, internalizing and externalizing symptoms. As part of a cluster-randomized trial, 1,210 high-risk students (mean age 13.7 years) in 19 London high schools (42.6% White, 54% male) were identified using the Substance Use Risk Profile Scale. Intervention school participants were invited to participate in personality-matched interventions by trained school staff. MacKinnon's products of coefficients method was used to compare 3 complementary mechanism hypotheses, namely, whether early changes in (a) alcohol use, (b) internalizing and externalizing symptoms, or (c) personality during the 6 months postintervention accounted for intervention effects over 2 years. Early intervention effects on drinking behaviors during the 6 months postintervention partially accounted for longer term intervention effects on the onset of binge drinking (95% confidence interval [CI] [-.349, -.062]) and drinking problems (95% CI [-.206, -.016]) over 2 years. Intervention effects on anxiety symptoms and conduct problems were partially mediated by early reductions in depressive symptoms (95% CI [-.013, -.001]; 95% CI [-.047, -.001]), and intervention effects on internalizing symptoms were also partially mediated by reductions in anxiety sensitivity (95% CI [-.003, 0]). 2-year intervention effects on problematic drinking were largely accounted for by early changes in drinking behaviors, and were not mediated by changes in mental health symptoms or personality risk factors. Early improvements in mood and anxiety sensitivity partially mediated longer term reductions in mental health problems. (c) 2016 APA, all rights reserved).

  10. The effects of a targeted multicomponent delirium intervention on postdischarge outcomes for hospitalized older adults.

    PubMed

    Bogardus, Sidney T; Desai, Mayur M; Williams, Christianna S; Leo-Summers, Linda; Acampora, Denise; Inouye, Sharon K

    2003-04-01

    We sought to determine whether a multicomponent hospital-based intervention targeted toward risk factors for delirium had any effect on patient outcomes 6 months later. We studied 705 patients aged 70 years or older who had been enrolled in a controlled trial of a multicomponent intervention at an academic medical center and who survived for at least 6 months after hospitalization. Outcomes included self-rated health, functional status, incontinence, depression, cognitive status, delirium, home health visits, homemaker visits, rehospitalization, and nursing home placement. Overall, there were no differences between the intervention and control groups for any of the 10 outcomes, except that incontinence was slightly less common in the intervention group (30% [103/344] vs. 37% [132/354], P = 0.02). Among high-risk patients, those in the intervention group had better self-rated health (among those with poor/bad self-rated health at baseline, P <0.001) and better functional status (among those with baseline functional impairment, P <0.001). There were no effects in the other six high-risk subgroups, including cognitive and behavioral outcomes (Folstein Mini-Mental State Examination, Geriatric Depression Scale, incontinence, and delirium) and health care utilization. In the group as a whole, we were unable to identify a lasting beneficial effect of the multicomponent intervention, although further efforts to identify appropriate subgroups for targeted interventions may be worthwhile. Other strategies are needed after hospital discharge to deter deterioration in susceptible elderly people. Copyright 2003 by Excerpta Medica Inc.

  11. Feasibility of an obesity intervention for paediatric primary care targeting parenting and children: Helping HAND.

    PubMed

    O'Connor, T M; Hilmers, A; Watson, K; Baranowski, T; Giardino, A P

    2013-01-01

      The primary care setting offers the opportunity to reach children and parents to encourage healthy lifestyle behaviours, and improve weight status among children.   Test the feasibility of Helping HAND (Healthy Activity and Nutrition Directions), an obesity intervention for 5- to 8-year-old children in primary care clinics.   A randomized controlled pilot study of Helping HAND, a 6-month intervention, targeted children with body mass index 85-99%tile and their parents. Intervention group attended monthly sessions and self-selected child behaviours and parenting practices to change. Control group received regular paediatric care and was wait-listed for Helping HAND. Session completion, participant satisfaction, child anthropometrics, dietary intake, physical activity, TV viewing and behaviour-specific parenting practices were measured pre and post intervention.   Forty parent-child dyads enrolled: 82.5% were Hispanic, 80% had a girl and 65% reported income ≤ $30, 000/year. There was 20% attrition from Helping HAND (attended <4/6 sessions). Families self-selected 4.35 (SD 1.75) behaviours to target during the 6-month programme and each of the seven behaviours was selected by 45-80% of the families. There were no between group differences in the child's body mass index z-score, dietary intake or physical activity post intervention. Intervention group viewed 14.9 (SE 2.3) h/week of TV post intervention versus control group 23.3 (SE 2.4) h/week (P < 0.05).   Helping HAND is feasible, due to low attrition, good programme attendance, and clinically relevant improvements in some child and parenting behaviours. © 2011 Blackwell Publishing Ltd.

  12. Targeting interventions for ethnic minority and low-income populations.

    PubMed

    Kumanyika, Shiriki; Grier, Sonya

    2006-01-01

    Although rates of childhood obesity among the general population are alarmingly high, they are higher still in ethnic minority and low-income communities. The disparities pose a major challenge for policymakers and practitioners planning strategies for obesity prevention. In this article Shiriki Kumanyika and Sonya Grier summarize differences in childhood obesity prevalence by race and ethnicity and by socioeconomic status. They show how various environmental factors can have larger effects on disadvantaged and minority children than on their advantaged white peers-and thus contribute to disparities in obesity rates. The authors show, for example, that low-income and minority children watch more television than white, non-poor children and are potentially exposed to more commercials advertising high-calorie, low-nutrient food during an average hour of TV programming. They note that neighborhoods where low-income and minority children live typically have more fast-food restaurants and fewer vendors of healthful foods than do wealthier or predominantly white neighborhoods. They cite such obstacles to physical activity as unsafe streets, dilapidated parks, and lack of facilities. In the schools that low-income and minority children attend, however, they see opportunities to lead the way to effective obesity prevention. Finally, the authors examine several aspects of the home environment-breast-feeding, television viewing, and parental behaviors-that may contribute to childhood obesity but be amenable to change through targeted intervention. Kumanyika and Grier point out that policymakers aiming to prevent obesity can use many existing policy levers to reach ethnic minority and low-income children and families: Medicaid, the State Child Health Insurance Program, and federal nutrition "safety net" programs. Ultimately, winning the fight against childhood obesity in minority and low-income communities will depend on the nation's will to change the social and physical

  13. Developing a targeted, theory-informed implementation intervention using two theoretical frameworks to address health professional and organisational factors: a case study to improve the management of mild traumatic brain injury in the emergency department.

    PubMed

    Tavender, Emma J; Bosch, Marije; Gruen, Russell L; Green, Sally E; Michie, Susan; Brennan, Sue E; Francis, Jill J; Ponsford, Jennie L; Knott, Jonathan C; Meares, Sue; Smyth, Tracy; O'Connor, Denise A

    2015-05-25

    Despite the availability of evidence-based guidelines for the management of mild traumatic brain injury in the emergency department (ED), variations in practice exist. Interventions designed to implement recommended behaviours can reduce this variation. Using theory to inform intervention development is advocated; however, there is no consensus on how to select or apply theory. Integrative theoretical frameworks, based on syntheses of theories and theoretical constructs relevant to implementation, have the potential to assist in the intervention development process. This paper describes the process of applying two theoretical frameworks to investigate the factors influencing recommended behaviours and the choice of behaviour change techniques and modes of delivery for an implementation intervention. A stepped approach was followed: (i) identification of locally applicable and actionable evidence-based recommendations as targets for change, (ii) selection and use of two theoretical frameworks for identifying barriers to and enablers of change (Theoretical Domains Framework and Model of Diffusion of Innovations in Service Organisations) and (iii) identification and operationalisation of intervention components (behaviour change techniques and modes of delivery) to address the barriers and enhance the enablers, informed by theory, evidence and feasibility/acceptability considerations. We illustrate this process in relation to one recommendation, prospective assessment of post-traumatic amnesia (PTA) by ED staff using a validated tool. Four recommendations for managing mild traumatic brain injury were targeted with the intervention. The intervention targeting the PTA recommendation consisted of 14 behaviour change techniques and addressed 6 theoretical domains and 5 organisational domains. The mode of delivery was informed by six Cochrane reviews. It was delivered via five intervention components : (i) local stakeholder meetings, (ii) identification of local opinion

  14. An Evaluation of Six Brief Interventions that Target Drug-Related Problems in Correctional Populations

    PubMed Central

    JOE, GEORGE W.; KNIGHT, KEVIN; SIMPSON, D. DWAYNE; FLYNN, PATRICK M.; MOREY, JANIS T.; BARTHOLOMEW, NORMA G.; TINDALL, MICHELE STATON; BURDON, WILLIAM M.; HALL, ELIZABETH A.; MARTIN, STEVE S.; O’CONNELL, DANIEL J.

    2012-01-01

    Finding brief effective treatments for criminal justice populations is a major public need. The CJ-DATS Targeted Intervention for Corrections (TIC), which consists of six brief interventions (Communication, Anger, Motivation, Criminal Thinking, Social Networks, and HIV/Sexual Health), were tested in separate federally-funded randomized control studies. In total, 1,573 criminal justice-involved individuals from 20 correction facilities participated (78% males; 54% white). Multi-level repeated measures analyses found significant gains in knowledge, attitudes, and psychosocial functioning (criteria basic to Knowledge, Attitude, and Practices (KAP) and TCU Treatment Process Models). While improvements were less consistent in criminal thinking, overall evidence supported efficacy for the TIC interventions. PMID:22547911

  15. A tailored target intervention on influence factors of quality of life in Chinese patients with hypertension.

    PubMed

    Qian, Yun; Zhang, Jingping; Lin, Yudi; Dong, Meihua; Xu, Ming; Qian, Yanhua; Wu, Leilei; Shi, Ping; Xu, Yizhi; Shen, Hongbing

    2009-02-01

    Studies suggested that hypertension was associated with impaired health-related quality of life and it is important to find a proper and feasible management of hypertension in the community. This study evaluates the effect of a tailored target intervention on influence factors of quality of life in Chinese patients with hypertension. A cross-sectional survey was carried out to investigate 644 patients with hypertension by using the Chinese version of the short form-36, and 195 patients were screened out to participate in the tailored target intervention. Multivariate linear regression analyses showed that age, gender, educational level, high intake of fried food, household income, attitude, knowledge, blood pressure, symptoms, serious events during the past year, duration of hypertension, and number of taking anti-hypertensive medicine were significantly correlated with quality of life. Grade-based management by community physicians and physical exercise had a positive effect on quality of life. After the 6-month intervention, the control rate of hypertension was increased from 32.0% to 39.4%, and the mean systolic and diastolic blood pressure values were significantly decreased to 137.2 and 85.7 mmHg vs. 140.9 and 87.6 mmHg at baseline, respectively. The intervention program resulted in overall improvement on total score of quality of life and mean scores of all the domains except social functioning in patients with hypertension. In view of the influence factors of quality of life, taking the tailored target intervention could not only improve the quality of life of hypertensive patients, but also effectively increase the control rate of hypertension.

  16. Pubertal assessment: targeted educational intervention for pediatric trainees.

    PubMed

    Khokhar, Aditi; Nagarajan, Sairaman; Ravichandran, Yagnaram; Perez-Colon, Sheila

    2017-08-18

    Background Timely and periodic pubertal assessment in children is vital to identify puberty related disorders. Pediatricians need to have working knowledge of puberty time and tempo. Pediatric residency is an important platform to acquire physical examination skills including pubertal assessment. Objective An educational intervention for teaching pubertal assessment was piloted on pediatric residents at our institution. Methods The intervention comprised of interactive lecture series, ID badge size Tanner stage cards and Tanner posters placed in residents' continuity clinics. Pre-intervention, post-intervention and 3 months post-intervention surveys for participating trainees were administered to determine the effectiveness of the intervention. Attitudes, practices, knowledge scores, and barriers to Tanner staging conduct were analyzed. Results Forty-three residents participated in the intervention. Knowledge scores of PGY1 (5.95 ± 1.6 vs. 7.47 ± 1.4, p < 0.01) improved right after the intervention, as did self-reported clinical practices of all trainees 3 months post- intervention with regards to conducting external genital examination and performing pubertal assessment. Confidence levels of pediatric trainees in conducting pubertal assessment and comfort levels in assessing the need for endocrine referral based on abnormal Tanner staging improved after the intervention, although the effect was not statistically significant. Conclusion Our intervention is a worthwhile technique for teaching pubertal assessment to residents as it is simple to conduct, easily reproducible, provides baseline knowledge needed for recognition of normal pubertal development and puberty related conditions, and instills confidence in residents.

  17. School-based interventions targeting stigma of mental illness: systematic review.

    PubMed

    Mellor, Catriona

    2014-08-01

    Aims and method To systematically review the published literature on the effectiveness of classroom-based interventions to tackle the stigma of mental illness in young people, and to identify any consistent elements within successful programmes. Results Seventeen studies were included in the analysis. A minority of studies reported a positive impact on stigma or knowledge outcomes at follow-up and there were considerable methodological shortcomings in the studies reviewed. These interventions varied substanitally in content and delivery. It was not possible to use this data to draw out what aspects make a successful intervention. There is currently no strong evidence to support previous conclusions that these types of intervention work for children and adolescents. Clinical implications When anti-stigma interventions for young people are rolled out in the future, it is important that the programme design and method of delivery have evidence to prove their effectiveness, and that the audience and setting are the most appropriate to target. There is a current lack of strong evidence to inform this.

  18. Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia.

    PubMed

    Copenhaver, Michael M; Tunku, Noor; Ezeabogu, Ifeoma; Potrepka, Jessica; Zahari, Muhammad Muhsin A; Kamarulzaman, Adeeba; Altice, Frederick L

    2011-01-01

    HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI-taking into account both empirical evidence and input from target organization stakeholders and target population members and their families-for use in real world prison settings where high-risk populations are concentrated.

  19. Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia

    PubMed Central

    Copenhaver, Michael M.; Tunku, Noor; Ezeabogu, Ifeoma; Potrepka, Jessica; Zahari, Muhammad Muhsin A.; Kamarulzaman, Adeeba; Altice, Frederick L.

    2011-01-01

    HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI—taking into account both empirical evidence and input from target organization stakeholders and target population members and their families—for use in real world prison settings where high-risk populations are concentrated. PMID:21860786

  20. Targeted mass media interventions promoting healthy behaviours to reduce risk of non-communicable diseases in adult, ethnic minorities.

    PubMed

    Mosdøl, Annhild; Lidal, Ingeborg B; Straumann, Gyri H; Vist, Gunn E

    2017-02-17

    Physical activity, a balanced diet, avoidance of tobacco exposure, and limited alcohol consumption may reduce morbidity and mortality from non-communicable diseases (NCDs). Mass media interventions are commonly used to encourage healthier behaviours in population groups. It is unclear whether targeted mass media interventions for ethnic minority groups are more or less effective in changing behaviours than those developed for the general population. To determine the effects of mass media interventions targeting adult ethnic minorities with messages about physical activity, dietary patterns, tobacco use or alcohol consumption to reduce the risk of NCDs. We searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, ERIC, SweMed+, and ISI Web of Science until August 2016. We also searched for grey literature in OpenGrey, Grey Literature Report, Eldis, and two relevant websites until October 2016. The searches were not restricted by language. We searched for individual and cluster-randomised controlled trials, controlled before-and-after studies (CBA) and interrupted time series studies (ITS). Relevant interventions promoted healthier behaviours related to physical activity, dietary patterns, tobacco use or alcohol consumption; were disseminated via mass media channels; and targeted ethnic minority groups. The population of interest comprised adults (≥ 18 years) from ethnic minority groups in the focal countries. Primary outcomes included indicators of behavioural change, self-reported behavioural change and knowledge and attitudes towards change. Secondary outcomes were the use of health promotion services and costs related to the project. Two authors independently reviewed the references to identify studies for inclusion. We extracted data and assessed the risk of bias in all included studies. We did not pool the results due to heterogeneity in comparisons made, outcomes, and study designs. We describe the results narratively and present them in 'Summary of findings

  1. Reliability of Therapist Self-Report on Treatment Targets and Focus in Family-Based Intervention

    PubMed Central

    Hogue, Aaron; Dauber, Sarah; Henderson, Craig E.; Liddle, Howard A.

    2013-01-01

    Reliable therapist-report methods appear to be an essential component of quality assurance procedures to support adoption of evidence-based practices in usual care, but studies have found weak correspondence between therapist and observer ratings of treatment techniques. This study examined therapist reliability and accuracy in rating intervention target (i.e., session participants) and focus (i.e., session content) in a manual-guided, family-based preventive intervention implemented with 50 inner-city adolescents at risk for substance use. A total of 106 sessions selected from three phases of treatment were rated via post-session self-report by the participating therapist and also via videotape by nonparticipant coders. Both groups estimated the amount of session time devoted to model-prescribed treatment targets (adolescent, parent, conjoint) and foci (family, school, peer, prosocial, drugs). Therapists demonstrated excellent reliability with coders for treatment targets and moderate to high reliability for treatment foci across the sample and within each phase. Also, therapists did not consistently overestimate their degree of activity with targets or foci. Implications of study findings for fidelity assessment in routine settings are discussed. PMID:24068479

  2. Incidence Rate of Prediabetes Progression to Diabetes: Modeling an Optimum Target Group for Intervention.

    PubMed

    DeJesus, Ramona S; Radecki Breitkopf, Carmen; Rutten, Lila J; Jacobson, Debra J; Wilson, Patrick M; St Sauver, Jennifer

    2016-09-30

    Thirty-seven percent of US adults have prediabetes. Various interventions can delay diabetes progression; however, the optimum target group for risk reduction is uncertain. This study estimated rate of progression to diabetes at 1 and 5 years among a cohort of patients from 3 primary care clinics and modeled the potential magnitude in diabetes incidence risk reduction of an intervention program among specific subgroups. Records of 106,821 empaneled patients in 2005 were reviewed. Generalized population attributable risk (PAR) statistics were calculated to estimate the impact of reducing fasting blood glucose on diabetes progression. Multiple intervention effects (varying levels of glucose reduction along with multiple adherence rates) were examined for those with baseline glucose from 110 to 119 mg/dL and ≥120 mg/dL. Ten percent of patients (n = 10,796) met criteria for prediabetes. The 1- and 5-year diabetes incidence rate was 38.6 and 40.24 per 1000 person-years, respectively. Age and obesity were independent predictors of increased progression rate. The generalized PAR for a 10-point reduction in the 110-119 mg/dL subgroup with 25% adherence was 7.6%. The generalized PAR for similar percent reduction and adherence level in patients with baseline glucose of ≥120 mg/dL was only 3.0%. Rate of progression to diabetes increased over time and with associated independent risk factors. Greater risk reduction in diabetes progression within the target population can be achieved when the intervention is successful in those with baseline glucose of 110-119 mg/dL. Modeling an optimum target group for a diabetes prevention intervention offers a novel and useful guide to planning and allocating resources in population health management.

  3. Small, medium, large or supersize? The development and evaluation of interventions targeted at portion size.

    PubMed

    Vermeer, W M; Steenhuis, I H M; Poelman, M P

    2014-07-01

    In the past decades, portion sizes of high-caloric foods and drinks have increased and can be considered an important environmental obesogenic factor. This paper describes a research project in which the feasibility and effectiveness of environmental interventions targeted at portion size was evaluated. The studies that we conducted revealed that portion size labeling, offering a larger variety of portion sizes, and proportional pricing (that is, a comparable price per unit regardless of the size) were considered feasible to implement according to both consumers and point-of-purchase representatives. Studies into the effectiveness of these interventions demonstrated that the impact of portion size labeling on the (intended) consumption of soft drinks was, at most, modest. Furthermore, the introduction of smaller portion sizes of hot meals in worksite cafeterias in addition to the existing size stimulated a moderate number of consumers to replace their large meals by a small meal. Elaborating on these findings, we advocate further research into communication and marketing strategies related to portion size interventions; the development of environmental portion size interventions as well as educational interventions that improve people's ability to deal with a 'super-sized' environment; the implementation of regulation with respect to portion size labeling, and the use of nudges to stimulate consumers to select healthier portion sizes.

  4. Educational interventions targeted at minors in situations of grave social vulnerability and their families

    NASA Astrophysics Data System (ADS)

    de La Caba Collado, Mariangeles; Bartau Rojas, Isabel

    2010-10-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The design, intervention and assessment process of this study was carried out in two phases over a period of a year and a half. For both phases, three different groups—of men/fathers, women/mothers and children—were established. Study variables (parenting skills and children's personal and social development) were evaluated before and after the intervention in every group, as well as during the entire process. The results, taking into account the improvements reported by all the participants (social workers, group monitors, fathers, mothers, children) show that inter-professional involvement and coordination at all phases of the intervention is vital in order to achieve small but significant improvements.

  5. Small, medium, large or supersize? The development and evaluation of interventions targeted at portion size

    PubMed Central

    Vermeer, W M; Steenhuis, I H M; Poelman, M P

    2014-01-01

    In the past decades, portion sizes of high-caloric foods and drinks have increased and can be considered an important environmental obesogenic factor. This paper describes a research project in which the feasibility and effectiveness of environmental interventions targeted at portion size was evaluated. The studies that we conducted revealed that portion size labeling, offering a larger variety of portion sizes, and proportional pricing (that is, a comparable price per unit regardless of the size) were considered feasible to implement according to both consumers and point-of-purchase representatives. Studies into the effectiveness of these interventions demonstrated that the impact of portion size labeling on the (intended) consumption of soft drinks was, at most, modest. Furthermore, the introduction of smaller portion sizes of hot meals in worksite cafeterias in addition to the existing size stimulated a moderate number of consumers to replace their large meals by a small meal. Elaborating on these findings, we advocate further research into communication and marketing strategies related to portion size interventions; the development of environmental portion size interventions as well as educational interventions that improve people's ability to deal with a ‘super-sized' environment; the implementation of regulation with respect to portion size labeling, and the use of nudges to stimulate consumers to select healthier portion sizes. PMID:25033959

  6. Adolescent Weight Control: An Intervention Targeting Parent Communication and Modeling Compared With Minimal Parental Involvement

    PubMed Central

    Hadley, Wendy; Sato, Amy; Kuhl, Elizabeth; Rancourt, Diana; Oster, Danielle; Lloyd-Richardson, Elizabeth

    2015-01-01

    Objective Adolescent weight control interventions demonstrate variable findings, with inconsistent data regarding the appropriate role for parents. The current study examined the efficacy of a standard adolescent behavioral weight control (BWC) intervention that also targeted parent–adolescent communication and parental modeling of healthy behaviors (Standard Behavioral Treatment + Enhanced Parenting; SBT + EP) compared with a standard BWC intervention (SBT). Methods 49 obese adolescents (M age = 15.10; SD = 1.33; 76% female; 67.3% non-Hispanic White) and a caregiver were randomly assigned to SBT or SBT + EP. Adolescent and caregiver weight and height, parental modeling, and weight-related communication were obtained at baseline and end of the 16-week intervention. Results Significant decreases in adolescent weight and increases in parental self-monitoring were observed across both conditions. Analyses of covariance revealed a trend for greater reduction in weight and negative maternal commentary among SBT condition participants. Conclusions Contrary to hypotheses, targeting parent–adolescent communication and parental modeling did not lead to better outcomes in adolescent weight control. PMID:25294840

  7. Involvement and targeted intervention of dysregulated Hedgehog signaling in osteosarcoma.

    PubMed

    Lo, Winnie W; Wunder, Jay S; Dickson, Brendan C; Campbell, Veronica; McGovern, Karen; Alman, Benjamin A; Andrulis, Irene L

    2014-02-15

    During development, the Hedgehog pathway plays important roles regulating the proliferation and differentiation of chondrocytes, providing a template for growing bone. In this study, the authors investigated the components of dysregulated Hedgehog signaling as potential therapeutic targets for osteosarcoma. Small-molecule agonists and antagonists that modulate the Hedgehog pathway at different levels were used to investigate the mechanisms of dysregulation and the efficacy of Hedgehog blockade in osteosarcoma cell lines. The inhibitory effect of a small-molecule Smoothened (SMO) antagonist, IPI-926 (saridegib), also was examined in patient-derived xenograft models. An inverse correlation was identified in osteosarcoma cell lines between endogenous glioma-associated oncogene 2 (GLI2) levels and Hedgehog pathway induction levels. Cells with high levels of GLI2 were sensitive to GLI inhibition, but not SMO inhibition, suggesting that GLI2 overexpression may be a mechanism of ligand-independent activation. In contrast, cells that expressed high levels of the Hedgehog ligand gene Indian hedgehog (IHH) and the target genes patched 1 (PTCH1) and GLI1 were sensitive to modulation of both SMO and GLI, suggesting ligand-dependent activation. In 2 xenograft models, active autocrine and paracrine, ligand-dependent Hedgehog signaling was identified. IPI-926 inhibited the Hedgehog signaling interactions between the tumor and the stroma and demonstrated antitumor efficacy in 1 of 2 ligand-dependent models. The current results indicate that both ligand-dependent and ligand-independent Hedgehog dysregulation may be involved in osteosarcoma. It is the first report to demonstrate Hedgehog signaling crosstalk between the tumor and the stroma in osteosarcoma. The inhibitory effect of IPI-926 warrants additional research and raises the possibility of using Hedgehog pathway inhibitors as targeted therapeutics to improve treatment for osteosarcoma. © 2013 American Cancer Society.

  8. Improving medication adherence with a targeted, technology-driven disease management intervention.

    PubMed

    Lawrence, David B; Allison, Wanda; Chen, Joyce C; Demand, Michael

    2008-06-01

    Treatment adherence is critical in managing chronic disease, but achieving it remains an elusive goal across many prevalent conditions. As part of its care management strategy, BlueCross BlueShield of South Carolina (BCBSSC) implemented the Longitudinal Adherence Treatment Evaluation program, a behavioral intervention to improve medication adherence among members with cardiovascular disease and/or diabetes. The objectives of this study were to 1) assess the effectiveness of telephonic intervention in influencing reinitiation of medication therapy, and 2) evaluate the rate and timing of medication reinitiation. BCBSSC applied algorithms against pharmacy claims data to identify patients prescribed targeted medications who were 60 or more days overdue for refills. This information was provided to care managers to address during their next patient contact. Care managers received focused training on techniques for medication behavior change, readiness to change, motivational interviewing, and active listening. Training also addressed common barriers to adherence and available resources, including side effect management, mail order benefits, drug assistance programs, medication organizers, and reminder systems. Overdue refills were tracked for 12 months, with medication reinitiation followed for an additional 3 months. In the intervention group, 94 patients were identified with 123 instances of late medication refills. In the age- and gender-matched comparison group, 61 patients were identified with 76 late refills. The intervention group had a significantly higher rate of medication reinitiation (59.3%) than the control group (42.1%; P < 0.05). Time to reinitiation was significantly shorter in the intervention group, 59.5 (+/- 69.0) days vs. 107.4 (+/- 109) days for the control group (P < 0.05). This initiative demonstrated that a targeted disease management intervention promoting patient behavior change increased the number of patients who reinitiated therapy after a

  9. Interventions targeting mental health self-stigma: A review and comparison.

    PubMed

    Yanos, Philip T; Lucksted, Alicia; Drapalski, Amy L; Roe, David; Lysaker, Paul

    2015-06-01

    With growing awareness of the impact of mental illness self-stigma, interest has arisen in the development of interventions to combat it. The present article briefly reviews and compares interventions targeting self-stigma to clarify the similarities and important differences between the interventions. We conducted a narrative review of published literature on interventions targeting self-stigma. Six intervention approaches (Healthy Self-Concept, Self-Stigma Reduction Program, Ending Self-Stigma, Narrative Enhancement and Cognitive Therapy, Coming Out Proud, and Anti-Stigma Photo-Voice Intervention) were identified and are discussed, and data is reviewed on format, group-leader backgrounds, languages, number of sessions, primary mechanisms of action, and the current state of data on their efficacy. We conclude with a discussion of common elements and important distinctions between the interventions and a consideration of which interventions might be best suited to particular populations or settings. (c) 2015 APA, all rights reserved).

  10. Interventions Targeting Mental Health Self-Stigma: A Review and Comparison

    PubMed Central

    Yanos, Philip T.; Lucksted, Alicia; Drapalski, Amy L.; Roe, David; Lysaker, Paul

    2014-01-01

    Objective With growing awareness of the impact of mental illness self-stigma, interest has arisen in the development of interventions to combat it. The present article briefly reviews and compares interventions targeting self-stigma to clarify the similarities and important differences between the interventions. Methods We conducted a narrative review of published literature on interventions targeting self-stigma. Results Six intervention approaches (Healthy Self-Concept, Self-Stigma Reduction Program, Ending Self-Stigma, Narrative Enhancement and Cognitive Therapy, Coming Out Proud, and Anti-Stigma Photo-Voice Intervention) were identified and are discussed, and data is reviewed on format, group-leader backgrounds, languages, number of sessions, primary mechanisms of action, and the current state of data on their efficacy. Conclusions and Implications for Practice We conclude with a discussion of common elements and important distinctions between the interventions and a consideration of which interventions might be best suited to particular populations or settings. PMID:25313530

  11. Study protocol for a systematic review of evidence for lifestyle interventions targeting smoking, sleep, alcohol/other drug use, physical activity, and healthy diet in people with bipolar disorder.

    PubMed

    Kay-Lambkin, Frances J; Thornton, Louise; Lappin, Julia M; Hanstock, Tanya; Sylvia, Louisa; Jacka, Felice; Baker, Amanda L; Berk, Michal; Mitchell, Phillip B; Callister, Robin; Rogers, Naomi; Webster, Stephanie; Dennis, Simon; Oldmeadow, Christopher; MacKinnon, Andrew; Doran, Christopher; Turner, Alyna; Hunt, Sally

    2016-07-05

    People with bipolar disorder (BD) have a mortality gap of up to 20 years compared to the general population. Physical conditions, such as cardiovascular disease (CVD) and cancer, cause the majority of excess deaths in psychiatric populations and are the leading causes of mortality in people with BD. However, comparatively little attention has been paid to reducing the risk of physical conditions in psychiatric populations. Unhealthy lifestyle behaviors are among the potentially modifiable risk factors for a range of commonly comorbid chronic medical conditions, including CVD, diabetes, and obesity. This systematic review will identify and evaluate the available evidence for effective interventions to reduce risk and promote healthy lifestyle behaviors in BD. We will search MEDLINE, Embase, PsychINFO, Cochrane Database of Systematic Reviews, and CINAHL for published research studies (with at least an abstract published in English) that evaluate behavioral or psychosocial interventions to address the following lifestyle factors in people with BD: tobacco use, physical inactivity, unhealthy diet, overweight or obesity, sleep-wake disturbance, and alcohol/other drug use. Primary outcomes for the review will be changes in tobacco use, level of physical activity, diet quality, sleep quality, alcohol use, and illicit drug use. Data on each primary outcome will be synthesized across available studies in that lifestyle area (e.g., tobacco abstinence, cigarettes smoked per day), and panel of research and clinical experts in each of the target lifestyle behaviors and those experienced with clinical and research with individuals with BD will determine how best to represent data related to that primary outcome. Seven members of the systematic review team will extract data, synthesize the evidence, and rate it for quality. Evidence will be synthesized via a narrative description of the behavioral interventions and their effectiveness in improving the healthy lifestyle behaviors

  12. The efficacy of targeted interventions for modifiable psychosocial risk factors of persistent nonspecific low back pain - a systematic review.

    PubMed

    Kent, Peter; Kjaer, Per

    2012-10-01

    There is considerable interest in whether best practice management of nonspecific low back pain (NSLBP) should include the targeting of treatment to subgroups of people with identifiable clinical characteristics. However, there are no published systematic reviews of the efficacy of targeted psychosocial interventions. This review aimed to determine if the efficacy of interventions for psychosocial risk factors of persistent NSLBP is improved when targeted to people with particular psychosocial characteristics. Bibliographic databases were searched. Inclusion criteria were randomised controlled trials of targeted psychosocial interventions that used trial designs capable of providing robust information on the efficacy of targeted treatment (treatment effect modification) for the outcomes of pain, activity limitation and psychosocial factors (fear avoidance, catastrophisation, anxiety and depression). Four studies met the inclusion criteria and collectively investigated nine hypotheses about targeted treatment on 28 subgroup/treatment outcomes. There were only two statistically significant results. Graded activity plus Treatment Based Classification targeted to people with high movement-related fear was more effective than Treatment Based Classification at reducing movement-related fear at 4 weeks. Active rehabilitation (physical exercise classes with cognitive-behavioural principles) was more effective than usual GP care at reducing activity limitation at 12 months, when targeted to people with higher movement-related pain. Few studies have investigated targeted psychosocial interventions in NSLBP, using trial designs suitable for measuring treatment effect modification, and they do not provide consistent evidence supporting such targeting. There is a need for appropriately designed and adequately powered trials to investigate targeted psychosocial interventions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. A systematic analysis of childhood obesity prevention interventions targeting Hispanic children: lessons learned from the previous decade.

    PubMed

    Branscum, P; Sharma, M

    2011-05-01

    Hispanic children suffer from the highest overall rates of prevalence for overweight and obesity in the US. In the last decade some interventions for prevention of childhood obesity have been developed and tailored to target this subgroup. The purpose of this review is to systematically analyze and summarize findings for health education and promotion interventions aimed at the prevention of childhood overweight and obesity among primarily Hispanic children. A systematic review of PubMed, CINAHL, and ERIC was done for the time period 2000 to May 2010. A posteriori effect size for the primary outcome of each intervention was calculated using G*Power. A total of nine interventions were located; five randomized controlled trials and four were either quasi-experimental or pilot studies. Among these studies, only four had significant findings, and calculated effect sizes (Cohen's f) ranged from small to medium with the highest f = 0.26. Interventions were more likely to be successful when participants were at higher risk for obesity, a parental component was included, the intervention contained theoretical underpinnings, the intervention was delivered by a dedicated staff, the intervention served older children and the intervention was longer in duration. More interventions need to be developed for Hispanic children. Future interventions should also develop and utilize culturally appropriate and sensitive materials and approaches. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

  14. Screen-Time Weight-loss Intervention Targeting Children at Home (SWITCH): a randomized controlled trial.

    PubMed

    Maddison, Ralph; Marsh, Samantha; Foley, Louise; Epstein, Leonard H; Olds, Timothy; Dewes, Ofa; Heke, Ihirangi; Carter, Karen; Jiang, Yannan; Mhurchu, Cliona Ni

    2014-09-10

    Screen-based activities, such as watching television (TV), playing video games, and using computers, are common sedentary behaviors among young people and have been linked with increased energy intake and overweight. Previous home-based sedentary behaviour interventions have been limited by focusing primarily on the child, small sample sizes, and short follow-up periods. The SWITCH (Screen-Time Weight-loss Intervention Targeting Children at Home) study aimed to determine the effect of a home-based, family-delivered intervention to reduce screen-based sedentary behaviour on body composition, sedentary behaviour, physical activity, and diet over 24 weeks in overweight and obese children. A two-arm, parallel, randomized controlled trial was conducted. Children and their primary caregiver living in Auckland, New Zealand were recruited via schools, community centres, and word of mouth. The intervention, delivered over 20 weeks, consisted of a face-to-face meeting with the parent/caregiver and the child to deliver intervention content, which focused on training and educating them to use a wide range of strategies designed to reduce their child's screen time. Families were given Time Machine TV monitoring devices to assist with allocating screen time, activity packages to promote alternative activities, online support via a website, and monthly newsletters. Control participants were given the intervention material on completion of follow-up. The primary outcome was change in children's BMI z-score from baseline to 24 weeks. Children (n = 251) aged 9-12 years and their primary caregiver were randomized to receive the SWITCH intervention (n = 127) or no intervention (controls; n = 124). There was no significant difference in change of zBMI between the intervention and control groups, although a favorable trend was observed (-0.016; 95% CI: -0.084, 0.051; p = 0.64). There were also no significant differences on secondary outcomes, except for a trend towards

  15. Effects of a Workplace Intervention Targeting Psychosocial Risk Factors on Safety and Health Outcomes.

    PubMed

    Hammer, Leslie B; Truxillo, Donald M; Bodner, Todd; Rineer, Jennifer; Pytlovany, Amy C; Richman, Amy

    2015-01-01

    The goal of this study was to test the effectiveness of a workplace intervention targeting work-life stress and safety-related psychosocial risk factors on health and safety outcomes. Data were collected over time using a randomized control trial design with 264 construction workers employed in an urban municipal department. The intervention involved family- and safety-supportive supervisor behavior training (computer-based), followed by two weeks of behavior tracking and a four-hour, facilitated team effectiveness session including supervisors and employees. A significant positive intervention effect was found for an objective measure of blood pressure at the 12-month follow-up. However, no significant intervention results were found for self-reported general health, safety participation, or safety compliance. These findings suggest that an intervention focused on supervisor support training and a team effectiveness process for planning and problem solving should be further refined and utilized in order to improve employee health with additional research on the beneficial effects on worker safety.

  16. A novel cognitive intervention for compulsive checking: Targeting maladaptive beliefs about memory.

    PubMed

    Alcolado, Gillian M; Radomsky, Adam S

    2016-12-01

    Compulsive checking is one of the most common symptoms of obsessive-compulsive disorder (OCD). Recently it has been proposed that those who check compulsively may believe their memory is poor, rather than having an actual memory impairment. The current study sought to develop and assess a brief cognitive intervention focused on improving maladaptive beliefs about memory, as they pertain to both checking symptoms and memory performance. Participants (N = 24) with a diagnosis of OCD and clinical levels of checking symptomatology were randomly assigned either to receive two weekly 1-hour therapy sessions or to self-monitor during a similar waitlist period. Time spent checking, checking symptoms, maladaptive beliefs about memory, and visuospatial memory were assessed both pre- and post-treatment/waitlist. Results showed that compared to the waitlist condition, individuals in the treatment condition displayed significant decreases in their maladaptive beliefs about memory and checking symptoms from pre- to post-intervention. They also exhibited increased recall performance on a measure of visuospatial memory. Changes in beliefs about memory were predictors of reduced post-intervention checking, but were not predictive of increased post-intervention memory scores. The lack of long term follow-up data and use of a waitlist control leave questions about the stability and specificity of the intervention. Findings provide preliminary evidence that strategies targeting beliefs about memory may be worthy of inclusion in cognitive-behavioural approaches to treating compulsive checking. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Effects of a Workplace Intervention Targeting Psychosocial Risk Factors on Safety and Health Outcomes

    PubMed Central

    Hammer, Leslie B.; Truxillo, Donald M.; Bodner, Todd; Rineer, Jennifer; Pytlovany, Amy C.; Richman, Amy

    2015-01-01

    The goal of this study was to test the effectiveness of a workplace intervention targeting work-life stress and safety-related psychosocial risk factors on health and safety outcomes. Data were collected over time using a randomized control trial design with 264 construction workers employed in an urban municipal department. The intervention involved family- and safety-supportive supervisor behavior training (computer-based), followed by two weeks of behavior tracking and a four-hour, facilitated team effectiveness session including supervisors and employees. A significant positive intervention effect was found for an objective measure of blood pressure at the 12-month follow-up. However, no significant intervention results were found for self-reported general health, safety participation, or safety compliance. These findings suggest that an intervention focused on supervisor support training and a team effectiveness process for planning and problem solving should be further refined and utilized in order to improve employee health with additional research on the beneficial effects on worker safety. PMID:26557703

  18. AMPK as Target for Intervention in Childhood and Adolescent Obesity

    PubMed Central

    Rojas, Joselyn; Arraiz, Nailet; Aguirre, Miguel; Velasco, Manuel; Bermúdez, Valmore

    2011-01-01

    Childhood obesity is a major worldwide health problem. Intervention programs to ameliorate the rate of obesity have been designed and implemented; yet the epidemic has no end near in sight. AMP-activated protein kinase (AMPK) has become one of the most important key elements in energy control, appetite regulation, myogenesis, adipocyte differentiation, and cellular stress management. Obesity is a multifactorial disease, which has a very strong genetic component, especially epigenetic factors. The intrauterine milieu has a determinant impact on adult life, since the measures taken for survival are kept throughout life thanks to epigenetic modification. Nutrigenomics studies the influence of certain food molecules on the metabolome profile, raising the question of an individualized obesity therapy according to metabolic (and probably) genetic features. Metformin, an insulin sensitizing agent, its known to lower insulin resistance and enhance metabolic profile, with an additional weight reduction capacity, via activation of AMPK. Exercise is coadjutant for lifestyle modifications, which also activates AMPK in several ways contributing to glucose and fat oxidation. The following review examines AMPK's role in obesity, applying its use as a tool for childhood and adolescent obesity. PMID:21318055

  19. Negative symptoms and social cognition: identifying targets for psychological interventions.

    PubMed

    Lincoln, Tania M; Mehl, Stephanie; Kesting, Marie-Luise; Rief, Winfried

    2011-09-01

    How to improve treatment for negative symptoms is a continuing topic of debate. Suggestions have been made to advance psychological understanding of negative symptoms by focusing on the social cognitive processes involved in symptom formation and maintenance. Following the recommendations by the National Institute of Mental Health workshop on social cognition in schizophrenia, this study investigated associations between negative symptoms and various aspects of social cognition including Theory of Mind (ToM), attribution, empathy, self-esteem, and interpersonal self-concepts in 75 patients with schizophrenia spectrum disorders and 75 healthy controls. Negative symptoms were significantly associated with difficulties in ToM, less readiness to be empathic, lower self-esteem, less self-serving bias, negative self-concepts related to interpersonal abilities, and dysfunctional acceptance beliefs. Different aspects of social cognition were mildly to moderately correlated and interacted in their impact on negative symptoms: Difficulties in ToM were associated with negative symptoms in persons with low but not in persons with medium or high levels of self-esteem. Taken together, the social cognition variables and their hypothesized interaction explained 39% of the variance in negative symptoms after controlling for neurocognition and depression. The results highlight the relevance of self-concepts related to social abilities, dysfunctional beliefs, and global self-worth alone and in interaction with ToM deficits for negative symptoms and thereby provide a helpful basis for advancing psychosocial interventions.

  20. Risks and Targeted Interventions: Firearms in Intimate Partner Violence.

    PubMed

    Zeoli, April M; Malinski, Rebecca; Turchan, Brandon

    2016-01-01

    The use of firearms in intimate partner violence (IPV) is widely recognized as an important public health threat. However, what we know about the risks of firearm access on IPV outcomes is limited. Therefore, we conducted a systematic review to determine the state of knowledge on 1) the risks of firearm access and use in IPV and 2) the effectiveness of interventions designed specifically to reduce firearm violence in intimate relationships. Only studies published in English in peer-reviewed journals from 1990 through 2014 were included. Results of the review suggest that, when violent intimates have access to firearms, IPV increases in severity and deadliness; however, increases in severity may not be due to firearm use. Additionally, statutes prohibiting persons under domestic violence restraining orders from accessing firearms are associated with reductions in intimate partner homicide, but certain provisions of these laws and their enforcement may impact their effectiveness. Future research should focus on elucidating the link between firearm access and increased IPV severity and on investigating whether and which specific provisions of domestic violence restraining order laws impact the laws' effectiveness. Additionally, more evaluations of initiatives designed to improve the enforcement of domestic violence restraining order firearm prohibitions are needed. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Legislative, educational, policy and other interventions targeting physicians’ interaction with pharmaceutical companies: a systematic review

    PubMed Central

    Alkhaled, Lina; Kahale, Lara; Nass, Hala; Brax, Hneine; Fadlallah, Racha; Badr, Kamal; Akl, Elie A

    2014-01-01

    Background Pharmaceutical company representatives likely influence the prescribing habits and professional behaviour of physicians. Objective The objective of this study was to systematically review the effects of interventions targeting practising physicians’ interactions with pharmaceutical companies. Eligibility criteria We included observational studies, non-randomised controlled trials (non-RCTs) and RCTs evaluating legislative, educational, policy or other interventions targeting the interactions between physicians and pharmaceutical companies. Data sources The search strategy included an electronic search of MEDLINE and EMBASE. Two reviewers performed duplicate and independent study selection, data abstraction and assessment of risk of bias. Appraisal and synthesis methods We assessed the risk of bias in each included study. We summarised the findings narratively because the nature of the data did not allow a meta-analysis to be conducted. We assessed the quality of evidence by outcome using the GRADE methodology. Results Of 11 189 identified citations, one RCT and three observational studies met the eligibility criteria. All four studies specifically targeted one type of interaction with pharmaceutical companies, that is, interactions with drug representatives. The RCT provided moderate quality evidence of no effect of a ‘collaborative approach’ between the pharmaceutical industry and a health authority. The three observational studies provided low quality evidence suggesting a positive effect of policies aiming to reduce interaction between physicians and pharmaceutical companies (by restricting free samples, promotional material, and meetings with pharmaceutical company representatives) on prescription behaviour. Limitations We identified too few studies to allow strong conclusions. Conclusions Available evidence suggests a potential impact of policies aiming to reduce interaction between physicians and drug representatives on physicians

  2. A Narrative Review of Social Media and Game-Based Nutrition Interventions Targeted at Young Adults.

    PubMed

    Nour, Monica; Yeung, Sin Hang; Partridge, Stephanie; Allman-Farinelli, Margaret

    2017-05-01

    The increased popularity of social media and mobile gaming among young adults provides an opportunity for innovative nutrition programs. This review evaluated the efficacy of these strategies in interventions targeted at 18- to 35-year-olds. The protocol was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Ten scientific databases, information technology conference proceedings, and gray literature were searched. Two reviewers conducted screening, data extraction, and quality assessments. Interventions were included if they used social media or electronic games. Comparisons were made pre- to post-intervention, or between intervention and control arms. Outcomes of interest included change in nutrition knowledge, attitudes, behavior, or weight and/or body composition. Eleven social media-based (randomized controlled trials [RCT] n=7) and six game-based [RCT n=1]) interventions were included. Overall quality of studies was low. Social media-based strategies included forum/blogs (n=5), Facebook (n=5), Twitter (n=1), YouTube (n=1), and chat rooms (n=1). Eight (RCT n=6) of 11 social media-based studies demonstrated improvements in outcomes. Findings suggested that social media may be more effective when combined with other strategies. Virtual reality games (n=3), web-based games (n=2), and a mobile application (n=1) were used in the gaming interventions. While a significant increase in knowledge was reported by three gaming studies (RCT=1), two used nonvalidated tools and longer-term measures of weight and behavioral outcomes were limited. The use of social media and gaming for nutrition promotion is in its infancy. Preliminary evidence suggests that these strategies have some utility for intervening with young adults. Further research using high-quality study designs is required, with measurement of outcomes over longer time periods. The systematic review protocol is registered with PROSPERO (registration number: CRD42015025427

  3. Feasibility of a targeted breast health education intervention for Chinese American immigrant women.

    PubMed

    Lee-Lin, Frances; Menon, Usha; Leo, Michael C; Pedhiwala, Nisreen

    2013-07-01

    To assess the feasibility and acceptability of a targeted educational intervention to increase mammography screening among Chinese American women. One-group pre- and post-test quasiexperimental design. Metropolitan areas of Portland, OR. 44 foreign-born Chinese American women aged 40 years and older. Participants who had not had a mammogram within the past 12 months were recruited and enrolled to a targeted breast health educational program. Before starting the group session, participants completed a baseline survey, which was administered again 12 weeks postintervention. Completion of mammography screening test, movement in stage of readiness, mammography and breast cancer knowledge, perceived susceptibility, perceived benefits, and perceived common and cultural barriers. The study response rate was high (71%). Of the 42 women who completed the study, 21 (50%) had a mammogram postintervention. The top three reasons for not completing a mammogram at the end of the study were no need or no symptom, busy, and reliance on family for assistance. Mean breast cancer susceptibility scores increased significantly at post-test as theorized (t[40] = -2.88, p < 0.01). Participants were more likely to obtain a mammogram when they had been in the United States for 3-15 years. A targeted program that aims to increase breast health knowledge, improve access, and remove barriers may promote mammography screening among Chinese American immigrant women. This promising intervention now being tested under a randomized, controlled design can be adapted to other Asian subgroups. Targeted breast health intervention is feasible for improving mammography screening among Chinese immigrant women. Educating these women about early detection is important, as the first sign of breast cancer usually shows on a woman's mammogram before it can be felt or any other symptoms are present. Immigrant women may be too busy to dedicate proper time to self-care behaviors; therefore, making it easier and

  4. Alveolar bone loss: mechanisms, potential therapeutic targets, and interventions.

    PubMed

    Intini, G; Katsuragi, Y; Kirkwood, K L; Yang, S

    2014-05-01

    This article reviews recent research into mechanisms underlying bone resorption and highlights avenues of investigation that may generate new therapies to combat alveolar bone loss in periodontitis. Several proteins, signaling pathways, stem cells, and dietary supplements are discussed as they relate to periodontal bone loss and regeneration. RGS12 is a crucial protein that mediates osteoclastogenesis and bone destruction, and a potential therapeutic target. RGS12 likely regulates osteoclast differentiation through regulating calcium influx to control the calcium oscillation-NFATc1 pathway. A working model for RGS10 and RGS12 in the regulation of Ca(2+) oscillations during osteoclast differentiation is proposed. Initiation of inflammation depends on host cell-microbe interactions, including the p38 mitogen-activated protein kinase (MAPK) signaling pathway. Oral p38 inhibitors reduced lipopolysaccharide (LPS)-induced bone destruction in a rat periodontitis model but showed unsatisfactory safety profiles. The p38 substrate MK2 is a more specific therapeutic target with potentially superior tolerability. Furthermore, MKP-1 shows anti-inflammatory activity, reducing inflammatory cytokine biosynthesis and bone resorption. Multipotent skeletal stem cell (SSC) populations exist within the bone marrow and periosteum of long bones. These bone-marrow-derived SSCs and periosteum-derived SSCs have shown therapeutic potential in several applications, including bone and periodontal regeneration. The existence of craniofacial bone-specific SSCs is suggested based on existing studies. The effects of calcium, vitamin D, and soy isoflavone supplementation on alveolar and skeletal bone loss in post-menopausal women were investigated. Supplementation resulted in stabilization of forearm bone mass density and a reduced rate of alveolar bone loss over 1 yr, compared with placebo. Periodontal attachment levels were also well-maintained and alveolar bone loss suppressed during 24 wk of

  5. External validity of post-stroke interventional gait rehabilitation studies.

    PubMed

    Kafri, Michal; Dickstein, Ruth

    2017-01-01

    Gait rehabilitation is a major component of stroke rehabilitation, and is supported by extensive research. The objective of this review was to examine the external validity of intervention studies aimed at improving gait in individuals post-stroke. To that end, two aspects of these studies were assessed: subjects' exclusion criteria and the ecological validity of the intervention, as manifested by the intervention's technological complexity and delivery setting. Additionally, we examined whether the target population as inferred from the titles/abstracts is broader than the population actually represented by the reported samples.

  6. Impacting Environmental and Public Health through the Use of Dual Targeted and Tailored Asthma Educational Interventions.

    PubMed

    Carrillo, Genny; Han, Daikwon; Lucio, Rose L; Seol, Yoon-Ho; Chong-Menard, Betty; Smith, Kenneth

    2015-01-01

    Home-based asthma environmental education for parents of asthmatic children is needed since many health professionals lack the time to offer it. However, developing targeted and tailored education is important in order to address the individual needs of participants. This nonrandomized longitudinal study examined knowledge on asthma with an Asthma and Healthy Homes educational intervention training offered to parents of children from low income families who reside in the Rio Grande Valley of Texas. Eighty-nine parents received the training and pre- and posttest surveys were used to measure knowledge outcomes. A standardized assessment on asthma triggers was used to identify the different triggers each child was exposed to, and a follow-up survey was conducted 6 months after the educational intervention to identify how many parents reported household and behavior changes as a result of the training. Results showed significant changes in behavior by participants as a result of the training received. This study suggests that these behavioral changes are attributed to the dual "targeted" and "tailored" educational interventions delivered to parents which resulted in a greater understanding of how to manage asthma by eliminating asthma triggers in their respective homes.

  7. Revisiting rose: comparing the benefits and costs of population-wide and targeted interventions.

    PubMed

    Ahern, Jennifer; Jones, Matthew R; Bakshis, Erin; Galea, Sandro

    2008-12-01

    Geoffrey Rose's two principal approaches to public health intervention are (1) targeted strategies focusing on individuals at a personal increased risk of disease and (2) population-wide approaches focusing on the whole population. Beyond his discussion of the strengths and weaknesses of these approaches, there is no empiric work examining the conditions under which one of these approaches may be better than the other. This article uses mathematical simulations to model the benefits and costs of the two approaches, varying the cut points for treatment, effect magnitudes, and costs of the interventions. These techniques then were applied to the specific example of an intervention on blood pressure to reduce cardiovascular disease. In the general simulation (using an inverse logit risk curve), lower costs of intervention, treating people with risk factor values at or above where the slope on the risk curve is at its steepest (for targeted interventions), and interventions with larger effects on reducing the risk factor (for population-wide interventions) provided benefit/cost advantages. In the specific blood pressure intervention example, lower-cost population-wide interventions had better benefit/cost ratios, but some targeted treatments with lower cutoffs prevented more absolute cases of disease. These simulations empirically evaluate some of Rose's original arguments. They can be replicated for particular interventions being considered and may be useful in helping public health decision makers assess potential intervention strategies.

  8. A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents.

    PubMed

    Hynynen, S-T; van Stralen, M M; Sniehotta, F F; Araújo-Soares, V; Hardeman, W; Chinapaw, M J M; Vasankari, T; Hankonen, N

    2016-01-01

    Lack of physical activity (PA) and high levels of sedentary behaviour (SB) have been associated with health problems. This systematic review evaluates the effectiveness of school-based interventions to increase PA and decrease SB among 15-19-year-old adolescents, and examines whether intervention characteristics (intervention length, delivery mode and intervention provider) and intervention content (i.e. behaviour change techniques, BCTs) are related to intervention effectiveness. A systematic search of randomised or cluster randomised controlled trials with outcome measures of PA and/or SB rendered 10 results. Risk of bias was assessed using the Cochrane risk of bias tool. Intervention content was coded using Behaviour Change Technique Taxonomy v1. Seven out of 10 studies reported significant increases in PA. Effects were generally small and short-term (Cohen's d ranged from 0.132 to 0.659). Two out of four studies that measured SB reported significant reductions in SB. Interventions that increased PA included a higher number of BCTs, specific BCTs (e.g., goal setting, action planning and self-monitoring), and were delivered by research staff. Intervention length and mode of delivery were unrelated to effectiveness. More studies are needed that evaluate long-term intervention effectiveness and target SBs among older adolescents.

  9. Interventional value of total flavonoids from Rhizoma Drynariae on Cathepsin K, a potential target of osteoporosis.

    PubMed

    Shi, Xiao-Lin; Liu, Kang; Wu, Lian-Guo

    2011-07-01

    Osteoporosis, the sixth most common disease in the world, is bringing increasingly serious harm to people's health. Cathepsin K, which plays an important role in bone resorption, is a potential target in the treatment of osteoporosis. Total flavonoids, the active ingredients in Rhizoma Drynariae, have shown obvious, therapeutic effect on osteoporosis. In previous studies, it was presumed that the mechanism for the therapeutic effect was through inhibiting the expression of Cathepsin K. However, there are still no detailed reports on some key issues such as the specific inhibitory results of total flavonoids on Cathepsin K and the pathway of inhibition and so on. Based on previous studies on total flavonoids from Rhizoma Drynariae, the pathway for the effect of, total flavonoids inhibiting Cathepsin K and their interventional value on Cathepsin K were analyzed in this paper, so as to explore the interventional feasibility and value of total flavonoids in Rhizoma Drynariae on Cathepsin K.

  10. Young drivers at railway crossings: an exploration of risk perception and target behaviours for intervention.

    PubMed

    Davey, J; Wallace, A; Stenson, N; Freeman, J

    2008-06-01

    Research into motorist understanding and behaviour at railway crossings is currently limited in Australia, despite 74 fatalities being recorded due to collisions between trains and motor vehicles from 1997 to 2002. The present study explored the knowledge, attitudes and self-reported behaviour of younger drivers aged 17-24 years, as an 'at risk' group. The objective of this study was to develop a formative understanding of the nature and underlying beliefs of younger drivers' behaviours at railway crossings, in order to inform specific crossing safety interventions for this group. Fifty-three young drivers from metropolitan and regional settings participated in semi-structured focused group interviews. Differences were detected between the groups, with regional participants displaying a higher level of risk-taking behaviours and lower risk perceptions. The results are discussed with reference to actual risk as indicated by a panel of experts in the field. Implications for intervention design targeting attitudes and behaviours are discussed.

  11. Molecular Targets Related to Inflammation and Insulin Resistance and Potential Interventions

    PubMed Central

    Hirabara, Sandro M.; Gorjão, Renata; Vinolo, Marco A.; Rodrigues, Alice C.; Nachbar, Renato T.; Curi, Rui

    2012-01-01

    Inflammation and insulin resistance are common in several chronic diseases, such as obesity, type 2 diabetes mellitus, metabolic syndrome, cancer, and cardiovascular diseases. Various studies show a relationship between these two factors, although the mechanisms involved are not completely understood yet. Here, we discuss the molecular basis of insulin resistance and inflammation and the molecular aspects on inflammatory pathways interfering in insulin action. Moreover, we explore interventions based on molecular targets for preventing or treating correlated disorders, advances for a better characterization, and understanding of the mechanisms and mediators involved in the different inflammatory and insulin resistance conditions. Finally, we address biotechnological studies for the development of new potential therapies and interventions. PMID:23049242

  12. Role of Context, Resources, and Target Population in the Fidelity of Critical Time Intervention.

    PubMed

    Barrenger, Stacey L; Kriegel, Liat S; Angell, Beth; Draine, Jeffrey

    2016-01-01

    The goal of this study was to understand departures from a model program, critical time intervention (CTI), when used with a population of men with mental illness who were leaving prison, a new population for the intervention. A fidelity study was conducted with the CTI Fidelity Scale Manual, and six program staff participated in semistructured interviews. Thematic analysis of interviews supplemented information on departures from the model. The overall fidelity score indicated a well-implemented program, but low scores on early engagement, early linking with community resources, monitoring the transfer of services from CTI to community services, and nine-month follow-up were related to the context of the prison setting, the population of men leaving prison, and environmental resources. The setting in which evidence-based practices are applied, the environmental resources available, and the target population may affect program fidelity.

  13. Interventions Targeting Sensory Challenges in Autism Spectrum Disorder: A Systematic Review.

    PubMed

    Weitlauf, Amy S; Sathe, Nila; McPheeters, Melissa L; Warren, Zachary E

    2017-06-01

    Sensory challenges are common among children with autism spectrum disorder (ASD). To evaluate the effectiveness and safety of interventions targeting sensory challenges in ASD. Databases, including Medline and PsycINFO. Two investigators independently screened studies against predetermined criteria. One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE), or confidence in the estimate of effects. Twenty-four studies, including 20 randomized controlled trials (RCTs), were included. Only 3 studies had low risk of bias. Populations, interventions, and outcomes varied. Limited, short-term studies reported potential positive effects of several approaches in discrete skill domains. Specifically, sensory integration-based approaches improved sensory and motor skills-related measures (low SOE). Environmental enrichment improved nonverbal cognitive skills (low SOE). Studies of auditory integration-based approaches did not improve language (low SOE). Massage improved symptom severity and sensory challenges in studies with likely overlapping participants (low SOE). Music therapy studies evaluated different protocols and outcomes, precluding synthesis (insufficient SOE). Some positive effects were reported for other approaches, but findings were inconsistent (insufficient SOE). Studies were small and short-term, and few fully categorized populations. Some interventions may yield modest short-term (<6 months) improvements in sensory- and ASD symptom severity-related outcomes; the evidence base is small, and the durability of the effects is unclear. Although some therapies may hold promise, substantial needs exist for continuing improvements in methodologic rigor. Copyright © 2017 by the American Academy of Pediatrics.

  14. Feasibility of a Tailored Intervention Targeting STD-Related Behaviors.

    ERIC Educational Resources Information Center

    Bellis, Jeffery M.; Grimely, Diane M.; Alexander, Leah R.

    2002-01-01

    Investigated whether high risk populations would be receptive to tailored, multimedia interventions to promote adoption of health-protective behaviors related to sexually transmitted disease (STD) prevention and control. Feedback from predominantly African American, urban participants aged 16-50 years, recruited from a STD clinic, indicated that…

  15. Interventions Targeting Attention in Young Children with Autism

    ERIC Educational Resources Information Center

    Patten, Elena; Watson, Linda R.

    2011-01-01

    Purpose: The ability to focus and sustain one's attention is critical for learning. Children with autism demonstrate unusual characteristics of attention from infancy. It is reasonable to assume that early anomalies in attention influence a child's developmental trajectories. Therapeutic interventions for autism often focus on core features of…

  16. Interventions Targeting Attention in Young Children with Autism

    ERIC Educational Resources Information Center

    Patten, Elena; Watson, Linda R.

    2011-01-01

    Purpose: The ability to focus and sustain one's attention is critical for learning. Children with autism demonstrate unusual characteristics of attention from infancy. It is reasonable to assume that early anomalies in attention influence a child's developmental trajectories. Therapeutic interventions for autism often focus on core features of…

  17. Cognitive Alignment with Performance Targeted Training Intervention Model: CAPTTIM

    DTIC Science & Technology

    2015-02-01

    Neurophysiological markers, as captured by eyetracking and electroencephalography ( EEG ), can assist in determining why misalignment between cognitive state...it indicates that a training intervention is needed. Neurophysiological markers as captured by eyetracking and electroencephalography ( EEG ) can...performance are necessary to truly understand optimal military decision making. In the process of operationalizing the definitions of exploration

  18. Development of a Culturally Targeted Smoking Cessation Intervention for African American Smokers

    PubMed Central

    Matthews, Alicia K.; Sánchez-Johnsen, Lisa; King, Andrea

    2013-01-01

    In this paper we describe the development a culturally targeted (CT) smoking cessation intervention for low-to-middle income African–American smokers. Based on theoretically based guidelines, modifications were made to a standard treatment manual for group-based smoking cessation counseling that incorporates cognitive-behavioral, motivational, and twelve step skills. Approximately 41% of the standard treatment materials were modified, and four new modules were developed. A pilot study was conducted to compare acceptability, feasibility and early outcome indicates in African American smokers randomized to the CT intervention compared with existing data from African American smokers treated using a non-targeted standard approach (ST). Outcomes from the CT pilot study were promising: results showed high levels of feasibility, acceptability and better adherence to nicotine replacement therapy, higher quit rates, and better retention and follow-up compared with the ST. Findings suggest that a culturally targeted and intensive group based smoking cessation treatment is plausibly effective in improving smoking cessation outcomes in African American smokers, warranting a larger randomized trial. PMID:19728056

  19. Evaluating Intervention Programs Targeting Parents to Manage Childhood Overweight and Obesity: A Systematic Review Using the RE-AIM Framework.

    PubMed

    Jang, Myoungock; Chao, Ariana; Whittemore, Robin

    2015-01-01

    Intervention programs targeting parents to manage childhood overweight and obesity have emerged based on parents influence on the health behaviors of their children. The purpose of this review was to systematically evaluate intervention programs targeting parents to manage childhood overweight and obesity using the Reach, Efficacy, Adopt, Implementation, and Maintenance (RE-AIM) framework. There was a moderate risk of bias across all studies. The overall proportion of studies (n=7) reporting on each dimension of the RE-AIM framework ranged from 78.6% (reach) to 23.8% (maintenance). The majority of intervention programs demonstrated improvement in child BMI. However intervention programs did not reach families of diverse race/ethnicity, were provided by highly trained professionals, and demonstrated high attrition, thus limiting generalizability. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Effectiveness of interventions targeting health behaviors in university and college staff: a systematic review.

    PubMed

    Plotnikoff, Ronald; Collins, Clare E; Williams, Rebecca; Germov, John; Callister, Robin

    2015-01-01

    Evaluate the literature on interventions targeting tertiary education staff within colleges and universities for improvements in health behaviors such as physical activity, dietary intake, and weight loss. One online database, Medline, was searched for literature published between January 1970 and February 2013. All quantitative study designs, including but not limited to randomized controlled trials, quasi-experimental studies, nonrandomized experimental trials, cohort studies, and case-control studies, were eligible. Data extraction was performed by one reviewer using a standardized form developed by the researchers. Extraction was checked for accuracy and consistency by a second reviewer. Data in relation to the above objective were extracted and described in a narrative synthesis. Seventeen studies were identified that focused on staff within the tertiary education setting. The review yielded overall positive results with 13 reporting significant health-related improvements. Weight loss, physical activity and fitness, and/or nutrition were the focus in more than half (n = 9) of the studies. This appears to be the first review to examine health interventions for tertiary education staff. There is scope to enhance cross-disciplinary collaboration in the development and implementation of a "Healthy University" settings-based approach to health promotion in tertiary education workplaces. Universities or colleges could serve as a research platform to evaluate such intervention strategies.

  1. Nonpharmacological Interventions in Targeting Pain-Related Brain Plasticity

    PubMed Central

    Clark, J. David

    2017-01-01

    Chronic pain is a highly prevalent and debilitating condition that is frequently associated with multiple comorbid psychiatric conditions and functional, biochemical, and anatomical alterations in various brain centers. Due to its widespread and diverse manifestations, chronic pain is often resistant to classical pharmacological treatment paradigms, prompting the search for alternative treatment approaches that are safe and efficacious. The current review will focus on the following themes: attentional and cognitive interventions, the role of global environmental factors, and the effects of exercise and physical rehabilitation in both chronic pain patients and preclinical pain models. The manuscript will discuss not only the analgesic efficacy of these therapies, but also their ability to reverse pain-related brain neuroplasticity. Finally, we will discuss the potential mechanisms of action for each of the interventions. PMID:28299206

  2. Nonpharmacological Interventions in Targeting Pain-Related Brain Plasticity.

    PubMed

    Tajerian, Maral; Clark, J David

    2017-01-01

    Chronic pain is a highly prevalent and debilitating condition that is frequently associated with multiple comorbid psychiatric conditions and functional, biochemical, and anatomical alterations in various brain centers. Due to its widespread and diverse manifestations, chronic pain is often resistant to classical pharmacological treatment paradigms, prompting the search for alternative treatment approaches that are safe and efficacious. The current review will focus on the following themes: attentional and cognitive interventions, the role of global environmental factors, and the effects of exercise and physical rehabilitation in both chronic pain patients and preclinical pain models. The manuscript will discuss not only the analgesic efficacy of these therapies, but also their ability to reverse pain-related brain neuroplasticity. Finally, we will discuss the potential mechanisms of action for each of the interventions.

  3. Can Targeted Intervention Mitigate Early Emotional and Behavioral Problems?: Generating Robust Evidence within Randomized Controlled Trials

    PubMed Central

    Doyle, Orla; McGlanaghy, Edel; O’Farrelly, Christine; Tremblay, Richard E.

    2016-01-01

    This study examined the impact of a targeted Irish early intervention program on children’s emotional and behavioral development using multiple methods to test the robustness of the results. Data on 164 Preparing for Life participants who were randomly assigned into an intervention group, involving home visits from pregnancy onwards, or a control group, was used to test the impact of the intervention on Child Behavior Checklist scores at 24-months. Using inverse probability weighting to account for differential attrition, permutation testing to address small sample size, and quantile regression to characterize the distributional impact of the intervention, we found that the few treatment effects were largely concentrated among boys most at risk of developing emotional and behavioral problems. The average treatment effect identified a 13% reduction in the likelihood of falling into the borderline clinical threshold for Total Problems. The interaction and subgroup analysis found that this main effect was driven by boys. The distributional analysis identified a 10-point reduction in the Externalizing Problems score for boys at the 90th percentile. No effects were observed for girls or for the continuous measures of Total, Internalizing, and Externalizing problems. These findings suggest that the impact of this prenatally commencing home visiting program may be limited to boys experiencing the most difficulties. Further adoption of the statistical methods applied here may help to improve the internal validity of randomized controlled trials and contribute to the field of evaluation science more generally. Trial Registration: ISRCTN Registry ISRCTN04631728 PMID:27253184

  4. Validity of teacher ratings in selecting influential aggressive adolescents for a targeted preventive intervention.

    PubMed

    Henry, David B; Miller-Johnson, Shari; Simon, Thomas R; Schoeny, Michael E

    2006-03-01

    This study describes a method for using teacher nominations and ratings to identify socially influential, aggressive middle school students for participation in a targeted violence prevention intervention. The teacher nomination method is compared with peer nominations of aggression and influence to obtain validity evidence. Participants were urban, predominantly African American and Latino sixth-grade students who were involved in a pilot study for a large multi-site violence prevention project. Convergent validity was suggested by the high correlation of teacher ratings of peer influence and peer nominations of social influence. The teacher ratings of influence demonstrated acceptable sensitivity and specificity when predicting peer nominations of influence among the most aggressive children. Results are discussed in terms of the application of teacher nominations and ratings in large trials and full implementation of targeted prevention programs.

  5. Validity of Teacher Ratings in Selecting Influential Aggressive Adolescents for a Targeted Preventive Intervention

    PubMed Central

    Henry, David B.; Miller-Johnson, Shari; Simon, Thomas R.; Schoeny, Michael E.

    2009-01-01

    This study describes a method for using teacher nominations and ratings to identify socially influential, aggressive middle school students for participation in a targeted violence prevention intervention. The teacher nomination method is compared with peer nominations of aggression and influence to obtain validity evidence. Participants were urban, predominantly African American and Latino sixth-grade students who were involved in a pilot study for a large multi-site violence prevention project. Convergent validity was suggested by the high correlation of teacher ratings of peer influence and peer nominations of social influence. The teacher ratings of influence demonstrated acceptable sensitivity and specificity when predicting peer nominations of influence among the most aggressive children. Results are discussed m terms of the application of teacher nominations and ratings in large trials and full implementation of targeted prevention programs. PMID:16378226

  6. Using GIS Mapping to Target Public Health Interventions: Examining Birth Outcomes Across GIS Techniques.

    PubMed

    MacQuillan, E L; Curtis, A B; Baker, K M; Paul, R; Back, Y O

    2017-08-01

    With advances in spatial analysis techniques, there has been a trend in recent public health research to assess the contribution of area-level factors to health disparity for a number of outcomes, including births. Although it is widely accepted that health disparity is best addressed by targeted, evidence-based and data-driven community efforts, and despite national and local focus in the U.S. to reduce infant mortality and improve maternal-child health, there is little work exploring how choice of scale and specific GIS visualization technique may alter the perception of analyses focused on health disparity in birth outcomes. Retrospective cohort study. Spatial analysis of individual-level vital records data for low birthweight and preterm births born to black women from 2007 to 2012 in one mid-sized Midwest city using different geographic information systems (GIS) visualization techniques [geocoded address records were aggregated at two levels of scale and additionally mapped using kernel density estimation (KDE)]. GIS analyses in this study support our hypothesis that choice of geographic scale (neighborhood or census tract) for aggregated birth data can alter programmatic decision-making. Results indicate that the relative merits of aggregated visualization or the use of KDE technique depend on the scale of intervention. The KDE map proved useful in targeting specific areas for interventions in cities with smaller populations and larger census tracts, where they allow for greater specificity in identifying intervention areas. When public health programmers seek to inform intervention placement in highly populated areas, however, aggregated data at the census tract level may be preferred, since it requires lower investments in terms of time and cartographic skill and, unlike neighborhood, census tracts are standardized in that they become smaller as the population density of an area increases.

  7. Social capital interventions targeting older people and their impact on health: a systematic review.

    PubMed

    Coll-Planas, Laura; Nyqvist, Fredrica; Puig, Teresa; Urrútia, Gerard; Solà, Ivan; Monteserín, Rosa

    2017-07-01

    Observational studies show that social capital is a protective health factor. Therefore, we aim to assess the currently unclear health impact of social capital interventions targeting older adults. We conducted a systematic review based on a logic model. Studies published between January 1980 and July 2015 were retrieved from MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Web of Science. We included randomised controlled trials targeting participants over 60 years old and focused on social capital or its components (eg, social support and social participation). The comparison group should not promote social capital. We assessed risk of bias and impact on health outcomes and use of health-related resources applying a procedure from the Canadian Agency for Drugs and Technologies in Health (CADTH) based on vote-counting and standardised decision rules. The review protocol was registered in PROSPERO (reference number CRD42014015362). We examined 17 341 abstracts and included 73 papers reporting 36 trials. Trials were clinically and methodologically diverse and reported positive effects in different contexts, populations and interventions across multiple subjective and objective measures. According to sufficiently reported outcomes, social capital interventions showed mixed effects on quality of life, well-being and self-perceived health and were generally ineffective on loneliness, mood and mortality. Eight trials with high quality showed favourable impacts on overall, mental and physical health, mortality and use of health-related resources. Our review highlights the lack of evidence and the diversity among trials, while supporting the potential of social capital interventions to reach comprehensive health effects in older adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Disease mapping for informing targeted health interventions: childhood pneumonia in Bohol, Philippines.

    PubMed

    Thomas, Deborah S K; Anthamatten, Peter; Root, Elisabeth Dowling; Lucero, Marilla; Nohynek, Hanna; Tallo, Veronica; Williams, Gail M; Simões, Eric A F

    2015-11-01

    Acute lower respiratory tract infections (ALRI) are the leading cause of childhood mortality worldwide. Currently, most developing countries assign resources at a district level, and yet District Medical Officers have few tools for directing targeted interventions to high mortality or morbidity areas. Mapping of ALRI at the local level can guide more efficient allocation of resources, coordination of efforts and targeted interventions, which are particularly relevant for health management in resource-scarce settings. An efficacy study of 11-valent pneumococcal vaccine was conducted in six municipalities in the Bohol Province of central Philippines from July 2000 to December 2004. Geocoded under-five pneumonia cases (using WHO classifications) were mapped to create spatial patterns of pneumonia at the local health unit (barangay) level. There were 2951 children with WHO-defined clinical pneumonia, of whom 1074 were severe or very severely ill, 278 were radiographic, and 219 were hypoxaemic. While most children with pneumonia were from urban barangays, there was a disproportionately higher distribution of severe/very severe pneumonia in rural barangays and the most severe hypoxaemic children were concentrated in the northern barangays most distant from the regional hospital. Mapping of ALRI at the local administrative health level can be performed relatively simply. If these principles are applied to routinely collected IMCI classification of disease at the district level in developing countries, such efforts can form the basis for directing public health and healthcare delivery efforts in a targeted manner. © 2015 John Wiley & Sons Ltd.

  9. Liver cell cancer--intervention studies.

    PubMed

    Linsell, C A

    1981-01-01

    The field studies leading to possible intervention procedures are reviewed. Currently the most promising form of intervention is the prevention of aflatoxin contamination of foodstuffs. It is essential that these are monitored and their efficacy in lowering the incidence of liver cancer measured. The association of liver cancer with hepatitis B infection may be a confounding factor and the impact of this on the study population must also be considered. The imminent production of vaccines for hepatitis B infection may provide an alternative or additional mode of intervention. The possibilities for intervention in liver cell cancer appear one of the brighter prospects for primary prevention of a cancer.

  10. A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand

    PubMed Central

    2013-01-01

    Background Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide prevention interventions targeting Indigenous peoples in Australia, Canada, United States and New Zealand; 2) critique their methodological quality; and 3) describe their main characteristics. Methods A systematic search of 17 electronic databases and 13 websites for the period 1981–2012 (inclusive) was undertaken. The reference lists of reviews of suicide prevention interventions were hand-searched for additional relevant studies not identified by the electronic and web search. The methodological quality of evaluations of suicide prevention interventions was assessed using a standardised assessment tool. Results Nine evaluations of suicide prevention interventions were identified: five targeting Native Americans; three targeting Aboriginal Australians; and one First Nation Canadians. The main intervention strategies employed included: Community Prevention, Gatekeeper Training, and Education. Only three of the nine evaluations measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. The methodological quality of evaluations was variable. Particular problems included weak study designs, reliance on self-report measures, highly variable consent and follow-up rates, and the absence of economic or cost analyses. Conclusions There is an urgent need for an increase in the number of evaluations of preventive interventions targeting reductions in Indigenous suicide using methodologically rigorous study designs across geographically

  11. Review of Interventions to Reduce Ultraviolet Tanning: Need for Treatments Targeting Excessive Tanning, an Emerging Addictive Behavior.

    PubMed

    Stapleton, Jerod L; Hillhouse, Joel; Levonyan-Radloff, Kristine; Manne, Sharon L

    2017-06-22

    Millions of Americans engage in tanning each year, defined as intentional ultraviolet radiation (UVR) exposure in the form of sunbathing or the use of indoor tanning beds. An emerging body of research suggests that UVR has addictive properties and some tanners engage in excessive tanning. This article provides an overview of the evidence of tanning addiction and a systematic review of existing tanning interventions with the goal of evaluating their potential to impact addicted tanners. Our search identified 24 intervention studies that were summarized and discussed according to 3 primary themes. First, there is a dearth of tanning interventions that target excessive tanning or are designed as treatments for tanning addiction. Second, tanning interventions are primarily educational interventions designed to increase knowledge of the risks of tanning. Third, there are notable aspects of existing tanning interventions that are relevant to addiction science, including the use of brief motivational and cognitive-behavioral-based interventions. Future directions are considered including recommendations for utilizing the existing evidence base to formulate interventions targeting excessive tanners. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. A systematic review of evidence for end-of-life communication interventions: Who do they target, how are they structured and do they work?

    PubMed

    Walczak, Adam; Butow, Phyllis N; Bu, Stella; Clayton, Josephine M

    2016-01-01

    To identify and synthesise evidence for interventions targeting end-of-life communication. Database, reference list and author searches were conducted to identify evaluations of end-of-life communication-focussed interventions. Data were extracted, synthesised and QUALSYST quality analyses were performed. Forty-five studies met inclusion criteria. Interventions targeted patients (n=6), caregivers (n=3), healthcare professionals (HCPs n=24) and multiple stakeholders (n=12). Interventions took various forms including communication skills training, education, advance care planning and structured practice changes. Substantial heterogeneity in study designs, outcomes, settings and measures was apparent and study quality was variable. A substantial number of end-of-life communication interventions have been evaluated. Interventions have particularly targeted HCPs in cancer settings, though patient, caregiver and multi-focal interventions have also been evaluated. While some interventions were efficacious in well-designed RCTs, most evidence was from less robust studies. While additional interventions targeting patients and caregivers are needed, multi-focal interventions may more effectively remove barriers to end-of-life communication. Despite the limitations evident in the existing literature, healthcare professionals may still derive useful insights into effective approaches to end-of-life communication if appropriate caution is exercised. However, additional RCTs, implementation studies and cost-benefit analyses are required to bolster arguments for implementing and resourcing communication interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Educational Interventions Targeted at Minors in Situations of Grave Social Vulnerability and Their Families

    ERIC Educational Resources Information Center

    de la Caba Collado, Mariangeles; Rojas, Isabel Bartau

    2010-01-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…

  14. An Evaluation of Six Brief Interventions that Target Drug-Related Problems in Correctional Populations

    ERIC Educational Resources Information Center

    Joe, George W.; Knight, Kevin; Simpson, D. Dwayne; Flynn, Patrick M.; Morey, Janis T.; Bartholomew, Norma G.; Tindall, Michele Staton; Burdon, William M.; Hall, Elizabeth A.; Martin, Steve S.; O'Connell, Daniel J.

    2012-01-01

    Finding brief effective treatments for criminal justice populations is a major public need. The CJ-DATS Targeted Intervention for Corrections (TIC), which consists of six brief interventions (communication, anger, motivation, criminal thinking, social networks, and HIV/sexual health), was tested in separate federally-funded randomized control…

  15. Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access

    ERIC Educational Resources Information Center

    Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.

    2016-01-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…

  16. Educational Interventions Targeted at Minors in Situations of Grave Social Vulnerability and Their Families

    ERIC Educational Resources Information Center

    de la Caba Collado, Mariangeles; Rojas, Isabel Bartau

    2010-01-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…

  17. The Unintended Consequences of Targeting: Young People's Lived Experiences of Social and Emotional Learning Interventions

    ERIC Educational Resources Information Center

    Evans, Rhiannon; Scourfield, Jonathan; Murphy, Simon

    2015-01-01

    In the past twenty years there has been a proliferation of targeted school-based social and emotional learning (SEL) interventions. However, the lived experience of young peoples' participation is often elided, while the potential for interventions to confer unintended and even adverse effects remains under-theorised and empirically…

  18. Psychostimulant and Sensory Stimulation Interventions That Target the Reading and Math Deficits of Students with ADHD

    ERIC Educational Resources Information Center

    Zentall, Sydney S.; Tom-Wright, Kinsey; Lee, Jiyeon

    2013-01-01

    Objective: The purpose of this review of students with attention deficit hyperactivity disorder (ADHD) was to summarize the following: (1) academic deficits in math and reading, (2) possible theoretical contributors to these deficits, and (3) psychostimulant interventions that target math and reading, as well as, parallel interventions involving…

  19. The Use and Effectiveness of a Targeted Math Intervention for Third Graders

    ERIC Educational Resources Information Center

    Pool, Juli L.; Carter, Gabriel M.; Johnson, Evelyn S.; Carter, Deborah R.

    2013-01-01

    Students who fail to develop proficiency in math skills in the primary grades are more likely to experience difficulties in the math curriculum later on. These students may be in need of a more targeted intervention, or Tier 2 supports, in mathematic instruction. Although the instructional principles of an effective math intervention are becoming…

  20. An Evaluation of Six Brief Interventions that Target Drug-Related Problems in Correctional Populations

    ERIC Educational Resources Information Center

    Joe, George W.; Knight, Kevin; Simpson, D. Dwayne; Flynn, Patrick M.; Morey, Janis T.; Bartholomew, Norma G.; Tindall, Michele Staton; Burdon, William M.; Hall, Elizabeth A.; Martin, Steve S.; O'Connell, Daniel J.

    2012-01-01

    Finding brief effective treatments for criminal justice populations is a major public need. The CJ-DATS Targeted Intervention for Corrections (TIC), which consists of six brief interventions (communication, anger, motivation, criminal thinking, social networks, and HIV/sexual health), was tested in separate federally-funded randomized control…

  1. Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access

    ERIC Educational Resources Information Center

    Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.

    2016-01-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…

  2. Psychostimulant and Sensory Stimulation Interventions That Target the Reading and Math Deficits of Students with ADHD

    ERIC Educational Resources Information Center

    Zentall, Sydney S.; Tom-Wright, Kinsey; Lee, Jiyeon

    2013-01-01

    Objective: The purpose of this review of students with attention deficit hyperactivity disorder (ADHD) was to summarize the following: (1) academic deficits in math and reading, (2) possible theoretical contributors to these deficits, and (3) psychostimulant interventions that target math and reading, as well as, parallel interventions involving…

  3. The Unintended Consequences of Targeting: Young People's Lived Experiences of Social and Emotional Learning Interventions

    ERIC Educational Resources Information Center

    Evans, Rhiannon; Scourfield, Jonathan; Murphy, Simon

    2015-01-01

    In the past twenty years there has been a proliferation of targeted school-based social and emotional learning (SEL) interventions. However, the lived experience of young peoples' participation is often elided, while the potential for interventions to confer unintended and even adverse effects remains under-theorised and empirically…

  4. Targeting EMT in cancer: opportunities for pharmacological intervention.

    PubMed

    Davis, Felicity M; Stewart, Teneale A; Thompson, Erik W; Monteith, Gregory R

    2014-09-01

    The spread of cancer cells to distant organs represents a major clinical challenge in the treatment of cancer. Epithelial-mesenchymal transition (EMT) has emerged as a key regulator of metastasis in some cancers by conferring an invasive phenotype. As well as facilitating metastasis, EMT is thought to generate cancer stem cells and contribute to therapy resistance. Therefore, the EMT pathway is of great therapeutic interest in the treatment of cancer and could be targeted either to prevent tumor dissemination in patients at high risk of developing metastatic lesions or to eradicate existing metastatic cancer cells in patients with more advanced disease. In this review, we discuss approaches for the design of EMT-based therapies in cancer, summarize evidence for some of the proposed EMT targets, and review the potential advantages and pitfalls of each approach.

  5. Focal adhesion kinase: targeting adhesion signaling pathways for therapeutic intervention.

    PubMed

    Parsons, J Thomas; Slack-Davis, Jill; Tilghman, Robert; Roberts, W Gregory

    2008-02-01

    The tumor microenvironment plays a central role in cancer progression and metastasis. Within this environment, cancer cells respond to a host of signals including growth factors and chemotactic factors, as well as signals from adjacent cells, cells in the surrounding stroma, and signals from the extracellular matrix. Targeting the pathways that mediate many of these signals has been a major goal in the effort to develop therapeutics.

  6. An Intervention Targeting Service Providers and Clients for Methadone Maintenance Treatment in China: A Cluster-randomized Trial

    PubMed Central

    Li, Li; Wu, Zunyou; Liang, Li-Jung; Lin, Chunqing; Zhang, Linglin; Guo, Sam; Rou, Keming; Li, Jianhua

    2012-01-01

    Aims This study examines the preliminary outcomes of an intervention targeting service providers in methadone maintenance therapy clinics in China. The intervention effects on both service providers and clients are reported. Design The MMT CARE intervention pilot was developed and implemented collaboratively with local health educators. After three group intervention sessions, trained providers in intervention clinics delivered two individual motivational interviewing sessions with their clients. Settings Six clinics in Sichuan, China, were randomized to either the MMT CARE intervention condition or a standard care condition. Participants A total of 41 providers and 179 clients were sampled from the six clinics. Measurements At baseline and 3-, 6-, and 9-month assessments, providers completed self-administrated paper/pencil questionnaires regarding provider-client interaction, methadone maintenance therapy knowledge, perceived job-related stigma, and clinic support. Clients completed a face-to-face survey about their concurrent drug use and drug avoidance self-efficacy. Mixed-effects regression models with clinic-level random effect were used to assess the intervention effects. Findings Significant intervention effects for providers were found in improved methadone maintenance therapy knowledge, provider-client interaction, and perceived clinic support. For clients, better improvements in drug avoidance self-efficacy and reduced concurrent drug use were observed for the intervention compared to the standard care group. Conclusions The methadone maintenance therapy CARE intervention targeting providers in methadone maintenance clinics can improve providers’ treatment knowledge and their interaction with clients. The intervention can also reduce clients’ drug using behavior through motivational interviewing sessions conducted by trained providers. PMID:22788780

  7. A Review of Supportive Interventions Targeting Individuals or Couples Undergoing Infertility Treatment: Directions for the Development of Interventions.

    PubMed

    Luk, Bronya Hi-Kwan; Loke, Alice Yuen

    2016-08-17

    The purpose of this systematic review is to explore the types, content, and outcomes of different psychosocial approaches used in existing interventions for infertile individuals or couples. Relevant intervention studies published in English between 2000 and 2014 were searched using the electronic databases MEDLINE, PsycINFO, and CINHAL Plus. A total of 23 articles were identified and included in this review. Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and counseling were the most commonly adopted psychosocial interventions for infertile individuals or couples. After reviewing the various approaches, directions are given on the development of interventions for couples suffering from infertility.

  8. Impacting Environmental and Public Health through the Use of Dual Targeted and Tailored Asthma Educational Interventions

    PubMed Central

    Carrillo, Genny; Lucio, Rose L.; Seol, Yoon-Ho; Chong-Menard, Betty; Smith, Kenneth

    2015-01-01

    Home-based asthma environmental education for parents of asthmatic children is needed since many health professionals lack the time to offer it. However, developing targeted and tailored education is important in order to address the individual needs of participants. This nonrandomized longitudinal study examined knowledge on asthma with an Asthma and Healthy Homes educational intervention training offered to parents of children from low income families who reside in the Rio Grande Valley of Texas. Eighty-nine parents received the training and pre- and posttest surveys were used to measure knowledge outcomes. A standardized assessment on asthma triggers was used to identify the different triggers each child was exposed to, and a follow-up survey was conducted 6 months after the educational intervention to identify how many parents reported household and behavior changes as a result of the training. Results showed significant changes in behavior by participants as a result of the training received. This study suggests that these behavioral changes are attributed to the dual “targeted” and “tailored” educational interventions delivered to parents which resulted in a greater understanding of how to manage asthma by eliminating asthma triggers in their respective homes. PMID:26240576

  9. Biological targets for therapeutic interventions in COPD: clinical potential

    PubMed Central

    Pelaia, Girolamo; Vatrella, Alessandro; Gallelli, Luca; Renda, Teresa; Caputi, Mario; Maselli, Rosario; Marsico, Serafino A

    2006-01-01

    COPD is a widespread inflammatory respiratory disorder characterized by a progressive, poorly reversible airflow limitation. Currently available therapies are mostly based on those used to treat asthma. However, such compounds are not able to effectively reduce the gradual functional deterioration, as well as the ongoing airway and lung inflammation occurring in COPD patients. Therefore, there is an urgent need to improve the efficacy of the existing drug classes and to develop new treatments, targeting the main cellular and molecular mechanisms underlying disease pathogenesis. These therapeutic strategies will be highlighted in the present review. PMID:18046869

  10. Live Webcam Coaching to Help Early Elementary Classroom Teachers Provide Effective Literacy Instruction for Struggling Readers: The Targeted Reading Intervention

    ERIC Educational Resources Information Center

    Vernon-Feagans, Lynne; Kainz, Kirsten; Hedrick, Amy; Ginsberg, Marnie; Amendum, Steve

    2013-01-01

    This study evaluated whether the Targeted Reading Intervention (TRI), a classroom teacher professional development program delivered through webcam technology literacy coaching, could provide rural classroom teachers with the instructional skills to help struggling readers progress rapidly in early reading. Fifteen rural schools were randomly…

  11. School-Based Interventions Targeting Challenging Behaviors Exhibited by Young Children with Autism Spectrum Disorder: A Systematic Literature Review

    ERIC Educational Resources Information Center

    Martinez, Jose R.; Werch, Brittany L.; Conroy, Maureen A.

    2016-01-01

    The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to decrease challenging behaviors in young children with Autism Spectrum Disorder (ASD). Reviewed studies employed a single-case experimental design, targeted challenging behaviors, included children 3-8 years old with ASD, and took…

  12. The Effectiveness of Social Skills Intervention Targeting Nonverbal Communication for Adolescents with Asperger Syndrome and Related Pervasive Developmental Delays.

    ERIC Educational Resources Information Center

    Barnhill, Gena P.; Cook, Katherine Tapscott; Tebbenkamp, Kelly; Myles, Brenda Smith

    2002-01-01

    A study investigated the effectiveness of an 8-week social skills intervention targeting nonverbal communication for eight adolescents with Asperger syndrome. Although minimal nonverbal communication skills development was apparent, some social relationships were developed and the ability of some participants to read the nonverbal communication of…

  13. Internet-Delivered Targeted Group Intervention for Body Dissatisfaction and Disordered Eating in Adolescent Girls: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Heinicke, Brooke E.; Paxton, Susan J.; McLean, Sian A.; Wertheim, Eleanor H.

    2007-01-01

    This study evaluated a targeted intervention designed to alleviate body image and eating problems in adolescent girls that was delivered over the internet so as to increase access to the program. The program consisted of six, 90-minute weekly small group, synchronous on-line sessions and was facilitated by a therapist and manual. Participants were…

  14. Building Social Competence in Preschool: The Effects of a Social Skills Intervention Targeting Children Enrolled in Head Start

    ERIC Educational Resources Information Center

    Stanton-Chapman, Tina L.; Walker, Virginia; Jamison, Kristen R.

    2014-01-01

    The current study evaluated the peer-to-peer interactions of at-risk children enrolled in Head Start who participated in a social pragmatic intervention targeting skills such as initiations, responses, name use, proximity, and turn-taking skills. Eight Head Start classroom teams received two workshops and two coaching sessions and were taught to…

  15. The Effectiveness of Social Skills Intervention Targeting Nonverbal Communication for Adolescents with Asperger Syndrome and Related Pervasive Developmental Delays.

    ERIC Educational Resources Information Center

    Barnhill, Gena P.; Cook, Katherine Tapscott; Tebbenkamp, Kelly; Myles, Brenda Smith

    2002-01-01

    A study investigated the effectiveness of an 8-week social skills intervention targeting nonverbal communication for eight adolescents with Asperger syndrome. Although minimal nonverbal communication skills development was apparent, some social relationships were developed and the ability of some participants to read the nonverbal communication of…

  16. School-Based Interventions Targeting Challenging Behaviors Exhibited by Young Children with Autism Spectrum Disorder: A Systematic Literature Review

    ERIC Educational Resources Information Center

    Martinez, Jose R.; Werch, Brittany L.; Conroy, Maureen A.

    2016-01-01

    The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to decrease challenging behaviors in young children with Autism Spectrum Disorder (ASD). Reviewed studies employed a single-case experimental design, targeted challenging behaviors, included children 3-8 years old with ASD, and took…

  17. Internet-Delivered Targeted Group Intervention for Body Dissatisfaction and Disordered Eating in Adolescent Girls: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Heinicke, Brooke E.; Paxton, Susan J.; McLean, Sian A.; Wertheim, Eleanor H.

    2007-01-01

    This study evaluated a targeted intervention designed to alleviate body image and eating problems in adolescent girls that was delivered over the internet so as to increase access to the program. The program consisted of six, 90-minute weekly small group, synchronous on-line sessions and was facilitated by a therapist and manual. Participants were…

  18. Frameworks for Proof-of-Concept Clinical Trials of Interventions That Target Fundamental Aging Processes.

    PubMed

    Justice, Jamie; Miller, Jordan D; Newman, John C; Hashmi, Shahrukh K; Halter, Jeffrey; Austad, Steve N; Barzilai, Nir; Kirkland, James L

    2016-11-01

    Therapies targeted at fundamental processes of aging may hold great promise for enhancing the health of a wide population by delaying or preventing a range of age-related diseases and conditions-a concept dubbed the "geroscience hypothesis." Early, proof-of-concept clinical trials will be a key step in the translation of therapies emerging from model organism and preclinical studies into clinical practice. This article summarizes the outcomes of an international meeting partly funded through the NIH R24 Geroscience Network, whose purpose was to generate concepts and frameworks for early, proof-of-concept clinical trials for therapeutic interventions that target fundamental processes of aging. The goals of proof-of-concept trials include generating preliminary signals of efficacy in an aging-related disease or outcome that will reduce the risk of conducting larger trials, contributing data and biological samples to support larger-scale research by strategic networks, and furthering a dialogue with regulatory agencies on appropriate registration indications. We describe three frameworks for proof-of-concept trials that target age-related chronic diseases, geriatric syndromes, or resilience to stressors. We propose strategic infrastructure and shared resources that could accelerate development of therapies that target fundamental aging processes.

  19. Frameworks for Proof-of-Concept Clinical Trials of Interventions That Target Fundamental Aging Processes

    PubMed Central

    Justice, Jamie; Miller, Jordan D.; Newman, John C.; Hashmi, Shahrukh K.; Halter, Jeffrey; Austad, Steve N.; Barzilai, Nir

    2016-01-01

    Therapies targeted at fundamental processes of aging may hold great promise for enhancing the health of a wide population by delaying or preventing a range of age-related diseases and conditions—a concept dubbed the “geroscience hypothesis.” Early, proof-of-concept clinical trials will be a key step in the translation of therapies emerging from model organism and preclinical studies into clinical practice. This article summarizes the outcomes of an international meeting partly funded through the NIH R24 Geroscience Network, whose purpose was to generate concepts and frameworks for early, proof-of-concept clinical trials for therapeutic interventions that target fundamental processes of aging. The goals of proof-of-concept trials include generating preliminary signals of efficacy in an aging-related disease or outcome that will reduce the risk of conducting larger trials, contributing data and biological samples to support larger-scale research by strategic networks, and furthering a dialogue with regulatory agencies on appropriate registration indications. We describe three frameworks for proof-of-concept trials that target age-related chronic diseases, geriatric syndromes, or resilience to stressors. We propose strategic infrastructure and shared resources that could accelerate development of therapies that target fundamental aging processes. PMID:27535966

  20. Vasculoprotection as a Convergent, Multi-Targeted Mechanism of Anti-AD Therapeutics and Interventions.

    PubMed

    Bhat, Narayan R

    2015-01-01

    Using a variety of animal models of Alzheimer's disease (AD), there have been a number of recent studies reporting varying degrees of success with anti-AD therapeutics. The efficacies are often discussed in terms of the modulatory effects of the compounds tested on identified or assumed targets among the known (or proposed) pathogenic and neuroprotective mechanisms, largely within the context of the dominant amyloid cascade hypothesis. However, it is clear that several of the relatively more efficacious treatments tend to be multifunctional and target multiple pathological processes associated with AD including most commonly, oxidative and metabolic stress and neuroinflammation. Increasing evidence suggests that vascular and neurodegenerative pathologies often co-exist and that neurovascular dysfunction plays a critical role in the development or progression of AD. In this review, we will discuss the significance of vasculoprotection or neurovascular unit integrity as a common, multi-targeted mechanism underlying the reported efficacy of a majority of anti-AD therapeutics--amyloid-targeted or otherwise--while providing a strong support for future neurovascular-based treatment strategies and interventions.

  1. Reactive oxygen species-targeted therapeutic interventions for atrial fibrillation

    PubMed Central

    Sovari, Ali A.; Dudley, Samuel C.

    2012-01-01

    Atrial fibrillation (AF) is the most common arrhythmia that requires medical attention, and its incidence is increasing. Current ion channel blockade therapies and catheter ablation have significant limitations in treatment of AF, mainly because they do not address the underlying pathophysiology of the disease. Oxidative stress has been implicated as a major underlying pathology that promotes AF; however, conventional antioxidants have not shown impressive therapeutic effects. A more careful design of antioxidant therapies and better selection of patients likely are required to treat effectively AF with antioxidant agents. Current evidence suggest inhibition of prominent cardiac sources of reactive oxygen species (ROS) such as nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and targeting subcellular compartments with the highest levels of ROS may prove to be effective therapies for AF. Increased serum markers of oxidative stress may be an important guide in selecting the AF patients who will most likely respond to antioxidant therapy. PMID:22934062

  2. Development of a Targeted Smoking Relapse-Prevention Intervention for Cancer Patients.

    PubMed

    Meltzer, Lauren R; Meade, Cathy D; Diaz, Diana B; Carrington, Monica S; Brandon, Thomas H; Jacobsen, Paul B; McCaffrey, Judith C; Haura, Eric B; Simmons, Vani N

    2016-08-01

    We describe the series of iterative steps used to develop a smoking relapse-prevention intervention customized to the needs of cancer patients. Informed by relevant literature and a series of preliminary studies, an educational tool (DVD) was developed to target the unique smoking relapse risk factors among cancer patients. Learner verification interviews were conducted with 10 cancer patients who recently quit smoking to elicit feedback and inform the development of the DVD. The DVD was then refined using iterative processes and feedback from the learner verification interviews. Major changes focused on visual appeal, and the inclusion of additional testimonials and graphics to increase comprehension of key points and further emphasize the message that the patient is in control of their ability to maintain their smoking abstinence. Together, these steps resulted in the creation of a DVD titled Surviving Smokefree®, which represents the first smoking relapse-prevention intervention for cancer patients. If found effective, the Surviving Smokefree® DVD is an easily disseminable and low-cost portable intervention which can assist cancer patients in maintaining smoking abstinence.

  3. Screening in brief intervention trials targeting excessive drinkers in general practice: systematic review and meta-analysis

    PubMed Central

    Beich, Anders; Thorsen, Thorkil; Rollnick, Stephen

    2003-01-01

    Objective To determine the effectiveness of programmes of screening in general practice for excessive alcohol use and providing brief interventions. Design Systematic review and meta-analysis of randomised controlled trials that used screening as a precursor to brief intervention. Setting General practice. Main outcome measures Number needed to treat, proportion of patients positive on screening, proportion given brief interventions, and effect of screening. Results The eight studies included for meta-analysis all used health questionnaires for screening, and the brief interventions included feedback, information, and advice. The studies contained several sources of bias that might lead to overestimates of the effects of intervention. External validity was compromised because typically three out of four people identified by screening as excessive users of alcohol did not qualify for the intervention after a secondary assessment. Overall, in 1000 screened patients, 90 screened positive and required further assessment, after which 25 qualified for brief intervention; after one year 2.6 (95% confidence interval 1.7 to 3.4) reported they drank less than the maximum recommended level. Conclusions Although even brief advice can reduce excessive drinking, screening in general practice does not seem to be an effective precursor to brief interventions targeting excessive alcohol use. This meta-analysis raises questions about the feasibility of screening in general practice for excessive use of alcohol. PMID:12958114

  4. A successful high-visibility enforcement intervention targeting underage drinking drivers.

    PubMed

    Johnson, Mark B

    2016-07-01

    To measure the effectiveness of a high-visibility enforcement campaign to reduce rates of underage drinking and driving. Mixed-model analysis compares rates of drinking and driving (1) between the baseline and intervention period and (2) between the baseline and follow-up period. The impact of the intervention was evaluated using roadside surveys and web surveys. Two college-town communities in the mid-Atlantic region of the United States. Study participants consisted of 6825 drivers stopped, interviewed and breathalyzed on weekend nights. Web survey data were collected from 2061 students from large state universities in each community. Increased high-visibility enforcement of drinking and driving laws, featuring the use of passive alcohol sensors by police, along with a coordinated publicity campaign. Roadside surveys measured breath alcohol concentrations (BrAC) of drivers. The web surveys measured self-reported drinking. Mixed-model analysis revealed a statistically significant reduction in drivers with BrACs ≥ 0.08 g/dl during the intervention and follow-up periods, F(2, 5744)  = 6.5, P < 0.01. The web-survey revealed that students under age 21 also reported significantly less driving after drinking during the intervention and follow-up periods, F(2, 1767)  = 4.6, P < 0.01. A high-visibility enforcement campaign targeting underage drinking and driving appeared to reduce both underage driving after drinking among US college students as well as drunk driving (breath alcohol concentration ≥ 0.08 g/dl) at any age.. © 2016 Society for the Study of Addiction.

  5. The Behavior Education Support and Treatment (BEST) school intervention program: pilot project data examining schoolwide, targeted-school, and targeted-home approaches.

    PubMed

    Waschbusch, Daniel A; Pelham, William E; Massetti, Greta

    2005-08-01

    As part of a pilot project, four elementary schools were randomly assigned to receive one of four interventions: (a) a schoolwide intervention that incorporated universal and targeted treatment, (b) a targeted-school intervention delivered to individual students in regular and special education classrooms, (c) a targeted-home intervention delivered in home and regular classroom settings, and (d) a control condition that did not receive a designated intervention. Results showed that the behavior of disruptive children in all schools improved during the course of the year, with some evidence that interventions provided complementary effects. These findings support the continued use of behavioral interventions in elementary schools and argue for interventions that combine different methods of delivering interventions.

  6. Anti-schistosomal Intervention Targets Identified by Lifecycle Transcriptomic Analyses

    PubMed Central

    Fitzpatrick, Jennifer M.; Peak, Emily; Perally, Samirah; Chalmers, Iain W.; Barrett, John; Yoshino, Timothy P.; Ivens, Alasdair C.; Hoffmann, Karl F.

    2009-01-01

    Background Novel methods to identify anthelmintic drug and vaccine targets are urgently needed, especially for those parasite species currently being controlled by singular, often limited strategies. A clearer understanding of the transcriptional components underpinning helminth development will enable identification of exploitable molecules essential for successful parasite/host interactions. Towards this end, we present a combinatorial, bioinformatics-led approach, employing both statistical and network analyses of transcriptomic data, for identifying new immunoprophylactic and therapeutic lead targets to combat schistosomiasis. Methodology/Principal Findings Utilisation of a Schistosoma mansoni oligonucleotide DNA microarray consisting of 37,632 elements enabled gene expression profiling from 15 distinct parasite lifecycle stages, spanning three unique ecological niches. Statistical approaches of data analysis revealed differential expression of 973 gene products that minimally describe the three major characteristics of schistosome development: asexual processes within intermediate snail hosts, sexual maturation within definitive vertebrate hosts and sexual dimorphism amongst adult male and female worms. Furthermore, we identified a group of 338 constitutively expressed schistosome gene products (including 41 transcripts sharing no sequence similarity outside the Platyhelminthes), which are likely to be essential for schistosome lifecycle progression. While highly informative, statistics-led bioinformatics mining of the transcriptional dataset has limitations, including the inability to identify higher order relationships between differentially expressed transcripts and lifecycle stages. Network analysis, coupled to Gene Ontology enrichment investigations, facilitated a re-examination of the dataset and identified 387 clusters (containing 12,132 gene products) displaying novel examples of developmentally regulated classes (including 294 schistosomula and

  7. Cutoff Designs for Community-Based Intervention Studies

    PubMed Central

    Pennell, Michael L.; Hade, Erinn M.; Murray, David M.; Rhoda, Dale A.

    2011-01-01

    Summary Public health interventions are often designed to target communities defined either geographically (e.g., cities, counties) or socially (e.g., schools or workplaces). The group randomized trial (GRT) is regarded as the gold standard for evaluating these interventions. However, community leaders may object to randomization as some groups may be denied a potentially beneficial intervention. Under a regression discontinuity design (RDD), individuals may be assigned to treatment based on the levels of a pretest measure, thereby allowing those most in need of the treatment to receive it. In this article, we consider analysis, power, and sample size issues in applying the RDD and related cutoff designs in community-based intervention studies. We examine the power of these designs as a function of intraclass correlation, number of groups, and number of members per group and compare results to the traditional GRT. PMID:21500240

  8. Adapting an Evidence-Based Intervention to Address Targeted Therapy-Related Fatigue in Chronic Myeloid Leukemia Patients.

    PubMed

    Poort, Hanneke; Meade, Cathy D; Knoop, Hans; Gielissen, Marieke F M; Pinilla-Ibarz, Javier; Jacobsen, Paul B

    2016-11-08

    Fatigue is one of the most important quality of life issues experienced by patients being treated with oral targeted therapy for chronic myeloid leukemia (CML). However, no intervention exists that specifically addresses strategies to reduce targeted therapy-related fatigue. This study adapted an evidence-based clinic-delivered intervention (EBI) "cognitive behavior therapy for post-cancer fatigue" for use in CML patients. The existing EBI was based on 6 established perpetuating factors of fatigue (ie, sleep, activity, helpful thinking, coping with cancer, social support, and fear of disease recurrence). Study aims were to gauge reactions to (1) existing content and (2) a new Internet-assisted intervention delivery format. Guided by the ADAPT-ITT framework, we used a series of systematic steps and adaptation methodologies, including semistructured interviews with CML patients and providers and feedback from topical experts. Patients were receptive to existing content topics and an Internet-assisted delivery format was acceptable. A key theme reflected the need for a new customized psychoeducational module about CML as a disease and its treatment. Both providers and patients held positive views about the potential of the adapted EBI to improve fatigue. Findings offered essential guidance for the adaptation and reinforced the utility of the adapted intervention. Adapting existing EBIs for new audiences contributes to advancing findings of evidence-based research, ultimately providing nurses and other healthcare providers with important referral options to interventions that may provide useful strategies to improve quality of life and reduce targeted therapy-related fatigue.

  9. Teachers' Perceptions of Georgia's Early Reading Intervention Program: A Qualitative Study

    ERIC Educational Resources Information Center

    Hobby, Patti Tennant

    2012-01-01

    This qualitative study used an ethnographic method to investigate teachers' perceptions of reading interventions delivered in a state-funded early intervention program (EIP). Academically at-risk students struggle to meet grade-level standards year after year, even with interventions involving small group, targeted assistance. Teacher perceptions…

  10. Early Antenatal Prediction of Gestational Diabetes in Obese Women: Development of Prediction Tools for Targeted Intervention

    PubMed Central

    White, Sara L.; Lawlor, Debbie A.; Briley, Annette L.; Nelson, Scott M.; Oteng-Ntim, Eugene; Sattar, Naveed; Seed, Paul T.; Welsh, Paul; Whitworth, Melissa; Poston, Lucilla; Pasupathy, Dharmintra

    2016-01-01

    All obese women are categorised as being of equally high risk of gestational diabetes (GDM) whereas the majority do not develop the disorder. Lifestyle and pharmacological interventions in unselected obese pregnant women have been unsuccessful in preventing GDM. Our aim was to develop a prediction tool for early identification of obese women at high risk of GDM to facilitate targeted interventions in those most likely to benefit. Clinical and anthropometric data and non-fasting blood samples were obtained at 15+0–18+6 weeks’ gestation in 1303 obese pregnant women from UPBEAT, a randomised controlled trial of a behavioural intervention. Twenty one candidate biomarkers associated with insulin resistance, and a targeted nuclear magnetic resonance (NMR) metabolome were measured. Prediction models were constructed using stepwise logistic regression. Twenty six percent of women (n = 337) developed GDM (International Association of Diabetes and Pregnancy Study Groups criteria). A model based on clinical and anthropometric variables (age, previous GDM, family history of type 2 diabetes, systolic blood pressure, sum of skinfold thicknesses, waist:height and neck:thigh ratios) provided an area under the curve of 0.71 (95%CI 0.68–0.74). This increased to 0.77 (95%CI 0.73–0.80) with addition of candidate biomarkers (random glucose, haemoglobin A1c (HbA1c), fructosamine, adiponectin, sex hormone binding globulin, triglycerides), but was not improved by addition of NMR metabolites (0.77; 95%CI 0.74–0.81). Clinically translatable models for GDM prediction including readily measurable variables e.g. mid-arm circumference, age, systolic blood pressure, HbA1c and adiponectin are described. Using a ≥35% risk threshold, all models identified a group of high risk obese women of whom approximately 50% (positive predictive value) later developed GDM, with a negative predictive value of 80%. Tools for early pregnancy identification of obese women at risk of GDM are described

  11. Early Antenatal Prediction of Gestational Diabetes in Obese Women: Development of Prediction Tools for Targeted Intervention.

    PubMed

    White, Sara L; Lawlor, Debbie A; Briley, Annette L; Godfrey, Keith M; Nelson, Scott M; Oteng-Ntim, Eugene; Robson, Stephen C; Sattar, Naveed; Seed, Paul T; Vieira, Matias C; Welsh, Paul; Whitworth, Melissa; Poston, Lucilla; Pasupathy, Dharmintra

    2016-01-01

    All obese women are categorised as being of equally high risk of gestational diabetes (GDM) whereas the majority do not develop the disorder. Lifestyle and pharmacological interventions in unselected obese pregnant women have been unsuccessful in preventing GDM. Our aim was to develop a prediction tool for early identification of obese women at high risk of GDM to facilitate targeted interventions in those most likely to benefit. Clinical and anthropometric data and non-fasting blood samples were obtained at 15+0-18+6 weeks' gestation in 1303 obese pregnant women from UPBEAT, a randomised controlled trial of a behavioural intervention. Twenty one candidate biomarkers associated with insulin resistance, and a targeted nuclear magnetic resonance (NMR) metabolome were measured. Prediction models were constructed using stepwise logistic regression. Twenty six percent of women (n = 337) developed GDM (International Association of Diabetes and Pregnancy Study Groups criteria). A model based on clinical and anthropometric variables (age, previous GDM, family history of type 2 diabetes, systolic blood pressure, sum of skinfold thicknesses, waist:height and neck:thigh ratios) provided an area under the curve of 0.71 (95%CI 0.68-0.74). This increased to 0.77 (95%CI 0.73-0.80) with addition of candidate biomarkers (random glucose, haemoglobin A1c (HbA1c), fructosamine, adiponectin, sex hormone binding globulin, triglycerides), but was not improved by addition of NMR metabolites (0.77; 95%CI 0.74-0.81). Clinically translatable models for GDM prediction including readily measurable variables e.g. mid-arm circumference, age, systolic blood pressure, HbA1c and adiponectin are described. Using a ≥35% risk threshold, all models identified a group of high risk obese women of whom approximately 50% (positive predictive value) later developed GDM, with a negative predictive value of 80%. Tools for early pregnancy identification of obese women at risk of GDM are described which could

  12. Breast Cancer Survivorship Care: Targeting a Colorectal Cancer Education Intervention

    PubMed Central

    Homan, Sherri G.; Yun, Shumei; Stewart, Bob R.; Armer, Jane M.

    2015-01-01

    Breast cancer survivors are at risk of developing a second primary cancer. Colorectal cancer (CRC) is one of the leading second primary cancers, and it is often preventable. We developed a multi-component educational tool to inform and encourage women breast cancer survivors to engage in CRC screening. To assess the strengths and weakness of the tool and to improve the relevancy to the target audience, we convened four focus groups of women breast cancer survivors in Missouri. We also assessed the potential impact of the tool on the knowledge, attitudes, and beliefs regarding CRC and collected information on the barriers to CRC screening through pre- and post-focus groups’ questionnaires. A total of 43 women breast cancer survivors participated and provided very valuable suggestions on design and content to update the tool. Through the process and comparing pre- and post-focus group assessments, a significantly higher proportion of breast cancer survivors strongly agreed or agreed that CRC is preventable (78.6% vs. 96.9%, p = 0.02) and became aware that they were at a slightly increased risk for CRC (18.6% vs. 51.7%, p = 0.003). The most cited barrier was the complexity of preparation for colonoscopy. PMID:26258794

  13. Breast Cancer Survivorship Care: Targeting a Colorectal Cancer Education Intervention.

    PubMed

    Homan, Sherri G; Yun, Shumei; Stewart, Bob R; Armer, Jane M

    2015-08-06

    Breast cancer survivors are at risk of developing a second primary cancer. Colorectal cancer (CRC) is one of the leading second primary cancers, and it is often preventable. We developed a multi-component educational tool to inform and encourage women breast cancer survivors to engage in CRC screening. To assess the strengths and weakness of the tool and to improve the relevancy to the target audience, we convened four focus groups of women breast cancer survivors in Missouri. We also assessed the potential impact of the tool on the knowledge, attitudes, and beliefs regarding CRC and collected information on the barriers to CRC screening through pre- and post-focus groups' questionnaires. A total of 43 women breast cancer survivors participated and provided very valuable suggestions on design and content to update the tool. Through the process and comparing pre- and post-focus group assessments, a significantly higher proportion of breast cancer survivors strongly agreed or agreed that CRC is preventable (78.6% vs. 96.9%, p = 0.02) and became aware that they were at a slightly increased risk for CRC (18.6% vs. 51.7%, p = 0.003). The most cited barrier was the complexity of preparation for colonoscopy.

  14. Cost effectiveness of targeted HIV prevention interventions for female sex workers in India.

    PubMed

    Prinja, Shankar; Bahuguna, Pankaj; Rudra, Shalini; Gupta, Indrani; Kaur, Manmeet; Mehendale, S M; Chatterjee, Susmita; Panda, Samiran; Kumar, Rajesh

    2011-06-01

    To ascertain the cost effectiveness of targeted interventions for female sex workers (FSW) under the National AIDS Control Programme in India. A compartmental mathematical Markov state model was used over a 20-year time horizon (1995-2015) to estimate the cost effectiveness of FSW targeted interventions, with a health system perspective. The incremental costs and effects of FSW targeted interventions were compared against a baseline scenario of mass media for the general population alone. The incremental cost-effectiveness ratio was computed at a 3% discount rate using HIV infections averted and disability-adjusted life-years (DALY) as benefit measures. It was assumed that the transmission of the HIV virus moves from a high-risk group (FSW) to the client population and finally to the general population (partners of clients). Targeted interventions for FSW result in a reduction of 47% (1.6 million) prevalent and 36% (2.7 million) cumulative HIV cases, respectively, in 2015. Adult HIV prevalence in India, with and without (mass media only) FSW interventions, would be 0.25% and 0.48% in 2015. Indian government and development partners spend an average US $104 (INR4680) per HIV infection averted and US $10.7 (INR483) per DALY averted. Discounting at 3%, FSW targeted interventions cost US $105.5 (INR4748) and US $10.9 (INR490) per HIV case and DALY averted, respectively. At the current gross domestic product in India, targeted intervention is a cost-effective strategy for HIV prevention in India.

  15. Music intervention study in abdominal surgery patients: challenges of an intervention study in clinical practice.

    PubMed

    Vaajoki, Anne; Pietilä, Anna-Maija; Kankkunen, Päivi; Vehviläinen-Julkunen, Katri

    2013-04-01

    Evidence-based nursing requires carefully designed interventions. This paper discusses methodological issues and explores practical solutions in the use of music intervention in pain management among adults after major abdominal surgery. There is a need to study nursing interventions that develop and test the effects of interventions to advanced clinical nursing knowledge and practice. There are challenges in carrying out intervention studies in clinical settings because of several interacting components and the length and complexity of the causal chains linking intervention with outcome. Intervention study is time-consuming and requires both researchers and participants' commitment to the study. Interdisciplinary and multiprofessional collaboration is also paramount. In this study, patients were allocated into the music group, in which patients listened to music 30 minutes at a time, or the control group, in which patients did not listen to any music during the same period.

  16. Medical specialization, profession, and mediating beliefs that predict stated likelihood of alcohol screening and brief intervention: targeting educational interventions.

    PubMed

    Gassman, Ruth A

    2003-09-01

    Practitioner-level educational approaches that promote screening and brief intervention (SBI) seldom consider providers' profession and medical specialization. Strategies that consider these variables may be better equipped to affect change in beliefs and behavior. The aim of this study was to identify beliefs that predict stated likelihood of practicing SBI by specialty and health profession in order to guide the direction of educational strategies. Physicians and nurse practitioners were studied that specialized in family, internal, obstetric gynecology (ObGyn), and pediatric medicine. The results indicated that independent of amount of previous postgraduate alcohol education and knowledge, self-rated competence mediated between specialty and likelihood of practicing SBI. For instance, low self-rated competence for ObGyn was a barrier that suppressed likelihood of practicing SBI. Other findings were that role legitimacy mediated the association between profession and likelihood of SBI, so that lack of role legitimacy was a barrier for physicians but not for nurse practitioners. We suggest that targeted educational strategies for ObGyn and pediatric clinicians may prove more effective than the prevalent one-size-fits all approaches aimed at general adult populations.

  17. What works with men? A systematic review of health promoting interventions targeting men

    PubMed Central

    Robertson, Lynn M; Douglas, Flora; Ludbrook, Anne; Reid, Garth; van Teijlingen, Edwin

    2008-01-01

    Background Encouraging men to make more effective use of (preventive) health services is considered one way of improving their health. The aim of this study was to appraise the available evidence of effective interventions aimed at improving men's health. Methods Systematic review of relevant studies identified through 14 electronic databases and other information resources. Results were pooled within health topic and described qualitatively. Results Of 11,749 citations screened, 338 articles were assessed and 27 met our inclusion criteria. Most studies were male sex-specific, i.e. prostate cancer screening and testicular self-examination. Other topics included alcohol, cardiovascular disease, diet and physical activity, skin cancer and smoking cessation. Twenty-three interventions were effective or partially effective and 18 studies satisfied all quality criteria. Conclusion Most of the existing evidence relates to male sex-specific health problems as opposed to general health concerns relevant to both men and women. There is little published evidence on how to improve men's uptake of services. We cannot conclude from this review that targeting men works better than providing services for all people. Large-scale studies are required to help produce evidence that is sufficiently robust to add to the small evidence base that currently exists in this field. PMID:18598339

  18. Targeting Interventions: Moderators of the Effects of Expressive Writing and Assertiveness Training on the Adjustment of International University Students.

    PubMed

    Hijazi, Alaa M; Tavakoli, Shedeh; Slavin-Spenny, Olga M; Lumley, Mark A

    2011-06-01

    Acculturative stress is a common experience for international students and is associated with psychological and physical problems. In a previous study, the authors reported that two stress reduction interventions-expressive writing (EW) and assertiveness training (AT)-had limited overall benefits among international students at an American University. The current analyses of data from that study investigated whether individual differences moderated the effects of EW and AT. Results indicate that greater acculturative stress at baseline predicted greater improvement from both interventions, compared with control. Women benefited more from AT than EW, except that EW improved women's physical symptoms. Men benefited more from EW than AT. Students with limited emotional awareness and expression tended to benefit from both interventions, relative to control. Finally, nation of origin cultural differences generally did not predict outcomes. It is concluded that the benefits of EW and AT and can be enhanced by targeting these interventions to specific subgroups of international students.

  19. Outcomes from a computer-assisted intervention simultaneously targeting cannabis and tobacco use.

    PubMed

    Lee, Dustin C; Budney, Alan J; Brunette, Mary F; Hughes, John R; Etter, Jean-Francois; Stanger, Catherine

    2015-10-01

    Cannabis users frequently report concurrent tobacco use, and tobacco use is associated with poorer outcomes during treatment for cannabis use disorders (CUD). Interventions that simultaneously target both tobacco and cannabis use disorders may enhance cessation outcomes for either or both substances. This study evaluated an intervention integrating highly effective treatments for cannabis and tobacco use disorders. Thirty-two participants meeting diagnostic criteria for CUD and reporting daily tobacco use were enrolled in a 12-week computer-assisted behavioral treatment for CUD. Participants were encouraged to participate in a tobacco intervention that included a computer-assisted behavioral treatment tailored for tobacco and cannabis co-users, and nicotine-replacement therapy (NRT). Cannabis and tobacco outcomes were evaluated using descriptive statistics and were compared to a historical control group that received treatment for CUD but not tobacco. Participants achieved 3.6±4.3 consecutive weeks of cannabis abstinence, which was comparable to the historical control group (3.1±4.4). A majority of the sample (78%) completed at least one tobacco module and 44% initiated NRT. Over half (56%) initiated tobacco quit attempts, and 28% were tobacco abstinent for at least two consecutive weeks. Participants showed greater reduction in tobacco use (cigarettes per day) than the historical control group, but differences in tobacco abstinence rates during the final month of treatment were not statistically significant (12.5% vs. 4%). Findings suggest that providing a tobacco intervention during treatment for CUD is feasible and may positively impact tobacco use without negatively affecting cannabis use outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Outcomes from a Computer-Assisted Intervention Simultaneously Targeting Cannabis and Tobacco Use

    PubMed Central

    Lee, Dustin C.; Budney, Alan J.; Brunette, Mary F.; Hughes, John R.; Etter, Jean-Francois; Stanger, Catherine

    2015-01-01

    BACKGROUND Cannabis users frequently report concurrent tobacco use, and tobacco use is associated with poorer outcomes during treatment for cannabis use disorders (CUD). Interventions that simultaneously target both tobacco and cannabis use disorders may enhance cessation outcomes for either or both substances. METHODS This study evaluated an intervention integrating highly effective treatments for cannabis and tobacco use disorders. Thirty-two participants meeting diagnostic criteria for CUD and reporting daily tobacco use were enrolled in a 12-week computer-assisted behavioral treatment for CUD. Participants were encouraged to participate in a tobacco intervention that included a computer-assisted behavioral treatment tailored for tobacco and cannabis co-users, and nicotine-replacement therapy (NRT). Cannabis and tobacco outcomes were evaluated using descriptive statistics and were compared to a historical control group that received treatment for CUD but not tobacco. RESULTS Participants achieved 3.6 ± 4.3 consecutive weeks of cannabis abstinence, which was comparable to the historical control group (3.1 ± 4.4). A majority of the sample (78%) completed at least one tobacco module and 44% initiated NRT. Over half (56%) initiated tobacco quit attempts, and 28% were tobacco abstinent for at least two consecutive weeks. Participants showed greater reduction in tobacco use (cigarettes per day) than the historical control group, but differences in tobacco abstinence rates during the final month of treatment were not statistically significant (12.5% vs 4%). CONCLUSION Findings suggest that providing a tobacco intervention during treatment for CUD is feasible and may positively impact tobacco use without negatively affecting cannabis use outcomes. PMID:26307942

  1. Personalized Boosters for a Computerized Intervention Targeting College Drinking: The Influence of Protective Behavioral Strategies

    ERIC Educational Resources Information Center

    Braitman, Abby L.; Henson, James M.

    2016-01-01

    Objective: Computerized interventions are cost-effective and can quickly deliver individual feedback to many students. However, in-person interventions are more efficacious. The current study sought to improve the efficacy of a popular online intervention via e-mailed boosters with personalized feedback. Participants: Participants were 213 student…

  2. Personalized Boosters for a Computerized Intervention Targeting College Drinking: The Influence of Protective Behavioral Strategies

    ERIC Educational Resources Information Center

    Braitman, Abby L.; Henson, James M.

    2016-01-01

    Objective: Computerized interventions are cost-effective and can quickly deliver individual feedback to many students. However, in-person interventions are more efficacious. The current study sought to improve the efficacy of a popular online intervention via e-mailed boosters with personalized feedback. Participants: Participants were 213 student…

  3. Development and feasibility of a community-partnered nutrition intervention targeting rural migrant communities in the Dominican Republic.

    PubMed

    Maliszewski, Genevieve; Enriquez, Maithe; Cheng, An-Lin; Logan, Pamela; Watts, Jennifer

    2017-07-01

    Research on health initiatives for rural batey communities in the Dominican Republic is needed. This study utilized a pretest-posttest design to examine the feasibility and acceptability of a nutritional intervention targeting rural migrant sugarcane families. Participants (N = 310) were primarily female (61%) and ranged in age from 13 to 64 years (M = 25.9; SD = 10.4). A convenience sample was recruited from six rural bateyes in the southern region of the Dominican Republic. The intervention was developed for the target population in partnership with a grass-roots organization. The intervention consisted of a short video in the participant's preferred language (Spanish or Creole) describing the importance of consuming a diverse diet. Participants then completed an interactive meal-planning activity to enhance skills learned in the video. The main outcome variable was knowledge and a secondary outcome was participants' performance on the interactive activity. Results showed that the intervention was well received by the target population and participants demonstrated a significant increase in nutrition knowledge (p < .001). Higher postintervention knowledge scores were positively correlated with higher activity skills scores. This novel intervention may have promise as a practical program to enhance the nutritional status of a vulnerable population of migrant sugarcane workers. © 2017 Wiley Periodicals, Inc.

  4. Application study of medical robots in vascular intervention.

    PubMed

    Lu, Wang-sheng; Xu, Wu-yi; Zhang, Jing; Liu, Da; Wang, Da-min; Jia, Po; Li, Zhi-cao; Wang, Tian-miao; Zhang, Da-peng; Tian, Zeng-min; Zeng, Yanjun

    2011-09-01

    Based on the background of minimally invasive surgery and applications of medical robots, a vascular interventional robotic system has been developed that can be used in the field of vascular intervention. The robotic system comprises a propulsion system, an image navigation system and a virtual surgery training system. Integration of the three systems constitutes a vascular intervention prototype robotic system used to carry out in vitro vascular intervention and animal experiments. On a transparent glass vascular model, a catheter was shown to enter an arbitrary branch of the vascular model with catheter motion meeting the requirements of clinical vascular intervention surgery (VIS); i.e. error band of catheter motion < 0.5 mm. In the animal experiments, 1.33-2.00 mm (4F-6F) diameter catheters were selectively inserted successfully into predefined targets in the animal, such as the renal, cardiovascular and cerebrovascular artery. Compared with conventional manual surgery, the time for robotic surgery is a little longer. There were no operative complications in the animal experiments. These simulation and animal study results demonstrate that this vascular interventional robotic system allows doctors to perform angiography remotely and prevents them from radiation exposure. The system may be the basis for further clinical applications of vascular intervention. Copyright © 2011 John Wiley & Sons, Ltd.

  5. Intervention modalities for targeting cognitive-motor interference in individuals with neurodegenerative disease: a systematic review.

    PubMed

    Wajda, Douglas A; Mirelman, Anat; Hausdorff, Jeffrey M; Sosnoff, Jacob J

    2017-03-01

    Individuals with neurodegenerative disease (NDD) commonly have elevated cognitive-motor interference, change in either cognitive or motor performance (or both) when tasks are performed simultaneously, compared to healthy controls. Given that cognitive-motor interference is related to reduced community ambulation and elevated fall risk, it is a target of rehabilitation interventions. Areas covered: This review details the collective findings of previous dual task interventions in individuals with NDD. A total of 21 investigations focusing on 4 different neurodegenerative diseases and one NDD precursor (Parkinson's disease, multiple sclerosis, Alzheimer's disease (AD), dementia other than AD, and mild cognitive impairment) consisting of 721 participants were reviewed. Expert commentary: Preliminary evidence from interventions targeting cognitive-motor interference, both directly and indirectly, show promising results for improving CMI in individuals with neurodegenerative diseases. Methodological limitations, common to pilot investigations preclude firm conclusions. Well-designed randomized control trials targeting cognitive motor interference are warranted.

  6. Interventions that involve parents to improve children's weight-related nutrition intake and activity patterns - what nutrition and activity targets and behaviour change techniques are associated with intervention effectiveness?

    PubMed

    Golley, R K; Hendrie, G A; Slater, A; Corsini, N

    2011-02-01

    Parent involvement is an important component of obesity prevention interventions. However, the best way to support parents remains unclear. This review identifies interventions targeting parents to improve children's weight status, dietary and/or activity patterns, examines whether intervention content and behaviour change techniques employed are associated with effectiveness. Seventeen studies, in English, 1998-2008, were included. Studies were evaluated by two reviewers for study quality, nutrition/activity content and behaviour change techniques using a validated quality assessment tool and behaviour change technique taxonomy. Study findings favoured intervention effectiveness in 11 of 17 studies. Interventions that were considered effective had similar features: better study quality, parents responsible for participation and implementation, greater parental involvement and inclusion of prompt barrier identification, restructure the home environment, prompt self-monitoring, prompt specific goal setting behaviour change techniques. Energy intake/density and food choices were more likely to be targeted in effective interventions. The number of lifestyle behaviours targeted did not appear to be associated with effectiveness. Intervention effectiveness was favoured when behaviour change techniques spanned the spectrum of behaviour change process. The review provides guidance for researchers to make informed decisions on how best to utilize resources in interventions to support and engage parents, and highlights a need for improvement in intervention content reporting practices. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

  7. Interventions among male clients of female sex workers in Benin, West Africa: an essential component of targeted HIV preventive interventions

    PubMed Central

    Lowndes, C M; Alary, M; Labbé, A‐C; Gnintoungbè, C; Belleau, M; Mukenge, L; Meda, H; Ndour, M; Anagonou, S; Gbaguidi, A

    2007-01-01

    Objectives To assess the impact of interventions targeted towards female sex workers (FSWs) and their male clients on client HIV/STI prevalence and sexual behaviour. Methods From 1993 to 2006, an HIV/STI preventive intervention focusing on condom promotion and STI care was implemented among FSWs in Cotonou, Benin, and then expanded to cover their male sexual partners in 2000. The interventions were scaled up to five other cities of Benin in 2001–2002. Serial cross‐sectional surveys of HIV/STI prevalence and sexual behaviour were carried out among clients in Cotonou in 1998, 2002 and 2005; and in the five other cities (O/Cotonou) in 2002 and 2005. Results Significant declines in gonorrhoea prevalence among clients of FSWs: Cotonou, from 5.4% in 1998 to 1.6% in 2005; O/Cotonou: from 3.5% in 2002 to 0.59% in 2005. Chlamydia prevalence also declined O/Cotonou, from 4.8% to 1.8%, while HIV prevalence remained stable. Reported condom use by clients with both FSWs and casual non‐FSW partners, but not regular partners, increased significantly. While condom use at last sex with an FSW was similar in Cotonou to O/Cotonou around the time of implementation of the interventions (56% in 1998 vs 49% in 2002, respectively), it had risen to similar levels by 2005 (95% and 96%, respectively). Conclusions These results demonstrate that it is possible to implement preventive and clinical services for clients of FSWs, and suggest that such interventions, integrated with those targeted towards FSWs, can have a significant effect on sexual behaviour and STI prevalence (particularly gonorrhoea) among this population. PMID:17942573

  8. Dengue vector management using insecticide treated materials and targeted interventions on productive breeding-sites in Guatemala

    PubMed Central

    2012-01-01

    Background In view of the epidemiological expansion of dengue worldwide and the availability of new tools and strategies particularly for controlling the primary dengue vector Aedes aegypti, an intervention study was set up to test the efficacy, cost and feasibility of a combined approach of insecticide treated materials (ITMs) alone and in combination with appropriate targeted interventions of the most productive vector breeding-sites. Methods The study was conducted as a cluster randomized community trial using “reduction of the vector population” as the main outcome variable. The trial had two arms: 10 intervention clusters (neighborhoods) and 10 control clusters in the town of Poptun Guatemala. Activities included entomological assessments (characteristics of breeding-sites, pupal productivity, Stegomyia indices) at baseline, 6 weeks after the first intervention (coverage of window and exterior doorways made of PermaNet 2.0 netting, factory treated with deltamethrin at 55 mg/m2, and of 200 L drums with similar treated material) and 6 weeks after the second intervention (combination of treated materials and other suitable interventions targeting productive breeding-sites i.e larviciding with Temephos, elimination etc.). The second intervention took place 17 months after the first intervention. The insecticide residual activity and the insecticidal content were also studied at different intervals. Additionally, information about demographic characteristics, cost of the intervention, coverage of houses protected and satisfaction in the population with the interventions was collected. Results At baseline (during the dry season) a variety of productive container types for Aedes pupae were identified: various container types holding >20 L, 200 L drums, washbasins and buckets (producing 83.7% of all pupae). After covering 100% of windows and exterior doorways and a small number of drums (where the commercial cover could be fixed) in 970 study households, tropical

  9. Dengue vector management using insecticide treated materials and targeted interventions on productive breeding-sites in Guatemala.

    PubMed

    Rizzo, Nidia; Gramajo, Rodrigo; Escobar, Maria Cabrera; Arana, Byron; Kroeger, Axel; Manrique-Saide, Pablo; Petzold, Max

    2012-10-30

    In view of the epidemiological expansion of dengue worldwide and the availability of new tools and strategies particularly for controlling the primary dengue vector Aedes aegypti, an intervention study was set up to test the efficacy, cost and feasibility of a combined approach of insecticide treated materials (ITMs) alone and in combination with appropriate targeted interventions of the most productive vector breeding-sites. The study was conducted as a cluster randomized community trial using "reduction of the vector population" as the main outcome variable. The trial had two arms: 10 intervention clusters (neighborhoods) and 10 control clusters in the town of Poptun Guatemala. Activities included entomological assessments (characteristics of breeding-sites, pupal productivity, Stegomyia indices) at baseline, 6 weeks after the first intervention (coverage of window and exterior doorways made of PermaNet 2.0 netting, factory treated with deltamethrin at 55 mg/m2, and of 200 L drums with similar treated material) and 6 weeks after the second intervention (combination of treated materials and other suitable interventions targeting productive breeding-sites i.e larviciding with Temephos, elimination etc.). The second intervention took place 17 months after the first intervention. The insecticide residual activity and the insecticidal content were also studied at different intervals. Additionally, information about demographic characteristics, cost of the intervention, coverage of houses protected and satisfaction in the population with the interventions was collected. At baseline (during the dry season) a variety of productive container types for Aedes pupae were identified: various container types holding >20 L, 200 L drums, washbasins and buckets (producing 83.7% of all pupae). After covering 100% of windows and exterior doorways and a small number of drums (where the commercial cover could be fixed) in 970 study households, tropical rains occurred in the area and

  10. 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

  11. Selecting control interventions for clinical outcome studies.

    PubMed

    Barkauskas, Violet H; Lusk, Sally L; Eakin, Brenda L

    2005-04-01

    In the current research environment the design and management of control groups is becoming more complex. The selection of a control group design is dependent on study goals, presence and quality of existing interventions, urgency of the problem or issue being addressed by the intervention, and factors related to the study site. The purpose of the presentation is to identify various approaches to the design of control groups in experimental studies and to identify their strengths, limitations, and applications. A case study exemplifies the issues associated with control group selection and design.

  12. GSK-3 as potential target for therapeutic intervention in cancer

    PubMed Central

    McCubrey, James A.; Steelman, Linda S.; Bertrand, Fred E.; Davis, Nicole M.; Sokolosky, Melissa; Abrams, Steve L.; Montalto, Giuseppe; D'Assoro, Antonino B.; Libra, Massimo; Nicoletti, Ferdinando; Maestro, Roberta; Basecke, Jorg; Rakus, Dariusz; Gizak, Agnieszka; Demidenko, Zoya; Cocco, Lucio; Martelli, Alberto M.; Cervello, Melchiorre

    2014-01-01

    The serine/threonine kinase glycogen synthase kinase-3 (GSK-3) was initially identified and studied in the regulation of glycogen synthesis. GSK-3 functions in a wide range of cellular processes. Aberrant activity of GSK-3 has been implicated in many human pathologies including: bipolar depression, Alzheimer's disease, Parkinson's disease, cancer, non-insulin-dependent diabetes mellitus (NIDDM) and others. In some cases, suppression of GSK-3 activity by phosphorylation by Akt and other kinases has been associated with cancer progression. In these cases, GSK-3 has tumor suppressor functions. In other cases, GSK-3 has been associated with tumor progression by stabilizing components of the beta-catenin complex. In these situations, GSK-3 has oncogenic properties. While many inhibitors to GSK-3 have been developed, their use remains controversial because of the ambiguous role of GSK-3 in cancer development. In this review, we will focus on the diverse roles that GSK-3 plays in various human cancers, in particular in solid tumors. Recently, GSK-3 has also been implicated in the generation of cancer stem cells in various cell types. We will also discuss how this pivotal kinase interacts with multiple signaling pathways such as: PI3K/PTEN/Akt/mTORC1, Ras/Raf/MEK/ERK, Wnt/beta-catenin, Hedgehog, Notch and others. PMID:24931005

  13. Examining the decay of HIV risk reduction outcomes following a community-friendly intervention targeting injection drug users in treatment.

    PubMed

    Copenhaver, Michael M; Lee, I-Ching

    2007-09-01

    It has become crucial for risk reduction interventions targeting injection drug users (IDUs) in treatment to be "community-friendly" and potent over time so that limited resources may be optimally utilized. This study examined (1) the extent to which observed post-intervention effects--including enhanced HIV-related knowledge, motivation, behavioral skills, and drug- and sex-risk reduction behavior--decayed over time and (2) whether repeating the intervention atfollow-up provided additional benefit. Approximately 10 months after completing an adapted, substantially shortened, version of an evidence-based intervention, participants completed a follow-up assessment and then repeated the intervention. No evidence of decay was found. Even so, after repeating the intervention, a trend toward additional sex-risk reduction was observed for participants at higher risk for HIV. Findings point to the potential for an adapted evidence-based intervention for IDUs to be both community-friendly and potent over time within community-based treatment settings.

  14. Cost-Effectiveness Analysis Comparing Pre-diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario's Autism Intervention Program.

    PubMed

    Penner, Melanie; Rayar, Meera; Bashir, Naazish; Roberts, S Wendy; Hancock-Howard, Rebecca L; Coyte, Peter C

    2015-09-01

    Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario Status Quo (SQ). The analyses took government and societal perspectives to age 65. We assigned probabilities of Independent, Semi-dependent or Dependent living based on projected IQ. Costs per person (in Canadian dollars) were ascribed to each living setting. From a government perspective, the ESDM-PD produced an additional 0.17 DFLYs for $8600 less than SQ. From a societal perspective, the ESDM-I produced an additional 0.53 DFLYs for $45,000 less than SQ. Pre-diagnosis interventions targeting ASD symptoms warrant further investigation.

  15. A Targeted Infection Prevention Intervention in Nursing Home Residents With Indwelling Devices

    PubMed Central

    Mody, Lona; Krein, Sarah L.; Saint, Sanjay K.; Min, Lillian C.; Montoya, Ana; Lansing, Bonnie; McNamara, Sara E.; Symons, Kathleen; Fisch, Jay; Koo, Evonne; Rye, Ruth Anne; Galecki, Andrzej; Kabeto, Mohammed U.; Fitzgerald, James T.; Olmsted, Russell N.; Kauffman, Carol A.; Bradley, Suzanne F.

    2015-01-01

    IMPORTANCE Indwelling devices (eg, urinary catheters and feeding tubes) are often used in nursing homes (NHs). Inadequate care of residents with these devices contributes to high rates of multidrug-resistant organisms (MDROs) and device-related infections in NHs. OBJECTIVE To test whether a multimodal targeted infection program (TIP) reduces the prevalence of MDROs and incident device-related infections. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial at 12 community-based NHs from May 2010 to April 2013. Participants were high-risk NH residents with urinary catheters, feeding tubes, or both. INTERVENTIONS Multimodal, including preemptive barrier precautions, active surveillance for MDROs and infections, and NH staff education. MAIN OUTCOMES AND MEASURES The primary outcome was the prevalence density rate of MDROs, defined as the total number of MDROs isolated per visit averaged over the duration of a resident's participation. Secondary outcomes included new MDRO acquisitions and new clinically defined device-associated infections. Data were analyzed using a mixed-effects multilevel Poisson regression model (primary outcome) and a Cox proportional hazards model (secondary outcome), adjusting for facility-level clustering and resident-level variables. RESULTS In total, 418 NH residents with indwelling devices were enrolled, with 34 174 device-days and 6557 anatomic sites sampled. Intervention NHs had a decrease in the overall MDRO prevalence density (rate ratio, 0.77; 95% CI, 0.62–0.94). The rate of new methicillin-resistant Staphylococcus aureus acquisitions was lower in the intervention group than in the control group (rate ratio, 0.78; 95% CI, 0.64–0.96). Hazard ratios for the first and all (including recurrent) clinically defined catheter-associated urinary tract infections were 0.54 (95% CI, 0.30–0.97) and 0.69 (95% CI, 0.49–0.99), respectively, in the intervention group and the control group. There were no reductions in new vancomycin

  16. Community-Based Intervention to Improve Cardiometabolic Targets in Patients With Stroke: A Randomized Controlled Trial.

    PubMed

    Olaiya, Muideen T; Cadilhac, Dominique A; Kim, Joosup; Nelson, Mark R; Srikanth, Velandai K; Gerraty, Richard P; Bladin, Christopher F; Fitzgerald, Sharyn M; Phan, Thanh; Frayne, Judith; Thrift, Amanda G

    2017-09-01

    Many guidelines for secondary prevention of stroke focus on controlling cardiometabolic risk factors. We investigated the effectiveness of a management program for attaining cardiometabolic targets in survivors of stroke/transient ischemic attack. Randomized controlled trial of survivors of stroke/transient ischemic attack aged ≥18 years. General practices were randomized to usual care (control) or an intervention comprising specialist review of care plans and nurse education in addition to usual care. The outcome is attainment of pre-defined cardiometabolic targets based on Australian guidelines. Multivariable regression was undertaken to determine efficacy and identify factors associated with attaining targets. Overall, 283 subjects were randomized to the intervention and 280 to controls. Although we found no between-group difference in overall cardiometabolic targets achieved at 12 months, the intervention group more often achieved control of low-density lipoprotein cholesterol (odds ratio, 1.97; 95% confidence interval, 1.18-3.29) than controls. At 24 months, no between-group differences were observed. Medication adherence was ≥80% at follow-up, but uptake of lifestyle/behavioral habits was poor. Older age, being male, being married/living with partner, and having greater functional ability or a history of diabetes mellitus were associated with attaining targets. The intervention in this largely negative trial only had a detectable effect on attaining target for lipids but not for other factors at 12 months or any factor at 24 months. This limited effect may be attributable to inadequate uptake of behavioral/lifestyle interventions, highlighting the need for new or better approaches to achieve meaningful behavioral change. URL: http://www.clinicaltrials.gov. Unique identifier: ACTRN12608000166370. © 2017 American Heart Association, Inc.

  17. Body Image and Self-Esteem among Adolescents undergoing an Intervention Targeting Dietary and Physical Activity Behaviors

    PubMed Central

    Huang, Jeannie S.; Norman, Gregory J.; Zabinski, Marion F.; Calfas, Karen; Patrick, Kevin

    2007-01-01

    Background Health promotion interventions can lead to awareness of health risk and subsequent adoption of beneficial changes in behavior. However, it is possible that interventions targeting behaviors associated with childhood obesity may also increase the likelihood of unhealthy eating and physical activity obsessions and behaviors. Objective To determine the effect of a one-year intervention targeting physical activity, sedentary and diet behaviors among adolescents on self-reported body image and self-esteem. Methods Body image and self-esteem were assessed for adolescents participating in the PACE+ study, a randomized controlled trial of a one-year behavioral intervention targeting physical activity, sedentary, and dietary behaviors. The Body Dissatisfaction subscale of the Eating Disorder Inventory and Rosenberg Self-Esteem scale were used to assess body image and self-esteem respectively, and measurements were performed at baseline, 6 and 12 months. Demographic characteristics and weight status of participants were also ascertained. Analysis of responses was performed via both between-group and within-group repeated measure analyses. Results 657 adolescents completed all measurements. Body image differences were found for age, sex and weight status at baseline, while self-esteem differences were demonstrated for sex, ethnicity and weight status. There were no intervention effects on body image or self-esteem for either girls or boys. Self-esteem and body satisfaction did not worsen as a result of participating in the PACE+ intervention for either boys or girls whether or not they lost or maintained their weight or gained weight. Girls assigned to the PACE intervention who experienced weight reduction or weight maintenance at either 6 or 12-months reported improvements in body image satisfaction (p=0.02) over time compared to subjects who had experienced weight gain during the 12-month study period. Conclusions Adverse effects on body satisfaction and self

  18. Body image and self-esteem among adolescents undergoing an intervention targeting dietary and physical activity behaviors.

    PubMed

    Huang, Jeannie S; Norman, Gregory J; Zabinski, Marion F; Calfas, Karen; Patrick, Kevin

    2007-03-01

    To determine the effect of a one-year intervention targeting physical activity, sedentary, and diet behaviors among adolescents on self-reported body image and self-esteem. Health promotion interventions can lead to awareness of health risk and subsequent adoption of beneficial changes in behavior. However, it is possible that interventions targeting behaviors associated with childhood obesity may also increase the likelihood of unhealthy eating and physical activity obsessions and behaviors. Body image and self-esteem were assessed for adolescents participating in the PACE+ study, a randomized controlled trial of a 1-year behavioral intervention targeting physical activity, sedentary, and dietary behaviors. The Body Dissatisfaction subscale of the Eating Disorder Inventory and Rosenberg Self-Esteem scale were used to assess body image and self-esteem, respectively, and measurements were performed at baseline, and at 6 and 12 months. Demographic characteristics and weight status of participants were also ascertained. Analysis of responses was performed via both between-group and within-group repeated measure analyses. There were 657 adolescents who completed all measurements. Body image differences were found for age, gender, and weight status at baseline, whereas self-esteem differences were demonstrated for gender, ethnicity, and weight status. There were no intervention effects on body image or self-esteem for either girls or boys. Self-esteem and body satisfaction did not worsen as a result of participating in the PACE+ intervention for either boys or girls whether or not they lost or maintained their weight or gained weight. Girls assigned to the PACE intervention who experienced weight reduction or weight maintenance at either 6 or 12 months reported improvements in body image satisfaction (p = .02) over time compared with subjects who had experienced weight gain during the 12-month study period. Adverse effects on body satisfaction and self-esteem were not

  19. Prevention of delirium in hospitalized older patients: risk factors and targeted intervention strategies.

    PubMed

    Inouye, S K

    2000-05-01

    Delirium is a common, costly, and potentially devastating condition for hospitalized older patients. Delirium is a multifactorial syndrome, involving the inter-relationship between patient vulnerability, or predisposing factors at admission, and noxious insults or precipitating factors during hospitalization. Through a series of studies, we first identified significant predisposing factors for delirium, including vision impairment, severe illness, cognitive impairment, and dehydration. Subsequently, significant precipitating factors were identified, including physical restraint use, malnutrition, adding more than three drugs, bladder catheter use, and any iatrogenic event. Through targeting preventive strategies towards six identified risk factors in a controlled clinical trial, we were successful in the primary prevention of delirium. In 852 subjects, the incidence of delirium was significantly reduced in the intervention group compared with usual care (9.9% vs 15.0%, matched odds ratio: 0.60; 95% confidence interval: 0.39-0.92). The total number of days and episodes of delirium were also significantly reduced in the intervention group. Based on this work, evidence-based recommendations for delirium prevention are proposed. While not all cases of delirium will be preventable with this approach, unifying medical and epidemiological approaches to delirium represents a key advance essential to reducing the high morbidity and mortality associated with delirium in the older population.

  20. Measuring the Cool Tool as a Targeted Intervention to Minimize Teacher Reprimands and Students' On-Task Behaviors in an Urban Elementary School

    ERIC Educational Resources Information Center

    Utley, Cheryl A.; Obiakor, Festus E.

    2015-01-01

    This study measured the effects of a targeted intervention, The Cool Tool, implemented in the secondary prevention tier to minimize teacher reprimands and students' on-task behaviors in an urban elementary school. The participants in the social skills intervention programs were seven teachers, across grades K-5. Assessments included pre-posttest…

  1. Measuring the Cool Tool as a Targeted Intervention to Minimize Teacher Reprimands and Students' On-Task Behaviors in an Urban Elementary School

    ERIC Educational Resources Information Center

    Utley, Cheryl A.; Obiakor, Festus E.

    2015-01-01

    This study measured the effects of a targeted intervention, The Cool Tool, implemented in the secondary prevention tier to minimize teacher reprimands and students' on-task behaviors in an urban elementary school. The participants in the social skills intervention programs were seven teachers, across grades K-5. Assessments included pre-posttest…

  2. A Problem Solving Intervention for hospice caregivers: a pilot study.

    PubMed

    Demiris, George; Oliver, Debra Parker; Washington, Karla; Fruehling, Lynne Thomas; Haggarty-Robbins, Donna; Doorenbos, Ardith; Wechkin, Hope; Berry, Donna

    2010-08-01

    The Problem Solving Intervention (PSI) is a structured, cognitive-behavioral intervention that provides people with problem-solving coping skills to help them face major negative life events and daily challenges. PSI has been applied to numerous settings but remains largely unexplored in the hospice setting. The aim of this pilot study was to demonstrate the feasibility of PSI targeting informal caregivers of hospice patients. We enrolled hospice caregivers who were receiving outpatient services from two hospice agencies. The intervention included three visits by a research team member. The agenda for each visit was informed by the problem-solving theoretical framework and was customized based on the most pressing problems identified by the caregivers. We enrolled 29 caregivers. Patient's pain was the most frequently identified problem. On average, caregivers reported a higher quality of life and lower level of anxiety postintervention than at baseline. An examination of the caregiver reaction assessment showed an increase of positive esteem average and a decrease of the average value of lack of family support, impact on finances, impact on schedules, and on health. After completing the intervention, caregivers reported lower levels of anxiety, improved problem solving skills, and a reduced negative impact of caregiving. Furthermore, caregivers reported high levels of satisfaction with the intervention, perceiving it as a platform to articulate their challenges and develop a plan to address them. Findings demonstrate the value of problem solving as a psycho-educational intervention in the hospice setting and call for further research in this area.

  3. The Targeted Reading Intervention: Face-to-Face vs. Webcam Literacy Coaching of Classroom Teachers

    ERIC Educational Resources Information Center

    Vernon-Feagans, L.; Bratsch-Hines, M.; Varghese, C.; Bean, A.; Hedrick, A.

    2015-01-01

    The targeted reading intervention (TRI) is a professional development program for rural kindergarten and first grade classroom teachers to help them provide effective reading strategies with struggling readers. In two randomized controlled trials, the TRI was delivered two ways: (1) literacy coaches provided support for classroom teachers through…

  4. Targeting Premalignant Lesions: Implications for Early Breast Cancer Detection and Intervention

    DTIC Science & Technology

    2016-04-01

    1 AWARD NUMBER: W81XWH-14-1-0032 TITLE: Targeting Premalignant Lesions: Implications for Early Breast Cancer Detection and Intervention...ABSTRACT Breast cancer progression constitutes a multistep process through a series of intermediate hyperplastic and neoplastic stages to invasive...Considerable numbers of CAFs are frequently observed within the tumor- associated stroma of various human cancers , including those of the breast

  5. Sustainability of a Targeted Intervention Package: First Step to Success in Oregon

    ERIC Educational Resources Information Center

    Loman, Sheldon L.; Rodriguez, Billie Jo; Horner, Robert H.

    2010-01-01

    Variables affecting the sustained implementation of evidence-based practices are receiving increased attention. A descriptive analysis of the variables associated with sustained implementation of First Step to Success (FSS), a targeted intervention for young students at risk for behavior disorders, is provided. Measures based on a conceptual model…

  6. Vowel Targeted Intervention for Children with Persisting Speech Difficulties: Impact on Intelligibility

    ERIC Educational Resources Information Center

    Speake, Jane; Stackhouse, Joy; Pascoe, Michelle

    2012-01-01

    Compared to the treatment of consonant segments, the treatment of vowels is infrequently described in the literature on children's speech difficulties. Vowel difficulties occur less frequently than those with consonants but may have significant impact on intelligibility. In order to evaluate the effectiveness of vowel targeted intervention (VTI)…

  7. Long-Term Effects of a Personality-Targeted Intervention to Reduce Alcohol Use in Adolescents

    ERIC Educational Resources Information Center

    Conrod, Patricia J.; Castellanos-Ryan, Natalie; Mackie, Clare

    2011-01-01

    Objective: To examine the long-term effects of a personality-targeted intervention on drinking quantity and frequency (QF), problem drinking, and personality-specific motivations for alcohol use in early adolescence. Method: A randomized control trial was carried out with 364 adolescents (median age 14) recruited from 13 secondary schools with…

  8. Appropriately Targeting Group Interventions for Academic Success Adopting the Clinical Model and PAR Profiles

    ERIC Educational Resources Information Center

    Johnson, Craig W.; Johnson, Ronald; Steigman, Michael; Odo, Chioma; Vijayan, Suvendra; Tata, Devadatta V.

    2016-01-01

    Prevalence of academic risk (PAR) group profiles provide data enabling empirically based group-specialized prescriptions for targeted academic success interventions to increase student retention, completion, and graduation rates, while improving allocation of institutional resources. Postsecondary student attrition engenders student debt,…

  9. Targeting Vulnerabilities to Risky Behavior: An Intervention for Promoting Adaptive Emotion Regulation in Adolescents

    ERIC Educational Resources Information Center

    Claro, Anthony; Boulanger, Marie-Michelle; Shaw, Steven R.

    2015-01-01

    The paper examined the effectiveness of an in-school intervention for adolescents designed to target emotional regulation skills related to risky behaviors. The Cognitive Emotion Regulation Intended for Youth (CERTIFY) program was delivered to at-risk adolescents in Montreal, Canada. Participants were drawn from an alternative high school and a…

  10. Long-Term Effects of a Personality-Targeted Intervention to Reduce Alcohol Use in Adolescents

    ERIC Educational Resources Information Center

    Conrod, Patricia J.; Castellanos-Ryan, Natalie; Mackie, Clare

    2011-01-01

    Objective: To examine the long-term effects of a personality-targeted intervention on drinking quantity and frequency (QF), problem drinking, and personality-specific motivations for alcohol use in early adolescence. Method: A randomized control trial was carried out with 364 adolescents (median age 14) recruited from 13 secondary schools with…

  11. Appropriately Targeting Group Interventions for Academic Success Adopting the Clinical Model and PAR Profiles

    ERIC Educational Resources Information Center

    Johnson, Craig W.; Johnson, Ronald; Steigman, Michael; Odo, Chioma; Vijayan, Suvendra; Tata, Devadatta V.

    2016-01-01

    Prevalence of academic risk (PAR) group profiles provide data enabling empirically based group-specialized prescriptions for targeted academic success interventions to increase student retention, completion, and graduation rates, while improving allocation of institutional resources. Postsecondary student attrition engenders student debt,…

  12. The 'robustness' of vocabulary intervention in the public schools: targets and techniques employed in speech-language therapy.

    PubMed

    Justice, Laura M; Schmitt, Mary Beth; Murphy, Kimberly A; Pratt, Amy; Biancone, Tricia

    2014-01-01

    This study examined vocabulary intervention-in terms of targets and techniques-for children with language impairment receiving speech-language therapy in public schools (i.e., non-fee-paying schools) in the United States. Vocabulary treatments and targets were examined with respect to their alignment with the empirically validated practice of rich vocabulary intervention. Participants were forty-eight 5-7-year-old children participating in kindergarten or the first-grade year of school, all of whom had vocabulary-specific goals on their individualized education programmes. Two therapy sessions per child were coded to determine what vocabulary words were being directly targeted and what techniques were used for each. Study findings showed that the majority of words directly targeted during therapy were lower-level basic vocabulary words (87%) and very few (1%) were academically relevant. On average, three techniques were used per word to promote deep understanding. Interpreting findings against empirical descriptions of rich vocabulary intervention indicates that children were exposed to some but not all aspects of this empirically supported practice.

  13. Case studies of ergonomic interventions in automotive parts distribution operations.

    PubMed

    Ulin, Sheryl S; Keyserling, W Monroe

    2004-12-01

    Ergonomic job analysis, intervention design, and intervention implementation are essential components of an ergonomics program designed to reduce worker exposure to risk factors associated with musculoskeletal disorders. As part of a 4-year study to reduce overexertion injuries in the service parts division of a major automaker, intervention case studies were identified that could be used at multiple facilities across the division. Interventions were developed and implemented. The three case studies include 1) self-elevating powered vehicle for transporting parts throughout the facility and for reaching to high bin locations; 2) lift and tilt pallet jacks for packing small parts into large bin-like containers; and 3) single-level telescoping conveyor used for delivering hand-held totes for subsequent sorting operations. Several analysis methods were used to assess worker exposure before and after intervention implementation (biomechanical analysis, posture analysis, worker interviews, and activity analysis). Following implementation, a decrease in exposure to risk factors for musculoskeletal disorders was documented. Worker interviews revealed acceptance and agreement that risk factors associated with the targeted tasks were reduced. Each case study includes a description of the implementation hurdles and can serve as both primary and secondary prevention of musculoskeletal disorders. Future work should document worker health and/or symptom changes as well as changes in risk factor exposure.

  14. Targeting Interventions: Moderators of the Effects of Expressive Writing and Assertiveness Training on the Adjustment of International University Students

    PubMed Central

    Hijazi, Alaa M.; Tavakoli, Shedeh; Slavin-Spenny, Olga M.; Lumley, Mark A.

    2011-01-01

    Acculturative stress is a common experience for international students and is associated with psychological and physical problems. In a previous study, the authors reported that two stress reduction interventions—expressive writing (EW) and assertiveness training (AT)—had limited overall benefits among international students at an American University. The current analyses of data from that study investigated whether individual differences moderated the effects of EW and AT. Results indicate that greater acculturative stress at baseline predicted greater improvement from both interventions, compared with control. Women benefited more from AT than EW, except that EW improved women’s physical symptoms. Men benefited more from EW than AT. Students with limited emotional awareness and expression tended to benefit from both interventions, relative to control. Finally, nation of origin cultural differences generally did not predict outcomes. It is concluded that the benefits of EW and AT and can be enhanced by targeting these interventions to specific subgroups of international students. PMID:21660220

  15. Economic assessments of small-scale drinking-water interventions in pursuit of MDG target 7C.

    PubMed

    Cameron, John; Jagals, Paul; Hunter, Paul R; Pedley, Steve; Pond, Katherine

    2011-12-01

    This paper uses an applied rural case study of a safer water intervention in South Africa to illustrate how three levels of economic assessment can be used to understand the impact of the intervention on people's well-being. It is set in the context of Millennium Development Goal 7 which sets a target (7C) for safe drinking-water provision and the challenges of reaching people in remote rural areas with relatively small-scale schemes. The assessment moves from cost efficiency to cost effectiveness to a full social cost-benefit analysis (SCBA) with an associated sensitivity test. In addition to demonstrating techniques of analysis, the paper brings out many of the challenges in understanding how safer drinking-water impacts on people's livelihoods. The SCBA shows the case study intervention is justified economically, though the sensitivity test suggests 'downside' vulnerability. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. A systematic review of the evidence on integration of targeted health interventions into health systems.

    PubMed

    Atun, Rifat; de Jongh, Thyra; Secci, Federica; Ohiri, Kelechi; Adeyi, Olusoji

    2010-01-01

    A longstanding debate on health systems organization relates to benefits of integrating health programmes that emphasize specific interventions into mainstream health systems to increase access and improve health outcomes. This debate has long been characterized by polarization of views and ideologies, with protagonists for and against integration arguing the relative merits of each approach. However, all too frequently these arguments have not been based on hard evidence. The presence of both integrated and non-integrated programmes in many countries suggests there may be benefits to either approach, but the relative merits of integration in various contexts and for different interventions have not been systematically analysed and documented. In this paper we present findings of a systematic review that explores a broad range of evidence on: (i) the extent and nature of the integration of targeted health programmes that emphasize specific interventions into critical health systems functions, (ii) how the integration or non-integration of health programmes into critical health systems functions in different contexts has influenced programme success, (iii) how contextual factors have affected the extent to which these programmes were integrated into critical health systems functions. Our analysis shows few instances where there is full integration of a health intervention or where an intervention is completely non-integrated. Instead, there exists a highly heterogeneous picture both for the nature and also for the extent of integration. Health systems combine both non-integrated and integrated interventions, but the balance of these interventions varies considerably.

  17. Healthcare professionals and managers' participation in developing an intervention: A pre-intervention study in the elderly care context

    PubMed Central

    Vedel, Isabelle; De Stampa, Matthieu; Bergman, Howard; Ankri, Joel; Cassou, Bernard; Blanchard, François; Lapointe, Liette

    2009-01-01

    Background In order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals. Nonetheless, pre-intervention studies are rarely conducted or are very limited in scope. Moreover, little is known about how to integrate the results of a pre-intervention study into an intervention. As part of a project to develop an intervention aimed at improving care for the elderly in France, a pre-intervention study was conducted to systematically gather data on the current practices, issues, and expectations of healthcare professionals and managers in order to determine the defining features of a successful intervention. Methods A qualitative study was carried out from 2004 to 2006 using a grounded theory approach and involving a purposeful sample of 56 healthcare professionals and managers in Paris, France. Four sources of evidence were used: interviews, focus groups, observation, and documentation. Results The stepwise approach comprised three phases, and each provided specific results. In the first step of the pre-intervention study, we gathered data on practices, perceived issues, and expectations of healthcare professionals and managers. The second step involved holding focus groups in order to define the characteristics of a tailor-made intervention. The third step allowed validation of the findings. Using this approach, we were able to design and develop an intervention in elderly care that met the professionals' and managers' expectations. Conclusion This article reports on an in-depth pre-intervention study that led to the design and development of an intervention in partnership with local healthcare professionals and managers. The stepwise approach represents an innovative strategy for developing tailored interventions, particularly in complex domains such as chronic care. It highlights the usefulness of seeking out the insight of healthcare

  18. A Molecular-Level Landscape of Diet-Gut Microbiome Interactions: Toward Dietary Interventions Targeting Bacterial Genes

    PubMed Central

    Ni, Yueqiong; Li, Jun

    2015-01-01

    ABSTRACT As diet is considered the major regulator of the gut ecosystem, the overall objective of this work was to demonstrate that a detailed knowledge of the phytochemical composition of food could add to our understanding of observed changes in functionality and activity of the gut microbiota. We used metatranscriptomic data from a human dietary intervention study to develop a network that consists of >400 compounds present in the administered plant-based diet linked to 609 microbial targets in the gut. Approximately 20% of the targeted bacterial proteins showed significant changes in their gene expression levels, while functional and topology analyses revealed that proteins in metabolic networks with high centrality are the most “vulnerable” targets. This global view and the mechanistic understanding of the associations between microbial gene expression and dietary molecules could be regarded as a promising methodological approach for targeting specific bacterial proteins that impact human health. PMID:26507230

  19. A targeted infection prevention intervention in nursing home residents with indwelling devices: a randomized clinical trial.

    PubMed

    Mody, Lona; Krein, Sarah L; Saint, Sanjay; Min, Lillian C; Montoya, Ana; Lansing, Bonnie; McNamara, Sara E; Symons, Kathleen; Fisch, Jay; Koo, Evonne; Rye, Ruth Anne; Galecki, Andrzej; Kabeto, Mohammed U; Fitzgerald, James T; Olmsted, Russell N; Kauffman, Carol A; Bradley, Suzanne F

    2015-05-01

    Indwelling devices (eg, urinary catheters and feeding tubes) are often used in nursing homes (NHs). Inadequate care of residents with these devices contributes to high rates of multidrug-resistant organisms (MDROs) and device-related infections in NHs. To test whether a multimodal targeted infection program (TIP) reduces the prevalence of MDROs and incident device-related infections. Randomized clinical trial at 12 community-based NHs from May 2010 to April 2013. Participants were high-risk NH residents with urinary catheters, feeding tubes, or both. Multimodal, including preemptive barrier precautions, active surveillance for MDROs and infections, and NH staff education. The primary outcome was the prevalence density rate of MDROs, defined as the total number of MDROs isolated per visit averaged over the duration of a resident's participation. Secondary outcomes included new MDRO acquisitions and new clinically defined device-associated infections. Data were analyzed using a mixed-effects multilevel Poisson regression model (primary outcome) and a Cox proportional hazards model (secondary outcome), adjusting for facility-level clustering and resident-level variables. In total, 418 NH residents with indwelling devices were enrolled, with 34,174 device-days and 6557 anatomic sites sampled. Intervention NHs had a decrease in the overall MDRO prevalence density (rate ratio, 0.77; 95% CI, 0.62-0.94). The rate of new methicillin-resistant Staphylococcus aureus acquisitions was lower in the intervention group than in the control group (rate ratio, 0.78; 95% CI, 0.64-0.96). Hazard ratios for the first and all (including recurrent) clinically defined catheter-associated urinary tract infections were 0.54 (95% CI, 0.30-0.97) and 0.69 (95% CI, 0.49-0.99), respectively, in the intervention group and the control group. There were no reductions in new vancomycin-resistant enterococci or resistant gram-negative bacilli acquisitions or in new feeding tube-associated pneumonias or

  20. Immunity to schistosomiasis: glycans are potential antigenic targets for immune intervention.

    PubMed

    Nyame, A Kwame; Lewis, Fred A; Doughty, Barbara L; Correa-Oliveira, Rodrigo; Cummings, Richard D

    2003-01-01

    The major humoral immune responses in animals infected with Schistosoma mansoni are directed toward carbohydrate antigens. Among these antigens are complex-type N-glycans expressing LDN [GalNAcbeta1-4GlcNAc-R], LDNF [GalNAcbeta1-4(Fucalpha1-3)GlcNAc-R], and polymeric Lewis x (Lex) [Galbeta1-4(Fucalpha1-3)GlcNAc]n-R epitopes. We have now evaluated the potential of the three glycan antigens as targets for immune-mediated intervention of infections and serodiagnosis. A variety of approaches were employed, including ELISA, Western blot, immunohistology, and in vitro complement lysis assays, to determine the immunogenicity of the glycans in infected humans, their localization on the parasites and their efficacy as targets for parasite lysis. Our results show that S. mansoni-infected patients, with either intestinal or hepatosplenic disease, generate predominantly IgM, but also IgG and IgA, antibodies to LDN, LDNF, and Lex. However, immune responses to Lex are generally lower than responses to LDN and LDNF and less specific to schistosome infections. Western blot analysis with monoclonal antibodies (mAb) to LDN, LDNF, and Lex determinants show that the glycan antigens occur on multiple glycoproteins from cercariae, 3-h, 48-h, and lung stage schistosomula, as well as adults and eggs. Immunohistological studies demonstrate that LDN, LDNF, and Lex are expressed on the parasite surface at all stages of development in the vertebrate host. Importantly, a mAb to LDN in the presence of complement efficiently kills schistosomula in vitro, as demonstrated by flow-cytometric assays that quantify cytolysis by propidium iodide uptake into damaged parasites. These findings raise the possibility that LDN and LDNF may be targets for vaccination and/or serodiagnosis of chronic schistosomiasis in humans.

  1. Future directions for interventions targeting PTSD in HIV-infected adults.

    PubMed

    Applebaum, Allison J; Bedoya, C Andres; Hendriksen, Ellen S; Wilkinson, Jesse L; Safren, Steven A; O'Cleirigh, Conall

    2015-01-01

    Although studies consistently report high rates of comorbid posttraumatic stress disorder (PTSD) and HIV infection, development and testing of PTSD treatment interventions in HIV-infected adults is limited. As such, the purpose of this review was twofold. First, this review augments the three existing reviews of research for PTSD in HIV-infected adults conducted within the past 10 years. We found two empirically supported cognitive-behavioral therapy-based interventions for the treatment of trauma-related symptoms in HIV-infected adults. Due to the continued limited number of effective interventions for this population, a second aim of our review was to draw from the expansive field of effective PTSD interventions for the general population to propose ways that future clinical intervention research may be tailored for HIV-infected adults. Therefore, in addition to a review, we conceptualized this paper as an opportunity to generate an ideal preview of the field of intervention research in this population.

  2. A culturally targeted intervention to promote breast cancer screening among low-income women in East Baltimore, Maryland.

    PubMed

    Garza, Mary A; Luan, Jingyu; Blinka, Marcela; Farabee-Lewis, Reverend Iris; Neuhaus, Charlotte E; Zabora, James R; Ford, Jean G

    2005-11-01

    In Maryland, outreach initiatives have been unsuccessful in engaging low-income African American women in mammography screening. This study aimed to identify factors influencing screening rates for low-income African American women. Based on the Health Belief Model, a modified time series design was used to implement a culturally targeted intervention to promote a no-cost mammography-screening program. Data were collected from women 40 years of age and older on their history of mammography use and their knowledge and beliefs about breast cancer. A 50% screening rate was achieved among 119 eligible participants. Significant predictors of screening behaviors were perceived barriers, lack of insurance, and limited knowledge. This culturally targeted intervention resulted in an unprecedented screening rate among low-income African American women in Baltimore, Maryland.

  3. Reducing dementia risk by targeting modifiable risk factors in mid-life: study protocol for the Innovative Midlife Intervention for Dementia Deterrence (In-MINDD) randomised controlled feasibility trial.

    PubMed

    O'Donnell, Catherine A; Browne, Susan; Pierce, Maria; McConnachie, Alex; Deckers, Kay; van Boxtel, Martin P J; Manera, Valeria; Köhler, Sebastian; Redmond, Muriel; Verhey, Frans R J; van den Akker, Marjan; Power, Kevin; Irving, Kate

    2015-01-01

    Dementia prevalence is increasing as populations live longer, with no cure and the costs of caring exceeding many other conditions. There is increasing evidence for modifiable risk factors which, if addressed in mid-life, can reduce the risk of developing dementia in later life. These include physical inactivity, low cognitive activity, mid-life obesity, high blood pressure, and high cholesterol. This study aims to assess the acceptability and feasibility and impact of giving those in mid-life, aged between 40 and 60 years, an individualised dementia risk modification score and profile and access to personalised on-line health information and goal setting in order to support the behaviour change required to reduce such dementia risk. A secondary aim is to understand participants' and practitioners' views of dementia prevention and explore the acceptability and integration of the Innovative Midlife Intervention for Dementia Deterrence (In-MINDD) intervention into daily life and routine practice. In-MINDD is a multi-centre, primary care-based, single-blinded randomised controlled feasibility trial currently being conducted in four European countries (France, Ireland, the Netherlands and the UK). Participants are being recruited from participating general practices. Inclusion criteria will include age between 40 and 60 years; at least one modifiable risk factor for dementia risk (including diabetes, hypertension, obesity, renal dysfunction, current smoker, raised cholesterol, coronary heart disease, current or previous history of depression, self-reported sedentary lifestyle, and self-reported low cognitive activity) access to the Internet. Primary outcome measure will be a change in dementia risk modification score over the timescale of the trial (6 months). A qualitative process evaluation will interview a sample of participants and practitioners about their views on the acceptability and feasibility of the trial and the links between modifiable risk factors and

  4. Targeted Interventions for Improved Equity in Maternal and Child Health in Low- and Middle-Income Settings: A Systematic Review and Meta-Analysis

    PubMed Central

    Målqvist, Mats; Yuan, Beibei; Trygg, Nadja; Selling, Katarina; Thomsen, Sarah

    2013-01-01

    Background Targeted interventions to improve maternal and child health is suggested as a feasible and sometimes even necessary strategy to reduce inequity. The objective of this systematic review was to gather the evidence of the effectiveness of targeted interventions to improve equity in MDG 4 and 5 outcomes. Methods and Findings We identified primary studies in all languages by searching nine health and social databases, including grey literature and dissertations. Studies evaluating the effect of an intervention tailored to address a structural determinant of inequity in maternal and child health were included. Thus general interventions targeting disadvantaged populations were excluded. Outcome measures were limited to indicators proposed for Millennium Development Goals 4 and 5. We identified 18 articles, whereof 15 evaluated various incentive programs, two evaluated a targeted policy intervention, and only one study evaluated an intervention addressing a cultural custom. Meta-analyses of the effectiveness of incentives programs showed a pooled effect size of RR 1.66 (95% CI 1.43–1.93) for antenatal care attendance (four studies with 2,476 participants) and RR 2.37 (95% CI 1.38–4.07) for health facility delivery (five studies with 25,625 participants). Meta-analyses were not performed for any of the other outcomes due to scarcity of studies. Conclusions The targeted interventions aiming to improve maternal and child health are mainly limited to addressing economic disparities through various incentive schemes like conditional cash transfers and voucher schemes. This is a feasible strategy to reduce inequity based on income. More innovative action-oriented research is needed to speed up progress in maternal and child survival among the most disadvantaged populations through interventions targeting the underlying structural determinants of inequity. PMID:23840474

  5. A Trial of an iPad™ Intervention Targeting Social Communication Skills in Children with Autism

    ERIC Educational Resources Information Center

    Fletcher-Watson, Sue; Petrou, Alexandra; Scott-Barrett, Juliet; Dicks, Pamela; Graham, Catherine; O'Hare, Anne; Pain, Helen; McConachie, Helen

    2016-01-01

    This study evaluated a technology-based early intervention for social communication skills in pre-schoolers in a randomised controlled trial. Participants were 54 children aged under 6 years with a diagnosis of autism, assigned to either intervention or control conditions. The app engaged children, who played consistently, regardless of…

  6. A Trial of an iPad™ Intervention Targeting Social Communication Skills in Children with Autism

    ERIC Educational Resources Information Center

    Fletcher-Watson, Sue; Petrou, Alexandra; Scott-Barrett, Juliet; Dicks, Pamela; Graham, Catherine; O'Hare, Anne; Pain, Helen; McConachie, Helen

    2016-01-01

    This study evaluated a technology-based early intervention for social communication skills in pre-schoolers in a randomised controlled trial. Participants were 54 children aged under 6 years with a diagnosis of autism, assigned to either intervention or control conditions. The app engaged children, who played consistently, regardless of…

  7. Firm Foundations: The Effectiveness of an Educational Psychologist Developed Intervention Targeting Early Numeracy Skills

    ERIC Educational Resources Information Center

    Somerville, Ros; Ayre, Kate; Tunbridge, Daniel; Cole, Katy; Stollery, Richard; Sanders, Mary

    2015-01-01

    This study evaluates the efficacy of a mathematics intervention devised by Essex Educational Psychology Service (EPS), UK. The intervention was designed to develop understanding and skills across four key domains within arithmetical development, by applying the principles of errorless learning, distributed practice and teaching to mastery. A…

  8. Firm Foundations: The Effectiveness of an Educational Psychologist Developed Intervention Targeting Early Numeracy Skills

    ERIC Educational Resources Information Center

    Somerville, Ros; Ayre, Kate; Tunbridge, Daniel; Cole, Katy; Stollery, Richard; Sanders, Mary

    2015-01-01

    This study evaluates the efficacy of a mathematics intervention devised by Essex Educational Psychology Service (EPS), UK. The intervention was designed to develop understanding and skills across four key domains within arithmetical development, by applying the principles of errorless learning, distributed practice and teaching to mastery. A…

  9. Exploring Environment-Intervention Fit: A Study of a Work Environment Intervention Program for the Care Sector

    PubMed Central

    Aust, Birgit; Flyvholm, Mari-Ann

    2015-01-01

    Targeting occupational health and safety interventions to different groups of employees and sectors is important. The aim of this study was to explore the environment-intervention fit of a Danish psychosocial work environment intervention program for the residential and home care sector. Focus group interviews with employees and interviews with mangers were conducted at 12 selected workplaces and a questionnaire survey was conducted with managers at all 115 workplaces. The interventions enhanced the probability of employees experiencing more “good” work days, where they could make a difference to the lives of clients. The interventions may therefore be characterized as culturally compelling and having a good fit with the immediate work environment of employees. The interventions furthermore seemed to fit well with the wider organizational environment and with recent changes in the societal and economic context of workplaces. However, some workplaces had difficulties with involving all employees and adapting the interventions to the organization of work. The findings suggest that flexibility and a variety of strategies to involve all employees are important aspects, if interventions are to fit well with the care sector. The focus on employees' conceptualization of a “good” work day may be useful for intervention research in other sectors. PMID:26380356

  10. Protocol for the atWork trial: a randomised controlled trial of a workplace intervention targeting subjective health complaints.

    PubMed

    Johnsen, Tone Langjordet; Indahl, Aage; Baste, Valborg; Eriksen, Hege Randi; Tveito, Torill Helene

    2016-08-19

    Subjective health complaints, such as musculoskeletal and mental health complaints, have a high prevalence in the general population, and account for a large proportion of sick leave in Norway. It may be difficult to prevent the occurrence of subjective health complaints, but it may be possible to influence employees' perception and management of these complaints, which in turn may have impact on sick leave and return to work after sick leave. Long term sick leave has many negative health and social consequences, and it is important to gain knowledge about effective interventions to prevent and reduce long term sick leave. This study is a cluster randomised controlled trial to evaluate the effect of the modified atWork intervention, targeting non-specific musculoskeletal complaints and mental health complaints. This intervention will be compared to the original atWork intervention targeting only non-specific musculoskeletal complaints. Kindergartens in Norway are invited to participate in the study and will be randomly assigned to one of the two interventions. Estimated sample size is 100 kindergartens, with a total of approximately 1100 employees. Primary outcome is sick leave at unit level, measured using register data from the Norwegian Labour and Welfare Administration. One kindergarten equals one unit, regardless of number of employees. Secondary outcomes will be measured at the individual level and include coping, health, job satisfaction, social support, and workplace inclusion, collected through questionnaires distributed at baseline and at 12 months follow up. All employees in the included kindergartens are eligible for participating in the survey. The effect evaluation of the modified atWork intervention is a large and comprehensive project, providing evidence-based information on prevention of long-term sick leave, which may be of considerable benefit both from a societal, organisational, and individual perspective. Clinicaltrials.gov: NCT02396797

  11. Review of recent behavioral interventions targeting older adults living with HIV/AIDS.

    PubMed

    Illa, Lourdes; Echenique, Marisa; Bustamante-Avellaneda, Victoria; Sanchez-Martinez, Mario

    2014-12-01

    Increasing attention has been paid to older adults living with HIV over the past few years given the increasing prevalence of HIV in this age group. Yet, despite numerous studies documenting psychosocial and behavioral differences between older and younger HIV-infected adults, few evidence-based behavioral interventions have been developed for this population. This review found only 12 manuscripts describing behavioral intervention studies in older HIV-positive adults published between 2011 and 2014, and they reported on a total of six interventions. Despite promising findings, there is a clear need for large-scale clinical trials to replicate these initial results and further develop additional interventions to address important clinical issues such as depression, sexual risk behaviors, cognition, and other significant issues affecting this cohort. This represents an exciting opportunity for behavioral scientists and HIV specialists to develop interventions that combine the psychological and behavioral with medical aspects of the disease.

  12. A Camp-based Intervention Targeting Independence Among Individuals with Spina Bifida

    PubMed Central

    O’Mahar, Kerry; Jandasek, Barbara; Zukerman, Jill

    2010-01-01

    Objective To design and evaluate a camp-based intervention, the goal of which was to increase independence among children, adolescents, and adults with spina bifida. Methods An intervention targeting independence was embedded within a typical week long camp experience. The intervention consisted of the following: collaborative (i.e., parent and camper) goal identification, group sessions consisting of psycho-education and cognitive tools, and goal monitoring by camp counselors. Camper and parent report of demographic variables, goal attainment, spina bifida knowledge, and independence were gathered. Interventionist report of adherence to the treatment manual was also collected. Results Campers made significant gains in individual goals, management of spina bifida responsibilities, and independence with general spina bifida tasks, with medium effect sizes observed in goal attainment. Conclusions Results indicated that significant progress was made on individually oriented goals from pre- to post-camp. Design issues are discussed. PMID:20026569

  13. Targeted and anonymized smartphone-based public health interventions in a participatory sensing system.

    PubMed

    Clarke, Andrew; Steele, Robert

    2014-01-01

    Public health interventions comprising information dissemination to affect behavioral adjustment have long been a significant component of public health campaigns. However, there has been limited development of public health intervention systems to make use of advances in mobile computing and telecommunications technologies. Such developments pose significant challenges to privacy and security where potentially sensitive data may be collected. In our previous work we identified and demonstrated the feasibility of using mobile devices as anonymous public health data collection devices as part of a Health Participatory Sensing Network (HPSN). An advanced capability of these networks extended in this paper would be the ability to distribute, apply, report on and analyze the usage and effectiveness of targeted public health interventions in an anonymous way. In this paper we describe such a platform, its place in the HPSN and demonstrate its feasibility through an implementation.

  14. Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States.

    PubMed

    Wilson, Patrick A; Valera, Pamela; Martos, Alexander J; Wittlin, Natalie M; Muñoz-Laboy, Miguel A; Parker, Richard G

    2016-01-01

    This article presents a systematic review of qualitative studies focusing on human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980 and 2014. Qualitative methods employed in the studies reviewed include in-depth interviews, focus groups, participant observation, and ethnography. We searched several databases (PubMed, PsychINFO, JSTOR, ERIC, Sociological Abstracts, and Google Scholar) for relevant articles using the following broad terms: "Black men" "Black gay/bisexual" or "Black men who have sex with men," and "qualitative" and/or "ethnography." We include 70 studies in this review. The key themes observed across studies were (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM.

  15. Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States

    PubMed Central

    Wilson, Patrick A.; Valera, Pamela; Martos, Alexander J.; Wittlin, Natalie M.; Muñoz-Laboy, Miguel A.; Parker, Richard G.

    2015-01-01

    This article presents a systematic review of qualitative studies focusing on the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980-2014. Qualitative methods employed in the studies reviewed include: in-depth interviews, focus groups, participant observation, and ethnography. We searched the following databases: PubMed, PsychINFO, JSTOR, ERIC, Sociological Abstracts, and Google Scholar for relevant articles using the following broad terms: “Black men” and/or “BMSM,” and “qualitative” and/or “ethnography.” Seventy studies were included in this review. The key themes observed across studies were: (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk-taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM. PMID:26241373

  16. Dropouts and Compliance in Exercise Interventions Targeting Bone Mineral Density in Adults: A Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Kelley, George A.; Kelley, Kristi S.

    2013-01-01

    Background. Dropouts and compliance to exercise interventions targeting bone mineral density (BMD) in adults are not well established. The purpose of this study was to address that gap. Methods. Meta-analysis of randomized controlled exercise intervention trials in adults ≥18 years of age. The primary outcomes were dropouts in the exercise and control groups as well as compliance to the exercise interventions. A random-effects model was used to pool results. Moderator analyses were conducted using mixed-effects ANOVA-like models and metaregression. Statistical significance was set at P ≤ 0.05. Results. Thirty-six studies representing 3,297 participants (1,855 exercise, 1,442 control) were included. Dropout rates in the exercise and control groups averaged 20.9% (95% CI 16.7%–25.9%) and 15.9% (11.8%–21.1%) while compliance to exercise was 76.3% (71.7%–80.3%). For both exercise and control groups, greater dropout rates were associated with studies conducted in the USA versus other countries, females versus males, premenopausal versus postmenopausal women, younger versus older participants, longer studies (controls only), and high- versus moderate-intensity training (exercisers only). Greater compliance to exercise was associated with being female, home- or facility-based exercise versus both, and shorter studies. Conclusion. These findings provide important information for researchers and practitioners with respect to exercise programs targeting BMD in adults. PMID:23862095

  17. Testing stage-specific effects of a stage-matched intervention: a randomized controlled trial targeting physical exercise and its predictors.

    PubMed

    Lippke, Sonia; Schwarzer, Ralf; Ziegelmann, Jochen P; Scholz, Urte; Schüz, Benjamin

    2010-08-01

    Health education interventions can be tailored toward stages of change. This strategy is based on theories that predict at which stage which variables are indicative of subsequent behavior change processes. For example, planning is regarded as being effective in intenders. However, rather few studies have tested whether matched interventions are more successful for stage transitions than mismatched ones. Also very few previous studies have identified specific variables as targets of stage-matched interventions. A 2 (condition) x 2 (stages) experimental study tested the effects of stage-matched interventions for 226 participants. The stage-matched intervention moved significantly more individuals forward to action than did the control condition. Stage-specific effects were found to corroborate 78% of the assumptions. Multiple mediator analyses revealed stage-specific mechanisms, indicating that intention and planning facilitated behavior change in intenders. Thus, health behavior interventions should take stages of change into account.

  18. Screening instruments for substance use and brief interventions targeting adolescents in primary care: A literature review

    PubMed Central

    Pilowsky, Daniel J; Wu, Li-Tzy

    2013-01-01

    Background A review of the literature was conducted to examine substance use screening instruments commonly used with adolescents in medical settings, their comparative usefulness, and SBIRT (Screening, Brief Intervention, and Referral to Treatment). Methods We screened two databases (Ovid MEDLINE and PsycINFO) targeting journal articles dealing with screening for alcohol and drug use in adolescence as well as adolescent SBIRT. Results Adolescents preferred paper forms and computerized questionnaires over interviews with physicians or nurses. The CRAFFT was the best studied instrument for screening for alcohol/drug use and related problems, and is the only tool with data to support its use in medical settings. Other screening instruments require more testing/evaluation in more representative samples of adolescents in primary care settings. Long term follow-up data to establish the efficacy of SBIRT in adolescence are not available. Innovative computerized approaches to screening for substance use in this population have recently been proposed. Although promising, they require further evaluation. Conclusions The CRAFFT has the most consistent data to support its use in primary care settings. The effects of SBIRT in adolescence have not been adequately evaluated. Adolescents’ opinions and preferences for SBIRT should be studied to improve their acceptance. PMID:23454877

  19. Sunscreen use in NCAA collegiate athletes: identifying targets for intervention and barriers to use.

    PubMed

    Wysong, Ashley; Gladstone, Hayes; Kim, David; Lingala, Bharathi; Copeland, Joyce; Tang, Jean Y

    2012-11-01

    Ultraviolet radiation is a known risk factor for skin cancer and photoaging. Athletes are at high-risk with frequent sun exposure during peak hours of ultraviolet radiation. The aim of this study was to identify attitudes, personal characteristics, and barriers associated with sunscreen use among a high-risk athlete population. A cross-sectional survey study conducted in 290 collegiate athletes from April 2010 to June 2011 at Duke and Stanford Universities. The average athlete spent 4h per day and 10 months per year training outdoors. While 96% agreed that sunscreen helps prevent skin cancer, over 50% never used sunscreen and 75% used sunscreen 3 or fewer days/week. Having a coach or athletic administrator discuss photoprotection was significantly associated with sunscreen use. Predictors of sunscreen use were female gender, sunburns in the last year, belief at risk for skin cancer, knowing someone with skin cancer, and being worried about wrinkles, sun burns, or skin cancer. Continued identification of characteristics and barriers to sunscreen use can lead to targeted interventions and education in this high-risk group of collegiate athletes with early and elevated total lifetime ultraviolet exposure. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Systematic review of universal school-based resilience interventions targeting adolescent tobacco, alcohol or illicit drug use: review protocol

    PubMed Central

    Hodder, Rebecca Kate; Freund, Megan; Wolfenden, Luke; Bowman, Jenny; Gillham, Karen; Dray, Julia; Wiggers, John

    2014-01-01

    Introduction Tobacco, alcohol and illicit drug use contribute significantly to global rates of morbidity and mortality. Despite evidence suggesting interventions designed to increase adolescent resilience may represent a means of reducing adolescent substance use, and schools providing a key opportunity to implement such interventions, existing systematic reviews assessing the effectiveness of school-based interventions targeting adolescent substance use have not examined this potential. Methods and analysis The aim of the systematic review is to determine whether universal interventions focused on enhancing the resilience of adolescents are effective in reducing adolescent substance use. Eligible studies will: include participants 5–18 years of age; report tobacco use, alcohol consumption or illicit drug use as outcomes; and implement a school-based intervention designed to promote internal (eg, self-esteem) and external (eg, school connectedness) resilience factors. Eligible study designs include randomised controlled trials, cluster randomised controlled trials, staggered enrolment trials, stepped wedged trials, quasi-randomised trials, quasi-experimental trials, time series/interrupted time-series trials, preference trials, regression discontinuity trials and natural experiment studies with a parallel control group. A search strategy including criteria for participants, study design, outcome, setting and intervention will be implemented in various electronic databases and information sources. Two reviewers will independently screen studies to assess eligibility, as well as extract data from, and assess risk of bias of included studies. A third reviewer will resolve any discrepancies. Attempts will be made to quantify trial effects by meta-analysis. Binary outcomes will be pooled and effect size reported using ORs. For continuous data, effect size of trials will be reported using a mean difference where trial outcomes report the same outcome using a

  1. A cross sectional evaluation of an alcohol intervention targeting young university students.

    PubMed

    Burns, Sharyn; Jancey, Jonine; Crawford, Gemma; Hallett, Jonathan; Portsmouth, Linda; Longo, Janelle

    2016-07-20

    Hazardous drinking has been found to be higher among young university students compared to their non-university peers. Although young university students are exposed to new and exciting experiences, including greater availability and emphasis on social functions involving alcohol there are few multi strategy comprehensive interventions aimed at reducing alcohol-related harms. Random cross sectional online surveys were administered to 18-24 year old students studying at the main campus of a large metropolitan university in Perth, Western Australia. Prior to the completion of the second survey an alcohol intervention was implemented on campus. Completed surveys were received from 2465 (Baseline; T1) and 2422 (Post Year 1: T2) students. Students who consumed alcohol in the past 12 months were categorised as low risk or hazardous drinkers using the Alcohol Use Disorders Identification Test (AUDIT). Due to the cross sectional nature of the two samples two-tailed two-proportion z-test and two sample t-tests were employed to determine statistical significance between the two time periods for categorical and continuous variables respectively. At T1 and T2 89.1 % and 87.2 % of the total sample reported drinking alcohol in the past month respectively. Hazardous levels of alcohol consumption reduced slightly between T1 (39.7 %) and T2 (38 %). In both time periods hazardous drinkers reported significantly higher mean scores for experienced harm, second-hand harm and witnessed harm scores compared to low risk drinkers (p <0.001). Hazardous drinkers were significantly more likely to experience academic problems due to their alcohol consumption and to report more positive alcohol expectations than low risk drinkers at both time periods (p <0.001). Harms and problems for students who report hazardous drinking are of concern and efforts should be made to ensure integrated and targeted strategies reach higher risk students and focus on specific issues such as driving while

  2. Interventions that target improvements in mental health for parents of children with autism spectrum disorders: A narrative review.

    PubMed

    Da Paz, Nikko S; Wallander, Jan L

    2017-02-01

    Prevalence of autism spectrum disorders (ASD) suggest that one in 68 children is affected. With convincing evidence that parenting a child with ASD is associated with elevated distress and mental health problems, researchers have begun to investigate treatments that directly target parents' psychological well-being. We conducted a narrative review of studies that empirically tested the effects of interventions targeting improvements in the mental health of parents of children with ASD. Following a range of search strategies, a total of 13 studies, seven randomized controlled trials (RCTs) and six pre-post test designs, met inclusion criteria. We calculated and reported effect sizes for all RCTs. On average, treatment produced medium to large effect sizes with improvements in parenting stress and general health, and reductions in depression and anxiety. Interventions that appeared promising included: Stress Management and Relaxation Techniques, Expressive Writing, Mindfulness-Based Stress Reduction, and Acceptance and Commitment Therapy. However, only one study conducted a follow-up assessment >3months post intervention. Study populations primarily consisted of English-speaking mothers, ages 39 to 42years. Conclusions were limited by small sample sizes, homogeneity of sample population, and reliance on self-report. Therefore, this body of research contains significant limitations in need of improvement for this field to move forward and benefit a sizable number of parents.

  3. Primary Care Interventions for Dementia Caregivers: 2-Year Outcomes from the REACH Study

    ERIC Educational Resources Information Center

    Burns, Robert; Nichols, Linda O.; Martindale-Adams, Jennifer; Graney, Marshall J.; Lummus, Allan

    2003-01-01

    Purpose: This study developed and tested two 24-month primary care interventions to alleviate the psychological distress suffered by the caregivers of those with Alzheimer's disease. The interventions, using targeted educational materials, were patient behavior management only, and patient behavior management plus caregiver stress-coping…

  4. Primary Care Interventions for Dementia Caregivers: 2-Year Outcomes from the REACH Study

    ERIC Educational Resources Information Center

    Burns, Robert; Nichols, Linda O.; Martindale-Adams, Jennifer; Graney, Marshall J.; Lummus, Allan

    2003-01-01

    Purpose: This study developed and tested two 24-month primary care interventions to alleviate the psychological distress suffered by the caregivers of those with Alzheimer's disease. The interventions, using targeted educational materials, were patient behavior management only, and patient behavior management plus caregiver stress-coping…

  5. Tailored and targeted interventions to encourage dilated fundus examinations in older African Americans

    PubMed Central

    Ellish, Nancy J.; Royak-Schaler, Renee; Higginbotham, Eve J.

    2012-01-01

    Objectives To compare the effects of a tailored and targeted print intervention in promoting dilated fundus examinations (DFEs) in older African Americans, and to determine if other factors are associated with getting a DFE. Methods African Americans, 65 years of age or older, who had not had a DFE in at least two years were recruited from community settings. Participants were randomized to receive either a tailored or targeted newsletter. Telephone follow-up was conducted at one, three, and six months to ascertain eye examination status. All self-reported DFEs were confirmed by contacting their eye doctor by telephone. Main outcome measure Doctor-confirmed DFE at six months. Results Of the 329 participants enrolled, 128 (38.9%) had a doctor-confirmed DFE. There was no difference in doctor-confirmed DFEs by intervention group (RR=1.07, 0.82–1.40 CI), with 66 participants in the tailored group (40.2%) and 62 (37.6%) participants in the targeted group having a doctor-confirmed DFE. Based on logistic regression analysis, reading the newsletter (OR=1.76, 1.08–2.87 CI) and planning on making an appointment for a DFE (OR=2.46, 1.42–4.26 CI) were significant predictors for getting a DFE. Conclusion The tailored and targeted interventions were equally effective in promoting doctor-confirmed DFEs at six months. Given the increases cost and effort associated with tailoring, our results suggest that well-designed targeted print messages can motivate older African Americans to get DFEs. PMID:22159679

  6. Tailored and targeted interventions to encourage dilated fundus examinations in older African Americans.

    PubMed

    Ellish, Nancy J; Royak-Schaler, Renee; Higginbotham, Eve J

    2011-12-01

    To compare the effects of a tailored (individualized) and targeted (designed for a subgroup) print intervention in promoting dilated fundus examinations (DFEs) in older African Americans and to determine whether other factors (eg, demographics, preventive health practices, health literacy score, behavioral intentions, and DFE rates) are associated with getting a DFE. African Americans aged 65 years or older who had not had a DFE in at least 2 years were recruited from community settings. Participants were randomized to receive either a tailored or targeted newsletter. Telephone follow-up was conducted at 1, 3, and 6 months to ascertain eye examination status. All participant-reported DFEs were confirmed by contacting their eye doctor (optometrist or ophthalmologist) by telephone. Main Outcome Measure  Eye doctor-confirmed DFE at 6 months. Of the 329 participants enrolled, 128 (38.9%) had an eye doctor-confirmed DFE. No significant difference was noted in this measure by intervention group (relative risk, 1.07; 95% confidence interval, 0.82-1.40), with 66 participants in the tailored group (40.2%) and 62 participants in the targeted group (37.6%) having an eye doctor-confirmed DFE. Based on logistic regression analysis, reading the newsletter (odds ratio, 1.76; 95% confidence interval, 1.08-2.87) and planning to make an appointment for a DFE (odds ratio, 2.46; 95% confidence interval, 1.42-4.26) were significant predictors for DFE. The tailored and targeted interventions were equally effective in promoting eye doctor-confirmed DFEs at 6 months. Given the increased cost and effort associated with tailoring, our results suggest that well-designed targeted print messages can motivate older African Americans to get DFEs. Trial Registration  clinicaltrials.gov Identifier: NCT00649766.

  7. Reaching hepatitis C virus elimination targets requires health system interventions to enhance the care cascade.

    PubMed

    Scott, Nick; Doyle, Joseph S; Wilson, David P; Wade, Amanda; Howell, Jess; Pedrana, Alisa; Thompson, Alexander; Hellard, Margaret E

    2017-09-01

    Modelling suggests that achieving the World Health Organization's elimination targets for hepatitis C virus (HCV) is possible by scaling up use of direct-acting antiviral (DAA) therapy. However, poor linkage to health services and retention in care presents a major barrier, in particular among people who inject drugs (PWID). We identify and assess the cost-effectiveness of additional health system interventions required to achieve HCV elimination targets in Australia, a setting where all people living with HCV have access to DAA therapy. We used a dynamic HCV transmission and liver-disease progression mathematical model among current and former PWID, capturing testing, treatment and other features of the care cascade. Interventions tested were: availability of point-of-care RNA testing; increased testing of PWID; using biomarkers in place of liver stiffness measurement; and scaling up primary care treatment delivery. The projected treatment uptake in Australia reduced the number of people living with HCV from approximately 230,000 in 2015 to approximately 24,000 by 2030 and reduced incidence by 45%. However, the majority (74%) of remaining infections were undiagnosed and among PWID. Scaling up primary care treatment delivery and using biomarkers in place of liver stiffness measurement only reduced incidence by a further 1% but saved AU$32 million by 2030, with no change to health outcomes. Additionally replacing HCV antibody testing with point-of-care RNA testing increased healthcare cost savings to AU$62 million, increased incidence reduction to 64% and gained 11,000 quality-adjusted life years, but critically, additional screening of PWID was required to achieve HCV elimination targets. Even with unlimited and unrestricted access to HCV DAA treatment, interventions to improve the HCV cascade of care and target PWID will be required to achieve elimination targets. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Universality properties of school-based preventive intervention targeted at cannabis use.

    PubMed

    Miovský, Michal; Voňková, Hana; Gabrhelík, Roman; Šťastná, Lenka

    2015-02-01

    This study aims to examine the effect of school-based preventive intervention on cannabis use in Czech adolescents with different levels of risk factors and provide evidence of its universality. A randomized controlled prevention trial with six waves was conducted over a period of 33 months. We used a two-level logistic random-intercept model for panel data; we first looked at the statistical significance of the effect of the intervention on cannabis use, controlling for the characteristics of the children and time dummies. Then we analyzed the effects of the interactions between the intervention and the characteristics of the children on cannabis use and related it to the definition of universal preventive interventions. The setting for the study was in basic schools in the Czech Republic in the years 2007-2010. A total of 1,874 sixth-graders (mean age 11.82 years) who completed the baseline testing. According to our results, the prevention intervention was effective. We found all the selected characteristics of the children to be relevant in relation to cannabis use, except their relationships with their friends. We showed empirically that the intervention is universal in two dimensions for the selected characteristics of the children. First, all adolescents who undergo the intervention are expected to benefit. Second, with respect to the effect of the intervention on cannabis use, the total level of individual risk of cannabis use is superior to the composition of the risk factors in the individual risk profile. We present indicative evidence that the drug prevention intervention may be considered a true universal preventive intervention.

  9. Pilot evaluation of a web-based intervention targeting sexual health service access.

    PubMed

    Brown, K E; Newby, K; Caley, M; Danahay, A; Kehal, I

    2016-04-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  10. Systematic review of universal resilience interventions targeting child and adolescent mental health in the school setting: review protocol.

    PubMed

    Dray, Julia; Bowman, Jenny; Wolfenden, Luke; Campbell, Elizabeth; Freund, Megan; Hodder, Rebecca; Wiggers, John

    2015-12-29

    The mental health of children and adolescents is a key area of health concern internationally. Previous empirical studies suggest that resilience may act as a protective mechanism towards the development of mental health problems. Resilience refers to the ability to employ a collection of protective factors to return to or maintain positive mental health following disadvantage or adversity. Schools represent a potential setting within which protective factors of all children and adolescents may be fostered through resilience-focussed interventions. Despite this potential, limited research has investigated the effectiveness of universal school-based resilience-focussed interventions on mental health outcomes in children and adolescents. The objective of the present review is to assess the effects of universal school-based resilience-focussed interventions, relative to a comparison group, on mental health outcomes in children and adolescents. Eligible studies will be randomised (including cluster-randomised) controlled trials of universal interventions explicitly described as resilience-focussed or comprising strategies to strengthen a minimum of three internal protective factors, targeting children aged 5 to 18 years, implemented within schools, and reporting a mental health outcome. Screening for studies will be conducted across six electronic databases: MEDLINE, PsycINFO, Educational Resources Information Center (ERIC), Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Central Register of Controlled Trials (CENTRAL). Two reviewers will retrieve eligible articles, assess risk of bias, and extract data. Where studies are sufficiently homogenous and reported outcomes are amenable for pooled synthesis, meta-analysis will be performed. Narrative description will be used to synthesise trial outcome data where data cannot be combined or heterogeneity exists. This review will aid in building an evidence

  11. Host-pathogen interactions in latent Mycobacterium tuberculosis infection: identification of new targets for tuberculosis intervention.

    PubMed

    Lin, May Young; Ottenhoff, Tom H M

    2008-03-01

    Mycobacterium tuberculosis (M. tuberculosis) is one of the worlds' most successful and sophisticated pathogens. It is estimated that over 2 billion people today harbour latent M. tuberculosis infection without any clinical symptoms. Since most new cases of active tuberculosis (TB) arise from this (growing) number of latently infected individuals, urgent measures to control TB reactivation are required, including more effective drugs and new TB vaccines. The currently widely used BCG vaccines, as well as most new generation TB-vaccines that are being developed are designed as prophylactic or as BCG-booster vaccines. Unfortunately, many of these vaccines are unlikely to be effective in individuals already latently infected with M. tuberculosis. Here we argue that detailed analysis of M. tuberculosis genes that are switched on predominantly during the latent stage of infection may lead to the identification of new M. tuberculosis targets for drug and vaccine development. First, we will describe essential host-pathogen interactions in TB with particular emphasis on TB latency and persistent infection. Subsequently, we will focus on a novel group of late-stage specific genes, encoded by the M. tuberculosis dormancy (dosR) regulon, and summarize recent studies describing human T-cell recognition of these dormancy antigens in relation to (latent) M. tuberculosis infection. We will discuss the possible relevance of these new classes of antigens for new TB intervention strategies.

  12. Screening trematodes for novel intervention targets: a proteomic and immunological comparison of Schistosoma haematobium, Schistosoma bovis and Echinostoma caproni

    PubMed Central

    HIGÓN, MELISSA; COWAN, GRAEME; NAUSCH, NORMAN; CAVANAGH, DAVID; OLEAGA, ANA; TOLEDO, RAFAEL; STOTHARD, J. RUSSELL; ANTÚNEZ, ORETO; MARCILLA, ANTONIO; BURCHMORE, RICHARD; MUTAPI, FRANCISCA

    2011-01-01

    SUMMARY With the current paucity of vaccine targets for parasitic diseases, particularly those in childhood, the aim of this study was to compare protein expression and immune cross-reactivity between the trematodes Schistosoma haematobium, S. bovis and Echinostoma caproni in the hope of identifying novel intervention targets. Native adult parasite proteins were separated by 2-dimensional gel electrophoresis and identified through electrospray ionisation tandem mass spectrometry to produce a reference gel. Proteins from differential gel electrophoresis analyses of the three parasite proteomes were compared and screened against sera from hamsters infected with S. haematobium and E. caproni following 2-dimensional Western blotting. Differential protein expression between the three species was observed with circa 5% of proteins from S. haematobium showing expression up-regulation compared to the other two species. There was 91% similarity between the proteomes of the two Schistosoma species and 81% and 78·6% similarity between S. haematobium and S. bovis versus E. caproni, respectively. Although there were some common cross-species antigens, species-species targets were revealed which, despite evolutionary homology, could be due to phenotypic plasticity arising from different host-parasite relationships. Nevertheless, this approach helps to identify novel intervention targets which could be used as broad-spectrum candidates for future use in human and veterinary vaccines. PMID:21729355

  13. Study of Target Handoff Techniques

    DTIC Science & Technology

    1978-11-01

    Figures Educational Testing Service " •i’atial Oi.....iLaLion Sheridan Supply * Spatial Visualization Sheridan Supply t i Word Fluency. As defined by... Service (ETS) in connec- tion with a project designed to study field independence.6 The under- 7 lying factor is identified as flea,ibility of closure...137 Air Force enlisted trainees. 6 Educational Testing Service (NIMH, Contract M-4186). 3J. W. French, R. B. Edstrom, and C. H. Price. Manual for Kit

  14. Dissection of the Process of Brain Metastasis Reveals Targets and Mechanisms for Molecular-based Intervention.

    PubMed

    Weidle, Ulrich H; Birzele, Fabian; Kollmorgen, Gwendlyn; Rüger, Rüdiger

    2016-01-01

    Brain metastases outnumber the incidence of brain tumors by a factor of ten. Patients with brain metastases have a dismal prognosis and current treatment modalities achieve only a modest clinical benefit. We discuss the process of brain metastasis with respect to mechanisms and involved targets to outline options for therapeutic intervention and focus on breast and lung cancer, as well as melanoma. We describe the process of penetration of the blood-brain-barrier (BBB) by disseminated tumor cells, establishment of a metastatic niche, colonization and outgrowth in the brain parenchyma. Furthermore, the role of angiogenesis in colonization of the brain parenchyma, interactions of extravasated tumor cells with microglia and astrocytes, as well as their propensity for neuromimicry, is discussed. We outline targets suitable for prevention of metastasis and summarize targets suitable for treatment of established brain metastases. Finally, we highlight the implications of findings revealing druggable mutations in brain metastases that cannot be identified in matching primary tumors.

  15. Quality assurance in non-interventional studies.

    PubMed

    Theobald, Karlheinz; Capan, Müge; Herbold, Marlis; Schinzel, Stefan; Hundt, Ferdinand

    2009-11-09

    Nowadays, drug research and surveillance after authorisation becomes more and more important for several reasons. Non-interventional studies (NIS) investigate various aspects of drug use including efficacy and safety under real life conditions. Such kind of health services research should be on a high scientific, methodological and organisational level. Therefore accompanying measures to improve or to keep the quality are highly recommended. The aim of quality management is: first to avoid bias of results by using an appropriate study design and an adequate data analysis, second to assure authenticity, completeness and validity of the data and third to identify and resolve deficiencies at an early stage. Basic principles are laid down in corresponding guidelines and recommendations of authorities, institutes and societies. Various guidelines for good epidemiological practice (GEP) were published by the U.S. Food and Drug Administration (FDA) and international and regional societies for epidemiology. In addition in Germany the Federal Institute for Drugs and Medical Devices (BfArM) together with the Paul Ehrlich Institute (PEI) and the German Association of Research-Based Pharmaceutical Companies (VFA) have published respectively recommendations dealing with quality aspects of non-interventional observational studies. Key points are the advanced publishing of information about the project, developing of a study plan/protocol containing the scientific objectives, a sample size justification and a description of the planned analyses and the publishing of a summary of the results timely after completion of the study. The quality of the data can be improved by using standardized case report forms (CRF) and the CRF should be reviewed and tested before start of study by some participants. A source data verification (SDV) should be performed in randomly selected centres - in between 2% and 5% of the centres depending on the number of participating centres. Before start of

  16. Targeted nanotechnologies for cancer intervention: a patent review (2010-2016).

    PubMed

    Pradeep, Priyamvada; Kumar, Pradeep; Choonara, Yahya E; Pillay, Viness

    2017-09-01

    In recent years, several active targeting nanostrategies have been patented for application in cancer theranostics. The versatility of nanostructures in terms of composition, manufacturability, functionalization, and matrix formation make them ideal for carrying large dose of bioactive contents, high density of targeting ligands on their surface, efficient delivery to the site of interest, and capable of forming multicomponent platforms. Areas covered: The patents were classified into polymeric and non-polymeric nanostructures and their applicability in addressing the targeting paradigm related to cancer intervention was explored. Specialized platforms such as nanoparticles, nanomicelles, nanocomposites, nanotubes, quantum dots, metal/silica particles, and dendrimers were cited as targeted nanostructures along with ligands such as antibody fragments, synthetic peptides, aptamers, small molecules, and folates. Here, we focused on patented targeted nanotechnological advances in recent years (2010-2016). Expert opinion: The formulation and performance prerequisites, available nanomaterial options, fabrication feasibility, and challenges and issues related with regulatory approval and patenting of cancer targeted nanocarriers are reviewed. Future research in this area should focus on clinically relevant bioactive combinations, better metastasis control, integration of imaging and theranostic techniques, predictive animal/pre-clinical models, maximal utilisation of extra- and intracellular tumor microenvironment for drug delivery, and exploring the metabolomic-, proteomic-, and genomic-based personalization of cancer nanomedicine.

  17. Designing Research Studies on Psychosocial Interventions in Autism

    ERIC Educational Resources Information Center

    Smith, Tristram; Scahill, Lawrence; Dawson, Geraldine; Guthrie, Donald; Lord, Catherine; Odom, Samuel; Rogers, Sally; Wagner, Ann

    2007-01-01

    To address methodological challenges in research on psychosocial interventions for autism spectrum disorder (ASD), a model was developed for systematically validating and disseminating interventions in a sequence of steps. First, initial efficacy studies are conducted to establish interventions as promising. Next, promising interventions are…

  18. Developmental phenotypes and causal pathways in attention deficit/hyperactivity disorder: potential targets for early intervention?

    PubMed

    Sonuga-Barke, Edmund J S; Halperin, Jeffrey M

    2010-04-01

    Early intervention approaches have rarely been implemented for the prevention of attention deficit/hyperactivity disorder (ADHD). In this paper we explore whether such an approach may represent an important new direction for therapeutic innovation. We propose that such an approach is most likely to be of value when grounded in and informed by developmental models of the dynamic, complex and heterogeneous nature of the condition. First, we set out a rationale for early intervention grounded in the science of ADHD viewed through developmental models. Second, we re-examine the concept of disorder-onset from the perspective of developmental trajectories and phenotypes. Third, we examine potential causal pathways to ADHD with regard to originating risk, pathophysiological mediators, environmental moderators and developmental continuities. Finally, we explore the potential value of strategies for identifying young children at risk for ADHD, and implementing interventions in ways that can target these underlying pathogenic processes. The utility of such an approach represents an important area for future research but still requires 'proof of concept'. Therefore prior to widespread clinical implementation, far greater knowledge is required of (i) developmental pathways into ADHD, (ii) the value of identifying neuropsychological mediators of these pathways, and (iii) the extent to which targeting mediating mechanisms will improve treatment outcomes for children with ADHD.

  19. Does Prevention Pay? Costs and Potential Cost-savings of School Interventions Targeting Children with Mental Health Problems.

    PubMed

    Wellander, Lisa; Wells, Michael B; Feldman, Inna

    2016-06-01

    In Sweden, the local government is responsible for funding schools in their district. One funding initiative is for schools to provide students with mental health problems with additional support via extra teachers, personal assistants, and special education classes. There are evidence-based preventive interventions delivered in schools, which have been shown to decrease the levels of students' mental health problems. However, little is known about how much the local government currently spends on students' mental health support and if evidence-based interventions could be financially beneficial. The aim of this study was to estimate the costs of providing additional support for students' mental health problems and the potential cost-offsets, defined as reduced school-based additional support, if two evidence-based school interventions targeting children's mental health problems were implemented in routine practice. This study uses data on the additional support students with mental health problems received in schools. Data was collected from one school district for students aged 6 to 16 years. We modeled two Swedish school interventions, Comet for Teachers and Social and Emotional Training (SET), which both had evidence of reducing mental health problems. We used a cost-offset analysis framework, assuming both interventions were fully implemented throughout the whole school district. Based on the published studies, the expected effects and the costs of the interventions were calculated. We defined the cost-offsets as the amount of predicted averted additional support for students with ongoing mental health problems who might no longer require receiving services such as one-on-one time with an extra teacher, a personal assistant, or to be placed in a special education classroom. A cost-offset analysis, from a payer's perspective (the local government responsible for school financing), was conducted comparing the costs of both interventions with the potential cost

  20. An Assessment of Intervention Fidelity in Published Social Work Intervention Research Studies

    ERIC Educational Resources Information Center

    Corley, Nicole A.; Kim, Irang

    2016-01-01

    Objectives: Intervention fidelity is a critical strategy to help advance the usefulness and integrity of social work research. This study assessed the extent to which a selected sample of published social work intervention researchers reported its intervention protocols. Methods: Six core social work journals were reviewed in this analysis. The…

  1. An Assessment of Intervention Fidelity in Published Social Work Intervention Research Studies

    ERIC Educational Resources Information Center

    Corley, Nicole A.; Kim, Irang

    2016-01-01

    Objectives: Intervention fidelity is a critical strategy to help advance the usefulness and integrity of social work research. This study assessed the extent to which a selected sample of published social work intervention researchers reported its intervention protocols. Methods: Six core social work journals were reviewed in this analysis. The…

  2. Etiologic study vis-à-vis intervention study.

    PubMed

    Miettinen, O S

    2010-10-01

    Understanding of the logic-dictated essence of the etiologic study, and similarly that of the intervention-study, in the advancement of the knowledge-base of medicine, remains incomplete. Viewing experimental intervention-studies ('clinical trials') as paradigmatic for etiologic studies-necessarily non-experimental-has been wrongheaded. This misunderstanding continues to impede understanding of the essence of what logic dictates to be the etiologic study, adduced decades ago but still commonly confused with the essence of the (seriously malformed) 'case-control' study. Correct understanding of the essence of the etiologic study would pave the way to improved understanding of the intervention study, notably as to how prognostic probability functions could be derived from the data now routinely produced in clinical trials. This paradigm reversal, too, has been previously proposed, but its understanding has remained fogged by wanting understanding of the etiologic study.

  3. Magnetic source imaging studies of dyslexia interventions.

    PubMed

    Simos, Panagiotis G; Fletcher, Jack M; Denton, Carolyn; Sarkari, Shirin; Billingsley-Marshall, Rebecca; Papanicolaou, Andrew C

    2006-01-01

    Rapidly accumulating evidence from functional brain imaging studies indicates that developmental reading disability is associated with a functional disruption of the brain circuits that normally develop to support reading-related processes. This article briefly overviews recent advances in methods that capture the anatomical outline and temporal (dynamic) features of regional brain activation during performance of reading tasks. One of these methods, magnetoencephalography (MEG) or magnetic sources imaging (MSI) is described in more detail in the context of investigations of changes in spatiotemporal patterns of brain activity associated with improvement in reading skills in response to various types of educational interventions.

  4. Mitochondria-targeted antioxidants and metabolic modulators as pharmacological interventions to slow ageing.

    PubMed

    Gruber, Jan; Fong, Sheng; Chen, Ce-Belle; Yoong, Sialee; Pastorin, Giorgia; Schaffer, Sebastian; Cheah, Irwin; Halliwell, Barry

    2013-01-01

    Populations in many nations today are rapidly ageing. This unprecedented demographic change represents one of the main challenges of our time. A defining property of the ageing process is a marked increase in the risk of mortality and morbidity with age. The incidence of cancer, cardiovascular and neurodegenerative diseases increases non-linearly, sometimes exponentially with age. One of the most important tasks in biogerontology is to develop interventions leading to an increase in healthy lifespan (health span), and a better understanding of basic mechanisms underlying the ageing process itself may lead to interventions able to delay or prevent many or even all age-dependent conditions. One of the putative basic mechanisms of ageing is age-dependent mitochondrial deterioration, closely associated with damage mediated by reactive oxygen species (ROS). Given the central role that mitochondria and mitochondrial dysfunction play not only in ageing but also in apoptosis, cancer, neurodegeneration and other age-related diseases there is great interest in approaches to protect mitochondria from ROS-mediated damage. In this review, we explore strategies of targeting mitochondria to reduce mitochondrial oxidative damage with the aim of preventing or delaying age-dependent decline in mitochondrial function and some of the resulting pathologies. We discuss mitochondria-targeted and -localized antioxidants (e.g.: MitoQ, SkQ, ergothioneine), mitochondrial metabolic modulators (e.g. dichloroacetic acid), and uncouplers (e.g.: uncoupling proteins, dinitrophenol) as well as some alternative future approaches for targeting compounds to the mitochondria, including advances from nanotechnology.

  5. Overview of community-based studies of depression screening interventions among the elderly population in Japan.

    PubMed

    Sakashita, Tomoe; Oyama, Hirofumi

    2016-01-01

    In most Western and Asian countries, a higher risk of suicide is found among elderly people than those in other age groups. However, the treatment needs of elderly people who are at risk of committing suicide are not well understood. We conducted an overview of studies that assessed the impact of suicide prevention interventions on suicide rates in elderly people in Japan. We interpreted the results of these studies, as well as prominent findings associated with other successful interventions, within a framework of the suicidal process and preventive strategies. We assessed six quasi-experimental studies of community-based interventions providing universal depression screening, subsequent care, and education to elderly people in Japan, and performed a combined analysis of outcome data. Screening interventions were associated with lower suicide rates. We also found a gender difference in the response to subsequent psychiatric or primary care. Two types of interventions decreased the rate of suicide among elderly people: crisis helplines and screening interventions. These interventions featured a close link between universal, selective, and indicated prevention strategies, which reflect different approaches tailored to the size and risk profile of the target individuals. Successful interventions appear to hinge on systematic links between multi-level prevention interventions. Multi-level interventions for depression screening may result in lower suicide rates among elderly individuals in communities, although primary care interventions alone appear to be insufficient in men. The benefit of linked multi-level prevention interventions may highlight the importance of the multiple steps and components of the suicidal process.

  6. Systematic Review of Behavioral Interventions Targeting Social Communication Difficulties After Traumatic Brain Injury.

    PubMed

    Finch, Emma; Copley, Anna; Cornwell, Petrea; Kelly, Crystal

    2016-08-01

    To determine whether behavioral interventions are beneficial for adults with social communication difficulties after traumatic brain injury (TBI). Electronic databases were searched through October 2013 to find behavioral intervention trials. Keywords used in our search were intervention, therapy, treatment, and program combined with pragmatic disorder, pragmatic impairment, social communication disorder/impairment, conversation disorder/impairment, social disorder/impairment, cognitive-linguistic and cognitive-communication deficit; adult; and traumatic brain injury, head injury, and brain injury. Hand searches of the reference lists of relevant articles were also conducted. To be selected for detailed review, articles found in the initial search were assessed by 2 reviewers and had to meet the following criteria: (1) population (adults with TBI); (2) intervention (behavioral intervention); and (3) outcomes (changes in social communication). Articles needed to describe interventions that were delivered directly to adults with TBI with or without other people (such as significant others) involved. Of the 2181 articles initially identified, 15 were selected for detailed review. Data were independently extracted by members of the research team, then collated and reviewed by the team. Of the 15 publications that met the study criteria, 7 were single-case design studies, 3 were randomized controlled trials, 1 was a nonrandomized controlled trial, and 4 were cohort studies. The methodological qualities of eligible articles were examined using the Physiotherapy Evidence Database and Single-Case Experimental Design rating scales. The interventions described in the studies fell into 2 broad categories: those addressing a specific impairment in social communication, and context-specific interventions with a holistic focus on social communication skills. Studies using context-sensitive approaches had been published more recently and were generally group studies with higher

  7. Children of Mothers with Borderline Personality Disorder: Identifying Parenting Behaviors as Potential Targets for Intervention

    PubMed Central

    Stepp, Stephanie D.; Whalen, Diana J.; Pilkonis, Paul A.; Hipwell, Alison E.; Levine, Michele D.

    2011-01-01

    Children of mothers with BPD should be considered a high-risk group given the wide array of poor psychosocial outcomes that have been found in these children. This paper describes the parenting strategies that might explain the transmission of vulnerability from mothers with BPD to their offspring, from infancy through adolescence. We conclude that oscillations between extreme forms of hostile control and passive aloofness in their interactions with their children may be unique to mothers with BPD. We provide an overview of interventions that are currently recommended for mothers and family members with BPD, namely attachment therapy and psychoeducational approaches. Based on an integration of the empirical findings on parenting and child outcomes as well as from the review of current approaches to intervention, we conclude with recommendations for treatment targets. We argue that mothers with BPD need psychoeducation regarding child development and recommended parenting practices and skills for providing consistent warmth and monitoring, including mindfulness-based parenting strategies. PMID:22299065

  8. Cognitive Interventions Targeting Brain Plasticity in the Prodromal and Early Phases of Schizophrenia

    PubMed Central

    Fisher, Melissa; Loewy, Rachel; Hardy, Kate; Schlosser, Danielle; Vinogradov, Sophia

    2016-01-01

    Several important paradigm shifts have occurred in the field of schizophrenia treatment, including an increased focus on early detection, the development of preemptive interventions, and the view of schizophrenia as a neurodevelopmental disease characterized by decreased efficiency and abnormal connectivity in cortical and subcortical neural networks. In this review article, we will briefly describe some of the neural impairments that contribute to the development of schizophrenia, with an emphasis on the impact of stress and trauma on cognitively vulnerable neural systems. We will then present current data on two behavioral interventions that target these critical risk factors and that aim to preempt the onset of schizophrenia in vulnerable individuals or improve the clinical course in recent onset schizophrenia: cognitive therapy and computerized cognitive training. PMID:23297786

  9. A multidimensional antimicrobial stewardship intervention targeting aztreonam use in patients with a reported penicillin allergy.

    PubMed

    Swearingen, Sara M; White, Cyle; Weidert, Sara; Hinds, Melisande; Narro, John P; Guarascio, Anthony J

    2016-04-01

    Local antimicrobial susceptibility patterns should be considered for antimicrobial therapy decisions. Antibiogram data can guide beta-lactam antibiotic use in the presence of a penicillin allergy, particularly when allergic cross-reactivity among antibiotic agents is unlikely. To evaluate the effect of a multidimensional antimicrobial stewardship intervention to improve antibiogram-driven antibiotic selection for patients with a reported penicillin allergy receiving aztreonam. This historically controlled, quasi-experimental study compared historical aztreonam use with prospective antibiotic selection following a pharmacist-led intervention in patients with a penicillin allergy. The impact of this intervention on aztreonam use, antimicrobial selection, patient allergy profile updates, length of stay, in-hospital mortality, and antibiotic cost savings was assessed. A significant reduction in median days of aztreonam therapy (4.0 vs. 2.0; p = 0.0001) and median days of therapy per 1000 patient days (14.5 vs. 9.3; p = 0.0001) was found in the intervention group. A pharmacist-led antimicrobial stewardship intervention facilitated antibiogram-driven antibiotic therapy while reducing aztreonam use in patients without an anaphylactic penicillin allergy. Further trials are needed to assess the utility of similar antimicrobial stewardship interventions for patients with penicillin allergy.

  10. Future directions for interventions targeting PTSD in HIV-infected adults

    PubMed Central

    Applebaum, Allison J.; Bedoya, C. Andres; Hendriksen, Ellen S.; Wilkinson, Jesse L.; Safren, Steven A.; O’Cleirigh, Conall

    2015-01-01

    Although studies consistently report high rates of comorbid Post Traumatic Stress Disorder (PTSD) and HIV infection, development and testing of PTSD treatment interventions in HIV-infected adults is limited. As such, the purpose of this review was twofold. First, this review augments the 3 existing reviews of research for PTSD in HIV-infected adults conducted within the past 10 years. We found 2 empirically supported cognitive-behavioral therapy (CBT)-based interventions for the treatment of trauma-related symptoms in HIV-infected adults. Due to the continued limited number of effective interventions for this population, a second aim of our review was to draw from the expansive field of effective PTSD interventions for the general population to propose ways that future clinical intervention research may be tailored for HIV-infected adults. Therefore, in addition to a review, we conceptualized this paper as an opportunity to generate an ideal preview of the field of intervention research in this population. PMID:25665885

  11. Optimising impact and sustainability: a qualitative process evaluation of a complex intervention targeted at compassionate care.

    PubMed

    Bridges, Jackie; May, Carl; Fuller, Alison; Griffiths, Peter; Wigley, Wendy; Gould, Lisa; Barker, Hannah; Libberton, Paula

    2017-09-15

    Despite concerns about the degree of compassion in contemporary healthcare, there is a dearth of evidence for health service managers about how to promote compassionate healthcare. This paper reports on the implementation of the Creating Learning Environments for Compassionate Care (CLECC) intervention by four hospital ward nursing teams. CLECC is a workplace educational intervention focused on developing sustainable leadership and work-team practices designed to support team relational capacity and compassionate care delivery. To identify and explain the extent to which CLECC was implemented into existing work practices by nursing staff, and to inform conclusions about how such interventions can be optimised to support compassionate care in acute settings. Process evaluation guided by normalisation process theory. Data gathered included staff interviews (n=47), observations (n=7 over 26 hours) and ward manager questionnaires on staffing (n=4). Frontline staff were keen to participate in CLECC, were able to implement many of the planned activities and valued the benefits to their well-being and to patient care. Nonetheless, factors outside of the direct influence of the ward teams mediated the impact and sustainability of the intervention. These factors included an organisational culture focused on tasks and targets that constrained opportunities for staff mutual support and learning. Relational work in caregiving organisations depends on individual caregiver agency and on whether or not this work is adequately supported by resources, norms and relationships located in the wider system. High cognitive participation in compassionate nursing care interventions such as CLECC by senior nurse managers is likely to result in improved impact and sustainability. © 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.

  12. A systematic review of family-based interventions targeting alcohol misuse and their potential to reduce alcohol-related harm in indigenous communities.

    PubMed

    Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony P; Doran, Christopher M

    2012-05-01

    Alcohol misuse is a major risk factor for harm in indigenous communities. The indigenous family unit is often the setting for, and is most adversely affected by, alcohol-related harm. Therefore, family-based alcohol interventions offer great potential to reduce alcohol-related harm in indigenous communities. This systematic review aims to identify peer-reviewed published evaluations of family-based alcohol interventions, critique the methodological quality of those studies, describe their intervention characteristics, and identify which interventions appear most promising to reduce alcohol-related harm in indigenous communities. Eleven electronic databases were searched. The reference lists of reviews of family-based approaches focused on alcohol interventions were hand-searched for additional relevant studies not identified by the electronic database search. Initially, 1,369 studies were identified, of which 21% (n = 142) were classified as intervention studies. Nineteen intervention studies were family-based alcohol interventions. Eleven of these studies included family members in the treatment of problem drinkers, and eight studies specifically targeted family members of problem drinkers. Methodological quality of studies varied, particularly in relation to study design, including confounding variables in the analyses, and follow-up rates. The evidence for the effectiveness of family-based alcohol interventions is less than optimal, although the reviewed studies did show improved outcomes. Given the important role of family in indigenous communities, there is merit in exploring family-based approaches to reduce alcohol-related harms. Tailored family-based approaches should be developed that include direct consultation with targeted indigenous communities.

  13. Recent approaches targeting beta-amyloid for therapeutic intervention of Alzheimer's disease.

    PubMed

    Cho, Jung-Eun; Kim, Jin Ryoun

    2011-09-01

    Alzheimer's disease (AD) is a neurodegenerative disorder characterized by neuropathological features comprising amyloid deposits and neuronal losses in brain. In AD, aggregation of a β amyloid peptide (Aβ), produced from proteolytic cleavage of amyloid precursor protein, is believed to be implicated in the pathophysiological cascade leading to neuronal death. Most AD drugs currently available can only alleviate symptoms rather than modify the underlying molecular cause of AD. In this review, we describe and discuss the recent patents issued within the past two years focusing on therapeutic interventions targeting at various Aβ-associated pathological mechanisms of AD. The described therapeutic strategies include 1) reduction of synthesis of Aβ, 2) inhibition of Aβ aggregation, 3) immunotherapeutic/enzymatic clearance of Aβ, 4) targeting other amyloidogenic proteins interacting with Aβ and 5) amelioration of Aβ downstream toxic effects. Important issues to be considered for further improvement of therapeutic efficacy of these approaches are also discussed.

  14. Recruiting participants to walking intervention studies: a systematic review

    PubMed Central

    2011-01-01

    Purpose Most researchers who are conducting physical activity trials face difficulties in recruiting participants who are representative of the population or from specific population groups. Participants who are often the hardest to recruit are often those who stand to benefit most (the least active, from ethnic and other minority groups, from neighbourhoods with high levels of deprivation, or have poor health). The aim of our study was to conduct a systematic review of published literature of walking interventions, in order to identify the impact, characteristics, and differential effects of recruitment strategies among particular population groups. Methods We conducted standard searches for studies from four sources, (i) electronic literature databases and websites, (ii) grey literature from internet sources, (iii) contact with experts to identify additional "grey" and other literature, and (iv) snowballing from reference lists of retrieved articles. Included studies were randomised controlled trials, controlled before-and-after experimental or observational qualitative studies, examining the effects of an intervention to encourage people to walk independently or in a group setting, and detailing methods of recruitment. Results Forty seven studies met the inclusion criteria. The overall quality of the descriptions of recruitment in the studies was poor with little detail reported on who undertook recruitment, or how long was spent planning/preparing and implementing the recruitment phase. Recruitment was conducted at locations that either matched where the intervention was delivered, or where the potential participants were asked to attend for the screening and signing up process. We identified a lack of conceptual clarity about the recruitment process and no standard metric to evaluate the effectiveness of recruitment. Conclusion Recruitment concepts, methods, and reporting in walking intervention trials are poorly developed, adding to other limitations in the

  15. The Impact of Hotspot-Targeted Interventions on Malaria Transmission in Rachuonyo South District in the Western Kenyan Highlands: A Cluster-Randomized Controlled Trial

    PubMed Central

    Bradley, John; Knight, Philip; Stone, William; Osoti, Victor; Makori, Euniah; Owaga, Chrispin; Odongo, Wycliffe; China, Pauline; Shagari, Shehu; Doumbo, Ogobara K.; Sauerwein, Robert W.; Kariuki, Simon; Drakeley, Chris; Stevenson, Jennifer; Cox, Jonathan

    2016-01-01

    that was statistically significant after adjustment for covariates (p = 0.024), but not 16 wk post-intervention (p = 0.265). We observed no statistically significant trend in the effect of the intervention on nPCR parasite prevalence in the evaluation zone in relation to distance from the hotspot boundary 8 wk (p = 0.27) or 16 wk post-intervention (p = 0.75). Thirty-six patients with clinical malaria confirmed by rapid diagnostic test could be located to intervention or control clusters, with no apparent difference between the study arms. In intervention clusters we caught an average of 1.14 female anophelines inside hotspots and 0.47 in evaluation zones; in control clusters we caught an average of 0.90 female anophelines inside hotspots and 0.50 in evaluation zones, with no apparent difference between study arms. Our trial was not powered to detect subtle effects of hotspot-targeted interventions nor designed to detect effects of interventions over multiple transmission seasons. Conclusions Despite high coverage, the impact of interventions targeting malaria vectors and human infections on nPCR parasite prevalence was modest, transient, and restricted to the targeted hotspot areas. Our findings suggest that transmission may not primarily occur from hotspots to the surrounding areas and that areas with highly heterogeneous but widespread malaria transmission may currently benefit most from an untargeted community-wide approach. Hotspot-targeted approaches may have more validity in settings where human settlement is more nuclear. Trial registration ClinicalTrials.gov NCT01575613 PMID:27071072

  16. Risk Factors for Tungiasis in Nigeria: Identification of Targets for Effective Intervention

    PubMed Central

    Ugbomoiko, Uade Samuel; Ariza, Liana; Ofoezie, Ifeanyi Emmanuel; Heukelbach, Jörg

    2007-01-01

    Background The parasitic skin disease tungiasis (caused by the flea Tunga penetrans) affects resource-poor communities in Latin America, the Caribbean and sub-Saharan Africa. Prevalences in endemic areas are high, and severe pathology occurs commonly. However, risk factors for infestation have never been assessed in Africa. Methods and Findings A cross-sectional study was conducted in Erekiti, a rural community in Lagos State (Nigeria), where tungiasis is endemic. Individuals were examined clinically for the presence of tungiasis, and a questionnaire was applied. Data from 643 individuals (86.6% of the target population) were analyzed; 252 (42.5%) were infested with T. penetrans. In the multivariate logistic regression analysis, presence of pigs on the compounds (adjusted odds ratio = 17.98; 95% confidence interval: 5.55–58.23), sand or clay floor inside houses (9.33; 5.06–17.19), and having the common resting place outside the house (7.14; 4.0–14.29) were the most important risk factors identified. The regular use of closed footwear (0.34; 0.18–0.62) and the use of insecticides indoors (0.2; 0.05–0.83) were protective against infestation. The population attributable fractions associated with tungiasis were: sand or clay floor inside the house (73.7%), resting usually outside the house (65.5%), no regular use of closed footwear (51.1%), and pigs on the compound (37.9%). Conclusion The presence of tungiasis in Erekiti is determined to an important extent by a limited number of modifiable variables. Effective and sustainable intervention measures addressing these factors need to be implemented in this and other West African communities with high disease burden. PMID:18160986

  17. Risk factors for tungiasis in Nigeria: identification of targets for effective intervention.

    PubMed

    Ugbomoiko, Uade Samuel; Ariza, Liana; Ofoezie, Ifeanyi Emmanuel; Heukelbach, Jörg

    2007-12-05

    The parasitic skin disease tungiasis (caused by the flea Tunga penetrans) affects resource-poor communities in Latin America, the Caribbean and sub-Saharan Africa. Prevalences in endemic areas are high, and severe pathology occurs commonly. However, risk factors for infestation have never been assessed in Africa. A cross-sectional study was conducted in Erekiti, a rural community in Lagos State (Nigeria), where tungiasis is endemic. Individuals were examined clinically for the presence of tungiasis, and a questionnaire was applied. Data from 643 individuals (86.6% of the target population) were analyzed; 252 (42.5%) were infested with T. penetrans. In the multivariate logistic regression analysis, presence of pigs on the compounds (adjusted odds ratio = 17.98; 95% confidence interval: 5.55-58.23), sand or clay floor inside houses (9.33; 5.06-17.19), and having the common resting place outside the house (7.14; 4.0-14.29) were the most important risk factors identified. The regular use of closed footwear (0.34; 0.18-0.62) and the use of insecticides indoors (0.2; 0.05-0.83) were protective against infestation. The population attributable fractions associated with tungiasis were: sand or clay floor inside the house (73.7%), resting usually outside the house (65.5%), no regular use of closed footwear (51.1%), and pigs on the compound (37.9%). The presence of tungiasis in Erekiti is determined to an important extent by a limited number of modifiable variables. Effective and sustainable intervention measures addressing these factors need to be implemented in this and other West African communities with high disease burden.

  18. Personality-Targeted Interventions Delay Uptake of Drinking and Decrease Risk of Alcohol-Related Problems when Delivered by Teachers

    ERIC Educational Resources Information Center

    O'Leary-Barrett, Maeve; Mackie, Clare J.; Castellanos-Ryan, Natalie; Al-Khudhairy, Nadia; Conrod, Patricia J.

    2010-01-01

    Objective: This trial examined the efficacy of teacher-delivered personality-targeted interventions for alcohol-misuse over a 6-month period. Method: This randomized controlled trial randomly allocated participating schools to intervention (n = 11) or control (n = 7) conditions. A total of 2,506 (mean age, 13.7 years) were assessed for elevated…

  19. Coping and Depressive Symptoms in Adolescents with a Chronic Medical Condition: A Search for Intervention Targets

    ERIC Educational Resources Information Center

    Kraaij, Vivian; Garnefski, Nadia

    2012-01-01

    The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for adolescents with a chronic medical condition. A wide range of coping techniques were studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 176 adolescents participated. They were…

  20. Coping and Depressive Symptoms in Adolescents with a Chronic Medical Condition: A Search for Intervention Targets

    ERIC Educational Resources Information Center

    Kraaij, Vivian; Garnefski, Nadia

    2012-01-01

    The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for adolescents with a chronic medical condition. A wide range of coping techniques were studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 176 adolescents participated. They were…

  1. Target Acquisition and Positioning Study (TAPS)

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The Scientific Instruments for the Large Space Telescope (LST) require a high degree of accuracy for positioning targets within their respective entrance apertures. The acquisition, verification of position, and guidance during an experiment must be accomplished with a minimum loss of observing time for the maximum effectiveness of the total mission. This study evaluates several viable concepts and modes of operation that are applicable for a Target Acquisition and Positioning System (TAPS) that is responsive to the LST instrument requirements.

  2. Improving food environments and tackling obesity: A realist systematic review of the policy success of regulatory interventions targeting population nutrition

    PubMed Central

    Sisnowski, Jana; Merlin, Tracy

    2017-01-01

    Background This systematic review (PROSPERO: CRD42015025276) employs a realist approach to investigate the effect of “real-world” policies targeting different aspects of the food environment that shape individual and collective nutrition. Objectives We were interested in assessing intermediate outcomes along the assumed causal pathway to “policy success”, in addition to the final outcome of changed consumption patterns. Data sources We performed a search of 16 databases through October 2015, with no initial restriction by language. Study eligibility criteria We included all publications that reported the effect of statutory provisions aimed at reducing the consumption of energy-dense foods and beverages in the general population. We allowed all methodological approaches that contained some measure of comparison, including studies of implementation progress. Study appraisal and synthesis methods We reviewed included studies using the appraisal tools for pre-post and observational studies developed by the National Heart, Lung, and Blood Institute. Given the considerable heterogeneity in interventions assessed, study designs employed, and outcome measures reported, we opted for a narrative synthesis of results. Results and implications Results drawn from 36 peer-reviewed articles and grey literature reports demonstrated that isolated regulatory interventions can improve intermediate outcomes, but fail to affect consumption at clinically significant levels. The included literature covered six different types of interventions, with 19 studies reporting on calorie posting on chain restaurant menus. The large majority of the identified interventions were conducted in the US. Early results from recent taxation measures were published after the review cut-off date but these suggested more favorable effects on consumption levels. Nevertheless, the evidence assessed in this review suggests that current policies are generally falling short of anticipated health impacts

  3. Are brief alcohol interventions targeting alcohol use efficacious in military and veteran populations? A meta-analysis.

    PubMed

    Doherty, A M; Mason, C; Fear, N T; Rona, R; Greenberg, N; Goodwin, L

    2017-09-01

    Rates of hazardous and harm-related drinking are higher in the military and veteran populations compared to the general population. Brief alcohol interventions (BAIs) targeting alcohol use appear to reduce harmful drinking in the general population. However, less is known about the efficacy of BAIs targeting alcohol in military and veteran populations. A systematic review and meta-analysis was conducted to assess the type and efficacy of BAIs used to reduce alcohol use in military and veteran populations conducted from 2000 onwards. The meta-analysis was conducted using a standardised outcome measure of change in average weekly drinks (AWDs) from baseline to follow-up. The search revealed 10 papers that met the search criteria, and that reported data on 11 interventions included in the systematic review. 8 papers (reporting on 9 different interventions) were included in the meta-analysis after 2 papers were excluded for which the relevant outcome data were not available. There was no overall effect of BAIs; a non-significant weekly drink reduction of 0.95 drinks was found (95% CI, -0.17 to 2.07). This lack of efficacy persisted regardless of military group (conscripts, serving or veterans) and method of delivery (i.e., face-to-face, web-based or written information). Furthermore, sensitivity analyses revealed this small drink reduction was driven mainly by a single study. Based on these findings, existing BAIs do not seem to be efficacious in reducing alcohol use in military populations, despite some encouraging results from one electronic intervention which was of extensive duration. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Adoption of workplaces and reach of employees for a multi-faceted intervention targeting low back pain among nurses' aides.

    PubMed

    Rasmussen, Charlotte Diana Nørregaard; Larsen, Anne Konring; Holtermann, Andreas; Søgaard, Karen; Jørgensen, Marie Birk

    2014-05-01

    Workplace adoption and reach of health promotion are important, but generally poorly reported. The aim of this study is therefore to evaluate the adoption of workplaces (organizational level) and reach of employees (individual level) of a multi-faceted workplace health promotion and work environment intervention targeting low back pain among nurses' aides in elderly care. Percentage of adopters was calculated among eligible workplaces and differences between adopters and non-adopters were evaluated through workplace registrations and manager questionnaires from all eligible workplaces. From the adopted workplaces reach was calculated among eligible employees as the percentage who responded on a questionnaire. Responders were compared with non-responders using data from company registrations. Among responders, comparisons based on questionnaire data were performed between those consenting to participate in the intervention (consenters) and those not consenting to participate in the intervention (non-consenters). Comparisons were done using Student's t-test for the continuous variables, Fisher's exact test for dichotomous variables and the Pearson's chi(2) for categorical variables. Moreover odds ratios for non-responding and non-consenting were investigated with binary logistic regression analyses. The project was adopted by 44% of the offered workplaces. The main differences between adopters and non-adopters were that workplaces adopting the intervention had a more stable organization as well as a management with positive beliefs of the intervention's potential benefits. Of eligible employees, 71% responded on the questionnaire and 57% consented to participate. Non-responders and non-consenters did not differ from the responders and consenters on demographic factors and health. However, more non-responders and non-consenters were low skilled, worked less than 30 hours pr. week, and worked evening and nightshift compared to responders and consenters, respectively

  5. Targeted neural network interventions for auditory hallucinations: Can TMS inform DBS?

    PubMed

    Taylor, Joseph J; Krystal, John H; D'Souza, Deepak C; Gerrard, Jason Lee; Corlett, Philip R

    2017-09-29

    The debilitating and refractory nature of auditory hallucinations (AH) in schizophrenia and other psychiatric disorders has stimulated investigations into neuromodulatory interventions that target the aberrant neural networks associated with them. Internal or invasive forms of brain stimulation such as deep brain stimulation (DBS) are currently being explored for treatment-refractory schizophrenia. The process of developing and implementing DBS is limited by symptom clustering within psychiatric constructs as well as a scarcity of causal tools with which to predict response, refine targeting or guide clinical decisions. Transcranial magnetic stimulation (TMS), an external or non-invasive form of brain stimulation, has shown some promise as a therapeutic intervention for AH but remains relatively underutilized as an investigational probe of clinically relevant neural networks. In this editorial, we propose that TMS has the potential to inform DBS by adding individualized causal evidence to an evaluation processes otherwise devoid of it in patients. Although there are significant limitations and safety concerns regarding DBS, the combination of TMS with computational modeling of neuroimaging and neurophysiological data could provide critical insights into more robust and adaptable network modulation. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Gut microbiota: A player in aging and a target for anti-aging intervention.

    PubMed

    Vaiserman, Alexander M; Koliada, Alexander K; Marotta, Francesco

    2017-05-01

    Aging-associated alterations in composition, diversity and functional features of intestinal microbiota are well-described in the modern literature. They are suggested to be caused by an age-related decline in immune system functioning (immunosenescence) and a low-grade chronic inflammation (inflammaging), which accompany many aging-associated pathologies. The microbiota-targeted dietary and probiotic interventions have been shown to favorably affect the host health and aging by an enhancement of antioxidant activity, improving immune homeostasis, suppression of chronic inflammation, regulation of fat deposition and metabolism and prevention of insulin resistance. Recently, a high effectiveness and safety of novel therapeutic application such as fecal microbiota transplantation in the prevention and treatment of age-related pathological conditions including atherosclerosis, type 2 diabetes and Parkinson's disease has been demonstrated. In this review, recent research findings are summarized on the role of gut micribiota in aging processes with emphasis on therapeutic potential of microbiome-targeted interventions in anti-aging medicine.

  7. Psychostimulant and sensory stimulation interventions that target the reading and math deficits of students with ADHD.

    PubMed

    Zentall, Sydney S; Tom-Wright, Kinsey; Lee, Jiyeon

    2013-05-01

    The purpose of this review of students with attention deficit hyperactivity disorder (ADHD) was to summarize the following: (1) academic deficits in math and reading, (2) possible theoretical contributors to these deficits, and (3) psychostimulant interventions that target math and reading, as well as, parallel interventions involving sensory stimulation. A comprehensive examination of the literature was conducted on children with ADHD with and without co-occurring disabilities, summarizing their reading and math achievement and the effects of psychostimulant and sensory stimulant interventions on these academic areas. Students without co-occurring disabilities (ADHD-) had fewer deficits in reading than in math and than students with co-occurring disabilities (ADHD+). Furthermore, students with ADHD+ demonstrated greater responsiveness to psychostimulants through improved reading recognition and math calculations, with limited gains in literal reading comprehension. Added sensory stimulation produced differential gains for both groups in reading recognition and comprehension and in math calculations and problem solving. The efficacy of psychostimulants was documented on specific areas of achievement for the ADHD+ group, but this review did not support the administration of psychostimulants for students with ADHD-. For both groups of students, differential gains, losses, and habituation were documented in response to sensory stimulation for both subareas within reading and math, which were interpreted as support for the optimal stimulation theory.

  8. Targeted intervention strategies to optimise diversion of BMW in the Dublin, Ireland region

    SciTech Connect

    Purcell, M.; Magette, W.L.

    2011-09-15

    Highlights: > Previous research indicates that targeted strategies designed for specific areas should lead to improved diversion. > Survey responses and GIS model predictions from previous research were the basis for goal setting. > Then logic modelling and behavioural research were employed to develop site-specific management intervention strategies. > Waste management initiatives can be tailored to specific needs of areas rather than one size fits all means currently used. - Abstract: Urgent transformation is required in Ireland to divert biodegradable municipal waste (BMW) from landfill and prevent increases in overall waste generation. When BMW is optimally managed, it becomes a resource with value instead of an unwanted by-product requiring disposal. An analysis of survey responses from commercial and residential sectors for the Dublin region in previous research by the authors proved that attitudes towards and behaviour regarding municipal solid waste is spatially variable. This finding indicates that targeted intervention strategies designed for specific geographic areas should lead to improved diversion rates of BMW from landfill, a requirement of the Landfill Directive 1999/31/EC. In the research described in this paper, survey responses and GIS model predictions from previous research were the basis for goal setting, after which logic modelling and behavioural research were employed to develop site-specific waste management intervention strategies. The main strategies devised include (a) roll out of the Brown Bin (Organics) Collection and Community Workshops in Dun Laoghaire Rathdown, (b) initiation of a Community Composting Project in Dublin City (c) implementation of a Waste Promotion and Motivation Scheme in South Dublin (d) development and distribution of a Waste Booklet to promote waste reduction activities in Fingal (e) region wide distribution of a Waste Booklet to the commercial sector and (f) Greening Irish Pubs Initiative. Each of these

  9. Indicators of the maximum radiation dose to the skin during percutaneous coronary intervention in different target vessels.

    PubMed

    Chida, Koichi; Saito, Haruo; Kagaya, Yutaka; Kohzuki, Masahiro; Takai, Yoshihiro; Takahashi, Shoki; Yamada, Shogo; Zuguchi, Masayuki

    2006-08-01

    To evaluate whether the maximum radiation dose to the patient's skin (MSD) can be estimated during percutaneous coronary intervention (PCI) procedures, we investigated the relationship between the MSD and fluoroscopic time, dose-area product (DAP), and body weight, separately analyzing the relationships for different target vessels. Many cases of skin injury caused by excessive radiation exposure during cardiac intervention procedures have been reported. However, real-time maximum-dose monitoring of the skin is unavailable for many cardiac intervention procedures. We studied 197 consecutive PCI procedures that involved a single target vessel and were conducted. The DAP was measured, and the MSD was calculated by a skin-dose mapping software program (Caregraph). The target vessels of the PCI procedures were divided into four groups based on the AHA classification system: AHA 5-10, left anterior descending artery domain (LAD), AHA 11-15, left circumflex artery domain (LCx), AHA 1-3 = R 1-3, and AHA 4 = R 4. The correlation coefficient (r) between the MSD and fluoroscopic time was higher for the right coronary artery (RCA) vessels (R 1-3, 0.852; R 4, 0.715) than for the left coronary artery (LCA) vessels (LAD, 0.527; LCx, 0.646), and the r value between the MSD and DAP was higher for the RCA vessels (R 1-3, 0.871; R 4, 0.898) than for the LCA vessels (LAD, 0.628; LCx, 0.694). Similarly, the correlation coefficient between the MSD and weight x fluoroscopic time (WFP) was higher for the RCA vessels (R 1-3, 0.874; R 4, 0.807) than for the LCA vessels (LAD, 0.551; LCx, 0.735). The DAP and WFP can be used to estimate the MSD during PCI in the RCA but not in the LCA, especially the LAD.

  10. Changing handwashing behaviour in southern Ethiopia: a longitudinal study on infrastructural and commitment interventions.

    PubMed

    Contzen, Nadja; Meili, Iara Helena; Mosler, Hans-Joachim

    2015-01-01

    Improved hand hygiene efficiently prevents the major killers of children under the age of five years in Ethiopia and globally, namely diarrhoeal and respiratory diseases. Effective handwashing interventions are thus in great demand. Evidence- and theory-based interventions, especially when matched to the target population's needs, are expected to perform better than common practice. To test this hypothesis, we selected two interventions drawing on a baseline questionnaire-study that applied the RANAS (Risk, Attitudes, Norms, Abilities, Self-regulation) approach and focused on the primary caregivers of households in four rural, water-scarce kebeles (smallest administrative units of Ethiopia) in southern Ethiopia (N = 462). The two interventions were tested in combination with a standard education intervention in a quasi-experiment, as follows: kebele 1, education intervention, namely an f-diagram exercise, (n = 23); kebele 2, education intervention and public-commitment (n = 122); kebele 3, education intervention and tippy-tap-promotion (i.e. handwashing-station-promotion; n = 150); kebele 4, education intervention, public-commitment and tippy-tap-promotion (n = 113). In kebeles 3 and 4, nearly 100% of the households followed the promotion and invested material and time to construct for themselves a tippy-tap. Three months after intervention termination, the tippy-taps were in use with water and soap being present in up to 83% of the households (kebele 4). Pre-post data analysis on self-reported handwashing revealed that the population-tailored interventions, and especially the tippy-tap-promotion, performed better than the standard education intervention. Tendencies in observed behaviour and a recently developed implicit self-measure pointed to similar results. Changing people's hand hygiene is known to be a challenging task, especially in a water-scarce environment. The present project suggests not only to apply theory and evidence to improve handwashing

  11. Targeted intervention strategies to optimise diversion of BMW in the Dublin, Ireland region.

    PubMed

    Purcell, M; Magette, W L

    2011-01-01

    Urgent transformation is required in Ireland to divert biodegradable municipal waste (BMW) from landfill and prevent increases in overall waste generation. When BMW is optimally managed, it becomes a resource with value instead of an unwanted by-product requiring disposal. An analysis of survey responses from commercial and residential sectors for the Dublin region in previous research by the authors proved that attitudes towards and behaviour regarding municipal solid waste is spatially variable. This finding indicates that targeted intervention strategies designed for specific geographic areas should lead to improved diversion rates of BMW from landfill, a requirement of the Landfill Directive 1999/31/EC. In the research described in this paper, survey responses and GIS model predictions from previous research were the basis for goal setting, after which logic modelling and behavioural research were employed to develop site-specific waste management intervention strategies. The main strategies devised include (a) roll out of the Brown Bin (Organics) Collection and Community Workshops in Dún Laoghaire Rathdown, (b) initiation of a Community Composting Project in Dublin City (c) implementation of a Waste Promotion and Motivation Scheme in South Dublin (d) development and distribution of a Waste Booklet to promote waste reduction activities in Fingal (e) region wide distribution of a Waste Booklet to the commercial sector and (f) Greening Irish Pubs Initiative. Each of these strategies was devised after interviews with both the residential and commercial sectors to help make optimal waste management the norm for both sectors. Strategy (b), (e) and (f) are detailed in this paper. By integrating a human element into accepted waste management approaches, these strategies will make optimal waste behaviour easier to achieve. Ultimately this will help divert waste from landfill and improve waste management practice as a whole for the region. This method of devising

  12. An Optimized System for Interventional MRI Guided Stereotactic Surgery: Preliminary Evaluation of Targeting Accuracy

    PubMed Central

    Larson, Paul S.; Starr, Philip A.; Bates, Geoffrey; Tansey, Lisa; Richardson, R. Mark; Martin, Alastair J.

    2011-01-01

    Background Deep brain stimulation (DBS) electrode placement using interventional MRI has been previously reported using a commercially available skull mounted aiming device (Medtronic Nexframe MR) and native MRI scanner software. This first-generation method has technical limitations that are inherent to the hardware and software used. A novel system (SurgiVision ClearPoint) consisting of an aiming device (SMARTFrame) and software has been developed specifically for iMRI interventions including DBS. Objective A series of phantom and cadaver tests were performed to determine the system’s capability, preliminary accuracy and workflow. Methods 18 experiments using a water phantom were used to determine predictive accuracy of the software. 16 experiments using a gelatin-filled skull phantom were used to determine targeting accuracy of the aiming device. 6 procedures in three cadaver heads were performed to compare workflow and accuracy of ClearPoint with Nexframe MR. Results Software prediction experiments showed an average error of 0.9±0.5 mm in magnitude in pitch and roll (mean pitch error −0.2±0.7 mm, mean roll error +0.2±0.7 mm) and an average error of 0.7±0.3 mm in X-Y translation with a slight anterior (0.5±0.3 mm) and lateral (0.4±0.3mm) bias. Targeting accuracy experiments showed average radial error of 0.5±0.3 mm. Cadaver experiments showed a radial error of 0.2±0.1 mm with the ClearPoint system (average procedure time 88±14 minutes) vs 0.6±0.2 mm with the Nexframe MR (average procedure time 92±12 minutes). Conclusion This novel system provides the submillimetric accuracy required for stereotactic interventions including DBS placement. It also overcomes technical limitations inherent in the first-generation iMRI system. PMID:21796000

  13. Commentary: The Challenge of Nonexperimental Interventions Studies in Social Work

    ERIC Educational Resources Information Center

    Schilling, Robert

    2010-01-01

    The challenging context of social work interventions require that most intervention studies will be derived from nonexperimental research designs. Two evaluation studies in this special issue employed nonrandomized designs to examine the efficacy of two programs--a police crisis intervention team designed to enhance officers' responses to mental…

  14. Pilot study of a compassion meditation intervention in chronic pain

    PubMed Central

    Chapin, Heather L; Darnall, Beth D; Seppala, Emma M; Doty, James R; Hah, Jennifer M; Mackey, Sean C

    2016-01-01

    Background The emergence of anger as an important predictor of chronic pain outcomes suggests that treatments that target anger may be particularly useful within the context of chronic pain. Eastern traditions prescribe compassion cultivation to treat persistent anger. Compassion cultivation has been shown to influence emotional processing and reduce negativity bias in the contexts of emotional and physical discomfort, thus suggesting it may be beneficial as a dual treatment for pain and anger. Our objective was to conduct a pilot study of a 9-week group compassion cultivation intervention in chronic pain to examine its effect on pain severity, anger, pain acceptance and pain-related interference. We also aimed to describe observer ratings provided by patients’ significant others and secondary effects of the intervention. Methods Pilot clinical trial with repeated measures design that included a within-subjects wait-list control period. Twelve chronic pain patients completed the intervention (F= 10). Data were collected from patients at enrollment, treatment baseline and post-treatment; participant significant others contributed data at the enrollment and post-treatment time points. Results In this predominantly female sample, patients had significantly reduced pain severity and anger and increased pain acceptance at post-treatment compared to treatment baseline. Significant other qualitative data corroborated patient reports for reductions in pain severity and anger. Conclusions Compassion meditation may be a useful adjunctive treatment for reducing pain severity and anger, and for increasing chronic pain acceptance. Patient reported reductions in anger were corroborated by their significant others. The significant other corroborations offer a novel contribution to the literature and highlight the observable emotional and behavioral changes in the patient participants that occurred following the compassion intervention. Future studies may further examine how

  15. Applying Theory of Mind Concepts When Designing Interventions Targeting Social Cognition among Youth Offenders

    ERIC Educational Resources Information Center

    Noel, Kristine K.; Westby, Carol

    2014-01-01

    This study employed a multiple baseline, across-participants, single-subject design to investigate the feasibility of an individual, narrative-based, social problem-solving intervention on the social problem-solving, narrative, and theory of mind (ToM) abilities of 3 incarcerated adolescent youth offenders identified as having emotional…

  16. Applying Theory of Mind Concepts When Designing Interventions Targeting Social Cognition among Youth Offenders

    ERIC Educational Resources Information Center

    Noel, Kristine K.; Westby, Carol

    2014-01-01

    This study employed a multiple baseline, across-participants, single-subject design to investigate the feasibility of an individual, narrative-based, social problem-solving intervention on the social problem-solving, narrative, and theory of mind (ToM) abilities of 3 incarcerated adolescent youth offenders identified as having emotional…

  17. Empirically Based School Interventions Targeted at Academic and Mental Health Functioning

    ERIC Educational Resources Information Center

    Hoagwood, Kimberly E.; Olin, S. Serene; Kerker, Bonnie D.; Kratochwill, Thomas R.; Crowe, Maura; Saka, Noa

    2007-01-01

    This review examines empirically based studies of school-based mental health interventions. The review identified 64 out of more than 2,000 articles published between 1990 and 2006 that met methodologically rigorous criteria for inclusion. Of these 64 articles, only 24 examined both mental health "and" educational outcomes. The majority of…

  18. Targeting the SAVA (Substance Abuse, Violence, and AIDS) Syndemic Among Women and Girls: A Global Review of Epidemiology and Integrated Interventions.

    PubMed

    Gilbert, Louisa; Raj, Anita; Hien, Denise; Stockman, Jamila; Terlikbayeva, Assel; Wyatt, Gail

    2015-06-01

    Multiple pathways link gender-based violence (GBV) to HIV and other sexually transmitted infections among women and girls who use or inject drugs. The aim of this article is to synthesize global literature that examines associations among the synergistic epidemics of substance abuse, violence, and HIV/AIDS, known as the SAVA syndemic. It also aims to identify a continuum of multilevel integrated interventions that target key SAVA syndemic mechanisms. We conducted a selective search strategy, prioritizing use of meta-analytic epidemiological and intervention studies that address different aspects of the SAVA syndemic among women and girls who use drugs worldwide from 2000 to 2015 using PubMed, MEDLINE, and Google Scholar. Robust evidence from different countries suggests that GBV significantly increases the risk of HIV and other sexually transmitted infections among women and girls who use drugs. Multiple structural, biological, and behavioral mechanisms link GBV and HIV among women and girls. Emerging research has identified a continuum of brief and extended multilevel GBV prevention and treatment interventions that may be integrated into a continuum of HIV prevention, testing, and treatment interventions to target key SAVA syndemic mechanisms among women and girls who use drugs. There remain significant methodological and geographical gaps in epidemiological and intervention research on the SAVA syndemic, particularly in low- and middle-income countries. This global review underscores the need to advance a continuum of multilevel integrated interventions that target salient mechanisms of the SAVA syndemic, especially for adolescent girls, young women, and transgender women who use drugs.

  19. Effect of a targeted education intervention on the incidence of waste-burning injuries in a military population.

    PubMed

    Kauvar, David S; Baer, David G

    2009-01-01

    The burning of waste is a common cause of accidental injury on the battlefield. This study was devised to determine the incidence of burns incurred while burning waste during U.S. military operations prior to and following an intervention targeted at reducing such injuries. The intervention consisted of memoranda outlining potential dangers and suggesting improved safety procedures. It was distributed to the combat theater (Iraq and Afghanistan) in March 2004. We reviewed military burn center records from March 2003 to March 2005. Demographics, injury data, and outcomes were recorded and compared between those casualties injured prior to and following the initiative. Twenty-four patients were injured while burning waste, 10% of military casualties admitted to the burn center during the study period. From March 2003 to March 2004, 20 patients were admitted with such injuries. The incidence of 1.67 per month was significantly (P<.05) higher than that seen the year after the intervention (four patients, 0.33 per month). TBSA burned was not different between the two time periods (9.8+/-8% before vs 6.3+/-7% after, P=.43). There were no deaths, and only one patient had an associated nonburn injury. Only 54% of patients returned to military duty. The initiative was followed by a significant decrease in the incidence of waste-burning injuries. We conclude that the initiative was successful and highlights the importance of continued military burn surveillance and prevention efforts.

  20. Systematic review of universal school-based resilience interventions targeting adolescent tobacco, alcohol or illicit drug use: review protocol.

    PubMed

    Hodder, Rebecca Kate; Freund, Megan; Wolfenden, Luke; Bowman, Jenny; Gillham, Karen; Dray, Julia; Wiggers, John

    2014-05-26

    Tobacco, alcohol and illicit drug use contribute significantly to global rates of morbidity and mortality. Despite evidence suggesting interventions designed to increase adolescent resilience may represent a means of reducing adolescent substance use, and schools providing a key opportunity to implement such interventions, existing systematic reviews assessing the effectiveness of school-based interventions targeting adolescent substance use have not examined this potential. The aim of the systematic review is to determine whether universal interventions focused on enhancing the resilience of adolescents are effective in reducing adolescent substance use. Eligible studies will: include participants 5-18 years of age; report tobacco use, alcohol consumption or illicit drug use as outcomes; and implement a school-based intervention designed to promote internal (eg, self-esteem) and external (eg, school connectedness) resilience factors. Eligible study designs include randomised controlled trials, cluster randomised controlled trials, staggered enrolment trials, stepped wedged trials, quasi-randomised trials, quasi-experimental trials, time series/interrupted time-series trials, preference trials, regression discontinuity trials and natural experiment studies with a parallel control group. A search strategy including criteria for participants, study design, outcome, setting and intervention will be implemented in various electronic databases and information sources. Two reviewers will independently screen studies to assess eligibility, as well as extract data from, and assess risk of bias of included studies. A third reviewer will resolve any discrepancies. Attempts will be made to quantify trial effects by meta-analysis. Binary outcomes will be pooled and effect size reported using ORs. For continuous data, effect size of trials will be reported using a mean difference where trial outcomes report the same outcome using a consistent measure, or standardised mean

  1. Enhancing the population impact of collaborative care interventions: mixed method development and implementation of stepped care targeting posttraumatic stress disorder and related comorbidities after acute trauma.

    PubMed

    Zatzick, Douglas; Rivara, Frederick; Jurkovich, Gregory; Russo, Joan; Trusz, Sarah Geiss; Wang, Jin; Wagner, Amy; Stephens, Kari; Dunn, Chris; Uehara, Edwina; Petrie, Megan; Engel, Charles; Davydow, Dimitri; Katon, Wayne

    2011-01-01

    The objective of the study was to develop and implement a stepped collaborative care intervention targeting posttraumatic stress disorder (PTSD) and related comorbidities to enhance the population impact of early trauma-focused interventions. We describe the design and implementation of the Trauma Survivors Outcomes and Support study. An interdisciplinary treatment development team was composed of trauma surgical, clinical psychiatric and mental health services "change agents" who spanned the boundaries between frontline trauma center clinical care and acute care policy. Mixed method clinical epidemiologic and clinical ethnographic studies informed the development of PTSD screening and intervention procedures. Two hundred seven acutely injured trauma survivors with high early PTSD symptom levels were randomized into the study. The stepped collaborative care model integrated care management (i.e., posttraumatic concern elicitation and amelioration, motivational interviewing and behavioral activation) with cognitive behavioral therapy and pharmacotherapy targeting PTSD. The model was feasibly implemented by frontline acute care masters in social work and nurse practioner providers. Stepped care protocols targeting PTSD may enhance the population impact of early interventions developed for survivors of individual and mass trauma by extending the reach of collaborative care interventions to acute care medical settings and other nonspecialty posttraumatic contexts. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Objectively coding intervention fidelity during a phone-based obesity prevention study.

    PubMed

    JaKa, Meghan M; Seburg, Elisabeth M; Roeder, Alison M; Sherwood, Nancy E

    Childhood obesity prevention studies have yielded disappointing results. Understanding intervention fidelity is necessary in explaining why interventions are (or are not) successful and ultimately improving future intervention. In spite of this, intervention fidelity it is not consistently reported in the obesity prevention literature. The purpose of the current study was to develop and utilize a coding protocol to objectively assess intervention fidelity in a phone-based obesity prevention study for parents of preschool-aged children. Both interventionists and independent coders completed session fidelity measures including time spent on target areas (media use, physical activity, etc.) and components of goal setting quality. Coders also rated participant engagement. Agreement between ratings by interventionists and coders, fidelity levels and changes in fidelity components over time are presented. Coders and interventionists showed high agreement when reporting time spent discussing different target areas. Interventionists consistently rated themselves higher than independent coders on measures of goal quality. Coder ratings of session quality were initially high, but some components declined slightly across the eight sessions. Future directions for intervention fidelity measurement and analysis are discussed, including utilizing changes in fidelity measures over time to predict study outcomes. Obtaining a more in-depth understanding of intervention fidelity has the potential to strengthen obesity interventions.

  3. Objectively coding intervention fidelity during a phone-based obesity prevention study

    PubMed Central

    Seburg, Elisabeth M.; Roeder, Alison M.; Sherwood, Nancy E.

    2015-01-01

    BACKGROUND Childhood obesity prevention studies have yielded disappointing results. Understanding intervention fidelity is necessary in explaining why interventions are (or are not) successful and ultimately improving future intervention. In spite of this, intervention fidelity it is not consistently reported in the obesity prevention literature. The purpose of the current study was to develop and utilize a coding protocol to objectively assess intervention fidelity in a phone-based obesity prevention study for parents of preschool-aged children. FINDINGS Both interventionists and independent coders completed session fidelity measures including time spent on target areas (media use, physical activity, etc.) and components of goal setting quality. Coders also rated participant engagement. Agreement between ratings by interventionists and coders, fidelity levels and changes in fidelity components over time are presented. Coders and interventionists showed high agreement when reporting time spent discussing different target areas. Interventionists consistently rated themselves higher than independent coders on measures of goal quality. Coder ratings of session quality were initially high, but some components declined slightly across the eight sessions. CONCLUSIONS Future directions for intervention fidelity measurement and analysis are discussed, including utilizing changes in fidelity measures over time to predict study outcomes. Obtaining a more in-depth understanding of intervention fidelity has the potential to strengthen obesity interventions. PMID:26618201

  4. The Cell’s Nucleolus: an Emerging Target for Chemotherapeutic Intervention

    PubMed Central

    Pickard, Amanda J.

    2013-01-01

    The transient nucleolus plays a central role in the upregulated synthesis of ribosomal RNA (rRNA) to sustain ribosome biogenesis, a hallmark of aberrant cell growth. This function, in conjunction with its unique pathohistological features in malignant cells and its ability to mediate apoptosis, renders this subnuclear structure a potential target for chemotherapeutic agents. In this Minireview, structurally and functionally diverse small molecules are discussed that have been reported to either interact with the nucleolus directly or perturb its function indirectly by acting on its dynamic components. These molecules include all major classes of nucleic acid-targeted agents, antimetabolites, kinase inhibitors, anti-inflammatory drugs, natural product antibiotics, oligopeptides, as well asnano-sized particles. Together, these molecules are invaluable probes of structure and function of the nucleolus. They also provide a unique opportunity to develop novel strategies for more selective and therefore better tolerated chemotherapeutic intervention. In this regard, inhibition of RNA polymerase I-mediated rRNA synthesis appears to be a promising mechanism of cancer cell kill. The recent development of molecules targeted at G-quadruplex forming rRNA gene sequences, which are currently undergoing clinical trials, seems to attest to the success of this approach. PMID:23881648

  5. Comparison of a Targeted Intervention Program Delivered Face-to-Face and by Personal Videoconferencing for Primary and Middle School Students with Mathematical Learning Difficulties

    ERIC Educational Resources Information Center

    Kestel, Eugénie

    2014-01-01

    This paper describes part of a mixed-methods study comparing the effectiveness of an individual, conceptual instruction based, tuition program delivered face-to-face and by personal videoconferencing (PVC) for 30 upper primary and middle school students with mathematical learning difficulties (MLDs). The experimental intervention targeted number…

  6. Targeted Interventions Improve Shared Agreement of Daily Goals in the Pediatric Intensive Care Unit

    PubMed Central

    Rehder, Kyle J; Uhl, Tammy L; Meliones, Jon N; Turner, David A; Smith, P Brian; Mistry, Kshitij P

    2011-01-01

    Objective To improve communication during daily rounds using sequential interventions. Design Prospective cohort study Setting Multidisciplinary pediatric intensive care unit in a university hospital. Subjects The multidisciplinary rounding team in the pediatric intensive care unit, including attending physicians, physician trainees, and nurses. Interventions Daily rounds on 736 patients were observed over a nine month period. Sequential interventions were timed 8–12 weeks apart: (1) Implementing a new resident daily progress note format, (2) creating a performance improvement `dashboard,' and (3) documenting patients' daily goals on bedside whiteboards. Measurements and Main Results Following all interventions, team agreement with the attending physician's stated daily goals increased from 56.9% to 82.7% (p < 0.0001). Mean agreement increased for each provider category: 65.2% to 88.8% for fellows (p < 0.0001), 55.0% to 83.8% for residents (p < 0.0001), and 54.1% to 77.4% for nurses (p < 0.0001). In addition, significant improvements were noted in provider behaviors following interventions. Barriers to communication (bedside nurse multitasking during rounds, interruptions during patient presentations, and group disassociation) were reduced, and the use of communication facilitators (review of the prior day's goals, inclusion of bedside nurse input, and order read back) increased. The percentage of providers reporting being `very satisfied' or `satisfied' with rounds increased from 42.6% to 78.3%, (p < 0.0001). Conclusions Shared agreement of patients' daily goals among key healthcare providers can be increased through process-oriented interventions. Improved agreement will potentially lead to improved quality of patient care and reduced medical errors. PMID:21478796

  7. Stakeholder engagement analysis - a bioethics dilemma in patient-targeted intervention: patients with temporomandibular joint disorders.

    PubMed

    Barkhordarian, Andre; Demerjian, Gary; Jan, Allison; Sama, Nateli; Nguyen, Mia; Du, Angela; Chiappelli, Francesco

    2015-01-20

    Modern health care in the field of Medicine, Dentistry and Nursing is grounded in fundamental philosophy and epistemology of translational science. Recently in the U.S major national initiatives have been implemented in the hope of closing the gaps that sometimes exist between the two fundamental components of translational science, the translational research and translational effectiveness. Subsequent to these initiatives, many improvements have been made; however, important bioethical issues and limitations do still exist that need to be addressed. One such issue is the stakeholder engagement and its assessment and validation. Federal, state and local organizations such as PCORI and AHRQ concur that the key to a better understanding of the relationship between translational research and translational effectiveness is the assessment of the extent to which stakeholders are actively engaged in the translational process of healthcare. The stakeholder engagement analysis identifies who the stakeholders are, maps their contribution and involvement, evaluates their priorities and opinions, and accesses their current knowledge base. This analysis however requires conceptualization and validation from the bioethics standpoint. Here, we examine the bioethical dilemma of stakeholder engagement analysis in the context of the person-environment fit (PE-fit) theoretical model. This model is an approach to quantifying stakeholder engagement analysis for the design of patient-targeted interventions. In our previous studies of Alzheimer patients, we have developed, validated and used a simple instrument based on the PE-fit model that can be adapted and utilized in a much less studied pathology as a clinical model that has a wide range of symptoms and manifestations, the temporomandibular joint disorders (TMD). The temporomandibular joint (TMJ) is the jaw joint endowed with sensory and motor innervations that project from within the central nervous system and its dysfunction can

  8. Enhancing the population impact of collaborative care interventions: Mixed method development and implementation of stepped care targeting posttraumatic stress disorder and related comorbidities after acute trauma

    PubMed Central

    Zatzick, Douglas; Rivara, Frederick; Jurkovich, Gregory; Russo, Joan; Trusz, Sarah Geiss; Wang, Jin; Wagner, Amy; Stephens, Kari; Dunn, Chris; Uehara, Edwina; Petrie, Megan; Engel, Charles; Davydow, Dimitri; Katon, Wayne

    2011-01-01

    Objective To develop and implement a stepped collaborative care intervention targeting PTSD and related co-morbidities to enhance the population impact of early trauma-focused interventions. Method We describe the design and implementation of the Trauma Survivors Outcomes & Support Study (TSOS II). An interdisciplinary treatment development team was comprised of trauma surgical, clinical psychiatric and mental health services “change agents” who spanned the boundaries between front-line trauma center clinical care and acute care policy. Mixed method clinical epidemiologic and clinical ethnographic studies informed the development of PTSD screening and intervention procedures. Results Two-hundred and seven acutely injured trauma survivors with high early PTSD symptom levels were randomized into the study. The stepped collaborative care model integrated care management (i.e., posttraumatic concern elicitation and amelioration, motivational interviewing, and behavioral activation) with cognitive behavioral therapy and pharmacotherapy targeting PTSD. The model was feasibly implemented by front-line acute care MSW and ARNP providers. Conclusions Stepped care protocols targeting PTSD may enhance the population impact of early interventions developed for survivors of individual and mass trauma by extending the reach of collaborative care interventions to acute care medical settings and other non-specialty posttraumatic contexts. PMID:21596205

  9. Adoption of workplaces and reach of employees for a multi-faceted intervention targeting low back pain among nurses’ aides

    PubMed Central

    2014-01-01

    Background Workplace adoption and reach of health promotion are important, but generally poorly reported. The aim of this study is therefore to evaluate the adoption of workplaces (organizational level) and reach of employees (individual level) of a multi-faceted workplace health promotion and work environment intervention targeting low back pain among nurses’ aides in elderly care. Methods Percentage of adopters was calculated among eligible workplaces and differences between adopters and non-adopters were evaluated through workplace registrations and manager questionnaires from all eligible workplaces. From the adopted workplaces reach was calculated among eligible employees as the percentage who responded on a questionnaire. Responders were compared with non-responders using data from company registrations. Among responders, comparisons based on questionnaire data were performed between those consenting to participate in the intervention (consenters) and those not consenting to participate in the intervention (non-consenters). Comparisons were done using Student's t-test for the continuous variables, Fisher's exact test for dichotomous variables and the Pearson’s chi2 for categorical variables. Moreover odds ratios for non-responding and non-consenting were investigated with binary logistic regression analyses. Results The project was adopted by 44% of the offered workplaces. The main differences between adopters and non-adopters were that workplaces adopting the intervention had a more stable organization as well as a management with positive beliefs of the intervention’s potential benefits. Of eligible employees, 71% responded on the questionnaire and 57% consented to participate. Non-responders and non-consenters did not differ from the responders and consenters on demographic factors and health. However, more non-responders and non-consenters were low skilled, worked less than 30 hours pr. week, and worked evening and nightshift compared to responders

  10. Social cognitive determinants of ecstasy use to target in evidence-based interventions: a meta-analytical review.

    PubMed

    Peters, Gjalt-Jorn Y; Kok, Gerjo; Abraham, Charles

    2008-01-01

    The health hazards and prevalence of ecstasy use have been documented in two decades of research, but no review reporting on potentially modifiable antecedents of use is available. The aim of this study was to integrate systematically research identifying cognitive correlates of ecstasy use. Such research has the potential to identify targets for evidence-based interventions designed to discourage use. The databases PsycINFO and MedLine were searched, inclusion criteria applied to resulting hits, and descendency and ancestry approaches applied to the selected publications. Reported associations between cognitive determinants, including intention to use and ecstasy use measures, were synthesized by calculating a weighted mean effect size, r. The pattern of associations lent support both to the theory of planned behaviour (TPB) and the expectancy approach as descriptions of potentially useful determinants. Attitudes were associated most strongly with intention and use, followed by subjective norm and perceived behavioural control. Consideration of the strength of associations and the potential modifiability of identified cognitions suggests that evidence-based interventions to discourage ecstasy use should target negative expectancies, perceived behavioural control and anticipated regret, and consider tailoring perceived behavioural control elements.

  11. Predictive Malaria Risk and Uncertainty Mapping in Nchelenge District, Zambia: Evidence of Widespread, Persistent Risk and Implications for Targeted Interventions

    PubMed Central

    Pinchoff, Jessie; Chaponda, Mike; Shields, Timothy; Lupiya, James; Kobayashi, Tamaki; Mulenga, Modest; Moss, William J.; Curriero, Frank C.

    2015-01-01

    Malaria risk maps may be used to guide policy decisions on whether vector control interventions should be targeted and, if so, where. Active surveillance for malaria was conducted through household surveys in Nchelenge District, Zambia from April 2012 through December 2014. Households were enumerated based on satellite imagery and randomly selected for study enrollment. At each visit, participants were administered a questionnaire and a malaria rapid diagnostic test (RDT). Logistic regression models were used to construct spatial prediction risk maps and maps of risk uncertainty. A total of 461 households were visited, comprising 1,725 participants, of whom 48% were RDT positive. Several environmental features were associated with increased household malaria risk in a multivariable logistic regression model adjusting for seasonal variation. The model was validated using both internal and external evaluation measures to generate and assess root mean square error, as well as sensitivity and specificity for predicted risk. The final, validated model was used to predict and map malaria risk including a measure of risk uncertainty. Malaria risk in a high, perennial transmission setting is widespread but heterogeneous at a local scale, with seasonal variation. Targeting malaria control interventions may not be appropriate in this epidemiological setting. PMID:26416106

  12. Predictive Malaria Risk and Uncertainty Mapping in Nchelenge District, Zambia: Evidence of Widespread, Persistent Risk and Implications for Targeted Interventions.

    PubMed

    Pinchoff, Jessie; Chaponda, Mike; Shields, Timothy; Lupiya, James; Kobayashi, Tamaki; Mulenga, Modest; Moss, William J; Curriero, Frank C

    2015-12-01

    Malaria risk maps may be used to guide policy decisions on whether vector control interventions should be targeted and, if so, where. Active surveillance for malaria was conducted through household surveys in Nchelenge District, Zambia from April 2012 through December 2014. Households were enumerated based on satellite imagery and randomly selected for study enrollment. At each visit, participants were administered a questionnaire and a malaria rapid diagnostic test (RDT). Logistic regression models were used to construct spatial prediction risk maps and maps of risk uncertainty. A total of 461 households were visited, comprising 1,725 participants, of whom 48% were RDT positive. Several environmental features were associated with increased household malaria risk in a multivariable logistic regression model adjusting for seasonal variation. The model was validated using both internal and external evaluation measures to generate and assess root mean square error, as well as sensitivity and specificity for predicted risk. The final, validated model was used to predict and map malaria risk including a measure of risk uncertainty. Malaria risk in a high, perennial transmission setting is widespread but heterogeneous at a local scale, with seasonal variation. Targeting malaria control interventions may not be appropriate in this epidemiological setting. © The American Society of Tropical Medicine and Hygiene.

  13. Social Competence Intervention for Parents (SCI-P): Comparing Outcomes for a Parent Education Program Targeting Adolescents with ASD

    PubMed Central

    Schultz, Tia R.; Stichter, Janine P.; Herzog, Melissa J.; McGhee, Stephanie D.; Lierheimer, Kristin

    2012-01-01

    Research has shown that parent education programs can address some of the distinct challenges that parents of youth with autism spectrum disorders (ASDs) encounter. This study examined the effectiveness of the Social Competence Intervention for Parents (SCI-P), a parent education program, administered in conjunction with a social competence intervention that targeted youth with ASD ages 11–14 (SCI-A). Using a quasi-experimental pre-post design, parents were assigned to either the SCI-P group (n = 16) or to the waitlist comparison group (n = 10). Analyses of covariance (ANCOVAs) revealed a significant effect for parent education participation such that SCI-P participants experienced significantly greater reductions in levels of stress and a trend for increases in parenting sense of competence from pre- to post-intervention. Moreover, parents in the SCI-P group reported high satisfaction with the program. These findings suggest that parent education can result in positive outcomes for parents' well being. PMID:22934178

  14. IMPACT: a multi-level family and school intervention targeting obesity in urban youth.

    PubMed

    Moore, Shirley M; Borawski, Elaine A; Cuttler, Leona; Ievers-Landis, Carolyn E; Love, Thomas E

    2013-11-01

    IMPACT (Ideas Moving Parents and Adolescents to Change Together) is a 3-group randomized, multi-level trial comparing the efficacy of two distinct behavioral interventions and a control condition on body mass index (BMI) in middle school urban youth who are overweight/obese. Interventions include: (1) SystemCHANGE (SC), a promising new behavior change approach that focuses on system redesign of the family environment and daily routines; (2) HealthyCHANGE (HC), a cognitive-behavioral and Motivational Interviewing (MI)-consistent approach to behavior change that focuses on increasing intrinsic motivation, self-monitoring, goal setting, and problem solving; and (3) diet and physical education counseling (attention control). In addition, about half of the participants are enrolled in a K-8 public school that offers an innovative community-sponsored fitness program, augmented by study-supported navigators. In addition to the primary interventions effects, the study assesses the moderating effect of the school environment on BMI, blood pressure, cardiovascular risk factors, and quality of life. The sample consists of 360 children entering 6th grade from a large urban school district in the Midwest, identified through an existing BMI screening program. The intervention period is 36 months, and measures are obtained at baseline, 12, 24, and 36 months. Using intent-to-treat analyses across the 36-month intervention window, we hypothesize that both SC and HC will have a greater impact on BMI and other health outcomes compared to health education alone, and that the enriched school environment will enhance these effects. This manuscript describes IMPACT's study design and methods. © 2013.

  15. A guided self-help intervention targeting psychological distress among head and neck cancer and lung cancer patients: motivation to start, experiences and perceived outcomes.

    PubMed

    Krebber, Anne-Marie H; van Uden-Kraan, Cornelia F; Melissant, Heleen C; Cuijpers, Pim; van Straten, Annemieke; Becker-Commissaris, Annemarie; Leemans, C René; Verdonck-de Leeuw, Irma M

    2017-01-01

    Recent results of a randomized clinical trial showed that a guided self-help intervention (based on problem-solving therapy) targeting psychological distress among head and neck cancer and lung cancer patients is effective. This study qualitatively explored motivation to start, experiences with and perceived outcomes of this intervention. Data were collected from semi-structured interviews of 16 patients. All interviews were audio-recorded and transcribed verbatim. Data were analyzed individually by two coders and coded into key issues and themes. Patients participated in the intervention for intrinsic (e.g. to help oneself) and for extrinsic reasons (e.g. being asked by a care professional or to help improve health care). Participants indicated positive and negative experiences with the intervention. Several participants appreciated participating as being a pleasant way to work on oneself, while others described participating as too confrontational. Some expressed their disappointment as they felt the intervention had brought them nothing or indicated that they felt worse temporarily, but most participants perceived positive outcomes of the intervention (e.g. feeling less distressed and having learned what matters in life). Cancer patients have various reasons to start a guided self-help intervention. Participants appreciated the guided self-help as intervention to address psychological distress, but there were also concerns. Most participants reported the intervention to be beneficial. The results suggest the need to identify patients who might benefit most from guided self-help targeting psychological distress and that interventions should be further tailored to individual cancer patients' requirements.

  16. A ventilation intervention study in classrooms to improve indoor air quality: the FRESH study.

    PubMed

    Rosbach, Jeannette T M; Vonk, Machiel; Duijm, Frans; van Ginkel, Jan T; Gehring, Ulrike; Brunekreef, Bert

    2013-12-17

    Classroom ventilation rates often do not meet building standards, although it is considered to be important to improve indoor air quality. Poor indoor air quality is thought to influence both children's health and performance. Poor ventilation in The Netherlands most often occurs in the heating season. To improve classroom ventilation a tailor made mechanical ventilation device was developed to improve outdoor air supply. This paper studies the effect of this intervention. The FRESH study (Forced-ventilation Related Environmental School Health) was designed to investigate the effect of a CO2 controlled mechanical ventilation intervention on classroom CO2 levels using a longitudinal cross-over design. Target CO2 concentrations were 800 and 1200 parts per million (ppm), respectively. The study included 18 classrooms from 17 schools from the north-eastern part of The Netherlands, 12 experimental classrooms and 6 control classrooms. Data on indoor levels of CO2, temperature and relative humidity were collected during three consecutive weeks per school during the heating seasons of 2010-2012. Associations between the intervention and weekly average indoor CO2 levels, classroom temperature and relative humidity were assessed by means of mixed models with random school-effects. At baseline, mean CO2 concentration for all schools was 1335 ppm (range: 763-2000 ppm). The intervention was able to significantly decrease CO2 levels in the intervention classrooms (F (2,10) = 17.59, p < 0.001), with a mean decrease of 491 ppm. With the target set at 800 ppm, mean CO2 was 841 ppm (range: 743-925 ppm); with the target set at 1200 ppm, mean CO2 was 975 ppm (range: 887-1077 ppm). Although the device was not capable of precisely achieving the two predefined levels of CO2, our study showed that classroom CO2 levels can be reduced by intervening on classroom ventilation using a CO2 controlled mechanical ventilation system.

  17. Study of Laser Interaction with Thin Targets

    SciTech Connect

    Boley, C D; Cutter, K P; Fochs, S N; Pax, P H; Rotter, M D; Rubenchik, A M; Yamamoto, R M

    2009-03-06

    For many targets of interest, the thickness is small compared to the conduction length during the engagement. In addition, the laser-material interaction region can be treated as flat. We have studied this regime with our 25 kW solid-state laser. We have demonstrated that airflow can reduce by approximately 40% the energy required to break through a thin target. This reduction is caused by the bulging of the softened material and the tearing and removal of the material by aerodynamic forces. We present elastic modeling which explains these results.

  18. 5T4 oncofoetal antigen: an attractive target for immune intervention in cancer.

    PubMed

    Stern, Peter L; Harrop, Richard

    2017-04-01

    The natural history of a patient's cancer is often characterised by genetic diversity and sequential sweeps of clonal dominance. It is therefore not surprising that identifying the most appropriate tumour-associated antigen for targeted intervention is challenging. The 5T4 oncofoetal antigen was identified by searching for surface molecules shared between human trophoblast and cancer cells with the rationale that they may function to allow survival of the foetus as a semi-allograft in the mother or a tumour in its host. The 5T4 protein is expressed by many different cancers but rarely in normal adult tissues. 5T4 molecules are 72 kD, heavily N-glycosylated proteins with several leucine-rich repeats which are often associated with protein-protein interactions. 5T4 expression is associated with the directional movement of cells through epithelial mesenchymal transition, potentiation of CXCL12/CXCR4 chemotaxis and inhibition of canonical Wnt/beta-catenin while favouring non-canonical pathway signalling; all processes which help drive the spread of cancer cells. The selective pattern of 5T4 tumour expression, association with a tumour-initiating phenotype plus a mechanistic involvement with cancer spread have underwritten the clinical development of different immunotherapeutic strategies including a vaccine, a tumour-targeted superantigen and an antibody drug conjugate. In addition, a chimeric antigen receptor T cell approach targeting 5T4 expressing tumour cells is in pre-clinical development. A key challenge will include how best to combine each 5T4 targeted immunotherapy with the most appropriate standard of care treatment (or adjunct therapy) to maximise the recovery of immune control and ultimately eliminate the tumour.

  19. Cost effectiveness of hepatitis C-related interventions targeting substance users and other high-risk groups: a systematic review.

    PubMed

    John-Baptiste, Ava; Yeung, Man Wah; Leung, Victoria; van der Velde, Gabrielle; Krahn, Murray

    2012-11-01

    In developed countries, injection drug users have the highest prevalence and incidence of hepatitis C virus (HCV) infection. Clinicians and policy makers have several options for reducing morbidity and mortality related to HCV infection, including preventing new infections, screening high-risk populations, and optimizing uptake and delivery of antiviral therapy. Cost-effectiveness analyses provide an estimate of the value for money associated with adopting healthcare interventions. Our objective was to determine the cost effectiveness of hepatitis C interventions (prevention, screening, treatment) targeting substance users and other groups with a high proportion of substance users. We conducted a systematic search of MEDLINE, EMBASE, CINAHL, HealthSTAR and EconLit, and the grey literature. Studies were critically appraised using the Drummond and Jefferson, Neumann et al. and Philips et al. checklists. We developed and applied a quality appraisal instrument specific to cost-effectiveness analyses of HCV interventions. In addition, we summarized cost-effectiveness estimates using a single currency and year ($US, year 2009 values). Twenty-one economic evaluations were included, which addressed prevention (three), screening (ten) and treatment (eight). The quality of the analyses varied greatly. A significant proportion did not incorporate important aspects of HCV natural history, disease costs and antiviral therapy. Incremental cost-effectiveness ratios (ICERs) ranged from dominant (less costly and more effective) to $US603,352 per QALY. However, many ICERs were less than $US100,000 per QALY. Screening and treatment interventions involving pegylated interferon and ribavirin were generally cost effective at the $US100,000 per QALY threshold, with the exception of some subgroups, such as immune compromised patients with genotype 1 infections. No clear consensus emerged from the studies demonstrating that prevention, screening or treatment provides better value for money

  20. Anthropological Assessment for Culturally Appropriate Interventions Targeting Men Who Have Sex With Men

    PubMed Central

    Silenzio, Vincent M. B.

    2003-01-01

    Although social and cultural factors play a fundamental role in the health of sexual minority populations and the development of culturally appropriate interventions, public health activities and research have sometimes lacked appropriate sophistication or attention to issues of cultural competency. In areas such as HIV prevention for men who have sex with men (MSM), biomedical interpretations of same-sex phenomena should be applied with caution. Communities and societies may broadly understand same-sex desire, attraction, behavior, and identity through age-structured/initiatory, gender-defined, profession/social role–defined, or egalitarian/gay frameworks. When more detailed, locally specific information is required, such as for youth, ethnic minorities, or urban versus rural populations, the approach to rapid anthropological assessment presented can provide nuanced insights for effective health programs targeting MSM. PMID:12773342

  1. Toll-like receptor modulation in cardiovascular disease: a target for intervention?

    PubMed

    Földes, Gábor; von Haehling, Stephan; Anker, Stefan D

    2006-08-01

    Toll-like receptors (TLRs) form a family of pattern recognition receptors that have emerged as key mediators of innate immunity. These receptors sense invading microbes and initiate the immune response. TLR-mediated inflammation is an important pathogenic link between innate immunity and a diverse panel of clinical disorders. Among the processes in which TLRs play a role are cardiovascular disorders such as cardiac ischaemia, coronary artery disease, ventricular remodelling, cancer angiogenesis or transplant rejection. From these, many important opportunities for disease modification through TLR signalling manipulation can be imagined. Their role as potential targets for therapeutic intervention is just beginning to be appreciated and this article reviews the current status of these treatment strategies for cardiovascular disease.

  2. Interventions targeted at women to encourage the uptake of cervical screening

    PubMed Central

    Everett, Thomas; Bryant, Andrew; Griffin, Michelle F; Martin-Hirsch, Pierre PL; Forbes, Carol A; Jepson, Ruth G

    2014-01-01

    Background World-wide, cervical cancer is the second most common cancer in women. Increasing the uptake of screening, alongside increasing informed choice is of great importance in controlling this disease through prevention and early detection. Objectives To assess the effectiveness of interventions aimed at women, to increase the uptake, including informed uptake, of cervical cancer screening. Search methods We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Issue 1, 2009. MEDLINE, EMBASE and LILACS databases up to March 2009. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. Selection criteria Randomised controlled trials (RCTs) of interventions to increase uptake/informed uptake of cervical cancer screening. Data collection and analysis Two review authors independently abstracted data and assessed risk of bias. Where possible the data were synthesised in a meta-analysis. Main results Thirty-eight trials met our inclusion criteria. These trials assessed the effectiveness of invitational and educational interventions, counselling, risk factor assessment and procedural interventions. Heterogeneity between trials limited statistical pooling of data. Overall, however, invitations appear to be effective methods of increasing uptake. In addition, there is limited evidence to support the use of educational materials. Secondary outcomes including cost data were incompletely documented so evidence was limited. Most trials were at moderate risk of bias. Informed uptake of cervical screening was not reported in any trials. Authors’ conclusions There is evidence to support the use of invitation letters to increase the uptake of cervical screening. There is limited evidence to support educational interventions but it is unclear what format is most effective. The majority of the studies are from

  3. Integration of targeted health interventions into health systems: a conceptual framework for analysis.

    PubMed

    Atun, Rifat; de Jongh, Thyra; Secci, Federica; Ohiri, Kelechi; Adeyi, Olusoji

    2010-03-01

    The benefits of integrating programmes that emphasize specific interventions into health systems to improve health outcomes have been widely debated. This debate has been driven by narrow binary considerations of integrated (horizontal) versus non-integrated (vertical) programmes, and characterized by polarization of views with protagonists for and against integration arguing the relative merits of each approach. The presence of both integrated and non-integrated programmes in many countries suggests benefits to each approach. While the terms 'vertical' and 'integrated' are widely used, they each describe a range of phenomena. In practice the dichotomy between vertical and horizontal is not rigid and the extent of verticality or integration varies between programmes. However, systematic analysis of the relative merits of integration in various contexts and for different interventions is complicated as there is no commonly accepted definition of 'integration'-a term loosely used to describe a variety of organizational arrangements for a range of programmes in different settings. We present an analytical framework which enables deconstruction of the term integration into multiple facets, each corresponding to a critical health system function. Our conceptual framework builds on theoretical propositions and empirical research in innovation studies, and in particular adoption and diffusion of innovations within health systems, and builds on our own earlier empirical research. It brings together the critical elements that affect adoption, diffusion and assimilation of a health intervention, and in doing so enables systematic and holistic exploration of the extent to which different interventions are integrated in varied settings and the reasons for the variation. The conceptual framework and the analytical approach we propose are intended to facilitate analysis in evaluative and formative studies of-and policies on-integration, for use in systematically comparing and

  4. Multicomponent targeted intervention to prevent delirium in hospitalized older patients: what is the economic value?

    PubMed

    Rizzo, J A; Bogardus, S T; Leo-Summers, L; Williams, C S; Acampora, D; Inouye, S K

    2001-07-01

    Delirium, or acute confusional state, is a common and serious occurrence among hospitalized older persons. Current estimates suggest that delirium complicates hospital stays for more than 2.3 million older persons each year, involving more than 17.5 million hospital days and accounting for more than $4 billion (1994 dollars) of Medicare expenditures. A 40% reduction was recently reported in the risk for delirium among hospitalized older persons receiving a multicomponent targeted risk factor intervention (MTI) strategy to prevent delirium, compared with subjects receiving usual hospital care.1 Before recommending that this preventive strategy be implemented in clinical practice, however, the cost implications must be thoroughly examined as well. The present analysis performs net cost evaluations of the MTI for the prevention of delirium among hospitalized patients. Hospital charge and cost-to-charge ratio data are linked to a database of 852 subjects, who were treated with MTI or usual care. Multivariable regression methods were used to help isolate the impact of MTI on hospital costs. These results were then combined with our earlier work on the impact of the MTI on delirium prevention to assess the cost effectiveness of this intervention. The MTI significantly reduced nonintervention costs among subjects at intermediate risk for developing delirium, but not among subjects at high risk. When MTI intervention costs were included, MTI had no significant effect on overall health care costs in the intermediate risk cohort, but raised overall costs in the high risk group. Because the MTI prevented delirium in the intermediate risk group without raising costs, the conclusion reached is that it is a cost effective treatment option for patients at intermediate risk for developing delirium. In contrast, the results suggest that the MTI is not cost effective for subjects at high risk.

  5. Qualitative investigation of targets for and barriers to interventions to prevent psychosis relapse

    PubMed Central

    2014-01-01

    Background Early signs based relapse prevention interventions for psychosis show promise. In order to examine how they might be improved we sought to better understand the early relapse process, service users’ abilities to identify early signs, and any potential facilitators and barriers to early signs interventions. Methods Data from in-depth interviews with a convenience sample of service users with psychosis varying in gender, age, duration of mental health problems, and time since last relapse were analysed using a thematic approach. Interview transcripts were coded inductively and relationships between emerging themes were examined by the research team to provide a thorough synthesis of the data. Results Three central themes emerged from the analysis: 1) recognising risk factors (how risk factors were identified and linked to relapse, and reactions to such risk factors); 2) identifying early signs (issues related to both recognising and recalling signs of relapse); 3) reacting to deterioration (participants’ thoughts and feelings in response to early signs, including help seeking and its challenges). Conclusions There was considerable variation in the attention participants had paid to pre-relapse signs, the ease with which they were able to recall them, and their reactions to them. For many, there were substantial barriers to help seeking from services. A family or friend confidant was an important means of assistance, although the supportive presence of significant others was not always available. Based on these results, a number of recommendations about facilitating service users’ recognition of early signs and targeting potential accelerants of relapse are made. PMID:25030092

  6. Children of mothers with borderline personality disorder: identifying parenting behaviors as potential targets for intervention.

    PubMed

    Stepp, Stephanie D; Whalen, Diana J; Pilkonis, Paul A; Hipwell, Alison E; Levine, Michele D

    2012-01-01

    Children of mothers with borderline personality disorder (BPD) should be considered a high-risk group given the wide array of poor psychosocial outcomes that have been found in these children. This article describes the parenting strategies that might explain the transmission of vulnerability from mothers with BPD to their offspring, from infancy through adolescence. We conclude that oscillations between extreme forms of hostile control and passive aloofness in their interactions with their children may be unique to mothers with BPD. We provide an overview of interventions that are currently recommended for mothers and family members with BPD, namely attachment therapy and psychoeducational approaches. On the basis of an integration of the empirical findings on parenting and child outcomes, as well as from the review of current approaches to intervention, we conclude with recommendations for treatment targets. We argue that mothers with BPD need psychoeducation regarding child development and recommended parenting practices and skills for providing consistent warmth and monitoring, including mindfulness-based parenting strategies.

  7. Interventions targeting child undernutrition in developing countries may be undermined by dietary exposure to aflatoxin.

    PubMed

    Watson, Sinead; Gong, Yun Yun; Routledge, Michael

    2017-06-13

    Child undernutrition, a form of malnutrition, is a major public health burden in developing countries. Supplementation interventions targeting the major micronutrient deficiencies have only reduced the burden of child undernutrition to a certain extent, indicating that there are other underlying determinants that need to be addressed. Aflatoxin exposure, which is also highly prevalent in developing countries, may be considered an aggravating factor for child undernutrition. Increasing evidence suggests that aflatoxin exposure can occur in any stage of life, including in utero through a trans-placental pathway and in early childhood (through contaminated weaning food and family food). Early life exposure to aflatoxin is associated with adverse effects on low birth weight, stunting, immune suppression, and the liver function damage. The mechanisms underlying impaired growth and aflatoxin exposure are still unclear but intestinal function damage, reduced immune function, and alteration in the insulin-like growth factor axis caused by the liver damage are the suggested hypotheses. Given the fact that both aflatoxin and child undernutrition are common in sub-Saharan Africa, effective interventions aimed at reducing undernutrition cannot be satisfactorily achieved until the interactive relationship between aflatoxin and child undernutrition is clearly understood, and an aflatoxin mitigation strategy takes effect in those vulnerable mothers and children.

  8. Development of a novel mindfulness and cognitive behavioral intervention for stress-eating: a comparative pilot study.

    PubMed

    Corsica, Joyce; Hood, Megan M; Katterman, Shawn; Kleinman, Brighid; Ivan, Iulia

    2014-12-01

    Stress-related eating is increasingly cited as a difficulty in managing healthy eating behaviors and weight. However few interventions have been designed to specifically target stress-related eating. In addition, the optimal target of such an intervention is unclear, as the target might be conceptualized as overall stress reduction or changing emotional eating-related thoughts and behaviors. This pilot study compared the effects of three interventions targeting those components individually and in combination on stress-related eating, perceived stress, and weight loss to determine whether the two intervention components are effective alone or are more effective when combined. Fifty-three overweight participants (98% female) who reported elevated levels of stress and stress-eating and were at risk for obesity were randomly assigned to one of three six-week interventions: a modified mindfulness-based stress reduction (MBSR) intervention, a cognitive behavioral stress-eating intervention (SEI), and a combined intervention that included all MBSR and SEI components. All three interventions significantly reduced perceived stress and stress-eating, but the combination intervention resulted in greater reductions and also produced a moderate effect on short term weight loss. Benefits persisted at six week follow-up.The pattern of results preliminarily suggests that the combination intervention (MBSR+SEI) may yield promise in the treatment of stress-related eating.

  9. Families' First Experiences with Early Intervention: National Early Intervention Longitudinal Study. NEILS Data Report.

    ERIC Educational Resources Information Center

    Bailey, Don; Scarborough, Anita; Hebbeler, Kathleen

    This report describes several aspects of families' experiences in beginning early intervention services using data from the National Early Intervention Longitudinal Study (NEILS). Funded by the U.S. Department of Education, NEILS is following a nationally representative sample of 3,338 infants and toddlers and their families from the time they…

  10. State-to-State Variations in Early Intervention Systems. National Early Intervention Longitudinal Study (NEILS).

    ERIC Educational Resources Information Center

    Hebbeler, Kathleen; Spiker, Donna; Wagner, Mary; Cameto, Renee; McKenna, Patti

    This report provides descriptive information on variations in selected features of state and local early intervention systems. Information was gathered from 20 states as part of the National Early Intervention Longitudinal Study (NEILS). Results indicate a considerable variation along a number of dimensions, including: eligibility criteria; type…

  11. Interventions targeting sexual and reproductive health and rights outcomes of young people living with HIV: a comprehensive review of current interventions from sub-Saharan Africa

    PubMed Central

    Pretorius, Leandri; Gibbs, Andrew; Crankshaw, Tamaryn; Willan, Samantha

    2015-01-01

    Background A growing number of young people (ages 10–24) are living with HIV (YPLWH) in sub-Saharan Africa (SSA). These YPLWH have particular needs and challenges related to their sexual and reproductive health and rights (SRHR). Contextual factors including gender inequalities, violence, stigma, and discrimination and lack of tailored services undermine YPLWH's SRHR. Objective Understand the scope and impact of interventions targeting YPLWH to improve SRH-related outcomes in SSA. Design We undertook a review to synthesise evaluated interventions (qualitative, quantitative, or mixed methods) aimed at improving the SRH outcomes of YPLWH in SSA with outcomes based on a World Health Organization framework of comprehensive SRHR approaches for women living with HIV. Using inclusion criteria, only six interventions were identified. Results Interventions sought to improve a range of direct and indirect SRH outcomes, including sexual behaviour, adherence, disclosure, and mental health. Four overarching issues emerged: 1) all interventions were structured according to cognitive behavioural therapy theories of behaviour change – while showing promise they do not tackle the wider gender, social, and economic contexts that shape YPLWH's SRH; 2) ‘significant others’ were included in two of the interventions, but further work needs to consider how to leverage parental/guardian support appropriately; 3) interventions only accessed young people who were already linked to care, participants were likely to have better SRH outcomes than those potentially more vulnerable YPLWH; and 4) none of the interventions explored the sexuality of young people. Conclusions There have been a limited number of evaluated interventions to strengthen SRH of YPLWH in SSA, and gaps exist in addressing the SRHR needs of YPLWH. Intervention approaches require greater scope and depth, including the need to address structural and contextual challenges. PMID:26534721

  12. Interventions targeting sexual and reproductive health and rights outcomes of young people living with HIV: a comprehensive review of current interventions from sub-Saharan Africa.

    PubMed

    Pretorius, Leandri; Gibbs, Andrew; Crankshaw, Tamaryn; Willan, Samantha

    2015-01-01

    A growing number of young people (ages 10-24) are living with HIV (YPLWH) in sub-Saharan Africa (SSA). These YPLWH have particular needs and challenges related to their sexual and reproductive health and rights (SRHR). Contextual factors including gender inequalities, violence, stigma, and discrimination and lack of tailored services undermine YPLWH's SRHR. Understand the scope and impact of interventions targeting YPLWH to improve SRH-related outcomes in SSA. We undertook a review to synthesise evaluated interventions (qualitative, quantitative, or mixed methods) aimed at improving the SRH outcomes of YPLWH in SSA with outcomes based on a World Health Organization framework of comprehensive SRHR approaches for women living with HIV. Using inclusion criteria, only six interventions were identified. Interventions sought to improve a range of direct and indirect SRH outcomes, including sexual behaviour, adherence, disclosure, and mental health. Four overarching issues emerged: 1) all interventions were structured according to cognitive behavioural therapy theories of behaviour change - while showing promise they do not tackle the wider gender, social, and economic contexts that shape YPLWH's SRH; 2) 'significant others' were included in two of the interventions, but further work needs to consider how to leverage parental/guardian support appropriately; 3) interventions only accessed young people who were already linked to care, participants were likely to have better SRH outcomes than those potentially more vulnerable YPLWH; and 4) none of the interventions explored the sexuality of young people. There have been a limited number of evaluated interventions to strengthen SRH of YPLWH in SSA, and gaps exist in addressing the SRHR needs of YPLWH. Intervention approaches require greater scope and depth, including the need to address structural and contextual challenges.

  13. Interventions targeting sexual and reproductive health and rights outcomes of young people living with HIV: a comprehensive review of current interventions from sub-Saharan Africa.

    PubMed

    Pretorius, Leandri; Gibbs, Andrew; Crankshaw, Tamaryn; Willan, Samantha

    2015-01-01

    Background A growing number of young people (ages 10-24) are living with HIV (YPLWH) in sub-Saharan Africa (SSA). These YPLWH have particular needs and challenges related to their sexual and reproductive health and rights (SRHR). Contextual factors including gender inequalities, violence, stigma, and discrimination and lack of tailored services undermine YPLWH's SRHR. Objective Understand the scope and impact of interventions targeting YPLWH to improve SRH-related outcomes in SSA. Design We undertook a review to synthesise evaluated interventions (qualitative, quantitative, or mixed methods) aimed at improving the SRH outcomes of YPLWH in SSA with outcomes based on a World Health Organization framework of comprehensive SRHR approaches for women living with HIV. Using inclusion criteria, only six interventions were identified. Results Interventions sought to improve a range of direct and indirect SRH outcomes, including sexual behaviour, adherence, disclosure, and mental health. Four overarching issues emerged: 1) all interventions were structured according to cognitive behavioural therapy theories of behaviour change - while showing promise they do not tackle the wider gender, social, and economic contexts that shape YPLWH's SRH; 2) 'significant others' were included in two of the interventions, but further work needs to consider how to leverage parental/guardian support appropriately; 3) interventions only accessed young people who were already linked to care, participants were likely to have better SRH outcomes than those potentially more vulnerable YPLWH; and 4) none of the interventions explored the sexuality of young people. Conclusions There have been a limited number of evaluated interventions to strengthen SRH of YPLWH in SSA, and gaps exist in addressing the SRHR needs of YPLWH. Intervention approaches require greater scope and depth, including the need to address structural and contextual challenges.

  14. Challenges in identifying target skills for math disability screening and intervention.

    PubMed

    Mazzocco, Michèle M M

    2005-01-01

    Gersten, Jordan, and Flojo (in this series) review their research on math difficulties, with an emphasis on applying current knowledge to inform practices of early identification and intervention. On a practical level, educators are in dire need of empirically based screening and intervention tools. From a scientific perspective, it is important to recognize the need to clearly define what we seek to identify and remediate, and to acknowledge that we are currently far from achieving this goal despite recent advances in the field. Among the studies reviewed by Gersten et al., as well as other studies by several other researchers, there is much variability in how mathematics difficulties are defined and measured, and even in the terms used to refer to them. I address the degree of consensus and controversy currently characterizing the state of math learning disabilities research, with an emphasis on the usefulness of a developmental perspective in appraising this young field.

  15. Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study.

    PubMed

    Fernell, Elisabeth; Hedvall, Åsa; Westerlund, Joakim; Höglund Carlsson, Lotta; Eriksson, Mats; Barnevik Olsson, Martina; Holm, Anette; Norrelgen, Fritjof; Kjellmer, Liselotte; Gillberg, Christopher

    2011-01-01

    Early intervention has been reported to improve outcome in children with autism spectrum disorders (ASDs). Several studies in the field have been randomized controlled trials (RCTs). The aim of this study was to assess ASD outcome in a large naturalistic study. Two hundred and eight children, aged 20-54 months, with a clinical diagnosis of ASD were given intervention and monitored prospectively in a naturalistic fashion over a period of 2 years. The toddlers were considered representative of all but the most severely multiple disabled preschool children with ASD in Stockholm county. They fell into three cognitive subgroups: one with learning disability, one with developmental delay, and one with normal intellectual functioning. Data on intervention type and intensity were gathered prospectively in a systematic fashion. Intervention was classified into intensive applied behaviour analysis (ABA) and non-intensive, targeted interventions, also based on ABA principles. Children were comprehensively assessed by a research team before the onset of intervention, and then, again, 2 years later. Change in Vineland adaptive behaviour scales composite scores from intake (T1) to leaving the study (T2) was set as the primary outcome variable. The research team remained blind to the type and intensity of interventions provided. One hundred and ninety-eight (95%) of the original samples stayed in the study throughout the whole 2-year period and 192 children had a complete Vineland composite score results both at T1 and T2. Vineland composite scores increased over the 2-year period. This increase was accounted for by the subgroup with normal cognitive functioning. There was no significant difference between the intensive and non-intensive groups. Individual variation was considerable, but no child in the study was "problem-free" at follow-up. Our data do not support that children with ASD generally benefit more from the most intensive ABA intervention programs than from less

  16. PKCδ-targeted intervention relieves chronic pain in a murine sickle cell disease model

    PubMed Central

    He, Ying; Wilkie, Diana J.; Nazari, Jonathan; Wang, Rui; Messing, Robert O.; DeSimone, Joseph; Molokie, Robert E.; Wang, Zaijie Jim

    2016-01-01

    Pain is a life-long symptom in sickle cell disease (SCD) and a predictor of disease progression and mortality, but little is known about its molecular mechanisms. Here, we characterized pain in a targeted knockin mouse model of SCD (TOW mouse) that exclusively expresses human alleles encoding normal α- and sickle β-globin. TOW mice exhibited ongoing spontaneous pain behavior and increased sensitivity to evoked pain compared with littermate control mice expressing normal human hemoglobins. PKCδ activation was elevated in the superficial laminae of the spinal cord dorsal horn in TOW mice, specifically in GABAergic inhibitory neurons. Functional inhibition and neuron-specific silencing of PKCδ attenuated spontaneous pain, mechanical allodynia, and heat hyperalgesia in TOW mice. Furthermore, we took a hematopoietic stem cell transplantation approach to generating a SCD model in PKCδ-deficient mice. Neither spontaneous pain nor evoked pain was detected in the mice lacking PKCδ despite full establishment of SCD phenotypes. These findings support a critical role of spinal PKCδ in the development of chronic pain in SCD, which may become a potential target for pharmacological interventions. PMID:27348590

  17. Metabolic Control of Type 2 Diabetes by Targeting the GLUT4 Glucose Transporter: Intervention Approaches.

    PubMed

    Alam, Fahmida; Islam, Md Asiful; Khalil, Md Ibrahim; Gan, Siew Hua

    2016-01-01

    Type 2 diabetes mellitus (T2DM), the most common form of diabetes, is characterized by insulin resistance in the hepatic and peripheral tissues. Glucose transporter 4 (GLUT4) plays a major role in the pathophysiology of T2DM. Its defective expression or translocation to the peripheral cell plasma membrane in T2DM patients hinders the entrance of glucose into the cell for energy production. In addition to suitable drugs, an appropriate diet and/or exercise can be implemented to target the increase in GLUT4 expression, GLUT4 concentrations and GLUT4 translocation to the cell surface when managing the glucose metabolism of T2DM patients. In this review, we discussed successful intervention strategies that were individually administered or coupled with diet and/or exercise and affected the expression and translocation of GLUT4 in T2DM while reducing the excess glucose load from the blood. Additionally, some potentially good synthetic and natural compounds, which can activate the insulin-independent GLUT4 signaling pathways for the efficient management of T2DM, are highlighted as possible targets or emerging alternative sources for future anti-diabetic drug development.

  18. A Group Contingency Plus Self-Management Intervention Targeting At-Risk Secondary Students’ Class-Work and Active Engagement

    PubMed Central

    Trevino-Maack, Sylvia I.; Kamps, Debra; Wills, Howard

    2015-01-01

    The purpose of the present study is to show that an independent group contingency (GC) combined with self-management strategies and randomized-reinforcer components can increase the amount of written work and active classroom responding in high school students. Three remedial reading classes and a total of 15 students participated in this study. Students used self-management strategies during independent reading time to increase the amount of writing in their reading logs. They used self-monitoring strategies to record whether or not they performed expected behaviors in class. A token economy using points and tickets was included in the GC to provide positive reinforcement for target responses. The results were analyzed through visual inspection of graphs and effect size computations and showed that the intervention increased the total amount of written words in the students’ reading logs and overall classroom and individual student academic engagement. PMID:26617432

  19. A Group Contingency Plus Self-Management Intervention Targeting At-Risk Secondary Students' Class-Work and Active Engagement.

    PubMed

    Trevino-Maack, Sylvia I; Kamps, Debra; Wills, Howard

    2015-01-01

    The purpose of the present study is to show that an independent group contingency (GC) combined with self-management strategies and randomized-reinforcer components can increase the amount of written work and active classroom responding in high school students. Three remedial reading classes and a total of 15 students participated in this study. Students used self-management strategies during independent reading time to increase the amount of writing in their reading logs. They used self-monitoring strategies to record whether or not they performed expected behaviors in class. A token economy using points and tickets was included in the GC to provide positive reinforcement for target responses. The results were analyzed through visual inspection of graphs and effect size computations and showed that the intervention increased the total amount of written words in the students' reading logs and overall classroom and individual student academic engagement.

  20. A Comparison of Recruitment Methods for an mHealth Intervention Targeting Mothers: Lessons from the Growing Healthy Program

    PubMed Central

    Litterbach, Eloise-Kate V; Denney-Wilson, Elizabeth A; Russell, Catherine G; Taki, Sarah; Ong, Kok-Leong; Elliott, Rosalind M; Lymer, Sharyn J; Campbell, Karen J

    2016-01-01

    Background Mobile health (mHealth) programs hold great promise for increasing the reach of public health interventions. However, mHealth is a relatively new field of research, presenting unique challenges for researchers. A key challenge is understanding the relative effectiveness and cost of various methods of recruitment to mHealth programs. Objective The objectives of this study were to (1) compare the effectiveness of various methods of recruitment to an mHealth intervention targeting healthy infant feeding practices, and (2) explore factors influencing practitioner referral to the intervention. Methods The Growing healthy study used a quasi-experimental design with an mHealth intervention group and a concurrent nonrandomized comparison group. Eligibility criteria included: expectant parents (>30 weeks of gestation) or parents with an infant <3 months old, ability to read and understand English, own a mobile phone, ≥18 years old, and living in Australia. Recruitment to the mHealth program consisted of: (1) practitioner-led recruitment through Maternal and Child Health nurses, midwives, and nurses in general practice; (2) face-to-face recruitment by researchers; and (3) online recruitment. Participants’ baseline surveys provided information regarding how participants heard about the study, and their sociodemographic details. Costs per participant recruited were calculated by taking into account direct advertising costs and researcher time/travel costs. Practitioner feedback relating to the recruitment process was obtained through a follow-up survey and qualitative interviews. Results A total of 300 participants were recruited to the mHealth intervention. The cost per participant recruited was lowest for online recruitment (AUD $14) and highest for practice nurse recruitment (AUD $586). Just over half of the intervention group (50.3%, 151/300) were recruited online over a 22-week period compared to practitioner recruitment (29.3%, 88/300 over 46 weeks) and

  1. A Comparison of Recruitment Methods for an mHealth Intervention Targeting Mothers: Lessons from the Growing Healthy Program.

    PubMed

    Laws, Rachel A; Litterbach, Eloise-Kate V; Denney-Wilson, Elizabeth A; Russell, Catherine G; Taki, Sarah; Ong, Kok-Leong; Elliott, Rosalind M; Lymer, Sharyn J; Campbell, Karen J

    2016-09-15

    Mobile health (mHealth) programs hold great promise for increasing the reach of public health interventions. However, mHealth is a relatively new field of research, presenting unique challenges for researchers. A key challenge is understanding the relative effectiveness and cost of various methods of recruitment to mHealth programs. The objectives of this study were to (1) compare the effectiveness of various methods of recruitment to an mHealth intervention targeting healthy infant feeding practices, and (2) explore factors influencing practitioner referral to the intervention. The Growing healthy study used a quasi-experimental design with an mHealth intervention group and a concurrent nonrandomized comparison group. Eligibility criteria included: expectant parents (>30 weeks of gestation) or parents with an infant <3 months old, ability to read and understand English, own a mobile phone, ≥18 years old, and living in Australia. Recruitment to the mHealth program consisted of: (1) practitioner-led recruitment through Maternal and Child Health nurses, midwives, and nurses in general practice; (2) face-to-face recruitment by researchers; and (3) online recruitment. Participants' baseline surveys provided information regarding how participants heard about the study, and their sociodemographic details. Costs per participant recruited were calculated by taking into account direct advertising costs and researcher time/travel costs. Practitioner feedback relating to the recruitment process was obtained through a follow-up survey and qualitative interviews. A total of 300 participants were recruited to the mHealth intervention. The cost per participant recruited was lowest for online recruitment (AUD $14) and highest for practice nurse recruitment (AUD $586). Just over half of the intervention group (50.3%, 151/300) were recruited online over a 22-week period compared to practitioner recruitment (29.3%, 88/300 over 46 weeks) and face-to-face recruitment by researchers

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

    ERIC Educational Resources Information Center

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

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

  3. Involvement of informal caregivers in supporting patients with COPD: a review of intervention studies

    PubMed Central

    Bryant, Jamie; Mansfield, Elise; Boyes, Allison W; Waller, Amy; Sanson-Fisher, Rob; Regan, Timothy

    2016-01-01

    Caregivers of individuals with COPD have a key role in maintaining patient adherence and optimizing patient function. However, no systematic review has examined how the caregiver role has been operationalized in interventions to improve outcomes of individuals with COPD or the quality or effectiveness of these interventions. The aims of this review were to 1) determine whether caregivers have been involved as part of interventions to improve outcomes of individuals with COPD; 2) determine the risk of bias within included intervention studies; and 3) examine the effectiveness of interventions that have involved caregivers in improving outcomes of individuals with COPD. The electronic databases of Medline, Embase, PsycINFO, and Cochrane Library were searched from January 2000 to November 2015. Experimental studies testing interventions that involved a caregiver to improve COPD patient outcomes were eligible. Nine studies involving caregivers met inclusion criteria. No studies reported any intervention components targeted solely at caregivers, with most instead including caregivers in dyadic or group education sessions about COPD delivered by health care professionals. The risk of bias identified in included studies was mixed. Seven of the nine studies were effective in improving a broad range of outcomes. These findings highlight that there is an urgent need for methodologically rigorous interventions to examine the effectiveness of strategies to assist caregivers to provide direct care, encourage adherence to health care provider recommendations, act as a health care advocate, and provide emotional and psychosocial support to individuals with COPD. PMID:27478372

  4. Community empowerment and involvement of female sex workers in targeted sexual and reproductive health interventions in Africa: a systematic review.

    PubMed

    Moore, Lizzie; Chersich, Matthew F; Steen, Richard; Reza-Paul, Sushena; Dhana, Ashar; Vuylsteke, Bea; Lafort, Yves; Scorgie, Fiona

    2014-06-10

    Female sex workers (FSWs) experience high levels of sexual and reproductive health (SRH) morbidity, violence and discrimination. Successful SRH interventions for FSWs in India and elsewhere have long prioritised community mobilisation and structural interventions, yet little is known about similar approaches in African settings. We systematically reviewed community empowerment processes within FSW SRH projects in Africa, and assessed them using a framework developed by Ashodaya, an Indian sex worker organisation. In November 2012 we searched Medline and Web of Science for studies of FSW health services in Africa, and consulted experts and websites of international organisations. Titles and abstracts were screened to identify studies describing relevant services, using a broad definition of empowerment. Data were extracted on service-delivery models and degree of FSW involvement, and analysed with reference to a four-stage framework developed by Ashodaya. This conceptualises community empowerment as progressing from (1) initial engagement with the sex worker community, to (2) community involvement in targeted activities, to (3) ownership, and finally, (4) sustainability of action beyond the community. Of 5413 articles screened, 129 were included, describing 42 projects. Targeted services in FSW 'hotspots' were generally isolated and limited in coverage and scope, mostly offering only free condoms and STI treatment. Many services were provided as part of research activities and offered via a clinic with associated community outreach. Empowerment processes were usually limited to peer-education (stage 2 of framework). Community mobilisation as an activity in its own right was rarely documented and while most projects successfully engaged communities, few progressed to involvement, community ownership or sustainability. Only a few interventions had evolved to facilitate collective action through formal democratic structures (stage 3). These reported improved sexual

  5. Community empowerment and involvement of female sex workers in targeted sexual and reproductive health interventions in Africa: a systematic review

    PubMed Central

    2014-01-01

    Background Female sex workers (FSWs) experience high levels of sexual and reproductive health (SRH) morbidity, violence and discrimination. Successful SRH interventions for FSWs in India and elsewhere have long prioritised community mobilisation and structural interventions, yet little is known about similar approaches in African settings. We systematically reviewed community empowerment processes within FSW SRH projects in Africa, and assessed them using a framework developed by Ashodaya, an Indian sex worker organisation. Methods In November 2012 we searched Medline and Web of Science for studies of FSW health services in Africa, and consulted experts and websites of international organisations. Titles and abstracts were screened to identify studies describing relevant services, using a broad definition of empowerment. Data were extracted on service-delivery models and degree of FSW involvement, and analysed with reference to a four-stage framework developed by Ashodaya. This conceptualises community empowerment as progressing from (1) initial engagement with the sex worker community, to (2) community involvement in targeted activities, to (3) ownership, and finally, (4) sustainability of action beyond the community. Results Of 5413 articles screened, 129 were included, describing 42 projects. Targeted services in FSW ‘hotspots’ were generally isolated and limited in coverage and scope, mostly offering only free condoms and STI treatment. Many services were provided as part of research activities and offered via a clinic with associated community outreach. Empowerment processes were usually limited to peer-education (stage 2 of framework). Community mobilisation as an activity in its own right was rarely documented and while most projects successfully engaged communities, few progressed to involvement, community ownership or sustainability. Only a few interventions had evolved to facilitate collective action through formal democratic structures (stage 3

  6. Impact of Targeted Educational Interventions on Clostridium difficile Infection Treatment in Critically Ill Adults.

    PubMed

    Hammond, Drayton A; Hughes, Catherine A; Painter, Jacob T; Pennick, Rose E; Chatterjee, Kshitij; Boye, Bradley; Meena, Nikhil

    2016-12-01

    Background: Clostridium difficile infection (CDI) is a growing clinical and economic burden throughout the world. Pharmacists often are members of the primary care team in the intensive care unit (ICU) setting; however, the impact of pharmacists educating other health care providers on appropriateness of CDI treatment has not been previously examined. Objective: This study was performed to determine the impact of structured educational interventions on CDI treatment on appropriateness of CDI treatment and clinical outcomes. Methods: This was a single-center, retrospective, cohort study of patients with CDI in the medical ICU at an academic medical center between January and June 2014 (pre-period) and 2015 (post-period). All patients were evaluated for appropriate CDI treatment before and after implementing pharmacist-provided educational interventions on CDI treatment. Results: Patients in the post-period were prescribed appropriate CDI treatment more frequently than patients in the pre-period (91.7% vs 41.7%; p = .03) and received fewer inappropriate doses of a CDI treatment agent (14 doses vs 30 doses). Patients in the pre-period had a shorter ICU length of stay [1.5 days (range, 1-19) vs 3.5 days (range, 2-36); p = .01] and a similar hospital length of stay [9.5 days (range, 4-24) vs 11.5 days (range, 3-56); p = .30]. Total time spent providing interventions was 4 hours. Conclusion: Patients had appropriate CDI treatment initiated more frequently in the post-period. This low-cost intervention strategy should be easy to implement in institutions where pharmacists interact with physicians during clinical rounds and should be evaluated in institutions where interactions between pharmacists and physicians occur more frequently in non-rounding situations.

  7. Pilot study demonstrating effectiveness of targeted education to improve informed consent understanding in AIDS clinical trials.

    PubMed

    Sengupta, Sohini; Lo, Bernard; Strauss, Ronald P; Eron, Joseph; Gifford, Allen L

    2011-11-01

    Assessing and improving informed consent understanding is equally important as obtaining consent from participants in clinical trial research, but developing interventions to target gaps in participants' informed consent understanding remains a challenge. We used a randomized controlled study design to pilot test an educational intervention to improve actual informed consent understanding of new enrollees in the Adult AIDS Clinical Trial Group (AACTG). Questionnaires were administered to 24 enrollees to assess their baseline understanding on eight elements of informed consent associated with AIDS clinical trials. Enrollees who scored 18/21(85%) or less were randomly assigned to in-person, targeted education (intervention), or delayed education (control). Two follow-up assessments were administered. Repeated measures ANOVA was performed to determine intervention effectiveness in improving actual informed consent understanding over time. Actual understanding improved at the immediate post-intervention time point with a significant score difference of 2.5 when comparing the intervention and delayed groups. In addition, there was a significant score difference of 3.2 when comparing baseline to three-month follow-up for the two groups, suggesting a statistically significant intervention effect to improve actual understanding of the basic elements of informed consent. The findings demonstrated that one-time targeted education can improve actual informed consent understanding one week after the intervention, but retention of these concepts may require periodic monitoring to ensure comprehension throughout the course of a clinical trial.

  8. Identification of brain-targeted bioactive dietary quercetin-3-O-glucuronide as a novel intervention for Alzheimer's disease

    PubMed Central

    Ho, Lap; Ferruzzi, Mario G.; Janle, Elsa M.; Wang, Jun; Gong, Bing; Chen, Tzu-Ying; Lobo, Jessica; Cooper, Bruce; Wu, Qing Li; Talcott, Stephen T.; Percival, Susan S.; Simon, James E.; Pasinetti, Giulio Maria

    2013-01-01

    Epidemiological and preclinical studies indicate that polyphenol intake from moderate consumption of red wines may lower the relative risk for developing Alzheimer's disease (AD) dementia. There is limited information regarding the specific biological activities and cellular and molecular mechanisms by which wine polyphenolic components might modulate AD. We assessed accumulations of polyphenols in the rat brain following oral dosage with a Cabernet Sauvignon red wine and tested brain-targeted polyphenols for potential beneficial AD disease-modifying activities. We identified accumulations of select polyphenolic metabolites in the brain. We demonstrated that, in comparison to vehicle-control treatment, one of the brain-targeted polyphenol metabolites, quercetin-3-O-glucuronide, significantly reduced the generation of β-amyloid (Aβ) peptides by primary neuron cultures generated from the Tg2576 AD mouse model. Another brain-targeted metabolite, malvidin-3-O-glucoside, had no detectable effect on Aβ generation. Moreover, in an in vitro analysis using the photo-induced cross-linking of unmodified proteins (PICUP) technique, we found that quercetin-3-O-glucuronide is also capable of interfering with the initial protein-protein interaction of Aβ1–40 and Aβ1–42 that is necessary for the formation of neurotoxic oligomeric Aβ species. Lastly, we found that quercetin-3-O-glucuronide treatment, compared to vehicle-control treatment, significantly improved AD-type deficits in hippocampal formation basal synaptic transmission and long-term potentiation, possibly through mechanisms involving the activation of the c-Jun N-terminal kinases and the mitogen-activated protein kinase signaling pathways. Brain-targeted quercetin-3-O-glucuronide may simultaneously modulate multiple independent AD disease-modifying mechanisms and, as such, may contribute to the benefits of dietary supplementation with red wines as an effective intervention for AD.—Ho, L., Ferruzzi, M. G

  9. Feasibility of a self-help web-based intervention targeting young cancer patients with sexual problems and fertility distress.

    PubMed

    Wiklander, Maria; Strandquist, Johanna; Obol, Claire Micaux; Eriksson, Lars E; Winterling, Jeanette; Rodriguez-Wallberg, Kenny A; Sjögren Fugl-Meyer, Kerstin; Ahlgren, Johan; Ljungman, Per; Lampic, Claudia; Wettergren, Lena

    2017-07-18

    The purpose of the study is to evaluate the feasibility of a self-help web-based intervention to alleviate sexual problems and fertility distress in adolescents and young adults with cancer. Twenty-three persons with cancer (19 women and 4 men, age 18-43, 1-5 years post-diagnosis of lymphoma, breast, gynecologic, central nervous system, or testicular cancer) were recruited to test a 2-month web-based program targeting sexual problems or fertility distress. The programs were organized in modules with educational and behavior change content, including texts, illustrations, exercises, and video vignettes. The program also included a discussion forum and an "ask the expert" forum. In addition, the sexuality program offered two telephone consultations. Feasibility (regarding demand, acceptability, preliminary efficacy, and functionality) was evaluated with the website system data, telephone interviews, continuous online evaluations, and study-specific measures. Fifteen participants completed four modules or more. Most of the program features were used and well accepted by these "committed users." The web-based format enabled flexible use by participants with diverse needs. Preliminary efficacy was indicated by self-reported increased knowledge and skill in handling sexual problems and fertility distress. The website was easy to use and functioned well technically. The present study indicated that this web-based intervention was feasible for adolescents and young adults with cancer. The effectiveness of the intervention in decreasing sexual problems and fertility distress will be tested in a population-based randomized controlled trial for adolescents and young adults with cancer. ISRCTN36621459.

  10. A randomized controlled trial of a multicomponent, targeted, low-literacy educational intervention compared with a nontargeted intervention to boost colorectal cancer screening with fecal immunochemical testing in community clinics.

    PubMed

    Davis, Stacy N; Christy, Shannon M; Chavarria, Enmanuel A; Abdulla, Rania; Sutton, Steven K; Schmidt, Alyssa R; Vadaparampil, Susan T; Quinn, Gwendolyn P; Simmons, Vani N; Ufondu, Chukwudi B; Ravindra, Chitra; Schultz, Ida; Roetzheim, Richard G; Shibata, David; Meade, Cathy D; Gwede, Clement K

    2017-04-15

    The objective of the current study was to improve colorectal cancer (CRC) screening uptake with the fecal immunochemical test (FIT). The current study investigated the differential impact of a multicomponent, targeted, low-literacy educational intervention compared with a standard, nontargeted educational intervention. Patients aged 50 to 75 years who were of average CRC risk and not up-to-date with CRC screening were recruited from either a federally qualified health center or a primary care community health clinic. Patients were randomized to the intervention condition (targeted photonovella booklet/DVD plus FIT kit) or comparison condition (standard Centers for Disease Control and Prevention brochure plus FIT kit). The main outcome was screening with FIT within 180 days of delivery of the intervention. Of the 416 participants, 54% were female; the participants were racially and ethnically diverse (66% white, 10% Hispanic, and 28% African American), predominantly of low income, and insured (the majority had county health insurance). Overall, the FIT completion rate was 81%, with 78.1% of participants in the intervention versus 83.5% of those in the comparison condition completing FIT (P =  .17). In multivariate analysis, having health insurance was found to be the primary factor predicting a lack of FIT screening (adjusted odds ratio, 2.10; 95% confidence interval, 1.04-4.26 [P =  .04]). The multicomponent, targeted, low-literacy materials were not found to be significantly different or more effective in increasing FIT uptake compared with the nontargeted materials. Provision of a FIT test plus education may provide a key impetus to improve the completion of CRC screening. The type of educational material (targeted vs nontargeted) may matter less. The findings of the current study provide a unique opportunity for clinics to adopt FIT and to choose the type of patient education materials based on clinic, provider, and patient preferences. Cancer 2017

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  13. Network Interventions on Physical Activity in an Afterschool Program: An Agent-Based Social Network Study

    PubMed Central

    Zhang, Jun; Shoham, David A.; Tesdahl, Eric

    2015-01-01

    Objectives. We studied simulated interventions that leveraged social networks to increase physical activity in children. Methods. We studied a real-world social network of 81 children (average age = 7.96 years) who lived in low socioeconomic status neighborhoods, and attended public schools and 1 of 2 structured afterschool programs. The sample was ethnically diverse, and 44% were overweight or obese. We used social network analysis and agent-based modeling simulations to test whether implementing a network intervention would increase children’s physical activity. We tested 3 intervention strategies. Results. The intervention that targeted opinion leaders was effective in increasing the average level of physical activity across the entire network. However, the intervention that targeted the most sedentary children was the best at increasing their physical activity levels. Conclusions. Which network intervention to implement depends on whether the goal is to shift the entire distribution of physical activity or to influence those most adversely affected by low physical activity. Agent-based modeling could be an important complement to traditional project planning tools, analogous to sample size and power analyses, to help researchers design more effective interventions for increasing children’s physical activity. PMID:25689202

  14. Network interventions on physical activity in an afterschool program: an agent-based social network study.

    PubMed

    Zhang, Jun; Shoham, David A; Tesdahl, Eric; Gesell, Sabina B

    2015-04-01

    We studied simulated interventions that leveraged social networks to increase physical activity in children. We studied a real-world social network of 81 children (average age = 7.96 years) who lived in low socioeconomic status neighborhoods, and attended public schools and 1 of 2 structured afterschool programs. The sample was ethnically diverse, and 44% were overweight or obese. We used social network analysis and agent-based modeling simulations to test whether implementing a network intervention would increase children's physical activity. We tested 3 intervention strategies. The intervention that targeted opinion leaders was effective in increasing the average level of physical activity across the entire network. However, the intervention that targeted the most sedentary children was the best at increasing their physical activity levels. Which network intervention to implement depends on whether the goal is to shift the entire distribution of physical activity or to influence those most adversely affected by low physical activity. Agent-based modeling could be an important complement to traditional project planning tools, analogous to sample size and power analyses, to help researchers design more effective interventions for increasing children's physical activity.

  15. Cost-Effectiveness Analysis Comparing Pre-Diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario's Autism Intervention Program

    ERIC Educational Resources Information Center

    Penner, Melanie; Rayar, Meera; Bashir, Naazish; Roberts, S. Wendy; Hancock-Howard, Rebecca L.; Coyte, Peter C.

    2015-01-01

    Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario…

  16. Cost-Effectiveness Analysis Comparing Pre-Diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario's Autism Intervention Program

    ERIC Educational Resources Information Center

    Penner, Melanie; Rayar, Meera; Bashir, Naazish; Roberts, S. Wendy; Hancock-Howard, Rebecca L.; Coyte, Peter C.

    2015-01-01

    Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario…

  17. Craving Behavior Intervention in Ameliorating College Students' Internet Game Disorder: A Longitudinal Study

    PubMed Central

    Deng, Lin-Yuan; Liu, Lu; Xia, Cui-Cui; Lan, Jing; Zhang, Jin-Tao; Fang, Xiao-Yi

    2017-01-01

    Craving, as a central feature of addiction and a precursor of relapse, is targeted recently in addiction intervention. While Internet gaming disorder (IGD), conceptualized as a behavioral addiction, is lack of effective treatment practice and exploration of its mechanism. This research aims to test the effectiveness and detect the active ingredients of craving behavior intervention (CBI) in mitigation of IGD among young adults. A total of 63 male college students with IGD were assigned into the intervention group (six-session CBI intervention) or the waiting-list control group. Structured questionnaires were administered at pre-intervention (T1), post-intervention (T2), 3-month follow-up (T3), and 6-month follow-up (T4). Compared to the control group, a significant decrease in the severity of IGD in intervention group was found at post-intervention and lasting to 6 months after intervention. The value changes of craving could partially mediate the relationship between intervention and changes of IGD among all effects tests (immediate, T2-T1; short-term, T3-T1; and long-term effects, T4-T1). Further, explorations of the active ingredients of intervention found depression relief and shift of psychological needs from Internet to real life significantly predict craving amelioration at both post-intervention and 6-month follow-up. Although preliminary, the current study provides evidence for the value of craving-aimed intervention practice in IGD treatment and identifies two potential active ingredients for mitigation of craving, and the long-term therapeutic benefits are further conferred. Registry name: The behavioral and brain mechanism of IGD; URL: https://www.clinicaltrials.gov/ct2/show/NCT02550405; Registration number: NCT02550405. PMID:28443046

  18. Craving Behavior Intervention in Ameliorating College Students' Internet Game Disorder: A Longitudinal Study.

    PubMed

    Deng, Lin-Yuan; Liu, Lu; Xia, Cui-Cui; Lan, Jing; Zhang, Jin-Tao; Fang, Xiao-Yi

    2017-01-01

    Craving, as a central feature of addiction and a precursor of relapse, is targeted recently in addiction intervention. While Internet gaming disorder (IGD), conceptualized as a behavioral addiction, is lack of effective treatment practice and exploration of its mechanism. This research aims to test the effectiveness and detect the active ingredients of craving behavior intervention (CBI) in mitigation of IGD among young adults. A total of 63 male college students with IGD were assigned into the intervention group (six-session CBI intervention) or the waiting-list control group. Structured questionnaires were administered at pre-intervention (T1), post-intervention (T2), 3-month follow-up (T3), and 6-month follow-up (T4). Compared to the control group, a significant decrease in the severity of IGD in intervention group was found at post-intervention and lasting to 6 months after intervention. The value changes of craving could partially mediate the relationship between intervention and changes of IGD among all effects tests (immediate, T2-T1; short-term, T3-T1; and long-term effects, T4-T1). Further, explorations of the active ingredients of intervention found depression relief and shift of psychological needs from Internet to real life significantly predict craving amelioration at both post-intervention and 6-month follow-up. Although preliminary, the current study provides evidence for the value of craving-aimed intervention practice in IGD treatment and identifies two potential active ingredients for mitigation of craving, and the long-term therapeutic benefits are further conferred. Registry name: The behavioral and brain mechanism of IGD; URL: https://www.clinicaltrials.gov/ct2/show/NCT02550405; Registration number: NCT02550405.

  19. Early detection of malaria foci for targeted interventions in endemic southern Zambia.

    PubMed

    Davis, Ryan G; Kamanga, Aniset; Castillo-Salgado, Carlos; Chime, Nnenna; Mharakurwa, Sungano; Shiff, Clive

    2011-09-12

    Zambia has achieved significant reductions in the burden of malaria through a strategy of "scaling-up" effective interventions. Progress toward ultimate malaria elimination will require sustained prevention coverage and further interruption of transmission through active strategies to identify and treat asymptomatic malaria reservoirs. A surveillance system in Zambia's Southern Province has begun to implement such an approach. An early detection system could be an additional tool to identify foci of elevated incidence for targeted intervention. Based on surveillance data collected weekly from 13 rural health centres (RHCs) divided into three transmission zones, early warning thresholds were created following a technique successfully implemented in Thailand. Alert levels were graphed for all 52 weeks of a year using the mean and 95% confidence interval upper limit of a Poisson distribution of the weekly diagnosed malaria cases for every available week of historic data (beginning in Aug, 2008) at each of the sites within a zone. Annually adjusted population estimates for the RHC catchment areas served as person-time of weekly exposure. The zonal threshold levels were validated against the incidence data from each of the 13 respective RHCs. Graphed threshold levels for the three zones generally conformed to observed seasonal incidence patterns. Comparing thresholds with historic weekly incidence values, the overall percentage of aberrant weeks ranged from 1.7% in Mbabala to 36.1% in Kamwanu. For most RHCs, the percentage of weeks above threshold was greater during the high transmission season and during the 2009 year compared to 2010. 39% of weeks breaching alert levels were part of a series of three or more consecutive aberrant weeks. The inconsistent sensitivity of the zonal threshold levels impugns the reliability of the alert system. With more years of surveillance data available, individual thresholds for each RHC could be calculated and compared to the technique

  20. Interventions targeting substance abuse among women survivors of intimate partner abuse: a meta-analysis.

    PubMed

    Fowler, Dawnovise N; Faulkner, Monica

    2011-12-01

    In this article, meta-analytic techniques are used to examine existing intervention studies (n = 11) to determine their effects on substance abuse among female samples of intimate partner abuse (IPA) survivors. This research serves as a starting point for greater attention in research and practice to the implementation of evidence-based, integrated services to address co-occurring substance abuse and IPA victimization among women as major intersecting public health problems. The results show greater effects in three main areas. First, greater effect sizes exist in studies where larger numbers of women experienced current IPA. Second, studies with a lower mean age also showed greater effect sizes than studies with a higher mean age. Lastly, studies with smaller sample sizes have greater effects. This research helps to facilitate cohesion in the knowledge base on this topic, and the findings of this meta-analysis, in particular, contribute needed information to gaps in the literature on the level of promise of existing interventions to impact substance abuse in this underserved population.

  1. Effects of comprehensive health assessment and targeted intervention on chair rise capacity in active and inactive community-dwelling older people.

    PubMed

    Tikkanen, Päivi; Lönnroos, Eija; Sipilä, Sarianna; Nykänen, Irma; Sulkava, Raimo; Hartikainen, Sirpa

    2013-01-01

    Being able to rise from a chair is an important daily life activity that requires sufficient lower extremity muscle power and postural control. To assess the effects of an individually tailored intervention on the chair rise capacity of active and inactive community-dwelling older men and women. This study included a community-based sample of ≥75-year-olds who were randomized into intervention (n = 299) and control (n = 260) groups. The intervention started in 2004 and ended in December 2006; all the participants of the intervention group received individually targeted physical activity counseling annually and had an opportunity to participate in supervised strength and balance training once a week. Chair rise tests were conducted annually. The mixed model of linear regression was used for unadjusted measurements and age, and the Mini-Mental State Examination and functional comorbidity index adjusted comparisons of effects of the intervention. The intervention improved the chair rise capacity in physically active women (adjusted mean difference -1.67 s, 95% confidence interval -3.21 to -0.13, p = 0.02). There was no improvement in inactive women or in men, regardless of their physical activity level. Intervention showed a positive effect on the chair rise capacity of physically active community-dwelling older women. Copyright © 2013 S. Karger AG, Basel.

  2. Preventing childhood obesity in early care and education settings: lessons from two intervention studies.

    PubMed

    Benjamin Neelon, S E; Østbye, T; Hales, D; Vaughn, A; Ward, D S

    2016-05-01

    Obesity prevention in young children is a public health priority. In the USA, nearly 10% of children less than 5 years of age are obese, and most attend some form of out-of-home child care. While a number of interventions have been conducted in early care and education settings, few have targeted the youngest children in care or the less formal types of child care like family child care homes. Additionally, only two previous studies provided recommendations to help inform future interventions. This paper presents lessons learned from two distinct intervention studies in early care and education settings to help guide researchers and public health professionals interested in implementing and evaluating similar interventions. We highlight two studies: one targeting children ages 4 to 24 months in child care centres and the other intervening in children 18 months to 4 years in family child care homes. We include lessons from our pilot studies and the ongoing larger trials. To date, our experiences suggest that an intervention should have a firm basis in behaviour change theory; an advisory group should help evaluate intervention materials and plan for delivery; and realistic recruitment goals should recognize economic challenges of the business of child care. A flexible data collection approach and realistic sample size calculations are needed because of high rates of child (and sometimes facility) turnover. An intervention that is relatively easy to implement is more likely to appeal to a wide variety of early care and education providers. Interventions to prevent obesity in early care and education have the potential to reach large numbers of children. It is important to consider the unique features and similarities of centres and family child care homes and take advantage of lessons learned from current studies in order to develop effective, evidence-based interventions. © 2016 John Wiley & Sons Ltd.

  3. Identification of brain-targeted bioactive dietary quercetin-3-O-glucuronide as a novel intervention for Alzheimer's disease.

    PubMed

    Ho, Lap; Ferruzzi, Mario G; Janle, Elsa M; Wang, Jun; Gong, Bing; Chen, Tzu-Ying; Lobo, Jessica; Cooper, Bruce; Wu, Qing Li; Talcott, Stephen T; Percival, Susan S; Simon, James E; Pasinetti, Giulio Maria

    2013-02-01

    Epidemiological and preclinical studies indicate that polyphenol intake from moderate consumption of red wines may lower the relative risk for developing Alzheimer's disease (AD) dementia. There is limited information regarding the specific biological activities and cellular and molecular mechanisms by which wine polyphenolic components might modulate AD. We assessed accumulations of polyphenols in the rat brain following oral dosage with a Cabernet Sauvignon red wine and tested brain-targeted polyphenols for potential beneficial AD disease-modifying activities. We identified accumulations of select polyphenolic metabolites in the brain. We demonstrated that, in comparison to vehicle-control treatment, one of the brain-targeted polyphenol metabolites, quercetin-3-O-glucuronide, significantly reduced the generation of β-amyloid (Aβ) peptides by primary neuron cultures generated from the Tg2576 AD mouse model. Another brain-targeted metabolite, malvidin-3-O-glucoside, had no detectable effect on Aβ generation. Moreover, in an in vitro analysis using the photo-induced cross-linking of unmodified proteins (PICUP) technique, we found that quercetin-3-O-glucuronide is also capable of interfering with the initial protein-protein interaction of Aβ(1-40) and Aβ(1-42) that is necessary for the formation of neurotoxic oligomeric Aβ species. Lastly, we found that quercetin-3-O-glucuronide treatment, compared to vehicle-control treatment, significantly improved AD-type deficits in hippocampal formation basal synaptic transmission and long-term potentiation, possibly through mechanisms involving the activation of the c-Jun N-terminal kinases and the mitogen-activated protein kinase signaling pathways. Brain-targeted quercetin-3-O-glucuronide may simultaneously modulate multiple independent AD disease-modifying mechanisms and, as such, may contribute to the benefits of dietary supplementation with red wines as an effective intervention for AD.

  4. Motivation for physical activity and exercise in severe mental illness: A systematic review of intervention studies.

    PubMed

    Farholm, Anders; Sørensen, Marit

    2016-06-01

    There has been increasing interest for research on motivation for physical activity (PA) and exercise among individuals with severe mental illness (SMI). The aim of this systematic review is to summarize findings from all intervention studies on PA or exercise that either include empirical data on motivational constructs or apply motivational techniques/theories in their intervention. Systematic searches of seven databases were conducted from database inception to February 2015. Studies were eligible if they: (i) included participants with SMI, (ii) had PA as part of the intervention, and (iii) reported empirical data on motivational constructs related to PA or incorporated motivational techniques/theory in their intervention. Of the 79 studies that met the inclusion criteria only one had motivation for PA as its main outcome. Nine additional interventions reported empirical data on motivational constructs. Altogether these studies yielded mixed results with respect to change in motivational constructs. Only one of those examined the association between motivation and PA, but found none. Sixty-four studies reported using motivational techniques/theory in their intervention. Motivational interviewing and goal-setting were the most popular techniques. Due to the exploratory nature of most of these studies, findings from intervention studies do not so far give very clear directions for motivational work with the patients. There is an urgent need for a more systematic theory based approach when developing strategies that target to increase engagement in PA among people with SMI. © 2016 Australian College of Mental Health Nurses Inc.

  5. A Randomized, Controlled Study of Computer-Based Intervention in Middle School Struggling Readers

    ERIC Educational Resources Information Center

    Given, Barbara K.; Wasserman, John D.; Chari, Sharmila A.; Beattie, Karen; Eden, Guinevere F.

    2008-01-01

    The current study was conducted to test the premise that computer-based intervention that targets auditory temporal processing combined with language exercises (Fast ForWord[R]) is effective in remediating children with disorders of language and reading. Sixty-five middle school struggling readers were randomly assigned to one of five groups and…

  6. First Step to Success Early Intervention Program: A Study of Effectiveness with Native-American Children

    ERIC Educational Resources Information Center

    Diken, Ibrahim H.; Rutherford, Robert B.

    2005-01-01

    This study examined the effectiveness of the First Step to Success (FSS) early intervention program with four Native-American students, their teachers, and their parents on (a) targeted students' problem behaviors, (b) class-wide student behaviors, and (c) teacher behaviors. Participant teachers and parents were also interviewed to gather their…

  7. 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…

  8. Coping Power Dissemination Study: Intervention and Special Education Effects on Academic Outcomes

    ERIC Educational Resources Information Center

    Lochman, John E.; Boxmeyer, Caroline L.; Powell, Nicole P.; Qu, Lixin; Wells, Karen; Windle, Michael

    2012-01-01

    This study examines whether a school-based preventive intervention for children with aggressive behavior affects children's academic outcomes when it is implemented by school counselors in a dissemination field trial. The Coping Power program targets empirical risk factors for aggressive behavior and focuses primarily on teaching social and…

  9. The effectiveness of intervention studies to decrease alcohol use in college undergraduate students: an integrative analysis.

    PubMed

    Hunter Fager, Judith; Mazurek Melnyk, Bernadette

    2004-01-01

    This analysis was performed to critique intervention studies targeted at decreasing alcohol use in college students for the purpose of (1) synthesizing the various types of interventions and outcomes used, (2) evaluating the effectiveness of the interventions, and (3) identifying the strengths and limitations of prior studies to make recommendations for evidence-based clinical practice and future research. An exhaustive literature search was performed for experimental studies conducted in the past 10 years. Analysis using 15 identified studies indicated the following strengths: (1) use of random assignment in many of the studies, (2) use of theoretical frameworks to guide the interventions, (3) replication of previous studies, and (4) inclusion of outcome measures of alcohol use, quantity, and frequency. Limitations included: (1) small convenience samples; (2) use of multiple tools to elicit outcomes, making it difficult to compare results across studies; (3) lack of long-term follow-up to assess sustainability of the interventions; (4) use of only self-report outcome measures, which rely on subject's recall memory; (5) lack of manipulation checks to assure that subjects actually processed the interventions; and (6) a paucity of stress and coping interventions. Extensive research to address the problem of college alcohol use indicates that while education is an integral part of the approach for this problem, it is ineffective when used alone as an intervention strategy. However, some empirical support exists for the use of brief motivational interventions to reduce alcohol use and harm. A personalized approach addressing expectancies and normative use employing a motivational interviewing style may produce desired outcomes. In addition, theory-based manualized approaches using stress and coping intervention strategies need to be developed and tested. In the design of future studies, careful attention also should be given to methodological issues such as sampling

  10. Effectiveness of mHealth Interventions Targeting Health Care Workers to Improve Pregnancy Outcomes in Low- and Middle-Income Countries: A Systematic Review

    PubMed Central

    Borgstein, Alexander Berend-Jan; Sondaal, Stephanie FV; Grobbee, Diederick E; Miltenburg, Andrea Solnes; Verwijs, Mirjam; Ansah, Evelyn K; Browne, Joyce L; Klipstein-Grobusch, Kerstin

    2016-01-01

    Background Low- and middle-income countries (LMICs) face the highest burden of maternal and neonatal deaths. Concurrently, they have the lowest number of physicians. Innovative methods such as the exchange of health-related information using mobile devices (mHealth) may support health care workers in the provision of antenatal, delivery, and postnatal care to improve maternal and neonatal outcomes in LMICs. Objective We conducted a systematic review evaluating the effectiveness of mHealth interventions targeting health care workers to improve maternal and neonatal outcomes in LMIC. Methods The Cochrane Library, PubMed, EMBASE, Global Health Library, and Popline were searched using predetermined search and indexing terms. Quality assessment was performed using an adapted Cochrane Risk of Bias Tool. A strength, weakness, opportunity, and threat analysis was performed for each included paper. Results A total of 19 studies were included for this systematic review, 10 intervention and 9 descriptive studies. mHealth interventions were used as communication, data collection, or educational tool by health care providers primarily at the community level in the provision of antenatal, delivery, and postnatal care. Interventions were used to track pregnant women to improve antenatal and delivery care, as well as facilitate referrals. None of the studies directly assessed the effect of mHealth on maternal and neonatal mortality. Challenges of mHealth interventions to assist health care workers consisted mainly of technical problems, such as mobile network coverage, internet access, electricity access, and maintenance of mobile phones. Conclusions mHealth interventions targeting health care workers have the potential to improve maternal and neonatal health services in LMICs. However, there is a gap in the knowledge whether mHealth interventions directly affect maternal and neonatal outcomes and future research should employ experimental designs with relevant outcome measures to

  11. Women With Early Menopause Have Higher Rates of Target Lesion Revascularization After Percutaneous Coronary Intervention.

    PubMed

    Zhang, Linlin; Wang, Zhijian; Liu, Xiaoli; Zhou, Zhiming; Zhao, Yingxin; Shi, Dongmei; Liu, Yuyang; Liang, Jing; Yang, Lixia; Chai, Meng; Zhou, Yujie

    2016-04-01

    Early menopause has been found to be associated with higher risk of cardiovascular disease. Our objective was to investigate the impact of early menopause on clinical outcomes for women undergoing percutaneous coronary intervention (PCI). We observed female patients with coronary artery disease (CAD) undergoing PCI and found that women with early menopause (≤46 years old) were more likely to have CAD risk factors and more severe coronary lesions. During the 18-month follow-up, early menopause was associated with similar risk of death and myocardial infarction but higher risk of target lesion revascularization (TLR; 7.8% vs 5.3%, P = .003) and major adverse cardiovascular events (MACEs; 11.3% vs 9.0%, P = .007). After adjustment, early menopause was an independent risk factor for 18-month MACEs (hazard ratio [HR], 1.54; 95% confidence interval [CI] 1.18-2.00) and TLR (HR 1.61; 95% CI 1.21-2.13). In conclusion, for women undergoing PCI, early menopause is associated with higher risk of MACE, which is mainly driven by risk of TLR. © The Author(s) 2015.

  12. EDITORIAL Neuroglia as a Central Element of Neurological Diseases: An Underappreciated Target for Therapeutic Intervention

    PubMed Central

    Peng, Liang; Parpura, Vladimir; Verkhratsky, Alexei

    2014-01-01

    Neuroglia of the central nervous system (CNS), represented by cells of neural (astrocytes, oligodendrocytes and NG2 glial cells) and myeloid (microglia) origins are fundamental for homeostasis of the nervous tissue. Astrocytes are critical for the development of the CNS, they are indispensable for synaptogenesis, and they define structural organisation of the nervous tissue, as well as the generation and maintenance of CNS-blood and cerebrospinal fluid-blood barriers. Astroglial cells control homeostasis of ions and neurotransmitters and provide neurones with metabolic support. Oligodendrocytes, through the process of myelination, as well as by homoeostatic support of axons provide for interneuronal connectivity. The NG2 cells receive direct synaptic inputs, and might be important elements of adult remyelination. Microglial cells, which originate from foetal macrophages invading the brain early in embryogenesis, shape the synaptic connections through removing of redundant synapses and phagocyting apoptotic neurones. Neuroglia also form the defensive system of the CNS through complex and context-specific programmes of activation, known as reactive gliosis. Many neurological diseases are associated with neurogliopathologies represented by asthenic and atrophic changes in glial cells that, through the loss or diminution of their homeostatic and defensive functions, assist evolution of pathology. Conceptually, neurological and psychiatric disorders can be regarded as failures of neuroglial homeostatic/ defensive responses, and, hence, glia represent a (much underappreciated) target for therapeutic intervention. PMID:25342938

  13. Inflammatory neuropathies: pathology, molecular markers and targets for specific therapeutic intervention.

    PubMed

    Ubogu, Eroboghene E

    2015-10-01

    Inflammatory neuropathies encompass groups of heterogeneous disorders characterized by pathogenic immune-mediated hematogenous leukocyte infiltration of peripheral nerves, nerve roots or both, with resultant demyelination or axonal degeneration or both. Inflammatory neuropathies may be divided into three major disease categories: Guillain-Barré syndrome (particularly the acute inflammatory demyelinating polyradiculoneuropathy variant), chronic inflammatory demyelinating polyradiculoneuropathy and nonsystemic vasculitic neuropathy (or peripheral nerve vasculitis). Despite major advances in molecular biology, pathology and genetics, the pathogenesis of these disorders remains elusive. There is insufficient knowledge on the mechanisms of hematogenous leukocyte trafficking into the peripheral nervous system to guide the development of specific molecular therapies for immune-mediated inflammatory neuropathies compared to disorders such as psoriasis, inflammatory bowel disease, rheumatoid arthritis or multiple sclerosis. The recent isolation and characterization of human endoneurial endothelial cells that form the blood-nerve barrier provides an opportunity to elucidate leukocyte-endothelial cell interactions critical to the pathogenesis of inflammatory neuropathies at the interface between the systemic circulation and peripheral nerve endoneurium. This review discusses our current knowledge of the classic pathological features of inflammatory neuropathies, attempts at molecular classification and genetic determinants, the utilization of in vitro and in vivo animal models to determine pathogenic mechanisms at the interface between the systemic circulation and the peripheral nervous system relevant to these disorders and prospects for future potential molecular pathology biomarkers and targets for specific therapeutic intervention.

  14. Inflammatory Neuropathies: Pathology, molecular markers and targets for specific therapeutic intervention

    PubMed Central

    Ubogu, Eroboghene E.

    2015-01-01

    Inflammatory neuropathies encompass groups of heterogeneous disorders characterized by pathogenic immune-mediated hematogenous leukocyte infiltration of peripheral nerves, nerve roots or both, with resultant demyelination or axonal degeneration or both. Inflammatory neuropathies may be divided into three major disease categories: Guillain-Barré syndrome (particularly the acute inflammatory demyelinating polyradiculoneuropathy variant), Chronic inflammatory demyelinating polyradiculoneuropathy and nonsystemic vasculitic neuropathy (or peripheral nerve vasculitis). Despite major advances in molecular biology, pathology and genetics, the pathogenesis of these disorders remains elusive. There is insufficient knowledge on the mechanisms of hematogenous leukocyte trafficking into the peripheral nervous system to guide the development of specific molecular therapies for immune-mediated inflammatory neuropathies compared to disorders such as psoriasis, inflammatory bowel disease, rheumatoid arthritis or multiple sclerosis. The recent isolation and characterization of human endoneurial endothelial cells that form the blood-nerve barrier provides an opportunity to elucidate leukocyte-endothelial cell interactions critical to the pathogenesis of inflammatory neuropathies at the interface between the systemic circulation and peripheral nerve endoneurium. This review discusses our current knowledge of the classic pathological features of inflammatory neuropathies, attempts at molecular classification and genetic determinants, the utilization of in vitro and in vivo animal models to determine pathogenic mechanisms at the interface between the systemic circulation and the peripheral nervous system relevant to these disorders and prospects for future potential molecular pathology biomarkers and targets for specific therapeutic intervention. PMID:26264608

  15. Partner randomized controlled trial: study protocol and coaching intervention.

    PubMed

    Garbutt, Jane M; Highstein, Gabrielle; Yan, Yan; Strunk, Robert C

    2012-04-02

    Many children with asthma live with frequent symptoms and activity limitations, and visits for urgent care are common. Many pediatricians do not regularly meet with families to monitor asthma control, identify concerns or problems with management, or provide self-management education. Effective interventions to improve asthma care such as small group training and care redesign have been difficult to disseminate into office practice. This paper describes the protocol for a randomized controlled trial (RCT) to evaluate a 12-month telephone-coaching program designed to support primary care management of children with persistent asthma and subsequently to improve asthma control and disease-related quality of life and reduce urgent care events for asthma care. Randomization occurred at the practice level with eligible families within a practice having access to the coaching program or to usual care. The coaching intervention was based on the transtheoretical model of behavior change. Targeted behaviors included 1) effective use of controller medications, 2) effective use of rescue medications and 3) monitoring to ensure optimal control. Trained lay coaches provided parents with education and support for asthma care, tailoring the information provided and frequency of contact to the parent's readiness to change their child's day-to-day asthma management. Coaching calls varied in frequency from weekly to monthly. For each participating family, follow-up measurements were obtained at 12- and 24-months after enrollment in the study during a telephone interview. The primary outcomes were the mean change in 1) the child's asthma control score, 2) the parent's quality of life score, and 3) the number of urgent care events assessed at 12 and 24 months. Secondary outcomes reflected adherence to guideline recommendations by the primary care pediatricians and included the proportion of children prescribed controller medications, having maintenance care visits at least twice a year

  16. Partner randomized controlled trial: study protocol and coaching intervention

    PubMed Central

    2012-01-01

    Background Many children with asthma live with frequent symptoms and activity limitations, and visits for urgent care are common. Many pediatricians do not regularly meet with families to monitor asthma control, identify concerns or problems with management, or provide self-management education. Effective interventions to improve asthma care such as small group training and care redesign have been difficult to disseminate into office practice. Methods and design This paper describes the protocol for a randomized controlled trial (RCT) to evaluate a 12-month telephone-coaching program designed to support primary care management of children with persistent asthma and subsequently to improve asthma control and disease-related quality of life and reduce urgent care events for asthma care. Randomization occurred at the practice level with eligible families within a practice having access to the coaching program or to usual care. The coaching intervention was based on the transtheoretical model of behavior change. Targeted behaviors included 1) effective use of controller medications, 2) effective use of rescue medications and 3) monitoring to ensure optimal control. Trained lay coaches provided parents with education and support for asthma care, tailoring the information provided and frequency of contact to the parent's readiness to change their child's day-to-day asthma management. Coaching calls varied in frequency from weekly to monthly. For each participating family, follow-up measurements were obtained at 12- and 24-months after enrollment in the study during a telephone interview. The primary outcomes were the mean change in 1) the child's asthma control score, 2) the parent's quality of life score, and 3) the number of urgent care events assessed at 12 and 24 months. Secondary outcomes reflected adherence to guideline recommendations by the primary care pediatricians and included the proportion of children prescribed controller medications, having maintenance

  17. Impact of Targeted Interventions on Trends in Central Line-Associated Bloodstream Infection: A Single-Center Experience From the Republic of Korea.

    PubMed

    Cho, Sun Young; Chung, Doo Ryeon; Ryu, Jae Geum; Choi, Jong Rim; Ahn, Nayeon; Kim, Seonwoo; Kim, Min-Ji; Ha, Young Eun; Kang, Cheol-In; Peck, Kyong Ran; Song, Jae-Hoon

    2017-06-01

    To assess the impact of targeted interventions on trends in central line-associated bloodstream infection. A before-and-after study between January 2013 and September 2014. Tertiary hospital in the Republic of Korea. All patients with central-line catheters in the hospital. In September 2013, interventions that targeted central line insertion practices were implemented in 10 ICUs, including compliance monitoring with a central line insertion practices bundle and use of an all-inclusive catheter kit. The impact of targeted interventions on trends in central line-associated bloodstream infection was evaluated by segmented autoregression analysis of an interrupted time series. The average hospital-wide central line-associated bloodstream infection rates in the baseline and intervention periods were 1.84 and 1.56 per 1,000 catheter-days, respectively. During the baseline period, there was an increase of central line-associated bloodstream infection rate of 0.12 per 1,000 catheter-days per month. In the intervention period, there was a decrease of central line-associated bloodstream infection rate of 0.16 per 1,000 catheter-days per month (change in slope, -0.28; 95% CI, -0.37 to -0.19; p < 0.0001). In ICUs, the average central line-associated bloodstream infection rates in the baseline and intervention periods were 1.92 and 1.64 per 1,000 catheter-days, respectively. During the baseline period, there was an increase of central line-associated bloodstream infection rate of 0.18 per 1,000 catheter-days per month in ICUs. After sequential-targeted interventions, there was a decrease of central line-associated bloodstream infection rate of 0.16 per 1,000 catheter-days per month (change in slope, -0.34; 95% CI, -0.50 to -0.18; p = 0.0007). Targeted interventions were associated with significant changes in trends in the occurrence rate of central line-associated bloodstream infection in ICUs and the entire hospital.

  18. A behavioral medicine intervention for older women living alone with chronic pain – a feasibility study

    PubMed Central

    Cederbom, Sara; Rydwik, Elisabeth; Söderlund, Anne; Denison, Eva; Frändin, Kerstin; von Heideken Wågert, Petra

    2014-01-01

    Background To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women. Materials and methods The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance. Results In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study. Conclusion Results from this study are encouraging, but the study procedure and interventions have to be refined and tested in a larger feasibility study to be able to evaluate the effects of these kinds of interventions on pain-related disability, pain-related beliefs, self-efficacy in everyday activities, and morale in the target group. Further research is also needed to refine and evaluate effects from individualized reminder routines, support to collect self-report data, safety procedures for

  19. Intervention Targeting Development of Socially Synchronous Engagement in Toddlers with Autism Spectrum Disorder: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Landa, Rebecca J.; Holman, Katherine C.; O'Neill, Allison H.; Stuart, Elizabeth A.

    2011-01-01

    Background: Social and communication impairments are core deficits and prognostic indicators of autism. We evaluated the impact of supplementing a comprehensive intervention with a curriculum targeting socially synchronous behavior on social outcomes of toddlers with autism spectrum disorders (ASD). Methods: Fifty toddlers with ASD, ages 21 to 33…

  20. Intervention Targeting Development of Socially Synchronous Engagement in Toddlers with Autism Spectrum Disorder: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Landa, Rebecca J.; Holman, Katherine C.; O'Neill, Allison H.; Stuart, Elizabeth A.

    2011-01-01

    Background: Social and communication impairments are core deficits and prognostic indicators of autism. We evaluated the impact of supplementing a comprehensive intervention with a curriculum targeting socially synchronous behavior on social outcomes of toddlers with autism spectrum disorders (ASD). Methods: Fifty toddlers with ASD, ages 21 to 33…

  1. A pilot study to delimit tsetse target populations in Zimbabwe.

    PubMed

    Chikowore, Gerald; Dicko, Ahmadou H; Chinwada, Peter; Zimba, Moses; Shereni, William; Roger, François; Bouyer, Jérémy; Guerrini, Laure

    2017-05-01

    Tsetse (Glossina sensu stricto) are cyclical vectors of human and animal trypanosomoses, that are presently targeted by the Pan African Tsetse and Trypanosomiasis Eradication Campaign (PATTEC) coordinated by the African Union. In order to achieve effective control of tsetse, there is need to produce elaborate plans to guide intervention programmes. A model intended to aid in the planning of intervention programmes and assist a fuller understanding of tsetse distribution was applied, in a pilot study in the Masoka area, Mid-Zambezi valley in Zimbabwe, and targeting two savannah species, Glossina morsitans morsitans and Glossina pallidipes. The field study was conducted between March and December 2015 in 105 sites following a standardized grid sampling frame. Presence data were used to study habitat suitability of both species based on climatic and environmental data derived from MODIS and SPOT 5 satellite images. Factors influencing distribution were studied using an Ecological Niche Factor Analysis (ENFA) whilst habitat suitability was predicted using a Maximum Entropy (MaxEnt) model at a spatial resolution of 250 m. Area Under the Curve (AUC), an indicator of model performance, was 0.89 for G. m. morsitans and 0.96 for G. pallidipes. We then used the predicted suitable areas to calculate the probability that flies were really absent from the grid cells where they were not captured during the study based on a probability model using a risk threshold of 0.05. Apart from grid cells where G. m. morsitans and G. pallidipes were captured, there was a high probability of presence in an additional 128 km2 and 144 km2 respectively. The modelling process promised to be useful in optimizing the outputs of presence/absence surveys, allowing the definition of tsetse infested areas with improved accuracy. The methodology proposed h