WorldWideScience

Sample records for safe effective interventions

  1. Setting priorities for safe motherhood interventions in resource-scarce settings.

    Science.gov (United States)

    Prata, Ndola; Sreenivas, Amita; Greig, Fiona; Walsh, Julia; Potts, Malcolm

    2010-01-01

    Guide policy-makers in prioritizing safe motherhood interventions. Three models (LOW, MED, HIGH) were constructed based on 34 sub-Saharan African countries to assess the relative cost-effectiveness of available safe motherhood interventions. Cost and effectiveness data were compiled and inserted into the WHO Mother Baby Package Costing Spreadsheet. For each model we assessed the percentage in maternal mortality reduction after implementing all interventions, and optimal combinations of interventions given restricted budgets of US$ 0.50, US$ 1.00, US$ 1.50 per capital maternal health expenditures respectively for LOW, MED, and HIGH models. The most cost-effective interventions were family planning and safe abortion (fpsa), antenatal care including misoprostol distribution for postpartum hemorrhage prevention at home deliveries (anc-miso), followed by sepsis treatment (sepsis) and facility-based postpartum hemorrhage management (pph). The combination of interventions that avert the greatest number of maternal deaths should be prioritized and expanded to cover the greatest number of women at risk. Those which save the most number of lives in each model are 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for LOW; 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for MED; and 'fpsa, anc-miso, sepsis, eclampsia treatment, safe delivery' for HIGH settings. Safe motherhood interventions save a significant number of newborn lives.

  2. Steering teens safe: a randomized trial of a parent-based intervention to improve safe teen driving.

    Science.gov (United States)

    Peek-Asa, Corinne; Cavanaugh, Joseph E; Yang, Jingzhen; Chande, Vidya; Young, Tracy; Ramirez, Marizen

    2014-07-31

    Crashes are the leading cause of death for teens, and parent-based interventions are a promising approach. We assess the effectiveness of Steering Teens Safe, a parent-focused program to increase safe teen driving. Steering Teens Safe aimed to improve parental communication with teens about safe driving using motivational interviewing techniques in conjunction with 19 safe driving lessons. A randomized controlled trial involved 145 parent-teen dyads (70 intervention and 75 control). Intervention parents received a 45-minute session to learn the program with four follow-up phone sessions, a DVD, and a workbook. Control parents received a standard brochure about safe driving. Scores were developed to measure teen-reported quantity and quality of parental communication about safe driving. The main outcome measure was a previously validated Risky Driving Score reported by teens. Because the Score was highly skewed, a generalized linear model based on a gamma distribution was used for analysis. Intervention teens ranked their parent's success in talking about driving safety higher than control teens (p = 0.035) and reported that their parents talked about more topics (non-significant difference). The Risky Driving Score was 21% lower in intervention compared to control teens (85% CI = 0.60, 1.00). Interaction between communication quantity and the intervention was examined. Intervention teens who reported more successful communication had a 42% lower Risky Driving Score (95% CI = 0.37, 0.94) than control parents with less successful communication. This program had a positive although not strong effect, and it may hold the most promise in partnership with other programs, such as Driver's Education or Graduated Driver's License policies. ClinicalTrials.gov NCT01014923. Registered Nov. 16, 2009.

  3. Effects of the SAFE Children preventive intervention on developmental trajectories of attention-deficit/hyperactivity disorder symptoms.

    Science.gov (United States)

    Fowler, Patrick J; Henry, David B; Schoeny, Michael; Gorman-Smith, Deborah; Tolan, Patrick H

    2014-11-01

    This study examined whether a family-based preventive intervention for inner-city children entering the first grade could alter the developmental course of attention-deficit/hyperactivity disorder (ADHD) symptoms. Participants were 424 families randomly selected and randomly assigned to a control condition (n = 192) or Schools and Families Educating Children (SAFE) Children (n = 232). SAFE Children combined family-focused prevention with academic tutoring to address multiple developmental-ecological needs. A booster intervention provided in the 4th grade to randomly assigned children in the initial intervention (n =101) evaluated the potential of increasing preventive effects. Follow-up occurred over 5 years with parents and teachers reporting on attention problems. Growth mixture models identified multiple developmental trajectories of ADHD symptoms. The initial phase of intervention placed children on more positive developmental trajectories for impulsivity and hyperactivity, demonstrating the potential for ADHD prevention in at-risk youth, but the SAFE Children booster had no additional effect on trajectory or change in ADHD indicators.

  4. Infant Safe Sleep Interventions, 1990-2015: A Review.

    Science.gov (United States)

    Salm Ward, Trina C; Balfour, Giselle M

    2016-02-01

    Sleep-related infant deaths remain a major public health issue. Multiple interventions have been implemented in efforts to increase adherence to safe sleep recommendations. We conducted a systematic review of the international research literature to synthesize research on interventions to reduce the risk of sleep-related deaths and their effectiveness in changing infant sleep practices. We searched PubMed, CINAHL, PsycINFO, and Google Scholar for peer-reviewed articles published between 1990 and 2015 which described an intervention and reported results. Twenty-nine articles were included for review. Studies focused on infant caregivers, health care professionals, peers, and child care professionals. Targeted behaviors included sleep position, location, removing items from the crib, breastfeeding, smoke exposure, clothing, pacifier use, and knowledge of Sudden Infant Death Syndrome. Most articles described multi-faceted interventions, including: one-on-one or group education, printed materials, visual displays, videos, and providing resources such as cribs, pacifiers, wearable blankets, and infant t-shirts. Two described public education campaigns, one used an educative questionnaire, and one encouraged maternal note taking. Health professional interventions included implementing safe sleep policies, in-service training, printed provider materials, eliciting agreement on a Declaration of Safe Sleep Practice, and sharing adherence data. Data collection methods included self-report via surveys and observational crib audits. Over half of the studies utilized comparison groups which helped determine effectiveness. Most articles reported some degree of success in changing some of the targeted behaviors; no studies reported complete adherence to recommendations. Future studies should incorporate rigorous evaluation plans, utilize comparison groups, and collect demographic and collect follow-up data.

  5. [Experimental intervention study of safe injection in basic-level hospitals in Hunan by medical staff].

    Science.gov (United States)

    Li, Li; Li, Yinglan; Long, Yanfang; Zhou, Yang; Lu, Jingmei; Wu, Ying

    2013-07-01

    To experimentally intervene safe injection by medical staff in basic-level hospitals and observe the recent and long-term effect after the intervention and to provide practical measures to improve safe injection. We used random sampling methods to set up groups in county hospitals and township hospitals of Hunan Province, and offered lectures, delivered safe injection guide, brochure and on-site guidance in the experimental group. We surveyed the 2 groups after the intervention at 1 month and 6 months to compare the effect of unsafe injection behaviors and safe injection behaviors. One month after the intervention, the unsafe injection rate in the experimental group decreased from 27.8% to 21.7%, while in the control group injection the unsafe injection rate rose from 26.0% to 27.9%, with significant difference (Pinjection rate in the experimental group declined to 18.4% while the unsafe injection rate in the control group also dropped to 22.4%, with significant difference (Pinjection rate was decreased in the experimental group at different intervention points, with significant difference (Psafe injection behavior scores in the experimental group were higher than those in the control group after the intervention of 1 month and 6 month intervention (Psafe injection, distribution of safe injection guide, and comprehensive intervention model can significantly change the primary care practitioners' behaviors in unsafe injections and it is worth promoting.

  6. Safe and effective use of medicines for ethnic minorities

    DEFF Research Database (Denmark)

    Dam, Pernille; El-Souri, Mira Mahmoud; Herborg, Hanne

    2015-01-01

    , there was a need to adapt a previously developed and validated medicine-based interventionsafe and effective use of medicines” to this vulnerable group of unemployed ethnic minority patients. Methods: The objective of this before-after study was to improve medicines adherence, health status and work ability...... of the target group through an individualized pharmacist delivered intervention with focus on safe and effective implementation of medical treatments. The target group was ethnic minorities of non-western origin affiliated with a job center. Results: At baseline, 35.7 % of the patients had a potential adherence...... to the intervention. Conclusion: The counseling program “Safe and effective use of medicines” was successfully adapted to unemployed ethnic minority patients, and tested in a new collaboration between job centers and community pharmacies. The counseling program resulted in statistically significant improvements...

  7. Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews.

    Science.gov (United States)

    Ryan, Rebecca; Santesso, Nancy; Lowe, Dianne; Hill, Sophie; Grimshaw, Jeremy; Prictor, Megan; Kaufman, Caroline; Cowie, Genevieve; Taylor, Michael

    2014-04-29

    Many systematic reviews exist on interventions to improve safe and effective medicines use by consumers, but research is distributed across diseases, populations and settings. The scope and focus of such reviews also vary widely, creating challenges for decision-makers seeking to inform decisions by using the evidence on consumers' medicines use.This is an update of a 2011 overview of systematic reviews, which synthesises the evidence, irrespective of disease, medicine type, population or setting, on the effectiveness of interventions to improve consumers' medicines use. To assess the effects of interventions which target healthcare consumers to promote safe and effective medicines use, by synthesising review-level evidence. We included systematic reviews published on the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. We identified relevant reviews by handsearching databases from their start dates to March 2012. We screened and ranked reviews based on relevance to consumers' medicines use, using criteria developed for this overview. We used standardised forms to extract data, and assessed reviews for methodological quality using the AMSTAR tool. We used standardised language to summarise results within and across reviews; and gave bottom-line statements about intervention effectiveness. Two review authors screened and selected reviews, and extracted and analysed data. We used a taxonomy of interventions to categorise reviews and guide syntheses. We included 75 systematic reviews of varied methodological quality. Reviews assessed interventions with diverse aims including support for behaviour change, risk minimisation and skills acquisition. No reviews aimed to promote systems-level consumer participation in medicines-related activities. Medicines adherence was the most frequently-reported outcome, but others such as knowledge, clinical and service-use outcomes were also reported. Adverse events were less commonly

  8. Evaluation of the CDC safe water-storage intervention to improve ...

    African Journals Online (AJOL)

    Evaluation of the CDC safe water-storage intervention to improve the microbiological quality of point-of-use drinking water in rural communities in South Africa. ... use of safe household water-storage devices and water treatment processes and improvement of hygiene and sanitation practices in these rural households.

  9. Interventions to Improve Safe Sleep Among Hospitalized Infants at Eight Children's Hospitals.

    Science.gov (United States)

    Kuhlmann, Stephanie; Ahlers-Schmidt, Carolyn R; Lukasiewicz, Gloria; Truong, Therese Macasiray

    2016-02-01

    Within hospital pediatric units, there is a lack of consistent application or modeling of the American Academy of Pediatrics recommendations for safe infant sleep. The purpose of this study was to improve safe sleep practices for infants in nonneonatal pediatric units with implementation of specific interventions. This multi-institutional study was conducted by using baseline observations collected for sleep location, position, and environment (collectively, "safe sleep") of infants admitted to pediatric units. Interventions consisted of: (1) staff education, including a commitment to promote safe sleep; (2) implementing site-generated safe sleep policies; (3) designating supply storage in patient rooms; and/or (4) caregiver education. Postintervention observations of safe sleep were collected. Eight hospitals participated from the Inpatient FOCUS Group of the Children's Hospital Association. Each site received institutional review board approval/exemption. Safe sleep was observed for 4.9% of 264 infants at baseline and 31.2% of 234 infants postintervention (Ppresent in 77% of cribs at baseline and 44% postintervention. However, the mean number of unsafe items observed in each sleeping environment was reduced by >50% (P=.001). Implementation of site-specific interventions seems to improve overall safe sleep in inpatient pediatric units, although continued improvement is needed. Specifically, extra items are persistently left in the sleeping environment. Moving forward, hospitals should evaluate their compliance with American Academy of Pediatrics recommendations and embrace initiatives to improve modeling of safe sleep. Copyright © 2016 by the American Academy of Pediatrics.

  10. Parenteral nutrition combined with rice soup can be a safe and effective intervention for congenital chylous ascites.

    Science.gov (United States)

    Cao, Yi; Yan, Weihui; Lu, Lina; Tao, Yijing; Lu, Wei; Chen, Yingwei; Tang, Qingya; Cai, Wei

    2016-01-01

    Congenital chylous ascites in the neonatal period is a rare entity. Total parenteral nutrition (TPN), medium chain triglyceride (MCT)-based diet, octreotide and repeated paracentesis are regarded as appropriate medical treatment for congenital chylous ascites, and surgery is recommended when conservative therapy has failed. We present two cases in which ascites were confirmed via an abdominal sonogram and diagnostic paracentesis. In our clinical experience, rice soup combined with PN can be a safe and effective intervention.

  11. Safe pediatric surgery: development and validation of preoperative interventions checklist

    Directory of Open Access Journals (Sweden)

    Maria Paula de Oliveira Pires

    2013-09-01

    Full Text Available OBJECTIVES: this study was aimed at developing and validating a checklist of preoperative pediatric interventions related to the safety of surgical patients. METHOD: methodological study concerning the construction and validation of an instrument with safe preoperative care indicators. The checklist was subject to validation through the Delphi technique, establishing a consensus level of 80%. RESULTS: five professional specialists in the area conducted the validation and a consensus on the content and the construct was reached after two applications of the Delphi technique. CONCLUSION: the "Safe Pediatric Surgery Checklist", simulating the preoperative trajectory of children, is an instrument capable of contributing to the preparation and promotion of safe surgery, as it identifies the presence or absence of measures required to promote patient safety.

  12. The effectiveness of different interventions to promote poison prevention behaviours in households with children: a network meta-analysis.

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    Achana, Felix A; Sutton, Alex J; Kendrick, Denise; Wynn, Persephone; Young, Ben; Jones, David R; Hubbard, Stephanie J; Cooper, Nicola J

    2015-01-01

    There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a "usual care or no intervention" which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children. Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model. 28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00) while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10). No one intervention package was more effective than the others in promoting safe storage of poisonous plants. The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the poison

  13. Exploring educational interventions to facilitate health professional students' professionally safe online presence.

    Science.gov (United States)

    Henning, Marcus A; Hawken, Susan; MacDonald, Joanna; McKimm, Judy; Brown, Menna; Moriarty, Helen; Gasquoine, Sue; Chan, Kwong; Hilder, Jo; Wilkinson, Tim

    2017-09-01

    To establish the most effective approach and type of educational intervention for health professional students, to enable them to maintain a professionally safe online presence. This was a qualitative, multinational, multi-institutional, multiprofessional study. Practical considerations (availability of participants) led us to use a combination of focus groups and individual interviews, strengthening our findings by triangulating our method of data collection. The study gathered data from 57 nursing, medical and paramedical students across four sites in three countries (Aotearoa/New Zealand, Australia and Wales). A content analysis was conducted to clarify how and why students used Facebook and what strategies they thought might be useful to ensure professional usage. A series of emergent codes were examined and a thematic analysis undertaken from which key themes were crystallized. The results illuminated the ways in which students use social networking sites (SNS). The three key themes to emerge from the data analysis were negotiating identities, distancing and risks. Students expressed the wish to have material about professional safety on SNS taught to them by authoritative figures to explain "the rules" as well as by peers to assist with practicalities. Our interactive research method demonstrated the transformative capacity of the students working in groups. Our study supports the need for an educational intervention to assist health professional students to navigate SNS safely and in a manner appropriate to their future roles as health professionals. Because health professional students develop their professional identity throughout their training, we suggest that the most appropriate intervention incorporate small group interactive sessions from those in authority, and from peers, combined with group work that facilitates and enhances the students' development of a professional identity.

  14. Assessing the effects of a sexually transmitted disease educational intervention on fraternity and sorority members' knowledge and attitudes toward safe sex behaviors.

    Science.gov (United States)

    Goldsberry, Jennifer; Moore, Leslie; MacMillan, Deborah; Butler, Scott

    2016-04-01

    College years are a time young adults examine high-risk sexual behaviors, increasing their risk for sexually transmitted diseases (STDs). Fraternity/sorority membership has been identified as one factor contributing to increased risky sexual behavior in college students. This study measured the effectiveness of an educational intervention targeting STD prevention in fraternity and sorority members, and examined relationships between STD knowledge, attitudes, and demographics. A descriptive, correlational design was used. Pre- and posttest data were collected from fraternity and sorority members (N = 132). Instruments measured demographic characteristics, STD knowledge, and attitudes toward safe sex behaviors. There was a significant increase in STD knowledge from baseline (M = 13.03, SD = 6.5) to 1 week (M = 20.27, SD = 4.9) t (131) = -13.53, p = .000. Males were more likely to report attitudes toward risky sexual behavior rs(132) = .323, p = .000, and as knowledge increased, attitudes became more favorable to safe sex behaviors (pre-STD knowledge and preintervention attitudes, r(132) = -.249, p = .004; post-STD knowledge and postintervention attitudes, rs(132) = -.307, p = .000). Results support that brief STD educational interventions can increase STD knowledge. College health centers must aim to provide sexual health education to all students at every visit. ©2016 American Association of Nurse Practitioners.

  15. Implementation Evaluation of "Steering Teens Safe": Engaging Parents to Deliver a New Parent-Based Teen Driving Intervention to Their Teens

    Science.gov (United States)

    Ramirez, Marizen; Yang, Jingzhen; Young, Tracy; Roth, Lisa; Garinger, Anne; Snetselaar, Linda; Peek-Asa, Corinne

    2013-01-01

    Parents play a fundamental role in teaching their children safe driving skills to reduce risk of motor vehicle crashes, the leading cause of death for teens. "Steering Teens Safe" is a new parent-based intervention that equips parents with communication skills to talk about, demonstrate, and practice safe driving behaviors and skills…

  16. A feasibility study to assess the effectiveness of safe dates for teen mothers.

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    Herrman, Judith W; Waterhouse, Julie K

    2014-01-01

    To determine the effectiveness of the adapted Safe Dates curriculum as an intervention for pregnant and/or parenting teens to prevent teen dating violence (TDV). This pre-/posttest, single-sample study provided a means to assess the effectiveness of an adapted Safe Dates curriculum for teen mothers. The adapted Safe Dates curriculum was implemented in three schools designed for the unique needs of teens who are pregnant and/or parenting. The final sample of 41 teen participants, with a mean age of 16.27, completed 80% of the curriculum and two of the three assessments. Most of the teens were pregnant during participation in the curriculum, and six had infants between age 1 and 3 months. The teen mothers completed the pretest, participated in the 10-session adapted Safe Dates curriculum, and completed the posttest at the end of the program and 1 month after program completion. The pre/posttest was adapted from the Safe Dates curriculum-specific evaluation instrument. Senior, undergraduate nursing students were trained in and implemented the curriculum. Participation in the adapted Safe Dates program yielded significant differences in the areas of responses to anger, gender stereotyping, awareness of resources for perpetrators and victims, and psychological violence perpetration. This adapted program may be effective in changing selected outcomes. The implementation of a larger scale, experimental/control group study may demonstrate the program's efficacy at reducing the incidence of TDV among teen mothers. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  17. Occupational driver safety: conceptualising a leadership-based intervention to improve safe driving performance.

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    Newnam, Sharon; Lewis, Ioni; Watson, Barry

    2012-03-01

    Occupational driving crashes are the most common cause of death and injury in the workplace. The physical and psychological outcomes following injury are also very costly to organizations. Thus, safe driving poses a managerial challenge. Some research has attempted to address this issue through modifying discrete and often simple target behaviours (e.g., driver training programs). However, current intervention approaches in the occupational driving field generally consider the role of organizational factors in workplace safety. This study adopts the A-B-C framework to identify the contingencies associated with an effective exchange of safety information within the occupational driving context. Utilizing a sample of occupational drivers and their supervisors, this multi-level study examines the contingencies associated with the exchange of safety information within the supervisor-driver relationship. Safety values are identified as an antecedent of the safety information exchange, and the quality of the leader-member exchange relationship and safe driving performance is identified as the behavioural consequences. We also examine the function of role overload as a factor influencing the relationship between safety values and the safety information exchange. Hierarchical linear modelling found that role overload moderated the relationship between supervisors' perceptions of the value given to safety and the safety information exchange. A significant relationship was also found between the safety information exchange and the subsequent quality of the leader-member exchange relationship. Finally, the quality of the leader-member exchange relationship was found to be significantly associated with safe driving performance. Theoretical and practical implications of these results are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Scale-Up of Safe & Civil Schools' Model for School-Wide Positive Behavioral Interventions and Supports

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    Smolkowski, Keith; Strycker, Lisa; Ward, Bryce

    2016-01-01

    This study evaluated the scale-up of a Safe & Civil Schools "Foundations: Establishing Positive Discipline Policies" positive behavioral interventions and supports initiative through 4 years of "real-world" implementation in a large urban school district. The study extends results from a previous randomized controlled trial…

  19. Effect of safe water on arsenicosis: A follow-up study

    Directory of Open Access Journals (Sweden)

    Kunal K Majumdar

    2014-01-01

    Full Text Available Background: Arsenic pollution in groundwater, used for drinking purposes, has been envisaged as a problem of global concern. Treatment options for the management symptoms of chronic arsenicosis are limited. Mitigation option available for dealing with the health problem of ground water arsenic contamination rests mainly on supply of arsenic safe water in arsenic-endemic region of Indo-Bangladesh subcontinent. Limited information is available regarding the long-term effect of chronic arsenic toxicity after stoppage of consumption of arsenic-containing water. Objective: The current study was, therefore, done to assess, objectively, the effect of drinking arsenic safe water (<50 μg/L on disease manifestation of arsenicosis. Results: Manifestations of various skin lesions and systemic diseases associated with chronic arsenic exposure were ascertained initially by carrying on baseline study on 208 participants in Nadia (Cohort-I, with skin lesion and Cohort-II, without skin lesion using a scoring system, as developed by us, and compared objectively at the end of each year for 3 year follow-up period. All the participants who had arsenic contaminated drinking water source in their houses were supplied with arsenic removal filters for getting arsenic-free water during the follow-up period. In participants belonging to Cohort-I, the skin score was found to improve significantly at the end of each year, and it was found to be reduced significantly from 2.17 ± 1.09 to 1.23 ± 1.17; P < 0.001 at the end of 3 year′s intervention study indicating beneficial effect of safe water on skin lesions. The systemic disease symptom score was also found to improve, but less significantly, at the end of 3 years in both the cohorts. Most important observation during the follow-up study was persistence of severe symptoms of chronic lung disease and severe skin lesion including Bowen′s disease in spite of taking arsenic-safe water. Further, death could not be

  20. Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania

    Directory of Open Access Journals (Sweden)

    Jahn Albrecht

    2010-04-01

    Full Text Available Abstract Background In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%, only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. Method This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs. Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Results Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (ρ Conclusion The study has demonstrated the effectiveness of community-based safe motherhood intervention in promoting the utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

  1. The Effects of Prompting and Reinforcement on Safe Behavior of Bicycle and Motorcycle Riders

    Science.gov (United States)

    Okinaka, Takeru; Shimazaki, Tsuneo

    2011-01-01

    A reversal design was used to evaluate the effects of vocal and written prompts as well as reinforcement on safe behavior (dismounting and walking bicycles or motorcycles on a sidewalk) on a university campus. Results indicated that an intervention that consisted of vocal and written prompts and reinforcement delivered by security guards was…

  2. Implementation evaluation of steering teens safe: engaging parents to deliver a new parent-based teen driving intervention to their teens.

    Science.gov (United States)

    Ramirez, Marizen; Yang, Jingzhen; Young, Tracy; Roth, Lisa; Garinger, Anne; Snetselaar, Linda; Peek-Asa, Corinne

    2013-08-01

    Parents play a fundamental role in teaching their children safe driving skills to reduce risk of motor vehicle crashes, the leading cause of death for teens. Steering Teens Safe is a new parent-based intervention that equips parents with communication skills to talk about, demonstrate, and practice safe driving behaviors and skills with their teens. This implementation evaluation focuses on a sample of 83 parents who delivered Steering Teens Safe to their teens. One-, 2- and 3-month follow-up assessments were conducted with intervention parents to evaluate the self-reported quantity and quality of talking about, demonstrating, and practicing safe driving goals with teens; perceived success and benefit of the program; and barriers to implementation. Over 3 months of follow-up, parents discussed driving goals with their teens for a median of 101.5 minutes. The most frequently addressed topics were general safety principles, including distracted driving, driving in bad weather, wearing a seat belt, and being a safe passenger. Parents spent a median of 30 minutes practicing safe driving skills such as changing lanes. Sixty-seven percent of parents talked to their children about rural road safety, but just 36% demonstrated and half practiced these skills with their teens. Barriers to implementation include time and opportunity barriers and resistant attitudes of their teens. However, barriers neither affected frequency of engagement nor parents' perceived benefit and comfort in delivering the program. Parents with time/opportunity barriers also had higher practice and demonstration times than parents without these barriers. Findings indicate high acceptability among parent implementers and promise for real-world delivery. Future studies are needed to assess intervention impact.

  3. Strategies and challenges for safe injection practice in developing countries.

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    Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

    2013-01-01

    Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

  4. The staying safe intervention: training people who inject drugs in strategies to avoid injection-related HCV and HIV infection.

    Science.gov (United States)

    Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria; Sandoval, Milagros; Cleland, Charles M; Jordan, Ashly; Hagan, Holly; Lune, Howard; Friedman, Samuel R

    2014-04-01

    This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks.

  5. Awareness tool for safe and responsible driving (OSCAR): a potential educational intervention for increasing interest, openness and knowledge about the abilities required and compensatory strategies among older drivers.

    Science.gov (United States)

    Levasseur, Mélanie; Audet, Thérèse; Gélinas, Isabelle; Bédard, Michel; Langlais, Marie-Ève; Therrien, France-Hélène; Renaud, Judith; Coallier, Jean-Claude; D'Amours, Monia

    2015-01-01

    This pilot study aimed to verify the impact of the awareness tool for safe and responsible driving (OSCAR) on older adults' (1) interest, openness, and knowledge about the abilities and compensatory strategies required for safe driving; (2) awareness of changes that have occurred in their own driving abilities; and (3) actual utilization of compensatory strategies. A preexperimental design, including a pretest (T0) and posttest (T1) 8 to 10 weeks after exposure to the intervention, was used with 48 drivers aged between 67 and 84. The participants had a valid driving license and drove at least once a week. Overall, the results demonstrate that OSCAR increased interest, openness, and knowledge about the abilities and compensatory strategies of older drivers (P driving, OSCAR also improved awareness of the changes that could negatively impact safe driving and enhanced utilization of compensatory strategies. While promoting safe driving and the prevention of crashes and injuries, this intervention could ultimately help older adults maintain or increase their transportation mobility. More studies are needed to further evaluate OSCAR and identify ways to improve its effectiveness.

  6. Implementation of Ray Safe i2 System for staff dose measuring in interventional radiology

    International Nuclear Information System (INIS)

    Gershan, Vesna; Atsovska, Violeta

    2013-01-01

    Interventional radiology procedures usually delivered the highest radiation dose to the patients as well as to medical personal. Beside another factors like patient size, fluoroscopy time, machine calibration etc., a good clinical practice has strong effects to staff and patient’s radiation dose. Materials and methods: In August 2012, a Ray Safe i2 system was installed in a private hospital in Skopje. The main purpose of this dosimetry system is to provide real time indication for the current exposure level of the medical personal. Knowing that, the staff has prerequisites to adjust their behavior to minimize unnecessary exposure like changing distance from exposed volume, C-ram angulations, field of view etc. and on this way to develop a good clinical practice. The Ray Safe i2 system is consisted by ten digital dosimeters, two dock stations, real time display, dose viewer and dose manager software. During interventional procedures, each involved staff wears dosimeter which measures and records X-Ray exposure every second and transfer the data wirelessly to the real time display. Color indication bars (green, yellow, red) represents the intensity of the currently received exposure, whereas green zone indicates < 0.2 mSv/h, yellow zone from 0.2 to 2 mSv/h and red zone indications from 2 to 20 mSv/h. Additionally, accumulated dose per individual is displayed next to the color indication bars. By using the software, information about personal dose history, such as annual dose, dose per particular session, hour, day or week, can be viewed and analyzed. Results: In this work it was found that staff accumulated doses were constantly increased over time, but reported number of procedures does not correspond to this tendency. Our assumption is that there is a misleading between reported number and actual performed procedures. Doctor1 received 55 times more dose than Doctor2 and Nurse1 received 11 to 3 times more dose than another Nurses. It was found a correlation of R2

  7. Effectiveness of community based Safe Motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania.

    Science.gov (United States)

    Mushi, Declare; Mpembeni, Rose; Jahn, Albrecht

    2010-04-01

    In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%), only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs). Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (rho utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

  8. "Same Room, Safe Place".

    Science.gov (United States)

    Keene Woods, Nikki

    2017-04-01

    There are many different professional stances on safe sleep and then there is the reality of caring for a newborn. There is a debate among professionals regarding safe sleep recommendations. The continum of recommendations vary from the American Academy of Pediatrics (AAP) Safe Sleep Guidelines to the bed-sharing recommendations from the Mother-Baby Behavioral Sleep Laboratory. The lack of consistent and uniform safe sleep recommendations from health professionals has been confusing for families but has more recently raised a real professional ethical dilemma. Despite years of focused safe sleep community education and interventions, sleep-related infant deaths are on the rise in many communities. This commentary calls for a united safe sleep message from all health professionals to improve health for mothers and infants most at-risk, "Same Room, Safe Place."

  9. The safe zone for blinded sternal interventions based on CT evaluation of midline congenital sternal foramina

    International Nuclear Information System (INIS)

    Boruah, Deb K.; Dhingani, Dhaval D.; Achar, Shashidhar; Augustine, Antony; Mahanta, Kangkana; Prakash, Arjun; Yadav, Rajnikant R.

    2016-01-01

    The aim of this study was to evaluate the safe zone for performing blind sternal procedures based on computed tomography (CT) evaluation of congenital midline sternal foramina using multidetector computed tomography (MDCT). This retrospective study was carried out on 1,180 patients who underwent MDCT of the thorax from March 2015 to February 2016. The MDCT images were evaluated in axial and reformatted planes. Morphometry and prevalence of midline congenital sternal foramina (SF) and manubrio-foraminal distance (MFD) were evaluated. The safe zone was defined for a blinded intervention, based on palpable anatomical landmarks. Data were presented in terms of percentage, mean ± standard deviation and calculations were carried out using Microsoft Excel. The prevalence of SF in our study sample was 11.6 %. The majority of SF were located in a typical position in the lower sternal body at the level of fifth costo-chondral junction (CCJ) in 108 patients (78.8 %). The structure directly beneath the SF was mediastinal fat in 73 patients (53.3 %), followed by anterior pericardium in 44 patients (32.1 %) and lung parenchyma in 20 patients (14.6 %). The mean MFD in our study population was 11.90 ± 1.31 cm. Sternal interventions should be avoided at the level of fourth to sixth CCJ, which is considered the danger zone. An intervention at the fourth to sixth CCJ may lead to disastrous consequences in patients who have SF. (orig.)

  10. The safe zone for blinded sternal interventions based on CT evaluation of midline congenital sternal foramina

    Energy Technology Data Exchange (ETDEWEB)

    Boruah, Deb K.; Dhingani, Dhaval D.; Achar, Shashidhar; Augustine, Antony; Mahanta, Kangkana [Assam Medical College and Hospital, Department of Radio-diagnosis, Dibrugarh, Assam (India); Prakash, Arjun [NIMHANS, Department of Radio-diagnosis, Bangalore, Karnataka (India); Yadav, Rajnikant R. [Sanjay Gandhi Post Graduate Institute and Medical Sciences, Department of Radio-diagnosis, Lucknow (India)

    2016-12-15

    The aim of this study was to evaluate the safe zone for performing blind sternal procedures based on computed tomography (CT) evaluation of congenital midline sternal foramina using multidetector computed tomography (MDCT). This retrospective study was carried out on 1,180 patients who underwent MDCT of the thorax from March 2015 to February 2016. The MDCT images were evaluated in axial and reformatted planes. Morphometry and prevalence of midline congenital sternal foramina (SF) and manubrio-foraminal distance (MFD) were evaluated. The safe zone was defined for a blinded intervention, based on palpable anatomical landmarks. Data were presented in terms of percentage, mean ± standard deviation and calculations were carried out using Microsoft Excel. The prevalence of SF in our study sample was 11.6 %. The majority of SF were located in a typical position in the lower sternal body at the level of fifth costo-chondral junction (CCJ) in 108 patients (78.8 %). The structure directly beneath the SF was mediastinal fat in 73 patients (53.3 %), followed by anterior pericardium in 44 patients (32.1 %) and lung parenchyma in 20 patients (14.6 %). The mean MFD in our study population was 11.90 ± 1.31 cm. Sternal interventions should be avoided at the level of fourth to sixth CCJ, which is considered the danger zone. An intervention at the fourth to sixth CCJ may lead to disastrous consequences in patients who have SF. (orig.)

  11. Effect of Safe Water on Arsenicosis: A Follow-up Study.

    Science.gov (United States)

    Majumdar, Kunal K; Ghose, Aloke; Ghose, Nilima; Biswas, Anirban; Mazumder, D N Guha

    2014-04-01

    Arsenic pollution in groundwater, used for drinking purposes, has been envisaged as a problem of global concern. Treatment options for the management symptoms of chronic arsenicosis are limited. Mitigation option available for dealing with the health problem of ground water arsenic contamination rests mainly on supply of arsenic safe water in arsenic-endemic region of Indo-Bangladesh subcontinent. Limited information is available regarding the long-term effect of chronic arsenic toxicity after stoppage of consumption of arsenic-containing water. The current study was, therefore, done to assess, objectively, the effect of drinking arsenic safe water (water source in their houses were supplied with arsenic removal filters for getting arsenic-free water during the follow-up period. In participants belonging to Cohort-I, the skin score was found to improve significantly at the end of each year, and it was found to be reduced significantly from 2.17 ± 1.09 to 1.23 ± 1.17; P water on skin lesions. The systemic disease symptom score was also found to improve, but less significantly, at the end of 3 years in both the cohorts. Most important observation during the follow-up study was persistence of severe symptoms of chronic lung disease and severe skin lesion including Bowen's disease in spite of taking arsenic-safe water. Further, death could not be prevented to occur because of lung cancer and severe lung disease. It is, therefore, an urgent need to make arrangement for availability of safe water source among the arsenic-affected people in the district. Many of the people in the affected villages are not aware of contamination of their home tube wells with arsenic. Awareness generation and motivation of the people for testing their drinking water sources for arsenic and environmental interventions like rain water harvesting, ground water recharge, and restricting excessive use of ground water for domestic and agricultural purposes are also important to prevent further

  12. Effectiveness of a WHO Safe Childbirth Checklist Coaching-based intervention on the availability of Essential Birth Supplies in Uttar Pradesh, India.

    Science.gov (United States)

    Maisonneuve, Jenny J; Semrau, Katherine E A; Maji, Pinki; Pratap Singh, Vinay; Miller, Kate A; Solsky, Ian; Dixit, Neeraj; Sharma, Jigyasa; Lagoo, Janaka; Panariello, Natalie; Neal, Brandon; Kalita, Tapan; Kara, Nabihah; Kumar, Vishwajeet; Hirschhorn, Lisa R

    2018-04-30

    Evaluate the impact of a World Health Organization Safe Childbirth Checklist coaching-based intervention (BetterBirth Program) on availability and procurement of essential childbirth-related supplies. Matched pair, cluster-randomized controlled trial. Uttar Pradesh, India. 120 government-sector health facilities (60 interventions, 60 controls). Supply-availability surveys were conducted quarterly in all sites. Coaches collected supply procurement sources from intervention sites. Coaching targeting implementation of Checklist with data feedback and action planning. Mean supply availability by study arm; change in procurement sources for intervention sites. At baseline, 6 and 12 months, the intervention sites had a mean of 20.9 (95% confidence interval (CI): 20.2-21.5); 22.4 (95% CI: 21.8-22.9) and 22.1 (95% CI:21.4-22.8) items, respectively. Control sites had 20.8 (95% CI: 20.3-21.3); 20.9 (95% CI: 20.3-21.5) and 21.7 (95% CI: 20.8-22.6) items at the same time-points. There was a small but statistically significant higher availability in intervention sites at 6 months (difference-in-difference (DID) = 1.43, P supply availability was seen at 6 months (DID = 4.0, P = 0.0002), with no significant difference by 12 months (DID = 1.5, P = 0.154). No change was seen in procurement sources with ~5% procured by patients with some rates as high as 29% (oxytocin). Implementation of the BetterBirth Program, incorporating supply availability, resulted in modest improvements with catch-up by control facilities by 12 months. Supply-chain coaching may be most beneficial in sites starting with lower supply availability. Efforts are needed to reduce reliance on patient-funding for some critical medications. ClinicalTrials.gov #NCT02148952; Universal Trial Number: U1111-1131-5647.

  13. The Effect of Nursing Quality Improvement and Mobile Health Interventions on Infant Sleep Practices: A Randomized Clinical Trial.

    Science.gov (United States)

    Moon, Rachel Y; Hauck, Fern R; Colson, Eve R; Kellams, Ann L; Geller, Nicole L; Heeren, Timothy; Kerr, Stephen M; Drake, Emily E; Tanabe, Kawai; McClain, Mary; Corwin, Michael J

    2017-07-25

    Inadequate adherence to recommendations known to reduce the risk of sudden unexpected infant death has contributed to a slowing in the decline of these deaths. To assess the effectiveness of 2 interventions separately and combined to promote infant safe sleep practices compared with control interventions. Four-group cluster randomized clinical trial of mothers of healthy term newborns who were recruited between March 2015 and May 2016 at 16 US hospitals with more than 100 births annually. Data collection ended in October 2016. All participants were beneficiaries of a nursing quality improvement campaign in infant safe sleep practices (intervention) or breastfeeding (control), and then received a 60-day mobile health program, in which mothers received frequent emails or text messages containing short videos with educational content about infant safe sleep practices (intervention) or breastfeeding (control) and queries about infant care practices. The primary outcome was maternal self-reported adherence to 4 infant safe sleep practices of sleep position (supine), sleep location (room sharing without bed sharing), soft bedding use (none), and pacifier use (any); data were collected by maternal survey when the infant was aged 60 to 240 days. Of the 1600 mothers who were randomized to 1 of 4 groups (400 per group), 1263 completed the survey (78.9%). The mean (SD) maternal age was 28.1 years (5.8 years) and 32.8% of respondents were non-Hispanic white, 32.3% Hispanic, 27.2% non-Hispanic black, and 7.7% other race/ethnicity. The mean (SD) infant age was 11.2 weeks (4.4 weeks) and 51.2% were female. In the adjusted analyses, mothers receiving the safe sleep mobile health intervention had higher prevalence of placing their infants supine compared with mothers receiving the control mobile health intervention (89.1% vs 80.2%, respectively; adjusted risk difference, 8.9% [95% CI, 5.3%-11.7%]), room sharing without bed sharing (82.8% vs 70.4%; adjusted risk difference, 12

  14. Can patient involvement improve patient safety? A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention.

    Science.gov (United States)

    Lawton, Rebecca; O'Hara, Jane Kathryn; Sheard, Laura; Armitage, Gerry; Cocks, Kim; Buckley, Hannah; Corbacho, Belen; Reynolds, Caroline; Marsh, Claire; Moore, Sally; Watt, Ian; Wright, John

    2017-08-01

    To evaluate the efficacy of the Patient Reporting and Action for a Safe Environment intervention. A multicentre cluster randomised controlled trial. Clusters were 33 hospital wards within five hospitals in the UK. All patients able to give informed consent were eligible to take part. Wards were allocated to the intervention or control condition. The ward-level intervention comprised two tools: (1) a questionnaire that asked patients about factors contributing to safety (patient measure of safety (PMOS)) and (2) a proforma for patients to report both safety concerns and positive experiences (patient incident reporting tool). Feedback was considered in multidisciplinary action planning meetings. Primary outcomes were routinely collected ward-level harm-free care (HFC) scores and patient-level feedback on safety (PMOS). Intervention uptake and retention of wards was 100% and patient participation was high (86%). We found no significant effect of the intervention on any outcomes at 6 or 12 months. However, for new harms (ie, those for which the wards were directly accountable) intervention wards did show greater, though non-significant, improvement compared with control wards. Analyses also indicated that improvements were largest for wards that showed the greatest compliance with the intervention. Adherence to the intervention, particularly the implementation of action plans, was poor. Patient safety outcomes may represent too blunt a measure. Patients are willing to provide feedback about the safety of their care. However, we were unable to demonstrate any overall effect of this intervention on either measure of patient safety and therefore cannot recommend this intervention for wider uptake. Findings indicate promise for increasing HFC where wards implement ≥75% of the intervention components. ISRCTN07689702; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions.

    Science.gov (United States)

    McKenzie, Lara B; Roberts, Kristin J; Clark, Roxanne; McAdams, Rebecca; Abdel-Rasoul, Mahmoud; Klein, Elizabeth G; Keim, Sarah A; Kristel, Orie; Szymanski, Alison; Cotton, Christopher G; Shields, Wendy C

    2018-03-12

    Many unintentional injuries that occur in and around the home can be prevented through the use of safety equipment and by consistently following existing safety recommendations. Unfortunately, uptake of these safety behaviors is unacceptably low. This paper describes the design of the Make Safe Happen® smartphone application evaluation study, which aims to evaluate a mobile technology-based safety behavior change intervention on parents' safety knowledge and actions. Make Safe Happen® app evaluation study is a randomized controlled trial. Participants will be parents of children aged 0-12 years who are recruited from national consumer online survey panels. Parents will complete a pretest survey, and will be randomized to receive the Make Safe Happen® app or a non-injury-related app, and then complete a posttest follow-up survey after 1 week. Primary outcomes are: (1) safety knowledge; (2) safety behaviors; (3) safety device acquisition and use, and (4) behavioral intention to take safety actions. Anticipated study results are presented. Wide-reaching interventions, to reach substantial parent and caregiver audiences, to effectively reduce childhood injuries are needed. This study will contribute to the evidence-base about how to increase safety knowledge and actions to prevent home-related injuries in children. NCT02751203 ; Pre-results.

  16. A randomised control crossover trial of a theory based intervention to improve sun-safe and healthy behaviours in construction workers: study protocol.

    Science.gov (United States)

    Nioi, Amanda; Wendelboe-Nelson, Charlotte; Cowan, Sue; Cowie, Hilary; Rashid, Shahzad; Ritchie, Peter; Cherrie, Mark; Lansdown, Terry C; Cherrie, John W

    2018-02-15

    Exposure to sunlight can have both positive and negative health impacts. Excessive exposure to ultra-violet (UV) radiation from the sun can cause skin cancer, however insufficient exposure to sunlight has a detrimental effect on production of Vitamin D. In the construction industry there are onsite proactive behaviours for safety, but sun-safety remains a low priority. There is limited research on understanding the barriers to adopting sun-safe behaviours and the association this may have with Vitamin D production. This paper reports a protocol for an intervention study, using text messaging in combination with a supportive smartphone App. The intervention aims to both reduce UV exposure during months with higher UV levels and promote appropriate dietary changes to boost Vitamin D levels during months with low UV levels. Approximately 60 construction workers will be recruited across the United Kingdom. A randomised control crossover trial (RCCT) will be used to test the intervention, with randomisation at site level - i.e. participants will receive both the control (no text messages or supportive App support) and intervention (daily text messages and supportive App). Using the Theory of Planned Behaviour (TPB) the intervention focuses on supporting sun-safety and healthy dietary decisions in relation to Vitamin D intake. The intervention emphasises cultivating the perception of normative support in the workplace, increasing awareness of control and self-efficacy in taking sun-protective behaviours, making healthier eating choices to boost Vitamin D, and tackling stigmas attached to image and group norms. Each study epoch will last 21 days with intervention text messages delivered on workdays only. The supportive App will provide supplementary information about sun protective behaviours and healthy dietary choices. The primary outcome measure is 25-hydroxy-Vitamin D [25(OH)D] level (obtained using blood spot sampling), which will be taken pre and post control and

  17. Social media interventions to prevent HIV: A review of interventions and methodological considerations.

    Science.gov (United States)

    Tso, Lai Sze; Tang, Weiming; Li, Haochu; Yan, H Yanna; Tucker, Joseph D

    2016-06-01

    Persistent new HIV infections and risky behaviors underscore the need for enhanced HIV prevention. Social media interventions may promote safe sexual behaviors, increase HIV testing uptake, and promote safe injection behaviors. This review discusses how social media interventions tap into the wisdom of crowds through crowdsourcing, build peer-mentored communities, and deliver interventions through social networks. Social media HIV prevention interventions are constrained by ethical issues, low social media usage among some key populations, and implementation issues. Comprehensive measurement of social media interventions to prevent HIV is necessary, but requires further development of metrics.

  18. Hypnosis Intervention Effects on Sleep Outcomes: A Systematic Review.

    Science.gov (United States)

    Chamine, Irina; Atchley, Rachel; Oken, Barry S

    2018-02-15

    Sleep improvement is a promising target for preventing and modifying many health problems. Hypnosis is considered a cost-effective and safe intervention with reported benefits for multiple health conditions. There is a growing body of research assessing the efficacy of hypnosis for various health conditions in which sleep was targeted as a primary or secondary outcome. This review aimed to investigate the effects of hypnosis interventions on sleep, to describe the hypnotic procedures, and to evaluate potential adverse effects of hypnosis. We reviewed studies (prior to January 2017) using hypnosis in adults for sleep problems and other conditions comorbid with sleep problems, with at least one sleep outcome measure. Randomized controlled trials and other prospective studies were included. One hundred thirty-nine nonduplicate abstracts were screened, and 24 of the reviewed papers were included for qualitative analysis. Overall, 58.3% of the included studies reported hypnosis benefit on sleep outcomes, with 12.5% reporting mixed results, and 29.2% reporting no hypnosis benefit; when only studies with lower risk of bias were reviewed the patterns were similar. Hypnosis intervention procedures were summarized and incidence of adverse experiences assessed. Hypnosis for sleep problems is a promising treatment that merits further investigation. Available evidence suggests low incidence of adverse events. The current evidence is limited because of few studies assessing populations with sleep complaints, small samples, and low methodological quality of the included studies. Our review points out some beneficial hypnosis effects on sleep but more high-quality studies on this topic are warranted. © 2018 American Academy of Sleep Medicine

  19. Clinical effect and necessity of interventional treatment in diabetic foot before and after amputation

    International Nuclear Information System (INIS)

    Fang Chun; Li Minghua; Cheng Yingsheng; Zhang Peilei; Wang Wu; Cheng Yongde

    2006-01-01

    Objective: To assess the clinical effect and necessity of interventional treatment in diabetic foot before and after amputation. Methods: Combined intravascular angioplasty with intraarterial medicine perfusing were carried out in fourteen patients with diabetic foot including 10 patients treated before amputation and 4 after amputation involving superficial femoral, deep femoral, tibial and fitular arteries. Among them seventeen vessels with irregular stenosis and obstruction were treated by intravascular angioplasty through balloon dilation. Results: The technical successful rate was 100%, no complication happened. The symptoms were relieved in all patients after treatment, including promotion of lower extremity arterial blood perfusion, reducing range of amputation and wound healing after amputation. Conclusions: Intravascular interventional treatment is safe, effective and valuable in diabetic foot before and after amputation. (authors)

  20. Effectiveness of a behavior change communication intervention to improve knowledge and perceptions about abortion in Bihar and Jharkhand, India.

    Science.gov (United States)

    Banerjee, Sushanta K; Andersen, Kathryn L; Warvadekar, Janardan; Pearson, Erin

    2013-09-01

    Although abortion became legal in India in 1971, many women are unaware of the law. Behavior change communication interventions may be an effective way to promote awareness of the law and change knowledge of and perceptions about abortion, particularly in settings in which abortion is stigmatized. To evaluate the effectiveness of a behavior change communication intervention to improve women's knowledge about India's abortion law and their perceptions about abortion, a quasi-experimental study was conducted in intervention and comparison districts in Bihar and Jharkhand. Household surveys were administered at baseline in 2008 and at follow-up in 2010 to independent, randomly selected cross-sectional samples of rural married women aged 15-49. Logistic regression difference-in-differences models were used to assess program effectiveness. Analysis demonstrated program effectiveness in improving awareness and perceptions about abortion. The changes in the odds of knowing that abortion is legal and where to obtain safe abortion services were larger between baseline and follow-up in the intervention districts than the changes in odds observed in the comparison districts (odds ratios, 16.1 and 1.9, respectively). Similarly, the increase in women's perception of greater social support for abortion within their families and the increase in perceived self-efficacy with respect to family planning and abortion between baseline and follow-up was greater in the intervention districts than in the comparison districts (coefficients, 0.17 and 0.18, respectively). Behavior change communication interventions can be effective in improving knowledge of and perceptions about abortion in settings in which lack of accurate knowledge hinders women's access to safe abortion services. Multiple approaches should be used when attempting to improve knowledge and perceptions about stigmatized health issues such as abortion.

  1. The challenge of improving boiling: lessons learned from a randomized controlled trial of water pasteurization and safe storage in Peru.

    Science.gov (United States)

    Heitzinger, K; Rocha, C A; Quick, R E; Montano, S M; Tilley, D H; Mock, C N; Carrasco, A J; Cabrera, R M; Hawes, S E

    2016-07-01

    Boiling is the most common method of household water treatment in developing countries; however, it is not always effectively practised. We conducted a randomized controlled trial among 210 households to assess the effectiveness of water pasteurization and safe-storage interventions in reducing Escherichia coli contamination of household drinking water in a water-boiling population in rural Peru. Households were randomized to receive either a safe-storage container or a safe-storage container plus water pasteurization indicator or to a control group. During a 13-week follow-up period, households that received a safe-storage container and water pasteurization indicator did not have a significantly different prevalence of stored drinking-water contamination relative to the control group [prevalence ratio (PR) 1·18, 95% confidence interval (CI) 0·92-1·52]. Similarly, receipt of a safe-storage container alone had no effect on prevalence of contamination (PR 1·02, 95% CI 0·79-1·31). Although use of water pasteurization indicators and locally available storage containers did not increase the safety of household drinking water in this study, future research could illuminate factors that facilitate the effective use of these interventions to improve water quality and reduce the risk of waterborne disease in populations that boil drinking water.

  2. Anatomical Basis for Safe and Effective Volumization of the Temple.

    Science.gov (United States)

    Breithaupt, Andrew D; Jones, Derek H; Braz, Andre; Narins, Rhoda; Weinkle, Susan

    2015-12-01

    One of the earliest but often unaddressed signs of facial aging is volume loss in the temple. Treatment of the area can produce satisfying results for both patient and practitioner. Safe injection requires explicit knowledge of the anatomy to avoid complications related to the multitude of vessels that course throughout the region at various depths. The authors aim to detail the anatomy of the area and provide a safe and easy-to-follow method for injection. The authors review the relevant anatomy of the temporal region and its application to cosmetic filler injections. The authors describe an easy-to-follow approach for a safe and effective injection window based on numerous anatomical studies. Injection in this area is not without risk, including potential blindness. The authors review the potential complications and their treatments. Hollowing of the temple is an early sign of aging that, when corrected, can lead to significant patient and practitioner satisfaction. Proper anatomically knowledge is required to avoid potentially severe complications. In this study, the authors present a reliable technique to safely and effectively augment this often undertreated area of the aging face.

  3. The Pathway to a Safe and Effective Medication Formulary for Exploration Spaceflight

    Science.gov (United States)

    Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; Mcguire, R. K. M.; Antonsen, E. L.

    2017-01-01

    PURPOSE: Exploration space missions pose several challenges to providing a comprehensive medication formulary designed to accommodate the size and space limitations of the spacecraft; while addressing the individual medications needs and preferences of the Crew; the negative outcome of a degrading inventory over time, the inability to resupply before expiration dates; and the need to properly forecast the best possible medication candidates to treat conditions that will occur in the future. METHODS: The Pharmacotherapeutics Discipline has partnered with the Exploration Medical Capabilities (ExMC) Element to develop and propose a research pathway that is comprehensively focused on evidence-based models and theories, as well as on new diagnostic tools and treatments or preventive measures aimed at closure of the Med02 “Pharmacy” Gap; defined in the Human Research Program’s (HRP) risk-based research strategy. The Med02 Gap promotes the challenge to identify a strategy to ensure that medications used to treat medical conditions during exploration space missions are available, safe, and effective. It is abundantly clear that pharmaceutical intervention is an essential component of risk management planning for astronaut healthcare during exploration space. However, the quandary still remains of how to assemble a formulary that is comprehensive enough to prevent or treat anticipated medical events; and is also chemically stable, safe, and robust enough to have sufficient potency to last for the duration of an exploration space mission. In cases where that is not possible, addressing this Gap requires exploration of novel drug development techniques, dosage forms, and dosage delivery platforms that enhance chemical stability as well as therapeutic effectiveness. RESULTS: The proposed research pathway outlines the steps, processes, procedures, and a research portfolio aimed at identifying a capability that will provide a safe and effective pharmacy for any specific

  4. A review of studies in the field of knowledge and safe behaviors of workers in Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Vahedian-Shahroodi

    2016-05-01

    Full Text Available Background and objective: One of the ways to prevent and control occupational accidents and educate people informing them of the risks and how to work safely. The aim of this study was to study the effectiveness of educational interventions to promote safe behavior and knowledge workers is studied. Methods: A systematic search of PubMed SID database and to obtain titles and abstracts containing data related to worker safety behaviors by examining the full text of 22 articles were selected and the results of which were analyzed Results: The group of workers includes training class. The impact of educational interventions: improving the safety of workers and the development of a safety culture in the workplace can be named. Most of the training programs designed for group discussion and the principles of adult learning. Conclusion: summary and analysis of the literature showed the need to promote safe behavior of workers. Since this behavior is very important, intervention is capable of knowledge, attitude, and perceived behavioral control about unsafe behavior change and improve the performance of their safety Paper Type: review Article.

  5. SAFE MOTHERHOOD INTERVENTION STUDIES IN AFRICA: A ...

    African Journals Online (AJOL)

    hi-tech

    2000-11-01

    Nov 1, 2000 ... East African Medical Journal Vol. .... The present literature review identified two studies ... strategies used were: education of community members ... Three studies tested interventions to reduce travel ... home outweighed the perceived benefit of the homes in ..... concept: the Nsawam, Ghana experience.

  6. Effects of nonpharmacological interventions on reducing fatigue after hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Hedayat Jafari

    2017-01-01

    Full Text Available Fatigue is one of the main complaints of patients undergoing allogeneic and autologous hematopoietic stem cell transplantation (HSCT. Since nonpharmacological interventions are cost-effective and causes fewer complications, this study aimed to review the studies performed on the effects of nonpharmacological interventions on fatigue in patients undergoing HSCT during September 2016. MEDLINE, CINAHL, Scientific Information Database, IranMedex, PubMed, ScienceDirect, Scopus, Magiran, and IRANDOC databases were searched using Persian and English keywords. A total of 1217 articles were retrieved, 21 of which were used in this study. Exercise is known as an effective intervention in alleviating physical and mental problems of patients undergoing stem cell transplant. This review-based study showed that nonpharmacological methods such as exercise might be effective in decreasing fatigue in patients undergoing stem cell transplant. There is a multitude of studies on some of the complementary and alternative therapy methods, such as music therapy, yoga, relaxation, and therapeutic massage. These studies demonstrated the positive effects of the aforementioned therapies on reduction of fatigue in patients undergoing stem cell transplantation. All the investigated methods in this study were nonaggressive, safe, and cost-effective and could be used along with common treatments or even as an alternative for pharmacological treatments for the reduction, or elimination of fatigue in patients undergoing stem cell transplantation. Given the advantages of complementary and alternative medicine, conducting further studies on this issue is recommended to reduce fatigue in patients after stem cell transplantation.

  7. Interventional radiology and undesirable effects

    International Nuclear Information System (INIS)

    Benderitter, M.

    2009-01-01

    As some procedures of interventional radiology are complex and long, doses received by patients can be high and cause undesired effects, notably on the skin or in underlying tissues (particularly in the brain as far as interventional neuroradiology is concerned and in lungs in the case of interventional cardiology). The author briefly discusses some deterministic effects in interventional radiology (influence of dose level, delay of appearance of effects, number of accidents). He briefly comments the diagnosis and treatment of severe radiological burns

  8. Percutaneous transgluteal drainage of pelvic abscesses in interventional radiology: A safe alternative to surgery.

    Science.gov (United States)

    Robert, B; Chivot, C; Rebibo, L; Sabbagh, C; Regimbeau, J-M; Yzet, T

    2016-02-01

    Interventional radiology plays an important role in the management of deep pelvic abscesses. Percutaneous drainage is currently considered as the first-line alternative to surgery. A transgluteal computed tomography (CT)-guided approach allows to access to deep infected collections avoiding many anatomical obstacles (vessels, nerves, bowel, bladder). The objective of this study was to assess the safety and efficacy of a transgluteal approach by reviewing our clinical experience. We reviewed medical records of patients having undergone percutaneous CT-guided transgluteal drainage for deep pelvic abscesses. We focused on the duration of catheter drainage, the complications related to the procedures and the rate of complete resolution. Between 2005 and 2013, 39patients (27women and 12men; mean age: 52.5) underwent transgluteal approach CT-guided percutaneous drainage of pelvis abscesses in our department. The origins of abscesses were postoperative complications in 34patients (87.2%) and infectious intra-abdominal disease in 5patients (12.8%). The mean duration of drainage was 8.3days (range: 3-33). Laboratory cultures were positive in 35patients (89.7%) and Escherichia coli was present in 71.4% of the positive samples. No major complication was observed. Drainage was successful in 38patients (97.4%). A transpiriformis approach was more significantly associated with intra-procedural pain (P=0.003). Percutaneous CT-guided drainage with a transgluteal approach is a safe, well-tolerated and effective alternative to surgery for deep pelvic abscesses. This approach should be considered as the first-line intention for the treatment of deep pelvic abscesses. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Effective and Safe Ships

    DEFF Research Database (Denmark)

    Pedersen, Preben Terndrup; Amdahl, Jørgen; Rutgersson, Olle

    1996-01-01

    A Joint Nordic Research project "Effecive and Safe Ships" is presented. The project is aiming to develop methods and tools for quantitative evaluation fo ship safety. This report is the report of the preliminary phase where the plan for the main project is developed. The objectives of the project...

  10. Why Do Parents with Toddlers Store Poisonous Products Safely?

    Directory of Open Access Journals (Sweden)

    Tinneke M. J. Beirens

    2010-01-01

    Full Text Available Unintentional poisoning is a major cause of nonfatal injuries in children aged 0–24 months. Associations between self-reported habits on the child safe storage of medication and cleaning products and family, and psychosocial factors were assessed, using a model based on the Protection Motivation Theory. By identifying correlates of safety behavior in this manner, more insight in factors which influence this behavior is obtained. Health promotion activities in order to promote safety behavior should address these factors in order to increase the effectiveness of the health message. Data were gathered from a cross-sectional survey using self-administered questionnaires, mailed to a population sample of 2470 parents with toddlers. The results indicate that the promotion of safe storage of medication and cleaning products should address the family situation, personal cognitive factors as well as social factors. Interventions should particularly focus on parents' self-efficacy of storing poisonous products in a child safe manner and on the vulnerability of their child in their home concerning an unintentional poisoning incident.

  11. The role of commitment strength in enhancing safe water consumption: mediation analysis of a cluster-randomized trial.

    Science.gov (United States)

    Inauen, Jennifer; Tobias, Robert; Mosler, Hans-Joachim

    2014-11-01

    The objectives of this study were to investigate the importance of commitment strength in the theory of planned behaviour (TPB) and to test whether behaviour change techniques (BCTs) aimed at increasing commitment strength indeed promote switching to arsenic-safe wells by changing commitment strength. A cluster-randomized controlled trial with four arms was conducted to compare an information-only intervention to information plus one, two, or three commitment-enhancing BCTs. Randomly selected households (N = 340) of Monoharganj, Bangladesh, in seven geographically separate areas, whose members were drinking arsenic-contaminated water at baseline and had access to arsenic-safe wells, participated in this trial. The areas were randomly allocated to the four intervention arms. Water consumption behaviour, variables of the TPB, commitment strength, and socio-demographic characteristics were assessed at baseline and at 3-month follow-up by structured face-to-face interviews. Mediation analysis was used to investigate the mechanisms of behaviour change. Changes in commitment strength significantly increased the explanatory power of the TPB to predict well-switching. Commitment-enhancing BCTs - public self-commitment, implementation intentions, and reminders - increased the behaviour change effects of information by up to 50%. Mediation analyses confirmed that the BCTs indeed increased well-switching by increasing commitment strength. Unexpectedly, however, mediation via changes in behavioural intentions was the strongest mechanism of the intervention effects. Commitment is an important construct to consider in water- and health-related behaviour change and may be for other health behaviours as well. BCTs that alter behavioural intentions and commitment strength proved highly effective at enhancing the behaviour change effects of information alone. Statement of contribution What is already known on this subject? Millions of people drink contaminated water even if they

  12. A New Look at Care in Pregnancy: Simple, Effective Interventions for Neglected Populations

    Science.gov (United States)

    Hodgins, Stephen; Tielsch, James; Rankin, Kristen; Robinson, Amber; Kearns, Annie; Caglia, Jacquelyn

    2016-01-01

    Background Although this is beginning to change, the content of antenatal care has been relatively neglected in safe-motherhood program efforts. This appears in part to be due to an unwarranted belief that interventions over this period have far less impact than those provided around the time of birth. In this par, we review available evidence for 21 interventions potentially deliverable during pregnancy at high coverage to neglected populations in low income countries, with regard to effectiveness in reducing risk of: maternal mortality, newborn mortality, stillbirth, prematurity and intrauterine growth restriction. Selection was restricted to interventions that can be provided by non-professional health auxiliaries and not requiring laboratory support. Methods In this narrative review, we included relevant Cochrane and other systematic reviews and did comprehensive bibliographic searches. Inclusion criteria varied by intervention; where available randomized controlled trial evidence was insufficient, observational study evidence was considered. For each intervention we focused on overall contribution to our outcomes of interest, across varying epidemiologies. Results In the aggregate, achieving high effective coverage for this set of interventions would very substantially reduce risk for our outcomes of interest and reduce outcome inequities. Certain specific interventions, if pushed to high coverage have significant potential impact across many settings. For example, reliable detection of pre-eclampsia followed by timely delivery could prevent up to ¼ of newborn and stillbirth deaths and over 90% of maternal eclampsia/pre-eclampsia deaths. Other interventions have potent effects in specific settings: in areas of high P falciparum burden, systematic use of insecticide-treated nets and/or intermittent presumptive therapy in pregnancy could reduce maternal mortality by up to 10%, newborn mortality by up to 20%, and stillbirths by up to 25–30%. Behavioral

  13. A New Look at Care in Pregnancy: Simple, Effective Interventions for Neglected Populations.

    Directory of Open Access Journals (Sweden)

    Stephen Hodgins

    Full Text Available Although this is beginning to change, the content of antenatal care has been relatively neglected in safe-motherhood program efforts. This appears in part to be due to an unwarranted belief that interventions over this period have far less impact than those provided around the time of birth. In this par, we review available evidence for 21 interventions potentially deliverable during pregnancy at high coverage to neglected populations in low income countries, with regard to effectiveness in reducing risk of: maternal mortality, newborn mortality, stillbirth, prematurity and intrauterine growth restriction. Selection was restricted to interventions that can be provided by non-professional health auxiliaries and not requiring laboratory support.In this narrative review, we included relevant Cochrane and other systematic reviews and did comprehensive bibliographic searches. Inclusion criteria varied by intervention; where available randomized controlled trial evidence was insufficient, observational study evidence was considered. For each intervention we focused on overall contribution to our outcomes of interest, across varying epidemiologies.In the aggregate, achieving high effective coverage for this set of interventions would very substantially reduce risk for our outcomes of interest and reduce outcome inequities. Certain specific interventions, if pushed to high coverage have significant potential impact across many settings. For example, reliable detection of pre-eclampsia followed by timely delivery could prevent up to ¼ of newborn and stillbirth deaths and over 90% of maternal eclampsia/pre-eclampsia deaths. Other interventions have potent effects in specific settings: in areas of high P falciparum burden, systematic use of insecticide-treated nets and/or intermittent presumptive therapy in pregnancy could reduce maternal mortality by up to 10%, newborn mortality by up to 20%, and stillbirths by up to 25-30%. Behavioral interventions

  14. Process evaluation of a lifestyle intervention to prevent diabetes and cardiovascular diseases in primary care

    NARCIS (Netherlands)

    Lakerveld, J.; Bot, S.D.M.; Chin A Paw, M.J.M.; van Tulder, M.W.; Kingo, L.; Nijpels, G.

    2012-01-01

    Effective, cost-effective, safe, and feasible interventions to improve lifestyle behavior in at-risk populations are needed in primary care. In the Hoorn Prevention Study, the authors implemented a theory-based lifestyle intervention in which trained practice nurses used an innovative combination of

  15. Interventional ovarian tube catheterization in treating tubal ectopic pregnancy

    International Nuclear Information System (INIS)

    Hu Yi; Xiong Linhui; Du Pianqin; Chen Jiabin

    2004-01-01

    Objective: To explore the feasibility and curative effect of treating tubal pregnancy through the fallopian tube with interventional catheterization decrease the difficulty of the procedure and shorten the consuming time. Methods: Applying the method of interventional catheterization of fallopian tube and injecting 0.5 mg atropine at the cervix beforehand, then 70 mg MTX was administered into the fallopian tube. Results: 113 patients were successfully recovered with health except one without any adversary complication. Conclusions: The interventional fallopian tube catheterization for treating ectopic pregnancy is a simple, safe, minitraumatic, quick and effective method. (authors)

  16. Urinary fluoride as a monitoring tool for assessing successful intervention in the provision of safe drinking water supply in five fluoride-affected villages in Dhar district, Madhya Pradesh, India.

    Science.gov (United States)

    Srikanth, R; Gautam, Anil; Jaiswal, Suresh Chandra; Singh, Pavitra

    2013-03-01

    Endemic fluorosis was detected in 31 villages in the Dhar district of Madhya Pradesh, Central India. Out of the 109 drinking water sources that were analyzed, about 67 % were found to contain high concentration of fluoride above the permissible level of 1.0 mg/l. Dental fluorosis among the primary school children in the age between 8 and 15 served as primary indicator for fluoride intoxication among the children. Urinary fluoride levels among the adults were found to be correlated with drinking water fluoride in 10 villages affected by fluoride. Intervention in the form of alternate safe water supply in five villages showed significant reduction in the urinary fluoride concentration when compared to the control village. Urinary fluoride serves as an excellent marker for assessing the effectiveness of intervention program in the fluoride-affected villages.

  17. Development of Safe and Effective Botanical Dietary Supplements.

    Science.gov (United States)

    van Breemen, Richard B

    2015-11-12

    Regulated differently than drugs or foods, the market for botanical dietary supplements continues to grow worldwide. The recently implemented U.S. FDA regulation that all botanical dietary supplements must be produced using good manufacturing practice is an important step toward enhancing the safety of these products, but additional safeguards could be implemented, and unlike drugs, there are currently no efficacy requirements. To ensure a safe and effective product, botanical dietary supplements should be developed in a manner analogous to pharmaceuticals that involves identification of mechanisms of action and active constituents, chemical standardization based on the active compounds, biological standardization based on pharmacological activity, preclinical evaluation of toxicity and potential for drug-botanical interactions, metabolism of active compounds, and finally, clinical studies of safety and efficacy. Completing these steps will enable the translation of botanicals from the field to safe human use as dietary supplements.

  18. Development of Safe and Effective Botanical Dietary Supplements

    Science.gov (United States)

    2015-01-01

    Regulated differently than drugs or foods, the market for botanical dietary supplements continues to grow worldwide. The recently implemented U.S. FDA regulation that all botanical dietary supplements must be produced using good manufacturing practice is an important step toward enhancing the safety of these products, but additional safeguards could be implemented, and unlike drugs, there are currently no efficacy requirements. To ensure a safe and effective product, botanical dietary supplements should be developed in a manner analogous to pharmaceuticals that involves identification of mechanisms of action and active constituents, chemical standardization based on the active compounds, biological standardization based on pharmacological activity, preclinical evaluation of toxicity and potential for drug–botanical interactions, metabolism of active compounds, and finally, clinical studies of safety and efficacy. Completing these steps will enable the translation of botanicals from the field to safe human use as dietary supplements. PMID:26125082

  19. Inherently safe technologies-chemical and nuclear

    International Nuclear Information System (INIS)

    Weinberg, A.M.

    1984-01-01

    Probabilistic risk assessments show an inverse relationship between the likelihood and the consequences of nuclear and chemical plant accidents, but the Bhopal accident has change public complacency about the safety of chemical plants to such an extent that public confidence is now at the same low level as with nuclear plants. The nuclear industry's response was to strengthen its institutions and improve its technologies, but the public may not be convinced. One solution is to develop reactors which do not depend upon the active intervention of humans of electromechanical devices to deal with emergencies, but which have physical properties that limit the possible temperature and power of a reactor. The Process Inherent Ultimately Safe and the modular High-Temperature Gas-Cooled reactors are two possibilities. the chemical industry needs to develop its own inherently safe design precepts that incorporate smallness, safe processes, and hardening against sabotage. 5 references

  20. Endovenous treatment of primary varicose veins: an effective and safe therapeutic alternative to stripping?

    International Nuclear Information System (INIS)

    Kluner, C.; Fischer, T.; Filimonow, S.; Hamm, B.; Kroencke, T.

    2005-01-01

    Endovenous laser therapy (EVLT) is a new, minimally invasive therapeutic option for treating primary varicose veins and provides an effective and safe alternative to conventional surgical management (stripping). Short-term and intermediate-term outcome is comparable to surgical stripping in terms of elimination of venous reflux (90% - 98%), resolution of visible varices (85%), and improvement of subjective complaints such as sensations of heaviness and tension (96%). Complications occur in 1% - 3% of cases, which is markedly below the rate of conventional surgical management (up to 30%). The intermediate-term incidence of recurrent varicosis in a vein treated by EVLT depends on the laser fluence applied and is reported to range from 7% - 9% compared to 10% - 20% after surgical intervention. Based on a review of the current literature and our own experience, this survey article presents an overview of the indications and contraindications, the technique and pathophysiology of laser-induced venous occlusion, and the results and possible complications of EVLT. (orig.)

  1. Microbes safely, effectively bioremediate oil field pits

    International Nuclear Information System (INIS)

    Shaw, B.; Block, C.S.; Mills, C.H.

    1995-01-01

    Natural and augmented bioremediation provides a safe, environmental, fast, and effective solution for removing hydrocarbon stains from soil. In 1992, Amoco sponsored a study with six bioremediation companies, which evaluated 14 different techniques. From this study, Amoco continued using Environmental Protection Co.'s (EPC) microbes for bioremediating more than 145 sites near Farmington, NM. EPC's microbes proved effective on various types of hydrocarbon molecules found in petroleum stained soils from heavy crude and paraffin to volatiles such as BTEX (benzene, toluene, ethylbenzene, xylene) compounds. Controlled laboratory tests have shown that these microbes can digest the hydrocarbon molecules with or without free oxygen present. It is believed that this adaptation gives these microbes their resilience. The paper describes the bioremediation process, environmental advantages, in situ and ex situ bioremediation, goals of bioremediation, temperature effects, time, cost, and example sites that were treated

  2. Gender-Specific HIV Prevention with Urban Early-Adolescent Girls: Outcomes of the Keepin' It Safe Program

    Science.gov (United States)

    Di Noia, Jennifer; Schinke, Steven P.

    2007-01-01

    This study evaluates the efficacy of Keepin' It Safe, a theory-based, gender-specific, CD-ROM-mediated HIV prevention program for urban, early adolescent girls. Intervention effects were examined in a randomized, pretest-posttest wait-list control-group design. Changes in HIV/AIDS knowledge, protective attitudes, and skills for reducing HIV…

  3. Analysis of the curative effect of interventional devascularization in hepatic cirrhosis, portal hypertension combined with upper gastrointestinal hemorrhage

    International Nuclear Information System (INIS)

    Wei Dingtai; Huang Hui; Huang Xiaomin; Lin Shifeng; Xin Yongtong; Ye Jian'an; Chen Youying

    2010-01-01

    Objective: To evaluate the curative effect of interventional embolization of gastroesophageal and splenic veins in patients with upper gastrointestinal hemorrhage from liver cirrhosis and portal hypertension. Methods: 11 patients with portal hypertension accompanying gastroesophageal variceal hemorrhage were treated with interventional devasculatization. The portal vein pressure, portal vein diameter and platelet before and after treatment as well as the therapeutic effect were evaluated. Results: The technical success rate and the rate of hemostasis were 100%. The portal vein pressure was (37.24±4.02), (40.38±4.15) and (26.33±4.14)cm H 2 O, respectively before and after the gastroesophageal variceal embolization (P=0.088) and after partial splenic vein embolization (P 9 /L, (173.64±55.47) x 10 9 /L (P<0.001), respectively,before and 2 weeks after interventional devascularization. Conclusion: Interventional devascularization can control bleeding immediately, decrease the portal vein pressure, and improve the peri-vascular platelets. It is safe and efficient in treating patients with upper gastrointestinal hemorrhage from liver cirrhosis and portal hypertension. (authors)

  4. Early Nutrition and Physical Activity Interventions in Childhood Cancer Survivors.

    Science.gov (United States)

    Zhang, Fang Fang; Kelly, Michael J; Must, Aviva

    2017-06-01

    Childhood cancer survivors experience excessive weight gain early in treatment. Lifestyle interventions need to be initiated early in cancer care to prevent the early onset of obesity and cardiovascular disease (CVD). We reviewed the existing literature on early lifestyle interventions in childhood cancer survivors and consider implications for clinical care. Few lifestyle interventions focus on improving nutrition in childhood cancer survivors. A consistent effect on reducing obesity and CVD risk factors is not evident from the limited number of studies with heterogeneous intervention characteristics, although interventions with a longer duration and follow-up show more promising trends. Future lifestyle interventions should be of a longer duration and include a nutrition component. Interventions with a longer duration and follow-up are needed to assess the timing and sustainability of the intervention effect. Lifestyle interventions introduced early in cancer care are both safe and feasible.

  5. Can a Costly Intervention Be Cost-effective?

    Science.gov (United States)

    Foster, E. Michael; Jones, Damon

    2009-01-01

    Objectives To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Results Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations. PMID:17088509

  6. A Faraday effect position sensor for interventional magnetic resonance imaging.

    Science.gov (United States)

    Bock, M; Umathum, R; Sikora, J; Brenner, S; Aguor, E N; Semmler, W

    2006-02-21

    An optical sensor is presented which determines the position and one degree of orientation within a magnetic resonance tomograph. The sensor utilizes the Faraday effect to measure the local magnetic field, which is modulated by switching additional linear magnetic fields, the gradients. Existing methods for instrument localization during an interventional MR procedure often use electrically conducting structures at the instruments that can heat up excessively during MRI and are thus a significant danger for the patient. The proposed optical Faraday effect position sensor consists of non-magnetic and electrically non-conducting components only so that heating is avoided and the sensor could be applied safely even within the human body. With a non-magnetic prototype set-up, experiments were performed to demonstrate the possibility of measuring both the localization and the orientation in a magnetic resonance tomograph. In a 30 mT m(-1) gradient field, a localization uncertainty of 1.5 cm could be achieved.

  7. Safe and effective error rate monitors for SS7 signaling links

    Science.gov (United States)

    Schmidt, Douglas C.

    1994-04-01

    This paper describes SS7 error monitor characteristics, discusses the existing SUERM (Signal Unit Error Rate Monitor), and develops the recently proposed EIM (Error Interval Monitor) for higher speed SS7 links. A SS7 error monitor is considered safe if it ensures acceptable link quality and is considered effective if it is tolerant to short-term phenomena. Formal criteria for safe and effective error monitors are formulated in this paper. This paper develops models of changeover transients, the unstable component of queue length resulting from errors. These models are in the form of recursive digital filters. Time is divided into sequential intervals. The filter's input is the number of errors which have occurred in each interval. The output is the corresponding change in transmit queue length. Engineered EIM's are constructed by comparing an estimated changeover transient with a threshold T using a transient model modified to enforce SS7 standards. When this estimate exceeds T, a changeover will be initiated and the link will be removed from service. EIM's can be differentiated from SUERM by the fact that EIM's monitor errors over an interval while SUERM's count errored messages. EIM's offer several advantages over SUERM's, including the fact that they are safe and effective, impose uniform standards in link quality, are easily implemented, and make minimal use of real-time resources.

  8. StaySafe: A self-administered android tablet application for helping individuals on probation make better decisions pertaining to health risk behaviors

    Directory of Open Access Journals (Sweden)

    Wayne E.K. Lehman

    2018-06-01

    Full Text Available This paper describes the development and protocol for feasibility and efficacy testing of a risk reduction intervention designed to improve behavioral health outcomes among drug offenders on probation under community supervision or in residential substance abuse treatment centers. StaySafe is a self-administered tablet-based intervention for teaching better decision-making skills regarding health risk behaviors, especially those involving HIV risks. We are using pre/post, experimental/control group randomized clinical trial (RCT in both community and residential probation settings with goals to 1 assess the feasibility and acceptance of StaySafe by examining participation rates and satisfaction measures, and 2 examine the impact of StaySafe on decision-making skills, confidence and motivation to avoid sex and drug risks, willingness to discuss health risks and concerns with helpful others, and engagement in health risk behaviors.StaySafe consists of 12 brief sessions and utilizes an evidence-based decision-making schema, called WORKIT, which guides participants through steps for identifying the problem and options, evaluating the options and making a decision about which option to carry out. Multiple sessions of StaySafe provide a practice effect so that the WORKIT steps become easily accessible to participants when making decisions. Three of the sessions provide participants a choice of activities designed to provide additional information about HIV and reinforce lessons learned during the WORKIT sessions. Preliminary data demonstrate feasibility and high levels of satisfaction with StaySafe. Keywords: Clinical trial, HIV, Probation, Tablet-based intervention, Decision-making

  9. Pediatric interventional radiology: vascular interventions

    International Nuclear Information System (INIS)

    Kandasamy, Devasenathipathy; Gamanagatti, Shivanand; Gupta, Arun Kumar

    2016-01-01

    Pediatric interventional radiology (PIR) comprises a range of minimally invasive diagnostic and therapeutic procedures that are performed using image guidance. PIR has emerged as an essential adjunct to various surgical and medical conditions. Over the years, technology has undergone dramatic and continuous evolution, making this speciality grow. In this review, the authors will discuss various vascular interventional procedures undertaken in pediatric patients. It is challenging for the interventional radiologist to accomplish a successful interventional procedure. There are many vascular interventional radiology procedures which are being performed and have changed the way the diseases are managed. Some of the procedures are life saving and have become the treatment of choice in those patients. The future is indeed bright for the practice and practitioners of pediatric vascular and non-vascular interventions. As more and more of the procedures that are currently being performed in adults get gradually adapted for use in the pediatric population, it may be possible to perform safe and successful interventions in many of the pediatric vascular lesions that are otherwise being referred for surgery. (author)

  10. The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Tsetis, Dimitrios, E-mail: tsetis@med.uoc.gr [University of Crete, Interventional Radiology Unit, Department of Radiology, University Hospital Heraklion, Faculty of Medicine (Greece); Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk [John Radcliff Hospital, Radiology Department (United Kingdom); Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it [Sapienza – University of Rome, Interventional Radiology Unit, Department of Radiological Sciences (Italy); Roberston, Iain, E-mail: bsiriain@gmail.com [Gartnavel General Hospital, Interventional Radiology Unit (United Kingdom); Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology (United Kingdom); Delden, Otto van, E-mail: o.m.vandelden@amc.uva.nl [Academic Medical Center, Department of Radiology (Netherlands); Radeleff, Boris, E-mail: boris.radeleff@med.uni-heidelberg.de [University Hospital of Heidelberg, Department for Diagnostic and Interventional Radiology (Germany); Müller-Hülsbeck, Stefan, E-mail: muehue@diako.de [Ev.-Luth. Diakonissenanstalt zu Flensburg – Zentrum für Gesundheit und Diakonie, Diagnostische u. Interventionelle Radiologie/Neuroradiologie (Germany); Szerbo-Trojanowska, Malgorzata, E-mail: m.trojanowska@umlub.pl [Medical University of Lublin, Interventional Radiology (Poland); Lee, Michael, E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland); Morgan, Robert, E-mail: robert.morgan@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom); Brountzos, Elias, E-mail: ebrountz@med.uoa.gr [National and Kapodistrian University of Athens (Greece); Belli, Anna Maria, E-mail: Anna.belli@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom)

    2016-04-15

    Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

  11. The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations

    International Nuclear Information System (INIS)

    Tsetis, Dimitrios; Uberoi, Raman; Fanelli, Fabrizio; Roberston, Iain; Krokidis, Miltiadis; Delden, Otto van; Radeleff, Boris; Müller-Hülsbeck, Stefan; Szerbo-Trojanowska, Malgorzata; Lee, Michael; Morgan, Robert; Brountzos, Elias; Belli, Anna Maria

    2016-01-01

    Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

  12. The effect of social marketing communication on safe driving.

    Science.gov (United States)

    Yang, Dong-Jenn; Lin, Wan-Chen; Lo, Jyue-Yu

    2011-12-01

    Processing of cognition, affect, and intention was investigated in viewers of advertisements to prevent speeding while driving. Results indicated that anchoring-point messages had greater effects on viewers' cognition, attitude, and behavioral intention than did messages without anchoring points. Further, the changes in message anchoring points altered participants' perceptions of acceptable and unacceptable judgments: a higher anchoring point in the form of speeding mortality was more persuasive in promoting the idea of reducing driving speed. Implications for creation of effective safe driving communications are discussed.

  13. Strategies and challenges for safe injection practice in developing countries

    OpenAIRE

    Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, KC Vikash

    2013-01-01

    Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the earl...

  14. Achieving pregnancy safely for HIV-serodiscordant couples: a social ecological approach.

    Science.gov (United States)

    Saleem, Haneefa T; Narasimhan, Manjulaa; Denison, Julie A; Kennedy, Caitlin E

    2017-03-08

    The recognition and fulfilment of the sexual and reproductive health and rights (SRHR) of all individuals and couples affected by HIV, including HIV-serodiscordant couples, requires intervention strategies aimed at achieving safe and healthy pregnancies and preventing undesired pregnancies. Reducing risk of horizontal and vertical transmission and addressing HIV-related infertility are key components of such interventions. In this commentary, we present challenges and opportunities for achieving safe pregnancies for serodiscordant couples through a social ecological lens. At the individual level, knowledge (e.g. of HIV status, assisted reproductive technologies) and skills (e.g. adhering to antiretroviral therapy or pre-exposure prophylaxis) are important. At the couple level, communication between partners around HIV status disclosure, fertility desires and safer pregnancy is required. Within the structural domain, social norms, stigma and discrimination from families, community and social networks influence individual and couple experiences. The availability and quality of safer conception and fertility support services within the healthcare system remains essential, including training for healthcare providers and strengthening integration of SRHR and HIV services. Policies, legislation and funding can improve access to SRHR services. A social ecological framework allows us to examine interactions between levels and how interventions at multiple levels can better support HIV-serodiscordant couples to achieve safe pregnancies. Strategies to achieve safer pregnancies should consider interrelated challenges at different levels of a social ecological framework. Interventions across multiple levels, implemented concurrently, have the potential to maximize impact and ensure the full SRHR of HIV-serodiscordant couples.

  15. Safety and effectiveness of moderate sedation for radiologic non-vascular intervention

    International Nuclear Information System (INIS)

    Kim, Tae-Hoon

    2006-01-01

    The purpose of this study was to prospectively characterize the safety and effectiveness of moderate sedation/analgesia for performing radiologic non-vascular abdominal intervention. During a 3-month period, a total of 63 adult patients with a mean age of 64 years (range:27-82) underwent moderate sedation for 72 radiologic non-vascular interventional procedures. A combination of fentanyl citrate and midazolam hydrochloride, based on the patient's body weight, was intravenously administered until the patient was drowsy and tranquil. The adverse events associated with this moderate sedation were assessed. The visual analog scale format was used to measure the subjective feelings of the patient's pre-pro- cedural anxiety and intraprocedural pain. The mean total dose per kilogram of body weight of fentanyl used in PTBD was 1.148 μg. The mean total dose per kilogram of body weight of midazolam was 0.035 mg in PTBD, PTGBD, AD, PCN, DJS, GS and FRA, 0.039 mg in TDC, and 0.043 mg in BS. A temporary reduction of systolic blood pressure to less than 80 mmHg was observed during 5 procedures (6.9%), whereas a temporary elevation of systolic blood pressure above 150 mmHg was observed during 10 procedures (13.8%). A reduction of arterial oxygen saturation to less than 90% was observed during 14 procedures (19.4%). None of the patients required pharmacologic reversal agents or cardiopulmonary resuscitation. The mean anxiety score recorded before all procedures was 5.2 (distressing). The mean pain score during the procedure, which was recorded after all procedures, was 2.9 (mild). Moderate sedation allows performance of safe and effective radiologic non-vascular intervention, and it is also easy for an interventional radiologist to use. The patients should be continuously monitored to check their vital signs and arterial oxygen saturation during the procedures

  16. Safety and effectiveness of moderate sedation for radiologic non-vascular intervention

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae-Hoon [Dankook University Hospital, Chungju (Korea, Republic of)

    2006-06-15

    The purpose of this study was to prospectively characterize the safety and effectiveness of moderate sedation/analgesia for performing radiologic non-vascular abdominal intervention. During a 3-month period, a total of 63 adult patients with a mean age of 64 years (range:27-82) underwent moderate sedation for 72 radiologic non-vascular interventional procedures. A combination of fentanyl citrate and midazolam hydrochloride, based on the patient's body weight, was intravenously administered until the patient was drowsy and tranquil. The adverse events associated with this moderate sedation were assessed. The visual analog scale format was used to measure the subjective feelings of the patient's pre-pro- cedural anxiety and intraprocedural pain. The mean total dose per kilogram of body weight of fentanyl used in PTBD was 1.148 {mu}g. The mean total dose per kilogram of body weight of midazolam was 0.035 mg in PTBD, PTGBD, AD, PCN, DJS, GS and FRA, 0.039 mg in TDC, and 0.043 mg in BS. A temporary reduction of systolic blood pressure to less than 80 mmHg was observed during 5 procedures (6.9%), whereas a temporary elevation of systolic blood pressure above 150 mmHg was observed during 10 procedures (13.8%). A reduction of arterial oxygen saturation to less than 90% was observed during 14 procedures (19.4%). None of the patients required pharmacologic reversal agents or cardiopulmonary resuscitation. The mean anxiety score recorded before all procedures was 5.2 (distressing). The mean pain score during the procedure, which was recorded after all procedures, was 2.9 (mild). Moderate sedation allows performance of safe and effective radiologic non-vascular intervention, and it is also easy for an interventional radiologist to use. The patients should be continuously monitored to check their vital signs and arterial oxygen saturation during the procedures.

  17. Parallel autonomy in automated vehicles : Safe motion generation with minimal intervention

    NARCIS (Netherlands)

    Schwarting, Wilko; Alonso Mora, J.; Pauli, Liam; Karaman, Sertac; Rus, Daniela; Chen, I-Ming; Nakamura, Yoshihiko

    2017-01-01

    Current state-of-the-art vehicle safety systems, such as assistive braking or automatic lane following, are still only able to help in relatively simple driving situations. We introduce a Parallel Autonomy shared-control framework that produces safe trajectories based on human inputs even in much

  18. Dextromethorphan: a case study on addressing abuse of a safe and effective drug.

    Science.gov (United States)

    Spangler, David C; Loyd, Catherine M; Skor, Emily E

    2016-06-23

    Dextromethorphan is a safe, effective cough suppressant, available without a prescription in the United States since 1958. Due to a perceived prevalence of abuse of dextromethorphan by teens, in 2007 the Drug Enforcement Administration requested the Food and Drug Administration evaluate whether dextromethorphan should be recommended for scheduling under the Controlled Substances Act. The Food and Drug Administration held an Advisory Committee meeting in 2010 to provide a scientific and medical evaluation of dextromethorphan and its abuse potential. To address reports of abuse, particularly by teens in the United States, the Consumer Healthcare Products Association initiated an abuse mitigation plan in 2010 with specific goals related to awareness of the behavior, perception of risk, social disapproval, and access to the products. In identifying abuse interventions, experts acknowledge that substance abuse among teens is a highly complex behavior and indicate that the best course of action is to address prevention by focusing on the factors that impact teen behavior. It is noteworthy that the annual prevalence of over-the-counter cough medicine abuse has sharply decreased since 2010. While a true cause-and-effect relationship cannot be assured, the Consumer Healthcare Products Association and its member companies believe that the increased awareness of the issue since the 2010 Food and Drug Administration Advisory Committee meeting, and the subsequent implementation of a well-delivered and targeted abuse mitigation plan that addressed the levers influencing teen decisions is contributing to the observed reduction in abuse. During the period of 2010-2015, reported abuse of dextromethorphan by 8(th), 10(th), and 12(th) graders decreased 35 %. The authors believe this reduction supports the view of the Consumer Healthcare Products Association at the outset of the abuse mitigation plan effort and today: Controlled substance scheduling or prescription requirements would

  19. Interventional therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Liang Jun; Yang Shibin; Yue Yu; Chen Tingcong

    2001-01-01

    Objective: To evaluate clinical application of arterial embolotherapy on hyperthyroidism. Methods: 11 patients with hyperthyroidism were performed with thyroid superior and inferior arterial super-selective arteriography and interventional embolization by polyvinyl alcohol (PVA), gelfoam particles and wool coil. Results: The procedures were succeeded in 11 patients. After the embolotherapy, the thyroid function gradually returned to normal level in 10 patients. The symptom was not controlled satisfactorily in 1 patient, who underwent the right thyroid inferior arteries super selective arteriography and interventional embolization, and then the thyroid function gradually returned to normal level. No serious complications occurred in all patients. Conclusions: Arterial embolotherapy is a safe, simple, symptomless, reliable and very effective for treatment of hyperthyroidism

  20. A cluster randomized controlled trial to assess the impact of SAFE on spousal violence against women and girls in slums of Dhaka, Bangladesh.

    Science.gov (United States)

    Naved, Ruchira Tabassum; Mamun, Mahfuz Al; Mourin, Sanjida Akhter; Parvin, Kausar

    2018-01-01

    Bangladesh reports one of the highest rates of intimate partner violence (IPV) in the world. Despite wide recognition of IPV as an important public health and human rights issue, evidence for IPV prevention is still inadequate. Lack of guidance on effective IPV prevention in Bangladesh resulted in targeting only women in most of the programmes. This paper assesses impact of SAFE, a 20-month intervention (March 2012 to October 2013) in slums of Dhaka on IPV and tests effectiveness of female only groups vs. no groups; and female + male groups vs. female only groups on IPV in the community using a three-arm cluster randomized controlled trial. SAFE's core activities included interactive group sessions, community mobilisation, and services. The last two activities were common across arms. Regression analyses (female survey: baseline n = 2,666; endline n = 2,670) showed no effect of SAFE on IPV against women aged 15-29. However, sub-group analyses demonstrated 21% risk reduction of physical IPV against adolescent girls aged 15-19 in the female + male group intervention arm. A consistent reduction in sexual violence was observed in both female and female + male arms for both groups of women, but the results were not statistically significant. The findings emphasise the importance of combining male and female interventions for reducing physical IPV against adolescent girls. Implications for future research have been discussed.

  1. The interventional therapy of lung abscess

    International Nuclear Information System (INIS)

    Huang Changcen

    2000-01-01

    Objective: To observe the therapeutic effect of chronic lung abscess by interventional therapy under CT guidance. Methods: The group consisted of 12 patients. Firstly, the positions of abscess were localized by CT, secondly under CT guidance puncturing into the abscess with a needle and then thirdly, drain aging through the abscess and injecting some antibiotics through the needle. The treatment consisted by 16 times with an average drawing volume out 10-100 ml, during 18-28 days as a course. All patients were cured. Conclusion: The interventional therapy under CT guidance for chronic lung abscess can increase the therapeutic effect, decrease the course of treatment and avoid the operation. Therefore, it is a safe, simple and convenient method

  2. Effect of a mobile phone-based intervention on post-abortion contraception: a randomized controlled trial in Cambodia

    Science.gov (United States)

    Ngo, Thoai D; Gold, Judy; Edwards, Phil; Vannak, Uk; Sokhey, Ly; Machiyama, Kazuyo; Slaymaker, Emma; Warnock, Ruby; McCarthy, Ona; Free, Caroline

    2015-01-01

    Abstract Objective To assess the effect of a mobile phone-based intervention (mHealth) on post-abortion contraception use by women in Cambodia. Methods The Mobile Technology for Improved Family Planning (MOTIF) study involved women who sought safe abortion services at four Marie Stopes International clinics in Cambodia. We randomly allocated 249 women to a mobile phone-based intervention, which comprised six automated, interactive voice messages with counsellor phone support, as required, whereas 251 women were allocated to a control group receiving standard care. The primary outcome was the self-reported use of an effective contraceptive method, 4 and 12 months after an abortion. Findings Data on effective contraceptive use were available for 431 (86%) participants at 4 months and 328 (66%) at 12 months. Significantly more women in the intervention than the control group reported effective contraception use at 4 months (64% versus 46%, respectively; relative risk, RR: 1.39; 95% confidence interval, CI: 1.17–1.66) but not at 12 months (50% versus 43%, respectively; RR: 1.16; 95% CI: 0.92–1.47). However, significantly more women in the intervention group reported using a long-acting contraceptive method at both follow-up times. There was no significant difference between the groups in repeat pregnancies or abortions at 4 or 12 months. Conclusion Adding a mobile phone-based intervention to abortion care services in Cambodia had a short-term effect on the overall use of any effective contraception, while the use of long-acting contraceptive methods lasted throughout the study period. PMID:26668436

  3. Adapting Certified Safe Farm to North Carolina Agriculture: An Implementation Study.

    Science.gov (United States)

    Storm, Julia F; LePrevost, Catherine E; Tutor-Marcom, Robin; Cope, W Gregory

    2016-01-01

    Certified Safe Farm (CSF) is a multimodal safety and health program developed and assessed through multiple controlled intervention studies in Iowa. Although developed with the intent to be broadly applicable to agriculture, CSF has not been widely implemented outside the midwestern United States. This article describes the CSF implementation process in North Carolina (NC), as piloted on a large-scale in three agriculturally diverse and productive counties of NC, and reports its effectiveness using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Implementation involved (1) capacity building through safety and health training, (2) adaptation of components of Iowa's CSF model to NC agriculture, (3) marketing and recruitment, and (4) formative evaluation, including an online survey and focus group discussion. From 2009 to 2012, 113 farms participated in at least one component of the CSF intervention, representing a NC farm participation rate of 3.1% in the study area. A major adaptation of NC implementation was the utilization of NC Cooperative Extension as the local driver of implementation in contrast to local AgriSafe clinics in Iowa. The most innovative adaptation to CSF components was the development of a defined economic incentive in the form of a cost-share program. The RE-AIM framework was found to be useful and relevant to the field of agricultural health and safety translational research. This study provides effectiveness measures and implementation alternatives useful for those considering implementing CSF. It informs current efforts to move CSF from research to practice through the National Sustainable Model CSF Program initiative.

  4. Day surgery is effective and safe for patients with great saphenous ...

    African Journals Online (AJOL)

    2015-11-02

    Nov 2, 2015 ... Conclusion: DS for GSVV is an effective and safe procedure, which was the same as IS. ... DS could decrease the average medical cost for patients and hospital stays ... Access this article online ..... Dunmade AD, Alabi BS.

  5. Punching loan sharks on the nose: effective interventions to reduce financial hardship in New Zealand.

    Science.gov (United States)

    Signal, Louise; Lanumata, Tolotea; Bowers, Sharron

    2012-08-01

    Growth in the high-cost, unregulated fringe lender market (with these lenders commonly referred to as loan sharks) has occurred both internationally and in New Zealand in recent years. The credit practices of loan sharks create financial hardship for many people including Māori, Pacific and low-income New Zealanders. This paper reports on research that explored strategies for reducing the impact of the fringe lender market on Māori, Pacific and low-income New Zealanders. A narrative literature review and 10 key informant interviews were conducted to provide information on how best to intervene to reduce the impact of the fringe lender market for these people. The main interventions identified were: two regulatory approaches, one for capping interest rates and another to create codes of responsible lending; access to safe affordable micro-finance options; financial literacy education; and Pacific cultural change around fa'alavelave, which are the 'obligations' of giving. Protecting consumers from the unsafe practices of fringe lenders requires a combined approach of discouraging the undesirable practices of fringe lenders through regulation and encouraging the growth of safe, affordable micro-finance options. Financial literacy education is a valuable activity for directing consumer attention to the safest options, but in isolation will have limited effect if options are limited. Health promoters have a valuable role to play in implementing these interventions.

  6. Escola segura Safe school

    Directory of Open Access Journals (Sweden)

    Edson Ferreira Liberal

    2005-11-01

    growing evidence that intervention has multiple components, focusing on health education practices, with the participation of the whole community. The aim of those interventions is to help students and community members to adopt healthy and safe behaviors. Schools are taking on an increasing role in health promotion, disease prevention, and injury prevention. In the context of prevention of external causes of morbidity and mortality, it is important to recognize a risky environment, places, and risk behaviors as favorable to injury and violence, as well as the concept of accident as something one can avoid. CONCLUSION: Implementation of safe schools represents a promising new direction for school-based preventive work. It is important to note that a safe school should intervene not only in its physical structure, but it should also make it as safe as possible by gathering the school community through health education, and mainly encouraging healthy behavior.

  7. The Effects of Music Intervention on Background Pain and Anxiety in Burn Patients: Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Najafi Ghezeljeh, Tahereh; Mohades Ardebili, Fatimah; Rafii, Forough; Haghani, Hamid

    2016-01-01

    This study aimed to investigate the effect of music on the background pain, anxiety, and relaxation levels in burn patients. In this pretest-posttest randomized controlled clinical trial, 100 hospitalized burn patients were selected through convenience sampling. Subjects randomly assigned to music and control groups. Data related to demographic and clinical characteristics, analgesics, and physiologic measures were collected by researcher-made tools. Visual analog scale was used to determine pain, anxiety, and relaxation levels before and after the intervention in 3 consecutive days. Patients' preferred music was offered once a day for 3 days. The control group only received routine care. Data were analyzed using SPSS-PC (V. 20.0). According to paired t-test, there were significant differences between mean scores of pain (P < .001), anxiety (P < .001), and relaxation (P < .001) levels before and after intervention in music group. Independent t-test indicated a significant difference between the mean scores of changes in pain, anxiety, and relaxation levels before and after intervention in music and control groups (P < .001). No differences were detected in the mean scores of physiologic measures between groups before and after music intervention. Music is an inexpensive, appropriate, and safe intervention for applying to burn patients with background pain and anxiety at rest. To produce more effective comfort for patients, it is necessary to compare different types and time lengths of music intervention to find the best approach.

  8. Safe sex

    Science.gov (United States)

    ... sex; Sexually transmitted - safe sex; GC - safe sex; Gonorrhea - safe sex; Herpes - safe sex; HIV - safe sex; ... contact. STIs include: Chlamydia Genital herpes Genital warts Gonorrhea Hepatitis HIV HPV Syphilis STIs are also called ...

  9. Mr.-Guided Cardiac Interventions Using Mr.-Safe Passive Devices: A Preclinical Study and First-in-Man Congenital Interventions

    NARCIS (Netherlands)

    Tzifa, A.; Krombach, G.A.; Kraemer, N.; Krueger, S.; Schuette, A.; Von Walter, M.; Schaeffter, T.; Qureshi, S.; Krasemann, T.; Rosenthal, E.; Schwartz, C.; Varma, G.; Buhl, A.; Kohlmeier, A.; Buecker, A.; Guenther, R.W.; Razavi, R.

    2011-01-01

    Background: Percutaneous cardiac interventions are currently performed under X-ray guidance. Magnetic resonance imaging has been employed to guide intravascular interventions in the past, but mainly in animals. Translation of MR-guided interventions into humans has been limited by the lack of fully

  10. Woman-centered research on access to safe abortion services and implications for behavioral change communication interventions: a cross-sectional study of women in Bihar and Jharkhand, India

    Directory of Open Access Journals (Sweden)

    Banerjee Sushanta K

    2012-03-01

    Full Text Available Abstract Background Unsafe abortion in India leads to significant morbidity and mortality. Abortion has been legal in India since 1971, and the availability of safe abortion services has increased. However, service availability has not led to a significant reduction in unsafe abortion. This study aimed to understand the gap between safe abortion availability and use of services in Bihar and Jharkhand, India by examining accessibility from the perspective of rural, Indian women. Methods Two-stage stratified random sampling was used to identify and enroll 1411 married women of reproductive age in four rural districts in Bihar and Jharkhand, India. Data were collected on women's socio-demographic characteristics; exposure to mass media and other information sources; and abortion-related knowledge, perceptions and practices. Multiple linear regression models were used to explore the association between knowledge and perceptions about abortion. Results Most women were poor, had never attended school, and had limited exposure to mass media. Instead, they relied on community health workers, family and friends for health information. Women who had knowledge about abortion, such as knowing an abortion method, were more likely to perceive that services are available (β = 0.079; p Conclusions Behavior change communication (BCC interventions, which address negative perceptions by improving community knowledge about abortion and support local availability of safe abortion services, are needed to increase enabling resources for women and improve potential access to services. Implementing BCC interventions is challenging in settings such as Bihar and Jharkhand where women may be difficult to reach directly, but interventions can target individuals in the community to transfer information to the women who need this information most. Interpersonal approaches that engage community leaders and influencers may also counteract negative social norms regarding

  11. Mifrenz: Safe email for children

    Directory of Open Access Journals (Sweden)

    Tim Hunt

    Full Text Available Products currently available for monitoring children\\'s email usage are either considered to encourage dubious ethical behaviour or are time consuming for parents to administer. This paper describes the development of a new email client application for children called Mifrenz. This new application gives parents the ability to let their children safely use email, with the minimum of intervention. It was developed using mostly free software and also with the desire to provide real first hand programming examples to demonstrate to students.

  12. Walking with music is a safe and viable tool for gait training in Parkinson's disease: the effect of a 13-week feasibility study on single and dual task walking.

    Science.gov (United States)

    de Bruin, Natalie; Doan, Jon B; Turnbull, George; Suchowersky, Oksana; Bonfield, Stephan; Hu, Bin; Brown, Lesley A

    2010-07-13

    This study explored the viability and efficacy of integrating cadence-matched, salient music into a walking intervention for patients with Parkinson's disease (PD). Twenty-two people with PD were randomised to a control (CTRL, n = 11) or experimental (MUSIC, n = 11) group. MUSIC subjects walked with an individualised music playlist three times a week for the intervention period. Playlists were designed to meet subject's musical preferences. In addition, the tempo of the music closely matched (±10-15 bpm) the subject's preferred cadence. CTRL subjects continued with their regular activities during the intervention. The effects of training accompanied by "walking songs" were evaluated using objective measures of gait score. The MUSIC group improved gait velocity, stride time, cadence, and motor symptom severity following the intervention. This is the first study to demonstrate that music listening can be safely implemented amongst PD patients during home exercise.

  13. Policing behaviors, safe injection self-efficacy, and intervening on injection risks: Moderated mediation results from a randomized trial.

    Science.gov (United States)

    Pitpitan, Eileen V; Patterson, Thomas L; Abramovitz, Daniela; Vera, Alicia; Martinez, Gustavo; Staines, Hugo; Strathdee, Steffanie A

    2016-01-01

    We aim to use conditional or moderated mediation to simultaneously test how and for whom an injection risk intervention was efficacious at reducing receptive needle sharing among female sex workers who inject drugs (FSWs-IDUs) in Mexico. Secondary analysis of data from a randomized trial. A total of 300 FSW-IDUs participated in Mujer Mas Segura in Ciudad Juarez, Mexico, and were randomized to an interactive injection risk intervention or a didactic injection risk intervention. We measured safe injection self-efficacy as the hypothesized mediator and policing behaviors (being arrested and syringe confiscation) as hypothesized moderators. In total, 213 women provided complete data for the current analyses. Conditional (moderated) mediation showed that the intervention affected receptive needle sharing through safe injection self-efficacy among women who experienced syringe confiscation. On average, police syringe confiscation was associated with lower safe injection self-efficacy (p = .04). Among those who experienced syringe confiscation, those who received the interactive (vs. didactic) intervention reported higher self-efficacy, which in turn predicted lower receptive needle sharing (p = .04). Whereas syringe confiscation by the police negatively affected safe injection self-efficacy and ultimately injection risk behavior, our interactive intervention helped to "buffer" this negative impact of police behavior on risky injection practices. The theory-based, active skills building elements included in the interactive condition, which were absent from the didactic condition, helped participants' self-efficacy for safer injection in the face of syringe confiscation. (c) 2015 APA, all rights reserved).

  14. Identifying Effective Components of Child Maltreatment Interventions: A Meta-analysis.

    Science.gov (United States)

    van der Put, Claudia E; Assink, Mark; Gubbels, Jeanne; Boekhout van Solinge, Noëlle F

    2018-06-01

    There is a lack of knowledge about specific components that make interventions effective in preventing or reducing child maltreatment. The aim of the present meta-analysis was to increase this knowledge by summarizing findings on effects of interventions for child maltreatment and by examining potential moderators of this effect, such as intervention components and study characteristics. Identifying effective components is essential for developing or improving child maltreatment interventions. A literature search yielded 121 independent studies (N = 39,044) examining the effects of interventions for preventing or reducing child maltreatment. From these studies, 352 effect sizes were extracted. The overall effect size was significant and small in magnitude for both preventive interventions (d = 0.26, p child maltreatment. For preventive interventions, larger effect sizes were found for short-term interventions (0-6 months), interventions focusing on increasing self-confidence of parents, and interventions delivered by professionals only. Further, effect sizes of preventive interventions increased as follow-up duration increased, which may indicate a sleeper effect of preventive interventions. For curative interventions, larger effect sizes were found for interventions focusing on improving parenting skills and interventions providing social and/or emotional support. Interventions can be effective in preventing or reducing child maltreatment. Theoretical and practical implications are discussed.

  15. Exercise intervention for patients diagnosed with operable non-small cell lung cancer

    DEFF Research Database (Denmark)

    Missel, Malene; Pedersen, Jesper Holst; Hendriksen, Carsten

    2015-01-01

    PURPOSE: The purpose was to explore operable lung cancer patient experiences with an exercise intervention from a longitudinal perspective according to patient motivation and patient perceived benefits and barriers of exercise. METHODS: Nineteen patients enrolled in an exercise intervention 2 weeks...... study dropped out of the intervention due to side effects of chemotherapy (n = 3) and external circumstances (n = 5). The mean attendance rate for the eleven participants who completed the intervention was 82 %. No patients experienced severe adverse events. Motivation for participation included...... patients' expectations of physical benefits and the security of having professionals present. Patients experienced physical and emotional benefits and affirmed their social identity. Barriers were primarily related to side effects of chemotherapy. CONCLUSION: The exercise intervention was undertaken safely...

  16. Image guided percutaneous splenic interventions

    International Nuclear Information System (INIS)

    Kang, Mandeep; Kalra, Naveen; Gulati, Madhu; Lal, Anupam; Kochhar, Rohit; Rajwanshi, Arvind

    2007-01-01

    Aim: The objective of this study is to evaluate the efficacy and safety of image-guided percutaneous splenic interventions as diagnostic or therapeutic procedures. Materials and methods: We performed a retrospective review of our interventional records from July 2001 to June 2006. Ninety-five image-guided percutaneous splenic interventions were performed after informed consent in 89 patients: 64 men and 25 women who ranged in age from 5 months to 71 years (mean, 38.4 years) under ultrasound (n = 93) or CT (n = 2) guidance. The procedures performed were fine needle aspiration biopsy of focal splenic lesions (n = 78) and aspiration (n = 10) or percutaneous catheter drainage of a splenic abscess (n = 7). Results: Splenic fine needle aspiration biopsy was successful in 62 (83.78%) of 74 patients with benign lesions diagnosed in 43 (58.1%) and malignancy in 19 (25.67%) patients. The most common pathologies included tuberculosis (26 patients, 35.13%) and lymphoma (14 patients, 18.91%). Therapeutic aspiration or pigtail catheter drainage was successful in all (100%) patients. There were no major complications. Conclusions: Image-guided splenic fine needle aspiration biopsy is a safe and accurate technique that can provide a definitive diagnosis in most patients with focal lesions in the spleen. This study also suggests that image-guided percutaneous aspiration or catheter drainage of splenic abscesses is a safe and effective alternative to surgery

  17. The Effects of Response Effort on Safe Performance by Therapists at an Autism Treatment Facility

    Science.gov (United States)

    Casella, Sarah E.; Wilder, David A.; Neidert, Pamela; Rey, Catalina; Compton, Megan; Chong, Ivy

    2010-01-01

    The effects of response effort on safe behaviors (i.e., glove wearing, hand sanitizing, and electrical outlet replacement) exhibited by therapists at an autism treatment center were examined. Participants were exposed to 2 or 3 levels of effort (i.e., high, medium, low) for each dependent variable. Results showed increased safe performance during…

  18. A stepped wedge, cluster-randomized trial of a household UV-disinfection and safe storage drinking water intervention in rural Baja California Sur, Mexico.

    Science.gov (United States)

    Gruber, Joshua S; Reygadas, Fermin; Arnold, Benjamin F; Ray, Isha; Nelson, Kara; Colford, John M

    2013-08-01

    In collaboration with a local non-profit organization, this study evaluated the expansion of a program that promoted and installed Mesita Azul, an ultraviolet-disinfection system designed to treat household drinking water in rural Mexico. We conducted a 15-month, cluster-randomized stepped wedge trial by randomizing the order in which 24 communities (444 households) received the intervention. We measured primary outcomes (water contamination and diarrhea) during seven household visits. The intervention increased the percentage of households with access to treated and safely stored drinking water (23-62%), and reduced the percentage of households with Escherichia coli contaminated drinking water (risk difference (RD): -19% [95% CI: -27%, -14%]). No significant reduction in diarrhea was observed (RD: -0.1% [95% CI: -1.1%, 0.9%]). We conclude that household water quality improvements measured in this study justify future promotion of the Mesita Azul, and that future studies to measure its health impact would be valuable if conducted in populations with higher diarrhea prevalence.

  19. Effect of Educational Program to Encourage Safe Sexual Behaviors Among Addicted Men Refered to Substance Abuse Treatment Centers in Hamadan, Western Iran: Applying the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Babak Moeini

    2014-06-01

    Full Text Available Introduction: Unsafe sexual behaviors as important risky behaviors can expose individuals and society to dangerous infectious disease such as AIDS and viral hepatitis. Considering the high prevalence of unsafe sexual behaviors, this study aimed to determine the effect of educational programs to encourage safe sexual behaviors among substance abusers referred to substance abuse treatment centers in Hamadan, Western Iran by applying the theory of planned behavior. Materials & Methods: This quasi-experimental study was performed on 104 men substance abusers (52 participants in each of the control and intervention groups referred to substance abuse treatment centers in Hamadan. Data collection tool was a questionnaire containing demographic information and the theory of planned behavior constructs. Before the educational program, questionnaires were completed by both groups. After the pretest in both groups, participants in the intervention group participated in four educational sessions designed based on the theory of planned behavior. Two months after the end of program, posttest was performed. Data was analyzed using independent T-test, chi-square, fisher exact test, McNemar’s test and multiple linear regressions using SPSS-16. Results: After educational intervention, the mean scores of the theory constructs (attitude toward behavior, subjective norms, behavioral control, behavioral intention and behaviors, in the intervention group increased significantly (P<0.05, despite the fact, changes were not significant in the control group. Conclusion: Implementation of educational courses to encourage safe sexual behaviors based on the theory of planned behavior can be beneficial for substance abusers referred to substance abuse treatment centers.

  20. Falls prevention in hospitals and mental health units: an extended evaluation of the FallSafe quality improvement project.

    Science.gov (United States)

    Healey, Frances; Lowe, Derek; Darowski, Adam; Windsor, Julie; Treml, Jonathan; Byrne, Lisa; Husk, Janet; Phipps, Jill

    2014-07-01

    inpatient falls are a major patient safety issue causing distress, injury and death. Systematic review suggests multifactorial assessment and intervention can reduce falls by 20-30%, but large-scale studies of implementation are few. This paper describes an extended evaluation of the FallSafe quality improvement project, which presented key components of multifactorial assessment and intervention as a care bundle. : data on delivery of falls prevention processes were collected at baseline and for 18 months from nine FallSafe units and nine control units. Data on falls were collected from local risk management systems for 24 months, and data on under-reporting through staff surveys. : in FallSafe units, delivery of seven care bundle components significantly improved; most improvements were sustained after active project support was withdrawn. Twelve-month moving average of reported fall rates showed a consistent downward trend in FallSafe units but not controls. Significant reductions in reported fall rate were found in FallSafe units (adjusted rate ratio (ARR) 0.75, 95% confidence interval (CI) 0.68-0.84 P control units (ARR 0.91, 95% CI 0.81-1.03 P = 0.13). No significant changes in injurious fall rate were found in FallSafe units (ARR 0.86, 95% CI 0.71-1.03 P = 0.11), or controls (ARR 0.88, 95% CI 0.72-1.08 P = 0.13). In FallSafe units, staff certain falls had been reported increased from 60 to 77%. : introducing evidence-based care bundles of multifactorial assessment and intervention using a quality improvement approach resulted in improved delivery of multifactorial assessment and intervention and significant reductions in fall rates, but not in injurious fall rates. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Families Matter! Presexual Risk Prevention Intervention

    Science.gov (United States)

    Lasswell, Sarah M.; Riley, Drewallyn B.; Poulsen, Melissa N.

    2013-01-01

    Parent-based HIV prevention programming may play an important role in reaching youths early to help establish lifelong patterns of safe and healthy sexual behaviors. Families Matter! is a 5-session, evidence-based behavioral intervention designed for primary caregivers of children aged 9 to 12 years to promote positive parenting and effective parent–child communication about sexuality and sexual risk reduction. The program’s 5-step capacity-building model was implemented with local government, community, and faith-based partners in 8 sub-Saharan African countries with good intervention fidelity and high levels of participant retention. Families Matter! may be useful in other resource-constrained settings. PMID:24028229

  2. Closed-system drug-transfer devices plus safe handling of hazardous drugs versus safe handling alone for reducing exposure to infusional hazardous drugs in healthcare staff.

    Science.gov (United States)

    Gurusamy, Kurinchi Selvan; Best, Lawrence Mj; Tanguay, Cynthia; Lennan, Elaine; Korva, Mika; Bussières, Jean-François

    2018-03-27

    Occupational exposure to hazardous drugs can decrease fertility and result in miscarriages, stillbirths, and cancers in healthcare staff. Several recommended practices aim to reduce this exposure, including protective clothing, gloves, and biological safety cabinets ('safe handling'). There is significant uncertainty as to whether using closed-system drug-transfer devices (CSTD) in addition to safe handling decreases the contamination and risk of staff exposure to infusional hazardous drugs compared to safe handling alone. To assess the effects of closed-system drug-transfer of infusional hazardous drugs plus safe handling versus safe handling alone for reducing staff exposure to infusional hazardous drugs and risk of staff contamination. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, OSH-UPDATE, CINAHL, Science Citation Index Expanded, economic evaluation databases, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov to October 2017. We included comparative studies of any study design (irrespective of language, blinding, or publication status) that compared CSTD plus safe handling versus safe handling alone for infusional hazardous drugs. Two review authors independently identified trials and extracted data. We calculated the risk ratio (RR) and mean difference (MD) with 95% confidence intervals (CI) using both fixed-effect and random-effects models. We assessed risk of bias according to the risk of bias in non-randomised studies of interventions (ROBINS-I) tool, used an intracluster correlation coefficient of 0.10, and we assessed the quality of the evidence using GRADE. We included 23 observational cluster studies (358 hospitals) in this review. We did not find any randomised controlled trials or formal economic evaluations. In 21 studies, the people who used the intervention (CSTD plus safe handling) and control (safe handling alone) were pharmacists or pharmacy

  3. FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies

    Directory of Open Access Journals (Sweden)

    Zuidmeer-Jongejan Laurian

    2012-03-01

    Full Text Available Abstract The FAST project (Food Allergy Specific Immunotherapy aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT, using subcutaneous injections with aqueous food extracts may be effective but has proven to be accompanied by too many anaphylactic side-effects. FAST aims to develop a safe alternative by replacing food extracts with hypoallergenic recombinant major allergens as the active ingredients of SIT. Both severe fish and peach allergy are caused by a single major allergen, parvalbumin (Cyp c 1 and lipid transfer protein (Pru p 3, respectively. Two approaches are being evaluated for achieving hypoallergenicity, i.e. site-directed mutagenesis and chemical modification. The most promising hypoallergens will be produced under GMP conditions. After pre-clinical testing (toxicology testing and efficacy in mouse models, SCIT with alum-absorbed hypoallergens will be evaluated in phase I/IIa and IIb randomized double-blind placebo-controlled (DBPC clinical trials, with the DBPC food challenge as primary read-out. To understand the underlying immune mechanisms in depth serological and cellular immune analyses will be performed, allowing identification of novel biomarkers for monitoring treatment efficacy. FAST aims at improving the quality of life of food allergic patients by providing a safe and effective treatment that will significantly lower their threshold for fish or peach intake, thereby decreasing their anxiety and dependence on rescue medication.

  4. FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies

    Science.gov (United States)

    2012-01-01

    The FAST project (Food Allergy Specific Immunotherapy) aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT), using subcutaneous injections with aqueous food extracts may be effective but has proven to be accompanied by too many anaphylactic side-effects. FAST aims to develop a safe alternative by replacing food extracts with hypoallergenic recombinant major allergens as the active ingredients of SIT. Both severe fish and peach allergy are caused by a single major allergen, parvalbumin (Cyp c 1) and lipid transfer protein (Pru p 3), respectively. Two approaches are being evaluated for achieving hypoallergenicity, i.e. site-directed mutagenesis and chemical modification. The most promising hypoallergens will be produced under GMP conditions. After pre-clinical testing (toxicology testing and efficacy in mouse models), SCIT with alum-absorbed hypoallergens will be evaluated in phase I/IIa and IIb randomized double-blind placebo-controlled (DBPC) clinical trials, with the DBPC food challenge as primary read-out. To understand the underlying immune mechanisms in depth serological and cellular immune analyses will be performed, allowing identification of novel biomarkers for monitoring treatment efficacy. FAST aims at improving the quality of life of food allergic patients by providing a safe and effective treatment that will significantly lower their threshold for fish or peach intake, thereby decreasing their anxiety and dependence on rescue medication. PMID:22409908

  5. Quality performance-based training enhances safe and effective transport operations

    International Nuclear Information System (INIS)

    McCall, D.L.

    1993-01-01

    If the hazardous materials transportation industry is to reduce human error, reduce accidents, and improve its public image, there must be assurance that transportation personnel are properly trained and qualified to perform their jobs in a safe and efficient manner. This training must make them intimately aware of the hazards and risks associated with transport activities, ensure understanding of responsibilities and liabilities unique to their job, and ensure that they can competently perform functional duties vital to safety. To ensure that trained and qualified personnel are on the job, it is essential that the training be performance-based and require trainees to demonstrate functional proficiency. Performance-based training has proven to be a highly effective means of ensuring personnel are qualified to conduct their assignments safely and efficiently. This training is designed around the basic premise that training must be provided that supplies the information necessary for each worker to perform their assigned duties at a predetermined and acceptable level of expertise and skill. (J.P.N.)

  6. The top 10 list for a safe and effective sign-out.

    Science.gov (United States)

    Kemp, Clinton D; Bath, Jonathan M; Berger, Jonathan; Bergsman, Aaron; Ellison, Trevor; Emery, Katherine; Garonzik-Wang, Jacqueline; Hui-Chou, Helen G; Mayo, Skye C; Serrano, Oscar K; Shridharani, Sachin; Zuberi, Kashif; Lipsett, Pamela A; Freischlag, Julie A

    2008-10-01

    With the advent of the 80-hour workweek, much attention has been focused on the benefits of shorter work hours regarding resident fatigue and reduced medical errors. Along with this change, however, there has been more reliance on multiple teams of residents who assume the care of inpatients at different times. In this new paradigm, a safe and effective sign-out process is needed to ensure a seamless transition of care from one resident to another. Several studies have been published on the sign-out process among interns in internal medicine, but the literature is sparse with regards to the best way to hand over care of a busy inpatient surgical service. To aid in this process, the Halsted surgical interns performed a review of the current literature on this topic. They also reflected on their personal experiences and developed a 10-point method for safe and effective sign-outs. This process is emphasized for incoming interns and used across the various surgical services at The Johns Hopkins Hospital.

  7. Clinical Practice Guideline: Safe Medication Use in the ICU.

    Science.gov (United States)

    Kane-Gill, Sandra L; Dasta, Joseph F; Buckley, Mitchell S; Devabhakthuni, Sandeep; Liu, Michael; Cohen, Henry; George, Elisabeth L; Pohlman, Anne S; Agarwal, Swati; Henneman, Elizabeth A; Bejian, Sharon M; Berenholtz, Sean M; Pepin, Jodie L; Scanlon, Mathew C; Smith, Brian S

    2017-09-01

    To provide ICU clinicians with evidence-based guidance on safe medication use practices for the critically ill. PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and ISI Web of Science for relevant material to December 2015. Based on three key components: 1) environment and patients, 2) the medication use process, and 3) the patient safety surveillance system. The committee collectively developed Population, Intervention, Comparator, Outcome questions and quality of evidence statements pertaining to medication errors and adverse drug events addressing the key components. A total of 34 Population, Intervention, Comparator, Outcome questions, five quality of evidence statements, and one commentary on disclosure was developed. Subcommittee members were assigned selected Population, Intervention, Comparator, Outcome questions or quality of evidence statements. Subcommittee members completed their Grading of Recommendations Assessment, Development, and Evaluation of the question with his/her quality of evidence assessment and proposed strength of recommendation, then the draft was reviewed by the relevant subcommittee. The subcommittee collectively reviewed the evidence profiles for each question they developed. After the draft was discussed and approved by the entire committee, then the document was circulated among all members for voting on the quality of evidence and strength of recommendation. The committee followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation system to determine quality of evidence and strength of recommendations. This guideline evaluates the ICU environment as a risk for medication-related events and the environmental changes that are possible to improve safe medication use. Prevention strategies for medication-related events are reviewed by medication use process node (prescribing, distribution, administration, monitoring). Detailed

  8. Effectiveness of medical interventions.

    Science.gov (United States)

    Stegenga, Jacob

    2015-12-01

    To be effective, a medical intervention must improve one's health by targeting a disease. The concept of disease, though, is controversial. Among the leading accounts of disease-naturalism, normativism, hybridism, and eliminativism-I defend a version of hybridism. A hybrid account of disease holds that for a state to be a disease that state must both (i) have a constitutive causal basis and (ii) cause harm. The dual requirement of hybridism entails that a medical intervention, to be deemed effective, must target either the constitutive causal basis of a disease or the harms caused by the disease (or ideally both). This provides a theoretical underpinning to the two principle aims of medical treatment: care and cure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. 75 FR 20854 - Medical Device Use in the Home Environment: Implications for the Safe and Effective Use of...

    Science.gov (United States)

    2010-04-21

    ...] Medical Device Use in the Home Environment: Implications for the Safe and Effective Use of Medical Device... related to the safe and effective use of medical device technology in the home environment. The workshop... the home environment. FDA will solicit feedback on: 1. The agency's current working definition of...

  10. Peer coaching and mentoring: a new model of educational intervention for safe patient handling in health care.

    Science.gov (United States)

    Alamgir, Hasanat; Drebit, Sharla; Li, Helen Guiyun; Kidd, Catherine; Tam, Helen; Fast, Catherine

    2011-08-01

    To reduce the risk of patient handling-related musculoskeletal injury, overhead ceiling lifts have been installed in health care facilities. To increase ceiling lift usage for a variety of patient handling tasks, a peer coaching and mentoring program was implemented among the direct care staff in the long-term care subsector in British Columbia, Canada. They received a 4-day training program on body mechanics, ergonomics, patient-handling techniques, ceiling lift usage, in addition to coaching skills. A questionnaire was administered among staff before and after the intervention to evaluate the program's effectiveness. There were 403 and 200 respondents to the pre-intervention and post-intervention questionnaires. In general, staff perceived the peer-coaching program to be effective. The number of staff who reported to be using ceiling lifts "often and always" went higher from 64.5% to 80.5% (<0.001) after coaching program implementation. Furthermore, staff reported that they were using the ceiling lifts for more types of tasks post-intervention. Staff reported that the peer coaching program has increased their safety awareness at work and confidence in using the ceiling lifts. The findings suggest that this educational model can increase the uptake of mechanical interventions for occupational health and safety initiatives. It appears that the training led to a greater awareness of the availability of or increased perceptions of the number of ceiling lifts, presumably through coaches advocating their use. Copyright © 2011 Wiley-Liss, Inc.

  11. Clinical effectiveness and cost-effectiveness of a multifaceted podiatry intervention for falls prevention in older people: a multicentre cohort randomised controlled trial (the REducing Falls with ORthoses and a Multifaceted podiatry intervention trial).

    Science.gov (United States)

    Cockayne, Sarah; Rodgers, Sara; Green, Lorraine; Fairhurst, Caroline; Adamson, Joy; Scantlebury, Arabella; Corbacho, Belen; Hewitt, Catherine E; Hicks, Kate; Hull, Robin; Keenan, Anne-Maree; Lamb, Sarah E; McIntosh, Caroline; Menz, Hylton B; Redmond, Anthony; Richardson, Zoe; Vernon, Wesley; Watson, Judith; Torgerson, David J

    2017-04-01

    intervention costs £252.17 more per participant (95% CI -£69.48 to £589.38) than usual care, was marginally more beneficial in terms of HRQoL measured via the EuroQoL-5 Dimensions [mean quality-adjusted life-year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314 QALYs] and had a 65% probability of being cost-effective at the National Institute for Health and Care Excellence threshold of £30,000 per QALY gained. The intervention was generally acceptable to podiatrists and trial participants. Owing to the difficulty in calculating a sample size for a count outcome, the sample size was based on detecting a difference in the proportion of participants experiencing at least one fall, and not the primary outcome. We are therefore unable to confirm if the trial was sufficiently powered for the primary outcome. The findings are not generalisable to patients who are not receiving podiatry care. The intervention was safe and potentially effective. Although the primary outcome measure did not reach significance, a lower fall rate was observed in the intervention group. The reduction in the proportion of older adults who experienced a fall was of borderline statistical significance. The economic evaluation suggests that the intervention could be cost-effective. Further research could examine whether or not the intervention could be delivered in group sessions, by physiotherapists, or in high-risk patients. Current Controlled Trials ISRCTN68240461. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 21, No. 24. See the NIHR Journals Library website for further project information.

  12. Day surgery is effective and safe for patients with great saphenous ...

    African Journals Online (AJOL)

    However, average hospital stays in DS group was 1 day, compared to 4.2 days in IS group. Moreover with respect to average medical cost (dollar), it was 780.33 dollars and 1021.06 dollars in DS and IS group, respectively. Conclusion: DS for GSVV is an effective and safe procedure, which was the same as IS. However ...

  13. Contrasting Causal Effects of Workplace Interventions.

    Science.gov (United States)

    Izano, Monika A; Brown, Daniel M; Neophytou, Andreas M; Garcia, Erika; Eisen, Ellen A

    2018-07-01

    Occupational exposure guidelines are ideally based on estimated effects of static interventions that assign constant exposure over a working lifetime. Static effects are difficult to estimate when follow-up extends beyond employment because their identifiability requires additional assumptions. Effects of dynamic interventions that assign exposure while at work, allowing subjects to leave and become unexposed thereafter, are more easily identifiable but result in different estimates. Given the practical implications of exposure limits, we explored the drivers of the differences between static and dynamic interventions in a simulation study where workers could terminate employment because of an intermediate adverse health event that functions as a time-varying confounder. The two effect estimates became more similar with increasing strength of the health event and outcome relationship and with increasing time between health event and employment termination. Estimates were most dissimilar when the intermediate health event occurred early in employment, providing an effective screening mechanism.

  14. Effects of a multifaceted implementation intervention to increase utilization of pharmacological treatments for alcohol use disorders in the US Veterans Health Administration.

    Science.gov (United States)

    Harris, Alex H S; Brown, Randall; Dawes, Michael; Dieperink, Eric; Myrick, Donald Hugh; Gerould, Heather; Wagner, Todd H; Wisdom, Jennifer P; Hagedorn, Hildi J

    2017-11-01

    Over 16 million Americans meet diagnostic criteria for alcohol use disorder (AUD), but only 7.8% of them receive formal treatment each year. Safe and effective pharmacological treatments for AUD exist; however, they are rarely prescribed. Therefore, we developed and pilot tested a multifaceted implementation intervention to improve consideration and receipt of effective pharmacologic treatments for AUD, focusing on primary care settings where patients have the most frequent contact with healthcare systems. The intervention included training of local providers to serve as champions and a website for primary care providers that included educational materials, a case-finding dashboard, and contact information for local and national clinical experts. We also mailed patients educational material about treatment options. The intervention was implemented at three large facilities of the Veterans Health Administration (VHA). An interrupted time series design, analyzed with segmented logistic regression, was used to evaluate the intervention's effects. The odds of a patient with AUD receiving one of the AUD medications was increasing throughout the pre-implementation period, and the rate of change (slope) increased significantly in the implementation period. Translating these numbers into percentages, at baseline 2.9% of patients filled a prescription for an AUD medication within 30days of a primary care visit. This increased to 3.8% by the end of the pre-implementation period (increasing 0.037% per month), and increased to 5.2% by the end of the implementation period (increasing 0.142% per month). However, the intervention effect was not significant when control sites were added, suggesting that improvement may have been driven by secular trends rather than solely by this intervention. Although the intervention was feasible, it was not effective. Continued analysis of process and implementation data including qualitative interviews with key stakeholders, may elucidate the

  15. The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study.

    Science.gov (United States)

    van der Krieke, Lian; Bird, Victoria; Leamy, Mary; Bacon, Faye; Dunn, Rebecca; Pesola, Francesca; Janosik, Monika; Le Boutillier, Clair; Williams, Julie; Slade, Mike

    2015-05-23

    Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility (SAFE) measure is a standardised assessment of implementation blocks and enablers. The aim of this study was to characterise and compare the implementation blocks and enablers for recommended psychosis interventions. SAFE was used to evaluate and compare three groups of interventions recommended in the 2014 NICE psychosis guideline: pharmacological (43 trials testing 5 interventions), psychosocial (65 trials testing 5 interventions), and recovery (19 trials testing 5 interventions). The 127 trial reports rated with SAFE were supplemented by published intervention manuals, research protocols, trial registrations and design papers. Differences in the number of blocks and enablers across the three interventions were tested statistically, and feasibility profiles were generated. There was no difference between psychosocial and recovery interventions in the number of blocks or enablers to implementation. Pharmacological interventions (a) had fewer blocks than both psychosocial interventions (χ (2)(3) = 133.77, p Feasibility profiles show that pharmacological interventions are relatively easy to implement but can sometimes involve risks. Psychosocial and recovery interventions are relatively complex but tend to be more flexible and more often manualised. SAFE ratings can contribute to tackling the current implementation challenges in mental health services, by providing a reporting guideline structure for researchers to maximise the potential for implementation and by informing prioritisation decisions by clinical guideline developers and service managers.

  16. Overweight and obesity: effectiveness of interventions in adults.

    Science.gov (United States)

    Gómez Puente, Juana María; Martínez-Marcos, Mercedes

    To identify the most effective interventions in overweight and obese adults. A narrative review through a search of the literature in databases PubMed, Cochrane, Joanna Briggs Institute, EMBASE, Cuiden y Cinahl with free and controlled language (MeSH terms) using Boolean operators AND and NOT. The research was limited to articles published between 2007 and 2015. Eighteen articles were selected based on the established inclusion and exclusion criteria. Different types of interventions were identified based on the modification of lifestyles, mainly diet, physical activity and behavior. Major differences were found in specific content, degree of intensity of interventions, time tracking and elements evaluated. Most of studies found statistically significant weight loss but this was limited in terms of weight and number of people. Web-based interventions have no uniform effect on weight loss but achieve similar levels to face-to-face interventions in maintaining weight loss. The combination of personalised diet, exercise and cognitive behavioural therapy is the most effective form of intervention in overweight and obesity. There is insufficient data to indicate whether group or individual interventions are more effective. Online intervention allows greater accessibility and lower cost. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  17. Internet interventions for mental health and addictions: current findings and future directions.

    Science.gov (United States)

    Cunningham, John A; Gulliver, Amelia; Farrer, Lou; Bennett, Kylie; Carron-Arthur, Bradley

    2014-12-01

    Over the last several years, there has been a substantial increase in the number of publications reporting on Internet interventions for mental health and addictions. This paper provides a summary of the recent research on Internet interventions for the most common mental health and addictions concerns-depression, anxiety, alcohol and smoking. There is considerable evidence for the effectiveness of Internet-based interventions targeting depression, anxiety disorders, alcohol use and smoking. Small to moderate effect sizes have been reported for interventions targeting depression, anxiety and alcohol use, and smoking interventions have shown large effects. The addition of human support to depression and anxiety interventions has generally resulted in larger treatments effects, but this trend has not been observed in trials of interventions targeting alcohol use. There is some evidence that online interventions can be as effective as face-to-face therapies, at least for anxiety disorders. Despite a proliferation of research activity in this area, gaps in knowledge remain. Future research should focus on the development and evaluation of interventions for different platforms (e.g. smartphone applications), examining the long-term impacts of these interventions, determining active intervention components and identifying methods for enhancing tailoring and engagement. Careful consideration should be given to the ongoing technical and clinical expertise required to ensure that Internet interventions are delivered safely and professionally in a rapidly changing technology environment.

  18. The Effectiveness of Psychoeducational Interventions Focused on Sexuality in Cancer.

    Science.gov (United States)

    Kim, Jung-Hee; Yang, Younghee; Hwang, Eun-Suk

    2015-01-01

    Although sexual health is a common concern for oncology patients, no practical guidelines to sexual intervention exist, perhaps because of a lack of systematic reviews or meta-analyses. The objectives of this study were to determine the effect size for psychoeducational intervention focused on sexuality and to compare effect sizes according to intervention outcomes and characteristic. We explored quantitative evidence for the effects of sexual intervention for cancer patients or partners by using the electronic databases. Among them, we considered 15 eligible articles. The meta-analysis provided 133 effect sizes from 15 primary studies. The analysis revealed significant improvements after intervention, with a random-effects standardized mean difference of 0.75. Psychoeducational interventions focused on sexuality after cancer diagnosis were effective for compliance (2.40), cognitive aspect (1.29), and psychological aspect (0.83). Individual-based interventions (0.85) were more effective in improving outcomes than group approach and group combined with individual intervention. With regard to intervention providers, registered nurse only (2.22) and team approach including the registered nurse (2.38) had the highest effect size. Face-to-face intervention combined with telephone or the Internet (1.04) demonstrated a higher effect size than face-to-face (0.62) and telephone (0.58) independently. We conducted an analysis of data from various subgroups of preexisting studies, obtained an overall estimate of the effectiveness of the intervention, and compared its effectiveness across variables that affect intervention outcomes. These results provide empirical data for evidence-based practice and inform the development of useful intervention programs through a comprehensive review and meta-analysis of the results.

  19. The Blue Dog: evaluation of an interactive software program to teach young children how to interact safely with dogs.

    Science.gov (United States)

    Schwebel, David C; Morrongiello, Barbara A; Davis, Aaron L; Stewart, Julia; Bell, Melissa

    2012-04-01

    Pre-post-randomized design evaluated The Blue Dog, a dog safety software program. 76 children aged 3.5-6 years completed 3 tasks to evaluate dog safety pre- and postintervention: (a) pictures (recognition of safe/risky behavior), (b) dollhouse (recall of safe behavior via simulated dollhouse scenarios), and (c) live dog (actual behavior with unfamiliar live dog). Following preintervention evaluation, children were randomly assigned to dog or fire safety conditions, each involving 3 weeks of home computer software use. Children using Blue Dog had greater change in recognition of risky dog situations than children learning fire safety. No between-group differences emerged in recall (dollhouse) or engagement (live-dog) in risky behavior. Families enjoyed using the software. Blue Dog taught children knowledge about safe engagement with dogs, but did not influence recall or implementation of safe behaviors. Dog bites represent a significant pediatric injury concern and continued development of effective interventions is needed.

  20. Effects of listening to music on pain intensity and pain distress after surgery: an intervention.

    Science.gov (United States)

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

    2012-03-01

    To evaluate the effects of music listening on pain intensity and pain distress on the first and second postoperative days in abdominal surgery patients and the long-term effects of music on the third postoperative day. Music has been found to relieve pain intensity in surgery patients. There are only a few studies on music intervention in abdominal surgery. Music intervention studies assessing multidimensional pain such as pain intensity and pain distress are also scarce. Prospective clinical study with two parallel groups. Patients undergoing elective abdominal surgery (n = 168) were divided into either a music group (n = 83) or a control group (n = 85). Patients assessed pain intensity and pain distress in bed rest, during deep breathing and in shifting position once in the evening of the operation day and on the first and second postoperative days in the morning, at noon and in the evening. On the third postoperative day, the patients assessed their pain intensity and pain distress only once. In the music group, the patients' pain intensity and pain distress in bed rest, during deep breathing and in shifting position were significantly lower on the second postoperative day compared with control group of patients. On the third postoperative day, when long-term effects of music on pain intensity and pain distress were assessed, there were no significant differences between music and control groups. This study demonstrates that the use of music alleviates pain intensity and pain distress in bed rest, during deep breathing and in shifting position after abdominal surgery on the second postoperative day. Music intervention is safe, inexpensive and easily used to improve the healing environment for abdominal surgery patients. Music intervention should be offered as an adjunct alternative to pharmacological pain relief after abdominal surgery in nursing practice. © 2011 Blackwell Publishing Ltd.

  1. Training Older Siblings to be Better Supervisors: An RCT Evaluating the "Safe Sibs" Program.

    Science.gov (United States)

    Schell, Stacey L; Morrongiello, Barbara A; Pogrebtsova, Ekaterina

    2015-09-01

    This study evaluated a new online training program, Safe Sibs, aimed at improving supervision knowledge and behaviors of sibling supervisors. Participants included older children (7-11 years) and their younger siblings (2-5 years). A randomized controlled trial design was used, with older siblings randomly assigned to either an intervention or wait-list control group. Before and after either the intervention or wait-list period, older siblings completed measures of supervision knowledge and their supervision behaviors were unobtrusively observed when with their younger sibling. Compared with the control group, the intervention group showed significant improvements in supervision knowledge (child development, knowledge of effective supervision practices, injury beliefs, intervention-specific knowledge) and in some aspects of supervision behavior (frequency of proactive safety behaviors to prevent supervisee access to injury hazards). Although adult supervision is ideal, this new program can support older children to become more knowledgeable and improved supervisors of younger ones. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Effects of a 3-year intervention: The Copenhagen School Child Intervention Study

    DEFF Research Database (Denmark)

    Bugge, Anna; El-Naaman, Bianca; Dencker, Magnus

    2012-01-01

    INTRODUCTION: This study assessed short and long term effects of a 3-year controlled school-based physical activity (PA) intervention on fatness, cardiorespiratory fitness (VO2peak) and cardiovascular disease (CVD) risk factors in children. METHODS: The study involved 18 schools (10 intervention...

  3. Nonspecific abdominal pain is a safe diagnosis.

    Science.gov (United States)

    Pennel, David John Laurie; Goergen, Nina; Driver, Chris P

    2014-11-01

    The aim of this study is to assess if a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe and if patients with this initial diagnosis are likely to require further investigation or surgical intervention. 3323 patients admitted with NSAP from July 1990 to September 2012 utilizing a prospective database of all surgical admissions were included. Readmission over the period of the study and specifically within 30 days of their initial presentation was identified together with any invasive investigation or surgical intervention. 319 children (9.6%) were subsequently readmitted with abdominal pain at some point during the study period. Of these, 78 (2.3%) were readmitted within 30 days. 118 (3.5%) children subsequently had an operation or invasive investigation some point following their initial admission. Of these 33 (0.6%) had the procedure within 3 months of the initial admission. 13 patients had an appendicectomy within 3 months of the initial presentation. Of these histology confirmed appendicitis in 8 patients. This gives an overall incidence of "missed" appendicitis of 0.2 % (8/3323). This study confirms that a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe in a pediatric population and the risk of "missing" appendicitis is only 0.2%. Patients and/or parents can be confidently reassured that the risk of missing organic pathology is very low. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. FAST: Towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies

    NARCIS (Netherlands)

    Zuidmeer-Jongejan, Laurian; Fernandez-Rivas, Montserrat; Poulsen, Lars K.; Neubauer, Angela; Asturias, Juan; Blom, Lars; Boye, Joyce; Bindslev-Jensen, Carsten; Clausen, Michael; Ferrara, Rosa; Garosi, Paula; Huber, Hans; Jensen, Bettina M.; Koppelman, Stef; Kowalski, Marek L.; Lewandowska-Polak, Anna; Linhart, Birgit; Maillere, Bernard; Mari, Adriano; Martinez, Alberto; Mills, Clare En; Nicoletti, Claudio; Opstelten, Dirk-Jan; Papadopoulos, Nikos G.; Portoles, Antonio; Rigby, Neil; Scala, Enrico; Schnoor, Heidi J.; Sigursdottir, Sigurveig; Stavroulakis, Georg; Stolz, Frank; Swoboda, Ines; Valenta, Rudolf; van den Hout, Rob; Versteeg, Serge A.; Witten, Marianne; van Ree, Ronald

    2012-01-01

    ABSTRACT: The FAST project (Food Allergy Specific Immunotherapy) aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT), using subcutaneous injections with

  5. Crafting safe and effective suicide prevention media messages: outcomes from a workshop in Australia.

    Science.gov (United States)

    Ftanou, Maria; Skehan, Jaelea; Krysinska, Karolina; Bryant, Marc; Spittal, Matthew J; Pirkis, Jane

    2018-01-01

    Suicide and suicide-related behaviours are major public health concerns in Australia and worldwide. One universal intervention that has received an increased focus as a means of preventing suicide is the use of media campaigns. There is, however, a lack of understanding of the kinds of campaign messages that are safe and effective. The current paper aims to expand on this knowledge. The study objectives were to: (1) explore what suicide prevention experts consider to be essential characteristics of effective and safe suicide media campaigns; (2) develop suicide prevention media messages; and (3) explore the impact that these messages might have on different audiences. We conducted a workshop in July 2015 which was attended by 21 experts (professionals with knowledge about suicide prevention and/or media campaigns, and people with a lived experience of suicide). The experts were split into three groups, and each group developed a suicide prevention message for one of the following target audiences: people at risk of suicide; family and peers of people at risk of suicide; and people bereaved by suicide. The three groups generally agreed that these messages had to include two key characteristics: (1) validate or reflect the target group's issues and needs; and (2) promote help-seeking behaviours. They noted, however, that messages that might have a positive impact for one target audience might inadvertently have a negative impact for other target audiences. In particular, they were concerned that messages designed for family and peers about being supportive and looking for warning signs might leave those who had been bereaved by suicide feeling isolated, guilty or traumatised. Workshop participants highlighted that gaps exist in relation to the use of appropriate language, were unsure of how to create destigmatising messages without normalising or sensationalising suicide and commented on the lack of evaluative evidence for the efficacy of media campaigns. Developing

  6. Soil intervention as a strategy for lead exposure prevention: The New Orleans lead-safe childcare playground project

    Energy Technology Data Exchange (ETDEWEB)

    Mielke, Howard W., E-mail: howard.mielke@gmail.com [Department of Chemistry, Tulane University, New Orleans, LA 70118 (United States); Center for Bioenvironmental Research at Tulane and Xavier Universities, 1430 Tulane Avenue SL-3, New Orleans, LA 70112 (United States); Covington, Tina P. [Charity School of Nursing, Delgado Community College, New Orleans, LA 70112-1397 (United States); College of Nursing, University of South Alabama, Doctor of Nursing Practice Program (student), Mobile AL 36688-0002 (United States); Mielke, Paul W. [Department of Statistics, Colorado State University, Fort Collins, CO 80523-1877 (United States); Wolman, Fredericka J. [Director of Pediatrics, Department of Children and Families, State of Connecticut, Hartford, CT 06473 (United States); Powell, Eric T.; Gonzales, Chris R. [Lead Lab, Inc., New Orleans, LA 70179-1125 (United States)

    2011-08-15

    The feasibility of reducing children's exposure to lead (Pb) polluted soil in New Orleans is tested. Childcare centers (median = 48 children) are often located in former residences. The extent of soil Pb was determined by selecting centers in both the core and outlying areas. The initial 558 mg/kg median soil Pb (range 14-3692 mg/kg) decreased to median 4.1 mg/kg (range 2.2-26.1 mg/kg) after intervention with geotextile covered by 15 cm of river alluvium. Pb loading decreased from a median of 4887 {mu}g/m{sup 2} (454 {mu}g/ft{sup 2}) range 603-56650 {mu}g/m{sup 2} (56-5263 {mu}g/ft{sup 2}) to a median of 398 {mu}g/m{sup 2} (37 {mu}g/ft{sup 2}) range 86-980 {mu}g/m{sup 2} (8-91 {mu}g/ft{sup 2}). Multi-Response Permutation Procedures indicate similar (P-values = 0.160-0.231) soil Pb at childcare centers compared to soil Pb of nearby residential communities. At {approx}$100 per child, soil Pb and surface loading were reduced within hours, advancing an upstream intervention conceptualization about Pb exposure prevention. - Highlights: > Upstream thinking refers to attending to causative agents that affect outcomes. > New Orleans has a high density soil Pb map of all residential communities. > Many childcare centers are located in Pb polluted residential communities. > Evaluation of childcare center playground soils substantiated severe Pb pollution. > Pursuing upstream thinking, low Pb soil was put on playgrounds to protect children. - Within hours, at a cost of about U.S. $100 (2010) per child, it is feasible to transform exterior play areas at childcare centers from Pb contaminated to Pb-safe with a large margin of safety.

  7. Ocular Chlamydia trachomatis infection under the SAFE strategy in Amhara, Ethiopia, 2011-2015.

    Science.gov (United States)

    Nash, Scott D; Stewart, Aisha E P; Zerihun, Mulat; Sata, Eshetu; Gessese, Demelash; Melaku, Berhanu; Endeshaw, Tekola; Chanyalew, Melsew; Chernet, Ambahun; Bayissasse, Belay; Moncada, Jeanne; Lietman, Thomas M; Emerson, Paul M; King, Jonathan D; Tadesse, Zerihun; Callahan, E Kelly

    2018-05-05

    WHO recommendations for starting and stopping mass antibiotic distributions are based on a clinical sign of trachoma, which is indirectly related to actual infection with the causative agent, Chlamydia trachomatis. This study aimed to understand the effect of SAFE (surgery, antibiotics, facial cleanliness, and environmental improvement) interventions on ocular chlamydia in Amhara, Ethiopia by describing the infection prevalence in a population-based sample of children ages 1-5 years. Population-based trachoma surveys were conducted in all districts of Amhara, from 2011 to 2015 following approximately 5 years of SAFE. Ocular swabs were collected from randomly selected children whose households were included in the surveys to estimate the zonal prevalence of chlamydial infection. The Abbott Realtime PCR assay was used to detect C. trachomatis DNA using the m2000 system. A total of 15,632 samples were collected across the 10 zones of Amhara. The prevalence of chlamydial infection in children ages 1-5 years was 5.7% (95% Confidence Interval: 4.2-7.3), zonal range 1.0% to 18.5%. Chlamydial infection and trachomatous-inflammation intense (TI) among children ages 1-9 were highly correlated at the zonal level, Spearman correlation(r)= 0.93; P<0.001, while chlamydial infection and trachomatous-inflammation follicular (TF) among children ages 1-9 years were moderately correlated, r= 0.57; P=0.084. After 5 years of SAFE there is appreciable ocular chlamydial infection in children ages 1-5 years, indicating that transmission has not been interrupted, and that interventions should continue. The sign TI was highly correlated with chlamydial infection and can be used as a proxy indicator of infection.

  8. Reasons for Testing Mediation in the Absence of an Intervention Effect: A Research Imperative in Prevention and Intervention Research.

    Science.gov (United States)

    O'Rourke, Holly P; MacKinnon, David P

    2018-03-01

    Mediation models are used in prevention and intervention research to assess the mechanisms by which interventions influence outcomes. However, researchers may not investigate mediators in the absence of intervention effects on the primary outcome variable. There is emerging evidence that in some situations, tests of mediated effects can be statistically significant when the total intervention effect is not statistically significant. In addition, there are important conceptual and practical reasons for investigating mediation when the intervention effect is nonsignificant. This article discusses the conditions under which mediation may be present when an intervention effect does not have a statistically significant effect and why mediation should always be considered important. Mediation may be present in the following conditions: when the total and mediated effects are equal in value, when the mediated and direct effects have opposing signs, when mediated effects are equal across single and multiple-mediator models, and when specific mediated effects have opposing signs. Mediation should be conducted in every study because it provides the opportunity to test known and replicable mediators, to use mediators as an intervention manipulation check, and to address action and conceptual theory in intervention models. Mediators are central to intervention programs, and mediators should be investigated for the valuable information they provide about the success or failure of interventions.

  9. Improving nutrition and physical activity in the workplace: a meta-analysis of intervention studies.

    Science.gov (United States)

    Hutchinson, Amanda D; Wilson, Carlene

    2012-06-01

    A comprehensive search of the literature for studies examining physical activity or nutrition interventions in the workplace, published between 1999 and March 2009, was conducted. This search identified 29 relevant studies. Interventions were grouped according to the theoretical framework on which the interventions were based (e.g. education, cognitive-behavioural, motivation enhancement, social influence, exercise). Weighted Cohen's d effect sizes, percentage overlap statistics, confidence intervals and fail safe Ns were calculated. Most theoretical approaches were associated with small effects. However, large effects were found for some measures of interventions using motivation enhancement. Effect sizes were larger for studies focusing on one health behaviour and for randomized controlled trials. The workplace is a suitable environment for making modest changes in the physical activity, nutrition and health of employees. Further research is necessary to determine whether these changes can be maintained in the long term.

  10. Cost-Effectiveness of a Clinical Childhood Obesity Intervention.

    Science.gov (United States)

    Sharifi, Mona; Franz, Calvin; Horan, Christine M; Giles, Catherine M; Long, Michael W; Ward, Zachary J; Resch, Stephen C; Marshall, Richard; Gortmaker, Steven L; Taveras, Elsie M

    2017-11-01

    To estimate the cost-effectiveness and population impact of the national implementation of the Study of Technology to Accelerate Research (STAR) intervention for childhood obesity. In the STAR cluster-randomized trial, 6- to 12-year-old children with obesity seen at pediatric practices with electronic health record (EHR)-based decision support for primary care providers and self-guided behavior-change support for parents had significantly smaller increases in BMI than children who received usual care. We used a microsimulation model of a national implementation of STAR from 2015 to 2025 among all pediatric primary care providers in the United States with fully functional EHRs to estimate cost, impact on obesity prevalence, and cost-effectiveness. The expected population reach of a 10-year national implementation is ∼2 million children, with intervention costs of $119 per child and $237 per BMI unit reduced. At 10 years, assuming maintenance of effect, the intervention is expected to avert 43 000 cases and 226 000 life-years with obesity at a net cost of $4085 per case and $774 per life-year with obesity averted. Limiting implementation to large practices and using higher estimates of EHR adoption improved both cost-effectiveness and reach, whereas decreasing the maintenance of the intervention's effect worsened the former. A childhood obesity intervention with electronic decision support for clinicians and self-guided behavior-change support for parents may be more cost-effective than previous clinical interventions. Effective and efficient interventions that target children with obesity are necessary and could work in synergy with population-level prevention strategies to accelerate progress in reducing obesity prevalence. Copyright © 2017 by the American Academy of Pediatrics.

  11. Assessing health and economic outcomes of interventions to reduce pregnancy-related mortality in Nigeria.

    Science.gov (United States)

    Erim, Daniel O; Resch, Stephen C; Goldie, Sue J

    2012-09-14

    Women in Nigeria face some of the highest maternal mortality risks in the world. We explore the benefits and cost-effectiveness of individual and integrated packages of interventions to prevent pregnancy-related deaths. We adapt a previously validated maternal mortality model to Nigeria. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to Southwest and Northeast zones using survey-based data. Strategies consisted of improving coverage of effective interventions, and could include improved logistics. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality, was cost saving in the Southwest zone and cost-effective elsewhere, and prevented nearly 1 in 5 abortion-related deaths. However, with a singular focus on family planning and safe abortion, mortality reduction would plateau below MDG 5. Strategies that could prevent 4 out of 5 maternal deaths included an integrated and stepwise approach that includes increased skilled deliveries, facility births, access to antenatal/postpartum care, improved recognition of referral need, transport, and availability quality of EmOC in addition to family planning and safe abortion. The economic benefits of these strategies ranged from being cost-saving to having incremental cost-effectiveness ratios less than $500 per YLS, well below Nigeria's per capita GDP. Early intensive efforts to improve family planning and control of fertility choices, accompanied by a stepwise effort to scale-up capacity for integrated maternal health services over several years, will save lives and provide equal or greater value than many public health interventions we consider among the most cost-effective (e.g., childhood immunization).

  12. Children affected by HIV/AIDS: SAFE, a model for promoting their security, health, and development.

    Science.gov (United States)

    Betancourt, Theresa S; Fawzi, Mary K S; Bruderlein, Claude; Desmond, Chris; Kim, Jim Y

    2010-05-01

    A human security framework posits that individuals are the focus of strategies that protect the safety and integrity of people by proactively promoting children's well being, placing particular emphasis on prevention efforts and health promotion. This article applies this framework to a rights-based approach in order to examine the health and human rights of children affected by HIV/AIDS. The SAFE model describes sources of insecurity faced by children across four fundamental dimensions of child well-being and the survival strategies that children and families may employ in response. The SAFE model includes: Safety/protection; Access to health care and basic physiological needs; Family/connection to others; and Education/livelihoods. We argue that it is critical to examine the situation of children through an integrated lens that effectively looks at human security and children's rights through a holistic approach to treatment and care rather than artificially limiting our scope of work to survival-oriented interventions for children affected by HIV/AIDS. Interventions targeted narrowly at children, in isolation of their social and communal environment as outlined in the SAFE model, may in fact undermine protective resources in operation in families and communities and present additional threats to children's basic security. An integrated approach to the basic security and care of children has implications for the prospects of millions of children directly infected or indirectly affected by HIV/AIDS around the world. The survival strategies that young people and their families engage in must be recognized as a roadmap for improving their protection and promoting healthy development. Although applied to children affected by HIV/AIDS in the present analysis, the SAFE model has implications for guiding the care and protection of children and families facing adversity due to an array of circumstances from armed conflict and displacement to situations of extreme poverty.

  13. 76 FR 12719 - Safe Schools/Healthy Students Program; Office of Safe and Drug-Free Schools; Safe Schools/Healthy...

    Science.gov (United States)

    2011-03-08

    ... DEPARTMENT OF EDUCATION Safe Schools/Healthy Students Program; Office of Safe and Drug- Free Schools; Safe Schools/Healthy Students Program; Catalog of Federal Domestic Assistance (CFDA) Numbers: 84... priorities, requirements, and definitions under the Safe Schools/Healthy Students (SS/HS) program. Since...

  14. The understanding of the special administration of nursing care in the intervention ward

    International Nuclear Information System (INIS)

    Feng Jianyu; Tian Ye; Wang Junlan

    2009-01-01

    Because of the particularity of the interventional therapy,that is,the interventional management covers a large scope in clinical application and involves the diagnosis and treatment of various diseases of multiple systems and organs,the clinical interventional practice has really brought an unprecedented challenge for the administration of the nursing care in the intervention ward. In our hospital, independent nursing group for the intervention ward was established two years ago. For the past two years, we have constantly groped and summarized the reasonable and effect administration of interventional nursing care. Pertinent administrative measures, such as nurse training, strengthening of communication with physicians and focusing on key links in nursing care and promptly finding out the weak points in clinical work, have effectively improved the quality of clinical nursing, in this way the clinical nursing practice has been integrated into the interventional therapy and the safe and high-quality nursing service has been provided to the patients. (authors)

  15. C-SAFE: A Computer-Delivered Sexual Health Promotion Program for Latinas.

    Science.gov (United States)

    Klein, Charles H; Kuhn, Tamara; Altamirano, Midori; Lomonaco, Carmela

    2017-07-01

    This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days in the past month when their mental health was not good (p = .02). C-SAFE condition women also reported more satisfaction than control condition women in their assessment of information presentation (on a scale of 1 = poor and 5 = excellent; C-SAFE = 4.45 vs. control = 4.25, p = .053) and having learned something new (C-SAFE = 95.1% vs. control = 79.3%, χ 2 importance of teachable moments, matching of delivery modalities to implementation contexts, and possible directions for evidence-based sexual health promotion programs given the current sexual health landscape.

  16. [Evidence-based effectiveness of road safety interventions: a literature review].

    Science.gov (United States)

    Novoa, Ana M; Pérez, Katherine; Borrell, Carme

    2009-01-01

    Only road safety interventions with scientific evidence supporting their effectiveness should be implemented. The objective of this study was to identify and summarize the available evidence on the effectiveness of road safety interventions in reducing road traffic collisions, injuries and deaths. All literature reviews published in scientific journals that assessed the effectiveness of one or more road safety interventions and whose outcome measure was road traffic crashes, injuries or fatalities were included. An exhaustive search was performed in scientific literature databases. The interventions were classified according to the evidence of their effectiveness in reducing road traffic injuries (effective interventions, insufficient evidence of effectiveness, ineffective interventions) following the structure of the Haddon matrix. Fifty-four reviews were included. Effective interventions were found before, during and after the collision, and across all factors: a) the individual: the graduated licensing system (31% road traffic injury reduction); b) the vehicle: electronic stability control system (2 to 41% reduction); c) the infrastructure: area-wide traffic calming (0 to 20%), and d) the social environment: speed cameras (7 to 30%). Certain road safety interventions are ineffective, mostly road safety education, and others require further investigation. The most successful interventions are those that reduce or eliminate the hazard and do not depend on changes in road users' behavior or on their knowledge of road safety issues. Interventions based exclusively on education are ineffective in reducing road traffic injuries.

  17. Creating Safe Spaces for Music Learning

    Science.gov (United States)

    Hendricks, Karin S.; Smith, Tawnya D.; Stanuch, Jennifer

    2014-01-01

    This article offers a practical model for fostering emotionally safe learning environments that instill in music students a positive sense of self-belief, freedom, and purpose. The authors examine the implications for music educators of creating effective learning environments and present recommendations for creating a safe space for learning,…

  18. Anaemia, its determinants and effect of different interventions amongst tea tribe adolescent girls living in Dibrugarh district of Assam

    Directory of Open Access Journals (Sweden)

    Tulika Goswami Mahanta

    2014-12-01

    Full Text Available Background: Nutritional anaemia, one of the major public health problems in India is associated with lower productivity, higher sickness rate and absenteeism having inter-generational effect. Morbidity during adolescent has implication on future safe motherhood, optimum growth and development of foetus and children. Aims and Objective: To assess, prevalence and determinants of anaemia and effect of different interventions amongst tea tribe adolescent girls. Materials & Methods: A community based intervention study was conducted covering 16 tea estates of Dibrugarh District, Assam. Variables includes socio-demographic, environmental, anthropometry, history of present and past illness, clinical examination and laboratory investigation including haemoglobin, serum ferritin, haemoglobin typing and routine stool examination. Interventions given were weekly IFA supplementation, dietary diversification, health promotion by monthly NHED, cooking demonstration, cooking competition and kitchen garden promotion and counselling to improve IFA compliance and remove barriers was done. SPSS and EpiInfo software, used to calculate of rates, ratios, chi-square test, Fisher Exact test and multiple logistic regression analysis. Results: Enrolments were 802, with mean age, 14.8 years. Anaemia prevalence was 96.3% with median serum ferritin, 22.9 ng/ml. Prevalence of Sickle cell anaemia was,12% and helminthiasis 84.20%.  History of passage of worms (9.1%, night blindness (5.6%, weakness (62.1%, loss of appetite (37.5%, gum bleeding (23.6%, loose motion (13%, loss of weight (9.9%, menstrual problem (19.3% was common. Following intervention mean haemoglobin difference was 1.48 gm/dl with 13.5% difference in prevalence. Associated morbidities showed significant reduction following active intervention. Conclusions: High anaemia prevalence requires urgent attention to avoid preventable morbidities. Implementation of different intervention in an integrated manner

  19. Anaemia, its determinants and effect of different interventions amongst tea tribe adolescent girls living in Dibrugarh district of Assam

    Directory of Open Access Journals (Sweden)

    Tulika Goswami Mahanta

    2014-12-01

    Full Text Available Background: Nutritional anaemia, one of the major public health problems in India is associated with lower productivity, higher sickness rate and absenteeism having inter-generational effect. Morbidity during adolescent has implication on future safe motherhood, optimum growth and development of foetus and children. Aims and Objective: To assess, prevalence and determinants of anaemia and effect of different interventions amongst tea tribe adolescent girls. Materials & Methods: A community based intervention study was conducted covering 16 tea estates of Dibrugarh District, Assam. Variables includes socio-demographic, environmental, anthropometry, history of present and past illness, clinical examination and laboratory investigation including haemoglobin, serum ferritin, haemoglobin typing and routine stool examination. Interventions given were weekly IFA supplementation, dietary diversification, health promotion by monthly NHED, cooking demonstration, cooking competition and kitchen garden promotion and counselling to improve IFA compliance and remove barriers was done. SPSS and EpiInfo software, used to calculate of rates, ratios, chi-square test, Fisher Exact test and multiple logistic regression analysis. Results: Enrolments were 802, with mean age, 14.8 years. Anaemia prevalence was 96.3% with median serum ferritin, 22.9 ng/ml. Prevalence of Sickle cell anaemia was,12% and helminthiasis 84.20%.  History of passage of worms (9.1%, night blindness (5.6%, weakness (62.1%, loss of appetite (37.5%, gum bleeding (23.6%, loose motion (13%, loss of weight (9.9%, menstrual problem (19.3% was common. Following intervention mean haemoglobin difference was 1.48 gm/dl with 13.5% difference in prevalence. Associated morbidities showed significant reduction following active intervention. Conclusions: High anaemia prevalence requires urgent attention to avoid preventable morbidities. Implementation of different intervention in an integrated manner was

  20. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

    Science.gov (United States)

    2011-01-01

    Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine

  1. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

    Directory of Open Access Journals (Sweden)

    Vos Theo

    2011-05-01

    Full Text Available Abstract Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention. Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates

  2. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia.

    Science.gov (United States)

    Phanthunane, Pudtan; Vos, Theo; Whiteford, Harvey; Bertram, Melanie

    2011-05-13

    Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine may be dominated and there are serious

  3. Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

    Science.gov (United States)

    Wong, Kenneth; Duncan, Tristram; Pearson, Andrew

    2007-07-01

    Open appendicectomy is the traditional standard treatment for appendicitis. Laparoscopic appendicectomy is perceived as a procedure with greater potential for complications and longer operative times. This paper examines the hypothesis that unsupervised laparoscopic appendicectomy by surgical trainees is a safe and time-effective valid alternative. Medical records, operating theatre records and histopathology reports of all patients undergoing laparoscopic and open appendicectomy over a 15-month period in two hospitals within an area health service were retrospectively reviewed. Data were analysed to compare patient features, pathology findings, operative times, complications, readmissions and mortality between laparoscopic and open groups and between unsupervised surgical trainee operators versus consultant surgeon operators. A total of 143 laparoscopic and 222 open appendicectomies were reviewed. Unsupervised trainees performed 64% of the laparoscopic appendicectomies and 55% of the open appendicectomies. There were no significant differences in complication rates, readmissions, mortality and length of stay between laparoscopic and open appendicectomy groups or between trainee and consultant surgeon operators. Conversion rates (laparoscopic to open approach) were similar for trainees and consultants. Unsupervised senior surgical trainees did not take significantly longer to perform laparoscopic appendicectomy when compared to unsupervised trainee-performed open appendicectomy. Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

  4. FMCSA Safety Program Effectiveness Measurement: Carrier Intervention Effectiveness Model, Version 1.1-Report for FY 2014 Interventions - Analysis Brief

    Science.gov (United States)

    2018-04-01

    The Carrier Intervention Effectiveness Model (CIEM) provides the Federal Motor Carrier Safety Administration (FMCSA) with a tool for measuring the safety benefits of carrier interventions conducted under the Compliance, Safety, Accountability (CSA) e...

  5. In Situ Surgery: Is It Safe ? (Experience with 60 cases) | El Sadat ...

    African Journals Online (AJOL)

    Conclusion: NSU is a safe place for performing in-situ surgery (ISS) without increased risk of infection. Successful operative intervention within NSU requires good planning and cooperation between anesthesiologist, surgeons, neonatologist and nursing staff. Maximum benefit is observed in neonates who have definite risk ...

  6. Qualitative Analysis of Infant Safe Sleep Public Campaign Messaging.

    Science.gov (United States)

    Peacock, Nadine R; Altfeld, Susan; Rosenthal, Allison L; Garland, Caitlin E; Massino, Jill M; Smith, Sherri L; Rowe, Hillary L; Wagener, Sarah E

    2018-03-01

    The 1994 Back to Sleep public education campaign resulted in dramatic reductions in sleep-related infant deaths, but comparable progress in recent years has been elusive. We conducted qualitative analyses of recent safe sleep campaigns from 13 U.S. cities. Goals were to (a) determine whether the campaigns reflect the full range of American Academy of Pediatrics (AAP) 2011 safe sleep recommendations, (b) describe tone and framing of the messages (e.g., use of fear appeals), (c) describe targeting/tailoring of messages to priority populations, and (d) ascertain whether the campaigns have been evaluated for reach and/or effectiveness. Methods included computer-assisted analyses of campaign materials and key informant interviews. All campaigns included "ABC" (Alone, Back, Crib) messaging; many ignored other AAP recommendations such as breastfeeding, room-sharing, immunizations, and avoiding smoke exposure. Campaigns frequently targeted priority populations such as African Americans. Fear appeals were used in three quarters of the campaigns, and 60% of the fear-based campaigns used guilt/blame messaging. We did not find published evaluation data for any of the campaigns. More attention is needed in public education campaigns to the full range of AAP recommendations, and evaluations are needed to determine the impact of these interventions on knowledge, behavior, and health outcomes.

  7. Perceptions about interventions to control schistosomiasis among the Lake Victoria island communities of Koome, Uganda.

    Directory of Open Access Journals (Sweden)

    Richard E Sanya

    2017-10-01

    Full Text Available Praziquantel-based mass treatment is the main approach to controlling schistosomiasis mansoni in endemic areas. Interventions such as provision and use of safe water, minimising contact with infested water, disposal of stool in latrines and snail control provide key avenues to break the transmission cycle and can sustain the benefits of mass treatment in the long term. Efforts are also being made to develop a schistosomiasis vaccine which, if effective, might reduce the incidence of re-infection after treatment. However, any interventions deployed need to be acceptable to, and sustainable by, the target communities.In this qualitative study, we investigated the perceptions of six Lake Victoria island communities of Koome, Uganda, about interventions to control Schistosoma mansoni infection and their willingness to participate in Schistosoma vaccine trials. Thirty-two in-depth interviews, 12 key informant interviews and 10 focus group discussions were conducted. Data were analysed using a thematic content approach.Intestinal schistosomiasis was not regarded as a serious health problem because a mass treatment programme is in place. However, the communities lack safe water sources and latrines. Mass treatment with praziquantel, safe water supplies and use of toilets were deemed the most acceptable interventions by the participants. The communities are willing to participate in Schistosoma vaccine trials.Knowledge of a community's perception about interventions to control schistosomiasis can be valuable to policy makers and programme implementers intending to set up interventions co-managed by the community members. In this study, the views of the Lake Victoria island communities of Koome are presented. This study also provides data to guide further work on alternative interventions such as Schistosoma vaccine trials in these communities.

  8. Perceptions about interventions to control schistosomiasis among the Lake Victoria island communities of Koome, Uganda.

    Science.gov (United States)

    Sanya, Richard E; Tumwesige, Edward; Elliott, Alison M; Seeley, Janet

    2017-10-01

    Praziquantel-based mass treatment is the main approach to controlling schistosomiasis mansoni in endemic areas. Interventions such as provision and use of safe water, minimising contact with infested water, disposal of stool in latrines and snail control provide key avenues to break the transmission cycle and can sustain the benefits of mass treatment in the long term. Efforts are also being made to develop a schistosomiasis vaccine which, if effective, might reduce the incidence of re-infection after treatment. However, any interventions deployed need to be acceptable to, and sustainable by, the target communities. In this qualitative study, we investigated the perceptions of six Lake Victoria island communities of Koome, Uganda, about interventions to control Schistosoma mansoni infection and their willingness to participate in Schistosoma vaccine trials. Thirty-two in-depth interviews, 12 key informant interviews and 10 focus group discussions were conducted. Data were analysed using a thematic content approach. Intestinal schistosomiasis was not regarded as a serious health problem because a mass treatment programme is in place. However, the communities lack safe water sources and latrines. Mass treatment with praziquantel, safe water supplies and use of toilets were deemed the most acceptable interventions by the participants. The communities are willing to participate in Schistosoma vaccine trials. Knowledge of a community's perception about interventions to control schistosomiasis can be valuable to policy makers and programme implementers intending to set up interventions co-managed by the community members. In this study, the views of the Lake Victoria island communities of Koome are presented. This study also provides data to guide further work on alternative interventions such as Schistosoma vaccine trials in these communities.

  9. Bully Prevention: Creating Safe and Inclusive Environments for Youth

    Directory of Open Access Journals (Sweden)

    Kimberly Allen

    2012-09-01

    Full Text Available Bullying is a major issue facing youth of all ages, backgrounds, and walks of life. In fact, 30% of youth report experiencing bullying on a monthly basis (Nansel, Overpeck, Pilla, Ruan, Simons-Murton & Scheidt, 2001. As a consequence, these youth are at much greater risk for a host of mental and physical problems (Ttofi & Farrington, 2008. Parents, teachers, educators and youth advocates all agree that this issue merits time and attention, yet many professionals are at a loss for understanding the issue or what resources might be most effective with their young audience. With the increased rates of bullying behaviors and growing research about effective prevention and intervention strategies, youth development professionals need guidance for creating and sustaining bully prevention efforts. The purpose of this article is to highlight the growing research on bully prevention and provide information for practitioners working to create safe and inclusive environments for youth.

  10. Cool and Safe: Multiplicity in Safe Innovation at Unilever

    Science.gov (United States)

    Penders, Bart

    2011-01-01

    This article presents the making of a safe innovation: the application of ice structuring protein (ISP) in edible ices. It argues that safety is not the absence of risk but is an active accomplishment; innovations are not "made safe afterward" but "safe innovations are made". Furthermore, there are multiple safeties to be accomplished in the…

  11. Intra-gestational sac injection for tubal pregnancy: an interventional approach

    International Nuclear Information System (INIS)

    Wang Yitang; Sun Xiaobo; Xu Xiaojun; Zhang Feiyue; Wu Ke; Song Yingxin; Han Mingjun

    2002-01-01

    Objective: It's an investigation of the procedure, effects and clinical application of the interventional intra-gestational sac injection as a treatment of tubal pregnancy. Methods: Under DSA guidance a selective salpingography was performed and MTX was injected into the gestational sac or oviduct. The procedure was performed in 13 cases with oviductal pregnancy before the gestational sac ruptured. Results: Technical success was obtained in all cases. The serum HCG began to fall in 7 days after the procedure, and dropped to normal level in 2-4 weeks of the procedure. Conclusion: Interventional selective salpingography and intra-gestational sac injection is a simple, safe and effective treatment of the un-ruptured tubal pregnancy

  12. Social safeness and disordered eating: Exploring underlying mechanisms of body appreciation and inflexible eating.

    Science.gov (United States)

    Pinto, Catarina; Ferreira, Cláudia; Mendes, Ana Laura; Trindade, Inês A

    2017-06-01

    Feelings of social safeness and connectedness have been associated with adaptive emotion regulation processes and well-being indicators. Further, literature has demonstrated that interpersonal experiences play an important role in the etiology and maintenance of body and eating psychopathology. However, the study of the role of social variables and emotion regulation processes in the engagement in inflexible eating rules and eating psychopathology is still in its early stages. The current study aims to fill some gaps within the literature and explore the mediator role of body appreciation and inflexible eating rules in the link between social safeness and disordered eating. Participants were 253 women, aged between 18 and 50 years old, who completed a series of online self-report measures. Results from the tested path analysis model showed that social safeness holds a significant effect on eating psychopathology, through the mechanisms of body appreciation and inflexible eating rules. Also, results suggested that women who present higher levels of social safeness tend to present a more positive and respectful attitude towards their body and decreased adoption of inflexible eating rules, which seem to explain lower levels of disordered eating behaviours. These findings seem to present empirical support for the development of intervention programs that promote a positive, affectionate and healthy relationship with one's body image, in order to prevent the inflexible adherence to eating rules and disordered eating behaviours.

  13. Cost-effectiveness analyses of self-harm strategies aimed at reducing the mortality of pesticide self-poisonings in Sri Lanka

    DEFF Research Database (Denmark)

    Madsen, Lizell Bustamante; Eddleston, Michael; Hansen, Kristian Schultz

    2015-01-01

    using this method. The aim of the present study is to assess the cost-effectiveness of an ongoing safe storage intervention currently taking place in a rural Sri Lankan district and to model the cost-effectiveness of implementing the safe storage intervention as well as four potential interventions...... (legislative, medical management, follow-up contact and mobile phone contact) on a national level. METHODS AND ANALYSIS: Study design for all the strategies is a cost-effectiveness analysis. A governmental perspective is adopted. The time horizon for tracking the associated costs and health outcomes...... of the safe storage intervention on district level runs over 3 years. The time horizon is extended to 5 years when modelling a full national roll-out of the respective interventions. The discounting of costs and health outcomes are undertaken at the recommended real rate of 3%. Threshold analyses...

  14. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions

    Directory of Open Access Journals (Sweden)

    Evans Philip H

    2011-02-01

    Full Text Available Abstract Background To develop more efficient programmes for promoting dietary and/or physical activity change (in order to prevent type 2 diabetes it is critical to ensure that the intervention components and characteristics most strongly associated with effectiveness are included. The aim of this systematic review of reviews was to identify intervention components that are associated with increased change in diet and/or physical activity in individuals at risk of type 2 diabetes. Methods MEDLINE, EMBASE, CINAHL, PsycInfo, and the Cochrane Library were searched for systematic reviews of interventions targeting diet and/or physical activity in adults at risk of developing type 2 diabetes from 1998 to 2008. Two reviewers independently selected reviews and rated methodological quality. Individual analyses from reviews relating effectiveness to intervention components were extracted, graded for evidence quality and summarised. Results Of 3856 identified articles, 30 met the inclusion criteria and 129 analyses related intervention components to effectiveness. These included causal analyses (based on randomisation of participants to different intervention conditions and associative analyses (e.g. meta-regression. Overall, interventions produced clinically meaningful weight loss (3-5 kg at 12 months; 2-3 kg at 36 months and increased physical activity (30-60 mins/week of moderate activity at 12-18 months. Based on causal analyses, intervention effectiveness was increased by engaging social support, targeting both diet and physical activity, and using well-defined/established behaviour change techniques. Increased effectiveness was also associated with increased contact frequency and using a specific cluster of "self-regulatory" behaviour change techniques (e.g. goal-setting, self-monitoring. No clear relationships were found between effectiveness and intervention setting, delivery mode, study population or delivery provider. Evidence on long

  15. Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ayman K.M. Hassan

    2015-03-01

    Conclusion: Our results indicate that AFCD2 is a simple and effective alternative to MC for hemostasis following PCI. Early sheath removal 2 h post PCI is feasible, safe, and improves the patient’s comfort.

  16. A community-based cluster randomised trial of safe storage to reduce pesticide self-poisoning in rural Sri Lanka

    DEFF Research Database (Denmark)

    Pearson, Melissa; Konradsen, Flemming; Gunnell, David

    2011-01-01

    . One approach to reducing access to pesticides is for households to store pesticides in lockable "safe-storage" containers. However, before this approach can be promoted, evidence is required on its effectiveness and safety. Methods/Design A community-based cluster randomised controlled trial has been...... at the 5% significance level. Secondary outcomes will include the incidence of all pesticide poisoning and total self-harm. Discussion This paper describes a large effectiveness study of a community intervention to reduce the burden of intentional poisoning in rural Sri Lanka. The study builds on a strong...... partnership between provincial health services, local and international researchers, and local communities. We discuss issues in relation to randomisation and contamination, engaging control villages, the intervention, and strategies to improve adherence. Trial Registritation The trial is registered...

  17. Is hydroxyethyl starch 130/0.4 safe?

    DEFF Research Database (Denmark)

    Haase, Nicolai; Perner, Anders

    2012-01-01

    ABSTRACT: It is heavily debated whether or not treatment with hydroxyethyl starch 130/0.4 contributes to the development of acute kidney failure in patients with severe sepsis. In the previous issue of Critical Care, Muller and colleagues report no association between initial resuscitation...... with hydroxyethyl starch 130/0.4 and renal impairment in a cohort of septic patients. Can we then consider hydroxyethyl starch 130/0.4 a safe intervention? The answer is no - observational data should be interpreted with caution and should mainly be used to identify risks, while safety must be assessed...

  18. ADHD in the Classroom: Effective Intervention Strategies

    Science.gov (United States)

    DuPaul, George J.; Weyandt, Lisa L.; Janusis, Grace M.

    2011-01-01

    School-related difficulties are commonly associated with attention deficit hyperactivity disorder (ADHD). This article describes effective school-based intervention strategies including behavioral interventions, modifications to academic instruction, and home-school communication programs. One overlooked aspect of treatment of children with ADHD…

  19. Assessing health and economic outcomes of interventions to reduce pregnancy-related mortality in Nigeria

    Directory of Open Access Journals (Sweden)

    Erim Daniel O

    2012-09-01

    Full Text Available Abstract Background Women in Nigeria face some of the highest maternal mortality risks in the world. We explore the benefits and cost-effectiveness of individual and integrated packages of interventions to prevent pregnancy-related deaths. Methods We adapt a previously validated maternal mortality model to Nigeria. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to Southwest and Northeast zones using survey-based data. Strategies consisted of improving coverage of effective interventions, and could include improved logistics. Results Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality, was cost saving in the Southwest zone and cost-effective elsewhere, and prevented nearly 1 in 5 abortion-related deaths. However, with a singular focus on family planning and safe abortion, mortality reduction would plateau below MDG 5. Strategies that could prevent 4 out of 5 maternal deaths included an integrated and stepwise approach that includes increased skilled deliveries, facility births, access to antenatal/postpartum care, improved recognition of referral need, transport, and availability quality of EmOC in addition to family planning and safe abortion. The economic benefits of these strategies ranged from being cost-saving to having incremental cost-effectiveness ratios less than $500 per YLS, well below Nigeria’s per capita GDP. Conclusions Early intensive efforts to improve family planning and control of fertility choices, accompanied by a stepwise effort to scale-up capacity for integrated maternal health services over several years, will save lives and provide equal or greater value than many public health interventions we consider among the most cost-effective (e.g., childhood immunization.

  20. The quest for a safe and effective canine distemper virus vaccine for black-footed ferrets

    Science.gov (United States)

    Wimsatt, Jeffrey; Biggins, Dean E.; Williams, Elizabeth S.; Becerra, Victor M.

    2006-01-01

    Canine distemper virus (CDV) causes a systemic disease that is highly virulent to mustelids and other carnivore (Order Carnivora) species and is found worldwide. Endemic canine distemper in wild and domestic carnivores in the United States has made reintroduction of endangered black-footed ferrets (Mustela nigripes) difficult in the absence of safe and effective CDV vaccines and vaccination practices. Toward this end, researchers have explored appropriate animal models and vaccine preparations in highly susceptible species. Published studies involving domestic ferrets (M. putorius furo) using Galaxy-D® and evaluating a recombinant canarypox-vectored vaccine for oral administration are reviewed. In addition, we present new findings in domestic and black-footed ferrets and Siberian polecats (M. eversmannii) that have extended our understanding of CDV in the black-footed ferret and other at-risk carnivore species. Original research presented here includes trials that determined an effective challenge dose (by route) of virulent CDV in domestic ferrets and Siberian polecats; the low likelihood of collateral vaccination with Galaxy-D; the adverse effect of modified-live virus boostering in black-footed ferrets receiving killed vaccine previously and the response of Siberian polecats receiving canarypoxvectored recombinant CDV vaccine (reCDV); the absence of an effect of reCDV vaccination on conception, pregnancy, and neonatal growth in Siberian polecats; and the apparent inefficacy of active reCDV vaccination during the period of passive immunity in young Siberian polecats. In the final section, we discuss emerging concerns and avenues for disease intervention that may present new opportunities to solve problems in vaccine safety, vaccine availability, field vaccine delivery, and other therapeutic modalities.

  1. The effect of community-based reproductive health communication interventions on contraceptive use among young married couples in Bihar, India.

    Science.gov (United States)

    Daniel, Elkan E; Masilamani, Rekha; Rahman, Mizanur

    2008-12-01

    Contraceptive use among young couples in India is low, and early childbearing and short birth intervals are common. The PRACHAR Project, an ongoing intervention in Bihar, seeks to increase contraceptive use for delaying and spacing births through communication interventions. Random samples of married women younger than 25 with no more than one child were surveyed in 2002-2003, before PRACHAR was implemented (N=1,995), and in 2004, 21-27 months after implementation (N=2,080). Contraceptive demand and use, and related attitudes and knowledge, were assessed in the two surveys in both intervention areas and comparison areas. Logistic regression was used to assess the effect of the interventions on these indicators. Contraceptive use was very low (2-6%) at baseline in both comparison and intervention areas. Demand for contraception increased from 25% at baseline to 40% at follow-up in intervention areas, but remained virtually unchanged in comparison areas. At follow-up, contraceptive use had risen in both areas, but the adjusted odds of use in intervention areas were 3.8 times those in comparison areas. Women in intervention areas had elevated odds of knowing that fertility varies during the menstrual cycle, and of agreeing that early childbirth can be harmful and that contraceptive use is necessary and safe for delaying first births (odds ratios, 1.6-3.0). Culturally appropriate, community-based communication programs that target youth and those who influence their decisions can create demand for contraception among young couples and lead to increased contraceptive use.

  2. Delayed percutaneous coronary intervention in patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Zhu Weiming; Tian Fang; Shi Li; Lan Xi

    2004-01-01

    Objective: To observe the clinical effects, safeness and prognosis of delayed percutaneous coronary intervention (PCI) for infarct related artery (IRA) in post-infarct patients. Methods: In total 53 patients with acute myocardial infarction (AMI) underwent delayed PCI within 5-15 days after the acute event. Conventional treatment (including thrombolytic therapy) was given in all patients as they were admitted. Results: Intervention was performed in 68 branches of IRA were, including 64 cases of PTCA followed by stent implantation and 4 cases of direct stent implantation. In total 68 stents were implanted. The TIMI classification was improved from the pre-PCI 0-2 to post-PCI 3. No patient died during the treatment. No repeated AMI, post-infarct angina and repeated recanalization happened in the hospitalization. A 5-48 month follow up showed there was 1 death (1.9%), 1 case of repeated myocardial infarction (1.9%), 3 cases of unstable angina (5.7%), 2 cases of repeated PCI and 1 case of CABG. The rate of repeated recanalization was 5.7%. Seven patients (13.2%) were admitted for the second time, who survived 6-48 months after the intervention. Conclusion: Delayed PCT can obviously improve the short and long term prognosis as well as the life quality of patients with AMI, which is a safe interventional procedure

  3. The effectiveness of educational interventions to enhance the adoption of fee-based arsenic testing in Bangladesh: a cluster randomized controlled trial.

    Science.gov (United States)

    George, Christine Marie; Inauen, Jennifer; Rahman, Sheikh Masudur; Zheng, Yan

    2013-07-01

    Arsenic (As) testing could help 22 million people, using drinking water sources that exceed the Bangladesh As standard, to identify safe sources. A cluster randomized controlled trial was conducted to evaluate the effectiveness of household education and local media in the increasing demand for fee-based As testing. Randomly selected households (N = 452) were divided into three interventions implemented by community workers: 1) fee-based As testing with household education (HE); 2) fee-based As testing with household education and a local media campaign (HELM); and 3) fee-based As testing alone (Control). The fee for the As test was US$ 0.28, higher than the cost of the test (US$ 0.16). Of households with untested wells, 93% in both intervention groups HE and HELM purchased an As test, whereas only 53% in the control group. In conclusion, fee-based As testing with household education is effective in the increasing demand for As testing in rural Bangladesh.

  4. Is Nintendo Wii an Effective Intervention for Individuals With Stroke? A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Cheok, Gary; Tan, Dawn; Low, Aiying; Hewitt, Jonathan

    2015-11-01

    To investigate the effectiveness of Nintendo Wii compared with no intervention or other exercise interventions in the rehabilitation of adults with stroke. Seven electronic databases were systematically searched to source for full-text studies published in peer-reviewed journals up to July 2014. Hand searches of reference lists were performed. Randomized controlled trials (RCTs) comparing Wii with no intervention or other exercise interventions, in patients with stroke, were selected. Methodological quality was assessed by 2 independent reviewers. Data pertaining to participants, interventions, outcomes, and clinical effectiveness were independently extracted by 2 reviewers using a standardized form and compared for accuracy. We calculated mean or standardized mean differences for analysis of continuous variables. Risk ratios were derived and 95% confidence intervals (CIs) calculated. Six studies were included. Three trials (64 participants) compared Wii and conventional rehabilitation versus conventional rehabilitation alone. Three trials (102 participants) compared Wii with other exercise interventions. The addition of Wii to conventional rehabilitation resulted in significant mean differences in favor of additional Wii compared with standard care for Timed Up and Go test (TUG) (0.81 points, CI 0.29-1.33, P = .002), but not for other mobility and functional outcomes: Functional Independence Measure (FIM) score (0.45, CI -0.21-1.11, P = .18), Berg Balance Score (-0.64, CI -3.66-2.39, P = .68), anteroposterior postural sway (0.23, CI -0.38-0.84, P = .46). No serious adverse events were reported, and when Wii was compared with exercise alone, we demonstrated a decreased risk of participants dropping out of follow-up (RR 0.40, CI 0.20-0.78, P = .007). The addition of Wii gaming to conventional rehabilitation in patients with chronic stroke significantly improved performance in TUG and not in the other physical measures. The pooled effect was small and not beyond the

  5. Effects of a Forgiveness Intervention for Older Adults

    Science.gov (United States)

    Allemand, Mathias; Steiner, Marianne; Hill, Patrick L.

    2013-01-01

    The authors' aim in the present study was to examine the effects of a brief forgiveness intervention for older adults. The psychoeducational group intervention consists of (a) established core components of previous forgiveness interventions and (b) additional components considering specific needs of older adults. Seventy-eight older adults (mean…

  6. The safe home project.

    Science.gov (United States)

    Arphorn, Sara; Jiraniratisai, Sopaphan; Rungtakul, Rungsri; Phutta, Nikom

    2011-12-01

    storage of chemicals were introduced among farmers. The awareness of healthcare using personal protective equipments is increased in all groups especially in farmers. Safe home by local occupational health volunteer is proposed to be one effective measure for improvement of quality of life.

  7. Interventional treatment for old thrombus in iliofemoral deep veins

    International Nuclear Information System (INIS)

    Qian Jun; Jiang Hong; Yang Yang

    2009-01-01

    Objective: To evaluate interventional management in treating old thrombus in iliofemoral deep veins. Methods: The clinical data and the interventional treatment results of 32 patients with chronic iliofemoral deep venous thrombosis were retrospectively reviewed and analyzed. Results: Technical success was achieved in 30 patients (93.8%). Twenty-nine endovascular stents were successfully placed in 25 patients. Postoperative therapeutic effects were as follows: grade I was obtained in 4 cases (12.5%), grade II in 16 cases (50.0%), grade III in 10 cases (31.3%) and grade IV in 2 cases (6.3%). Twenty-nine patients were followed-up for a mean period of 13.0 ± 6.8 months, and three patients were lost in touch. The follow-up results were as follows: grade I was seen in 3 cases (10.3%), grade II in 14 cases (48.3%) and grade III in 12 cases (41.4%). Conclusion: Interventional management is a minimally-invasive, safe and effective treatment for chronic iliofemoral deep venous thrombosis. (authors)

  8. Dosimetry in Interventional Radiology - Effective Dose Estimation

    International Nuclear Information System (INIS)

    Miljanic, S.; Buls, N.; Clerinx, P.; Jarvinen, H.; Nikodemova, D.; Ranogajec-Komor, M; D'Errico, F.

    2008-01-01

    Interventional radiological procedures can lead to significant radiation doses to patients and to staff members. In order to evaluate the personal doses with respect to the regulatory dose limits, doses measured by dosimeters have to be converted to effective doses (E). Measurement of personal dose equivalent Hp(10) using a single unshielded dosimeter above the lead apron can lead to significant overestimation of the effective dose, while the measurement with dosimeter under the apron can lead to underestimation. To improve the accuracy, measurements with two dosimeters, one above and the other under the apron have been suggested ( d ouble dosimetry ) . The ICRP has recommended that interventional radiology departments develop a policy that staff should wear two dosimeters. The aim of this study was to review the double dosimetry algorithms for the calculation of effective dose in high dose interventional radiology procedures. The results will be used to develop general guidelines for personal dosimetry in interventional radiology procedures. This work has been carried out by Working Group 9 (Radiation protection dosimetry of medical staff) of the CONRAD project, which is a Coordination Action supported by the European Commission within its 6th Framework Program.(author)

  9. Effects of a Sedentary Intervention on Cognitive Function.

    Science.gov (United States)

    Edwards, Meghan K; Loprinzi, Paul D

    2018-03-01

    To examine the effects of a free-living, sedentary-inducing intervention on cognitive function. Randomized controlled, parallel group intervention. University campus. Thirty-three young adults (n = 23 intervention; n = 10 control). The intervention group was asked to eliminate all exercise and minimize steps to ≤5000 steps/day for 1 week, whereas the control group was asked to continue normal physical activity (PA) levels for 1 week. Both groups completed a series of 8 cognitive function assessments (assessing multiple parameters of cognition) preintervention and immediately postintervention. The intervention group was asked to resume normal PA levels for 1 week postintervention and completed the cognitive assessments for a third time at 2 weeks postintervention. Split-plot repeated-measures analysis of variance. The results of our statistical analyses showed that the group × time interaction effect was not significant ( P > .05) for any of the evaluated cognitive parameters. These findings demonstrate the need for future experimental investigations of sedentary behavior to better understand its effects on cognitive function. However, although previous work has demonstrated favorable effects of acute and chronic PA on cognitive function, our findings suggest that a 1-week period of reduced PA does not detrimentally affect cognitive function, which may have encouraging implications for individuals going through a temporary relapse in PA.

  10. Safe physiotherapy interventions in large cervical disc herniations.

    LENUS (Irish Health Repository)

    Keramat, Keramat Ullah

    2012-01-01

    A 34-year-old woman was seen in a physiotherapy department with signs and symptoms of cervical radiculopathy. Loss of cervical lordosis and a large paracentral to intraforaminal disc prolapse (8 mm) at C5-C6 level was reported on MRI. She was taking diclofenac sodium, tramadol HCl, diazepam and pregabalin for the preceding 2 months and no significant improvement, except temporary relief, was reported. She was referred to physiotherapy while awaiting a surgical opinion from a neurosurgeon. In physiotherapy she was treated with mobilisation of the upper thoracic spine from C7 to T6 level. A cervical extension exercise was performed with prior voluntary extension of the thoracic spine and elevated shoulders. She was advised to continue the same at home. General posture advice was given. Signs and symptoms resolved within the following four sessions of treatment over 3 weeks. Surgical intervention was subsequently deemed unnecessary.

  11. The effect of a sweet potato, footbath, and acupressure intervention in preventing constipation in hospitalized patients with acute coronary syndromes.

    Science.gov (United States)

    Ren, Kai; Qiu, Jingbo; Wang, Xiaohua; Niu, Fenglin; Jiang, Tingbo

    2012-01-01

    Constipation is a common health problem that adversely affects quality of life and the prognosis of hospitalized patients with acute coronary syndromes (ACS). The purpose of this study was to develop and test the sweet potato/footbath/acupressure massage (SFA) intervention as a safe treatment for prevention of constipation and to increase satisfaction with bowel emptying in hospitalized patients with ACS. The study was a prospective, randomized controlled trial with a sample of 93 patients (SFA group, n = 44; usual care group, n = 49). Patients in the SFA group received SFA intervention combined with usual care. The results showed that there were statistical differences between the two groups in terms of (1) the incidence of constipation; (2) the use of laxatives and enemas; (3) patients' subjective satisfaction with their bowel emptying during hospitalization; and (4) sensation of incomplete evacuation and anorectal obstruction/blockade. The SFA intervention was more effective, economical, and practical than usual care alone in managing constipation and satisfaction with defecation in patients hospitalized with ACS.

  12. Cost-effectiveness of preventive interventions to reduce alcohol consumption in Denmark.

    Directory of Open Access Journals (Sweden)

    Astrid Ledgaard Holm

    Full Text Available INTRODUCTION: Excessive alcohol consumption increases the risk of many diseases and injuries, and the Global Burden of Disease 2010 study estimated that 6% of the burden of disease in Denmark is due to alcohol consumption. Alcohol consumption thus places a considerable economic burden on society. METHODS: We analysed the cost-effectiveness of six interventions aimed at preventing alcohol abuse in the adult Danish population: 30% increased taxation, increased minimum legal drinking age, advertisement bans, limited hours of retail sales, and brief and longer individual interventions. Potential health effects were evaluated as changes in incidence, prevalence and mortality of alcohol-related diseases and injuries. Net costs were calculated as the sum of intervention costs and cost offsets related to treatment of alcohol-related outcomes, based on health care costs from Danish national registers. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs for each intervention. We also created an intervention pathway to determine the optimal sequence of interventions and their combined effects. RESULTS: Three of the analysed interventions (advertising bans, limited hours of retail sales and taxation were cost-saving, and the remaining three interventions were all cost-effective. Net costs varied from € -17 million per year for advertisement ban to € 8 million for longer individual intervention. Effectiveness varied from 115 disability-adjusted life years (DALY per year for minimum legal drinking age to 2,900 DALY for advertisement ban. The total annual effect if all interventions were implemented would be 7,300 DALY, with a net cost of € -30 million. CONCLUSION: Our results show that interventions targeting the whole population were more effective than individual-focused interventions. A ban on alcohol advertising, limited hours of retail sale and increased taxation had the highest probability of being cost

  13. Cost-effectiveness of preventive interventions to reduce alcohol consumption in Denmark.

    Science.gov (United States)

    Holm, Astrid Ledgaard; Veerman, Lennert; Cobiac, Linda; Ekholm, Ola; Diderichsen, Finn

    2014-01-01

    Excessive alcohol consumption increases the risk of many diseases and injuries, and the Global Burden of Disease 2010 study estimated that 6% of the burden of disease in Denmark is due to alcohol consumption. Alcohol consumption thus places a considerable economic burden on society. We analysed the cost-effectiveness of six interventions aimed at preventing alcohol abuse in the adult Danish population: 30% increased taxation, increased minimum legal drinking age, advertisement bans, limited hours of retail sales, and brief and longer individual interventions. Potential health effects were evaluated as changes in incidence, prevalence and mortality of alcohol-related diseases and injuries. Net costs were calculated as the sum of intervention costs and cost offsets related to treatment of alcohol-related outcomes, based on health care costs from Danish national registers. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs) for each intervention. We also created an intervention pathway to determine the optimal sequence of interventions and their combined effects. Three of the analysed interventions (advertising bans, limited hours of retail sales and taxation) were cost-saving, and the remaining three interventions were all cost-effective. Net costs varied from € -17 million per year for advertisement ban to € 8 million for longer individual intervention. Effectiveness varied from 115 disability-adjusted life years (DALY) per year for minimum legal drinking age to 2,900 DALY for advertisement ban. The total annual effect if all interventions were implemented would be 7,300 DALY, with a net cost of € -30 million. Our results show that interventions targeting the whole population were more effective than individual-focused interventions. A ban on alcohol advertising, limited hours of retail sale and increased taxation had the highest probability of being cost-saving and should thus be first priority for implementation.

  14. Effects of the Smartphone Application "Safe Patients" on Knowledge of Patient Safety Issues Among Surgical Patients.

    Science.gov (United States)

    Cho, Sumi; Lee, Eunjoo

    2017-12-01

    Recently, the patient's role in preventing adverse events has been emphasized. Patients who are more knowledgeable about safety issues are more likely to engage in safety initiatives. Therefore, nurses need to develop techniques and tools that increase patients' knowledge in preventing adverse events. For this reason, an educational smartphone application for patient safety called "Safe Patients" was developed through an iterative process involving a literature review, expert consultations, and pilot testing of the application. To determine the effect of "Safe Patients," it was implemented for patients in surgical units in a tertiary hospital in South Korea. The change in patients' knowledge about patient safety was measured using seven true/false questions developed in this study. A one-group pretest and posttest design was used, and a total of 123 of 190 possible participants were tested. The percentage of correct answers significantly increased from 64.5% to 75.8% (P effectively improve patients' knowledge of safety issues. This will ultimately empower patients to engage in safe practices and prevent adverse events related to surgery.

  15. Overview of reviews: mechanical interventions for the treatment and management of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Lisy, Karolina; White, Heath; Pearson, Alan

    2014-12-01

    Chronic obstructive pulmonary disease (COPD) is characterized by a progressive and non-reversible airflow limitation and symptoms of breathlessness, sputum production and cough. COPD is the fourth most common cause of mortality worldwide and represents a significant social and economic burden. As such, effective strategies that might be employed to treat COPD and manage symptoms need to be investigated. This overview aimed to summarize the existing evidence available in the Cochrane Library regarding the use of mechanical interventions used for the treatment and management of COPD. Systematic reviews that included adult participants with diagnosed COPD who received a mechanical intervention were included. Five reviews were included, and due to the heterogeneity of these reviews, direct and indirect comparisons of the effects of the intervention were not possible. Instead, data of the effectiveness of each intervention were extracted and summarized in tables and discussed as a narrative summary. Interventions included non-invasive positive pressure ventilation (NPPV), positive airway pressure (PEP) devices and neuromuscular electrical stimulation (NMES). Evidence regarding the effectiveness of NPPV was limited, and available data do not support the use of NPPV for patients with stable COPD. NPPV might, however, be of benefit as a weaning strategy for intubated patients and for patients experiencing respiratory failure; however, more research is required. Although PEP devices are considered as a safe airway clearance technique, data do not reveal a clear clinical benefit to their use. NMES is also regarded as safe for patients with COPD, and might also be beneficial in improving exercise tolerance and improving quality of life for patients with COPD. © 2014 Wiley Publishing Asia Pty Ltd.

  16. Cost-Effectiveness of a Nonpharmacological Intervention in Pediatric Burn Care.

    Science.gov (United States)

    Brown, Nadia J; David, Michael; Cuttle, Leila; Kimble, Roy M; Rodger, Sylvia; Higashi, Hideki

    2015-07-01

    To report the cost-effectiveness of a tailored handheld computerized procedural preparation and distraction intervention (Ditto) used during pediatric burn wound care in comparison to standard practice. An economic evaluation was performed alongside a randomized controlled trial of 75 children aged 4 to 13 years who presented with a burn to the Royal Children's Hospital, Brisbane, Australia. Participants were randomized to either the Ditto intervention (n = 35) or standard practice (n = 40) to measure the effect of the intervention on days taken for burns to re-epithelialize. Direct medical, direct nonmedical, and indirect cost data during burn re-epithelialization were extracted from the randomized controlled trial data and combined with scar management cost data obtained retrospectively from medical charts. Nonparametric bootstrapping was used to estimate statistical uncertainty in cost and effect differences and cost-effectiveness ratios. On average, the Ditto intervention reduced the time to re-epithelialize by 3 days at AU$194 less cost for each patient compared with standard practice. The incremental cost-effectiveness plane showed that 78% of the simulated results were within the more effective and less costly quadrant and 22% were in the more effective and more costly quadrant, suggesting a 78% probability that the Ditto intervention dominates standard practice (i.e., cost-saving). At a willingness-to-pay threshold of AU$120, there is a 95% probability that the Ditto intervention is cost-effective (or cost-saving) against standard care. This economic evaluation showed the Ditto intervention to be highly cost-effective against standard practice at a minimal cost for the significant benefits gained, supporting the implementation of the Ditto intervention during burn wound care. Copyright © 2015. Published by Elsevier Inc.

  17. Using mobile technology to promote safe sex and sexual health in adolescents: current practices and future recommendations

    Directory of Open Access Journals (Sweden)

    Cornelius JB

    2016-04-01

    Full Text Available Judith B Cornelius,1 Josephine A Appiah2 1School of Nursing, 2Health Services Research Doctoral Program, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA Abstract: Youth and young adults (19–24 years of age shoulder the burden of sexually transmitted infections accounting for nearly half of all new infections annually. Mobile technology is one way that we have reached this population with safer sex information but challenges exist with the delivery process. The literature between 2010 and 2015 was reviewed for data on safe sex and sexual health information delivered using mobile cell phone devices. A search for relevant databases revealed that 17 articles met our inclusion criteria. Findings suggest that mobile cell phone interventions are an effective mode for delivering safe sex and sexual health information to youth; those at the highest risk may not be able to access cell phones based on availability and cost of the text messages or data plans. Keywords: mobile, safe sex, sexual health, practices, recommendations

  18. Effectiveness of Evidence-Based Asthma Interventions.

    Science.gov (United States)

    Kennedy, Suzanne; Bailey, Ryan; Jaffee, Katy; Markus, Anne; Gerstein, Maya; Stevens, David M; Lesch, Julie Kennedy; Malveaux, Floyd J; Mitchell, Herman

    2017-06-01

    Researchers often struggle with the gap between efficacy and effectiveness in clinical research. To bridge this gap, the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study adapted an efficacious, randomized controlled trial that resulted in evidence-based asthma interventions in community health centers. Children (aged 5-12 years; N = 590) with moderate to severe asthma were enrolled from 3 intervention and 3 geographically/capacity-matched control sites in high-risk, low-income communities located in Arizona, Michigan, and Puerto Rico. The asthma intervention was tailored to the participant's allergen sensitivity and exposure, and it comprised 4 visits over the course of 1 year. Study visits were documented and monitored prospectively via electronic data capture. Asthma symptoms and health care utilization were evaluated at baseline, and at 6 and 12 months. A total of 314 intervention children and 276 control children were enrolled in the study. Allergen sensitivity testing (96%) and home environmental assessments (89%) were performed on the majority of intervention children. Overall study activity completion (eg, intervention visits, clinical assessments) was 70%. Overall and individual site participant symptom days in the previous 4 weeks were significantly reduced compared with control findings (control, change of -2.28; intervention, change of -3.27; difference, -0.99; P asthma in these high-need populations. Copyright © 2017 by the American Academy of Pediatrics.

  19. The SafeCOP ECSEL Project: Safe Cooperating Cyber-Physical Systems Using Wireless Communication

    DEFF Research Database (Denmark)

    Pop, Paul; Scholle, Detlef; Hansson, Hans

    2016-01-01

    This paper presents an overview of the ECSEL project entitled "Safe Cooperating Cyber-Physical Systems using Wireless Communication" (SafeCOP), which runs during the period 2016 -- 2019. SafeCOP targets safety-related Cooperating Cyber-Physical Systems (CO-CPS) characterised by use of wireless...... detection of abnormal behaviour, triggering if needed a safe degraded mode. SafeCOP will also develop methods and tools, which will be used to produce safety assurance evidence needed to certify cooperative functions. SafeCOP will extend current wireless technologies to ensure safe and secure cooperation...

  20. Effectiveness of an Educational Intervention on Medical Students' Knowledge About and Attitude Towards Electroconvulsive Therapy.

    Science.gov (United States)

    Solomon, Susan; Simiyon, Manjula; Vedachalam, Ahalya

    2016-04-01

    This study was done to determine the effectiveness of a lecture and exposure to electroconvulsive therapy (ECT) followed by interaction with patient, on medical students' knowledge about and attitude towards electroconvulsive therapy. A questionnaire was administered to second year medical students to determine their baseline knowledge about and attitude towards electroconvulsive therapy. Following this, they underwent two educational interventions, a lecture on ECT and exposure to the procedure and interaction with the patient and relative, and their knowledge and attitude were reassessed after each intervention using the same questionnaire. Eighty-one students completed all the three assessments. Students' knowledge about ECT at baseline was minimal (mean 3.58 out of 12). Their knowledge increased significantly after the lecture (mean 10.3), and there was further increase following exposure to the procedure and subsequent interaction with the patient and relative (mean 11.1). At baseline, students had an overall negative attitude towards ECT. There was significant improvement on all attitude items following the lecture. Exposure to the procedure resulted in further improvement in attitude regarding whether ECT is a cruel treatment and has to be used as a last resort. Exposure to ECT in lecture and clinical scenarios followed by interaction with the patient should be included in the undergraduate medical curriculum to improve students' knowledge and attitude about this safe, effective, and potentially lifesaving treatment modality.

  1. Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery.

    Science.gov (United States)

    2014-03-01

    In 2011, one in three women who gave birth in the United States did so by cesarean delivery. Cesarean birth can be life-saving for the fetus, the mother, or both in certain cases. However, the rapid increase in cesarean birth rates from 1996 to 2011 without clear evidence of concomitant decreases in maternal or neonatal morbidity or mortality raises significant concern that cesarean delivery is overused. Variation in the rates of nulliparous, term, singleton, vertex cesarean births also indicates that clinical practice patterns affect the number of cesarean births performed. The most common indications for primary cesarean delivery include, in order of frequency, labor dystocia, abnormal or indeterminate (formerly, nonreassuring) fetal heart rate tracing, fetal malpresentation, multiple gestation, and suspected fetal macrosomia. Safe reduction of the rate of primary cesarean deliveries will require different approaches for each of these, as well as other, indications. For example, it may be necessary to revisit the definition of labor dystocia because recent data show that contemporary labor progresses at a rate substantially slower than what was historically taught. Additionally, improved and standardized fetal heart rate interpretation and management may have an effect. Increasing women's access to nonmedical interventions during labor, such as continuous labor and delivery support, also has been shown to reduce cesarean birth rates. External cephalic version for breech presentation and a trial of labor for women with twin gestations when the first twin is in cephalic presentation are other of several examples of interventions that can contribute to the safe lowering of the primary cesarean delivery rate.

  2. Association between the safe delivery app and quality of care and perinatal survival in Ethiopia

    DEFF Research Database (Denmark)

    Lund, Stine; Boas, Ida Marie; Bedesa, Tariku

    2016-01-01

    the health care workers' knowledge and skills in neonatal resuscitation as long as 12 months after introduction. Perinatal mortality was nonsignificantly reduced after the intervention. The results are highly relevant in low-income countries, where quality of care is challenged by a lack of continuing......Importance: Health apps in low-income countries are emerging tools with the potential to improve quality of health care services, but few apps undergo rigorous scientific evaluation. Objective: To determine the effects of the safe delivery app (SDA) on perinatal survival and on health care workers......' knowledge and skills in neonatal resuscitation. Design, setting, and participants: In a cluster-randomized clinical trial in 5 rural districts of Ethiopia, 73 health care facilities were randomized to the mobile phone intervention or to standard care (control). From September 1, 2013, to February 1, 2015...

  3. Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion

    Science.gov (United States)

    Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara

    2014-01-01

    In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…

  4. Cost-effectiveness analysis of lifestyle intervention in obese infertile women.

    Science.gov (United States)

    van Oers, A M; Mutsaerts, M A Q; Burggraaff, J M; Kuchenbecker, W K H; Perquin, D A M; Koks, C A M; van Golde, R; Kaaijk, E M; Schierbeek, J M; Klijn, N F; van Kasteren, Y M; Land, J A; Mol, B W J; Hoek, A; Groen, H

    2017-07-01

    What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women? Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint. In infertile couples, obesity decreases conception chances. We previously showed that lifestyle intervention prior to infertility treatment in obese infertile women did not increase the healthy singleton vaginal live birth rate at term, but increased natural conceptions, especially in anovulatory women. Cost-effectiveness analyses could provide relevant additional information to guide decisions regarding offering a lifestyle intervention to obese infertile women. The cost-effectiveness of lifestyle intervention preceding infertility treatment compared to prompt infertility treatment was evaluated based on data of a previous RCT, the LIFEstyle study. The primary outcome for effectiveness was the vaginal birth of a healthy singleton at term within 24 months after randomization (the healthy live birth rate). The economic evaluation was performed from a hospital perspective and included direct medical costs of the lifestyle intervention, infertility treatments, medication and pregnancy in the intervention and control group. In addition, we performed exploratory cost-effectiveness analyses of scenarios with additional effectiveness outcomes (overall live birth within 24 months and overall live birth conceived within 24 months) and of subgroups, i.e. of ovulatory and anovulatory women, women birth rates were 27 and 35% in the intervention group and the control group, respectively (effect difference of -8.1%, P birth rate. Mean costs per healthy live birth event were €15 932 in the intervention group and €15 912 in the

  5. Effectiveness of the Language Intervention Programme for Preschool Children.

    Science.gov (United States)

    Lousada, Marisa; Ramalho, Margarida; Marques, Carolina

    2016-01-01

    This paper investigates the effectiveness of the Language Intervention Programme for the treatment of 14 preschool-aged children with primary language impairment. We used a waiting list control design, in which half the sample (7 children) received immediate intervention with the Language Intervention Programme, whereas the remaining children received treatment after a 4-week delay. The intervention consisted of 8 individual biweekly sessions. Outcome measures of language ability (receptive semantic and morphosyntactic, expressive semantic and morphosyntactic, and metalinguistic) were taken before and after intervention. After 4 weeks of intervention, the experimental group showed significant improvements in language (receptive, expressive and metalinguistic skills), but no differences were found for those in the waiting control group. After 4 weeks of intervention for the control group, significant progress in language was also observed. The Language Intervention Programme was found to be effective in treating language skills of children with language impairment, providing clinical evidence for speech and language therapists to employ this programme for the treatment of preschool children with language disorders. © 2016 S. Karger AG, Basel.

  6. Vacuum-Assisted Abdominal Closure Is Safe and Effective

    DEFF Research Database (Denmark)

    Jensen, R O; Buchbjerg, T; Simonsen, R M

    2017-01-01

    less likely to develop large hernias and had better self-evaluated physical health score (p mental health was found. CONCLUSION: The abdominal VAC treatment in patients with abdominal catastrophes is safe and with a relative low complication rate. Whether it might be superior...

  7. Safe Kids Worldwide

    Science.gov (United States)

    ... Blog Videos Newsletter facebook twitter instagram pinterest gplus youtube Search Menu Why It Matters Who We Are What We Do Find Your Safe Kids Safe Kids Day Main menu Keeping All Kids Safe Safety Tips Get Involved 4 Star Charity Donate Text Burns and Scalds 4 tips ...

  8. Implementation of Safe-by-Design for Nanomaterial Development and Safe Innovation: Why We Need a Comprehensive Approach.

    Science.gov (United States)

    Kraegeloh, Annette; Suarez-Merino, Blanca; Sluijters, Teun; Micheletti, Christian

    2018-04-14

    Manufactured nanomaterials (MNMs) are regarded as key components of innovations in various fields with high potential impact (e.g., energy generation and storage, electronics, photonics, diagnostics, theranostics, or drug delivery agents). Widespread use of MNMs raises concerns about their safety for humans and the environment, possibly limiting the impact of the nanotechnology-based innovation. The development of safe MNMs and nanoproducts has to result in a safe as well as functional material or product. Its safe use, and disposal at the end of its life cycle must be taken into account too. However, not all MNMs are similarly useful for all applications, some might bear a higher hazard potential than others, and use scenarios could lead to different exposure probabilities. To improve both safety and efficacy of nanotechnology, we think that a new proactive approach is necessary, based on pre-regulatory safety assessment and dialogue between stakeholders. On the basis of the work carried out in different European Union (EU) initiatives, developing and integrating MNMs Safe-by-Design and Trusted Environments (NANoREG, ProSafe, and NanoReg2), we present our point of view here. This concept, when fully developed, will allow for cost effective industrial innovation, and an exchange of key information between regulators and innovators. Regulators are thus informed about incoming innovations in good time, supporting a proactive regulatory action. The final goal is to contribute to the nanotechnology governance, having faster, cheaper, effective, and safer nano-products on the market.

  9. Effects of Current Forward Market Intervention in the Korean Currency Crisis

    Directory of Open Access Journals (Sweden)

    Woosik Moon

    2001-06-01

    Full Text Available This paper investigates the effect of the exchange market interventions of the Bank of Korea on the exchange rate of Korean won vis-a-vis US dollar during the 1997 currency crisis. In particular, this paper tests the effects of spot and forward market interventions, using daily intervention data of the Bank of Korea. During the 1997 period, Korea faced two series of crisis in January-March and September-November. It turns out that the spot market intervention was effective in stabilizing the spot market exchange rate at least during the first crisis period. In contrast, there seemed no effect of the forward market intervention. Forward market intervention was rather destabilizing through forward exchange rate during the second crisis period. This implies that even though the forward and sterilized spot market interventions are equivalent in their effect on exchange rate, these two instruments can widely diverge from each other under the circumstances of exchange rate volatility and speculation.

  10. Systematic review and meta-analysis of behavioral interventions to improve child pedestrian safety.

    Science.gov (United States)

    Schwebel, David C; Barton, Benjamin K; Shen, Jiabin; Wells, Hayley L; Bogar, Ashley; Heath, Gretchen; McCullough, David

    2014-09-01

    Pedestrian injuries represent a pediatric public health challenge. This systematic review/meta-analysis evaluated behavioral interventions to teach children pedestrian safety. Multiple strategies derived eligible manuscripts (published before April 1, 2013, randomized design, evaluated behavioral child pedestrian safety interventions). Screening 1,951 abstracts yielded 125 full-text retrievals. 25 were retained for data extraction, and 6 were later omitted due to insufficient data. In all, 19 articles reporting 25 studies were included. Risk of bias and quality of evidence were assessed. Behavioral interventions generally improve children's pedestrian safety, both immediately after training and at follow-up several months later. Quality of the evidence was low to moderate. Available evidence suggested interventions targeting dash-out prevention, crossing at parked cars, and selecting safe routes across intersections were effective. Individualized/small-group training for children was the most effective training strategy based on available evidence. Behaviorally based interventions improve children's pedestrian safety. Efforts should continue to develop creative, cost-efficient, and effective interventions. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Safe and Liquid Mortgage Bonds

    DEFF Research Database (Denmark)

    Dick-Nielsen, Jens; Gyntelberg, Jacob; Lund, Jesper

    This paper shows that strict match pass-through funding of covered bonds provides safe and liquid mortgage bonds. Despite a 30% drop in house prices during the 2008 global crisis Danish mortgage bonds remained as liquid as most European government bonds. The Danish pass-through system effectively...... eliminates credit risk from the investor's perspective. Similar to other safe bonds, funding liquidity becomes the main driver of mortgage bond liquidity and this creates commonality in liquidity across markets and countries. These findings have implications for how to design a robust mortgage bond system...

  12. Brief Motivational Intervention in a Non-Treatment Seeking Population of Heavy Drinkers - a Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Hansen, Anders Blædel Gottlieb; Becker, Ulrik; Søgaard Nielsen, Anette

    2010-01-01

    of 12,364 adults led to inclusion of 772 heavy drinkers (defined as weekly alcohol consumption above the Danish safe drinking limits (168 grams of alcohol for women, 252 grams for men), who were randomized into a control (n=381) or an intervention (n=391) group. The intervention consisted of a brief......Background: Heavy alcohol drinking has a significant impact on public health in most Western countries. Brief interventions are effective in decreasing alcohol consumption. In a Danish context, the feasibility and effectiveness of screening and subsequent brief intervention has been questioned. Aim...... (approx. 10 minute) motivational intervention and two leaflets about alcohol. The control group received two leaflets about alcohol. Follow-up took place after 6/12 months on 670/612 persons. Outcome measure was self-reported reduction in alcohol consumption. Results : At 6 and 12 month follow...

  13. Local hemostatic matrix for endoscope-assisted removal of intracerebral hemorrhage is safe and effective

    Directory of Open Access Journals (Sweden)

    Hui-Tzung Luh

    2018-01-01

    Conclusion: This study shows that local application of FloSeal Hemostatic Matrix is safe and effective for hemostasis during MIE evacuation of ICH. In our experience, this shortens the operation time, especially in cases with intraoperative bleeding. A large, prospective, randomized trial is needed to confirm the findings.

  14. Meta-analyses on behavioral interventions to reduce the risk of transmission of HIV.

    Science.gov (United States)

    Vergidis, Paschalis I; Falagas, Matthew E

    2009-06-01

    Different behavioral interventions have found to be efficacious in reducing high-risk sexual activity. Interventions have been evaluated in both original research and meta-analytic reviews. Most of the studies have shown that interventions are efficacious among different study populations. In adolescents, both in- and out-of-the classroom interventions showed a decrease in the risk of unprotected sex. In African Americans, greater efficacy was found for interventions including peer education. For Latinos, effect was larger in interventions with segmentation in the same gender. Geographic and social isolation are barriers in approaching MSM. For IDUs, interventions provided within a treatment program have an impact on risk reduction above that produced by drug treatment alone. Finally, people diagnosed with HIV tend to reduce their sexual risk behavior. However, adherence to safe sex practices for life can be challenging. Relentless efforts for implementation of behavioral interventions to decrease high-risk behavior are necessary to decrease HIV transmission.

  15. Robin Hood effects on motivation in math: Family interest moderates the effects of relevance interventions.

    Science.gov (United States)

    Häfner, Isabelle; Flunger, Barbara; Dicke, Anna-Lena; Gaspard, Hanna; Brisson, Brigitte M; Nagengast, Benjamin; Trautwein, Ulrich

    2017-08-01

    Using a cluster randomized field trial, the present study tested whether 2 relevance interventions affected students' value beliefs, self-concept, and effort in math differently depending on family background (socioeconomic status, family interest (FI), and parental utility value). Eighty-two classrooms were randomly assigned to either 1 of 2 intervention conditions or a control group. Data from 1,916 students (M age = 14.62, SD age = 0.47) and their predominantly Caucasian middle-class parents were obtained via separate questionnaires. Multilevel regression analyses with cross-level interactions were used to investigate differential intervention effects on students' motivational beliefs 6 weeks and 5 months after the intervention. Socioeconomic status, FI, and parental utility values were investigated as moderators of the intervention effects. The intervention conditions were especially effective in promoting students' utility, attainment, intrinsic value beliefs, and effort 5 months after the intervention for students whose parents reported lower levels of math interest. Furthermore, students whose parents reported low math utility values especially profited in terms of their utility and attainment math values 5 months after the intervention. No systematic differential intervention effects were found for socioeconomic status. These results highlight the effectiveness of relevance interventions in decreasing motivational gaps between students from families with fewer or more motivational resources. Findings point to the substantial importance of motivational family resources, which have been neglected in previous research. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. Insights into workplace bullying: psychosocial drivers and effective interventions

    Science.gov (United States)

    Escartín, Jordi

    2016-01-01

    Research on effectiveness of workplace bullying interventions has lagged behind descriptive studies on this topic. The literature on bullying intervention research has only recently expanded to a point that allows for synthesis of findings across empirical studies. This study addresses the question of whether workplace bullying can be reduced in prevalence and consequences, if so to what extent and by which strategies and interventions. It opens with a brief overview of the nature of bullying at work and discussion of some precursors and existing interventions. However, its principal focus is on the findings obtained from selected (quasi-) experimental longitudinal studies on antibullying interventions, drawing together the results of studies conducted in Europe, USA, and Australia, including several economic sectors, and concerned about primary, secondary, and tertiary prevention programs and strategies. Additional emphasis is considered from the psychosocial drivers highlighted both from prescriptive and cross-sectional studies and factual empirical studies. One randomized control study and seven quasiexperimental longitudinal studies were identified by searching electronic databases and bibliographies and via contact with experts. The majority of outcomes evidenced some level of change, mostly positive, suggesting that workplace bullying interventions are more likely to affect knowledge, attitudes, and self-perceptions, but actual bullying behaviors showed much more mixed results. In general, growing effectiveness was stated as the level of intervention increased from primary to tertiary prevention. However, methodological problems relating to the evaluation designs in most studies do not allow direct attribution of these findings to the interventions. Overall, the evaluation of antibullying interventions must flourish and be improved, requiring close cooperation between practitioners and academics to design, implement, and evaluate effective interventions based

  17. An evaluation of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program.

    Science.gov (United States)

    Portwood, Sharon G; Lambert, Richard G; Abrams, Lyndon P; Nelson, Ellissa Brooks

    2011-08-01

    This study evaluated the effectiveness of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program, developed by the American Psychological Association in collaboration with the National Association for the Education of Young Children, as an economical primary prevention intervention for child maltreatment. Using an experimental design with random assignment to groups, program impact on participating parents' knowledge, behavior, and attitudes compared to those of a comparison group of parents receiving standard community-based support services was examined. As hypothesized, the ACT Parents Raising Safe Kids program achieved positive results in several areas related to effective parenting, including a reduction in the use of harsh verbal and physical discipline and an increase in nurturing behavior. Positive results were observable both at the conclusion of the ACT program and at three-month follow-up. Results further indicated a positive impact on parent expectations and social support for those parents with the greatest need in these areas. Qualitative data collected through focus groups demonstrated that parents themselves perceived numerous benefits to the ACT program, including assistance in controlling their anger, learning and implementing better parenting and discipline strategies, and recognizing when their child's behavior is developmentally appropriate. Overall, findings suggest that the ACT Parents Raising Safe Kids program is a promising primary prevention strategy that can be implemented across diverse community settings.

  18. Dose-dependent effect of fluoride on clinical and subclinical indices of fluorosis in school going children and its mitigation by supply of safe drinking water for 5 years: an Indian study.

    Science.gov (United States)

    Khandare, Arjun L; Validandi, Vakdevi; Gourineni, Shankar Rao; Gopalan, Viswanathan; Nagalla, Balakrishna

    2018-02-02

    Fluorosis is a public health problem in India; to know its prevalence and severity along with its mitigation measures is very important. The present study has been undertaken with the aim to assess the F dose-dependent clinical and subclinical symptoms of fluorosis and reversal of the disease by providing safe drinking water. For this purpose, a cross-sectional study was undertaken in 1934 schoolgoing children, Nalgonda district. Study villages were categorized into control (category I, F = 0.87 mg/L), affected (category II, F = 2.53 mg/L, and category III, F = 3.77 mg/L), and intervention categories (category IV, F = water and urinary fluoride (UF) in different categories. However, there was a significant decrease in the UF levels in the intervention category IV compared to affected group (category III). Fluoride altered the clinical (dental fluorosis and stunting) and subclinical indices (urine and blood) of fluorosis in a dose-dependent manner. In conclusion, the biochemical indices were altered in a dose-dependent manner and intervention with safe drinking water for 5 years in intervention group-mitigated clinical and subclinical symptoms of fluorosis.

  19. The application of Fasudil in treating vascular spasm occurred in interventional treatment for hepatocellular carcinomas

    International Nuclear Information System (INIS)

    Fan Xiaoqiang; Shen Jie; Zhang Xuena; Liu Qiuru; Ma Aiying

    2011-01-01

    Objective: To explore an effective way to treat the vascular spasm occurred during TACE for hepatocellular carcinomas. Methods: During interventional chemoembolization for hepatocellular carcinomas, Fasudil of 2.5 mg was injected via the catheter if vessel spasm occurred, which was followed by DSA to determine the dilatation of the arteries. Adverse effect was observed and recorded. Results: After the injection of Fasudil the vascular spasm was completely relieved in all the 30 cases. The interventional procedure for hepatocellular carcinomas was successfully accomplished in all patients. No obvious side effect occurred. Conclusion: The injection of Fasudil via the catheter is an effective and safe method to eliminate vessel spasm occurred during TACE for hepatocellular carcinomas. (authors)

  20. Long-Term Effectiveness of a Brief Restorative Justice Intervention.

    Science.gov (United States)

    Kennedy, Joseph L D; Tuliao, Antover P; Flower, KayLee N; Tibbs, Jessie J; McChargue, Dennis E

    2018-06-01

    This research investigated the effectiveness of a brief Restorative Justice Intervention. Probationers who attended a Restorative Justice Intervention ( n = 383) were compared with probationers receiving treatment as usual ( n = 130) over a 2- to 6-year follow-up period. The proportion of individuals who recidivated in the control condition ( n = 89, 68.46%) were higher compared with those who recidivated in the intervention condition ( n = 127, 33.16%; z = 7.04, p restorative justice. Implications of these effects are discussed.

  1. Insights into workplace bullying: psychosocial drivers and effective interventions

    Directory of Open Access Journals (Sweden)

    Escartín J

    2016-06-01

    Full Text Available Jordi Escartín Department of Social Psychology, Facultad de Psicologia, Universitat de Barcelona, Passeig de la Vall d’Hebrón, Barcelona, Spain Abstract: Research on effectiveness of workplace bullying interventions has lagged behind descriptive studies on this topic. The literature on bullying intervention research has only recently expanded to a point that allows for synthesis of findings across empirical studies. This study addresses the question of whether workplace bullying can be reduced in prevalence and consequences, if so to what extent and by which strategies and interventions. It opens with a brief overview of the nature of bullying at work and discussion of some precursors and existing interventions. However, its principal focus is on the findings obtained from selected (quasi- experimental longitudinal studies on antibullying interventions, drawing together the results of studies conducted in Europe, USA, and Australia, including several economic sectors, and concerned about primary, secondary, and tertiary prevention programs and strategies. Additional emphasis is considered from the psychosocial drivers highlighted both from prescriptive and cross-sectional studies and factual empirical studies. One randomized control study and seven quasiexperimental longitudinal studies were identified by searching electronic databases and bibliographies and via contact with experts. The majority of outcomes evidenced some level of change, mostly positive, suggesting that workplace bullying interventions are more likely to affect knowledge, attitudes, and self-perceptions, but actual bullying behaviors showed much more mixed results. In general, growing effectiveness was stated as the level of intervention increased from primary to tertiary prevention. However, methodological problems relating to the evaluation designs in most studies do not allow direct attribution of these findings to the interventions. Overall, the evaluation of

  2. Physical and cognitive task analysis in interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, S [School of Psychology, University of Liverpool, Liverpool (United Kingdom); Healey, A [Royal Liverpool University Hospital, Liverpool (United Kingdom); Evans, J [Royal Liverpool University Hospital, Liverpool (United Kingdom); Murphy, M [Royal Liverpool University Hospital, Liverpool (United Kingdom); Crawshaw, M [Department of Psychology, University of Hull, Hull (United Kingdom); Gould, D [Royal Liverpool University Hospital, Liverpool (United Kingdom)

    2006-01-15

    AIM: To identify, describe and detail the cognitive thought processes, decision-making, and physical actions involved in the preparation and successful performance of core interventional radiology procedures. MATERIALS AND METHODS: Five commonly performed core interventional radiology procedures were selected for cognitive task analysis. Several examples of each procedure being performed by consultant interventional radiologists were videoed. The videos of those procedures, and the steps required for successful outcome, were analysed by a psychologist and an interventional radiologist. Once a skeleton algorithm of the procedures was defined, further refinement was achieved using individual interview techniques with consultant interventional radiologists. Additionally a critique of each iteration of the established algorithm was sought from non-participating independent consultant interventional radiologists. RESULTS: Detailed task descriptions and decision protocols were developed for five interventional radiology procedures (arterial puncture, nephrostomy, venous access, biopsy-using both ultrasound and computed tomography, and percutaneous transhepatic cholangiogram). Identical tasks performed within these procedures were identified and standardized within the protocols. CONCLUSIONS: Complex procedures were broken down and their constituent processes identified. This might be suitable for use as a training protocol to provide a universally acceptable safe practice at the most fundamental level. It is envisaged that data collected in this way can be used as an educational resource for trainees and could provide the basis for a training curriculum in interventional radiology. It will direct trainees towards safe practice of the highest standard. It will also provide performance objectives of a simulator model.

  3. Physical and cognitive task analysis in interventional radiology

    International Nuclear Information System (INIS)

    Johnson, S.; Healey, A.; Evans, J.; Murphy, M.; Crawshaw, M.; Gould, D.

    2006-01-01

    AIM: To identify, describe and detail the cognitive thought processes, decision-making, and physical actions involved in the preparation and successful performance of core interventional radiology procedures. MATERIALS AND METHODS: Five commonly performed core interventional radiology procedures were selected for cognitive task analysis. Several examples of each procedure being performed by consultant interventional radiologists were videoed. The videos of those procedures, and the steps required for successful outcome, were analysed by a psychologist and an interventional radiologist. Once a skeleton algorithm of the procedures was defined, further refinement was achieved using individual interview techniques with consultant interventional radiologists. Additionally a critique of each iteration of the established algorithm was sought from non-participating independent consultant interventional radiologists. RESULTS: Detailed task descriptions and decision protocols were developed for five interventional radiology procedures (arterial puncture, nephrostomy, venous access, biopsy-using both ultrasound and computed tomography, and percutaneous transhepatic cholangiogram). Identical tasks performed within these procedures were identified and standardized within the protocols. CONCLUSIONS: Complex procedures were broken down and their constituent processes identified. This might be suitable for use as a training protocol to provide a universally acceptable safe practice at the most fundamental level. It is envisaged that data collected in this way can be used as an educational resource for trainees and could provide the basis for a training curriculum in interventional radiology. It will direct trainees towards safe practice of the highest standard. It will also provide performance objectives of a simulator model

  4. Effectiveness of a Grief Intervention for Caregivers of People With Dementia.

    Science.gov (United States)

    MacCourt, Penny; McLennan, Marianne; Somers, Sandie; Krawczyk, Marian

    2017-08-01

    In this article, we report on the structure and effectiveness of a grief management coaching intervention with caregivers of individuals with dementia. The intervention was informed by Marwit and Meuser's Caregiver Grief Model and considered levels of grief, sense of empowerment, coping, and resilience using five methods of delivery. Results indicate that the intervention had significant positive effects on caregivers' levels of grief and increased their levels of empowerment, coping, and resilience. The intervention was found to be effective across caregivers' characteristics as well as across five delivery modalities. Through description of this intervention, as well as outcome, this research contributes to the body of knowledge about caregivers' disenfranchised grief and ways to effectively address it.

  5. Prepare to protect: Operating and maintaining a tornado safe room.

    Science.gov (United States)

    Herseth, Andrew; Goldsmith-Grinspoon, Jennifer; Scott, Pataya

    2017-06-01

    Operating and maintaining a tornado safe room can be critical to the effective continuity of business operations because a firm's most valuable asset is its people. This paper describes aspects of operations and maintenance (O&M) for existing tornado safe rooms as well as a few planning and design aspects that affect the ultimate operation of a safe room for situations where a safe room is planned, but not yet constructed. The information is based on several Federal Emergency Management Agency safe room publications that provide guidance on emergency management and operations, as well as the design and construction of tornado safe rooms.

  6. Cost-effectiveness of interventions to promote physical activity: a modelling study.

    Directory of Open Access Journals (Sweden)

    Linda J Cobiac

    2009-07-01

    Full Text Available BACKGROUND: Physical inactivity is a key risk factor for chronic disease, but a growing number of people are not achieving the recommended levels of physical activity necessary for good health. Australians are no exception; despite Australia's image as a sporting nation, with success at the elite level, the majority of Australians do not get enough physical activity. There are many options for intervention, from individually tailored advice, such as counselling from a general practitioner, to population-wide approaches, such as mass media campaigns, but the most cost-effective mix of interventions is unknown. In this study we evaluate the cost-effectiveness of interventions to promote physical activity. METHODS AND FINDINGS: From evidence of intervention efficacy in the physical activity literature and evaluation of the health sector costs of intervention and disease treatment, we model the cost impacts and health outcomes of six physical activity interventions, over the lifetime of the Australian population. We then determine cost-effectiveness of each intervention against current practice for physical activity intervention in Australia and derive the optimal pathway for implementation. Based on current evidence of intervention effectiveness, the intervention programs that encourage use of pedometers (Dominant and mass media-based community campaigns (Dominant are the most cost-effective strategies to implement and are very likely to be cost-saving. The internet-based intervention program (AUS$3,000/DALY, the GP physical activity prescription program (AUS$12,000/DALY, and the program to encourage more active transport (AUS$20,000/DALY, although less likely to be cost-saving, have a high probability of being under a AUS$50,000 per DALY threshold. GP referral to an exercise physiologist (AUS$79,000/DALY is the least cost-effective option if high time and travel costs for patients in screening and consulting an exercise physiologist are considered

  7. Interventional embolization for refractory hyperthyroidism

    International Nuclear Information System (INIS)

    Jiang Guomin; Zhang Yunping; Chen Yaxian; Zhao Jinwei; Yang Weihuai; Chen Jinluo

    2001-01-01

    Objective: To evaluate the clinical effects of the thyroid artery embolization for refractory hyperthyroidism. Methods: Super selective catheterization and interventional embolization of thyroid superior and inferior arteries were performed with PVA microspheres and Gelfoam particles. Changes of function and size of thyroid were investigated after embolization. Results: The procedures were succeeded in all 21 patients. Followed up by 3-12 months, serum level of thyroid hormones dropped significantly (median FT 3 from 17.1 pmol/L to 7.44 pmol/L, median FT 4 from 51.1 pmol/L to 23.3 pmol/L, P< 0.01). The size of thyroid glands decreased remarkably. Symptoms of hyperthyroidism were controlled in 4 patients and were effectively controlled through low dose antithyroid medication in 17 patients. No serious complications occurred. Conclusions: Thyroid artery embolization is a new safe and effective method for refractory hyperthyroidism

  8. Intervention-engagement and its role in the effectiveness of stage-matched interventions promoting physical exercise.

    Science.gov (United States)

    Richert, Jana; Lippke, Sonia; Ziegelmann, Jochen P

    2011-01-01

    Intervention-engagement has received little attention in sports medicine as well as research and promotion of physical exercise. The construct is important, however, in the understanding of why interventions work. This study aimed at shedding more light on the interplay of engagement and the subsequent effectiveness of physical exercise interventions. A three-stage model differentiating among nonintenders, intenders, and actors informed the intervention design in this study. In an Internet-based randomized controlled trial (RCT) with two measurement points, N = 326 participants received a stage-matched, stage-mismatched, or control treatment. Assessed variables were goal setting, planning, behavior, and intervention-engagement. It was found that regarding goal setting, nonintenders in the stage-matched intervention and those who engaged highly in the stage-matched intervention improved significantly over time. Regarding planning, intenders in the matched condition as well as all actors increased their levels over time. Regarding behavior, nonintenders and intenders having engaged highly in the intervention improved more than those having engaged little. In order to help nonintenders progress on their way toward goal behavior, it is necessary that they engage highly in a stage-matched intervention. Implications for exercise promotion are that interventions should also aim at increasing participants' intervention-engagement.

  9. Cost-effectiveness of nutritional intervention on healing of pressure ulcers.

    Science.gov (United States)

    Hisashige, Akinori; Ohura, Takehiko

    2012-12-01

    Pressure ulcers not only affect quality of life among the elderly, but also bring a large economic burden. There is limited evidence available for the effectiveness of nutritional interventions for treatment of pressure ulcers. In Japan, recently, a 60-patient randomized controlled trial of nutritional intervention on pressure ulcers demonstrated improvement in healing of pressure ulcers, compared with conventional management. To evaluate value for money of nutritional intervention on healing of pressure ulcers, cost-effective analysis was carried out using these trial results. The analysis was carried out from a societal perspective. As effectiveness measures, pressure ulcer days (PUDs) and quality-adjusted life years (QALYs) were estimated. Prevalence of pressure ulcers was estimated by the Kaplan-Meier method. Utility score for pressure ulcers is derived from a cross-sectional survey among health professionals related to pressure ulcers. Costs (e.g., nutritional interventions and management of pressure ulcers) were estimated from trial data during observation and follow-up. Stochastic and qualitative sensitivity analyses were performed to examine the robustness of results. For observation (12 weeks) and follow-up (12-week observation plus 4-week follow-up), nutritional intervention reduced PUDs by 9.6 and 16.2 per person, and gained 0.226 × 10(-2) QALYs and 0.382 × 10(-2) QALYs per person, respectively. In addition, costs were reduced by $542 and $881 per person, respectively. This means nutritional intervention is dominant (cost savings and greater effectiveness). The sensitivity analyses showed the robustness of these results. Economic evaluation of nutritional intervention on healing pressure ulcers from a small randomized controlled trial showed that this intervention is cost saving with health improvement. Further studies are required to determine whether this is a cost-effective intervention for widespread use. Copyright © 2012 Elsevier Ltd and

  10. Effects of feedback in an online algebra intervention

    NARCIS (Netherlands)

    Bokhove, C.; Drijvers, P.H.M.

    2012-01-01

    The design and arrangement of appropriate automatic feedback in digital learning environment is a widely recognized issue. In this article, we investigate the effect of feedback on the design and the results of a digital intervention for algebra. Three feedback principles guided the intervention:

  11. Efficacy and safety of transradial percutaneous coronary intervention using sheathless guide catheter technique

    Directory of Open Access Journals (Sweden)

    Mohamed Aboel-Kassem F. Abdelmegid

    2014-03-01

    Conclusions: TR PCI via standard and sheathless hydrophilic-coated GC techniques are effective and safe with high rate of procedural success and low rate of asymptomatic radial artery occlusion. Moreover, TR PCI using sheathless GC technique has the advantage of performing complex intervention requiring large bore catheters that can not be performed via standard TR PCI using 6F GC.

  12. Effectiveness of psychosocial interventions in abused children and their families.

    Science.gov (United States)

    Derakhshanpour, Firoozeh; Hajebi, Ahmad; Panaghi, Leili; Ahmadabadi, Zohre

    2017-01-01

    Background: Child abuse is a significant public health and social problem worldwide. It can be described as a failure to provide care and protection for children by the parents or other caregivers. This study aimed at evaluating the effectiveness of psychosocial interventions in abused children and their families. Methods: This quasi-experimental study was conducted in the psychosocial support unit of a pediatric hospital in Bandar Abbas, Iran, from 2012 to 2013. The participants consisted of child abuse cases and their parents who referred to the psychosocial support unit to receive services. Services delivered in this unit included parenting skills training, psychiatric treatments, and supportive services. The effectiveness of the interventions was assessed with Child Abuse Questionnaire, General Health Questionnaire (GHQ), and Strengths and Difficulties Questionnaires (SDQ). Participants were assessed at baseline, at 3, and 6 months follow-ups. ANOVA with repeated measures and Friedman test were used to evaluate the effect of the interventions. Results: A total of 68 children and their parents enrolled in this study, of whom 53% were males. Post-intervention follow-ups revealed significant changes in mothers' general health questionnaire (pchildren's conduct problem (pabuses significantly decreased (p<0.001). Conclusion: Our findings revealed that psychosocial interventions effectively improved child-parents interaction and mental health of parents. The effectiveness of interventions based on subgroup analysis and implications of the results have been discussed for further development of psychosocial interventions in the health system.

  13. Effectiveness of Interventions to Reduce Coronary Heart Disease Risk

    African Journals Online (AJOL)

    Objective: To determine the effectiveness of coronary heart disease risk reduction interventions. Methods: The effects of lipid lowering interventions as well as dietary and lifestyle modifications on some risk factors of CHD were studied retrospectively in 47 males and 53 female patients [aged 33 to 61 years; mean age 47.20 ...

  14. Safe and Effective Ag Nanoparticles Immobilized Antimicrobial NanoNonwovens

    DEFF Research Database (Denmark)

    Song, Jie; Chen, Menglin; Regina, Viduthalai R.

    2012-01-01

    and possibility of introduction of secondary pollution. Here, we present a novel strategy to produce a safe and effective antimicrobial nanononwoven material by immobilizing AgNPs on a rigid polymer nanofibrous matrix through simple co-electrospinning of pre-prepaired AgNPs and polystyrene (PS). Distribution...... of the AgNPs on the surface of PS fibers was achieved by tuning fiber diameters during electrospinning. Atomic force microscopy (AFM) analysis revealed that the AgNPs distributed at the fiber surface were still covered by a layer of polymer, which inhibited their antimicrobial activity. UV/ozone treatment...... was thus employed to degrade the polymer coating without loosening the AgNPs, resulting in an active antimicrobial nonwoven against Gram-positive Staphylococcus xylosus. The mechanism based on cellular uptake of silver ions via close contact to the surface of AgNPs is proposed. The novel nanononwoven...

  15. [Sciatic nerve block "out-of-plane" distal to the bifurcation: effective and safe].

    Science.gov (United States)

    Geiser, T; Apel, J; Vicent, O; Büttner, J

    2017-03-01

    Ultrasound guided distal sciatic nerve block (DSB) at bifurcation level shows fast onset and provides excellent success rates. However, its safe performance might be difficult for the unexperienced physician. Just slightly distal to the bifurcation, the tibial nerve (TN) and common fibular nerve (CFN) can be shown clearly separated from each other. Therefore, we investigated if a block done here would provide similar quality results compared to the DSB proximally to the division, with a potentially lower risk of nerve damage. In this randomized, prospective trial, 56 patients per group received either a DSB distal to the bifurcation "out-of-plane" (dist.) or proximally "in-plane" (prox.) with 30 ml of Mepivacaine 1% each. Success was tested by a blinded examiner after 15 and 30 min respectively (sensory and motor block of TN and CFN: 0 = none, 2 = complete, change of skin temperature). Videos of the blocks were inspected by an independent expert retrospectively with regard to the spread of the local anesthetic (LA) and accidental intraneural injection. Cumulative single nerve measurements and temperature changes revealed significant shorter onset and better efficacy (dist/prox: 15 min: 3.13 ± 1.86/1.82 ± 1.62; 30 min: 5.73 ± 1.92/3.21 ± 1.88; T 15 min : 30.3 ± 3.48/28.0 ± 3.67, T 30 min . 33.0 ± 2.46/30.6 ± 3.86; MV/SD; ANOVA; p safe application of the LA, so an effective block can be done with just one injection. DSB slightly distal to the bifurcation, in an out-of-plane technique between the TN and CFN, can be done fast, effectively and safe.

  16. Interventional and surgical management of abdominal compartment syndrome in severe acute pancreatitis.

    Science.gov (United States)

    Dambrauskas, Zilvinas; Parseliūnas, Audrius; Maleckas, Almantas; Gulbinas, Antanas; Barauskas, Giedrius; Pundzius, Juozas

    2010-01-01

    Management of the abdominal compartment syndrome during severe acute pancreatitis by the open abdomen method is associated with considerable morbidity and resource utilization. Thus, the aim of this study was to evaluate the safety and efficacy of the ultrasound-guided percutaneous interventions and/or minimally invasive surgery in the treatment of abdominal compartment syndrome. Forty-four patients with severe acute pancreatitis were enrolled into a prospective study and treated according to the standard management protocol. Interventional and/or surgical management of abdominal compartment syndrome was employed in 6 (13.6%) cases. In the context of this study, we assessed the feasibility and effectiveness of subcutaneous fasciotomy of the anterior m. rectus abdominis sheath, as well as the role of ultrasound-guided drainage of intra-abdominal and peripancreatic fluid collections in the management of abdominal compartment syndrome. Subcutaneous fasciotomy of the anterior m. rectus sheath and ultrasound-guided drainage of intra-abdominal and peripancreatic fluid collections seem to be safe (minor risk of bleeding or infection, closed abdomen, and easy care for the patient) and effective (resulted in a sustained decrease of intra-abdominal pressure to 13-16 mm Hg and regression of organ failures after intervention). Subcutaneous anterior m. rectus fasciotomy may appear to be beneficial in case of refractory abdominal compartment syndrome avoiding morbidity associated with the open abdomen technique. Both the subcutaneous fasciotomy and ultrasound-guided drainage of intra-abdominal and/or peripancreatic fluid collections seem to be safe and effective alternatives in the management of abdominal compartment syndrome; however, prospective studies are needed to further evaluate their clinical role.

  17. The clinical application of interventional therapy for lower limb deep venous thrombosis

    International Nuclear Information System (INIS)

    Tang Maoshun; Gao Wenhui; Chen Zhou; Zhang Ming; Qian Sheng

    2009-01-01

    Objective: To evaluate the clinical effect of comprehensive interventional treatment for lower extremity deep venous thrombosis. Methods: Comprehensive interventional therapy was performed in 33 patients with lower extremity deep venous thrombosis. The clinical data and the therapeutic results were retrospectively analyzed. Of 33 patients, placement of inferior vena cava filter with postoperative anticoagulant and thrombolytic therapy was employed in 10, while placing of inferior vena cava filter together with reopening of the affected-side iliac-femoral vein was carried out in 23. Results: During the follow-up period, no serious complications, such as massive hemorrhage and lethal pulmonary artery embolism, occurred. Complete dissolution of the thrombus in the lower extremity deep vein was obtained in 23 cases, and partial dissolution of the thrombus in 10 cases. Conclusion: Comprehensive interventional therapy is an effective,safe and feasible technique for the treatment of lower limb deep venous thrombosis. (authors)

  18. Interventional therapy for gastrointestinal hemorrhage induced by Dieulafoy disease

    International Nuclear Information System (INIS)

    Su Xiuqin; Yu Shiping; Zhang Jin; Zhang Caizhen; Yuan Wei; Meng Xiangwen

    2008-01-01

    Objective: To investigate and assess the efficiency and clinical value of interventional therapy for gastrointestinal hemorrhage induced by Dieulafoy disease. Methods: Ten patients definitely diagnosed with Dieulafoy disease suffering from massive acute gastrointestinal hemorrhage received celiac arterial and left gastric arterial angiography, outcoming with 8 positively and 2 negative cases. Among them, 6 were embolized with gelfoam particles and the other two with aneurismal dilatation received gelfoam particles and spring steel coils; and one of the negtive cases was given hypophysin and without intervention to the other. Results: Among the 8 intra-arterial embolized cases, only 1 case rebleeded on the third day after gelfoam embolization, and then treated by surgical operation, and the rest 7 showed no rebleeding. One case with hypophysin treatment rehabilitated after one week. Conclusions: Interventional therapeutics is a safe and effective emergency management for gastrointestinal hemorrhage induced by Dieulafoy disease. (authors)

  19. Manned underwater intervention during deep-water operations

    Energy Technology Data Exchange (ETDEWEB)

    Lothe, Mikal Sjur

    2010-07-01

    The focus for deep and remote areas operations are Remote Operated systems. Manned intervention is generally first choice when looking for intervention methods in most areas of the world. As an industry we need to focus on the most cost effective and safe method for construction, Maintenance and Repair. The focus is on advances in diving methods related to surface oriented and saturation diving, such as shallow water tie-ins of risers and umbilicals, inspection and evaluations of FPSOs including thruster change-out and wet docking. Also, the options for efficient repair scenarios utilizing man's ability to work in low visibility areas by feel etc. Finally the presentation will show new technology in Saturation Diving based on the 24 man saturation systems onboard the 3rd generation Divex systems used by Technip and Subsea 7. (Author)

  20. Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH) Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review.

    Science.gov (United States)

    Ramesh, Anita; Blanchet, Karl; Ensink, Jeroen H J; Roberts, Bayard

    2015-01-01

    Water, sanitation, and hygiene (WASH) interventions are amongst the most crucial in humanitarian crises, although the impact of the different WASH interventions on health outcomes remains unclear. To examine the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluate current evidence on their effectiveness against health outcomes in these contexts. A systematic literature review was conducted of primary and grey quantitative literature on WASH interventions measured against health outcomes in humanitarian crises occurring from 1980-2014. Populations of interest were those in resident in humanitarian settings, with a focus on acute crisis and early recovery stages of humanitarian crises in low and middle-income countries. Interventions of interest were WASH-related, while outcomes of interest were health-related. Study quality was assessed via STROBE/CONSORT criteria. Results were analyzed descriptively, and PRISMA reporting was followed. Of 3963 studies initially retrieved, only 6 published studies measured a statistically significant change in health outcome as a result of a WASH intervention. All 6 studies employed point-of-use (POU) water quality interventions, with 50% using safe water storage (SWS) and 35% using household water treatment (HWT). All 6 studies used self-reported diarrhea outcomes, 2 studies also reported laboratory confirmed outcomes, and 2 studies reported health treatment outcomes (e.g. clinical admissions). 1 study measured WASH intervention success in relation to both health and water quality outcomes; 1 study recorded uptake (use of soap) as well as health outcomes. 2 studies were unblinded randomized-controlled trials, while 4 were uncontrolled longitudinal studies. 2 studies were graded as providing high quality evidence; 3 studies provided moderate and 1 study low quality evidence. The current evidence base on the impact of WASH interventions on health outcomes in humanitarian

  1. Evaluating Intervention Effects in a Diagnostic Classification Model Framework

    Science.gov (United States)

    Madison, Matthew J.; Bradshaw, Laine

    2018-01-01

    The evaluation of intervention effects is an important objective of educational research. One way to evaluate the effectiveness of an intervention is to conduct an experiment that assigns individuals to control and treatment groups. In the context of pretest/posttest designed studies, this is referred to as a control-group pretest/posttest design.…

  2. DroidSafe

    Science.gov (United States)

    2016-12-01

    Massachusetts Avenue, Build E19-750 Cambridge , MA 02139-4307 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS...Activity objects illustrating the challenges of points-to and information flow analysis...measure how many malicious flows Droid- Safe was able to detect). As these results illustrate , DroidSafe implements an analysis of unprece- dented

  3. Clinical study of interventional therapy for acute cerebral infarction

    International Nuclear Information System (INIS)

    Xiang Guangze; Xiao Yiming; Wen Zhilin

    2004-01-01

    Objective: To evaluate the clinical efficacy and safety of interventional therapy for acute cerebral infarction. Method: Using urokinase, 35 patients with acute cerebral infarction within 24 hours were treated by intra-artery thrombolytic therapy. Europe stroke scale (ESS), Barthel index (BI) were used to evaluate the recovery of neurological functions. Result: ESS score increase rapidly after thrombolytisis, and there were significant difference between the two teams. Thirteen of 13 cases treated within 6 hours from onset showed complete/partial recanalization in cerebral angiography and intraparenchymal hemorrhagic rate were 0%, twenty-six of 35 cases treated within 24 hours showed complete/partial recanalization and intraparenchymal hemorrhagic rate were 5.71%. Conclusion: Interventional therapy for acute cerebral infarction within 6h were safe and effective. (authors)

  4. Safe havens in Europe

    DEFF Research Database (Denmark)

    Paldam, Martin

    2013-01-01

    Eleven safe havens exist in Europe providing offshore banking and low taxes. Ten of these states are very small while Switzerland is moderately small. All 11 countries are richer than their large neighbors. It is shown that causality is from small to safe haven to wealth, and that theoretically...... equilibriums are likely to exist where a certain regulation is substantially lower in a small country than in its big neighbor. This generates a large capital inflow to the safe havens. The pool of funds that may reach the safe havens is shown to be huge. It is far in excess of the absorptive capacity...... of the safe havens, but it still explains, why they are rich. Microstates offer a veil of anonymity to funds passing through, and Switzerland offers safe storage of funds....

  5. From Safe Systems to Patient Safety

    DEFF Research Database (Denmark)

    Aarts, J.; Nøhr, C.

    2010-01-01

    for the third conference with the theme: The ability to design, implement and evaluate safe, useable and effective systems within complex health care organizations. The theme for this conference was "Designing and Implementing Health IT: from safe systems to patient safety". The contributions have reflected...... and implementation of safe systems and thus contribute to the agenda of patient safety? The contributions demonstrate how the health informatics community has contributed to the performance of significant research and to translating research findings to develop health care delivery and improve patient safety......This volume presents the papers from the fourth International Conference on Information Technology in Health Care: Socio-technical Approaches held in Aalborg, Denmark in June 2010. In 2001 the first conference was held in Rotterdam, The Netherlands with the theme: Sociotechnical' approaches...

  6. Traveling Safely with Medicines

    Science.gov (United States)

    ... Medications Safely My Medicine List How to Administer Traveling Safely with Medicines Planes, trains, cars – even boats ... your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you ...

  7. Causal Client Models in Selecting Effective Interventions: A Cognitive Mapping Study

    Science.gov (United States)

    de Kwaadsteniet, Leontien; Hagmayer, York; Krol, Nicole P. C. M.; Witteman, Cilia L. M.

    2010-01-01

    An important reason to choose an intervention to treat psychological problems of clients is the expectation that the intervention will be effective in alleviating the problems. The authors investigated whether clinicians base their ratings of the effectiveness of interventions on models that they construct representing the factors causing and…

  8. Associations between active trachoma and community intervention with Antibiotics, Facial cleanliness, and Environmental improvement (A,F,E.

    Directory of Open Access Journals (Sweden)

    Jeremiah Ngondi

    2008-04-01

    Full Text Available Surgery, Antibiotics, Facial cleanliness and Environmental improvement (SAFE are advocated by the World Health Organization (WHO for trachoma control. However, few studies have evaluated the complete SAFE strategy, and of these, none have investigated the associations of Antibiotics, Facial cleanliness, and Environmental improvement (A,F,E interventions and active trachoma. We aimed to investigate associations between active trachoma and A,F,E interventions in communities in Southern Sudan.Surveys were undertaken in four districts after 3 years of implementation of the SAFE strategy. Children aged 1-9 years were examined for trachoma and uptake of SAFE assessed through interviews and observations. Using ordinal logistic regression, associations between signs of active trachoma and A,F,E interventions were explored. Trachomatous inflammation-intense (TI was considered more severe than trachomatous inflammation-follicular (TF. A total of 1,712 children from 25 clusters (villages were included in the analysis. Overall uptake of A,F,E interventions was: 53.0% of the eligible children had received at least one treatment with azithromycin; 62.4% children had a clean face on examination; 72.5% households reported washing faces of children two or more times a day; 73.1% households had received health education; 44.4% of households had water accessible within 30 minutes; and 6.3% households had pit latrines. Adjusting for age, sex, and district baseline prevalence of active trachoma, factors independently associated with reduced odds of a more severe active trachoma sign were: receiving three treatments with azithromycin (odds ratio [OR] = 0.1; 95% confidence interval [CI] 0.0-0.4; clean face (OR = 0.3; 95% CI 0.2-0.4; washing faces of children three or more times daily (OR = 0.4; 95% CI 0.3-0.7; and presence and use of a pit latrine in the household (OR = 0.4; 95% CI 0.2-0.9.Analysis of associations between the A,F,E components of the SAFE strategy and

  9. The community-based participatory intervention effect of "HIV-RAAP".

    Science.gov (United States)

    Yancey, Elleen M; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H; Yuan, Keming

    2012-07-01

    To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission.

  10. Combined SAFE/SNAP approach to safeguards evaluation

    International Nuclear Information System (INIS)

    Engi, D.; Chapman, L.D.; Grant, F.H.; Polito, J.

    1980-01-01

    The scope of a safeguards evaluation model can efficiently address one of two issues: (1) global safeguards effectiveness or (2) vulnerability analysis for individual scenarios. The Safeguards Automated Facility Evaluation (SAFE) focuses on the first issue, while the Safeguards Network Analysis Procedure (SNAP) is directed towards the second. A combined SAFE/SNAP approach to the problem of safeguards evaluation is described and illustrated through an example. 4 refs

  11. The Program Cost of a Brief Video Intervention Shown in Sexually Transmitted Disease Clinic Waiting Rooms.

    Science.gov (United States)

    Gift, Thomas L; OʼDonnell, Lydia N; Rietmeijer, Cornelis A; Malotte, Kevin C; Klausner, Jeffrey D; Margolis, Andrew D; Borkowf, Craig B; Kent, Charlotte K; Warner, Lee

    2016-01-01

    Patients in sexually transmitted disease (STD) clinic waiting rooms represent a potential audience for delivering health messages via video-based interventions. A controlled trial at 3 sites found that patients exposed to one intervention, Safe in the City, had a significantly lower incidence of STDs compared with patients in the control condition. An evaluation of the intervention's cost could help determine whether such interventions are programmatically viable. The cost of producing the Safe in the City intervention was estimated using study records, including logs, calendars, and contract invoices. Production costs were divided by the 1650 digital video kits initially fabricated to get an estimated cost per digital video. Clinic costs for showing the video in waiting rooms included staff time costs for equipment operation and hardware depreciation and were estimated for the 21-month study observation period retrospectively. The intervention cost an estimated $416,966 to develop, equaling $253 per digital video disk produced. Per-site costs to show the video intervention were estimated to be $2699 during the randomized trial. The cost of producing and implementing Safe in the City intervention suggests that similar interventions could potentially be produced and made available to end users at a price that would both cover production costs and be low enough that the end users could afford them.

  12. The Effects of Training, Feedback, and Participant Involvement in Behavioral Safety Observations on Office Ergonomic Behavior

    Science.gov (United States)

    Sasson, Joseph R.; Austin, John

    2005-01-01

    Eleven computer terminal operators participated in an experiment that assessed effects of several interventions aimed at increasing safe ergonomic performance. All participants received ergonomics training and performance feedback while six of them collected observations of safe behavior among the remaining five participants. Effects of…

  13. Safe affordable fission engine (SAFE 30) module conductivity test thermal model correlation

    International Nuclear Information System (INIS)

    Roman, Jose

    2001-01-01

    model and the corresponding data will later be used to evaluate the heat transfer characteristics of the SAFE 30 core, and perform various design trade-offs. Finally, the test data is evaluated to determine the effect of the tri-cusp insert on heat transfer. It is found that the tri-cusps cause a significant increase in module heat transfer

  14. Technology-supported dietary and lifestyle interventions in healthy pregnant women: a systematic review.

    Science.gov (United States)

    O'Brien, O A; McCarthy, M; Gibney, E R; McAuliffe, F M

    2014-07-01

    Overweight and obesity are associated with increased risk of adverse maternal and fetal outcomes. However, the actuality of delivering effective lifestyle interventions in clinical practice is hampered by a high demand for resources. The use of technology to assist lifestyle interventions needs to be explored as a valid method of reducing strain on resources, and enhancing the effectiveness and population reach of interventions. The aim was to systematically review the literature on the use of technology-supported lifestyle interventions for healthy pregnant women and their impact on maternal outcomes. Online databases and registries were searched in March 2013. Primary outcomes of selected English language studies were fasting maternal glucose, incidence of gestational diabetes mellitus (GDM) and maternal gestational weight gain. Secondary outcomes were intervention uptake and acceptance, and dietary or physical activity modification. Studies whose subjects were diagnosed with GDM prior to intervention were excluded. The minimal number of eligible studies and varying outcomes precluded formal meta-analysis of the data. Initially, 203 articles were identified and screened. Seven articles, including five randomised controlled trials, met inclusion criteria for the current review. Results demonstrate several potential benefits associated with technology-supported interventions in pregnancy, despite minimal search results. Although communication technology holds potential as a safe therapeutic tool for the support of lifestyle interventions in pregnancy, there is a paucity of data on its effectiveness. Further RCTs examining the effectiveness of communication technology are required, particularly among those most likely to benefit from lifestyle interventions, such as overweight and obese pregnant women.

  15. Brief Behavioral Sleep Intervention for Adolescents: An Effectiveness Study.

    Science.gov (United States)

    Paavonen, E Juulia; Huurre, Taina; Tilli, Maija; Kiviruusu, Olli; Partonen, Timo

    2016-01-01

    Sleep disturbances are common among adolescents, but there are no brief interventions to treat them. The objective of this study was to evaluate the effectiveness of a brief semistructured, individually delivered sleep intervention to ameliorate adolescents' sleeping difficulties and lengthen sleep duration. All students aged 16-18 years in a high school were screened for sleeping difficulties and 36 students with the highest sleep problem scores were invited to the intervention. Postintervention improvements were observed on self-reported and actiwatch-registered sleep duration, self-reported sleep quality and sleep latency, perceived stress and anxiety (all p values sleep efficiency and sleep latency did not change (p > 0.05). A brief individual sleep intervention can be effective in lengthening sleep duration and improving subjective sleep quality and well-being among adolescents.

  16. Effective return-to-work interventions after acquired brain injury: A systematic review.

    Science.gov (United States)

    Donker-Cools, Birgit H P M; Daams, Joost G; Wind, Haije; Frings-Dresen, Monique H W

    2016-01-01

    To gather knowledge about effective return-to-work (RTW) interventions for patients with acquired brain injury (ABI). A database search was performed in PubMed, EMBASE, PsycINFO, CINAHL and the Cochrane Library using keywords and Medical Subject Headings. Studies were included if they met inclusion criteria: adult patients with non-progressive ABI, working pre-injury and an intervention principally designed to improve RTW as an outcome. The methodological quality of included studies was determined and evidence was assessed qualitatively. Twelve studies were included, of which five were randomized controlled trials and seven were cohort studies. Nine studies had sufficient methodological quality. There is strong evidence that work-directed interventions in combination with education/coaching are effective regarding RTW and there are indicative findings for the effectiveness of work-directed interventions in combination with skills training and education/coaching. Reported components of the most effective interventions were tailored approach, early intervention, involvement of patient and employer, work or workplace accommodations, work practice and training of social and work-related skills, including coping and emotional support. Effective RTW interventions for patients with ABI are a combination of work-directed interventions, coaching/education and/or skills training. These interventions have the potential to facilitate sustained RTW for patients with ABI.

  17. Adjuvant single-fraction radiotherapy is safe and effective for intractable keloids

    International Nuclear Information System (INIS)

    Song, Changhoon; Wu, Honggyun; Chang, Hak; Kim, Il Han; Ha, Sung W.

    2014-01-01

    The aim of this study was to assess the feasibility and efficacy of high-dose, single-fraction electron beam radiotherapy for therapy-resistant keloids. Before 2010, intractable keloids were treated at our institution with post-operative irradiation of 6-15 Gy in 3-5 fractionations. For convenience and cost effectiveness, we have changed our treatment protocol to high-dose single-fraction radiotherapy. A total of 12 patients with 16 keloid lesions were treated from January 2010 to January 2013 in our department. A 10-Gy dose of electron irradiation was given within 72 h of the surgical excision. The mean follow-up period was 20 months. Treatments were well tolerated, and there was no recurrence in any of the patients. Severe adverse effects were not observed. Surgical excision of the keloid, followed by immediate, single-fraction, high-dose radiotherapy, is both safe and effective in preventing recurrence of therapy-resistant keloids. (author)

  18. Technology strategy for cost-effective drilling and intervention; Technology Target Areas; TTA4 - Cost effective drilling and intervention

    Energy Technology Data Exchange (ETDEWEB)

    2007-07-01

    The main goals of the OG21 initiative are to (1) develop new technology and knowledge to increase the value creation of Norwegian oil and gas resources and (2) enhance the export of Norwegian oil and gas technology. The OG21 Cost-effective Drilling and Intervention (CEDI) Technology Target Area (TTA) has identified some key strategic drilling and well intervention needs to help meet the goals of OG21. These key strategic drilling and well intervention needs are based on a review of present and anticipated future offshore-Norway drilling and well intervention conditions and the Norwegian drilling and well intervention industry. A gap analysis has been performed to assess the extent to which current drilling and well intervention research and development and other activities will meet the key strategic needs. Based on the identified strategic drilling and well intervention needs and the current industry res each and development and other activities, the most important technology areas for meeting the OG21 goals are: environment-friendly and low-cost exploration wells; low-cost methods for well intervention/sidetracks; faster and extended-reach drilling; deep water drilling, completion and intervention; offshore automated drilling; subsea and sub-ice drilling; drilling through basalt and tight carbonates; drilling and completion in salt formation. More specific goals for each area: reduce cost of exploration wells by 50%; reduce cost for well intervention/sidetracks by 50%; increase drilling efficiency by 40%; reduce drilling cost in deep water by 40 %; enable offshore automated drilling before 2012; enable automated drilling from seabed in 2020. Particular focus should be placed on developing new technology for low-cost exploration wells to stem the downward trends in the number of exploration wells drilled and the volume of discovered resources. The CEDI TTA has the following additional recommendations: The perceived gaps in addressing the key strategic drilling and

  19. Incredible Years parenting interventions: current effectiveness research and future directions.

    Science.gov (United States)

    Gardner, Frances; Leijten, Patty

    2017-06-01

    The Incredible Years parenting intervention is a social learning theory-based programme for reducing children's conduct problems. Dozens of randomized trials, many by independent investigators, find consistent effects of Incredible Years on children's conduct problems across multiple countries and settings. However, in common with other interventions, these average effects hide much variability in the responses of individual children and families. Innovative moderator research is needed to enhance scientific understanding of why individual children and parents respond differently to intervention. Additionally, research is needed to test whether there are ways to make Incredible Years more effective and accessible for families and service providers, especially in low resource settings, by developing innovative delivery systems using new media, and by systematically testing for essential components of parenting interventions. Copyright © 2017. Published by Elsevier Ltd.

  20. Effectiveness of knowledge translation interventions to improve cancer pain management.

    Science.gov (United States)

    Cummings, Greta G; Olivo, Susan Armijo; Biondo, Patricia D; Stiles, Carla R; Yurtseven, Ozden; Fainsinger, Robin L; Hagen, Neil A

    2011-05-01

    Cancer pain is prevalent, yet patients do not receive best care despite widely available evidence. Although national cancer control policies call for education, effectiveness of such programs is unclear and best practices are not well defined. To examine existing evidence on whether knowledge translation (KT) interventions targeting health care providers, patients, and caregivers improve cancer pain outcomes. A systematic review and meta-analysis were undertaken to evaluate primary studies that examined effects of KT interventions on providers and patients. Twenty-six studies met the inclusion criteria. Five studies reported interventions targeting health care providers, four focused on patients or their families, one study examined patients and their significant others, and 16 studies examined patients only. Seven quantitative comparisons measured the statistical effects of interventions. A significant difference favoring the treatment group in least pain intensity (95% confidence interval [CI]: 0.44, 1.42) and in usual pain/average pain (95% CI: 0.13, 0.74) was observed. No other statistical differences were observed. However, most studies were assessed as having high risk of bias and failed to report sufficient information about the intervention dose, quality of educational material, fidelity, and other key factors required to evaluate effectiveness of intervention design. Trials that used a higher dose of KT intervention (characterized by extensive follow-up, comprehensive educational program, and higher resource allocation) were significantly more likely to have positive results than trials that did not use this approach. Further attention to methodological issues to improve educational interventions and research to clarify factors that lead to better pain control are urgently needed. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

  1. Sun Safe Mode Controller Design for LADEE

    Science.gov (United States)

    Fusco, Jesse C.; Swei, Sean S. M.; Nakamura, Robert H.

    2015-01-01

    This paper presents the development of sun safe controllers which are designed to keep the spacecraft power positive and thermally balanced in the event an anomaly is detected. Employed by NASA's Lunar Atmosphere and Dust Environment Explorer (LADEE), the controllers utilize the measured sun vector and the spacecraft body rates for feedback control. To improve the accuracy of sun vector estimation, the least square minimization approach is applied to process the sensor data, which is proven to be effective and accurate. To validate the controllers, the LADEE spacecraft model engaging the sun safe mode was first simulated and then compared with the actual LADEE orbital fight data. The results demonstrated the applicability of the proposed sun safe controllers.

  2. Identifying effective components of child maltreatment interventions: A meta-analysis

    NARCIS (Netherlands)

    van der Put, C.E.; Assink, M.; Gubbels, J.; Boekhout van Solinge, N.F.

    There is a lack of knowledge about specific components that make interventions effective in preventing or reducing child maltreatment. The aim of the present meta-analysis was to increase this knowledge by summarizing findings on effects of interventions for child maltreatment and by examining

  3. Vitamins, Are They Safe?

    Directory of Open Access Journals (Sweden)

    Hadi Hamishehkar

    2016-12-01

    Full Text Available The consumption of a daily multivitamin among people all over the world is dramatically increasing in recent years. Most of the people believe that if vitamins are not effective, at least they are safe. However, the long term health consequences of vitamins consumption are unknown. This study aimed to assess the side effects and possible harmful and detrimental properties of vitamins and to discuss whether vitamins can be used as safe health products or dietary supplements. We performed a MEDLINE/PubMed, EMBASE, Scopus and Google Scholar search and assessed reference lists of the included studies which were published from 1993 through 2015. The studies, with an emphasis on RCTs (randomized controlled clinical trials, were reviewed. As some vitamins such as fat-soluble vitamins (vitamin A, vitamin D, vitamin E, and also some of the water-soluble vitamins like folic acid may cause adverse events and some like vitamin C is widely taken assuming that it has so many benefits and no harm, we included relevant studies with negative or undesired results regarding the effect of these vitamins on health. Our recommendation is that taking high-dose supplements of vitamins A, E, D, C, and folic acid is not always effective for prevention of disease, and it can even be harmful to the health.

  4. The effects of the Odense Overweight Intervention Study

    DEFF Research Database (Denmark)

    Larsen, Kristian Traberg; Huang, Tao; Ried-Larsen, Mathias

    of the DCIA in BMI z-score, clustered risk z-score, systolic blood pressure, abdominal fat-%, waist circumference, cardiorespiratory fitness, and total cholesterol/HDL ratio. In body fat-%, waist circumference and triglycerides, there is only a significant group difference at 6 weeks and not at 52 weeks......Aim: The primary aim of the study is to evaluate the effect of the Odense Overweight Intervention Study on BMI development. Methods: The OOIS is a semi-blinded randomized controlled trial with three measurement occasions. Participants were allocated into two intervention arms; a day camp...... intervention arm (DCIA) and a standard intervention arm (SIA). For the DCIA the camp lasted for six weeks and consisted of fun-based physical activities, healthy eating, and health classes. The following 10 months a family based intervention was accomplished. The SIA was offered a weekly activity session...

  5. Improving Safe Sleep Modeling in the Hospital through Policy Implementation.

    Science.gov (United States)

    Heitmann, Rachel; Nilles, Ester K; Jeans, Ashley; Moreland, Jackie; Clarke, Chris; McDonald, Morgan F; Warren, Michael D

    2017-11-01

    Introduction Sleep-related infant deaths are major contributors to Tennessee's high infant mortality rate. The purpose of this initiative was to evaluate the impact of policy-based efforts to improve modeling of safe sleep practices by health care providers in hospital settings across Tennessee. Methods Safe sleep policies were developed and implemented at 71 hospitals in Tennessee. Policies, at minimum, were required to address staff training on the American Academy of Pediatrics' safe sleep recommendations, correct modeling of infant safe sleep practices, and parent education. Hospital data on process measures related to training and results of crib audits were compiled for analysis. Results The overall observance of infants who were found with any risk factors for unsafe sleep decreased 45.6% (p ≤ 0.001) from the first crib audit to the last crib audit. Significant decreases were noted for specific risk factors, including infants found asleep not on their back, with a toy or object in the crib, and not sleeping in a crib. Significant improvements were observed at hospitals where printed materials or video were utilized for training staff compared to face-to-face training. Discussion Statewide implementation of the hospital policy intervention resulted in significant reductions in infants found in unsafe sleep situations. The most common risk factors for sleep-related infant deaths can be modeled in hospitals. This effort has the potential to reduce sleep-related infant deaths and ultimately infant mortality.

  6. Evaluating health effects of transport interventions methodologic case study.

    Science.gov (United States)

    Ogilvie, David; Mitchell, Richard; Mutrie, Nanette; Petticrew, Mark; Platt, Stephen

    2006-08-01

    There is little evidence about the effects of environmental interventions on population levels of physical activity. Major transport projects may promote or discourage physical activity in the form of walking and cycling, but researching the health effects of such "natural experiments" in transport policy or infrastructure is challenging. Case study of attempts in 2004-2005 to evaluate the effects of two major transport projects in Scotland: an urban congestion charging scheme in Edinburgh, and a new urban motorway (freeway) in Glasgow. These interventions are typical of many major transport projects. They are unique to their context. They cannot easily be separated from the other components of the wider policies within which they occur. When, where, and how they are implemented are political decisions over which researchers have no control. Baseline data collection required for longitudinal studies may need to be planned before the intervention is certain to take place. There is no simple way of defining a population or area exposed to the intervention or of defining control groups. Changes in quantitative measures of health-related behavior may be difficult to detect. Major transport projects have clear potential to influence population health, but it is difficult to define the interventions, categorize exposure, or measure outcomes in ways that are likely to be seen as credible in the field of public health intervention research. A final study design is proposed in which multiple methods and spatial levels of analysis are combined in a longitudinal quasi-experimental study.

  7. Interventional therapy for nutcracker syndrome (report of 6 cases)

    International Nuclear Information System (INIS)

    Xia Xiangwen; Liang Huimin; Fang Gansheng; Zhao Long; Huang Rui

    2008-01-01

    Objective: To study the imaging features of nutcracker syndrome (compression of left renal vein), and to assess the value of the interventional therapy for this disease. Methods: The clinical data of 6 cases of nutcracker syndrome undertaken interventional therapy were collected to analyze the clinical features, imaging characteristics and interventional therapeutic value together with comprehensive literatures. Results: The imaging appearance of the 6 cases showed typical left renal vein compression. The average in between angle of superior mesenteric artery(SMA)and abdominal aorta(At)was 20.6 degree ± 4.04 degree in MPR reconstructed imaging of CTA. The blood pressure gradient between proximal and distal compression sites was(6.4 ± 0.36) cmH 2 O. No complications of displacement and defluxion and restenosis occurred after stenting for a year. The subjective symptoms of the 6 patients improved significantly. Conclusion: Endovascular stenting is a safe, mini-traumatic and effective therapy for nutcracker syndrome. (authors)

  8. Clinical applications of virtual navigation bronchial intervention.

    Science.gov (United States)

    Kajiwara, Naohiro; Maehara, Sachio; Maeda, Junichi; Hagiwara, Masaru; Okano, Tetsuya; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

    2018-01-01

    In patients with bronchial tumors, we frequently consider endoscopic treatment as the first treatment of choice. All computed tomography (CT) must satisfy several conditions necessary to analyze images by Synapse Vincent. To select safer and more precise approaches for patients with bronchial tumors, we determined the indications and efficacy of virtual navigation intervention for the treatment of bronchial tumors. We examined the efficacy of virtual navigation bronchial intervention for the treatment of bronchial tumors located at a variety of sites in the tracheobronchial tree using a high-speed 3-dimensional (3D) image analysis system, Synapse Vincent. Constructed images can be utilized to decide on the simulation and interventional strategy as well as for navigation during interventional manipulation in two cases. Synapse Vincent was used to determine the optimal planning of virtual navigation bronchial intervention. Moreover, this system can detect tumor location and alsodepict surrounding tissues, quickly, accurately, and safely. The feasibility and safety of Synapse Vincent in performing useful preoperative simulation and navigation of surgical procedures can lead to safer, more precise, and less invasion for the patient, and makes it easy to construct an image, depending on the purpose, in 5-10 minutes using Synapse Vincent. Moreover, if the lesion is in the parenchyma or sub-bronchial lumen, it helps to perform simulation with virtual skeletal subtraction to estimate potential lesion movement. By using virtual navigation system for simulation, bronchial intervention was performed with no complications safely and precisely. Preoperative simulation using virtual navigation bronchial intervention reduces the surgeon's stress levels, particularly when highly skilled techniques are needed to operate on lesions. This task, including both preoperative simulation and intraoperative navigation, leads to greater safety and precision. These technological instruments

  9. The effectiveness of community-based coordinating interventions in dementia care: a meta-analysis and subgroup analysis of intervention components.

    Science.gov (United States)

    Backhouse, Amy; Ukoumunne, Obioha C; Richards, David A; McCabe, Rose; Watkins, Ross; Dickens, Chris

    2017-11-13

    Interventions aiming to coordinate services for the community-based dementia population vary in components, organisation and implementation. In this review we aimed to evaluate the effectiveness of community-based care coordinating interventions on health outcomes and investigate whether specific components of interventions influence their effects. We searched four databases from inception to April 2017: Medline, The Cochrane Library, EMBASE and PsycINFO. This was aided by a search of four grey literature databases, and backward and forward citation tracking of included papers. Title and abstract screening was followed by a full text screen by two independent reviewers, and quality was assessed using the CASP appraisal tool. We then conducted meta-analyses and subgroup analyses. A total of 14 randomised controlled trials (RCTs) involving 10,372 participants were included in the review. Altogether we carried out 12 meta-analyses and 19 subgroup analyses. Meta-analyses found coordinating interventions showed a statistically significant improvement in both patient behaviour measured using the Neuropsychiatric Inventory (NPI) (mean difference (MD) = -9.5; 95% confidence interval (CI): -18.1 to -1.0; p = 0.03; number of studies (n) = 4; I 2  = 88%) and caregiver burden (standardised mean difference (SMD) = -0.54; 95% CI: -1.01 to -0.07; p = 0.02; n = 5, I 2  = 92%) compared to the control group. Subgroup analyses found interventions using a case manager with a nursing background showed a greater positive effect on caregiver quality of life than those that used case managers from other professional backgrounds (SMD = 0.94 versus 0.03, respectively; p < 0.001). Interventions that did not provide supervision for the case managers showed greater effectiveness for reducing the percentage of patients that are institutionalised compared to those that provided supervision (odds ratio (OR) = 0.27 versus 0.96 respectively; p = 0.02). There was little

  10. The effectiveness of community-based coordinating interventions in dementia care: a meta-analysis and subgroup analysis of intervention components

    Directory of Open Access Journals (Sweden)

    Amy Backhouse

    2017-11-01

    Full Text Available Abstract Background Interventions aiming to coordinate services for the community-based dementia population vary in components, organisation and implementation. In this review we aimed to evaluate the effectiveness of community-based care coordinating interventions on health outcomes and investigate whether specific components of interventions influence their effects. Methods We searched four databases from inception to April 2017: Medline, The Cochrane Library, EMBASE and PsycINFO. This was aided by a search of four grey literature databases, and backward and forward citation tracking of included papers. Title and abstract screening was followed by a full text screen by two independent reviewers, and quality was assessed using the CASP appraisal tool. We then conducted meta-analyses and subgroup analyses. Results A total of 14 randomised controlled trials (RCTs involving 10,372 participants were included in the review. Altogether we carried out 12 meta-analyses and 19 subgroup analyses. Meta-analyses found coordinating interventions showed a statistically significant improvement in both patient behaviour measured using the Neuropsychiatric Inventory (NPI (mean difference (MD = −9.5; 95% confidence interval (CI: −18.1 to −1.0; p = 0.03; number of studies (n = 4; I2 = 88% and caregiver burden (standardised mean difference (SMD = −0.54; 95% CI: -1.01 to −0.07; p = 0.02; n = 5, I2 = 92% compared to the control group. Subgroup analyses found interventions using a case manager with a nursing background showed a greater positive effect on caregiver quality of life than those that used case managers from other professional backgrounds (SMD = 0.94 versus 0.03, respectively; p < 0.001. Interventions that did not provide supervision for the case managers showed greater effectiveness for reducing the percentage of patients that are institutionalised compared to those that provided supervision (odds ratio (OR = 0.27 versus 0

  11. Focusing on Mental Health, Not Metal Detectors: Three Building Blocks of Safe and Effective Schools.

    Science.gov (United States)

    Simpson, Richard; Kline, Sue Ann; Barnhill, Gena; Griswold, Deborah

    2000-01-01

    Many measures schools are implementing in response to recent violence will protect students but do little to address the complex social interactions that support violence. This article describes an approach that includes five research-based steps for creating safe and effective schools. This approach contains ways to help the learning environment,…

  12. Kids Safe and Smokefree (KiSS): a randomized controlled trial of a multilevel intervention to reduce secondhand tobacco smoke exposure in children.

    Science.gov (United States)

    Lepore, Stephen J; Winickoff, Jonathan P; Moughan, Beth; Bryant-Stephens, Tyra C; Taylor, Daniel R; Fleece, David; Davey, Adam; Nair, Uma S; Godfrey, Melissa; Collins, Bradley N

    2013-08-30

    Secondhand smoke exposure (SHSe) harms children's health, yet effective interventions to reduce child SHSe in the home and car have proven difficult to operationalize in pediatric practice. A multilevel intervention combining pediatric healthcare providers' advice with behavioral counseling and navigation to pharmacological cessation aids may improve SHSe control in pediatric populations. This trial uses a randomized, two-group design with three measurement periods: pre-intervention, end of treatment and 12-month follow-up. Smoking parents of children parents about child SHSe, advise about SHSe harms, and refer smokers to cessation resources. After receiving clinic intervention, eligible parents are randomized to receive: (a) a 3-month telephone-based behavioral counseling intervention designed to promote reduction in child SHSe, parent smoking cessation, and navigation to access nicotine replacement therapy or cessation medication or (b) an attention control nutrition education intervention. Healthcare providers and assessors are blind to group assignment. Cotinine is used to bioverify child SHSe (primary outcome) and parent quit status. This study tests an innovative multilevel approach to reducing child SHSe. The approach is sustainable, because clinics can easily integrate the tobacco intervention prompts related to "ask, advise, and refer" guidelines into electronic health records and refer smokers to free evidence-based behavioral counseling interventions, such as state quitlines. NCT01745393 (clinicaltrials.gov).

  13. Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancy.

    Science.gov (United States)

    Shin, Beomsu; Chang, Boksoon; Kim, Hojoong; Jeong, Byeong-Ho

    2018-03-13

    Interventional bronchoscopy is considered an effective treatment option for malignant central airway obstruction (MCAO). However, there are few reports of interventional bronchoscopy in patients with MCAOs due to extra-pulmonary malignancy. Therefore, the objective of this study was to investigate treatment outcomes and prognostic factors for bronchoscopic intervention in patients with MCAO due to extra-pulmonary malignancy. We retrospectively analyzed consecutive 98 patients with MCAO due to extra-pulmonary malignancy who underwent interventional bronchoscopy between 2004 and 2014 at Samsung Medical Center (Seoul, Korea). The most common primary site of malignancy was esophageal cancer (37.9%), followed by thyroid cancer (16.3%) and head & neck cancer (10.2%). Bronchoscopic interventions were usually performed using a combination of mechanical debulking (84.7%), stent insertion (70.4%), and laser cauterization (37.8%). Of 98 patients, 76 (77.6%) patients had MCAO due to progression of malignancy, and 42 (42.9%) patients had exhausted all other anti-cancer treatment at the time of bronchoscopic intervention. Technical success was achieved in 89.9% of patients, and acute complications and procedure-related deaths occurred in 20.4% and 3.1% of patients, respectively. Reduced survival was associated with MCAO due to cancer other than thyroid cancer or lymphoma, mixed lesions, and not receiving adjuvant treatment after bronchoscopic intervention. Bronchoscopic intervention could be a safe and effective procedure for MCAO due to end-stage extra-pulmonary malignancies. In addition, we identified possible prognostic factors for poor survival after intervention, which could guide clinicians select candidates that will benefit from bronchoscopic intervention.

  14. Is Stacking Intervention Components Cost-Effective? An Analysis of the Incredible Years Program

    Science.gov (United States)

    Foster, E. Michael; Olchowski, Allison E.; Webster-Stratton, Carolyn H.

    2007-01-01

    The cost-effectiveness of delivering stacked multiple intervention components for children is compared to implementing single intervention by analyzing the Incredible Years Series program. The result suggests multiple intervention components are more cost-effective than single intervention components.

  15. Intervention Effectiveness of The Incredible Years : New Insights Into Sociodemographic and Intervention-Based Moderators

    NARCIS (Netherlands)

    Weeland, Joyce; Chhangur, Rabia R.; van der Giessen, Danielle; Matthys, Walter; de Castro, Bram Orobio; Overbeek, Geertjan

    2017-01-01

    We tested the effectiveness of the preventive behavioral parent training (BPT) program, The Incredible Years (IY), and the independent effects of previously suggested sociodemographic and intervention-based moderator variables (i.e., initial severity of externalizing problem behavior, child gender,

  16. Spatiotemporal spread of the 2014 outbreak of Ebola virus disease in Liberia and the effectiveness of non-pharmaceutical interventions: a computational modelling analysis.

    Science.gov (United States)

    Merler, Stefano; Ajelli, Marco; Fumanelli, Laura; Gomes, Marcelo F C; Piontti, Ana Pastore Y; Rossi, Luca; Chao, Dennis L; Longini, Ira M; Halloran, M Elizabeth; Vespignani, Alessandro

    2015-02-01

    The 2014 epidemic of Ebola virus disease in parts of west Africa defines an unprecedented health threat. We developed a model of Ebola virus transmission that integrates detailed geographical and demographic data from Liberia to overcome the limitations of non-spatial approaches in projecting the disease dynamics and assessing non-pharmaceutical control interventions. We modelled the movements of individuals, including patients not infected with Ebola virus, seeking assistance in health-care facilities, the movements of individuals taking care of patients infected with Ebola virus not admitted to hospital, and the attendance of funerals. Individuals were grouped into randomly assigned households (size based on Demographic Health Survey data) that were geographically placed to match population density estimates on a grid of 3157 cells covering the country. The spatial agent-based model was calibrated with a Markov chain Monte Carlo approach. The model was used to estimate Ebola virus transmission parameters and investigate the effectiveness of interventions such as availability of Ebola treatment units, safe burials procedures, and household protection kits. Up to Aug 16, 2014, we estimated that 38·3% of infections (95% CI 17·4-76·4) were acquired in hospitals, 30·7% (14·1-46·4) in households, and 8·6% (3·2-11·8) while participating in funerals. We noted that the movement and mixing, in hospitals at the early stage of the epidemic, of patients infected with Ebola virus and those not infected was a sufficient driver of the reported pattern of spatial spread. The subsequent decrease of incidence at country and county level is attributable to the increasing availability of Ebola treatment units (which in turn contributed to drastically decreased hospital transmission), safe burials, and distribution of household protection kits. The model allows assessment of intervention options and the understanding of their role in the decrease in incidence reported since

  17. Assessing the impact of a school-based safe water intervention on household adoption of point-of-use water treatment practices in southern India.

    Science.gov (United States)

    Freeman, Matthew C; Clasen, Thomas

    2011-03-01

    We assessed a pilot project by UNICEF and Hindustan Unilever Limited to improve the quality of drinking water for children in schools through adoption of improved drinking water practices among households in southern India. The intervention consisted of providing classrooms of 200 schools a commercial water purifier, and providing basic hygiene and water treatment information to students, parents, and teachers. We found no evidence that the intervention was effective in improving awareness or uptake of effective water treatment practices at home. A similar proportion of household members in the intervention and control groups boiled their water (P = 0.60), used a ceramic filtration system (P = 0.33), and used a cloth filter (P = 0.89). One year after the launch of the campaign, household ownership of the commercial purifier promoted at schools was higher in the intervention group (26%) than the control group (19%), but this difference was not statistically significant (P = 0.53).

  18. Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study.

    Science.gov (United States)

    Dunleavy, K; Kava, K; Goldberg, A; Malek, M H; Talley, S A; Tutag-Lehr, V; Hildreth, J

    2016-09-01

    To determine the effectiveness of Pilates and yoga group exercise interventions for individuals with chronic neck pain (CNP). Quasi-randomised parallel controlled study. Community, university and private practice settings in four locations. Fifty-six individuals with CNP scoring ≥3/10 on the numeric pain rating scale for >3 months (controls n=17, Pilates n=20, yoga n=19). Exercise participants completed 12 small-group sessions with modifications and progressions supervised by a physiotherapist. The primary outcome measure was the Neck Disability Index (NDI). Secondary outcomes were pain ratings, range of movement and postural measurements collected at baseline, 6 weeks and 12 weeks. Follow-up was performed 6 weeks after completion of the exercise classes (Week 18). NDI decreased significantly in the Pilates {baseline: 11.1 [standard deviation (SD) 4.3] vs Week 12: 6.8 (SD 4.3); mean difference -4.3 (95% confidence interval -1.64 to -6.7); PPilates and yoga group exercise interventions with appropriate modifications and supervision were safe and equally effective for decreasing disability and pain compared with the control group for individuals with mild-to-moderate CNP. Physiotherapists may consider including these approaches in a plan of care. ClinicalTrials.gov NCT01999283. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  19. The anterior interhemispheric approach: a safe and effective approach to anterior skull base lesions.

    Science.gov (United States)

    Mielke, Dorothee; Mayfrank, Lothar; Psychogios, Marios Nikos; Rohde, Veit

    2014-04-01

    Many approaches to the anterior skull base have been reported. Frequently used are the pterional, the unilateral or bilateral frontobasal, the supraorbital and the frontolateral approach. Recently, endoscopic transnasal approaches have become more popular. The benefits of each approach has to be weighted against its complications and limitations. The aim of this study was to investigate if the anterior interhemispheric approach (AIA) could be a safe and effective alternative approach to tumorous and non-tumorous lesions of the anterior skull base. We screened the operative records of all patients with an anterior skull base lesion undergoing transcranial surgery. We have used the AIA in 61 patients. These were exclusively patients with either olfactory groove meningioma (OGM) (n = 43), ethmoidal dural arteriovenous fistula (dAVF) ( n = 6) or frontobasal fractures of the anterior midline with cerebrospinal fluid (CSF) leakage ( n = 12). Patient records were evaluated concerning accessibility of the lesion, realization of surgical aims (complete tumor removal, dAVF obliteration, closure of the dural tear), and approach related complications. The use of the AIA exclusively in OGMs, ethmoidal dAVFs and midline frontobasal fractures indicated that we considered lateralized frontobasal lesions not suitable to be treated successfully. If restricted to these three pathologies, the AIA is highly effective and safe. The surgical aim (complete tumor removal, complete dAVF occlusion, no rhinorrhea) was achieved in all patients. The complication rate was 11.5 % (wound infection (n = 2; 3.2 %), contusion of the genu of the corpus callosum, subdural hygroma, epileptic seizure, anosmia and asymptomatic bleed into the tumor cavity (n = 1 each). Only the contusion of the corpus callosum was directly related to the approach (1.6 %). Olfaction, if present before surgery, was preserved in all patients, except one (1.6 %). The AIA is an effective and a safe approach

  20. Administration of triclabendazole is safe and effective in controlling fascioliasis in an endemic community of the Bolivian Altiplano.

    Science.gov (United States)

    Villegas, Fidel; Angles, René; Barrientos, René; Barrios, Gary; Valero, María Adela; Hamed, Kamal; Grueninger, Heiner; Ault, Steven K; Montresor, Antonio; Engels, Dirk; Mas-Coma, Santiago; Gabrielli, Albis Francesco

    2012-01-01

    The Bolivian northern Altiplano is characterized by a high prevalence of Fasciola hepatica infection. In order to assess the feasibility, safety and efficacy of large-scale administration of triclabendazole as an appropriate public health measure to control morbidity associated with fascioliasis, a pilot intervention was implemented in 2008. Schoolchildren from an endemic community were screened for fascioliasis and treated with a single administration of triclabendazole (10 mg/kg). Interviews to assess the occurrence of adverse events were conducted on treatment day, one week later, and one month after treatment. Further parasitological screenings were performed three months after treatment and again two months later (following a further treatment) in order to evaluate the efficacy of the intervention. Ninety infected children were administered triclabendazole. Adverse events were infrequent and mild. No serious adverse events were reported. Observed cure rates were 77.8% after one treatment and 97.8% after two treatments, while egg reduction rates ranged between 74% and 90.3% after one treatment, and between 84.2% and 99.9% after two treatments. The proportion of high-intensity infections (≥ 400 epg) decreased from 7.8% to 1.1% after one treatment and to 0% after two treatments. Administration of triclabendazole is a feasible, safe and efficacious public health intervention in an endemic community in the Bolivian Altiplano, suggesting that preventive chemotherapy can be applied to control of fascioliasis. Further investigations are needed to define the most appropriate frequency of treatment.

  1. Cost-effectiveness of population-level physical activity interventions: a systematic review.

    Science.gov (United States)

    Laine, Johanna; Kuvaja-Köllner, Virpi; Pietilä, Eija; Koivuneva, Mikko; Valtonen, Hannu; Kankaanpää, Eila

    2014-01-01

    This systematic review synthesizes the evidence on the cost-effectiveness of population-level interventions to promote physical activity. A systematic literature search was conducted between May and August 2013 in four databases: PubMed, Scopus, Web of Science, and SPORTDiscus. Only primary and preventive interventions aimed at promoting and maintaining physical activity in wide population groups were included. An economic evaluation of both effectiveness and cost was required. Secondary interventions and interventions targeting selected population groups or focusing on single individuals were excluded. Interventions were searched for in six different categories: (1) environment, (2) built environment, (3) sports clubs and enhanced access, (4) schools, (5) mass media and community-based, and (6) workplace. The systematic search yielded 2058 articles, of which 10 articles met the selection criteria. The costs of interventions were converted to costs per person per day in 2012 U.S. dollars. The physical activity results were calculated as metabolic equivalent of task hours (MET-hours, or MET-h) gained per person per day. Cost-effectiveness ratios were presented as dollars per MET-hours gained. The intervention scale and the budget impact of interventions were taken into account. The most efficient interventions to increase physical activity were community rail-trails ($.006/MET-h), pedometers ($.014/MET-h), and school health education programs ($.056/MET-h). Improving opportunities for walking and biking seems to increase physical activity cost-effectively. However, it is necessary to be careful in generalizing the results because of the small number of studies. This review provides important information for decision makers.

  2. Development, Implementation and Evaluation of an Educational Intervention to Prevent Low Speed Vehicle Run-Over Events: Lessons Learned.

    Science.gov (United States)

    Griffin, Bronwyn; Watt, Kerrianne; Kimble, Roy; Shields, Linda

    2018-04-05

    There is a growing body of literature regarding low speed vehicle runover (LSVRO) events among children. To date, no literature exists on evaluation of interventions to address this serious childhood injury. Knowledge, attitudes, and behaviour regarding LSVROs were assessed via survey at a shopping centre (pre-intervention), then five months later (post-intervention), to investigate the effect of a population level educational intervention in Queensland, Australia. Participants' knowledge regarding frequency of LSVRO events was poor. No participant demonstrated 'adequate behaviour' in relation to four safe driveway behaviours pre-intervention; this increased at post-intervention ( p experience reflects the 'real-world' challenges associated with implementing prevention strategies. We suggest a multi-faceted approach involving media (including social media), legislative changes, subsidies (for reversing cameras), and education to prevent LSVROs.

  3. Effects of delayed psychosocial interventions versus early psychosocial interventions for women with early stage breast cancer

    NARCIS (Netherlands)

    Vos, Petra J.; Visser, Adriaan P.; Garssen, Bert; Duivenvoorden, Hugo J.; de Haes, Hanneke C. J. M.

    2006-01-01

    The importance of psychosocial counselling after a diagnosis of cancer has been acknowledged and many intervention studies have been carried out, with the aim to find out which types of intervention are most effective in enhancing quality of life in cancer patients. A factor which could be part of

  4. Effects of organisational-level interventions at work on employees’ health: a systematic review

    Science.gov (United States)

    2014-01-01

    Background Organisational-level workplace interventions are thought to produce more sustainable effects on the health of employees than interventions targeting individual behaviours. However, scientific evidence from intervention studies does not fully support this notion. It is therefore important to explore conditions of positive health effects by systematically reviewing available studies. We set out to evaluate the effectiveness of 39 health-related intervention studies targeting a variety of working conditions. Methods Systematic review. Organisational-level workplace interventions aiming at improving employees’ health were identified in electronic databases and manual searches. The appraisal of studies was adapted from the Cochrane Back Review Group guidelines. To improve comparability of the widely varying studies we classified the interventions according to the main approaches towards modifying working conditions. Based on this classification we applied a logistic regression model to estimate significant intervention effects. Results 39 intervention studies published between 1993 and 2012 were included. In terms of methodology the majority of interventions were of medium quality, and four studies only had a high level of evidence. About half of the studies (19) reported significant effects. There was a marginally significant probability of reporting effects among interventions targeting several organisational-level modifications simultaneously (Odds ratio (OR) 2.71; 95% CI 0.94-11.12), compared to those targeting one dimension only. Conclusions Despite the heterogeneity of the 39 organisational-level workplace interventions underlying this review, we were able to compare their effects by applying broad classification categories. Success rates were higher among more comprehensive interventions tackling material, organisational and work-time related conditions simultaneously. To increase the number of successful organisational-level interventions in the

  5. Effects of organisational-level interventions at work on employees' health: a systematic review.

    Science.gov (United States)

    Montano, Diego; Hoven, Hanno; Siegrist, Johannes

    2014-02-08

    Organisational-level workplace interventions are thought to produce more sustainable effects on the health of employees than interventions targeting individual behaviours. However, scientific evidence from intervention studies does not fully support this notion. It is therefore important to explore conditions of positive health effects by systematically reviewing available studies. We set out to evaluate the effectiveness of 39 health-related intervention studies targeting a variety of working conditions. Systematic review. Organisational-level workplace interventions aiming at improving employees' health were identified in electronic databases and manual searches. The appraisal of studies was adapted from the Cochrane Back Review Group guidelines. To improve comparability of the widely varying studies we classified the interventions according to the main approaches towards modifying working conditions. Based on this classification we applied a logistic regression model to estimate significant intervention effects. 39 intervention studies published between 1993 and 2012 were included. In terms of methodology the majority of interventions were of medium quality, and four studies only had a high level of evidence. About half of the studies (19) reported significant effects. There was a marginally significant probability of reporting effects among interventions targeting several organisational-level modifications simultaneously (Odds ratio (OR) 2.71; 95% CI 0.94-11.12), compared to those targeting one dimension only. Despite the heterogeneity of the 39 organisational-level workplace interventions underlying this review, we were able to compare their effects by applying broad classification categories. Success rates were higher among more comprehensive interventions tackling material, organisational and work-time related conditions simultaneously. To increase the number of successful organisational-level interventions in the future, commonly reported obstacles against

  6. Evaluating Cost-Effectiveness of Interventions that Affect Fertility and Childbearing: How Health Effects are Measured Matters

    Science.gov (United States)

    Goldhaber-Fiebert, Jeremy D.; Brandeau, Margaret L.

    2015-01-01

    Background Current guidelines for economic evaluations of health interventions define relevant outcomes as those accruing to individuals receiving interventions. Little consensus exists on counting health impacts on current and future fertility and childbearing. Objective To characterize current practices for counting such health outcomes. Design We developed a framework characterizing health interventions with direct and/or indirect effects on fertility and childbearing and how such outcomes are reported. We identified interventions spanning the framework and performed a targeted literature review for economic evaluations of these interventions. For each article, we characterized how the potential health outcomes from each intervention were considered, focusing on QALYs associated with fertility and childbearing. Results We reviewed 108 studies, identifying seven themes: 1) Studies were heterogeneous in reporting outcomes. 2) Studies often selected outcomes for inclusion that tend to bias toward finding the intervention to be cost-effective. 3) Studies often avoided the challenges of assigning QALYs for pregnancy and fertility by instead considering cost per intermediate outcome. 4) Even for the same intervention, studies took heterogeneous approaches to outcome evaluation. 5) Studies employed multiple, competing rationales for whether and how to include fertility-related QALYs and whose QALYs to include. 6) Studies examining interventions with indirect effects on fertility typically ignored such QALYs. 7) Even recent studies had these shortcomings. Limitations The review was targeted rather than systematic. Conclusions Economic evaluations inconsistently consider QALYs from current and future fertility and childbearing in ways that frequently appear biased towards the interventions considered. As the Panel on Cost-Effectiveness in Health and Medicine updates its guidelines, making the practice of cost-effectiveness analysis more consistent is a priority. Our

  7. Moderating Effects of Weather-Related Factors on a Physical Activity Intervention.

    Science.gov (United States)

    Welch, Whitney A; Spring, Bonnie; Phillips, Siobhan M; Siddique, Juned

    2018-05-01

    The purpose of this study is to identify whether weather-related factors moderate the effect of a physical activity (PA) intervention. Participants (N=204, 77% female, mean age 33 [SD=11] years, mean BMI 28.2 [SD=7.1]) from the Make Better Choices 1 trial, enrolled April 2005 to April 2008, were randomized to one of two treatment conditions: (1) increase moderate to vigorous physical activity (MVPA) treatment group, or (2) decrease sedentary behavior control group. Participants wore an accelerometer for 5 weeks: a 2-week baseline assessment followed by a 3-week intervention. Accelerometer data were used to estimate minutes/day of MVPA. Average daily temperature, day length, and precipitation were obtained from the National Climatic Data Center and combined with the accelerometer data. Linear mixed effects models were used to determine whether these weather-related factors moderated the effect of the intervention on MVPA. Separate models were fit for season, daily average temperature, and day length. There was a significant moderating effect of season on MVPA such that the PA intervention, as compared with control, increased MVPA 10.4 minutes more in the summer than in the winter (95% CI=1.1, 19.6, p=0.029). There was a significant moderating effect of daily temperature such that every 10°F increase in temperature was associated with an additional 1.5 minutes/day increase in the difference in MVPA increase between the two intervention conditions (95% CI=0.1, 2.9, p=0.015). There was a significant moderating effect of day length such that every additional hour of daylight was associated with a 2.23-minute increase in the PA intervention's impact on increasing MVPA (95% CI=0.8, 3.7, p=0.002). Day length and temperature had a significant moderating effect on change in MVPA during a PA intervention such that the intervention was less effective on colder days and on shorter days, independently. These results suggest that strategies to overcome environmental barriers

  8. Combined SAFE/SNAP approach to safeguards evaluation

    International Nuclear Information System (INIS)

    Engi, D.; Chapman, L.D.; Grant, F.H.; Polito, J.

    1980-01-01

    Generally, the scope of a safeguards evaluation model can efficiently address one of two issues, (1) global safeguards effectiveness, or (2) vulnerability analysis for individual scenarios. The Safeguards Automated Facility Evaluation (SAFE) focuses on (1) while the Safeguards Network Analysis Procedure (SNAP) is directed at (2). SAFE addresses (1) in that it considers the entire facility, i.e., the composite system of hardware and human components, in one global analysis. SNAP addresses (2) by providing a safeguards modeling symbology sufficiently flexible to represent quite complex scenarios from the standpoint of hardware interfaces while also accounting for a rich variety of human decision making. A combined SAFE/SNAP approach to the problem of safeguards evaluation is described and illustrated through an example

  9. Non-vascular interventional therapy for respiratory diseases

    International Nuclear Information System (INIS)

    Ji Hongjian; Chen Liping; Wang Hui; Cheng Yongde

    2009-01-01

    To review the recent literature relating to non-vascular interventional therapy of respiratory diseases. Metal airway stent insertion can immediately relieve tracheobronchial obstruction and improve pulmonary function. However, as there is a high occurrence of the restenosis after stent insertion, it should be very careful to use metal stenting to treat the benign airway obstruction. Compared with traditional lung volume reduction surgery in treating severe emphysema, bronchoscopic lung volume reduction appears to be effective, safe and less invasive, although its clinical usefullness need to be further proved. Endoscopic occlusion of bronchial fistula represents an effective alternative to surgical treatment. Percutaneous lung biopsy under ultrasound or CT guidance has been applied successfully in the management of both benign and malignant lesions. (authors)

  10. A Brief Pre-Intervention Analysis and Demonstration of the Effects of a Behavioral Safety Package on Postural Behaviors of Pharmacy Employees

    Science.gov (United States)

    Fante, Rhiannon; Gravina, Nicole; Austin, John

    2007-01-01

    This study employed a pre-intervention analysis to determine factors that contributed to safe ergonomic postures in a small pharmacy. The pharmacy was located on a university campus and employed both pharmacists and pharmacy technicians. Three of the eight pharmacy employees had experienced various repetitive motion injuries that resulted in a…

  11. Social Interface Model: Theorizing Ecological Post-Delivery Processes for Intervention Effects.

    Science.gov (United States)

    Pettigrew, Jonathan; Segrott, Jeremy; Ray, Colter D; Littlecott, Hannah

    2018-01-03

    Successful prevention programs depend on a complex interplay among aspects of the intervention, the participant, the specific intervention setting, and the broader set of contexts with which a participant interacts. There is a need to theorize what happens as participants bring intervention ideas and behaviors into other life-contexts, and theory has not yet specified how social interactions about interventions may influence outcomes. To address this gap, we use an ecological perspective to develop the social interface model. This paper presents the key components of the model and its potential to aid the design and implementation of prevention interventions. The model is predicated on the idea that intervention message effectiveness depends not only on message aspects but also on the participants' adoption and adaptation of the message vis-à-vis their social ecology. The model depicts processes by which intervention messages are received and enacted by participants through social processes occurring within and between relevant microsystems. Mesosystem interfaces (negligible interface, transference, co-dependence, and interdependence) can facilitate or detract from intervention effects. The social interface model advances prevention science by theorizing that practitioners can create better quality interventions by planning for what occurs after interventions are delivered.

  12. Bridging research and practice: community-researcher partnerships for replicating effective interventions.

    Science.gov (United States)

    Rotheram-Borus, M J; Rebchook, G M; Kelly, J A; Adams, J; Neumann, M S

    2000-01-01

    Long-term collaborations among researchers, staff and volunteers in community-based agencies, staff in institutional settings, and health advocates present challenges. Each group has different missions, procedures, attributes, and rewards. This article reviews areas of potential conflict and suggests strategies for coping with these challenges. During the replication of five effective HIV prevention interventions, strategies for maintaining mutually beneficial collaborations included selecting agencies with infrastructures that could support research-based interventions; obtaining letters of understanding that clarified roles, responsibilities, and time frames; and setting training schedules with opportunities for observing, practicing, becoming invested in, and repeatedly implementing the intervention. The process of implementing interventions highlighted educating funders of research and public health services about (a) the costs of disseminating interventions, (b) the need for innovation to new modalities and theories for delivering effective interventions, and (c) adopting strategies of marketing research and quality engineering when designing interventions.

  13. Cost-effectiveness of Campylobacter interventions on broiler farms in six European countries

    DEFF Research Database (Denmark)

    van Wagenberg, C.P.A.; van Horne, P.L.M.; Sommer, Helle Mølgaard

    2016-01-01

    interventions on broiler farms in six European countries: Denmark, the Netherlands, Norway, Poland, Spain, and United Kingdom. The cost-effectiveness ratio of an intervention was the estimated costs of the intervention divided by the estimated public health benefits due to the intervention, and was expressed......Broilers are an important reservoir for human Campylobacter infections, one of the leading causes of acute diarrheal disease in humans worldwide. Therefore, it is relevant to control Campylobacter on broiler farms. This study estimated the cost-effectiveness ratios of eight Campylobacter...... in euro per avoided disability-adjusted life year (DALY). Interventions were selected on the basis of a European risk factor study and other risk factor research. A deterministic simulation model was developed to estimate the cost-effectiveness ratio of each intervention, if it would be implemented on all...

  14. Determinants and effectiveness of foreign exchange market intervention in Georgia

    Czech Academy of Sciences Publication Activity Database

    Loiseau-Aslanidi, Olga

    2011-01-01

    Roč. 47, č. 4 (2011), s. 75-95 ISSN 1540-496X R&D Projects: GA MŠk LC542 Grant - others:UK(CZ) GAUK 259027 Institutional research plan: CEZ:MSM0021620846 Keywords : determinants of intervention * effectiveness of intervention * foreign exchange intervention Subject RIV: AH - Economics Impact factor: 0.953, year: 2011

  15. Which non-technical skills do junior doctors require to prescribe safely? A systematic review.

    Science.gov (United States)

    Dearden, Effie; Mellanby, Edward; Cameron, Helen; Harden, Jeni

    2015-12-01

    Prescribing errors are a major source of avoidable morbidity and mortality. Junior doctors write most in-hospital prescriptions and are the least experienced members of the healthcare team. This puts them at high risk of error and makes them attractive targets for interventions to improve prescription safety. Error analysis has shown a background of complex environments with multiple contributory conditions. Similar conditions in other high risk industries, such as aviation, have led to an increased understanding of so-called human factors and the use of non-technical skills (NTS) training to try to reduce error. To date no research has examined the NTS required for safe prescribing. The aim of this review was to develop a prototype NTS taxonomy for safe prescribing, by junior doctors, in hospital settings. A systematic search identified 14 studies analyzing prescribing behaviours and errors by junior doctors. Framework analysis was used to extract data from the studies and identify behaviours related to categories of NTS that might be relevant to safe and effective prescribing performance by junior doctors. Categories were derived from existing literature and inductively from the data. A prototype taxonomy of relevant categories (situational awareness, decision making, communication and team working, and task management) and elements was constructed. This prototype will form the basis of future work to create a tool that can be used for training and assessment of medical students and junior doctors to reduce prescribing error in the future. © 2015 The British Pharmacological Society.

  16. Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study.

    Science.gov (United States)

    Erichsen Andersson, Annette; Frödin, Maria; Dellenborg, Lisen; Wallin, Lars; Hök, Jesper; Gillespie, Brigid M; Wikström, Ewa

    2018-01-04

    Hand hygiene and aseptic techniques are essential preventives in combating hospital-acquired infections. However, implementation of these strategies in the operating room remains suboptimal. There is a paucity of intervention studies providing detailed information on effective methods for change. This study aimed to evaluate the process of implementing a theory-driven knowledge translation program for improved use of hand hygiene and aseptic techniques in the operating room. The study was set in an operating department of a university hospital. The intervention was underpinned by theories on organizational learning, culture and person centeredness. Qualitative process data were collected via participant observations and analyzed using a thematic approach. Doubts that hand-hygiene practices are effective in preventing hospital acquired infections, strong boundaries and distrust between professional groups and a lack of psychological safety were identified as barriers towards change. Facilitated interprofessional dialogue and learning in "safe spaces" worked as mechanisms for motivation and engagement. Allowing for the free expression of different opinions, doubts and viewing resistance as a natural part of any change was effective in engaging all professional categories in co-creation of clinical relevant solutions to improve hand hygiene. Enabling nurses and physicians to think and talk differently about hospital acquired infections and hand hygiene requires a shift from the concept of one-way directed compliance towards change and learning as the result of a participatory and meaning-making process. The present study is a part of the Safe Hands project, and is registered with ClinicalTrials.gov (ID: NCT02983136 ). Date of registration 2016/11/28, retrospectively registered.

  17. SAFE Newsletter

    OpenAIRE

    2013-01-01

    The Center of Excellence SAFE – “Sustainable Architecture for Finance in Europe” – is a cooperation of the Center for Financial Studies and Goethe University Frankfurt. It is funded by the LOEWE initiative of the State of Hessen (Landes-Offensive zur Entwicklung wissenschaftlich-ökonomischer Exzellenz). SAFE brings together more than 40 professors and just as many junior researchers who are all dedicated to conducting research in support of a sustainable financial architecture. The Center has...

  18. Synthesis of febrifugine derivatives and development of an effective and safe tetrahydroquinazoline-type antimalarial.

    Science.gov (United States)

    Kikuchi, Haruhisa; Horoiwa, Seiko; Kasahara, Ryota; Hariguchi, Norimitsu; Matsumoto, Makoto; Oshima, Yoshiteru

    2014-04-09

    Febrifugine, a quinazoline alkaloid isolated from Dichroa febrifuga roots, shows powerful antimalarial activity against Plasmodium falciparum. Although the use of ferifugine as an antimalarial drug has been precluded because of its severe side effects, its potent antimalarial activity has stimulated medicinal chemists to pursue its derivatives instead, which may provide valuable leads for novel antimalarial drugs. In the present study, we synthesized new derivatives of febrifugine and evaluated their in vitro and in vivo antimalarial activities to develop antimalarials that are more effective and safer. As a result, we proposed tetrahydroquinazoline-type derivative as a safe and effective antimalarial candidate. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. Attitudinal, behavioral, and biological outcomes of a community popular opinion leader intervention in China.

    Science.gov (United States)

    Rotheram-Borus, Mary Jane; Li, Li; Liang, Li-Jung; Wen, Yi; Wu, Zunyou

    2011-10-01

    The effects of a community popular opinion leader (CPOL) intervention were examined among market vendors in a city on the eastern coast of China. Employees of 40 food markets were enrolled in a study that provided HIV-related education and tests, and treatment for sexually transmitted diseases (STDs). Twenty markets were randomly assigned to a CPOL intervention (N = 1,695) and 20 markets to a control condition (N = 1,616). Market employees in the intervention condition reported positive attitudes regarding STD/HIV prevention and more frequent discussions about safe sex than those in the control condition. Compared with baseline, the prevalence of unprotected sexual acts and new STDs were significantly lower within each study condition 24 months later. Although the CPOL intervention achieved its goal of shifting attitudes within food markets, the gains did not lead to the expected behavioral and biological outcomes.

  20. FMCSA safety program effectiveness measurement : carrier intervention effectiveness model, version 1.0 : [analysis brief].

    Science.gov (United States)

    2015-01-01

    The Carrier Intervention Effectiveness Model (CIEM) : provides the Federal Motor Carrier Safety : Administration (FMCSA) with a tool for measuring : the safety benefits of carrier interventions conducted : under the Compliance, Safety, Accountability...

  1. The costs, benefits, and cost-effectiveness of interventions to reduce maternal morbidity and mortality in Mexico.

    Directory of Open Access Journals (Sweden)

    Delphine Hu

    Full Text Available BACKGROUND: In Mexico, the lifetime risk of dying from maternal causes is 1 in 370 compared to 1 in 2,500 in the U.S. Although national efforts have been made to improve maternal services in the last decade, it is unclear if Millennium Development Goal 5--to reduce maternal mortality by three-quarters by 2015--will be met. METHODOLOGY/PRINCIPAL FINDINGS: We developed an empirically calibrated model that simulates the natural history of pregnancy and pregnancy-related complications in a cohort of 15-year-old women followed over their lifetime. After synthesizing national and sub-national trends in maternal mortality, the model was calibrated to current intervention-specific coverage levels and validated by comparing model-projected life expectancy, total fertility rate, crude birth rate and maternal mortality ratio with Mexico-specific data. Using both published and primary data, we assessed the comparative health and economic outcomes of alternative strategies to reduce maternal morbidity and mortality. A dual approach that increased coverage of family planning by 15%, and assured access to safe abortion for all women desiring elective termination of pregnancy, reduced mortality by 43% and was cost saving compared to current practice. The most effective strategy added a third component, enhanced access to comprehensive emergency obstetric care for at least 90% of women requiring referral. At a national level, this strategy reduced mortality by 75%, cost less than current practice, and had an incremental cost-effectiveness ratio of $300 per DALY relative to the next best strategy. Analyses conducted at the state level yielded similar results. CONCLUSIONS/SIGNIFICANCE: Increasing the provision of family planning and assuring access to safe abortion are feasible, complementary and cost-effective strategies that would provide the greatest benefit within a short-time frame. Incremental improvements in access to high-quality intrapartum and emergency

  2. Effect of Intrafix® SafeSet infusion apparatus on phlebitis in a neurological intensive care unit: a case-control study.

    Science.gov (United States)

    Liu, F; Chen, D; Liao, Y; Diao, L; Liu, Y; Wu, M; Xue, X; You, C; Kang, Y

    2012-01-01

    To investigate the effect of the Intrafix(®) SafeSet infusion apparatus on the incidence of phlebitis in patients being intravenously infused in a neurological intensive care unit (ICU). Patients aged > 12 years, with no history of diabetes mellitus and no existing phlebitis, requiring a daily peripheral intravenous infusion of ≥ 8 h with the total period lasting ≥ 3 days, were enrolled. Infusions were performed using the Intrafix(®) SafeSet or normal infusion apparatus. Incidence of phlebitis (scored according to the Infusion Nursing Standards of Practice of the American Infusion Nurses Society) was analysed. Patients (n = 1545) were allocated to Intrafix(®) SafeSet (n = 709) or normal infusion (n = 836) groups, matched for age, gender and preliminary diagnosis. Incidence of phlebitis was significantly higher using normal infusion apparatus compared with the Intrafix(®) SafeSet (23.4% versus 17.9%, respectively). Intrafix(®) SafeSet infusion apparatus significantly reduced the incidence of phlebitis in patients in the neurological ICU, compared with normal infusion apparatus, and may be suitable for use in routine clinical practice.

  3. Intensive medical student involvement in short-term surgical trips provides safe and effective patient care: a case review

    Directory of Open Access Journals (Sweden)

    Macleod Jana B

    2011-09-01

    Full Text Available Abstract Background The hierarchical nature of medical education has been thought necessary for the safe care of patients. In this setting, medical students in particular have limited opportunities for experiential learning. We report on a student-faculty collaboration that has successfully operated an annual, short-term surgical intervention in Haiti for the last three years. Medical students were responsible for logistics and were overseen by faculty members for patient care. Substantial planning with local partners ensured that trip activities supplemented existing surgical services. A case review was performed hypothesizing that such trips could provide effective surgical care while also providing a suitable educational experience. Findings Over three week-long trips, 64 cases were performed without any reported complications, and no immediate perioperative morbidity or mortality. A plurality of cases were complex urological procedures that required surgical skills that were locally unavailable (43%. Surgical productivity was twice that of comparable peer institutions in the region. Student roles in patient care were greatly expanded in comparison to those at U.S. academic medical centers and appropriate supervision was maintained. Discussion This demonstration project suggests that a properly designed surgical trip model can effectively balance the surgical needs of the community with an opportunity to expose young trainees to a clinical and cross-cultural experience rarely provided at this early stage of medical education. Few formalized programs currently exist although the experience above suggests the rewarding potential for broad-based adoption.

  4. Acceptance and Use of Eight Arsenic-Safe Drinking Water Options in Bangladesh

    Science.gov (United States)

    Inauen, Jennifer; Hossain, Mohammad Mojahidul; Johnston, Richard B.; Mosler, Hans-Joachim

    2013-01-01

    Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to

  5. Estimating intervention effects of prevention programs: accounting for noncompliance.

    Science.gov (United States)

    Stuart, Elizabeth A; Perry, Deborah F; Le, Huynh-Nhu; Ialongo, Nicholas S

    2008-12-01

    Individuals not fully complying with their assigned treatments is a common problem encountered in randomized evaluations of behavioral interventions. Treatment group members rarely attend all sessions or do all "required" activities; control group members sometimes find ways to participate in aspects of the intervention. As a result, there is often interest in estimating both the effect of being assigned to participate in the intervention, as well as the impact of actually participating and doing all of the required activities. Methods known broadly as "complier average causal effects" (CACE) or "instrumental variables" (IV) methods have been developed to estimate this latter effect, but they are more commonly applied in medical and treatment research. Since the use of these statistical techniques in prevention trials has been less widespread, many prevention scientists may not be familiar with the underlying assumptions and limitations of CACE and IV approaches. This paper provides an introduction to these methods, described in the context of randomized controlled trials of two preventive interventions: one for perinatal depression among at-risk women and the other for aggressive disruptive behavior in children. Through these case studies, the underlying assumptions and limitations of these methods are highlighted.

  6. The Stochastic Dynamics for Ecological Tourism System with Visitor Educational Intervention

    Directory of Open Access Journals (Sweden)

    Dongping Wei

    2013-01-01

    Full Text Available The ever-increasing visitation in parks and protected areas continues to present a considerable challenge for worldwide land managers with allowing recreational use while preserving natural conditions. In China, the fast expanding visitation in protected areas is quickly damaging the natural resources and precious culture without effective visitor education, while regulation and site management are also gaining very limited efficacy. We propose a differential equation to describe the ecological tourism system. Shown by the theoretical proof and numerical simulation, the ecological tourism system is unstable without any perturbed factors, especially visitor educational intervention, because the solution of the dynamic system explodes in a finite time given any initial value. Supposing that the intrinsic increasing rate of stakeholders in the systems stochastically perturbed by the visitor educational intervention, we discover that the stochastic dynamic model can effectively suppress the explosion of the solution. As such, we demonstrate that the tourism system can develop steadily and safely even under a large amount of visitors in public vacation, when employing continuous visitor education intervention programmes.

  7. A Review of CAM for Procedural Pain in Infancy: Part II. Other Interventions

    Directory of Open Access Journals (Sweden)

    Jennie C. I. Tsao

    2008-01-01

    Full Text Available This article is the second in a two-part series reviewing the empirical evidence for complementary and alternative medicine (CAM approaches for the management of pain related to medical procedures in infants up to 6 weeks of age. Part I of this series investigated the effects of sucrose with or without non-nutritive sucking (NNS. The present article examines other CAM interventions for procedural pain including music-based interventions, olfactory stimulation, kangaroo care and swaddling. Computerized databases were searched for relevant studies including prior reviews and primary trials. Preliminary support was revealed for the analgesic effects of the CAM modalities reviewed. However, the overall quality of the evidence for these approaches remains relatively weak. Additional well-designed trials incorporating rigorous methodology are required. Such investigations will assist in the development of evidence-based guidelines on the use of CAM interventions either alone or in concert with conventional approaches to provide safe, reliable analgesia for infant procedural pain.

  8. Effects of a Workplace Intervention on Parent-Child Relationships.

    Science.gov (United States)

    McHale, Susan M; Davis, Kelly D; Green, Kaylin; Casper, Lynne; Kan, Marni L; Kelly, Erin L; King, Rosalind Berkowitz; Okechukwu, Cassandra

    2016-02-01

    This study tested whether effects of a workplace intervention, aimed at promoting employees' schedule control and supervisor support for personal and family life, had implications for parent-adolescent relationships; we also tested whether parent-child relationships differed as a function of how many intervention program sessions participants attended. Data came from a group randomized trial of a workplace intervention, delivered in the information technology division of a Fortune 500 company. Analyses focused on 125 parent-adolescent dyads that completed baseline and 12-month follow-up home interviews. Results revealed no main effects of the intervention, but children of employees who attended 75% or more program sessions reported more time with their parent and more parent education involvement compared to adolescents whose parents attended less than 75% of sessions, and they tended to report more time with parent and more parental solicitation of information about their experiences compared to adolescents whose parents were randomly assigned to the usual practice condition.

  9. Preference-based comparative effectiveness and cost–effectiveness: a review and relevance of value-based medicine for vitreoretinal interventions.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Lieske, P Alexander

    2012-05-01

    This analysis discusses the comparative effectiveness and cost-effectiveness of vitreoretinal interventions, measured in quality-adjusted life years (QALYs) and percentage patient value (PPV gain, or improvement in quality of life and/or length of life). The material is relevant since the Patient Protection and Affordable Care Act enacted by Congress with the support of the President has emphasized the critical importance of patient-based preferences. The majority of preference-based, comparative effectiveness and cost-effectiveness vitreoretinal interventions assessed in the US healthcare literature are Value-Based Medicine analyses, thus comparable. These interventions confer a mean patient (human) value gain (improvement in quality of life) of 8.3% [SD 6.3%, 95% confidence interval (CI) + 2.6%]. The average cost-utility of these vitreoretinal interventions is US$23 026/QALY (SD US$24 508, 95% CI + US$8770). Most vitreoretinal interventions are very cost effective using a conventional US standard of US$50 000/QALY as the upper anchor for a very cost-effective intervention, and the World Health Organization of approximately US$142 200/QALY as the upper anchor for a cost-effective intervention. Most vitreoretinal interventions confer considerable patient value and are very cost effective. Further standardization across healthcare is needed in the preference-based, comparative and cost-utility (cost-effectiveness) arena. The metrics of PPV (percentage patient value) gain and US$/PPV (dollars expended per percentage patient value gain) or financial value gain may be more user-friendly than the QALY.

  10. Age differences in workplace intervention effects on employees' nighttime and daytime sleep.

    Science.gov (United States)

    Lee, Soomi; Almeida, David M; Berkman, Lisa; Olson, Ryan; Moen, Phyllis; Buxton, Orfeu M

    2016-12-01

    To examine the effects of a workplace flexibility/support intervention on employees' sleep quantity and quality during nights and days and whether the effects differ by employee age. Cluster-randomized controlled trial. Information technology industry workplaces. US employees ( M age = 46.9 years) at an information technology firm who provided actigraphy at baseline and a 12-month follow-up (N = 396; n = 195 intervention, n = 201 control). The Work, Family, and Health Study intervention aimed to increase workplace flexibility and support. The intervention consisted of facilitated discussions to help employees increase control over when and where they work as well as manager-specific training sessions to increase manager support for employees' work-family issues. Nighttime sleep duration, wake after sleep onset (WASO), and nap duration were measured with wrist actigraphy. Day-to-day variability in these variables (min 2 ) was also estimated. Intervention employees increased nighttime sleep duration at 12 months, by 9 minutes per day, relative to control employees. There were interaction effects between the intervention and age on daytime nap duration and day-to-day variability in WASO. Older employees (56-70 years) in the intervention condition decreased nap duration at 12 months relative to older employees in the control condition. Older employees in the intervention condition also exhibited a greater decrease in day-to-day variability of WASO at 12 months compared with their baseline. The workplace flexibility/support intervention was effective in enhancing employees' sleep health by increasing nighttime sleep duration. Furthermore, the intervention was particularly effective for older employees in decreasing their daytime nap duration and day-to-day variability in WASO.

  11. Motives and Effectiveness of Forex Interventions; Evidence from Peru

    OpenAIRE

    Melesse Tashu

    2014-01-01

    This paper assesses empirically the motives and effectiveness of forex interventions in Peru. While the central bank of Peru states that its forex interventions aim only at containing excessive exchange rate volatility, the results of this paper show that, in practice, the interventions seem to have aimed at “leaning against the wind” as well. The results also show that forex sales, but not forex purchases, react to volatility, indicating asymmetry in the central bank’s reactions to episodes ...

  12. C.A.M.P.: A Community-Based Approach to Promoting Safe Sex Behavior in Adolescence.

    Science.gov (United States)

    Guzman, Bianca L.; Casad, Bettina J.; Schlehofer-Sutton, Michele M.; Villanueva, Christina M.; Feria, Aida

    The primary goal of this study was to assess the Community Awareness Motivation Partnership (C.A.M.P.) theater intervention based on the behavioral ecological model. C.A.M.P addresses the role of contraceptive use in safe sex behavior through an informative and entertaining culturally relevant dramatization program. Adolescents (N=1613) between…

  13. Modeling the effect of comprehensive interventions on Ebola virus transmission

    Science.gov (United States)

    Shen, Mingwang; Xiao, Yanni; Rong, Libin

    2015-10-01

    Since the re-emergence of Ebola in West Africa in 2014, comprehensive and stringent interventions have been implemented to decelerate the spread of the disease. The effectiveness of interventions still remains unclear. In this paper, we develop an epidemiological model that includes various controlling measures to systematically evaluate their effects on the disease transmission dynamics. By fitting the model to reported cumulative cases and deaths in Guinea, Sierra Leone and Liberia until March 22, 2015, we estimate the basic reproduction number in these countries as 1.2552, 1.6093 and 1.7994, respectively. Model analysis shows that there exists a threshold of the effectiveness of isolation, below which increasing the fraction of latent individuals diagnosed prior to symptoms onset or shortening the duration between symptoms onset and isolation may lead to more Ebola infection. This challenges an existing view. Media coverage plays a substantial role in reducing the final epidemic size. The response to reported cumulative infected cases and deaths may have a different effect on the epidemic spread in different countries. Among all the interventions, we find that shortening the duration between death and burial and improving the effectiveness of isolation are two effective interventions for controlling the outbreak of Ebola virus infection.

  14. A multicenter, longitudinal, interventional, double blind randomized clinical trial in hematopoietic cell transplant recipients residing in remote areas: Lessons learned from the late cytomegalovirus prevention trial

    Directory of Open Access Journals (Sweden)

    Louise E. Kimball

    2016-12-01

    Conclusion: Complex randomized, double-blind, multicenter interventional trials with treatment decisions made at a central coordinating site can be conducted safely and effectively according to Good Clinical Practice (GCP guidelines over a large geographic area.

  15. Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Anita Ramesh

    Full Text Available Water, sanitation, and hygiene (WASH interventions are amongst the most crucial in humanitarian crises, although the impact of the different WASH interventions on health outcomes remains unclear.To examine the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluate current evidence on their effectiveness against health outcomes in these contexts.A systematic literature review was conducted of primary and grey quantitative literature on WASH interventions measured against health outcomes in humanitarian crises occurring from 1980-2014. Populations of interest were those in resident in humanitarian settings, with a focus on acute crisis and early recovery stages of humanitarian crises in low and middle-income countries. Interventions of interest were WASH-related, while outcomes of interest were health-related. Study quality was assessed via STROBE/CONSORT criteria. Results were analyzed descriptively, and PRISMA reporting was followed.Of 3963 studies initially retrieved, only 6 published studies measured a statistically significant change in health outcome as a result of a WASH intervention. All 6 studies employed point-of-use (POU water quality interventions, with 50% using safe water storage (SWS and 35% using household water treatment (HWT. All 6 studies used self-reported diarrhea outcomes, 2 studies also reported laboratory confirmed outcomes, and 2 studies reported health treatment outcomes (e.g. clinical admissions. 1 study measured WASH intervention success in relation to both health and water quality outcomes; 1 study recorded uptake (use of soap as well as health outcomes. 2 studies were unblinded randomized-controlled trials, while 4 were uncontrolled longitudinal studies. 2 studies were graded as providing high quality evidence; 3 studies provided moderate and 1 study low quality evidence.The current evidence base on the impact of WASH interventions on health outcomes in

  16. Radiological safety for the public during nuclear emergencies: application of intervention levels and derived intervention levels

    International Nuclear Information System (INIS)

    Thomas, G.; Kumar, K.S.

    2006-01-01

    Control of radiation exposures to the public following a major nuclear accident can be achieved through intervention by implementing countermeasures such as sheltering, iodine prophylaxis, evacuation, control of foodstuff, etc. Intervention levels (I.L.) are formulated such that exposure to individuals from all exposure pathways is well below the thresholds for deterministic effects, and risk of stochastic health effects to individuals and overall incidence of stochastic effects in the exposed population are minimized. It is also necessary to translate such I.L. into quantities, called derived intervention levels (D.I.L.) that can be measured. The I.L. followed in various countries for the recommended countermeasures cater to the exposure range of 1-50 mSv for sheltering, 10-500 mSv for evacuation, 30- 1000 mSv for iodine prophylaxis and 1-10 mSv for food control. The models used for these are based on conservative estimations assuming maximum dose delivered to the critical group for the pathway assumed. While the concept of upper dose level above which countermeasures is always justified to avoid deterministic effects, the lower range of dose levels have to be optimised based on various parameters as discussed in this paper. While arriving at the I.L., the question to be addressed is: How much (dose) risk should be averted by the intervention planned? Implementation of any countermeasure will result in some inconvenience/ limitation of resource/ disruption and consequently, a positive net benefit will justify the intervention. Sheltering may result in substantially less disruption than evacuation, but if the type of sheltering is not offering enough radiation shielding or ventilation protection, this may not result in significant reduction of exposure. It is to be ensured that deterministic effects are totally avoided and it is possible to define a safe threshold exposure and above which balancing risks and benefits is not applicable. While the dose limit for the

  17. SafeNet: a methodology for integrating general-purpose unsafe devices in safe-robot rehabilitation systems.

    Science.gov (United States)

    Vicentini, Federico; Pedrocchi, Nicola; Malosio, Matteo; Molinari Tosatti, Lorenzo

    2014-09-01

    Robot-assisted neurorehabilitation often involves networked systems of sensors ("sensory rooms") and powerful devices in physical interaction with weak users. Safety is unquestionably a primary concern. Some lightweight robot platforms and devices designed on purpose include safety properties using redundant sensors or intrinsic safety design (e.g. compliance and backdrivability, limited exchange of energy). Nonetheless, the entire "sensory room" shall be required to be fail-safe and safely monitored as a system at large. Yet, sensor capabilities and control algorithms used in functional therapies require, in general, frequent updates or re-configurations, making a safety-grade release of such devices hardly sustainable in cost-effectiveness and development time. As such, promising integrated platforms for human-in-the-loop therapies could not find clinical application and manufacturing support because of lacking in the maintenance of global fail-safe properties. Under the general context of cross-machinery safety standards, the paper presents a methodology called SafeNet for helping in extending the safety rate of Human Robot Interaction (HRI) systems using unsafe components, including sensors and controllers. SafeNet considers, in fact, the robotic system as a device at large and applies the principles of functional safety (as in ISO 13489-1) through a set of architectural procedures and implementation rules. The enabled capability of monitoring a network of unsafe devices through redundant computational nodes, allows the usage of any custom sensors and algorithms, usually planned and assembled at therapy planning-time rather than at platform design-time. A case study is presented with an actual implementation of the proposed methodology. A specific architectural solution is applied to an example of robot-assisted upper-limb rehabilitation with online motion tracking. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Recent advances in non-vascular interventional diagnosis and treatment of thyroid nodules

    International Nuclear Information System (INIS)

    Lu Liming; Zhou Weisheng

    2009-01-01

    Non-vascular interventional diagnostic methods of thyroid nodules include ultrasonography-guided fine-needle aspiration cytology (USgFNAC) and ultrasonography-guided core-needle biopsy (USgCNB). USgFNAC is a practical method used to select and to guide the treatment of various thyroid nodules, however, it is difficult to make a differentiation between benign and malignant lesions simply to rely on the findings of a small number of cells. USgCNB has the advantage of being able to obtain satisfactory specimen enough for making a histological diagnosis, although this procedure is contraindicated in some patients. Non-vascular interventional treatments of thyroid nodules include percutaneous ethanol injection (PEI) and ultrasonography-guided interstitial laser photocoagulation (USgILP). Both PEI and USgILP have fine effect on the benign thyroid nodules. Compared with PEI, laser-induced necrosis can be well controlled, thus, the adverse reactions, such as the formation of fibrosis adjacent to the nodule, vocal cord paralysis, etc. can be avoided.Non-vascular interventional treatments may cause some untoward effects. For the diagnosis and treatment of thyroid nodules, the non-vascular interventional procedure is simple, safe, effective and economic with less complications, therefore, this technique is worth being popularized in clinical practice. (authors)

  19. The effect of organisational context on organisational development (OD interventions

    Directory of Open Access Journals (Sweden)

    Sanjana Brijball Parumasur

    2012-05-01

    Research purpose: This article examines national and international OD practices. It assesses the effect of diverse cultures and cultural values for determining the effectiveness of OD interventions. Motivation for the study: Most organisational change and development programmes fail and only a few result in increased competitiveness, improvements and profitability. This emphasises the need for change interventions to give sufficient attention to leadership, cultures, managing change and adopting context-based OD interventions. Research design, approach and method: This article is a literature review of the current trends and research in the area of OD interventions. It synthesises the influence that cultures and cultural orientations have on determining which OD intervention strategies organisations should adopt in different cultures. Main findings: The analysis emphasises how important it is to achieve congruence between the OD interventions organisations select and their local cultures. Practical/managerial implications: It is important to note the evolving nature of the political and economic climates that influence national cultures and that they emphasise that interventions that reflect OD values, which are tailor-made and shaped to the needs of local cultures, are necessary. Contribution/value-add: This study links various OD interventions to Hofstede’s dimensions for differentiating national cultures. It provides guidelines for aligning the practices and techniques of OD to the values and cultures of the organisations and societies in which they are to be implemented.

  20. Effectiveness of a grief intervention for caregivers of people with dementia

    OpenAIRE

    MacCourt, Penny; McLennan, Marianne; Somers, Sandie; Krawczyk, Marian

    2017-01-01

    In this article, we report on the structure and effectiveness of a grief management coaching intervention with caregivers of individuals with dementia. The intervention was informed by Marwit and Meuser’s Caregiver Grief Model and considered levels of grief, sense of empowerment, coping, and resilience using five methods of delivery. Results indicate that the intervention had significant positive effects on caregivers’ levels of grief and increased their levels of empowerment, coping, and res...

  1. Transportation and Aging: An Updated Research Agenda for Advancing Safe Mobility.

    Science.gov (United States)

    Dickerson, Anne E; Molnar, Lisa; Bedard, Michel; Eby, David W; Classen, Sherrilene; Polgar, Janice

    2017-10-01

    This article discusses what is currently known about three important topics related to older driver safety and mobility: screening and evaluation, education and training interventions, and in-vehicle technology. Progress is being made to improve the safe mobility of older adults in these key areas; however, significant research gaps remain. This article advances the state of knowledge by identifying these gaps, and proposing further research topics will improve the lives of older adults. In addition, we discuss several themes that emerged from the review, including the need for multidisciplinary, community-wide solutions; large-scale, longitudinal studies; improved education/training for both older adults themselves and the variety of stakeholders involved in older adult transportation; and programs and interventions that are flexible and responsive to individual needs and differences.

  2. Work Stress Interventions in Hospital Care: Effectiveness of the DISCovery Method

    Directory of Open Access Journals (Sweden)

    Irene Niks

    2018-02-01

    Full Text Available Effective interventions to prevent work stress and to improve health, well-being, and performance of employees are of the utmost importance. This quasi-experimental intervention study presents a specific method for diagnosis of psychosocial risk factors at work and subsequent development and implementation of tailored work stress interventions, the so-called DISCovery method. This method aims at improving employee health, well-being, and performance by optimizing the balance between job demands, job resources, and recovery from work. The aim of the study is to quantitatively assess the effectiveness of the DISCovery method in hospital care. Specifically, we used a three-wave longitudinal, quasi-experimental multiple-case study approach with intervention and comparison groups in health care work. Positive changes were found for members of the intervention groups, relative to members of the corresponding comparison groups, with respect to targeted work-related characteristics and targeted health, well-being, and performance outcomes. Overall, results lend support for the effectiveness of the DISCovery method in hospital care.

  3. Work Stress Interventions in Hospital Care: Effectiveness of the DISCovery Method.

    Science.gov (United States)

    Niks, Irene; de Jonge, Jan; Gevers, Josette; Houtman, Irene

    2018-02-13

    Effective interventions to prevent work stress and to improve health, well-being, and performance of employees are of the utmost importance. This quasi-experimental intervention study presents a specific method for diagnosis of psychosocial risk factors at work and subsequent development and implementation of tailored work stress interventions, the so-called DISCovery method. This method aims at improving employee health, well-being, and performance by optimizing the balance between job demands, job resources, and recovery from work. The aim of the study is to quantitatively assess the effectiveness of the DISCovery method in hospital care. Specifically, we used a three-wave longitudinal, quasi-experimental multiple-case study approach with intervention and comparison groups in health care work. Positive changes were found for members of the intervention groups, relative to members of the corresponding comparison groups, with respect to targeted work-related characteristics and targeted health, well-being, and performance outcomes. Overall, results lend support for the effectiveness of the DISCovery method in hospital care.

  4. Work Stress Interventions in Hospital Care: Effectiveness of the DISCovery Method

    Science.gov (United States)

    Niks, Irene; Gevers, Josette

    2018-01-01

    Effective interventions to prevent work stress and to improve health, well-being, and performance of employees are of the utmost importance. This quasi-experimental intervention study presents a specific method for diagnosis of psychosocial risk factors at work and subsequent development and implementation of tailored work stress interventions, the so-called DISCovery method. This method aims at improving employee health, well-being, and performance by optimizing the balance between job demands, job resources, and recovery from work. The aim of the study is to quantitatively assess the effectiveness of the DISCovery method in hospital care. Specifically, we used a three-wave longitudinal, quasi-experimental multiple-case study approach with intervention and comparison groups in health care work. Positive changes were found for members of the intervention groups, relative to members of the corresponding comparison groups, with respect to targeted work-related characteristics and targeted health, well-being, and performance outcomes. Overall, results lend support for the effectiveness of the DISCovery method in hospital care. PMID:29438350

  5. The effectiveness of psychological first aid as a disaster intervention tool: research analysis of peer-reviewed literature from 1990-2010.

    Science.gov (United States)

    Fox, Jeffrey H; Burkle, Frederick M; Bass, Judith; Pia, Francesco A; Epstein, Jonathan L; Markenson, David

    2012-10-01

    The Advisory Council of the American Red Cross Disaster Services requested that an independent study determine whether first-aid providers without professional mental health training, when confronted with people who have experienced a traumatic event, offer a "safe, effective and feasible intervention." Standard databases were searched by an expert panel from 1990 to September 2010 using the keyword phrase "psychological first aid." Documents were included if the process was referred to as care provided to victims, first responders, or volunteers and excluded if it was not associated with a disaster or mass casualty event, or was used after individual nondisaster traumas such as rape and murder. This search yielded 58 citations. It was determined that adequate scientific evidence for psychological first aid is lacking but widely supported by expert opinion and rational conjecture. No controlled studies were found. There is insufficient evidence supporting a treatment standard or a treatment guideline. Sufficient evidence for psychological first aid is widely supported by available objective observations and expert opinion and best fits the category of "evidence informed" but without proof of effectiveness. An intervention provided by volunteers without professional mental health training for people who have experienced a traumatic event offers an acceptable option. Further outcome research is recommended.

  6. Safe motherhood at risk?

    Science.gov (United States)

    Thompson, A

    1996-12-01

    Health professionals' negative attitudes toward clients often exacerbate the problems women face in terms of health status and access to health care. Thus, the health professionals can themselves be obstacles to women seeking the health care they need. A key challenge to midwives, in addition to providing technically competent services, is gaining insight into the people for whom they are responsible so that childbirth traditions are treated with respect and women are offered dignity. Safe motherhood requires intersectoral collaboration. Many innovative approaches to safe motherhood are based on the community's participation in planning services that meet the needs of women. Other approaches are based on decentralization of services. For example, a large university teaching hospital in Lusaka, Zambia, set up birthing centers around the city to take the pressure off the hospital. Midwives head up these centers, which are close to the women's homes. Decentralization of delivery services has improved the physical and emotional outcomes for mothers and newborns. Midwives must be prepared to articulate concerns about inequalities and deficiencies in the health care system in order to persuade the government to change. Women, including midwives, need to form multidisciplinary alliances to work together to effect change. The front-line workers in maternity care are midwives. They should adopt the following strategies to become even more effective in their efforts to make motherhood safer. They should listen to what women say about their needs. They should scale services to a manageable, human scale. They should learn the skills to become politically active advocates. They should work with other midwives, women, leaders, and other professional groups. Motherhood can be safe when women have more control over their own decision making, the education to liberate themselves to make their own decisions, and access to skilled care.

  7. Effects of web-based interventions on cancer patients' symptoms: review of randomized trials.

    Science.gov (United States)

    Fridriksdottir, N; Gunnarsdottir, S; Zoëga, S; Ingadottir, B; Hafsteinsdottir, E J G

    2018-02-01

    Symptom management is of high priority in cancer care. Information and communication technology allows interventions to be provided through the internet to enhance the delivery of care. This study aimed to review the effects of web-based interventions on cancer patients' symptoms. MEDLINE, PSychINFO, PubMed, CINAHL, and Cochrane databases were systematically searched. Included were randomized controlled trials (RCTs), pilot RCTs, or quasi-experimental (QE) studies focusing on web-based interventions in adult cancer patients with at least one outcome primary or secondary, in terms of symptoms, treatment side effects, or distress. Data were analyzed study by study. Twenty studies were identified. All web interventions included information, 16 included self-management support, 14 included self-monitoring, 13 included feedback/tailored information, 12 used communication with health-care professionals, and eight used communication with other patients. Overall, 13 studies reported positive symptom outcomes. Psychological distress was reported in eight studies with positive intervention effects in three. Symptoms of anxiety/depression were reported in ten studies with positive intervention effects in five. Somatic symptom severity was reported in ten studies with intervention effects found in six, and symptom distress was reported in six studies with intervention effects found in all. This review shows the promising potential of web-based interventions for cancer symptom management, although it was limited by considerable heterogeneity in the interventions tested and targeted outcomes. The multidimensional nature of symptoms was partly addressed; only one study was guided by a comprehensive theoretical model of cancer symptom management. It can only be speculated which web elements are important for effective symptom outcomes. Further testing is needed for web-based cancer symptom management.

  8. Real-Time Effects of Central Bank Interventions in the Euro Market

    DEFF Research Database (Denmark)

    Fatum, Rasmus; Pedersen, Jesper

    This paper investigates the real-time effects of foreign exchange intervention using official intraday intervention data provided by the Danish central bank. Denmark is currently pursuing an active intervention policy under the provisions of the Exchange Rate Mechanism (ERM II) and intervenes...

  9. The effect of organisational context on organisational development (OD) interventions

    OpenAIRE

    Sanjana Brijball Parumasur

    2012-01-01

    Orientation: Systematic and congruent organisational structures, systems, strategies and designs are necessary for the successful implementation of organisational development (OD) interventions. Research purpose: This article examines national and international OD practices. It assesses the effect of diverse cultures and cultural values for determining the effectiveness of OD interventions. Motivation for the study: Most organisational change and development programmes fail and only a ...

  10. Safe Grid

    Science.gov (United States)

    Chow, Edward T.; Stewart, Helen; Korsmeyer, David (Technical Monitor)

    2003-01-01

    The biggest users of GRID technologies came from the science and technology communities. These consist of government, industry and academia (national and international). The NASA GRID is moving into a higher technology readiness level (TRL) today; and as a joint effort among these leaders within government, academia, and industry, the NASA GRID plans to extend availability to enable scientists and engineers across these geographical boundaries collaborate to solve important problems facing the world in the 21 st century. In order to enable NASA programs and missions to use IPG resources for program and mission design, the IPG capabilities needs to be accessible from inside the NASA center networks. However, because different NASA centers maintain different security domains, the GRID penetration across different firewalls is a concern for center security people. This is the reason why some IPG resources are been separated from the NASA center network. Also, because of the center network security and ITAR concerns, the NASA IPG resource owner may not have full control over who can access remotely from outside the NASA center. In order to obtain organizational approval for secured remote access, the IPG infrastructure needs to be adapted to work with the NASA business process. Improvements need to be made before the IPG can be used for NASA program and mission development. The Secured Advanced Federated Environment (SAFE) technology is designed to provide federated security across NASA center and NASA partner's security domains. Instead of one giant center firewall which can be difficult to modify for different GRID applications, the SAFE "micro security domain" provide large number of professionally managed "micro firewalls" that can allow NASA centers to accept remote IPG access without the worry of damaging other center resources. The SAFE policy-driven capability-based federated security mechanism can enable joint organizational and resource owner approved remote

  11. THE EFFECTIVENESS OF TEACCH INTERVENTION IN AUTISM SPECTRUM DISORDER: A REVIEW STUDY

    Directory of Open Access Journals (Sweden)

    Pilar Sanz-Cervera

    2018-01-01

    Full Text Available This work includes a review of the literature to analyze the effectiveness of the TEACCH intervention, as well as the effect of this intervention on the level of parental and teachers’ stress of children with autism spectrum disorder (ASD. Considering the inclusion criteria, a total of 14 studies were analyzed. Regardless of the context of intervention, all the studies revealed developmental abilities improvements and a reduction in autistic symptoms and maladaptative behaviors. In 11 of the 14 studies, statistically significant improvements were obtained. As for the effect of the TEACCH intervention in the level of the parents or teachers stress, out of the 7 studies that evaluated stress, 5 of them obtained a significant decrease between Pre and Post measurements. Considering these results, TEACCH intervention could be effective not only improving the child’s development, but also enhancing the adults’ level of well-being.

  12. Administration of Triclabendazole Is Safe and Effective in Controlling Fascioliasis in an Endemic Community of the Bolivian Altiplano

    Science.gov (United States)

    Villegas, Fidel; Angles, René; Barrientos, René; Barrios, Gary; Valero, María Adela; Hamed, Kamal; Grueninger, Heiner; Ault, Steven K.; Montresor, Antonio; Engels, Dirk; Mas-Coma, Santiago; Gabrielli, Albis Francesco

    2012-01-01

    Background The Bolivian northern Altiplano is characterized by a high prevalence of Fasciola hepatica infection. In order to assess the feasibility, safety and efficacy of large-scale administration of triclabendazole as an appropriate public health measure to control morbidity associated with fascioliasis, a pilot intervention was implemented in 2008. Materials and Methods Schoolchildren from an endemic community were screened for fascioliasis and treated with a single administration of triclabendazole (10 mg/kg). Interviews to assess the occurrence of adverse events were conducted on treatment day, one week later, and one month after treatment. Further parasitological screenings were performed three months after treatment and again two months later (following a further treatment) in order to evaluate the efficacy of the intervention. Results Ninety infected children were administered triclabendazole. Adverse events were infrequent and mild. No serious adverse events were reported. Observed cure rates were 77.8% after one treatment and 97.8% after two treatments, while egg reduction rates ranged between 74% and 90.3% after one treatment, and between 84.2% and 99.9% after two treatments. The proportion of high-intensity infections (≥400 epg) decreased from 7.8% to 1.1% after one treatment and to 0% after two treatments. Conclusion Administration of triclabendazole is a feasible, safe and efficacious public health intervention in an endemic community in the Bolivian Altiplano, suggesting that preventive chemotherapy can be applied to control of fascioliasis. Further investigations are needed to define the most appropriate frequency of treatment. PMID:22880138

  13. Effect assessment in work environment interventions: a methodological reflection.

    Science.gov (United States)

    Neumann, W P; Eklund, J; Hansson, B; Lindbeck, L

    2010-01-01

    This paper addresses a number of issues for work environment intervention (WEI) researchers in light of the mixed results reported in the literature. If researchers emphasise study quality over intervention quality, reviews that exclude case studies with high quality and multifactorial interventions may be vulnerable to 'quality criteria selection bias'. Learning from 'failed' interventions is inhibited by both publication bias and reporting lengths that limit information on relevant contextual and implementation factors. The authors argue for the need to develop evaluation approaches consistent with the complexity of multifactorial WEIs that: a) are owned by and aimed at the whole organisation; and b) include intervention in early design stages where potential impact is highest. Context variety, complexity and instability in and around organisations suggest that attention might usefully shift from generalisable 'proof of effectiveness' to a more nuanced identification of intervention elements and the situations in which they are more likely to work as intended. STATEMENT OF RELEVANCE: This paper considers ergonomics interventions from perspectives of what constitutes quality and 'proof". It points to limitations of traditional experimental intervention designs and argues that the complexity of organisational change, and the need for multifactorial interventions that reach deep into work processes for greater impact, should be recognised.

  14. [Effective interventions to reduce absenteeism among hospital nurses].

    Science.gov (United States)

    Blanca-Gutiérrez, Joaquín Jesús; Jiménez-Díaz, María del Carmen; Escalera-Franco, Luis Felipe

    2013-01-01

    To select and summarize the interventions that have proved effective in reducing absenteeism among hospital nurses. A scoping review was conducted through a literature search using Medline, Web of Science, Cinahl, Embase, Lilacs, Cuiden and Cochrane Library Plus databases. Of a total of 361 articles extracted, 15 were finally selected for this review. The implementation of multifaceted support or physical training programs can produce positive results in terms of reducing absenteeism among hospital nurses. Cognitive-behavioral type interventions require studies with larger samples to provide conclusive results. Establishing more flexible working shifts may also reduce absenteeism rates, although again studies with larger samples are needed. Programs aimed at managing change developed by nurses themselves, participatory management of professional relations, the support provided by supervisors who are opposed to hierarchical leadership styles, and wage supplements that reward the lack of absence can also reduce these types of indicators. Absenteeism can be considered as a final result and a consequence of the level of job satisfaction. The effectiveness of interventions to reduce absenteeism among hospital nurses will no doubt largely depend on the ability of these interventions to increase the job satisfaction of these workers. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. A 'simple anterior fish excluder' (SAFE for mitigating penaeid-trawl bycatch.

    Directory of Open Access Journals (Sweden)

    Matthew J McHugh

    Full Text Available Various plastic strips and sheets (termed 'simple anterior fish excluders'-SAFEs were positioned across the openings of penaeid trawls in attempts at reducing the unwanted bycatches of small teleosts. Initially, three SAFEs (a single wire without, and with small and large plastic panels were compared against a control (no SAFE on paired beam trawls. All SAFEs maintained targeted Metapenaeus macleayi catches, while the largest plastic SAFE significantly reduced total bycatch by 51% and the numbers of Pomatomus saltatrix, Mugil cephalus and Herklotsichthys castelnaui by up to 58%. A redesigned SAFE ('continuous plastic' was subsequently tested (against a control on paired otter trawls, significantly reducing total bycatch by 28% and P. saltatrix and H. castelnaui by up to 42%. The continuous-plastic SAFE also significantly reduced M. macleayi catches by ~7%, but this was explained by ~5% less wing-end spread, and could be simply negated through otter-board refinement. Further work is required to refine the tested SAFEs, and to quantify species-specific escape mechanisms. Nevertheless, the SAFE concept might represent an effective approach for improving penaeid-trawl selectivity.

  16. [The effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children].

    Science.gov (United States)

    Tak, Young-Ran; An, Ji-Yeon; Kim, Young-A; Woo, Hae-Young

    2007-10-01

    The purpose of this study was to identify the effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children. Thirty-two participants (BMI>or=85 percentile or relative obesity>or=10) were allocated to the PABM-intervention group and behavior modification only intervention group. The PABM-intervention was composed of exercise intervention consisting of 50 minutes of physical activity(Hip-hop dance & gym-based exercises) twice a week and the behavior modification intervention consisted of 50 minutes of instruction for modifying lifestyle habits(diet & exercise) once a week. Effectiveness of intervention was based on waist circumference, BP, HDL-cholesterol, TG, and fasting glucose before and after the intervention. The proportion of subjects with 1, 2, 3 or more metabolic risk factors were 28.1, 43.8, and 15.6%, respectively. After the 8-week intervention, waist circumference, systolic BP, diastolic BP, and HDL-cholesterol changed significantly(p<.01) in the PABM group. This provides evidence that a PABM-intervention is effective in changing metabolic risk factors such as waist circumference, systolic BP, diastolic BP, and HDL-cholesterol in overweight and obese elementary school children.

  17. The Effects of Mindfulness-Based Intervention on Children's Attention Regulation.

    Science.gov (United States)

    Felver, Joshua C; Tipsord, Jessica M; Morris, Maxwell J; Racer, Kristina Hiatt; Dishion, Thomas J

    2017-08-01

    This article describes results from a randomized clinical trial of a mindfulness-based intervention for parents and children, Mindful Family Stress Reduction, on a behavioral measure of attention in youths, the Attention Network Task (ANT). Forty-one parent-child dyads were randomly assigned to either the mindfulness-based intervention condition or a wait-list control. School-age youths completed the ANT before and after the intervention. Results demonstrate significant, medium-size ( f 2 = -.16) intervention effects to the conflict monitoring subsystem of the ANT such that those in the intervention condition decreased in conflict monitoring more than those in the wait-list control. Youths in the intervention condition also showed improvements in their orienting subsystem scores, compared with controls. Mindfulness-based interventions for youths have potential utility to improve attentional self-regulation, and future research should consider incorporating measures of attention into interventions that use mindfulness training.

  18. Novel and viable acetylcholinesterase target site for developing effective and environmentally safe insecticides.

    Science.gov (United States)

    Pang, Yuan-Ping; Brimijoin, Stephen; Ragsdale, David W; Zhu, Kun Yan; Suranyi, Robert

    2012-04-01

    Insect pests are responsible for human suffering and financial losses worldwide. New and environmentally safe insecticides are urgently needed to cope with these serious problems. Resistance to current insecticides has resulted in a resurgence of insect pests, and growing concerns about insecticide toxicity to humans discourage the use of insecticides for pest control. The small market for insecticides has hampered insecticide development; however, advances in genomics and structural genomics offer new opportunities to develop insecticides that are less dependent on the insecticide market. This review summarizes the literature data that support the hypothesis that an insect-specific cysteine residue located at the opening of the acetylcholinesterase active site is a promising target site for developing new insecticides with reduced off-target toxicity and low propensity for insect resistance. These data are used to discuss the differences between targeting the insect-specific cysteine residue and targeting the ubiquitous catalytic serine residue of acetylcholinesterase from the perspective of reducing off-target toxicity and insect resistance. Also discussed is the prospect of developing cysteine-targeting anticholinesterases as effective and environmentally safe insecticides for control of disease vectors, crop damage, and residential insect pests within the financial confines of the present insecticide market.

  19. Understanding effects in reviews of implementation interventions using the Theoretical Domains Framework.

    Science.gov (United States)

    Little, Elizabeth A; Presseau, Justin; Eccles, Martin P

    2015-06-17

    Behavioural theory can be used to better understand the effects of behaviour change interventions targeting healthcare professional behaviour to improve quality of care. However, the explicit use of theory is rarely reported despite interventions inevitably involving at least an implicit idea of what factors to target to implement change. There is a quality of care gap in the post-fracture investigation (bone mineral density (BMD) scanning) and management (bisphosphonate prescription) of patients at risk of osteoporosis. We aimed to use the Theoretical Domains Framework (TDF) within a systematic review of interventions to improve quality of care in post-fracture investigation. Our objectives were to explore which theoretical factors the interventions in the review may have been targeting and how this might be related to the size of the effect on rates of BMD scanning and osteoporosis treatment with bisphosphonate medication. A behavioural scientist and a clinician independently coded TDF domains in intervention and control groups. Quantitative analyses explored the relationship between intervention effect size and total number of domains targeted, and as number of different domains targeted. Nine randomised controlled trials (RCTs) (10 interventions) were analysed. The five theoretical domains most frequently coded as being targeted by the interventions in the review included "memory, attention and decision processes", "knowledge", "environmental context and resources", "social influences" and "beliefs about consequences". Each intervention targeted a combination of at least four of these five domains. Analyses identified an inverse relationship between both number of times and number of different domains coded and the effect size for BMD scanning but not for bisphosphonate prescription, suggesting that the more domains the intervention targeted, the lower the observed effect size. When explicit use of theory to inform interventions is absent, it is possible to

  20. The intraday effects of central bank intervention on exchange rate spreads

    DEFF Research Database (Denmark)

    Fatum, Rasmus; Pedersen, Jesper; Sørensen, Peter Norman

    2013-01-01

    We investigate the intraday effects of intra-marginal intervention in a horizontal band on the exchange rate spread. Official intraday data on Danish intervention transactions in the ERM II, the Exchange Rate Mechanism of the European Union, facilitates our analysis. We show that intervention...

  1. Effectiveness of a Handwriting Intervention With At-Risk Kindergarteners.

    Science.gov (United States)

    Zylstra, Sheryl Eckberg; Pfeiffer, Beth

    2016-01-01

    We examined the effectiveness of an occupational therapist-led handwriting intervention for special education and at-risk kindergarteners. We incorporated a two-group, pretest-posttest design. Both groups consisted of kindergarteners receiving individualized education program (IEP) or Response to Intervention (RtI) support. An occupational therapist provided biweekly group handwriting instruction using the Size Matters Handwriting Program to students in the intervention group (n = 23). The control group (n = 12) received the standard handwriting instruction. Students in the intervention group demonstrated significantly greater gains in handwriting legibility than students in the control group. Students in the intervention group also demonstrated significantly greater gains in the prereading skills of uppercase letter recognition, lowercase letter recognition, and letter sound recognition. This study provides preliminary support for an occupational therapist-led handwriting intervention to improve writing legibility and letter recognition in kindergarteners receiving RtI and IEP supports. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  2. Response to Intervention for Middle School Students with Reading Difficulties: Effects of a Primary and Secondary Intervention

    Science.gov (United States)

    Vaughn, Sharon; Cirino, Paul T.; Wanzek, Jeanne; Wexler, Jade; Fletcher, Jack M.; Denton, Carolyn D.; Barth, Amy; Romain, Melissa; Francis, David J.

    2010-01-01

    This study examined the effectiveness of a yearlong, researcher-provided, Tier 2 (secondary) intervention with a group of sixth-graders. The intervention emphasized word recognition, vocabulary, fluency, and comprehension. Participants scored below a proficiency level on their state accountability test and were compared to a similar group of…

  3. A Phenomenological Study of Nurse Manager Interventions Related to Workplace Bullying.

    Science.gov (United States)

    Skarbek, Anita J; Johnson, Sandra; Dawson, Christina M

    2015-10-01

    The aim of this study was to acquire nurse managers' perspectives as to the scope of workplace bullying, which interventions were deemed as effective and ineffective, and what environmental characteristics cultivated a healthy, caring work environment. Research has linked workplace bullying among RNs to medical errors, unsafe hospital environments, and negative patient outcomes. Limited research had been conducted with nurse managers to discern their perspectives. Six nurse managers from hospital settings participated in in-depth, semistructured interviews. Ray's theory of bureaucratic caring guided the study. These themes emerged: (a) awareness, (b) scope of the problem, (c) quality of performance, and (d) healthy, caring environment. Findings indicated mandated antibullying programs were not as effective as individual manager interventions. Systems must be in place to hold individuals accountable for their behavior. Communication, collective support, and teamwork are essential to create environments that lead to the delivery of safe, optimum patient care.

  4. FMCSA Safety Program Effectiveness Measurement: Carrier Intervention Effectiveness Model (CIEM), Version 1.1 Report for Fiscal Year 2014 Interventions

    Science.gov (United States)

    2018-04-01

    The Federal Motor Carrier Safety Administration (FMCSA), in cooperation with the John A. Volpe National Transportation Systems Center (Volpe), has developed a quantitative model to measure the effectiveness of motor carrier interventions in terms of ...

  5. FMCSA safety program effectiveness measurement : Carrier Intervention Effectiveness Model (CIEM), Version 1.1, report for fiscal year 2013 interventions.

    Science.gov (United States)

    2017-04-01

    The Federal Motor Carrier Safety Administration (FMCSA), in cooperation with the John A. Volpe National Transportation Systems Center (Volpe), has developed a quantitative model to measure the effectiveness of motor carrier interventions in terms of ...

  6. The Effects of Expressive Writing Interventions for Patients With Cancer: A Meta-Analysis.

    Science.gov (United States)

    Oh, Pok-Ja; Kim, Soo Hyun

    2016-07-01

    To evaluate the effects of expressive writing (EW) interventions in patients with cancer.
. Electronic databases searched included both international and Korean databases through January 2015.
. Of the 20 trials that met the eligibility criteria of this review, a meta-analysis was conducted of 14 articles involving 13 randomized and 1 nonrandomized trials with 1,718 patients with cancer. EW interventions were compared with a neutral writing intervention or usual care (no writing). A significant small effect was noted on relieving cancer symptoms; however, the effects on psychological and cognitive outcomes were not significant. When subgroup analysis by control condition was performed, a significant effect on health-related quality of life was found between the EW intervention group and the usual care group. 
. EW had significant small effects only on cancer symptoms. The findings suggest that the traditional EW intervention protocol may need to be intensified to confirm its effect on patients with cancer.
. Current evidence for EW as a nursing intervention for improving physical, psychological, and cognitive outcomes among patients with cancer is promising, but not conclusive.

  7. Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan

    Directory of Open Access Journals (Sweden)

    Becker Stan

    2010-11-01

    Full Text Available Abstract Background Pakistan has high maternal mortality, particularly in the rural areas. The delay in decision making to seek medical care during obstetric emergencies remains a significant factor in maternal mortality. Methods We present results from an experimental study in rural Pakistan. Village clusters were randomly assigned to intervention and control arms (16 clusters each. In the intervention clusters, women were provided information on safe motherhood through pictorial booklets and audiocassettes; traditional birth attendants were trained in clean delivery and recognition of obstetric and newborn complications; and emergency transportation systems were set up. In eight of the 16 intervention clusters, husbands also received specially designed education materials on safe motherhood and family planning. Pre- and post-intervention surveys on selected maternal and neonatal health indicators were conducted in all 32 clusters. A district-wide survey was conducted two years after project completion to measure any residual impact of the interventions. Results Pregnant women in intervention clusters received prenatal care and prophylactic iron therapy more frequently than pregnant women in control clusters. Providing safe motherhood education to husbands resulted in further improvement of some indicators. There was a small but significant increase in percent of hospital deliveries but no impact on the use of skilled birth attendants. Perinatal mortality reduced significantly in clusters where only wives received information and education in safe motherhood. The survey to assess residual impact showed similar results. Conclusions We conclude that providing safe motherhood education increased the probability of pregnant women having prenatal care and utilization of health services for obstetric complications.

  8. Intervention effects on physical activity: the HEIA study - a cluster randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Although school-based interventions to promote physical activity in adolescents have been suggested in several recent reviews, questions have been raised regarding the effects of the strategies and the methodology applied and for whom the interventions are effective. The aim of the present study was to investigate effects of a school-based intervention program: the HEalth in Adolescents (HEIA) study, on change in physical activity, and furthermore, to explore whether potential effects varied by gender, weight status, initial physical activity level and parental education level. Methods This was a cluster randomized controlled 20 month intervention study which included 700 11-year-olds. Main outcome-variable was mean count per minute (cpm) derived from ActiGraph accelerometers (Model 7164/GT1M). Weight and height were measured objectively. Adolescents reported their pubertal status in a questionnaire and parents reported their education level on the consent form. Linear mixed models were used to test intervention effects and to account for the clustering effect of sampling by school. Results The present study showed an intervention effect on overall physical activity at the level of p = 0.05 with a net effect of 50 cpm increase from baseline to post intervention in favour of the intervention group (95% CI −0.4, 100). Subgroup analyses showed that the effect appeared to be more profound among girls (Est 65 cpm, CI 5, 124, p = 0.03) and among participants in the low-activity group (Est 92 cpm, CI 41, 142, p activity group, respectively. Furthermore, the intervention affected physical activity among the normal weight group more positively than among the overweight, and participants with parents having 13–16 years of education more positively than participants with parents having either a lower or higher number of years of education. The intervention seemed to succeed in reducing time spent sedentary among girls but not among boys. Conclusions A

  9. Procedures for the Safe Transport of Radioactive Material

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jang Lyul; Chung, K. K.; Lee, J. I.; Chang, S. Y.; Lee, T. Y

    2007-11-15

    This technical report describes the procedure and work responsibility along with the regulation and standard necessary for the safe transport of radioactive or contaminated materials. This report, therefore, can be effectively used to secure the public safety as well as to prevent the disastrous event which might be resulted from the transport process of radioactive materials by establishing a procedure and method on the safe packing, handling and transport of radioactive materials.

  10. Consensus statement on defining and measuring negative effects of Internet interventions

    Directory of Open Access Journals (Sweden)

    Alexander Rozental

    2014-03-01

    Full Text Available Internet interventions have great potential for alleviating emotional distress, promoting mental health, and enhancing well-being. Numerous clinical trials have demonstrated their efficacy for a number of psychiatric conditions, and interventions delivered via the Internet will likely become a common alternative to face-to-face treatment. Meanwhile, research has paid little attention to the negative effects associated with treatment, warranting further investigation of the possibility that some patients might deteriorate or encounter adverse events despite receiving best available care. Evidence from research of face-to-face treatment suggests that negative effects afflict 5–10% of all patients undergoing treatment in terms of deterioration. However, there is currently a lack of consensus on how to define and measure negative effects in psychotherapy research in general, leaving researchers without practical guidelines for monitoring and reporting negative effects in clinical trials. The current paper therefore seeks to provide recommendations that could promote the study of negative effects in Internet interventions with the aim of increasing the knowledge of its occurrence and characteristics. Ten leading experts in the field of Internet interventions were invited to participate and share their perspective on how to explore negative effects, using the Delphi technique to facilitate a dialog and reach an agreement. The authors discuss the importance of conducting research on negative effects in order to further the understanding of its incidence and different features. Suggestions on how to classify and measure negative effects in Internet interventions are proposed, involving methods from both quantitative and qualitative research. Potential mechanisms underlying negative effects are also discussed, differentiating common factors shared with face-to-face treatments from those unique to treatments delivered via the Internet. The authors

  11. Modeling malaria control intervention effect in KwaZulu-Natal, South Africa using intervention time series analysis.

    Science.gov (United States)

    Ebhuoma, Osadolor; Gebreslasie, Michael; Magubane, Lethumusa

    The change of the malaria control intervention policy in South Africa (SA), re-introduction of dichlorodiphenyltrichloroethane (DDT), may be responsible for the low and sustained malaria transmission in KwaZulu-Natal (KZN). We evaluated the effect of the re-introduction of DDT on malaria in KZN and suggested practical ways the province can strengthen her already existing malaria control and elimination efforts, to achieve zero malaria transmission. We obtained confirmed monthly malaria cases in KZN from the malaria control program of KZN from 1998 to 2014. The seasonal autoregressive integrated moving average (SARIMA) intervention time series analysis (ITSA) was employed to model the effect of the re-introduction of DDT on confirmed monthly malaria cases. The result is an abrupt and permanent decline of monthly malaria cases (w 0 =-1174.781, p-value=0.003) following the implementation of the intervention policy. The sustained low malaria cases observed over a long period suggests that the continued usage of DDT did not result in insecticide resistance as earlier anticipated. It may be due to exophagic malaria vectors, which renders the indoor residual spraying not totally effective. Therefore, the feasibility of reducing malaria transmission to zero in KZN requires other reliable and complementary intervention resources to optimize the existing ones. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. The Community-based Participatory Intervention Effect of “HIV-RAAP”

    Science.gov (United States)

    Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

    2012-01-01

    Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

  13. Telehealth Stroke Dysphagia Evaluation Is Safe and Effective.

    Science.gov (United States)

    Morrell, Kate; Hyers, Megan; Stuchiner, Tamela; Lucas, Lindsay; Schwartz, Karissa; Mako, Jenniffer; Spinelli, Kateri J; Yanase, Lisa

    2017-01-01

    Rapid evaluation of dysphagia poststroke significantly lowers rates of aspiration pneumonia. Logistical barriers often significantly delay in-person dysphagia evaluation by speech language pathologists (SLPs) in remote and rural hospitals. Clinical swallow evaluations delivered via telehealth have been validated in a number of clinical contexts, yet no one has specifically validated a teleswallow evaluation for in-hospital post-stroke dysphagia assessment. A team of 6 SLPs experienced in stroke care and a telestroke neurologist designed, implemented, and tested a teleswallow evaluation for acute stroke patients, in which 100 patients across 2 affiliated, urban certified stroke centers were sequentially evaluated by a bedside and telehealth SLP. Inter-rater reliability was analyzed using percent agreement, Cohen's kappa, Kendall's tau-b, and Wilcoxon matched-pairs signed rank tests. Logistic regression models accounting for age and gender were used to test the impact of stroke severity and stroke location on agreement. We found excellent agreement for both liquid (91% agreement; kappa = 0.808; Kendall's tau-b = 0.813, p Dysphagia evaluation by a remote SLP via telehealth is safe and effective following stroke. We plan to implement teleswallow across our multistate telestroke network as standard practice for poststroke dysphagia evaluation. © 2017 S. Karger AG, Basel.

  14. [Are Interventions Promoting Physical Activity Cost-Effective? A Systematic Review of Reviews].

    Science.gov (United States)

    Rütten, Alfred; Abu-Omar, Karim; Burlacu, Ionut; Schätzlein, Valentin; Suhrcke, Marc

    2017-03-01

    On the basis of international published reviews, this systematic review aims to determine the health economic benefits of interventions promoting physical activity.This review of reviews is based on a systematic literature research in 10 databases (e. g. PubMed, Scopus, SPORTDiscus) supplemented by hand searches from January 2000 to October 2015. Publications were considered in the English or German language only. Results of identified reviews were derived.In total, 18 reviews were identified that could be attributed to interventions promoting physical activity (2 reviews focusing on population-based physical activity interventions, 10 reviews on individual-based and 6 reviews on both population-based and individual-based physical activity interventions). Results showed that population-based physical activity interventions are of great health economic potential if reaching a wider population at comparably low costs. Outstanding are political and environmental strategies, as well as interventions supporting behavioural change through information. The most comprehensive documentation for interventions promoting physical activity could be found for individual-based strategies (i. e. exercise advice or exercise programs). However, such programs are comparatively less cost-effective due to limited reach and higher utilization of resources.The present study provides an extensive review and analysis of the current international state of research regarding the health economic evaluation of interventions promoting physical activity. Results show favourable cost-effectiveness for interventions promoting physical activity, though significant differences in the effectiveness between various interventions were noticed. The greatest potential for cost-effectiveness can be seen in population-based interventions. At the same time, there is a need to acknowledge the limitations of the economic evidence in this field which are attributable to methodological challenges and

  15. Effectiveness of an educational feedback intervention on drug prescribing in dental practice.

    Science.gov (United States)

    Rauniar, G P; Das, B P; Manandhar, T R; Bhattacharya, S K

    2012-01-01

    Irrational use of drugs as well as inappropriate and over drug prescribing leads to unnecessary expenditures and emergence of resistant bacterial strains. Feedback intervention on drug prescribing habits and face to face educational intervention of prescription audit would be effective in rationalizing prescribing practices. To measure the impact of educational feedback intervention on the prescribing behavior of dental surgeons. Prospective audit of twelve hundred outpatients prescriptions in dental OPD at BPKIHS of those dental surgeon who attended the educational intervention session was collected randomly by trained persons on customized data collection sheet before and after educational intervention. A total 1200 prescription were collected, 300 before and 300 after intervention period at the internal of one month, three months and six months. Majority of the prescriptions (39.33%) contained four drugs but after intervention, prescriptions contained mostly one drug, 73% in first month, 78.67% in third month and 65.34% in six month. Mean number of drugs per prescription after intervention were decreased. There was increased number of generic names of drugs after intervention. Amoxicillin, Metronidazole, Chlorhexidine, Povidone iodine gargle, Nimesulide, Ibuprofen, Ibuprofen + paracetamol, and Paracetamol were most commonly prescribed by dental prescribers before and after intervention. Selection of antimicrobial was done on empirical basis which was correct because Amoxicillin concentration reaches effectively in gingival crevicular fluid and Metronidazole covered effectively against anaerobic bacteria were found in orodental infection. The uses of topical anti-infective preparation as irrigants of choice that can kill majority of micro-organisms found is root canal and dental tubules and minimize systemic use of antimicrobials. Nimesulide prescribing needs to be rationalized. Feedback educational intervention of prescription audit is effective to improve their

  16. Analysis of the complications in interventional treatment for Budd-Chiari syndrome

    International Nuclear Information System (INIS)

    Niu Zhike; Lv Guanghua; Du Fei; Guo Yanxia; Guan Lan

    2010-01-01

    Objective: To discuss the causes and the prevention measures of the complications occurred after interventional therapy for different type of Budd-Chiari syndrome (BCS). Methods: Based on the type of BCS, the corresponding interventional management was adopted in 204 patients with BCS. The interventional procedures included PTA and stent placement of inferior vena cava (IVC), percutaneous transhepatic recanalization and dilation (PTRD) of hepatic vein, percutaneous trans jugular or trans inferior vena cava recanalization, dilation and stent placement of hepatic vein and trans jugular intrahepatic portal-systemic stenting shunt (TIPSS). Results: The successful rate of interventional therapy was 95.5% (21 / 22) for type Ia, 81.8% (9/11) for type Ib, 97.3% (109/112) for type IIa, 92.9% (13/14) for type IIb, 88.9% (8/9) for type IIIa, 100% (2/2) type IIIb, 92% (23/25) for type IVa and 88.9% (8/9) for type IVb BCS. The main complications occurred during or after the operation included acute cardiac insufficiency (n=2), pulmonary arterial embolization (n=4), disseminated intravascular coagulation (n=1), extravasation of contrast medium (n=3), arrhythmia (n=2), and cardiac tamponade (n=1). Conclusion: Interventional therapy is simple, safe and effective for the treatment of BCS, but its indications should be strictly considered and all kinds of effective prevention measures should be taken to avoid or to reduce the possible complications. (authors)

  17. N,N-diethyl phenylacetamide (DEPA): A safe and effective repellent for personal protection against hematophagous arthropods.

    Science.gov (United States)

    Kalyanasundaram, Muthuswami; Mathew, Nisha

    2006-05-01

    Repellents play an important role in protecting humans from the bites of insect pests. An effective and safe repellent will be useful in reducing human-vector contact and thereby help in the interruption of vector borne disease transmission. Because of the unavailability of m-toluic acid in India for the manufacture of N,N-diethyl m-toluamide (DEET), there is a need to develop an alternate effective and safe insect repellent. In total, 120 substituted amides were synthesized and tested for repellency at 1.0 mg/cm2 under laboratory conditions. Among these amides, N,N-diethyl phenylacetamide (DEPA), applied at 1.0 mg/cm2 in different oil bases, was found to exhibit promising repellency (6-8 h) in the laboratory when tested against Aedes aegypti (L.) The repellent DEPA was evaluated on army personnel in comparison with dimethylphthalate (DMP) and DEET against mosquitoes, black flies, and land leeches under field condition in the North-East Frontier area of India. Both DEPA and DEET displayed broad-spectrum repellency. DEPA was more effective than DMP against all test organisms. However, no significant difference was noticed between DEPA and DEET for repellency at 0.25 and 0.5 mg/cm2 against black flies and mosquitoes. DMP was the least effective among the three compounds in the field studies. The relative potency of DEPA in comparison with DEET and DMP for repellency against Phlebotomine sand flies also was determined. At 0.1 mg/cm2, both DEPA and DEET were found to be equally effective with a protection time from 4.37 +/- 0.08 to 4.45 +/- 0.15 h. Both compounds were significantly more effective than DMP. At 0.2 mg/cm2, DEPA and DEET provided protection times of 6.52 +/- 0.08 and 7.15 +/- 0.15 h, respectively. DEPA was formulated into a vanishing cream, a pharmacologically safe polymer-based liquid, and a liposphere lotion. The vanishing cream and the two-polymer liquid formulations enhanced protection times from 4.4 to 6.5 and 7.13 h, respectively, compared with an

  18. Long-term effectiveness and cost-effectiveness of smoking cessation interventions in patients with COPD

    NARCIS (Netherlands)

    Hoogendoorn, Martine; Feenstra, Talitha L.; Hoogenveen, Rudolf T.; Rutten-van Molken, Maureen P. M. H.

    Background The aim of this study was to estimate the long-term (cost-) effectiveness of smoking cessation interventions for patients with chronic obstructive pulmonary disease (COPD). Methods A systematic review was performed of randomised controlled trials on smoking cessation interventions in

  19. Promoting Early, Safe Return to Work in Injured Employees: A Randomized Trial of a Supervisor Training Intervention in a Healthcare Setting.

    Science.gov (United States)

    Spector, June T; Reul, Nicholas K

    2017-03-01

    Purpose Supervisors in the healthcare sector have the potential to contribute to disability prevention in injured employees. Published data on the evaluation of return to work (RTW) interventions aimed at direct supervisors are scarce. We sought to determine the effect of a brief audiovisual supervisor training module on supervisor RTW attitudes and knowledge. Methods A parallel-group study, using equal randomization, comparing the training module intervention to usual practice in healthcare supervisors at a quaternary care hospital was conducted. Differences between groups in changes in RTW attitude and knowledge survey question scores between baseline and 3 months were assessed using the Mann-Whitney U test. The Benjamini-Hochberg-Yekutieli procedure was used to control for false discovery rate and generate adjusted p values. Results Forty supervisors were allocated to the intervention group and 41 to the usual practice group. Attitude and knowledge scores for most questions improved between baseline and immediately after intervention administration. Comparing intervention (n = 33) and usual practice groups (n = 37), there was a trend toward greater increase between baseline and 3 months follow-up in agreement that the supervisor can manage the RTW process (U = 515, adjusted p value = 0.074) and in confidence that the supervisor can answer employees' questions (U = 514, adjusted p value = 0.074) in the intervention group, although these findings were not statistically significant. Conclusions The training intervention may have provided the initial tools for supervisors to navigate the RTW process in collaboration with others in the RTW community of practice. A larger study with longer follow-up is needed to confirm results.

  20. Effects of a worksite tobacco control intervention in India: the Mumbai worksite tobacco control study, a cluster-randomised trial.

    Science.gov (United States)

    Sorensen, Glorian; Pednekar, Mangesh; Cordeira, Laura Shulman; Pawar, Pratibha; Nagler, Eve M; Stoddard, Anne M; Kim, Hae-Young; Gupta, Prakash C

    2017-03-01

    We assessed a worksite intervention designed to promote tobacco control among workers in the manufacturing sector in Greater Mumbai, India. We used a cluster-randomised design to test an integrated health promotion/health protection intervention, the Healthy, Safe, and Tobacco-free Worksites programme. Between July 2012 and July 2013, we recruited 20 worksites on a rolling basis and randomly assigned them to intervention or delayed-intervention control conditions. The follow-up survey was conducted between December 2013 and November 2014. The difference in 30-day quit rates between intervention and control conditions was statistically significant for production workers (OR=2.25, p=0.03), although not for the overall sample (OR=1.70; p=0.12). The intervention resulted in a doubling of the 6-month cessation rates among workers in the intervention worksites compared to those in the control, for production workers (OR=2.29; p=0.07) and for the overall sample (OR=1.81; p=0.13), but the difference did not reach statistical significance. These findings demonstrate the potential impact of a tobacco control intervention that combined tobacco control and health protection programming within Indian manufacturing worksites. NCT01841879. 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/.

  1. A simulation model for designing effective interventions in early childhood caries.

    Science.gov (United States)

    Hirsch, Gary B; Edelstein, Burton L; Frosh, Marcy; Anselmo, Theresa

    2012-01-01

    Early childhood caries (ECC)--tooth decay among children younger than 6 years--is prevalent and consequential, affecting nearly half of US 5-year-olds, despite being highly preventable. Various interventions have been explored to limit caries activity leading to cavities, but little is known about the long-term effects and costs of these interventions. We developed a system dynamics model to determine which interventions, singly and in combination, could have the greatest effect in reducing caries experience and cost in a population of children aged birth to 5 years. System dynamics is a computer simulation technique useful to policy makers in choosing the most appropriate interventions for their populations. This study of Colorado preschool children models 6 categories of ECC intervention--applying fluorides, limiting cariogenic bacterial transmission from mothers to children, using xylitol directly with children, clinical treatment, motivational interviewing, and combinations of these--to compare their relative effect and cost. The model projects 10-year intervention costs ranging from $6 million to $245 million and relative reductions in cavity prevalence ranging from none to 79.1% from the baseline. Interventions targeting the youngest children take 2 to 4 years longer to affect the entire population of preschool-age children but ultimately exert a greater benefit in reducing ECC; interventions targeting the highest-risk children provide the greatest return on investment, and combined interventions that target ECC at several stages of its natural history have the greatest potential for cavity reduction. Some interventions save more in dental repair than their cost; all produce substantial reductions in repair cost. By using data relevant to any geographic area, this system model can provide policy makers with information to maximize the return on public health and clinical care investments.

  2. Effects of a digital intervention on the development of algebraic expertise

    NARCIS (Netherlands)

    Bokhove, C.; Drijvers, P.H.M.

    2012-01-01

    In this article we report on the effects of a digital intervention on the development of algebraic expertise of 17-18 year old students in the Netherlands. The question to be answered was whether the intervention would be effective and what factors influenced the outcome. With notions of

  3. Why and for Whom May Coping Planning Have Adverse Effects? A Moderated Mediation Analysis.

    Science.gov (United States)

    Inauen, Jennifer; Stocker, Andrea; Scholz, Urte

    2018-05-09

    Coping planning, the formation of plans to overcome behavioral barriers is assumed to promote health behavior maintenance, but the literature on this is inconsistent. In this study, we aimed to investigate the mechanisms of a coping planning intervention that adversely affected maintained safe water consumption. We also explored perceived behavioral difficulty as a potential moderator of coping planning interventions. In the second phase of a cluster-randomised trial, households (N = 177 analyzed) were randomly allocated to a coping planning intervention or a comparison group (repetition of interventions from first intervention phase). Safe water consumption, the mechanisms of coping planning, and perceived difficulty were measured pre-post. The data were analyzed using mediation and moderated mediation analysis. Changes in behavioral intention mediated the intervention effects on behavioral maintenance (b = -0.36, 95% CI [-0.91, -0.03]). Changes in perceived coping planning (b = 0.08, 95% CI [-0.12, 0.34]), and maintenance self-efficacy (b = -0.13, 95% CI [-0.45, 0.01]) did not mediate the effects. Prior perceived difficulty moderated the coping planning intervention effects on maintenance via intention. Coping planning may decrease motivation for health behavior maintenance for persons who experienced few barriers prior to the planning intervention. © 2018 The International Association of Applied Psychology.

  4. Safe and Effective Gene Therapy for Murine Wiskott-Aldrich Syndrome Using an Insulated Lentiviral Vector

    Directory of Open Access Journals (Sweden)

    Swati Singh

    2017-03-01

    Full Text Available Wiskott-Aldrich syndrome (WAS is a life-threatening immunodeficiency caused by mutations within the WAS gene. Viral gene therapy to restore WAS protein (WASp expression in hematopoietic cells of patients with WAS has the potential to improve outcomes relative to the current standard of care, allogeneic bone marrow transplantation. However, the development of viral vectors that are both safe and effective has been problematic. While use of viral transcriptional promoters may increase the risk of insertional mutagenesis, cellular promoters may not achieve WASp expression levels necessary for optimal therapeutic effect. Here we evaluate a self-inactivating (SIN lentiviral vector combining a chromatin insulator upstream of a viral MND (MPSV LTR, NCR deleted, dl587 PBS promoter driving WASp expression. Used as a gene therapeutic in Was−/− mice, this vector resulted in stable WASp+ cells in all hematopoietic lineages and rescue of T and B cell defects with a low number of viral integrations per cell, without evidence of insertional mutagenesis in serial bone marrow transplants. In a gene transfer experiment in non-human primates, the insulated MND promoter (driving GFP expression demonstrated long-term polyclonal engraftment of GFP+ cells. These observations demonstrate that the insulated MND promoter safely and efficiently reconstitutes clinically effective WASp expression and should be considered for future WAS therapy.

  5. LACK OF AWARENESS ABOUT SAFE BLOOD IN PAKISTANI POPULATION

    Directory of Open Access Journals (Sweden)

    Muhammad Usman

    2014-12-01

    Full Text Available Blood transfusion is a life saving procedure in various transfusion-dependent life threatening conditions and donation of safe blood is a prerequisite for achieving this goal. This study was designed to evaluate the awareness regarding “safe blood” in Pakistani population. This study was conducted at a large scale through a population survey. The test population was divided into two groups i.e. general population and students. The Performa was designed for a general and student population and included 20 questions related to awareness of safe blood. A total of 4900 individuals belonging to different ethnic groups were included in this population survey. Results of social survey were analyzed by using Usman and Moin awareness chart. Results of this study revealed profound unawareness about safe blood in Pakistani population. This study found lack of awareness about safe blood as a major factor that is playing a vital role in the propagation of blood borne diseases in Pakistan. To secure the recipients from blood borne complications through blood donation, it is necessary to create effective awareness about safe blood in Pakistani population.

  6. Development of Safe Food Handling Guidelines for Korean Consumers.

    Science.gov (United States)

    Kang, Hee-Jin; Lee, Min-Woo; Hwang, In-Kyeong; Kim, Jeong-Weon

    2015-08-01

    The purpose of this study was to develop guidelines for Korean consumers with regard to safe food handling practices at home by identifying current food handling issues. Korean consumers' behaviors regarding their safe food handling were identified via survey questionnaires that included items on individual hygiene practices, prepreparation steps when cooking, the cooking process, and the storage of leftover foods. The subjects were 417 Korean parents with elementary school children living in Seoul and Gyeonggi Province in the central area of Korea. The survey results revealed gaps between the knowledge or practices of Korean consumers and scientific evidence pertaining to safe food handling practices. Based on these findings, a leaflet on safe food handling guidelines was developed in accordance with Korean food culture. These guidelines suggest personal hygiene practices as well as fundamental principles and procedures for safe food handling from the stage of food purchase to that of keeping leftover dishes. A pilot application study with 50 consumers revealed that the guidelines effectively improved Korean consumers' safe food handling practices, suggesting that they can serve as practical educational material suitable for Korean consumers.

  7. Antipsychotic interventions in prodromal psychosis: safety issues.

    Science.gov (United States)

    Liu, Chen-Chung; Demjaha, Arsime

    2013-03-01

    In recent years, psychopharmacological intervention in prodromal psychosis, also known as the ultra-high risk (UHR) mental state for psychosis, has attracted much attention. Whilst it has been shown that antipsychotic use in UHR individuals may be effective in potentially delaying or even averting progression to frank psychosis, their use in subjects that do not necessarily convert to psychosis has raised considerable ethical concerns because of their adverse effects. Recent treatment guidelines for patients at UHR for psychosis recommend the use of antipsychotics only in exceptional conditions and with great precautions. To date only a few studies have investigated the use of antipsychotic medications in UHR patients and the potential benefits and risks related to their use in prodromal psychosis remain unclear. We review here all published studies that included UHR patients treated with antipsychotics, regardless of study design. These studies were all of second-generation antipsychotics, given that first-generation antipsychotics cannot be recommended because of their adverse drug reactions. We specifically examine the available descriptions of adverse reactions of the individual antipsychotic medication in each study and discuss the potential effects of various demographic and clinical factors that may impact on safety issues of pharmacological interventions in UHR patients. Clinical trials to date investigating potential benefits of antipsychotic treatments in preventing transition to psychosis were of relatively short duration and have involved a small number of patients. Whilst it appears that pharmacological intervention at this stage may be effective in both reducing the psychopathology and decreasing transition rates, and is potentially safe, in the absence of sufficient evidence-based knowledge to guide treatment, definitive clinical recommendations and guidelines cannot be derived. Certain adverse events take time to develop, such as metabolic syndrome

  8. Evaluating a Safe Space Training for School Counselors and Trainees Using a Randomized Control Group Design

    Science.gov (United States)

    Byrd, Rebekah; Hays, Danica G.

    2014-01-01

    School counselors need to advocate and act as an ally for all students. Safe Space, a training designed to facilitate competency for working with and serving LGBTQ youth (i.e., LGBTQ competency), has received increased attention in the field of school counseling. However, limited empirical support exists for training interventions such as Safe…

  9. Systematic review and meta-analysis of music interventions in hypertension treatment: a quest for answers.

    Science.gov (United States)

    Kühlmann, Anne Y R; Etnel, Jonathan R G; Roos-Hesselink, Jolien W; Jeekel, Johannes; Bogers, Ad J J C; Takkenberg, Johanna J M

    2016-04-19

    Adverse effects, treatment resistance and high costs associated with pharmacological treatment of hypertension have led to growing interest in non-pharmacological complementary therapies such as music interventions. This meta-analysis aims to provide an overview of reported evidence on the efficacy of music interventions in the treatment of hypertension. A systematic literature search was conducted for publications on the effect of music interventions on blood pressure in adult hypertensive subjects published between January 1990-June 2014. Randomized controlled trials with a follow-up duration ≥28 days were included. Blood pressure measures were pooled using inverse variance weighting. Of the 1689 abstracts reviewed, 10 randomized controlled trials were included. Random-effects pooling of the music intervention groups showed a trend toward a decrease in mean systolic blood pressure (SBP) from 144 mmHg(95 % CI:137-152) to 134 mmHg(95 % CI:124-144), and in mean diastolic blood pressure (DBP) from 84 mmHg(95 % CI:78-89) to 78 mmHg(95 % CI:73-84). Fixed-effect analysis of a subgroup of 3 trials with valid control groups showed a significant decrease in pooled mean SBP and DBP in both intervention and control groups. A comparison between music intervention groups and control groups was not possible due to unavailable measures of dispersion. This systematic review and meta-analysis revealed a trend towards a decrease in blood pressure in hypertensive patients who received music interventions, but failed to establish a cause-effect relationship between music interventions and blood pressure reduction. Considering the potential value of this safe, low-cost intervention, well-designed, high quality and sufficiently powered randomized studies assessing the efficacy of music interventions in the treatment of hypertension are warranted.

  10. Intervention Effectiveness in Reducing Prejudice against Transsexuals

    Science.gov (United States)

    Case, Kim A.; Stewart, Briana

    2013-01-01

    The transgender community encounters pervasive prejudice, discrimination, and violence, yet social science literature lacks research that focuses on reduction of antitransgender prejudice. This experimental study examined the effectiveness of three interventions aimed at decreasing negative attitudes toward transsexuals, correcting participants'…

  11. The Safe Area in the Parieto-Occipital Lobe in the Human Brain: Diffusion Tensor Tractography.

    Science.gov (United States)

    Jang, Sung Ho; Kim, Seong Ho; Kwon, Hyeok Gyu

    2015-06-01

    A recent study reported on the relatively safe area in the frontal lobe for performance of neurological interventions; however, no study on the posterior safe area has been reported. In this study, using diffusion tensor tractography, we attempted to identify the safe area in the parieto-occipital lobe in healthy subjects. A total of 47 healthy subjects were recruited for this study. Eleven neural tracts were reconstructed in and around the parieto-occipital area of the brain using diffusion tensor tractography. The safe area, which is free from any trajectory of 10 neural tracts, was measured anteriorly and medially from the line of the most posterior and lateral margin of the brain at 5 axial levels (from the cerebral cortex to the corona radiata). The anterior boundaries of the safe area in the upper cerebral cortex, lower cerebral cortex, centrum semiovale, upper corona radiata, and lower corona radiata levels were located at 31.0, 32.6, 32.7, 35.1, and 35.2 mm anteriorly from the line of the most posterior margin of the brain, respectively, and the medial boundaries were located at an average of 34.7, 38.1, 39.2, 36.1, and 33.6 mm medially from the line of the most lateral margin of the brain, respectively. According to our findings, the safe area was located in the posterolateral portion of the parieto-occipital lobe in the shape of a triangle. However, we found no safe area in the deep white matter around the lateral ventricle. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Effects of a digital intervention on the development of algebraic expertise

    NARCIS (Netherlands)

    Bokhove, C.; Drijvers, P.H.M.

    2012-01-01

    In this article we report on the effects of a digital intervention on the development of algebraic expertise of 17–18 year old students in the Netherlands. The question to be answered was whether the intervention would be effective and what factors influenced the outcome. With notions of formative

  13. Cost-effectiveness of early intervention in first-episode psychosis

    DEFF Research Database (Denmark)

    Hastrup, Lene Halling; Kronborg, C; Bertelsen, M

    2013-01-01

    Background Information about the cost-effectiveness of early intervention programmes for first-episode psychosis is limited. Aims To evaluate the cost-effectiveness of an intensive early-intervention programme (called OPUS) (trial registration NCT00157313) consisting of enriched assertive community...... treatment, psychoeducational family treatment and social skills training for individuals with first-episode psychosis compared with standard treatment. Method An incremental cost-effectiveness analysis of a randomised controlled trial, adopting a public sector perspective was undertaken. Results The mean...... treatment group (51.13, s.d. = 15.92). However, the mean GAF did not differ significantly between the groups at 5-year follow-up (55.35 (s.d. = 18.28) and 54.16 (s.d. = 18.41), respectively). Cost-effectiveness planes based on non-parametric bootstrapping showed that OPUS was less costly and more effective...

  14. Durability of effect of massage therapy on blood pressure

    Directory of Open Access Journals (Sweden)

    Mahshid Givi

    2013-01-01

    Conclusions: Findings of the study indicated that massage therapy was a safe, effective, applicable and cost-effective intervention in controlling BP of the pre-hypertension women and it can be used in the health care centers and even at home.

  15. Sustainability of arsenic mitigation interventions – an evaluation of different alternative safe drinking water options provided in Matlab, an arsenic hot spot in Bangladesh

    Directory of Open Access Journals (Sweden)

    MOHAMMED eHOSSAIN

    2015-05-01

    Full Text Available The wide spread occurrence of geogenic arsenic (As in Bangladesh groundwater drastically reduced the safe water access across the country. Since its discovery in 1993, different mitigation options tested at household and community scale have resulted in limited success. In an arsenic hotspot of southeastern Bangladesh, 841 arsenic removal filter (ARF, 190 surface water filter membrane, 23 pond sand filter (PSF, 147 rain water harvester (RWH and 59 As-safe tubewell were distributed among the severely exposed population by AsMat, a Sida supported project. After three-four years of providing these safe water options, this study was carried out during 2010-2011 for performance analysis of these options, in terms of technical viability and effectiveness and thus to evaluate the preference of different options to the end users. Household and community based surveys were done to make an assessment of the current water use pattern as impact of the distributed options, overall condition of the options provided and to identify the reasons why these options are in use and/or abandoned. In total, 284 households were surveyed and information was collected for 23 PSF, 147 RWH and 59 tubewells. None of the filters was found in use. Among other options distributed, 13% of PSF, 40% RWH and 93% of tubewell were found functioning. In all cases, tubewells were found As-safe. About 89% of households are currently using tubewell water which was 58% before. Filter was abandoned for high cost and complicated maintenance. The use of RWH and PSF was not found user friendly and ensuring year round water quality is a big challenge. Arsenic-safe tubewell was found as a widely accepted option mainly because of its easy operation and availability of water, good water quality and negligible maintenance. This study validated tubewell as the most feasible option and holds significance for planning water supply projects, improving mitigation policy as well as developing awareness

  16. A review of the nature and effectiveness of nutrition interventions in adult males--a guide for intervention strategies.

    Science.gov (United States)

    Taylor, Pennie J; Kolt, Gregory S; Vandelanotte, Corneel; Caperchione, Cristina M; Mummery, W Kerry; George, Emma S; Karunanithi, Mohanraj; Noakes, Manny J

    2013-01-29

    Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1) published from January 1990 to August 2011 and 2) male only studies (≥18 years) or 3) where males contributed to >90% of the active cohort. A study must have described, (i) a significant change (pstudies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg) and/or BMI (kg/m2) changes (p≤0.05). Four studies had effective interventions (pself-monitoring and tailored feedback. Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to guide researchers in making informed decisions on how to best utilise resources in interventions to engage adult males while highlighting the need for improved reporting of intervention protocols.

  17. Retrograde placement of double-J ureteral stent with interventional therapy for the treatment of ureteral stricture

    International Nuclear Information System (INIS)

    Kong Jian; Xu Linfeng; Liang Huimin; Zheng Chuansheng; Zheng Jinlong; Feng Gansheng

    2000-01-01

    Objective: To evaluate the retrograde placement of Double-J ureteral stent with interventional therapy for the treatment of ureteral stricture. Methods: Twenty patients with ureteral stricture of various causes were treated with retrograde placing Double-J ureteral stent by interventional therapy. Results: The Double-J stent was successfully performed in all twenty patients. The successful rate of placing stent was 100%. The cure rate was 90% (18/20). The complications such as urinary leakage, wound infection, and bleeding were markedly decreased. The indication, duration of indwelling and complication of the indwelling stent were discussed. Conclusion: Retrograde placing Double-J stent with interventional therapy is simple and less invasive. It is believed to be a safe and effective method for the treatment of ureteral stricture

  18. Impact of Treatment Integrity on Intervention Effectiveness

    Science.gov (United States)

    Fryling, Mitch J.; Wallace, Michele D.; Yassine, Jordan N.

    2012-01-01

    Treatment integrity has cogent implications for intervention effectiveness. Understanding these implications is an important, but often neglected, undertaking in behavior analysis. This paper reviews current research on treatment integrity in applied behavior analysis. Specifically, we review research evaluating the relation between integrity…

  19. The human factor: the critical importance of effective teamwork and communication in providing safe care

    OpenAIRE

    Leonard, M; Graham, S; Bonacum, D

    2004-01-01

    Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members...

  20. Safe Harbor Legislation for Juvenile Victims of Sex Trafficking: A Myopic View of Improvements in Practice

    Directory of Open Access Journals (Sweden)

    Kimberly Mehlman-Orozco

    2015-02-01

    Full Text Available Current social and political realties have focused attention on human trafficking in the United States. Although new mechanisms for criminalizing offenders and protecting victims are increasingly funded and implemented across the country, empirical exploration into the efficacy of these interventions is lacking. This article uses yearly count data on juvenile prostitution arrests aggregated at the state level to explore the criminalization of commercial sexually exploited children post safe harbor policy implementation. Preliminary data from four states suggests that the passage of safe harbor laws may not reduce the number of juveniles arrested for prostitution crimes. Implications for future research are discussed.

  1. Animal-assisted intervention in dementia: effects on quality of life.

    Science.gov (United States)

    Nordgren, Lena; Engström, Gabriella

    2014-02-01

    There is a need to develop nonpharmacological treatments and methods which can serve as alternatives or complements to medications in dementia care. Previous research indicates that animal-assisted intervention (AAI) can be beneficial. The purpose of the present pilot project was to evaluate effects of AAI on quality of life (QoL) in people with dementia in four Swedish nursing homes. A pretest/posttest research design was used. Twenty people (12 women, 8 men; aged 58 to 88) were included. Nine people completed the intervention which comprised 10 training sessions with a certified therapy dog team. QoL improved in the expected direction after the intervention (p = .035). Even though the effects of AAI may not be discernible over longer periods of time, there are still immediate effects which can promote better QoL for people living with dementia diseases.

  2. Using Chest Vibration Nursing Intervention to Improve Expectoration of Airway Secretions and Prevent Lung Collapse in Ventilated ICU Patients: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Yu-Chih Chen

    2009-06-01

    Conclusion: The results suggest that chest vibration may contribute to expectoration and thus improve lung collapse among ventilated patients in an ICU. Chest vibration nursing intervention is a safe and effective alternative pulmonary clearance method and can be used on patients who are on ventilators in ICUs.

  3. Safeguards Automated Facility Evaluation (SAFE) methodology

    International Nuclear Information System (INIS)

    Chapman, L.D.; Grady, L.M.; Bennett, H.A.; Sasser, D.W.; Engi, D.

    1978-08-01

    An automated approach to facility safeguards effectiveness evaluation has been developed. This automated process, called Safeguards Automated Facility Evaluation (SAFE), consists of a collection of a continuous stream of operational modules for facility characterization, the selection of critical paths, and the evaluation of safeguards effectiveness along these paths. The technique has been implemented on an interactive computer time-sharing system and makes use of computer graphics for the processing and presentation of information. Using this technique, a comprehensive evaluation of a safeguards system can be provided by systematically varying the parameters that characterize the physical protection components of a facility to reflect the perceived adversary attributes and strategy, environmental conditions, and site operational conditions. The SAFE procedure has broad applications in the nuclear facility safeguards field as well as in the security field in general. Any fixed facility containing valuable materials or components to be protected from theft or sabotage could be analyzed using this same automated evaluation technique

  4. Effectiveness of the Costa Rican Central Bank forex intervention

    Directory of Open Access Journals (Sweden)

    Julio César Espinoza Rodríguez

    2016-03-01

    Full Text Available This paper represents an empirical approach to assess the effectiveness of foreign exchange interventions following the criteria by K. Domínguez (1998 using a GARCH model based on the work by C. Broto (2012. Analyses are conducted to evaluate the FOREX rules of intervention followed by the BCCR, and the probability of occurrence of an intervention is estimated using a LOGIT model.  In addition, the paper attempts to analyze what happened to the exchange arrangements applied in Costa Rica as a result of the 2006 exchange rate flexibility and transition to inflation targets.

  5. Interventional procedures of the isolated iliac arterial aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Ohm, Joon Young [The Catholic Univ. of Korea College of Medicine, Bucheon (Korea, Republic of); Shin, Byung Seok; Ahn, Moon Sang [Chungnam National Univ. Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dankook Univ. Hospital, Cheonan (Korea, Republic of); Kim, Ho Jun [Konyang Univ. Hospital, Daejeon (Korea, Republic of)

    2012-05-15

    To report the results of treatment isolated iliac arterial aneurysms by interventional procedures. Over a period of 5 years, 7 isolated iliac artery aneurysms (4 in the common iliac artery, 3 in the internal iliac artery) in 7 patients (3 women, 4 men; mean age, 65.7 years) were treated using interventional procedures. The mean aneurysm size was 35 mm (range, 30-45 mm). The common iliac aneurysms were treated using a unilateral stent graft (2 balloon expandable, 2 self expandable) with coil embolization of the internal iliac artery (n = 3), except for 1 aneurysm that ruptured. Coil embolization alone was performed for aneurysms involving only the internal iliac artery (n = 3). All patients were treated successfully, except for 1 with an initial remnant of type 2 endoleak. There were no perioperative complications. No leakage or complication occurred at the mean follow up of 14 months (range 2-29 months). One patient with a ruptured aneurysm died of multi organ failure during the follow up period. Three aneurysms had decreased in size on follow up CT. Interventional procedures with stent grafting and coil embolization are safe and effective treatments for isolated iliac artery aneurysms.

  6. DSA diagnosis and interventional management of postoperative bleeding

    International Nuclear Information System (INIS)

    Li Yuwei; Zhang Fuqiang; Li Yunhui; Yuan Liang; Si Guangyan; Liu Lili

    2009-01-01

    Objective: To discuss the clinical application of DSA and interventional management in diagnosing and treating the bleeding after surgery. Methods: The clinical data and the interventional management of 14 patients with DSA-proved postoperative bleeding, encountered during the period of Aug. 2005-Jan. 2008, were retrospectively analyzed. The surgeries included subtotal gastrectomy (n=4), pancreatoduodenectomy (n=3), cesarean section (n=2), nephrolithotomy (n=3), heminephrectomy (n=1), internal hemorrhoidectomy (n=1). Results: Seventeen arterial bleeding sites were demonstrated, including gastroduodenal (n=2), left gastric (n=4), phrenic (n=1), short gastric (n=1), superior mesenteric (n=2), renal (n=4), uterine (n=2) and internal pudendal (n=1) artery. The diagnosis was confirmed with DSA in all 14 patients, of which embolization was successfully carried out in 13 in one session (92.8%). The remaining one case had to be operated again to stop the bleeding because of the failure of the superselective catheterization. No serious complications, such as organ necrosis or visceral dysfunction, occurred. Conclusion: As a safe, minimally-invasive and effective technique, DSA and interventional management are very helpful in diagnosing and treating the bleeding after surgery. (authors)

  7. Effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, T; Tønnesen, H; Møller, A M

    2009-01-01

    BACKGROUND: The aim of this study was to examine the effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation itself. METHODS: Relevant databases were searched for randomized controlled trials (RCTs) of preoperative smoking cessation interventions....... Trial inclusion, risk of bias assessment and data extraction were performed by two authors. Risk ratios for the above outcomes were calculated and pooled effects estimated using the fixed-effect method. RESULTS: Eleven RCTs were included containing 1194 patients. Smoking interventions were intensive......, medium intensity and less intensive. Follow-up for postoperative complications was 30 days. For smoking cessation it was from the day of surgery to 12 months thereafter. Overall, the interventions significantly reduced the occurrence of complications (pooled risk ratio 0.56 (95 per cent confidence...

  8. Congruence between patient characteristics and interventions may partly explain medication adherence intervention effectiveness: an analysis of 190 randomized controlled trials from a Cochrane systematic review.

    Science.gov (United States)

    Allemann, Samuel S; Nieuwlaat, Robby; Navarro, Tamara; Haynes, Brian; Hersberger, Kurt E; Arnet, Isabelle

    2017-11-01

    Due to the negative outcomes of medication nonadherence, interventions to improve adherence have been the focus of countless studies. The congruence between adherence-related patient characteristics and interventions may partly explain the variability of effectiveness in medication adherence studies. In their latest update of a Cochrane review reporting inconsistent effects of adherence interventions, the authors offered access to their database for subanalysis. We aimed to use this database to assess congruence between adherence-related patient characteristics and interventions and its association with intervention effects. We developed a congruence score consisting of six features related to inclusion criteria, patient characteristics at baseline, and intervention design. Two independent raters extracted and scored items from the 190 studies available in the Cochrane database. We correlated overall congruence score and individual features with intervention effects regarding adherence and clinical outcomes using Kruskal-Wallis rank sum test and Fisher's exact test. Interrater reliability for newly extracted data was almost perfect with a Cohen's Kappa of 0.92 [95% confidence interval (CI) = 0.89-0.94; P congruence score nor any other individual feature (i.e., "determinants of nonadherence as inclusion criteria," "tailoring of interventions to the inclusion criteria," "reasons for nonadherence assessed at baseline," "adjustment of intervention to individual patient needs," and "theory-based interventions") was significantly associated with intervention effects. The presence of only six studies that included nonadherent patients and the interdependency of this feature with the remaining five might preclude a conclusive assessment of congruence between patient characteristics and adherence interventions. In order to obtain clinical benefits from effective adherence interventions, we encourage researchers to focus on the inclusion of nonadherent patients. Copyright

  9. Effects of Integrated Health Management Intervention on Overweight and Obesity

    Directory of Open Access Journals (Sweden)

    Yiting Yang

    2017-01-01

    Full Text Available Overweight or obese adults aged 20~55 years and living in Beijing more than one year were randomly divided into different management groups. A one-year integrated health management intervention was applied in the health management groups. The physical indicators and metabolic indicators changed after one-year intervention on the overweight and obese adults. The annual reduction of the physical indicators was significant in all groups (p<0.05 except the weight loss in the placebo + general management group. The health management and the dietary supplement have statistically significant (p<0.001, p<0.001 effects on the annual reduction of these indicators and interactive effect between them was found on some of these indicators such as bodyweight, body mass index (BMI, body fat ratio (BFR, and hipline (p<0.05. The dietary supplement + health management group had the best annual reduction effects for the indicators among the groups. Integrated health management interventions including both dietary supplements intervention and health management could improve metabolic indicators in overweight and obese adults together with the physical indicators, suggesting the intermediated role of metabolic indictors in controlling obesity.

  10. From efficacy to effectiveness and beyond: what next for brief interventions in primary care?

    Directory of Open Access Journals (Sweden)

    Amy eO'Donnell

    2014-08-01

    Full Text Available Background: Robust evidence supports the effectiveness of screening and brief alcohol interventions in primary healthcare. However lack of understanding about their ‘active ingredients’ and concerns over the extent to which current approaches remain faithful to their original theoretical roots, has led some to demand a cautious approach to future roll-out pending further research. Against this background, this paper provides a timely overview of the development of the brief alcohol intervention evidence base in order to assess the extent to which it has achieved the four key levels of intervention research: efficacy; effectiveness; implementation; and demonstration.Methods: Narrative overview based on:(1 results of a review of systematic reviews and meta-analyses of the effectiveness of brief alcohol intervention in primary healthcare;(2 synthesis of the findings of key additional primary studies on the improvement and evaluation of brief alcohol intervention implementation in routine primary healthcare.Results: The brief intervention field seems to constitute an almost perfect example of the evaluation of a complex intervention. Early evaluations of screening and brief intervention approaches included more tightly controlled efficacy trials and have been followed by more pragmatic trials of effectiveness in routine clinical practice. Most recently, attention has shifted to dissemination, implementation and wider-scale roll-out. However, delivery in routine primary health remains inconsistent, with an identified knowledge gap around how to successfully embed brief alcohol intervention approaches in mainstream care, and as yet unanswered questions concerning what specific intervention component prompt the positive changes in alcohol consumption.Conclusion: Both the efficacy and effectiveness of brief alcohol interventions have been comprehensively demonstrated, and intervention effects seem replicable and stable over time, and across

  11. Effectiveness of nutritional intervention in overweight women in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nathália Luíza Ferreira

    2014-12-01

    Full Text Available Objective: To assess the effectiveness of nutritional intervention in overweight women undergoing Primary Health Care.Methods: An intervention study was conducted with overweight adult and elderly women aged 20 years or older (body mass index ≥25.0 kg/m² and ≥27.0 kg/m², respectively who were subjected to 12 months of individual nutritional monitoring. The effectiveness of the intervention was assessed by dietary, health, and anthropometric indicators.Results: Most of the 71 individuals were adults with a low income and poor level of education. After the intervention, there was an increase in number of meals and in the frequency of breakfasting. Moreover, there were more fruits and vegetables consumed, in addition to a decrease in household availability of salt, sugar, oil, and fried foods consumption. An improvement in health and weight self-perception was observed, as well as a decrease in body mass and abdominal adiposity, in particular among those participating in several consultations (n >9.Conclusion: The proposed nutritional intervention was effective and viable for improving the care of overweight individuals and those suffering from destabilized comorbidities, and may be extended to other contexts.

  12. Are Detox Diets Safe?

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Are Detox Diets Safe? KidsHealth / For Teens / Are Detox Diets ... seguras las dietas de desintoxicación? What Is a Detox Diet? The name sounds reassuring — everyone knows that ...

  13. Cognitive interventions in patients with dementia living in long-term care facilities: Systematic review and meta-analysis.

    Science.gov (United States)

    Folkerts, Ann-Kristin; Roheger, Mandy; Franklin, Jeremy; Middelstädt, Jennifer; Kalbe, Elke

    2017-11-01

    Previous reviews and meta-analyses demonstrated effects of cognitive interventions in dementia, but none specifically considered residents with dementia in long-term care (LTC) facilities. To analyse the efficacy of cognitive interventions in institutionalised individuals with dementia. After identifying 27 articles, a systematic review was performed. A meta-analysis was calculated for 15 studies of the randomized controlled trials regarding effects on relevant outcomes. Fixed-effects meta-analyses were conducted using standardized mean differences (SMD) of changes from baseline pooled using the inverse variance method. When comparing cognitive interventions to passive control groups, the meta-analysis revealed significant moderate effects on global cognition (SMD=0.47, 95% CI 0.27-0.67), autobiographical memory (0.67, 0.02-1.31), and behavioral and psychological symptoms in dementia (BPSD; 0.71, 0.06-1.36). Significant small effects were detected for quality of life (QoL; 0.37, 0.05-0.70). Moderate effects on activities of daily living (0.28; -0.02 to 0.58) failed to reach significance; no effects were found on depression (0.22; -0.08 to 0.51). Significant moderate effects of global cognition (0.55; 0.22-0.89) and depression (0.64; 0.21-1.07) were also found for cognitive interventions contrasting active control groups. No harmful events related to the participation in the interventions were observed. Cognitive interventions are safe and effective for residents with dementia in LTC. However, while it seems clear that cognitive benefits can specifially be assigned to these forms of intervention, further research is necessary to clarify whether the effects on BPSD and QoL reflect unspecific changes due to additional attention. Furthermore, future studies will have to determine which intervention type yields the largest benefits. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Examination of the Relationship between Psychosocial Mediators and Intervention Effects in It’s Your Game: An Effective HIV/STI/Pregnancy Prevention Intervention for Middle School Students

    Directory of Open Access Journals (Sweden)

    Elizabeth Baumler

    2012-01-01

    Full Text Available A set of mediation analyses were carried out in this study using data from It’s Your Game. . .Keep It Real (IYG, a successful HIV/STI/pregnancy prevention program. The IYG study evaluated a skill and normbased. HIV/STI/pregnancy prevention program that was implemented from 2004 to 2007 among 907 urban low-income middle school youth in Houston, TX, USA. Analyses were carried out to investigate the degree to which a set of proposed psychosocial measures of behavioral knowledge, perceived self-efficacy, behavioral, and normative beliefs, and perceived risky situations, all targeted by the intervention, mediated the intervention’s effectiveness in reducing initiation of sex. The mediation process was assessed by examining the significance and size of the estimated effects from the mediating pathways. The findings from this study provide evidence that the majority of the psychosocial mediators targeted by the IYG intervention are indeed related to the desired behavior and provide evidence that the conceptual theory underlying the targeted psychosocial mediators in the intervention is appropriate. Two of the psychosocial mediators significantly mediated the intervention effect, knowledge of STI signs and symptoms and refusal self-efficacy. This study suggests that the underlying causal mechanisms of action of these interventions are complex and warrant further analyses.

  15. Ergonomic Chair Explorative Intervention Study: Effect on Chronic ...

    African Journals Online (AJOL)

    Ergonomic Chair Explorative Intervention Study: Effect on Chronic Upper ... they are associated with a complex relationship between individual, work-related and ... in chronic upper quadrant musculoskeletal dysfunction and work productivity ...

  16. The effects on student health of interventions modifying the school environment: systematic review.

    Science.gov (United States)

    Bonell, C; Wells, H; Harden, A; Jamal, F; Fletcher, A; Thomas, J; Campbell, R; Petticrew, M; Whitehead, M; Murphy, S; Moore, L

    2013-08-01

    Owing to the limited effectiveness of traditional health education curricula in schools, there is increasing interest in interventions aiming to promote young people's health by modifying the school environment. Existing systematic reviews cannot determine whether environmental intervention is effective because they examine interventions combining environmental modifications and traditional health education. This gap is significant because school-environment interventions are complex to implement and may be sidelined in underfunded and attainment-focused school systems without evidence to support such an approach. This systematic review examined the effectiveness of school-environment interventions without health-education components on student health and inequalities. This was a systematic review of experimental/quasi-experimental studies of school-environment interventions. Sixteen databases were searched, eliciting 62 329 references which were screened, with included studies quality assessed, data extracted and narratively synthesised. Sixteen reports of 10 studies were included, all from the USA and the UK. Five evaluations of interventions aiming to develop a stronger sense of community and/or improve relationships between staff and students suggested potential benefits particularly regarding violence and aggression. Two trials of interventions enabling students to advocate for changes in school catering and physical activity reported benefits for physical activity but not diet. Three evaluations of improvements to school playgrounds offered weak evidence of effects on physical activity. School environment interventions show the potential to improve young people's health particularly regarding violence, aggression and physical activity. Further trials are required to provide a stronger and more generalisable evidence base.

  17. Effects of Critical Thinking Intervention for Early Childhood Teacher Candidates

    Science.gov (United States)

    Han, Heejeong Sophia; Brown, E. Todd

    2013-01-01

    This study is based on an intervention designed to enhance early childhood teacher candidates' critical thinking abilities. The concept, elements, standards, and traits of critical thinking were integrated into the main course contents, and the effects of the intervention were examined. The results indicated that early childhood teacher…

  18. Effects of irritant chemicals on Aedes aegypti resting behavior: is there a simple shift to untreated "safe sites"?

    Directory of Open Access Journals (Sweden)

    Hortance Manda

    2011-07-01

    Full Text Available BACKGROUND: Previous studies have identified the behavioral responses of Aedes aegypti to irritant and repellent chemicals that can be exploited to reduce man-vector contact. Maximum efficacy of interventions based on irritant chemical actions will, however, require full knowledge of variables that influence vector resting behavior and how untreated "safe sites" contribute to overall impact. METHODS: Using a laboratory box assay, resting patterns of two population strains of female Ae. aegypti (THAI and PERU were evaluated against two material types (cotton and polyester at various dark:light surface area coverage (SAC ratio and contrast configuration (horizontal and vertical under chemical-free and treated conditions. Chemicals evaluated were alphacypermethrin and DDT at varying concentrations. RESULTS: Under chemical-free conditions, dark material had significantly higher resting counts compared to light material at all SAC, and significantly increased when material was in horizontal configuration. Cotton elicited stronger response than polyester. Within the treatment assays, significantly higher resting counts were observed on chemical-treated dark material compared to untreated light fabric. However, compared to matched controls, significantly less resting observations were made on chemical-treated dark material overall. Most importantly, resting observations on untreated light material (or "safe sites" in the treatment assay did not significantly increase for many of the tests, even at 25% SAC. Knockdown rates were ≤5% for all assays. Significantly more observations of flying mosquitoes were made in test assays under chemical-treatment conditions as compared to controls. CONCLUSIONS/SIGNIFICANCE: When preferred Ae. aegypti resting sites are treated with chemicals, even at reduced treatment coverage area, mosquitoes do not simply move to safe sites (untreated areas following contact with the treated material. Instead, they become agitated

  19. Effects of a performance and quality improvement intervention on the work environment in HIV-related care: a quasi-experimental evaluation in Zambia.

    Science.gov (United States)

    Bazant, Eva; Sarkar, Supriya; Banda, Joseph; Kanjipite, Webby; Reinhardt, Stephanie; Shasulwe, Hildah; Mulilo, Joyce Monica Chongo; Kim, Young Mi

    2014-12-20

    Human resource shortages and reforms in HIV-related care make it challenging for frontline health care providers in southern Africa to deliver high-quality services. At health facilities of the Zambian Defence Forces, a performance and quality improvement approach was implemented to improve HIV-related care and was evaluated in 2010/2011. Changes in providers' work environment and perceived quality of HIV-related care were assessed to complement data of provider performance. The intervention involved on-site training, supportive supervision, and action planning focusing on detailed service delivery standards. The quasi-experimental evaluation collected pre- and post-intervention data from eight intervention and comparison facilities matched on defence force branch and baseline client volume. Overall, 101 providers responded to a 24-item questionnaire on the work environment, covering topics of drugs, supplies, and equipment; training, feedback, and supervision; compensation; staffing; safety; fulfilment; and HIV services quality. In bivariate analysis and multivariate analyses, we assessed changes within each study group and between the two groups. In the bivariate analysis, the intervention group providers reported improvements in the work environment on adequacy of equipment, feeling safe from harm, confidence in clinical skills, and reduced isolation, while the comparison group reported worsening of the work environment on supplies, training, safety, and departmental morale.In the multivariate analysis, the intervention group's improvement and the comparison group's decline were significant on perceived adequacy of drugs, supplies, and equipment; constructive feedback received from supervisor and co-workers; and feeling safe from physical harm (all P equipment). Further, the item "provider lacks confidence in some clinical skills" declined in the intervention group but increased in the comparison group (P = -0.005). In multivariate analysis, changes in perceived

  20. Endovascular interventions for multiple trauma

    International Nuclear Information System (INIS)

    Kinstner, C.; Funovics, M.

    2014-01-01

    In recent years interventional radiology has significantly changed the management of injured patients with multiple trauma. Currently nearly all vessels can be reached within a reasonably short time with the help of specially preshaped catheters and guide wires to achieve bleeding control of arterial und venous bleeding. Whereas bleeding control formerly required extensive open surgery, current interventional methods allow temporary vessel occlusion (occlusion balloons), permanent embolization and stenting. In injured patients with multiple trauma preinterventional procedural planning is performed with the help of multidetector computed tomography whenever possible. Interventional radiology not only allows minimization of therapeutic trauma but also a considerably shorter treatment time. Interventional bleeding control has developed into a standard method in the management of vascular trauma of the chest and abdomen as well as in vascular injuries of the upper and lower extremities when open surgical access is associated with increased risk. Additionally, pelvic trauma, vascular trauma of the superior thoracic aperture and parenchymal arterial lacerations of organs that can be at least partially preserved are primarily managed by interventional methods. In an interdisciplinary setting interventional radiology provides a safe and efficient means of rapid bleeding control in nearly all vascular territories in addition to open surgical access. (orig.) [de

  1. [Radiation protection in interventional radiology].

    Science.gov (United States)

    Adamus, R; Loose, R; Wucherer, M; Uder, M; Galster, M

    2016-03-01

    The application of ionizing radiation in medicine seems to be a safe procedure for patients as well as for occupational exposition to personnel. The developments in interventional radiology with fluoroscopy and dose-intensive interventions require intensified radiation protection. It is recommended that all available tools should be used for this purpose. Besides the options for instruments, x‑ray protection at the intervention table must be intensively practiced with lead aprons and mounted lead glass. A special focus on eye protection to prevent cataracts is also recommended. The development of cataracts might no longer be deterministic, as confirmed by new data; therefore, the International Commission on Radiological Protection (ICRP) has lowered the threshold dose value for eyes from 150 mSv/year to 20 mSv/year. Measurements show that the new values can be achieved by applying all X‑ray protection measures plus lead-containing eyeglasses.

  2. Safe Anesthesia For Every Tot

    DEFF Research Database (Denmark)

    Weiss, Markus; Vutskits, Laszlo; Hansen, Tom G

    2015-01-01

    PURPOSE OF REVIEW: The term 'safe use of anesthesia in children is ill-defined and requires definition of and focus on the 'safe conduct of pediatric anesthesia'. RECENT FINDINGS: The Safe Anesthesia For Every Tot initiative (www.safetots.org) has been set up during the last year to focus...... on the safe conduct of pediatric anesthesia. This initiative aims to provide guidance on markers of quality anesthesia care. The introduction and implementation of national regulations of 'who, where, when and how' are required and will result in an improved perioperative outcome in vulnerable children....... The improvement of teaching, training, education and supervision of the safe conduct of pediatric anesthesia are the main goals of the safetots.org initiative. SUMMARY: This initiative addresses the well known perioperative risks in young children, perioperative causes for cerebral morbidity as well as gaps...

  3. Reducing musculoskeletal discomfort: effects of an office ergonomics workplace and training intervention.

    Science.gov (United States)

    Robertson, Michelle M; O'Neill, Michael J

    2003-01-01

    Effects of an office ergonomics workplace and training intervention on workers' knowledge and self-reported musculoskeletal pain and discomfort were investigated. An instructional systems design process was used to develop an office ergonomics training program and the evaluation tools used to measure the effectiveness of the training program on workers' office ergonomics knowledge and skills. It was hypothesized that the training and workplace intervention would allow the worker to more effectively use their workplace through increased office ergonomics knowledge and skills. Following the intervention, there was a significant increase in workers' office ergonomics knowledge and awareness. Self-reported work-related musculoskeletal disorders significantly decreased for the group who had a workplace change and received ergonomic training relative to a workplace change-only group and a no intervention control group.

  4. Cost-effectiveness of interventions to prevent cardiovascular disease in Australia's indigenous population.

    Science.gov (United States)

    Ong, Katherine S; Carter, Rob; Vos, Theo; Kelaher, Margaret; Anderson, Ian

    2014-05-01

    Cardiovascular disease is the leading cause of disease burden in Australia's Indigenous population, and the greatest contributor to the Indigenous 'health gap'. Economic evidence can help identify interventions that efficiently address this discrepancy. Five interventions (one community-based and four pharmacological) to prevent cardiovascular disease in Australia's Indigenous population were subject to economic evaluation. Pharmacological interventions were evaluated as delivered either via Aboriginal Community Controlled Health Services or mainstream general practitioner services. Cost-utility analysis methods were used, with health benefit measured in disability-adjusted life-years saved. All pharmacological interventions produced more Indigenous health benefit when delivered via Indigenous health services, but cost-effectiveness ratios were higher due to greater health service costs. Cost-effectiveness ratios were also higher in remote than in non-remote regions. The polypill was the most cost-effective intervention evaluated, while the community-based intervention produced the most health gain. Local and decision-making contextual factors are important in the conduct and interpretation of economic evaluations. For Australia's Indigenous population, different models of health service provision impact on reach and cost-effectiveness results. Both the extent of health gain and cost-effectiveness are important considerations for policy-makers in light of government objectives to address health inequities and bridge the health gap. Copyright © 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

  5. Costs and cost-effectiveness of malaria control interventions - a systematic review

    Directory of Open Access Journals (Sweden)

    White Michael T

    2011-11-01

    Full Text Available Abstract Background The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs, indoor residual spraying (IRS, intermittent preventive treatment (IPT, diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. Methods A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. Results Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54 for ITNs, $6.70 (range $2.22-$12.85 for IRS, $0.60 (range $0.48-$1.08 for IPT in infants, $4.03 (range $1.25-$11.80 for IPT in children, and $2.06 (range $0.47-$3.36 for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34. The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65 and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87. Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110 for ITNs, $143 (range $135

  6. Interventions to mitigate the effects of poverty and inequality on mental health.

    Science.gov (United States)

    Wahlbeck, Kristian; Cresswell-Smith, Johanna; Haaramo, Peija; Parkkonen, Johannes

    2017-05-01

    To review psychosocial and policy interventions which mitigate the effects of poverty and inequality on mental health. Systematic reviews, controlled trials and realist evaluations of the last 10 years are reviewed, without age or geographical restrictions. Effective psychosocial interventions on individual and family level, such as parenting support programmes, exist. The evidence for mental health impact of broader community-based interventions, e.g. community outreach workers, or service-based interventions, e.g. social prescribing and debt advice is scarce. Likewise, the availability of evidence for the mental health impact of policy level interventions, such as poverty alleviation or youth guarantee, is quite restricted. The social, economic, and physical environments in which people live shape mental health and many common mental disorders. There are effective early interventions to promote mental health in vulnerable groups, but it is necessary to both initiate and facilitate a cross-sectoral approach, and to form partnerships between different government departments, civic society organisations and other stakeholders. This approach is referred to as Mental Health in All Policies and it can be applied to all public policy levels from local policies to supranational.

  7. HRD Interventions, Employee Competencies and Organizational Effectiveness: An Empirical Study

    Science.gov (United States)

    Potnuru, Rama Krishna Gupta; Sahoo, Chandan Kumar

    2016-01-01

    Purpose: The purpose of the study is to examine the impact of human resource development (HRD) interventions on organizational effectiveness by means of employee competencies which are built by some of the selected HRD interventions. Design/methodology/approach: An integrated research model has been developed by combining the principal factors…

  8. Evaluating SafeClub: can risk management training improve the safety activities of community soccer clubs?

    Science.gov (United States)

    Abbott, K; Klarenaar, P; Donaldson, A; Sherker, S

    2008-06-01

    To evaluate a sports safety-focused risk-management training programme. Controlled before and after test. Four community soccer associations in Sydney, Australia. 76 clubs (32 intervention, 44 control) at baseline, and 67 clubs (27 intervention, 40 control) at post-season and 12-month follow-ups. SafeClub, a sports safety-focused risk-management training programme (3x2 hour sessions) based on adult-learning principles and injury-prevention concepts and models. Changes in mean policy, infrastructure and overall safety scores as measured using a modified version of the Sports Safety Audit Tool. There was no significant difference in the mean policy, infrastructure and overall safety scores of intervention and control clubs at baseline. Intervention clubs achieved higher post-season mean policy (11.9 intervention vs 7.5 controls), infrastructure (15.2 vs 10.3) and overall safety (27.0 vs 17.8) scores than did controls. These differences were greater at the 12-month follow-up: policy (16.4 vs 7.6); infrastructure (24.7 vs 10.7); and overall safety (41.1 vs 18.3). General linear modelling indicated that intervention clubs achieved statistically significantly higher policy (prisk-management practice, in a sustainable way.

  9. Effectiveness of online word of mouth on exposure to an Internet-delivered intervention.

    Science.gov (United States)

    Crutzen, Rik; de Nooijer, Jascha; Brouwer, Wendy; Oenema, Anke; Brug, Johannes; de Vries, Nanne

    2009-07-01

    The use of online word of mouth (WOM) seems a promising strategy to motivate young people to visit Internet-delivered interventions. An Internet-delivered intervention aimed at changing implicit attitudes related to alcohol was used in two experiments to test effectiveness of e-mail invitations on a first visit to the intervention. The results of the first experiment (N = 196) showed that an invitation by e-mail from a friend was more effective to attract young adults (aged 18-24 years) to the intervention website than an invitation from an institution. A 2 x 2 design was used in the second experiment (N = 236) to test manipulations of argument strength and the use of peripheral cues in invitations. Results showed that weak arguments were more effective to attract young adults to the intervention website when an incentive was withheld. These results need to be taken into account when using online WOM as a strategy to improve exposure to Internet-delivered interventions.

  10. Effect of music intervention on apathy in nursing home residents with dementia.

    Science.gov (United States)

    Tang, Qiubi; Zhou, Ying; Yang, Shuixian; Thomas, Wong Kwok Shing; Smith, Graeme D; Yang, Zhi; Yuan, Lexin; Chung, Joanne Wai-Yee

    2018-03-15

    This study examined the effectiveness of group music intervention in the treatment of nursing home residents with apathy. Apathy can clinically defined with a score of 40 or above on the apathy evaluation scale (AES). Seventy-seven residents were randomly assigned to the intervention or control group. The intervention group was given a music intervention programme, which included listening to traditional music, including nostalgic songs, and playing musical instruments three times a week, for a total of twelve weeks. Results demonstrated a decrease in apathy scores in the intervention group (z = 4.667, P  0.05). Cognitive function, as assessed by Mini Mental State Examination (MMSE) score, was stable in the intervention group (t = 1.720, P > 0.05), but declined in the control group (t = -1.973, P <0.05). We conclude that music intervention has the potential to be an effective therapy for the treatment of apathy in the early stages of dementia. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Development, Implementation and Evaluation of an Educational Intervention to Prevent Low Speed Vehicle Run-Over Events: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Bronwyn Griffin

    2018-04-01

    Full Text Available There is a growing body of literature regarding low speed vehicle runover (LSVRO events among children. To date, no literature exists on evaluation of interventions to address this serious childhood injury. Knowledge, attitudes, and behaviour regarding LSVROs were assessed via survey at a shopping centre (pre-intervention, then five months later (post-intervention, to investigate the effect of a population level educational intervention in Queensland, Australia. Participants’ knowledge regarding frequency of LSVRO events was poor. No participant demonstrated ‘adequate behaviour’ in relation to four safe driveway behaviours pre-intervention; this increased at post-intervention (p < 0.05. Most of the sample perceived other’s driveway behaviour as inadequate, and this reduced significantly (<0.05. Perceived effectiveness of LSVRO prevention strategies increased from pre- to post-intervention, but not significantly. TV was the greatest source of knowledge regarding LSVROs pre- and post-intervention. This study provides some evidence that the educational campaign and opportunistic media engagement were successful in increasing awareness and improving behaviour regarding LSVROs. While there are several limitations to this study, our experience reflects the ‘real-world’ challenges associated with implementing prevention strategies. We suggest a multi-faceted approach involving media (including social media, legislative changes, subsidies (for reversing cameras, and education to prevent LSVROs.

  12. Effects of an intensive data-based decision making intervention on teacher efficacy

    NARCIS (Netherlands)

    van der Scheer, Emmelien; Visscher, Arend J.

    2016-01-01

    Research into the effects of interventions on teacher efficacy is scarce. In this study, the long-term effects of an intensive data-based decision making intervention on teacher efficacy of mainly grade 4 teachers were investigated by means of a delayed treatment control group design (62 teachers).

  13. Effectiveness of Occupational Therapy Interventions for Lower-Extremity Musculoskeletal Disorders: A Systematic Review.

    Science.gov (United States)

    Dorsey, Julie; Bradshaw, Michelle

    Lower-extremity (LE) musculoskeletal disorders (MSDs) can have a major impact on the ability to carry out daily activities. The effectiveness of interventions must be examined to enable occupational therapy practitioners to deliver the most appropriate services. This systematic review examined the literature published between 1995 and July 2014 that investigated the effectiveness of occupational therapy interventions for LE MSDs. Forty-three articles met the criteria and were reviewed. Occupational therapy interventions varied on the basis of population subgroup: hip fracture, LE joint replacement, LE amputation or limb loss, and nonsurgical osteoarthritis and pain. The results indicate an overall strong role for occupational therapy in treating clients with LE MSDs. Activity pacing is an effective intervention for nonsurgical LE MSDs, and multidisciplinary rehabilitation is effective for LE joint replacement and amputation. Further research on specific occupational therapy interventions in this important area is needed. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  14. A cost-effectiveness threshold analysis of a multidisciplinary structured educational intervention in pediatric asthma.

    Science.gov (United States)

    Rodriguez-Martinez, Carlos E; Sossa-Briceño, Monica P; Castro-Rodriguez, Jose A

    2018-05-01

    Asthma educational interventions have been shown to improve several clinically and economically important outcomes. However, these interventions are costly in themselves and could lead to even higher disease costs. A cost-effectiveness threshold analysis would be helpful in determining the threshold value of the cost of educational interventions, leading to these interventions being cost-effective. The aim of the present study was to perform a cost-effectiveness threshold analysis to determine the level at which the cost of a pediatric asthma educational intervention would be cost-effective and cost-saving. A Markov-type model was developed in order to estimate costs and health outcomes of a simulated cohort of pediatric patients with persistent asthma treated over a 12-month period. Effectiveness parameters were obtained from a single uncontrolled before-and-after study performed with Colombian asthmatic children. Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable "quality-adjusted life-years" (QALYs). A deterministic threshold sensitivity analysis showed that the asthma educational intervention will be cost-saving to the health system if its cost is under US$513.20. Additionally, the analysis showed that the cost of the intervention would have to be below US$967.40 in order to be cost-effective. This study identified the level at which the cost of a pediatric asthma educational intervention will be cost-effective and cost-saving for the health system in Colombia. Our findings could be a useful aid for decision makers in efficiently allocating limited resources when planning asthma educational interventions for pediatric patients.

  15. Effects of Career Choice Intervention on Components of Career Preparation

    Science.gov (United States)

    Koivisto, Petri; Vinokur, Amiram D.; Vuori, Jukka

    2011-01-01

    This randomized experimental study (N = 1,034) examines both the direct and the indirect effects of the Towards Working Life intervention on 2 components of adolescents' career preparation: preparedness for career choice and attitude toward career planning. The intervention comprised a 1-week workshop program, the proximal goals of which were to…

  16. Can basic life support personnel safely determine that advanced life support is not needed?

    Science.gov (United States)

    Cone, D C; Wydro, G C

    2001-01-01

    To determine whether firefighter/emergency medical technicians-basic (FF/EMT-Bs) staffing basic life support (BLS) ambulances in a two-tiered emergency medical services (EMS) system can safely determine when advanced life support (ALS) is not needed. This was a prospective, observational study conducted in two academic emergency departments (EDs) receiving patients from a large urban fire-based EMS system. Runs were studied to which ALS and BLS ambulances were simultaneously dispatched, with the patient transported by the BLS unit. Prospectively established criteria for potential need for ALS were used to determine whether the FF/EMT-B's decision to cancel the ALS unit was safe, and simple outcomes (admission rate, length of stay, mortality) were examined. In the system studied, BLS crews may cancel responding ALS units at their discretion; there are no protocols or medical criteria for cancellation. A convenience sample of 69 cases was collected. In 52 cases (75%), the BLS providers indicated that they cancelled the responding ALS unit because they did not feel ALS was needed. Of these, 40 (77%) met study criteria for ALS: 39 had potentially serious chief complaints, nine had abnormal vital signs, and ten had physical exam findings that warranted ALS. Forty-five (87%) received an intervention immediately upon ED arrival that could have been provided in the field by an ALS unit, and 16 (31%) were admitted, with a median length of stay of 3.3 days (range 1.1-73.4 days). One patient died. Firefighter/EMT-Bs, working without protocols or medical criteria, cannot always safely determine which patients may require ALS intervention.

  17. Being safe: making the decision to have a planned home birth in the United States.

    Science.gov (United States)

    Lothian, Judith A

    2013-01-01

    Although there is evidence that supports the safety of planned home birth for healthy women, less than 1 percent of women in the United States choose to have their baby at home. An ethnographic study of the experience of planned home birth provided rich descriptions of women's experiences planning, preparing for, and having a home birth.This article describes findings related to how women make the decision to have a planned home birth. For these women, being safe emerged as central in making the decision. For them, being safe included four factors: avoiding technological birth interventions, knowing the midwife and the midwife knowing them, feeling comfortable and protected at home, and knowing that backup hospital medical care was accessible if needed.

  18. A review of the nature and effectiveness of nutrition interventions in adult males – a guide for intervention strategies

    Directory of Open Access Journals (Sweden)

    Taylor Pennie J

    2013-01-01

    Full Text Available Abstract Background Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. Methods A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1 published from January 1990 to August 2011 and 2 male only studies (≥18 years or 3 where males contributed to >90% of the active cohort. A study must have described, (i a significant change (p Results Nine studies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg and/or BMI (kg/m2 changes (p≤0.05. Four studies had effective interventions (p Intervention features, which appeared to be associated with better outcomes, include the delivery of quantitative information on diet and the use of self-monitoring and tailored feedback. Conclusion Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to

  19. Effectiveness of a Pregnancy Smoking Intervention: The Tennessee Intervention for Pregnant Smokers Program

    Science.gov (United States)

    Bailey, Beth A.

    2015-01-01

    Despite the known dangers of pregnancy smoking, rates remain high, especially in the rural, Southern United States. Interventions are effective, but few have been developed and tested in regions with high rates of pregnancy smoking, a culture that normalizes smoking, and a hard-to-reach prenatal population. The goals were to describe a smoking…

  20. Use of WALLANT technique in hand surgery, safe and advantageous. Personal experience

    Directory of Open Access Journals (Sweden)

    Mihaela Pertea

    2018-05-01

    Full Text Available Objectives. To confirm the efficiency of using local anesthesia with lidocaine and epinephrine in hand surgery. Materials and methods. 75 patients in whom we used local anesthesia with 1% lidocaine and epinephrine in solution 1: 100 000. We evaluated the amount of used anesthetic, the time to onset of anesthesia, intraoperative bleeding, the duration of intervention and hospitalization, immediate postoperative complications. Results. It has been no case of digital necrosis or other vascular complications and no intraoperative bleeding. The amount of the used anesthetic varied. In no case it was necessary to use of phentolamine as an antidote to the effects of adrenaline. Conclusions. Wide awake local anesthesia no tourniquet technique is safe, having many advantages: it is not necessary to use the tourniquet with or without intravenous sedation, the surgeon and patient comfort is maximum, there is no risk of digital necrosis, hospitalization time is short and the costs are minimal.

  1. Working safely in gamma radiography. A training manual for industrial radiographers

    International Nuclear Information System (INIS)

    McGuire, S.A.; Peabody, C.A.

    1982-09-01

    This manual is designed for classroom training in working safely in industrial radiography using gamma sources. The purpose is to train radiographers' assistants to work safely as a qualified gamma radiographer. The contents cover the essentials of radiation, radiation protection, emergency procedures, gamma cameras, and biological effects of radiation

  2. Effect of a ball skill intervention on children's ball skills and cognitive functions.

    Science.gov (United States)

    Westendorp, Marieke; Houwen, Suzanne; Hartman, Esther; Mombarg, Remo; Smith, Joanne; Visscher, Chris

    2014-02-01

    This study examined the effect of a 16-wk ball skill intervention on the ball skills, executive functioning (in terms of problem solving and cognitive flexibility), and in how far improved executive functioning leads to improved reading and mathematics performance of children with learning disorders. Ninety-one children with learning disorders (age 7-11 yr old) were recruited from six classes in a Dutch special-needs primary school. The six classes were assigned randomly either to the intervention or to the control group. The control group received the school's regular physical education lessons. In the intervention group, ball skills were practiced in relative static, simple settings as well as in more dynamic and cognitive demanding settings. Both groups received two 40-min lessons per week. Children's scores on the Test of Gross Motor Development-2 (ball skills), Tower of London (problem solving), Trail Making Test (cognitive flexibility), Dutch Analysis of Individual Word Forms (reading), and the Dutch World in Numbers test (mathematics) at pretest, posttest, and retention test were used to examine intervention effects. The results showed that the intervention group significantly improved their ball skills, whereas the control group did not. No intervention effects were found on the cognitive parameters. However, within the intervention group, a positive relationship (r = 0.41, P = 0.007) was found between the change in ball skill performance and the change in problem solving: the larger children's improvement in ball skills, the larger their improvement in problem solving. The present ball skill intervention is an effective instrument to improve the ball skills of children with learning disorders. Further research is needed to examine the effect of the ball skill intervention on the cognitive parameters in this population.

  3. Interventions to Mitigate the Psychological Effects of Media Violence on Aggressive Behavior.

    Science.gov (United States)

    Eron, Leonard D.

    1986-01-01

    Describes and evaluates attempts to mitigate effect that watching television violence has on young children. Most relevant studies have been laboratory experiments, and there is no reported evidence that any intervention has been effective over long-term. Concludes that interventions combining cognitive and behavioral approaches have most promise,…

  4. Commercial experience with facility deactivation to safe storage

    Energy Technology Data Exchange (ETDEWEB)

    Sype, T.T. [Sandia National Labs., Albuquerque, NM (United States); Fischer, S.R. [Los Alamos National Lab., NM (United States); Lee, J.H. Jr.; Sanchez, L.C.; Ottinger, C.A.; Pirtle, G.J. [Sandia National Labs., Albuquerque, NM (United States)

    1995-09-01

    The Department of Energy (DOE) has shutdown many production reactors; the Department has begun a major effort to also shutdown a wide variety of other nuclear facilities. Because so many facilities are being closed, it is necessary to place many of them into a safe- storage status, i.e., deactivation, before conducting decommissioning- for perhaps as long as 20 years. The challenge is to achieve this safe-storage condition in a cost-effective manner while remaining in compliance with applicable regulations. The DOE Office of Environmental Management, Office of Transition and Management, commissioned a lessons-learned study of commercial experience with safe storage and decommissioning. Although the majority of the commercial experience has been with reactors, many of the lessons learned presented in this document can provide insight into transitioning challenges that Will be faced by the DOE weapons complex.

  5. Commercial experience with facility deactivation to safe storage

    International Nuclear Information System (INIS)

    Sype, T.T.; Fischer, S.R.; Lee, J.H. Jr.; Sanchez, L.C.; Ottinger, C.A.; Pirtle, G.J.

    1995-09-01

    The Department of Energy (DOE) has shutdown many production reactors; the Department has begun a major effort to also shutdown a wide variety of other nuclear facilities. Because so many facilities are being closed, it is necessary to place many of them into a safe- storage status, i.e., deactivation, before conducting decommissioning- for perhaps as long as 20 years. The challenge is to achieve this safe-storage condition in a cost-effective manner while remaining in compliance with applicable regulations. The DOE Office of Environmental Management, Office of Transition and Management, commissioned a lessons-learned study of commercial experience with safe storage and decommissioning. Although the majority of the commercial experience has been with reactors, many of the lessons learned presented in this document can provide insight into transitioning challenges that Will be faced by the DOE weapons complex

  6. Effectiveness of an intervention for reducing social stigma towards mental illness in adolescents.

    Science.gov (United States)

    Vila-Badia, Regina; Martínez-Zambrano, Francisco; Arenas, Otilia; Casas-Anguera, Emma; García-Morales, Esther; Villellas, Raúl; Martín, José Ramón; Pérez-Franco, María Belén; Valduciel, Tamara; Casellas, Diana; García-Franco, Mar; Miguel, Jose; Balsera, Joaquim; Pascual, Gemma; Julia, Eugènia; Ochoa, Susana

    2016-06-22

    To evaluate the effectiveness of an intervention for reducing social stigma towards mental illness in adolescents. The effect of gender and knowledge of someone with mental illness was measured. Two hundred and eighty secondary school students were evaluated using the Community Attitudes towards Mental Illness (CAMI) questionnaire. The schools were randomized and some received the intervention and others acted as the control group. The programme consisted of providing information via a documentary film and of contact with healthcare staff in order to reduce the social stigma within the school environment. The intervention was effective in reducing the CAMI authoritarianism and social restrictiveness subscales. The intervention showed significant changes in girls in terms of authoritarianism and social restrictiveness, while boys only showed significant changes in authoritarianism. Following the intervention, a significant reduction was found in authoritarianism and social restrictiveness in those who knew someone with mental illness, and only in authoritarianism in those who did not know anyone with mental illness. The intervention was effective to reduce social stigma towards people with mental illness, especially in the area of authoritarianism. Some differences were found depending on gender and whether or not the subjects knew someone with mental illness.

  7. Effects of falls prevention interventions on falls outcomes for hospitalised adults: protocol for a systematic review with meta-analysis.

    Science.gov (United States)

    Slade, Susan C; Carey, David L; Hill, Anne-Marie; Morris, Meg E

    2017-11-12

    Falls are a major global public health problem and leading cause of accidental or unintentional injury and hospitalisation. Falls in hospital are associated with longer length of stay, readmissions and poor outcomes. Falls prevention is informed by knowledge of reversible falls risk factors and accurate risk identification. The extent to which hospital falls are prevented by evidence-based practice, patient self-management initiatives, environmental modifications and optimisation of falls prevention systems awaits confirmation. Published reviews have mainly evaluated community settings and residential care facilities. A better understanding of hospital falls and the most effective strategies to prevent them is vital to keeping people safe. To evaluate the effectiveness of falls prevention interventions on reducing falls in hospitalised adults (acute and subacute wards, rehabilitation, mental health, operating theatre and emergency departments). We also summarise components of effective falls prevention interventions. This protocol has been registered. The systematic review will be informed by Cochrane guidelines and reported according to the Preferred Reporting Items for Systematic review and Meta-Analysis statement. randomised controlled trials, quasi-randomised trials or controlled clinical trials that evaluate falls prevention interventions for use by hospitalised adults or employees. Electronic databases will be searched using key terms including falls, accidental falls, prevention, hospital, rehabilitation, emergency, mental health, acute and subacute. Pairs of independent reviewers will conduct all review steps. Included studies will be evaluated for risk of bias. Data for variables such as age, participant characteristics, settings and interventions will be extracted and analysed with descriptive statistics and meta-analysis where possible. The results will be presented textually, with flow charts, summary tables, statistical analysis (and meta

  8. Are Social Networking Sites Making Health Behavior Change Interventions More Effective? A Meta-Analytic Review.

    Science.gov (United States)

    Yang, Qinghua

    2017-03-01

    The increasing popularity of social networking sites (SNSs) has drawn scholarly attention in recent years, and a large amount of efforts have been made in applying SNSs to health behavior change interventions. However, these interventions showed mixed results, with a large variance of effect sizes in Cohen's d ranging from -1.17 to 1.28. To provide a better understanding of SNS-based interventions' effectiveness, a meta-analysis of 21 studies examining the effects of health interventions using SNS was conducted. Results indicated that health behavior change interventions using SNS are effective in general, but the effects were moderated by health topic, methodological features, and participant features. Theoretical and practical implications of findings are discussed.

  9. Long-term effectiveness and cost-effectiveness of smoking cessation interventions in patients with COPD.

    Science.gov (United States)

    Hoogendoorn, Martine; Feenstra, Talitha L; Hoogenveen, Rudolf T; Rutten-van Mölken, Maureen P M H

    2010-08-01

    The aim of this study was to estimate the long-term (cost-) effectiveness of smoking cessation interventions for patients with chronic obstructive pulmonary disease (COPD). A systematic review was performed of randomised controlled trials on smoking cessation interventions in patients with COPD reporting 12-month biochemical validated abstinence rates. The different interventions were grouped into four categories: usual care, minimal counselling, intensive counselling and intensive counselling + pharmacotherapy ('pharmacotherapy'). For each category the average 12-month continuous abstinence rate and intervention costs were estimated. A dynamic population model for COPD was used to project the long-term (cost-) effectiveness (25 years) of 1-year implementation of the interventions for 50% of the patients with COPD who smoked compared with usual care. Uncertainty and one-way sensitivity analyses were performed for variations in the calculation of the abstinence rates, the type of projection, intervention costs and discount rates. Nine studies were selected. The average 12-month continuous abstinence rates were estimated to be 1.4% for usual care, 2.6% for minimal counselling, 6.0% for intensive counselling and 12.3% for pharmacotherapy. Compared with usual care, the costs per quality-adjusted life year (QALY) gained for minimal counselling, intensive counselling and pharmacotherapy were euro 16 900, euro 8200 and euro 2400, respectively. The results were most sensitive to variations in the estimation of the abstinence rates and discount rates. Compared with usual care, intensive counselling and pharmacotherapy resulted in low costs per QALY gained with ratios comparable to results for smoking cessation in the general population. Compared with intensive counselling, pharmacotherapy was cost saving and dominated the other interventions.

  10. Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India

    Directory of Open Access Journals (Sweden)

    Kumar G Anil

    2010-05-01

    Full Text Available Abstract Background Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. Methods Based on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY saved as a measure of cost-effectiveness of each type of HIV prevention intervention. Results The point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions. Conclusions The point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India.

  11. A safe and cost-effective PMMA carbon source for MgB{sub 2}

    Energy Technology Data Exchange (ETDEWEB)

    Ranot, Mahipal; Shinde, K. P.; Oh, Y. S.; Kang, S. H.; Chung, K. C. [Korea Institute of Materials Science, Changwon (Korea, Republic of); Jang, S. H. [Kiswire Advanced Technology Ltd, Daejeon (Korea, Republic of); Sinha, B. B. [National Centre for Nanoscience and Nanotechnology, University of Mumbai, Mumbai (India); Bhardwaj, A. [Dept. of Physics, Sungkyunkwan University, Suwon (Korea, Republic of)

    2017-03-15

    Carbon is proven to be very effective in pinning the magnetic vortices and improving the superconducting performance of MgB2 at high fields. In this work, we have used polymethyl methacrylate (PMMA) polymer as a safe and cost effective carbon source. The effects of molecular weight of PMMA on crystal structure, microstructure as well as on superconducting properties of MgB2 were studied. X-ray diffraction analysis revealed that there is a noticeable shift in (100) and (110) Bragg reflections towards higher angles, while no shift was observed in (002) reflections for MgB2 doped with different molecular weights of PMMA. This indicates that carbon could be substituted in the boron honeycomb layers without affecting the interlayer interactions. As compared to undoped MgB2, substantial enhancement in Jc(H) properties was obtained for PMMA-doped MgB2 samples both at 5 K and 20 K. The enhancement could be attributed to the effective carbon substitution for boron and the refinement of crystallite size by PMMA doping.

  12. Effectiveness of Membrane Filtration to Improve Drinking Water: A Quasi-Experimental Study from Rural Southern India.

    Science.gov (United States)

    Francis, Mark Rohit; Sarkar, Rajiv; Roy, Sheela; Jaffar, Shabbar; Mohan, Venkata Raghava; Kang, Gagandeep; Balraj, Vinohar

    2016-11-02

    Since point-of-use methods of water filtration have shown limited acceptance in Vellore, southern India, this study evaluated the effectiveness of decentralized membrane filtration 1) with safe storage, 2) without safe storage, versus 3) no intervention, consisting of central chlorination as per government guidelines, in improving the microbiological quality of drinking water and preventing childhood diarrhea. Periodic testing of water sources, pre-/postfiltration samples, and household water, and a biweekly follow up of children less than 2 years of age was done for 1 year. The membrane filters achieved a log reduction of 0.86 (0.69-1.06), 1.14 (0.99-1.30), and 0.79 (0.67-0.94) for total coliforms, fecal coliforms, and Escherichia coli, respectively, in field conditions. A 24% (incidence rate ratio, IRR [95% confidence interval, CI] = 0.76 [0.51-1.13]; P = 0.178) reduction in diarrheal incidence in the intervention village with safe storage and a 14% (IRR [95% CI] = 1.14 [0.75-1.77]; P = 0.530) increase in incidence for the intervention village without safe storage versus no intervention village was observed, although not statistically significant. Microbiologically, the membrane filters decreased fecal contamination; however, provision of decentralized membrane-filtered water with or without safe storage was not protective against childhood diarrhea. © The American Society of Tropical Medicine and Hygiene.

  13. How safe is safe?

    International Nuclear Information System (INIS)

    Hughes, C.F.; Flood, M.

    1996-01-01

    Full text: The Australian Register of Therapeutic Goods lists over 25,000 medical device types currently supplied to Australian consumers. It is widely assumed that all goods listed on this register have been fully evaluated for safety and efficacy by the Therapeutic Goods Administration. However, only 1,010 devices are registered and thereby subject to full premarket evaluation. Five classes of registerable devices were arbitrarily assigned in 1986 based on overseas experience (Canada and the USA) and the work of several Advisory Panels convened by the then Minister of Health, Dr Neal Blewett. Some products have been removed from registerable categories, while others have been added. These decisions were made after reviewing device performance and problems. In May 1987, the Therapeutic Device Evaluation Committee (TDEC) and the Therapeutic Goods Administration introduced the Australian Therapeutic Device Problem Reporting Scheme. Under this scheme, any interested person can report medical device related problems to the Department for investigation. Each problem is investigated, a cause and/or outcome assigned and appropriate action is taken. Analysis of problem reports received indicates that no regulatory action was necessary in 34% of investigations. However, 24% of products required product improvement and recalls and/or safety alerts were issued for approximately 10% of problems investigated. In only 5% was the problem not confirmed by departmental investigation. The actual effect of the problem reported was temporary or minor injury in 10% of patients. In 2%, death or serious injury resulted. Forty-four percent of problems did not lead to patient injury at all and in 44% the problem was not related to the patient and/or his well being. However, the potential effect of death or serious injury was present in 17% of device problems. In 26% of reported events, temporary or minor injury could have occurred. Specific device related problems include the Bjork Shiley

  14. [EFFECT OF A HEALTHY EATING AND PHYSICAL ACTIVITY INTERVENTION PROGRAM ON CHILHOOD OBESITY].

    Science.gov (United States)

    Díaz Martínez, Ximena; Mena Bastías, Carmen; Celis-Moralesl, Carlos; Salas, Carlos; Valdivia Moral, Pedro

    2015-07-01

    interventions aiming to develop healthy lifestyle behaviours at early age could be an effective way of reducing childhood obesity. to evaluate the effect of a dietary and physical activity intervention on reducing childhood obesity. 312 students took part on this 5 month intervention study. The intervention included dietary talk delivered to children and their parents in addition to 45 minutes of daily physical activity modules. Nutritional status was assessed using the Obesity Task Force criteria. Changes in dietary behaviours and physical activity were assessed using questionnaires administrated to the parents. body mass index decreased significantly post intervention (-0.2 kg.m-2), however, this reduction was driven by boys (-0.3 kg.m-2). Similarly, waist circumference shows a significant reduction in boys (-0.4 cm) but not girls. Children with overweight or obesity shows greater reductions in obesity-related traits, which were related to changes in dietary and physical activity post interventions. multidisciplinary interventions applied to children between 5 and 7 years old are effective on reducing body mass index and improving dietary and physical activity behaviours in overweight and obese children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  15. The effectiveness of conservation interventions to overcome the urban-environmental paradox.

    Science.gov (United States)

    McDonald, Robert I

    2015-10-01

    Globally, urbanization is rapidly growing cities and towns at a historically unprecedented rate, and this rapid urban growth is influencing many facets of the environment. This paper reviews the effectiveness of conservation interventions that are designed to increase urban sustainability. It presents evidence for an apparent urban-environmental paradox: while the process of urban growth converts natural habitat to other land covers and degrades natural resources and ecosystem function, the increase in human population can increase demand for natural resources and ecosystem services. The fundamental problem that many conservation interventions try to address is that most facets of the environment are common or public goods, and are hence undervalued in decision making (market failure). The paper presents a threefold classification of conservation interventions in cities: conservation in the city (protecting biodiversity), conservation by the city (reducing per capita resource and energy use), and conservation for cities (projects that maintain or enhance ecosystem services). It ends by discussing methods for spatially targeting conservation interventions of all three types and for quantifying the effectiveness of interventions retrospectively. © 2015 New York Academy of Sciences.

  16. Working safely in gamma radiography. A training manual for industrial radiographers

    Energy Technology Data Exchange (ETDEWEB)

    McGuire, S.A.; Peabody, C.A.

    1982-09-01

    This manual is designed for classroom training in working safely in industrial radiography using gamma sources. The purpose is to train radiographers' assistants to work safely as a qualified gamma radiographer. The contents cover the essentials of radiation, radiation protection, emergency procedures, gamma cameras, and biological effects of radiation. (ACR)

  17. Effective intervention programming: improving maternal adjustment through parent education.

    Science.gov (United States)

    Farris, Jaelyn R; Bert, Shannon S Carothers; Nicholson, Jody S; Glass, Kerrie; Borkowski, John G

    2013-05-01

    This study assessed the secondary effects of a parent training intervention program on maternal adjustment, with a focus on understanding ways in which program efficacy differed for participants as a function of whether or not their children had behavior problems. Mothers (N = 99) of toddlers (2-3 years of age) were randomly assigned to receive one of three levels of intervention: (1) informational booklet (2) booklet + face-to-face parent training sessions, or (3) booklet + web-based parent training sessions. Findings indicated that all levels of intervention were associated with increases in maternal well-being for participants with typically developing children. Mothers of toddlers with behavior problems, however, did not benefit from receiving only the booklet but significantly benefitted from receiving either the face-to-face or web-based interventions. Findings are discussed in terms of efficient and efficacious program dissemination and the resulting implications for public policy.

  18. Effects of an Alternative to Suspension Intervention in a Therapeutic High School

    Science.gov (United States)

    Hernandez-Melis, Claudia; Fenning, Pamela; Lawrence, Elizabeth

    2016-01-01

    The purpose of the current study was to assess the effects of an alternative to suspension intervention on students' subsequent major referrals. The intervention included activities designed to teach social coping strategies as well as mediation to resolve interpersonal conflicts. The intervention was implemented in a therapeutic high school, and…

  19. SAFE/SNAP application to shipboard security

    International Nuclear Information System (INIS)

    Grady, L.M.; Walker, J.L.; Polito, J.

    1981-11-01

    An application of the combined Safeguards Automated Facility Evaluation/Safeguards Network Analysis Procedure (SAFE/SNAP) modeling technique to a physical protection system (PPS) aboard a generic ship is described. This application was performed as an example of how the SAFE and SNAP techniques could be used. Estimates of probability of interruption and neutralization for the example shipboard PPS are provided by SAFE as well as an adversary scenario, which serves as input to SNAP. This adversary scenario is analyzed by SNAP through four cases which incorporate increasingly detailed security force tactics. Comparisons between the results of the SAFE and SNAP analyses are made and conclusions drawn on the validity of each technique. Feedback from SNAP to SAFE is described, and recommendations for upgrading the ship based on the results of the SAFE/SNAP application are also discussed

  20. Effectiveness of self-help psychological interventions for treating and preventing postpartum depression: a meta-analysis.

    Science.gov (United States)

    Lin, Ping-Zhen; Xue, Jiao-Mei; Yang, Bei; Li, Meng; Cao, Feng-Lin

    2018-04-04

    Previous studies have reported different effect sizes for self-help interventions designed to reduce postpartum depression symptoms; therefore, a comprehensive quantitative review of the research was required. A meta-analysis was conducted to examine the effectiveness of self-help interventions designed to treat and prevent postpartum depression, and identified nine relevant randomized controlled trials. Differences in depressive symptoms between self-help interventions and control conditions, changes in depressive symptoms following self-help interventions, and differences in postintervention recovery and improvement rates between self-help interventions and control conditions were assessed in separate analyses. In treatment trials, depression scores continued to decrease from baseline to posttreatment and follow-up assessment in treatment subgroups. Changes in treatment subgroups' depression scores from baseline to postintervention assessment were greater relative to those observed in prevention subgroups. Self-help interventions produced larger overall effects on postpartum depression, relative to those observed in control conditions, in posttreatment (Hedges' g = 0.51) and follow-up (Hedges' g = 0.32) assessments; and self-help interventions were significantly more effective, relative to control conditions, in promoting recovery from postpartum depression. Effectiveness in preventing depression did not differ significantly between self-help interventions and control conditions.The findings suggested that self-help interventions designed to treat postpartum depression reduced levels of depressive symptoms effectively and decreased the risk of postpartum depression.

  1. Can we respond mindfully to distressing voices? A systematic review of evidence for engagement, acceptability, effectiveness and mechanisms of change for mindfulness-based interventions for people distressed by hearing voices

    Directory of Open Access Journals (Sweden)

    Clara eStrauss

    2015-08-01

    Full Text Available Adapted mindfulness-based interventions (MBIs could be of benefit for people distressed by hearing voices. This paper presents a systematic review of studies exploring this possibility and we ask five questions: (1 Is trait mindfulness associated with reduced distress and disturbance in relation to hearing voices? (2 Are MBIs feasible for people distressed by hearing voices? (3 Are MBIs acceptable and safe for people distressed by hearing voices? (4 Are MBIs effective at reducing distress and disturbance in people distressed by hearing voices? (5 If effective, what are the mechanisms of change through which MBIs for distressing voices work?Fifteen studies were identified through a systematic search (n=479. In relation to the five review questions: (1 data from cross-sectional studies showed an association between trait mindfulness and distress and disturbance in relation to hearing voices; (2 evidence from qualitative studies suggested that people distressed by hearing voices could engage meaningfully in mindfulness practice; (3 MBIs were seen as acceptable and safe; (4 there were no adequately powered RCTs allowing conclusions about effectiveness to be drawn; and (5 it was not possible to draw on robust empirical data to comment on potential mechanisms of change although findings from the qualitative studies identified three potential change processes; (i reorientation of attention; (ii decentring; and (iii acceptance of voices. This review provided evidence that MBIs are engaging, acceptable and safe. Evidence for effectiveness in reducing distress and disturbance is lacking however. We call for funding for adequately powered RCTs that will allow questions of effectiveness, maintenance of effects, mechanisms of change and moderators of outcome to be definitively addressed.

  2. Effectiveness of physical activity intervention among government employees with metabolic syndrome

    OpenAIRE

    Chee Huei Phing; Hazizi Abu Saad; M.Y. Barakatun Nisak; M.T. Mohd Nasir

    2017-01-01

    Background/Objective: Our study aimed to assess the effects of physical activity interventions via standing banners (point-of-decision prompt) and aerobics classes to promote physical activity among individuals with metabolic syndrome. Methods: We conducted a cluster randomized controlled intervention trial (16-week intervention and 8-week follow-up). Malaysian government employees in Putrajaya, Malaysia, with metabolic syndrome were randomly assigned by cluster to a point-of-decision prom...

  3. Gender differences on effectiveness of a school-based physical activity intervention for reducing cardiometabolic risk: a cluster randomized trial.

    Science.gov (United States)

    Martínez-Vizcaíno, Vicente; Sánchez-López, Mairena; Notario-Pacheco, Blanca; Salcedo-Aguilar, Fernando; Solera-Martínez, Montserrat; Franquelo-Morales, Pablo; López-Martínez, Sara; García-Prieto, Jorge C; Arias-Palencia, Natalia; Torrijos-Niño, Coral; Mora-Rodríguez, Ricardo; Rodríguez-Artalejo, Fernando

    2014-12-10

    schoolchildren regardless of body weight, is a safe and effective measure to reduce adiposity in both genders and to improve cardiometabolic risk profile in girls. Clinical trials NCT01277224.

  4. Safe abortion information hotlines: An effective strategy for increasing women's access to safe abortions in Latin America.

    Science.gov (United States)

    Drovetta, Raquel Irene

    2015-05-01

    This paper describes the implementation of five Safe Abortion Information Hotlines (SAIH), a strategy developed by feminist collectives in a growing number of countries where abortion is legally restricted and unsafe. These hotlines have a range of goals and take different forms, but they all offer information by telephone to women about how to terminate a pregnancy using misoprostol. The paper is based on a qualitative study carried out in 2012-2014 of the structure, goals and experiences of hotlines in five Latin American countries: Argentina, Chile, Ecuador, Peru and Venezuela. The methodology included participatory observation of activities of the SAIH, and in-depth interviews with feminist activists who offer these services and with 14 women who used information provided by these hotlines to induce their own abortions. The findings are also based on a review of materials obtained from the five hotline collectives involved: documents and reports, social media posts, and details of public demonstrations and statements. These hotlines have had a positive impact on access to safe abortions for women whom they help. Providing these services requires knowledge and information skills, but little infrastructure. They have the potential to reduce the risk to women's health and lives of unsafe abortion, and should be promoted as part of public health policy, not only in Latin America but also other countries. Additionally, they promote women's autonomy and right to decide whether to continue or terminate a pregnancy. Copyright © 2015. Published by Elsevier Ltd.

  5. Development of an intervention program to increase effective behaviours by patients and clinicians in psychiatric services: Intervention Mapping study.

    Science.gov (United States)

    Koekkoek, Bauke; van Meijel, Berno; Schene, Aart; Hutschemaekers, Giel

    2010-10-25

    Health clinicians perceive certain patients as 'difficult' across all settings, including mental health care. In this area, patients with non-psychotic disorders that become long-term care users may be perceived as obstructing their own recovery or seeking secondary gain. This negative perception of patients results in ineffective responses and low-quality care by health clinicians. Using the concept of illness behaviour, this paper describes the development, implementation, and planned evaluation of a structured intervention aimed at prevention and management of ineffective behaviours by long-term non-psychotic patients and their treating clinicians. The principles of Intervention Mapping were applied to guide the development, implementation, and planned evaluation of the intervention. Qualitative (individual and group interviews), quantitative (survey), and mixed methods (Delphi-procedure) research was used to gain a broad perspective of the problem. Empirical findings, theoretical models, and existing evidence were combined to construct a program tailored to the needs of the target groups. A structured program to increase effective illness behaviour in long-term non-psychotic patients and effective professional behaviour in their treating clinicians was developed, consisting of three subsequent stages and four substantial components, that is described in detail. Implementation took place and evaluation of the intervention is being carried out. Intervention Mapping proved to be a suitable method to develop a structured intervention for a multi-faceted problem in mental health care.

  6. When the Safe Alternative Is Not That Safe: Tramadol Prescribing in Children

    Directory of Open Access Journals (Sweden)

    Frédérique Rodieux

    2018-03-01

    Full Text Available Children represent a vulnerable population in which management of nociceptive pain is complex. Drug responses in children differ from adults due to age-related differences. Moreover, therapeutic choices are limited by the lack of indication for a number of analgesic drugs due to the challenge of conducting clinical trials in children. Furthermore the assessment of efficacy as well as tolerance may be complicated by children’s inability to communicate properly. According to the World Health Organization, weak opioids such as tramadol and codeine, may be used in addition to paracetamol and ibuprofen for moderate nociceptive pain in both children and adults. However, codeine prescription has been restricted for the last 5 years in children because of the risk of fatal overdoses linked to the variable activity of cytochrome P450 (CYP 2D6 which bioactivates codeine. Even though tramadol has been considered a safe alternative to codeine, it is well established that tramadol pharmacodynamic opioid effects, efficacy and safety, are also largely influenced by CYP2D6 activity. For this reason, the US Food and Drug Administration recently released a boxed warning regarding the use of tramadol in children. To provide safe and effective tramadol prescription in children, a personalized approach, with dose adaptation according to CYP2D6 activity, would certainly be the safest method. We therefore recommend this approach in children requiring chronic or recurrent nociceptive pain treatment with tramadol. In case of acute inpatients nociceptive pain management, prescribing tramadol at the minimal effective dose, in a child appropriate dosage form and after clear instructions are given to the parents, remains reasonable based on current data. In all other situations, morphine should be preferred for moderate to severe nociceptive pain conditions.

  7. The intervention effects ofa community-based hypertension control ...

    African Journals Online (AJOL)

    population was screened for hypertension, non- ... a large effect in the subgroup above the cut-off point for hypertension .... were addressed by means of posters, billboards and mailings in ... intensity intervention (UI) that focused on the use of.

  8. Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial: Post-Intervention Results

    Science.gov (United States)

    Fitzgibbon, M. L.; Stolley, M. R.; Schiffer, L.; Braunschweig, C. L.; Gomez, S. L.; Van Horn, L.; Dyer, A.

    2013-01-01

    The preschool years offer an opportunity to interrupt the trajectory toward obesity in black children. The Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial was a group-randomized controlled trial assessing the feasibility and effectiveness of a teacher-delivered weight control intervention for black preschool children. The 618 participating children were enrolled in 18 schools administered by the Chicago Public Schools. Children enrolled in the 9 schools randomized to the intervention group received a 14-week weight control intervention delivered by their classroom teachers. Children in the 9 control schools received a general health intervention. Height and weight, physical activity, screen time, and diet data were collected at baseline and post-intervention. At post-intervention, children in the intervention schools engaged in more moderate-to vigorous physical activity than children in the control schools (difference between adjusted group means=7.46 min/day, p=.02). Also, children in the intervention group had less total screen time (−27.8 min/day, p=.05). There were no significant differences in BMI, BMI Z score, or dietary intake. It is feasible to adapt an obesity prevention program to be taught by classroom teachers. The intervention showed positive influences on physical activity and screen time, but not diet. Measuring diet and physical activity in preschool children remains a challenge, and interventions delivered by classroom teachers require both intensive initial training and ongoing individualized supervision. PMID:21193852

  9. Preclinical Studies of a Kidney Safe Iodinated Contrast Agent.

    Science.gov (United States)

    Rowe, Elizabeth S; Rowe, Vernon D; Biswas, Sangita; Mosher, Gerold; Insisienmay, Lovella; Ozias, Marlies K; Gralinski, Michael R; Hunter, John; Barnett, James S

    2016-09-01

    Contrast-induced acute kidney injury (CI-AKI) is a serious complication of the use of iodinated contrast agents. This problem is particularly acute in interventional neurology and interventional cardiology, probably due to the intra-arterial route of injection, high contrast volumes, and preexisting risk factors of these patients. In an attempt to develop a contrast agent that is less damaging to the kidneys, we have studied the effects of adding a small amount of the substituted cyclodextrin, sulfobutyl-ether-β-cyclodextrin (SBECD), to iohexol in rodent models of renal toxicity. Renally compromised mice and rats were injected with iohexol and iohexol-SBECD via the tail vein. The renal pathology, creatinine clearance, and survival benefits of iohexol-SBECD were studied. The safety of direct intra-arterial injection of the iohexol-SBECD formulation was studied in a dog heart model system. Mechanism of action studies in cell culture model using a human kidney cell line was performed using flow cytometry. Nephrotoxicity was significantly reduced using iohexol-SBECD compared to iohexol alone, at mole ratios of iohexol:SBECD of 1:0.025. SBECD increased survival from 50% to 88% in a rat survival study. In the dog heart model, iohexol-SBECD was safe. Cell culture studies suggest that SBECD interferes with the early stages of contrast-induced apoptosis in a human renal cell line. We have shown that the addition of a small amount of SBECD (one molecule of SBECD per 40 iohexol molecules) significantly protects rodent kidneys from CI-AKI. Further development of this new formulation of iodinated contrast is warranted. © 2016 The Authors. Journal of Neuroimaging published by Wiley Periodicals, Inc. on behalf of American Society of Neuroimaging.

  10. When Safe Proved Risky: Commercial Paper during the Financial Crisis of 2007-2009

    OpenAIRE

    Marcin Kacperczyk; Philipp Schnabl

    2010-01-01

    Commercial paper is a short-term debt instrument issued by large corporations. The commercial paper market has long been viewed as a bastion of high liquidity and low risk. But twice during the financial crisis of 2007-2009, the commercial paper market nearly dried up and ceased being perceived as a safe haven. Major interventions by the Federal Reserve, including large outright purchases of commercial paper, were eventually used to support both issuers of and investors in commercial paper. W...

  11. Subgroup effects of occupational therapy-based intervention for people with advanced cancer.

    Science.gov (United States)

    Sampedro Pilegaard, Marc; Oestergaard, Lisa Gregersen; la Cour, Karen; Thit Johnsen, Anna; Brandt, Åse

    2018-03-23

    Many people with advanced cancer have decreased ability to perform activities of daily living (ADL). We recently performed a randomized, controlled trial (RCT) assessing the efficacy of an occupational therapy-based program, the 'Cancer Home-Life Intervention' in people with advanced cancer (N = 242) and found no overall effects on ADL ability. However, heterogeneity of treatment effect may disguise subgroup differences. To investigate whether subgroups of people with advanced cancer gain positive effects from the 'Cancer Home-Life Intervention' on ADL ability. An exploratory subgroup analysis including 191 participants from a RCT. The outcome was ADL motor ability measured by the Assessment of Motor and Process Skills (AMPS). Subgroups were defined by age, gender, years of education, type of primary tumor, functional level, and activity problems. The 'Cancer Home-Life Intervention' had no statistically significant effect in the six subgroups. Modifying effects of age (0.30 [95% CI: -0.05 to 0.64]) and gender (0.23 [95% CI: -0.11 to 0.57]) were not found. There were no subgroup effects of the 'Cancer Home-Life Intervention'on ADL motor ability. Some indications suggest greater effects for those aged below 69 years; however, this result should be interpreted with caution.

  12. The effectiveness of social marketing interventions for health improvement: what's the evidence?

    Science.gov (United States)

    Gordon, Ross; McDermott, Laura; Stead, Martine; Angus, Kathryn

    2006-12-01

    To review the effectiveness of social marketing interventions designed to improve diet, increase physical activity, and tackle substance misuse. This article describes three reviews of systematic reviews and primary studies that evaluate social marketing effectiveness. All three reviews used pre-defined search and inclusion criteria and defined social marketing interventions as those which adopted six key social marketing principles. The reviews provide evidence that social marketing interventions can be effective in improving diet, increasing exercise, and tackling the misuse of substances like alcohol, tobacco, and illicit drugs. There is evidence that social marketing interventions can work with a range of target groups, in different settings, and can work upstream as well as with individuals. Social marketing provides a very promising framework for improving health both at the individual level and at wider environmental and policy-levels. Problems with research design, lack of conceptual understanding or implementation are valid research concerns.

  13. Work stress interventions in hospital care : Effectiveness of the DISCovery method

    NARCIS (Netherlands)

    Niks, I.M.W.; de Jonge, J.; Gevers, J.M.P.; Houtman, I.L.D.

    2018-01-01

    Effective interventions to prevent work stress and to improve health, well-being, and performance of employees are of the utmost importance. This quasi-experimental intervention study presents a specific method for diagnosis of psychosocial risk factors at work and subsequent development and

  14. Work Stress Interventions in Hospital Care: Effectiveness of the DISCovery Method

    NARCIS (Netherlands)

    Niks, I.M.W.; Gevers, J.M.P.; Jonge, J. de; Houtman, I.L.D.

    2018-01-01

    Effective interventions to prevent work stress and to improve health, well-being, and performance of employees are of the utmost importance. This quasi-experimental intervention study presents a specific method for diagnosis of psychosocial risk factors at work and subsequent development and

  15. Safe Oral Triiodo-L-Thyronine Therapy Protects from Post-Infarct Cardiac Dysfunction and Arrhythmias without Cardiovascular Adverse Effects.

    Directory of Open Access Journals (Sweden)

    Viswanathan Rajagopalan

    Full Text Available A large body of evidence suggests that thyroid hormones (THs are beneficial for the treatment of cardiovascular disorders. We have shown that 3 days of triiodo-L-thyronine (T3 treatment in myocardial infarction (MI rats increased left ventricular (LV contractility and decreased myocyte apoptosis. However, no clinically translatable protocol is established for T3 treatment of ischemic heart disease. We hypothesized that low-dose oral T3 will offer safe therapeutic benefits in MI.Adult female rats underwent left coronary artery ligation or sham surgeries. T3 (~6 μg/kg/day was available in drinking water ad libitum immediately following MI and continuing for 2 month(s (mo. Compared to vehicle-treated MI, the oral T3-treated MI group at 2 mo had markedly improved anesthetized Magnetic Resonance Imaging-based LV ejection fraction and volumes without significant negative changes in heart rate, serum TH levels or heart weight, indicating safe therapy. Remarkably, T3 decreased the incidence of inducible atrial tachyarrhythmias by 88% and improved remodeling. These were accompanied by restoration of gene expression involving several key pathways including thyroid, ion channels, fibrosis, sympathetic, mitochondria and autophagy.Low-dose oral T3 dramatically improved post-MI cardiac performance, decreased atrial arrhythmias and cardiac remodeling, and reversed many adverse changes in gene expression with no observable negative effects. This study also provides a safe and effective treatment/monitoring protocol that should readily translate to humans.

  16. Systematic review: Effective home support in dementia care, components and impacts - Stage 2, effectiveness of home support interventions.

    Science.gov (United States)

    Clarkson, Paul; Hughes, Jane; Roe, Brenda; Giebel, Clarissa M; Jolley, David; Poland, Fiona; Abendstern, Michele; Chester, Helen; Challis, David

    2018-03-01

    The aim of this study was to explicate the outcomes of home support interventions for older people with dementia and/or their carers to inform clinical practice, policy and research. Most people with dementia receive support at home. However, components and effectiveness of home support interventions have been little explored. Systematic review with narrative summary. Electronic searches of published studies in English using PubMed, Cochrane Central Register of Controlled Trials, PsychINFO, CINAHL, Applied Social Science Index and CSA Social Services Abstracts. Databases and sources were searched from inception to April 2014 with no date restrictions to locate studies. The PRISMA statement was followed and established systematic review methods used. Using 14 components of care for people with dementia and their carers, identified previously, data across studies were synthesized. Interventions were grouped and described and effectiveness ratings applied. Qualitative studies were synthesized using key themes. Seventy studies (four qualitative) were included. Most were directed to carers and of high quality. Seven interventions for carers and two for people with dementia were identified, covering 81% of studies. Those relating to daily living, cognitive training and physical activity for people with dementia were absent. Measures of effectiveness were influenced mainly by the intensity (duration and frequency) of interventions. Those containing education, social support and behaviour management appeared most effective. These interventions reflect emergent patterns of home support. Research is required to identify effective interventions linked to the stage of dementia, which can be applied as part of routine clinical care. © 2017 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    Directory of Open Access Journals (Sweden)

    Leslie B. Hammer

    2015-01-01

    Full Text Available 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.

  19. Surveillance and Maintenance Plan for the 105-C Reactor Safe Storage Enclosure

    International Nuclear Information System (INIS)

    Logan, T. E.

    1998-01-01

    This document provides a plan for implementing surveillance and maintenance activities to ensure that the 105-C Reactor Safe Storage Enclosure is maintained in a safe, environmentally secure, and cost-effective manner until subsequent closure during the final disposition phase of decommissioning

  20. Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer.

    Science.gov (United States)

    Antoni, Michael H

    2013-03-01

    A diagnosis of cancer and subsequent treatments place demands on psychological adaptation. Behavioral research suggests the importance of cognitive, behavioral, and social factors in facilitating adaptation during active treatment and throughout cancer survivorship, which forms the rationale for the use of many psychosocial interventions in cancer patients. This cancer experience may also affect physiological adaptation systems (e.g., neuroendocrine) in parallel with psychological adaptation changes (negative affect). Changes in adaptation may alter tumor growth-promoting processes (increased angiogenesis, migration and invasion, and inflammation) and tumor defense processes (decreased cellular immunity) relevant for cancer progression and the quality of life of cancer patients. Some evidence suggests that psychosocial intervention can improve psychological and physiological adaptation indicators in cancer patients. However, less is known about whether these interventions can influence tumor activity and tumor growth-promoting processes and whether changes in these processes could explain the psychosocial intervention effects on recurrence and survival documented to date. Documenting that psychosocial interventions can modulate molecular activities (e.g., transcriptional indicators of cell signaling) that govern tumor promoting and tumor defense processes on the one hand, and clinical disease course on the other is a key challenge for biobehavioral oncology research. This mini-review will summarize current knowledge on psychological and physiological adaptation processes affected throughout the stress of the cancer experience, and the effects of psychosocial interventions on psychological adaptation, cancer disease progression, and changes in stress-related biobehavioral processes that may mediate intervention effects on clinical cancer outcomes. Very recent intervention work in breast cancer will be used to illuminate emerging trends in molecular probes of

  1. Chernobyl new safe confinement

    International Nuclear Information System (INIS)

    Dodd, L.

    2011-01-01

    The author presents the new safe confinement that will be commissioned at Unit 4 of the Chernobyl NPP in 2015. The confinement will ensure that Chernobyl Unit 4 will be placed in an environmentally safe condition for at least next 100 years. The article highlights the current work status, future perspectives and the feasibility of confinement concept [ru

  2. Asymptotically Safe Dark Matter

    DEFF Research Database (Denmark)

    Sannino, Francesco; Shoemaker, Ian M.

    2015-01-01

    We introduce a new paradigm for dark matter (DM) interactions in which the interaction strength is asymptotically safe. In models of this type, the coupling strength is small at low energies but increases at higher energies, and asymptotically approaches a finite constant value. The resulting...... searches are the primary ways to constrain or discover asymptotically safe dark matter....

  3. Understanding the occupational and organizational boundaries to safe hospital discharge.

    Science.gov (United States)

    Waring, Justin; Marshall, Fiona; Bishop, Simon

    2015-01-01

    Safe hospital discharge relies upon communication and coordination across multiple occupational and organizational boundaries. Our aim was to understand how these boundaries can exacerbate health system complexity and represent latent sociocultural threats to safe discharge. An ethnographic study was conducted in two local health and social care systems (health economies) in England, focusing on two clinical areas: stroke and hip fracture patients. Data collection involved 345 hours of observations and 220 semi-structured interviews with health and social care professionals, patients and their lay carers. Hospital discharge involves a dynamic network of interactions between heterogeneous health and social care actors, each characterized by divergent ways of organizing discharge activities; cultures of collaboration and interaction and understanding of what discharge involves and how it contributes to patient recovery. These interrelated dimensions elaborate the occupational and organisational boundaries that can influence communication and coordination in hospital discharge. Hospital discharge relies upon the coordination of multiple actors working across occupational and organizational boundaries. Attention to the sociocultural boundaries that influence communication and coordination can help inform interventions that might support enhanced discharge safety. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  4. Effects of a worksite physical activity intervention for hospital nurses who are working mothers.

    Science.gov (United States)

    Tucker, Sharon J; Lanningham-Foster, Lorraine M; Murphy, Justyne N; Thompson, Warren G; Weymiller, Audrey J; Lohse, Christine; Levine, James A

    2011-09-01

    Hospital nurses who are working mothers are challenged to maintain their personal health and model healthy behaviors for their children. This study aimed to develop and test an innovative 10-week worksite physical activity intervention integrated into the work flow of hospital-based nurses who were mothers. Three volunteer adult medical-surgical nursing units participated as intervention units. Fifty-eight nurses (30 intervention and 28 control) provided baseline and post-intervention repeated measurements of physical activity (steps) and body composition. Intervention participants provided post-intervention focus group feedback. For both groups, daily steps averaged more than 12,400 at baseline and post-intervention. No significant effects were found for physical activity; significant effects were found for fat mass, fat index, and percent fat (p working mothers. Future research is warranted with a larger sample, longer intervention, and additional measures. Copyright 2011, SLACK Incorporated.

  5. [The Necessity and the Current Status of Safe Handling of Anticancer Drugs].

    Science.gov (United States)

    Kanda, Kiyoko

    2017-07-01

    Number of people who handle anticancer drugs in their profession is increasing. Anticancer drugs, which are hazardous drugs(HD), exert cytocidal effects on cancer cells, but many have also been shown to have mutagenicity, teratogenicity and carcinogenicity; therefore, safe handling of anticancer drugs is necessary. In July 2015, the first Japanese guidelines for exposure control measures, namely, the "Joint Guidelines for Safe Handling of Cancer Chemotherapy Drugs", were published jointly by 3 societies. Our guideline is the creation of the Japanese Society of Cancer Nursing(JSCN), Japanese Society of Medical Oncology(JSMO)and Japanese Society of Pharmaceutical Oncology(JASPO)and has a historical significance. This paper states the necessity of safe handling of anticancer drugs, Japan's recent movement of safe handling, the introduction of joint guidelines of safe handling of anticancer drugs, and new movement of safe handling of USP chapter 800 in the United States.

  6. Intervention Effects on Adolescent Physical Activity in the Multicomponent SPACE Study

    DEFF Research Database (Denmark)

    Toftager, Mette; Christiansen, Lars B; Ersbøll, Annette K

    2014-01-01

    BACKGROUND: Multicomponent school-based interventions have the potential to reduce the age-related decline in adolescents' physical activity (PA), yet there is not consistent evidence to guide non-curricular and school environment interventions. The aim of this study was to assess the effectiveness......-up. A total of 1,348 students (11-13 years, in grade 5 and 6) enrolled in the study at baseline. The 14 schools included in the study were located in the Region of Southern Denmark. The intervention consisted of organizational and physical changes in the school environment with a total of 11 intervention...

  7. Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions

    NARCIS (Netherlands)

    Prenger, Hendrikje Cornelia; Pieterse, Marcel E.; Braakman-Jansen, Louise Marie Antoinette; van der Palen, Jacobus Adrianus Maria; Christenhusz, Lieke C.A.; Seydel, E.R.

    2013-01-01

    Background Cost-effectiveness analyses of behavioral interventions typically use a dichotomous outcome criterion. However, achieving behavioral change is a complex process involving several steps towards a change in behavior. Delayed effects may occur after an intervention period ends, which can

  8. Iatrogenic Hepatitis C Virus Transmission and Safe Injection Practices.

    Science.gov (United States)

    Defendorf, Charles M; Paul, Sindy; Scott, George J

    2018-05-01

    Hepatitis C virus (HCV) infection poses significant adverse health effects. Improper use of vials, needles, syringes, intravenous bags, tubing, and connectors for injections and infusions is a current preventable cause of iatrogenic HCV transmission. Numerous cases have demonstrated the need for continued vigilance and the widespread nature of this iatrogenic infection risk across a variety of medical practice settings in the United States. Failure to implement the evidence-based Centers for Disease Control and Prevention (CDC) infection prevention guidelines exposes patients to preventable harm. The guidelines establish the requirement to notify patients in cases of suspected virus transmission, as well as to screen those patients who would not otherwise have been at risk for HCV seroconversion and other bloodborne pathogens. Legal and regulatory ramifications, including state, criminal, and tort laws, hold physicians and other health care professionals accountable to use safe injection practices. This article reviews the major health risks of HCV infection, significant effects of iatrogenic infection transmission, CDC guidelines for safe injection practices, and legal regulations and ramifications designed to promote safe injection practices.

  9. Field efficacy evaluation and post-treatment contamination risk assessment of an ultraviolet disinfection and safe storage system.

    Science.gov (United States)

    Reygadas, Fermin; Gruber, Joshua S; Ray, Isha; Nelson, Kara L

    2015-11-15

    Inconsistent use of household water treatment and safe storage (HWTS) systems reduces their potential health benefits. Ultraviolet (UV) disinfection is more convenient than some existing HWTS systems, but it does not provide post-treatment residual disinfectant, which could leave drinking water vulnerable to recontamination. In this paper, using as-treated analyses, we report on the field efficacy of a UV disinfection system at improving household drinking water quality in rural Mexico. We further assess the risk of post-treatment contamination from the UV system, and develop a process-based model to better understand household risk factors for recontamination. This study was part of a larger cluster-randomized stepped wedge trial, and the results complement previously published population-level results of the intervention on diarrheal prevalence and water quality. Based on the presence of Escherichia coli (proportion of households with ≥ 1 E. coli/100 mL), we estimated a risk difference of -28.0% (95% confidence interval (CI): -33.9%, -22.1%) when comparing intervention to control households; -38.6% (CI: -48.9%, -28.2%) when comparing post- and pre-intervention results; and -37.1% (CI: -45.2%, -28.9%) when comparing UV disinfected water to alternatives within the household. We found substantial increases in post-treatment E. coli contamination when comparing samples from the UV system effluent (5.0%) to samples taken from the storage container (21.1%) and drinking glasses (26.0%). We found that improved household infrastructure, additional extractions from the storage container, additional time from when the storage container was filled, and increased experience of the UV system operator were associated with reductions in post-treatment contamination. Our results suggest that the UV system is efficacious at improving household water quality when used as intended. Promoting safe storage habits is essential for an effective UV system dissemination. The drinking

  10. Physician-based activity counseling: intervention effects on mediators of motivational readiness for physical activity.

    Science.gov (United States)

    Pinto, B M; Lynn, H; Marcus, B H; DePue, J; Goldstein, M G

    2001-01-01

    In theory-based interventions for behavior change, there is a need to examine the effects of interventions on the underlying theoretical constructs and the mediating role of such constructs. These two questions are addressed in the Physically Active for Life study, a randomized trial of physician-based exercise counseling for older adults. Three hundred fifty-five patients participated (intervention n = 181, control n = 174; mean age = 65.6 years). The underlying theories used were the Transtheoretical Model, Social Cognitive Theory and the constructs of decisional balance (benefits and barriers), self-efficacy, and behavioral and cognitive processes of change. Motivational readiness for physical activity and related constructs were assessed at baseline, 6 weeks, and 8 months. Linear or logistic mixed effects models were used to examine intervention effects on the constructs, and logistic mixed effects models were used for mediator analyses. At 6 weeks, the intervention had significant effects on decisional balance, self-efficacy, and behavioral processes, but these effects were not maintained at 8 months. At 6 weeks, only decisional balance and behavioral processes were identified as mediators of motivational readiness outcomes. Results suggest that interventions of greater intensity and duration may be needed for sustained changes in mediators and motivational readiness for physical activity among older adults.

  11. Combining eastern and western practices for safe and effective endoscopic resection of large complex colorectal lesions.

    Science.gov (United States)

    Emmanuel, Andrew; Gulati, Shraddha; Burt, Margaret; Hayee, Bu'Hussain; Haji, Amyn

    2018-05-01

    Endoscopic resection of large colorectal polyps is well established. However, significant differences in technique exist between eastern and western interventional endoscopists. We report the results of endoscopic resection of large complex colorectal lesions from a specialist unit that combines eastern and western techniques for assessment and resection. Endoscopic resections of colorectal lesions of at least 2 cm were included. Lesions were assessed using magnification chromoendoscopy supplemented by colonoscopic ultrasound in selected cases. A lesion-specific approach to resection with endoscopic mucosal resection or endoscopic submucosal dissection (ESD) was used. Surveillance endoscopy was performed at 3 (SC1) and 12 (SC2) months. Four hundred and sixty-six large (≥20 mm) colorectal lesions (mean size 54.8 mm) were resected. Three hundread and fifty-six were resected using endoscopic mucosal resection and 110 by ESD or hybrid ESD. Fifty-one percent of lesions had been subjected to previous failed attempts at resection or heavy manipulation (≥6 biopsies). Nevertheless, endoscopic resection was deemed successful after an initial attempt in 98%. Recurrence occurred in 15% and could be treated with endoscopic resection in most. Only two patients required surgery for perforation. Nine patients had postprocedure bleeding; only two required endoscopic clips. Ninety-six percent of patients without invasive cancer were free from recurrence and had avoided surgery at last follow-up. Combining eastern and western practices for assessment and resection results in safe and effective organ-conserving treatment of complex colorectal lesions. Accurate assessment before and after resection using magnification chromoendoscopy and a lesion-specific approach to resection, incorporating ESD where appropriate, are important factors in achieving these results.

  12. A systematic literature review of the effectiveness of non-pharmacological interventions to prevent wandering in dementia and evaluation of the ethical implications and acceptability of their use.

    Science.gov (United States)

    Robinson, L; Hutchings, D; Corner, L; Beyer, F; Dickinson, H; Vanoli, A; Finch, T; Hughes, J; Ballard, C; May, C; Bond, J

    2006-08-01

    ethical concerns exist with the use of electronic tagging and tracking devices and physical barriers. Existing literature ignores the perspectives of people with dementia. The small number of participants with dementia expressed caution regarding the use of unfamiliar technology. Balancing risk and risk assessment was an important theme for all carers in the management of wandering. There is no robust evidence so far to recommend the use of any non-pharmacological intervention to reduce or prevent wandering in people with dementia. High-quality studies, preferably randomised controlled trials, are needed to determine the clinical and cost-effectiveness of non-pharmacological interventions that allow safe wandering and are considered practically and ethically acceptable by carers and people with dementia. Large-scale, long-term cohort studies are needed to evaluate the morbidity and mortality associated with wandering in dementia for people both in the community and in residential care. Such data would inform future long-term cost-effectiveness studies.

  13. An unfinished agenda on adolescent health: Opportunities for interventions.

    Science.gov (United States)

    Lassi, Zohra S; Salam, Rehana A; Das, Jai K; Wazny, Kerri; Bhutta, Zulfiqar A

    2015-08-01

    The Millennium Development Goal era has resulted in improvements in maternal and child health worldwide. As more children are surviving past their fifth birthday, the population of adolescents is increasing. Adolescence is a time of significant developmental transition; adolescence sets the stage for adult health through risks taken and beneficial and detrimental habits that are formed and it is thus an optimal time to target health interventions. Beginning interventions in adolescence or even earlier in childhood maximizes the impact on the individual's health in adult life. Evidence suggests that interventions to promote sexual and reproductive health, physical activity and healthy lifestyle, mental health and wellbeing, safe and hazard-free environment, improving access to nutritious and healthy foods, and minimizing exposure to substance abuse can improve health outcomes in young adolescents. School-based delivery strategies appear to be the most highly evaluated for improving adolescent health; they have been used to deliver interventions such as sexual health, substance abuse prevention, and nutritional interventions. Use of social media and information technologies, cash transfers, social protection, and micro-finance initiatives are promising strategies; however, given the lack of rigorous evaluations, there is a need for further research. Additional research is also warranted to strengthen the evidence base by establishing causality, understanding the differential impacts of adolescent health in different contexts particularly in low- and middle-income countries. In addition, research and evaluation in the domain of adolescent health must focus on how to implement interventions effectively at-scale, sustain the impacts over time and ensure equitable outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. CURRENT CONCEPTS IN BIOMECHANICAL INTERVENTIONS FOR PATELLOFEMORAL PAIN

    Science.gov (United States)

    Meira, Erik P.

    2016-01-01

    Patellofemoral pain (PFP) has historically been a complex and enigmatic issue. Many of the factors thought to relate to PFP remain after patients' symptoms have resolved making their clinical importance difficult to determine. The tissue homeostasis model proposed by Dye in 2005 can assist with understanding and implementing biomechanical interventions for PFP. Under this model, the goal of interventions for PFP should be to re-establish patellofemoral joint (PFJ) homeostasis through a temporary alteration of load to the offended tissue, followed by incrementally restoring the envelope of function to the baseline level or higher. High levels of PFJ loads, particularly in the presence of an altered PFJ environment, are thought to be a factor in the development of PFP. Clinical interventions often aim to alter the biomechanical patterns that are thought to result in elevated PFJ loads while concurrently increasing the load tolerance capabilities of the tissue through therapeutic exercise. Biomechanics may play a role in PFJ load modification not only when addressing proximal and distal components, but also when considering the involvement of more local factors such as the quadriceps musculature. Biomechanical considerations should consider the entire kinetic chain including the hip and the foot/ankle complex, however the beneficial effects of these interventions may not be the result of long-term biomechanical changes. Biomechanical alterations may be achieved through movement retraining, but the interventions likely need to be task-specific to alter movement patterns. The purpose of this commentary is to describe biomechanical interventions for the athlete with PFP to encourage a safe and complete return to sport. Level of Evidence 5 PMID:27904791

  15. Short-Term Effects of Traditional and Alternative Community Interventions to Address Food Insecurity.

    Directory of Open Access Journals (Sweden)

    Federico Roncarolo

    Full Text Available Despite the effects of food insecurity on health are well documented, clear governmental policies to face food insecurity do not exist in western countries. In Canada, interventions to face food insecurity are developed at the community level and can be categorized into two basic strategies: those providing an immediate response to the need for food, defined "traditional" and those targeting the improvement of participants' social cohesion, capabilities and management of their own nutrition, defined "alternative".The objective of this study was to evaluate the effects of food insecurity interventions on food security status and perceived health of participants.This was a longitudinal multilevel study implemented in Montreal, Quebec, Canada. Participants were recruited in a two-stage cluster sampling frame. Clustering units were community organizations working on food insecurity; units of analysis were participants in community food security interventions. A total of 450 participants were interviewed at the beginning and after 9 months of participation in traditional or alternative food security interventions. Food security and perceived health were investigated as dependent variables. Differences overtime were assessed through multilevel regression models.Participants in traditional interventions lowered their food insecurity at follow-up. Decreases among participants in alternative interventions were not statistically significant. Participants in traditional interventions also improved physical (B coefficient 3.00, CI 95% 0.42-5.59 and mental health (B coefficient 6.25, CI 95% 4.15-8.35.Our results challenge the widely held view suggesting the ineffectiveness of traditional interventions in the short term. Although effects may be intervention-dependent, food banks decreased food insecurity and, in so doing, positively affected perceived health. Although study findings demonstrate that food banks offer short term reprise from the effects of food

  16. 75 FR 1734 - Children’s Online Privacy Protection Rule Safe Harbor Proposed Self-Regulatory Guidelines; i-SAFE...

    Science.gov (United States)

    2010-01-13

    ... Proposed Self-Regulatory Guidelines; i-SAFE, Inc. Application for Safe Harbor AGENCY: Federal Trade... for public comment concerning proposed self-regulatory guidelines submitted by i-SAFE, Inc. under the... approval self-regulatory guidelines that would implement the Rule's protections.\\3\\ \\1\\ 64 FR 59888 (1999...

  17. Educational intervention and functional decline among older people: the modifying effects of social capital.

    Science.gov (United States)

    Poulsen, Tine; Siersma, Volkert Dirk; Lund, Rikke; Christensen, Ulla; Vass, Mikkel; Avlund, Kirsten

    2014-05-01

    To analyse if social capital modifies the effect of educational intervention of home visitors on mobility disability. Earlier studies have found that educational intervention of home visitors has a positive effect of older peoples' functional decline, but how social capital might modify this effect is still unknown. We used the Danish Intervention Study on Preventive Home Visits - a prospective cohort study including 2863 75-year-olds and 1171 80-year-olds in 34 Danish municipalities - to analyse the modifying effect of different aspects of social capital on the effect of educational intervention of home visitors on functional decline. The three measures of social capital (bonding, bridging, and linking) were measured at contextual level. Data was analysed with multivariate linear regression model using generalised estimating equations to account for repeated measurements. We found that 80-year-olds living in municipalities with high bonding (B=0.089, p=0.0279) and high linking (B=0.0929; p=0.0217) had significant better mobility disability in average at 3-year follow up if their municipality had received intervention. With the unique design of the Danish Intervention Study on Preventive Home Visits and with theory-based measures of social capital that distinguish between three aspects of social capital with focus on older people, this study contributes to the literature about the role of social capital for interventions on mobility disability.

  18. Clinical Inquiry: Is megestrol acetate safe and effective for malnourished nursing home residents?

    Science.gov (United States)

    Wen, Frances K; Millar, James; Oberst-Walsh, Linda; Nashelsky, Joan

    2018-02-01

    No. Megestrol acetate (MA) is neither safe nor effective for stimulating appetite in malnourished nursing home residents. It increases the risk of deep vein thrombosis (strength of recommendation [SOR]: C, 2 retrospective chart reviews), but isn't associated with other new or worsening events or disorders (SOR: B, single randomized controlled trial [RCT]). Over a 25-week period, MA wasn't associated with increased mortality (SOR: B, single RCT). After 44 months, however, MA-treated patients showed decreased median survival (SOR: B, single case-control study). Consistent, meaningful weight gain was not observed with MA treatment (SOR: B, single case-control study, single RCT, 2 retrospective chart reviews, single prospective case-series).

  19. A Simulation Model for Designing Effective Interventions in Early Childhood Caries

    OpenAIRE

    Hirsch, Gary B.; Edelstein, Burton L.; Frosh, Marcy; Anselmo, Theresa

    2012-01-01

    Introduction Early childhood caries (ECC) — tooth decay among children younger than 6 years — is prevalent and consequential, affecting nearly half of US 5-year-olds, despite being highly preventable. Various interventions have been explored to limit caries activity leading to cavities, but little is known about the long-term effects and costs of these interventions. We developed a system dynamics model to determine which interventions, singly and in combination, could have the greatest effec...

  20. Safeness of radiological machinery

    International Nuclear Information System (INIS)

    Yokoyama, Shun

    1979-01-01

    The human factors affecting the safeness of radiological machinery, which are often very big and complicated machines, are described from the stand point of handling. 20 to 50% of the troubles on equipments seem to be caused by men. This percentage will become even higher in highly developed equipments. Human factors have a great influence on the safeness of radiological equipments. As the human factors, there are sensory factors and knowledge factors as well as psychological factors, and the combination of these factors causes mishandling and danger. Medical services at present are divided in various areas, and consist of the teamwork of the people in various professions. Good human relationship, education and control are highly required to secure the safeness. (Kobatake, H.)

  1. Taking snapshots of preventive interventions : On the effectiveness of preventive interventions for youth and how it relates to implementation and conflict of interest

    NARCIS (Netherlands)

    Goossens, F.X.

    2017-01-01

    Intervention studies This dissertation describes three trials in which the effectiveness of three preventive interventions for youth were tested in the Netherlands. The interventions aim to improve the social and emotional development of children in elementary school (PATHS), reduce alcohol use and

  2. Effectiveness of training intervention to improve medical student's information literacy skills.

    Science.gov (United States)

    Abdekhoda, Mohammadhiwa; Dehnad, Afsaneh; Yousefi, Mahmood

    2016-12-01

    This study aimed to assess the efficiency of delivering a 4-month course of "effective literature search" among medical postgraduate students for improving information literacy skills. This was a cross-sectional study in which 90 postgraduate students were randomly selected and participated in 12 training sessions. Effective search strategies were presented and the students' attitude and competency concerning online search were measured by a pre- and post-questionnaires and skill tests. Data were analyzed by SPSS version 16 using t-test. There was a significant improvement (p=0.00), in student's attitude. The mean (standard deviation [SD]) was 2.9 (0.8) before intervention versus the mean (SD) 3.9 (0.7) after intervention. Students' familiarity with medical resources and databases improved significantly. The data showed a significant increase (p=0.03), in students' competency score concerning search strategy design and conducting a search. The mean (SD) was 2.04 (0.7) before intervention versus the mean (SD) 3.07 (0.8) after intervention. Also, students' ability in applying search and meta search engine improved significantly. This study clearly acknowledges that the training intervention provides considerable opportunity to improve medical student's information literacy skills.

  3. The effectiveness of dyadic interventions for people with dementia and their caregivers.

    Science.gov (United States)

    Moon, Heehyul; Adams, Kathryn Betts

    2013-11-01

    The need for dyadic intervention is enhanced with increasing numbers of older adults with early-stage dementia. The purpose of this paper is to review the effects of dyadic interventions on caregivers (CGs) and care recipients (CRs) at the early stage of dementia. Four databases, AgeLine, Medline, EBSCO, and PyscINFO were searched and relevant literature from 2000 onwards was reviewed. The twelve studies identified used a variety of intervention approaches including support group, counseling, cognitive stimulation, skill training, and notebook-keeping. This review suggests that intervention programs for early-stage dementia caregiving dyads were feasible and well accepted by participants. The reviewed studies provided rich evidence of the significance of mutual understanding and communication to partners' well-being and relationship quality within the caregiving process. The findings suggest that these intervention approaches improved cognitive function of the CRs, social relations, and the relationship between the primary CG and the CR, although evidence of long-term effectiveness is lacking.

  4. How effective are expressive writing interventions for adolescents? A meta-analytic review.

    Science.gov (United States)

    Travagin, Gabriele; Margola, Davide; Revenson, Tracey A

    2015-03-01

    This meta-analysis evaluated the effects of the expressive writing intervention (EW; Pennebaker & Beall, 1986) among adolescents. Twenty-one independent studies that assessed the efficacy of expressive writing on youth samples aged 10-18 ears were collected and analyzed. Results indicated an overall mean g-effect size that was positive in direction but relatively small (0.127), as well as significant g-effect sizes ranging from 0.107 to 0.246 for the outcome domains of Emotional Distress, Problem Behavior, Social Adjustment, and School Participation. Few significant effects were found within specific outcome domains for putative moderator variables that included characteristics of the participants, intervention instructions, or research design. Studies involving adolescents with high levels of emotional problems at baseline reported larger effects on school performance. Studies that implemented a higher dosage intervention (i.e., greater number and, to some extent, greater spacing of sessions) reported larger effects on somatic complaints. Overall, the findings suggest that expressive writing tends to produce small yet significant improvements on adolescents' well-being. The findings highlight the importance of modifying the traditional expressive writing protocol to enhance its efficacy and reduce potential detrimental effects. At this stage of research the evidence on expressive writing as a viable intervention for adolescents is promising but not decisive. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Analytical basis for evaluating the effect of unplanned interventions on the effectiveness of a human-robot system

    International Nuclear Information System (INIS)

    Shah, Julie A.; Saleh, Joseph H.; Hoffman, Jeffrey A.

    2008-01-01

    Increasing prevalence of human-robot systems in a variety of applications raises the question of how to design these systems to best leverage the capabilities of humans and robots. In this paper, we address the relationships between reliability, productivity, and risk to humans from human-robot systems operating in a hostile environment. Objectives for maximizing the effectiveness of a human-robot system are presented, which capture these coupled relationships, and reliability parameters are proposed to characterize unplanned interventions between a human and robot. The reliability metrics defined here take on an expanded meaning in which the underlying concept of failure in traditional reliability analysis is replaced by the notion of intervention. In the context of human-robotic systems, an intervention is not only driven by component failures, but includes many other factors that can make a robotic agent to request or a human agent to provide intervention, as we argue in this paper. The effect of unplanned interventions on the effectiveness of human-robot systems is then investigated analytically using traditional reliability analysis. Finally, we discuss the implications of these analytical trends on the design and evaluation of human-robot systems

  6. Effectiveness of public health interventions in food safety: a systematic review.

    Science.gov (United States)

    Campbell, M E; Gardner, C E; Dwyer, J J; Isaacs, S M; Krueger, P D; Ying, J Y

    1998-01-01

    To summarize evidence on the effectiveness of public health interventions regarding food safety at restaurants, institutions, homes and other community-based settings. This systematic review of published and unpublished studies involved a comprehensive literature search, screening for relevance, quality assessment of relevant studies, data extraction and synthesis. The interventions identified in 15 studies included in this review were grouped into three categories: inspections, food handler training, and community-based education. The evidence suggests that: routine inspection (at least once per year) of food service premises is effective in reducing the risk of foodborne illness; food handler training can improve the knowledge and practices of food handlers; and selected community-based education programs can increase public knowledge of food safety. There is some evidence for the effectiveness of multiple public health interventions on food safety. Future research needs include evaluation of HACCP and community-based education programs.

  7. Effect of Wii-intervention on balance of children with poor motor performance.

    Science.gov (United States)

    Mombarg, Remo; Jelsma, Dorothee; Hartman, Esther

    2013-09-01

    The purpose of this study was to investigate the effects of training with the Wii-balance board on balance and balance-related skills of children with poor motor performance. Twenty-nine children (23 boys, 6 girls; aged 7-12 years) participated in this study and were randomly assigned to an experimental and control group. All children scored below the 16th percentile on a standardized test of motor ability and balance skills (Movement Assessment Battery for children (M-ABC-2)). Before and after a six-week Wii-intervention (M=8h, 22 min, SD=53 min), the balance skills of the experimental group and control group were measured with the M-ABC-2 and the Bruininks-Oseretsky test of motor proficiency (BOT-2). Both groups improved on all tests. The M-ABC-2 and the BOT-2 total balance-scores of the experimental group improved significantly from pre to post intervention, whereas those of the control group showed no significant progress. This resulted in significant interaction-effects, favoring the experimental children. No transfer-effects of the intervention on balance-related skills were demonstrated. Our findings showed that the Wii-balance board is an effective intervention for children with poor balance control. Further development and investigation of the intervention could be directed toward the implementation of the newly acquired balance-skills in daily life. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Interventional therapy for acute myocardial infarction associated with postinfarction ventricular septal rupture: report of 6 cases

    International Nuclear Information System (INIS)

    Zhou Ling; Xie Dujiang; Dong Jing; Wu Chengquan; Tian Nailiang; Li Xiaobo; Wang Rong; Chen Shaoliang

    2014-01-01

    Objective: To evaluate the curative effect of interventional therapy in treating acute myocardial infarction (AMI) associated with postinfarction ventricular septal rupture (VSR). Methods: Transcatheter closure was performed in 6 patients with VSR which was caused by AMI. Percutaneous coronary intervention (PCI) was also carried out according to patient's clinical condition. The results were analyzed. Results: The interval between the occurrence of VSR and the performance of transcatheter closure ranged from 3 to 30 days. Of the six patients, transcatheter closure failed in two, who died from cardiogenic shock during hospitalization. The remaining 4 patients experienced a successful transcatheter closure procedure, and their cardiac function was improved during the follow-up period lasting for 0.5-4 years. Conclusion: Interventional transcatheter treatment is safe and feasible for acute myocardial infarction complicated by postinfarction ventricular septal rupture. (authors)

  9. General practitioners' perceptions of the effectiveness of medical interventions: an exploration of underlying constructs

    Directory of Open Access Journals (Sweden)

    Marteau Theresa M

    2010-02-01

    Full Text Available Abstract Background Many interventions shown to be effective through clinical trials are not readily implemented in clinical practice. Unfortunately, little is known regarding how clinicians construct their perceptions of the effectiveness of medical interventions. This study aims to explore general practitioners' perceptions of the nature of 'effectiveness'. Methods The design was qualitative in nature using the repertory grid technique to elicit the constructs underlying the perceived effectiveness of a range of medical interventions. Eight medical interventions were used as stimuli (diclophenac to reduce acute pain, cognitive behaviour therapy to treat depression, weight loss surgery to achieve weight loss, diet and exercise to prevent type 2 diabetes, statins to prevent heart disease, stopping smoking to prevent heart disease, nicotine replacement therapy to stop smoking, and stop smoking groups to stop smoking. The setting involved face-to-face interviews followed by questionnaires in London Primary Care Trusts. Participants included a random sample of 13 general practitioners. Results Analysis of the ratings showed that the constructs clustered around two dimensions: low patient effort versus high patient effort (dimension one, and small impact versus large impact (dimension two. Dimension one represented constructs such as 'success requires little motivation', 'not a lifestyle intervention', and 'health-care professional led intervention'. Dimension two represented constructs such as 'weak and/or minimal evidence of effectiveness', 'small treatment effect for users', 'a small proportion of users will benefit' and 'not cost-effective'. Constructs within each dimension were closely related. Conclusions General practitioners judged the effectiveness of medical interventions by considering two broad dimensions: the extent to which interventions involve patient effort, and the size of their impact. The latter is informed by trial evidence, but

  10. Transuterinal artery interventional therapy for fallopian tubal pregnancy

    International Nuclear Information System (INIS)

    Jiang Zaibo; Shan Hong; Guan Shouhai; Ma Zhuang; Huang Mingsheng; Li Zhengran; Zhu Kangshun; Chen Hanwei; Xiao Jibo; Mu Yongsheng

    2001-01-01

    Objective: To study the methods and clinical effect of transuterinal artery interventional therapy of fallopian tubal pregnancy. Methods: The authors cured 34 cases of fallopian tubal pregnancy by interventional methods. In the procedure, 4.1 - 5.0 F catheters were used for performing super selective angiography in uterine artery and then infusing Methotrexate 50-100 mg. Finally gelfoam particles or stripes were used to embolise uterine artery. Before and after the procedure, patients showed changes of clinical symptom, physical signs. Value of urine β-hCG and size of pregnancy cyst were studied. Results: 31 cases were succeeded. The successful rate was 91%. 37 fallopian tubal arteries were displayed in 40 uterine arterial angiographies. The stain of ovary was shown done in 21 cases, the appearance rate was 68%. The stain of pregnant cyst was in six cases, the appearance rate was 18%. Conclusion: It is safe and efficient in performing transuterine artery chemo-embolization for therapy of fallopian tubal pregnancy. It could prevent and control fatal bleeding induced by pregnancy cyst rupture

  11. Does shelf space management intervention have an effect on calorie turnover at supermarkets?

    DEFF Research Database (Denmark)

    Adam, Abdulfatah; Jensen, Jørgen Dejgård; Sommer, Iben

    2017-01-01

    . An experimental controlled trial has been conducted using 10 supermarkets in Denmark. The study looked specifically into the possible effect of shelf space management intervention at supermarkets. The study found a significant intervention effect for individual products targeted by the project. But overall, care...

  12. Measuring User Compliance and Cost Effectiveness of Safe Drinking Water Programs: A Cluster-Randomized Study of Household Ultraviolet Disinfection in Rural Mexico.

    Science.gov (United States)

    Reygadas, Fermín; Gruber, Joshua S; Dreizler, Lindsay; Nelson, Kara L; Ray, Isha

    2018-03-01

    Low adoption and compliance levels for household water treatment and safe storage (HWTS) technologies have made it challenging for these systems to achieve measurable health benefits in the developing world. User compliance remains an inconsistently defined and poorly understood feature of HWTS programs. In this article, we develop a comprehensive approach to understanding HWTS compliance. First, our Safe Drinking Water Compliance Framework disaggregates and measures the components of compliance from initial adoption of the HWTS to exclusive consumption of treated water. We apply this framework to an ultraviolet (UV)-based safe water system in a cluster-randomized controlled trial in rural Mexico. Second, we evaluate a no-frills (or "Basic") variant of the program as well as an improved (or "Enhanced") variant, to test if subtle changes in the user interface of HWTS programs could improve compliance. Finally, we perform a full-cost analysis of both variants to assess their cost effectiveness (CE) in achieving compliance. We define "compliance" strictly as the habit of consuming safe water. We find that compliance was significantly higher in the groups where the UV program variants were rolled out than in the control groups. The Enhanced variant performed better immediately postintervention than the Basic, but compliance (and thus CE) degraded with time such that no effective difference remained between the two versions of the program.

  13. The effect of an intervention on schoolchildren's susceptibility to a peer's candy intake

    NARCIS (Netherlands)

    Bevelander, K.E.; Engels, R.C.M.E.; Anschutz, D.J.; Wansink, B.

    2013-01-01

    BACKGROUND/OBJECTIVES: The aim of the study was to pilot test two interventions designed to reduce children's susceptibility to peers' candy intake and to determine if interventions had different effects on boys and girls. SUBJECTS/METHODS: In the standard intervention, peer modeling was explained

  14. Community-level effect of the reproductive health vouchers program on out-of-pocket spending on family planning and safe motherhood services in Kenya.

    Science.gov (United States)

    Obare, Francis; Warren, Charlotte; Kanya, Lucy; Abuya, Timothy; Bellows, Ben

    2015-08-25

    Although vouchers can protect individuals in low-income countries from financial catastrophe and impoverishment arising from out-of-pocket expenditures on healthcare, their effectiveness in achieving this goal depends on whether both service and transport costs are subsidized as well as other factors such as service availability in a given locality and community perceptions about the quality of care. This paper examines the community-level effect of the reproductive health vouchers program on out-of-pocket expenditure on family planning, antenatal, delivery and postnatal care services in Kenya. Data are from two rounds of cross-sectional household surveys in voucher and non-voucher sites. The first survey was conducted between May 2010 and July 2011 among 2,933 women aged 15-49 years while the second survey took place between July and October 2012 among 3,094 women of similar age groups. The effect of the program on out-of-pocket expenditure is determined by difference-in-differences estimation. Analysis entails comparison of changes in proportions, means and medians as well as estimation of multivariate linear regression models with interaction terms between indicators for study site (voucher or non-voucher) and period of study (2010-2011 or 2012). There were significantly greater declines in the proportions of women from voucher sites that paid for antenatal, delivery and postnatal care services at health facilities compared to those from non-voucher sites. The changes were also consistent with increased uptake of the safe motherhood voucher in intervention sites over time. There was, however, no significant difference in changes in the proportions of women from voucher and non-voucher sites that paid for family planning services. The results further show that there were significant differences in changes in the amount paid for family planning and antenatal care services by women from voucher compared to those from non-voucher sites. Although there were greater

  15. "I feel free": Experiences of a dance intervention for adolescent girls with internalizing problems.

    Science.gov (United States)

    Duberg, Anna; Möller, Margareta; Sunvisson, Helena

    2016-01-01

    Adolescent girls today suffer from internalizing problems such as somatic symptoms and mental health problems at higher rates compared to those of previous decades, and effective interventions are warranted. The aim of this study was to explore the experiences of participating in an 8-month dance intervention. This qualitative study was embedded in a randomized controlled trial of a dance intervention for adolescent girls with internalizing problems. A total of 112 girls aged 13-18 were included in the study. The dance intervention group comprised 59 girls, 24 of whom were strategically chosen to be interviewed. Data were analyzed using qualitative content analysis with an inductive approach. The experiences of the dance intervention resulted in five generic categories: (1) An Oasis from Stress, which represents the fundamental basis of the intervention; (2) Supportive Togetherness, the setting; (3) Enjoyment and Empowerment, the immediate effect; (4) Finding Acceptance and Trust in Own Ability, the outcome; and (5) Dance as Emotional Expression, the use of the intervention. One main category emerged, Finding Embodied Self-Trust That Opens New Doors, which emphasizes the increased trust in the self and the ability to approach life with a sense of freedom and openness. The central understanding of the adolescent girls' experiences was that the dance intervention enriched and gave access to personal resources. With the non-judgmental atmosphere and supportive togetherness as a safe platform, the enjoyment and empowerment in dancing gave rise to acceptance, trust in ability, and emotional expression. Taken together, this increased self-trust and they discovered a new ability to "claim space." Findings from this study may provide practical information on designing future interventions for adolescent girls with internalizing problems.

  16. A method for Effect Modifier Assessment in ergonomic intervention research – The EMA method

    DEFF Research Database (Denmark)

    Edwards, Kasper; Winkel, Jørgen

    2016-01-01

    Introduction: Ergonomic intervention research includes studies in which researchers arrange (or follow) changes in working conditions to determine the effects in risk factors and/or health. Often this research takes place at workplaces and not in a controlled environment of a laboratory. The effe......Introduction: Ergonomic intervention research includes studies in which researchers arrange (or follow) changes in working conditions to determine the effects in risk factors and/or health. Often this research takes place at workplaces and not in a controlled environment of a laboratory...... of the literature revealed lack of or poor consideration of effect modifiers in ergonomic intervention research. We present a method that has been developed over the course of several years parallel to intervention studies in healthcare. Material and methods: The EMA method is a type of group interview including 3...... sources. Conclusion: The EMA method seems to offer a feasible procedure to obtain significant knowledge on potential effect modifiers in ergonomic intervention research. However, further development and validation is suggested....

  17. Reducing stillbirths: interventions during labour

    Science.gov (United States)

    Darmstadt, Gary L; Yakoob, Mohammad Yawar; Haws, Rachel A; Menezes, Esme V; Soomro, Tanya; Bhutta, Zulfiqar A

    2009-01-01

    on perinatal mortality. There was limited evidence of impact for maternal hyperoxygenation, and concerns remain about maternal safety. Transcervical amnioinfusion for meconium staining appears promising for low/middle income-country application according to the findings of many small studies, but a large randomised trial of the intervention had no significant impact on perinatal mortality, suggesting that further studies are needed. Conclusion Although the global appeal to prioritise access to emergency obstetric care, especially vacuum extraction and Caesarean section, rests largely on observational and population-based data, these interventions are clearly life-saving in many cases of fetal compromise. Safe, comprehensive essential and emergency obstetric care is particularly needed, and can make the greatest impact on stillbirth rates, in low-resource settings. Other advanced interventions such as amnioinfusion and hyperoxygenation may reduce perinatal mortality, but concerns about safety and effectiveness require further study before they can be routinely included in programs. PMID:19426469

  18. Effectiveness of pads and enclosures as safety interventions on consumer trampolines

    Science.gov (United States)

    Eager, David; Scarrott, Carl; Sushinsky, George

    2010-01-01

    Background Trampolines continue to be a major source of childhood injury. Objective To examine available data on trampoline injuries in order to determine the effectiveness of padding and enclosures. Design Trampoline injuries from the NEISS database from 2002 to 2007 were reclassified into five cause-categories, to examine evidence for injury trends. Setting The ASTM trampoline standard recommendations for safety padding were upgraded in 1999 and enclosures were introduced in 1997. This is the first study to examine the impact of these changes. Patients The sampling frame comprises patients with NEISS product code ‘consumer trampolines’ (1233). A systematic sample of 360 patients each year is taken. Interventions The prominent interventions recommended by the ASTM are netting enclosures to prevent falling off and safety padding to cover frames and springs. Main outcome measures Proportion of injuries within each cause-category and trend estimates. Results There was no evidence for a decline within the injury cause-categories that should be prevented by these interventions from 2002 to 2007. Conclusions If these interventions were effective the associated injury causes would be in decline. Instead they remain close to half of all trampoline injuries with no significant change over the period of the study. Follow-up studies are proposed to determine the reasons. Given the number of injuries involved it is recommended that steps be taken to ensure these safety interventions or their equivalents are in place, work properly and remain effective for the life of consumer trampolines. PMID:20570986

  19. The Effect of Tier 2 Intervention for Phonemic Awareness in a Response-to-Intervention Model in Low-Income Preschool Classrooms

    Science.gov (United States)

    Koutsoftas, Anthony D.; Harmon, Mary Towle; Gray, Shelley

    2009-01-01

    Purpose: This study assessed the effectiveness of a Tier 2 intervention that was designed to increase the phonemic awareness skills of low-income preschoolers who were enrolled in Early Reading First classrooms. Method: Thirty-four preschoolers participated in a multiple baseline across participants treatment design. Tier 2 intervention for…

  20. Effect of intervention programs in schools to reduce screen time: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Roberta Roggia Friedrich

    Full Text Available OBJECTIVE:to evaluate the effects of intervention program strategies on the time spent on activities such as watching television, playing videogames, and using the computer among schoolchildren.SOURCES:a search for randomized controlled trials available in the literature was performed in the following electronic databases: PubMed, Lilacs, Embase, Scopus, Web of Science, and Cochrane Library using the following Keywords randomized controlled trial, intervention studies, sedentary lifestyle, screen time, and school. A summary measure based on the standardized mean difference was used with a 95% confidence interval.DATA SYNTHESIS: a total of 1,552 studies were identified, of which 16 were included in the meta-analysis. The interventions in the randomized controlled trials (n = 8,785 showed a significant effect in reducing screen time, with a standardized mean difference (random effect of: -0.25 (-0.37, -0.13, p < 0.01.CONCLUSION:interventions have demonstrated the positive effects of the decrease of screen time among schoolchildren.

  1. Cost-Effectiveness Analysis of Breast Cancer Control Interventions in Peru

    Science.gov (United States)

    Zelle, Sten G.; Vidaurre, Tatiana; Abugattas, Julio E.; Manrique, Javier E.; Sarria, Gustavo; Jeronimo, José; Seinfeld, Janice N.; Lauer, Jeremy A.; Sepulveda, Cecilia R.; Venegas, Diego; Baltussen, Rob

    2013-01-01

    Objectives In Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant for the Peruvian context. Methods We performed a cost-effectiveness analysis (CEA) according to WHO-CHOICE guidelines, from a healthcare perspective. Different screening, early detection, palliative, and treatment interventions were evaluated using mathematical modeling. Effectiveness estimates were based on observational studies, modeling, and on information from Instituto Nacional de Enfermedades Neoplásicas (INEN). Resource utilizations and unit costs were based on estimates from INEN and observational studies. Cost-effectiveness estimates are in 2012 United States dollars (US$) per disability adjusted life year (DALY) averted. Results The current breast cancer program in Peru ($8,426 per DALY averted) could be improved through implementing triennial or biennial screening strategies. These strategies seem the most cost-effective in Peru, particularly when mobile mammography is applied (from $4,125 per DALY averted), or when both CBE screening and mammography screening are combined (from $4,239 per DALY averted). Triennially, these interventions costs between $63 million and $72 million per year. Late stage treatment, trastuzumab therapy and annual screening strategies are the least cost-effective. Conclusions Our analysis suggests that breast cancer control in Peru should be oriented towards early detection through combining fixed and mobile mammography screening (age 45-69) triennially. However, a phased introduction of triennial CBE screening (age 40-69) with upfront FNA in non-urban settings, and both CBE (age 40-49) and fixed mammography screening (age 50-69) in urban settings, seems a more feasible option and is also cost-effective. The implementation of this

  2. Clinical exercise interventions in alcohol use disorders: a systematic review.

    Science.gov (United States)

    Giesen, Esther S; Deimel, Hubertus; Bloch, Wilhelm

    2015-05-01

    The therapeutic impact of exercise interventions in psychiatric diseases such as depression, anxiety and schizophrenia has already been proven through several reviews whereas substance use disorders such as alcohol use disorders (AUD) have so far less frequently been a matter of investigation. Although several publications have summarized studies focusing on physical activities in substance use disorders, no systematic review exists summarizing the evidence of exercise interventions in AUD. A total of 14 studies using the Medline Database, CCMed, Cochrane Library and PsychINFO were identified and met the inclusion criteria. In order to evaluate the evidence, we used the evaluation system of the Oxford Centre for Evidence-Based Medicine (2011). Due to methodological flaws the overall evidence of the studies is rated level "3" but primarily findings confirm that exercise interventions as a complementary treatment component in AUD are feasible and safe. No adverse events were reported. This systematic review indicates that exercise may have beneficial effects on certain domains of physical functioning including VO2max, basal heart rate, physical activity level and strength. Inconsistent effects with a slight trend towards a positive effect on anxiety, mood management, craving, and drinking behavior have been shown and need to be verified. Results must be interpreted cautiously due to the numerous methodological flaws and the heterogeneity of the interventions and measures. However, according to preclinical studies several mechanisms of action are conceivable, especially as to alcohol-related outcomes and additionally seem to be promising. RCTs with high methodological quality are urgently needed in future research to establish evidence-based exercise recommendations for the treatment of AUD. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. [Effects of transtheoretical model intervention on improving self-esteem of obese children].

    Science.gov (United States)

    Zhang, Xueyan; Zhou, Leshan; Li, Chenchen

    2013-07-01

    To explore the effects of transtheoretical model (TTM) intervention on improving self-esteem status of obese children. A quasi-experimental research was conducted using a repeated-measure, pretest-posttest control group design in one randomly-selected boarding school of Changsha, Hunan Province in China. Seventy-three obesity students (54 males, 19 females) among grade three to six were included. All participants received first assessment, including: demographic data, stage of change questionnaire, and the Self-Esteem Scale (SES). According to the baseline data, different intervention measures based on TTM were given to different students to promote them to begin exercise and improve their self-esteem status. Follow-up assessments were collected respectively at 1- and 6- month after intervention. Intervention effects on proportion of obese children and self-esteem status as well as BMI were explored. All analyses were conducted using SPSS 17.0. After intervention, the proportion of obese children in precontemplation and maintenance stages was significantly different (P children who are in the later stages have higher self-esteem scores than those in former stages. Intervention based on TTM can help obese children move through the stages of change.

  4. Totally tubeless percutaneous nephrolithotomy: is it safe and effective in preschool children?

    Science.gov (United States)

    Ozturk, Ahmet; Guven, Selcuk; Kilinc, Mehmet; Topbaş, Emrah; Piskin, Mesut; Arslan, Mehmet

    2010-12-01

    After the introduction of tubeless percutaneous nephrolithotomy (PNL), many studies conducted in adult patients have confirmed its efficacy and safety. There are limited studies reporting that tubeless PNL can be safely applied in children, however. Furthermore, there are no reports that evaluate the use of totally tubeless PNL in children. The present study evaluates the results of totally tubeless PNL in preschool children. The data of children seen in our clinic who were considered suitable for totally tubeless PNL were analyzed. Of 16 children, 8 patients underwent totally tubeless PNL (group 1) and 8 standard PNL (group 2). The two groups of patients were compared with regard to length of hospitalization, analgesic requirements, transfusion rates, hemoglobin (Hb) decrease, and immediate, early, and late complications. The mean ages of the patients were 56.6 months (9-84 mos) and 56.0 months (5-84 mos), and the mean follow-up was 21.5 months (3-44 mos) and 43.4 months (36-54 mos) in groups 1 and 2, respectively. Both groups were similar with regard to age, stone size, Hb change, and complications. Although operation duration, hospitalization period, and analgesic requirement were less in the totally tubeless PNL group, these differences were not statistically significant. The latest application of PNL, totally tubeless PNL, is also a safe and effective procedure in very small children if they are selected properly and if the surgeon has sufficient experience with the procedure. More studies with a higher number of participants are needed, however, to confirm that totally tubeless PNL increases the comfort of pediatric patients, decreases their hospitalization period, and is more economical.

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

    Science.gov (United States)

    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.

  6. Intervention effects on dietary intake among children by maternal education level: results of the Copenhagen School Child Intervention Study (CoSCIS).

    Science.gov (United States)

    Jensen, Britt W; von Kappelgaard, Lene M; Nielsen, Birgit M; Husby, Ida; Bugge, Anna; El-Naaman, Bianca; Andersen, Lars B; Trolle, Ellen; Heitmann, Berit L

    2015-03-28

    Dietary intake among Danish children, in general, does not comply with the official recommendations. The objectives of the present study were to evaluate the 3-year effect of a multi-component school-based intervention on nutrient intake in children, and to examine whether an intervention effect depended on maternal education level. A total of 307 children (intervention group: n 184; comparison group: n 123) were included in the present study. All had information on dietary intake pre- and post-intervention (mean age 6·8 and 9·5 years for intervention and comparison groups, respectively) assessed by a 7-d food record. Analyses were conducted based on the daily intake of macronutrients (energy percentage (E%)), fatty acids (E%), added sugar (E%) and dietary fibre (g/d and g/MJ). Analyses were stratified by maternal education level into three categories. Changes in nutrient intake were observed in the intervention group, mainly among children of mothers with a short education ( education (β = -0·8, 95 % CI -1·5, -0·03, P= 0·04). This multi-component school-based intervention resulted in changes in the dietary intake, particularly among children of mothers with a short education. As the dietary intake of this subgroup generally differs most from the recommendations, the results of the present study are particularly encouraging.

  7. Safe and effective use of medicines for patients with type 2 diabetes - A randomized controlled trial of two interventions delivered by local pharmacies

    DEFF Research Database (Denmark)

    Kjeldsen, Lene Juel; Bjerrum, Lars; Dam, Pernille

    2015-01-01

    Poor management of chronic medical treatments may result in severe health consequences for patients as well as costs for society. Non-adherence is common among patients with type 2 diabetes. Interventions by community pharmacists may assist in improving adherence and consequently health outcomes...

  8. Effects of music interventions on emotional States and running performance.

    Science.gov (United States)

    Lane, Andrew M; Davis, Paul A; Devonport, Tracey J

    2011-01-01

    The present study compared the effects of two different music interventions on changes in emotional states before and during running, and also explored effects of music interventions upon performance outcome. Volunteer participants (n = 65) who regularly listened to music when running registered online to participate in a three-stage study. Participants attempted to attain a personally important running goal to establish baseline performance. Thereafter, participants were randomly assigned to either a self-selected music group or an Audiofuel music group. Audiofuel produce pieces of music designed to assist synchronous running. The self-selected music group followed guidelines for selecting motivating playlists. In both experimental groups, participants used the Brunel Music Rating Inventory-2 (BMRI-2) to facilitate selection of motivational music. Participants again completed the BMRI-2 post- intervention to assess the motivational qualities of Audiofuel music or the music they selected for use during the study. Results revealed no significant differences between self-selected music and Audiofuel music on all variables analyzed. Participants in both music groups reported increased pleasant emotions and decreased unpleasant emotions following intervention. Significant performance improvements were demonstrated post-intervention with participants reporting a belief that emotional states related to performance. Further analysis indicated that enhanced performance was significantly greater among participants reporting music to be motivational as indicated by high scores on the BMRI-2. Findings suggest that both individual athletes and practitioners should consider using the BMRI-2 when selecting music for running. Key pointsListening to music with a high motivational quotient as indicated by scores on the BMRI-2 was associated with enhanced running performance and meta-emotional beliefs that emotions experienced during running helped performance.Beliefs on the

  9. EFFECTS OF MUSIC INTERVENTIONS ON EMOTIONAL STATES AND RUNNING PERFORMANCE

    Directory of Open Access Journals (Sweden)

    Andrew M. Lane

    2011-06-01

    Full Text Available The present study compared the effects of two different music interventions on changes in emotional states before and during running, and also explored effects of music interventions upon performance outcome. Volunteer participants (n = 65 who regularly listened to music when running registered online to participate in a three-stage study. Participants attempted to attain a personally important running goal to establish baseline performance. Thereafter, participants were randomly assigned to either a self-selected music group or an Audiofuel music group. Audiofuel produce pieces of music designed to assist synchronous running. The self-selected music group followed guidelines for selecting motivating playlists. In both experimental groups, participants used the Brunel Music Rating Inventory-2 (BMRI-2 to facilitate selection of motivational music. Participants again completed the BMRI-2 post- intervention to assess the motivational qualities of Audiofuel music or the music they selected for use during the study. Results revealed no significant differences between self-selected music and Audiofuel music on all variables analyzed. Participants in both music groups reported increased pleasant emotions and decreased unpleasant emotions following intervention. Significant performance improvements were demonstrated post-intervention with participants reporting a belief that emotional states related to performance. Further analysis indicated that enhanced performance was significantly greater among participants reporting music to be motivational as indicated by high scores on the BMRI-2. Findings suggest that both individual athletes and practitioners should consider using the BMRI-2 when selecting music for running

  10. Safe Cooperating Cyber-Physical Systems using Wireless Communication

    DEFF Research Database (Denmark)

    Pop, Paul; Scholle, Detlef; Sljivo, Irfan

    2017-01-01

    This paper presents an overview of the ECSEL project entitled ―Safe Cooperating Cyber-Physical Systems using Wireless Communication‖ (SafeCOP), which runs during the period 2016–2019. SafeCOP targets safety-related Cooperating Cyber-Physical Systems (CO-CPS) characterised by use of wireless...... detection of abnormal behaviour, triggering if needed a safe degraded mode. SafeCOP will also develop methods and tools, which will be used to produce safety assurance evidence needed to certify cooperative functions. SafeCOP will extend current wireless technologies to ensure safe and secure cooperation...

  11. Effect of office ergonomics intervention on reducing musculoskeletal symptoms.

    Science.gov (United States)

    Amick, Benjamin C; Robertson, Michelle M; DeRango, Kelly; Bazzani, Lianna; Moore, Anne; Rooney, Ted; Harrist, Ron

    2003-12-15

    Office workers invited and agreeing to participate were assigned to one of three study groups: a group receiving a highly adjustable chair with office ergonomics training, a training-only group, and a control group receiving the training at the end of the study. To examine the effect of office ergonomics intervention in reducing musculoskeletal symptom growth over the workday and, secondarily, pain levels throughout the day. Data collection occurred 2 months and 1 month before the intervention and 2, 6, and 12 months postintervention. During each round, a short daily symptom survey was completed at the beginning, middle, and end of the workday for 5 days during a workweek to measure total bodily pain growth over the workday. Multilevel statistical models were used to test hypotheses. The chair-with-training intervention lowered symptom growth over the workday (P = 0.012) after 12 months of follow-up. No evidence suggested that training alone lowered symptom growth over the workday (P = 0.461); however, average pain levels in both intervention groups were reduced over the workday. Workers who received a highly adjustable chair and office ergonomics training had reduced symptom growth over the workday. The lack of a training-only group effect supports implementing training in conjunction with highly adjustable office furniture and equipment to reduce symptom growth. The ability to reduce symptom growth has implications for understanding how to prevent musculoskeletal injuries in knowledge workers.

  12. Does Working Memory Moderate the Effects of Fraction Intervention? An Aptitude-Treatment Interaction

    Science.gov (United States)

    Fuchs, Lynn S.; Schumacher, Robin F.; Sterba, Sonya K.; Long, Jessica; Namkung, Jessica; Malone, Amelia; Hamlett, Carol L.; Jordan, Nancy C.; Gersten, Russell; Siegler, Robert S.; Changas, Paul

    2014-01-01

    This study investigated whether individual differences in working memory (WM) moderate effects of 2 variations of intervention designed to improve at-risk 4th graders' fraction knowledge. We also examined the effects of each intervention condition against a business-as-usual control group and assessed whether children's measurement interpretation…

  13. The Effect of Game-Based Interventions in Rehabilitation of Diabetics

    DEFF Research Database (Denmark)

    Christensen, Jan; Valentiner, Laura Staun; Petersen, Rikke Juelsgaard

    2016-01-01

    on the effect of game-based interventions on HbA1c, diabetes-related knowledge, and physical outcomes in rehabilitation of diabetes patients. METHODS: We conducted a systematic literature search in MEDLINE, EMBASE, PEDro, Scopus, Cochrane Central Register of Controlled Trials, CINAHL, and Psych INFO in October...... 2014 based on a priori defined inclusion criteria: patients with diabetes (type 1 or type 2), game-based interventions, and randomized controlled trials. RESULTS: The database search identified 1,101 potential articles for screening, four of which were eligible for the present systematic review. Game......). No difference was found between game-based interventions and usual care or waiting lists in terms of diabetes-related knowledge (one study). DISCUSSION: PA is important for diabetes management. The present review indicates that game-based interventions are not superior to ordinary PA in controlling HbA1c. Due...

  14. Early intervention as a catalyst for effective early childhood ...

    African Journals Online (AJOL)

    ... of positive attitudes towards children with disabilities in a country like Ghana. ... As Ghana strides towards mainstreaming early childhood education in the quest ... an integrated, inclusive and effective early intervention programme becomes ...

  15. Interventional management of spine eosinophilic granuloma in children: preliminary investigation of its clinical value

    International Nuclear Information System (INIS)

    He Yu; Wu Chungen; Gu Yifeng; Cheng Yongde

    2011-01-01

    Objective: To assess the clinical value of interventional management in treating spine eosinophilic granuloma in children. Methods: Interventional therapies, including per cutaneous biopsy and percutaneous vertebroplasty (PVP), were carried out in three child patients with five pathologically-proved eosinophilic granuloma lesions, which were localized in the vertebrae. The clinical data were retrospectively analyzed. Visual analogue pain scale (VAS) and Oswesty disability index (ODI) were assessed before and after operation. Results: A total of four operations were successfully carried out in all of three patients. The mean VAS score reduced from 7 before treatment of 1 after treatment. The mean ODI decreased from preoperative 52.5% to postoperative 10.5%. During procedures no significant complications occurred except for cement leakage in some cases. Pain relief and daily activity were remarkably improved after treatment. All patients were followed up for 3 months to 5 years. Conclusion: For the treatment of spine eosinophilic granuloma in children, interventional techniques are mini-invasive, safe and effective therapeutic methods. (authors)

  16. Erythromycin as a safe and effective treatment option for erythema annulare centrifugum

    Directory of Open Access Journals (Sweden)

    Fu-Chen Chuang

    2015-01-01

    Full Text Available Background: Erythema annulare centrifugum (EAC is an inflammatory dermatosis with unknown etiology. It is usually self-limited, but chronic disease may be difficult to treat. We observed incidentally the therapeutic effect of erythromycin for EAC among patients taking erythromycin for other diseases. Aim: To evaluate the treatment response of erythromycin for EAC. Materials and Methods: During the study period, from July 2007 to February 2011, all patients with EAC were assigned to erythromycin stearate tablet 1000 mg per day for two weeks. EAC was diagnosed by a constellation of clinical and pathological findings. The efficacy (before and after the treatment was assessed clinically by one dermatologist and photographically by two blinded dermatologists. Secondary outcomes included adverse drug effects and recurrence. Results: Eight patients were enrolled in this study. Most patients had chronic relapsing disease with poor response to previous treatment. All the patients showed rapid response with profound reduction in the size of lesion and erythema two weeks after initiation of erythromycin treatment. The response was so obvious and complete that a coincidental response was less likely. Three patients had recurrence of disease and they tended to have more extensive lesions. Readministration of erythromycin was effective. All patients tolerated the treatment well. Conclusion: Our study documented erythromycin as a safe and cost-effective treatment for EAC.

  17. The Dutch Obesity Intervention in Teenagers (DOiT) cluster controlled implementation trial: intervention effects and mediators and moderators of adiposity and energy balance-related behaviours.

    Science.gov (United States)

    van Nassau, Femke; Singh, Amika S; Cerin, Ester; Salmon, Jo; van Mechelen, Willem; Brug, Johannes; Chinapaw, Mai Jm

    2014-12-24

    The Dutch Obesity Intervention in Teenagers (DOiT) programme is an evidence-based obesity prevention programme tailored to adolescents attending the first two years of prevocational education in the Netherlands. The initial programme showed promising results during an effectiveness trial. The programme was adapted and prepared for nationwide dissemination. To gain more insight into the process of translating evidence-based approaches into 'real world' (i.e., 'natural') conditions, our research aims were to evaluate the impact of the DOiT-implementation programme on adolescents' adiposity and energy balance-related behaviours during natural dissemination and to explore the mediating and moderating factors underlying the DOiT intervention effects. We conducted a cluster-controlled implementation trial with 20 voluntary intervention schools (n=1002 adolescents) and 9 comparable control schools (n = 484 adolescents). We measured adolescents' body height and weight, skinfold thicknesses, and waist circumference. We assessed adolescents' dietary and physical activity behaviours by means of self-report. Data were collected at baseline and at 20-months follow-up. We used multivariable multilevel linear or logistic regression analyses to evaluate the intervention effects and to test the hypothesised behavioural mediating factors. We checked for potential effect modification by gender, ethnicity and education level. We found no significant intervention effects on any of the adiposity measures or behavioural outcomes. Furthermore, we found no mediating effects by any of the hypothesised behavioural mediators. Stratified analyses for gender showed that the intervention was effective in reducing sugar-containing beverage consumption in girls (B = -188.2 ml/day; 95% CI = -344.0; -32.3). In boys, we found a significant positive intervention effect on breakfast frequency (B = 0.29 days/week; 95% CI = 0.01; 0.58). Stratified analyses for education level showed

  18. InaSAFE applications in disaster preparedness

    Science.gov (United States)

    Pranantyo, Ignatius Ryan; Fadmastuti, Mahardika; Chandra, Fredy

    2015-04-01

    Disaster preparedness activities aim to reduce the impact of disasters by being better prepared to respond when a disaster occurs. In order to better anticipate requirements during a disaster, contingency planning activities can be undertaken prior to a disaster based on a realistic disaster scenario. InaSAFE is a tool that can inform this process. InaSAFE is a free and open source software that estimates the impact to people and infrastructure from potential hazard scenarios. By using InaSAFE, disaster managers can develop scenarios of disaster impacts (people and infrastructures affected) to inform their contingency plan and emergency response operation plan. While InaSAFE provides the software framework exposure data and hazard data are needed as inputs to run this software. Then InaSAFE can be used to forecast the impact of the hazard scenario to the exposure data. InaSAFE outputs include estimates of the number of people, buildings and roads are affected, list of minimum needs (rice and clean water), and response checklist. InaSAFE is developed by Indonesia's National Disaster Management Agency (BNPB) and the Australian Government, through the Australia-Indonesia Facility for Disaster Reduction (AIFDR), in partnership with the World Bank - Global Facility for Disaster Reduction and Recovery (GFDRR). This software has been used in many parts of Indonesia, including Padang, Maumere, Jakarta, and Slamet Mountain for emergency response and contingency planning.

  19. Effectiveness of the Gold Standard Programme compared with other smoking cessation interventions in Denmark

    DEFF Research Database (Denmark)

    Rasmussen, Mette; Fernández, Esteve; Tønnesen, Hanne

    2017-01-01

    Objectives: We compared the effectiveness of the Gold Standard Programme (a comprehensive smoking cessation intervention commonly used in Denmark) with other face-to-face smoking cessation programmes in Denmark after implementation in real life, and we identified factors associated with successful...... did not want further contact, who intentionally were not followed up or who lacked information about the intervention they received were excluded. A total of 46 287 smokers were included. Interventions: Various real-life smoking cessation interventions were identified and compared: The Gold Standard...... smokers. The follow-up rate was 74%. Women were less likely to remain abstinent, OR 0.83 (CI 0.79 to 0.87). Short interventions were more effective among men. After adjusting for confounders, the Gold Standard Programme was the only intervention with significant results across sex, increasing the odds...

  20. Acupuncture and related interventions for smoking cessation.

    Science.gov (United States)

    White, Adrian R; Rampes, Hagen; Liu, Jian Ping; Stead, Lindsay F; Campbell, John

    2014-01-23

    is justified since these are popular interventions and safe when correctly applied, though these interventions alone are likely to be less effective than evidence-based interventions.