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Sample records for community therapy effect

  1. Effectiveness of Trauma-Focused Cognitive Behavioral Therapy in a community-based program.

    Science.gov (United States)

    Konanur, Sheila; Muller, Robert T; Cinamon, Julie S; Thornback, Kristin; Zorzella, Karina P M

    2015-12-01

    Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a widely used treatment model for trauma-exposed children and adolescents (Cohen, Mannarino, & Deblinger, 2006). The Healthy Coping Program (HCP) was a multi-site community based intervention carried out in a diverse Canadian city. A randomized, waitlist-control design was used to evaluate the effectiveness of TF-CBT with trauma-exposed school-aged children (Muller & DiPaolo, 2008). A total of 113 children referred for clinical services and their caregivers completed the Trauma Symptom Checklist for Children (Briere, 1996) and the Trauma Symptom Checklist for Young Children (Briere, 2005). Data were collected pre-waitlist, pre-assessment, pre-therapy, post-therapy, and six months after the completion of TF-CBT. The passage of time alone in the absence of clinical services was ineffective in reducing children's posttraumatic symptoms. In contrast, children and caregivers reported significant reductions in children's posttraumatic stress (PTS) following assessment and treatment. The reduction in PTS was maintained at six month follow-up. Findings of the current study support the use of the TF-CBT model in community-based settings in a diverse metropolis. Clinical implications are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Immunomodulatory effects of pidotimod in adults with community-acquired pneumonia undergoing standard antibiotic therapy.

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    Trabattoni, D; Clerici, M; Centanni, S; Mantero, M; Garziano, M; Blasi, F

    2017-06-01

    The morbidity and mortality of community-acquired pneumonia (CAP) are still elevated and two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvants, including corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects but their efficacy is only partial. We examined the immunomodulatory activity of Pidotimod (PDT), a synthetic dipeptide molecule in adult patients hospitalized for CAP. Sixteen patients with a diagnosis of CAP and a PSI score III or IV and/or a CURB-65 0-2 were randomized to receive either levofloxacin 500 mg b.i.d. alone or levofloxacin plus PDT (800mg, 2 daily doses). Blood samples were drawn at baseline (T0), before initiation of therapy, as well as 3 (T3), and 5 (T5) days after initiation of therapy. Immunologic and clinical parameters were analyzed at each time point. Supplementation of antibiotic therapy with PDT resulted in an upregulation of antimicrobial and of immunomodulatory proteins as well as in an increased percentage of Toll like receptor (TLR)2- and TLR4, and of CD80- and CD86-expressing immune cells. Notably, Pidotimod supplementation was also associated with a robust reduction of TNFα-producing immune cells. No significant differences were observed in clinical parameters. These results confirm that supplementation of antibiotic therapy with Pidotimod in patients with CAP results in a potentially beneficial modulation of innate immunity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. The effectiveness of problem solving therapy in deprived South African communities: results from a pilot study

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    Marks Isaac

    2011-09-01

    Full Text Available Abstract Background The majority of South Africans with a DSM-IV diagnosis receive no treatment for their mental health problems. There is a move to simplify treatment for common mental disorders (CMDs in order to ease access. Brief problem solving therapy (PST might fill the treatment gap for CMD's in deprived communities in South Africa. This pilot study evaluates the feasibility, acceptability and effectiveness of this PST program for CMD's in deprived communities around Cape Town. Methods A Dutch problem solving program was adapted and translated into English, Xhosa and Afrikaans and thereafter implemented in townships around Cape Town. An initial attempt to recruit participants for online PST proved difficult, and so the program was adapted to a booklet format. Volunteers experiencing psychological distress were invited to participate in the either individually or group delivered 5-week during self-help program. To evaluate the effectiveness, psychological distress was administered through self-report questionnaires. After completion of the intervention participants also rated the program on various acceptability aspects. Results Of 103 participants, 73 completed 5 weeks of brief PST in a booklet/workshop format. There were significantly more dropouts in those who used the booklet individually than in the group. Psychological distress measured on the K-10 and SRQ fell significantly and the program was evaluated positively. Conclusions The results suggest that brief problem solving in a booklet/workshop format may be an effective, feasible and acceptable short-term treatment for people with CMD's in deprived communities. In this setting, group delivery of PST had lower drop-out rates than individual delivery, and was more feasible and acceptable. Randomized controlled trials are needed to evaluate the effect of brief self-help PST more rigorously.

  4. The effects of group reminiscence therapy on depression, self-esteem, and affect balance of Chinese community-dwelling elderly.

    Science.gov (United States)

    Zhou, Wenjuan; He, Guoping; Gao, Jing; Yuan, Qun; Feng, Hui; Zhang, Clarence K

    2012-01-01

    To study the effects of group reminiscence therapy on depressive symptoms, self-esteem, and affect balance among community dwelling elderly. Eight communities were randomly selected from 372 eligible communities in Changsha city. They were randomly divided into four experimental groups and four control group. Geriatric Depression Scale (GDS) was used to screen entire 478 older adults living in these 8 communities. One hundred and sixty five of them had a GDS score between 11 and 25; among them, 125 participated in the study finally. The elderly group who were in the control group received health education, while the intervention group received both health education and group reminiscence therapy for 6 weeks. Both groups were assessed with the GDS, Self-Esteem Scale (SES), and Affect Balance Scale (ABS) before and after the 6-week-intervention. The results were analyzed using a mixed effect model with fixed effect of the intervention and random effect of the community, incorporating the structured randomness at the community level. After 6 weeks' therapy, the GDS scores in the intervention group decreased significantly compared to those in the control group (pcommunity-dwelling elderly. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. Effects of a physical therapy program on quality of life among community-dwelling elderly women: randomized-controlled trial

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    Mariana Chaves Aveiro

    Full Text Available INTRODUCTION: Health promotion policies for encouraging elderly to remain active, independent and, effectively have a positive effect on their quality of life. OBJECTIVE: To verify the effects of a low-intensity group-based physical therapy program on quality of life among community-dwelling elderly women. MATERIALS AND METHODS: It was carried out a randomized controlled trial. Seventeen women (67.8 ± 4.9 years old that completed 12-week training program and 10 women (68.9 ± 5.7 years old that were included in control group answered the abbreviated version for World Health Organization Quality of life Questionnaire - WHOQOL-bref at baseline and after 12 weeks. Exercise group performed stretching, resistance and balance training. Intragroup and intergroup analysis was made using Wilcoxon and Mann-Whitney U tests, respectively. The level of significance used for all comparisons was 5%. Furthermore, it was determined the Reliable Change Index (RCI as part of JT Method. RESULTS: Exercise group presented a significant improvement for Psychological domain (p = 0.047 after 12-week physical therapy program. Otherwise, control group presented a significant worsening for overall (p = 0.01, physical (p = 0.01 and psychological (p = 0.008 domains. Exercise group presented two participants with positive reliable change (PRC for social domain, two participants with PRC for Environment domain. Overall and Physical domain presented three participants with PRC. Psychological domain presented four participants with PRC and one with negative reliable change. CONCLUSION: A low-intensity group-based physical therapy program may contribute in order to maintain quality of life and improve some psychological aspects among community-dwelling elderly women.

  6. Manualized supportive-expressive psychotherapy versus nonmanualized community-delivered psychodynamic therapy for patients with personality disorders: bridging efficacy and effectiveness.

    Science.gov (United States)

    Vinnars, Bo; Barber, Jacques P; Norén, Kristina; Gallop, Robert; Weinryb, Robert M

    2005-10-01

    Time-limited manualized dynamic psychotherapy was compared with community-delivered psychodynamic therapy for outpatients with personality disorders. In a stratified randomized clinical trial, 156 patients with any personality disorder diagnosis were randomly assigned either to 40 sessions of supportive-expressive psychotherapy (N=80) or to community-delivered psychodynamic therapy (N=76). Assessments were made at intake and 1 and 2 years after intake. Patients were recruited consecutively from two community mental health centers (CMHCs), assessed with the Structural Clinical Interview for DSM-IV Axis II Personality Disorders, and included if they had a diagnosis of any DSM-IV personality disorder. The outcome measures included the presence of a personality disorder diagnosis, personality disorder severity index, level of psychiatric symptoms (SCL-90), Global Assessment of Functioning Scale score, and number of therapy sessions. General mixed-model analysis of variance was used to assess group and time effects. In both treatment conditions, the global level of functioning improved while there were decreases in the prevalence of patients fulfilling criteria for a personality disorder diagnosis, personality disorder severity, and psychiatric symptoms. There was no difference in effect between treatments. During the follow-up period, patients who received supportive-expressive psychotherapy made significantly fewer visits to the CMHCs than the patients who received community-delivered psychodynamic therapy. Manualized supportive-expressive psychotherapy was as effective as nonmanualized community-delivered psychodynamic therapy conducted by experienced dynamic clinicians.

  7. Comparative effectiveness of cognitive and dynamic therapies for major depressive disorder in a community mental health setting: study protocol for a randomized non-inferiority trial.

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    Connolly Gibbons, Mary Beth; Mack, Rachel; Lee, Jacqueline; Gallop, Robert; Thompson, Donald; Burock, Debra; Crits-Christoph, Paul

    2014-01-01

    There is substantial evidence that cognitive therapy is an effective intervention for the treatment of major depressive disorder. Although dynamic psychotherapies have been widely studied and are commonly practiced worldwide, there are few randomized comparisons of cognitive therapy and dynamic therapy for major depressive disorder. We are completing data collection on a randomized non-inferiority trial comparing the effectiveness of cognitive therapy and short-term dynamic psychotherapy in the treatment of major depressive disorder in the community mental health setting. Therapists employed in the community setting have been recruited for training in either short-term dynamic psychotherapy or cognitive therapy. Patients seeking services at the community site who meet criteria for major depressive disorder based on a blind independent diagnostic interview are randomized to 16 sessions of treatment. All patients are assessed at baseline and months 1, 2, 4, and 5 utilizing a comprehensive battery. This study adds to the growing literature evaluating the effectiveness of short-term dynamic psychotherapy for specific diagnostic groups. These results will have implications for the dissemination of effective interventions for major depressive disorder in community mental health settings. This trial is registered at ClinicalTrials.gov, a service of the United States National Institute of Health. NIH Identifier: NCT01207271. Registered 21 September 2010.

  8. Effects of Community Exercise Therapy on Metabolic, Brain, Physical, and Cognitive Function Following Stroke: A Randomized Controlled Pilot Trial.

    Science.gov (United States)

    Moore, Sarah A; Hallsworth, Kate; Jakovljevic, Djordje G; Blamire, Andrew M; He, Jiabao; Ford, Gary A; Rochester, Lynn; Trenell, Michael I

    2015-08-01

    Exercise therapy could potentially modify metabolic risk factors and brain physiology alongside improving function post stroke. To explore the short-term metabolic, brain, cognitive, and functional effects of exercise following stroke. A total of 40 participants (>50 years, >6 months post stroke, independently mobile) were recruited to a single-blind, parallel, randomized controlled trial of community-based exercise (19 weeks, 3 times/wk, "exercise" group) or stretching ("control" group). Primary outcome measures were glucose control and cerebral blood flow. Secondary outcome measures were cardiorespiratory fitness, blood pressure, lipid profile, body composition, cerebral tissue atrophy and regional brain metabolism, and physical and cognitive function. Exercise did not change glucose control (homeostasis model assessment 1·5 ± 0·8 to 1·5 ± 0·7 vs 1·6 ± 0·8 to 1·7 ± 0·7, P = .97; CI = -0·5 to 0·49). Medial temporal lobe tissue blood flow increased with exercise (38 ± 8 to 42 ± 10 mL/100 g/min; P physical function, and cognition also improved with exercise. Exercise therapy improves short-term metabolic, brain, physical, and cognitive function, without changes in glucose control following stroke. The long-term impact of exercise on stroke recurrence, cardiovascular health, and disability should now be explored. © The Author(s) 2014.

  9. Effects of community occupational therapy on quality of life, mood, and health status in dementia patients and their caregivers: a randomized controlled trial.

    NARCIS (Netherlands)

    Graff, M.J.L.; Vernooij-Dassen, M.J.F.J.; Thijssen, M.; Dekker, J.; Hoefnagels, W.H.L.; Olde Rikkert, M.G.M.

    2007-01-01

    BACKGROUND: Cure of dementia is not possible, but quality of life of patients and caregivers can be improved. Our aim is to investigate effects of community occupational therapy on dementia patients' and caregivers' quality of life, mood, and health status and caregivers' sense of control over life.

  10. Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial.

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    Luk, Edwin K; Gorelik, Alexandra; Irving, Louis; Khan, Fary

    2017-03-06

    To investigate whether the use of cognitive behavioural therapy in pulmonary rehabilitation addresses the depression and anxiety burden and thereby improves rehabilitation outcomes. Prospective controlled clinical trial. A total of 70 patients with chronic obstructive pulmonary disease who were referred to a community centre for pulmonary rehabilitation. Patients were allocated to either the control group, consisting of pulmonary rehabilitation alone, or to the treatment group, receiving pulmonary rehabilitation and an additional 6 sessions of group-based cognitive behavioural therapy. Assessments consisting of questionnaires and walk tests were conducted pre- and post-pulmonary rehabilitation. A total of 28 patients were enrolled. The cognitive behavioural therapy group had significant improvements in exercise capacity following pulmonary rehabilitation (mean change 32.9 m, p = 0.043), which was maintained at 3 months post-pulmonary rehabilitation (mean change 23.4 m, p = 0.045). Patients in the cognitive behavioural therapy group showed significant short-term improvements in fatigue, stress and depression (mean change 2.4, p = 0.016, 3.9, p = 0.024 and 4.3, p = 0.047, respectively) and a 3-month post-pulmonary rehabilitation improvement in anxiety score (mean change 3.1, p = 0.01). No significant changes were seen in the control group. The addition of cognitive behavioural therapy improved patients' physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.

  11. Promoting health within the community: community therapy as strategy

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    Martha Fuentes R

    2011-07-01

    Full Text Available Objective: to identify, by assessing the records of community therapy meetings, the everyday problems that affect communities in order to understand and map the pain and suffering expressed by the participants. Methodology: the records created by the therapists after each meeting were used for data collection. The following two topics were chosen for analysis purposes: the problems that were presented and the ones that were chosen. Likewise, analysis categories were identified based on the frequency with which they were mentioned by the participants. The records of 774 meetings were analyzed. Such meetings took place from August, 2006 to December, 2008. An average of 9 to 20 people attended each meeting. Results: openness, freedom, warmth, and respect were characteristics of these meetings. The most common problems were: domestic violence, sexual abuse, divorce, discrimination, feelings of guilt, abandonment, rage, fear, negligence, problems with children, partners, co-workers or neighbors, losing one’s job, one’s loved ones or one’s material possessions, drug addiction, alcoholism, smoking, etc. Conclusions: community therapy has led not only to identify the people who really are in need of treatment, but also contributed to reduce the demand for the municipality’s health services. Having people meet without judging them by what they say, feel or think makes it easier for them to cope with their suffering and fears. It also creates social support networks, develops better attitudes of solidarity, responsibility and affectiveness, empowers the people and the community, and makes it easier to find better ways of overcoming problems. At the same time, it makes it possible to learn how people live and cope with their daily problems, thus allowing them to reframe these problems, and enabling the development of more effective care.

  12. [Effects of cognitive behavioral therapy program on mental health problems in children dealing with trauma: focused on community district victimized by oil spill].

    Science.gov (United States)

    Sohn, Jung Nam; Lee, Yong-Mi

    2012-02-01

    This study was done to evaluate the effects of cognitive behavioral therapy in a victimized community district and to determine if the program is an effective nursing intervention to reduce posttraumatic stress disorder symptom, depression and state anxiety. A nonequivalent control group design was used for the study. The participants, 32 elementary school students, were selected from grades 4, 5, 6 and each student was assigned to either the experimental (16) or control (16) group. Cognitive behavioral therapy was used as the experimental treatment from April 9 to May 28, 2009. The experimental group received cognitive behavior therapy intervention 8 times. Data analysis was done using ANCOVA with SPSS 17.0. After the intervention, the experimental group showed significantly lower levels of posttraumatic stress disorder symptoms than the control group. The findings from this study suggest that cognitive behavioral therapy is an effective nursing intervention to decrease the level of mental health problems of children in victimized district. Further research is required in order to identify the continuous effects of cognitive behavioral therapy.

  13. Effects of community occupational therapy on quality of life, mood, and health status in dementia patients and their caregivers: a randomized controlled trial.

    Science.gov (United States)

    Graff, Maud J L; Vernooij-Dassen, Myrra J M; Thijssen, Marjolein; Dekker, Joost; Hoefnagels, Willibrord H L; Olderikkert, Marcel G M

    2007-09-01

    Cure of dementia is not possible, but quality of life of patients and caregivers can be improved. Our aim is to investigate effects of community occupational therapy on dementia patients' and caregivers' quality of life, mood, and health status and caregivers' sense of control over life. Community-dwelling patients aged 65 years or older, with mild-to-moderate dementia, and their informal caregivers (n = 135 couples of patients with their caregivers) were randomly assigned to 10 sessions of occupational therapy over 5 weeks or no intervention. Cognitive and behavioral interventions were used to train patients in the use of aids to compensate for cognitive decline and caregivers in coping behaviors and supervision. Outcomes, measured at baseline, 6 weeks, and 12 weeks, were patients' and caregivers' quality of life (Dementia Quality of Life Instrument, Dqol), patients' mood (Cornell Scale for Depression, CSD), caregivers' mood (Center for Epidemiologic Studies Depression Scale, CES-D), patients' and caregivers' health status (General Health Questionnaire, GHQ-12), and caregivers' sense of control over life (Mastery Scale). Improvement on patients' Dqol overall (0.8; 95% confidence interval [CI], 0.6-.1, effect size 1.3) and caregivers' Dqol overall (0.7; 95% CI, 0.5-.9, effect size 1.2) was significantly better in the intervention group as compared to controls. Scores on other outcome measures also improved significantly. This improvement was still significant at 12 weeks. Community occupational therapy should be advocated both for dementia patients and their caregivers, because it improves their mood, quality of life, and health status and caregivers' sense of control over life. Effects were still present at follow-up.

  14. Intra-Arterial Therapy for Acute Stroke and the Effect of Technological Advances on Recanalization: Findings in a Community Hospital.

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    Goldstein, Jonas H; Denslow, Sheri A; Goldstein, Samuel J; Marx, William F; Short, John G; Taylor, Reid D; Schneider, Alexander L

    2016-01-01

    Recent randomized controlled studies have shown improvement in recanalization outcomes when physicians use the latest intra-arterial therapy devices in patients with acute, large-vessel, intracranial occlusions. The goal of this study was to explore how new procedures affected degree of and time to recanalization at a single center over the past 12 years as technology has improved. Patients were included in the study if they had a large or medium intracranial vessel occlusion and had undergone intra-arterial therapy for acute stroke during the period 2002-2013. Therapies were categorized as intra-arterial thrombolysis with tissue plasminogen activator (IA tPA), mechanical thrombectomy using 1st-generation devices (Merci and Penumbra), or mechanical thrombectomy using 2nd-generation devices (stent-trievers). Recanalization was defined using a modified Thrombolysis in Cerebral Infarction (TICI) scale. Primary treatment was IA tPA in 24 (12.4%) patients, 1st-generation devices in 128 (66.0%) patients, and 2nd-generation devices in 42 (21.6%) patients. TICI 2b was achieved in 7 (29.2%) patients treated with IA tPA, in 79 (61.7%) patients treated with 1st-generation devices, and in 38 (90.5%) patients treated with 2nd-generation devices. Compared to patients treated with IA tPA, patients treated with 2nd-generation devices were more likely to reach TICI 2b recanalization (odds ratio, 11.66; 95% CI, 1.56-87.01), and they did so in shorter times. Technological advances over 12 years in endovascular stroke treatments significantly improved the chance of and reduced time to achieving TICI 2b recanalization in our community hospital. This shows the importance of adopting new technologies in a rapidly evolving field in order to provide the best-practice standard of care for the people of our region. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  15. Immunomodulatory adjuvant therapy in severe community-acquired pneumonia.

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    Morton, Ben; Pennington, Shaun Harry; Gordon, Stephen B

    2014-10-01

    Severe pneumonia has a high mortality (38.2%) despite evidence-based therapy. Rising rates of antimicrobial resistance increase the urgency to develop new treatment strategies. Multiple adjuvant therapies for pneumonia have been investigated but none are currently licensed. Profound immune dysregulation occurs in patients with severe infection. An initial hyper-inflammatory response is followed by a secondary hypo-inflammatory response with 'immune-paralysis'. There is focus on the development of immunostimulatory agents to improve host ability to combat primary infection and reduce secondary infections. Successful treatments must be targeted to immune response; promising biomarkers exist but have not yet reached common bedside practice. We explore evidence for adjuvant therapies in community-acquired pneumonia. We highlight novel potential treatment strategies using a broad-based search strategy to include publications in pneumonia and severe sepsis. We explore reasons for the failure to develop effective adjuvant therapies and highlight the need for targeted therapy specific to immune activity.

  16. Utilizing Benchmarking to Study the Effectiveness of Parent-Child Interaction Therapy Implemented in a Community Setting

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    Self-Brown, Shannon; Valente, Jessica R.; Wild, Robert C.; Whitaker, Daniel J.; Galanter, Rachel; Dorsey, Shannon; Stanley, Jenelle

    2012-01-01

    Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of…

  17. Evaluating the real-world effectiveness of cognitive-behavior therapy efficacy research on eating disorders: a case study from a community-based clinical setting.

    Science.gov (United States)

    Lowe, Michael R; Bunnell, Douglas W; Neeren, Amy M; Chernyak, Yelena; Greberman, Laurel

    2011-01-01

    There is a growing consensus that there is a need to test the real-world effectiveness of eating disorder therapies that show promise in efficacy research. This article provides a narrative account of an NIMH-funded study that attempted to apply efficacy findings from CBT research to an Intensive Outpatient Program (IOP) at the largest community-based eating disorder program in the United States. We describe the study as originally envisioned as well as the various challenges that the researchers and the IOP staff encountered in implementing this study. The different training, assumptions, and "ways of knowing" of the research team and the treatment staff in regard to the nature of eating disorders and their treatment created multiple challenges for both groups during the study period. We describe valuable lessons learned about how to-and how not to-implement effectiveness designs in clinical settings that are relatively unfamiliar with empirically-based research findings. It is hoped that our experience in attempting to apply efficacy-based research findings on eating disorders treatment in a community-based clinical setting will prove helpful to other researchers and service providers engaging in such translational research. Copyright © 2010 Wiley Periodicals, Inc.

  18. The study of cognitive – behavior training effectiveness on decreasing depresive symptoms in community therapy center resident addicts

    Directory of Open Access Journals (Sweden)

    2009-02-01

    Discussion: The results show that psychological interventions in cognitive behavioral approach played a very crucial role in reducing depression in the addict's resident at the therapeutic community. Therefore, depression, that is one of the relapse risk factors, could be obviated and more success gained.

  19. A Community Art Therapy Group for Adults with Chronic Pain

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    O'Neill, Aimee; Moss, Hilary

    2015-01-01

    This paper describes a community art therapy group for people living with chronic pain. Nine adults were offered 12 weekly group art therapy sessions that included art therapy activities such as guided imagery focusing on body scans followed by art responses and artistic expressions of the pain experience. This pilot group art therapy program is…

  20. The European hadron therapy community touches base

    CERN Multimedia

    Audrey Ballantine, Manuela Cirilli, Evangelia Dimovasili, Manjit Dosanjh, Seamus Hegarty

    2010-01-01

    The European hadron therapy community gathered in Stockholm from 3 to 5 September for the annual ENLIGHT workshops. Three of the four EC-funded projects born under the umbrella of ENLIGHT (see box) were discussed in the prestigious Nobel Forum at the Karolinska Institutet.   Souvenir photo from the ENLIGHT workshops On its second birthday, the PARTNER Initial Training Network was especially under the spotlight, as the European Commission conducted a formal project review bringing together the institutes, companies and young researchers involved. The 21 PARTNER researchers experienced the thrill of presenting their work in this privileged setting. During the coffee breaks, they joked about this being their only chance in life to speak in the Nobel Forum – but who knows what these brilliant young minds will achieve! They certainly impressed the European Commission’s Project Officer Gianluca Coluccio and Expert Reviewer Kaisa Hellevuo, who stated that PARTNER is a showcase proj...

  1. Effectiveness of a training package for implementing a community-based occupational therapy program in dementia: a cluster randomized controlled trial.

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    Döpp, Carola M E; Graff, Maud J L; Teerenstra, Steven; Olde Rikkert, Marcel G M; Nijhuis-van der Sanden, Maria W G; Vernooij-Dassen, Myrra J F J

    2015-10-01

    Evaluate the effectiveness of a training package to implement a community occupational therapy program for people with dementia and their caregiver (COTiD). Cluster randomized controlled trial. A total of 45 service units including 94 occupational therapists, 48 managers, 80 physicians, treating 71 client-caregiver couples. Control intervention: A postgraduate course for occupational therapists only. A training package including the usual postgraduate course, additional training days, outreach visits, regional meetings, and access to a reporting system for occupational therapists. Physicians and managers received newsletters, had access to a website, and were approached by telephone. The intended adherence of therapists to the COTiD program. This was assessed using vignettes. clients' daily functioning, caregivers' sense of competence, quality of life, and self-perceived performance of daily activities of both clients and caregivers. Between-group differences were assessed using multilevel analyses with therapist and intervention factors as covariates. No significant between-group differences between baseline and 12 months were found for adherence (1.58, 95% CI -0.10 to 3.25), nor for any client or caregiver outcome. A higher number of coaching sessions and higher self-perceived knowledge of dementia at baseline positively correlated with adherence scores. In contrast, experiencing more support from occupational therapy colleagues or having conducted more COTiD treatments at baseline negatively affected adherence scores. The training package was not effective in increasing therapist adherence and client-caregiver outcomes. This study suggests that coaching sessions and increasing therapist knowledge on dementia positively affect adherence. NCT01117285. © The Author(s) 2014.

  2. Antiretroviral therapy in a community clinic - early lessons from a ...

    African Journals Online (AJOL)

    Antiretroviral therapy in a community clinic - early lessons from a pilot project. L Bekker, C. Orrell, L. Reader, K. Matoti, K Cohen, R Martell, F Abdullah, R Wood. Abstract. Objectives. To report on operational and clinical problems encountered during the first 6 months of a community-based antiretroviral therapy (ART) ...

  3. Effect of cognitive behavioral group therapy for recovery of self-esteem on community-living individuals with mental illness: Non-randomized controlled trial.

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    Kunikata, Hiroko; Yoshinaga, Naoki; Nakajima, Kazuo

    2016-10-01

    The aim of this study was to examine over a 12-month post-intervention period whether the participation of community-living individuals with mental illness in cognitive behavioral group therapy for recovery of self-esteem (CBGTRS) resulted in improved outcomes. This was a non-randomized controlled trial. The participants were persons with mental illness who resided in communities in the Chugoku region of Japan. In total, 41 were assigned to an experimental group (CBGTRS intervention, 12 group sessions), and 21 to a control group. Outcome indices (self-esteem, moods, cognition, subjective well-being, psychiatric symptoms) were measured for the experimental group prior to intervention (T0), immediately post-intervention (T1), and at 3 (T2) and 12 (T3) months post-intervention. The control group was measured at the same intervals. For the experimental group, self-esteem scores at T1, T2, and T3 were significantly higher than at T0. Moods and cognition scores remained significantly low until T2. Scores for Inadequate Mental Mastery in the subjective well-being index had not decreased by T3. Confidence in Coping remained significantly high until T2. Psychiatric symptoms scores at T0, T1, T2, and T3 were significantly lower than at T0. The means and standard errors for self-esteem and Inadequate Mental Mastery increased until T3, and those for Tension-Anxiety, Depression-Dejection, and Confusion decreased until T2. From within-group trends and between-group differences in self-esteem, we conclude that CBGTRS may have a relatively long-term effect on self-esteem recovery. T2 is the turning point for moods and cognition; thus, follow-up is needed 3 months following the initial program. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  4. A randomized, controlled clinical trial: the effect of mindfulness-based cognitive therapy on generalized anxiety disorder among Chinese community patients: protocol for a randomized trial.

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    Wong, Samuel Y S; Mak, Winnie W S; Cheung, Eliza Y L; Ling, Candy Y M; Lui, Wacy W S; Tang, W K; Wong, Rebecca L P; Lo, Herman H M; Mercer, Stewart; Ma, Helen S W

    2011-11-29

    Research suggests that an eight-week Mindfulness-Based Cognitive Therapy (MBCT) program may be effective in the treatment of generalized anxiety disorders. Our objective is to compare the clinical effectiveness of the MBCT program with a psycho-education programme and usual care in reducing anxiety symptoms in people suffering from generalized anxiety disorder. A three armed randomized, controlled clinical trial including 9-month post-treatment follow-up is proposed. Participants screened positive using the Structure Clinical Interview for DSM-IV (SCID) for general anxiety disorder will be recruited from community-based clinics. 228 participants will be randomly allocated to the MBCT program plus usual care, psycho-education program plus usual care or the usual care group. Validated Chinese version of instruments measuring anxiety and worry symptoms, depression, quality of life and health service utilization will be used. Our primary end point is the change of anxiety and worry score (Beck Anxiety Inventory and Penn State Worry Scale) from baseline to the end of intervention. For primary analyses, treatment outcomes will be assessed by ANCOVA, with change in anxiety score as the baseline variable, while the baseline anxiety score and other baseline characteristics that significantly differ between groups will serve as covariates. This is a first randomized controlled trial that compare the effectiveness of MBCT with an active control, findings will advance current knowledge in the management of GAD and the way that group intervention can be delivered and inform future research. Unique Trail Number (assigned by Centre for Clinical Trails, Clinical Trials registry, The Chinese University of Hong Kong): CUHK_CCT00267.

  5. A randomized, controlled clinical trial: the effect of mindfulness-based cognitive therapy on generalized anxiety disorder among Chinese community patients: protocol for a randomized trial

    Directory of Open Access Journals (Sweden)

    Wong Samuel YS

    2011-11-01

    Full Text Available Abstract Background Research suggests that an eight-week Mindfulness-Based Cognitive Therapy (MBCT program may be effective in the treatment of generalized anxiety disorders. Our objective is to compare the clinical effectiveness of the MBCT program with a psycho-education programme and usual care in reducing anxiety symptoms in people suffering from generalized anxiety disorder. Methods A three armed randomized, controlled clinical trial including 9-month post-treatment follow-up is proposed. Participants screened positive using the Structure Clinical Interview for DSM-IV (SCID for general anxiety disorder will be recruited from community-based clinics. 228 participants will be randomly allocated to the MBCT program plus usual care, psycho-education program plus usual care or the usual care group. Validated Chinese version of instruments measuring anxiety and worry symptoms, depression, quality of life and health service utilization will be used. Our primary end point is the change of anxiety and worry score (Beck Anxiety Inventory and Penn State Worry Scale from baseline to the end of intervention. For primary analyses, treatment outcomes will be assessed by ANCOVA, with change in anxiety score as the baseline variable, while the baseline anxiety score and other baseline characteristics that significantly differ between groups will serve as covariates. Conclusions This is a first randomized controlled trial that compare the effectiveness of MBCT with an active control, findings will advance current knowledge in the management of GAD and the way that group intervention can be delivered and inform future research. Unique Trail Number (assigned by Centre for Clinical Trails, Clinical Trials registry, The Chinese University of Hong Kong: CUHK_CCT00267

  6. Occupational Therapy and Community Reintegration of Persons with Brain Injury

    Science.gov (United States)

    Fact Sheet Occupational Therapy and Community Reintegration of Persons With Brain Injury Brain injuries can affect motor, sensory, cognitive, and behavioral functioning. A person who has sustained a brain ...

  7. Pilot Study of Community-Based Cognitive Behavioral Group Therapy for Adolescents with Social Phobia.

    Science.gov (United States)

    Baer, Susan; Garland, E. Jane

    2005-01-01

    Objective: A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia, simplified both in terms of time and labor intensity from a previously studied program (Social Effectiveness Therapy for Children and Adolescents) to be more appropriate for a community outpatient psychiatric…

  8. The effect of stimulation therapy and donepezil on cognitive function in Alzheimer’s disease. A community based RCT with a two-by-two factorial design

    Directory of Open Access Journals (Sweden)

    Andersen Fred

    2012-07-01

    Full Text Available Abstract Background Progressive neurodegeneration in Alzheimer’s disease (AD induces cognitive deterioration, and there is controversy regarding the optimal treatment strategy in early AD. Stimulation therapy, including physical exercise and cholinesterase inhibitors are both reported to postpone cognitive deterioration in separate studies. We aimed to study the effect of stimulation therapy and the additional effect of donepezil on cognitive function in early AD. Method Design: A two-by-two factorial trial comprising stimulation therapy for one year compared to standard care to which a randomized double-blinded placebo controlled trial with donepezil was added. Setting: Nine rural municipalities in Northern Norway. Participants: 187 participants 65 years and older with a recent diagnosis of mild or moderate AD were included in the study of which 146 completed a one-year follow-up. INTERVENTIONS: In five municipalities the participants received stimulation therapy whereas participants in four received standard care. All participants were randomised double-blindly to donepezil or placebo and tested with three different cognitive tests four times during the one-year study period. Main outcome: Changes in MMSE sum score. Secondary outcome: Changes in ADAS-Cog and Clock Drawing Test. Results MMSE scores remained unchanged amongst AD participants receiving stimulation therapy and those receiving standard care. The results were consistent for ADAS-Cog and Clock Drawing Test. No time trend differences were found during one-year follow-up between groups receiving stimulation therapy versus standard care or between donepezil versus placebo. Conclusion In rural AD patients non-pharmacological and pharmacological therapy did not improve outcome compared with standard care but all groups retained cognitive function during one year follow-up. Other studies are needed to confirm these results. Trial registration ClinicalTrials.gov (Identifier: NCT00443014

  9. Re-imagining occupational therapy clients as communities: Presenting the community-centred practice framework.

    Science.gov (United States)

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

    2018-01-09

    Occupational therapists' are increasingly working with communities and providing services at the community level. There is, however, a lack of conceptual frameworks to guide this work. The aim of this article is to present a new conceptual framework for community-centered practice in occupational therapy. The conceptual framework was developed from qualitative multi-case research on exemplars of community participation. The first was, a network of Canadian food security programs, and the second, a rural Australian community banking initiative. Key themes were identified from across the case studies, and cross-case findings interpreted using occupational therapy and occupational science knowledge, and relevant social theory. The outcome is a four-stage, occupation-focused, community-centered practice framework. The Community-Centred Practice Framework can be used by occupational therapists to understand and apply a community-centered practice approach. The four stages are: (1) Community Identity, (2) Community Occupations, (3) Community Resources and Barriers, and (4) Participation Enablement. Further research is needed to trial and critically evaluate the framework, to assess its usefulness as a robust, occupation-focused, frame of reference to guide community-centered practice in occupational therapy. The proposed framework should assist occupational therapists to conceptualize community-centered practice, and to utilize and apply theory.

  10. [Cardiac effects of radiation therapy].

    Science.gov (United States)

    Tuohinen, Suvi; Turpeinen, Anu; Skyttä, Tanja; Kellokumpu-Lehtinen, Pirkko-Liisa

    2015-01-01

    Because of increased life-expentancy cancer patients having undergone radiation therapy nowadays live longer, and late-appearing adverse effects are therefore playing a more significant role. Radiation therapy given to the chest is known to approximately double the risk of heart disease, the cumulative total radiation dose being the most important risk-increasing factor. The most significant adverse effects appear only years after the treatment. The mortality from late manifestations reduces the total benefit of radiation therapy. Patients with radiation therapy due to a cancer of the left breast or Hodgkin's lymphoma are particularly susceptible to cardiac effects. A safe radiation dose is not known.

  11. Health Promotion of University Students: contributions of community therapy.

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    Cintia Poleto Buzeli

    2012-01-01

    Full Text Available With this experience report of a master’s degree and two teachers of graduate Nursing School of Nursing Federal University of Mato Grosso, we sought to reflect on the Community Therapy (TC as a practice of collective care offered to students university students. Our goal is to report the experience of performing TC wheels in an academic environment, offer theoretical and methodological principles for the structuring and implementation of this practice care to college students at other universities. Was used for data collection direct observation of the wheels of TC the professional experiences as nurses and therapists community and appreciation of documents of such as the registration form filled out by the TC meetings and therapist co-therapist after each wheel TC. The reported experience has demonstrated the effectiveness of TC for the promotion of health thin this group, showing its importance as a practice for the creation and strengthening of ties between the community, the establishment of solidarity networks among students, as being a space speech and listening to their sufferings, their appreciation of life and its potential for promoting self-esteem and to encourage the development of a democract and civic consciousness.

  12. Occupational therapy internship in the community

    Directory of Open Access Journals (Sweden)

    Andreisi Carbone Anversa

    2016-10-01

    Full Text Available Introduction: The organization of Primary Health Care through the family health strategy calls for comprehensive and continuous attention of the residents on their area of expertise. Objective: To reflect on Occupational Therapy practice next to a Family Health Strategy (FHS, aiming to raise and expand the profession inclusion in this area and discuss the challenges and field potentials. Method: This is a report of professional and academic experiences that describes training and services activities. The practical activities were developed in partnership with FHS in Santa Maria, Rio Grande do Sul, Brazil. The group, composed by 10 interns, conducted household interventions, all accompanied by supervisors. On 27 cases assisted, each individual received the Occupational Therapy service once a week, during one hour. Results: It was exciting to know, in fact, the subjects reality, their social context, daily life, organizational mode - allowing a series of interventions which would not be appropriate in a clinical environment. In addition, the home care provided a closer relationship among health professionals with patients and their families. Conclusion: Through mistakes, successes, obstacles and learning, a process of maturation and experiences with unique subjects, various diseases, illness and care, resulted in a unique moment that made possible to suggest how important it is, for both trainees and society, to make real this link between academia and health facilities, seeking services qualification.

  13. Building a Community-Academic Partnership: Implementing a Community-Based Trial of Telephone Cognitive Behavioral Therapy for Rural Latinos

    Directory of Open Access Journals (Sweden)

    Eugene Aisenberg

    2012-01-01

    Full Text Available Concerns about the appropriate use of EBP with ethnic minority clients and the ability of community agencies to implement and sustain EBP persist and emphasize the need for community-academic research partnerships that can be used to develop, adapt, and test culturally responsive EBP in community settings. In this paper, we describe the processes of developing a community-academic partnership that implemented and pilot tested an evidence-based telephone cognitive behavioral therapy program. Originally demonstrated to be effective for urban, middle-income, English-speaking primary care patients with major depression, the program was adapted and pilot tested for use with rural, uninsured, low-income, Latino (primarily Spanish-speaking primary care patients with major depressive disorder in a primary care site in a community health center in rural Eastern Washington. The values of community-based participatory research and community-partnered participatory research informed each phase of this randomized clinical trial and the development of a community-academic partnership. Information regarding this partnership may guide future community practice, research, implementation, and workforce development efforts to address mental health disparities by implementing culturally tailored EBP in underserved communities.

  14. Late effects from hadron therapy

    Energy Technology Data Exchange (ETDEWEB)

    Blakely, Eleanor A.; Chang, Polly Y.

    2004-06-01

    Successful cancer patient survival and local tumor control from hadron radiotherapy warrant a discussion of potential secondary late effects from the radiation. The study of late-appearing clinical effects from particle beams of protons, carbon, or heavier ions is a relatively new field with few data. However, new clinical information is available from pioneer hadron radiotherapy programs in the USA, Japan, Germany and Switzerland. This paper will review available data on late tissue effects from particle radiation exposures, and discuss its importance to the future of hadron therapy. Potential late radiation effects are associated with irradiated normal tissue volumes at risk that in many cases can be reduced with hadron therapy. However, normal tissues present within hadron treatment volumes can demonstrate enhanced responses compared to conventional modes of therapy. Late endpoints of concern include induction of secondary cancers, cataract, fibrosis, neurodegeneration, vascular damage, and immunological, endocrine and hereditary effects. Low-dose tissue effects at tumor margins need further study, and there is need for more acute molecular studies underlying late effects of hadron therapy.

  15. Late effects from hadron therapy.

    Science.gov (United States)

    Blakely, Eleanor A; Chang, Polly Y

    2004-12-01

    Successful cancer patient survival and local tumor control from hadron radiotherapy warrant a discussion of potential secondary late effects from the radiation. The study of late-appearing clinical effects from particle beams of protons, carbon, or heavier ions is a relatively new field with few data. However, new clinical information is available from pioneer hadron radiotherapy programs in the USA, Japan, Germany and Switzerland. This paper will review available data on late tissue effects from particle radiation exposures, and discuss its importance to the future of hadron therapy. Potential late radiation effects are associated with irradiated normal tissue volumes at risk that in many cases can be reduced with hadron therapy. However, normal tissues present within hadron treatment volumes can demonstrate enhanced responses compared to conventional modes of therapy. Late endpoints of concern include induction of secondary cancers, cataract, fibrosis, neurodegeneration, vascular damage, and immunological, endocrine and hereditary effects. Low-dose tissue effects at tumor margins need further study, and there is need for more acute molecular studies underlying late effects of hadron therapy.

  16. Telephone-Administered Cognitive Behavioral Therapy for Veterans Served by Community-Based Outpatient Clinics

    Science.gov (United States)

    Mohr, David C.; Carmody, Timothy; Erickson, Lauren; Jin, Ling; Leader, Julie

    2011-01-01

    Objective: Multiple trials have found telephone-administered cognitive behavioral therapy (T-CBT) to be effective for the treatment of depression. The aim of this study was to evaluate T-CBT for the treatment of depression among veterans served by community-based outpatient clinics (CBOCs) outside of major urban areas. Method: Eighty-five veterans…

  17. Transportability of Multisystemic Therapy to Community Settings: Can a Program Sustain Outcomes without MST Services Oversight?

    Science.gov (United States)

    Smith-Boydston, Julianne M.; Holtzman, Rochelle J.; Roberts, Michael C.

    2014-01-01

    Background: Multisystemic therapy (MST) has been shown to be effective in treating delinquent behavior in youth. However, some community agencies with MST programs are unable to afford the ongoing costs of licensure and quality assurance oversight provided by MST services. Objective: The present study utilized retrospective archival analyses of…

  18. Integrating Medication Therapy Management (MTM) Services Provided by Community Pharmacists into a Community-Based Accountable Care Organization (ACO).

    Science.gov (United States)

    Isetts, Brian

    2017-10-16

    (1) Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM) services provided by community pharmacists into the clinical care teams and the health information technology (HIT) infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO). (2) Methods: The continuous quality improvement evaluation methodology employed in this project was the context + mechanism = outcome (CMO) model to account for the fact that programs only work insofar as they introduce promising ideas, solutions and opportunities in the appropriate social and cultural contexts. Collaborations between a 12-county ACO and 15 community pharmacies in Southwest Minnesota served as the social context for this feasibility study of MTM referrals to community pharmacists. (3) Results: All 15 community pharmacy sites were integrated into the HIT infrastructure through Direct Secure Messaging, and there were 32 recipients who received MTM services subsequent to referrals from the ACO at 5 of the 15 community pharmacies over a 1-year implementation phase. (4) Conclusion: At the conclusion of this project, an effective electronic communication and MTM referral system was activated, and consideration was given to community pharmacists providing MTM in future ACO shared savings agreements.

  19. Microvascular Effects Of Photodynamic Therapy.

    Science.gov (United States)

    Wieman, T. J.; Fingar, Victor H.

    1989-06-01

    Tumor destruction in photodynamic therapy is the result of the combination of direct cellular toxicity and damage to tumor microvasculature. These phenomena appear to be caused by tissue interactions with toxic oxygen compounds which are formed when light interacts with photosensitizing agents. Although injury to cell membranes, mitochondria and the nucleus have been noted, such injuries by themselves tend to be sublethal and cannot totally account for the effectiveness of PDT. The mechanism of effect of PDT on the vasculature has not been fully investigated. The vascular effects are believed to involve both intravascular and perivascular phenomena. Platelet aggregation appears to be an early event. Changes to the endothelium, and smooth muscle contraction as well as increased capillary permeability have also been observed during therapy. Initial experiments using'cyclooxygenase inhibitors indicate that arachidonic acid metabolites are active elements in producing the vascular phase of the therapeutic response and that these microvasculature effects appear to be critical to permanent tumor destruction.

  20. ADJUNCTIVE THERAPY OF COMMUNITY-ACKUIRED PNEUMONIA: NECESSITY AND SUFFICIENCY

    Directory of Open Access Journals (Sweden)

    L. V. Savchenkova

    2016-01-01

    Full Text Available Objective: analysis of pathogenetic and  symptomatic therapy of community-acquired pneumonia in the prehospital and at the stage  of hospital treatment of disease in hospitals of city Khujand of the Republic of Tajikistan.Materials and  methods: A retrospective analysis of 393 case  histories of  patients treated for  community-acquired pneumonia in  the  hospital Khujand from  2011  to  2015  is conducted. The estimation of the scope  and efficiency of the additional medical support for the treatment of communityacquired pneumonia was conducted, take  into  account the drugs  that  given  to patients in an outpatient setting and  in a hospital. Analyzed purpose rationale, adequacy of dose, duration of treatment and  compliance of the  activities with existing international and  national guidelines for the treatment  of community-acquired pneumonia.Results:  the  study found that  in  clinical  practice, 57% of  patients with  community-acquired pneumonia received funds pathogenetic and  symptomatic therapy. It  is  found that  quite  often  prescribed drugs  with  unproven efficiency. Thus,  75%  of patients received expectorants and  mucolytic drugs,   42.2% of  patients  received anti-allergic medicals. Non-steroidal anti-inflammatory medicals received 37.9% of patients with  community-acquired pneumonia, almost  30% of patients receiving infusion therapy. Quite often  (15.7% patients with   community-acquired  pneumonia  prescribed antifungal drugs  and  antiprotozoal drug  – metronidazole (59%  of cases.  Furthermore, in complex treatment of community-acquired pneumonia include vitamin C (23.1% and vitamin B (65.9%.Conclusion: the  analysis of pharmacotherapy community-acquired pneumonia showed that  in the treatment of this disease occurs  unjustified polypharmacy. Quite often  prescribe drugs with unproven efficacy and, as a consequence of a significant frequency of clinical

  1. Implementation of transdiagnostic cognitive therapy in community behavioral health: The Beck Community Initiative.

    Science.gov (United States)

    Creed, Torrey A; Frankel, Sarah A; German, Ramaris E; Green, Kelly L; Jager-Hyman, Shari; Taylor, Kristin P; Adler, Abby D; Wolk, Courtney B; Stirman, Shannon W; Waltman, Scott H; Williston, Michael A; Sherrill, Rachel; Evans, Arthur C; Beck, Aaron T

    2016-12-01

    Progress bringing evidence-based practice (EBP) to community behavioral health (CBH) has been slow. This study investigated feasibility, acceptability, and fidelity outcomes of a program to implement transdiagnostic cognitive therapy (CT) across diverse CBH settings, in response to a policy shift toward EBP. Clinicians (n = 348) from 30 CBH programs participated in workshops and 6 months of consultation. Clinician retention was examined to assess feasibility, and clinician feedback and attitudes were evaluated to assess implementation acceptability. Experts rated clinicians' work samples at baseline, mid-, and end-of-consultation with the Cognitive Therapy Rating Scale (CTRS) to assess fidelity. Feasibility was demonstrated through high program retention (i.e., only 4.9% of clinicians withdrew). Turnover of clinicians who participated was low (13.5%) compared to typical CBH turnover rates, even during the high-demand training period. Clinicians reported high acceptability of EBP and CT, and self-reported comfort using CT improved significantly over time. Most clinicians (79.6%) reached established benchmarks of CT competency by the final assessment point. Mixed-effects hierarchical linear models indicated that CTRS scores increased significantly from baseline to the competency assessment (p < .001), on average by 18.65 points. Outcomes did not vary significantly between settings (i.e., outpatient vs. other). Even clinicians motivated by policy-change rather than self-nomination may feasibly be trained to deliver a case-conceptualization driven EBP with high levels of competency and acceptability. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. [Side Effects of Occupational Group Therapy].

    Science.gov (United States)

    Flöge, B; Fay, D; Jöbges, M; Linden, M; Muschalla, B

    2016-12-01

    Background: Occupational therapy is an important co-therapy in psychiatric therapy. It is a common belief that no risks are associated with occupational therapy. Negative effects caused by group therapy, especially occupational therapy, have not been in the focus of research yet. In this study we want to illustrate possible types and intensities of group side effects through occupational therapy. Patients and Methods: Patients of an inpatient rehabilitation facility filled out the Adverse Treatment Reaction Group Checklist. The checklist contains 47 items divided in six dimensions: group size, content, group participants, group outcome and global. The self-rating used a 5-point likert scale (0 = not at all; 4 = very much, extremely stressful) and gives information about types and intensities of the side effects. Results: 88.9 % of 45 patients reported negative effects of occupational group therapy. 28.9 % of the patients rated the side effect as at least severe. Discussion: Occupational therapy is associated with side effects as every other group therapy. Possible side effects caused by group therapy should be considered while planning and implementing occupational therapy. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Training community therapists to deliver cognitive behavioral therapy in the aftermath of disaster.

    Science.gov (United States)

    Hamblen, Jessica L; Norris, Fran H; Gibson, Laura; Lee, Linda

    2010-01-01

    In this paper we examine the effectiveness of disseminating Cognitive Behavioral Therapy for Postdisaster Distress (CBT-PD) to community therapists in Baton Rouge, Louisiana following Hurricane Katrina. One hundred four therapists attended a two-day training in CBT-PD with on-going case consultation. Pre- and post-training, therapists rated eight core cognitive behavioral therapy elements on their importance, how well they understood how to deliver the element, and how confident they were in their ability to deliver the element. Post-training they completed a CBT-PD knowledge questionnaire and session fidelity forms. Seventy-seven clients completed satisfaction questionnaires and reported on how often they utilized the skills taught in CBT-PD. Therapists showed significant improvements in their ratings of the importance of various elements of cognitive behavioral therapy, their knowledge and understanding of those elements, and their confidence that they could use them effectively. Immediately following the training 90% of therapists demonstrated excellent retention of CBT-PD. Self-report measures from both therapists and clients indicated that critical session elements were delivered. This work suggests that CBT-PD can be applied in a real-world setting and that community therapists can be trained in relatively short time spans with on-going support. This finding is especially important in the disaster field given that communities are likely to find themselves in emergency situations in which a number of non-expert trauma therapists will need to deliver trauma services.

  4. Ethical dimension of circle Integrative Community Therapy on qualitative research

    Directory of Open Access Journals (Sweden)

    Paula Renata Miranda dos Santos

    2014-12-01

    Full Text Available This study discusses ethical issues in research involving human beings and seeks to understand the relationship between qualitative research and the ethical care guidelines for Integrative Community Therapy (ICT circles based on Resolution 466/12 of the National Health Council of the Ministry of Health of Brazil. This is documentary research, which analyzed Resolution 466/12 and ICT circles seeking to make a connection between the ethical guidelines contained in both. The analysis of the corpus was directed toward the construction of the following results: the person's perception, cultural diversity and community. It also brings in consideration of the influence of the ethical dimension of the ICT circles on qualitative research. We conclude that ICT circles are innovative in the sense of the diversity of participants and respect for cultural and social differences. Thus, ICT circles promote acquisition of quality information for social research as well as compliance with the ethical guidelines outlined in Resolution No. 466/12.

  5. Ethical dimension of circle Integrative Community Therapy on qualitative research

    Directory of Open Access Journals (Sweden)

    Paula Renata Miranda dos Santos

    Full Text Available This study discusses ethical issues in research involving human beings and seeks to understand the relationship between qualitative research and the ethical care guidelines for Integrative Community Therapy (ICT circles based on Resolution 466/12 of the National Health Council of the Ministry of Health of Brazil. This is documentary research, which analyzed Resolution 466/12 and ICT circles seeking to make a connection between the ethical guidelines contained in both. The analysis of the corpus was directed toward the construction of the following results: the person's perception, cultural diversity and community. It also brings in consideration of the influence of the ethical dimension of the ICT circles on qualitative research. We conclude that ICT circles are innovative in the sense of the diversity of participants and respect for cultural and social differences. Thus, ICT circles promote acquisition of quality information for social research as well as compliance with the ethical guidelines outlined in Resolution No. 466/12.

  6. A new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial

    NARCIS (Netherlands)

    Dopp, C.M.E.; Graff, M.J.L.; Teerenstra, S.; Adang, E.M.M.; Nijhuis-Van der Sanden, R.; Olde Rikkert, M.G.M.; Vernooij-Dassen, M.J.F.J.

    2011-01-01

    BACKGROUND: Even effective interventions for people with dementia and their caregivers require specific implementation efforts. A pilot study showed that the highly effective community occupational therapy in dementia (COTiD) program was not implemented optimally due to various barriers. To decrease

  7. Treatment of Individuals with Borderline Personality Disorder Using Dialectical Behavior Therapy in a Community Mental Health Setting: Clinical Application and a Preliminary Investigation

    Science.gov (United States)

    Ben-Porath, Denise D.; Peterson, Gregory A.; Smee, Jacqueline

    2004-01-01

    This article describes an effort to implement and examine dialectical behavior therapy's (DBT) effectiveness in a community mental health setting. Modifications made to address unique aspects of community mental health settings are described. Barriers encountered in implementation of DBT treatment in community mental health settings, such as staff…

  8. Community therapy application in intervention with adolescents: new strategies for prevention and promotion

    Directory of Open Access Journals (Sweden)

    Flávia Cristina Zago

    2013-08-01

    Full Text Available Given adolescents vulnerability facing transformations and resistances, the group work used by Occupational Therapy through techniques and dynamics favors expression, anxiety control and biopsychosocial maturity in intervention. Currently, one strategy used with teenagers is Community Therapy (CT, because it provides a welcoming environment where all are equal and can share their sufferings, anxieties and affinities. Thus, this study examined the effectiveness of group activities used in occupational therapy as warm up strategies in Community Therapy circles. Eleven teenagers aged 12 to 14 years old participated in the research. The study was carried out in a social institution that aims to support children and youth in the municipality of Uberaba, Minas Gerais state. Video and photo images and handwritten records were used as data collection instruments during the application of the 12 strategies, divided into three categories: competition, cooperation, and self-knowledge/self-esteem, applied for warming up the CT circles. Data were analyzed and presented through the use of a chart for better visualization and understanding of the adolescents’ behavior during the warm up CT circles. The results obtained showed dispute, unrest, lack of attention and sociability; behaviors that are inherent to adolescence due to the several changes, emotional alterations and search for identity that these subjects experience. Based on the survey results, it was possible observe that the behaviors have triggered direct-indirect relationship with the strategies used as facilitators in the discussion development regarding the issues addressed in the CT circles.

  9. A Hermeneutic Phenomenological Study of Community Mural Making and Social Action Art Therapy

    Science.gov (United States)

    Rossetto, Erica

    2012-01-01

    Through a hermeneutic phenomenological study of interview data from 8 community artists, the author sought to discover commonalities and differences in the worldviews and philosophies of self that underlie community mural making as they relate to art therapy as social action and art therapy practice within a traditional Western cultural framework.…

  10. Aging in Community Nutrition, Diet Therapy, and Nutrition and Aging Textbooks

    Science.gov (United States)

    O'Neill, Peggy Schafer; Wellman, Nancy S.; Himburg, Susan P.; Johnson, Paulette; Elfenbein, Pamela

    2005-01-01

    Using content analysis, this study evaluated the aging content and context in 11 nutrition sub-specialty textbooks: community nutrition (n = 3), diet therapy (n = 4), and nutrition and aging (n = 4). Pages with paragraphs on aging were identified in community nutrition and diet therapy textbooks, and 10% random samples of pages were evaluated in…

  11. Effectiveness of hypnosis therapy and Gestalt therapy as depression treatments

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    Elizabeth González-Ramírez

    2017-03-01

    Full Text Available We analyzed the effectiveness of two psychological therapies to treat depression in the Culiacan population, Mexico. According to criteria of MINI (international Neuropsychiatric interview, 30 individuals from a total of 300 were selected and diagnosed with some kind of depression. Patients were divided in three groups: 1 treatment with hypnosis therapy, 2 treatment with Gestalt-hypnosis therapy, and 3 control group. Before and after the treatments the Beck Anxiety Inventory (BAI was applied to know the depression level of the analyzed groups. The results show that the three groups were presenting a moderated level of depression. The groups under hypnosis therapy and Gestalt-hypnosis therapy show statistical differences between pre-test and post-test. The hypnosis therapy shows significant statistic differences to treat depression with respect to the other two groups. In conclusion, the therapeutic hypnosis is an effective treatment and has relevance to treat depression, while other therapeutic treatments tend to be slow and with minor result. This study is the first of this kind carried out in Culiacan in Sinaloa, Mexico.

  12. Exposure therapy for problem gambling in rural communities: a program model and early outcomes.

    Science.gov (United States)

    Riley, Ben; Smith, David; Oakes, Jane

    2011-06-01

    Rural South Australia contains a higher share of electronic gaming machines and gambling expenditure per capita than metropolitan areas, raising concerns about the risk of problem gambling in these communities. This paper describes the implementation and outcomes of an outreach behavioural psychotherapy (exposure therapy) program for problem gambling in rural South Australia. A retrospective cohort study design was used for 551 adult treatment-seeking problem gamblers who presented to the Statewide Gambling Therapy Service in South Australia. Fifty-one gamblers were from rural areas and participated in the outreach program. Outcomes were compared between gamblers who participated in either the metropolitan-based or rural outreach program. Outcome measures used: South Oaks Gambling Screen, Kessler Psychological Distress Scale, Work and Social Adjustment Scale, and hours gambled the previous month. Sixty-one per cent of clients (n = 551) completed treatment. There was no significant association between service location and number of treatment completers. Significant improvements were recorded across all outcome measures for both groups with small to large effect sizes, and there were no significant differences in outcomes at post-treatment between the groups while controlling for baseline scores. Both metropolitan and rural clients reported significant clinical improvement. Given the risk of problem gambling in rural communities, these early outcomes are encouraging. These findings will inform future treatment planning and service delivery for rural clients, and guide further research into the effectiveness of exposure therapy for problem gambling. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  13. Creating Sustainable Community Engagement Initiatives in a Graduate Physical Therapy Program

    Science.gov (United States)

    Palombaro, Kerstin M.; Lattanzi, Jill B.; Dole, Robin L.

    2010-01-01

    Many institutions of higher learning engage in activities related to community building. At Widener University, the Institute for Physical Therapy Education has undergone a process to build on relationships with those in its community to create service-learning and community engagement activities that were first initiated with short-term, one-time…

  14. Perceived Effectiveness of Community-driven Development ...

    African Journals Online (AJOL)

    The failure of Top-down approach and Donor-driven development projects in Nigeria had necessitated a new approach that is community driven. This paper reports the perceived effectiveness of Community Driven Development CDD approach to Community and Social Development Projects CSDP execution in Oyo state.

  15. Professional Learning Communities: Assessment--Development--Effects.

    Science.gov (United States)

    Hipp, Kristine Kiefer; Huffman, Jane Bumpers

    This presentation addresses three topics: (1) the assessment of professional learning communities in schools; (2) the design and development of professional learning communities in schools; and (3) the effects of professional learning communities in schools. The purpose of this brief document is to share descriptions, processes, and materials…

  16. Current and future etiologic therapy of bacterial pneumonia. 1. Antibiotic therapy for community-acquired pneumonia

    Directory of Open Access Journals (Sweden)

    А.Е. Abaturov

    2017-04-01

    Full Text Available The progressive increase in the prevalence of respiratory infections caused by multiresistant pathogenic agents is a serious problem requiring strict indications and development of algorithms for prescribing antibacterial drugs for pneumonia treatment. Amoxicillin is a drug of choice for the treatment of community-acquired pneumonia with a mild and uncomplicated course in children. The indications for prescribing macrolides are the patient’s allergy to β-lactam antibiotics or suspect mycoplasmal or chlamydial etiology of pneumonia. The choice of amoxicillin/clavulanate or cephalosporins for oral administration is proved by the laboratory data or a clinical suspicion of pneumonia caused by pathogens producing β-lactamases. The treatment strategy with the use of non-antibiotic agents for antibiotic-associated diseases therapy is being actively developed currently.

  17. Music therapy and Alzheimer's disease: Cognitive, psychological, and behavioural effects.

    Science.gov (United States)

    Gómez Gallego, M; Gómez García, J

    2017-06-01

    Music therapy is one of the types of active ageing programmes which are offered to elderly people. The usefulness of this programme in the field of dementia is beginning to be recognised by the scientific community, since studies have reported physical, cognitive, and psychological benefits. Further studies detailing the changes resulting from the use of music therapy with Alzheimer patients are needed. Determine the clinical improvement profile of Alzheimer patients who have undergone music therapy. Forty-two patients with mild to moderate Alzheimer disease underwent music therapy for 6 weeks. The changes in results on the Mini-mental State Examination, Neuropsychiatric Inventory, Hospital Anxiety and Depression Scale and Barthel Index scores were studied. We also analysed whether or not these changes were influenced by the degree of dementia severity. Significant improvement was observed in memory, orientation, depression and anxiety (HAD scale) in both mild and moderate cases; in anxiety (NPI scale) in mild cases; and in delirium, hallucinations, agitation, irritability, and language disorders in the group with moderate Alzheimer disease. The effect on cognitive measures was appreciable after only 4 music therapy sessions. In the sample studied, music therapy improved some cognitive, psychological, and behavioural alterations in patients with Alzheimer disease. Combining music therapy with dance therapy to improve motor and functional impairment would be an interesting line of research. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Home- and Community-Based Occupational Therapy Improves Functioning in Frail Older People: A Systematic Review.

    Science.gov (United States)

    De Coninck, Leen; Bekkering, Geertruida E; Bouckaert, Leen; Declercq, Anja; Graff, Maud J L; Aertgeerts, Bert

    2017-08-01

    The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community-dwelling physically frail older people. We conducted a systematic review and meta-analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions. Meta-analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons. Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of -0.30 (95% CI -0.50 to -0.11; P = .002), for social participation -0.44 (95% CI -0.69, -0.19; P = .0007) and for mobility -0.45 (95% CI -0.78 to -0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found. There is strong evidence that occupational therapy improves functioning in community-dwelling physically frail older people. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  19. Ivermectin Therapy for Onchocerciasis: Effect on Some ...

    African Journals Online (AJOL)

    Ivermectin Therapy for Onchocerciasis: Effect on Some Haematological and Biochemical Parameters. EN Shu, EO Eze, T Nubila, EO Onwujekwe. Abstract. Objective: To investigate leucocyte mobilization, acid phosphatase and acetylcholinesterase activities during ivermectin therapy for onchocerciasis, to shed light on the ...

  20. Building Community Pharmacy Work System Capacity for Medication Therapy Management

    Directory of Open Access Journals (Sweden)

    Jon C. Schommer, Ph.D.

    2012-01-01

    Full Text Available Questions within and outside of the pharmacy profession frequently arise about a community pharmacy’s capacity to provide patient-care services and maximize contributions to public health. It is surmised that community pharmacy locations must possess specific attributes and have identifiable resources within the location to effectively initiate and optimize their capacity to deliver patient care services in conjunction with medication distribution and other services. The purpose of this paper is to describe three research domains that can help pharmacies make the transition from “traditional” business models to “patient care centered” practices: (1 Work System Design, (2 Entrepreneurial Orientation, and (3 Organizational Flexibility. From these research domains, we identified 21 Work System Design themes, 4 dimensions of Entrepreneurial Orientation, and 4 types of Organizational Flexibility that can be used in combination to assist a practice location in transforming its business model to a “patient care centered” practice. The self-assessment tools we described in this paper could help realign an organization’s activities to initiate and optimize capacity for patient care.

  1. Mechanisms of change in cognitive therapy for major depressive disorder in the community mental health setting.

    Science.gov (United States)

    Crits-Christoph, Paul; Gallop, Robert; Diehl, Caroline K; Yin, Seohyun; Gibbons, Mary Beth Connolly

    2017-06-01

    This study examined the relation of change in theory-relevant cognitive variables to depressive symptom change over the course of cognitive therapy, as well as the specificity of change mechanisms to cognitive therapy as compared with dynamic therapy. There were 237 adult outpatients who were randomized to either cognitive (n = 119) or dynamic (n = 118) therapy for major depressive disorder in a community mental health setting. Assessments of compensatory skills (Ways of Responding Community Version and Self-Report Version), dysfunctional attitudes (Dysfunctional Attitudes Scale), and depressogenic schemas (Psychological Distance Scaling Task) were obtained at baseline and months 1, 2, and 5 following baseline. Primary outcome was measured using the Hamilton Rating Scale for Depression. Across both therapy conditions, change in all 3 cognitive domains was associated with concurrent change in depressive symptoms. After controlling for other cognitive variables, increased interconnectedness of the positive achievement-related schema was significantly associated with concurrent symptom change in cognitive (rp = .26, p therapy (rp = .08, p = .29). Increases in positive compensatory skills were associated with subsequent change in depressive symptoms in cognitive therapy (rp = -.36, p = .003), but not in dynamic therapy (rp = .11, p = .386). Results provide support for the compensatory skills model of cognitive therapy (CT) within a community mental health setting. Additional research is necessary to understand other possible mechanisms of change in CT in the community setting. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. THE OUTCOME OF ANTIBIOTIC THERAPY AMONG CHILDREN WITH SEVERE COMMUNITY ACQUIRED PNEUMONIA

    Directory of Open Access Journals (Sweden)

    M. R. Usman

    2015-08-01

    Full Text Available Background: The effect of human immunodeficiency virus (HIV status on the evolution of community acquired pneumonia (CAP is still controversial. There are controversies regarding antibiotic treatment outcome of CAP in HIV infected children. Objective: The aim of this study was to investigate possible differences in hospital outcomes, with compared the outcome of the treatment in severe CAP among HIV infected and HIV uninfected children which had an empiric antibiotic therapy. Methods: A case control study of 80 patients with severe CAP in Department of Child Health, Sanglah General Hospital, Bali-Indonesia. We evaluated clinical features for seeing the effectiveness of the antibiotic therapy according to Department of Child Health, Sanglah General Hospital’s clinical pathway for severe pneumonia between HIV infected and HIV uninfected patients. Results: 58% patients in failure treatment and 45% patients in favorable treatment were HIV infected. There were similar characteristics from both groups, except malnutrition condition was statistically significant contribute the outcome (OR 2.87 (95% CI 1.098 to 7.500, p= 0.031. There was no significantly statistic difference of the outcome in HIV infected as compared to HIV uninfected patients with severe CAP (OR 1.65 (95% CI 0.683 to 4.002, p= 0.263. Conclusion: HIV infection was not gave an effect on the outcome of severe CAP patients which had an antibiotic therapy based on Department of Child Health, Sanglah General Hospital’s clinical pathway for severe pneumonia.

  3. A Networking of Community-Based Speech Therapy: Borabue District, Maha Sarakham.

    Science.gov (United States)

    Pumnum, Tawitree; Kum-ud, Weawta; Prathanee, Benjamas

    2015-08-01

    Most children with cleft lip and palate have articulation problems because of compensatory articulation disorders from velopharyngeal insufficiency. Theoretically, children should receive speech therapy from a speech and language pathologist (SLP) 1-2 sessions per week. For developing countries, particularly Thailand, most of them cannot reach standard speech services because of limitation of speech services and SLP Networking of a Community-Based Speech Model might be an appropriate way to solve this problem. To study the effectiveness of a networking of Khon Kaen University (KKU) Community-Based Speech Model, Non Thong Tambon Health Promotion Hospital, Borabue, Maha Sarakham, in decreasing the number of articulation errors for children with CLP. Six children with cleft lip and palate (CLP) who lived in Borabue and the surrounding district, Maha Sarakham, and had medical records in Srinagarind Hospital. They were assessed for pre- and post-articulation errors and provided speech therapy by SLP via teaching on service for speech assistant (SA). Then, children with CLP received speech correction (SC) by SA based on assignment and caregivers practiced home program for a year. Networking of Non Thong Tambon Health Promotion Hospital, Borabue, Maha Sarakham significantly reduce the number of post-articulation errors for 3 children with CLP. There were factors affecting the results in treatment of other children as follows: delayed speech and language development, hypernaslaity, and consistency of SC at local hospital and home. A networking of KKU Community-Based Speech Model, Non Thong Tambon Health Promotion Hospital, Borabue, and Maha Sarakham was a good way to enhance speech therapy in Thailand or other developing countries, where have limitation of speech services or lack of professionals.

  4. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis.

    NARCIS (Netherlands)

    Vries, N.M. de; Ravensberg, C.D. van; Hobbelen, J.S.; Olde Rikkert, M.G.; Staal, J.B.; Nijhuis-Van der Sanden, M.W.

    2012-01-01

    This is the first meta-analysis focusing on elderly patients with mobility problems, physical disability and/or multi-morbidity. The aim of this study is to assess the effect of physical exercise therapy on mobility, physical functioning, physical activity and quality of life. A broad systematic

  5. Art therapy: an underutilized, yet effective tool

    Directory of Open Access Journals (Sweden)

    Robert A. Bitonte

    2014-03-01

    Full Text Available Art therapy has been recognized as beneficial and effective since first described by Adrian Hill in 1942. Even before this time, art therapy was utilized for moral reinforcement and psychoanalysis. Art therapy aids patients with, but not limited to, chronic illness, physical challenges, and cancer in both pediatric and adult scenarios. Although effective in patient care, the practice of art therapy is extremely underutilized, especially in suburban areas. While conducting our own study in northeastern Ohio, USA, we found that only one out of the five inpatient institutions in the suburban area of Mahoning County, Ohio, that we contacted provided continuous art therapy to it’s patients. In the metropolitan area of Cuyahoga County, Ohio, only eight of the twenty-two inpatient institutions in the area provided art therapy. There could be many reasons as to why art therapy is not frequently used in these areas, and medical institutions in general. The cause of this could be the amount of research done on the practice. Although difficult to conduct formal research on such a broad field, the American Art Therapy Association has succeeded in doing such, with studies showing improvement of the patient groups emotionally and mentally in many case types.

  6. Art Therapy: An Underutilized, yet Effective Tool.

    Science.gov (United States)

    Bitonte, Robert A; De Santo, Marisa

    2014-03-04

    Art therapy has been recognized as beneficial and effective since first described by Adrian Hill in 1942. Even before this time, art therapy was utilized for moral reinforcement and psychoanalysis. Art therapy aids patients with, but not limited to, chronic illness, physical challenges, and cancer in both pediatric and adult scenarios. Although effective in patient care, the practice of art therapy is extremely underutilized, especially in suburban areas. While conducting our own study in northeastern Ohio, USA, we found that only one out of the five inpatient institutions in the suburban area of Mahoning County, Ohio, that we contacted provided continuous art therapy to it's patients. In the metropolitan area of Cuyahoga County, Ohio, only eight of the twenty-two inpatient institutions in the area provided art therapy. There could be many reasons as to why art therapy is not frequently used in these areas, and medical institutions in general. The cause of this could be the amount of research done on the practice. Although difficult to conduct formal research on such a broad field, the American Art Therapy Association has succeeded in doing such, with studies showing improvement of the patient groups emotionally and mentally in many case types.

  7. Pharmaceutical intervention in menopausal patients with hormone replacement therapy in a community pharmacy from Antofagasta

    Directory of Open Access Journals (Sweden)

    Alejandrina Alucema

    2015-02-01

    Full Text Available Context: Hormone replacement therapy (HRT is the most widely used treatment for controlling the effects of menopause. This type of therapy causes some drug-related problems (DRP, which requires monitoring to control the negative effects and ensure patient adherence to therapy. Aims: Perform a pharmacotherapeutic monitoring and educate to menopausal patients in HRT of a community pharmacy from the city of Antofagasta. Methods: A 98-menopausal patients underwent a pharmaceutical intervention to identify the PRM and its resolution. It was applied to them a survey before and after educational activities about this disease and HRT to determine the knowledge on the subject. Results: During the pharmacotherapeutic monitoring was determined that 55% of patients using combined HRT. 62 DRPs were detected, of which 43 were resolved (69%; the most were Patient-Pharmacist (73%. The better resolution DRP were DRP 4(b “frequency of inadequate administration” and DRP 2(a “no medical indication”. At baseline, 90% had an inadequate level of knowledge about the disease and THR, 8% intermediate, and only 2% adequate. After the implementation of the education strategy, the level of knowledge increased, achieving at the end of the study only intermediate (10% and adequate (90% levels. Conclusions: The results confirm the importance of pharmaceutical intervention for the identification and resolution of DRP and the requirement to establish educational strategies to increase the knowledge about menopause and HRT in menopausal patients.

  8. Play Therapy for Bereaved Children: Adapting Strategies to Community, School, and Home Settings

    Science.gov (United States)

    Webb, Nancy Boyd

    2011-01-01

    Play therapy is a highly adaptable treatment method that can be modified according to children's ages, circumstances, and settings in which counseling occurs. Play therapy may be used in schools, community settings, and homes to help children following the death of a significant other. After reviewing basic developmental factors that affect…

  9. Adapting cognitive behavioral therapy for psychosis for case managers: increasing access to services in a community mental health agency.

    Science.gov (United States)

    Montesano, Vicki L; Sivec, Harry J; Munetz, Mark R; Pelton, Jeremy R; Turkington, Douglas

    2014-03-01

    The purpose of this article is twofold: (a) to describe the adaptation of an evidence-based practice and, (b) using a dissemination framework, to describe the process of implementing the practice at a community mental health agency. The authors describe the training concept and dissemination framework of implementing an emerging practice: high-yield cognitive behavioral techniques for psychosis, which is rooted in cognitive behavioral therapy. Thirteen case managers who represented teams from across the agency delivered the adapted practice at a community mental health agency. Implementation required buy in from all stakeholders, communication across disciplines, persistence, and flexibility. It appears that the use of a dissemination framework that is grounded in the literature, yet flexible, eases the process of implementing an adapted practice. Further research focusing on the effectiveness of this approach, along with the impact of implementing a full spectrum of cognitive behavioral therapy services for individuals with persistent psychotic symptoms, based on cognitive behavioral therapy principles, is indicated.

  10. Effectiveness of trained community volunteers in improving ...

    African Journals Online (AJOL)

    2015-03-18

    Mar 18, 2015 ... study was aimed at determining the effectiveness of trained community volunteers in delivering multiple anti‑malaria interventions to achieve rapid .... to life‑saving treatment and improved the health system efficiency while .... home management of malaria community daily case register adapted from the ...

  11. Creating a community-physical therapy partnership to increase physical activity in urban African-American adults.

    Science.gov (United States)

    Healey, William E; Reed, Monique; Huber, Gail

    2013-01-01

    Racial disparities in health across the United States remain, and in some cities have worsened despite increased focus at federal and local levels. One approach to addressing health inequity is community-based participatory research (CBPR). The purpose of this paper is to describe the develop ment of an ongoing community-physical therapy partnership focused on physical activity (PA), which aims to improve the health of African-American community members and engage physical therapist (PT) students in CBPR. Three main research projects that resulted from an initial partnership-building seed grant include (1) community focus groups, (2) training of community PA promoters, and (3) pilot investigation of PA promoter effectiveness. Results from each project informed the next. Focus groups findings led to development of a PA pro moter training curriculum. PA promoters were accepted by the community, with potential to increase PA. Focus on the community issue of PA fostered and sustained the partnership. Community and academic partners benefitted from funding, structure, and time to create meaningful, trusting, and sustainable relationships committed to improving health. Engaging PT students with community residents provided learning opportunities that promote respect and appreciation of the social, economic, and environmental context of future patients.

  12. Effects of compound music program on cognitive function and QOL in community-dwelling elderly

    OpenAIRE

    Fujita, Takaaki; Ito, Akemi; Kikuchi, Nana; Kakinuma, Tomohiro; Sato, Yoshihisa

    2016-01-01

    [Purpose] Interventions using music, physical exercise, and reminiscence therapy are widely used both for rehabilitation and care of the elderly. This study aimed to investigate the effect of structured interventions comprising music, physical exercise, and reminiscence therapy on cognitive function and quality of life of the community-dwelling elderly. [Subjects and Methods] The study included 15 community-dwelling elderly people who used a day-care center. Participants underwent sessions co...

  13. Side Effects of Hormone Therapy

    Science.gov (United States)

    ... and maintaining the typical male characteristics, such as body hair growth, muscle mass, sexual desire, and erectile function, and contributes to a host of other normal physiologic processes in the body. The list of potential effects of testosterone loss ...

  14. Effects of a Randomized Comprehensive Psychosocial Intervention Based on Cognitive Behavioral Therapy Theory and Motivational Interviewing Techniques for Community Rehabilitation of Patients With Opioid Use Disorders in Shanghai, China.

    Science.gov (United States)

    Zhong, Na; Yuan, Ying; Chen, Hanhui; Jiang, Haifeng; Du, Jiang; Sun, Haiming; Hao, Wei; Zhao, Min

    2015-01-01

    China is faced with the challenge of community rehabilitation of persons with opioid use disorders. A 1-year comprehensive psychosocial intervention (CPI) was developed, and its effectiveness was assessed in terms of its ability to improve community rehabilitation of persons with opioid use disorders after their release from detention in compulsory treatment centers in Shanghai, China. Participants were randomized to the CPI (n = 90) condition or the usual community care (UCC, n = 90) as a control condition. The Addiction Severity Index, Symptom Checklist-90, and Medical Outcomes Study 36-Item Short Form Health Survey were administered at baseline and at the end of the intervention. Urine screens were used to increase the validity of self-reported drug use. Compared with the UCC group at follow-up, the CPI group showed lower scores in 6 dimensions of the Symptom Checklist-90: somatization, obsessive-compulsive, anxiety, phobia-anxiety, paranoia, and psychoticism. Members of the CPI group had higher scores in 2 dimensions of the 36-Item Short Form Health Survey—physical role limitation and emotional role limitation—compared with the UCC group (P 0.05). The CPI condition improved participants' mental health and quality of life, and it could be a promising community rehabilitation approach for patients with opioid use disorders in recovery.

  15. The bystander effect of cancer gene therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lumniczky, K.; Safrany, G. (Department of Molecular and Tumour Radiobiology, National Research Institute for Radiobiology and Radiohygiene, Budapest (Hungary))

    2008-12-15

    Cancer gene therapy is a new, promising therapeutic agent. In the clinic, it should be used in combination with existing modalities, such as tumour irradiation. First, we summarise the most important fields of cancer gene therapy: gene directed enzyme pro-drug therapy; the activation of an anti-tumour immune attack; restoration of the wild type p53 status; the application of new, replication competent and oncolytic viral vectors; tumour specific, as well as radiation- and hypoxia-induced gene expression. Special emphasizes are put on the combined effect of these modalities with local tumour irradiation. Using the available vector systems, only a small portion of the cancer cells will contain the therapeutic genes under therapeutic situations. Bystander cell killing might contribute to the success of various gene therapy protocols. We summarise the evidences that lethal bystander effects may occur during cancer gene therapy. Bystander effects are especially important in the gene directed enzyme pro-drug therapy. There, bystander cell killing might have different routes: cell communication through gap junction intercellular contacts; release of toxic metabolites into the neighbourhood or to larger distances; phagocytosis of apoptotic bodies; and the activation of the immune system. Bystander cell killing can be enhanced by the introduction of gap junction proteins into the cells, by further activating the immune system with immune-stimulatory molecules, or by introducing genes into the cells that help the transfer of cytotoxic genes and / or metabolites into the bystander cells. In conclusion, there should be additional improvements in cancer gene therapy for the more efficient clinical application. (orig.)

  16. Community-implemented trauma therapy for former child soldiers in Northern Uganda: a randomized controlled trial.

    Science.gov (United States)

    Ertl, Verena; Pfeiffer, Anett; Schauer, Elisabeth; Elbert, Thomas; Neuner, Frank

    2011-08-03

    The psychological rehabilitation of former child soldiers and their successful reintegration into postconflict society present challenges. Despite high rates of impairment, there have been no randomized controlled trials examining the feasibility and efficacy of mental health interventions for former child soldiers. To assess the efficacy of a community-based intervention targeting symptoms of posttraumatic stress disorder (PTSD) in formerly abducted individuals. Randomized controlled trial recruiting 85 former child soldiers with PTSD from a population-based survey of 1113 Northern Ugandans aged 12 to 25 years, conducted between November 2007 and October 2009 in camps for internally displaced persons. Participants were randomized to 1 of 3 groups: narrative exposure therapy (n = 29), an academic catch-up program with elements of supportive counseling (n = 28), or a waiting list (n = 28). Symptoms of PTSD and trauma-related feelings of guilt were measured using the Clinician-Administered PTSD Scale. The respective sections of the Mini International Neuropsychiatric Interview were used to assess depression and suicide risk, and a locally adapted scale was used to measure perceived stigmatization. Symptoms of PTSD, depression, and related impairment were assessed before treatment and at 3 months, 6 months, and 12 months postintervention. Treatments were carried out in 8 sessions by trained local lay therapists, directly in the communities. Change in PTSD severity, assessed over a 1-year period after treatment. Secondary outcome measures were depression symptoms, severity of suicidal ideation, feelings of guilt, and perceived stigmatization. PTSD symptom severity (range, 0-148) was significantly more improved in the narrative exposure therapy group than in the academic catch-up (mean change difference, -14.06 [95% confidence interval, -27.19 to -0.92]) and waiting-list (mean change difference, -13.04 [95% confidence interval, -26.79 to 0.72]) groups. Contrast analyses

  17. Helper Therapy in an Online Suicide Prevention Community

    Science.gov (United States)

    Greidanus, Elaine; Everall, Robin D.

    2010-01-01

    Individuals who feel comfortable using Internet-based communication often seek help online when they are feeling distressed. This study examines an online community formed to provide support for distressed adolescents. Content analysis revealed themes in a series of online postings from youth who were experiencing suicidal thoughts. Youth…

  18. Multidimensional Family Therapy: Evidence Base for Transdiagnostic Treatment Outcomes, Change Mechanisms, and Implementation in Community Settings.

    Science.gov (United States)

    Liddle, Howard A

    2016-09-01

    This article summarizes the 30+-year evidence base of Multidimensional Family Therapy (MDFT), a comprehensive treatment for youth substance abuse and antisocial behaviors. Findings from four types of MDFT studies are discussed: hybrid efficacy/effectiveness randomized controlled trials, therapy process studies, cost analyses, and implementation trials. This research has evaluated various versions of MDFT. These studies have systematically tested adaptations of MDFT for diverse treatment settings in different care sectors (mental health, substance abuse, juvenile justice, and child welfare), as well as adaptations according to treatment delivery features and client impairment level, including adolescents presenting with multiple psychiatric diagnoses. Many published scientific reviews, including meta-analyses, national and international government publications, and evidence-based treatment registries, offer consistent conclusions about the clinical effectiveness of MDFT compared with standard services as well as active treatments. The diverse and continuing MDFT research, the favorable, multi-source independent evaluations, combined with the documented receptivity of youth, parents, community-based clinicians and administrators, and national and international MDFT training programs (U.S.-based organization is MDFT International, www.mdft.org; and Europe-based organization is www.mdft.nl) all support the potential for continued transfer of MDFT to real-world clinical settings. © 2016 Family Process Institute.

  19. A new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Adang Eddy

    2011-03-01

    Full Text Available Abstract Background Even effective interventions for people with dementia and their caregivers require specific implementation efforts. A pilot study showed that the highly effective community occupational therapy in dementia (COTiD program was not implemented optimally due to various barriers. To decrease these barriers and make implementation of the program more effective a combined implementation (CI strategy was developed. In our study we will compare the effectiveness of this CI strategy with the usual educational (ED strategy. Methods In this cluster randomized, single-blinded, controlled trial, each cluster consists of at least two occupational therapists, a manager, and a physician working at Dutch healthcare organizations that deliver community occupational therapy. Forty-five clusters, stratified by healthcare setting (nursing home, hospital, mental health service, have been allocated randomly to either the intervention group (CI strategy or the control group (ED strategy. The study population consists of the professionals included in each cluster and community-dwelling people with dementia and their caregivers. The primary outcome measures are the use of community OT, the adherence of OTs to the COTiD program, and the cost effectiveness of implementing the COTiD program in outpatient care. Secondary outcome measures are patient and caregiver outcomes and knowledge of managers, physicians and OTs about the COTiD program. Discussion Implementation research is fairly new in the field of occupational therapy, making this a unique study. This study does not only evaluate the effects of the CI-strategy on professionals, but also the effects of professionals' degree of implementation on client and caregiver outcomes. Clinical trials registration NCT01117285

  20. Integrating community pharmacy into community based anti-retroviral therapy program: A pilot implementation in Abuja, Nigeria.

    Directory of Open Access Journals (Sweden)

    Yohanna Kambai Avong

    Full Text Available The landscape of Human Immunodeficiency Virus (HIV epidemic control is shifting with the United Nations Programme on HIV/AIDS (UNAIDS 90-90-90 benchmarks for epidemic control. Community-based Antiretroviral Therapy (CART models have improved treatment uptake and demonstrated good clinical outcomes. We assessed the feasibility of integrating community pharmacy as a task shift structure for differentiated community ART in Abuja-Nigeria.Stable patients on first line ART regimens from public health facilities were referred to community pharmacies in different locations within the Federal Capital Territory, Abuja for prescription refills and treatment maintenance. Bio-demographic and clinical data were collected from February 25, 2016 to May 31st, 2017 and descriptive statistics analysis applied. The outcomes of measure were prescription refill and patient retention in care at the community pharmacy.Almost 10% of stable patients on treatment were successfully devolved from eight health facilities to ten community pharmacies. Median age of the participants was 35 years [interquartile range (IQR; 30, 41] with married women in the majority. Prescription refill was 100% and almost all the participants (99.3% were retained in care after they were devolved to the community pharmacies. Only one participant was lost-to-follow-up as a result of death.Excellent prescription refill and high retention in care with very low loss-to-follow-up were associated with the community pharmacy model. The use of community pharmacy for community ART is feasible in Nigeria. We recommend the scale up of the model in all the 36 states of Nigeria.

  1. [Using DGGE to analyze bacteria community structure changes in subgingival plaque after periodontal initial therapy].

    Science.gov (United States)

    Zhou, Yan-bin; Shu, Rong; Liu, Da-li

    2012-02-01

    To analyze bacteria community structure changes in subgingival plaque after initial therapy, and to provide experimental evidences for clinical decision. Six patients with chronic periodontitis were chosen. Subgingival plaque samples, as well as clinical indexes, were collected at baseline and six weeks after initial therapy. The generated two different 16S rDNA fragments of subgingival plaque samples were separated by denaturing gel, creating bands patterns representative of community structure. Subsequent cluster analysis was made. The clinical indexes were improved significantly. The diversity of population of clinical subgingival samples was not significantly different between baseline and 6 weeks after initial therapy. Through cluster analysis, it was confirmed that same patient got similar subgingival plaque between baseline and 6 weeks after treatment. Same patient tend to get similar subgingival plaque between baseline and after initial therapy. DGGE can detect the microbial composition of subgingival plaque.

  2. Effects of antiretroviral therapy on semen quality

    NARCIS (Netherlands)

    van Leeuwen, Elisabeth; Wit, Ferdinand W.; Repping, Sjoerd; Eeftinck Schattenkerk, Jan Karel M.; Reiss, Peter; van der Veen, Fulco; Prins, Jan M.

    2008-01-01

    OBJECTIVE: To evaluate the effect of combination antiretroviral therapy (cART) on semen quality. DESIGN: A longitudinal cohort study. SETTING: The HIV outpatient clinic of the Academic Medical Centre in Amsterdam, the Netherlands. SUBJECTS: A cohort of 34 male patients with different estimated

  3. EFFECTS OF ELECTROCONVULSIVE THERAPY ON CARDIOVASCULAR SYSTEM

    OpenAIRE

    CHAUDHARY, S; RAJURIA, SS

    1995-01-01

    Effects of electroconvulsive therapy on the pulse rate, blood pressure and electrocardiogram were studied in forty consecutive physically healthy inpatients undergoing ECT for their psychiatric disabilities. Tachycardia and elevated blood pressure occurred frequently. Sinus arrhythmias, atrial and ventricular premature beats and minor ST-T changes were also observed. All these changes reversed within thirty minutes.

  4. Investigating the experiences in a school-based occupational therapy program to inform community-based paediatric occupational therapy practice.

    Science.gov (United States)

    Rens, Lezahn; Joosten, Annette

    2014-06-01

    A collaborative approach with teachers is required when providing community-based occupational therapy to educationally at risk children. Collaborators share common goals and interact and support each other but challenges arise in providing collaborative occupational therapy in settings outside the school environment. The aim of this study was to capture experiences of teachers and occupational therapists working within a school-based occupational therapy program to determine if their experiences could inform collaborative practice. In this pilot study, participant responses to questionnaires (n = 32) about their experiences formed the basis for focus groups and individual interviews. Two focus group were conducted, one with teachers (n = 11) and one with occupational therapy participants (n = 6). Individual interviews were conducted with the supervising occupational therapist, school principal and two leading teachers. Descriptive statistics were used to analyse the data from closed questions, and thematic analysis using a constant comparison approach was used to analyse open ended questions, focus groups and interviews. Three main themes emerged: (i) the need for occupational therapists to spend time in the school, to explain their role, build relationships, understand classroom routines and the teacher role; (ii) occupational therapists need to not see themselves as the expert but develop equal partnerships to set collaborative goals and (iii) occupational therapists advocating for all parties to be informed throughout the occupational therapy process. The pilot study findings identified teacher and therapist experiences within the school setting that could inform improved collaborative practice with teachers and community-based occupational therapists and these findings warrant further investigation. © 2013 Occupational Therapy Australia.

  5. Comparison effectiveness of Dialectic Behavioral Therapy and Behavior Cognitive Therapy on Depression in the Multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Narges Zamani

    2017-03-01

    . [Text in Persian] Tad J, Bouhart A. Clinical psychologic principles and consultation. Firooz Bakht M, Translator Tehran: Rasa Pub; 2007. [Text in Persian] Cuijpers P, van Straten A, Andersson G, Van Open P. Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies. J Consult Clin Psychol 2008;76(6:909-22. Ganji M. Abnormal psychology based on DSM-5. Tehran: Savalane Pub; 2013. [Full Text in Persian] 15. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scale (DASS with the beck depression and anxiety inventories. Behav Res Ther 1995;33(3:335-43.   Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinton RP. Psychometric properties of the 42-item and 21-item version of the depression anxiety stress scale in clinical group and a community sample. Psychol Assess 1998;10(2:176-81. Samani S, Jokar B. A study on the reliability and validity of the short form of the depression anxiety stress scale (dass-21. J Social Sci Humanis 2007;26(3:65-75. [Full Text in Persian] McKay M, Wood JC, Brantley J. The dialectical behavior therapy skills workbook: Practical DBT Exercises for learning mindfulness, interpersonal. Oakland: New Harbinger Pub; 2007. Miller AL, Rathus JH, Linehan MM. Dialectical behavior therapy with suicidal adolescents. NewYork: Guilford Press; 2006. Zamani N, Farhadi M, Jamilian HR ,Habibi M. Effectiveness of group dialectical behavior therapy (based on Acceptance and Commitment on expulsive anger and impulsive behaviors. Arak Med Univ J 2014;17(11:53-61. [Full Text in Persian] Alilloo MM, Sharifi MA. Dialectical behavior therapy for borderline personality disorder. Tehran, Iran. Tehran: Tehran Univ Pub; 2011. [Text in Persian] Greenberger D, Padesky C. Mind over Mood: Psychology foundation. In: Lovibond PF, Lovibond SH. Manual for the depression anxiety stress scale. 2nd ed. Sydney: Psychology Foundation; 1995. Van den Bosch LM, Verheul R, Schippers GM, van den Brink W

  6. A randomized community trial of prepackaged and homemade oral rehydration therapies.

    Science.gov (United States)

    Kassaye, M; Larson, C; Carlson, D

    1994-12-01

    To compare the effectiveness of prepackaged oral rehydration solutions with homemade cereal-based oral rehydration therapy in the treatment of acute childhood diarrhea in children younger than 5 years. In Ethiopia, approximately 40% of all mortality in children younger than 5 years, or over 200,000 annual deaths, is attributable to acute childhood diarrhea. Less than 15% of the episodes of acute childhood diarrhea are treated with oral rehydration solutions. Two hundred ninety-one children younger than 5 years with acute childhood diarrhea. A randomized field trial comparing the effectiveness of an entirely homemade cereal-based oral rehydration therapy (HC-ORT, n = 103) with two alternative prepackaged salt solutions, a glucose-based oral rehydration solution (G-ORS, n = 98) and a cereal-based oral rehydration solution (C-ORS, n = 90), in the treatment of mild to moderate acute childhood diarrhea in children younger than 5 years. Subjects in the HC-ORT group demonstrated equivalent or better weight gain than those in the C-ORS or G-ORS groups at 24, 48, 72, and 96 hours following the onset of treatment. The beneficial weight-gain effect of HC-ORT was most pronounced in infants younger than 12 months, following adjustment for demographic and baseline clinical characteristics. Compliance with ORT use through 96 hours was significantly better among caretakers of children receiving HC-ORT. Minor errors in the preparation of these oral rehydration regimens occurred more frequently among caretakers preparing either of the cereal-based ones. That HC-ORT is an effective, culturally more acceptable alternative to G-ORS or C-ORS. The implementation of well-monitored, community-based HC-ORT programs in less developed countries is recommended.

  7. Analysis of pharmacist-provided medication therapy management (MTM) services in community pharmacies over 7 years.

    Science.gov (United States)

    Barnett, Mitchell J; Frank, Jessica; Wehring, Heidi; Newland, Brand; VonMuenster, Shannon; Kumbera, Patty; Halterman, Tom; Perry, Paul J

    2009-01-01

    Although community pharmacists have historically been paid primarily for drug distribution and dispensing services, medication therapy management (MTM) services evolved in the 1990s as a means for pharmacists and other providers to assist physicians and patients in managing clinical, service, and cost outcomes of drug therapy. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA 2003) and the subsequent implementation of Medicare Part D in January 2006 for the more than 20 million Medicare beneficiaries enrolled in the Part D benefit formalized MTM services for a subset of high-cost patients. Although Medicare Part D has provided a new opportunity for defining the value of pharmacist-provided MTM services in the health care system, few publications exist which quantify changes in the provision of pharmacist-provided MTM services over time. To (a) describe the changes over a 7-year period in the primary types of MTM services provided by community pharmacies that have contracted with drug plan sponsors through an MTM administrative services company, and (b) quantify potential MTM-related cost savings based on pharmacists' self-assessments of the likely effects of their interventions on health care utilization. Medication therapy management claims from a multistate MTM administrative services company were analyzed over the 7-year period from January 1, 2000, through December 31, 2006. Data extracted from each MTM claim included patient demographics (e.g., age and gender), the drug and type that triggered the intervention (e.g., drug therapeutic class and therapy type as either acute, intermittent, or chronic), and specific information about the service provided (e.g., Reason, Action, Result, and Estimated Cost Avoidance [ECA]). ECA values are derived from average national health care utilization costs, which are applied to pharmacist self-assessment of the "reasonable and foreseeable" outcome of the intervention. ECA values are updated

  8. Pharmacy Characteristics Associated with the Provision of Drug Therapy Services in Nonmetropolitan Community Pharmacies

    Science.gov (United States)

    Gadkari, Abhijit S.; Mott, David A.; Kreling, David H.; Bonnarens, Joseph K.

    2009-01-01

    Context: Higher prevalence of chronic diseases and reduced access to other health professionals in rural areas suggest that rural Medicare enrollees will benefit from pharmacist-provided drug therapy services (DTS). Purpose: The purpose of this study was to describe non-metropolitan community pharmacy sites in Wisconsin, the provision of DTS at…

  9. Aging in community nutrition, diet therapy, and nutrition and aging textbooks.

    Science.gov (United States)

    O'Neill, Peggy Schafer; Wellman, Nancy S; Himburg, Susan P; Johnson, Paulette; Elfenbien, Pamela

    2005-01-01

    Using content analysis, this study evaluated the aging content and context in 11 nutrition sub-specialty textbooks: community nutrition (n = 3), diet therapy (n = 4), and nutrition and aging (n = 4). Pages with paragraphs on aging were identified in community nutrition and diet therapy textbooks, and 10% random samples of pages were evaluated in nutrition and aging textbooks. Paragraphs were assigned to one of four categories: gerontology, nutrition as primary, nutrition as secondary, or tertiary prevention. A total of 310 pages was qualitatively analyzed using NUD*IST 5 software and quantitatively with percentages. Only 7% of community nutrition and 2% of diet therapy pages were devoted to aging. There was little integration of aging beyond the chapters on aging. Community nutrition had the most gerontology (30%) and primary prevention (43%) content. Diet therapy and nutrition and aging had more secondary prevention (33% and 42%, respectively) and tertiary prevention (27% each) content. Some important databases and studies were absent. Of the 1,239 ageism words, 10% were positive, 53% neutral, and 36% negative. Photographs were generally positive. Women, but not minorities, reflected current older adult demographics. Future textbook editions should address aging more comprehensively and positively to better prepare dietitians for the job market. Recommendations for authors, course instructors, and publishers are given.

  10. Constraints To Effective Community Development Projects Among ...

    African Journals Online (AJOL)

    The study focused on the perceived constraints to effective community development projects among rural households in Calabar agricultural zone of Cross River State, Nigeria. Data were collected with the aid of structured questionnaire from 104 randomly selected respondents in the study area. Data analysis was by the ...

  11. Effective Strategies for Sustaining Professional Learning Communities

    Science.gov (United States)

    Bennett, Patricia R.

    2010-01-01

    Professional Learning Communities (PLCs), in which educators work collaboratively to improve learning for students, need effective strategies to sustain them. PLCs promote continuous improvement in student learning and build academic success with increased teacher expertise. Grounded in organizational systems theory, participative leadership…

  12. Effectiveness of trained community volunteers in improving ...

    African Journals Online (AJOL)

    Introduction: Malaria accounts for 70% of illnesses and 30% of deaths among children under 5 years in Nigeria. This study was aimed at determining the effectiveness of trained community volunteers in delivering multiple anti‑malaria interventions to achieve rapid reduction in morbidity and mortality among under 5 children ...

  13. Community Effects on Youth Sexual Activity.

    Science.gov (United States)

    Baumer, Eric P.; South, Scott J.

    2001-01-01

    Longitudinal data were used from National Survey of Children to examine the impact of community socioeconomic status on four dimensions of adolescent premarital sexual activity: time of first intercourse; frequency of intercourse; number of different sex partners; and likelihood of engaging in unprotected sex. Significant positive effects of…

  14. Laughter therapy as an intervention to promote psychological well-being of volunteer community care workers working with HIV-affected families.

    Science.gov (United States)

    Hatzipapas, Irene; Visser, Maretha J; Janse van Rensburg, Estie

    2017-12-01

    The study explores the experiences of volunteer community care workers working with HIV-affected families, participating in laughter therapy. Laughter therapy is being used as an intervention to positively influence individuals experiencing various forms of emotional distress. Community care workers play a vital role in the support of the HIV/AIDS-infected and -affected members in communities. The nature of this type of work and their limited training contributes to high levels of secondary trauma and emotional exhaustion. The purpose of the study was firstly, to explore the effects of working with orphans and vulnerable children (OVC) on the community care workers and secondly, to establish the impact that laughter therapy has to positively combat stresses of working within the care workers' environment. All the community care workers from a community-based organisation that provides care for HIV/AIDS-infected and -affected OVC and their families in the greater region of Soweto, South Africa, took part in daily laughter therapy sessions for one month. To assess the experiences of participants of laughter therapy, seven community care workers agreed to participate in a mixed method assessment. Interviews were conducted before and after the intervention using the Interpretative Phenomenological Analysis as framework. As supportive data, a stress and anxiety and depression scale were added in the interview. Participants reported more positive emotions, positive coping, improved interpersonal relationships and improvement in their care work after exposure to laughter therapy. Quantitative results on stress, anxiety and depression for each participant confirmed observed changes. Laughter therapy as a self-care technique has potential as a low-cost intervention strategy to reduce stress and counteract negative emotions among people working in highly emotional environments.

  15. Outcomes of couples with infidelity in a community-based sample of couple therapy.

    Science.gov (United States)

    Atkins, David C; Marín, Rebeca A; Lo, Tracy T Y; Klann, Notker; Hahlweg, Kurt

    2010-04-01

    Infidelity is an often cited problem for couples seeking therapy, but the research literature to date is very limited on couple therapy outcomes when infidelity is a problem. The current study is a secondary analysis of a community-based sample of couple therapy in Germany and Austria. Outcomes for 145 couples who reported infidelity as a problem in their relationship were compared with 385 couples who sought therapy for other reasons. Analyses based on hierarchical linear modeling revealed that infidelity couples were significantly more distressed and reported more depressive symptoms at the start of therapy but continued improving through the end of therapy and to 6 months posttherapy. At the follow-up assessment, infidelity couples were not statistically distinguishable from non-infidelity couples, replicating previous research. Sexual dissatisfaction did not depend on infidelity status. Although there was substantial missing data, sensitivity analyses suggested that the primary findings were not due to missing data. The current findings based on a large community sample replicated previous work from an efficacy trial and show generally optimistic results for couples in which there has been an affair. 2010 APA, all rights reserved

  16. THE EFFECTIVENESS OF PLAY THERAPY AND MUSICAL THERAPY IN REDUCING THE HOSPITALIZATION STRESS

    Directory of Open Access Journals (Sweden)

    Yuni Sufyanti Arief

    2017-07-01

    Full Text Available Introduction: Hospitalization in pediatric patients may caused an anxiety and stress in all age levels. Several techniques can be applied to reduced hospitalization stress in children, such as playing therapy and music therapy. The objective of this study was to analyze the difference of effectiveness between both therapies in reducing the hospitalization stress in 4-6 years old children. Method: A quasy-experimental pre-posttest design was used in this study. There were 18 respondents, divided into three groups, i.e. group one receiving playing therapy, group two receiving music therapy and the last group as control group. Data were collected by using observation sheet before and after intervention to recognize the hospitalization stress. Data were analyzed by using Wilcoxon Signed Rank Test and Mann Whitney U Test with significance level of α<0.05. Result: Result showed that playing therapy and music therapy had significant effect to reduce the hospitalization stress with p=0.027 for play therapy, p=0.024 for musical therapy, and p=0.068 for control. Mann Whitney U Test revealed that there were no difference in the effectiveness of play therapy and musical therapy in reducing the hospitalization stress with p=0.009 for play therapy and control group, p=0.012 for music therapy and control group, and p=0.684 for playing therapy and musical therapy. Discussion: It can be concluded that play therapy and musical therapy are equally effective to reduce the hospitalization stress in children. It’s recommended for nurses in pediatric ward to do  playg therapy and musical therapy periodically.

  17. Premature ejaculation: do we have effective therapy?

    Science.gov (United States)

    Serefoglu, Ege Can; Saitz, Theodore R; Trost, Landon; Hellstrom, Wayne J G

    2013-03-01

    Premature ejaculation (PE) is the most common sexual dysfunction, with the majority of PE patients remaining undiagnosed and undertreated. Despite its prevalence, there is a current paucity of data regarding available treatment options and mechanisms. The objective of the current investigation is to review and summarize pertinent literature on therapeutic options for the treatment of PE, including behavioral/psychologic, oral pharmacotherapy, and surgery. A pubmed search was conducted on articles reporting data on available treatment options for PE. Articles describing potential mechanisms of action were additionally included for review. Preference was given towards randomized, controlled trials, when available. PE remains an underdiagnosed and undertreated disease process, with limited data available regarding potential underlying mechanisms and long-term outcomes of treatment options. Psychological/behavioral therapies, including the stop-start, squeeze, and pelvic floor rehabilitation techniques have demonstrated improvements in short-term series, with decreased efficacy with additional follow-up. Topical therapies, which are commonly utilized result in prolonged intravaginal ejaculatory latency time (IELT) at the expense of potential penile/vaginal Hypothesia. Oral therapies similarly demonstrate improved IELTs with variable side effect profiles and include selective serotonin reuptake inhibitors (daily or on demand), phosphodiesterase-5 inhibitors, alpha-1 adrenergic antagonists, and tramadol. Alternative therapies such as acupuncture have shown benefits in limited studies. Surgery is not commonly performed and is not recommended by available guidelines. PE is a common condition, with limited data available regarding its underlying pathophysiology and treatment. Available therapies include topical, oral, behavioral/psychologic modification, or a combination thereof. Additional research is required to assess the optimal treatment strategies and algorithms as

  18. Treating Child Disruptive Behavior in High-Risk Families: A Comparative Effectiveness Trial from a Community-Based Implementation

    NARCIS (Netherlands)

    Abrahamse, Mariëlle; Junger, Marianne; van Wouwe, Mirjam A.M.M.; Boer, Frits; Lindauer, Ramon J.L.

    2015-01-01

    Parent management training programs have proven the most effective way to treat child behavior problems. This study reports on an effectiveness trial of a community-based implementation of Parent–Child Interaction Therapy (PCIT) in comparison with the Dutch-developed Family Creative Therapy (FCT).

  19. An unusual effect of interferential therapy.

    LENUS (Irish Health Repository)

    Keramat, Keramat Ullah

    2012-11-01

    In this report, a patient with severe shoulder pain was treated with interferential currents, a commonly used modality in physiotherapy for the management of pain. He reported loss of concentration, drowsiness, decreased alertness and gait disturbance, along with analgaesia, for 4-5 h after each treatment. He was regularly taking tramadol HCl for pain relief. Endogenous opioids produced in response to interferential therapy may be excessive or may interact with the tramadol HCl and potentiate its effect. There is no published report of interferential-induced symptoms, as described above, in the authors\\' knowledge. The clinician using interferential currents should be aware of this possible effect.

  20. The Role of Occupational Therapy in Community-Based Programming: Addressing Childhood Health Promotion

    Directory of Open Access Journals (Sweden)

    Julie Kugel

    2017-01-01

    Full Text Available Background: Obesity and poor health habits impact youth’s health and occupational participation. Occupational therapy’s role in preventing and treating obesity continues to emerge in the research literature. This article explores the impact of a community-based program emphasizing health and wellness for female youth. Methods: Five girls 11 to 13 years of age participated in the healthy occupations program. Before and after the program, the participants engaged in an individual semi-structured interview and completed the Canadian Occupational Performance Measure and the CATCH Kids Club Questionnaire. The youth participated in a focus group midprogram. Results: The participants were receptive to information regarding healthy behaviors and initiated positive health behavior changes after implementation of a 7-week healthy lifestyle community- based program. Conclusion: Occupational therapy can collaborate with community partners to provide programming focused on health promotion and prevention as part of the interprofessional approach to preventing and treating childhood obesity and building healthier communities.

  1. Effects of hormone therapy on brain structure

    OpenAIRE

    Kantarci, Kejal; Tosakulwong, Nirubol; Lesnick, Timothy G.; Zuk, Samantha M.; Gunter, Jeffrey L.; Gleason, Carey E.; Wharton, Whitney; Dowling, N. Maritza; Vemuri, Prashanthi; Senjem, Matthew L.; Shuster, Lynne T.; Bailey, Kent R.; Rocca, Walter A.; Jack, Clifford R.; Asthana, Sanjay

    2016-01-01

    Objective: To investigate the effects of hormone therapy on brain structure in a randomized, double-blinded, placebo-controlled trial in recently postmenopausal women. Methods: Participants (aged 42?56 years, within 5?36 months past menopause) in the Kronos Early Estrogen Prevention Study were randomized to (1) 0.45 mg/d oral conjugated equine estrogens (CEE), (2) 50 ?g/d transdermal 17?-estradiol, or (3) placebo pills and patch for 48 months. Oral progesterone (200 mg/d) was given to active ...

  2. [Contributions by integrative community therapy to users of Psychosocial Care Centers (CAPS) and family members: thematic oral history].

    Science.gov (United States)

    Carvalho, Mariana Albernaz Pinheiro de; Dias, Maria Djair; Miranda, Francisco Arnoldo Nunes de; Ferreira Filha, Maria de Oliveira

    2013-10-01

    The aim of this study was to analyze contributions by integrative community therapy to behavior changes in users of Psychosocial Care Centers (CAPS). This was a comprehensive-interpretative study with a qualitative approach, based on thematic oral history. The study site was the Caminhar Center in João Pessoa, Paraíba State, Brazil. The study material was produced with interviews conducted with six subjects and was discussed using thematic analysis as proposed by Minayo, providing the basis for two major thematic lines: integrative community therapy as a liberating praxis and changes that make the difference. The subjects' stories revealed significant changes in the personal, professional, and community fields, based on their inclusion in the integrative community therapy circles, a strategy that promoted the recovery of processes of natural socialization that constitute human life. The use of integrative community therapy was clearly related to proposals for the participants' psychosocial integration and rehabilitation.

  3. Role for Occupational Therapy in Community Mental Health: Using Policy to Advance Scholarship of Practice.

    Science.gov (United States)

    Mahaffey, Lisa; Burson, Kathrine A; Januszewski, Celeste; Pitts, Deborah B; Preissner, Katharine

    2015-01-01

    Occupational therapists must be aware of professional and policy trends. More importantly, occupational therapists must be involved in efforts to influence policy both for the profession and for the people they serve (Bonder, 1987). Using the state of Illinois as an example, this article reviews the policies and initiatives that impact service decisions for persons with psychiatric disabilities as well as the rationale for including occupational therapy in community mental health service provision. Despite challenges in building a workforce of occupational therapists in the mental health system, this article makes the argument that the current climate of emerging policy and litigation combined with the supporting evidence provides the impetus to strengthen mental health as a primary area of practice. Implications for scholarship of practice related to occupational therapy services in community mental health programs for individuals with psychiatric disability are discussed.

  4. Study the effect of hyperbaric oxygen therapy in Egyptian autistic ...

    African Journals Online (AJOL)

    Farida El-baz

    2014-02-20

    15%). Antiepileptic (Tegretol). 2 (10%). ASD: autistic spectrum disorder. AD: typical autism. AS: asperger syndrome. HBOT: hyperbaric oxygen therapy. Study the effect of hyperbaric oxygen therapy in Egyptian autistic children: ...

  5. Comparative Outcome Analysis of Penicillin-Based Versus Fluoroquinolone-Based Antibiotic Therapy for Community-Acquired Pneumonia

    Science.gov (United States)

    Wang, Chi-Chuan; Lin, Chia-Hui; Lin, Kuan-Yin; Chuang, Yu-Chung; Sheng, Wang-Huei

    2016-01-01

    Abstract Community-acquired pneumonia (CAP) is a common but potentially life-threatening condition, but limited information exists on the effectiveness of fluoroquinolones compared to β-lactams in outpatient settings. We aimed to compare the effectiveness and outcomes of penicillins versus respiratory fluoroquinolones for CAP at outpatient clinics. This was a claim-based retrospective cohort study. Patients aged 20 years or older with at least 1 new pneumonia treatment episode were included, and the index penicillin or respiratory fluoroquinolone therapies for a pneumonia episode were at least 5 days in duration. The 2 groups were matched by propensity scores. Cox proportional hazard models were used to compare the rates of hospitalizations/emergence service visits and 30-day mortality. A logistic model was used to compare the likelihood of treatment failure between the 2 groups. After propensity score matching, 2622 matched pairs were included in the final model. The likelihood of treatment failure of fluoroquinolone-based therapy was lower than that of penicillin-based therapy (adjusted odds ratio [AOR], 0.88; 95% confidence interval [95%CI], 0.77–0.99), but no differences were found in hospitalization/emergence service (ES) visits (adjusted hazard ratio [HR], 1.27; 95% CI, 0.92–1.74) and 30-day mortality (adjusted HR, 0.69; 95% CI, 0.30–1.62) between the 2 groups. The likelihood of treatment failure of fluoroquinolone-based therapy was lower than that of penicillin-based therapy for CAP on an outpatient clinic basis. However, this effect may be marginal. Further investigation into the comparative effectiveness of these 2 treatment options is warranted. PMID:26871827

  6. The Effect of Art Therapy on Cognitive Performance among Ethnically Diverse Older Adults

    Science.gov (United States)

    Pike, Amanda Alders

    2013-01-01

    This study examined the effect of art therapy on the cognitive performance of a multisite, ethnically diverse sample ("N" = 91) of older adults. Participants were recruited from several U.S. facilities that included a community center, a retirement center, an adult daycare, an assisted living facility, and a skilled nursing facility.…

  7. Effects of Structural Family Therapy on Child and Maternal Mental Health Symptomatology

    Science.gov (United States)

    Weaver, Addie; Greeno, Catherine G.; Marcus, Steven C.; Fusco, Rachel A.; Zimmerman, Tina; Anderson, Carol

    2013-01-01

    Objective: This pilot study examined the effect of structural family therapy (SFT) on children's impairment and depressive symptomatology and mothers' depressive symptomatology and anxiety for 31 families served by a community mental health clinic. Method: A one group predesign/postdesign, with a baseline and two follow-up time points, was used.…

  8. Cost-effectiveness of multisystemic therapy versus usual treatment for young people with antisocial problems

    NARCIS (Netherlands)

    Vermeulen, Karin M.; Jansen, Daniëlle E.M.C.; Knorth, Erik J.; Buskens, Erik; Reijneveld, Sijmen A.

    2017-01-01

    BACKGROUND: Behavioural problems are common among adolescents. The burden on society in social disturbance, health, failures to contribute and costs has triggered innovative community-based interventions such as multisystemic therapy (MST). AIMS: Our aim was to compare the cost-effectiveness of MST

  9. The effect of exercise therapy on fatigue in multiple sclerosis

    DEFF Research Database (Denmark)

    Andreasen, A; Stenager, E; Dalgas, U

    2011-01-01

    Fatigue occurs in the majority of patients with multiple sclerosis (MS) and therapeutic possibilities are few. Exercise therapy is a therapeutic option but no studies have systematically reviewed the existing literature evaluating the effect of exercise therapy on MS fatigue.......Fatigue occurs in the majority of patients with multiple sclerosis (MS) and therapeutic possibilities are few. Exercise therapy is a therapeutic option but no studies have systematically reviewed the existing literature evaluating the effect of exercise therapy on MS fatigue....

  10. Immunomodulatory activity of pidotimod administered with standard antibiotic therapy in children hospitalized for community-acquired pneumonia.

    Science.gov (United States)

    Esposito, Susanna; Garziano, Micaela; Rainone, Veronica; Trabattoni, Daria; Biasin, Mara; Senatore, Laura; Marchisio, Paola; Rossi, Marta; Principi, Nicola; Clerici, Mario

    2015-09-03

    Several attempts to improve immune function in young children have been made and encouraging results have been collected with pidotimod (PDT), a synthetic dipeptide molecule that seems to have immunomodulatory activity on both innate and adaptive responses. Until now, the effects of PDT on the immune system have only been studied in vivo after long-term administration to evaluate whether its immunomodulatory activity might prevent the development of infections. This study was planned to evaluate the immunomodulatory activity of PDT administered together with standard antibiotic therapy in children hospitalized for community-acquired pneumonia (CAP). A total of 20 children hospitalized for community-acquired pneumonia (CAP) were randomized at a 1:1 ratio to receive either standard antibiotics plus pidotimod (PDT) or standard antibiotics alone to evaluate the immunomodulatory activity of PDT. Blood samples for the evaluation of immunological parameters were drawn at the time of recruitment (T0) (i.e., before therapy administration), at T3 and T5 (i.e., 3 and 5 days after the initiation of therapy) as well as at T21 (i.e., 7 days after the therapy ended). Following pneumococcal polysaccharide stimulation, the percentage of dendritic cells (DCs) expressing activation and costimulatory molecules was significantly higher in children receiving PDT plus antibiotics than in the controls. A significant increase in tumor necrosis factor-α and/or interleukin-12 secretion and expression of toll like receptor 2 was observed in PDT-treated children compared with controls; this was followed by an increased release of proinflammatory cytokines by monocytes. In the PDT-treated group, mRNA expression of antimicrobial peptides and genes involved in the inflammatory response were also augmented in comparison with the controls. These results demonstrate, for the first time, that PDT administered together with standard antibiotics is associated with a favorable persistent

  11. Effects of Community Screening for Helicobacter pylori

    DEFF Research Database (Denmark)

    Bomme, Maria; Hansen, Jane Møller; Wildner-Christensen, Mette

    2017-01-01

    BACKGROUND & AIMS: Helicobacter pylori (Hp) eradication improves the prognosis of peptic ulcer disease (PUD), dyspepsia, and possibly gastric cancer. Hp screening tests are accurate and eradication therapy is effective. Hp population screening seems attractive. The aim of this study was to evaluate...... the long-term effect of Hp population screening and eradication on dyspepsia prevalence and the incidence of PUD, and as secondary outcomes to assess the effect on health-care consumption and quality of life. METHODS: At baseline in 1998-1999 20,011 individuals aged 40-65 years were randomized to Hp...... screening and eradication or a control group with no screening. Both groups received a questionnaire on dyspepsia and quality of life. Register data were obtained for all randomized individuals. RESULTS: Baseline questionnaire response rate was 63%. Of the 5,749 screened, 1,007 (17.5%) individuals were Hp...

  12. Three essential factors in effective acupunture therapy.

    Science.gov (United States)

    Bresler, D E; Kroening, R J

    1976-01-01

    Three essential factors for achieving effective therapeutic results utilizing acupuncture are described: (1) Immune/inflammatory reactions are mobilized when any area of the skin is sufficiently stimulated. (2) Peripheral neural stimulation occurs when specific acupuncture loci are mechanically, electrically, chemically, or thermally activated. Precise stimulation of specific loci (i.e. peripheral neural receptors) may modulate central nervous system regulation of specific physiological functions in the body. (3) Psychological support is well known to be an important factor in all healing experiences, and that includes acupuncture therapy. The authors suggest that the most effective application of acupuncture involves sufficient stimulation of properly selected and precisely localized acupuncture loci combined with a dedicated concern for health that is clearly communicated to patients.

  13. Effect of electroconvulsive therapy on hematological parameters.

    Science.gov (United States)

    Chaturvedi, S; Chadda, R K; Rusia, U; Jain, N

    2001-11-30

    Although a complete blood count is part of the evaluation before the use of electroconvulsive therapy (ECT), there are no known hematological contraindications for the procedure. A preliminary study was done on 31 randomly selected psychiatric patients (chronic schizophrenia, n=10; acute depression, n=8; acute mania, n=6; acute psychosis, n=6; delusional disorder, n=1) receiving ECT to study its hematological effects. Blood samples were drawn just before and 0, 1 and 2 h after ECT. Hemoglobin (Hb%), total and differential leukocyte count (TLC and DLC), red blood cell (RBC) count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and platelet count were measured on a fully automated hematology analyzer (Sysmex K-1000). Significant changes were found in TLC, percentage of polymorphs and lymphocytes, and Hb%. Changes in other parameters were not statistically significant. More such studies are needed to substantiate these observations and to understand the mechanism and implication of these effects.

  14. ABIFLOX EFFICACY IN COMPLEX THERAPY OF PATIENTS WITH COMMUNITY ACQUIRED PNEUMONIA

    Directory of Open Access Journals (Sweden)

    T. I. Lyadova

    2013-12-01

    Full Text Available The article presents the results of the study, during which the efficacy of levofloxacin in the treatment of patients with community-acquired pneumonia was evaluated. It was found that levofloxacin is a highly effective treatment for patients with community-acquired pneumonia.

  15. Effects of and Perspectives for Therapy

    Directory of Open Access Journals (Sweden)

    Margaret J. Mayston

    2001-01-01

    Full Text Available The movement disorder of cerebral palsy (CP is expressed in a variety of ways and to varying degrees in each individual. The condition has become more complex over the last 20 years with the increasing survival of children born at less than 28 to 30 weeks gestationai age. Impairments present in children with CP as a direct result of the brain injury or occurring indirectly to compensate for underlying problems include abnormal muscle tone; weakness and lack of fitness; limited variety of muscle synergies; contracture and altered biomechanics, the net result being limited functional ability. Other contributors to the motor disorder include sensory, cognitive and perceptual impairments. In recent years understanding of the motor problem has increased, but less is known about effects of therapy. Evidence suggests that therapy can improve functional possibilities for children with cerebral palsy but is inconclusive as to which approach might be most beneficial. The therapist requires an understanding of the interaction of all systems, cognitive/perceptual, motor, musculoskeletal, sensory and behavioral, in the context of the development and plasticity of the CNS. It is necessary to understand the limitations of the damaged immature nervous system, but important to optimize the child's functional possibilities.

  16. Appropriate targeting of artemisinin-based combination therapy by community health workers using malaria rapid diagnostic tests

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham

    2016-01-01

    OBJECTIVE: To compare the impact of malaria rapid diagnostic tests (mRDTs), used by community health workers (CHWs), on the proportion of children artemisinin-based combination therapy (ACT), vs. presumptive treatment. METHODS: Cluster...

  17. Effect of vibration versus suspension therapy on balance in children ...

    African Journals Online (AJOL)

    Khaled A. Olama

    2012-03-03

    Mar 3, 2012 ... Effect of vibration versus suspension therapy on balance in children with hemiparetic cerebral palsy. Khaled A. Olama *, Nahed S. Thabit. Department of Physical Therapy for Disturbance of Growth and Development in Children and its Surgery,. Faculty of Physical Therapy, Cairo University, Cairo, Egypt.

  18. Computerized Cognitive Behavioral Therapy for Insomnia in a Community Health Setting.

    Science.gov (United States)

    Feuerstein, Seth; Hodges, Sarah E; Keenaghan, Brian; Bessette, Andrew; Forselius, Erica; Morgan, Peter T

    2017-02-15

    Insomnia, though quite common in the general population, is especially prevalent among individuals with co-occurring mental illnesses, patients whose condition can be further exacerbated by insomnia and vice versa. For individuals taking one or more psychotropic medications, cognitive behavioral therapy for insomnia (CBT-I), the gold standard in insomnia treatment, is a particularly favorable option (vis-à-vis pharmacotherapy). However, CBT-I can be inaccessible for persons with low socioeconomic status, a group that includes many with psychiatric diagnoses. Computer-based delivery of CBT-I (cb-CBT-I) has the potential to be a cost-effective tool that could greatly improve accessibility for this at-risk demographic. Thirty-four participants with insomnia who were currently engaged in mental health care treatment were randomized to an active control group (sleep diary group; n = 16) or cb-CBT-I (n = 18) during weekly outpatient sessions over the course of 6 w. All participants completed sleep and activity logs at each appointment, whereas those in the cb-CBT-I group also completed one session of the cb-CBT-I program each week. cb-CBT-I treatment was associated with lower scores (improved sleep) on the Pittsburgh Sleep Quality Index (PSQI). Post hoc tests demonstrated a between groups difference at week 6 (p = 0.02), with a statistically significant decrease in PSQI scores in the cb-CBT-I group (p = 0.0006) but not in the sleep diary group (p = 0.35). cb-CBT-I improves sleep in individuals with insomnia and co-occurring mental illness. The significant improvements on the PSQI suggest that implementing a cb-CBT-I treatment in a community mental health center would be a simple and effective treatment for improving sleep over a short period of time. A commentary on this article appears in this issue on page 161.

  19. An online community of practice to support evidence-based physiotherapy practice in manual therapy.

    Science.gov (United States)

    Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara

    2014-01-01

    The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital

  20. Superharmonic microbubble Doppler effect in ultrasound therapy

    Science.gov (United States)

    Pouliopoulos, Antonios N; Choi, James J

    2016-01-01

    Abstract The introduction of microbubbles in focused ultrasound therapies has enabled a diverse range of non-invasive technologies: sonoporation to deliver drugs into cells, sonothrombolysis to dissolve blood clots, and blood-brain barrier opening to deliver drugs into the brain. Current methods for passively monitoring the microbubble dynamics responsible for these therapeutic effects can identify the cavitation position by passive acoustic mapping and cavitation mode by spectral analysis. Here, we introduce a new feature that can be monitored: microbubble effective velocity. Previous studies have shown that echoes from short imaging pulses had a Doppler shift that was produced by the movement of microbubbles. Therapeutic pulses are longer (>1 000 cycles) and thus produce a larger alteration of microbubble distribution due to primary and secondary acoustic radiation force effects which cannot be monitored using pulse-echo techniques. In our experiments, we captured and analyzed the Doppler shift during long therapeutic pulses using a passive cavitation detector. A population of microbubbles (5  ×  104–5  ×  107 microbubbles ml−1) was embedded in a vessel (inner diameter: 4 mm) and sonicated using a 0.5 MHz focused ultrasound transducer (peak-rarefactional pressure: 75–366 kPa, pulse length: 50 000 cycles or 100 ms) within a water tank. Microbubble acoustic emissions were captured with a coaxially aligned 7.5 MHz passive cavitation detector and spectrally analyzed to measure the Doppler shift for multiple harmonics above the 10th harmonic (i.e. superharmonics). A Doppler shift was observed on the order of tens of kHz with respect to the primary superharmonic peak and is due to the axial movement of the microbubbles. The position, amplitude and width of the Doppler peaks depended on the acoustic pressure and the microbubble concentration. Higher pressures increased the effective velocity of the microbubbles up to 3 m s−1, prior to

  1. Superharmonic microbubble Doppler effect in ultrasound therapy.

    Science.gov (United States)

    Pouliopoulos, Antonios N; Choi, James J

    2016-08-21

    The introduction of microbubbles in focused ultrasound therapies has enabled a diverse range of non-invasive technologies: sonoporation to deliver drugs into cells, sonothrombolysis to dissolve blood clots, and blood-brain barrier opening to deliver drugs into the brain. Current methods for passively monitoring the microbubble dynamics responsible for these therapeutic effects can identify the cavitation position by passive acoustic mapping and cavitation mode by spectral analysis. Here, we introduce a new feature that can be monitored: microbubble effective velocity. Previous studies have shown that echoes from short imaging pulses had a Doppler shift that was produced by the movement of microbubbles. Therapeutic pulses are longer (>1 000 cycles) and thus produce a larger alteration of microbubble distribution due to primary and secondary acoustic radiation force effects which cannot be monitored using pulse-echo techniques. In our experiments, we captured and analyzed the Doppler shift during long therapeutic pulses using a passive cavitation detector. A population of microbubbles (5  ×  10(4)-5  ×  10(7) microbubbles ml(-1)) was embedded in a vessel (inner diameter: 4 mm) and sonicated using a 0.5 MHz focused ultrasound transducer (peak-rarefactional pressure: 75-366 kPa, pulse length: 50 000 cycles or 100 ms) within a water tank. Microbubble acoustic emissions were captured with a coaxially aligned 7.5 MHz passive cavitation detector and spectrally analyzed to measure the Doppler shift for multiple harmonics above the 10th harmonic (i.e. superharmonics). A Doppler shift was observed on the order of tens of kHz with respect to the primary superharmonic peak and is due to the axial movement of the microbubbles. The position, amplitude and width of the Doppler peaks depended on the acoustic pressure and the microbubble concentration. Higher pressures increased the effective velocity of the microbubbles up to 3 m s(-1), prior to the onset

  2. Community of practice in occupational therapy for mental health on primary care: expectations and impacts

    Directory of Open Access Journals (Sweden)

    Taís Quevedo Marcolino

    2016-10-01

    Full Text Available Introduction: Primary Healthcare constitutes a recent field of practice for occupational therapy, creating formative demands and calling for practice investigation to create knowledge inherent to this context. Community of Practice/CoP had been used as theoretical frame to investigate and promote professional development. We implement a CoP for seven occupational therapists working on mental health primary care. Objective: To present the expectations of professionals about CoP and their perceptions of the impact of this formative tool for construction and adequacy of the occupational therapy care. Method: The CoP had been organized on monthly meetings, recorded, transcribed and submitted to thematic analysis. Results: We found 2 major themes: 1.Expectations for CoP, with 5 subthemes (CoP as a tool for professional strength; Space for support and continence; Space for exchange of knowledge and information; Tool for systematize and formalize occupational therapy practice; Opportunity to understand the practice scenario and work performed and 2.Impacts of CoP, with 2 subthemes (CoP as support and continence; Space for reflection on action. Conclusion: Community of Practice revealed itself able to promote reflection on practice, addressing formative needs on methodological and theoretical questions as well as personal and emotional aspects related to work.

  3. Developmental trajectories of amphibian microbiota: response to bacterial therapy depends on initial community structure.

    Science.gov (United States)

    Davis, Leyla R; Bigler, Laurent; Woodhams, Douglas C

    2017-04-01

    Improving host health through microbial manipulation requires untangling factors that shape the microbiome. There is currently little understanding of how initial community structure may drive the microbiota trajectory across host development or influence bacterial therapy outcomes. Probiotic baths of surface symbionts, Pseudomonas fluorescens and Flavobacterium johnsoniae were administered to 240 tadpoles of the midwife toad, Alytes obstetricans in semi-natural outdoor mesocosms originating from geographically and genetically distinct populations in Switzerland. Host bacterial and fungal assemblages were compared in tadpoles from the pond of origin, across metamorphosis, and in toadlets via microbial fingerprinting. Bacterial and fungal community structures differed significantly among populations and a microbial population signature persisted from the tadpole stage, through metamorphosis, and following probiotic treatment. A minimal core surface microbiota is described by persistence through development and by shared membership across populations. The impact of F. johnsoniae on the tadpole surface microbiome was assessed with shotgun metagenomics. Bacterial therapy reduced abundance, diversity, and functional repertoire compared to untreated controls. A correlation between host skin peptides and microbiota suggests a mechanism of host-directed symbiosis throughout development. Early developmental stages are ideal targets for amphibian bacterial therapy that can govern a microbiome trajectory at critical timepoints and may impact susceptibility to disease. © 2017 Society for Applied Microbiology and John Wiley & Sons Ltd.

  4. Delivering cognitive processing therapy in a community health setting: The influence of Latino culture and community violence on posttraumatic cognitions.

    Science.gov (United States)

    Marques, Luana; Eustis, Elizabeth H; Dixon, Louise; Valentine, Sarah E; Borba, Christina P C; Simon, Naomi; Kaysen, Debra; Wiltsey-Stirman, Shannon

    2016-01-01

    Despite the applicability of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) to addressing sequelae of a range of traumatic events, few studies have evaluated whether the treatment itself is applicable across diverse populations. The present study examined differences and similarities among non-Latino, Latino Spanish-speaking, and Latino English-speaking clients in rigid beliefs-or "stuck points"-associated with PTSD symptoms in a sample of community mental health clients. We utilized the procedures of content analysis to analyze stuck point logs and impact statements of 29 participants enrolled in a larger implementation trial for CPT. Findings indicated that the content of stuck points was similar across Latino and non-Latino clients, although fewer total stuck points were identified for Latino clients compared to non-Latino clients. Given that identification of stuck points is central to implementing CPT, difficulty identifying stuck points could pose significant challenges for implementing CPT among Latino clients and warrants further examination. Thematic analysis of impact statements revealed the importance of family, religion, and the urban context (e.g., poverty, violence exposure) in understanding how clients organize beliefs and emotions associated with trauma. Clinical recommendations for implementing CPT in community settings and the identification of stuck points are provided. (c) 2016 APA, all rights reserved).

  5. WHEDA study: effectiveness of occupational therapy at home for older people with dementia and their caregivers--the design of a pragmatic randomised controlled trial evaluating a Dutch programme in seven German centres.

    NARCIS (Netherlands)

    Voigt-Radloff, S.; Graff, M.J.L.; Leonhart, R.; Schornstein, K.; Vernooy-Dassen, M.J.F.J.; Olde Rikkert, M.G.M.; Huell, M.

    2009-01-01

    BACKGROUND: A recent Dutch mono-centre randomised controlled trial has shown that occupational therapy improves daily functioning in dementia. The aim of this present study is to compare the effects of the Dutch community occupational therapy programme with a community occupational therapy

  6. Community stakeholders’ perspectives on the role of occupational therapy in primary healthcare: Implications for practice

    Directory of Open Access Journals (Sweden)

    Deshini Naidoo

    2017-01-01

    Full Text Available Background: Primary healthcare (PHC is central to increased access and transformation in South African healthcare. There is limited literature about services required by occupational therapists in PHC. Despite policy being in place, the implementation of services at grassroots level does not always occur adequately.Objectives: This study aimed at gaining an understanding of the challenges of being disabled and the services required by occupational therapists (OTs in rural communities in order to better inform the occupational therapy (OT training curriculum. Method: An exploratory, descriptive qualitative design was implemented using purposive sampling to recruit 23 community healthcare workers from the uGu district. Snowball sampling was used to recruit 37 members of the uGu community, which included people with disability (PWD and caregivers of PWDs. Audio-recorded focus groups and semi-structured interviews were used to collect data, which were thematically analysed. Ethical approval was obtained from the Biomedical and Research Ethics Committee of the University of KwaZulu-Natal (BE248/14.Results: Two main themes emerged namely: firstly, the challenges faced by the disabled community and secondly appropriate opportunities for intervention in PHC. A snapshot of the social and physical inaccessibility challenges experienced by the community was created. Challenges included physical and sexual abuse, discrimination and marginalisation. Community-based rehabilitation and ideas for health promotion and prevention were identified as possible strategies for OT intervention.Conclusion: The understanding of the intervention required by OT in PHC was enhanced through obtaining the views of various stakeholders’ on the role. This study highlighted the gaps in community-based services that OTs should offer in this context.

  7. Transformative learning experience for physical therapy students through a community health promotion project for mothers of hearing-challenged children

    OpenAIRE

    Yokogawa, Masami; Notoya, Masako; Madokoro, Sachiko

    2017-01-01

    [Purpose] The purpose of this project was to expose physical therapy students to transformative learning through a community health promotion project for mothers of hearing-challenged children. [Subjects and Methods] The participants were three mothers with their respective hearing-challenged child and twenty physical therapy students. The project consisted of seven sessions supervised throughout by a physical therapy instructor. The students participated in seven sessions, while the mothers ...

  8. Aphasia therapy in the age of globalization: cross-linguistic therapy effects in bilingual aphasia.

    Science.gov (United States)

    Ansaldo, Ana Inés; Saidi, Ladan Ghazi

    2014-01-01

    Globalization imposes challenges to the field of behavioural neurology, among which is an increase in the prevalence of bilingual aphasia. Thus, aphasiologists have increasingly focused on bilingual aphasia therapy and, more recently, on the identification of the most efficient procedures for triggering language recovery in bilinguals with aphasia. Therapy in both languages is often not available, and, thus, researchers have focused on the transfer of therapy effects from the treated language to the untreated one. This paper discusses the literature on bilingual aphasia therapy, with a focus on cross-linguistic therapy effects from the language in which therapy is provided to the untreated language. Fifteen articles including two systematic reviews, providing details on pre- and posttherapy in the adult bilingual population with poststroke aphasia and anomia are discussed with regard to variables that can influence the presence or absence of cross-linguistic transfer of therapy effects. . The potential for CLT of therapy effects from the treated to the untreated language depends on the word type, the degree of structural overlap between languages, the type of therapy approach, the pre- and postmorbid language proficiency profiles, and the status of the cognitive control circuit.

  9. Aphasia Therapy in the Age of Globalization: Cross-Linguistic Therapy Effects in Bilingual Aphasia

    Science.gov (United States)

    Ansaldo, Ana Inés; Saidi, Ladan Ghazi

    2014-01-01

    Introduction. Globalization imposes challenges to the field of behavioural neurology, among which is an increase in the prevalence of bilingual aphasia. Thus, aphasiologists have increasingly focused on bilingual aphasia therapy and, more recently, on the identification of the most efficient procedures for triggering language recovery in bilinguals with aphasia. Therapy in both languages is often not available, and, thus, researchers have focused on the transfer of therapy effects from the treated language to the untreated one. Aim. This paper discusses the literature on bilingual aphasia therapy, with a focus on cross-linguistic therapy effects from the language in which therapy is provided to the untreated language. Methods. Fifteen articles including two systematic reviews, providing details on pre- and posttherapy in the adult bilingual population with poststroke aphasia and anomia are discussed with regard to variables that can influence the presence or absence of cross-linguistic transfer of therapy effects. Results and Discussion. The potential for CLT of therapy effects from the treated to the untreated language depends on the word type, the degree of structural overlap between languages, the type of therapy approach, the pre- and postmorbid language proficiency profiles, and the status of the cognitive control circuit. PMID:24825963

  10. EFFECTS OF DANCE AND MUSIC THERAPY

    OpenAIRE

    Dr. Saroj Kothari

    2017-01-01

    Arts have consistently been part of life as well as healing throughout the history of humankind. Today, expressive therapies have an increasingly recognized role in mental health, rehabilitation and medicine. The expressive therapies are defined as the use of art, music, dance/movement drama, poetry/creative writing, play and sand play within the context of psychotherapy, counseling, rehabilitation or health care. Through the centuries, the healing nature of these expressive therapies has bee...

  11. Challenges of Empirical Antibiotic Therapy for Community-Acquired Pneumonia in Children.

    Science.gov (United States)

    Rodrigues, Charlene M C

    2017-01-01

    Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality globally, responsible for more than 14% of deaths in children younger than 5 years of age. Due to difficulties with pathogen identification and diagnostics of CAP in children, targeted antimicrobial therapy is not possible, hence the widespread use of empirical antibiotics, in particular penicillins, cephalosporin, and macrolides. This review aimed to address medical, societal, and political issues associated with the widespread use of empirical antibiotics for CAP in the United Kingdom, India, and Nigeria. A literature review was performed identifying the challenges pertaining to the use of widespread empirical antibiotics for CAP in children. A qualitative analysis of included studies identified relevant themes. Empirical guidance was based on guidelines from the World Health Organization, British Thoracic Society, and Infectious Diseases Society of America, used in both industrialized and resource-poor settings. In the United Kingdom there was poor adherence to antibiotics guidelines. There was developing antibiotic resistance to penicillins and macrolides in both developing and industrialized regions. There were difficulties accessing the care and treatment when needed in Nigeria. Prevention strategies with vaccination against Streptococcus pneumonia, Haemophilus influenza, and measles are particularly important in these regions. Effective and timely treatment is required for CAP and empirical antibiotics are evidence-based and appropriate in most settings. However, better diagnostics and education to target treatment may help to prevent antibiotic resistance. Ensuring the secure financing of clean food and water, sanitation, and public health infrastructure are also required to reduce the burden of disease in children in developing countries.

  12. Impact of dialectical behavior therapy versus community treatment by experts on emotional experience, expression, and acceptance in borderline personality disorder.

    Science.gov (United States)

    Neacsiu, Andrada D; Lungu, Anita; Harned, Melanie S; Rizvi, Shireen L; Linehan, Marsha M

    2014-02-01

    Evidence suggests that heightened negative affectivity is a prominent feature of Borderline Personality Disorder (BPD) that often leads to maladaptive behaviors. Nevertheless, there is little research examining treatment effects on the experience and expression of specific negative emotions. Dialectical Behavior Therapy (DBT) is an effective treatment for BPD, hypothesized to reduce negative affectivity (Linehan, 1993a). The present study analyzes secondary data from a randomized controlled trial with the aim to assess the unique effectiveness of DBT when compared to Community Treatment by Experts (CTBE) in changing the experience, expression, and acceptance of negative emotions. Suicidal and/or self-injuring women with BPD (n = 101) were randomly assigned to DBT or CTBE for one year of treatment and one year of follow-up. Several indices of emotional experience and expression were assessed. Results indicate that DBT decreased experiential avoidance and expressed anger significantly more than CTBE. No differences between DBT and CTBE were found in improving guilt, shame, anxiety, or anger suppression, trait, and control. These results suggest that DBT has unique effects on improving the expression of anger and experiential avoidance, whereas changes in the experience of specific negative emotions may be accounted for by general factors associated with expert therapy. Implications of the findings are discussed. Published by Elsevier Ltd.

  13. Predictors of community therapists' use of therapy techniques in a large public mental health system.

    Science.gov (United States)

    Beidas, Rinad S; Marcus, Steven; Aarons, Gregory A; Hoagwood, Kimberly E; Schoenwald, Sonja; Evans, Arthur C; Hurford, Matthew O; Hadley, Trevor; Barg, Frances K; Walsh, Lucia M; Adams, Danielle R; Mandell, David S

    2015-04-01

    Few studies have examined the effects of individual and organizational characteristics on the use of evidence-based practices in mental health care. Improved understanding of these factors could guide future implementation efforts to ensure effective adoption, implementation, and sustainment of evidence-based practices. To estimate the relative contribution of individual and organizational factors on therapist self-reported use of cognitive-behavioral, family, and psychodynamic therapy techniques within the context of a large-scale effort to increase use of evidence-based practices in an urban public mental health system serving youth and families. In this observational, cross-sectional study of 23 organizations, data were collected from March 1 through July 25, 2013. We used purposive sampling to recruit the 29 largest child-serving agencies, which together serve approximately 80% of youth receiving publically funded mental health care. The final sample included 19 agencies with 23 sites, 130 therapists, 36 supervisors, and 22 executive administrators. Therapist self-reported use of cognitive-behavioral, family, and psychodynamic therapy techniques, as measured by the Therapist Procedures Checklist-Family Revised. Individual factors accounted for the following percentages of the overall variation: cognitive-behavioral therapy techniques, 16%; family therapy techniques, 7%; and psychodynamic therapy techniques, 20%. Organizational factors accounted for the following percentages of the overall variation: cognitive-behavioral therapy techniques, 23%; family therapy techniques, 19%; and psychodynamic therapy techniques, 7%. Older therapists and therapists with more open attitudes were more likely to endorse use of cognitive-behavioral therapy techniques, as were those in organizations that had spent fewer years participating in evidence-based practice initiatives, had more resistant cultures, and had more functional climates. Women were more likely to endorse use of

  14. A Comparative Effectiveness of Acceptance and Commitment Therapy and Group Cognitive Therapy for Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Shima Tamannaeifar

    2014-08-01

    Full Text Available Background: Acceptance and commitment therapy (ACT is a new method of psychotherapy for major depressive disorder (MDD. The aim of this experimental study is evaluating the effectiveness of acceptance and commitment therapy and cognitive therapy. Materials and Methods: In this randomized clinical trial, 19 depressive out-patients were randomly divided into 2 groups (acceptance and commitment therapy and cognitive therapy. Twelve therapeutic sessions administered in consulting center of Tehran University twice a week. All the subjects were tested by Beck Depression Inventory (BDI-II and the Ruminative Response Scale (RRS before and after the treatments. Data were analyzed by multivariate analysis of covariance (MANCOVA. Results: The results show no significant differences between the two groups in terms of the variables of depression and rumination. Conclusion: Overall, the results suggest that ACT is an effective treatment, the effectiveness of which appears equivalent to that of CT.

  15. Adverse effects of IgG therapy.

    Science.gov (United States)

    Berger, Melvin

    2013-01-01

    IgG is widely used for patients with immune deficiencies and in a broad range of autoimmune and inflammatory disorders. Up to 40% of intravenous infusions of IgG may be associated with adverse effects (AEs), which are mostly uncomfortable or unpleasant but often are not serious. The most common infusion-related AE is headache. More serious reactions, including true anaphylaxis and anaphylactoid reactions, occur less frequently. Most reactions are related to the rate of infusion and can be prevented or treated just by slowing the infusion rate. Medications such as nonsteroidal anti-inflammatory drugs, antihistamines, or corticosteroids also may be helpful in preventing or treating these common AEs. IgA deficiency with the potential of IgG or IgE antibodies against IgA increases the risk of some AEs but should not be viewed as a contraindication if IgG therapy is needed. Potentially serious AEs include renal dysfunction and/or failure, thromboembolic events, and acute hemolysis. These events usually are multifactorial, related to combinations of constituents in the IgG product as well as risk factors for the recipient. Awareness of these factors should allow minimization of the risks and consequences of these AEs. Subcutaneous IgG is absorbed more slowly into the circulation and has a lower incidence of AEs, but awareness and diligence are necessary whenever IgG is administered. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Effect of levothyroxine therapy on dyslipidemia in hypothyroid patients

    African Journals Online (AJOL)

    Effect of levothyroxine therapy on dyslipidemia in hypothyroid patients. ... Internet Journal of Medical Update - EJOURNAL ... (both subclinical and overt hypothyroidism), its association with dyslipidemia and whether replacement therapy with thyroid hormone has an effect on plasma lipid profile of hypothyroid patients.

  17. Psycho-education with problem solving (PEPS) therapy for adults with personality disorder: a pragmatic multi-site community-based randomised clinical trial.

    Science.gov (United States)

    McMurran, Mary; Crawford, Mike J; Reilly, Joseph G; McCrone, Paul; Moran, Paul; Williams, Hywel; Adams, Clive E; Duggan, Conor; Delport, Juan; Whitham, Diane; Day, Florence

    2011-08-24

    Impairment in social functioning is a key component of personality disorder. Therefore psycho-education and problem solving (PEPS) therapy may benefit people with this disorder. Psycho-education aims to educate, build rapport, and motivate people for problem solving therapy. Problem solving therapy aims to help clients solve interpersonal problems positively and rationally, thereby improving social functioning and reducing distress. PEPS therapy has been evaluated with community adults with personality disorder in an exploratory trial. At the end of treatment, compared to a wait-list control group, those treated with PEPS therapy showed better social functioning, as measured by the Social Functioning Questionnaire (SFQ). A definitive evaluation is now being conducted to determine whether PEPS therapy is a clinically and cost-effective treatment for people with personality disorder This is a pragmatic, two-arm, multi-centre, parallel, randomised controlled clinical trial. The target population is community-dwelling adults with one or more personality disorder, as identified by the International Personality Disorder Examination (IPDE). Inclusion criteria are: Living in the community (including residential or supported care settings); presence of one or more personality disorder; aged 18 or over; proficiency in spoken English; capacity to provide informed consent. Exclusion criteria are: Primary diagnosis of a functional psychosis; insufficient degree of literacy, comprehension or attention to be able to engage in trial therapy and assessments; currently engaged in a specific programme of psychological treatment for personality disorder or likely to start such treatment during the trial period; currently enrolled in any other trial. Suitable participants are randomly allocated to PEPS therapy plus treatment as usual (TAU) or TAU only. We aim to recruit 340 men and women. The primary outcome is social functioning as measured by the SFQ. A reduction (i.e., an

  18. Predictors of Oral Rehydration Therapy use among under-five children with diarrhea in Eastern Ethiopia: a community based case control study

    Directory of Open Access Journals (Sweden)

    Mengistie Bezatu

    2012-11-01

    Full Text Available Abstract Background Rehydration therapy is a critical intervention to save the lives of children during the episodes of diarrhea. However, millions of children die every year due to failure to replace fluid effectively. The objective of this study was to identify the predictors of Oral Rehydration Therapy use among under-five children with diarrhea. Method A community based unmatched case control study was conducted in Kersa district, Eastern Ethiopia, in February, 2011. The cases were 241 under-five children with diarrhea in the preceding two weeks before the survey and who had received Oral Rehydration Therapy while the controls were 253 under-five children with diarrhea in the preceding two weeks before the survey and who had not received Oral Rehydration Therapy. The cases and the controls were compared to find out the factors that were associated with the utilization of Oral Rehydration Therapy. Result The study revealed that caregivers’ previous experience of Oral Rehydration Therapy use (AOR = 4.05, 95% CI = 2.63–6.22, seeking advice or treatment from health facilities, (AOR = 3.25, 95% CI = 2.06–5.11 and knowledge of Oral Rehydration Therapy (AOR = 3.09, 95% CI = 1.97–4.85 were found to be the positive determinants of Oral Rehydration Therapy use. Perception of teething as a cause of diarrhea was negatively associated with the utilization of Oral rehydration Therapy (AOR = 0.61, 95% CI = 0.37–0.98. Conclusion Health education should be strengthened on the benefit, preparation, early initiation of Oral Rehydration Therapy and the causes of diarrhea. Attention should be given to those who do not have previous experience of Oral Rehydration Therapy use and have less frequent contacts with the health facilities.

  19. Predictors of Oral Rehydration Therapy use among under-five children with diarrhea in Eastern Ethiopia: a community based case control study.

    Science.gov (United States)

    Mengistie, Bezatu; Berhane, Yemane; Worku, Alemayehu

    2012-11-24

    Rehydration therapy is a critical intervention to save the lives of children during the episodes of diarrhea. However, millions of children die every year due to failure to replace fluid effectively. The objective of this study was to identify the predictors of Oral Rehydration Therapy use among under-five children with diarrhea. A community based unmatched case control study was conducted in Kersa district, Eastern Ethiopia, in February, 2011. The cases were 241 under-five children with diarrhea in the preceding two weeks before the survey and who had received Oral Rehydration Therapy while the controls were 253 under-five children with diarrhea in the preceding two weeks before the survey and who had not received Oral Rehydration Therapy. The cases and the controls were compared to find out the factors that were associated with the utilization of Oral Rehydration Therapy. The study revealed that caregivers' previous experience of Oral Rehydration Therapy use (AOR = 4.05, 95% CI = 2.63-6.22), seeking advice or treatment from health facilities, (AOR = 3.25, 95% CI = 2.06-5.11) and knowledge of Oral Rehydration Therapy (AOR = 3.09, 95% CI = 1.97-4.85) were found to be the positive determinants of Oral Rehydration Therapy use. Perception of teething as a cause of diarrhea was negatively associated with the utilization of Oral rehydration Therapy (AOR = 0.61, 95% CI = 0.37-0.98). Health education should be strengthened on the benefit, preparation, early initiation of Oral Rehydration Therapy and the causes of diarrhea. Attention should be given to those who do not have previous experience of Oral Rehydration Therapy use and have less frequent contacts with the health facilities.

  20. the effects of highly active antiretroviral therapy (haart)

    African Journals Online (AJOL)

    ymphocyt@ count in a highly active antiretroviral therapy (HAART) has been found to profoundly and durably inhibit HIV production, extend overall long term effectiveness, help in the preservation of overall- term term effect and provide a salvage ...

  1. The 'ripple effect': Towards researching improvisational music therapy in dementia care homes.

    Science.gov (United States)

    Pavlicevic, Mercédès; Tsiris, Giorgos; Wood, Stuart; Powell, Harriet; Graham, Janet; Sanderson, Richard; Millman, Rachel; Gibson, Jane

    2015-09-01

    Increased interest in, and demand for, music therapy provision for persons with dementia prompted this study's exploration of music therapists' strategies for creating musical communities in dementia care settings, considering the needs and resources of people affected by dementia. Focus group discussions and detailed iterative study of improvisational music therapy work by six experienced practitioners clarify the contextual immediacy and socio-musical complexities of music therapy in dementia care homes. Music therapy's 'ripple effect', with resonances from micro (person-to-person musicking), to meso (musicking beyond 'session time') and macro level (within the care home and beyond), implies that all who are part of the dementia care ecology need opportunities for flourishing, shared participation, and for expanded self-identities; beyond 'staff', 'residents', or 'being in distress'. On such basis, managers and funders might consider an extended brief for music therapists' roles, to include generating and maintaining musical wellbeing throughout residential care settings. © The Author(s) 2013.

  2. Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial.

    Science.gov (United States)

    Davidson, K M; Tyrer, P; Tata, P; Cooke, D; Gumley, A; Ford, I; Walker, A; Bezlyak, V; Seivewright, H; Robertson, H; Crawford, M J

    2009-04-01

    Little information exists on treatment effectiveness in antisocial personality disorder (ASPD). We investigated the feasibility and effectiveness of carrying out a randomized controlled trial of cognitive behaviour therapy (CBT) in men with ASPD who were aggressive. This was an exploratory two-centre, randomized controlled trial in a community setting. Fifty-two adult men with a diagnosis of ASPD, with acts of aggression in the 6 months prior to the study, were randomized to either treatment as usual (TAU) plus CBT, or usual treatment alone. Change over 12 months of follow-up was assessed in the occurrence of any act of aggression and also in terms of alcohol misuse, mental state, beliefs and social functioning. The follow-up rate was 79%. At 12 months, both groups reported a decrease in the occurrence of any acts of verbal or physical aggression. Trends in the data, in favour of CBT, were noted for problematic drinking, social functioning and beliefs about others. CBT did not improve outcomes more than usual treatment for men with ASPD who are aggressive and living in the community in this exploratory study. However, the data suggest that a larger study is required to fully assess the effectiveness of CBT in reducing aggression, alcohol misuse and improving social functioning and view of others. It is feasible to carry out a rigorous randomized controlled trial in this group.

  3. EFFECTIVENESS OF MANUAL THERAPY VERSUS EXERCISE THERAPY FOR THE MANAGEMENT OF KNEE OSTEOARTHRITIS IN KARACHI PAKISTAN

    Directory of Open Access Journals (Sweden)

    Ayesha Zakir

    2016-02-01

    Full Text Available Introduction: Among musculoskeletal disorders knee Osteoarthritis (OA is exceedingly prevailing articular disorder affecting people and it is a major cause of disability and socioeconomic burden. It is more common in women than men. Entities with knee OA must often undergo a variety of problems, such as pain and tenderness in joints, movement limitation, crepitus on movement, swelling, recurrent effusion, and local inflammation which ultimately leads to limitation in physical function, like lack of ability to perform Activities of Daily Living (ADL or Instrumental Activities of Daily Living (IADL. For reducing knee pain in osteoarthritis several conventional treatment methods are used world widely but most extensively used in our country are pharmacologic and physical therapy. The objective of the study is to find out the effectiveness of Manual therapy verses Exercise therapy for the management of knee osteoarthritis. Methods: Sixty patients including both male and female with mean age (51years and SD of (5.1 were enrolled in the study and divided randomly in to two groups. Those who were assigned as group A had received Manual therapy and those who were assigned as group B had received Exercise therapy. Participants had received three treatment sessions of 30 min per week for consecutive 4 weeks. OUTCOME MEASURE: WOMAC index score for pain, stiffness and physical function was used to evaluate the baseline score and treatment effects after 12 therapy sessions. Results: Study showed significant improvement in both groups before and after the treatment but in comparison manual therapy group showed significant results with respect to pain subscale (p=0.003 and physical function subscale (p=0.004. Conclusion: Significant difference found between manual therapy and exercise therapy treatment approaches in treating knee osteoarthritis. Findings of this study revealed the fact that short term treatment sessions of manual therapy were superior to

  4. Effects of hormone therapy on brain structure

    Science.gov (United States)

    Tosakulwong, Nirubol; Lesnick, Timothy G.; Zuk, Samantha M.; Gunter, Jeffrey L.; Gleason, Carey E.; Wharton, Whitney; Dowling, N. Maritza; Vemuri, Prashanthi; Senjem, Matthew L.; Shuster, Lynne T.; Bailey, Kent R.; Rocca, Walter A.; Jack, Clifford R.; Asthana, Sanjay; Miller, Virginia M.

    2016-01-01

    Objective: To investigate the effects of hormone therapy on brain structure in a randomized, double-blinded, placebo-controlled trial in recently postmenopausal women. Methods: Participants (aged 42–56 years, within 5–36 months past menopause) in the Kronos Early Estrogen Prevention Study were randomized to (1) 0.45 mg/d oral conjugated equine estrogens (CEE), (2) 50 μg/d transdermal 17β-estradiol, or (3) placebo pills and patch for 48 months. Oral progesterone (200 mg/d) was given to active treatment groups for 12 days each month. MRI and cognitive testing were performed in a subset of participants at baseline, and at 18, 36, and 48 months of randomization (n = 95). Changes in whole brain, ventricular, and white matter hyperintensity volumes, and in global cognitive function, were measured. Results: Higher rates of ventricular expansion were observed in both the CEE and the 17β-estradiol groups compared to placebo; however, the difference was significant only in the CEE group (p = 0.01). Rates of ventricular expansion correlated with rates of decrease in brain volume (r = −0.58; p ≤ 0.001) and with rates of increase in white matter hyperintensity volume (r = 0.27; p = 0.01) after adjusting for age. The changes were not different between the CEE and 17β-estradiol groups for any of the MRI measures. The change in global cognitive function was not different across the groups. Conclusions: Ventricular volumes increased to a greater extent in recently menopausal women who received CEE compared to placebo but without changes in cognitive performance. Because the sample size was small and the follow-up limited to 4 years, the findings should be interpreted with caution and need confirmation. Classification of evidence: This study provides Class I evidence that brain ventricular volume increased to a greater extent in recently menopausal women who received oral CEE compared to placebo. PMID:27473135

  5. Effects of manual therapy on shoulder pain in office workers

    OpenAIRE

    Go, Seong-Uk; Lee, Byoung-Hee

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of manual therapy on shoulder pain in office workers. [Subjects and Methods] Subjects included 38 office workers who were randomly divided into two groups: a manual therapy group of 19 subjects and a shoulder stabilization exercise group of 19 subjects. All subjects underwent evaluation of the pressure pain threshold in the splenius capitis and upper, middle, and lower trapezius muscles on both sides. The manual therapy used in ...

  6. Effects of Music Therapy on Drug Therapy of Adult Psychiatric Outpatients: A Pilot Randomized Controlled Study

    Science.gov (United States)

    Degli Stefani, Mario; Biasutti, Michele

    2016-01-01

    Objective: Framed in the patients’ engagement perspective, the current study aims to determine the effects of group music therapy in addition to drug care in comparison with drug care in addition to other non-expressive group activities in the treatment of psychiatric outpatients. Method: Participants (n = 27) with ICD-10 diagnoses of F20 (schizophrenia), F25 (schizoaffective disorders), F31 (bipolar affective disorder), F32 (depressive episode), and F60 (specific personality disorders) were randomized to receive group music therapy plus standard care (48 weekly sessions of 2 h) or standard care only. The clinical measures included dosages of neuroleptics, benzodiazepines, mood stabilizers, and antidepressants. Results: The participants who received group music therapy demonstrated greater improvement in drug dosage with respect to neuroleptics than those who did not receive group music therapy. Antidepressants had an increment for both groups that was significant only for the control group. Benzodiazepines and mood stabilizers did not show any significant change in either group. Conclusion: Group music therapy combined with standard drug care was effective for controlling neuroleptic drug dosages in adult psychiatric outpatients who received group music therapy. We discussed the likely applications of group music therapy in psychiatry and the possible contribution of music therapy in improving the psychopathological condition of adult outpatients. In addition, the implications for the patient-centered perspective were also discussed. PMID:27774073

  7. Effects of Music Therapy on Drug Therapy of Adult Psychiatric Outpatients: A Pilot Randomized Controlled Study.

    Science.gov (United States)

    Degli Stefani, Mario; Biasutti, Michele

    2016-01-01

    Objective: Framed in the patients' engagement perspective, the current study aims to determine the effects of group music therapy in addition to drug care in comparison with drug care in addition to other non-expressive group activities in the treatment of psychiatric outpatients. Method: Participants ( n = 27) with ICD-10 diagnoses of F20 (schizophrenia), F25 (schizoaffective disorders), F31 (bipolar affective disorder), F32 (depressive episode), and F60 (specific personality disorders) were randomized to receive group music therapy plus standard care (48 weekly sessions of 2 h) or standard care only. The clinical measures included dosages of neuroleptics, benzodiazepines, mood stabilizers, and antidepressants. Results: The participants who received group music therapy demonstrated greater improvement in drug dosage with respect to neuroleptics than those who did not receive group music therapy. Antidepressants had an increment for both groups that was significant only for the control group. Benzodiazepines and mood stabilizers did not show any significant change in either group. Conclusion: Group music therapy combined with standard drug care was effective for controlling neuroleptic drug dosages in adult psychiatric outpatients who received group music therapy. We discussed the likely applications of group music therapy in psychiatry and the possible contribution of music therapy in improving the psychopathological condition of adult outpatients. In addition, the implications for the patient-centered perspective were also discussed.

  8. Effects of music therapy on drug therapy of adult psychiatric outpatients: A pilot randomised controlled study

    Directory of Open Access Journals (Sweden)

    Mario Degli Stefani

    2016-10-01

    Full Text Available Objective: Framed in the patients’ engagement perspective, the current study aims to determine the effects of group music therapy in addition to drug care in comparison with drug care in the treatment of psychiatric outpatients. Method: Participants (n = 27 with ICD-10 diagnoses of F20 (schizophrenia, F25 (schizoaffective disorders, F31 (bipolar affective disorder, F32 (depressive episode and F60 (specific personality disorders were randomised to receive group music therapy plus standard care (48 weekly sessions of two hours or standard care only. The clinical measures included dosages of neuroleptics, benzodiazepines, mood stabilisers and antidepressants. Results: The participants who received group music therapy demonstrated greater improvement in drug dosage relative to neuroleptics than those who did not receive group music therapy. Antidepressants had an increment for both groups that was significant only for the control group. Benzodiazepines and mood stabilisers did not show any significant change in either group. Conclusions: Group music therapy combined with standard drug care is effective for controlling neuroleptic drug dosages in adult psychiatric outpatients who received group music therapy. We discuss the likely applications of group music therapy in psychiatry and the possible contribution of music therapy in improving the psychopathological condition of adult outpatients. In addition, the implications for the patient-centred perspective were also discussed.

  9. Community mental health provider modifications to cognitive therapy: implications for sustainability.

    Science.gov (United States)

    Wiltsey Stirman, Shannon; Calloway, Amber; Toder, Katherine; Miller, Christopher J; Devito, Andrea K; Meisel, Samuel N; Xhezo, Regina; Evans, Arthur C; Beck, Aaron T; Crits-Christoph, Paul

    2013-10-01

    This study identified modifications to an evidence-based psychosocial treatment (cognitive therapy) within a community mental health system after clinicians had received intensive training and consultation. A coding system, consisting of four types of contextual modifications, 12 types of content-related modifications, seven levels at which modifications can occur, and a code for changes to training or evaluation processes, was applied to data from interviews with 27 clinicians who treat adult consumers within a mental health system. Nine of 12 content modifications were endorsed, and four (tailoring, integration into other therapeutic approaches, loosening structure, and drift) accounted for 65% of all modifications identified. Contextual modifications were rarely endorsed by clinicians in this sample. Modifications typically occurred at the client or clinician level. Clinicians in community mental health settings made several modifications to an evidence-based practice (EBP), often in an effort to improve the fit of the intervention to the client's needs or to the clinician's therapeutic style. These findings have implications for implementation and sustainability of EBPs in community settings, client-level outcomes, and training and consultation.

  10. The earnings effect of education at community colleges

    OpenAIRE

    Marcotte, Dave E.

    2006-01-01

    In this paper, I make use of data from the 2000 follow-up of the National Education Longitudinal Survey (NELS) post-secondary education transcript files to extend what is known about the value of education at community colleges. I examine the effects of enrollment in community colleges on students' subsequent earnings. I estimate the effects of credits earned separate from credentials because community colleges are often used as a means for students to engage in study not necessarily leading ...

  11. Effect of modified constrained induced movement therapy on ...

    African Journals Online (AJOL)

    Ehab M. Abdel-Kafy

    2012-12-21

    Dec 21, 2012 ... Effect of modified constrained induced movement therapy on improving arm function in children with obstetric brachial plexus injury. Ehab M. Abdel-Kafy, Hebatallah M. Kamal *, Samah A. Elshemy. Department of Physical Therapy for Disturbances of Growth and Developmental Disorders in Children and its ...

  12. Clinical effect of Fuzheng quyu therapy in patients undergoing ...

    African Journals Online (AJOL)

    Purpose: To examine the clinical effect of Fuzheng Quyu therapy in patients undergoing radiotherapy after cervical carcinoma ... Conclusion: Herbal therapy designed to nourish vital energy and eliminates blood stasis relieves high- level blood coagulation ..... improves immunity, regulates neural and endocrine functions ...

  13. Effects of Cognitive Behaviour and Social Learning Therapies On ...

    African Journals Online (AJOL)

    This study investigated the effects of Cognitive Behaviour Therapy and Social Learning Therapy on adolescents' aggressiveness among senior secondary students in Lagos Metropolis. It used the quasi-experimental pretest-posttest control group design. The participants were one hundred and fifty-four adolescents ...

  14. Pharmacodynamic Effect of N-Acetylcysteine as Adjunctive Therapy ...

    African Journals Online (AJOL)

    Purpose: To evaluate the pharmacodynamic effect of N-acetylcysteine (NAC) in mild systemic lupus erythematosus (SLE) patients in order to implement NAC as adjunctive therapy in SLE population. Methods: Forty mild SLE patients were randomly allocated to receive 1800 mg of NAC with SLE standard therapy or receive ...

  15. The cost and effectiveness of surfactant replacement therapy at ...

    African Journals Online (AJOL)

    therapy ms of. The cost and effectiveness of surfactant replacement therapy at Johannesburg. Hospital, November 1991. December 1992 v. A. Davies, D. E. Ballot, ..... neural d retinopa developm ventilate these, 69 backgro. Main o urban ba developm. Study infants d. Tygerber at 3-mon. Result significa and ges babies w.

  16. Venous Leg Ulcers: Effectiveness of new compression therapy/moist ...

    African Journals Online (AJOL)

    suffers from leg ulcers. In 60–80% of these cases, chronic venous insufficiency is the pathophysiological cause. Here, a holistic approach of compression therapy combined with moist wound healing is the most effective approach and one that is recommended by therapy guidelines. Despite the above finding, it is a widely ...

  17. Effectiveness of medication / auricular therapy / phyto-therapy combination in the treatment of hypertensive patients

    Directory of Open Access Journals (Sweden)

    José Ramón Martínez Pérez

    2015-10-01

    Full Text Available Background: hypertension is one of the main cardiovascular risk factors, so its control improves the life expectancy of patients.Objective: to assess the effects of a treatment combining medication with auricular therapy and phyto-therapy in hypertensive patients assisted at the health area of ”Romárico Oro” Polyclinic, in Puerto Padre, Las Tunas province.Methods: an intervention study was carried out in 68 hypertensive patients of the health area of “Romárico Oro” Polyclinic in Puerto Padre from April, 2013 to April, 2014. The patients were distributed at random into two equal groups; the first received medication combined with auricular therapy and phyto-therapy, while the second one received only medication. The statistical analysis was done by means of Statistic system, t-student and Chi-Square tests were used and p< or =0.05 was considered as level of statistical significance.Results: by the end of the intervention, 73, 53% of the patients of the group with the combination of drug treatment and auricular therapy and phyto-therapy were controlled. In this group, the diastolic filling pressure diminished to 2, 2 mm Hg and the systolic gradient to 3, 66 mm, regarding the group treated only with drugs. Only one patient, representing the 2, 94% showed adverse reaction to the natural and traditional treatment.Conclusions: the combination of medication with auricular therapy and phyto-therapy proved to be effective, corroborated by a significant decrease of quantity of crisis, diastolic and systolic filling pressure values and increase of number of patients with their disease controlled; the report of only one complication shows the innocuousness of the auricular therapy and phyto-therapy treatment.

  18. Medication therapy management services in North Carolina community pharmacies: current practice patterns and projected demand.

    Science.gov (United States)

    Hansen, Richard A; Roth, Mary T; Brouwer, Emily S; Herndon, Susan; Christensen, Dale B

    2006-01-01

    To evaluate the types of cognitive services offered and the number of patients being served in community pharmacies, determine the number of pharmacies that plan to offer medication therapy management (MTM) services under the Medicare Part D prescription drug benefit, and assess whether current and expected practices will meet the potential needs of enrollees. Cross-sectional study. North Carolina in January 2005. 1,593 community pharmacy managers. Survey using a Web-based tool. Provision of cognitive services and number of patients for whom services are provided. A total of 262 (16%) pharmacy managers provided usable responses. Approximately 42% of respondents (n = 110) indicated that they provide some type of cognitive service. Comprehensive MTM services, or services consistent with the professionwide consensus definition, were provided by 31% of respondents (n = 81). Independent pharmacies were more likely to offer some type of service compared with chain pharmacies (58% versus 31%, respectively; P Pharmacy managers with a doctor of pharmacy degree were less likely than pharmacy managers with a bachelor's degree to offer services in their pharmacies (P = .02), and pharmacies with pharmacists on staff who had received certificate training were more likely to offer cognitive services (P = .03). Of all respondents, 28% (n = 73) indicated that they planned to offer MTM services under the Medicare Part D prescription drug benefit. Comparing these results with those of a 1999 survey of North Carolina pharmacists that used some of the same items, the percentage of community pharmacies that provide cognitive services has increased in the intervening years but remains low. Among the services being offered in 2005, most were focused on patient education and training, coordinating and integrating care, and medication regimen reviews. Implementation of MTM services under the Medicare Part D prescription drug benefit should hasten the development and offering of these

  19. The Effectiveness of Cupping Therapy on Relieving Chronic Neck and Shoulder Pain: A Randomized Controlled Trial

    OpenAIRE

    Lee-Mei Chi; Li-Mei Lin; Chien-Lin Chen; Shu-Fang Wang; Hui-Ling Lai; Tai-Chu Peng

    2016-01-01

    The research aimed to investigate the effectiveness of cupping therapy (CT) in changes on skin surface temperature (SST) for relieving chronic neck and shoulder pain (NSP) among community residents. A single-blind experimental design constituted of sixty subjects with self-perceived NSP. The subjects were randomly allocated to two groups. The cupping group received CT at SI 15, GB 21, and LI 15 acupuncture points, and the control group received no intervention. Pain was assessed using the SST...

  20. Current Aspects of Antibiotic Therapy of Community-Acquired Pneumonia in Children of Early and Preschool Age (Review

    Directory of Open Access Journals (Sweden)

    S.A. Mokiya-Serbina

    2016-04-01

    Full Text Available In this article we analyzed current antibiotic resistance of S.pneumoniae. We showed local (region data on sensitivity of pneumococcus to aminopenicillins, macrolides and cephalosporines traditionally used in schemes of empirical antibiotic therapy of community-acquired pneumonia in children under 5 years. We laid basic principles of rational antibiotic therapy based on the analysis of current national and foreign guidelines on the treatment of community-acquired pneumonia. Insignificant differences in the schemes of empirical antibiotic therapy are marked due to peculiarities of local resistance of S.pneumoniae in different countries. We discussed propriety of some positions of empirical antibiotic therapy in children of early and preschool age.

  1. Theoretical basis of the community effect in development

    Directory of Open Access Journals (Sweden)

    Kuttler Celine

    2011-04-01

    Full Text Available Abstract Background Genetically identical cells often show significant variation in gene expression profile and behaviour even in the same physiological condition. Notably, embryonic cells destined to the same tissue maintain a uniform transcriptional regulatory state and form a homogeneous cell group. One mechanism to keep the homogeneity within embryonic tissues is the so-called community effect in animal development. The community effect is an interaction among a group of many nearby precursor cells, and is necessary for them to maintain tissue-specific gene expression and differentiate in a coordinated manner. Although it has been shown that the cell-cell communication by a diffusible factor plays a crucial role, it is not immediately obvious why a community effect needs many cells. Results In this work, we propose a model of the community effect in development, which consists in a linear gene cascade and cell-cell communication. We examined the properties of the model theoretically using a combination of stochastic and deterministic modelling methods. We have derived the analytical formula for the threshold size of a cell population that is necessary for a community effect, which is in good agreement with stochastic simulation results. Conclusions Our theoretical analysis indicates that a simple model with a linear gene cascade and cell-cell communication is sufficient to reproduce the community effect in development. The model explains why a community needs many cells. It suggests that the community's long-term behaviour is independent of the initial induction level, although the initiation of a community effect requires a sufficient amount of inducing signal. The mechanism of the community effect revealed by our theoretical analysis is analogous to that of quorum sensing in bacteria. The community effect may underlie the size control in animal development and also the genesis of autosomal dominant diseases including tumorigenesis.

  2. Effective Teaching in Higher Education: The Community College Connection

    Science.gov (United States)

    Shepherd, Kimberly M.

    2009-01-01

    Although community colleges are seen as "teaching institutions" there is little, if any, data to support this notion. This study looked at community college instructors' conceptions of effective teaching and their reported usage of effective teaching methods. Survey method was chosen as the most efficient means of collecting an amount of data that…

  3. Effectiveness of Manual Therapy Combined With Physical Therapy in Treatment of Patellofemoral Pain Syndrome: Systematic Review.

    Science.gov (United States)

    Espí-López, Gemma Victoria; Arnal-Gómez, Anna; Balasch-Bernat, Mercè; Inglés, Marta

    2017-06-01

    The purpose of this study was to conduct a review of randomized controlled trials (RCTs) to determine the treatment effectiveness of the combination of manual therapy (MT) with other physical therapy techniques. Systematic searches of scientific literature were undertaken on PubMed and the Cochrane Library (2004-2014). The following terms were used: "patellofemoral pain syndrome," "physical therapy," "manual therapy," and "manipulation." RCTs that studied adults diagnosed with patellofemoral pain syndrome (PFPS) treated by MT and physical therapy approaches were included. The quality of the studies was assessed by the Jadad Scale. Five RCTs with an acceptable methodological quality (Jadad ≥ 3) were selected. The studies indicated that MT combined with physical therapy has some effect on reducing pain and improving function in PFPS, especially when applied on the full kinetic chain and when strengthening hip and knee muscles. The different combinations of MT and physical therapy programs analyzed in this review suggest that giving more emphasis to proximal stabilization and full kinetic chain treatments in PFPS will help better alleviation of symptoms.

  4. Paternal involvement in Multisystemic Therapy: Effects on adolescent outcomes and maternal depression

    NARCIS (Netherlands)

    Gervan, S.; Granic, I.; Solomon, T.; Blokland, K.; Ferguson, B.

    2012-01-01

    The association between paternal involvement in therapy, adolescent outcomes and maternal depression was examined within the context of Multisystemic Therapy (MST), an empirically supported, family- and community-based treatment for antisocial adolescents. Ninety-nine families were recruited from

  5. Long-term Effectiveness of Intensive Therapy in Chronic Stroke.

    Science.gov (United States)

    Wu, Xiaotian; Guarino, Peter; Lo, Albert C; Peduzzi, Peter; Wininger, Michael

    2016-07-01

    Background While recent clinical trials involving robot-assisted therapy have failed to show clinically significant improvement versus conventional therapy, it is possible that a broader strategy of intensive therapy-to include robot-assisted rehabilitation-may yield clinically meaningful outcomes. Objective To test the immediate and sustained effects of intensive therapy (robot-assisted therapy plus intensive conventional therapy) on outcomes in a chronic stroke population. Methods A multivariate mixed-effects model adjusted for important covariates was established to measure the effect of intensive therapy versus usual care. A total of 127 chronic stroke patients from 4 Veterans Affairs medical centers were randomized to either robot-assisted therapy (n = 49), intensive comparison therapy (n = 50), or usual care (n = 28), in the VA-ROBOTICS randomized clinical trial. Patients were at least 6 months poststroke, of moderate-to-severe upper limb impairment. The primary outcome measure was the Fugl-Meyer Assessment at 12 and 36 weeks. Results There was significant benefit of intensive therapy over usual care on the Fugl-Meyer Assessment at 12 weeks with a mean difference of 4.0 points (95% CI = 1.3-6.7); P = .005; however, by 36 weeks, the benefit was attenuated (mean difference 3.4; 95% CI = -0.02 to 6.9; P = .05). Subgroup analyses showed significant interactions between treatment and age, treatment and time since stroke. Conclusions Motor benefits from intensive therapy compared with usual care were observed at 12 and 36 weeks posttherapy; however, this difference was attenuated at 36 weeks. Subgroups analysis showed that younger age, and a shorter time since stroke were associated with greater immediate and long-term improvement of motor function. © The Author(s) 2015.

  6. Intracerebral Hemorrhages in Adults with Community Associated Bacterial Meningitis in Adults: Should We Reconsider Anticoagulant Therapy?

    Science.gov (United States)

    Mook-Kanamori, Barry B.; Fritz, Daan; Brouwer, Matthijs C.; van der Ende, Arie; van de Beek, Diederik

    2012-01-01

    Objective To study the incidence, clinical presentation and outcome of intracranial hemorrhagic complications in adult patients with community associated bacterial meningitis. Methods Nationwide prospective cohort study from all hospitals in the Netherlands, from 1 March 2006, through 31 December 2010. Results Of the 860 episodes of bacterial meningitis that were included, 24 were diagnosed with intracranial hemorrhagic complications: 8 upon presentation and 16 during clinical course. Clinical presentation between patients with or without intracranial hemorrhage was similar. Causative bacteria were Streptococcus pneumoniae in 16 patients (67%), Staphylococcus aureus in 5 (21%), Pseudomonas aeruginosa and Listeria monocytogenes both in 1 patient (4%). Occurrence of intracranial hemorrhage was associated with death (63% vs. 15%, Pbacterial meningitis. Since anticoagulant therapy use is associated with increased risk for intracranial hemorrhage, physicians may consider reversing or temporarily discontinuing anticoagulation in patients with bacterial meningitis. PMID:23028898

  7. MONITORING OF THE EFFECTIVENESS OF ANTIPLATELET THERAPY IN CARDIOLOGY PRACTICE

    Directory of Open Access Journals (Sweden)

    N. F. Puchinian

    2017-01-01

    Full Text Available Monitoring of the effectiveness of drug therapy is one of the most debated issues in everyday clinical practice. The emergence of new drugs,  methods of analysis, standards, management protocols, and clinical guidelines increases the information load on practitioners and requires a significant investment of time and efforts for self-education. The purpose of the review is to help practitioners in summary form to obtain the necessary information on the issue of control of antiplatelet therapy. The review brings together data  from current  clinical recommendations on antiplatelet therapy in patients with ischemic heart disease, gives information of existing approaches to control of antiplatelet therapy specified in the guidelines and the consensuses of experts. It presents information on the most common modern methods of monitoring of the antiplatelet therapy effectiveness.

  8. Community perceptions of malaria and malaria treatment behaviour in a rural district of Ghana: implications for artemisinin combination therapy

    Directory of Open Access Journals (Sweden)

    Boahen Owusu

    2010-07-01

    Full Text Available Abstract Background Artesunate-amodiaquine (AS-AQ was introduced in Ghana as the first line drug for treatment of uncomplicated malaria in 2004. We report the perceptions of malaria and malaria treatment behaviour, the community awareness of and perceptions about AS-AQ two years after the introduction of this ACT treatment for malaria. Methods Two surveys were conducted; a cross-sectional survey of 729 randomly selected household heads (urban-362, rural-367 and 282 women with children Results Majority of respondents ( > 75% in the sampled survey mentioned mosquito bites as the cause of malaria. Other causes mentioned include environmental factors (e.g. dirty surroundings and standing in the sun. Close to 60% of the household heads and 40% of the care-givers interviewed did not know about AS-AQ. The community respondents who knew about and had ever taken AS-AQ perceived it to be a good drug; although they mentioned they had experienced some side effects including headaches and body weakness. Co-blistered AS-AQ was available in all the government health facilities in the study area. Different formulations of ACTs were however found in urban chemical shops but not in rural chemical stores where monotherapy antimalarials were predominant. Conclusion The knowledge of fever as a symptom of malaria is high among the study population. The awareness of AS-AQ therapy and its side-effect was low in the study area. Community education and sensitization, targeting all categories of the population, has to be intensified to ensure an efficient implementation process.

  9. Failure mode and effects analysis: A community practice perspective.

    Science.gov (United States)

    Schuller, Bradley W; Burns, Angi; Ceilley, Elizabeth A; King, Alan; LeTourneau, Joan; Markovic, Alexander; Sterkel, Lynda; Taplin, Brigid; Wanner, Jennifer; Albert, Jeffrey M

    2017-11-01

    To report our early experiences with failure mode and effects analysis (FMEA) in a community practice setting. The FMEA facilitator received extensive training at the AAPM Summer School. Early efforts focused on department education and emphasized the need for process evaluation in the context of high profile radiation therapy accidents. A multidisciplinary team was assembled with representation from each of the major department disciplines. Stereotactic radiosurgery (SRS) was identified as the most appropriate treatment technique for the first FMEA evaluation, as it is largely self-contained and has the potential to produce high impact failure modes. Process mapping was completed using breakout sessions, and then compiled into a simple electronic format. Weekly sessions were used to complete the FMEA evaluation. Risk priority number (RPN) values > 100 or severity scores of 9 or 10 were considered high risk. The overall time commitment was also tracked. The final SRS process map contained 15 major process steps and 183 subprocess steps. Splitting the process map into individual assignments was a successful strategy for our group. The process map was designed to contain enough detail such that another radiation oncology team would be able to perform our procedures. Continuous facilitator involvement helped maintain consistent scoring during FMEA. Practice changes were made responding to the highest RPN scores, and new resulting RPN scores were below our high-risk threshold. The estimated person-hour equivalent for project completion was 258 hr. This report provides important details on the initial steps we took to complete our first FMEA, providing guidance for community practices seeking to incorporate this process into their quality assurance (QA) program. Determining the feasibility of implementing complex QA processes into different practice settings will take on increasing significance as the field of radiation oncology transitions into the new TG-100 QA

  10. Effectiveness of β-Lactam Monotherapy vs Macrolide Combination Therapy for Children Hospitalized With Pneumonia.

    Science.gov (United States)

    Williams, Derek J; Edwards, Kathryn M; Self, Wesley H; Zhu, Yuwei; Arnold, Sandra R; McCullers, Jonathan A; Ampofo, Krow; Pavia, Andrew T; Anderson, Evan J; Hicks, Lauri A; Bramley, Anna M; Jain, Seema; Grijalva, Carlos G

    2017-12-01

    β-Lactam monotherapy and β-lactam plus macrolide combination therapy are both common empirical treatment strategies for children hospitalized with pneumonia, but few studies have evaluated the effectiveness of these 2 treatment approaches. To compare the effectiveness of β-lactam monotherapy vs β-lactam plus macrolide combination therapy among a cohort of children hospitalized with pneumonia. We analyzed data from the Etiology of Pneumonia in the Community Study, a multicenter, prospective, population-based study of community-acquired pneumonia hospitalizations conducted from January 1, 2010, to June 30, 2012, in 3 children's hospitals in Nashville, Tennessee; Memphis, Tennessee; and Salt Lake City, Utah. The study included all children (up to 18 years of age) who were hospitalized with radiographically confirmed pneumonia and who received β-lactam monotherapy or β-lactam plus macrolide combination therapy. Data analysis was completed in April 2017. We defined the referent as β-lactam monotherapy, including exclusive use of an oral or parenteral second- or third-generation cephalosporin, penicillin, ampicillin, ampicillin-sulbactam, amoxicillin, or amoxicillin-clavulanate. Use of a β-lactam plus an oral or parenteral macrolide (azithromycin or clarithromycin) served as the comparison group. We modeled the association between these groups and patients' length of stay using multivariable Cox proportional hazards regression. Covariates included demographic, clinical, and radiographic variables. We further evaluated length of stay in a cohort matched by propensity to receive combination therapy. Logistic regression was used to evaluate secondary outcomes in the unmatched cohort, including intensive care admission, rehospitalizations, and self-reported recovery at follow-up. Our study included 1418 children (693 girls and 725 boys) with a median age of 27 months (interquartile range, 12-69 months). This cohort was 60.1% of the 2358 children enrolled in the

  11. Effect of different diode laser powers in photodynamic therapy

    CSIR Research Space (South Africa)

    Maduray, K

    2010-09-01

    Full Text Available This preliminary photodynamic therapy study investigated the effect of different diode laser powers (mW) for the activation of two photosensitizers (AlTSPc, aluminum tetrasulfonatedphthalocyanine and ZnTSPc, zinc tetrasulfonatedphthalocyanine...

  12. Retrograde amnesia after electroconvulsive therapy: a temporary effect?

    NARCIS (Netherlands)

    Meeter, M.; Janssen, S.M.J.; Birkenhager, T.; van den Broek, W.W.

    2011-01-01

    Objective: Although electroconvulsive therapy (ECT) is generally considered effective against depression, it remains controversial because of its association with retrograde memory loss. Here, we assessed memory after ECT in circumstances most likely to yield strong retrograde amnesia. Method: A

  13. A growing fire hazard concern in communities: home oxygen therapy and continued smoking habits.

    Science.gov (United States)

    Galligan, Catherine J; Markkanen, Pia K; Fantasia, Linda M; Gore, Rebecca J; Sama, Susan R; Quinn, Margaret M

    2015-02-01

    The Safe Home Care Project investigated both qualitatively and quantitatively a range of occupational safety and health hazards, as well as injury and illness prevention practices, among home care aides in Massachusetts. This article reports on a hazard identified by aides during the study's initial focus groups: smoking by home care clients on long-term oxygen therapy. Following the qualitative phase we conducted a cross-sectional survey among 1,249 aides and found that medical oxygen was present in 9 percent of aide visits (314 of aides' 3,484 recent client visits) and that 25 percent of clients on oxygen therapy were described as smokers. Based on our findings, the Board of Health in a local town conducted a pilot study to address fire hazards related to medical oxygen. Medical oxygen combined with smoking or other sources of ignition is a serious fire and explosion hazard that threatens not only workers who visit homes but also communities. © 2015 SAGE Publications.

  14. Impact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study.

    Science.gov (United States)

    Pereira, J M; Gonçalves-Pereira, J; Ribeiro, O; Baptista, J P; Froes, F; Paiva, J A

    2018-02-01

    Antibiotic therapy (AT) is the cornerstone of the management of severe community-acquired pneumonia (CAP). However, the best treatment strategy is far from being established. To evaluate the impact of different aspects of AT on the outcome of critically ill patients with CAP, we performed a post hoc analysis of all CAP patients enrolled in a prospective, observational, multicentre study. Of the 502 patients included, 76% received combination therapy, mainly a β-lactam with a macrolide (80%). AT was inappropriate in 16% of all microbiologically documented CAP (n=177). Hospital and 6months mortality were 34% and 35%. In adjusted multivariate logistic regression analysis, combination AT with a macrolide was independently associated with a reduction in hospital (OR 0.17, 95%CI 0.06-0.51) and 6months (OR 0.21, 95%CI 0.07-0.57) mortality. Prolonged AT (>7days) was associated with a longer ICU (14 vs. 7days; p7days had no survival benefit and was associated with a longer LOS. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Chimeric Antigen Receptor T-Cell Therapy for the Community Oncologist.

    Science.gov (United States)

    Maus, Marcela V; Levine, Bruce L

    2016-05-01

    : The field of cancer immunotherapy has rapidly progressed in the past decade as several therapeutic modalities have entered into the clinic. One such immunotherapy that has shown promise in the treatment of cancer is the use of chimeric antigen receptor (CAR)-modified T lymphocytes. CARs are engineered receptors constructed from antigen recognition regions of antibodies fused to T-cell signaling and costimulatory domains that can be used to reprogram a patient's T cells to specifically target tumor cells. CAR T-cell therapy has demonstrated sustained complete responses for some patients with advanced leukemia, and a number of CAR therapies are being evaluated in clinical studies. CAR T-cell therapy-associated toxicities, including cytokine release syndrome, macrophage activation syndrome, and tumor lysis syndrome, have been observed and effectively managed in the clinic. In patients with significant clinical responses, sustained B-cell aplasia has also been observed and is a marker of CAR T-cell persistence that might provide long-term disease control. Education on CAR T-cell therapy efficacy and safety management is critical for clinicians and patients who are considering this novel type of treatment. In the present report, the current landscape of CAR T-cell therapy, the effective management of patients undergoing treatment, and which patients are the most suitable candidates for current trials are discussed. The present report describes the current status of chimeric antigen receptor (CAR) T lymphocytes as an immunotherapy for patients with relapsed or refractory B-cell malignancies. CAR T cells targeting CD19, a protein expressed on many B-cell malignancies, typically induce high complete response rates in patients with B-cell leukemia or lymphoma who have very limited therapeutic options. Recent clinical trial results of CD19 CAR T-cell therapies and the management of CAR T-cell-associated adverse events are discussed. The present report will therefore inform

  16. From autonomy to community; new perspectives on tumorigenicity and therapy resistance.

    Science.gov (United States)

    Skrbo, Nirma; Tenstad, Ellen; Mælandsmo, Gunhild M; Sørlie, Therese; Andersen, Kristin

    2015-12-01

    Subclones of cancer cells evading treatment represent the major challenge in oncology. Despite recent advances, tumors not responding to treatments are still a severe risk to cancer patients, and oncologists have, as of now, little effective therapy to offer patients with systemic cancer disease. The widely discussed cancer stem cell (CSC) paradigm was originally launched as an explanation to the existence of small cell populations resistant to therapy within the heterogeneous tumor, but has so far unfortunately, offered little concrete improvement in cancer treatment regimes. The launch of the CSC hypothesis did, however, highlight the significance of therapy targeting specific tumor-driving processes, and even more importantly, an increased awareness of a phenomenon well known to stem cell researchers; non-genetic phenotypic heterogeneity of cells with common origin. Here, the scientific background of the CSC theory is revisited and the evidence for CSCs is discussed, along with the importance of considering CSC's dependency of their habitat for survival and growth. Furthermore, recent advances in cancer cell heterogeneity and new possibilities for studying therapy responses in cell clones within the natural tumor environment using patient derived xenograft (PDX) models, are reviewed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Ketogenic diet therapy is effective in encephalitis with refractory seizures.

    Science.gov (United States)

    Matsuzono, Kosuke; Kurata, Tomoko; Deguchi, Shoko; Yamashita, Toru; Deguchi, Kentaro; Abe, Koji

    2014-10-01

    Although ketogenic diet therapy is effective in refractory seizures in childhood, its effect on adult encephalitis with similar refractory seizures and prolonged encephalopathy has not been well reported. We report here a case of a 22-year-old man with acute encephalitis with refractory repetitive partial seizures (AERRPS). Partial seizures of the face developed to repeated generalized convulsions, which were refractory against anti-epileptic drugs and a high dose of propofol. After struggling for 9 months, he dramatically recovered after ketogenic diet therapy. Ketogenic diet therapy may be an important tool to help cure AERRPS.

  18. The clinical effects of music therapy in palliative medicine.

    Science.gov (United States)

    Gallagher, Lisa M; Lagman, Ruth; Walsh, Declan; Davis, Mellar P; Legrand, Susan B

    2006-08-01

    This study was to objectively assess the effect of music therapy on patients with advanced disease. Two hundred patients with chronic and/or advanced illnesses were prospectively evaluated. The effects of music therapy on these patients are reported. Visual analog scales, the Happy/Sad Faces Assessment Tool, and a behavior scale recorded pre- and post-music therapy scores on standardized data collection forms. A computerized database was used to collect and analyze the data. Utilizing the Wilcoxon signed rank test and a paired t test, music therapy improved anxiety, body movement, facial expression, mood, pain, shortness of breath, and verbalizations. Sessions with family members were also evaluated, and music therapy improved families' facial expressions, mood, and verbalizations. All improvements were statistically significant (Pmusic therapy. Objective data were obtained for a large number of patients with advanced disease. This is a significant addition to the quantitative literature on music therapy in this unique patient population. Our results suggest that music therapy is invaluable in palliative medicine.

  19. Community pharmacy-based medication therapy management services: financial impact for patients.

    Science.gov (United States)

    Dodson, Sarah E; Ruisinger, Janelle F; Howard, Patricia A; Hare, Sarah E; Barnes, Brian J

    2012-07-01

    To determine the direct financial impact for patients resulting from Medication Therapy Management (MTM) interventions made by community pharmacists. Secondary objectives include evaluating the patient and physician acceptance rates of the community pharmacists' recommended MTM interventions. This was a retrospective observational study conducted at 20 Price Chopper and Hen House grocery store chain pharmacies in the Kansas City metro area from January 1, 2010 to December 31, 2010. Study patients were Medicare Part D beneficiaries eligible for MTM services. The primary outcome was the change in patient out-of-pocket prescription medication expense as a result of MTM services. Of 128 patients included in this study, 68% experienced no out-of-pocket financial impact on their medication expenses as a result of MTM services. A total of 27% of the patients realized a cost-savings (USD440.50 per year, (SD=289.69)) while another 5% of patients saw a cost increase in out-of-pocket expense (USD255.66 per year, (SD=324.48)). The net financial impact for all 128 patients who participated in MTM services was an average savings of USD102.83 per patient per year (SD=269.18, pimpact on out-of-pocket medication expense. Additionally, the majority of the pharmacists' recommended interventions (53%) were accepted by patients and prescribers.

  20. Occupational therapy practice community: process evaluation by the participants and researchers

    Directory of Open Access Journals (Sweden)

    Sandra Maria Galheigo

    2015-09-01

    Full Text Available This article presents the results of a participatory action research with occupational therapists in a community of practice which purpose was to discuss the care production provided by occupational therapy to hospitalized children and adolescents. The participants were nine occupational therapists from hospitals of the city of São Paulo. Ten face-to-face meetings were conducted and a Web-mediated environment was created for conducting virtual activities. The face meetings were recorded and tapped. This article aims to present the evaluation made by the participants and researchers about the process experienced in the community. Through content analysis, seventeen reporting units were identified and grouped into four main themes: the dialogic process; theoretical and practical implications; reflective process; participatory process and its barriers. The process evaluation showed that dialogue during the meetings contributed to a sense of belonging, integration, and awareness/group cohesion and made possible discussing and reflecting on topics relevant to the practice of occupational therapist. Direct communication proved to be the main form of exchange among the professionals in the group. The participants working conditions, the computers and virtual environments access issues, the surplus work generated by meetings and the displacement in urban centers were complicating factors for the participant’s greater adhesion. Evaluation showed that this strategy favored the construction of shared knowledge, and its implementation can foster reflection, research development and knowledge production, as well as contribute to the occupational therapist professional practice improvement.

  1. Effects of ozone therapy on facial nerve regeneration

    OpenAIRE

    Ozbay, Isa; Ital, Ilker; Kucur, Cuneyt; Akcılar, Raziye; Deger, Aysenur; Aktas, Savas; Oghan, Fatih

    2017-01-01

    Abstract Introduction: Ozone may promote moderate oxidative stress, which increases antioxidant endogenous systems. There are a number of antioxidants that have been investigated therapeutically for improving peripheral nerve regeneration. However, no previous studies have reported the effect of ozone therapy on facial nerve regeneration. Objective: We aimed to evaluate the effect of ozone therapy on facial nerve regeneration. Methods: Fourteen Wistar albino rats were randomly divided into...

  2. Effect of Combination Therapy on Joint Destruction in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Graudal, N.; Hubeck-Graudal, T.; Tarp, S.

    2014-01-01

    Background: Despite significant cost differences, the comparative effect of combination treatments of disease modifying anti-rheumatic drugs (DMARDs) with and without biologic agents has rarely been examined. Thus we performed a network meta-analysis on the effect of combination therapies...... on progression of radiographic joint erosions in patients with rheumatoid arthritis (RA). Methods and Findings: The following combination drug therapies compared versus single DMARD were investigated: Double DMARD: 2 DMARDs (methotrexate, sulfasalazine, leflunomide, injectable gold, cyclosporine, chloroquine...

  3. Androgen deprivation therapy for prostate cancer and the risk of hospitalisation for community-acquired pneumonia.

    Science.gov (United States)

    Hicks, Blánaid M; Yin, Hui; Bladou, Franck; Ernst, Pierre; Azoulay, Laurent

    2017-07-01

    Androgens have been shown to influence both the immune system and lung tissue, raising the hypothesis that androgen deprivation therapy (ADT) for prostate cancer may increase the risk of pneumonia. Thus, the aim of this study was to determine whether ADT is associated with an increased risk of hospitalisation for community-acquired pneumonia in patients with prostate cancer. This was a population-based cohort study using the United Kingdom Clinical Practice Research Datalink linked to the Hospital Episode Statistics repository. The cohort consisted of 20 310 men newly diagnosed with non-metastatic prostate cancer between 1 April 1998 and 31 March 2015. Time-dependent Cox proportional hazards models were used to estimate adjusted HRs and 95% CIs for hospitalisation for community-acquired pneumonia associated with current and past use of ADT compared with non-use. During a mean follow-up of 4.3 years, there were 621 incident hospitalisations for community-acquired pneumonia (incidence rate: 7.2/1000 person-years). Current ADT use was associated with an 81% increased risk of hospitalisation for community-acquired pneumonia (12.1 vs 3.8 per 1000 person-years, respectively; HR 1.81, 95% CI 1.47 to 2.23). The association was observed within the first six months of use (HR 1.73, 95% CI 1.23 to 2.42) and remained elevated with increasing durations of use (≥25 months; HR 1.79, 95% CI 1.39 to 2.30). In contrast, past ADT use was not associated with an increased risk (HR 1.23, 95% CI 0.95 to 1.60). The use of ADT is associated with an increased risk of hospitalisation for community-acquired pneumonia in men with prostate cancer. 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/.

  4. DOT-C: A cluster randomised feasibility trial evaluating directly observed anti-HCV therapy in a population receiving opioid substitute therapy from community pharmacy.

    Science.gov (United States)

    Radley, Andrew; Tait, Jan; Dillon, John F

    2017-09-01

    Direct-acting antiviral therapy (DAAs) for hepatitis C infection (HCV) have a much smaller burden of treatment than interferon-based regimes, require less monitoring and are very effective. New pathways are required to increase access to treatment amongst people prescribed opioid substitution therapy (OST). An exploratory cluster randomised controlled trial with mixed methods evaluation was undertaken to compare the uptake of dried blood spot testing (DBST) and treatment of people with genotype 1 HCV infection in a conventional service pathway versus a pharmacist-led pathway in a population receiving OST. Pharmacies randomised to the conventional pathway obtained 58 DBST from 244 patients (24%):15 new reactive tests and 33 new negative tests were identified. Within the pharmacist-led pathway, 94 DBST were obtained from 262 patients (36%): 26 new reactive tests and 54 new negative tests were identified. Participants in the pharmacist-led pathway were more likely to take a DBST (ptreatment through the conventional pathway, 4 patients from 15 with new reactive tests (27%) attended clinic for assessment. In the pharmacist-led treatment pathway, 20 patients from 26 with new reactive tests (77%) attended for assessment blood tests. Participants in the pharmacist-led pathway were more likely to proceed through the assessment for treatment (ptreatment through the conventional pathway and three patients completed treatment through the pharmacist-led pathway. The process evaluation identified key themes important to service user completers and staff participants. The study provides evidence that testing and treatment for HCV in a pharmacist led-pathway is a feasible treatment pathway for people who receive supervised OST consumption through community pharmacies. This feasibility trial therefore provides sufficient confirmation to justify proceeding to a full trial. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Effects of drought on avian community structure

    Science.gov (United States)

    Thomas P. Albright; Anna M. Pidgeon; Chadwick D. Rittenhouse; Murray K. Clayton; Curtis H. Flather; Patrick D. Culbert; Brian D. Wardlow; Volker C. Radeloff

    2010-01-01

    Droughts are expected to become more frequent under global climate change. Avifauna depend on precipitation for hydration, cover, and food. While there are indications that avian communities respond negatively to drought, little is known about the response of birds with differing functional and behavioural traits, what time periods and indicators of drought are most...

  6. Effects of sulfadiazine on soil bacterial communities

    DEFF Research Database (Denmark)

    Hangler, Martin

    as fertilizers on agricultural lands they represent a route for antibiotics into the soil environment where they may persist and affect levels of antibiotic resistance in soil microbial communities over time. In this work the level of tolerance to the antibiotic sulfadiazine (SDZ) was studied in a number...

  7. Effectiveness of trained community volunteers in improving ...

    African Journals Online (AJOL)

    2015-03-18

    Mar 18, 2015 ... of children <5 years of age, with an evaluation of its outcome on their knowledge and practice of malaria prevention and case management among the experimental group compared with the control group. The study made use of eight. Community volunteers (six females and two males) who were trained to ...

  8. BEYOND ZERO HARM: Promoting effective community participation ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Mining-affected communities globally, and specifically in West Africa, experience both the potential of important socio-economic development opportunities and the negative socio-economic and environmental impacts of mining ... IDRC partner the World Economic Forum is building a hub for inclusive growth solutions.

  9. Subacromial impingement syndrome--effectiveness of physiotherapy and manual therapy.

    Science.gov (United States)

    Gebremariam, Lukas; Hay, Elaine M; van der Sande, Renske; Rinkel, Willem D; Koes, Bart W; Huisstede, Bionka M A

    2014-08-01

    The subacromial impingement syndrome (SIS) includes the rotator cuff syndrome, tendonitis and bursitis of the shoulder. Treatment includes surgical and non-surgical modalities. Non-surgical treatment is used to reduce pain, to decrease the subacromial inflammation, to heal the compromised rotator cuff and to restore satisfactory function of the shoulder. To select the most appropriate non-surgical intervention and to identify gaps in scientific knowledge, we explored the effectiveness of the interventions used, concentrating on the effectiveness of physiotherapy and manual therapy. The Cochrane Library, PubMed, EMBASE, PEDro and CINAHL were searched for relevant systematic reviews and randomised clinical trials (RCTs). Two reviewers independently extracted data and assessed the methodological quality. A best-evidence synthesis was used to summarise the results. Two reviews and 10 RCTs were included. One RCT studied manual therapy as an add-on therapy to self-training. All other studies studied the effect of physiotherapy: effectiveness of exercise therapy, mobilisation as an add-on therapy to exercises, ultrasound, laser and pulsed electromagnetic field. Moderate evidence was found for the effectiveness of hyperthermia compared to exercise therapy or ultrasound in the short term. Hyperthermia and exercise therapy were more effective in comparison to controls or placebo in the short term (moderate evidence). For the effectiveness of hyperthermia, no midterm or long-term results were studied. In the midterm, exercise therapy gave the best results (moderate evidence) compared to placebo or controls. For other interventions, conflicting, limited or no evidence was found. Some physiotherapeutic treatments seem to be promising (moderate evidence) to treat SIS, but more research is needed before firm conclusions can be drawn. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Community effectiveness of copepods for dengue vector control: systematic review.

    Science.gov (United States)

    Lazaro, A; Han, W W; Manrique-Saide, P; George, L; Velayudhan, R; Toledo, J; Runge Ranzinger, S; Horstick, O

    2015-06-01

    Vector control remains the only available method for primary prevention of dengue. Several interventions exist for dengue vector control, with limited evidence of their efficacy and community effectiveness. This systematic review compiles and analyses the existing global evidence for community effectiveness of copepods for dengue vector control. The systematic review follows the PRISMA statement, searching six relevant databases. Applying all inclusion and exclusion criteria, 11 articles were included. There is evidence that cyclopoid copepods (Mesocyclops spp.) could potentially be an effective vector control option, as shown in five community effectiveness studies in Vietnam. This includes long-term effectiveness for larval and adult control of Ae. aegypti, as well as dengue incidence. However, this success has so far not been replicated elsewhere (six studies, three community effectiveness studies--Costa Rica, Mexico and USA, and three studies analysing both efficacy and community effectiveness--Honduras, Laos and USA), probably due to community participation, environmental and/or biological factors. Judging by the quality of existing studies, there is a lack of good study design, data quality and appropriate statistics. There is limited evidence for the use of cyclopoid copepods as a single intervention. There are very few studies, and more are needed in other communities and environments. Clear best practice guidelines for the methodology of entomological studies should be developed. © 2015 John Wiley & Sons Ltd.

  11. Analgesic effectiveness of prophylactic therapy and continued therapy with naproxen sodium post simple extraction.

    Directory of Open Access Journals (Sweden)

    Angel Asmat-Abanto

    2015-02-01

    Full Text Available To compare the analgesic effectiveness of the prophylactic therapy and continued therapy with naproxen sodium after a simple dental extraction. Material and methods: This prospective randomized, parallel, single-blind clinical trial was developed in the Dental Clinic of the Universidad Alas Peruanas in Trujillo (Peru. The patients, who required simple extraction due to dental caries, were randomly distributed into three groups: 30 of them took 550mg naproxen sodium in the preoperative period and then every 12 hours, other 30 took 550mg naproxen sodium in the postoperative period and then every 12 hours, and 30(control group, received 400mg ibuprofen in the postoperative period and then every 8 hours, depending on the established criteria. The procedure was standardized, analgesic effectiveness was assessed by visual analog scale and the presence of adverse drug reactions was evaluated as well. Data were analyzed using ANOVA and Duncan’s test using IBM SPSS 22 with a significance level of 5%. Results: Continued therapy with naproxen sodium showed greater analgesic effectiveness after a simple extraction at 1, 8 and 24 hours (p<0.005. Conclusion: Continued therapy with naproxen sodium presented greater effectiveness than prophylactic therapy with naproxen sodium after a simple extraction.

  12. Effective Community Relations: A Handbook for Independent Schools

    Science.gov (United States)

    Murphy, Charlotte

    2004-01-01

    If readers want to improve ties with their local community, government, town, or civic groups, then this is the handbook to read. This guide focuses on how to conduct a community relations audit, develop a CR strategy, build a CR team, communicate more effectively with neighbors, and handle crises well. The handbook also includes a sample economic…

  13. Community specificity: life and afterlife effects of genes.

    Science.gov (United States)

    Whitham, Thomas G; Gehring, Catherine A; Lamit, Louis J; Wojtowicz, Todd; Evans, Luke M; Keith, Arthur R; Smith, David Solance

    2012-05-01

    Community-level genetic specificity results when individual genotypes or populations of the same species support different communities. Our review of the literature shows that genetic specificity exhibits both life and afterlife effects; it is a widespread phenomenon occurring in diverse taxonomic groups, aquatic to terrestrial ecosystems, and species-poor to species-rich systems. Such specificity affects species interactions, evolution, ecosystem processes and leads to community feedbacks on the performance of the individuals expressing the traits. Thus, genetic specificity by communities appears to be fundamentally important, suggesting that specificity is a major driver of the biodiversity and stability of the world's ecosystems. Copyright © 2012. Published by Elsevier Ltd.

  14. Establishing a community of practice for Occupational Therapy curriculum development: the value of a two-way process.

    Science.gov (United States)

    Thomas, Yvonne; Judd, Jenni

    2015-08-01

    A novel application of the concept of a community of practice was adopted in the development of a revised curriculum for undergraduate occupational therapy education in July 2012. University Academic staff and invited practice scholars met together, half yearly for day long meetings to develop and review a new curriculum. The formation of this community of practice allowed for open discourse and feedback to integrate theory and practice. A qualitative study utilised two focus groups, one for academic staff and one for practice scholars, at the end of the third meeting. The focus groups were facilitated by an external researcher, recorded and transcribed verbatim. Thematic analysis elicited five major themes. Participants reported a sense of community and commitment to the curriculum process. Five themes emerged from the focus groups: (i) a sense of community; (ii) a two-way process with mutual benefits; (iii) benefits to the curriculum and to student learning; (iv) future opportunities including resilience of graduates, and potential research collaborations; and (v) the structure and process of engaging in the community of practice. The commitment of time, planning and resources required to establish and participate in collaborative curriculum development with practice scholars is shown to be a valuable investment for occupational therapy academics, expert practice scholars and ultimately for student learning. Further studies of student and graduate outcomes from the curriculum are warranted. Potential future outcomes of this process include resilience in graduates and collaborative research with practice scholars. © 2015 Occupational Therapy Australia.

  15. Effects of music therapy on mood in stroke patients.

    Science.gov (United States)

    Kim, Dong Soo; Park, Yoon Ghil; Choi, Jung Hwa; Im, Sang-Hee; Jung, Kang Jae; Cha, Young A; Jung, Chul Oh; Yoon, Yeo Hoon

    2011-11-01

    To investigate the effects of music therapy on depressive mood and anxiety in post-stroke patients and evaluate satisfaction levels of patients and caregivers. Eighteen post-stroke patients, within six months of onset and mini mental status examination score of over 20, participated in this study. Patients were divided into music and control groups. The experimental group participated in the music therapy program for four weeks. Psychological status was evaluated with the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) before and after music therapy. Satisfaction with music therapy was evaluated by a questionnaire. BAI and BDI scores showed a greater decrease in the music group than the control group after music therapy, but only the decrease of BDI scores were statistically significant (p=0.048). Music therapy satisfaction in patients and caregivers was affirmative. Music therapy has a positive effect on mood in post-stroke patients and may be beneficial for mood improvement with stroke. These results are encouraging, but further studies are needed in this field.

  16. Effects of Music Therapy on Mood in Stroke Patients

    Science.gov (United States)

    Kim, Dong Soo; Choi, Jung Hwa; Im, Sang-Hee; Jung, Kang Jae; Cha, Young A; Jung, Chul Oh; Yoon, Yeo Hoon

    2011-01-01

    Purpose To investigate the effects of music therapy on depressive mood and anxiety in post-stroke patients and evaluate satisfaction levels of patients and caregivers. Materials and Methods Eighteen post-stroke patients, within six months of onset and mini mental status examination score of over 20, participated in this study. Patients were divided into music and control groups. The experimental group participated in the music therapy program for four weeks. Psychological status was evaluated with the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) before and after music therapy. Satisfaction with music therapy was evaluated by a questionnaire. Results BAI and BDI scores showed a greater decrease in the music group than the control group after music therapy, but only the decrease of BDI scores were statistically significant (p=0.048). Music therapy satisfaction in patients and caregivers was affirmative. Conclusion Music therapy has a positive effect on mood in post-stroke patients and may be beneficial for mood improvement with stroke. These results are encouraging, but further studies are needed in this field. PMID:22028163

  17. A Randomized Clinical Trial of Multisystemic Therapy with Juvenile Sexual Offenders: Effects on Youth Social Ecology and Criminal Activity

    Science.gov (United States)

    Borduin, Charles M.; Schaeffer, Cindy M.; Heiblum, Naamith

    2009-01-01

    A randomized clinical trial evaluated the efficacy of multisystemic therapy (MST) versus usual community services (UCS) for 48 juvenile sexual offenders at high risk of committing additional serious crimes. Results from multiagent assessment batteries conducted before and after treatment showed that MST was more effective than UCS in improving key…

  18. Melanoma patient imaging in the era of effective systemic therapies.

    Science.gov (United States)

    Stodell, M; Thompson, J F; Emmett, L; Uren, R F; Kapoor, R; Saw, R P M

    2017-08-01

    Imaging plays a critical role in the current multi-disciplinary management of patients with melanoma. It is used for primary disease staging, surgical planning, and surveillance in high-risk patients, and for monitoring the effects of systemic or loco-regional therapies. Several different imaging modalities have been utilised in the past. Contemporary imaging practises vary geographically depending on clinical guidelines, physician preferences, availability and cost. Targeted therapies and immunotherapies have revolutionised the treatment of patients with metastatic melanoma over the last few years. With this have come new patterns of disease that were not observed after conventional therapies, and new criteria to assess therapeutic responses. In this article we review the role of imaging for patients with melanoma in the era of effective systemic therapies and discuss likely future developments. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  19. Effects of Music Therapy on Mood in Stroke Patients

    OpenAIRE

    Kim, Dong Soo; Park, Yoon Ghil; Choi, Jung Hwa; Im, Sang-Hee; Jung, Kang Jae; Cha, Young A; Jung, Chul Oh; Yoon, Yeo Hoon

    2011-01-01

    Purpose To investigate the effects of music therapy on depressive mood and anxiety in post-stroke patients and evaluate satisfaction levels of patients and caregivers. Materials and Methods Eighteen post-stroke patients, within six months of onset and mini mental status examination score of over 20, participated in this study. Patients were divided into music and control groups. The experimental group participated in the music therapy program for four weeks. Psychological status was evaluated...

  20. Effect of thrombolytic therapy on postinfarction myocardial ischemia

    DEFF Research Database (Denmark)

    Mickley, H; Junker, A; Møller, M

    1994-01-01

    In patients with acute myocardial infarction a substantial reduction in mortality can be achieved by early intravenous thrombolytic therapy. The beneficial effect of thrombolysis on left ventricular function is relatively small, and it seems unlikely that this minor improvement alone can...... be responsible for the reduction in cardiac death. So far it has not been clearly established how thrombolytic therapy affects postinfarction myocardial ischemia. From studies evaluating ST segment changes on exercise testing or ambulatory monitoring it is concluded that thrombolysis probably results...

  1. The effects of maitland orthopedic manual therapy on improving constipation

    OpenAIRE

    Koo, Ja-Pung; Choi, Jung-Hyun; Kim, Nyeon-Jun

    2016-01-01

    [Purpose] This study aimed to examine the effects of interventions on constipation and to provide basic data for physical therapy in internal medicine. [Subjects and Methods] The colon transit times of 30 subjects were measured and after the interventions. Fifteen subjects were assigned to a Maitland orthopedic manual therapy group, and 15 subjects were assigned to a dietary fiber group. [Results] The analysis of changes in colon transit time showed statistically significant differences in le...

  2. Cost-effectiveness of ceftriaxone in the treatment of community ...

    African Journals Online (AJOL)

    effectiveness of four intravenous antibiotic treatment regimens in the treatment of severe community-acquired pneumonia (CAP) in adults in a private hospital setting. The study compared some third-generation cephalosporin regimens with a ...

  3. Individualization of antibacterial therapy in severe community acquired pneumonia considering systemic inflammation and immune status

    Directory of Open Access Journals (Sweden)

    Pertseva Т.О.

    2013-06-01

    Full Text Available Individualization of antibiotic therapy (ABT of patients with severe community-acquired pneumonia (CAP is a key issue in the world. Today the role of various biomarkers in ABT individualization in patients with CAP, including markers of systemic inflammation and cellular immunity is vividly discussed. But their variability at different etiological factors of CAP according to the immunological reactivity of patients was not studied at all. That’s why the aim of our study was to evaluate the diagnostic value of marker of systemic inflammation procalcitonin (PCT and marker of cellular immunity CD4+ in patients with severe CAP, considering etiological factor and their role in individualization of antibiotic preparation (ABP choice in these patients. A study group consisted of patients with severe CAP without HIV and identified respiratory pathogen. Comparison group consisted of HIV-positive persons, who accounted nearly 17% of all the patients. According to the results of this work it was revealed that in all patients CAP was accompanied with marked inflammatory response (which is confirmed by 250 times higher than normal serum PCT (level and severe immunodeficiency state, even in HIV absence. The markers changed depending on CAP etiology. In CAP caused by Gr(- pathogens PCT levels was 500 times higher than normal, and the number of CD4+ was less than normal in all patients. Conclusions: 1 reduced number of CD4, less than 200 ml-1 in patients with severe CAP, accompanied by a sharp increase in serum PCT level is a marker of Gr(- respiratory pathogen; 2 the imbalance between clinical symptoms and normal serum PCT level against a sharp decline in CD4+number is an indication to search for HIV and administration of the antipneumocystic therapy.

  4. The effects of maitland orthopedic manual therapy on improving constipation.

    Science.gov (United States)

    Koo, Ja-Pung; Choi, Jung-Hyun; Kim, Nyeon-Jun

    2016-10-01

    [Purpose] This study aimed to examine the effects of interventions on constipation and to provide basic data for physical therapy in internal medicine. [Subjects and Methods] The colon transit times of 30 subjects were measured and after the interventions. Fifteen subjects were assigned to a Maitland orthopedic manual therapy group, and 15 subjects were assigned to a dietary fiber group. [Results] The analysis of changes in colon transit time showed statistically significant differences in left colon transit time, rectosigmoid colon transit time, and total colon transit time for the Maitland orthopedic manual therapy group and statistically significant differences in rectosigmoid colon transit time and total colon transit time for the dietary fiber group. An analysis of group differences in the effects of Maitland orthopedic manual therapy and dietary fiber showed that the Maitland orthopedic manual therapy group achieved statistically significantly larger declines in rectosigmoid colon transit time and total colon transit time compared with the dietary fiber group. [Conclusion] This study confirmed that Maitland orthopedic manual therapy can be an effective treatment method for internal conditions such as functional constipation by almost normalizing the colon transit time, not only by improving the symptoms of constipation but also by facilitating intestinal movements.

  5. Addressing Behavioral Health Disparities for Somali Immigrants Through Group Cognitive Behavioral Therapy Led by Community Health Workers.

    Science.gov (United States)

    Pratt, Rebekah; Ahmed, Nimo; Noor, Sahra; Sharif, Hiba; Raymond, Nancy; Williams, Chris

    2017-02-01

    To test the feasibility and acceptability of implementing an evidence-based, peer-delivered mental health intervention for Somali women in Minnesota, and to assess the impact of the intervention on the mental health of those who received the training. In a feasibility study, 11 Somali female community health workers were trained to deliver an 8-session cognitive behavioral therapy intervention. Each of the trainers recruited 5 participants through community outreach, resulting in 55 participants in the intervention. Self-assessed measures of mood were collected from study participants throughout the intervention, and focus groups were conducted. The 55 Somali women who participated recorded significant improvements in mood, with self-reported decreases in anxiety and increases in happiness. Focus group data showed the intervention was well received, particularly because it was delivered by a fellow community member. Participants reported gaining skills in problem solving, stress reduction, and anger management. Participants also felt that the intervention helped to address some of the stigma around mental health in their community. Delivery of cognitive behavioral therapy by a community health workers offered an acceptable way to build positive mental health in the Somali community.

  6. Medication Therapy Management in community pharmacy practice: core elements of an MTM service (version 1.0).

    Science.gov (United States)

    2005-01-01

    To develop a model framework of Medication Therapy Management (MTM) in community pharmacy designed to improve care, enhance communication among patients and providers, improve collaboration among providers, and optimize medication use that leads to improved patient outcomes. Peer-reviewed literature, structured discussions with community pharmacy leaders and representatives from pharmacy benefit providers and health plans, and input from pharmacists and pharmacy associations. Building on an MTM consensus definition adopted by 11 national pharmacy organizations in July 2004, this model describes core elements of an MTM service that can be provided by pharmacists across the spectrum of community pharmacy. The model is structured for pharmacists to use with all patients in need of MTM services, both in the private and public sector. The model describes five core elements of MTM in the community pharmacy setting: medication therapy review (MTR), a personal medication record (PMR), a medication action plan (MAP), intervention and referral, and documentation and follow-up. The MTR can be comprehensive or targeted, depending onthe needs of the patient. The PMR and MAP are patient-centered documents intended to be used by the patient to improve medication self-management. A collaborative approach to patient care involving patients, pharmacists, and physicians and other health care providers is advocated in the model. General patient eligibility considerations are also described. A model framework for consideration by community pharmacists in developing MTM services is described. The model consists of five core elements for MTM service delivery in community pharmacy practice.

  7. Community pharmacy-based medication therapy management services: financial impact for patients

    Directory of Open Access Journals (Sweden)

    Ruisinger JF

    2012-09-01

    Full Text Available Objective: To determine the direct financial impact for patients resulting from Medication Therapy Management (MTM interventions made by community pharmacists. Secondary objectives include evaluating the patient and physician acceptance rates of the community pharmacists’ recommended MTM interventions.Methods: This was a retrospective observational study conducted at 20 Price Chopper and Hen House grocery store chain pharmacies in the Kansas City metro area from January 1, 2010 to December 31, 2010. Study patients were Medicare Part D beneficiaries eligible for MTM services. The primary outcome was the change in patient out-of-pocket prescription medication expense as a result of MTM services.Results: Of 128 patients included in this study, 68% experienced no out-of-pocket financial impact on their medication expenses as a result of MTM services. A total of 27% of the patients realized a cost-savings (USD440.50 per year, (SD=289.69 while another 5% of patients saw a cost increase in out-of-pocket expense (USD255.66 per year, (SD=324.48. The net financial impact for all 128 patients who participated in MTM services was an average savings of USD102.83 per patient per year (SD=269.18, p<0.0001. Pharmacists attempted a total of 732 recommendations; 391 (53% were accepted by both the patient and their prescriber. A total of 341 (47% recommendations were not accepted because of patient refusal (290, 85% or prescriber refusal (51, 15%.Conclusions: Patient participation in MTM services reduces patient out-of-pocket medication expense. However, this savings is driven by only 32% of subjects who are experiencing a financial impact on out-of-pocket medication expense. Additionally, the majority of the pharmacists’ recommended interventions (53% were accepted by patients and prescribers.

  8. Ecological and evolutionary effects of stickleback on community structure.

    Science.gov (United States)

    Des Roches, Simone; Shurin, Jonathan B; Schluter, Dolph; Harmon, Luke J

    2013-01-01

    Species' ecology and evolution can have strong effects on communities. Both may change concurrently when species colonize a new ecosystem. We know little, however, about the combined effects of ecological and evolutionary change on community structure. We simultaneously examined the effects of top-predator ecology and evolution on freshwater community parameters using recently evolved generalist and specialist ecotypes of three-spine stickleback (Gasterosteus aculeatus). We used a mesocosm experiment to directly examine the effects of ecological (fish presence and density) and evolutionary (phenotypic diversity and specialization) factors on community structure at lower trophic levels. We evaluated zooplankton biomass and composition, periphyton and phytoplankton chlorophyll-a concentration, and net primary production among treatments containing different densities and diversities of stickleback. Our results showed that both ecological and evolutionary differences in the top-predator affect different aspects of community structure and composition. Community structure, specifically the abundance of organisms at each trophic level, was affected by stickleback presence and density, whereas composition of zooplankton was influenced by stickleback diversity and specialization. Primary productivity, in terms of chlorophyll-a concentration and net primary production was affected by ecological but not evolutionary factors. Our results stress the importance of concurrently evaluating both changes in density and phenotypic diversity on the structure and composition of communities.

  9. Ecological and evolutionary effects of stickleback on community structure.

    Directory of Open Access Journals (Sweden)

    Simone Des Roches

    Full Text Available Species' ecology and evolution can have strong effects on communities. Both may change concurrently when species colonize a new ecosystem. We know little, however, about the combined effects of ecological and evolutionary change on community structure. We simultaneously examined the effects of top-predator ecology and evolution on freshwater community parameters using recently evolved generalist and specialist ecotypes of three-spine stickleback (Gasterosteus aculeatus. We used a mesocosm experiment to directly examine the effects of ecological (fish presence and density and evolutionary (phenotypic diversity and specialization factors on community structure at lower trophic levels. We evaluated zooplankton biomass and composition, periphyton and phytoplankton chlorophyll-a concentration, and net primary production among treatments containing different densities and diversities of stickleback. Our results showed that both ecological and evolutionary differences in the top-predator affect different aspects of community structure and composition. Community structure, specifically the abundance of organisms at each trophic level, was affected by stickleback presence and density, whereas composition of zooplankton was influenced by stickleback diversity and specialization. Primary productivity, in terms of chlorophyll-a concentration and net primary production was affected by ecological but not evolutionary factors. Our results stress the importance of concurrently evaluating both changes in density and phenotypic diversity on the structure and composition of communities.

  10. AUTHENTİC LEADERSHIP EFFECT ON SENSE OF COMMUNITY

    OpenAIRE

    Güler, Mürsel; Boz, Dursun

    2017-01-01

    The purpose of this study is to determine the effect of authenticleadership on the sense of community. The study was carried out on 304 religious officials working in Kütahya. Theeffect of the leader's authenticity in investigating religion officers as acommunity with their colleagues was investigated. As a result of the fact thatthe leader's self-awareness is high, it is concluded that the religiousofficers are effective in forming community feeling.

  11. Effects of a single-session assertiveness music therapy role playing protocol for psychiatric inpatients.

    Science.gov (United States)

    Silverman, Michael J

    2011-01-01

    The purpose of this study was to implement and measure the effectiveness of a single-session assertiveness music therapy role playing protocol for psychiatric inpatients. Participants (N=133) were randomly assigned by group to one of three conditions: (a) Assertiveness Music Therapy, (b) No Music Assertiveness, or (c) Music No Assertiveness. Participants in both assertiveness conditions role played a number of different commonly occurring scenarios at an inpatient psychiatric facility and in the community. There were no significant between-group differences in posttest quality of life, locus of control, or other subscales. However, participants in both assertiveness conditions tended to have slightly higher internal locus of control and overall quality of life scores than participants in the music no assertiveness condition. Additionally, the assertiveness music therapy condition had higher attendance rates than the other conditions. A higher percentage of participants from both the assertiveness music therapy and music no assertiveness conditions indicated they thought their session was the most helpful/therapeutic group therapy session in which they had participated; this was not the case for the assertiveness no music condition. Future research is warranted to measure the effects of protocols that can help psychiatric patients generalize skills learned in treatment.

  12. Steam inhalation therapy: severe scalds as an adverse side effect

    Science.gov (United States)

    Baartmans, Martin; Kerkhof, Evelien; Vloemans, Jos; Dokter, Jan; Nijman, Susanne; Tibboel, Dick; Nieuwenhuis, Marianne

    2012-01-01

    Background Steam inhalation therapy is often recommended in the treatment of a common cold. However, it has no proven benefit and may in fact have serious adverse side effects in terms of burn injuries. Aim To quantify the human and economic costs of steam inhalation therapy in terms of burn injury. Design and setting A prospective database study of all patients admitted to the burn centres (Beverwijk, Groningen, Rotterdam) and the hospital emergency departments in the Netherlands. Method Number and extent of burn injuries as a result of steam inhalation therapy were analysed, as well as an approximation made of the direct costs for their medical treatment. Results Annually, on average three people are admitted to in one of the Dutch burn centres for burns resulting from steam inhalation therapy. Most victims were children, and they needed skin grafting more often than adults. The total direct medical costs for burn centre and emergency department treatment were €115 500 (£93 000), emotional costs are not reflected. Conclusion As steam inhalation therapy has no proven benefit and the number and extent of complications of this therapy in terms of burn injury are significant, especially in children, steam inhalation therapy should be considered a dangerous procedure and not recommended anymore in professional guidelines and patient brochures. PMID:22781995

  13. The effect of exercise therapy on fatigue in multiple sclerosis.

    Science.gov (United States)

    Andreasen, A K; Stenager, E; Dalgas, U

    2011-09-01

    Fatigue occurs in the majority of patients with multiple sclerosis (MS) and therapeutic possibilities are few. Exercise therapy is a therapeutic option but no studies have systematically reviewed the existing literature evaluating the effect of exercise therapy on MS fatigue. To determine the effect of exercise therapy on MS fatigue by systematically reviewing the literature. A comprehensive literature search (PubMed, SweMed +, Embase, Cochrane, CINAHL, PEDro, Sport Discuss and Bibliotek.dk) was conducted. Studies evaluating the effect of exercise therapy on MS fatigue show heterogeneous results and only few studies have evaluated MS fatigue as the primary outcome. The heterogeneous findings seem to be related to the selected study population, which in many studies are non-fatigued. Most studies that have included fatigued patients with MS show positive effects, although it is not clear whether any exercise modalities are superior to others because there are no comparative studies regarding different exercise interventions. Exercise therapy has the potential to induce a positive effect on MS fatigue, but findings are heterogeneous probably because many studies have applied non-fatigued study populations. Furthermore, only few studies have evaluated MS fatigue as the primary outcome measure, emphasizing the need for future studies within this field.

  14. Evaluation of the effect of cognitive therapy on perioperative anxiety ...

    African Journals Online (AJOL)

    Study Objective: Surgical paients have been known to benefit immensely from psychological interventions. This study set out to assess the pre and postoperative anxiety levels and depression and the effect of cognitive therapy among Nigerian surgical patients. The effects of gender and educational status on perioperative ...

  15. Effects of music therapy under general anesthesia in patients ...

    African Journals Online (AJOL)

    2016-12-13

    Dec 13, 2016 ... Background: Music therapy, an innovative approach that has proven effectiveness in many medical conditions, seems beneficial also in managing surgical patients. The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness.

  16. The immediate effect of vibration therapy on flexibility in female ...

    African Journals Online (AJOL)

    Therefore, the aim of this study was to investigate the acute effects of vibration therapy on the flexibility of female gymnasts. A pre-test, post-test design was used to evaluate this effect. Fifty two gymnasts were assigned to either the control group or to one of three experimental groups. For both the pre- and post-testing all ...

  17. Effect of Progesterone Therapy versus Diet Modification on ...

    African Journals Online (AJOL)

    Effect of Progesterone Therapy versus Diet Modification on Constipation during Pregnancy. ... Aim: To compare the effect of progesterone versus diet modification in the treatment of constipation during pregnancy. Subjects and Methods: ... A randomized placebo controlled trial is required to confirm the data of this study.

  18. Effects of music therapy under general anesthesia in patients ...

    African Journals Online (AJOL)

    Background: Music therapy, an innovative approach that has proven effectiveness in many medical conditions, seems beneficial also in managing surgical patients. The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness. Methods: This is a ...

  19. Physicians' Preferences for Communication of Pharmacist-Provided Medication Therapy Management in Community Pharmacy.

    Science.gov (United States)

    Guthrie, Kendall D; Stoner, Steven C; Hartwig, D Matthew; May, Justin R; Nicolaus, Sara E; Schramm, Andrew M; DiDonato, Kristen L

    2017-02-01

    (1) To identify physicians' preferences in regard to pharmacist-provided medication therapy management (MTM) communication in the community pharmacy setting; (2) to identify physicians' perceived barriers to communicating with a pharmacist regarding MTM; and (3) to determine whether Missouri physicians feel MTM is beneficial for their patients. A cross-sectional prospective survey study of 2021 family and general practice physicians registered with MO HealthNet, Missouri's Medicaid program. The majority (52.8%) of physicians preferred MTM data to be communicated via fax. Most physicians who provided care to patients in long-term care (LTC) facilities (81.0%) preferred to be contacted at their practice location as opposed to the LTC facility. The greatest barriers to communication were lack of time and inefficient communication practices. Improved/enhanced communication was the most common suggestion for improvement in the MTM process. Approximately 67% of respondents reported MTM as beneficial or somewhat beneficial for their patients. Survey respondents saw value in the MTM services offered by pharmacists. However, pharmacists should use the identified preferences and barriers to improve their currently utilized communication practices in hopes of increasing acceptance of recommendations. Ultimately, this may assist MTM providers in working collaboratively with patients' physicians.

  20. Community-acquired pneumonia and positive urinary antigen tests: Factors associated with targeted antibiotic therapy.

    Science.gov (United States)

    Mothes, A; Léotard, S; Nicolle, I; Smets, A; Chirio, D; Rotomondo, C; Tiger, F; Del Giudice, P; Perrin, C; Néri, D; Foucault, C; Della Guardia, M; Hyvernat, H; Roger, P-M

    2016-10-01

    The use of rapid microbiological tests is supported by antimicrobial stewardship policies. Targeted antibiotic therapy (TAT) for community-acquired pneumonia (CAP) with positive urinary antigen test (UAT) has been associated with a favorable impact on outcome. We aimed to determine the factors associated with TAT prescription. We conducted a retrospective multicenter study including all patients presenting with CAP and positive UAT for Streptococcus pneumoniae or Legionella pneumophila from January 2010 to December 2013. Patients presenting with aspiration pneumonia, coinfection, and neutropenia were excluded. CAP severity was assessed using the Pneumonia Severity Index (PSI). TAT was defined as the administration of amoxicillin for pneumococcal infection and either macrolides or fluoroquinolones (inactive against S. pneumoniae) for Legionella infection. A total of 861 patients were included, including 687 pneumococcal infections and 174 legionellosis from eight facilities and 37 medical departments. TAT was prescribed to 273 patients (32%). Four factors were found independently associated with a lower rate of TAT: a PSI score≥4 (OR 0.37), Hospital A (OR 0.41), hospitalization in the intensive care unit (OR 0.44), and cardiac comorbidities (OR 0.60). Four other factors were associated with a high rate of TAT: positive blood culture for S. pneumoniae (OR 2.32), Hospitals B (OR 2.34), E (OR 2.68), and H (OR 9.32). TAT in CAP with positive UAT was related to the hospitals as well as to patient characteristics. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Clinicians' perspectives on cognitive therapy in community mental health settings: implications for training and implementation.

    Science.gov (United States)

    Stirman, Shannon Wiltsey; Gutiérrez-Colina, Ana; Toder, Katherine; Esposito, Gregory; Barg, Frances; Castro, Frank; Beck, Aaron T; Crits-Christoph, Paul

    2013-07-01

    Policymakers are investing significant resources in large-scale training and implementation programs for evidence-based psychological treatments (EBPTs) in public mental health systems. However, relatively little research has been conducted to understand factors that may influence the success of efforts to implement EBPTs for adult consumers of mental health services. In a formative investigation during the development of a program to implement cognitive therapy (CT) in a community mental health system, we surveyed and interviewed clinicians and clinical administrators to identify potential influences on CT implementation within their agencies. Four primary themes were identified. Two related to attitudes towards CT: (1) ability to address client needs and issues that are perceived as most central to their presenting problems, and (2) reluctance to fully implement CT. Two themes were relevant to context: (1) agency-level barriers, specifically workload and productivity concerns and reactions to change, and (2) agency-level facilitators, specifically, treatment planning requirements and openness to training. These findings provide information that can be used to develop strategies to facilitate the implementation of CT interventions for clients being treated in public-sector settings.

  2. Effectiveness of Music Therapy in Alzheimer Patients: Systematic Review

    Directory of Open Access Journals (Sweden)

    Neslihan Lok

    Full Text Available The incidence of Alzheimers disease increases with advancing age. This increase cause significant economic and emotional burden on family and national health care system which makes Alzheimers disease a national issue to be considered. Music therapy could be an alternative treatment approach in Alzheimer's disease. Especially in the second stage of Alzheimers disease, growth and expansion of amyloid plaques results in anger and aggression among patients. Calming effects of music might be beneficial in management of patients during this period. This study is a systematic review of researches conducted to determine the effects of music therapy in Alzheimer's diseases. In sum results have supported possible positive effects of music therapy on Alzheimer patients. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(3.000: 266-274

  3. The Effectiveness of Art Therapy in the Treatment of Traumatized Adults: A Systematic Review on Art Therapy and Trauma

    NARCIS (Netherlands)

    Schouten, K.A.; Niet, G.J. De; Knipscheer, J.W.; Kleber, R.J.; Hutschemaekers, G.J.M.

    2015-01-01

    Art therapy has often been applied in the treatment of traumatized adults, and good results in clinical practice have been reported. However, although art therapy experts underline these benefits, the effectiveness of art therapy in trauma treatment has not been established by systematic review. The

  4. The Effectiveness of Art Therapy in the Treatment of Traumatized Adults. A Systematic Review on Art Therapy and Trauma

    NARCIS (Netherlands)

    Schouten, K.A.; Niet, G.J. De; Knipscheer, J.W.; Kleber, R.J.; Hutschemaekers, G.J.M.

    2015-01-01

    Art therapy has often been applied in the treatment of traumatized adults, and good results in clinical practice have been reported. However, although art therapy experts underline these benefits, the effectiveness of art therapy in trauma treatment has not been established by systematic review. The

  5. Effectiveness of Schema Therapy on Symptoms Intensity Reduction and Anxiety

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Montazeri

    2014-05-01

    Full Text Available The aim of this study was to determine the effectiveness of schema therapy on symptoms intensity reduction and anxiety in a special case with obsessive compulsive personality disorder. In this study a single case method with A-B design was used on a woman with obsessive compulsive personality disorder that was diagnosed by semi-structure interview for axis I and II of DSM-IV-TR (SCID. Martukovich -s obsessive compulsive personality disorder questionnaire and Beck -s anxiety inventory were used to collect data. Schema therapy intervention was effective in symptom reduction of obsessive compulsive personality disorder.

  6. Effectiveness of Compounded Bioidentical Hormone Replacement Therapy: An Observational Cohort Study

    Directory of Open Access Journals (Sweden)

    Daniels Kelly R

    2011-06-01

    Full Text Available Abstract Background Bioidentical Hormone Replacement Therapy (BHRT is believed it to be a safer and equally effective alternative to Conventional Hormone Therapy for the relief of menopausal symptoms; however, data are needed to support these claims. The objective of this study is to evaluate the effectiveness of compounded BHRT provided in six community pharmacies. Methods This was an observational cohort study of women between the ages of 18-89 who received a compounded BHRT product from January 1, 2003 to April 30, 2010 in six community pharmacies. Data included patient demographics, comorbidities, therapeutic outcomes, and hormone therapies. Women self-rated menopausal symptoms as absent, mild, moderate, or severe. Descriptive statistics were used to characterize the patient population, BHRT use, and adverse events. Patient symptom severity was compared at baseline and 3 to 6 months follow-up using the Wilcoxon signed-rank test. Results Women (n = 296 receiving BHRT at Oakdell Pharmacy had a mean (standard deviation age of 52 (9 years. The most common BHRT dosage forms utilized were topical (71% and oral (43%. Compounded BHRT regimens were generally initiated at low doses regardless of route. Women experienced a 25% decrease in emotional lability (p Conclusions This study demonstrates that compounded BHRT improves mood symptoms. Larger studies are needed to examine the impact on vasomotor symptoms, myocardial infarction and breast cancer.

  7. A strategy for improving community effectiveness of HIV/AIDS intervention design: the Community Readiness Model in the Caribbean.

    Science.gov (United States)

    McCoy, H Virginia; Malow, Robert; Edwards, Ruth W; Thurland, Anne; Rosenberg, Rhonda

    2007-01-01

    The Community Readiness Model (CR) offers a solution to the development of prevention strategies at the community level that makes use of community collaborations and community capacity. CR was administered in the U.S. Virgin Islands on St. Thomas, St. Croix, and St. John. All three islands scored lowest on dimensions of community climate and highest on knowledge of efforts to fight HIV/AIDS. The findings suggest that initial intervention efforts should improve the community climate of HIV/AIDS denial and stigma prior to introducing interventions that address HIV/AIDS risk behaviors. Community collaborators identify the interplay of social, structural, and political-economic factors for effective prevention.

  8. "Nihilism" of chronic heart failure therapy in children and why effective therapy is withheld.

    Science.gov (United States)

    Schranz, Dietmar; Voelkel, Norbert F

    2016-04-01

    Major advances in chronic heart failure (cHF) therapy have been achieved and documented in adult patients, while research regarding the mechanisms and therapy of cHF in children has lagged behind. Based on receptor physiological studies and pharmacological knowledge, treatment with specific ß1-adrenergic receptor blocker (ARB), tissue angiotensin-converting enzyme inhibitor (ACE-I), and mineralocorticoid antagonists have to be recommended in children despite lack of sufficient data derived from prospective randomized studies. At our institution, bisoprolol, lisinopril, and spironolactone have been firmly established to treat systolic cHF, hypoplastic left heart syndrome (HLHS) following hybrid approach and congenital left-right shunt diseases, latest in patients where surgery has to be delayed. Chronic therapy with long-acting diuretics and fluid restriction are not advocated because short-term effects are achieved at the expense of further neuro-humoral stimulation. It remains unclear why diuretics are recommended although evidence-based studies, documenting long-term benefit, are missing. However, that is true for all currently used drugs for pediatric cHF. This review focuses on the prevailing "nihilism" of cHF therapy in children with the goal to encourage physicians to treat pediatric cHF with a rationally designed therapy, which combines available agents that have been shown to improve survival in adult patients with cHF. Because of the lack of clinical trials, which generate the needed evidence, surrogate variables like heart and respiratory rate, weight gain, image-derived data, and biomarkers should be monitored and used instead. The recommended pharmacological therapy for systolic heart failure is also provided as the basis for utilizing reversible pulmonary arterial banding (PAB) as a novel strategy in young children with dilative cardiomyopathy (DCM) with preserved right ventricular function. • Heart failure (HF) in children is a serious public

  9. Understanding community pharmacist perceptions and knowledge about HIV preexposure prophylaxis (PrEP) therapy in a Mountain West state.

    Science.gov (United States)

    Unni, Elizabeth J; Lian, Nadia; Kuykendall, William

    2016-01-01

    Preexposure prophylaxis (PrEP) therapy is prescribed to HIV-negative individuals who are at high risk of contracting the virus to reduce the risk of transmission. Adherence to therapy is essential for optimal treatment outcome, and community pharmacists have an important role in achieving this through patient counseling. The objectives of this study were to measure pharmacists' actual knowledge about HIV PrEP therapy, perceptions about their HIV PrEP therapy knowledge, and intention to counsel patients about PrEP therapy. A cross-sectional survey was conducted among community pharmacists in Utah to measure their actual knowledge and perceptions of knowledge about PrEP therapy based on the basic information from the Centers for Disease Control website. In addition, the pharmacist's intention to counsel patients on PrEP therapy was measured with the use of the validated Godin 12-item tool. Descriptive analyses and t tests identified characteristics based on gender, degree earned, and years of practice in pharmacy. Regression analysis determined significant predictors of the intention to counsel. There were 251 responses (75% PharmD, 61% male, 42% >10 years' experience as a pharmacist). An exploratory factor analysis of the Godin 12-item tool demonstrated 4 domains: beliefs about capabilities, social influence, moral norms, and intention to counsel patients. There was no difference in the intention to counsel based on gender. Pharmacists with a PharmD and less than 10 years of experience had significantly higher knowledge and intention to counsel. The actual knowledge score of the respondents was significantly higher than their perceptions of their knowledge. Multiple regression results showed that the beliefs about capabilities and social influence were significant predictors of intention to counsel. Educating community pharmacists on PrEP therapy using pharmacists who are considered to be opinion leaders in the pharmacy profession can affect the social influence

  10. A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth.

    Science.gov (United States)

    Jensen, Tine K; Holt, Tonje; Ormhaug, Silje M; Egeland, Karina; Granly, Lene; Hoaas, Live C; Hukkelberg, Silje S; Indregard, Tore; Stormyren, Shirley D; Wentzel-Larsen, Tore

    2014-01-01

    The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several randomized controlled trials. However, few trials have been conducted in community clinics, few have used therapy as usual (TAU) as a comparison group, and none have been conducted outside of the United States. The objective of this study was to evaluate the effectiveness of TF-CBT in regular community settings compared with TAU. One hundred fifty-six traumatized youth (M age = 15.1 years, range = 10-18; 79.5% girls) were randomly assigned to TF-CBT or TAU. Intent-to-treat analysis using mixed effects models showed that youth receiving TF-CBT reported significantly lower levels of posttraumatic stress symptoms (est. = 5.78, d = 0.51), 95% CI [2.32, 9.23]; depression (est. = 7.00, d = 0.54), 95% CI [2.04, 11.96]; and general mental health symptoms (est. = 2.54, d = 0.45), 95% CI [0.50, 4.58], compared with youth in the TAU group. Youth assigned to TF-CBT showed significantly greater improvements in functional impairment (est. = -1.05, d = -0.55), 95% CI [-1.67, -0.42]. Although the same trend was found for anxiety reduction, this difference was not statistically significant (est. = 4.34, d = 0.30), 95% CI [-1.50, 10.19]. Significantly fewer youths in the TF-CBT condition were diagnosed with posttraumatic stress disorder compared to youths in the TAU condition, χ(2)(1, N = 116) = 4.61, p = .031, Phi = .20). Findings indicate that TF-CBT is effective in treating traumatized youth in community mental health clinics and that the program may also be successfully implemented in countries outside the United States.

  11. Cost-Effectiveness of Surgery, Stereotactic Body Radiation Therapy, and Systemic Therapy for Pulmonary Oligometastases

    Energy Technology Data Exchange (ETDEWEB)

    Lester-Coll, Nataniel H., E-mail: nataniel.lester-coll@yale.edu [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Rutter, Charles E.; Bledsoe, Trevor J. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Goldberg, Sarah B. [Department of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, Connecticut (United States); Decker, Roy H.; Yu, James B. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States)

    2016-06-01

    Introduction: Pulmonary oligometastases have conventionally been managed with surgery and/or systemic therapy. However, given concerns about the high cost of systemic therapy and improvements in local treatment of metastatic cancer, the optimal cost-effective management of these patients is unclear. Therefore, we sought to assess the cost-effectiveness of initial management strategies for pulmonary oligometastases. Methods and Materials: A cost-effectiveness analysis using a Markov modeling approach was used to compare average cumulative costs, quality adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) among 3 initial disease management strategies: video-assisted thoracic surgery (VATS) wedge resection, stereotactic body radiation therapy (SBRT), and systemic therapy among 5 different cohorts of patient disease: (1) melanoma; (2) non-small cell lung cancer adenocarcinoma without an EGFR mutation (NSCLC AC); (3) NSCLC with an EGFR mutation (NSCLC EGFRm AC); (4) NSCLC squamous cell carcinoma (NSCLC SCC); and (5) colon cancer. One-way sensitivity analyses and probabilistic sensitivity analyses were performed to analyze uncertainty with regard to model parameters. Results: In the base case, SBRT was cost effective for melanoma, with costs/net QALYs of $467,787/0.85. In patients with NSCLC, the most cost-effective strategies were SBRT for AC ($156,725/0.80), paclitaxel/carboplatin for SCC ($123,799/0.48), and erlotinib for EGFRm AC ($147,091/1.90). Stereotactic body radiation therapy was marginally cost-effective for EGFRm AC compared to erlotinib with an incremental cost-effectiveness ratio of $126,303/QALY. For colon cancer, VATS wedge resection ($147,730/2.14) was the most cost-effective strategy. Variables with the greatest influence in the model were erlotinib-associated progression-free survival (EGFRm AC), toxicity (EGFRm AC), cost of SBRT (NSCLC SCC), and patient utilities (all histologies). Conclusions: Video-assisted thoracic

  12. Development of a medication therapy management superbill for ambulatory care/community pharmacy practice.

    Science.gov (United States)

    Hogue, Michael D; McDonough, Randy; Bennett, Marialice; Bryner, Crystal; Thomas, Renee Ahrens

    2009-01-01

    To explain the purpose of superbills, suggest strategies for incorporating superbills into pharmacy practice, and propose a model superbill for consideration by practitioners. Ambulatory pharmacies in the United States. Superbills have been used by physicians and other health care providers for many years as a way of efficiently communicating to the office staff, the patient, and even the insurer the types of services that have been provided at the point of care. The profession of pharmacy has not routinely used superbills in the past; however, given the recognition of pharmacists as providers of medication therapy management (MTM) services, immunizations, disease management, and other specialty preventive health services, the time has come for pharmacists to begin using superbills. Not applicable. A sample superbill, suitable for adaptation by individual providers of medication therapy management and other clinical pharmacy services, is provided in this article. Superbills may or may not improve the pharmacist's overall ability to receive insurance remuneration, but the authors believe that greater recognition by patients of the nondispensing activities of pharmacists can be achieved by using a superbill and that this may lead to more opportunities for payment for MTM in the future. Research is needed to assess whether incorporating superbills into a variety of pharmacy practice settings improves patient perceptions of the pharmacist and to discover how superbills effect practice efficiency.

  13. Fungicide effects on fungal community composition in the wheat phyllosphere.

    Science.gov (United States)

    Karlsson, Ida; Friberg, Hanna; Steinberg, Christian; Persson, Paula

    2014-01-01

    The fungicides used to control diseases in cereal production can have adverse effects on non-target fungi, with possible consequences for plant health and productivity. This study examined fungicide effects on fungal communities on winter wheat leaves in two areas of Sweden. High-throughput 454 sequencing of the fungal ITS2 region yielded 235 operational taxonomic units (OTUs) at the species level from the 18 fields studied. It was found that commonly used fungicides had moderate but significant effect on fungal community composition in the wheat phyllosphere. The relative abundance of several saprotrophs was altered by fungicide use, while the effect on common wheat pathogens was mixed. The fungal community on wheat leaves consisted mainly of basidiomycete yeasts, saprotrophic ascomycetes and plant pathogens. A core set of six fungal OTUs representing saprotrophic species was identified. These were present across all fields, although overall the difference in OTU richness was large between the two areas studied.

  14. Fungicide effects on fungal community composition in the wheat phyllosphere.

    Directory of Open Access Journals (Sweden)

    Ida Karlsson

    Full Text Available The fungicides used to control diseases in cereal production can have adverse effects on non-target fungi, with possible consequences for plant health and productivity. This study examined fungicide effects on fungal communities on winter wheat leaves in two areas of Sweden. High-throughput 454 sequencing of the fungal ITS2 region yielded 235 operational taxonomic units (OTUs at the species level from the 18 fields studied. It was found that commonly used fungicides had moderate but significant effect on fungal community composition in the wheat phyllosphere. The relative abundance of several saprotrophs was altered by fungicide use, while the effect on common wheat pathogens was mixed. The fungal community on wheat leaves consisted mainly of basidiomycete yeasts, saprotrophic ascomycetes and plant pathogens. A core set of six fungal OTUs representing saprotrophic species was identified. These were present across all fields, although overall the difference in OTU richness was large between the two areas studied.

  15. Implementing evidence-based patient and family education on oral anticoagulation therapy: a community-based participatory project.

    Science.gov (United States)

    Shaha, Maya; Wüthrich, Erika; Stauffer, Yvonne; Herczeg, Franziska; Fattinger, Karin; Hirter, Kathrin; Papalini, Marianne; Herrmann, Luzia

    2015-06-01

    This study aimed at developing and implementing evidence-based patient and family education on oral anticoagulation therapy. The number of persons with chronic diseases who live at home is increasing. They have to manage multiple diseases and complex treatments. One such treatment is oral anticoagulation therapy, a high risk variable dose medication. Adherence to oral anticoagulation therapy is jeopardised by limited information about the medications, their risk and complications, the impact of individual daily routine and the limited inclusion of family members in education. Hence, improved and tailored education is essential for patients and families to manage oral anticoagulation therapy at home. A community-based participatory research design combined with the Precede-Proceed model was used including a systematic literature review, posteducation analysis, an online nurse survey, a documentation analysis and patient/family interviews. The study was conducted between April 2010-December 2012 at a department of general internal medicine in a teaching hospital in Switzerland. Participants were the department's nursing and medical professionals including the patients and their families. The evidence-based patient and family education on oral anticoagulation therapy emerged comprising a learning assessment, teaching units, clarification of responsibilities of nurse professionals and documentation guidelines. The inclusion of the whole department has contributed to the development and implementation of this evidence-based patient family education on oral anticoagulation therapy, which encompasses local characteristics and patient preferences. This education is now being used throughout the department. © 2015 John Wiley & Sons Ltd.

  16. Effect of season and meteorological conditions on community noise annoyance

    NARCIS (Netherlands)

    Miedema, H.M.E.; Fields, J.M.; Vos, H.

    2005-01-01

    More than 80 000 residents' responses to transportation noise from 42 studies conducted at different times of year provide statistical estimates of the effects of season and meteorological conditions on community response to noise. The strongest evidence for a seasonal effect comes from 7 years of

  17. The importance of priority effects for riparian plant community dynamics

    NARCIS (Netherlands)

    Sarneel, Judith M.|info:eu-repo/dai/nl/304836923; Kardol, Paul; Nilsson, Christer

    Questions The order of plant species arrival can affect recruitment and subsequent plant community development via priority effects, but is often overlooked. Priority effects occur when early-colonizing plant species affect the establishment of later-arriving species, and are hypothesized to depend

  18. Phylogenetic relatedness predicts priority effects in nectar yeast communities.

    Science.gov (United States)

    Peay, Kabir G; Belisle, Melinda; Fukami, Tadashi

    2012-02-22

    Priority effects, in which the outcome of species interactions depends on the order of their arrival, are a key component of many models of community assembly. Yet, much remains unknown about how priority effects vary in strength among species in a community and what factors explain this variation. We experimented with a model natural community in laboratory microcosms that allowed us to quantify the strength of priority effects for most of the yeast species found in the floral nectar of a hummingbird-pollinated shrub at a biological preserve in northern California. We found that priority effects were widespread, with late-arriving species experiencing strong negative effects from early-arriving species. However, the magnitude of priority effects varied across species pairs. This variation was phylogenetically non-random, with priority effects stronger between closer relatives. Analysis of carbon and amino acid consumption profiles indicated that competition between closer relatives was more intense owing to higher ecological similarity, consistent with Darwin's naturalization hypothesis. These results suggest that phylogenetic relatedness between potential colonists may explain the strength of priority effects and, as a consequence, the degree to which community assembly is historically contingent.

  19. The protective effect of community factors on childhood asthma.

    Science.gov (United States)

    Gupta, Ruchi S; Zhang, Xingyou; Sharp, Lisa K; Shannon, John J; Weiss, Kevin B

    2009-06-01

    Asthma burden in the US is not evenly distributed. Although asthma prevalence varies widely across urban neighborhoods, little attention has been paid to the community as a key contributor. To determine the effect of positive socio-environmental community factors on childhood asthma prevalence in Chicago. From 2003 to 2005, an asthma screening survey was conducted among children attending Chicago Public/Catholic schools from kindergarten through eighth grade. One hundred five schools participated, yielding a stratified representation of 4 race-income groups. Positive community factors, such as social capital, economic potential, and community amenities, were assessed by using the Metro Chicago Information Center's Community Vitality Index. Of the surveys returned, 45,177 (92%) were geocoded into 287 neighborhoods. Neighborhoods were divided into quartile groups by asthma prevalence (mean, 8%, 12%, 17%, 25%). Community vitality (54% vs 44%; P vitality as well as social capital continued to contribute significantly to asthma variation. Asthma prevalence in Chicago is strongly associated with socio-environmental factors thought to enrich a community. A deeper understanding of this impact may lend insight into interventions to reduce childhood asthma.

  20. Individual cognitive-behavioral therapy and behavioral couples therapy in alcohol use disorder: A comparative evaluation in community-based addiction treatment centers

    NARCIS (Netherlands)

    Vedel, E.; Emmelkamp, P.M.G.; Schippers, G.M.

    2008-01-01

    Background: Alcohol abuse serves as a chronic stressor between partners and has a deleterious effect on relationship functioning. Behavioral Couples Therapy (BCT) for alcohol dependence, studied as an adjunct to individual outpatient counseling, has shown to be effective in decreasing alcohol

  1. Radioiodine therapy in patients with Graves' disease and the effects of prior carbimazole therapy.

    Science.gov (United States)

    Karyampudi, Arun; Hamide, Abdoul; Halanaik, Dhanapathi; Sahoo, Jaya Prakash; Kamalanathan, Sadishkumar

    2014-09-01

    The use of radioiodine as the first line of treatment in Graves' disease is restricted in India because of its limited availability and an unrealistic risk perception associated with it. Additionally, the effectiveness of radioiodine ablation in Graves' disease is influenced by many factors. Prior medical antithyroid therapy is one such important factor. To analyze the efficacy of low dose radioiodine therapy (5 mCi) in treatment of naive patients of Graves' disease in comparison to that in which it was already primed with an antithyroid drug, carbimazole. A non-randomized, interventional study conducted in the Department of Medicine and Endocrinology of a tertiary care institute in South India. The study had two groups; Group A (36 treatment naive, uncomplicated Graves' disease patients) and B (34 Graves' disease patients on carbimazole prior to radioiodine therapy). Both groups had baseline clinical, biochemical evaluation and were reassessed at 3 and 6 months for evaluating the clinical status for possible documentation of cure. The cure rate was 61.1% in drug naive group and 58.8% in pretreated group at 6 months following radioiodine (P = 0.845). Higher baseline 999m technicium (99m Tc) uptake, male gender, BMI and higher baseline free thyroxine (fT4) level predicted treatment failure following radioiodine therapy. Administration of carbimazole prior to low dose radioiodine therapy does not alter the efficacy of radioiodine. Low fixed dose (5 mCi) of radioactive iodine may be a safe and effective primary therapeutic option in Graves' disease patients pretreated with antithyroid drugs.

  2. PREDATOR IDENTITY AND ADDITIVE EFFECTS IN A TREEHOLE COMMUNITY

    OpenAIRE

    GRISWOLD, MARCUS W.; Lounibos,L Philip

    2006-01-01

    Multiple predator species can interact as well as strongly affect lower trophic levels, resulting in complex, nonadditive effects on prey populations and community structure. Studies of aquatic systems have shown that interactive effects of predators on prey are not necessarily predictable from the direct effects of each species alone. To test for complex interactions, the individual and combined effects of a top and intermediate predator on larvae of native and invasive mosquito prey were ex...

  3. Effect of vibration versus suspension therapy on balance in children ...

    African Journals Online (AJOL)

    Most cerebral palsy children have deficits in balance, co-ordination, and gait throughout childhood and adulthood. So, it is essential to seek an ideal physical therapy program to help in solving such widespread problem. The present study was conducted to compare between the effect of vibration training and suspension ...

  4. The effectiveness of rational emotive therapy on achievement ...

    African Journals Online (AJOL)

    The main purpose of this study was to examine the effectiveness of Rational Emotive Behaviour Therapy on Students Achievement Motivation. It made use of ninety eight (98) SS 1 students randomly selected from two schools in Sapele Local Govt Area in Sapele Local Govt Area of Delta State. It is a quasi experimental ...

  5. Study the effect of hyperbaric oxygen therapy in Egyptian autistic ...

    African Journals Online (AJOL)

    Farida El-baz

    2014-02-20

    Feb 20, 2014 ... tissues. The aim of this work was to study the effect of hyperbaric oxygen therapy in autistic Egyp- tian children. Patients and methods: This prospective clinical trial study was conducted on 20 children diag- nosed as autism based on DSM-IV-TR criteria (diagnostic and statistical manual of mental disor-.

  6. Clinical effect of Fuzheng quyu therapy in patients undergoing ...

    African Journals Online (AJOL)

    Clinical effect of Fuzheng quyu therapy in patients undergoing radiotherapy after cervical carcinoma surgery. ... Tropical Journal of Pharmaceutical Research ... only, whereas those in the study group received treatment designed to nourish healthy vital energy and eliminate blood stasis in addition to radiotherapy. Changes ...

  7. Phonological Therapy in Jargon Aphasia: Effects on Naming and Neologisms

    Science.gov (United States)

    Bose, Arpita

    2013-01-01

    Background: Jargon aphasia is one of the most intractable forms of aphasia with limited recommendation on amelioration of associated naming difficulties and neologisms. The few naming therapy studies that exist in jargon aphasia have utilized either semantic or phonological approaches, but the results have been equivocal. Moreover, the effect of…

  8. Comparative effectiveness of reality therapy and self-efficacy ...

    African Journals Online (AJOL)

    As in most other parts of the world, violent behaviour is common and is a wide spread feature among youths in Nigeria; especially in the recent times. The study investigated the comparative effectiveness of Reality Therapy and self- efficacy techniques in reducing violent behaviour among Secondary School students in ...

  9. Effect of Simultaneous Administration of Antiretroviral Therapy and ...

    African Journals Online (AJOL)

    The simultaneous effect of highly active anti-retroviral therapy (HAART) and nutritional supplements on cluster of differentiation4 (CD4)count of 100 people living with HIV/AIDS (PLWHA) was investigated. CD4 cell count was determined using the Cyflow SL-3. Individuals with baseline CD4 counts less than 200 cells/ìl were ...

  10. Comparative Effect of Rational Emotive Behaviour Therapy and ...

    African Journals Online (AJOL)

    The study compared the effectiveness of two (2) counselling techniques namely rational emotive behaviour therapy (REBT) and Token Economy (TE) in enhancing junior secondary student performance in Basic Science. One hundred and eighty (180) JSS II students were drawn as sample from both public and private ...

  11. The Study of the Effects of Cognitive Restructuring Therapy on ...

    African Journals Online (AJOL)

    This paper is an extract from a larger study. The study investigated the relative effectiveness of Cognitive Restructuring (C.R) therapy in the reduction of cigarette smoking behaviour of undergraduate students from South West of Nigeria. The research followed a pre test post test control group design. sixty volunteer ...

  12. Effectiveness of music therapy in the psycho- social management of ...

    African Journals Online (AJOL)

    The study recommended that medical social workers should incorporate music therapy into array of social services rendered to patients and relatives. Also, administrators of hospitals, hospices and rehabilitation homes should establish Music Units for the benefits of patients and relatives. KEY TERMS: Effectiveness, music ...

  13. Cortisol response to critical illness: Effect of intensive insulin therapy

    NARCIS (Netherlands)

    I. Vanhorebeek (Ilse); R.P. Peeters (Robin); S.V. Perre (Sarah Vander); I. Jans (Ivo); P.J. Wouters (Pieter); K. Skogstrand (Kristin); T.K. Hansen (Troels); R. Bouillon (Roger); G. van den Berghe (Greet)

    2006-01-01

    textabstractContext: Both excessive and insufficient activation of the hypothalamic-pituitary-adrenal axis in response to critical illness is associated with increased mortality. Objective: The objective of the study was to study the effect of intensive insulin therapy, recently shown to reduce

  14. Effect of Antioxidants on the Outcome of Therapy in Paraquat ...

    African Journals Online (AJOL)

    Erah

    Purpose: The present study was conducted to determine the effect of vitamins C and E administration on the outcome of therapy in patients with paraquat intoxication admitted in the Poisoning Emergency. Department (PED) of Noor Teaching General Hospital, Isfahan, Iran. Methods: We studied retrospectively medical ...

  15. Effect of high dose thiamine therapy on activity and molecular ...

    African Journals Online (AJOL)

    ajl yemi

    2011-11-28

    Nov 28, 2011 ... This study was therefore designed to investigate the effect of high dose thiamine therapy on the activity and molecular aspects of transketolase in Type 2 diabetic patients. Over 100 Type 2 microalbuminuric diabetics were enrolled in a randomized, double blind placebo controlled clinical trial for 6 months.

  16. Effect bf Rational Emotive Behaviour Therapy on the Level of ...

    African Journals Online (AJOL)

    This study was carried out to evaluate the effectiveness or otherwise of Rational Emotive Behaviour Therapy in reducing the level of general and examination anxieties with a view to fostering better academic performance in English Language among students who had failed this subject at least once. Ninety eight students in ...

  17. The effectiveness of Multisystemic Therapy (MST): a meta-analysis

    NARCIS (Netherlands)

    van der Stouwe, T.; Asscher, J.J.; Stams, G.J.J.M.; Deković, M.; van der Laan, P.H.

    2014-01-01

    Multisystemic Therapy (MST) is a well-established intervention for juvenile delinquents and/or adolescents showing social, emotional and behavioral problems. A multilevel meta-analysis of k = 22 studies, containing 332 effect sizes, consisting of N = 4066 juveniles, was conducted to examine the

  18. The effectiveness of Multisystemic Therapy (MST) : A meta-analysis

    NARCIS (Netherlands)

    van der Stouwe, Trudy; Asscher, Jessica J.; Stams, Geert Jan J. M.; Dekovic, Maja; van der Laan, Peter H.

    Multisystemic Therapy (MST) is a well-established intervention for juvenile delinquents and/or adolescents showing social, emotional and behavioral problems. A multilevel meta-analysis of k = 22 studies, containing 332 effect sizes, consisting of N = 4066 juveniles, was conducted to examine the

  19. The effect of thrombolytic therapy on QT dispersion in acute ...

    African Journals Online (AJOL)

    Purpose: We aimed to determine the effect of intravenous thrombolytic therapy on QT dispersion (QTd) and its role in the prediction of reperfusion arrhythmias. Materials and Methods: Twenty patients with acute myocardial infarction (MI) were enrolled in the study. Measurements of QTd were carried out prior to thrombolytic ...

  20. Effects of adherence to antiretroviral therapy on body mass index ...

    African Journals Online (AJOL)

    Objective: This study determined the effect of adherence to highly active antiretroviral therapy (HAART) on body mass index (BMI) and immunological and virological parameters of people living with HIV/AIDS (PLWHA) attending University College Hospital, Ibadan. Methodology: Prospective cohort of consenting PLWHA ...

  1. Effects of Actinomycete Secondary Metabolites on Sediment Microbial Communities.

    Science.gov (United States)

    Patin, Nastassia V; Schorn, Michelle; Aguinaldo, Kristen; Lincecum, Tommie; Moore, Bradley S; Jensen, Paul R

    2017-02-15

    Marine sediments harbor complex microbial communities that remain poorly studied relative to other biomes such as seawater. Moreover, bacteria in these communities produce antibiotics and other bioactive secondary metabolites, yet little is known about how these compounds affect microbial community structure. In this study, we used next-generation amplicon sequencing to assess native microbial community composition in shallow tropical marine sediments. The results revealed complex communities comprised of largely uncultured taxa, with considerable spatial heterogeneity and known antibiotic producers comprising only a small fraction of the total diversity. Organic extracts from cultured strains of the sediment-dwelling actinomycete genus Salinispora were then used in mesocosm studies to address how secondary metabolites shape sediment community composition. We identified predatory bacteria and other taxa that were consistently reduced in the extract-treated mesocosms, suggesting that they may be the targets of allelopathic interactions. We tested related taxa for extract sensitivity and found general agreement with the culture-independent results. Conversely, several taxa were enriched in the extract-treated mesocosms, suggesting that some bacteria benefited from the interactions. The results provide evidence that bacterial secondary metabolites can have complex and significant effects on sediment microbial communities. Ocean sediments represent one of Earth's largest and most poorly studied biomes. These habitats are characterized by complex microbial communities where competition for space and nutrients can be intense. This study addressed the hypothesis that secondary metabolites produced by the sediment-inhabiting actinomycete Salinispora arenicola affect community composition and thus mediate interactions among competing microbes. Next-generation amplicon sequencing of mesocosm experiments revealed complex communities that shifted following exposure to S

  2. Community coalition project directors: what makes them effective leaders?

    Science.gov (United States)

    Alexander, Mary Perry; Zakocs, Ronda C; Earp, Jo Anne L; French, Elizabeth

    2006-01-01

    Effective leaders, both voluntary and paid, facilitate successful coalitions. The attributes that characterize effective project directors, however, are unclear. Our aim was to identify characteristics of effective project directors leading community coalitions. The study examined 13 project directors who led eight community-based coalitions established to combat substance abuse. We inductively identified common characteristics and leadership effectiveness of the project directors by abstracting data from detailed ethnographic studies of these coalitions. We assessed the validity of leadership effectiveness by comparing data abstracted from ethnographic studies with two independent ratings. We then employed a cross-case comparison strategy for analyzing patterns among the common characteristics identified and leadership effectiveness. Six characteristics emerged among the project directors studied: status with community (insider vs outsider); shared leadership; bridge building skills; substance abuse expertise; vision; and management style. Shared leadership, bridge building skills, and insider status were consistently related to leadership effectiveness. Less support was found for substance abuse expertise or vision. When hiring project directors, coalition leaders may consider assessing whether candidates are "insiders" within the community and demonstrate shared leadership and bridge building skills.

  3. [Topical problems of empiric therapy of community-acquired pneumonia in outpatient practice].

    Science.gov (United States)

    Stepanova, I I; Chorbinskaya, S A; Baryshnikonva, G A; Nikiforova, N V; Pokutniy, N F; Zverkov, I V; Maslovskyi, L V; Kotenko, K V

    2016-01-01

    Community-acquired pneumonia is one of prevalent infectious respiratory diseases. Adequate treatment of community-acquired pneumonia, with consideration of the disease severity and microbial resistence, remains extremely topical. The article covers contemporary views of community-acquired pneumonia treatment standards. The authors described results of personal research aimed to study antibacterial treatment for community-acquired pneumonia on outpatient basis over 2004-2012, evaluated correspondence of the treatment to the national clinical recommendations.

  4. Impact of procalcitonin-guided therapy for hospitalized community-acquired pneumonia on reducing antibiotic consumption and costs in Japan.

    Science.gov (United States)

    Ito, Akihiro; Ishida, Tadashi; Tokumasu, Hironobu; Washio, Yasuyoshi; Yamazaki, Akio; Ito, Yuhei; Tachibana, Hiromasa

    2017-03-01

    This study aimed to investigate the usefulness of procalcitonin-guided therapy in hospitalized community-acquired pneumonia patients to reduce antibiotic duration and costs without worsening prognosis. 352 hospitalized community-acquired pneumonia patients in an observational cohort study in which procalcitonin was measured three times serially, on admission (Day 1) and 2-3 days (Day 3) and 6-8 days (Day 7) after admission, between October 2010 and February 2016 were reviewed retrospectively. Antibiotics could be stopped if Day 7 procalcitonin was pneumonia by theoretical procalcitonin guidance for community-acquired pneumonia treatment. Using theoretical procalcitonin guidance, antibiotic duration could be reduced from 12.6 to 8.6 days (P pneumonia severity using A-DROP, CURB-65, and PSI between two groups. Procalcitonin-guided therapy may be useful in hospitalized community-acquired pneumonia patients to reduce antibiotic duration and costs without worsening the prognosis. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  5. Have complementary therapies demonstrated effectiveness in rheumatoid arthritis?

    Science.gov (United States)

    Fernández-Llanio Comella, Nagore; Fernández Matilla, Meritxell; Castellano Cuesta, Juan Antonio

    2016-01-01

    In recent decades the treatment of rheumatoid arthritis (RA) has improved thanks to the use of highly effective drugs. However, patients usually require long term therapy, which is not free of side effects. Therefore RA patients often demand complementary medicine, they seek additional sources of relief and/or less side effects. In fact 30-60% of rheumatic patients use some form of complementary medicine. Therefore, from conventional medicine, if we want to optimally treat our patients facilitating communication with them we must know the most commonly used complementary medicines. The aim of this review is to assess, based on published scientific research, what complementary therapies commonly used by patients with RA are effective and safe. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  6. Two Effective Heuristics for Beam Angle Optimization in Radiation Therapy

    CERN Document Server

    Yarmand, Hamed

    2013-01-01

    In radiation therapy, mathematical methods have been used for optimizing treatment planning for delivery of sufficient dose to the cancerous cells while keeping the dose to critical surrounding structures minimal. This optimization problem can be modeled using mixed integer programming (MIP) whose solution gives the optimal beam orientation as well as optimal beam intensity. The challenge, however, is the computation time for this large scale MIP. We propose and investigate two novel heuristic approaches to reduce the computation time considerably while attaining high-quality solutions. We introduce a family of heuristic cuts based on the concept of 'adjacent beams' and a beam elimination scheme based on the contribution of each beam to deliver the dose to the tumor in the ideal plan in which all potential beams can be used simultaneously. We show the effectiveness of these heuristics for intensity modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT) on a clinical liver case.

  7. Optic and otic side effects of molecular targeted therapies.

    Science.gov (United States)

    O'Leary, Colleen

    2014-08-01

    To discuss the optic and otic toxicities associated with molecular targeted therapies including description, presentation, grading, and management of these toxicities. PubMed, CINAHL, the Cochrane Library and nursing text books. Although targeted therapies often do not have the same systemic toxicities as chemotherapy, they have their own unique side effects. Optic and otic toxicities are seen with a variety of targeted therapies and, although these are not life-threatening toxicities, they do have the potential to severely impair a patient's quality of life. Baseline optic and otic assessments along with periodic assessments throughout treatment can lead to early recognition of problems with the eyes or ears. Recognition and treatment of these problems will help maintain the patient's quality of life. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Effectiveness of Gestalt Therapy on Happiness of Elderly People

    Directory of Open Access Journals (Sweden)

    Heiman Saadati

    2013-07-01

    Full Text Available Objectives: The aim of this study was to examine the effectiveness of Gestalt therapy on the happiness of elderly people. Methods & Materials: This is an experimental study with a pre-test- post-test design and control group. Sample of the study selected from elderly members of Shad Senior Social Club. 50 older members were evaluated according to inclusion/ exclusion criteria and by Abbreviated Mental Test Score. 28 participants selected and divided into 2 equal groups randomly. Oxford Happiness Scale was administered to both. Gestalt therapy sessions for the intervention group were administered in 90 minutes weekly meetings for 8 successive weeks. The post-test data collected after the last session. Data analyzed by using t-test for independent groups. Results: T-test results showed that the mean difference between the two groups were significant (P<0.01 and Gestalt therapy increased the happiness of intervention group significantly. Happiness scores of intervention group in all sub-scales were also significantly higher in post-test compared to control group (P<0.001. Conclusion: The results showed that Gestalt therapy can be helpful in enhancing positive emotions and happiness in older people. Implementation of Gestalt therapy sessions in nursing homes, and retirement centers are recommended.

  9. Effects of manual therapy on shoulder pain in office workers.

    Science.gov (United States)

    Go, Seong-Uk; Lee, Byoung-Hee

    2016-09-01

    [Purpose] The purpose of this study was to determine the effects of manual therapy on shoulder pain in office workers. [Subjects and Methods] Subjects included 38 office workers who were randomly divided into two groups: a manual therapy group of 19 subjects and a shoulder stabilization exercise group of 19 subjects. All subjects underwent evaluation of the pressure pain threshold in the splenius capitis and upper, middle, and lower trapezius muscles on both sides. The manual therapy used in the study was designed to include soft-tissue mobilization, prone thoracic mobilization, prone selected thoracic mobilization, cervical mobilization, and thoracic manipulation. Both groups underwent training of two 40-minute sessions per week for 6 weeks. [Results] After the intervention, both groups showed significantly increased pressure pain thresholds in the splenius capitis and upper, middle, and lower trapezius muscles on both sides. The manual therapy group showed greater improvements than did the shoulder stabilization exercise group in the splenius capitis on both sides, left upper trapezius, middle trapezius on both sides, and right lower trapezius. [Conclusion] The results of this study suggest that manual therapy for shoulder pain is feasible and suitable for office workers and may be useful in clinical rehabilitation.

  10. Effective recruitment and retention strategies in community health programs.

    Science.gov (United States)

    McCann, Jennifer; Ridgers, Nicola D; Carver, Alison; Thornton, Lukar E; Teychenne, Megan

    2013-08-01

    The aim of this project was to identify effective recruitment and retention strategies used by health-promotion organisations that focus on increasing physical activity and improving nutrition within the local community. Semistructured telephone or face-to-face interviews with 25 key informants from stakeholder organisations were conducted. Key informants discussed strategies used by their organisation to effectively recruit and retain participants into community-based healthy eating and/or physical activity programs. Transcribed data were analysed with NVivo software. Effective recruitment strategies included word of mouth, links with organisations, dissemination of printed materials, media, referrals, cross-promotion of programs and face-to-face methods. Effective retention strategies included encouraging a sense of community ownership, social opportunities, recruiting a suitable leader and offering flexibility and support. Fees and support for recruiting and retaining participants was also identified. This study provides novel insights to a greatly under researched topic in the field of health promotion. There are two key take-home messages from the present study that are applicable to health practitioners as well as developers and deliverers of community health-promotion programs: (1) it is imperative that all community health organisations report on the effectiveness of their recruitment and retention, both successes and failures; and (2) there is a clear need to tailor the recruitment and retention approach to the target population and the setting the program is occurring in. SO WHAT? These findings provide important insights for the development of future community-based healthy eating and physical activity programs.

  11. Effects of pesticides on community composition and activity of sediment microbes--responses at various levels of microbial community organization.

    Science.gov (United States)

    Widenfalk, Anneli; Bertilsson, Stefan; Sundh, Ingvar; Goedkoop, Willem

    2008-04-01

    A freshwater sediment was exposed to the pesticides captan, glyphosate, isoproturon, and pirimicarb at environmentally relevant and high concentrations. Effects on sediment microorganisms were studied by measuring bacterial activity, fungal and total microbial biomass as community-level endpoints. At the sub-community level, microbial community structure was analysed (PLFA composition and bacterial 16S rRNA genotyping, T-RFLP). Community-level endpoints were not affected by pesticide exposure. At lower levels of microbial community organization, however, molecular methods revealed treatment-induced changes in community composition. Captan and glyphosate exposure caused significant shifts in bacterial community composition (as T-RFLP) at environmentally relevant concentrations. Furthermore, differences in microbial community composition among pesticide treatments were found, indicating that test compounds and exposure concentrations induced multidirectional shifts. Our study showed that community-level end points failed to detect these changes, underpinning the need for application of molecular techniques in aquatic ecotoxicology.

  12. In vivo assessment of antiretroviral therapy-associated side effects

    Directory of Open Access Journals (Sweden)

    Eduardo Milton Ramos-Sanchez

    2014-07-01

    Full Text Available Antiretroviral therapy has been associated with side effects, either from the drug itself or in conjunction with the effects of human immunodeficiency virus infection. Here, we evaluated the side effects of the protease inhibitor (PI indinavir in hamsters consuming a normal or high-fat diet. Indinavir treatment increased the hamster death rate and resulted in an increase in triglyceride, cholesterol and glucose serum levels and a reduction in anti-oxLDL auto-antibodies. The treatment led to histopathological alterations of the kidney and the heart. These results suggest that hamsters are an interesting model for the study of the side effects of antiretroviral drugs, such as PIs.

  13. Community of practice in occupational therapy for mental health on primary care: expectations and impacts

    National Research Council Canada - National Science Library

    Taís Quevedo Marcolino; Eliane Nascimento Fantinatti; Alana de Paiva Nogueira Fornereto Gozzi; Maria Fernanda Barboza Cid

    2016-01-01

    Introduction: Primary Healthcare constitutes a recent field of practice for occupational therapy, creating formative demands and calling for practice investigation to create knowledge inherent to this context...

  14. [Conservative therapy of female urinary incontinence--potential and effect].

    Science.gov (United States)

    Horcicka, L; Chmel, R; Novácková, M

    2005-01-01

    Non-surgical treatment of female stress urinary incontinence is not as effective as surgical methods but it is very successful in indicated cases. Rehabilitation of the pelvic floor muscles (Kegel exercises, vaginal cones, and electrostimulation of the pelvic floor muscles), drug treatment (alfa-mimetics, tricyclic antidepressives, estrogens, duloxetin), pessarotherapy and uretral obturator devices represent possibilities of conservative therapy of the stress incontinence. Conservative therapy is the method of choice in the treatment of urge incontinence. The most successful are anticholinergic drugs but they have very frequent serious side effects (dryness of the mucous membranes, accommodation disorders, constipation). Spasmolytics, estrogens and tricyclic antidepressives are the other popular used drugs. Life style modification, bladder training and electrostimulation represent very important parts of the conservative treatment. Effectiveness of the non-surgical treatment of both urge and stress urinary incontinence can not reach 100 percent but it helps very much in the quality of life improvement of incontinent women.

  15. Hypomagnesemia in chronic obstructive lung disease: effect of therapy.

    Science.gov (United States)

    Rolla, G; Bucca, C; Bugiani, M; Oliva, A; Branciforte, L

    1990-01-01

    In 95 patients with severe chronic airway obstruction (FEV1 33.2 +/- 12% of predicted; mean +/- SE), we investigated whether drug therapy had any influence on serum Mg levels. 11/95 patients had a serum Mg less than 1.45 mEq/l (lower normal limit). Multiple-regression analysis showed that the use of diuretics was associated with a significantly lower serum Mg level (1.59 +/- CI 0.06 mEq/l vs. an adjusted mean of 1.71 mEq/l; F = 11, 2, p less than 0.001). There was a significant negative correlation between serum Mg and the length of oral steroid therapy (1.64 +/- CI 0.02 mEq/l for less than 24 months of therapy vs. 1.52 +/- CI 0.06 mEq/l for greater than 24 months of therapy; F = 7, 3, p less than 0.005). No effect of theophylline, inhaled steroids or beta 2-agonists on serum Mg was observed. Because of potential negative effects of hypomagnesemia on respiratory function, routine serum magnesium determination is recommended in patients with chronic obstructive lung disease taking diuretic drugs or corticosteroids.

  16. Effect of cognitive-behavior therapy for betrayed women

    Directory of Open Access Journals (Sweden)

    Mehrangiz Shoaa Kazemi

    2017-07-01

    Full Text Available Infidelity is the most frequently cited cause of divorce and is described by couple therapists as among the most difficult problems to treat.im of this study was effect of cognitive-behavioral therapy for betrayed women in Tehran city Method was pre experimental. Sampling was purposeful in which 15 wives (20-35 years old were selected. They had experienced betrayals that were participating in cognitive- behavioral therapy. Cognitive-behavioral therapy sessions at three stages sessions after preliminary interview they were assessed by the spouse betrayal examination questionnaire and general health questionnaire-28 in pre-training. Then they had every week 1 session of 90 minutes. After the end of session again assessed by post-test. Mean and standard deviation of mental health showed significantly difference after sessions at post-test stage. There was significant effect in cognitive -behavioral therapy of sessions for improving mental health of betrayed women. We recommend behavioral technique in similar situations for betrayed women.

  17. Student and Community Partner Expectations for Effective Community-Engaged Learning Partnerships

    Science.gov (United States)

    Stack-Cutler, Holly; Dorow, Sara

    2012-01-01

    Student insight and community partner feedback can contribute to understanding and thus improve community-engaged learning practices. Student and community partner voices, however, are not often heard during community-engaged learning development. To ascertain student and community partner expectations for community-engaged learning, thematic…

  18. Occupational therapy consultation for case managers in community mental health: exploring strategies to improve job satisfaction and self-efficacy.

    Science.gov (United States)

    Chapleau, Ann; Seroczynski, A D; Meyers, Susan; Lamb, Kristen; Haynes, Susan

    2011-01-01

    The purpose of this study was 2-fold: (1) to examine to what extent case managers' job satisfaction and self-efficacy were impacted by the addition of an occupational therapy consultation model and (2) to identify factors that both positively and negatively impacted the occupational therapy consultation services. The study was conducted at a mental health community support program in a local homeless center. In a 2-year study, a mixed-methods design was used to study changes over time in job satisfaction and perceived self-efficacy among 14 case managers who received ongoing occupational therapy consultation. Job satisfaction and self-efficacy data were obtained using standardized questionnaires. Qualitative data related to factors impacting the consultation program were obtained using open-ended written questions, focus groups, and individual interviews. Statistically significant differences in job satisfaction and perceptions of self-efficacy were found 18 months into the study, when case managers were more actively seeking occupational therapy consultation services and were reporting improved client outcomes from occupational therapy intervention. In addition, themes related to both positive and negative factors impacting the occupational therapy consultation program were identified and provided useful data for development of future consultation services. IMPLICATION FOR CASE MANAGEMENT PRACTICE: Results suggest that ongoing training and professional support for case managers who are paraprofessionals and/or new to mental health practice may improve job satisfaction and efficacy. Occupational therapy consultation may be helpful in developing services for health promotion, including self-care management, cognitive assessments, activity-based programming, and home safety evaluation and modification. In addition, new graduates and paraprofessional case managers working with clients who are high utilizers of services may benefit from smaller caseloads and support

  19. Effects of cognitive remediation therapy versus other interventions on cognitive functioning in schizophrenia inpatients.

    Science.gov (United States)

    Linke, Magdalena; Jankowski, Konrad S; Wichniak, Adam; Jarema, Marek; Wykes, Til

    2017-05-01

    Computerised cognitive remediation therapy (CCRT) has been shown to improve cognitive function in individuals with schizophrenia beyond effects of other forms of therapy. However, results vary between studies, and most are aimed at individuals who are living in the community. Very few studies have investigated its efficacy in psychiatric wards in order to assess whether or not this is a suitable site to start the therapy. This study evaluated CCRT efficacy among schizophrenia inpatients who received a broad range of therapeutic interventions in a psychiatric ward. A randomised controlled trial of CCRT versus an active control in 66 young inpatients with a diagnosis of schizophrenia was conducted. The intervention lasted for 6 weeks and its efficacy was assessed with the composite score of the MATRICS Consensus Cognitive Battery. Both groups improved similarly in cognitive function and psychopathological symptoms. However, the CCRT group improved more than the controls in negative symptoms. This result shows that providing a drill and practice cognitive remediation to inpatients does not produce benefits for cognitive functioning substantially greater than other forms of therapy provided in a ward, but it is more efficient in reduction of negative symptoms. Our results suggest that CRT might be considered as a promising intervention for reducing negative symptoms in schizophrenia individuals.

  20. Effectiveness of using ultrasound therapy and manual therapy in the conservative treatment of calcaneal spur – pilot study

    Directory of Open Access Journals (Sweden)

    Twarowska Natalia

    2016-06-01

    Full Text Available Introduction: Calcaneal spur is a pathology of the fibrocartilage enthesis of the Achilles tendon and plantar fascia or a pathology of the mixed enthesis of the flexor digitorum brevis muscle. Ultrasound therapy is commonly applied in the conservative treatment of a calcaneal spur. Foot muscle strengthening exercises, stretching exercises and soft tissue therapy are indicated as effective methods of conservative treatment. The aim of the study was to compare and assess the effects of ultrasound therapy and selected techniques of manual therapy on pain level and functional state in patients with calcaneal spur.

  1. Effects Of HIV stigma reduction interventions in diasporic communities: insights from the CHAMP study.

    Science.gov (United States)

    Li, Alan Tai-Wai; Fung, Kenneth Po-Lun; Maticka-Tyndale, Eleanor; Wong, Josephine Pui-Hing

    2017-10-24

    Racialized diasporic communities in Canada experience disproportionate burden of HIV infection. Their increased vulnerabilities are associated with interlocking challenges, including barriers in accessing resources, migration and settlement stress, and systemic exclusion. Further, people living with HIV (PLHIV) in these diasporic communities face stigma and discrimination in both mainstream Canadian society as well as their own ethno-racial communities. HIV stigma negatively impacts all aspects of HIV care, from testing to disclosure to treatment and ongoing care. In response to these challenges, a Toronto based community organization developed and implemented the CHAMP project to engage people living with HIV/AIDS (PLHIV) and leaders from different service sectors from the African/Caribbean, Asian and Latino communities to explore challenges and strategies to reduce HIV stigma and build community resilience. The study engaged 66 PLHIV and ethno-racial leaders from faith, media and social justice sectors in two stigma-reduction training programs: Acceptance Commitment Therapy Training (ACT) and Social Justice Capacity Building (SJCB). Data collection included pre-and post- intervention surveys, focus groups and monthly activity logs. Participants were followed for a year and data on changes in the participants' attitudes and behaviors as well as their actual engagement in HIV prevention, PLHIV support and stigma reduction activities were collected. CHAMP results showed that the interventions were effective in reducing HIV stigma and increasing participants' readiness to take action towards positive social change. Participants' activity logs over a period of 9 months after completing the training showed they had engaged in 1090 championship activities to advocate for HIV related health equity and social justice issues affecting racialized and newcomer PLHIV and communities.

  2. Massage therapy improves the development of HIV-exposed infants living in a low socio-economic, peri-urban community of South Africa.

    Science.gov (United States)

    Perez, E M; Carrara, H; Bourne, L; Berg, A; Swanevelder, S; Hendricks, M K

    2015-02-01

    The aim of this study was to assess the effect of massage therapy on the growth and development of infants of HIV-infected mothers in a low socio-economic community in Cape Town. It was a prospective, randomised, controlled intervention trial that included massage therapy and control groups of HIV-infected mothers and their normal birth weight infants who were enrolled in the prevention of mother-to-child transmission (PMTCT) programme. Participants were recruited at the 6-week clinic visit and followed up every 2 weeks until their infants were 9 months of age. Mother-infant pairs in the massage therapy and control groups included 73 and 88 at 6 weeks and 55 and 58 at 9 months, respectively. Mothers in the intervention group were trained to massage their infants for 15 min daily. The socioeconomic status, immunity, relationship with the partner and mental pain of mothers; the infants' dietary intake, anthropometry and development (Griffiths Mental Development Scales); and haematological and iron status of mothers and infants were assessed at baseline and follow-up. Nine infants (5.3%) were HIV-infected on the HIV DNA PCR test at 6 weeks. Despite significantly higher levels of maternal mental pain, infants in the massage therapy compared to control group scored higher in all five of the Griffiths Scales of Mental Development and significantly higher in the mean quotient (p=0.002) and mean percentile (p=0.004) for the hearing and speech scale at 9 months. Based on the mean difference in scores, the massage therapy group showed greater improvement for all five scales compared to the control group. The mean difference in scores was significantly greater for the hearing and speech quotient (21.9 vs. 11.2) (pmassage therapy compared to the control group. These scales remained significant when adjusting for the relationship with the partner and maternal mental pain. Both groups had lower scores in the performance scale at 9 months although this was significantly worse in

  3. Effective management of venous thromboembolism in the community: non-vitamin K antagonist oral anticoagulants

    Directory of Open Access Journals (Sweden)

    Patel R

    2016-05-01

    Full Text Available Raj Patel Department of Haematological Medicine, King's Thrombosis Centre, King's College Hospital, London, UK Abstract: Anticoagulation therapy is essential for the effective treatment and secondary prevention of venous thromboembolism (VTE. For many years, anticoagulation for acute VTE was limited to the use of initial parenteral heparin, overlapping with and followed by a vitamin K antagonist. Although highly effective, this regimen has several limitations and is particularly challenging when given in an ambulatory setting. Current treatment pathways for most patients with deep-vein thrombosis typically involve initial hospital or community-based ambulatory care with subsequent follow-up in a secondary care setting. With the introduction of non-vitamin K antagonist oral anticoagulants (NOACs into routine clinical practice, it is now possible for the initial acute management of patients with deep-vein thrombosis to be undertaken by primary care. As hospital admissions associated with VTE become shorter, primary care will play an increasingly important role in the long-term management of these patients. Although the NOACs can potentially simplify patient management and improve clinical outcomes, primary care physicians may be less familiar with these new treatments compared with traditional therapy. To assist primary care physicians in further understanding the role of the NOACs, this article outlines the main differences between NOACs and traditional anticoagulation therapy and discusses the benefit–risk profile of the different NOACs in the treatment and secondary prevention of recurrent VTE. Key considerations for the use of NOACs in the primary care setting are highlighted, including dose transition, risk assessment and follow-up, duration of anticoagulant therapy, how to minimize bleeding risks, and the importance of patient education and counseling. Keywords: venous thromboembolism, oral anticoagulant, prevention, treatment, primary

  4. Management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association.

    Science.gov (United States)

    Avin, Keith G; Hanke, Timothy A; Kirk-Sanchez, Neva; McDonough, Christine M; Shubert, Tiffany E; Hardage, Jason; Hartley, Greg

    2015-06-01

    Falls in older adults are a major public health concern due to high prevalence, impact on health outcomes and quality of life, and treatment costs. Physical therapists can play a major role in reducing fall risk for older adults; however, existing clinical practice guidelines (CPGs) related to fall prevention and management are not targeted to physical therapists. The purpose of this clinical guidance statement (CGS) is to provide recommendations to physical therapists to help improve outcomes in the identification and management of fall risk in community-dwelling older adults. The Subcommittee on Evidence-Based Documents of the Practice Committee of the Academy of Geriatric Physical Therapy developed this CGS. Existing CPGs were identified by systematic search and critically appraised using the Appraisal of Guidelines, Research, and Evaluation in Europe II (AGREE II) tool. Through this process, 3 CPGs were recommended for inclusion in the CGS and were synthesized and summarized. Screening recommendations include asking all older adults in contact with a health care provider whether they have fallen in the previous year or have concerns about balance or walking. Follow-up should include screening for balance and mobility impairments. Older adults who screen positive should have a targeted multifactorial assessment and targeted intervention. The components of this assessment and intervention are reviewed in this CGS, and barriers and issues related to implementation are discussed. A gap analysis supports the need for the development of a physical therapy-specific CPG to provide more precise recommendations for screening and assessment measures, exercise parameters, and delivery models. This CGS provides recommendations to assist physical therapists in the identification and management of fall risk in older community-dwelling adults. © 2015 American Physical Therapy Association.

  5. Eliciting Drivers of Community Perceptions of Mining Projects through Effective Community Engagement

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2016-07-01

    Full Text Available Sustainable mining has received much attention in recent years as a consequence of the negative impacts of mining and public awareness. The aim of this paper is to provide mining companies guidance on improving the sustainability of their sites through effective community engagement based on recent advances in the literature. It begins with a review of the literature on sustainable development and its relationship to stakeholder engagement. It then uses the literature to determine the dominant factors that affect community perceptions of mining projects. These factors are classified into five categories: environmental, economic, social, governance and demographic factors. Then, we propose a new two-stage method based on discrete choice theory and the classification that can improve stakeholder engagement and be cost-effective. Further work is required to validate the proposed method, although it shows potential to overcome some of the challenges plaguing current approaches.

  6. Effective Outpatient Care in the Community: One German Way ...

    African Journals Online (AJOL)

    Conclusion: The simple sum core (PRS) allows calculating the risk of LSH on the basis of a small number of characteristics drawn from usually registered psychiatric base data and can help psychiatric services to concentrate on high risk patients. Key Words: Community Psychiatry, German Model, Effectiveness. Journal of ...

  7. The Fish Community of an East African Mangrove: Effects of ...

    African Journals Online (AJOL)

    Fish may enter mangroves in order to avoid predators, but may not need to do so if turbidity provides a sufficient predator refuge outside the forest. This study assessed the effects of turbidity in the field and laboratory on mangrove fish community structure and behaviour. The extent to which fish penetrate into mangroves has ...

  8. Effective Leadership Strategies for the Community College President.

    Science.gov (United States)

    Lewis, Marjorie D.

    To be effective, community college presidents must understand what leadership is, particularly as it applies to higher education. They must also understand the evolution of the role of the president over the last 30 years, from "manager" or "builder" in the early years to the more recent position of "motivator." There is little agreement in the…

  9. Effect of Some Environmental Variables on the Community Structure ...

    African Journals Online (AJOL)

    Water samples and zooplankton were collected monthly for five months in three sites in Wushishi Dam, Niger State. The study was undertaken to look at effect of some environmental variables on zooplankton community in the dam. Dissolved oxygen (DO) was highest in site 1 with mean value of 2.60±0.248 mg/l. There was ...

  10. The Effectiveness of Community-Based Nutrition Education on the ...

    African Journals Online (AJOL)

    This systematic review aimed at examining the best available evidence on the effectiveness of community-based nutrition education in improving the nutrition status of under five children in developing countries. Methods : A systematic search of the literature was conducted utilising the following data bases: Cumulative ...

  11. Perceptions of the Glass Ceiling Effect in Community Colleges

    Science.gov (United States)

    Myers, Cheryl E.

    2010-01-01

    The purpose of this study was to determine the existence of a glass ceiling effect within community colleges by examining faculty, staff and administrator's perceptions of a glass ceiling as it relates to the advancement of women at their institutions. This was done by using a cross-sectional survey administered electronically to faculty, staff…

  12. Effect of Recreational Fish Feeding on Reef Fish Community ...

    African Journals Online (AJOL)

    Feeding fish with bread or other food is widely used by tour operators to enhance human-animal interactions in coral reefs. Little is known, however, about the effects of recreational fish feeding on fish community structure and fish behaviour. These two issues were examined in this study within three marine protected areas ...

  13. Effects of sediment input on aquatic animal communities in new ...

    African Journals Online (AJOL)

    The effects of sediment input on aquatic animal communities in New Calabar River in Rivers State Nigeria were studied. Samples of the sediments were collected using Ekman's grab. Sediments were seived through various mesh sizes until fme silt was obtained. Macroinvertebrates were collected using scoop nets.

  14. Evaluating the Effectiveness of Remedial Mathematics at the Community College

    Science.gov (United States)

    Lawrence, Daysha Monique

    2011-01-01

    The purpose of this study was to evaluate the effectiveness of remedial math courses at the community college level through an examination of short-term academic success variables. For the purposes of this study, short-term academic success was defined as passing required remedial math course(s) and the first college-level math course with a C or…

  15. Effective Outpatient Care in the Community: One German Way ...

    African Journals Online (AJOL)

    Aim: To evaluate the effectiveness of the German model of community psychiatry at the Medical University of Hanover. Patients and Methods: Three hundred and thirteen (313) patients treated over a period of ten years (1987-1996) at the Social Psychiatry Department of the University of Hanover were anonymously grouped ...

  16. effects of sediment input on aquatic animal communities in new ...

    African Journals Online (AJOL)

    USER

    The effects of sediment input on aquatic animal communities in New Calabar River in Rivers State Nigeria were studied. Samples of the sediments were collected using Ekman's grab. Sediments were seived through various mesh sizes until fme silt was obtained. Macroinvertebrates were collected using scoop nets.

  17. Effectiveness of a community intervention on malaria in rural ...

    African Journals Online (AJOL)

    Effectiveness of a community intervention on malaria in rural Tanzania - a randomised controlled trial. ... Fever and reported fever decreased significantly and the mean body weight of the children increased significantly over the study period in both control and intervention groups. Conclusion: The decrease in anaemia was ...

  18. Effectiveness of community based seed multiplication in enhancing ...

    African Journals Online (AJOL)

    Community Based Seed Multiplication (CBSM) approaches have been used by agricultural research and development actors to improve farmers' access to quality seed in many developing countries. CBSM can be private or public driven. However, ways of designing the CBSM for optimum effectiveness under public and ...

  19. Effects of sulfamethoxazole on soil microbial communities after adding substrate.

    NARCIS (Netherlands)

    Demoling, L.A.; Baath, E.; Greve, G.D.; Wouterse, M.; Schmitt, H.|info:eu-repo/dai/nl/304831042

    2009-01-01

    The effect of the antibiotic sulfamethoxazole (SMX) on soil bacteria was studied using two methods (leucine incorporation and Biolog plates) of estimating pollution-induced community tolerance (PICT). SMX was added to an agricultural soil in a microcosm setup. The addition of different substrates

  20. Community Awareness of Adverse Effects of Nonsteroidal Anti ...

    African Journals Online (AJOL)

    Secretary

    health personnel to educate patients on the potential adverse effects of the non- steroidal anti-inflammatory drugs. Key words: Non-steroidal anti-inflammatory drugs, adverse drug reactions, community knowledge, Ilala Municipality. INTRODUCTION. Nonsteroidal anti-inflammatory drugs. (NSAIDs) are drugs with analgesic,.

  1. Synergistic antimicrobial effect of photodynamic therapy and ciprofloxacin.

    Science.gov (United States)

    Ronqui, Maria Rita; de Aguiar Coletti, Tatiana Maria Starck Fogaça; de Freitas, Laura Marise; Miranda, Elaine Toscano; Fontana, Carla Raquel

    2016-05-01

    The occurrence of a variety of pathogens resistant to current antibiotics remains the major problem in medical care, especially when bacterial infections are established as biofilms. In this study, we propose the use of photodynamic therapy (PDT) as a monotherapy and associated with antibiotic as an alternative treatment. The aim of this study was to analyze the effects of PDT mediated by methylene blue (MB) on Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922) in both biofilm and planktonic phases. Several concentrations of MB and light doses were tested. The bactericidal effects of PDT as a monotherapy did not increase with the concentration of photosensitizer, but were light dose-dependent. In addition, bacteria in biofilms were less affected than cells in the planktonic phase. Although not concentration-dependent, the disruption effect of PDT on biofilms was clearly illustrated by scanning electron microscopy (SEM). We also carried out experiments that evaluated the synergistic effect of photodynamic therapy and the antibiotic ciprofloxacin. The best results were obtained after combination treatment of photodynamic therapy followed by ciprofloxacin on biofilms, which increased bacterial reduction on biofilms, resulting in a 5.4 log reduction for S. aureus biofilm and approximately 7 log for E. coli biofilm. Copyright © 2016. Published by Elsevier B.V.

  2. Comprehensive family therapy: an effective approach for cognitive rehabilitation in schizophrenia

    National Research Council Canada - National Science Library

    Cai, Jun; Zhu, Yi; Zhang, Weibo; Wang, Yanfeng; Zhang, Chen

    2015-01-01

    .... An 18-month follow-up clinical trial of 256 stabilized patients with schizophrenia at six communities in Shanghai, People's Republic of China were randomly assigned to into either a comprehensive family therapy (CFT...

  3. Antibody Therapy Could Be an Effective Method for HIV-1 Prevention, Treatment | FNLCR

    Science.gov (United States)

    Four recent studies have given the scientific community a better understanding of how human immunodeficiency virus (HIV) establishes and maintains itself in an infected individual and how antibody therapy may help prevent or fight the disease. Curren

  4. Exchanging knowledge within a community of practice: toward an epistemology of practice in Occupational Therapy paediatric hospital care

    Directory of Open Access Journals (Sweden)

    Sandra Maria Galheigo

    2017-09-01

    Full Text Available Objective: This research proposed the creation of a community of practice (CoP with the objective of: (i analysing the feasibility of a CoP as a means of generating knowledge among occupational therapists and (ii investigating the practice of occupational therapy with hospitalized children and adolescents. This article privileges the results of one of the predominantly discussed themes - the use of assessments and strategies of evaluation in Occupational Therapy in the hospital context. Method: A participatory action research study was undertaken with nine occupational therapists in face-to-face meetings combined with virtual tasks on an on-line platform. A hermeneutic and dialectical method was used to interpret the results. Results: The CoP produced practical knowledge about the use of assessments with hospitalized children and adolescents and demonstrated to be a strategy of knowledge development through dialogue and collaborative reflection on practice. Conclusion: Research on the implementation of communities of practice offers a promising approach to the production of knowledge in occupational therapy. The generated knowledge is representative of occupational therapists’ experiences and demonstrates an example of an epistemology of practice.

  5. Transformative learning experience for physical therapy students through a community health promotion project for mothers of hearing-challenged children.

    Science.gov (United States)

    Yokogawa, Masami; Notoya, Masako; Madokoro, Sachiko

    2017-04-01

    [Purpose] The purpose of this project was to expose physical therapy students to transformative learning through a community health promotion project for mothers of hearing-challenged children. [Subjects and Methods] The participants were three mothers with their respective hearing-challenged child and twenty physical therapy students. The project consisted of seven sessions supervised throughout by a physical therapy instructor. The students participated in seven sessions, while the mothers were required to attend only two sessions of a health checkup and exercise program. [Results] Through the interaction between the mothers and students, the former felt physically and mentally refreshed, and the latter experienced transformative learning. The mother's physical status showed that all parameters for health variables were within normal range. However, it was found that mothers had little time for their personal mental or physical well-being because their focus was on planning and executing daily assignments for development of the child's verbal skills. [Conclusion] This project contributed to the students' learning experience and provided them with tools for possible future interest and involvement in community activity. The exercise session appeared to stimulate in the mothers an awareness and importance of their own personal and mental well-being.

  6. Theatre of the oppressed and environmental justice communities: a transformational therapy for the body politic.

    Science.gov (United States)

    Sullivan, John; Petronella, Sharon; Brooks, Edward; Murillo, Maria; Primeau, Loree; Ward, Jonathan

    2008-03-01

    Community Environmental Forum Theatre at UTMB-NIEHS Center in Environmental Toxicology uses Augusto Boal's Theatre of the Oppressed (TO) to promote involvement of citizens, scientists, and health professionals in deconstructing toxic exposures, risk factors, and cumulative stressors that impact the well-being of communities. The TO process encourages collective empowerment of communities by disseminating information and elaborating support networks. TO also elicits transformation and growth on a personal level via a dramaturgical system that restores spontaneity through image-making and improvisation. An NIEHS Environmental Justice Project, Communities Organized against Asthma & Lead, illustrates this interplay of personal and collective change in Houston, Texas.

  7. The effectiveness of narrative therapy with young people with autism.

    Science.gov (United States)

    Cashin, Andrew; Browne, Graeme; Bradbury, Joanne; Mulder, Ann

    2013-02-01

    The aim of this pilot study was to be the first step toward empirically determining whether narrative therapy is effective in helping young people with autism who present with emotional and behavioral problems. Autism is increasingly being recognized in young people with average and above intelligence. Because of the nature of autism, these young people have difficulty navigating the challenges of school and adolescence. Narrative therapy can help them with their current difficulties and also help them develop skills to address future challenges. Narrative therapy involves working with a person to examine and edit the stories the person tells himself or herself about the world. It is designed to promote social adaptation while working on specific problems of living. This pilot intervention study used a convenience sample of 10 young people with autism (10-16 years) to evaluate the effectiveness of five 1 hr sessions of narrative therapy conducted over 10 weeks. The study used the parent-rated Strengths and Difficulties Questionnaire (SDQ) as the primary outcome measure. Secondary outcome measures were the Kessler-10 Scale of Psychological Distress (K-10), the Beck Hopelessness Scale, and a stress biomarker, the salivary cortisol to dehydroepiandrosterone (DHEA) ratio. Significant improvement in psychological distress identified through the K-10 was demonstrated. Significant improvement was identified on the Emotional Symptoms Scale of the SDQ. The cortisol:DHEA ratio was responsive and a power analysis indicated that further study is indicated with a larger sample. Narrative therapy has merit as an intervention with young people with autism. Further research is indicated. © 2012 Wiley Periodicals, Inc.

  8. Effects of PAH-Contaminated Soil on Rhizosphere Microbial Communities

    DEFF Research Database (Denmark)

    Pritchina, Olga; Ely, Cairn; Smets, Barth F.

    2011-01-01

    Bacterial associations with plant roots are thought to contribute to the success of phytoremediation. We tested the effect of addition of a polycyclic aromatic hydrocarbon contaminated soil on the structure of the rhizosphere microbial communities of wheat (Triticum aestivum), lettuce (Lactuca...... sativa var. Tango), zucchini (Cucurbita pepo spp. pepo var. Black Beauty), and pumpkin (C. pepo spp. pepo var. Howden) 16S rDNA terminal restriction fragment length polymorphism (T-RFLP) profiles of rhizosphere microbial communities from different soil/plant combinations were compared with a pairwise...

  9. Effect of Group Cognitive-Behavioral Therapy on Depression

    Directory of Open Access Journals (Sweden)

    F Ranjbar

    2010-09-01

    Full Text Available Introduction: Depression is the most prevalent psychotic disorder. In order to cure and prevent the recurrence of this disease, it is necessary to gain more information about remedial methods like Group Cognitive- Behavior Therapy. The aim of this study was to investigate the effects of group cognitive-behavioral therapy on the amount of depression on the patients. Methods: This study was experimental and it included both experimental and control group with a pre test. The subjects were selected from patients with mild depression. Their Beck inventory score ranged between 17-20. Patients were randomly divided in two groups. The subjects of experimental group received eight sessions of group cognitive-behavioral therapy. The Beck depression test was completed by the subjects in three phases before the intervention, after the intervention and one month after that. The data was transferred to SPSS program and analyzed. Results: The results indicated a significant difference between the experimental and control group after the intervention at Beck tests (P=0.043. Furthermore, there was a significant difference in the experimental group between the depression score in patients before and after the intervention (p=0.033 and the score of patients before and one month after the intervention (p=0.492. Conclusion: Group Cognitive-Behavioral therapy decreases depression in patients who suffer from mild depression.

  10. Contrasting effects of different mammalian herbivores on sagebrush plant communities.

    Directory of Open Access Journals (Sweden)

    Kari E Veblen

    Full Text Available Herbivory by both grazing and browsing ungulates shapes the structure and functioning of terrestrial ecosystems worldwide, and both types of herbivory have been implicated in major ecosystem state changes. Despite the ecological consequences of differences in diets and feeding habits among herbivores, studies that experimentally distinguish effects of grazing from spatially co-occurring, but temporally segregated browsing are extremely rare. Here we use a set of long-term exclosures in northern Utah, USA, to determine how domestic grazers vs. wild ungulate herbivores (including browsers and mixed feeders affect sagebrush-dominated plant communities that historically covered ~62 million ha in North America. We sampled plant community properties and found that after 22 years grazing and browsing elicited perceptible changes in overall plant community composition and distinct responses by individual plant species. In the woody layer of the plant community, release from winter and spring wild ungulate herbivory increased densities of larger Wyoming big sagebrush (Artemisia tridentata, ssp. wyomingensis at the expense of small sagebrush, while disturbance associated with either cattle or wild ungulate activity alone was sufficient to increase bare ground and reduce cover of biological soil crusts. The perennial bunchgrass, bottlebrush squirretail (Elymus elymoides, responded positively to release from summer cattle grazing, and in turn appeared to competitively suppress another more grazing tolerant perennial grass, Sandberg's blue grass (Poa secunda. Grazing by domestic cattle also was associated with increased non-native species biomass. Together, these results illustrate that ungulate herbivory has not caused sagebrush plant communities to undergo dramatic state shifts; however clear, herbivore-driven shifts are evident. In a dry, perennial-dominated system where plant community changes can occur very slowly, our results provide insights into

  11. Diabetes Nutrition Therapy: Effectiveness, Macronutrients, Eating Patterns and Weight Management.

    Science.gov (United States)

    Franz, Marion J

    2016-04-01

    Diabetes nutrition therapy provided for individuals with diabetes must be based on research documenting effectiveness. The roles of differing macronutrient percentages, eating patterns and weight loss interventions are controversial. A review of research related to these topics is summarized. Clinical trials as well as systematic reviews and Cochrane reviews report an approximately 1-2% lowering of hemoglobin A1c as well as other beneficial outcomes from nutrition therapy interventions, depending on the type and duration of diabetes and level of glycemic control. There are no ideal percentages of macronutrients or eating patterns or both that apply to all persons with diabetes. Clinical trials demonstrate the effectiveness of modest weight loss and physical activity for the prevention or delay of type 2 diabetes. However, as the disease progresses, weight loss interventions may or may not result in beneficial glycemic and other metabolic outcomes. To be effective, diabetes nutrition therapy must be individualized. Treatment goals, personal preferences (eg, tradition, culture, religion, health beliefs and economics) and the individual׳s ability and willingness to make lifestyle changes all must be considered when educating or counseling individuals with diabetes. A healthy eating pattern emphasizing nutrient-dense foods in appropriate portion sizes, regular physical activity and support are important. A reduced energy intake for persons with prediabetes or type 2 diabetes and matching insulin to planned carbohydrate intake for insulin users is nutrition therapy interventions shown to be effective in achieving glycemic and other metabolic outcomes. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  12. [Randomized controlled trials terminated prematurely: beneficial therapy effects].

    Science.gov (United States)

    Kluth, L A; Rink, M; Ahyai, S A; Fisch, M; Shariat, S F; Dahm, P

    2013-08-01

    Randomized controlled trials (RCTs) stopped prematurely for beneficial therapy effects are becoming increasingly more prevalent in the urological literature and often receive great attention in the public and medical media. Urologists who practice evidence-based medicine should be aware of the potential bias and the different reasons why and how early termination of RCTs can and will affect the results. This review provides insights into the challenges clinical urologists face by interpreting the results of prematurely terminated RCTs.

  13. Temperature and species richness effects in phytoplankton communities.

    Science.gov (United States)

    Schabhüttl, Stefanie; Hingsamer, Peter; Weigelhofer, Gabriele; Hein, Thomas; Weigert, Achim; Striebel, Maren

    2013-02-01

    Phytoplankton play an important role as primary producers and thus can affect higher trophic levels. Phytoplankton growth and diversity may, besides other factors, be controlled by seasonal temperature changes and increasing water temperatures. In this study, we investigated the combined effects of temperature and diversity on phytoplankton growth. In a controlled laboratory experiment, monocultures of 15 freshwater phytoplankton taxa (green algae, cyanobacteria, and diatoms) as well as 25 mixed communities of different species richness (2-12 species) and taxa composition were exposed to constant temperatures of 12, 18, and 24 °C. Additionally, they were exposed to short-term daily temperature peaks of +4 °C. Increased species richness had a positive effect on phytoplankton growth rates and phosphorous content at all temperature levels, with maximum values occurring at 18 °C. Overyielding was observed at almost all temperature levels and could mostly be explained by complementary traits. Higher temperatures resulted in higher fractions of cyanobacteria in communities. This negative effect of temperature on phytoplankton diversity following a shift in community composition was most obvious in communities adapted to cooler temperatures, pointing to the assumption that relative temperature changes may be more important than absolute ones.

  14. Effects of organic farming on communities of arbuscular mycorrhizal fungi.

    Science.gov (United States)

    Lee, Si-Woo; Lee, Eun-Hwa; Eom, Ahn-Heum

    2008-03-01

    Red pepper (Capsicum annum L.) roots and soils representing different agricultural management practices such as conventional (CON), no-chemical (NOC), and organic farming systems (ORG) were collected from 32 farm field sites in Kyunggi, Korea to investigate the effects of these agricultural practices on arbuscular mycorrhizal (AM) symbiosis. ORG inoculum significantly increased plant growth compared to inoculum from CON and NOC. A community analysis of AM fungi (AMF) using morphological features of spores revealed that AMF spore abundance and species diversity were significantly higher in ORG than in CON. Additionally, a community analysis of AMF colonizing roots using a molecular technique revealed higher AMF diversity in ORG than in CON. These results suggest that agricultural practices significantly influence AM fungal community structure and mycorrhizal inoculum potential.

  15. Medication therapy management services in community pharmacy: a pilot programme in HIV specialty pharmacies.

    Science.gov (United States)

    Rosenquist, Ashley; Best, Brookie M; Miller, Teresa A; Gilmer, Todd P; Hirsch, Jan D

    2010-12-01

    Pharmacist-provided medication therapy management services (MTMS) have been shown to increase patient's adherence to medications, improve health outcomes and reduce overall medical costs. The purpose of this study was to describe a pilot programme that provided pharmacy-based MTMS for patients with HIV/AIDS in the state of California, USA. Pharmacists from the 10 pilot pharmacies were surveyed using an online data collection tool. Information was collected to describe the types of MTMS offered, proportion of patients actively using specific MTMS, pharmacist beliefs regarding effect on patient outcomes and barriers to providing MTMS, ability to offer MTMS without pilot programme funding and specialized pharmacist or staff training. Each responding pharmacy (7 of 10) varied in the number of HIV/AIDS patients served and prescription volume. All pharmacists had completed HIV/AIDS-related continuing education programmes, and some had other advanced training. The type of MTMS being offered varied at each pharmacy with 'individualized counselling by a pharmacist when overuse or underuse was detected' and 'refill reminders by telephone' being actively used by the largest proportion of patients. Most, but not all, pharmacists cited reimbursement as a barrier to MTMS provision. Pharmacists believed the MTMS they provide resulted in improved satisfaction (patient and provider), medication usage, therapeutics response and patient quality of life. The type of MTMS offered, and proportion of patients actively using, varied among participating pilot pharmacies. © 2010 Blackwell Publishing Ltd.

  16. Effects of ozone therapy on facial nerve regeneration

    Directory of Open Access Journals (Sweden)

    Isa Ozbay

    Full Text Available Abstract Introduction: Ozone may promote moderate oxidative stress, which increases antioxidant endogenous systems. There are a number of antioxidants that have been investigated therapeutically for improving peripheral nerve regeneration. However, no previous studies have reported the effect of ozone therapy on facial nerve regeneration. Objective: We aimed to evaluate the effect of ozone therapy on facial nerve regeneration. Methods: Fourteen Wistar albino rats were randomly divided into two groups with experimental nerve crush injuries: a control group, which received saline treatment post-crush, and an experimental group, which received ozone treatment. All animals underwent surgery in which the left facial nerve was exposed and crushed. Treatment with saline or ozone began on the day of the nerve crush. Left facial nerve stimulation thresholds were measured before crush, immediately after crush, and after 30 days. After measuring nerve stimulation thresholds at 30 days post-injury, the crushed facial nerve was excised. All specimens were studied using light and electron microscopy. Results: Post-crushing, the ozone-treated group had lower stimulation thresholds than the saline group. Although this did not achieve statistical significance, it is indicative of greater functional improvement in the ozone group. Significant differences were found in vascular congestion, macrovacuolization, and myelin thickness between the ozone and control groups. Significant differences were also found in axonal degeneration and myelin ultrastructure between the two groups. Conclusion: We found that ozone therapy exerted beneficial effect on the regeneration of crushed facial nerves in rats.

  17. [Effects of forest restoration patterns on soil microbial communities].

    Science.gov (United States)

    Zheng, Hua; Ouyang, Zhiyun; Wang, Xiaoke; Fang, Zhiguo; Zhao, Tongqian; Miao, Hong

    2004-11-01

    In this paper, soil microbial community properties of five vegetation patterns were measured by bacterial, microbial biomass carbon and metabolic diversity (BIOLOG) assays to evaluate the effects of different forest restoration patterns on soil microbial community. The results showed that among five sampling sites, soil microbial biomass carbon and bacterial amount were the highest under natural secondary forest, while those in CK were the least. In BIOLOG assays, the average well colour development (AWCD) and the richness and diversity indices indicated the differences of microbial metabolic diversity. The variation tendency of the indices was the same as that of microbial biomass and bacterial amount. It is suggested that under natural secondary forest, soil microbial community had a stronger ability of utilizing carbon source and a greater functional diversity than that in plantations and CK. The metabolic diversity of microbial communities in 0-20 and 20-40 cm soil layers showed a fairly good correlation with root biomass (r = 0.933, P forest, and natural restoration should be more propitious to improve the structure and function of soil microbial community.

  18. Brief strategic therapy in a child community clinic. A follow-up report.

    Science.gov (United States)

    Eisenberg, J; Wahrman, O

    1994-01-01

    This paper reports the outcome of brief strategic therapy, practiced according to the model described by S. de Shazer, in an out-patient child psychiatry clinic during 4 years. Forty-two clients were interviewed in a span of 6 to 18 months after termination of therapy and asked about symptomatic improvement and satisfaction with the treatment. The results showed that brief strategic therapy achieved lasting complaint resolution in a high percentage of cases, high satisfaction rates with little relapse or need for additional interventions.

  19. Penicillin as empirical therapy for patients hospitalised with community acquired pneumonia at a Danish hospital

    DEFF Research Database (Denmark)

    Kirk, O; Glenthøj, Jonathan Peter; Dragsted, Ulrik Bak

    2001-01-01

    and outcome parameters were collected. Three groups were established according to the initial choice of antibiotic(s): penicillin only (n = 160); non-allergic patients starting broader spectrum therapy (n = 54); and patients with suspected penicillin allergy (n = 29). RESULTS: The overall mortality within...... treated with penicillin monotherapy. No differences in clinical outcomes were documented between patients treated empirically with broad-spectrum therapy and penicillin monotherapy. Therefore, penicillin seems to be a reasonable first choice for initial therapy of HCAP in Denmark as in other regions...

  20. Quality of Life, Integrative Community Therapy, Family Support, and Satisfaction with Health Services Among Elderly Adults with and without Symptoms of Depression.

    Science.gov (United States)

    de Lima Silva, Vanessa; de Medeiros, Caroline Addison Carvalho Xavier; Guerra, Gerlane Coelho Bernardo; Ferreira, Priscila Helena Antunes; de Araújo Júnior, Raimundo Fernandes; de Araújo Barbosa, Stphannie Jamyla; de Araújo, Aurigena Antunes

    2017-06-01

    The aim of this cross-sectional study was to analyse quality of life, socio-demographic characteristics, family support, satisfaction with health services, and effect of integrative community therapy among non-institutionalised elderly adults with and without symptoms of depression in the state of Rio Grande do Norte, Brazil. Data from elderly adults with (n = 59) and without (n = 61) depressive symptoms were compared. The instruments used were the Mini-Mental State Examination, the short version of the Geriatric Depression Scale, a clinical socio-demographic questionnaire, the abbreviated version of the World Health Organisation Quality of Life questionnaire, the Family Assessment Device, and the Patient Satisfaction with Mental Health Services Rating Scale. Elderly adults with depressive symptoms had lower quality of life in the social relations domain than did those without depressive symptoms (p = 0.003). In addition, compared with those without depression, fewer elderly adults with depressive symptoms attended integrative community therapy (p = 0.04); they also reported a low degree of family involvement in problem solving (p = 0.04) and showed apathy regarding their satisfaction with health services (p = 0.007). These results have important implications in the decision-making process with regard to strategies for improving the health status of elderly adults with depressive symptoms.

  1. Achieving Results through Community School Partnerships: How District and Community Leaders Are Building Effective, Sustainable Relationships

    Science.gov (United States)

    Blank, Martin J.; Jacobson, Reuben; Melaville, Atelia

    2012-01-01

    A community school is a place and a set of partnerships connecting a school, the families of students, and the surrounding community. A community school is distinguished by an integrated focus on academics, youth development, family support, health and social services, and community development. The community school strategy is central to efforts…

  2. Perspectives on Cognitive Therapy Training within Community Mental Health Settings: Implications for Clinician Satisfaction and Skill Development.

    Science.gov (United States)

    Wiltsey Stirman, Shannon; Miller, Christopher J; Toder, Katherine; Calloway, Amber; Beck, Aaron T; Evans, Arthur C; Crits-Christoph, Paul

    2012-01-01

    Despite the mounting evidence of the benefits of cognitive therapy for depression and suicidal behaviors over usual care, like other evidence-based psychosocial treatments (EBTs), it has not been widely adopted in clinical practice. Studies have shown that training followed by intensive consultation is needed to prepare providers to an appropriate level of competency in complex, multisession treatment packages such as cognitive therapy. Given the critical role of training in EBT implementation, more information on factors associated with the success and challenges of training programs is needed. To identify potential reasons for variation in training outcomes across ten agencies in a large, urban community mental health system, we explored program evaluation data and examined provider, consultant, and training program administrator perspectives through follow-up interviews. Perceptions of cognitive therapy, contextual factors, and reactions to feedback on audio recordings emerged as broad categories of themes identified from interviews. These factors may interact and impact clinician efforts to learn cognitive therapy and deliver it skillfully in their practice. The findings highlight experiences and stakeholder perspectives that may contribute to more or less successful training outcomes.

  3. Perspectives on Cognitive Therapy Training within Community Mental Health Settings: Implications for Clinician Satisfaction and Skill Development

    Directory of Open Access Journals (Sweden)

    Shannon Wiltsey Stirman

    2012-01-01

    Full Text Available Despite the mounting evidence of the benefits of cognitive therapy for depression and suicidal behaviors over usual care, like other evidence-based psychosocial treatments (EBTs, it has not been widely adopted in clinical practice. Studies have shown that training followed by intensive consultation is needed to prepare providers to an appropriate level of competency in complex, multisession treatment packages such as cognitive therapy. Given the critical role of training in EBT implementation, more information on factors associated with the success and challenges of training programs is needed. To identify potential reasons for variation in training outcomes across ten agencies in a large, urban community mental health system, we explored program evaluation data and examined provider, consultant, and training program administrator perspectives through follow-up interviews. Perceptions of cognitive therapy, contextual factors, and reactions to feedback on audio recordings emerged as broad categories of themes identified from interviews. These factors may interact and impact clinician efforts to learn cognitive therapy and deliver it skillfully in their practice. The findings highlight experiences and stakeholder perspectives that may contribute to more or less successful training outcomes.

  4. Stem Cell Therapies for the Treatment of Radiation-Induced Normal Tissue Side Effects

    NARCIS (Netherlands)

    Benderitter, Marc; Caviggioli, Fabio; Chapel, Alain; Coppes, Robert P.; Guha, Chandan; Klinger, Marco; Malard, Olivier; Stewart, Fiona; Tamarat, Radia; Van Luijk, Peter; Limoli, Charles L.

    2014-01-01

    Significance: Targeted irradiation is an effective cancer therapy but damage inflicted to normal tissues surrounding the tumor may cause severe complications. While certain pharmacologic strategies can temper the adverse effects of irradiation, stem cell therapies provide unique opportunities for

  5. The effect of yoga therapy on selected psychological variables among male patients with insomnia

    National Research Council Canada - National Science Library

    Sobana, R; Parthasarathy, S; Duraisamy; Jaiganesh, K; Vadivel, S

    2013-01-01

    .... Yoga therapy is beneficial in such disorders and it has fewer side effects. The aim of this study was to find out the effect of yoga therapy on selected psychological variables among men with insomnia...

  6. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women

    DEFF Research Database (Denmark)

    Schierbeck, Louise Lind; Rejnmark, Lars; Tofteng, Charlotte Landbo

    2012-01-01

    To investigate the long term effect of hormone replacement therapy on cardiovascular outcomes in recently postmenopausal women.......To investigate the long term effect of hormone replacement therapy on cardiovascular outcomes in recently postmenopausal women....

  7. Evaluation of a Community Pharmacy-Based Screening Questionnaire to Identify Patients at Risk for Drug Therapy Problems.

    Science.gov (United States)

    Pammett, Robert T; Blackburn, David; Taylor, Jeff; Mansell, Kerry; Kwan, Debbie; Papoushek, Christine; Jorgenson, Derek

    2015-09-01

    To determine if a short screening questionnaire can identify patients at risk for drug therapy problems (DTPs) in a community pharmacy setting. Self-administered questionnaire. Three community pharmacies in Saskatoon, Canada. Forty-nine adults who were picking up a refill prescription for a medication that had remained stable over the past 6 months (i.e., no changes to drug, dose, or regimen) during 4 consecutive weeks at each of the three pharmacies between November 2013 and February 2014. All patients completed a self-administered screening questionnaire and underwent a blinded comprehensive medication assessment with a clinical pharmacist. Agreement between the screening questionnaire responses and responses based on information from the medication assessment were assessed with Cohen's κ coefficient. The DTPs identified during the medication assessments were categorized in one of the eight standard DTP categories: unnecessary drug therapy, inappropriate drug, subtherapeutic dose, supratherapeutic dose, drug therapy required, adverse drug reaction, noncompliance, and other or unsure. The DTPs were also assigned a severity-mild, moderate, or severe-using adapted Schneider criteria. The number and severity of DTPs identified were compared among patients categorized as high versus low risk for DTPs as determined by the questionnaire responses. Of the 49 patients who completed the study, 18 (37%) were high risk and 31 (63%) low risk. The agreement between risk categorization based on the screening questionnaire and medication assessment was very good (κ = 0.91, p<0.01). Also, patients identified as high risk on the screening questionnaire had a mean of 3.7 (p<0.01) more DTPs than low-risk patients. Seventeen (94%) of the 18 high-risk patients had at least one moderate or severe DTP compared with 15 (48%) of the 31 low-risk patients. The screening questionnaire was a reliable method for identifying patients in community pharmacies who have a large number of DTPs

  8. Effects of smoking in patients treated with cardiac resynchronization therapy.

    Science.gov (United States)

    Perrotta, Laura; Xhaferi, Brunilda; Chiostri, Marco; Pieragnoli, Paolo; Ricciardi, Giuseppe; Di Biase, Luigi; Natale, Andrea; Ricceri, Ilaria; Biria, Mazda; Lakkireddy, Dhanunjay; Valleggi, Alessandro; Emdin, Michele; Michelotti, Federica; Mascioli, Giosuè; Pandozi, Angela; Santini, Massimo; Padeletti, Luigi

    2014-04-01

    Smoking is associated with increased morbidity and mortality in cardiac patients. However, data on the prognostic impact of smoking in heart failure (HF) patients on cardiac resynchronization therapy with defibrillator (CRT-D) are absent. We investigated the effects of smoking on all-cause mortality and on a composite endpoint (all-cause death/appropriate device therapy), appropriate and inappropriate device therapy, in 649 patients with HF who underwent CRT-D between January 2003 and October 2011 in 6 Centers (4 in Italy and 2 in USA). 68 patients were current smokers, 396 previous-smokers (patients who had smoked in the past but who had quit before the CRT-D implant), and 185 had never smoked. The risk of each endpoint by smoking status was evaluated with both Kaplan-Meier and Cox proportional-hazard analysis. After adjusting for age, left ventricular ejection fraction, QRS width and ischemic etiology, both current and previous smoking were independent predictors of all-cause death [HR = 5.07 (95 % CI 2.68-9.58), p therapy compared to never smokers [HR = 21.74 (4.53-104.25), p = 0.005]. Our study indicates that in patients with HF who received a CRT-D device, current and previous smoking increase the event rate per person-time of death and of appropriate and inappropriate ICD therapy more than other known negative prognostic factors such as age, left ventricular dysfunction, prolonged QRS duration and ischemic etiology.

  9. Paternal Involvement in Multisystemic Therapy: Effects on Adolescent Outcomes and Maternal Depression

    Science.gov (United States)

    Gervan, Shannon; Granic, Isabela; Solomon, Tracy; Blokland, Kirsten; Ferguson, Bruce

    2012-01-01

    The association between paternal involvement in therapy, adolescent outcomes and maternal depression was examined within the context of Multisystemic Therapy (MST), an empirically supported, family- and community-based treatment for antisocial adolescents. Ninety-nine families were recruited from five mental health agencies providing MST. We…

  10. Breast Cancer, Aromatase Inhibitor Therapy, and Sexual Functioning: A Pilot Study of the Effects of Vaginal Testosterone Therapy

    Directory of Open Access Journals (Sweden)

    Melissa Dahir, DNP, IF

    2014-04-01

    Conclusions: The use of a compounded testosterone vaginal cream applied daily for 4 weeks improves reported sexual health quality of life in women with breast cancer taking AIs. Dahir M and Travers‐Gustafson D. Breast cancer, aromatase inhibitor therapy, and sexual functioning: A pilot study of the effects of vaginal testosterone therapy. Sex Med 2014;2:8–15.

  11. Public-academic partnerships: the Beck Initiative: a partnership to implement cognitive therapy in a community behavioral health system.

    Science.gov (United States)

    Stirman, Shannon Wiltsey; Buchhofer, Regina; McLaulin, J Bryce; Evans, Arthur C; Beck, Aaron T

    2009-10-01

    The Beck Initiative is a partnership between researchers and clinicians at a large university and an urban behavioral health managed care system. Both partners share a commitment to ensuring that consumers in the community have access to competently delivered, individualized, evidence-based mental health care and that the providers who serve them have the support they need to deliver high-quality evidence-based treatments. Central features of the program are individualized training and consultation in cognitive therapy for each provider agency and policies to promote the sustainability of the initiative and its continuing evolution to meet the needs of providers and consumers.

  12. Lack of proton pump inhibitor trial prior to commencing therapy for eosinophilic esophagitis is common in the community.

    Science.gov (United States)

    Whitson, M J; Lynch, K L; Yang, Y-X; Metz, D C; Falk, G W

    2017-12-22

    Eosinophilic esophagitis is characterized by eosinophil inflammation restricted to the esophagus and the resulting symptoms of esophageal dysfunction. Critical to the diagnosis of eosinophilic esophagitis is a trial of proton pump inhibitor therapy to exclude alternative causes of esophageal eosinophilia such as proton pump inhibitor-responsive esophageal eosinophilia. While consensus guidelines recommend a proton pump inhibitor trial prior to diagnosis, little is known about its implementation in clinical practice. The primary aim of this study is to assess the frequency of proton pump inhibitor trial prior to the diagnosis of eosinophilic esophagitis in community practice. The secondary aim is to assess the frequency of other treatments for eosinophilic esophagitis, including topical steroids and/or dietary therapy, in patients who did not undergo a proton pump inhibitor trial prior to diagnosis or who had an alternative diagnosis to eosinophilic esophagitis upon completed workup. We conducted a single-center, case series of patients referred to the Hospital of the University of Pennsylvania for eosinophilic esophagitis management between 2010 and 2015. This case series consisted of 125 patients who were referred from community practitioners with a presumptive diagnosis of eosinophilic esophagitis. Upon review, 90 out of 125 (72%) patients had not had a proton pump inhibitor trial or esophageal pH testing prior to the diagnosis of eosinophilic esophagitis being made. Of these patients, 77.8% (70/90) had already received either topical steroid or dietary therapy for presumed eosinophilic esophagitis. Of the 125 patients initially diagnosed with eosinophilic esophagitis, 32 (25.6%) were found to have an alternative diagnosis, and 79.2% of this subset of patients (25/32) had previously received topical steroid or dietary therapy. This study demonstrates that a substantial number of patients with presumed eosinophilic esophagitis have not had a proton pump inhibitor

  13. Effect of Acupotomy Therapy on Lateral Epicondylitis Diagnosed by Ultrasonography

    Directory of Open Access Journals (Sweden)

    Lim Nara

    2011-06-01

    Full Text Available Purpose: This observation was to report the clinical effects of acupotomy in treating lateral epicondylitis. Methods: Three patients diagnosed with lateral epicondylitis were treated with acupotomy. Two were male and one was female. The improvement of symptom were evaluated by visual analog scale (VAS and self-consciousness symptoms of Cozen test. Results: After one treatments, patient's chief complaint and the pain near the lateral epicondyle while cozen test were notably improved. Conclusions: This study demonstrates that oriental medical treatment with acuputomy therapy has significant effect in improving symptoms of lateral epicondylitis. As though we had not wide experienced in this treatment, more research is needed.

  14. Effect of biofield therapy in the human brain.

    Science.gov (United States)

    Uchida, Seiya; Iha, Takehiko; Yamaoka, Kiyoshi; Nitta, Kazuo; Sugano, Hisanobu

    2012-09-01

    The effects of Okada Purifying Therapy (OPT), a form of subtle energy (biofield) therapy that originated in Japan, were investigated. Electroencephalograms and the Profile of Mood States scores were measured using a crossover design during OPT and placebo sessions. Nineteen (19) healthy Japanese adults (mean age±standard deviation: 40.8±11.2 years; 10 females) with no previous experience of biofield therapy participated in this study. Each session lasted 15 minutes. A single-blind, randomized design with a protocol consisting of regular cycles with eyes open followed by eyes closed was used. The power spectral value was calculated in θ (4.0-7.9 Hz), α (8.0-12.9 Hz), and β (13.0-29.9 Hz) frequency ranges. The power spectral value of the α band at F(p1), F(p2), F(7), F(z), F(8), C(3), C(z), C(4), and P(z) increased significantly in the OPT session compared with the placebo session. Mood state was improved after both sessions, and no significant difference was found between the two sessions. OPT was more effective in increasing α waves in the frontal and central cortex than a placebo treatment.

  15. Evaluating seasonal dynamics of bacterial communities in marine fish aquaculture: a preliminary study before applying phage therapy.

    Science.gov (United States)

    Pereira, Carla; Salvador, Sara; Arrojado, Cátia; Silva, Yolanda; Santos, Ana L; Cunha, Angela; Gomes, Newton C M; Gomes, Newton; Almeida, Adelaide

    2011-04-01

    The increasing problem of antibiotic resistance in common pathogenic bacteria and the concern about the spreading of antibiotics in the environment bring the need to find new methods to control fish pathogens. Phage therapy represents a potential alternative to antibiotics, but its use in aquaculture requires a detailed understanding of bacterial communities, namely of fish pathogenic bacteria. Therefore, in this study the seasonal dynamics of the overall bacterial communities, microbiological water quality and disease-causing bacteria were followed in a marine aquaculture system of Ria de Aveiro (Portugal). Analysis of the bacterial diversity of the water samples by denaturing gradient gel electrophoresis (DGGE) of 16S rRNA gene fragments indicates that the bacterial community structure varied seasonally, showing a higher complexity during the warm season. The diversity of the main fish pathogenic bacteria, assessed by DGGE targeting the Vibrio genus, showed lower seasonal variation, with new dominating populations appearing mainly in the spring. Bacterial indicators, faecal coliforms and enterococci, enumerated by the filter-membrane method, also varied seasonally. The fluorescent in situ hybridization (FISH) results showed that the specific groups of bacteria varied during the study period and that the non-indigenous Enterobactereaceae family was the most abundant group followed by Vibrio and Aeromonas. The seasonal variation detected in terms of density and structure of total and pathogenic bacterial communities demonstrates the need for a careful monitoring of water through the year in order to select the suitable phages to inactivate fish pathogenic bacteria. The spring season seems to be the critical time period when phage therapy should be applied.

  16. Effects of gamma-globulin therapy in severely epileptic children.

    Science.gov (United States)

    Bedini, R; de Feo, M R; Orano, A; Rocchi, L

    1985-01-01

    The effects of gamma-globulin therapy have been studied from clinical, immunological, and electrographic perspectives in 10 children affected by severe organic epilepsy. After the first or the second injection of large doses of IgG, an appreciable reduction in seizure frequency and an improvement in behavioral and psychological performance were observed in seven children. These clinical modifications were not correlated with an important decrease of the EEG epileptic elements, but in most cases they were associated to an increase in alpha activity and/or in power of the predominant EEG frequency. These changes were observed during the entire treatment period and tended to disappear when therapy was interrupted. No significant changes in both immunological data and plasma levels of antiepileptic drugs accompanied the clinical and EEG changes.

  17. Effectiveness of Biofield Therapy for Patients Diagnosed With Fibromyalgia.

    Science.gov (United States)

    Sarmento, Fernando; Tanaka, Hideaki; Cordeiro, Eduarda; Suzuki, Kiyoshi

    2017-10-02

    Context • Fibromyalgia (FM) is a disorder with an unknown etiology; symptoms include physical and psychological stress, widespread chronic pain, insomnia, and depression. Mind-body medicine and aerobic exercise have shown positive effects for symptom control. Several studies have reported positive effects for biofield therapy for FM, but when other studies have compared the treatment with a sham control, they have not found those beneficial effects. Objective • The study intended to examine the effects of a biofield therapy called Okada purifying therapy on patients' FM symptoms. Design • An open-label, self-controlled study was conducted with 2 groups of FM patients. Setting • The study was conducted at an integrative medicine clinic in Portugal. Participants • Twelve patients, aged 25 to 59 y, with symptoms of FM for the 3 mo before the study, participated. Participants agreed not to receive any new treatment other than the intervention throughout the study as a condition for participation. Intervention • Participants received 50 min of biofield therapy 2 ×/wk for 3 mo, either during the first half of the 6-mo study for group A or the second half for group B. The second half of the study was designated as a sham control for group A, and the first half of the study was designated as a sham control for group B. Outcome Measures • Measures included the Beck depression inventory (BDI), the fibromyalgia impact questionnaire (FIQ), the tender point index (TPI), and changes in the dosage of prescribed medication. Results • A significant change was observed for scores in the FIQ (P = .027), BDI (P = .027), and TPI (P = .027) in the second group of patients who received the intervention in the second half of the 6-mo study. Seven of 11 participants taking prescribed medications reduced their dosage. Conclusion • Biofield therapy may help reduce symptoms of depression, chronic widespread pain, and tenderness among patients suffering from FM. Larger

  18. Building Effective Community-University Partnerships: Are Universities Truly Ready?

    Science.gov (United States)

    Curwood, Susan Eckerle; Munger, Felix; Mitchell, Terry; Mackeigan, Mary; Farrar, Ashley

    2011-01-01

    Community service learning and community-based research necessitate the development of strong community-university partnerships. In this paper, students, faculty, and a community partner critically reflect upon the process of establishing a long-term community-university partnership through the integration of a community service learning component…

  19. Osteoporosis and thyrotropin-suppressive therapy: reduced effectiveness of alendronate.

    Science.gov (United States)

    Panico, Annalisa; Lupoli, Gelsy Arianna; Fonderico, Francesco; Marciello, Francesca; Martinelli, Addolorata; Assante, Roberta; Lupoli, Giovanni

    2009-05-01

    Many reports of the effect of exogenous thyroxine therapy on bone mineral density (BMD) show a relationship between excess thyroid hormone administration and osteoporosis. The aim of this study was to evaluate the effect of antibone resorptive agents, in particular alendronate (ALN) on BMD in postmenopausal osteoporotic women with thyroid carcinoma who were receiving long-term thyrotropin (TSH)-suppressive therapy with thyroxine. Seventy-four postmenopausal women with low BMD (T-score or =0.05 and < or =0.1 microU/mL) for about 3-9 years were selected for the study. The patients were divided into three groups according to the length of levothyroxine (LT(4)) treatment prior to the beginning of the study: group A (TSH-suppressive therapy for about 3 years), group B (for about 6 years), and group C (for about 9 years). These patients were compared with 74 matched women not taking LT(4). All patients and controls were treated with bisphosphonates, calcium, and vitamin D for 2 years and evaluated. After 24 months of treatment group A showed a 7.8% increase in lumbar BMD; group B, a 4.6% increase; and group C, a 0.86% increase. In the control group BMD increased 8.2%. A significant difference was found in both lumbar and femoral BMD increase among the three groups: group C had a lower BMD increase than group A (p < 0.001) and B (p < 0.001). In postmenopausal women who were receiving adequate amounts of calcium and vitamin D in their diet ALN was less effective for those who were also receiving TSH-suppressive doses of LT(4) for either 6 or 9 years. The positive effect of ALN on BMD was less for longer periods of LT(4) treatment. It seems likely that other bisphosphonates would also be less effective in increasing BMD in postmenopausal women receiving TSH-suppressing doses of LT(4).

  20. Implementation and Operational Research: Community-Based Adherence Clubs for the Management of Stable Antiretroviral Therapy Patients in Cape Town, South Africa: A Cohort Study.

    Science.gov (United States)

    Grimsrud, Anna; Lesosky, Maia; Kalombo, Cathy; Bekker, Linda-Gail; Myer, Landon

    2016-01-01

    Community-based models of antiretroviral therapy (ART) delivery are widely discussed as a priority in the expansion of HIV treatment services, but data on their effectiveness are limited. We examined outcomes of ART patients decentralized to community-based adherence clubs (CACs) in Cape Town, South Africa and compared these to patients managed in the community health center. The analysis included 8150 adults initiating ART from 2002 to 2012 in a public sector service followed until the end of 2013. From June 2012, stable patients (on ART >12 months, suppressed viral load) were referred to CACs. Loss to follow-up (LTFU) was compared between services using proportional hazards models with time-varying covariates and inverse probability weights of CAC participation. Of the 2113 CAC patients (71% female, 7% youth ages ≤ 24 years), 94% were retained on ART after 12 months. Among CAC patients, LTFU [adjusted hazard ratio (aHR): 2.17, 95% confidence interval (CI): 1.26 to 3.73 ] and viral rebound (aHR 2.24, 95% CI: 1.00 to 5.04) were twice as likely in youth (16-24 years old) compared with older patients, but no difference in the risk of LTFU or viral rebound was observed by sex (P-values 0.613 and 0.278, respectively). CAC participation was associated with a 67% reduction in the risk of LTFU (aHR: 0.33, 95% CI: 0.27 to 0.40) compared with community health centre, and this association persisted when stratified by patient demographic and clinic characteristics. CACs are associated with reduced risk of LTFU compared with facility-based care. Community-based models represent an important development to facilitate ART delivery and possibly improve patient outcomes.

  1. [Effectiveness of occupational therapy and other non-pharmacological therapies in cognitive impairment and Alzheimer's disease].

    Science.gov (United States)

    Matilla-Mora, Rosa; Martínez-Piédrola, Rosa María; Fernández Huete, Javier

    A review is presented on the existing knowledge about the usefulness of the occupational therapy in the non-pharmacological treatment of Alzheimer's disease. After conducting a literature search of the period 2010-2015, 25 articles that met the inclusion criteria were selected. The evidence obtained showed the efficiency and effectiveness of OT in delaying the progression of various disorders, especially when structured home OT programs are used. These programs should include aerobic and strengthening, sensory stimulation, and cognitive and memory training exercises based on learning without mistakes. These have shown benefits in the performance of activities of daily living, cognitive and emotional functioning. The importance is stressed of the combined and individual household level intervention and caregiver education. Finally, the need for more studies on the effectiveness of long-term sensory stimulation is highlighted. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. The effects of massage therapy on pain management in the acute care setting.

    Science.gov (United States)

    Adams, Rose; White, Barb; Beckett, Cynthia

    2010-03-17

    Pain management remains a critical issue for hospitals and is receiving the attention of hospital accreditation organizations. The acute care setting of the hospital provides an excellent opportunity for the integration of massage therapy for pain management into the team-centered approach of patient care. This preliminary study evaluated the effect of the use of massage therapy on inpatient pain levels in the acute care setting. The study was conducted at Flagstaff Medical Center in Flagstaff, Arizona-a nonprofit community hospital serving a large rural area of northern Arizona. A convenience sample was used to identify research participants. Pain levels before and after massage therapy were recorded using a 0 - 10 visual analog scale. Quantitative and qualitative methods were used for analysis of this descriptive study. Hospital inpatients (n = 53) from medical, surgical, and obstetrics units participated in the current research by each receiving one or more massage therapy sessions averaging 30 minutes each. The number of sessions received depended on the length of the hospital stay. Before massage, the mean pain level recorded by the patients was 5.18 [standard deviation (SD): 2.01]. After massage, the mean pain level was 2.33 (SD: 2.10). The observed reduction in pain was statistically significant: paired samples t(52) = 12.43, r = .67, d = 1.38, p Qualitative data illustrated improvement in all areas, with the most significant areas of impact reported being overall pain level, emotional well-being, relaxation, and ability to sleep. This study shows that integration of massage therapy into the acute care setting creates overall positive results in the patient's ability to deal with the challenging physical and psychological aspects of their health condition. The study demonstrated not only significant reduction in pain levels, but also the interrelatedness of pain, relaxation, sleep, emotions, recovery, and finally, the healing process.

  3. Cognitive behavioral therapy for depressed adolescents exposed to interpersonal trauma: an initial effectiveness trial.

    Science.gov (United States)

    Shirk, Stephen R; Deprince, Anne P; Crisostomo, Patrice S; Labus, Jennifer

    2014-03-01

    Four clinical trials have shown that a history of interpersonal trauma is associated with diminished response to cognitive-behavioral therapy (CBT) for adolescent depression. An efficacious CBT protocol for adolescent depression was modified to address cognitive deficits and distortions associated with interpersonal trauma. Initial feasibility, acceptability, and treatment impact of the modified treatment (m-CBT) were evaluated in a randomized effectiveness trial conducted in community clinics. Clients were 43 referred adolescents with a depressive disorder and a history of interpersonal trauma. Adolescents either received m-CBT or usual care (UC) therapy. Results indicated that m-CBT was delivered with good fidelity by community clinicians, but that number of sessions completed was attenuated in both m-CBT and UC. Adolescents reported high levels of treatment satisfaction and acceptability for the new treatment. There were significant reductions in depressive symptoms over time, but no differences in outcomes between groups. Although the new treatment produced promising results, it did not outperform UC. Implications for treatment development are considered. (c) 2014 APA, all rights reserved.

  4. Effectiveness of community forest management at reducing deforestation in Madagascar

    DEFF Research Database (Denmark)

    Rasolofoson, Ranaivo Andriarilala; Ferraro, Paul J.; Jenkins, Clinton N.

    2015-01-01

    Community Forest Management (CFM) is a widespread conservation approach in the tropics. It is also promoted as a means by which payment for ecosystem services schemes can be implemented. However, evidence on its performance is weak. We investigated the effectiveness of CFM at reducing deforestation...... restricted the sample to only where information suggests effective CFM implementation on the ground. Likewise, we cannot detect an effect of CFM where commercial use of natural resources is allowed. However, we can detect a reduction in deforestation in CFM that does not permit commercial uses, compared...

  5. Comparative effectiveness of injection therapies in lateral epicondylitis

    DEFF Research Database (Denmark)

    Krogh, Thøger Persson; Bartels, Else Marie; Ellingsen, Torkell Juulsgaad

    2013-01-01

    Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available....

  6. Is cognitive-behavioural therapy more effective than relaxation therapy in the treatment of anxiety disorders? A meta-analysis.

    Science.gov (United States)

    Montero-Marin, Jesus; Garcia-Campayo, Javier; López-Montoyo, Alba; Zabaleta-Del-Olmo, Edurne; Cuijpers, Pim

    2017-10-17

    It is not clear whether relaxation therapies are more or less effective than cognitive and behavioural therapies in the treatment of anxiety. The aims of the present study were to examine the effects of relaxation techniques compared to cognitive and behavioural therapies in reducing anxiety symptoms, and whether they have comparable efficacy across disorders. We conducted a meta-analysis of 50 studies (2801 patients) comparing relaxation training with cognitive and behavioural treatments of anxiety. The overall effect size (ES) across all anxiety outcomes, with only one combined ES in each study, was g = -0.27 [95% confidence interval (CI) = -0.41 to -0.13], favouring cognitive and behavioural therapies (number needed to treat = 6.61). However, no significant difference between relaxation and cognitive and behavioural therapies was found for generalized anxiety disorder, panic disorder, social anxiety disorder and specific phobias (considering social anxiety and specific phobias separately). Heterogeneity was moderate (I 2 = 52; 95% CI = 33-65). The ES was significantly associated with age (p cognitive and/or behavioural therapy (p = 0.015), quality of intervention (p = 0.007), relaxation treatment format (p cognitive and behavioural therapies in the treatment of post-traumatic stress disorder, and obsessive-compulsive disorder and it might also be less effective at 1-year follow-up for panic, but there is no evidence that it is less effective for other anxiety disorders.

  7. Comparison of the Effects of Low-Level Laser Therapy and Ozone Therapy on Bone Healing.

    Science.gov (United States)

    Alan, Hilal; Vardi, Nigar; Özgür, Cem; Acar, Ahmet Hüseyin; Hüseyin, Ahmet; Yolcu, Ümit; Doğan, Derya Ozdemir

    2015-07-01

    This study aims to compare the effect of low-level laser therapy (LLLT) and ozone therapy on the bone healing. Thirty-six adult male Wistar albino rats were used for this study. Monocortical defects were shaped in right femur of all rats. Defects were filled with nano-hydroxyapatite graft. The animals were divided into 3 groups and each group was than divided into 2 subgroups. Then, LLLT with a diode laser was applied to the first group (G1), ozone therapy was applied to the second group (G2), and no treatment was applied to the third group as a control group (G3). Animals were sacrificed after 4th and 8th weeks and the sections were examined to evaluate the density of the inflammation, the formation of connective tissue, the osteogenic potential, and osteocalcin activity. As a result, there were no significant differences among the groups of 4 weeks in terms of new bone formation. In the immunohistochemical assessment, the number of osteocalcin-positive cells was higher in the laser group compared to the other group of 4 weeks; this difference was statistically significant in the LLLT and ozone groups (P ozone groups; furthermore, there was a statistically significant difference in the LLLT in comparison with the control group at 8th week (P < 0.05). At the same time immunohistochemical assessment showed that osteocalcin-positive cells were considerably higher in G2 than G1 at 8th week (P < 0.05). The findings of this study may be the result of differences in the number of treatment sessions. Further studies are therefore needed to determine the optimal treatment modality.

  8. Occupational therapy interventions for chronic diseases: a scoping review

    National Research Council Canada - National Science Library

    Hand, Carri; Law, Mary; McColl, Mary Ann

    2011-01-01

    We reviewed the evidence regarding the effectiveness of community occupational therapy interventions, delivered alone or within a multidisciplinary team, in improving occupational outcomes for adults...

  9. Effects of tinnitus retraining therapy involving monaural noise generators.

    Science.gov (United States)

    Oishi, Naoki; Shinden, Seiichi; Kanzaki, Sho; Saito, Hideyuki; Inoue, Yasuhiro; Ogawa, Kaoru

    2013-02-01

    The aim of this study was to assess how tinnitus retraining therapy (TRT) employing monaural noise generators (NGs) affects tinnitus patients. Ninety-five patients with chronic tinnitus were included in this study. All received directive counseling and monaural NGs without any other combination treatment. Effects were evaluated with the Tinnitus Handicap Inventory (THI) 6, 12, and 24 months after the start of treatment. Multiple regression analysis was used to evaluate factors associated with improvement of THI scores. We observed a significant improvement in the average THI scores, which ranged from 59 at baseline to 36 after 6 months and were stable up to 24 months. Severely distressed (SD) patients experienced more benefits from the therapy than moderately distressed (MD) patients. Multiple regression analysis revealed that the presence of transient anxiety symptoms, measured by the state section of the State Trait Anxiety Inventory at the beginning of treatment, were associated the most to a decline in THI scores in SD patients. Pure-tone average at three mid frequencies was a negatively contributing factor. Analysis of MD patients did not provide a good model. In conclusion, TRT employing monaural NGs was an effective intervention especially for SD patients, although plateau of the effects after 6 months may be indicative of limitation of applying NGs monoaurally. Reducing the patients' hearing handicap may reinforce the effects of TRT in SD patients. Additional evaluation and interventions for both SD and MD patients might be needed.

  10. A systematic literature review on the effectiveness of eurythmy therapy.

    Science.gov (United States)

    Lötzke, Désirée; Heusser, Peter; Büssing, Arndt

    2015-07-01

    Eurythmy therapy is a movement therapy of anthroposophic medicine that can have effects on a person's physical body, spirit, and soul. The aim of this publication was to update and summarize the relevant literature on the effectiveness of eurythmy in a therapeutic context since 2008. Different databases like PubMed, MEDPILOT, Research Gate, The Cochrane Library, DIMDI, Arthe and also the journal databases Der Merkurstab and the European Journal of Integrative Medicine were searched for prospective and retrospective clinical trials in German or English language. There were no limitations for indication, considered outcome or age of participants. Studies were evaluated with regard to their description of the assembly process and treatment, adequate reporting of follow-ups, and equality of comparison groups in controlled trials. Eleven studies met the inclusion criteria. These included two single-arm, non-controlled pilot studies, two publications on the same non-randomized controlled trial and one case study; six further studies referred to a prospective cohort study, the Anthroposophic Medicine Outcome Study. Most of these studies described positives treatment effects with varying effect sizes. The studies were heterogynous according to the indications, age groups, study design and measured outcome. The methodological quality of the studies varied considerably. There were no clear improvements since 2008, when the recommendations were published in the first review. Eurythmy seems to be a beneficial add-on in a therapeutic context that can improve the health conditions of affected persons. More methodologically sound studies are needed to substantiate this positive impression.

  11. Effect of adjuvant therapies on recurrence in aneurysmal bone cysts.

    Science.gov (United States)

    Keçeci, Burçin; Küçük, Levent; Isayev, Alovsat; Sabah, Dündar

    2014-01-01

    The aim of this study was to define the effective factors such as surgical method, age and cavity filling materials on local recurrence in the treatment of aneurysmal bone cysts. The study included 85 patients (mean age: 17.9 years) that received surgical treatment for primary aneurysmal bone cyst. Nine were treated with cyst excision and 76 with intralesional curettage. The intralesional curettage group was divided into 3 subgroups according to adjuvant therapies applied; the first group received no additional adjuvant therapy, the second group received additional high-speed burr and the third group received additional high-speed burr and alcohol/phenol adjuvant treatments. Bone graft or bone cement was used to fill in the cavity. Mean follow-up period was 107.5 months. Groups were analyzed statistically in terms of local recurrence. Onset of cyst in ages under 10 and 20 years were considered a negative prognostic factor and analyzed statistically. Local recurrence occurred in 10 (11.8%) patients. Mean duration between the initial operation and recurrence was 10 months. There was no significant difference in terms of local recurrence among the surgical treatment groups, adjuvant therapy groups, age groups and bone graft and bone cement groups. Careful curettage of the entire cyst wall remains the most important step in the intralesional treatment of aneurysmal bone cyst.

  12. Additional effective dose by patients undergoing NAI-131 capsules therapy

    Energy Technology Data Exchange (ETDEWEB)

    Orlic, M.; Jovanovic, M.; Spasic Jokic, V.; Cuknic, O.; Ilic, Z.; Vranjes Djuric, S. [VINCA - Institute of Nuclear Sciences, Belgrade, Serbia and Montenegro (Yugoslavia)

    2006-07-01

    Capsules or solutions containing Na{sup 131}I are indicated for the therapy of some thyroid carcinomas such as functioning metastatic papillary or follicular carcinoma of the thyroid; and for the treatment of hyperthyroidism (diffuse toxic goiter and single or multiple toxic nodular goiter). The recommended dosage ranges of Na{sup 131}I capsules or solution for the therapy of the average patient (70 kg) are: (3.7-5.55) GBq for ablation of normal thyroid tissue; (3.7-7.4) GBq for subsequent treatments; a (148-370) MBq for hyperthyroidism. The purpose of this paper is to calculate effective dose as a result of iodine-131 capsules remaining in stomach before absorption starts. This result can determine the disadvantage of capsule versus solution containing sodium iodine-131 (Na{sup 131}I) in radionuclide therapy application from radiation protection point of view. The Monte Carlo code MCNP4b was used to model transport of gamma and beta particles emitted by radionuclide {sup 131}I treated as a point source at the bottom of stomach. Absorbed energy per unit transformation in stomach and surrounding organs has been calculated. (authors)

  13. The effectiveness of manual therapy in supraspinatus tendinopathy.

    Science.gov (United States)

    Şenbursa, Gamze; Baltaci, Gül; Atay, Ö Ahmet

    2011-01-01

    The aim of this randomized controlled study was to assess the efficacy of manual therapy in the treatment of patients with symptomatic supraspinatus tendinopathy. Seventy-seven patients (age range, 30 to 55 years) with supraspinatus tendinopathy, were randomly assigned to one of the three treatment groups: a supervised exercise program (Group 1), a supervised exercise program combined with joint and soft tissue mobilization (Group 2), or a home-based rehabilitation program (Group 3). All patients had rehabilitation for 12 weeks. Pain level was evaluated with a visual analogue scale (VAS) and the range of motion (ROM) was measured with a goniometer. The Modified American Shoulder and Elbow Surgery (MASES) score was used in functional assessment. Flexion, abduction, internal and external rotation strengths were measured with a manual muscle test. All patients were evaluated before, and at the 4th and 12th week of the rehabilitation. All groups experienced significant decrease in pain and an increase in shoulder muscle strength and function by both the 4th and 12th weeks of treatment (p0.05). However, the greatest improvement in functionality was found in Group 2. Supervised exercise, supervised and manual therapy, and home-based exercise are all effective and promising methods in the rehabilitation of the patients with subacromial impingement syndrome. The addition of an initial manual therapy may improve the results of the rehabilitation with exercise.

  14. The Effect of Coaching on a Faith Community Volunteer's Use of Effective Teaching Behaviors

    Science.gov (United States)

    Baggerman, Melanie A.; Ault, Melinda Jones; Collins, Belva C.; Spriggs, Amy D.; Slocum, Victoria

    2015-01-01

    An important part of quality of life for people with moderate and severe disabilities (MSDs) is being involved in extracurricular and community activities. However, volunteers, who may not have experience with including people with MSDs, lead most community activities. The purpose of this study was to demonstrate the effectiveness of teacher…

  15. The effect of radiation therapy on hemophilic arthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jin Oh; Hong, Seong Eon; Kim, Sang Gi; Shin, Dong Oh [School of Medicine, KyungHee University, Seoul (Korea, Republic of)

    2005-06-15

    Repetitive bleeding into the joint space is the cause of debilitative hemophilic arthropathy. To interrupt this process, we treated the hemophilic patients suffering from repetitive joint bleeding with radiation therapy. From 1997 to 2001, a total of 41 joints from 37 hemophilic arthropathy patients were treated with radiation therapy at KyungHee University Hospital. The treated joints were 35 ankles, 3 knees and 3 elbows, respectively. The age of the patients ranged from 4 to 27 years (median age: 11 years). The radiation dose ranged from 900 cGy to 2360 cGy (median dose: 900 cGy). The fraction size was 150 cGy, 180 cGy or 200 cGy. The number of bleeding in one year before and after radiotherapy was compared. There was a tendency of frequent bleeding for the patients younger than 11 ({rho} 0.051) but there was also a tendency for more improvement in this group ({rho} 0.057). The number of joint bleedings was related with joint pain ({rho} 0.012) and joint swelling ({rho} = 0.033) but not with the Arbold-Hilgartner stage ({rho} 0.739),cartilage destruction ({rho} = 0.718) and synovial hypertrophy ({rho} = 0.079). The number of bleeding was reduced in thirty-three cases, and eight cases showed no improvement after radiation therapy. The average number of bleeding in a month was 2.52 before radiotherapy, but this was reduced to 1.4 after radiotherapy ({rho} = 0.017). Radiation therapy was effective for the hemophilia patients with repetitive joint bleeding to decrease the bleeding frequency and to prevent hemophilic arthropathy.

  16. Effect of levothyroxine therapy on hypertension in hypothyroid patients

    Directory of Open Access Journals (Sweden)

    A K Kapoor

    2012-01-01

    Full Text Available The aim of this study was to observe whether levothyroxine replacement therapy has an effect on hypertension in patients of hypothyroidism. This prospective study included all newly diagnosed cases of hypothyroidism (overt or subclinical with hypertension, of either sex between 21-70 years of age. Levothyroxine replacement therapy was administered continuously during study period. Patients were clinically assessed for blood pressure before and every 3-4 monthly on levothyroxine therapy. Statistical analysis was carried out using a paired Student’s t-test. During one year study period, out of 180 newly diagnosed hypothyroid cases enrolled, 88 had overt hypothyroidism (OH and 92 subclinical hypothyroidism (SH. Male: female ratio was 1: 6.5. Of these, hypertension was present in 51 (28.33% patients (33 OH and 18 SH. Only diastolic blood pressure was raised in 28(54.9% cases, systolic in 12 (23.53% and both systolic and diastolic in 11 (21.57% cases. Incidence of only diastolic hypertension was comparatively more in overt hypothyroidism (57.57% than subclinical hypothyroidism (50%. Complete reversal of hypertension was observed in 8 out of 17 SH and 18 out of 29 OH cases while partial reversal was noted in one case in each category. A statistically significant decrease in mean values of both systolic and diastolic blood pressure was observed in patients of SH as well as OH. Hypertension is fairly common in patients of hypothyroidism. Replacement therapy with levothyroxine is quite helpful in reversing hypertension, a potential cardiovascular risk factor.

  17. Effects of pesticides on community composition and activity of sediment microbes - responses at various levels of microbial community organization

    Energy Technology Data Exchange (ETDEWEB)

    Widenfalk, Anneli [Department of Environmental Assessment, Swedish University of Agricultural Sciences, P.O. Box 7050, SE-750 07 Uppsala (Sweden)], E-mail: anneli.widenfalk@kemi.se; Bertilsson, Stefan [Limnology/Department of Ecology and Evolution, Evolutionary Biology Centre, Uppsala University, Norbyvaegen 20, SE-752 36 Uppsala (Sweden); Sundh, Ingvar [Department of Microbiology, Swedish University of Agricultural Sciences, P.O. Box 7025, SE-750 07 Uppsala (Sweden); Goedkoop, Willem [Department of Environmental Assessment, Swedish University of Agricultural Sciences, P.O. Box 7050, SE-750 07 Uppsala (Sweden)

    2008-04-15

    A freshwater sediment was exposed to the pesticides captan, glyphosate, isoproturon, and pirimicarb at environmentally relevant and high concentrations. Effects on sediment microorganisms were studied by measuring bacterial activity, fungal and total microbial biomass as community-level endpoints. At the sub-community level, microbial community structure was analysed (PLFA composition and bacterial 16S rRNA genotyping, T-RFLP). Community-level endpoints were not affected by pesticide exposure. At lower levels of microbial community organization, however, molecular methods revealed treatment-induced changes in community composition. Captan and glyphosate exposure caused significant shifts in bacterial community composition (as T-RFLP) at environmentally relevant concentrations. Furthermore, differences in microbial community composition among pesticide treatments were found, indicating that test compounds and exposure concentrations induced multidirectional shifts. Our study showed that community-level end points failed to detect these changes, underpinning the need for application of molecular techniques in aquatic ecotoxicology. - Molecular techniques revealed pesticide-induced changes at lower levels of microbial community organization that were not detected by community-level end points.

  18. Effectiveness of using ultrasound therapy and manual therapy in the conservative treatment of calcaneal spur – pilot study

    OpenAIRE

    Twarowska Natalia; Niemierzycka Agnieszka

    2016-01-01

    Introduction: Calcaneal spur is a pathology of the fibrocartilage enthesis of the Achilles tendon and plantar fascia or a pathology of the mixed enthesis of the flexor digitorum brevis muscle. Ultrasound therapy is commonly applied in the conservative treatment of a calcaneal spur. Foot muscle strengthening exercises, stretching exercises and soft tissue therapy are indicated as effective methods of conservative treatment. The aim of the study was to compare and assess the effects of ultrasou...

  19. Effects of ozone therapy on facial nerve regeneration.

    Science.gov (United States)

    Ozbay, Isa; Ital, Ilker; Kucur, Cuneyt; Akcılar, Raziye; Deger, Aysenur; Aktas, Savas; Oghan, Fatih

    Ozone may promote moderate oxidative stress, which increases antioxidant endogenous systems. There are a number of antioxidants that have been investigated therapeutically for improving peripheral nerve regeneration. However, no previous studies have reported the effect of ozone therapy on facial nerve regeneration. We aimed to evaluate the effect of ozone therapy on facial nerve regeneration. Fourteen Wistar albino rats were randomly divided into two groups with experimental nerve crush injuries: a control group, which received saline treatment post-crush, and an experimental group, which received ozone treatment. All animals underwent surgery in which the left facial nerve was exposed and crushed. Treatment with saline or ozone began on the day of the nerve crush. Left facial nerve stimulation thresholds were measured before crush, immediately after crush, and after 30 days. After measuring nerve stimulation thresholds at 30 days post-injury, the crushed facial nerve was excised. All specimens were studied using light and electron microscopy. Post-crushing, the ozone-treated group had lower stimulation thresholds than the saline group. Although this did not achieve statistical significance, it is indicative of greater functional improvement in the ozone group. Significant differences were found in vascular congestion, macrovacuolization, and myelin thickness between the ozone and control groups. Significant differences were also found in axonal degeneration and myelin ultrastructure between the two groups. We found that ozone therapy exerted beneficial effect on the regeneration of crushed facial nerves in rats. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  20. Glyphosate effects on soil rhizosphere-associated bacterial communities.

    Science.gov (United States)

    Newman, Molli M; Hoilett, Nigel; Lorenz, Nicola; Dick, Richard P; Liles, Mark R; Ramsier, Cliff; Kloepper, Joseph W

    2016-02-01

    Glyphosate is one of the most widely used herbicides in agriculture with predictions that 1.35 million metric tons will be used annually by 2017. With the advent of glyphosate tolerant (GT) cropping more than 10 years ago, there is now concern for non-target effects on soil microbial communities that has potential to negatively affect soil functions, plant health, and crop productivity. Although extensive research has been done on short-term response to glyphosate, relatively little information is available on long-term effects. Therefore, the overall objective was to investigate shifts in the rhizosphere bacterial community following long-term glyphosate application on GT corn and soybean in the greenhouse. In this study, rhizosphere soil was sampled from rhizoboxes following 4 growth periods, and bacterial community composition was compared between glyphosate treated and untreated rhizospheres using next-generation barcoded sequencing. In the presence or absence of glyphosate, corn and soybean rhizospheres were dominated by members of the phyla Proteobacteria, Acidobacteria, and Actinobacteria. Proteobacteria (particularly gammaproteobacteria) increased in relative abundance for both crops following glyphosate exposure, and the relative abundance of Acidobacteria decreased in response to glyphosate exposure. Given that some members of the Acidobacteria are involved in biogeochemical processes, a decrease in their abundance could lead to significant changes in nutrient status of the rhizosphere. Our results also highlight the need for applying culture-independent approaches in studying the effects of pesticides on the soil and rhizosphere microbial community. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Effects of trampling limitation on coastal dune plant communities.

    Science.gov (United States)

    Santoro, Riccardo; Jucker, Tommaso; Prisco, Irene; Carboni, Marta; Battisti, Corrado; Acosta, Alicia T R

    2012-03-01

    Sandy coastlines are sensitive ecosystems where human activities can have considerable negative impacts. In particular, trampling by beach visitors is a disturbance that affects dune vegetation both at the species and community level. In this study we assess the effects of the limitation of human trampling on dune vegetation in a coastal protected area of Central Italy. We compare plant species diversity in two recently fenced sectors with that of an unfenced area (and therefore subject to human trampling) using rarefaction curves and a diversity/dominance approach during a two year study period. Our results indicate that limiting human trampling seems to be a key factor in driving changes in the plant diversity of dune systems. In 2007 the regression lines of species abundance as a function of rank showed steep slopes and high Y-intercept values in all sectors, indicating a comparable level of stress and dominance across the entire study site. On the contrary, in 2009 the regression lines of the two fenced sectors clearly diverge from that of the open sector, showing less steep slopes. This change in the slopes of the tendency lines, evidenced by the diversity/dominance diagrams and related to an increase in species diversity, suggests the recovery of plant communities in the two fences between 2007 and 2009. In general, plant communities subject to trampling tended to be poorer in species and less structured, since only dominant and tolerant plant species persisted. Furthermore, limiting trampling appears to have produced positive changes in the dune vegetation assemblage after a period of only two years. These results are encouraging for the management of coastal dune systems. They highlight how a simple and cost-effective management strategy, based on passive recovery conservation measures (i.e., fence building), can be a quick (1–2 years) and effective method for improving and safeguarding the diversity of dune plant communities.

  2. Effects of photodynamic therapy on rapidly growing nontuberculous mycobacteria keratitis.

    Science.gov (United States)

    Shih, Min-Hsiu; Huang, Fu-Chin

    2011-01-05

    The authors investigated the antimicrobial effect of methylene blue (MB)-mediated photodynamic therapy (PDT) on Mycobacterium fortuitum keratitis. In the in vitro study, the mycobacterial suspension and colonies were treated with the following: no MB, no light (normal control); MB and no light (dye control); light and no MB (light control); MB and light (PDT). Morphologic characteristics were examined by transmission electron microscopy. The bactericidal effects of combined PDT and antibiotic therapy (ciprofloxacin, moxifloxacin, and amikacin) were determined using the broth microdilution technique. Twenty-one rabbits with Mycobacterium keratitis were randomly divided into three groups (no treatment, topical amikacin treatment, and PDT combined with amikacin treatment). The clinical features of keratitis were scored and graded before treatment and before euthanatization. The diseased corneas were trephined for quantitative bacteriologic analysis to determine the antibacterial efficacy of the treatment. In the in vitro tests, the bacterial count had a 2-log reduction immediately after PDT treatment at 100 J/cm(2) with 10(-3)% MB. After PDT at 100 J/cm(2) with 10(-2)% MB, almost no viable bacteria were detected. PDT had a synergistic antimicrobial effect in combination with antibiotics. The phototoxicity occurred in the cytoplasm first and then disrupted the mycobacterial cell walls by lysis. In the rabbit keratitis model, combined PDT resulted in significantly less bacterial burden (P PDT against Mycobacterium fortuitum. PDT could be a potential alternative treatment for nontuberculous mycobacterial corneal infections.

  3. [Identifying predictive factors for therapy nonadherence among hypertensive, older adults from a community in southern Chile].

    Science.gov (United States)

    Mendoza-Parra, Sara; Merino, José Manuel; Barriga, Omar A

    2009-02-01

    To identify the predictive factors associated with therapy nonadherence among hypertensive older adults, based on functional dependency, memory disorders, self-perceived wellbeing, abuse, and depression in an area of southern Chile. A quantitative, exploratory study of a sample of 211 hypertensive, older adults (29.1% of those being treated by the cardiovascular program at the Centro de Salud Familiar San Pedro, in the province of Concepción, del Bío Bío region, Chile). Seven instruments were applied: Pfeiffer's short mental status questionnaire, Yesavage's geriatric depression scale, the elder abuse screening scale, the morale scale of the Philadelphia Geriatric Center, the health behavior scale, the Lawton assessment of instrumental activities of daily living (ADL), and the Katz ADL index. Following an analysis of the important components, latent variables were identified. Two latent variables were identified: social connectedness-measured by the variables depression, abuse, and social satisfaction-and autonomy-measured by the variables mental health and ability to perform basic and instrumental ADLs. These latent variables accounted for 39.7% and 20.7% of nonadherence to therapy, respectively. The latent variables proposed here can be used as predictive factors for therapy nonadherence in elderly adults with arterial hypertension. Causes of nonadherence to therapy cannot be assessed solely at health care centers; but rather, an understanding of the home environment is needed and treatment should be adapted according to the needs that exist there.

  4. A qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique.

    Directory of Open Access Journals (Sweden)

    Freya Rasschaert

    Full Text Available BACKGROUND: To improve retention on ART, Médecins Sans Frontières, the Ministry of Health and patients piloted a community-based antiretroviral distribution and adherence monitoring model through Community ART Groups (CAG in Tete, Mozambique. By December 2012, almost 6000 patients on ART had formed groups of whom 95.7% were retained in care. We conducted a qualitative study to evaluate the relevance, dynamic and impact of the CAG model on patients, their communities and the healthcare system. METHODS: Between October 2011 and May 2012, we conducted 16 focus group discussions and 24 in-depth interviews with the major stakeholders involved in the CAG model. Audio-recorded data were transcribed verbatim and analysed using a grounded theory approach. RESULTS: Six key themes emerged from the data: 1 Barriers to access HIV care, 2 CAG functioning and actors involved, 3 Benefits for CAG members, 4 Impacts of CAG beyond the group members, 5 Setbacks, and 6 Acceptance and future expectations of the CAG model. The model provides cost and time savings, certainty of ART access and mutual peer support resulting in better adherence to treatment. Through the active role of patients, HIV information could be conveyed to the broader community, leading to an increased uptake of services and positive transformation of the identity of people living with HIV. Potential pitfalls included limited access to CAG for those most vulnerable to defaulting, some inequity to patients in individual ART care and a high dependency on counsellors. CONCLUSION: The CAG model resulted in active patient involvement and empowerment, and the creation of a supportive environment improving the ART retention. It also sparked a reorientation of healthcare services towards the community and strengthened community actions. Successful implementation and scalability requires (a the acceptance of patients as partners in health, (b adequate resources, and (c a well-functioning monitoring and

  5. A multicentre RCT on community occupational therapy in Alzheimer's disease: 10 sessions are not better than one consultation.

    Science.gov (United States)

    Voigt-Radloff, Sebastian; Graff, Maud; Leonhart, Rainer; Schornstein, Katrin; Jessen, Frank; Bohlken, Jens; Metz, Brigitte; Fellgiebel, Andreas; Dodel, Richard; Eschweiler, Gerhard; Vernooij-Dassen, Myrra; Olde Rikkert, Marcel; Hüll, Michael

    2011-08-09

    To compare the benefits and harms of a Dutch 10-session Community Occupational Therapy programme for patients with Alzheimer's disease with the impact of a one session consultation at home in German routine healthcare. A seven-centre, parallel group, active controlled randomised controlled trial. Patients and carers were not masked. Assessors were fully blind for treatment allocation for one of two primary-outcome measurements. Patients' homes. Patients with mild to moderate Alzheimer's disease (Mini-Mental State Examination 14-24), living in the community with primary carer available and without severe depression or behavioural symptoms, were eligible. Experimental 10 home visits within 5 weeks by an occupational therapist, educating patients in the performance of simplified daily activities and in the use of aids to compensate for cognitive decline; and educating carers in coping with behaviour of the patient and in giving supervision to the patient. Control one home visit including individual counselling of patient and carer and explanation of a leaflet on coping with dementia in daily life. The primary outcome was the patient's daily functioning measured with the Interview of Deterioration in Daily activities in Dementia and the Perceive, Recall, Plan and Perform System of Task Analysis. Assessments were at baseline, 6, 16 and 26 weeks, with a postal assessment at 52 weeks. 141 patients were 1:1 randomised to the experimental (N=71) and control group (N=70). Data for 54 and 50 participants were analysed. Patients' daily functioning did not differ significantly between the experimental and control group at week 6, 16, 26 or 52 and remained stable over 26 weeks in both groups. No adverse events were associated with the interventions. In German healthcare, a Dutch 10-session community occupational therapy was not better than a one-session consultation for the daily functioning of patients with Alzheimer's disease. Further research on the transfer of complex

  6. Effects of basic human values on host community acculturation orientations.

    Science.gov (United States)

    Sapienza, Irene; Hichy, Zira; Guarnera, Maria; Nuovo, Santo Di

    2010-08-01

    Although literature provides evidence for the relationship between values and acculturation, the relationship between host community acculturation orientations has not yet been investigated. In this study we tested the effects of four high-order values (openness to change, self-transcendence, conservation, and self-enhancement, devised according to Schwartz's model) on host community acculturation orientations towards immigrants (devised according the interactive acculturation model) in the public domain of employment and the private domain of endogamy/exogamy. Participants were 264 Italian University students, who completed a questionnaire containing the Portrait Values Questionnaire, a measure of personal values, and the Host Community Acculturation Scale, aimed at measuring Italian acculturation strategies towards three groups of immigrants: Immigrants (the general category), Chinese (the valued immigrant group), and Albanians (the devalued immigrant group). Results showed that personal values are related to the adoption of acculturation orientations: In particular, the values that mostly impacted on acculturation orientations were self-transcendence and conservation. Values concerning self-transcendence encourage the adoption of integrationism, integrationism-transformation, and individualism and reduce the adoption of assimilationism, segregationism, and exclusionism. Values concerning conservation encourage the adoption of assimilation, segregation and exclusion orientations and reduce the adoption of both types of integrationism and individualism. Minor effects were found regarding self-enhancement and openness to change.

  7. Effects of Radiation Therapy on Established Neurogenic Heterotopic Ossification.

    Science.gov (United States)

    Lee, Chan Ho; Shim, Su Jung; Kim, Hyun Jung; Yang, Hyuna; Kang, Youn Joo

    2016-12-01

    Heterotopic ossification (HO) is frequently seen on rehabilitation units after spinal cord injuries, fractures, brain injuries, and limb amputations. Currently, there is no effective treatment for HO other than prophylaxis with anti-inflammatory medications, irradiation, and bisphosphonate administration. These prophylactic treatments are not effective for managing ectopic bone once it has formed. Here we describe three cases of established neurogenic HO treated with radiation therapy (RT). All patients had decreased serum alkaline phosphatase (ALP) and bone-specific ALP levels with decreased pain but increased range of motion immediately after RT. Post-treatment X-rays revealed no further growth of the HO. All patients maintained clinical and laboratory improvements 4 or 6 months after the RT. Our results suggest that RT is safe and effective in decreasing pain and activity of neurogenic HO.

  8. Effects of Multidimensional Family Therapy (MDFT) on Nonopioid Drug Abuse:

    DEFF Research Database (Denmark)

    Filges, Trine; Andersen, Ditte; Jørgensen, Anne-Marie Klint

    2015-01-01

    trials. Meta-analytic methods were used to quantitatively synthesize study results.  Results: The search yielded five studies that met inclusion criteria. MDFT was found to be more effective than other treatments on drug abuse problem severity and drug use frequency in the short run but not in the long...... run and demonstrated positive effects on treatment retention compared to control conditions.  Discussion: While additional research is needed, the review offers support for MDFT as a treatment to young nonopioid drug abusers. The number of studies included in this review was limited, however......Purpose: This review evaluates the evidence of the effects of multidimensional family therapy (MDFT) on drug use reduction in young people for the treatment of nonopioid drug use.  Method: We followed Campbell Collaboration guidelines to conduct a systematic review of randomized and nonrandomized...

  9. The therapeutic effect of neurologic music therapy and speech language therapy in post-stroke aphasic patients.

    Science.gov (United States)

    Lim, Kil-Byung; Kim, Yong-Kyun; Lee, Hong-Jae; Yoo, Jeehyun; Hwang, Ji Youn; Kim, Jeong-Ah; Kim, Sung-Kyun

    2013-08-01

    To investigate the therapeutic effect of neurologic music therapy (NMT) and speech language therapy (SLT) through improvement of the aphasia quotient (AQ) in post-stroke aphasic patients. Twenty-one post-stroke, nonfluent aphasia patients who had ischemic/hemorrhagic stroke on radiologic evaluation were divided into the NMT and SLT groups. They received NMT and SLT for 1 month. Language function was assessed by Korean version-Western Aphasia Battery before and after therapy. NMT consisted of therapeutic singing and melodic intonation therapy, and SLT consisted of language-oriented therapy. Significant improvements were revealed in AQ, repetition, and naming after therapy in the NMT group and improvements in repetition in the SLT group of chronic stroke patients (p<0.05). There were significant improvements in language ability in the NMT group of subacute stroke patients. However, there was no significant improvement in the SLT group of subacute stroke patients. We concluded that the two therapies are effective treatments in the chronic stage of stroke and NMT is effective in subacute post-stroke aphasic patients.

  10. The effectiveness of art therapy in the treatment of traumatized adults: a systematic review on art therapy and trauma.

    Science.gov (United States)

    Schouten, Karin Alice; de Niet, Gerrit J; Knipscheer, Jeroen W; Kleber, Rolf J; Hutschemaekers, Giel J M

    2015-04-01

    Art therapy has often been applied in the treatment of traumatized adults, and good results in clinical practice have been reported. However, although art therapy experts underline these benefits, the effectiveness of art therapy in trauma treatment has not been established by systematic review. The aim of this systematic review is to identify and evaluate empirical evidence of the effectiveness of art therapy for trauma treatment. As a result of the systematic review, six controlled, comparative studies on art therapy for trauma in adult patients were found. In half of the included studies, a significant decrease in psychological trauma symptoms was found in the treatment groups, and one study reported a significant decrease in depression. Although there are limitations in the number of included studies, the number of participants, the heterogeneity of included studies, and their methodological quality, the results contribute to insight into the effectiveness of art therapy in trauma treatment and form an evidence base for the urgent need for further research on art therapy and trauma treatment. © The Author(s) 2014.

  11. Effectiveness of community-based football compared to usual care in men with prostate cancer

    DEFF Research Database (Denmark)

    Bjerre, Eik; Bruun, Ditte Marie; Tolver, Anders

    2016-01-01

    has been suggested and previously studies have shown improvements of disease specific quality of life and a reduction in treatment-related toxicity. Cohort studies with long term follow up have suggested that physical activity is associated with improved survival in prostate cancer patients......, whole body and regional bone markers, as well as physical activity and functional capacity at 12 weeks and six months. Safety outcome variables will be falls resulting in seeking medical assessment and fractures during the six-month period. DISCUSSION: Football is viewed as a case for non....... Previously one randomised controlled trial has examined the efficacy of football in prostate cancer patients undergoing androgen deprivation therapy to usual care and reported positive effects on lean body mass and bone markers. Against this background, we wish to examine the effectiveness of community...

  12. Restoration of a temperate reef: Effects on the fish community

    DEFF Research Database (Denmark)

    Støttrup, Josianne; Stenberg, Claus; Dahl, Karsten

    2014-01-01

    Trindel in Kattegat, Denmark, has now been re-established with the aim of restoring the reef’s historical structure and function. The effects of the restoration on the local fish community are reported here. Fishing surveys using gillnets and fyke nets were conducted before the restoration (2007) and four...... years after the restoration of the reef (2012). Species of the family Labridae, which have a high affinity for rocky reefs, dominated both before and after the restoration. Commercially important species such as cod Gadus morhua, and saithe Pollachius virens, occurred infrequently in the catches in 2007....... The findings highlight the importance of reef habitats for fish communities and the need for their protection...

  13. Empirical third-generation cephalosporin therapy for adults with community-onset Enterobacteriaceae bacteraemia: Impact of revised CLSI breakpoints.

    Science.gov (United States)

    Hsieh, Chih-Chia; Lee, Chung-Hsun; Li, Ming-Chi; Hong, Ming-Yuan; Chi, Chih-Hsien; Lee, Ching-Chi

    2016-04-01

    Third-generation cephalosporins (3GCs) [ceftriaxone (CRO) and cefotaxime (CTX)] have remarkable potency against Enterobacteriaceae and are commonly prescribed for the treatment of community-onset bacteraemia. However, clinical evidence supporting the updated interpretive criteria of the Clinical and Laboratory Standards Institute (CLSI) is limited. Adults with community-onset monomicrobial Enterobacteriaceae bacteraemia treated empirically with CRO or CTX were recruited. Clinical information was collected from medical records and CTX MICs were determined using the broth microdilution method. Eligible patients (n=409) were categorised into de-escalation (260; 63.6%), no switch (115; 28.1%) and escalation (34; 8.3%) groups according to the type of definitive antibiotics. Multivariate regression revealed five independent predictors of 28-day mortality: fatal co-morbidities based on McCabe classification [odds ratio (OR)=19.96; PCLSI breakpoints) were not associated with mortality. Furthermore, clinical failure and 28-day mortality rates had a tendency to increase with increasing CTX MIC (γ=1.00; P=0.01). Conclusively, focusing on patients with community-onset Enterobacteriaceae bacteraemia receiving empirical 3GC therapy, the present study provides clinically critical evidence to validate the proposed reduction in the susceptibility breakpoint of CTX to MIC≤1mg/L. Copyright © 2016 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  14. The effectiveness of Multisystemic Therapy (MST): a meta-analysis.

    Science.gov (United States)

    van der Stouwe, Trudy; Asscher, Jessica J; Stams, Geert Jan J M; Deković, Maja; van der Laan, Peter H

    2014-08-01

    Multisystemic Therapy (MST) is a well-established intervention for juvenile delinquents and/or adolescents showing social, emotional and behavioral problems. A multilevel meta-analysis of k=22 studies, containing 332 effect sizes, consisting of N=4066 juveniles, was conducted to examine the effectiveness of MST. Small but significant treatment effects were found on delinquency (primary outcome) and psychopathology, substance use, family factors, out-of-home placement and peer factors, whereas no significant treatment effect was found for skills and cognitions. Moderator analyses showed that study characteristics (country where the research was conducted, efficacy versus effectiveness, and study quality), treatment characteristics (single versus multiple control treatments and duration of MST treatment), sample characteristics (target population, age, gender and ethnicity) and outcome characteristics (non-specific versus violent/non-violent offending, correction for pretreatment differences, and informant type) moderated the effectiveness of MST. MST seems most effective with juveniles under the age of 15, with severe starting conditions. Furthermore, the effectiveness of MST may be improved when treatment for older juveniles is focused more on peer relationships and risks and protective factors in the school domain. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Effects of oral motor therapy in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Seray Nural Sigan

    2013-01-01

    Full Text Available Aim: Oral motor dysfunction is a common issue in children with cerebral palsy (CP. Drooling, difficulties with sucking, swallowing, and chewing are some of the problems often seen. In this study, we aimed to research the effect of oral motor therapy on pediatric CP patients with feeding problems. Materials and Methods: Included in this single centered, randomized, prospective study were 81 children aged 12-42 months who had been diagnosed with CP, had oral motor dysfunction and were observed at the Pediatric Neurology outpatient clinic of the Children′s Health and Diseases Department, Istanbul Medical Faculty, Istanbul University. Patients were randomized into two groups: The training group and the control group. One patient from the training group dropped out of the study because of not participating regularly. Following initial evaluation of all patients by a blinded physiotherapist and pedagogue, patients in the training group participated in 1 h oral motor training sessions with a different physiotherapist once a week for 6 months. All patients kept on routine physiotherapy by their own physiotherapists. Oral motor assessment form, functional feeding assessment (FFA subscale of the multidisciplinary feeding profile (MFP and the Bayley scales of infant development (BSID-II were used to evaluate oral motor function, swallowing, chewing, the gag reflex, the asymmetrical tonic neck reflex, tongue, jaw, and mouth function, severity of drooling, aspiration, choking, independent feeding and tolerated food texture during the initial examination and 6 months later. Results: When the initial and post-therapy FFA and BSID-II scores received by patients in the training and the study group were compared, the training group showed a statistically significant improvement (P < 0.05. Conclusion: Oral motor therapy has a beneficial effect on feeding problems in children with CP.

  16. Effect of Vision Therapy on Accommodation in Myopic Chinese Children

    Directory of Open Access Journals (Sweden)

    Martin Ming-Leung Ma

    2016-01-01

    Full Text Available Introduction. We evaluated the effectiveness of office-based accommodative/vergence therapy (OBAVT with home reinforcement to improve accommodative function in myopic children with poor accommodative response. Methods. This was a prospective unmasked pilot study. 14 Chinese myopic children aged 8 to 12 years with at least 1 D of lag of accommodation were enrolled. All subjects received 12 weeks of 60-minute office-based accommodative/vergence therapy (OBAVT with home reinforcement. Primary outcome measure was the change in monocular lag of accommodation from baseline visit to 12-week visit measured by Shinnipon open-field autorefractor. Secondary outcome measures were the changes in accommodative amplitude and monocular accommodative facility. Results. All participants completed the study. The lag of accommodation at baseline visit was 1.29 ± 0.21 D and it was reduced to 0.84 ± 0.19 D at 12-week visit. This difference (−0.46 ± 0.22 D; 95% confidence interval: −0.33 to −0.58 D is statistically significant (p<0.0001. OBAVT also increased the amplitude and facility by 3.66 ± 3.36 D (p=0.0013; 95% confidence interval: 1.72 to 5.60 D and 10.9 ± 4.8 cpm (p<0.0001; 95% confidence interval: 8.1 to 13.6 cpm, respectively. Conclusion. Standardized 12 weeks of OBAVT with home reinforcement is able to significantly reduce monocular lag of accommodation and increase monocular accommodative amplitude and facility. A randomized clinical trial designed to investigate the effect of vision therapy on myopia progression is warranted.

  17. [Comparing the effects of drug therapy, physical therapy, and exercise on pain, disability, and depression in patients with chronic low back pain].

    Science.gov (United States)

    Ko, Ja Kyung

    2007-08-01

    This research was conducted to compare the effects of drug therapy, physical therapy, and exercise on pain, disability, and depression in patients with chronic low back pain. The research design of this study was a nonequivalent control group pretest-posttest design. The subjects of this study were 28 patients for the drug therapy & physical therapy, 24 patients for the drug therapy & exercise, and 22 patients for the physical therapy & exercise. Data was collected by MVAS, Oswestry disability questionnaires, and questionnaires of depression. It was analyzed by paired t-test for effectiveness, ANOVA, and Scheffe for comparison of the effects of the 3 experimental treatments, using SPSS/WIN 12.0. There were no effects of drug therapy & physical therapy on pain, disability, and depression. However, there were effects of drug therapy & exercise and the physical therapy & exercise on pain, disability, and depression. The effects of physical therapy & exercise on pain, disability, and depression were the greatest, but there was no statistically significant differences between the drug therapy & exercise and the physical therapy & exercise. Exercise is regarded as a more effective and easily accessible nursing intervention to apply alone than drug therapy or physical therapy simultaneously in reducing pain, disability and depression.

  18. Leadership Strategies for Community College Effectiveness: Outcomes of the North Carolina Community College Presidents' Leadership Institute. A Technical Report.

    Science.gov (United States)

    Campbell, Dale F.; And Others

    Developed as a result of the North Carolina Community College President's Leadership Institute, this volume discusses the successful use of selected adaptive strategies to enhance community college effectiveness. Following information on the Institute and an overview of the volume, most of the remaining chapters review the work of prominent…

  19. The Experiences of Occupational Therapy Clinicians as Educators: The Community College Context

    Science.gov (United States)

    Cline, Nichelle Lea

    2012-01-01

    The purpose of this qualitative study was to explore the clinical fieldwork educator role in the community college from the perspective of the clinician. While there are numerous fieldwork studies from the perspectives of the students and the academic institutions, there is a paucity of literature regarding the meaning that fieldwork educators…

  20. Revised SWAB guidelines for antimicrobial therapy of community-acquired pneumonia

    NARCIS (Netherlands)

    Schouten, JA; Prins, JM; Bonten, MJ; Degener, J; Janknegt, RE; Hollander, JMR; Jonkers, RE; Wijnands, WJ; Verheij, TJ; Sachs, APE; Kullberg, BJ

    The Dutch Working Party on Antibiotic Policy (SWAB) develops evidence-based guidelines, aimed at optimalisation of antibiotic use and limitation of the spread of antimicrobial resistance. A revision of the SWAB guideline for the treatment of community-acquired pneumonia (CAP), published in 1998, was

  1. Trace metal availability and effects on benthic community structure in floodplain lakes

    NARCIS (Netherlands)

    Griethuysen, van C.; Baren, van J.; Peeters, E.T.H.M.; Koelmans, A.A.

    2004-01-01

    Effects of contaminants on communities are difficult to assess and poorly understood. We analyzed in situ effects of trace metals and common environmental variables on benthic macroinvertebrate communities in floodplain lakes. Alternative measures of trace metal availability were evaluated,

  2. Cognitive Training for Dementia Patients in the Community & Art Therapy Programs of 'Goyang Centenarian's Good Memory School'.

    Science.gov (United States)

    Lee, Wang-jun

    2016-01-01

    Myong Ji Hospital has launched the 'public health Service project team' for the first time in Korea as a private institution to carry forward and administer public health projects and services in a more structured way. Notably, Goyang Centenarian's Good Memory School has deliberately provided various art therapy programs to those who have a high risk of dementia in pursuit of promoting dementia prevention, and maintaining a positive mind and healthy body for any required daily activities for senior living. Participating patients have expressed remarkable satisfaction, and the art therapy programs have not only shown the effectiveness of strengthening the mental status of the cognitively-impaired patients but have also proposed a feasible non-pharmacological therapy option, which promotes the quality of their daily living and lowers the burden for their caregivers.

  3. Effect of hyperbaric oxygen therapy on complete blood count.

    Science.gov (United States)

    Gunes, Ali Erdal; Aktas, Samil

    2017-01-01

    Complete blood count (CBC) is a routine diagnostic procedure for patients and a part of routine health inspection for healthy individuals. The effect of hyperbaric oxygen (HBO₂) on CBC is not known. The objective of this study was to determine the effects of HBO₂ on blood parameters in CBC with long-term HBO₂ therapy. In this study, patients received HBO₂ at the department of Underwater and Hyperbaric Clinical Medicine. CBC results were obtained at specific time points during HBO₂ therapy. The study recruited a total of 140 patients who met the research inclusion criteria. Patients were treated for 55.5 ± 41 days. During the treatment period, they underwent HBO₂ sessions for an average of 35.9 ± 24.9 times. Five groups were created as follows: before the treatment; between 1-20 sessions; between 21-40 sessions; between 41-60 sessions; and more than 60 sessions. The results of the present study showed that a number of alterations occurred in CBC values in patients who received HBO₂. HBO₂ reduces the number of platelets, but this was not clinically significant. According to the results, HBO₂ does not have any effect on hemoglobin, hematocrit, red blood cells, mean corpuscular volume, mean corpuscular hemoglobin, red blood cell distribution width, mean corpuscular hemoglobin concentration, platelet count, platelet distribution width and mean platelet volume. Except for a temporary reduction in platelet count, HBO₂ has no effect on CBC parameters. Medical professionals may use the outcome of this study in their routine examinations, as it suggests that the changes in CBC driven by HBO₂ are not statistically significant, and could be disregarded. More research is needed to examine the effects of HBO₂ on other blood parameters. Copyright© Undersea and Hyperbaric Medical Society.

  4. Assessment of the effects of massage therapy on premenstrual syndrome

    Directory of Open Access Journals (Sweden)

    Leily Ghaedi

    2011-05-01

    Full Text Available Background: Premenstrual syndrome is characterized by the cyclic occurrence physical, psychological and behavioral symptoms during the luteal phase of the menstruation cycle and will be disappear within a few days of the onset of menstruation. The aim of this research was to assess the effect of massage therapy on premenstrual syndrome. Materials and Method: A randomized clinical trial was carried out on 30 volunteer students of Tehran University with PMS diagnosis. After surveying two menstruation cycles and confirming PMS existence, subjects were randomly assigned into massage and control group. Massage protocol was performed for eight weeks. Volunteers completed Daily Symptom Rating (DSR during 2 cycles before and 2 cycles after intervention. Data collected via data gathering form, criteria for PMS (DSM- IV, DSR and Beck test. Data were analyzed by descriptive and analytic statistics (χ2, Fischer's exact test, paired and independent t tests.Results: In comparison between before and after intervention, massage group showed significant decrease averagely in mean of somatic (56.7%, psychological (64.8% (p<0.001.This is while, in control group only mean of somatic symptoms (averagely 21.2% relieved obviously (p=0.02. comparing two groups often intervention, we did not found any significant difference in mean of somatic symptoms while psychological (p=0.01 and total symptoms (p=0.03 in massage group was significantly less than controls.Conclusion: The authors concluded that massage therapy is an effective method for relieving symptoms of premenstrual syndrome

  5. Late Effects of Radiation Therapy in Pediatric Cancer Survivors.

    Science.gov (United States)

    Arain, Abeer; Herman, Terence; Matthiesen, Chance

    2015-04-01

    The overall survival rates of many pediatric cancers continue to improve with each decade due to new advances in therapy. As this trend continues, the focus and importance of minimizing acute and long-term toxicity associated with treatment is paramount. While significant research regarding many of the late responses of normal tissues associated with radiation exposure has been established, future endeavors must be directed toward the identification of therapy related factors including radiation total dose, dose rate, exposure, and target treatment volumes. Awareness of short and long-term health risks of these patients is important and careful follow-up of long-term survivors is essential. In this report, we review some selected late adverse effects including the development of secondary malignancies, cardiotoxicity, physiological changes to glandular tissue, hormonal and reproductive changes to germ cells, and neurocognitive changes. Furthermore, we compared the differences regarding late effects of normal tissues associated with the use of proton versus photon radiotherapy, a topic that has received a great deal of attention in pediatric cancer and is increasing in utilization in the United States and world-wide.

  6. Selection for niche differentiation in plant communities increases biodiversity effects.

    Science.gov (United States)

    Zuppinger-Dingley, Debra; Schmid, Bernhard; Petermann, Jana S; Yadav, Varuna; De Deyn, Gerlinde B; Flynn, Dan F B

    2014-11-06

    In experimental plant communities, relationships between biodiversity and ecosystem functioning have been found to strengthen over time, a fact often attributed to increased resource complementarity between species in mixtures and negative plant-soil feedbacks in monocultures. Here we show that selection for niche differentiation between species can drive this increasing biodiversity effect. Growing 12 grassland species in test monocultures and mixtures, we found character displacement between species and increased biodiversity effects when plants had been selected over 8 years in species mixtures rather than in monocultures. When grown in mixtures, relative differences in height and specific leaf area between plant species selected in mixtures (mixture types) were greater than between species selected in monocultures (monoculture types). Furthermore, net biodiversity and complementarity effects were greater in mixtures of mixture types than in mixtures of monoculture types. Our study demonstrates a novel mechanism for the increase in biodiversity effects: selection for increased niche differentiation through character displacement. Selection in diverse mixtures may therefore increase species coexistence and ecosystem functioning in natural communities and may also allow increased mixture yields in agriculture or forestry. However, loss of biodiversity and prolonged selection of crops in monoculture may compromise this potential for selection in the longer term.

  7. Effectiveness of Cognitive-Behavioral Therapy and Physical Therapy for Provoked Vestibulodynia: A Randomized Pilot Study.

    Science.gov (United States)

    Goldfinger, Corrie; Pukall, Caroline F; Thibault-Gagnon, Stephanie; McLean, Linda; Chamberlain, Susan

    2016-01-01

    Non-medical and non-surgical treatments for provoked vestibulodynia target psychological, sexual, and pelvic floor muscle factors that maintain the condition. The goal of the study was to compare the effects of cognitive-behavioral therapy (CBT) and physical therapy (PT) on pain and psychosexual outcomes in women with provoked vestibulodynia. In a clinical trial, 20 women with provoked vestibulodynia were randomly assigned to receive CBT or comprehensive PT. Participants were assessed before treatment, after treatment, and at 6-month follow-up by gynecologic examination, structured interviews, and standardized questionnaires measuring pain, psychological, and sexual variables. Outcome measurements were based on an adaptation of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials recommendations. The primary outcome was change in intercourse pain intensity. Secondary outcomes included pain during the cotton swab test, pain with various sexual and non-sexual activities, and sexual functioning and negative pain cognitions. The two treatment groups demonstrated significant decreases in vulvar pain during sexual intercourse, with 70% and 80% of participants in the CBT and PT groups demonstrating a moderate clinically important decrease in pain (≥30%) after treatment. Participants in the two groups also had significant improvements in pain during the gynecologic examination, the percentage of painful intercourse attempts, the percentage of activities resulting in pain, and the ability to continue intercourse without stopping because of pain. Psychological outcomes, including pain catastrophizing and perceived control over pain, also showed improvement in the two groups. Significant improvements in sexual functioning were observed only in participants who completed CBT. Few between-group differences were identified other than the PT group showing earlier improvements in some outcomes. Nearly all improvements were maintained at the 6-month

  8. Effect of photodynamic therapy on clinical isolates of Staphylococcus spp.

    Science.gov (United States)

    Miyabe, Michelle; Junqueira, Juliana Campos; Costa, Anna Carolina Borges Pereira da; Jorge, Antonio Olavo Cardoso; Ribeiro, Martha Simões; Feist, Ilíria Salomão

    2011-01-01

    Staphylococcus spp. are opportunistic microorganisms known for their capacity to develop resistance against antimicrobial agents. The objective of this study was to evaluate the effect of photodynamic therapy (PDT) on 20 Staphylococcus strains isolated from the human oral cavity, including S. aureus, S. schleiferi, S. epidermidis, S. capitis, S. haemolyticus, and S. lentus. A suspension of each Staphylococcus strain (10(6) cells/mL) was submitted to PDT using methylene blue and a low power laser. The isolated effects of methylene blue, laser treatment and ciprofloxacin were also evaluated. After the experimental treatments, 0.1 mL aliquots of the suspensions were seeded onto BHI agar for determination of the number of colony-forming units (CFU/mL). The results were analyzed by analysis of variance and Tukey's test (p Staphylococcus isolates studied.

  9. The effect of mindfulness-based therapy for cancer patients

    DEFF Research Database (Denmark)

    Piet, Jacob

    Objective: The use of mindfulness-based therapy (MBT) in oncology settings has become increasingly popular, and research in the field has rapidly expanded. The objective was by means of a systematic review and meta-analysis to evaluate the current evidence for the effect of MBT on symptoms...... of anxiety and depression in adult cancer patients and survivors. Method: Electronic databases were searched, and researchers were contacted for further relevant studies. Twenty-two independent studies with a total of 1,403 participants were included. Studies were coded for quality (range: 0–4), and overall......) and 0.44 for symptoms of depression (p .001). These effect sizes appeared robust. Furthermore, in RCTs, MBT significantly improved mindfulness skills (Hedges’s g0.39). Conclusion: While the overall quality of existing clinical trials varies considerably, there appears to be some positive evidence from...

  10. Developing a Referral Protocol for Community-Based Occupational Therapy Services in Taiwan: A Logistic Regression Analysis.

    Science.gov (United States)

    Mao, Hui-Fen; Chang, Ling-Hui; Tsai, Athena Yi-Jung; Huang, Wen-Ni; Wang, Jye

    2016-01-01

    Because resources for long-term care services are limited, timely and appropriate referral for rehabilitation services is critical for optimizing clients' functions and successfully integrating them into the community. We investigated which client characteristics are most relevant in predicting Taiwan's community-based occupational therapy (OT) service referral based on experts' beliefs. Data were collected in face-to-face interviews using the Multidimensional Assessment Instrument (MDAI). Community-dwelling participants (n = 221) ≥ 18 years old who reported disabilities in the previous National Survey of Long-term Care Needs in Taiwan were enrolled. The standard for referral was the judgment and agreement of two experienced occupational therapists who reviewed the results of the MDAI. Logistic regressions and Generalized Additive Models were used for analysis. Two predictive models were proposed, one using basic activities of daily living (BADLs) and one using instrumental ADLs (IADLs). Dementia, psychiatric disorders, cognitive impairment, joint range-of-motion limitations, fear of falling, behavioral or emotional problems, expressive deficits (in the BADL-based model), and limitations in IADLs or BADLs were significantly correlated with the need for referral. Both models showed high area under the curve (AUC) values on receiver operating curve testing (AUC = 0.977 and 0.972, respectively). The probability of being referred for community OT services was calculated using the referral algorithm. The referral protocol facilitated communication between healthcare professionals to make appropriate decisions for OT referrals. The methods and findings should be useful for developing referral protocols for other long-term care services.

  11. Developing a Referral Protocol for Community-Based Occupational Therapy Services in Taiwan: A Logistic Regression Analysis.

    Directory of Open Access Journals (Sweden)

    Hui-Fen Mao

    Full Text Available Because resources for long-term care services are limited, timely and appropriate referral for rehabilitation services is critical for optimizing clients' functions and successfully integrating them into the community. We investigated which client characteristics are most relevant in predicting Taiwan's community-based occupational therapy (OT service referral based on experts' beliefs. Data were collected in face-to-face interviews using the Multidimensional Assessment Instrument (MDAI. Community-dwelling participants (n = 221 ≥ 18 years old who reported disabilities in the previous National Survey of Long-term Care Needs in Taiwan were enrolled. The standard for referral was the judgment and agreement of two experienced occupational therapists who reviewed the results of the MDAI. Logistic regressions and Generalized Additive Models were used for analysis. Two predictive models were proposed, one using basic activities of daily living (BADLs and one using instrumental ADLs (IADLs. Dementia, psychiatric disorders, cognitive impairment, joint range-of-motion limitations, fear of falling, behavioral or emotional problems, expressive deficits (in the BADL-based model, and limitations in IADLs or BADLs were significantly correlated with the need for referral. Both models showed high area under the curve (AUC values on receiver operating curve testing (AUC = 0.977 and 0.972, respectively. The probability of being referred for community OT services was calculated using the referral algorithm. The referral protocol facilitated communication between healthcare professionals to make appropriate decisions for OT referrals. The methods and findings should be useful for developing referral protocols for other long-term care services.

  12. Engineering effect of Pinna nobilis shells on benthic communities

    Directory of Open Access Journals (Sweden)

    Lotfi Rabaoui

    2015-07-01

    Full Text Available Within the framework of the possibility of using the Mediterranean pen shell Pinna nobilis in restoration and conservation plans of benthic habitats, an in situ experiment was conducted using empty P. nobilis shells. The latter were transplanted in a bare soft-bottomed area and their associated fauna were followed along 120 days and compared at different temporal points and with the assemblages living in the surrounding soft-sediment area. Compared to soft-sediment communities, an evidently increasing succession of species richness, abundance, and diversity descriptors (Shannon-Wiener H′ and Pielou's evenness J′ was observed with the community inhabiting empty Pinna shells. Among the forty-five (45 species found in association with the transplanted empty shells, seventeen (17 were found constantly in the three temporal points; the other twenty-eight (28 species appeared in the samples collected in the second and/or third sampling time. While motile and sessile species associated to Pinna shells showed an increasing pattern of appearance and abundance along the experiment time, those of soft sediment remained almost constant. The comparison between Pinna shells and soft-sediment associated communities showed that the species richness was slightly different between the two different sample types (49 for soft sediment versus 45 for empty Pinna shells; however the total abundance was found more important with empty Pinna shells. The results obtained herein argue in favor of the important engineering effect of P. nobilis in soft benthic habitats and therefore for the necessity of its conservation.

  13. Feasibility and effectiveness of two community-based HIV testing models in rural Swaziland.

    Science.gov (United States)

    Parker, Lucy Anne; Jobanputra, Kiran; Rusike, Lorraine; Mazibuko, Sikhathele; Okello, Velephi; Kerschberger, Bernhard; Jouquet, Guillaume; Cyr, Joanne; Teck, Roger

    2015-07-01

    To evaluate the feasibility (population reached, costs) and effectiveness (positivity rates, linkage to care) of two strategies of community-based HIV testing and counselling (HTC) in rural Swaziland. Strategies used were mobile HTC (MHTC) and home-based HTC (HBHTC). Information on age, sex, previous testing and HIV results was obtained from routine HTC records. A consecutive series of individuals testing HIV-positive were followed up for 6 months from the test date to assess linkage to care. A total of 9 060 people were tested: 2 034 through MHTC and 7 026 through HBHTC. A higher proportion of children and adolescents (<20 years) were tested through HBHTC than MHTC (57% vs. 17%; P < 0.001). MHTC reached a higher proportion of adult men than HBHTC (42% vs. 39%; P = 0.015). Of 398 HIV-positive individuals, only 135 (34%) were enrolled in HIV care within 6 months. Of 42 individuals eligible for antiretroviral therapy, 22 (52%) started treatment within 6 months. Linkage to care was lowest among people who had tested previously and those aged 20-40 years. HBHTC was 50% cheaper (US$11 per person tested; $797 per individual enrolled in HIV care) than MHTC ($24 and $1698, respectively). In this high HIV prevalence setting, a community-based testing programme achieved high uptake of testing and appears to be an effective and affordable way to encourage large numbers of people to learn their HIV status (particularly underserved populations such as men and young people). However, for community HTC to impact mortality and incidence, strategies need to be implemented to ensure people testing HIV-positive in the community are linked to HIV care. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  14. Community

    African Journals Online (AJOL)

    study community related the mode of transmíssion to the bite of infective mosquitoes and 43.7% of ... mosquitoes. Mosquitoes are mainly believed to bite human beings at night (73,2%), breed in stagnant water (71%) and rest in dark places inside houses during daytime (44.3%). ... Maize and enset (false banana) are the.

  15. [Effects of Group Cognitive Behavioral Therapy on Social Anxiety Disorders].

    Science.gov (United States)

    Li, Yu-Chen; Meng, Ya-Jing; Yuan, Min-Lan; Zhu, Hong-Ru; Ren, Zheng-Jia; Qiu, Chang-Jian; Zhang, Wei

    2017-11-01

    To evaluate the effect of group cognitive behavioral therapy (GCBT) on social anxiety disorders (SAD). A total of 50 patients with SAD were recruited in this study. A survey containing the Liebowitz social anxiety scale (LSAS),the automatic thoughts questionnaire (ATQ),the fear of negative evaluation questionnaire (FNE),the social support rating scale (SSRS),the tridimensional personality questionnaire (TPQ),and the egna minnen barndoms uppfostran (EMBU) was administered before and (one week) after the GCBT,including in the 50 healthy controls. About 21 patients completed the eight-week GCBT (once a week,2 h a session). Follow-up surveys were conducted on 40 patients (22 patients treated with GCBT and 18 untreated) over a 1-5 year period. Significant differences were found between the SAD patients and healthy controls in thinking mode,personality characteristics,social support,parental rearing styles,and social anxiety symptoms. Significant decrease in social anxiety symptom ( t =4.06, P =0.000) , negative automatic thoughts ( t =4.58, P =0.000) and fear for rejection ( t =3.85, P =0.000) were observed after the GCBT therapy. Such improvement was positively correlated with subjective social support ( r =0.361, P =0.022) ,and negatively correlated with rejection of father ( r =-0.431, P =0.005) . There was also statistical difference between the patients with and without the GCBT therapy ( P =0.033) . GCBT treatment can relieve SAD symptoms by changing the negative cognitive of SAD patients. Social support and rejection of father affects the prognosis of SAD.

  16. [Effect of the music-therapy under spinal anesthesia].

    Science.gov (United States)

    Maeyama, Akihiko; Kodaka, Mitsuharu; Miyao, Hideki

    2009-06-01

    Since no pre-medication has been widely accepted especially in spinal anesthesia, anesthesiologists should manage the control of patient's anxiety during surgery. Instead of sedatives, we have been using music-therapy during spinal anesthesia. Bispectral index monitoring (BIS) is used as one of the sedation indices in spinal anesthesia. The aim of this study was to assess the music-therapy on reducing anxiety of patients under spinal anesthesia using BIS and interview type psychology test, State Trait Anxiety Inventory (STAI). Fifty-eight ASA physical status I-II patients scheduled for spinal anesthesia, were randomly allocated into M group (music group, n=29) or C group (control, n=29). BIS, EMG, and SQI of both groups were obtained continuously with computer system. Patients in M group listened to music by head phone and those in C group were left free under ordinary operating theater environment. Trait Anxiety Inventory (STAI-TA) score was obtained preoperatively for property-based anxiety and the State Anxiety Inventory (STAI-SA) score was obtained postoperatively for condition-based anxiety. Time averaged BIS scores (pre-surgery, during-surgery and post-surgery period)were obtained during operation. Time averaged BIS values of M and C group in pre-surgery period, during-surgery period, and post-surgery period were 95.3+/-0.4 vs 95.8+/-0.4 (NS), 87.6+/-7.5 vs 95.1+/-2.8 (Pscores of both groups were not different. Music-therapy reduced BIS value and was effective to reduce patient's anxiety during spinal anesthesia.

  17. [Effect of combined application of ozone therapy and gravitational therapy on the remote results of complex treatment of geriatric patients].

    Science.gov (United States)

    Makarov, I V; Shchukin, Yu V; Lukashova, A V

    2017-01-01

    The article presents the remote results of treatment of an obliterating atherosclerosis of arteries of the lower extremities of the II stage at patients of advanced and senile age after the combined use of ozone therapy and gravitational therapy. We performed a prospective randomized study in three parallel groups (139 patients). The 1st group (n=57) received standard medical therapy in combination with ozone therapy; the group was divided into two subgroups: for patients of subgroup 1a (n=28) - intravenous ozonized physiological solution was performed, for patients of subgroup 1b (n=29) - major ozonized autohemotherapy. For patients of the 2nd group (n=62) - a comprehensive treatment, including gravitational therapy in addition to medical ozone, was carried out. In this group were also identified two subgroups: subgroup 2a (n=31) - patients received standard medical therapy in combination with ozonized physiological solution and gravitational therapy, subgroup 2b (n=31) - standard medical therapy in conjunction with major ozonized autohemotherapy and gravitational therapy. The 3rd control group (n=20) included patients, who received only standard medical therapy. Dynamics of changes of a stage of a disease and the number of surgeries in the remote period was estimated (up to 7 years). After 6 months of follow-on stages of the distribution of the disease patients significantly (p>0,05) did not differ from the initial amount. Analysis of survival and probable risk at 7 years of follow-Cox regression method revealed a maximum efficiency in the subgroup 2a where the risk of probability of surgeries and also increases in a stage of a disease effectively decreased.

  18. Cognitive effects of calligraphy therapy for older people: a randomized controlled trial in Hong Kong

    Directory of Open Access Journals (Sweden)

    Kwok TCY

    2011-10-01

    Full Text Available Timothy CY Kwok1,2, Xue Bai1,3, Henry SR Kao4,5, Jessie CY Li1, Florence KY Ho11Jockey Club Centre for Positive Ageing; 2Department of Medicine and Therapeutics, The Chinese University of Hong Kong; 3Department of Social Work and Social Administration; 4Department of Psychology, The University of Hong Kong, Hong Kong; 5Department of Psychology, Fu Jen Catholic University, TaiwanBackground: This pilot study investigated the effects of calligraphy therapy on cognitive function in older Hong Kong Chinese people with mild cognitive impairment.Methods: A single-blind, randomized controlled trial was carried out in a sample of 31 adults aged 65 years or older with mild cognitive impairment. They were randomly assigned to receive either intensive calligraphy training led by a trained research assistant for eight weeks (calligraphy group, n = 14 or no calligraphy treatment (control group, n = 17. Participants' cognitive function was assessed by the Chinese version of the Mini-Mental State Examination (CMMSE before and after calligraphy treatment. Repeated measures analysis of variance and paired samples t-tests were used to analyze the data.Results: A significant interaction effect of time and intervention was detected [F (1, 29 = 9.11, P = 0.005, η2= 0.24]. The calligraphy group was found to have a prominent increase in CMMSE global score, and scores in the cognitive areas of orientation, attention, and calculation after two months (∆M = 2.36, P < 0.01, whereas their counterparts in the control group experienced a decline in CMMSE score (∆M = -0.41, P < 0.05.Conclusion: Calligraphy therapy was effective for enhancing cognitive function in older people with mild cognitive impairment and should be incorporated as part of routine programs in both community and residential care settings.Keywords: calligraphy therapy, Chinese elderly, mild cognitive impairment, cognitive function, randomized controlled trial

  19. Current principles of effective therapy for ovarian cancer

    Directory of Open Access Journals (Sweden)

    L. A. Ashrafyan

    2015-01-01

    Full Text Available In spite of all of modern medicine»s advances, ovarian cancer (OC mortality remains to be incommensurably high and to hold the lead among gynecological cancers. The initial cause of this deplorable statistics is the absence of a clear concept of the pathogenesis of OC and hence the justified prevention and methodology of early diagnosis of the disease; in this connection, therapy that proves to be ineffective is frequently used by medical oncologists in their daily practice. As a consequence, there is a high proportion of its further progression: the rates of early and late recurrences were about 30 and 60–65 %, respectively; most of which are drug resistant to further chemotherapy cycles. By taking into account these strikingly modest statistics, it becomes apparent that oncologists desire to make changes in the existing treatment regimen to achieve meaningful results. To use target drugs is one of these promising areas owing to new views on the concept of the pathogenesis of OC.Nevertheless, considering a wide variety of the signaling cascades and molecules, which are involved in the process of carcinogenesis, even target compounds, if they have only one point of application, cannot always produce their desirable therapeutic effect and their co-administration is responsible for high toxicity. In this light, the most effective drugs are indole-3-carbinol and epigallocathechin-3-gallate, which virtually cause no adverse reactions and can block various molecular targets at different levels of the mechanism of malignant transformation. Based on L. A. Ashrafyan, s concept of two pathogenetic variants of sporadic OC (2009 and on the recent findings in molecular biology and epigenetics, the incorporation of the above medications into the standard treatment regimen for OC should increase survival rates and change the nature of recurrence by that of more locally advanced forms. On this basis, a clinical trial was carried out to study

  20. Management of plant communities on set-aside land and its effects on earthworm communities

    NARCIS (Netherlands)

    Gormsen, D.; Hedlund, K.; Korthals, G.W.; Mortimer, S.R.; Pizl, V.; Smilauerova, M.; Sugg, E.

    2004-01-01

    Plant communities of set-aside agricultural land in a European project were managed in order to enhance plant succession towards weed-resistant, mid-successional grassland. Here, we ask if the management of a plant community affects the earthworm community. Field experiments were established in four

  1. Zidovudine therapy: Effect(s) on histology of the kidney of wister rats ...

    African Journals Online (AJOL)

    This study investigated the histo-morphological effect(s) of Zidovudine therapy on the kidney of Wister rats. Fifteen Wistar rats obtained from the Animal house of the College of Medicine, Ambrose Alli University, Ekpoma, Edo State, Nigeria, were used for this study. A three week period of acclimatisation was allowed.

  2. Clinical and economic consequences of failure of initial antibiotic therapy for patients with community-onset complicated intra-abdominal infections.

    Directory of Open Access Journals (Sweden)

    Yong Pil Chong

    Full Text Available Complicated intra-abdominal infection (cIAI is infection that extends beyond the hollow viscus of origin into the peritoneal space, and is associated with either abscess formation or peritonitis. There are few studies that have assessed the actual costs and outcomes associated with failure of initial antibiotic therapy for cIAI. The aims of this study were to evaluate risk factors and impact on costs and outcomes of failure of initial antibiotic therapy for community-onset cIAI.A retrospective study was performed at eleven tertiary-care hospitals. Hospitalized adults with community-onset cIAI who underwent an appropriate source control procedure between August 2008 and September 2011 were included. Failure of initial antibiotic therapy was defined as a change of antibiotics due to a lack of improvement of the clinical symptoms and signs associated with cIAI in the first week.A total of 514 patients hospitalized for community-onset cIAI were included in the analysis. The mean age of the patients was 53.3 ± 17.6 years, 72 patients (14% had health care-associated infection, and 48 (9% experienced failure of initial antibiotic therapy. Failure of initial antibiotic therapy was associated with increased costs and morbidity. After adjustment for covariates, patients with unsuccessful initial therapy received an additional 2.9 days of parenteral antibiotic therapy, were hospitalized for an additional 5.3 days, and incurred $3,287 in additional inpatient charges. Independent risk factors for failure of initial antibiotic therapy were health care-associated infection, solid cancer, and APACHE II ≥13.To improve outcomes and costs in patients with community-onset cIAI, rapid assessment of health care-associated risk factors and severity of disease, selection of an appropriate antibiotic regimen accordingly, and early infection source control should be performed.

  3. Effects of Community African Drumming on Generalised Anxiety in Teenagers

    OpenAIRE

    David Akombo

    2013-01-01

    The purpose of this study was to test the effects of community music projects (CMPs), such as after-school African drumming circles, on academic performance and generalised anxiety in adolescents. Adolescents from a Junior High (7th, 8th, and 9th graders, age range from 12-14) in the State of Utah (USA) participated in the study. A one-sample t-test found a significant difference in reading scores (df(4) p=.004). A paired samples t-test found a significant relationship between the maths trait...

  4. Effect of physical therapy on breast cancer related lymphedema

    DEFF Research Database (Denmark)

    Tambour, Mette; Tange, Berit; Christensen, Robin Daniel Kjersgaard

    2014-01-01

    BACKGROUND: Physical therapy treatment of patients with lymphedema includes treatment based on the principles of 'Complete Decongestive Therapy' (CDT). CDT consists of the following components; skin care, manual lymphatic drainage, bandaging and exercises. The scientific evidence regarding what...

  5. Anticancer effects of lactoferrin: underlying mechanisms and future trends in cancer therapy.

    Science.gov (United States)

    Zhang, Yunlei; Lima, Cristovao F; Rodrigues, Ligia R

    2014-12-01

    Lactoferrin has been widely studied over the last 70 years, and its role in diverse biological functions is now well known and generally accepted by the scientific community. Usually, alterations of the lactoferrin gene in cells are associated with an increased incidence of cancer. Several studies suggest that exogenous treatment with lactoferrin and its derivatives can efficiently inhibit the growth of tumors and reduce susceptibility to cancer. None of these studies, however, reported a consistent outcome with regard to the mechanisms underlying the anticancer effects of lactoferrin. In this review, the association of lactoferrin with cancer is thoroughly discussed, from lactoferrin gene expression to the potential use of lactoferrin in cancer therapy. Lactoferrin cytotoxicity against several cancers is reported to occur in distinct ways under different conditions, namely by cell membrane disruption, apoptosis induction, cell cycle arrest, and cell immunoreaction. Based on these mechanisms, new strategies to improve the anticancer effects of the lactoferrin protein and/or its derivatives are proposed. The potential for lactoferrin in the field of cancer research (including as a chemotherapeutic agent in cancer therapy) is also discussed. © 2014 International Life Sciences Institute.

  6. How to Effectively Use Bismuth Quadruple Therapy: The Good, the Bad, and the Ugly.

    Science.gov (United States)

    Graham, David Y; Lee, Sun-Young

    2015-09-01

    Bismuth triple therapy was the first effective Helicobacter pylori eradication therapy. The addition of a proton pump inhibitor helped overcome metronidazole resistance. Its primary indication is penicillin allergy or when clarithromycin and metronidazole resistance are both common. Resistance to the primary first-line therapy have centered on complexity and difficulties with compliance. Understanding regional differences in effectiveness remains unexplained because of the lack of studies including susceptibility testing and adherence data. We discuss regimen variations including substitutions of doxycycline, amoxicillin, and twice a day therapy and provide suggestions regarding what is needed to rationally and effectively use bismuth quadruple therapy. Published by Elsevier Inc.

  7. The effects of lip bumper therapy in the mixed dentition.

    Science.gov (United States)

    Davidovitch, M; McInnis, D; Lindauer, S J

    1997-01-01

    A prospective clinical trial was undertaken to study the effects of 6 months of continuous lip bumper therapy on patients in the mixed dentition with mild-to-moderate mandibular arch perimeter deficiency. Thirty-four patients, ages 7.9 to 13.1 years (mean = 10.2), seeking treatment in the postgraduate orthodontic clinic of the Medical College of Virginia, presented possessing 3 to 8 mm of mandibular crowding, with both mandibular primary second molars, were randomly placed in either the treatment or nontreatment group. Treated subjects underwent continuous lip bumper therapy, whereas the control subjects were monitored without undergoing any active treatment, each for 6 months. Arch dimension changes were assessed with study models. Alterations of mandibular incisor position were measured from lateral cephalometric radiographs. Mandibular left permanent first molar position changes were determined from both lateral cephalometric and tomographic radiographs, with the resolution of each imaging technique in measuring molar tooth movement also compared. It was found that significant differences in mandibular incisor inclination, molar position, arch length, and arch perimeter existed between treated and untreated subjects. In addition, multiple observer analysis showed that cephalometric examination lacks sensitivity when used to measure molar movement.

  8. Effects of a laser acupuncture therapy on treating pain

    Science.gov (United States)

    Wong, Wai-on; Xiao, Shaojun; Ip, Wing-Yuk; Guo, Xia

    2001-10-01

    Laser acupuncture (LA) has been utilized as a combined approach of Chinese traditional acupuncture and low-level laser therapy since its emergence in 1973. Its mechanisms are not well understood and the standardization of clinical protocols has not been established. In this study, we used a diode laser to irradiate on four acupuncture points for normal subjects to investigate the effect of LA. For each point, the irradiation lasted for three minutes. The median nerve conduction velocity was measured within a 30 minutes interval at day 1, day 5, and day 10 respectively. Patients with chronic carpal tunnel syndrome (CTS) were given LA therapy for three stages at most with a one-week interval between two stages. Treatment outcome measurements included patients' subjective feedback (McGill pain questionnaire, VAS) and objective measurements (physical examination, kinesiological properties and NCSs). It was a randomized single-blind controlled trial. For normal subjects, motor nerve fiber was sensitive to LA and the motor conduction velocity was decreased very significantly (p received LA application. For CTS patients, the outcomes except pinch test indicated that LA could improve patient's conduction. These results suggested that LA could cause the change of nerve conduction.

  9. People With Cerebral Palsy: Effects of and Perspectives for Therapy

    Science.gov (United States)

    Mayston, Margaret J.

    2001-01-01

    The movement disorder of cerebral palsy (CP) is expressed in a variety of ways and to varying degrees in each individual. The condition has become more complex over the last 20 years with the increasing survival of children born at less than 28 to 30 weeks gestationai age. Impairments present in children with CP as a direct result of the brain injury or occurring indirectly to compensate for underlying problems include abnormal muscle tone; weakness and lack of fitness; limited variety of muscle synergies; contracture and altered biomechanics, the net result being limited functional ability. Other contributors to the motor disorder include sensory, cognitive and perceptual impairments. In recent years understanding of the motor problem has increased, but less is known about effects of therapy. Evidence suggests that therapy can improve functional possibilities for children with cerebral palsy but is inconclusive as to which approach might be most beneficial. The therapist requires an understanding of the interaction of all systems, cognitive/perceptual, motor, musculoskeletal, sensory and behavioral, in the context of the development and plasticity of the CNS. It is necessary to understand the limitations of the damaged immature nervous system, but important to optimize the child's functional possibilities. PMID:11530888

  10. Early and Late Onset Side Effects of Photodynamic Therapy

    Directory of Open Access Journals (Sweden)

    Francesco Borgia

    2018-01-01

    Full Text Available Photodynamic Therapy (PDT is a non-invasive treatment successfully used for neoplastic, inflammatory and infectious skin diseases. One of its strengths is represented by the high safety profile, even in elderly and/or immuno-depressed subjects. PDT, however, may induce early and late onset side effects. Erythema, pain, burns, edema, itching, desquamation, and pustular formation, often in association with each other, are frequently observed in course of exposure to the light source and in the hours/days immediately after the therapy. In particular, pain is a clinically relevant short-term complication that also reduces long-term patient satisfaction. Rare complications are urticaria, contact dermatitis at the site of application of the photosensitizer, and erosive pustular dermatosis. Debated is the relationship between PDT and carcinogenesis: the eruptive appearance of squamous cell carcinoma (SCC in previously treated areas has been correlated to a condition of local and/or systemic immunosuppression or to the selection of PDT-resistant SCC. Here we review the literature, with particular emphasis to the pathogenic hypotheses underlying these observations.

  11. Effect of interstitial low level laser therapy on tibial defect

    Science.gov (United States)

    Lee, Sangyeob; Ha, Myungjin; Hwang, Donghyun; Yu, Sungkon; Jang, Seulki; Park, Jihoon; Radfar, Edalat; Kim, Hansung; Jung, Byungjo

    2016-03-01

    Tibial defect is very common musculoskeletal disorder which makes patient painful and uncomfortable. Many studies about bone regeneration tried to figure out fast bone healing on early phase. It is already known that low level laser therapy (LLLT) is very convenient and good for beginning of bone disorder. However, light scattering and absorption obstruct musculoskeletal therapy which need optimal photon energy delivery. This study has used an interstitial laser probe (ILP) to overcome the limitations of light penetration depth and scattering. Animals (mouse, C57BL/6) were divided into three groups: laser treated test group 1 (660 nm; power 10 mW; total energy 5 J) and test group 2 (660 nm; power 20 mW; total energy 10 J); and untreated control group. All animals were taken surgical operation to make tibial defect on right crest of tibia. The test groups were treated every 48 hours with ILP. Bone volume and X-ray attenuation coefficient were measured on 0, 14th and 28th day with u-CT after treatment and were used to evaluate effect of LLLT. Results show that bone volume of test groups has been improved more than control group. X-ray attenuation coefficients of each groups have slightly different. The results suggest that LLLT combined with ILP may affect on early phase of bone regeneration and may be used in various musculoskeletal disease in deep tissue layer.

  12. Effects of chronic prednisone therapy on mood and memory.

    Science.gov (United States)

    Brown, E Sherwood; Vera, Elizabeth; Frol, Alan B; Woolston, Dixie J; Johnson, Brandy

    2007-04-01

    In animals, stress and corticosteroids can be associated with both reversible and irreversible changes in the hippocampus. Changes in memory and hippocampal structure, perhaps in part due to cortisol elevations, are reported in some patients with mood disorders. Minimal data are available on the effects of long-term exposure to corticosteroids on the human hippocampus. We previously reported greater depressive symptom severity, poorer memory and smaller hippocampal volumes in patients with asthma or rheumatic diseases receiving long-term prednisone therapy than in controls. In this report, patients and controls were assessed a mean of 4 years after the first assessment to determine if depressive and manic symptoms and cognition remained stable, improved or worsened. Seven prednisone-treated patients and six controls were identified and agreed to reassessment with psychiatric symptom and neurocognitive measures. Follow-up MRIs for hippocampal volume analysis were available for two prednisone-treated participants. With the exception of an increase in depressive symptoms in those receiving prednisone, participants and controls did not show significant change in mood or cognition from the initial assessment. One participant discontinued prednisone and showed improvement in psychiatric symptoms and cognition. Hippocampal volumes were available in two prednisone-treated participants and showed inconsistent findings. A limitation is the small sample size. Our findings, although preliminary in nature, suggest that long-term prednisone therapy is associated with initial changes in mood, memory and hippocampal volume that appear to stabilize over time.

  13. Cutaneous side-effects during therapy of melanoma by vemurafenib

    Directory of Open Access Journals (Sweden)

    Anna Ankudowicz

    2015-06-01

    Full Text Available Introduction. Vemurafenib is a selective inhibitor of serine-threonine kinase BRAF used in the treatment of advanced melanoma with BRAF mutation. Effectiveness of this drug was confirmed in a large clinical trial, which led to the increase of its usage. During treatment with vemurafenib, particular attention should be paid to the numerous side effects, including those concerning the skin. Vemurafenib is highly toxic to the skin. Skin lesions occurring during the treatment of melanoma with this medicament can be divided into: early (observed 3 to 6 weeks after beginning treatment, late (observed 6 weeks after beginning treatment and hypersensitivity reactions to vemurafenib. Objective. Presentation of vemurafenib toxic effects on the skin and side effects that can be caused by this drug. Case report. We present a 58-year-old woman with metastatic melanoma who was treated with vemurafenib. During the course of therapy, numerous adverse reactions, including inflammatory tumors, emergence of a number of melanocytic naevi, skin horns, alopecia, hyperkeratosis of the palms and soles, and palmar erythrodysesthesia were observed. She was treated with anti-inflammatory drugs, an antibiotic, circulation-improving preparations and local moisturizing and keratolytic treatment. The patient remains under the care of oncologists and dermatologists. Conclusions. The new generation anti-cancer drugs bring hope for a cure or prolongation of life, but can also significantly reduce the quality of life by inducing both general and local adverse side effects. Oncological patients should also be taken care of by dermatologists.

  14. The Pros and Cons of Getting Engaged in an Online Social Community Embedded Within Digital Cognitive Behavioral Therapy for Insomnia: Survey Among Users

    OpenAIRE

    Coulson, Neil S.; Smedley, Richard; Bostock, Sophie; Kyle, Simon D.; Gollancz, Rosie; Luik, Annemarie I.; Hames, Peter; Espie, Colin

    2016-01-01

    Background Sleepio is a proven digital sleep improvement program based on cognitive behavioral therapy techniques. Users have the option to join an online community that includes weekly expert discussions, peer-to-peer discussion forums, and personal message walls. Objective The aim of this study was to conduct an online survey to (1) explore the reasons for deciding to engage with the Sleepio online community, (2) explore the potential benefits arising from engagement with the online communi...

  15. Efficacy and Safety of Adjunctive Corticosteroids Therapy for Severe Community-Acquired Pneumonia in Adults: An Updated Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Bi, Jirui; Yang, Jin; Wang, Ying; Yao, Cijiang; Mei, Jing; Liu, Ying; Cao, Jiyu; Lu, Youjin

    2016-01-01

    Adjunctive corticosteroids therapy is an attractive option for community-acquired pneumonia (CAP) treatment. However, the effectiveness of adjunctive corticosteroids on mortality of CAP remains inconsistent, especially in severe CAP. We performed a meta-analysis to evaluate the efficacy and safety of adjunctive corticosteroids in severe CAP patients. Three databases of PubMed, EMBASE and Cochrane Library were searched for related studies published in English up to December, 2015. Randomized controlled trials (RCTs) of corticosteroids in hospitalized adults with severe CAP were included. Meta-analysis was performed by a random-effect model with STATA 11.0 software. We estimated the summary risk ratios (RRs) or effect size (ES) with its corresponding 95% confidence interval (95%CI) to assess the outcomes. We included 8 RCTs enrolling 528 severe CAP patients. Adjunctive corticosteroids significantly reduced all-cause mortality (RR = 0.46, 95%CI: 0.28 to 0.77, p = 0.003), risk of adult respiratory distress syndrome (ARDS) (RR = 0.23, 95%CI: 0.07 to 0.80, p = 0.02) and need for mechanical ventilation (RR = 0.50, 95%CI: 0.27 to 0.92, p = 0.026). Adjunctive corticosteroids did not increase frequency of hyperglycemia requiring treatment (RR = 1.03, 95%CI: 0.61 to 1.72, p = 0.91) or gastrointestinal hemorrhage (RR = 0.66, 95%CI: 0.19 to 2.31, p = 0.52). In subgroup analysis by duration of corticosteroids, we found that prolonged corticosteroids therapy significantly reduced all-cause mortality (RR = 0.41, 95%CI: 0.20 to 0.83, p = 0.01) and length of hospital stay (-4.76 days, 95% CI:-8.13 to -1.40, p = 0.006). Results from this meta-analysis suggested that adjunctive corticosteroids therapy was safe and beneficial for severe CAP. In addition, prolonged corticosteroids therapy was more effective. These results should be confirmed by adequately powered studies in the future.

  16. Agroforestry management in vineyards: effects on soil microbial communities

    Science.gov (United States)

    Montagne, Virginie; Nowak, Virginie; Guilland, Charles; Gontier, Laure; Dufourcq, Thierry; Guenser, Josépha; Grimaldi, Juliette; Bourgade, Emilie; Ranjard, Lionel

    2017-04-01

    Some vineyard practices (tillage, chemical weeding or pest management) are generally known to impact the environment with particular negative effects on the diversity and the abundance of soil microorganisms, and cause water and soil pollutions. In an agro-ecological context, innovative cropping systems have been developed to improve ecosystem services. Among them, agroforestry offers strategies of sustainable land management practices. It consists in intercropping trees with annual/perennial/fodder crop on the same plot but it is weakly referenced with grapevine. The present study assesses the effects of intercropped and neighbouring trees on the soil of three agroforestry vineyards, in south-western France regions. More precisely soils of the different plots were sampled and the impact of the distance to the tree or to the neighbouring trees (forest) on soil microbial community has been considered. Indigenous soil microbial communities were characterized by a metagenomic approach that consisted in extracting the molecular microbial biomass, then in calculating the soil fungi/bacteria ratio - obtained by qPCR - and then in characterizing the soil microbial diversity - through Illumina sequencing of 16S and 18S regions. Our results showed a significant difference between the soil of agroforestry vineyards and the soil sampled in the neighbouring forest in terms of microbial abundance and diversity. However, only structure and composition of bacterial community seem to be influenced by the implanted trees in the vine plots. In addition, the comparison of microbial co-occurrence networks between vine and forest plots as well as inside vine plots according to distance to the tree allow revealing a more sensitive impact of agroforestry practices. Altogether, the results we obtained build up the first references for concerning the soil of agroforestry vineyards which will be interpreted in terms of soil quality, functioning and sustainability.

  17. Effective recruitment of minority populations through community-led strategies.

    Science.gov (United States)

    Horowitz, Carol R; Brenner, Barbara L; Lachapelle, Susanne; Amara, Duna A; Arniella, Guedy

    2009-12-01

    Traditional research approaches frequently fail to yield representative numbers of people of color in research. Community-based participatory research (CBPR) may be an important strategy for partnering with and reaching populations that bear a greater burden of illness but have been historically difficult to engage. The Community Action Board, consisting of 20 East Harlem residents, leaders, and advocates, used CBPR to compare the effectiveness of various strategies in recruiting and enrolling adults with prediabetes into a peer-led, diabetes prevention intervention. The board created five recruitment strategies: recruiting through clinicians; recruiting at large public events such as farmers markets; organizing special local recruitment events; recruiting at local organizations; and recruiting through a partner-led approach, in which community partners developed and managed the recruitment efforts at their sites. In 3 months, 555 local adults were approached; 249 were appropriate candidates for further evaluation (overweight, nonpregnant, East Harlem residents without known diabetes); 179 consented and returned in a fasting state for 1/2 day of prediabetes testing; 99 had prediabetes and enrolled in a pilot randomized trial. The partner-led approach was highly successful, recruiting 68% of those enrolled. This strategy was also the most efficient; 34% of those approached through partners were ultimately enrolled, versus 0%-17% enrolled through the other four strategies. Participants were predominantly low-income, uninsured, undereducated, Spanish-speaking women. This CBPR approach highlights the value of partner-led recruitment to identify, reach out to, and motivate a vulnerable population into participation in research, using techniques that may be unfamiliar to researchers but are nevertheless rigorous and effective.

  18. The survey for pharmacist in community pharmacy concerning the usefullness of oral rehydration therapy (ORT) in self-medication and the state of sales of products for ORT.

    Science.gov (United States)

    Morimoto, Yasuko; Harada, Shinichi; Nakamoto, Kazuo; Tokuyama, Shogo

    2013-01-01

    The usefulness as one of the tools for self-medication of oral rehydration therapy (ORT), recommended as a safe and effective therapy for mild to moderate dehydration, was surveyed by questionnaire for pharmacists in community pharmacies. ORT products were sold in 112 pharmacies (61%), and the common product was OS-1(®). Approximately 50% of sellers answered that they had no particular difficulty in explaining ORT. Percentage to answer "hard to describe" is significantly higher in pharmacists who believe there is a need to consider underlying health conditions of customers or patients when implementing ORT. Around 77% of pharmacists considered ORT to be useful in patients as a method of self-medication. A significant number of pharmacists selling ORT products depends on the consultation from customers or patients and provide advice to them confirming that ORT was useful. From these results, it was suggested that further information concerning ORT, such as its use in patients with chronic disorders or signs for completion, and the initiative of pharmacists to participate are necessary for spread the efficacy of ORT for self-medication in patients.

  19. Effect of Reiki therapy on pain and anxiety in adults: an in-depth literature review of randomized trials with effect size calculations.

    Science.gov (United States)

    Thrane, Susan; Cohen, Susan M

    2014-12-01

    The objective of this study was to calculate the effect of Reiki therapy for pain and anxiety in randomized clinical trials. A systematic search of PubMed, ProQuest, Cochrane, PsychInfo, CINAHL, Web of Science, Global Health, and Medline databases was conducted using the search terms pain, anxiety, and Reiki. The Center for Reiki Research also was examined for articles. Studies that used randomization and a control or usual care group, used Reiki therapy in one arm of the study, were published in 2000 or later in peer-reviewed journals in English, and measured pain or anxiety were included. After removing duplicates, 49 articles were examined and 12 articles received full review. Seven studies met the inclusion criteria: four articles studied cancer patients, one examined post-surgical patients, and two analyzed community dwelling older adults. Effect sizes were calculated for all studies using Cohen's d statistic. Effect sizes for within group differences ranged from d = 0.24 for decrease in anxiety in women undergoing breast biopsy to d = 2.08 for decreased pain in community dwelling adults. The between group differences ranged from d = 0.32 for decrease of pain in a Reiki versus rest intervention for cancer patients to d = 4.5 for decrease in pain in community dwelling adults. Although the number of studies is limited, based on the size Cohen's d statistics calculated in this review, there is evidence to suggest that Reiki therapy may be effective for pain and anxiety. Continued research using Reiki therapy with larger sample sizes, consistently randomized groups, and standardized treatment protocols is recommended. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  20. Effects of Music Therapy for Children and Adolescents with Psychopathology: A Meta-analysis

    Science.gov (United States)

    Gold, Christian; Voracek, Martin; Wigram, Tony

    2004-01-01

    Background: The objectives of this review were to examine the overall efficacy of music therapy for children and adolescents with psychopathology, and to examine how the size of the effect of music therapy is influenced by the type of pathology, client's age, music therapy approach, and type of outcome. Method: Eleven studies were included for…

  1. The effect of cognitive behavior therapy in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Kraaimaat, F. W.; Brons, M. R.; Geenen, R.; Bijlsma, J. W.

    1995-01-01

    In order to examine the effectiveness of cognitive behavioral therapy for patients with rheumatoid arthritis (RA) three patients groups were studied: a cognitive behavioral therapy group (CBT), an occupational therapy group (OT), and a waiting-list control group. The CBT received a comprehensive,

  2. Syntactic versus Lexical Therapy for Anomia in Acquired Aphasia: Differential Effects on Narrative and Conversation

    Science.gov (United States)

    Herbert, Ruth; Gregory, Emma; Best, Wendy

    2014-01-01

    Background: Previous studies of therapy for acquired anomia have treated nouns in isolation. The effect on nouns in connected speech remains unclear. In a recent study in 2012, we used a novel noun syntax therapy and found an increase in the number of determiner plus noun constructions in narrative after therapy. Aims: Two aims arose from the…

  3. Perceptions about implementation of a Narrative Community-based Group Therapy for Afro-Colombians victims of Violence

    Directory of Open Access Journals (Sweden)

    Gisel Viviana Osorio-Cuellar

    Full Text Available Abstract Given the context and the number of armed conflict victims in the Colombian Pacific coast and their difficulties to access psycho-social care, Narrative Community-based Group Therapy appears as a viable mental health intervention. The objective of this study is to describe the process of implementation and results of the intervention in Afro-Colombian victims of violence, in the municipalities of Buenaventura and Quibdó. More specifically, we will be looking at the perspectives of workers and supervisors, through evaluative case studies and individual in-depth interviews. The therapy allows us to identify support and coping systems through coexistence, communication and interaction. It requires an adaptation process to the diversity of knowledge and expressions of victims of Colombian violence, greater empathy from care providers and rigor in their profiles selection, facilities ensuring security and confidentiality, and links with other educational, employment and recreational organizations. It is important to include these results while improving current and future intervention processes.

  4. Perceptions about implementation of a Narrative Community-based Group Therapy for Afro-Colombians victims of Violence.

    Science.gov (United States)

    Osorio-Cuellar, Gisel Viviana; Pacichana-Quinayáz, Sara Gabriela; Bonilla-Escobar, Francisco Javier; Fandiño-Losada, Andrés; Gutiérrez-Martinez, Maria Isabel

    2017-09-01

    Given the context and the number of armed conflict victims in the Colombian Pacific coast and their difficulties to access psycho-social care, Narrative Community-based Group Therapy appears as a viable mental health intervention. The objective of this study is to describe the process of implementation and results of the intervention in Afro-Colombian victims of violence, in the municipalities of Buenaventura and Quibdó. More specifically, we will be looking at the perspectives of workers and supervisors, through evaluative case studies and individual in-depth interviews. The therapy allows us to identify support and coping systems through coexistence, communication and interaction. It requires an adaptation process to the diversity of knowledge and expressions of victims of Colombian violence, greater empathy from care providers and rigor in their profiles selection, facilities ensuring security and confidentiality, and links with other educational, employment and recreational organizations. It is important to include these results while improving current and future intervention processes.

  5. Effects of Community African Drumming on Generalised Anxiety in Teenagers

    Directory of Open Access Journals (Sweden)

    David Akombo

    2013-07-01

    Full Text Available The purpose of this study was to test the effects of community music projects (CMPs, such as after-school African drumming circles, on academic performance and generalised anxiety in adolescents. Adolescents from a Junior High (7th, 8th, and 9th graders, age range from 12-14 in the State of Utah (USA participated in the study. A one-sample t-test found a significant difference in reading scores (df(4 p=.004. A paired samples t-test found a significant relationship between the maths trait anxiety score pre-intervention and the total state anxiety score pre-test (df(4 p=.033. A paired samples t-test found a significant relationship between the reading trait anxiety score post-intervention and the total state anxiety score post-test (df(4 p=.030. This research demonstrates the effectiveness of community music such as drumming for reducing anxiety and also for improving academic performance in adolescents. CMPs are recommended as a non-invasive intervention modality for adolescents.

  6. Understanding dementia: effective information access from the Deaf community's perspective.

    Science.gov (United States)

    Young, Alys; Ferguson-Coleman, Emma; Keady, John

    2016-01-01

    This study concerns older Deaf sign language users in the UK. Its aim was to explore how to enable effective information access and promote awareness and understanding of dementia from a culturally Deaf perspective. A purposive sample of 26 Deaf people without dementia participated in one of three focus groups facilitated directly in British Sign Language (BSL) without an intermediate interpreter. The sample was differentiated by age, role in the Deaf community, and diversity of educational attainment and professional experience. A phenomenological approach underpinned the thematic analysis of data. The findings demonstrate: (i) translation into (BSL) is a necessary but not sufficient condition to support understanding. Attention to culturally preferred means of engagement with information is vital; (ii) the content of information is best presented utilising structures and formats which cohere with Deaf people's visual cognitive strengths; and (iii) the importance of cultural values and cultural practices in raising awareness and building understanding of dementia. These include collective rather than individual responsibility for knowledge transfer and the pan-national nature of knowledge transfer among Deaf people(s). The discussion demonstrates how these specific features of effective information access and awareness building have universal implications relevant to public engagement and the promotion of general knowledge consistent with the National Dementia Strategy (England). © 2014 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

  7. Arsenic from community water fluoridation: quantifying the effect.

    Science.gov (United States)

    Peterson, Emily; Shapiro, Howard; Li, Ye; Minnery, John G; Copes, Ray

    2016-04-01

    Community water fluoridation is a WHO recommended strategy to prevent dental carries. One debated concern is that hydrofluorosilicic acid, used to fluoridate water, contains arsenic and poses a health risk. This study was undertaken to determine if fluoridation contributes to arsenic in drinking water, to estimate the amount of additional arsenic associated with fluoridation, and compare this to the National Sanitation Foundation/American National Standards Institute (NSF/ANSI) standard and estimates from other researchers. Using surveillance data from Ontario drinking water systems, mixed effects linear regression was performed to examine the effect of fluoridation status on the difference in arsenic concentration between raw water and treated water samples. On average, drinking water treatment was found to reduce arsenic levels in water in both fluoridated and non-fluoridated systems by 0.2 μg/L. However, fluoridated systems were associated with an additional 0.078 μg/L (95% CI 0.021, 0.136) of arsenic in water when compared to non-fluoridated systems (P = 0.008) while controlling for raw water arsenic concentrations, types of treatment processes, and source water type. Our estimate is consistent with concentrations expected from other research and is less than 10% of the NSF/ANSI standard of 1 μg/L arsenic in water. This study provides further information to inform decision-making regarding community water fluoridation.

  8. Effects of Smoking Cessation Media and Community Campaigns in Taiwan.

    Science.gov (United States)

    Chang, Fong-Ching; Sung, Hai-Yen; Zhu, Shu-Hong; Feng, Tzung-Yee; Chiou, Shu-Ti

    2017-01-01

    To examine the effects of a smoking cessation campaign. Data from the 2010-2011 Taiwan Adult Tobacco Surveys were analyzed. The study was set among a nationally representative sample of adults in Taiwan. The surveys included 16,282 and 16,886 adults in 2010 and 2011, respectively, while our analyses focused on current smokers, 2518 and 2507 adults in 2010 and 2011, respectively. In 2010 the Taiwanese government launched a national smoking cessation campaign through mass media in conjunction with community-based smoking cessation programs throughout the nation. Outcome variables include awareness of cessation services, quit attempts, intention to quit, and use of quitting method. Multivariate logistic regressions were used to analyze data. The implementation of the national smoking cessation campaign was associated with an increase in awareness of cessation services (odds ratio [OR] = 1.36; 95% confidence interval [CI] = 1.20-1.53), in quit attempts (OR = 1.12; 95% CI = 1.01-1.25), in use of unassisted quitting methods (OR = 1.39; 95% CI = 1.13-1.72), and in intention to quit smoking (OR = 1.15; 95% CI = 1.02-1.30). The implementation of the national smoking cessation campaign through media and community programs was effective in increasing smokers' awareness of cessation services, quit attempts, and intention to quit.

  9. Enhancing antibiofilm efficacy in antimicrobial photodynamic therapy: effect of microbubbles

    Science.gov (United States)

    Kishen, Anil; George, Saji

    2013-02-01

    In this study, we tested the hypothesis that a microbubble containing photosensitizer when activated with light would enable comprehensive disinfection of bacterial biofilms in infected root dentin by antimicrobial photodynamic therapy (APDT). Experiments were conducted in two stages. In the stage-1, microbubble containing photosensitizing formulation was tested for its photochemical properties. In the stage-2, the efficacy of microbubble containing photosensitizing formulation was tested on in vitro infected root canal model, developed with monospecies biofilm models of Enterococcus faecalis on root dentin substrate. The findings from this study showed that the microbubble containing photosensitizing formulation was overall the most effective formulation for photooxidation, generation of singlet oxygen, and in disinfecting the biofilm bacteria in the infected root canal model. This modified photosensitizing formulation will have potential advantages in eliminating bacterial biofilms from infected root dentin.

  10. Effects of Progressive Muscle Relaxation Therapy in Colorectal Cancer Patients.

    Science.gov (United States)

    Kim, Kyeng Jin; Na, Yeon Kyung; Hong, Hae Sook

    2016-08-01

    This study aimed to examine the effect of progressive muscle relaxation therapy (PMRT) on cortisol level, the Stress Arousal Checklist (SACL) score, blood pressure, and heart rate in colorectal cancer patients undergoing laparoscopic surgery. Forty-six patients were divided into control and experimental groups. Cortisol levels, blood pressure, and heart rate were measured before surgery and between 8:00 and 11:00 a.m. on the first, third, and fifth days after surgery. SACL score was measured before surgery and on the fifth day after surgery at the same time points. PMRT was performed twice a day for 5 days. Analyses of covariance with advanced covariate levels and t tests showed that PMRT helps colorectal cancer patients achieve a lower stress response and provides an important basis for stress control. © The Author(s) 2016.

  11. Effects of low-level laser therapy on wound healing

    Directory of Open Access Journals (Sweden)

    Fabiana do Socorro da Silva Dias Andrade

    Full Text Available OBJECTIVE: To gather and clarify the actual effects of low-level laser therapy on wound healing and its most effective ways of application in human and veterinary medicine.METHODS: We searched original articles published in journals between the years 2000 and 2011, in Spanish, English, French and Portuguese languages, belonging to the following databases: Lilacs, Medline, PubMed and Bireme; Tey should contain the methodological description of the experimental design and parameters used.RESULTS: doses ranging from 3 to 6 J/cm2 appear to be more effective and doses 10 above J/cm2 are associated with deleterious effects. The wavelengths ranging from 632.8 to 1000 nm remain as those that provide more satisfactory results in the wound healing process.CONCLUSION: Low-level laser can be safely applied to accelerate the resolution of cutaneous wounds, although this fact is closely related to the election of parameters such as dose, time of exposure and wavelength.

  12. [Urinary pneumococcal or Legionella antigen detection tests and low-spectrum antibiotic therapy for community-acquired pneumonia].

    Science.gov (United States)

    Roger, P-M; Risso, K; Hyvernat, H; Landraud, L; Vassallo, M; Dellamonica, J; de Salvador, F; Cua, E; Bernardin, G

    2010-06-01

    We performed urinary antigen tests for pneumococcus and Legionella for patients with community-acquired pneumonia (CAP), to prescribe a documented antibiotic therapy. We report the efficiency of low-spectrum antibiotic treatment, illustrating the inappropriateness of bacteriological respiratory sampling. Patients with CAP were enrolled from three different units; the pneumonia severity index was used to assess the disease. Respiratory samples were also listed. Low-spectrum antibiotic therapy was amoxicillin for pneumococcal infection, and macrolides or non-anti-pneumococcal fluoroquinolone for legionellosis. Six hundred and seventy-five CAP were diagnosed during the study period,, 150 with positive urinary antigen tests (23%), among which 108 pneumococcal infections (73%), 40 legionellosis (26%), and two mixed infections. The pneumonia severity index was 106+/-38. Amoxicillin was prescribed in 108 cases, fluoroquinolone in 24 cases, macrolide in 18 cases. The outcome was favourable for 138 patients (92%). Eighty three respiratory samples allowed identification of a bacterium for 58 patients (39%), among which 24 strains were not in the antibiotic spectrum: Haemophilus influenzae and Pseudmomonas aeruginosa in six cases, Staphylococcus aureus in five cases, Klebsiella pneumoniae in two cases, and another Gram negative bacillus in five cases. These strains were resistant in vitro to the prescribed treatment in 19/24 cases (79%). One out of 12 patients who died had a respiratory sample positive for Enterobacter spp strain resistant to the ongoing antibiotic treatment. The low-spectrum antibiotic therapy based on urinary antigen tests is efficient, and demonstrates respiratory tract colonisation with bacteriological strains usually considered as pathogenic.

  13. [The effects of the taping therapy on range of motion, pain and depression in stroke patient].

    Science.gov (United States)

    Kwon, Seon-Suk

    2003-08-01

    The purpose of this study was to test the effect of Taping therapy on Range of Motion, pain, and depression in stroke patients in the home without complete recovery as a means of nursing intervention. Twenty seven subjects out of fifty four people who were attending in the stroke self-help group in one community health center in S city were asked to participate in this Quai-experimental study. The Taping therapy was a method that stick to the illness area and the point of pressure pain, the elastic and cross tape without medicine treatment with domestic products. Nursing intervention was independently completed by researcher once a week over two period of 12 weeks from September 2001 to March 2002 year. Data were analyzed using the SPSS win. The homogeneity between the experimental group and control group was test by chi2 and t-test. The difference of experimental before and after were tested by the unpaired t-test. The shoulder joint flexion and abduction, the elbow joint flexion and extension, the hip joint flexion, and the flexion of knee joint in the ROM of the experimental group were significantly improved over those of the control group. In difference of pain, rest and painful movement, the experimental group were significantly decreased over those of the control group. The difference of depression in experimental before and after was significantly decreased in the experimental group over those of the control group. The Taping therapy intervention proved effect pain relief and depression decrease as well as promote of range of motion.

  14. Road zone effects in small-mammal communities

    Science.gov (United States)

    Bissonette, J.A.; Rosa, S.A.

    2009-01-01

    Our study focused on the putative effects of roads on small-mammal communities in a high desert region of southern Utah. Specifically, we tested whether or not roads create adjacent zones characterized by lower small- mammal densities, abundance, and diversity. We sampled abundance of small mammals at increasing distances from Interstate 15 during two summers. We recorded 11 genera and 13 species. We detected no clear abundance, density, or diversity effects relative to distance from the road. Only two of 13 species were never captured near roads. The abundance of the remaining 11 small mammal species was either similar at different distances from the road or higher closer to the road. We conclude that although roads may act as barriers and possible sources of mortality, adjacent zones of vegetation often provide favorable microhabitat in the desert landscape for many small mammals. ?? 2009 by the author(s).

  15. Road Zone Effects in Small-Mammal Communities

    Directory of Open Access Journals (Sweden)

    John A. Bissonette

    2009-06-01

    Full Text Available Our study focused on the putative effects of roads on small-mammal communities in a high desert region of southern Utah. Specifically, we tested whether or not roads create adjacent zones characterized by lower small- mammal densities, abundance, and diversity. We sampled abundance of small mammals at increasing distances from Interstate 15 during two summers. We recorded 11 genera and 13 species. We detected no clear abundance, density, or diversity effects relative to distance from the road. Only two of 13 species were never captured near roads. The abundance of the remaining 11 small mammal species was either similar at different distances from the road or higher closer to the road. We conclude that although roads may act as barriers and possible sources of mortality, adjacent zones of vegetation often provide favorable microhabitat in the desert landscape for many small mammals.

  16. Effectiveness of Advanced Stay Strong, Stay Healthy in Community Settings

    Directory of Open Access Journals (Sweden)

    Emily M. Crowe MS

    2015-07-01

    Full Text Available The goal of this research was to investigate the effectiveness of the 10-week, University of Missouri (MU Extension strength training program Advanced Stay Strong, Stay Healthy (ASSSH. It was hypothesized that the program can improve strength, balance, agility, and flexibility—all physical measures of falling among seniors. Matched pair t tests were used to compare differences in five physical measures of health, body composition, and percent body fat (%BF. Two-way ANOVA was conducted to examine the age effects on changes in physical health from the start and finish of the exercise program. Following programming, participants significantly improved strength, flexibility, and balance, and significantly reduced %BF ( p < .05. Our data indicate that ASSSH can improve the physical health of senior citizens and can successfully be translated into community practice by MU Extension professionals.

  17. Effects of high intensity laser therapy on pain and function of patients with chronic back pain.

    Science.gov (United States)

    Choi, Hyeun-Woo; Lee, Jongmin; Lee, Sangyong; Choi, Jioun; Lee, Kwansub; Kim, Byung-Kon; Kim, Gook-Joo

    2017-06-01

    [Purpose] This study examined the effects of High Intensity Laser Therapy on pain and function of patients with chronic back pain. [Subjects and Methods] This study evenly divided a total of 20 patients with chronic back pain into a conservative physical therapy group that received conservative physical therapy, and a high intensity laser therapy group that received High Intensity Laser Therapy after conservative physical therapy. All patients received the therapy three times a week for four weeks. For the high intensity laser therapy group, treatment was applied to the L1-L5 and S1 regions for 10 minutes by using a high intensity laser device while vertically maintaining the separation distance from handpiece to skin at approximately 1 cm. A visual analog scale was used to measure the pain and Oswestry Disability Index was used for functional evaluation. [Results] In a within-group comparison of the conservative physical therapy and high intensity laser therapy groups, both the visual analog scale and Oswestry Disability Index significantly decreased. In a between-group comparison after treatment, the high intensity laser therapy group showed a significantly lower visual analog scale and Oswestry Disability Index than the conservative physical therapy group. [Conclusion] High Intensity Laser Therapy can be an effective nonsurgical intervention method for reducing pain and helping the performance of daily routines of patients who have chronic back pain.

  18. Interactive effects of nutrient additions and predation on infaunal communities

    Science.gov (United States)

    Posey, M.H.; Alphin, T.D.; Cahoon, L.; Lindquist, D.; Becker, M.E.

    1999-01-01

    Nutrient additions represent an important anthropogenic stress on coastal ecosystems. At moderate levels, increased nutrients may lead to increased primary production and, possibly, to increased biomass of consumers although complex trophic interactions may modify or mask these effects. We examined the influence of nutrient additions and interactive effects of trophic interactions (predation) on benthic infaunal composition and abundances through small-scale field experiments in 2 estuaries that differed in ambient nutrient conditions. A blocked experimental design was used that allowed an assessment of direct nutrient effects in the presence and absence of predation by epibenthic predators as well as an assessment of the independent effects of predation. Benthic microalgal production increased with experimental nutrient additions and was greater when infaunal abundances were lower, but there were no significant interactions between these factors. Increased abundances of one infaunal taxa, Laeonereis culveri, as well as the grazer feeding guild were observed with nutrient additions and a number of taxa exhibited higher abundances with predator exclusion. In contrast to results from freshwater systems there were no significant interactive effects between nutrient additions and predator exclusion as was predicted. The infaunal responses observed here emphasize the importance of both bottom-up (nutrient addition and primary producer driven) and top-down (predation) controls in structuring benthic communities. These processes may work at different spatial and temporal scales, and affect different taxa, making observation of potential interactive effects difficult.

  19. Headwater streams and forest management: Does ecoregional context influence logging effects on benthic communities?

    Science.gov (United States)

    R. Bruce Medhurst; Mark S. Wipfli; Chris Binckley; Karl Polivka; Paul F. Hessburg; R. Brion. Salter

    2010-01-01

    Effects of forest management on stream communities have been widely documented, but the role that climate plays in the disturbance outcomes is not understood. In order to determine whether the effect of disturbance from forest management on headwater stream communities varies by climate, we evaluated benthic macroinvertebrate communities in 24 headwater streams that...

  20. Medication therapy management and condition care services in a community-based employer setting.

    Science.gov (United States)

    Johannigman, Mark J; Leifheit, Michael; Bellman, Nick; Pierce, Tracey; Marriott, Angela; Bishop, Cheryl

    2010-08-15

    A program in which health-system pharmacists and pharmacy technicians provide medication therapy management (MTM), wellness, and condition care (disease management) services under contract with local businesses is described. The health-system pharmacy department's Center for Medication Management contracts directly with company benefits departments for defined services to participating employees. The services include an initial wellness and MTM session and, for certain patients identified during the initial session, ongoing condition care. The initial appointment includes a medication history, point-of-care testing for serum lipids and glucose, body composition analysis, and completion of a health risk assessment. The pharmacist conducts a structured MTM session, reviews the patient's test results and risk factors, provides health education, discusses opportunities for cost savings, and documents all activities on the patient's medication action plan. Eligibility for the condition care program is based on a diagnosis of diabetes, hypertension, asthma, heart failure, or hyperlipidemia or elevation of lipid or glucose levels. Findings are summarized for employers after the initial wellness screening and at six-month intervals. Patients receiving condition care sign a customized contract, establish goals, attend up to four MTM sessions per year, and track their information on a website; employers may offer incentives for participation. When pharmacists recommend adjustments to therapy or cost-saving changes, it is up to patients to discuss these with their physician. A survey completed by each patient after the initial wellness session has indicated high satisfaction. Direct cost savings related to medication changes have averaged $253 per patient per year. Total cost savings to companies in the first year of the program averaged $1011 per patient. For the health system, the program has been financially sustainable. Key laboratory values indicate positive clinical

  1. The effectiveness of community-based cycling promotion: findings from the Cycling Connecting Communities project in Sydney, Australia

    Directory of Open Access Journals (Sweden)

    Merom Dafna

    2010-01-01

    Full Text Available Abstract Background Encouraging cycling is an important way to increase physical activity in the community. The Cycling Connecting Communities (CCC Project is a community-based cycling promotion program that included a range of community engagement and social marketing activities, such as organised bike rides and events, cycling skills courses, the distribution of cycling maps of the area and coverage in the local press. The aim of the study was to assess the effectiveness of this program designed to encourage the use of newly completed off-road cycle paths through south west Sydney, Australia. Methods The evaluation used a quasi-experimental design that consisted of a pre- and post-intervention telephone survey (24 months apart of a cohort of residents (n = 909 in the intervention area (n = 520 (Fairfield and Liverpool and a socio-demographically similar comparison area (n = 389 (Bankstown. Both areas had similar bicycle infrastructure. Four bicycle counters were placed on the main bicycle paths in the intervention and comparison areas to monitor daily bicycle use before and after the intervention. Results The telephone survey results showed significantly greater awareness of the Cycling Connecting Communities project (13.5% vs 8.0%, p Conclusion Despite relatively modest resources, the Cycling Connecting Communities project achieved significant increases in bicycle path use, and increased cycling in some sub-groups. However, this community based intervention with limited funding had very limited reach into the community and did not increase population cycling levels.

  2. Effects of historic metal(loid) pollution on earthworm communities.

    Science.gov (United States)

    Lévêque, Thibaut; Capowiez, Yvan; Schreck, Eva; Mombo, Stéphane; Mazzia, Christophe; Foucault, Yann; Dumat, Camille

    2015-04-01

    The effects of metal(loid)s (Pb, Cd, Cu, Zn, As and Sb) from atmospheric fallout on earthworm communities were investigated in a fallow meadow located close to a 60-year-old lead recycling factory. We examined abundance and species diversity as well as the ratio of adult-to-juvenile earthworms, along five 140 m parallel transects. The influence of soil pollution on the earthworm community at the plot scale was put in context by measuring some physico-chemical soil characteristics (OM content, N content, pH), as well as total and bioavailable metal(loid) concentrations. Earthworms were absent in the highly polluted area (concentration from 30,000 to 5000 mg Pb·kg(-1) of dried soil), just near the factory (0-30 m area). A clear and almost linear relationship was observed between the proportion of juvenile versus mature earthworms and the pollution gradient, with a greater proportion of adults in the most polluted zones (only adult earthworms were observed from 30 to 50 m). Apporectodea longa was the main species present just near the smelter (80% of the earthworms were A. longa from 30 to 50 m). The earthworm density was found to increase progressively from five individuals·m(-2) at 30 m to 135 individuals·m(-2) at 140 m from the factory. On average, metal(loid) accumulation in earthworm tissues decreased linearly with distance from the factory. The concentration of exchangeable metal(loid)s in earthworm surface casts was higher than that of the overall soil. Finally, our field study clearly demonstrated that metal(loid) pollution has a direct impact on earthworm communities (abundance, diversity and proportion of juveniles) especially when Pb concentrations in soil were higher than 2050 mg·kg(-1). Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Analgesic effects of manual therapy in patients with musculoskeletal pain: a systematic review

    OpenAIRE

    Struyf, F.; Nijs, J.; Meeys, M.; Meuffels, D.; Vries, de, W.; Voogt, L.P.

    2015-01-01

    BACKGROUND: Current evidence shows that manual therapy elicits analgesic effect in different populations (healthy, pain inflicted and patients with musculoskeletal pain) when carried out at the spinal column, although the clinical significance of these effects remains unclear. Also the analgesic effects of manual therapy on peripheral joints have not been systematically reviewed. METHODS: A systematic review was carried out following the PRISMA-guidelines. Manual therapy was defined as any ma...

  4. The effect of music therapy on cognitive functioning among older adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Li, Hui-Chi; Wang, Hsiu-Hung; Chou, Fan-Hao; Chen, Kuei-Min

    2015-01-01

    To conduct a systematic review and a meta-analysis of current studies to determine whether music therapy affects the cognitive function of older people. The databases surveyed include PsycINFO, PsycARTICLES, PubMed, MEDLINE, CINAHL, AgeLine, Cochrane Library, and the Chinese Electronic Periodical Services (CEPS) as well as the reference lists of the included studies. The Consolidated Standards of Reporting Trials (CONSORT) extension checklist for nonpharmacologic treatment was used to evaluate the literature. Music therapy intervention offered in nursing homes, hospitals, or communities. A total of 234 participants from 5 studies were assessed in the meta-analysis, with a mean age per study of 71.4 to 82.0 years. Cognitive outcome domains were analyzed in a systematic review. The short-term effects of music therapy in Mini-Mental State Examination data for meta-analysis were compiled. A forest plot was constructed using a fixed effect model to obtain a pooled mean difference. Active music therapy comprising singing and other musical activities was generally determined to effect a significant improvement in the Mini-Mental State Examination according to individual retrieval studies. However, this study showed no significant improvement in the short-term effects of music therapy when all related studies in meta-analysis were combined. The pooled mean difference was 0.73 (95% confidence interval -0.07 to 1.54; Z = 1.79; P = .07) for using music therapy overall and 0.74 (95% confidence interval -0.08 to 1.56; Z = 1.76; P = .08) for using active music therapy. The findings of the meta-analysis indicate that the short-term effects of music therapy do not improve the cognitive function of older people. Future studies that utilize a good quality methodology with a long-term design and diversified active music therapy are recommended. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  5. Effectiveness of Cognitive Behavioral Group Therapy for Treatment of Panic Disorder: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Servet Kacar Basaran

    2016-03-01

    Full Text Available This study aims to review empirical studies that evaluate effectiveness of cognitive-behavioral group therapy programs for treatment for panic disorder. Articles in English and Turkish that were published between the years of 2000 and 2015 (February have been searched in the national and international databases. The articles that were not therapy effectiveness studies, and group therapies that not based on cognitive behavioral approach were eliminated. The remaining 19 studies that were met the criteria were introduced in terms of method, therapy characteristics and results. The results of the studies showed that cognitive behavioral group therapies have similar efficacy with individual cognitive behavioral therapy on panic disorder symptoms (panic attacks frequency, the level of agoraphobia etc. and comorbid disorders (depression, anxiety sensitivity. However, cognitive behavioral group therapy is more cost-effective. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(Supplement 1: 79-94

  6. COGNITION AND SUICIDE: EFFECTIVENESS OF COGNITIVE BEHAVIOUR THERAPY

    Directory of Open Access Journals (Sweden)

    Lence Miloseva

    2016-06-01

    Full Text Available The aim of this review paper is to show an overview of the empirical evidence of effectiveness of cognitive behavioral therapy (CBT in reducing suicidal cognitions and suicidal behavior. The topic of suicidal cognition and suicidal behavior is of special importance to clinicians and practitioners. Analyses of empirical findings from the oldest, first systematic review and meta-analysis and the newest one shown that there not enough evidence from clinical trials to suggest that CBT focusing on mental illness reduces suicidal cognitions and behaviors. But, from the other hand, CBT focusing on suicidal cognitions and suicidal behaviors was found to be effective. Taking into consideration the effectiveness of this psychotherapy, we can conclude that it is preferable for clinicians to be trained in working with CBT techniques focused on suicidal cognition and behavior that are independent of treatment of mental disorders. In addition, it is necessary to initiate new research that will make it possible to create preventive and interventional programs dedicated to reducing the risk of suicide.

  7. Effect of photodynamic therapy on clinical isolates of Staphylococcus spp

    Directory of Open Access Journals (Sweden)

    Michelle Miyabe

    2011-06-01

    Full Text Available Staphylococcus spp. are opportunistic microorganisms known for their capacity to develop resistance against antimicrobial agents. The objective of this study was to evaluate the effect of photodynamic therapy (PDT on 20 Staphylococcus strains isolated from the human oral cavity, including S. aureus, S. schleiferi, S. epidermidis, S. capitis, S. haemolyticus, and S. lentus. A suspension of each Staphylococcus strain (10(6 cells/mL was submitted to PDT using methylene blue and a low power laser. The isolated effects of methylene blue, laser treatment and ciprofloxacin were also evaluated. After the experimental treatments, 0.1 mL aliquots of the suspensions were seeded onto BHI agar for determination of the number of colony-forming units (CFU/mL. The results were analyzed by analysis of variance and Tukey's test (p < 0.05. The mean reduction in bacterial counts of the strains submitted to PDT ranged from 4.89 to 6.83 CFU (log10/mL, with the observation of a decreasing susceptibility to treatment of S. schleiferi, S. haemolyticus, S. epidermidis, S. capitis, S. aureus, and S. lentus. The results showed that PDT was effective in reducing the number of viable cells of all clinical Staphylococcus isolates studied.

  8. Effects of biochar blends on microbial community composition in two coastal plain soils

    Science.gov (United States)

    The amendment of soil with biochar has been demonstrated to have an effect not only on the soil physicochemical properties, but also on soil microbial community composition and activity. Previous reports have demonstrated significant impacts on soil microbial community structure....

  9. Comprehensive family therapy: an effective approach for cognitive rehabilitation in schizophrenia

    Directory of Open Access Journals (Sweden)

    Cai J

    2015-05-01

    Full Text Available Jun Cai,1 Yi Zhu,1 Weibo Zhang,1 Yanfeng Wang,1 Chen Zhang2 1Center for Disease Control and Prevention, Shanghai Mental Health Center, 2Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China Background: Antipsychotic medication has limited abilities to improve the cognitive impairments that accompany schizophrenia. Adding psychosocial treatment may result in marked improvements in cognitive function, as compared to antipsychotic treatment alone. We hypothesized that a combination of individual and family interventions may be a useful cognitive rehabilitation paradigm for schizophrenia.  Materials and methods: An 18-month follow-up clinical trial of 256 stabilized patients with schizophrenia at six communities in Shanghai, People’s Republic of China were randomly assigned to into either a comprehensive family therapy (CFT group or a usual daily care (UDC group. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS and the Positive and Negative Syndrome Scale (PANSS were the primary outcome instruments for this study.  Results: There was no significant difference between the CFT and UDC for all demographic characteristics at the baseline assessment. During the 18-month follow-up observation, changes in RBANS total score indicated that patients undergoing CFT showed greater improvement from baseline to the follow-up assessments in cognitive function than those in the UDC group (F=9.77, P=0.002. Post hoc analysis showed that the CFT group presented with significant differences in the RBANS total score, immediate memory, visuospatial skill, language, attention, and delayed memory sections compared with the UDC after 18 months of follow-up (all P<0.01.Conclusion: Our findings suggest that CFT can be easily adapted and may prove to be an effective approach for improving cognitive function in patients with schizophrenia. Our program

  10. Predator identity and additive effects in a treehole community.

    Science.gov (United States)

    Griswold, Marcus W; Lounibos, L Philip

    2006-04-01

    Multiple predator species can interact as well as strongly affect lower trophic levels, resulting in complex, nonadditive effects on prey populations and community structure. Studies of aquatic systems have shown that interactive effects of predators on prey are not necessarily predictable from the direct effects of each species alone. To test for complex interactions, the individual and combined effects of a top and intermediate predator on larvae of native and invasive mosquito prey were examined in artificial analogues of water-filled treeholes. The combined effects of the two predators were accurately predicted from single predator treatments by a multiplicative risk model, indicating additivity. Overall survivorship of both prey species decreased greatly in the presence of the top predator Toxorhynchites rutilus. By itself, the intermediate predator Corethrella appendiculata increased survivorship of the native prey species Ochlerotatus triseriatus and decreased survivorship of the invasive prey species Aedes albopictus relative to treatments without predators. Intraguild predation did not occur until alternative prey numbers had been reduced by approximately one-half. Owing to changes in size structure accompanying its growth, T. rutilus consumed more prey as time progressed, whereas C. appendiculata consumed less. The intermediate predator, C. appendiculata, changed species composition by preferentially consuming A. albopictus, while the top predator, T. rutilus, reduced prey density, regardless of species. Although species interactions were in most cases predicted from pairwise interactions, risk reduction from predator interference occurred when C. appendiculata densities were increased and when the predators were similarly sized.

  11. PREDATOR IDENTITY AND ADDITIVE EFFECTS IN A TREEHOLE COMMUNITY

    Science.gov (United States)

    Griswold, Marcus W.; Lounibos, L. Philip

    2007-01-01

    Multiple predator species can interact as well as strongly affect lower trophic levels, resulting in complex, nonadditive effects on prey populations and community structure. Studies of aquatic systems have shown that interactive effects of predators on prey are not necessarily predictable from the direct effects of each species alone. To test for complex interactions, the individual and combined effects of a top and intermediate predator on larvae of native and invasive mosquito prey were examined in artificial analogues of water-filled treeholes. The combined effects of the two predators were accurately predicted from single predator treatments by a multiplicative risk model, indicating additivity. Overall survivorship of both prey species decreased greatly in the presence of the top predator Toxorhynchites rutilus. By itself, the intermediate predator Corethrella appendiculata increased survivorship of the native prey species Ochlerotatus triseriatus and decreased survivorship of the invasive prey species Aedes albopictus relative to treatments without predators. Intraguild predation did not occur until alternative prey numbers had been reduced by approximately one-half. Owing to changes in size structure accompanying its growth, T. rutilus consumed more prey as time progressed, whereas C. appendiculata consumed less. The intermediate predator, C. appendiculata, changed species composition by preferentially consuming A. albopictus, while the top predator, T. rutilus, reduced prey density, regardless of species. Although species interactions were in most cases predicted from pairwise interactions, risk reduction from predator interference occurred when C. appendiculata densities were increased and when the predators were similarly sized. PMID:16676542

  12. Evaluation of Photoelectron Therapy Effect on Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    bahram Mofid

    2007-10-01

    Full Text Available Mofid B1, Navabpoor M2, Alizadeh Azimi M3 1. Assistant professor, Department of Radiotherapy, Faculty of Para-Medicine, Shahid Beheshti University of medical sciences 2. Instructor, Department of Technology of radiology, Faculty of Para-Medicine, Shahid Beheshti University of medical sciences Abstract Background: Photoelectron therapy method has been usad successfully, on the body phantom, cancer cells culture and animals. In this method, drugs containing x-Ray opaque factors–with high atomic numbers–are injected into the patient’s vein. After appropriate drug accumulation, about at least ten percent of the total injected amounts, 200kev. up to 300kev. of localized x-Ray beams is radiated to the site of the tumor. The Ethic Committee of Shahid Beheshti University of Medical Education and Health Services authorized the implementation of this new cancer treatment method, initially only on the group of patients who suffered from hepato-cellular carcinoma. Hepato cellular carcinoma is one of the most current malignancies of liver. In some cases, in addition to surgery, several approaches exist to come near the aim of predominating hepato-cellular carcinoma such as chemotherapy, current Radiation Therapy, Radio-Frequency application (RF, Trans-Artepical Chemo Embolization, (TACE, and Percutaneous Ethanol Injection (PEI. The effectiveness of the above-mentioned methods is about 10%-47%, applied alone or along side each other. Materials and methods: This study was a clinical-trial one. In this study, first, lipiodol (an x-ray opaque material with a high atomic number was transferred into the main vessel terminating to the tumor by angio-catheterization. Then,200kev. up to 250kev. of localized x-ray was radiated to the site of the tumor in one session. The drug volume was proportionally selected to the volume of the tumor, and the irradiation intensity was between 400 to 600cent.Gy. the beam energy absorption capacity of this drug is as times as

  13. Wilms tumour: prognostic factors, staging, therapy and late effects

    Energy Technology Data Exchange (ETDEWEB)

    Kaste, Sue C. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); Dome, Jeffrey S. [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); Babyn, Paul S. [Hospital for Sick Children, Department of Radiology, Toronto (Canada); Graf, Norbert M. [University Hospital of the Saarland, Clinic for Pediatric Oncology and Hematology, Homburg (Germany); Grundy, Paul [University of Alberta, Division of Pediatric Hematology, Oncology and Palliative Care, and Northern Alberta Children' s Cancer Program, Edmonton (Canada); Godzinski, Jan [Mother and Child Institute, Department of Oncological Surgery for Children and Adolescents, Warsaw (Poland); Levitt, Gill A. [Great Ormond Street Hospital for Sick Children NHS Trust, Paediatric Oncology, London (United Kingdom); Jenkinson, Helen [Birmingham Children' s Hospital NHS Trust, Oncology Department, Birmingham (United Kingdom)

    2008-01-15

    Wilms tumour is the most common malignant renal tumour in children. Dramatic improvements in survival have occurred as the result of advances in anaesthetic and surgical management, irradiation and chemotherapy. Current therapies are based on trials and studies primarily conducted by large multi-institutional cooperatives including the Societe Internationale d'Oncologie Pediatrique (SIOP) and the Children's Oncology Group (COG). The primary goals are to treat patients according to well-defined risk groups in order to achieve the highest cure rates, to decrease the frequency and intensity of acute and late toxicity and to minimize the cost of therapy. The SIOP trials and studies largely focus on the issue of preoperative therapy, whereas the COG trials and studies start with primary surgery. This paper reviews prognostic factors and staging systems for Wilms tumour and its current treatment with surgery and chemotherapy. Surgery remains a crucial part of treatment for nephroblastoma, providing local primary tumour control and adequate staging and possibly controlling the metastatic spread and central vascular extension of the disease. Partial nephrectomy, when technically feasible, seems reasonable not only in those with bilateral disease but also in those with unilateral disease where the patient has urological disorders or syndromes predisposing to malignancy. Partial nephrectomy, however, is frequently not sufficient for an anaplastic variant of tumour. The late effects for Wilms tumour and its treatment are also reviewed. The treatment of Wilms tumour has been a success story, and currently in excess of 80% of children diagnosed with Wilms tumour can look forward to long-term survival, with less than 20% experiencing serious morbidity at 20 years from diagnosis. The late complications are a consequence of the type and intensity of treatment required, which in turn reflects the nature and extent of the original tumour. Continual international trial

  14. Effectiveness of community forestry in Prey Long forest, Cambodia.

    Science.gov (United States)

    Lambrick, Frances H; Brown, Nick D; Lawrence, Anna; Bebber, Daniel P

    2014-04-01

    Cambodia has 57% forest cover, the second highest in the Greater Mekong region, and a high deforestation rate (1.2%/year, 2005-2010). Community forestry (CF) has been proposed as a way to reduce deforestation and support livelihoods through local management of forests. CF is expanding rapidly in Cambodia. The National Forests Program aims to designate one million hectares of forest to CF by 2030. However, the effectiveness of CF in conservation is not clear due to a global lack of controlled comparisons, multiple meanings of CF, and the context-specific nature of CF implementation. We assessed the effectiveness of CF by comparing 9 CF sites with paired controls in state production forest in the area of Prey Long forest, Cambodia. We assessed forest condition in 18-20 randomly placed variable-radius plots and fixed-area regeneration plots. We surveyed 10% of households in each of the 9 CF villages to determine the proportion that used forest products, as a measure of household dependence on the forest. CF sites had fewer signs of anthropogenic damage (cut stems, stumps, and burned trees), higher aboveground biomass, more regenerating stems, and reduced canopy openness than control areas. Abundance of economically valuable species, however, was higher in control sites. We used survey results and geographic parameters to model factors affecting CF outcomes. Interaction between management type, CF or control, and forest dependence indicated that CF was more effective in cases where the community relied on forest products for subsistence use and income. © 2014 Society for Conservation Biology.

  15. Cognitive-Behavioral Therapy versus Usual Clinical Care for Youth Depression: An Initial Test of Transportability to Community Clinics and Clinicians

    Science.gov (United States)

    Weisz, John R.; Southam-Gerow, Michael A.; Gordis, Elana B.; Connor-Smith, Jennifer K.; Chu, Brian C.; Langer, David A.; McLeod, Bryce D.; Jensen-Doss, Amanda; Updegraff, Alanna; Weiss, Bahr

    2009-01-01

    Community clinic therapists were randomized to (a) brief training and supervision in cognitive-behavioral therapy (CBT) for youth depression or (b) usual care (UC). The therapists treated 57 youths (56% girls), ages 8-15, of whom 33% were Caucasian, 26% were African American, and 26% were Latino/Latina. Most youths were from low-income families…

  16. Restoration of a temperate reef: Effects on the fish community

    DEFF Research Database (Denmark)

    Støttrup, Josianne; Stenberg, Claus; Dahl, Karsten

    2014-01-01

    The extraction of large boulders from coastal reefs for construction of harbours and coastal protection has led to habitat degradation for local fish populations through the destruction of cavernous reefs and changes in macroalgal cover resulting from a loss of substrate. The temperate reef at Læ....... The findings highlight the importance of reef habitats for fish communities and the need for their protection......The extraction of large boulders from coastal reefs for construction of harbours and coastal protection has led to habitat degradation for local fish populations through the destruction of cavernous reefs and changes in macroalgal cover resulting from a loss of substrate. The temperate reef at Læsø...... Trindel in Kattegat, Denmark, has now been re-established with the aim of restoring the reef’s historical structure and function. The effects of the restoration on the local fish community are reported here. Fishing surveys using gillnets and fyke nets were conducted before the restoration (2007) and four...

  17. Effectiveness of manual therapies: the UK evidence report

    Science.gov (United States)

    2010-01-01

    Background The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. Methods The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs. Results By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines. Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments. Conclusions Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham

  18. Effectiveness of manual therapies: the UK evidence report.

    Science.gov (United States)

    Bronfort, Gert; Haas, Mitch; Evans, Roni; Leininger, Brent; Triano, Jay

    2010-02-25

    The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs. By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments. Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1

  19. Effectiveness of manual therapies: the UK evidence report

    Directory of Open Access Journals (Sweden)

    Leininger Brent

    2010-02-01

    Full Text Available Abstract Background The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. Methods The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs, widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs. Results By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines. Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments. Conclusions Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and

  20. The balance effect of acupuncture therapy among stroke patients.

    Science.gov (United States)

    Huang, Shih-Wei; Wang, Wei-Te; Yang, Tsung-Hsien; Liou, Tsan-Hon; Chen, Guan-Yu; Lin, Li-Fong

    2014-08-01

    To analyze how acupuncture therapy affects balance in patients experiencing their first stroke and to identify the stroke group with greatest improvement in balance after acupuncture intervention. Retrospective case-control study. Ward of a medical university hospital. A total of 629 stroke patients were enrolled initially; 345 patients met the study criteria and 132 were analyzed (66 each in the study and control groups). The study group received physiotherapy combined with acupuncture and the control group received only physiotherapy. The Postural Assessment Scale for Stroke patients (PASS) was used to evaluate balance. This balance scale system can be subdivided into static balance (PASS-MP, maintain posture) and dynamic balance (PASS-CP, change posture). This study revealed no statistically significant improvement of balance in the study group (t test). When patients with high Brunnstrom stage (Br stage) and low Br stage were analyzed separately, once again no statistical difference was detected between the study and control groups of those with high Br stage. However, among low-Br stage patients, the study group showed significant improvement in static balance (mean PASS-MP score±standard deviation: 4.7±3.7) compared with the control group (PASS-MP score: 2.8±2.7) (pstroke patients with a low Br stage, acupuncture therapy can improve static balance during rehabilitation. However, the effect on balance was limited among high-Br stage patients. This study provides information valuable to patients with hemiplegic stroke because it suggests that acupuncture can be used to improve balance. A prospective double-blind, randomized, controlled study design is recommended for future studies in patients with hemiplegic stroke.

  1. Acupuncture effectiveness as a complementary therapy in functional dyspepsia patients.

    Science.gov (United States)

    Lima, Flávia Altaf da Rocha; Ferreira, Lincoln Eduardo Villela Vieira de Castro; Pace, Fábio Heleno de Lima

    2013-01-01

    Functional dyspepsia represents a frequent gastrointestinal disorder in clinical practice. According to the Roma III criteria, functional dyspepsia can be classified into two types as the predominant symptom: epigastric pain and postprandial discomfort. Even though the pathophysiology is still uncertain, the functional dyspepsia seems to be related to multiple mechanisms, among them visceral hypersensitivity, changes in the gastroduodenal motility and gastric accommodation and psychological factors. Evaluate the effectiveness of acupuncture as a complementary to conventional treatment in functional dyspepsia patients. Randomized clinical trial in which were enrolled patients with functional dyspepsia patients in according with Rome III criteria. One group was submitted to drug therapy and specific acupuncture (GI) and the other to drug therapy and non-specific acupuncture (GII). The gastrointestinal symptoms, presence of psychiatric disorders and quality of life were evaluated, at the end and three months after treatment. After 4 weeks of treatment there was improvement of gastrointestinal symptoms in Group I (55 ± 12 vs 29 ± 8.8; P = 0.001) and Group II (50.5 ± 10.2 vs 46 ± 10.5; P = 0.001). Quality of life was significantly better in Group I than group II (93.4 ± 7.3 vs 102.4 ± 5.1; P = 0.001). Anxiety (93.3% vs 0%; P = 0.001) and depression (46.7% vs 0%; P = 0.004) were significantly lower in Group I than group II. When comparing the two groups after 4 weeks of treatment, gastrointestinal symptoms (29 ± 8.8 vs 46 ± 10.5; Pacupuncture treatment is superior to conventional treatment. Further studies with more patients are needed to confirm these findings.

  2. Effectiveness of enhanced communication therapy in the first four months after stroke for aphasia and dysarthria: a randomised controlled trial

    Science.gov (United States)

    Hesketh, Anne; Patchick, Emma; Young, Alys; Davies, Linda; Vail, Andy; Long, Andrew F; Watkins, Caroline; Wilkinson, Mo; Pearl, Gill; Ralph, Matthew A Lambon; Tyrrell, Pippa

    2012-01-01

    Objective To assess the effectiveness of enhanced communication therapy in the first four months after stroke compared with an attention control (unstructured social contact). Design Externally randomised, pragmatic, parallel, superiority trial with blinded outcome assessment. Setting Twelve UK hospital and community stroke services. Participants 170 adults (mean age 70 years) randomised within two weeks of admission to hospital with stroke (December 2006 to January 2010) whom speech and language therapists deemed eligible, and 135 carers. Interventions Enhanced, agreed best practice, communication therapy specific to aphasia or dysarthria, offered by speech and language therapists according to participants’ needs for up to four months, with continuity from hospital to community. Comparison was with similarly resourced social contact (without communication therapy) from employed visitors. Outcome measures Primary outcome was blinded, functional communicative ability at six months on the Therapy Outcome Measure (TOM) activity subscale. Secondary outcomes (unblinded, six months): participants’ perceptions on the Communication Outcomes After Stroke scale (COAST); carers’ perceptions of participants from part of the Carer COAST; carers’ wellbeing on Carers of Older People in Europe Index and quality of life items from Carer COAST; and serious adverse events. Results Therapist and visitor contact both had good uptake from service users. An average 22 contacts (intervention or control) over 13 weeks were accepted by users. Impairment focused therapy was the approach most often used by the speech and language therapists. Visitors most often provided general conversation. In total, 81/85 of the intervention group and 72/85 of the control group completed the primary outcome measure. Both groups improved on the TOM activity subscale. The estimated six months group difference was not statistically significant, with 0.25 (95% CI –0.19 to 0.69) points in favour of

  3. Community involvement, planning and coping skills: pilot outcomes of a recreational-therapy intervention for adults with schizophrenia.

    Science.gov (United States)

    Snethen, Gretchen; McCormick, Bryan P; Van Puymbroeck, Marieke

    2012-01-01

    The Independence through Community Access and Navigation (I-CAN) intervention was developed to increase community participation in adults with schizophrenia spectrum disorders (SSD) through identification of interest-based recreation activities and supported participation. Ten individuals consented to participate in a 10-week pilot intervention. Eight individuals participated in the intervention, during which time they worked with a recreational therapist to identify interest-based recreation activities, develop participation goals and coparticipate with the recreational therapist. At the end of the intervention, seven participants were involved in a semistructured interview to understand their perceptions of the intervention, including its outcomes and effectiveness. Therapists' notes and transcripts from the semistructured interviews were used to understand clients' perception of the intervention. Thematic analyses of seven exit interviews suggested the primary perceived outcomes of the intervention included: increased community involvement; development of planning skills; and the development of coping skills. These were facilitated by the therapeutic relationship between the client and therapist. This project provides preliminary support for the I-CAN as a participant-centered method for individuals with SSD to develop skills in the community. Implications for practice and future research are presented.

  4. Music therapy and the effects on laboring women.

    Science.gov (United States)

    Robinson, Amber

    2002-01-01

    Wiand's (1997) study supported the use of music therapy to decrease pain and anxiety. The results of this study could be used to support a research utilization project to educate nurses on the potential benefits of music therapy among laboring women. Nurses and physicians could collaborate together to educate clients on music therapy to decrease pain and anxiety. Feasibility issues would include education of the nurses to use music therapy and the cost of developing different types of music. Future research could be done to study a larger sample size. Other research is needed to determine what type of music works best with laboring women.

  5. The Effect of Service Learning on Community College Students

    Science.gov (United States)

    Sass, Margaret S.; Coll, Ken

    2015-01-01

    This study discusses the implementation of a service learning component in community college communication 101 level courses. Through the execution of a service learning component in communication classes at a community college, students' communicative competency and attitude toward community service is assessed. Using two different delivery…

  6. Community Schools as an Effective Strategy for Reform. Research Brief

    Science.gov (United States)

    Daniel, Julia; Snyder, Jon David

    2016-01-01

    Research literature finds that community school models offering various agreed-upon features provide an excellent social return on investment and significant promise for providing opportunities for learning and promoting well-being in students and communities. Community schools show significant promise for addressing barriers to learning and…

  7. Community reintegration of stroke survivors: the effect of a community navigation intervention.

    Science.gov (United States)

    Montgomery, Phyllis; Jermyn, Darren; Bailey, Patricia; Nangia, Parveen; Egan, Mary; Mossey, Sharolyn

    2015-01-01

    The overall aim of the proposed study is to examine a newly implemented navigation intervention intended to support stroke survivors' community integration during the first year following hospital discharge in four regions of Ontario, Canada. Stroke is a leading cause of disability worldwide. Stroke survivors living in the community require regular, ongoing follow-up to assess recovery, prevent deterioration and maximize health outcomes. Internationally published evidence, often conducted in large urban centres, suggests that community reintegration services are an important component of the continuum of care for stroke survivors. This evidence, however, often does not address the particular challenges inherent in smaller urban and rural contexts. The design of this 2-year mixed-method study will use cohort and focused ethnography. The three stages of this study include: (1) collection of quantitative data to profile the health status, support and extent of community reintegration of stroke survivors; (2) collection of qualitative data from stroke survivors and their care partners about community reintegration and navigation; and following triangulation of findings (3) knowledge translation activities. This study was ethically approved by the academic Research Ethics Board and clinical Research Ethics Board (Sudbury, Ontario) and funded by the Ontario Stroke Network (Canada). Results will describe experiences and outcomes of a community navigation intervention. Engagement of multiple stakeholders has the potential to develop a shared understanding of community reintegration and generate evidence informed recommendations for service enhancement at critical points in stroke recovery to support survivor and community well-being. © 2014 John Wiley & Sons Ltd.

  8. The effect of antihypertensive therapy on dry eye disease.

    Science.gov (United States)

    Kalkan Akcay, Emine; Akcay, Murat; Can, Gamze Dereli; Aslan, Nabi; Uysal, Betul Seher; Ceran, Basak Bostanci; Koseahya, Pinar; Cagil, Nurullah

    2015-01-01

    There is a generalization that "antihypertensive (antiHT) therapy causes Dry Eye Syndrome", which has been claimed for years however most of the publications are epidemiological studies. We performed a clinical study to investigate the effects of antiHT agents on tear function. The aim of this article is to evaluate the effects of different classes of antiHT medications on tear osmolarity, ocular surface problems and dry eye symptoms. Prospective, non-randomized a clinical study. A total of 71 patients who would be initiated antiHT medication due to elevated systemic blood pressure were included in the study. Thirty of these patients were given antiHT drugs containing diuretic (diuretic +), and 41 of them were given diuretic-free drugs (diuretic -). While the number of the patients medicated in the group that received Angiotensin Converting Enzyme inhibitors (ACE inh)/Angiotensin receptor blockers (ARB) (ACE/ARB +) was 29, the number of those medicated in the ACE/ARB-free group (ACE/ARB -) was 42. Ocular surface disease index scores, tear osmolarity, Schirmer I test, tear film break-up time (TBUT), fluorescein (FL) and rose bengal corneal staining patterns of the patients were analyzed. The patients were examined through the repetition of all the tests in the 1st and the 3rd month. The participants (n = 71) comprised 38 males and 33 females with a mean age of 51.8 ± 10.4. When the first (0-1st month) and the third month (0-3rd months) control measurements between diuretics (+) and diuretics (-) groups before and after antiHT therapies were compared, a statistically significant difference was not found in any of the tests applied. When the 0-1st month measurements of ACE/ARB (+) and ACE/ARB (-) groups were compared, it was observed that staining with FL in ACE/ARB (+) group decreased in a statistically significant manner (p = 0.035) and there was a significant increase in TBUT values (p = 0.022). The use of antiHT drugs containing diuretic had no

  9. Advancing coalition theory: the effect of coalition factors on community capacity mediated by member engagement.

    Science.gov (United States)

    Kegler, Michelle C; Swan, Deanne W

    2012-08-01

    Community coalitions have the potential to enhance a community's capacity to engage in effective problem solving for a range of community concerns. Although numerous studies have documented correlations between member engagement and coalition processes and structural characteristics, fewer have examined associations between coalition factors and community capacity outcomes. The current study uses data from an evaluation of the California Healthy Cities and Communities program to examine pathways between coalition factors (i.e. membership, processes), member engagement (i.e. participation, satisfaction) and community capacity as hypothesized by the Community Coalition Action Theory (CCAT). Surveys were completed by 231 members of 19 healthy cities and communities coalitions. Multilevel mediation analyses were used to examine possible mediating effects of member engagement on three community capacity indicators: new skills, sense of community and social capital. Results generally supported CCAT. Member engagement mediated the effects of leadership and staffing on community capacity outcomes. Results also showed that member engagement mediated several relationships between process variables (i.e. task focus, cohesion) and community capacity, but several unmediated direct effects were also observed. This suggests that although member engagement does explain some relationships, it alone is not sufficient to explain how coalition processes influence indicators of community capacity.

  10. Predicting richness effects on ecosystem function in natural communities

    DEFF Research Database (Denmark)

    Dangles, Olivier; Crespo-Pérez, Verónica; Andino, Patricio

    2011-01-01

    among the three shredder species, indicating complementary resource use and/or facilitation. By integrating survey and experimental data in surface response analyses we found that observed B-EF patterns fit those predicted by a linear model that described litter decomposition rates as a function...... to their structural simplicity and their low levels of human impacts, extreme species-poor ecosystems may provide new insights into B-EF relationships in natural systems. We address this issue using shredder invertebrate communities and organic matter decomposition rates in 24 high-altitude (3200-3900 m) Neotropical...... streams as a study model. We first assessed the effects of stream characteristics and shredder diversity and abundance on organic matter decomposition rates in coarse- and fine-mesh bags. We found the interaction term shredder richness x shredder abundance had the most significant impact on decomposition...

  11. Attitudes of the UK ear, nose and throat clinical community to the future potential use of stem cell therapies to treat deafness.

    Science.gov (United States)

    Ali, Khalid H M; Williams, David J; Jackson, Peter; Pau, Henry P

    2012-03-01

    Hearing loss is commonly due to the degeneration and death of hair cells and their associated spiral ganglion neurons. A total of 250 million people are affected worldwide. Stem cell treatments offer new and powerful strategies to enable recovery from hearing loss. This study focuses on the translational process required to move stem cell therapy from the laboratory to clinical use as a novel treatment of deafness and an alternative to conventional therapy. In particular, this study aims to inform and enable the adoption process for such therapies, including understanding the awareness of and attitudes towards stem cell therapy for hearing loss among ear, nose and throat surgeons, physicians, audiologists and scientists, who are key stakeholders in the adoption process. A structured questionnaire has been developed and applied to assess the knowledge and awareness of the clinical community with respect to the future potential use of stem cell therapies to treat deafness. Results showed >87% of the clinicians sampled have very little or no knowledge of stem cell therapy. A total of 11% have been asked by patients about the use of stem cell therapies to treat deafness, and 64% felt a new treatment is needed for deafness. Significantly, 40% felt that a stem cell therapy would be a good adjuvant to a cochlear implant. In total, 78% were supportive of investment in stem cell therapy research and manufacturing. This investment should be in work directed at those areas where clinicians favor adoption. Alignment is required between the scientific and clinical communities. This should not only take into account the likelihood of scientific success when pursuing the therapeutic alternatives, but should also consider the clinical trial requirements, regulatory landscape and reimbursement conditions for each option.

  12. Effect of size heterogeneity on community identification in complex networks

    Energy Technology Data Exchange (ETDEWEB)

    Danon, L.; Diaz-Guilera, A.; Arenas, A.

    2008-01-01

    Identifying community structure can be a potent tool in the analysis and understanding of the structure of complex networks. Up to now, methods for evaluating the performance of identification algorithms use ad-hoc networks with communities of equal size. We show that inhomogeneities in community sizes can and do affect the performance of algorithms considerably, and propose an alternative method which takes these factors into account. Furthermore, we propose a simple modification of the algorithm proposed by Newman for community detection (Phys. Rev. E 69 066133) which treats communities of different sizes on an equal footing, and show that it outperforms the original algorithm while retaining its speed.

  13. Effects of music therapy on pain, discomfort, and depression for patients with leg fractures.

    Science.gov (United States)

    Kwon, In Sook; Kim, Jungnam; Park, Kyung Min

    2006-06-01

    To determine the effects of music therapy on pain, discomfort, and depression for patients with leg fractures. Data were collected from 40 patients admitted in an orthopedic surgery care unit. The subjects included 20 intervention group members and 20 control group members. Music therapy was offered to intervention group members once a day for 3 days for 30-60 minutes per day. Pain was measured with a numeric rating scale and by measuring vital signs. Discomfort and depression were measured with self-administered questionnaires. Patients who received music therapy had a lower degree of pain than patients who did not receive music therapy as measured by the numeric pain score (pmusic therapy also had a lower degree of discomfort than patients who were not provided with this therapy (pmusic therapy is an effective method for decreasing pain and dis-comfort for patients with leg fractures.

  14. A controlled study of agoraphobia and the independent effect of virtual reality exposure therapy.

    Science.gov (United States)

    Malbos, Eric; Rapee, Ronald M; Kavakli, Manolya

    2013-02-01

    Past controlled clinical trials centred on virtual reality exposure therapy (VRET) for agoraphobia mostly used multicomponent therapy with success. However, the present paper aimed to evaluate the independent effect of VRET for agoraphobia. A controlled study involving 18 agoraphobic participants assigned to two groups: VRET only and VRET with cognitive therapy. Nine specific virtual environments were developed using an affordable game level editor. Questionnaires, behavioural tests and physiological measures indicated a positive effect of VRET. Correlations supported the predictive value of presence towards treatment outcome. The addition of cognitive therapy did not provide significant additional benefit. Overall, the isolated effects of VRET did not seem to be significantly less than the effects of VRET combined with cognitive therapy. Future research should explore the use of other components in addition to cognitive therapy and VRET for agoraphobia as well as its possible use in patients' homes.

  15. 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.

  16. Estradiol Therapy After Menopause Mitigates Effects of Stress on Cortisol and Working Memory.

    Science.gov (United States)

    Herrera, Alexandra Ycaza; Hodis, Howard N; Mack, Wendy J; Mather, Mara

    2017-12-01

    Postmenopausal estradiol therapy (ET) can reduce the stress response. However, it remains unclear whether such reductions can mitigate effects of stress on cognition. Investigate effects of ET on cortisol response to a physical stressor, cold pressor test (CPT), and whether ET attenuates stress effects on working memory. Women completed the CPT or control condition across two sessions and subsequently completed a sentence span task. General community: Participants were recruited from the Early vs Late Intervention Trial with Estradiol (ELITE). ELITE participants (mean age = 66, standard deviation age = 6.8) in this study did not suffer from any major chronic illness or use medications known to affect the stress response or cognition. Participants had received a median of randomized 4.7 years of estradiol (n = 21) or placebo (n = 21) treatment at time of participation in this study. Salivary cortisol and sentence span task performance. Women assigned to estradiol exhibited blunted cortisol responses to CPT compared with placebo (P = 0.017) and lesser negative effects of stress on working memory (P = 0.048). We present evidence suggesting ET may protect certain types of cognition in the presence of stress. Such estrogenic protection against stress hormone exposure may prove beneficial to both cognition and the neural circuitry that maintains and propagates cognitive faculties.

  17. Empirical therapies among adults hospitalized for community-acquired upper urinary tract infections: A decision-tree analysis of mortality, costs, and resistance.

    Science.gov (United States)

    Parienti, J J; Lucet, J C; Lefort, A; Armand-Lefèvre, L; Wolff, M; Caron, F; Cattoir, V; Yazdanpanah, Y

    2015-09-01

    Poor outcomes occur when patients with serious infections receive antibiotics to which the organisms are resistant. Decision trees simulated in-hospital mortality, costs, incremental cost-effectiveness ratio per life year saved, and carbapenem resistance according to 3 empirical antibiotic strategies among adults hospitalized for community-acquired (CA) upper urinary tract infections (UTIs): ceftriaxone (CRO) plus gentamicin (GM) in the intensive care unit (ICU), imipenem (IMP), and individualized choice (IMP or CRO) based on clinical risk factors for CA- extended-spectrum β-lactamase (ESBL). The estimated prevalence of CA-ESBL on admission was 5% (range, 1.3%-17.6%); 3% and 97% were admitted to the ICU and medical ward (MW), respectively. In the ICU, CRO plus GM was dominated; IMP was cost-effective (incremental cost-effectiveness ratio: €4,400 per life year saved compared with individualized choice). In the MW, IMP had no impact on mortality and was less costly (-€142 per patient vs CRO, -€38 vs individualized choice). The dominance of IMP was consistent in sensitivity analyses. Compared with CRO, colonization by carbapenem-resistant pathogens increased by an odds ratio of 4.5 in the IMP strategy. Among the ICU patients, empirical IMP therapy reduces mortality at an acceptable cost. Among MW patients, individualized choice or CRO is preferred to limit carbapenem resistance at a reasonable cost. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  18. [Management of side-effects of targeted therapies in renal cancer: gastrointestinal side-effects].

    Science.gov (United States)

    Davin, Jean-Louis; Ducrotté, Philippe; Houédé, Nadine

    2011-01-01

    Several types of gastrointestinal complications can occur during treatment with targeted therapies: diarrhoea, nausea and vomiting, abnormalities in hepatic and pancreatic profiles, etc. Gastrointestinal problems in targeted therapy can have a significant impact on the general status of patients, their weight and their adherence to the treatment. The prevention, screening and rapid treatment of these side-effects are essential elements of patient care and can limit the associated dose reductions and loss of therapeutic benefit. In the case of diarrhoea, treatment must be started at the onset of grade 1 or 2 diarrhoea (four to six stools per day), with loperamide or racecadotril. Treatment with targeted therapy must be stopped if there is diarrhoea of grade 3 or 4 (more than six stools per day). In the case of nausea/vomiting or burning pain in the oesophagus, symptomatic treatment without stopping the targeted therapy is recommended. Biological assessment including transaminases, total and conjugated bilirubin should be prescribed before treatment initiation with targeted therapy. An elevation in alkaline phosphatases without elevation of transaminases suggests primarily the existence of hepatic metastases. In the event of worsening of the hepatic profile, if ALT greater than 5N, treatment must be stopped and specialist advice sought. Copyright © 2011 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  19. The Incremental Effects of Manual Therapy or Booster Sessions in Addition to Exercise Therapy for Knee Osteoarthritis: A Randomized Clinical Trial.

    Science.gov (United States)

    Abbott, J Haxby; Chapple, Catherine M; Fitzgerald, G Kelley; Fritz, Julie M; Childs, John D; Harcombe, Helen; Stout, Kirsten

    2015-12-01

    A factorial randomized controlled trial. To investigate the addition of manual therapy to exercise therapy for the reduction of pain and increase of physical function in people with knee osteoarthritis (OA), and whether "booster sessions" compared to consecutive sessions may improve outcomes. The benefits of providing manual therapy in addition to exercise therapy, or of distributing treatment sessions over time using periodic booster sessions, in people with knee OA are not well established. All participants had knee OA and were provided 12 sessions of multimodal exercise therapy supervised by a physical therapist. Participants were randomly allocated to 1 of 4 groups: exercise therapy in consecutive sessions, exercise therapy distributed over a year using booster sessions, exercise therapy plus manual therapy without booster sessions, and exercise therapy plus manual therapy with booster sessions. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score; 0-240 scale) at 1-year follow-up. Secondary outcome measures were the numeric pain-rating scale and physical performance tests. Of 75 participants recruited, 66 (88%) were retained at 1-year follow-up. Factorial analysis of covariance of the main effects showed significant benefit from booster sessions (P = .009) and manual therapy (P = .023) over exercise therapy alone. Group analysis showed that exercise therapy with booster sessions (WOMAC score, -46.0 points; 95% confidence interval [CI]: -80.0, -12.0) and exercise therapy plus manual therapy (WOMAC score, -37.5 points; 95% CI: -69.7, -5.5) had superior effects compared with exercise therapy alone. The combined strategy of exercise therapy plus manual therapy with booster sessions was not superior to exercise therapy alone. Distributing 12 sessions of exercise therapy over a year in the form of booster sessions was more effective than providing 12 consecutive exercise therapy sessions. Providing manual

  20. Radiation Therapy in Keloids Treatment: History, Strategy, Effectiveness, and Complication

    Directory of Open Access Journals (Sweden)

    Jing Xu

    2017-01-01

    Conclusions: Both past and present evidence support the idea that combination therapy of radiation and surgical therapy is safe and feasible. However, the optimization of treatment strategy was based on different radiation types and should take dose, fractions, interval, and complications into consideration, which will then decrease the rate of recurrence and increase the level of satisfaction.

  1. Oxygen therapies and their effects on wound healing

    NARCIS (Netherlands)

    de Smet, Gijs H. J.; Kroese, Leonard F.; Menon, Anand G.; Jeekel, Johannes; van Pelt, Antoon W. J.; Kleinrensink, Gert-Jan; Lange, Johan F.

    Oxygen is an important factor for wound healing. Although several different therapies investigated the use of oxygen to aid wound healing, the results of these studies are not unequivocal. This systematic review summarizes the clinical and experimental studies regarding different oxygen therapies

  2. Pharmacodynamic Effect of N-Acetylcysteine as Adjunctive Therapy ...

    African Journals Online (AJOL)

    Erah

    erythematosus (SLE) patients in order to implement NAC as adjunctive therapy in SLE population. Methods: Forty mild ... required in this regard. Keywords: Pharmacodynamics, N-Acetylcysteine, Systemic lupus erythematosus, Adjunctive therapy. ..... physical and mental health in women ages 60 to. 103 years. J Lab Clin ...

  3. the effects of highly active antiretroviral therapy (haart)

    African Journals Online (AJOL)

    Design: A case control study of 70 HIV-infected subjects placed on highly active antiretroviral therapy. Thirty. HIV-infected yet to ... on HAART for 12 weeks while controls that were yet to start therapy were monitored as controls. CD4 lymphocyte count ..... conversion to development of full blown AIDS. J. Aquir Immune Defic ...

  4. The Effect of Nutritional Therapy on Rehabilitation of Alcoholics.

    Science.gov (United States)

    Guenther, Ruth M.

    In this study, nutrition therapy was found to be an important variable in the successful treatment of alcoholism. Traditional treatment methods, such as psychological and institutional approaches, social and group therapy, and chemotherapy, are noted. Research on nutritional needs of individuals has led to an orthomolecular concept which holds…

  5. Cascading effects of ocean acidification in a rocky subtidal community.

    Directory of Open Access Journals (Sweden)

    Valentina Asnaghi

    Full Text Available Temperate marine rocky habitats may be alternatively characterized by well vegetated macroalgal assemblages or barren grounds, as a consequence of direct and indirect human impacts (e.g. overfishing and grazing pressure by herbivorous organisms. In future scenarios of ocean acidification, calcifying organisms are expected to be less competitive: among these two key elements of the rocky subtidal food web, coralline algae and sea urchins. In order to highlight how the effects of increased pCO2 on individual calcifying species will be exacerbated by interactions with other trophic levels, we performed an experiment simultaneously testing ocean acidification effects on primary producers (calcifying and non-calcifying algae and their grazers (sea urchins. Artificial communities, composed by juveniles of the sea urchin Paracentrotus lividus and calcifying (Corallina elongata and non-calcifying (Cystoseira amentacea var stricta, Dictyota dichotoma macroalgae, were subjected to pCO2 levels of 390, 550, 750 and 1000 µatm in the laboratory. Our study highlighted a direct pCO2 effect on coralline algae and on sea urchin defense from predation (test robustness. There was no direct effect on the non-calcifying macroalgae. More interestingly, we highlighted diet-mediated effects on test robustness and on the Aristotle's lantern size. In a future scenario of ocean acidification a decrease of sea urchins' density is expected, due to lower defense from predation, as a direct consequence of pH decrease, and to a reduced availability of calcifying macroalgae, important component of urchins' diet. The effects of ocean acidification may therefore be contrasting on well vegetated macroalgal assemblages and barren grounds: in the absence of other human impacts, a decrease of biodiversity can be predicted in vegetated macroalgal assemblages, whereas a lower density of sea urchin could help the recovery of shallow subtidal rocky areas affected by overfishing from

  6. Cascading effects of ocean acidification in a rocky subtidal community.

    Science.gov (United States)

    Asnaghi, Valentina; Chiantore, Mariachiara; Mangialajo, Luisa; Gazeau, Frédéric; Francour, Patrice; Alliouane, Samir; Gattuso, Jean-Pierre

    2013-01-01

    Temperate marine rocky habitats may be alternatively characterized by well vegetated macroalgal assemblages or barren grounds, as a consequence of direct and indirect human impacts (e.g. overfishing) and grazing pressure by herbivorous organisms. In future scenarios of ocean acidification, calcifying organisms are expected to be less competitive: among these two key elements of the rocky subtidal food web, coralline algae and sea urchins. In order to highlight how the effects of increased pCO2 on individual calcifying species will be exacerbated by interactions with other trophic levels, we performed an experiment simultaneously testing ocean acidification effects on primary producers (calcifying and non-calcifying algae) and their grazers (sea urchins). Artificial communities, composed by juveniles of the sea urchin Paracentrotus lividus and calcifying (Corallina elongata) and non-calcifying (Cystoseira amentacea var stricta, Dictyota dichotoma) macroalgae, were subjected to pCO2 levels of 390, 550, 750 and 1000 µatm in the laboratory. Our study highlighted a direct pCO2 effect on coralline algae and on sea urchin defense from predation (test robustness). There was no direct effect on the non-calcifying macroalgae. More interestingly, we highlighted diet-mediated effects on test robustness and on the Aristotle's lantern size. In a future scenario of ocean acidification a decrease of sea urchins' density is expected, due to lower defense from predation, as a direct consequence of pH decrease, and to a reduced availability of calcifying macroalgae, important component of urchins' diet. The effects of ocean acidification may therefore be contrasting on well vegetated macroalgal assemblages and barren grounds: in the absence of other human impacts, a decrease of biodiversity can be predicted in vegetated macroalgal assemblages, whereas a lower density of sea urchin could help the recovery of shallow subtidal rocky areas affected by overfishing from barren grounds to

  7. Comparison of Cognitive-Behavioural Therapy and Psychodynamic Therapy in the Treatment of Anxiety among University Students: An Effectiveness Study

    Science.gov (United States)

    Monti, Fiorella; Tonetti, Lorenzo; Ricci Bitti, Pio Enrico

    2014-01-01

    The aim of the present study was to compare the effectiveness of cognitive-behavioural (CBT) and psychodynamic (PDT) therapies in the treatment of anxiety among university students. To this aim, the Symptom Questionnaire (SQ) was completed by 30 students assigned to CBT and by 24 students assigned to PDT, both at the beginning and at the end of…

  8. Effects of scoria-cone eruptions upon nearby human communities

    Science.gov (United States)

    Ort, M.H.; Elson, M.D.; Anderson, K.C.; Duffield, W.A.; Hooten, J.A.; Champion, D.E.; Waring, G.

    2008-01-01

    Scoria-cone eruptions are typically low in volume and explosivity compared with eruptions from stratovolcanoes, but they can affect local populations profoundly. Scoria-cone eruption effects vary dramatically due to eruption style, tephra blanket extent, climate, types of land use, the culture and complexity of the affected group, and resulting governmental action. A comparison of a historic eruption (Pari??cutin, Me??xico) with prehistoric eruptions (herein we primarily focus on Sunset Crater in northern Arizona, USA) elucidates the controls on and effects of these variables. Long-term effects of lava flows extend little beyond the flow edges. These flows, however, can be used for defensive purposes, providing refuges from invasion for those who know them well. In arid lands, tephra blankets serve as mulches, decreasing runoff and evaporation, increasing infiltration, and regulating soil temperature. Management and retention of these scoria mulches, which can open new areas for agriculture, become a priority for farming communities. In humid areas, though, the tephra blanket may impede plant growth and increase erosion. Cultural responses to eruptions vary, from cultural collapse, through fragmentation of society, dramatic changes, and development of new technologies, to little apparent change. Eruptions may also be viewed as retribution for poor behavior, and attempts are made to mollify angry gods. ?? 2008 Geological Society of America.

  9. Disseminating Comparative Effectiveness Research Through Community-based Experiential Learning.

    Science.gov (United States)

    Hansen, Richard A; Williamson, Margaret; Stevenson, Lynn; Davis, Brandy R; Evans, R Lee

    2017-02-25

    Objectives. To launch and evaluate a comparative effectiveness research education and dissemination program as part of an introductory pharmacy practice experience (IPPE). Methods. First- through third-year PharmD students received training on comparative effectiveness research and disseminated printed educational materials to patients in the community who they were monitoring longitudinally (n=314). Students completed an assessment and initial visit documentation form at the first visit, and a follow-up assessment and documentation form at a subsequent visit. Results. Twenty-three diabetes patients, 29 acid-reflux patients, 30 osteoarthritis patients, and 50 hypertension patients received materials. Aside from the patient asking questions, which was the most common outcome (n=44), the program resulted in 38 additional actions, which included stopping, starting, or changing treatments or health behaviors, or having additional follow-up or diagnostic testing. Small but positive improvements in patient understanding, confidence, and self-efficacy were observed. Conclusions. Dissemination of comparative effectiveness research materials in an IPPE program demonstrated a positive trend in markers of informed decision-making.

  10. [Effectiveness of an online cognitive behavioral therapy for insomnia].

    Science.gov (United States)

    Friðgeirsdóttir, Guðlaug; Jóhannsson, Gunnar; Ellertsson, Steindór; Björnsdóttir, Erla

    2015-04-01

    Insomnia is a common health problem with serious mental and physical consequences as well as increased economical costs. The use of hypnotics in Iceland is immense in spite of cognitive behavioral therapy for insomnia (CBT-I) being recommended as the first choice treatment of chronic insomnia. To meet the needs of more individuals suffering from insomnia, online CBT-I was established at betrisvefn.is. The objective of this research was to evaluate the effectiveness of this internet-based CBT-I. One hundred seventy-five users (mean age 46 y (18-79 y)) started a 6 week online intervention for insomnia. The drop-out rate was 29%, leaving a final sample of 125 users. The intervention is based on well-established face-to-face CBT-I. Sleep diaries were used to determine changes in sleep efficiency, sleep onset latency and wake after sleep onset. Treatment effects were assesed after 6 weeks of treatment and at the 6 week follow-up. Significant improvement was found in all main sleep variables except for 5% decrease in total sleep time (TST). Effects were sustained at 6 week follow-up and TST increased. The use of hypnotics decreased significantly. This form of treatment seems to suit its users very well and over 94% would recommend the treatment. Internet interventions for insomnia seem to have good potential. CBT-I will hopefully be offered as the first line treatment for chronic insomnia in Iceland instead of hypnotics as the availability of the CBT-I is growing. Thus, the burden on health care clinics might reduce along with the hypnotics use and the considerable costs of insomnia.

  11. TEMPORALLY VARIABLE GEOGRAPHICAL DISTANCE EFFECTS CONTRIBUTE TO THE ASSEMBLY OF ROOT-ASSOCIATED FUNGAL COMMUNITIES

    Directory of Open Access Journals (Sweden)

    Christopher James Barnes

    2016-02-01

    Full Text Available Root-associated fungi are key contributors to ecosystem functioning, however the factors which determine community assembly are still relatively poorly understood. This study simultaneously quantified the roles of geographical distance, environmental heterogeneity and time in determining root-associated fungal community composition at the local scale within a short rotation coppice (SRC willow plantation. Culture independent molecular analyses of the root-associated fungal community suggested a strong but temporally variable effect of geographical distance between fungal communities on composition at the local geographical level. Whilst these distance effects were most prevalent on October communities, soil pH had an effect on structuring of the communities throughout the sampling period. Given the temporal variation in the effects of geographical distance and the environment for shaping root-associated fungal communities, there is clearly need for a temporal component to sampling strategies in future investigations of fungal biogeography.

  12. Temporally Variable Geographical Distance Effects Contribute to the Assembly of Root-Associated Fungal Communities.

    Science.gov (United States)

    Barnes, Christopher J; van der Gast, Christopher J; Burns, Caitlin A; McNamara, Niall P; Bending, Gary D

    2016-01-01

    Root-associated fungi are key contributors to ecosystem functioning, however, the factors which determine community assembly are still relatively poorly understood. This study simultaneously quantified the roles of geographical distance, environmental heterogeneity and time in determining root-associated fungal community composition at the local scale within a short rotation coppice (SRC) willow plantation. Culture independent molecular analyses of the root-associated fungal community suggested a strong but temporally variable effect of geographical distance among fungal communities in terms of composition at the local geographical level. Whilst these distance effects were most prevalent on October communities, soil pH had an effect on structuring of the communities throughout the sampling period. Given the temporal variation in the effects of geographical distance and the environment for shaping root-associated fungal communities, there is clearly need for a temporal component to sampling strategies in future investigations of fungal ecology.

  13. Chronic effects of an invasive species on an animal community.

    Science.gov (United States)

    Doody, J Sean; Rhind, David; Green, Brian; Castellano, Christina; McHenry, Colin; Clulow, Simon

    2017-08-01

    Invasive species can trigger trophic cascades in animal communities, but published cases involving their removal of top predators are extremely rare. An exception is the invasive cane toad (Rhinella marina) in Australia, which has caused severe population declines in monitor lizards, triggering trophic cascades that facilitated dramatic and sometimes unexpected increases in several prey of the predators, including smaller lizards, snakes, turtles, crocodiles, and birds. Persistence of isolated populations of these predators with a decades-long sympatry with toads suggests the possibility of recovery, but alternative explanations are possible. Confirming predator recovery requires longer-term study of populations with both baseline and immediate post-invasion densities. Previously, we quantified short-term impacts of invasive cane toads on animal communities over seven years at two sites in tropical Australia. Herein, we test the hypothesis that predators have begun to recover by repeating the study 12 yr after the initial toad invasion. The three predatory lizards that experienced 71-97% declines in the short-term study showed no sign of recovery, and indeed a worse fate: two of the three species were no longer detectable in 630 km of river surveys, suggesting local extirpation. Two mesopredators that had increased markedly in the short term due to these predator losses showed diverse responses in the medium term; a small lizard species increased by ~500%, while populations of a snake species showed little change. Our results indicate a system still in ecological turmoil, having not yet reached a "new equilibrium" more than a decade after the initial invasion; predator losses due to this toxic invasive species, and thus downstream effects, were not transient. Given that cane toads have proven too prolific to eradicate or control, we suggest that recovery of impacted predators must occur unassisted by evolutionary means: dispersal into extinction sites from

  14. The effect of mirror therapy on the management of phantom limb pain.

    Science.gov (United States)

    Yıldırım, Meltem; Kanan, Nevin

    2016-07-01

    In the last two decades, mirror therapy has become a frequently used method of managing phantom limb pain (PLP). However, the role of nurses in mirror therapy has not yet been well defined. This study examined the effect of mirror therapy on the management of PLP, and discusses the importance of mirror therapy in the nursing care of amputee patients. This quasi-experimental study was conducted in the pain management department of a university hospital and a prosthesis clinic in İstanbul, Turkey, with 15 amputee patients who had PLP. Forty minutes of practical mirror therapy training was given to the patients and they were asked to practice at home for 4 weeks. Patients were asked to record the severity of their PLP before and after the therapy each day using 0-10 Numeric Pain Intensity Scale. Mirror therapy practiced for 4 weeks provided a significant decrease in severity of PLP. There was no significant relationship between the effect of mirror therapy and demographic, amputation or PLP-related characteristics. Patients who were not using prosthesis had greater benefit from mirror therapy. Mirror therapy can be used as an adjunct to medical and surgical treatment of PLP. It is a method that patients can practice independently, enhancing self-control over phantom pain. As mirror therapy is a safe, economical, and easy-to-use treatment method, it should be considered in the nursing care plan for patients with PLP.

  15. Differentiated effects of community schooling on cognitive and social-emotional learning outcomes

    NARCIS (Netherlands)

    Heers, M.; Ghysels, J.; Groot, W.; Maassen van den Brink, H.

    2015-01-01

    Community schools are becoming increasingly popular. They aim to enhance children’s educational performance by offering extended educational and social services. As community schools mainly focus on disadvantaged children, this study evaluates the effects of community schooling on the educational

  16. LIVESTOCK GRAZING EFFECTS ON ANT COMMUNITIES IN THE EASTERN MOJAVE DESERT, USA

    Science.gov (United States)

    The effects of livestock grazing on composition and structure of ant communities were examined in the eastern Mojave Desert, USA for the purpose of evaluating ant communities as potential indicators of rangeland condition. Metrics for ant communities, vegetation, and other groun...

  17. Genotoxic and apoptotic effects of Goeckerman therapy for psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Borska, L.; Andrys, C.; Krejsek, J.; Hamakova, K.; Kremlacek, J.; Palicka, V.; Ranna, D.; Fiala, Z. [Charles University Prague, Prague (Czech Republic). Faculty of Medicine

    2010-03-15

    Goeckerman therapy (GT) for psoriasis is based on cutaneous application of crude coal tar (polycyclic aromatic hydrocarbons (PAH)) and exposure to ultraviolet radiation (UVR). PAH and UVR are mutagenic, carcinogenic and immunotoxic agents that promote apoptosis. We evaluated dermal absorption of PAH as well as the genotoxic and apoptotic effects of GT in 20 patients with psoriasis, by determining numbers of chromosomal abnormalities in peripheral lymphocytes, and levels of 1-hydroxypyrene (1-OHP), p53 protein and soluble FasL (sFasL) in urine and/or blood, before and after GT. Psoriasis Area and Severity Index (PASI) score was used to evaluate clinical efficacy of GT. Compared with pre-treatment levels, there was a significant increase in urine 1-OHP, indicating a high degree of dermal absorption of PAH (P <0.01). We also found a significant increase in the number of chromosomal abnormalities in peripheral blood lymphocytes (P <0.001), suggesting that GT is genotoxic; significantly increased p53 protein in plasma (P <0.05), an indicator of cell response to DNA damage; and significantly increased sFasL in serum (P <0.01), an indicator of apoptosis. The PASI score was significantly decreased after GT (P <0.001), confirming clinical benefit of this treatment. Our results demonstrate high dermal absorption of PAH during GT and provide evidence that GT promotes genotoxicity and apoptosis.

  18. Effects of orofacial myofunctional therapy on temporomandibular disorders.

    Science.gov (United States)

    de Felício, Cláudia Maria; de Oliveira, Melchior Melissa; da Silva, Marco Antonio Moreira Rodrigues

    2010-10-01

    The objectives of the current study were to analyze the effects of orofacial myofunctional therapy (OMT) on the treatment of subjects with associated articular and muscular temporomandibular disorders (TMD). Thirty subjects with associated articular and muscular TMD, according to the Research Diagnostic Criteria (RDC/TMD), were randomly divided into groups: 10 were treated with OMT (T group), 10 with an occlusal splint (OS group), and 10 untreated control group with TMD (SC). Ten subjects without TMD represented the asymptomatic group (AC). All subjects had a clinical examination and were interviewed to determine Helkimo's Indexes (Di and Ai), the frequency and severity of signs and symptoms, and orofacial myofunctional evaluation. During the diagnostic phase, there were significant differences between groups T and AC. There were no significant differences between group T and OC and SC groups. During the final phase, groups T and OS presented significant improvement, however, the group T presented better results and differed significantly from group OS regarding the number of subjects classified as Aill; the severity of muscular pain and TMJ pain; the frequency of headache and the muscles and stomatognathic functions. The group T differed significantly from the SC group but no longer differed significantly from the AC group. OMT favored a significant reduction of pain sensitivity to palpation of all muscles studied but not for the TMJs; an increased measure of mandibular range of motion; reduced Helkimo's Di and Ai scores; reduced frequency and severity of signs and symptoms; and increased scores for orofacial myofunctional conditions.

  19. Effect of Spinal Manipulative Therapy on the Singing Voice.

    Science.gov (United States)

    Fachinatto, Ana Paula A; Duprat, André de Campos; Silva, Marta Andrada E; Bracher, Eduardo Sawaya Botelho; Benedicto, Camila de Carvalho; Luz, Victor Botta Colangelo; Nogueira, Maruan Nogueira; Fonseca, Beatriz Suster Gomes

    2015-09-01

    This study investigated the effect of spinal manipulative therapy (SMT) on the singing voice of male individuals. Randomized, controlled, case-crossover trial. Twenty-nine subjects were selected among male members of the Heralds of the Gospel. This association was chosen because it is a group of persons with similar singing activities. Participants were randomly assigned to two groups: (A) chiropractic SMT procedure and (B) nontherapeutic transcutaneous electrical nerve stimulation (TENS) procedure. Recordings of the singing voice of each participant were taken immediately before and after the procedures. After a 14-day period, procedures were switched between groups: participants who underwent SMT on the first day were subjected to TENS and vice versa. Recordings were subjected to perceptual audio and acoustic evaluations. The same recording segment of each participant was selected. Perceptual audio evaluation was performed by a specialist panel (SP). Recordings of each participant were randomly presented thus making the SP blind to intervention type and recording session (before/after intervention). Recordings compiled in a randomized order were also subjected to acoustic evaluation. No differences in the quality of the singing on perceptual audio evaluation were observed between TENS and SMT. No differences in the quality of the singing voice of asymptomatic male singers were observed on perceptual audio evaluation or acoustic evaluation after a single spinal manipulative intervention of the thoracic and cervical spine. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Effect of Low Llevel Therapy on Orthodontic Movement in Human

    Directory of Open Access Journals (Sweden)

    Hosseini MH

    2011-12-01

    Full Text Available Background and Aims: Lasers with different characteristics have been used to stimulate orthodontic tooth movement. Considering the contradictory findings in this regard, this study was designed to assess the effect of low level laser therapy (LLLT on the rate of orthodontic tooth movement.Materials and Methods: In this randomized clinical trial study, 12 patients (4 boys and 8 girls; average age:16.9 ± 3.4 with extracted upper first premolars and required canine retraction into extraction site were included. While in both sides canines were retracted by NiTi coil spring, one side was exposed to GaAlAs laser (890 nm. LLLT was done (on the buccal and palatal mucosa by slow movement of probe at the beginning of the first month. Impression and cast fabrication performed at the beginning of retraction, one and two months later. The amount of retraction on the cast was measured with the aid of a reference plaque fabricated on the rogae using a digital caliper. Data were analyzed using paired sample T-test and one-sample Kolmogorov-Simirnov test. Results: There was no significant difference in the amounts of canine movement between laser exposed and control sides (P>0.05. Conclusion: The energy dose of laser used in this study (72 J per each tooth was not appropriate for increasing dental movement.