Mental Health Promotion as a New Goal in Public Mental Health Care: A Randomized Controlled Trial of an Intervention Enhanching Psychological Flexibility

NARCIS (Netherlands)

Fledderus, M.; Bohlmeijer, Ernst Thomas; Smit, Filip; Westerhof, Gerben Johan

2010-01-01

Objectives: We assessed whether an intervention based on acceptance and commitment therapy (ACT) and mindfulness was successful in promoting positive mental health by enhancing psychological flexibility. Methods: Participants were 93 adults with mild to moderate psychological distress. They were

A Couple-Based Psychological Treatment for Chronic Pain and Relationship Distress.

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Cano, Annmarie; Corley, Angelia M; Clark, Shannon M; Martinez, Sarah C

2018-02-01

Chronic pain impacts individuals with pain as well as their loved ones. Yet, there has been little attention to the social context in individual psychological treatment approaches to chronic pain management. With this need in mind, we developed a couple-based treatment, "Mindful Living and Relating," aimed at alleviating pain and suffering by promoting couples' psychological and relational flexibility skills. Currently, there is no integrative treatment that fully harnesses the power of the couple, treating both the individual with chronic pain and the spouse as two individuals who are each in need of developing greater psychological and relational flexibility to improve their own and their partners' health. Mindfulness, acceptance, and values-based action exercises were used to promote psychological flexibility. The intervention also targets relational flexibility, which we define as the ability to interact with one's partner, fully attending to the present moment, and responding empathically in a way that serves one's own and one's partner's values. To this end, the intervention also included exercises aimed at applying psychological flexibility skills to social interactions as well as emotional disclosure and empathic responding exercises to enhance relational flexibility. The case presented demonstrates that healthy coping with pain and stress may be most successful and sustainable when one is involved in a supportive relationship with someone who also practices psychological flexibility skills and when both partners use relational flexibility skills during their interactions.

Impact of Treatment Integrity on Intervention Effectiveness

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Fryling, Mitch J.; Wallace, Michele D.; Yassine, Jordan N.

2012-01-01

Treatment integrity has cogent implications for intervention effectiveness. Understanding these implications is an important, but often neglected, undertaking in behavior analysis. This paper reviews current research on treatment integrity in applied behavior analysis. Specifically, we review research evaluating the relation between integrity…

Behavioral Lifestyle Intervention in the Treatment of Obesity

Directory of Open Access Journals (Sweden)

Shannon M. Looney

2013-01-01

Full Text Available This article provides an overview of research regarding adult behavioral lifestyle intervention for obesity treatment. We first describe two trials using a behavioral lifestyle intervention to induce weight loss in adults, the Diabetes Prevention Program (DPP and the Look AHEAD (Action for Health in Diabetes trial. We then review the three main components of a behavioral lifestyle intervention program: behavior therapy, an energy- and fat-restricted diet, and a moderate- to vigorous-intensity physical activity prescription. Research regarding the influence of dietary prescriptions focusing on macronutrient composition, meal replacements, and more novel dietary approaches (such as reducing dietary variety and energy density on weight loss is examined. Methods to assist with meeting physical activity goals, such as shortening exercise bouts, using a pedometer, and having access to exercise equipment within the home, are reviewed. To assist with improving weight loss outcomes, broadening activity goals to include resistance training and a reduction in sedentary behavior are considered. To increase the accessibility of behavioral lifestyle interventions to treat obesity in the broader population, translation of efficacious interventions such as the DPP, must be undertaken. Translational studies have successfully altered the DPP to reduce treatment intensity and/or used alternative modalities to implement the DPP in primary care, worksite, and church settings; several examples are provided. The use of new methodologies or technologies that provide individualized treatment and real-time feedback, and which may further enhance weight loss in behavioral lifestyle interventions, is also discussed.

Improvement of organic solar cells by flexible substrate and ITO surface treatments

International Nuclear Information System (INIS)

Cheng, Yuang-Tung; Ho, Jyh-Jier; Wang, Chien-Kun; Lee, William; Lu, Chih-Chiang; Yau, Bao-Shun; Nain, Jhen-Liang; Chang, Shun-Hsyung; Chang, Chiu-Cheng; Wang, Kang L.

2010-01-01

In this paper, surface treatments on polyethylene terephthalate with polymeric hard coating (PET-HC) substrates are described. The effect of the contact angle on the treatment is first investigated. It has been observed that detergent is quite effective in removing organic contamination on the flexible PET-HC substrates. Next, using a DC-reactive magnetron sputter, indium tin oxide (ITO) thin films of 90 nm are grown on a substrate treated by detergent. Then, various ITO surface treatments are made for improving the performance of the finally developed organic solar cells with structure Al/P3HT:PCBM/PEDOT:PSS/ITO/PET. It is found that the parameters of the ITO including resistivity, carrier concentration, transmittance, surface morphology, and work function depended on the surface treatments and significantly influence the solar cell performance. With the optimal conditions for detergent treatment on flexible PET substrates, the ITO film with a resistivity of 5.6 x 10 -4 Ω cm and average optical transmittance of 84.1% in the visible region are obtained. The optimal ITO surface treated by detergent for 5 min and then by UV ozone for 20 min exhibits the best WF value of 5.22 eV. This improves about 8.30% in the WF compared with that of the untreated ITO film. In the case of optimal treatment with the organic photovoltaic device, meanwhile, 36.6% enhancement in short circuit current density (J sc ) and 92.7% enhancement in conversion efficiency (η) over the untreated solar cell are obtained.

Flexible intramedullary nailing for the treatment of unicameral bone cysts in long bones.

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Roposch, A; Saraph, V; Linhart, W E

2000-10-01

Unicameral bone cyst is characterized by its tenacity and risk of recurrence. Pathological fracture is common and is often the presenting symptom. The objective of the present study was to evaluate the results of flexible intramedullary nailing for the treatment of a unicameral bone cyst with or without a pathological fracture. Flexible intramedullary nailing for the treatment of a unicameral bone cyst was performed in thirty-two patients. Thirty of these patients presented with a pathological fracture; twenty-four were managed immediately with intramedullary nailing, and the other six had been managed conservatively at other clinics before they were referred to our department. The remaining two cysts were detected incidentally. The cyst was located in the humerus in twenty-one patients, in the femur in nine, and in the radius in two. The mean age of the patients at the time of surgery was 9.8 years, and the mean duration of follow-up was 53.7 months. Radiographic evaluation was performed according to the criteria of Capanna et al., and the cyst was classified as completely healed, healed with residual radiolucency (osteolysis), recurred, or having no response. The healing period ranged from three to 105 months. Fourteen cysts healed completely, and sixteen healed with residual radiolucent areas visible on radiographs. There was recurrence of two cysts that had healed with residual radiolucency. All of the cysts in the present study responded to treatment. A change of nails was necessary in nine patients, as the nails had become too short after bone growth. No major complications were observed. Flexible intramedullary nailing provides early stability, which allows early mobilization and thus obviates the need for a plaster cast and decreases the prevalence of the most common complication: a pathological fracture. This method of treatment also allows for an early return to normal activity.

A Meta-Analysis of Treatment Interventions for Internet Addiction Among Korean Adolescents.

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Chun, JongSerl; Shim, HaiSun; Kim, Soyoun

2017-04-01

This study comprehensively examined the effects of treatment interventions for Internet addiction among adolescents in South Korea through a meta-analysis. We analyzed 70 domestic master's theses and journal articles that reported on controlled studies and involved pre- and post-test analyses in the design. The dates of these publications fall between 2000 and 2015. The total effect size, calculated by random-effect analysis (g), revealed that interventions for the treatment of Internet addiction were effective (ES = 1.838). Meta-ANOVAs revealed differences between groups based on a theoretical model, intervention group size, and intervention duration. Integrative therapy produced larger effect sizes (ES = 2.794) compared to other treatment models such as cognitive behavioral therapy and reality therapy. Effect sizes for interventions, including nine to 12 people (ES = 2.178), were larger than those of interventions including more or fewer participants. Finally, treatment interventions that lasted 8 or more weeks revealed larger effect sizes (ES = 2.294) compared to shorter interventions. The study findings suggest directions for the development and effective operation of future Internet addiction interventions among Korean adolescents. Increasing the effectiveness of these interventions requires an integrative theoretical model, an intervention group size of nine to 12 participants, and a long-term intervention.

Treatment Acceptability of Interventions Published in Six School Psychology Journals

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Villarreal, Victor; Ponce, Christopher; Gutierrez, Heveli

2015-01-01

Treatment acceptability (TA) is critical when selecting and implementing an intervention, as TA is associated with treatment outcomes. The significance of TA is reflected in school psychology models for services that state that school psychologists should address TA during development, implementation, and evaluation of interventions. However, the…

A clinical treatment intervention for dysphoria: externalizing metaphors therapy.

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McGuinty, Everett; Armstrong, David; Carrière, Anne-Marie

2014-01-01

The purpose of this article is to explore a novel, short-term treatment intervention for internalizing behaviours. This intervention is primarily based upon an externalizing process, transforming of metaphoric imagery, and shifting of underlying maladaptive emotional schemas. This article addresses the clinical population of children and youth, specifically through outlining the protocol, externalizing metaphors therapy. A selective review of significant works regarding the efficacy of short-term therapy was conducted, including the process of change within narrative therapy. It is proposed that two specific processes account for the mental health change experienced by clients who receive this new treatment intervention: (1) externalization of problems and (2) purposeful client-generated metaphor manipulation, impacting upon underlying schemas. From these theoretical constructs, the present article outlines a three-session treatment protocol that manualizes these key clinical processes. A case study is presented to illustrate this intervention for anxiety and depression. Further clinical research is underway to address the testable hypotheses resulting from the current theoretical model. Clinical trials in brief psychotherapy are suggested to empirically evaluate the efficacy of this new treatment intervention for dysphoria. This article outlines a short-term treatment intervention for anxiety and depression (dysphoira) through a novel 3-session model, where the clinician-practitioner can obtain competency through a one-day workshop.Its relevance for the clinical researcher and the mental health community is in its versatility in addressing internalizing behavior for four clinical populations: (1) children and adolescents; (2) children and adolescents on the autism spectrum; (3) adults in general; and, (4) adults with a dual-diagnosis. The treatment protocol described within is based upon the externalizing and deconstructive properties of Narrative Therapy, and the

CF4 plasma treatment-assisted inkjet printing for color pixel flexible display

International Nuclear Information System (INIS)

Tortissier, G; Daunay, B; Jalabert, L; Lambert, P; Kim, B; Fujita, H; Toshiyoshi, H; Ginet, P

2011-01-01

In this paper we report a MEMS flexible display device based on the color filter Fabry–Perot interferometer and fabricated on a transparent and flexible polyethylene naphthalate substrate. Targeting easy processing, fast evolution and reduced fabrication steps, inkjet printing is selected as a promising technology. CF 4 plasma surface treatment parameters' influence has been investigated through a design of experiment protocol. Important contact angle increase has led to pattern resolution between 50 and 100 µm depending on solutions and substrate nature. Finally, the designed device presents three primary color pixels with satisfying color purity (CIE 1931 chromaticity diagram—red: x = 0.52, y = 0.36; blue: x = 0.13, y = 0.20; green: x = 0.25, y = 0.57).

Flexibility in Men's Sexual Practices in Response to Iatrogenic Erectile Dysfunction after Prostate Cancer Treatment

Directory of Open Access Journals (Sweden)

Gary W. Dowsett, PhD

2014-08-01

Conclusions: Flexibility in sexual practice is possible for some men, both nonheterosexual and heterosexual, in the face of iatrogenic ED. Advising PCa patients of the possibilities of sexual strategies that include AI may help them in reestablishing a sex life that is not erection dependent. Dowsett GW, Lyons A, Duncan D, and Wassersug RJ. Flexibility in men's sexual practices in response to iatrogenic erectile dysfunction after prostate cancer treatment. Sex Med 2014;2:115–120.

Treatment Integrity in a Home-Based Pre-Reading Intervention Programme

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van Otterloo, Sandra G.; van der Leij, Aryan; Veldkamp, Esther

2006-01-01

Treatment integrity is an underexposed issue in the phonological awareness intervention research. The current study assessed the integrity of treatment of the families (N = 32) participating in the experimental condition of a home-based pre-reading intervention study. The participating kindergartners were all genetically at risk for developing…

Clinical observation of interventional treatment for tubal pregnancy

International Nuclear Information System (INIS)

Chen Zhilin; Zhang Qing; Ye Lijing; He Mei

2002-01-01

Objective: To investigate a new method to of conservative treatment of treat tubal pregnancy. Methods: 20 cases of tubal pregnancy were treated by two conservative methods. Among them, 10 cases received single dose 5-fluorouracil perfusion through the super selective catheterization for uterus artery. Others took RU486 orally and received intra-muscular injection of testosterone. Results: Hospitalization was shorter, less salpingectomy was recommended, and blood HCG decreased faster in interventional group, than in control group. Conclusion: The 5-fluorouracil interventional treatment had its advantages for tubal pregnancy

Interventions for the treatment of Frey's syndrome.

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Li, Chunjie; Wu, Fanglong; Zhang, Qi; Gao, Qinghong; Shi, Zongdao; Li, Longjiang

2015-03-17

Frey's syndrome is a rare disorder, the symptoms of which include sweating, flushing and warming over the preauricular and temporal areas following a gustatory stimulus. It often occurs in patients who have undergone parotidectomy, submandibular gland surgery, radical neck dissection, infection and traumatic injury in the parotid region, and is caused by the aberrant regrowth of facial autonomic nerve fibres. Currently there are several options used to treat patients with Frey's syndrome; for example, the topical application of anticholinergics and antiperspirants, and the intradermal injection of botulinum toxin. It is uncertain which treatment is most effective and safe. To assess the efficacy and safety of different interventions for the treatment of Frey's syndrome. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; ICTRP and additional sources for published and unpublished trials. The date of the search was 28 April 2014. We included randomised or quasi-randomised controlled trials (RCTs) in participants diagnosed with Frey's syndrome using a clinical standard such as Minor's starch-iodine test. We planned to include trials in which participants received any intervention versus no treatment (observation) or an alternative intervention, with or without a second active treatment. Our primary outcome measures were success rate (as assessed clinically by Minor's starch-iodine test, the iodine-sublimated paper histogram method, blotting paper technique or another method) and adverse events. Our secondary outcome measure was success rate as assessed by patients (disappearance or improvement of symptoms). We used the standard methodological procedures expected by The Cochrane Collaboration. We identified no RCTs or quasi-RCTs that fulfilled the inclusion criteria. Our searches retrieved eight potentially relevant studies, but after

Flexibility training and the repeated-bout effect: priming interventions prior to eccentric training of the knee flexors.

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Leslie, Andrew W; Lanovaz, Joel L; Andrushko, Justin W; Farthing, Jonathan P

2017-10-01

Both the repeated-bout effect and increased flexibility have been linked to reduced muscle damage, fatigue, and strength loss after intense eccentric exercise. Our purpose was to compare the eccentric-training (ECC) response after first priming the muscles with either static flexibility training or a single intense bout of eccentric exercise. Twenty-five participants were randomly assigned to flexibility training (n = 8; 3×/week; 30 min/day), a single bout of intense eccentric exercise (n = 9), or no intervention (control; n = 8) during a 4-week priming phase, prior to completing a subsequent 4-week period of eccentric training of the knee flexors. Testing was completed prior to the priming phase, before ECC, during acute ECC (0 h, 24 h, and 48 h after bouts 1 and 4), and after ECC. Measures included muscle thickness (MT; via ultrasound); isometric, concentric, and eccentric strength; muscle power (dynamometer); electromyography; range of motion; optimal angle of peak torque; and soreness (visual analog scale). Flexibility training and single-bout groups had 47% less soreness at 48 h after the first bout of ECC compared with control (p training group had 10% less soreness at 48 h after the fourth ECC bout compared with both the single-bout and control groups (p training group (-9%) after the fourth ECC bout compared with control (-19%; p training may be more effective than a single session of eccentric exercise in reducing adverse symptoms during the acute stages of eccentric training; however, these benefits did not translate into greater performance after training.

The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial.

NARCIS (Netherlands)

Fledderus, M.; Bohlmeijer, Ernst Thomas; Fox, Gerardus J.A.; Schreurs, Karlein Maria Gertrudis; Spinhoven, Philip

2013-01-01

This study examined the role of psychological flexibility, as a risk factor and as a process of change, in a self-help Acceptance and Commitment Therapy (ACT) intervention for adults with mild to moderate depression and anxiety. Participants were randomized to the self-help programme with e-mail

Internet-Based Interventions for Addictive Behaviours: A Systematic Review.

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Chebli, Jaymee-Lee; Blaszczynski, Alexander; Gainsbury, Sally M

2016-12-01

Internet-based interventions have emerged as a new treatment and intervention modality for psychological disorders. Given their features of treatment flexibility, anonymity and confidentiality, this modality may be well suited in the management of addictive behaviours. A systematic literature review of the effectiveness and treatment outcomes of Internet-based interventions for smoking cessation, problematic alcohol use, substance abuse and gambling was performed. Studies were included if they met the following criteria: clients received a structured therapeutic Internet-based intervention for a problematic and addictive behaviour; included more than five clients; effectiveness was based on at least one outcome; outcome variables were measured before and immediately following the interventions; had a follow-up period; and involved at least minimal therapist contact over the course of the program. Sixteen relevant studies were found; nine addressed the effects of Internet-based interventions on smoking cessation, four on gambling, two on alcohol and one on opioid dependence. All studies demonstrated positive treatment outcomes for their respective addictive behaviours. The current review concluded that Internet-based interventions are effective in achieving positive behavioural change through reducing problematic behaviours. This mode of therapy has been found to have the capacity to provide effective and practical services for those who might have remained untreated, subsequently reducing the barriers for help-seekers. This in turn provides imperative information to treatment providers, policy makers, and academic researchers.

Flexible protective gloves: The emperor's new clothes

International Nuclear Information System (INIS)

Kelsey, C.A.; Mettler, F.A. Jr.

1990-01-01

The risk of developing skin cancer is estimated for interventional radiologists who do and do not wear thin, flexible protective leaded gloves. The use of these gloves is extremely expensive in terms of dollars per potential cancer prevented. Good radiographic practice without the use of flexible protective gloves provides adequate protection

Flexibility within Fidelity

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Kendall, Philip C.; Gosch, Elizabeth; Furr, Jami M.; Sood, Erica

2008-01-01

The authors address concerns regarding manual-based treatments, highlighting the role of flexibility and creativity. A cognitive-behavioral therapy for youth anxiety called the Coping Cat program demonstrates the flexible application of manuals and emphasizes the importance of a child-centered, personalized approach that involves the child in the…

The effects of the Bowen technique on hamstring flexibility over time: a randomised controlled trial.

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Marr, Michelle; Baker, Julian; Lambon, Nicky; Perry, Jo

2011-07-01

The hamstring muscles are regularly implicated in recurrent injuries, movement dysfunction and low back pain. Links between limited flexibility and development of neuromusculoskeletal symptoms are frequently reported. The Bowen Technique is used to treat many conditions including lack of flexibility. The study set out to investigate the effect of the Bowen Technique on hamstring flexibility over time. An assessor-blind, prospective, randomised controlled trial was performed on 120 asymptomatic volunteers. Participants were randomly allocated into a control group or Bowen group. Three flexibility measurements occurred over one week, using an active knee extension test. The intervention group received a single Bowen treatment. A repeated measures univariate analysis of variance, across both groups for the three time periods, revealed significant within-subject and between-subject differences for the Bowen group. Continuing increases in flexibility levels were observed over one week. No significant change over time was noted for the control group. Copyright © 2010 Elsevier Ltd. All rights reserved.

Interventional treatment of diabetic ischemic diseases of lower limb:a therapeutic observation

International Nuclear Information System (INIS)

Wang Zhaoyang; Liu Xiang

2010-01-01

Objective: To assess the clinical effects of endovascular interventional treatment for diabetic ischemic diseases of lower limb. Methods: Endovascular interventional management was performed in 47 patients with diabetic ischemic diseases of lower limb. The ankle-to-brachial index and the diameter of lower limb vessel were estimated both before the treatment and 3, 30 days after the treatment. The results were compared and analyzed. Results: Obvious improvement in ankle-to-brachial index and the diameter of lower limb vessel were observed after the treatment. Conclusion: Endovascular interventional treatment is very effective and reliable for diabetic ischemic diseases of lower limb. (authors)

Development and Plasticity of Cognitive Flexibility in Early and Middle Childhood.

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Buttelmann, Frances; Karbach, Julia

2017-01-01

Cognitive flexibility, the ability to flexibly switch between tasks, is a core dimension of executive functions (EFs) allowing to control actions and to adapt flexibly to changing environments. It supports the management of multiple tasks, the development of novel, adaptive behavior and is associated with various life outcomes. Cognitive flexibility develops rapidly in preschool and continuously increases well into adolescence, mirroring the growth of neural networks involving the prefrontal cortex. Over the past decade, there has been increasing interest in interventions designed to improve cognitive flexibility in children in order to support the many developmental outcomes associated with cognitive flexibility. This article provides a brief review of the development and plasticity of cognitive flexibility across early and middle childhood (i.e., from preschool to elementary school age). Focusing on interventions designed to improve cognitive flexibility in typically developing children, we report evidence for significant training and transfer effects while acknowledging that current findings on transfer are heterogeneous. Finally, we introduce metacognitive training as a promising new approach to promote cognitive flexibility and to support transfer of training.

Acute effect of different time periods of passive static stretching on the hamstring flexibility.

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Cini, Anelize; de Vasconcelos, Gabriela Souza; Lima, Claudia Silveira

2017-01-01

Several factors are associated with the presence of chronic low back pain; one of them is the flexibility of the hamstring muscles that influences the posture of the pelvic spine. Investigate the influence of two different time periods of passive static stretching on the flexibility of the hamstring. Forty-six physiotherapy students were divided into two groups performing stretching exercises: 30 s and 60 s duration. The collections consisted of: (1) pre-test: evaluation of the flexibility of the hip and knee, using a manual goniometer by means of the following tests: Straight Leg Raise Test (SLR), Passive Hip Flexion Test (PHFT) and Modified Knee Extension Test (MKET), (2) intervention: stretching with different runtimes, (3) post-test: reappraisal of flexibility, conducted immediately after the intervention. Significant difference was observed intra groups, group that did stretching exercises lasting 30 seconds (G30) (SLR p = 0.000. PHFT p = 0.003 and MKET p = 0.000) and group that did stretching exercises lasting 60 seconds (G60) (SLR p = 0.000. PHFT p = 0.001 and MKET p = 0.002). Comparing the groups, no significant difference was found (SLR p = 0.307; PHFT p = 0.904; MKET p = 0.132). Thus it can be inferred that 30 seconds are sufficient for increased flexibility of young women. Therefore the time-treatment sessions can be optimized. Only the acute effect of stretching was observed; further investigation of the long-term effect is required.

Neurodevelopmental Treatment (NDT): Therapeutic Intervention and Its Efficacy.

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Stern, Francine Martin; Gorga, Delia

1988-01-01

Use of neurodevelopmental treatment, also known as the Bobath method, is discussed, including its history, philosophy, goals, and treatment emphasis with infants and children with movement disorders. Examples of children before and after therapeutic intervention illustrate use of the technique, and controversies in measuring therapy efficacy are…

The treatment of tubal pregnancy by interventional technique through uterine artery

International Nuclear Information System (INIS)

Li Lizhao; Zhang Yonghui; Chen Zhu; Ge Xiaobing; Li Jiehua

2004-01-01

Objective: To study the feasibility and the clinical effect of the treatment of tubule pregnancy by using interventional technique through selective uterine artery. Methods: By using seldinger's method, 48 cases received interventional treatment, followed by perfusion of methotrexate (MTX) 100 mg through Tube 4-5 F. The concentration of serum β-HCG, the changes of pelvic cavity, and the open condition of amnion by ultrasonic examination. Results: The cure rate of 47 cases was 97.92%. No serious reaction. After treatment, the mean time that the serum β-HCG concentration returned to normal was 14-28 days and the mean time was 18 days. Conclusion: The treatment of tubule pregnancy by interventional technique proved no harmful effect to reproductive organs and quick recovery. It is worth spreading

Intervention program in college instrumental musicians, with kinematics analysis of cello and flute playing: a combined program of yogic breathing and muscle strengthening-flexibility exercises.

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Lee, Sang-Hie; Carey, Stephanie; Dubey, Rajiv; Matz, Rachel

2012-06-01

College musicians encounter health risks not dissimilar to those of professional musicians. Fifteen collegiate instrumental musicians participated in the intervention program of yogic-breathing and muscle-strengthening and flexibility exercises for 8 weeks. Pre- and post-intervention data from the Health-Pain-Injury Inventory (HPI) and the Physical & Musical-Performance Efficacy Assessment Survey (PME) were analyzed for the effects of the program on the musicians' physical and musical-performance efficacy. HPI results showed that the majority of our sample had healthy lifestyles and minimal pain and injuries but irregular eating and exercise habits. The pre-intervention PME data showed a high level of musical efficacy (i.e., awareness of music technique, tone, and flow) but a low-level of physical efficacy (i.e., awareness of posture, tension, and movement flexibility). Post-intervention data showed that the program improved physical efficacy by increased awareness of posture and tension. In 2 volunteer musicians, kinematics motion analysis was conducted for exploratory purposes. Our cellist played the scale using a larger range of motion (ROM) in right shoulder flexion and abduction and slightly increased rotation while keeping decreased right elbow ROM after the intervention program. The flutist shifted the body weight from one foot to the other more in the second playing post-intervention. These changes can be attributed to the increased physical efficacy that allowed freedom to express musicality. Findings from these case scenarios provide empirically based hypotheses for further study. We share our experience so that others may use our model and instruments to develop studies with larger samples.

Dilemma-focused intervention for unipolar depression: a treatment manual.

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Feixas, Guillem; Compañ, Victoria

2016-07-12

This article introduces a new treatment protocol for depression. Based on previous research which indicated the presence of cognitive conflicts in depression, this study created an intervention manual to address these conflicts. The therapy manual for depressive patients followed the guideline for inclusion in clinical trials (stage II), which has received high recognition. A preliminary version (stage I) of this manual was formulated based on other, more general dilemma-focused therapy publications, inspired by personal construct theory (PCT), and input from clinical experience. The resulting version was then applied during the 8-session format of a pilot study with patients diagnosed with major depressive disorder or dysthymia. Finally, feedback was requested from seasoned and highly respected therapists, some of whom were familiar with PCT. According to the mentioned guideline, the intervention manual selected the theoretical framework, in this case PCT, to include its conceptualization of depression and resolution of dilemmas (to foster clinical improvement) as a main treatment goal. The manual was then contrasted with psychoanalytic psychotherapy, cognitive-behavior therapy (CBT), motivational interviewing (MI), and other similar approaches such as cognitive-analytic therapy and coherence therapy. Following these conceptual clarifications, the specific interventions included in the manual were defined according to both categories: their unique and essential components and those conceived as common psychotherapeutic factors. Next, the general structure and content for each session were presented. The structure consisted of seven well-defined individual sessions with an additional session, which could complement any of the former sessions to address the patient's issues in greater depth, if needed. This Dilemma-Focused Intervention manual aimed to improve the treatment outcome for depression by offering an intervention that could be combined with other general

Surgical treatment of hallux valgus associated with flexible flatfoot during growing age.

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Faldini, Cesare; Nanni, Matteo; Traina, Francesco; Fabbri, Daniele; Borghi, Raffaele; Giannini, Sandro

2016-04-01

During growth, hallux valgus could present associated with flatfoot. Considering the current disagreement about correction of hallux valgus during growth and the lack of reports about simultaneous correction of hallux valgus associated with flexible flatfoot, we present simultaneous treatment of both deformities during growth combining subtalar arthroeresis and SERI first metatarsal osteotomy, reporting results at an average five-year follow-up. Thirty-two children (64 feet, age range 8-12 years) affected by hallux valgus associated with flexible flatfoot underwent surgical treatment combining SERI first metatarsal osteotomy and subtalar arthroereisis with bioabsorbable endorthotic implant. Clinical evaluation was summarized with AOFAS score, and standard standing radiographs were performed. AOFAS score ranged from 86 ± 2 to 98 ± 2 (hindfoot) and from 80 ± 4 to 98 ± 2 (forefoot). HVA ranged from 21° ± 2 to 5° ± 2, IMA from 14° ± 2 to 7° ± 2, DMAA from 18° ± 2 to 2° ± 2, and Meary's angle from 162° ± 11 to 175° ± 4. Complications included one case of delayed wound healing, inflammatory skin reaction around the outlet of the percutaneous Kirschner wire in two cases, displacement of the endorthotic implant in one case, and a second surgery to replace the implant. SERI osteotomy and subtalar arthroereisis resulted in an effective, technically simple and easily combined approach, with a high rate of good results and low rate of complications at mid-term follow-up. These techniques performed simultaneously represent a viable option in case of hallux valgus associated with flexible flatfoot during growth. Nevertheless, considering the limitations of this study, we believe that a larger case series and a longer follow-up should be desirable.

Body image flexibility: A predictor and moderator of outcome in transdiagnostic outpatient eating disorder treatment.

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Pellizzer, Mia L; Waller, Glenn; Wade, Tracey D

2018-04-01

Predictors of attrition and predictors and moderators of outcome were explored in a transdiagnostic sample of patients who received ten-session cognitive behavioral therapy (CBT-T) for nonunderweight eating disorders. Body image flexibility, a protective positive body image construct, was hypothesized to be a significant moderator. Data from two case series were combined to form a sample of 78 participants who received CBT-T. Baseline measures of body image, negative affect, personality, and motivation (readiness to change and self-efficacy) were included as potential predictors. Global eating disorder psychopathology at each assessment point (baseline, mid- and post-treatment, 1- and 3-month follow-up) was the outcome variable. Predictors of attrition were assessed using logistic regression, and multilevel modeling was applied for predictors and moderators of outcome. Body image flexibility emerged as the strongest predictor and moderator of global eating disorder psychopathology, followed by body image avoidance. Body checking, negative affect, personality beliefs, and self-efficacy were significant predictors of global eating disorder psychopathology. Higher body image flexibility predicted lower global eating disorder psychopathology at every assessment point. Further research is required to replicate findings and explore the benefit of focusing on positive body image in treatment. © 2018 Wiley Periodicals, Inc.

Interventional radiological treatment in complications of pancreatitis

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Memis, Ahmet E-mail: ahmemis@yahoo.com; Parildar, Mustafa

2002-09-01

Percutaneous interventional therapy plays an important role in treating complications of acute and chronic pancreatitis. With the development of cross-sectional imaging and advanced interventional techniques, percutaneous drainage has become the preferred treatment for pancreatic fluid collections such as acute collections, pseudocysts and abscesses. Abscess and pancreatic hemorrhage are the most life threatening complications of pancreatitis. Massive hemorrhage is rare but frequently lethal. As a rule, bleeding complications of pancreatitis require prompt diagnosis and an aggressive surgical approach. In unstable patients with a severely bleeding pseudoaneurysm, hemostasis can be obtained by occlusion with mechanical devices.

Interventional radiological treatment in complications of pancreatitis

International Nuclear Information System (INIS)

Memis, Ahmet; Parildar, Mustafa

2002-01-01

Percutaneous interventional therapy plays an important role in treating complications of acute and chronic pancreatitis. With the development of cross-sectional imaging and advanced interventional techniques, percutaneous drainage has become the preferred treatment for pancreatic fluid collections such as acute collections, pseudocysts and abscesses. Abscess and pancreatic hemorrhage are the most life threatening complications of pancreatitis. Massive hemorrhage is rare but frequently lethal. As a rule, bleeding complications of pancreatitis require prompt diagnosis and an aggressive surgical approach. In unstable patients with a severely bleeding pseudoaneurysm, hemostasis can be obtained by occlusion with mechanical devices

Etanercept provides an effective, safe and flexible short- and long-term treatment regimen for moderate-to-severe psoriasis: a systematic review of current evidence.

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Strohal, Robert; Chimenti, Sergio; Vena, Gino Antonio; Girolomoni, Giampiero

2013-06-01

The treatment of psoriasis requires long-lasting intervention. Conventional treatments for psoriasis comprise topical, phototherapeutic and systemic modalities, such as methotrexate or cyclosporine. Biological therapies are advocated by treatment guidelines for the use in moderate-to-severe psoriasis, when conventional treatments have failed, are contraindicated or are associated with severe adverse events. Etanercept is an anti-TNF recombinant fusion protein that has emerged as a standard biologic treatment option for moderate-to-severe psoriasis. The present review summarizes data from pivotal and post-marketing randomized controlled etanercept trials to treat moderate-to-severe psoriasis for 24 weeks and longer. During the first 12 weeks, etanercept can be administered in different dosing regimens: 50 mg twice weekly (BIW) and 50 mg once weekly. Although both regimens are effective, it has been shown that the 50 mg BIW dosage leads to higher response rates at week 24. In addition, after 24 weeks' treatment etanercept provides the unique possibility of continuous or intermittent long-term treatment programmes. The medium- to long-term efficacy of etanercept was consistent, regardless of whether etanercept therapy was interrupted or continuous. Taking the chronic nature of psoriasis into account, this flexibility in dosing regimen bestows a key advantage in facilitating individualisation of long-term treatment according to patient needs.

Effects of a 12-Week Hatha Yoga Intervention on Cardiorespiratory Endurance, Muscular Strength and Endurance, and Flexibility in Hong Kong Chinese Adults: A Controlled Clinical Trial

Directory of Open Access Journals (Sweden)

Caren Lau

2015-01-01

Full Text Available Objective. To examine the effects of a 12-week Hatha yoga intervention on cardiorespiratory endurance, muscular strength and endurance, and flexibility in Chinese adults. Methods. 173 adults (aged 52.0 ± 7.5 years were assigned to either the yoga intervention group (n=87 or the waitlist control group (n=86. 19 dropped out from the study. Primary outcomes were changes in cardiorespiratory endurance (resting heart rate (HR and maximal oxygen uptake (VO2max, muscular strength and endurance (curl-up and push-up tests, and lower back and hamstring flexibility (the modified back-saver sit-and-reach (MBS test. Results. Compared to controls, the yoga group achieved significant improvements in VO2max (P<0.01, curl-up (P<0.05 and push-up (P<0.001 tests, and the MBS left and right leg tests (both P<0.001 in both genders. Significant change was also found for resting HR between groups in women (P<0.05 but not in men. Further analysis comparing participants between younger and older subgroups yielded similar findings, except that the older participants in the yoga group failed to improve resting HR or the curl-up test versus control. Adherence (89% and attendance (94% were high. No serious adverse events occurred. Conclusion. A 12-week Hatha yoga intervention has favorable effects on cardiorespiratory endurance, muscular strength and endurance, and flexibility in Chinese adults.

The effects of an individual, multistep intervention on adherence to treatment in hemodialysis patients.

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Rafiee Vardanjani, Leila; Parvin, Neda; Mahmoodi Shan, Gholamreza

2015-07-01

The present study was conducted to investigate the effect of individual, multistep intervention on adherence to treatment in hemodialysis patients referred to a hemodialysis center in Shahrekord, Iran. In this interventional study, hemodialysis patients referring the center of the study were randomly assigned into two control and intervention groups (each 33). The control group received routine treatment, recommended dietary and fluid restrictions. The intervention group participated in eight individual interventional sessions accompanied routine treatment. At the beginning and the end of the study, routine laboratory tests and end-stage renal disease-adherence questionnaire were filled out for patients in both groups. The data were analyzed using Mann-Whitney and Wilcoxon tests. At the end of the study, the two groups showed a significant difference in all domains of adherence except adherence to diet and adherence was better in the intervention group (p adherence to dialysis program (p = 0.04, r = 0.254). After intervention, serum phosphorus decreased significantly in the intervention group (p Adherence to treatment is one of the major problems in hemodialysis patients; however, comprehensive interventions are required in view of individual condition. Implications for Rehabilitation Adherence to treatment means that all patients' behaviors (diet, fluids and drugs intake) should be in line with the recommendations given by healthcare professionals. There is evidence on the association between adherence to treatment and decreased risk of hospitalization in dialysis patients. Individual structured programs are most likely to be successful in encouraging adherence to treatment.

Fetal alcohol spectrum disorders: experimental treatments and strategies for intervention.

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Idrus, Nirelia M; Thomas, Jennifer D

2011-01-01

Despite the known damaging effects of prenatal alcohol exposure, women continue to drink during pregnancy, creating a need for effective interventions and treatments for fetal alcohol spectrum disorders (FASD). Experimental models can be useful in identifying potential treatments, and this article describes the spectrum of experimental therapeutics that currently are being investigated, including pharmacological, nutritional, and environmental/behavioral interventions. Some treatments target the underlying mechanisms that contribute to alcohol-induced damage, protecting against alcohol's teratogenic effects, whereas other treatments may enhance central nervous system plasticity either during alcohol exposure or long after alcohol exposure has ceased. The insights gained to date from experimental models offer several candidates for attenuating the deficits associated with FASD.

Constructing a Theory- and Evidence-Based Treatment Rationale for Complex eHealth Interventions: Development of an Online Alcohol Intervention Using an Intervention Mapping Approach.

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Brendryen, Håvar; Johansen, Ayna; Nesvåg, Sverre; Kok, Gerjo; Duckert, Fanny

2013-01-23

Due to limited reporting of intervention rationale, little is known about what distinguishes a good intervention from a poor one. To support improved design, there is a need for comprehensive reports on novel and complex theory-based interventions. Specifically, the emerging trend of just-in-time tailoring of content in response to change in target behavior or emotional state is promising. The objective of this study was to give a systematic and comprehensive description of the treatment rationale of an online alcohol intervention called Balance. We used the intervention mapping protocol to describe the treatment rationale of Balance. The intervention targets at-risk drinking, and it is delivered by email, mobile phone text messaging, and tailored interactive webpages combining text, pictures, and prerecorded audio. The rationale of the current treatment was derived from a self-regulation perspective, and the overarching idea was to support continued self-regulation throughout the behavior change process. Maintaining the change efforts over time and coping adaptively during critical moments (eg, immediately before and after a lapse) are key factors to successful behavior change. Important elements of the treatment rationale to achieving these elements were: (1) emotion regulation as an inoculation strategy against self-regulation failure, (2) avoiding lapses by adaptive coping, and (3) avoiding relapse by resuming the change efforts after a lapse. Two distinct and complementary delivery strategies were used, including a day-to-day tunnel approach in combination with just-in-time therapy. The tunnel strategy was in accordance with the need for continuous self-regulation and it functions as a platform from which just-in-time therapy was launched. Just-in-time therapy was used to support coping during critical moments, and started when the client reports either low self-efficacy or that they were drinking above target levels. The descriptions of the treatment

Couples-based interventions following prostate cancer treatment: a narrative review

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Emanu, Jessica C.; Avildsen, Isabelle

2015-01-01

Background Sexual dysfunction following prostate cancer (PC) treatment often results in sexual avoidance and a loss of sexual intimacy, which can lead to relationship distress. This review aims to evaluate six studies intended to address relational and sexual intimacy following PC treatment and discuss methodological concerns which may help produce more effective interventions. Methods Electronic databases used to conduct literature searches included Medline, PsychINFO, and Web of Science. Studies were included if they were: randomized controlled trials (RCTs) using samples of men diagnosed with PC of any stage, had a psychosocial intervention, and addressed at least one sexual and relational outcome. Results As a whole, the literature has produced mixed results. While significant findings were reported, many of the primary hypotheses were not achieved. The six studies show that men with PC may benefit from education and support related to treatment options for erectile dysfunction (ED), whereas their partners may benefit more from interventions focused on relational issues. Important methodological limitations included: selection of general outcome measures as opposed to measures specific to sexuality or intimacy outcomes, lack of assessing distress or bother of the patient/couples as study entry criteria, heterogeneity of study populations, and lack of innovative intervention content as the current studies tested standard educational interventions, sex therapies techniques, and couples therapy strategies with only marginal success. Conclusions Interventions based on innovative theoretical approaches as well as study designs that address the outlined methodological limitations are needed in this area. PMID:26813683

Further substantial improvement of interventional diagnosis and treatment via portal vein system

International Nuclear Information System (INIS)

Yang Weizhu; Chen Yongde

2006-01-01

Along with the development of interventional appliances and proficiency of operational skills, the interventional diagnosis and treatment via hepatic portal vein system have achieved great progress and improvement. However, in order to further exploit the advantages of interventional diagnosis and treatment, the review of the anatomical structures, normal aberrance of portal venous system were needed. Getting familiar with pathologic condition to discover the new interventional appliances and embolic agents, and then in term of conduct the research on a very tough substantial base in a down-to-earth manner were important. (authors)

Peripheral arterial angiography and interventional treatment in diabetic foot ulcers

International Nuclear Information System (INIS)

Guo Xiaohua; Cheng Yongde; Hu Suying; He Jianrong; Lin Kaiqin; Jin Honglai; Shi Shijie

2003-01-01

Objective: To assess the changes of peripheral arteries and choice of interventional treatment in diabetic foot ulcers. Methods: Thirty-six diabetic patients with foot ulcers were examined by lower extremity DSA with simultaneous ultrasonic Doppler examination for correlative study and interventional treatment carried out in 17 segmental stenotic cases. Among them, 12 patients were treated by PTA and 5 patients by intravascular stenting. Results: Irregular stenoses and obstruction were observed in all patients with peripheral foot ulcers. DSA examination was more reliable comparing with Doppler examination for demonstration of the arterial injury above the level of popliteal artery. PTA and primary stenting were effective in all of these subjects outcoming with promotion of the lower extremity arterial blood perfusion and foreseen curing efficacy. Conclusions: Peripheral arterial stenoses were common in diabetic patients with foot ulcers. In clinical practice, DSA examination and interventional treatment could give a fertile prognosis and reduce disabling

Sensitivity of Disease Parameters to Flexible Budesonide/Formoterol Treatment in an Allergic Rat Model

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Brange , Charlotte; Smailagic , Amir; Jansson , Anne-Helene; Middleton , Brian; Miller-Larsson , Anna; Taylor , John D.; Silberstein , David S.; Lal , Harbans

2009-01-01

Sensitivity of Disease Parameters to Flexible Budesonide/Formoterol Treatment in an Allergic Rat Model correspondance: Corresponding author. Tel.: +46 46 33 6256; fax: +46 46 33 6624. (Brange, Charlotte) (Brange, Charlotte) AstraZeneca R&D Lund--> , Lund--> - SWEDEN (Brange, Charlotte) AstraZeneca R&D Lund--> , Lund--> - SWEDEN (Brange, Charlotte) AstraZeneca R&D Lun...

The clinical choice in the method of interventional treatment to portal hypertension

International Nuclear Information System (INIS)

Shen Qi; Jiang Zhongpu; Ren Lijun

2004-01-01

Objective: To explore the selection of reasonable interventional treatment to portal hypertension under different conditions. Methods: The data of 76 patients with portal hypertension and interventional treatment from 1997 to 2002 were retrospectively analyzed. 26 patients were treated with transjugular intrahepatic porto-systemic stent shunt (TIPSS). Of these 26 patients, 11 patients suffered from hemorrhage after surgery treatment by devascularization, 6 patients with hemorrhage after stomach mirror treatment, and 9 patients with ineffective medicine treatment. 50 patients were treated with percutaneous transhepatic variceal embolization (PTVE) combined with partial splenic embolization (PSE), and they all showed inefficacy by medicine treatment. Free portal pressure ( FPP) in pre- and post-treatment was measured in all 76 cases. The hepatic volume was measured by spiral-CT before and one year after the treatment. Results: In TIPSS group, FPP was reduced from (3.85 ± 0.42) kPa to (3.09 ± 0.44) kPa (t=3.682, P 3 was obviously higher than those with volume more than 700 cm 3 after TIPSS (χ 2 =4.37, P<0.05). Hypersplenism was completely resolved in both groups. Conclusion: The two kinds interventional treatments for portal hypertension each have their own advantages and disadvantages. The selection of interventional treatment should be based on the actual needs of the patients. The hepatic volume is a diathesis of importance in the evaluation and selection of treatment methods. (authors)

Treatment of Chronic Pain for Adults 65 and Over: Analyses of Outcomes and Changes in Psychological Flexibility Following Interdisciplinary Acceptance and Commitment Therapy (ACT).

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Scott, Whitney; Daly, Aisling; Yu, Lin; McCracken, Lance M

2017-02-01

The purpose of this study was to examine the effectiveness of acceptance and commitment therapy (ACT) for older adults with chronic pain. Secondarily, we examined the associations between changes on processes of psychological flexibility and treatment outcome variables. Participants were 60 adults with chronic pain age 65 and older selected from a larger consecutive sample of 928 adults of any age. All participants had longstanding pain that was associated with significant distress and disability. Participants completed measures of pain, functioning, and depression, and processes of psychological flexibility at baseline, immediately post-treatment, and at a 9-month follow-up. Treatment consisted of a 2- or 4-week residential program based on principles of ACT delivered by an interdisciplinary team. Treatment was designed to increase daily functioning by enhancing key processes of psychological flexibility, including openness, awareness, and committed action. Participants showed significant improvements in functioning and mental health at posttreatment. Participants also showed significant increases in pain acceptance and committed action from pre- to post-treatment. Small effect sizes were observed for most treatment outcome and process variables in the pre-treatment to follow-up intervals; however, these improvements were not statistically significant. In secondary analyses, changes in facets of psychological flexibility were significantly associated with improvements in social functioning and mental health. This study supports the potential effectiveness of ACT for chronic pain among older adults. Future research is needed to determine how to maximize the impact of this treatment, particularly through greater impact on psychological flexibility.

Trichotillomania: the impact of treatment history on the outcome of an Internet-based intervention.

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Weidt, Steffi; Bruehl, Annette Beatrix; Delsignore, Aba; Zai, Gwyneth; Kuenburg, Alexa; Klaghofer, Richard; Rufer, Michael

2017-01-01

Many patients suffering from trichotillomania (TTM) have never undergone treatment. Without treatment, TTM often presents with a chronic course. Characteristics of TTM individuals who have never been treated (untreated) remain largely unknown. Whether treatment history impacts Internet-based interventions has not yet been investigated. We aimed to answer whether Internet-based interventions can reach untreated individuals and whether treatment history is associated with certain characteristics and impacts on the outcome of an Internet-based intervention. We provided Internet-based interventions. Subjects were characterized at three time points using the Massachusetts General Hospital Hairpulling Scale, Hamilton Depression Rating Scale, and the World Health Organization Quality of Life questionnaire. Of 105 individuals, 34 were untreated. Health-related quality of life (HRQoL) was markedly impaired in untreated and treated individuals. Symptom severity did not differ between untreated and treated individuals. Nontreatment was associated with fewer depressive symptoms ( P =0.002). Treatment history demonstrated no impact on the outcome of Internet-based interventions. Results demonstrate that Internet-based interventions can reach untreated TTM individuals. They show that untreated individuals benefit as much as treated individuals from such interventions. Future Internet-based interventions should focus on how to best reach/support untreated individuals with TTM. Additionally, future studies may examine whether Internet-based interventions can reach and help untreated individuals suffering from other psychiatric disorders.

Evidence Map of Prevention and Treatment Interventions for Depression in Young People

Directory of Open Access Journals (Sweden)

Patrick Callahan

2012-01-01

Full Text Available Introduction. Depression in adolescents and young people is associated with reduced social, occupational, and interpersonal functioning, increases in suicide and self-harm behaviours, and problematic substance use. Age-appropriate, evidence-based treatments are required to provide optimal care. Methods. “Evidence mapping” methodology was used to quantify the nature and distribution of the extant high-quality research into the prevention and treatment of depression in young people across psychological, medical, and other treatment domains. Results. Prevention research is dominated by cognitive-behavioral- (CBT- based interventions. Treatment studies predominantly consist of CBT and SSRI medication trials, with few trials of other psychological interventions or complementary/alternative treatments. Quality studies on relapse prevention and treatment for persistent depression are distinctly lacking. Conclusions. This map demonstrates opportunities for future research to address the numerous evidence gaps for interventions to prevent or treat depression in young people, which are of interest to clinical researchers, policy makers, and funding bodies.

Short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children: A randomized controlled trial.

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Hsieh, Ru-Lan; Peng, Hui-Ling; Lee, Wen-Chung

2018-05-01

Limited evidence is available regarding the effects of insoles on pediatric flexible flatfoot because of the heterogeneity and low methodological quality of previous studies. The purpose of this prospective trial is to examine the short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children by using the International Classification of Functioning, randomized controlled Disability, and Health (ICF) framework. This study was conducted in a rehabilitation outpatient clinic of a teaching hospital. Fifty-two children with symptomatic flexible flatfoot were included. The children in the treatment group wore customized arch support insoles for 12 weeks, whereas those in the control group did not wear the insoles. Both clinical and radiographic measurements, including the navicular drop, foot posture index, Beighton hypermobility score, talonavicular coverage angle, calcaneal inclination angle, and calcaneal-first metatarsal angle, were used for diagnosing flexible flatfoot. Physical activity (10-m normal and fast walking, stair ascent, stair descent, and chair rising), physical function, and psychometric properties (Pediatric Outcome Data Collection Instrument and Pediatric Quality of Life Inventory) were evaluated at the baseline and 12 weeks after the intervention. Compared with the control group, the treatment group exhibited significant improvement in pain/comfort (P = .048), physical health (P = .035), stair ascent time (P = .015), upper extremity and physical function (P = .016), and transfer and basic mobility (P = .042) during the intervention period. Children with flexible flatfoot who wore customized arch support insoles for 12 weeks exhibited significantly improved pain/comfort, physical health, stair ascent time, upper extremity and physical function, and transfer and basic mobility. These variables belong to the domains of body functions and structures and activity and participation in the ICF

Interventional treatment for old thrombus in iliofemoral deep veins

International Nuclear Information System (INIS)

Qian Jun; Jiang Hong; Yang Yang

2009-01-01

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

Treatment of lymphatic nodes metastasis in advanced cancer with interventional chemotherapy combined radiotherapy

International Nuclear Information System (INIS)

Xia Shian; Guo Weijian; Wu Guohua; Lin Qing; Jiang Mawei; Yao Yuan

2000-01-01

Objective: To evaluate the clinical effects of treatment with interventional chemotherapy combined radiotherapy for lymphatic nodes metastasis in advanced cancer. Methods: Treated with interventional chemotherapy for 27 cases of lymphatic rode metastasis once a month with average 2-3 times totally. Simultaneously treated with linear accelerator radiotherapy with average dose of 40-50 Gy/20-25 times/4-5 weeks. Results: To evaluate the clinical effects after finished the whole treatment program two months later. CR + PR reached 77.8% (24/27). All patients showed tolerance to accept the treatment. Conclusion: Treatment for lymphatic node metastasis in advanced cancer with interventional chemotherapy combined radiation therapy seems to be a valuable way

Effects of a pilates school program on hamstrings flexibility of adolescents

OpenAIRE

González-Gálvez, Noelia; Poyatos, María Carrasco; Pardo, Pablo Jorge Marcos; Vale, Rodrigo Gomes de Souza; Feito, Yuri

2015-01-01

INTRODUCTION: Low levels of hamstring flexibility may trigger certain acute and chronic pathologies and injuries. Poor flexibility is observed among teenagers and several authors have recommended the use of specific programs in this population to improve flexibility levels. The Pilates Method (PM) may be an appropriate intervention to achieve this purpose and has rarely been used with this population. Objective: Study was to assess changes in the flexibility of hamstrings after running a dida...

Dopamine treatment and cognitive functioning in individuals with Parkinson's disease: the "cognitive flexibility" hypothesis seems to work.

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Costa, Alberto; Peppe, Antonella; Mazzù, Ilenia; Longarzo, Mariachiara; Caltagirone, Carlo; Carlesimo, Giovanni A

2014-01-01

Previous data suggest that (i) dopamine modulates the ability to implement nonroutine schemata and update operations (flexibility processes) and that (ii) dopamine-related improvement may be related to baseline dopamine levels in target pathways (inverted U-shaped hypothesis). To investigate above hypotheses in individuals with Parkinson's disease (PD). Twenty PD patients were administered tasks varying as to flexibility load in two treatment conditions: (i) "off" condition, about 18 hours after dopamine dose and (ii) "on" condition, after dopamine administration. PD patients were separated into two groups: low performers (i.e., performance on Digit Span Backward below the sample mean) and high performers (i.e., performance above the mean). Twenty healthy individuals performed the tasks in two sessions without taking drugs. Passing from the "off" to the "on" state, only low performer PD patients significantly improved their performance on high-flexibility measures (interference condition of the Stroop test; P flexibility tasks. These findings document that high-flexibility processes are sensitive to dopamine neuromodulation in the early phases of PD. This is in line with the hypothesis that striatal dopamine pathways, affected early by PD, are precociously implicated in the expression of cognitive disorders in these individuals.

Simulation analysis of resource flexibility on healthcare processes.

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Simwita, Yusta W; Helgheim, Berit I

2016-01-01

This paper uses discrete event simulation to explore the best resource flexibility scenario and examine the effect of implementing resource flexibility on different stages of patient treatment process. Specifically we investigate the effect of resource flexibility on patient waiting time and throughput in an orthopedic care process. We further seek to explore on how implementation of resource flexibility on patient treatment processes affects patient access to healthcare services. We focus on two resources, namely, orthopedic surgeon and operating room. The observational approach was used to collect process data. The developed model was validated by comparing the simulation output with actual patient data collected from the studied orthopedic care process. We developed different scenarios to identify the best resource flexibility scenario and explore the effect of resource flexibility on patient waiting time, throughput, and future changes in demand. The developed scenarios focused on creating flexibility on service capacity of this care process by altering the amount of additional human resource capacity at different stages of patient care process and extending the use of operating room capacity. The study found that resource flexibility can improve responsiveness to patient demand in the treatment process. Testing different scenarios showed that the introduction of resource flexibility reduces patient waiting time and improves throughput. The simulation results show that patient access to health services can be improved by implementing resource flexibility at different stages of the patient treatment process. This study contributes to the current health care literature by explaining how implementing resource flexibility at different stages of patient care processes can improve ability to respond to increasing patients demands. This study was limited to a single patient process; studies focusing on additional processes are recommended.

Treatment response to the RENEW weight loss intervention in schizophrenia: impact of intervention setting.

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Brown, Catana; Goetz, Jeannine; Hamera, Edna; Gajewski, Byron

2014-11-01

Individuals with serious mental illness have high rates of obesity and a need for specialized weight loss intervention programs. This study examines the efficacy of the RENEW weight loss intervention and examines the impact of the intervention setting on outcomes. 136 individuals with serious mental illness from 4 different settings were randomly assigned to receive the RENEW weight loss intervention or a control condition of treatment as usual. The RENEW intervention is a one year program that includes an intensive, maintenance and intermittent supports phase. The intervention group experienced a modest weight loss of 4.8 lbs at 3 months, 4.1 lbs at 6 months and a slight weight gain of 1.5 lbs at 12 months. The control group gained a total of 6.2 lbs at 12 months. However when settings were examined separately the responder sites had a weight loss of 9.4 lbs at 3 months, 10.9 lbs at 6 months and 7 lbs at 12 months. These results suggest that the settings in which individuals receive services may act as a support or hindrance toward response to weight loss interventions. The concept of the obesogenic environment deserves further examination as a factor in the success of weight loss programs. Copyright © 2014 Elsevier B.V. All rights reserved.

Interventional treatment of iliac vein compression syndrome

International Nuclear Information System (INIS)

Li Xiaoqiang; Zhou Weiming; Nie Zhonglin; Yu Chaowen

2002-01-01

Objective: To explore the clinical significance of interventional treatment of iliac vein compression syndrome (IVCS). Methods: Percutaneous transluminal angioplasty (PTA) was performed in 40 cases. Thirty-three cases underwent endovascular stent implantation and 27 cases underwent second-stage left saphenous vein ligation and stripping and the valves of left femoral veins narrowing. Thirty-one cases were followed-up postoperatively and the duration was 6-66 months (mean 28 months). Results: The dilation of iliac veins was successful in 36 cases and there were god efficacy in all patients when they discharged from hospital. Followed-up during post-operation, all the limbs ulcers were cured and varicose veins disappeared. The skin pigmentation disappeared in 17 of 19 cases and markedly relieved in 2 cases. Left lower limb swelling disappeared in 15 of 17 cases and relieved in 2 cases. Conclusion: There is good efficacy in the interventional treatment of left iliac vein lesions, but second-stage procedures should be performed in secondary lesions of saphenous veins and valves of femoral veins

Culture-centered Career Intervention. [and] Diversity, Flexibility, and Career Interventions.

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Spokane, Arnold R.; Fouad, Nadya A.; Swanson, Jane L.; Walsh, W. Bruce

2003-01-01

Includes two commentaries on the special section. Spokane, Fouad, and Swanson emphasize the importance of two dimensions of clients' cultural context: dominant/subordinate and individual/collective. Walsh highlights research needs related to career intervention and personality, culture, process, and socioeconomic status. (Contains 15 and 11…

The Interventional Arm of the Flexibility In Duty-Hour Requirements for Surgical Trainees Trial: First-Year Data Show Superior Quality In-Training Initiative Outcomes.

Science.gov (United States)

Mirmehdi, Issa; O'Neal, Cindy-Marie; Moon, Davis; MacNew, Heather; Senkowski, Christopher

With the implementation of strict 80-hour work week in general surgery training, serious questions have been raised concerning the quality of surgical education and the ability of newly trained general surgeons to independently operate. Programs that were randomized to the interventional arm of the Flexibility In duty-hour Requirements for Surgical Trainees (FIRST) Trial were able to decrease transitions and allow for better continuity by virtue of less constraints on duty-hour rules. Using National Surgical Quality Improvement Program Quality In-Training Initiative data along with duty-hour violations compared with old rules, it was hypothesized that quality of care would be improved and outcomes would be equivalent or better than the traditional duty-hour rules. It was also hypothesized that resident perception of compliance with duty hour would not change with implementation of new regulations based on FIRST trial. Flexible work hours were implemented on July 1, 2014. National Surgical Quality Improvement Program Quality In-Training Initiative information was reviewed from July 2014 to January 2015. Patient risk factors and outcomes were compared between institutional resident cases and the national cohort for comparison. Residents' duty-hour logs and violations during this period were compared to the 6-month period before the implementation of the FIRST trial. The annual Accreditation Council for Graduate Medical Education resident survey was used to assess the residents' perception of compliance with duty hours. With respect to the postoperative complications, the only statistically significant measures were higher prevalence of pneumonia (3.4% vs. 1.5%, p flexible duty hours. All other measures of postoperative surgical complications showed no difference. The total number of duty-hour violations decreased from 54 to 16. Had the institution not been part of the interventional arm of the FIRST trial, this number would have increased to 238. The residents

Psychosocial interventions for fatigue during cancer treatment with palliative intent.

Science.gov (United States)

Poort, Hanneke; Peters, Marlies; Bleijenberg, Gijs; Gielissen, Marieke Fm; Goedendorp, Martine Margaretha; Jacobsen, Paul; Verhagen, Stans; Knoop, Hans

2017-07-14

Fatigue is a prevalent and burdensome symptom for patients with incurable cancer receiving cancer treatment with palliative intent and is associated with reduced quality of life. Psychosocial interventions seem promising for management of fatigue among cancer patients. To assess the effects of psychosocial interventions for fatigue in adult patients with incurable cancer receiving cancer treatment with palliative intent. We searched the following databases: CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, and seven clinical trial registries; we also searched the reference lists of articles. The date of our most recent search was 29 November 2016. We included randomised controlled trials that compared psychosocial interventions in adults aged 18 years or over undergoing cancer treatment with palliative intent for incurable cancer versus usual care or other controls. Psychosocial interventions were defined as various kinds of interventions provided to influence or change cognitions, emotions, behaviours, social interactions, or a combination of these. Psychosocial interventions of interest to this review had to involve at least two interactions between the patient and the care provider in which the care provider gave the patient personal feedback concerning changes sought by these interventions. We included trials that reported fatigue as an outcome of interest. We used standard methodological procedures expected by Cochrane. Two review authors independently considered trials for inclusion in the review, assessed risk of bias, and extracted data, including information on adverse events. We assessed the quality of evidence using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) and created a 'Summary of findings' table. We identified 14 studies (16 reports) that met inclusion criteria for this review and involved 3077 randomised participants in total. Most of these studies included a mixed sample of participants; we obtained data for the subset of

The Relationship Between Posttraumatic Stress Disorder and Chronic Pain in People Seeking Treatment for Chronic Pain: The Mediating Role of Psychological Flexibility.

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Åkerblom, Sophia; Perrin, Sean; Rivano Fischer, Marcelo; McCracken, Lance M

2018-06-01

The symptoms of posttraumatic stress disorder (PTSD) and chronic pain are thought to interact to increase the severity and impact of both conditions, but the mechanisms by which they interact remain unclear. This study examines the relationship between PTSD and chronic pain and whether indices of Psychological Flexibility mediate the relationship between these 2 conditions. Standardized self-report measures of PTSD, pain severity, pain interference, depression, and psychological flexibility (pain-related acceptance, committed action, cognitive fusion, and values-based action) were obtained from 315 people seeking treatment for chronic pain who also reported at least 1 traumatic experience. People seeking treatment for chronic pain and reporting symptoms consistent with a current diagnosis of PTSD had significantly higher levels of pain severity, pain interference, depression, and cognitive fusion and lower levels of pain-related acceptance and committed action than those reporting symptoms below the diagnostic threshold for PTSD. Pain-related acceptance, committed action, cognitive fusion, and depression mediated the relationship between PTSD and pain severity/interference, with pain-related acceptance being the strongest mediator from the Psychological Flexibility model. Processes from the Psychological Flexibility model were identified as mediators of the relationship between PTSD and chronic pain in people seeking treatment for chronic pain. The Psychological Flexibility model may be useful as an overarching model to help understand the relationship between PTSD and chronic pain. It is possible that targeting pain-related acceptance, committed action, and cognitive fusion (among other processes) in the treatment of chronic pain may produce corresponding improvements in comorbid symptoms of PTSD when these are present and may reduce impacts of PTSD on outcomes of chronic pain. Conversely, targeting of these processes in the treatment of PTSD may produce similar

Increasing work-time influence: consequences for flexibility, variability, regularity and predictability.

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Nabe-Nielsen, Kirsten; Garde, Anne Helene; Aust, Birgit; Diderichsen, Finn

2012-01-01

This quasi-experimental study investigated how an intervention aiming at increasing eldercare workers' influence on their working hours affected the flexibility, variability, regularity and predictability of the working hours. We used baseline (n = 296) and follow-up (n = 274) questionnaire data and interviews with intervention-group participants (n = 32). The work units in the intervention group designed their own intervention comprising either implementation of computerised self-scheduling (subgroup A), collection of information about the employees' work-time preferences by questionnaires (subgroup B), or discussion of working hours (subgroup C). Only computerised self-scheduling changed the working hours and the way they were planned. These changes implied more flexible but less regular working hours and an experience of less predictability and less continuity in the care of clients and in the co-operation with colleagues. In subgroup B and C, the participants ended up discussing the potential consequences of more work-time influence without actually implementing any changes. Employee work-time influence may buffer the adverse effects of shift work. However, our intervention study suggested that while increasing the individual flexibility, increasing work-time influence may also result in decreased regularity of the working hours and less continuity in the care of clients and co-operation with colleagues.

Treatment and technical intervention time analysis of a robotic stereotactic radiotherapy system.

Science.gov (United States)

Crop, F; Lacornerie, T; Szymczak, H; Felin, A; Bailleux, C; Mirabel, X; Lartigau, E

2014-02-01

The purpose of this study is to obtain a better operational knowledge of Stereotactic Body Radiotherapy (SBRT) treatments with CyberKnife(r). An analysis of both In-room Times (IRT) and technical interventions of 5 years of treatments was performed, during which more than 1600 patients were treated for various indications, including liver (21%), lung (29%), intracranial (13%), head and neck (11%) and prostate (7%). Technical interventions were recorded along with the time of the failure, time to the intervention, and the complexity and duration of the repair. Analyses of Time Between Failures (TBF) and Service Disrupting TBF(disr) were performed. Treatment time data and variability per indication and following different system upgrades were evaluated. Large variations of IRTs were found between indications, but also large variations for each indication. The combination of the time reduction Tool (using Iris(r)) and Improved Stop Handling was of major impact to shortening of treatment times. The first implementation of the Iris collimator alone did not lead to significantly shorter IRTs for us except during prostate treatments. This was mostly due to the addition at the same time of larger rotational compensation for prostate treatments (58 instead of 1.58). Significant differences of duration between the first fraction and following fractions of a treatment, representing the necessity of defining imaging parameters and explanation to patients, were found for liver (12 min) and lung treatments using Xsight(r) Spine (5 min). Liver and lung treatments represent the longest IRT's and involve the largest variability's in IRT. The malfunction rate of the system followed a Weibull distribution with the shape and scale parameters of 0.8 and 39.7. Mean TBF(disr) was 68 work hours. 60 to 80% of the service disrupting interventions were resolved within 30-60 min, 5% required external intervention and 30% occurred in the morning. The presented results can be applied in the

The interventional treatment with two stents in malignant hilar obstruction

International Nuclear Information System (INIS)

Gao Kun; Dai Dingke; Zhao Renyou; Qian Xiaojun

2006-01-01

Objective: To evaluate the methodology of interventional treatment with two stents in malignant hilar obstructions. Methods: Retrospectively analyzing the two stents, interventional management of unresectable malignant hilar obstruction in 22 patients included unilateral and bilateral puncture routes for placing 'T' shape stent set and 'Y' shape stent set, respectively; together with recording the related complications. Results: The overall technical success rate was 100%, without severe complication. The total serum bilirubin reduced from (337.9 + 81.7) μmol/L before procedure to (129.1 + 51.1) μmol/L after the stent placement. Stent obstruction was found in 8 cases at 6 months; 5 cases by the time of 6-12 months and only 2 cases after 1 year. Conclusion: The method of two stents interventional treatment is a safe and useful management for malignant hilar obstructions. (authors)

Utility of Flexible Ureterorenoscopy and Laser Lithotripsy in the Treatment of Multiple Intrarenal Stones

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Hasan Yılmaz

2017-09-01

Full Text Available Objective: We aimed to determine the safety and efficacy of flexible ureterorenoscopy and Holmium laser lithotripsy in treating multiple intrarenal stones. Materials and Methods: We identified 32 consecutive patients with multiple intrarenal stones who underwent flexible ureterorenoscopy and/or laser lithotripsy performed by a single surgeon. Informed consent was obtained from all participants before treatment. Each patient was evaluated in terms of stone location, stone number, stone size, stone burden (cumulative stone length, body mass index, operative time, stone-free rate, and perioperative complications. Results: The median age of the patients was 38 years [interquartile range (IQR, 34.25-52.00]. The patients had a total of 75 intrarenal calculi. The average number of stones per patient was 2.50 (IQR, 2.0-3.0. The median total stone burden per patient was 23.0 mm (IQR, 19.0-28.0 mm. Twenty-one patients (65.5% had stone burdens >20 mm, and 11 (34.5% had burdens ≤20 mm. The overall final stone-free rate was 78.1%. The stone-free rates for patients with stone burdens ≤20 mm and >20 mm were 81.8% (9/11 and 76.2% (16/21, respectively (p=0.544. A perioperative complication (urinary leakage occurred in one patient. Postoperative complications were recorded in four (12.5% patients; a urinary tract infection in one, pain requiring parenteral medication in two, and hematuria in one. Conclusion: Flexible ureterorenoscopy combined with laser lithotripsy may be an effective treatment option for patients with multiple intrarenal stones; we noted only a few minor complications. The success rate was higher in patients with stone burdens ≤20 mm.

Can counter-stereotypes boost flexible thinking?

NARCIS (Netherlands)

Goclowska, M.A.; Crisp, R.J.; Labuschagne, K.

2013-01-01

To reduce prejudice psychologists design interventions requiring people to think of counter-stereotypes (i.e., people who defy stereotypic expectations—a strong woman, a Black President). Grounded in the idea that stereotypes constrain the ability to think flexibly, we propose that thinking of

Improving general flexibility with a mind-body approach: a randomized, controlled trial using neuro emotional Technique®.

Science.gov (United States)

Jensen, Anne M; Ramasamy, Adaikalavan; Hall, Michael W

2012-08-01

General flexibility is a key component of health, well-being, and general physical conditioning. Reduced flexibility has both physical and mental/emotional etiologies and can lead to musculoskeletal injuries and athletic underperformance. Few studies have tested the effectiveness of a mind-body therapy on general flexibility. The aim of this study was to investigate if Neuro Emotional Technique® (NET), a mind-body technique shown to be effective in reducing stress, can also improve general flexibility. The sit-and-reach test (SR) score was used as a measure of general flexibility. Forty-five healthy participants were recruited from the general population and assessed for their initial SR score before being randomly allocated to receive (a) two 20-minute sessions of NET (experimental group); (b) two 20-minute sessions of stretching instruction (active control group); or (c) no intervention or instruction (passive control group). After intervention, the participants were reassessed in a similar manner by the same blind assessor. The participants also answered questions about demographics, usual water and caffeine consumption, and activity level, and they completed an anxiety/mood psychometric preintervention and postintervention. The mean (SD) change in the SR score was +3.1 cm (2.5) in the NET group, +1.2 cm (2.3) in the active control group and +1.0 cm (2.6) in the passive control group. Although all the 3 groups showed some improvement, the improvement in the NET group was statistically significant when compared with that of either the passive controls (p = 0.015) or the active controls (p = 0.021). This study suggests that NET could provide an effective treatment in improving general flexibility. A larger study is required to confirm these findings and also to assess longer term effectiveness of this therapy on general flexibility.

Does cognitive behavioral therapy alter mental defeat and cognitive flexibility in patients with panic disorder?

Science.gov (United States)

Nagata, Shinobu; Seki, Yoichi; Shibuya, Takayuki; Yokoo, Mizue; Murata, Tomokazu; Hiramatsu, Yoichi; Yamada, Fuminori; Ibuki, Hanae; Minamitani, Noriko; Yoshinaga, Naoki; Kusunoki, Muga; Inada, Yasushi; Kawasoe, Nobuko; Adachi, Soichiro; Oshiro, Keiko; Matsuzawa, Daisuke; Hirano, Yoshiyuki; Yoshimura, Kensuke; Nakazato, Michiko; Iyo, Masaomi; Nakagawa, Akiko; Shimizu, Eiji

2018-01-12

Mental defeat and cognitive flexibility have been studied as explanatory factors for depression and posttraumatic stress disorder. This study examined mental defeat and cognitive flexibility scores in patients with panic disorder (PD) before and after cognitive behavioral therapy (CBT), and compared them to those of a gender- and age-matched healthy control group. Patients with PD (n = 15) received 16 weekly individual CBT sessions, and the control group (n = 35) received no treatment. Patients completed the Mental Defeat Scale and the Cognitive Flexibility Scale before the intervention, following eight CBT sessions, and following 16 CBT sessions, while the control group did so only prior to receiving CBT (baseline). The patients' pre-CBT Mental Defeat and Cognitive Flexibility Scale scores were significantly higher on the Mental Defeat Scale and lower on the Cognitive Flexibility Scale than those of the control group participants were. In addition, the average Mental Defeat Scale scores of the patients decreased significantly, from 22.2 to 12.4, while their average Cognitive Flexibility Scale scores increased significantly, from 42.8 to 49.5. These results suggest that CBT can reduce mental defeat and increase cognitive flexibility in patients with PD Trial registration The study was registered retrospectively in the national UMIN Clinical Trials Registry on June 10, 2016 (registration ID: UMIN000022693).

Assessment of Metabolic Flexibility of Old and Adult Mice Using Three Noninvasive, Indirect Calorimetry-Based Treatments

NARCIS (Netherlands)

Duivenvoorde, L.P.M.; Schothorst, van E.M.; Swarts, J.J.M.; Keijer, J.

2015-01-01

Indirect calorimetry (InCa) can potentially be used to noninvasively assess metabolic and age-related flexibility. To assess the use of InCa for this purpose, we tested the sensitivity and response stability over time of three InCa-based treatments in old versus adult mice. Diurnal patterns of

Flexible Training's Intrusion on Work/Life Balance

Directory of Open Access Journals (Sweden)

Zane BERGE

2005-04-01

Full Text Available Flexible Training's Intrusion on Work/Life Balance Seema TAKIYAJennifer ARCHBOLDZane BERGEBaltimore, USA Learning interventions should be aligned with the human learning system. To be effective, they have to support human learning, not work against it. Thalheimer, 2004 ABSTRACT With more companies allowing “flextime”, more access to elearning, and telecomuting, the line between workplace flexibility and work-life balance begins to blur. Companies “sell” to employees the flexibility of being able to complete training programs from the comfort of the participant's home, allowing them to learn at their own speed. In many ways, this solution is of great value to many employees. What also must be considered with the flexibility such training offers, is the unintentional consequences. This article explores questions such as does this flexibility create a 24-hour work day where the employee is continually accessible to work? Does it result in less family, personal and leisure time to the detriment of the worker?

Efficacy of an Internet-based depression intervention to improve rates of treatment in adolescent mothers.

Science.gov (United States)

Cynthia Logsdon, M; Myers, John; Rushton, Jeff; Gregg, Jennifer L; Josephson, Allan M; Davis, Deborah Winders; Brothers, Kyle; Baisch, Kristin; Carabello, Anissa; Vogt, Krista; Jones, Kayla; Angermeier, Jennifer

2018-06-01

Approximately 400,000 adolescents give birth in the USA annually. Although one-half experience depressive symptoms, less than 25% comply with referrals for depression evaluation and treatment. The current study tested the effectiveness of an Internet-based depression intervention on seeking depression treatment. Based upon the theory of planned behavior (TPB), the intervention included vignettes, questions and answers, and resources. Before the intervention, immediately after the intervention, and 2 weeks later the adolescent mothers (n = 151) answered questions related to TPB variables and depression treatment. Data were compared to adolescent mothers (n = 138) in the control group. Data were collected in community organizations or home visits for the control group. Adolescent mothers in the intervention group answered questions and completed the intervention from a computer of their choice. The adolescents were primarily African American (89.2%), less than high school educated (51.7%), had given birth in last year (97.1%), with a mean age 18.2 years. The intervention led to significant changes in attitude, perceived control, intention to seek mental health treatment, and actually seeking depression treatment. Untreated postpartum depression dramatically impacts a mother's relationship with her child, her functioning at work and school, health care-seeking behaviors, mothering skills, and her development as well as the development of her child. An Internet-based depression intervention is an inexpensive method to increase rates of depression treatment.

Uterine artery embolization: The interventional treatment of female genital diseases

Energy Technology Data Exchange (ETDEWEB)

Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Yang, Seung Boo [Dept. of Radiology, Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of); Goo, Dong Erk; Kim, Yong Jae [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of); Lee, Jae Myeong [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kang, Chae Hoon [Dept. of Radiology, Gangneung Asan Hospital, Gangneung (Korea, Republic of); Ohm, Joon Young [Dept. of Radiology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon (Korea, Republic of); Kim, Young Jun [Dept. of Radiology, Presbyterian Medical Center, Jeonju (Korea, Republic of)

2017-01-15

The uterus is the major female sex organ and is essential for pregnancy. The organ is located in the pelvic cavity. It is usually fist-sized with its volume changing from 75 to 200 cc depending on the menstrual cycle. There are various diseases associated with the uterus, including malignancy, uterine myoma, postpartum hemorrhage, and vascular malformation. The conventional surgical treatment for these diseases is hysterectomy. However, hysterectomy has some risk, and there may be complications associated with the surgery and anesthesia. In addition, hysterectomy results in loss of fertility and loss of female characteristics, both of which may lead to emotional problems. After uterine artery embolization (UAE) was performed for post-partum bleeding in 1979 and for uterine myoma in 1995, interventional treatment of UAE replaced the existing surgical treatment of hysterectomy. UAE is performed widely as a minimally invasive treatment modality that can preserve the uterus, make pregnancy and childbirth possible and resolve emotional problems. The interventional treatment has become increasingly popular to treat various female genital diseases.

Interventional treatment of un-ruptured tubal pregnancy

International Nuclear Information System (INIS)

Shan Hong; Ma Zhuang; Jiang Zaibo; Yan Ying; Guan Shouhai; Zhu Kangshun; Huang Mingsheng; Chen Hanwei

2000-01-01

Objective: To discuss some concept about interventional treatment of tubal pregnancy. Methods: The procedure of trans-vaginal tubal intra-gestational SAC injection (IGSI) or percutaneous intra-utero-arterial infusion (IUAI) was selected for treatment of 40 patients with un-ruptured tubal pregnancy. Methotrexate (MTX), Rosch-Thurmoud fallopian tube catheterization set, and the general angiographic catheters of 4.1-5.0 F were used for the procedure. Ultrasound and urine beta-hCG were the main indexes monitoring the therapeutic effects. Results: 12 of 40 patients underwent a total of 15 IGSI. Of these, 3 patients required a second injection; 28 of 40 cases were treated with IUAI. The total successful rate of termination of ectopic pregnancy was 97.5%, the mean resolution time for reduction of beta-hCG concentration was 11.7 days (range 4-28), the range of menstruation recovery time was 7-45 days. Conclusion: The interventional therapy for tubal pregnancy will be more widely applied, on the basis of a better understanding about the pathology, characteristics of embryonic sac development and blood supply, the regular change of concentration of serum and urine hCG in tubal pregnancy

Effects of a pilates school program on hamstrings flexibility of adolescents

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Noelia González-Gálvez

2015-08-01

Full Text Available INTRODUCTION: Low levels of hamstring flexibility may trigger certain acute and chronic pathologies and injuries. Poor flexibility is observed among teenagers and several authors have recommended the use of specific programs in this population to improve flexibility levels. The Pilates Method (PM may be an appropriate intervention to achieve this purpose and has rarely been used with this population. Objective: Study was to assess changes in the flexibility of hamstrings after running a didactic PM unit for high-school students.METHODS: This research was developed through a quasi-experimental design. The sample consisted of 66 high-school students divided into experimental group (EG=39 and control group (CG=27. The intervention was carried out 2 times a week for six weeks. Each session lasted 55 minutes divided into three parts: warm-up, main part and cool down. Hamstring flexibility was assessed using the toe-touch test. Paired Student t-test and t-test for independent samples were applied. The size of the effect (d was determined.RESULTS: The EG showed significant provident in hamstring flexibility (+3.54±3.9cm. The effect size was low (d>d>0,2d>0.21.15 which means that a large proportion of participants improved their results.CONCLUSION: This study showed that six-weeks of Pilates training in Physical Education classes has significantly improved the hamstrings flexibility among adolescents.

Interventional method in diagnosis and treatment of vascular complication after liver transplantation

International Nuclear Information System (INIS)

Huang Yonghui; Yang Jianyong; Chen Wei; Zhuang Wenquan; Yu Shenping; Chen Guihua

2001-01-01

Objective: To evaluate the role of interventional method in the diagnosis and treatment of vascular complication after liver transplantation. Methods: Seven patients (3 vena cava stenosis, 1 hepatic artery stenosis, 2 hepatic artery thrombosis, and 1 hepatic artery pseudo-aneurysm) with vascular complication after liver transplantation had been studied retrospectively, including the correlative biochemistry data and angiographic signs. Results: Among the 7 patients, 6 patients had been successfully treated by interventional radiology procedure. The technical success rate was 85.56%. The renal functions of 3 patients with vena cava stenosis who had been treated by angioplasty improved satisfactorily. The survival time after this intervention of these 3 patients ranged from 10 days to 20 months. 1 patient still lived 20 months after the intervention, 2 died of other complications beside caval stenosis within one month after the intervention. The hepatic function of the 4 patients with hepatic artery complications treated by interventional procedures had not been redressed. Conclusion: Angiography played an important role in diagnosing the hepatic vascular complication after liver transplantation. The result of interventional radiology treatment of vena cava stenosis was encouraging

Early intervention for preventing posttraumatic stress disorder: an Internet-based virtual reality treatment

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Sara A. Freedman

2015-04-01

Full Text Available Background: Posttraumatic stress disorder (PTSD develops in approximately 20% of people exposed to a traumatic event, and studies have shown that cognitive-behavioral therapy (CBT is effective as a treatment for chronic PTSD. It has also been shown to prevent PTSD when delivered early after a traumatic event. However, studies have shown that uptake of early treatment is generally low, and therefore, the need to provide interventions through other mediums has been identified. The use of technology may overcome barriers to treatment. Objective: This paper describes a randomized controlled trial that will examine an early CBT intervention for PTSD. The treatment incorporates virtual reality (VR as a method for delivering exposure-based elements of the treatment. The intervention is Internet based, such that the therapist and patient will “meet” in a secure online site. This site will also include multi-media components of the treatment (such as videos, audios, VR that can be accessed by the patient between sessions. Method: Two hundred patients arriving to a Level 1 emergency department following a motor vehicle accident will be randomly assigned to either treatment or control groups. Inclusion criteria are age 18–65, PTSD symptoms 2 weeks posttrauma related to current trauma, no suicidality, no psychosis. Patients will be assessed by telephone by a team blind to the study group, on four occasions: before and after treatment, and 6 and 12 months posttreatment. The primary outcome is PTSD symptoms at follow up. Secondary outcomes include depression and cost effectiveness. Analyses will be on an intention-to-treat basis. Discussion: The results will provide more insight into the effects of preventive interventions, in general, and Internet-based early interventions, in particular, on PTSD, in an injured population, during the acute phase after trauma. We will discuss possible strengths and limitations.

Percutaneous interventional mitral regurgitation treatment using the Mitra-Clip system

DEFF Research Database (Denmark)

Boekstegers, P; Hausleiter, J; Baldus, S

2014-01-01

The interventional treatment of mitral valve regurgitation by the MitraClip procedure has grown rapidly in Germany and Europe during the past years. The MitraClip procedure has the potential to treat high-risk patients with secondary mitral valve regurgitation and poor left ventricular function....... Furthermore, patients with primary mitral valve regurgitation may be treated successfully by the MitraClip procedure in case of high surgical risk or in very old patients. At the same time it has been emphasised that the MitraClip interventional treatment is still at an early stage of clinical development....... The largest clinical experience with the MitraClip procedure so far is probably present in some German cardiovascular centers, which here summarise their recommendations on the current indications and procedural steps of the MitraClip treatment. These recommendations of the AGIK and ALKK may present a basis...

The Preference for Internet-Based Psychological Interventions by Individuals Without Past or Current Use of Mental Health Treatment Delivered Online: A Survey Study With Mixed-Methods Analysis

Science.gov (United States)

Mattsson, Susanne; Olsson, Erik Martin Gustaf

2016-01-01

Background The use of the Internet has the potential to increase access to evidence-based mental health services for a far-reaching population at a low cost. However, low take-up rates in routine care indicate that barriers for implementing Internet-based interventions have not yet been fully identified. Objective The aim of this study was to evaluate the preference for Internet-based psychological interventions as compared to treatment delivered face to face among individuals without past or current use of mental health treatment delivered online. A further aim was to investigate predictors of treatment preference and to complement the quantitative analyses with qualitative data about the perceived advantages and disadvantages of Internet-based interventions. Methods Two convenience samples were used. Sample 1 was recruited in an occupational setting (n=231) and Sample 2 consisted of individuals previously treated for cancer (n=208). Data were collected using a paper-and-pencil survey and analyzed using mixed methods. Results The preference for Internet-based psychological interventions was low in both Sample 1 (6.5%) and Sample 2 (2.6%). Most participants preferred psychological interventions delivered face to face. Use of the Internet to search for and read health-related information was a significant predictor of treatment preference in both Sample 1 (odds ratio [OR] 2.82, 95% CI 1.18-6.75) and Sample 2 (OR 3.52, 95% CI 1.33-9.29). Being born outside of Sweden was a significant predictor of preference for Internet-based interventions, but only in Sample 2 (OR 6.24, 95% CI 1.29-30.16). Similar advantages and disadvantages were mentioned in both samples. Perceived advantages of Internet-based interventions included flexibility regarding time and location, low effort, accessibility, anonymity, credibility, user empowerment, and improved communication between therapist and client. Perceived disadvantages included anonymity, low credibility, impoverished

Background characteristics and treatment-related factors associated with treatment success or failure in a non-pharmacological intervention for dementia caregivers.

Science.gov (United States)

Rose, Karen C; Gitlin, Laura N

2017-06-01

Non-pharmacological interventions for persons with dementia often rely on family caregivers for implementation. However, caregivers differ in their readiness to use strategies. This study examines dyadic characteristics and treatment-related mechanisms associated with treatment success (high readiness to use strategies) and failure (low readiness to use strategies) at the conclusion of the Advancing Caregiver Training (ACT) intervention. Caregiver and person with dementia characteristics and treatment-related variables (treatment participation, number and type of strategies introduced and enacted) were examined in 110 caregivers in intervention. Interventionists rated readiness (1=precontemplation; 2=contemplation; 3=preparation; 4=action) of caregivers to use strategies at the final ACT session. Univariate analyses examined dyadic characteristics, and Multiple Analysis of Covariance (MANCOVA) and Analyses of Covariance (ANCOVA) examined treatment-related factors associated with readiness to use strategies at treatment completion. At treatment completion, 28.2% (N=31) scored in pre-action and 71.8% (N=79) at action. Caregivers at pre-action readiness levels were more likely than those at action to be a spouse, report greater financial difficulties and be managing fewer problem behaviors. Although both groups were introduced an equivalent number of non-pharmacological strategies, caregivers at pre-action were less likely than those at action to report enacting strategies. Certain dyadic characteristics and treatment-related factors were associated with treatment failure including financial strain and lack of strategy integration. Findings suggest that developing intervention components to address financial concerns and increase opportunities for practicing strategies and then using them between treatment sessions may be important for caregivers at risk of treatment failure.

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

International Nuclear Information System (INIS)

Lu Liming; Zhou Weisheng

2009-01-01

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

Partial Treatment Requests and Underlying Motives of Applicants for Gender Affirming Interventions

NARCIS (Netherlands)

Beek, T.F.; Kreukels, B.P.C.; Cohen-Kettenis, P.T.; Steensma, T.D.

2015-01-01

Introduction: Historically, only individuals with a cross-gender identity who wanted to receive a full treatment, were eligible for "complete sex reassignment" consisting of feminizing/masculinizing hormone treatment and several surgical interventions including genital surgery (full treatment).

Flexible guided self-determination intervention for younger adults with poorly controlled Type 1 diabetes, decreased HbA1c and psychosocial distress in women but not in men

DEFF Research Database (Denmark)

Zoffmann, V; Vistisen, D; Due-Christensen, M

2015-01-01

AIM: To report results from an 18-month randomized controlled trial (RCT) testing the effectiveness of a flexible guided self-determination (GSD) intervention on glycaemic control and psychosocial distress in younger adults with poorly controlled Type 1 diabetes. METHODS: Between January 2010 and...

Physical activity and sedentary behaviour in a flexible office-based workplace: Employee perceptions and priorities for change.

Science.gov (United States)

Olsen, Heidi M; Brown, Wendy J; Kolbe-Alexander, Tracy; Burton, Nicola W

2018-04-18

Many Australian employees now regularly work from home in some capacity. This new way of working has not been widely studied in relation to the potential implications for employees' health-related behaviour or workplace health promotion. The aim of this study was to explore office-based employees' perceptions of the impact of flexible work on physical activity and sedentary behaviour; and preferences for associated interventions. Three focus groups were conducted with office-based employees (n = 28) 6 months after the introduction of a flexible work policy. A semi-structured interview format with open-ended questions was used with summary statements to check understanding. Sessions were audiotaped, and dominant themes were identified. Findings on intervention preferences were interpreted using a social cognitive framework. An overview of results was provided to a group of managers (n = 9) for comment. Employees reported that physical activity was not impacted, but sedentary behaviour had increased, with flexible work. Intervention preferences focussed on occupational sedentary behaviour, self-regulation, prompts and social connections, and not the physical work environment. Managers agreed with employees' preferences and also wanted interventions to be sustainable. Self-directed interventions with social components and targeting occupational sedentary behaviour were more acceptable than physical activity interventions in this flexible workplace. SO WHAT?: Health promotion for workplaces with flexible work practices may benefit from prioritising strategies that promote self-regulation and social connections rather than being linked to the physical worksite. © 2018 Australian Health Promotion Association.

The Effect of Corrective Exercises on Flexibility and Strength in Postural Scoliosis of Adolescent Girls

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Mahboube Karbalaaie

2011-01-01

Full Text Available Objective: The aim of this study was to investigate the effect of corrective exercises on flexibility and strength in Postural Scoliosis of adolescent girls. Materials & Methods: This quasi experimental research was applied as a clinical trial and had done on 40 girls with postural scoliosis those were selected by convenient sampling and assigned to control (n=20 and experimental (n=20 group by simple randomized method. The experimental group received corrective exercises for 30 days and the control group was given no intervention. Flexibility and strength was measured before and after 30 days in all subjects. Data were analyzed by use of Paired T and Independent T tests. Results: There was statistically significant difference in Flexibility and Strength of experimental group between before and after intervention (P<0/001, but There was no significant difference between groups after intervention (P=0.6. Conclusions: This study demonstrates that corrective exercises can lead to improvement of flexibility and strength in scoliosis girls.

Cognitive Flexibility in Obsessive Compulsive Disorder

DEFF Research Database (Denmark)

Jónsson, Hjalti; Salkovskis, Paul M.

BT for problems such as OCD requires a level of cognitive flexibility (that is the ability to take a different perspective on ones problems). It could be argued that problems in set shifting (by neuropsychological tests) might underpin problems in this area. Two assessments were used (1: perception...... of cognitive flexibility was assessed by questionnaire 2: neuropsychological evaluation of set shifting). This study will recruit three groups: OCD patients, anxious and healthy controls. Cognitive flexibility is measured using modified version of the Cognitive Flexibility Scale (Martin & Rubin, 1995......) and neuropsychological measures of cognitive flexibility (Wisconsin Cart Sorting Test, Trail Making Test A/B, The Brixton Test). IN addition to the group comparison, the relationship between perceived flexibility, set shifting and psychopathology will be investigated. The implications of the findings for treatment...

Ovarian failure and cancer treatment: Incidence and interventions for premenopausal women

International Nuclear Information System (INIS)

Feldman, J.E.

1989-01-01

Ovarian failure may be a long-term consequence of cancer treatment for premenopausal women. Caused by several treatments, including radiation therapy and the alkylating agents, it produces signs and symptoms associated with menopause: hot flashes, amenorrhea, dyspareunia, loss of libido, and irritability. Critical factors that determine ovarian functioning after treatment for cancer are the patient's age at the time of therapy, the amount of radiation that the ovaries received, and the dose of the antineoplastic agent(s). Medical interventions, such as hormonal therapy and surgical repositioning of the ovaries, may maintain ovarian function for some women. Nursing intervention includes assessment, education, and counseling. Counseling focuses on how the prematurely menopausal patient feels about herself as indicated by self-esteem, body image, and sexuality

Ovarian failure and cancer treatment: Incidence and interventions for premenopausal women

Energy Technology Data Exchange (ETDEWEB)

Feldman, J.E.

1989-09-01

Ovarian failure may be a long-term consequence of cancer treatment for premenopausal women. Caused by several treatments, including radiation therapy and the alkylating agents, it produces signs and symptoms associated with menopause: hot flashes, amenorrhea, dyspareunia, loss of libido, and irritability. Critical factors that determine ovarian functioning after treatment for cancer are the patient's age at the time of therapy, the amount of radiation that the ovaries received, and the dose of the antineoplastic agent(s). Medical interventions, such as hormonal therapy and surgical repositioning of the ovaries, may maintain ovarian function for some women. Nursing intervention includes assessment, education, and counseling. Counseling focuses on how the prematurely menopausal patient feels about herself as indicated by self-esteem, body image, and sexuality.

Interventions for replacing missing teeth: treatment of peri-implantitis.

Science.gov (United States)

Esposito, Marco; Grusovin, Maria Gabriella; Worthington, Helen V

2012-01-18

One of the key factors for the long-term success of oral implants is the maintenance of healthy tissues around them. Bacterial plaque accumulation induces inflammatory changes in the soft tissues surrounding oral implants and it may lead to their progressive destruction (peri-implantitis) and ultimately to implant failure. Different treatment strategies for peri-implantitis have been suggested, however it is unclear which are the most effective. To identify the most effective interventions for treating peri-implantitis around osseointegrated dental implants. We searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of the identified randomised controlled trials (RCTs) and relevant review articles for studies outside the handsearched journals. We wrote to authors of all identified RCTs, to more than 55 dental implant manufacturers and an Internet discussion group to find unpublished or ongoing RCTs. No language restrictions were applied. The last electronic search was conducted on 9 June 2011. All RCTs comparing agents or interventions for treating peri-implantitis around dental implants. Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. We contacted the authors for missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals (CI). Heterogeneity was to be investigated including both clinical and methodological factors. Fifteen eligible trials were identified, but six were excluded. The following interventions were compared in the nine included studies: different non-surgical interventions (five trials); adjunctive treatments to non-surgical interventions (one trial); different surgical interventions (two trials

Interventions for enhancing medication compliance/adherence with benefits in treatment outcomes

Directory of Open Access Journals (Sweden)

Hagen, Anja

2007-01-01

Full Text Available Scientific background: Poor compliance or adherence in drug therapy can cause increased morbidity, mortality and enormous costs in the healthcare system (in Germany annually approximately 10 billion euros. Different methods are used for enhancing the compliance or adherence. Research questions: The evaluation addresses the questions about existence, efficacy, cost-benefit relation as well as ethical-social and juridical implications of strategies for enhancing compliance or adherence in drug therapy with concomitant improvements in treatment outcomes. Methods: A systematic literature search was conducted in the medical, also health economic relevant, literature databases in January 2007, beginning from 2002. Systematic reviews on the basis of (randomised controlled trials (RCT concerning interventions to enhance compliance or adherence with regard to treatment outcomes as well as systematic reviews of health economic analyses were included in the evaluation. Additionally, it was also searched for publications which primarily considered ethical-social and juridical aspects of these interventions for the German context. Results: One systematic review with data for 57 RCT was included in the medical evaluation and one systematic review with data for six studies into the health economic evaluation. No publication primary concerning ethical-social or juridical implications could be identified. A significant positive effect on the treatment outcome was reported for 22 evaluated interventions. For many interventions the results can be classified as reliable: counseling with providing an information leaflet and compliance diary chart followed by phone consultation for helicobacter pylori positive patients, repeated counseling for patients with acute asthma symptoms, telephone calls to establish the level of compliance and to make recommendations based on that for the therapy of cardiovascular diseases, calls of an automated telephone system with phone

Trichotillomania: the impact of treatment history on the outcome of an Internet-based intervention

Directory of Open Access Journals (Sweden)

Weidt S

2017-04-01

Full Text Available Steffi Weidt,1 Annette Beatrix Bruehl,2,3 Aba Delsignore,1 Gwyneth Zai,2,4–6 Alexa Kuenburg,1 Richard Klaghofer,1 Michael Rufer1 1Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland; 2Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; 3Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zurich, Switzerland; 4Department of Psychiatry, Institute of Medical Science, University of Toronto, 5Neurogenetics Section, Centre for Addiction and Mental Health, 6Department of Psychiatry, Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada Background: Many patients suffering from trichotillomania (TTM have never undergone treatment. Without treatment, TTM often presents with a chronic course. Characteristics of TTM individuals who have never been treated (untreated remain largely unknown. Whether treatment history impacts Internet-based interventions has not yet been investigated. We aimed to answer whether Internet-based interventions can reach untreated individuals and whether treatment history is associated with certain characteristics and impacts on the outcome of an Internet-based intervention.Methods: We provided Internet-based interventions. Subjects were characterized at three time points using the Massachusetts General Hospital Hairpulling Scale, Hamilton Depression Rating Scale, and the World Health Organization Quality of Life questionnaire.Results: Of 105 individuals, 34 were untreated. Health-related quality of life (HRQoL was markedly impaired in untreated and treated individuals. Symptom severity did not differ between untreated and treated individuals. Nontreatment was associated with fewer depressive symptoms (P=0.002. Treatment history demonstrated no impact on the outcome of Internet-based interventions.Conclusion: Results

Ethics of the early intervention in the treatment of schizophrenia.

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Filaković, Pavo; Degmecić, Dunja; Koić, Elvira; Benić, Domagoj

2007-09-01

When second generation antipsychotics were introduced in the mid 1990-s they offered the possibility of early psychopharmacological interventions in the treatment of schizophrenia. The idea applying antipsychotics in the prodromal phase of schizophrenia today is an realistic option. However ethical dilemmas about offering antipsychotics to the adolescents with at risk mental states, of whom only a few are real prodromes of schizophrenia remain for clinicians. In the literature about the ethics of the early interventions in psychiatry there are still many ethical questions which call for caution because of the low predictive value of at risk mental states, of which only 40% turn out to be a real prodrome of schizophrenia. These ethical questions can be addressed in three categories: - how to best identify who should receive early pharmacological intervention? - what this intervention should consist of? - how to evaluate treatment efficacy in the absence of illness base rates in the adolescents with a real prodrome of schizophrenia? Besides, arguing against the concept of early psychopharmacological interventions in the adolescent population are the fact of the unknown effect of antipsychotics on the developing brain as well as negative effects of stigma on those adolescents who receive them. The authors in the article analyse these ethical questions and take the side of those clinicians who think that caution and careful ethical judgment are needed before the prescribing of antipsychotics to adolescents with at risk mental states.

Evaluation of Flexible Force Sensors for Pressure Monitoring in Treatment of Chronic Venous Disorders.

Science.gov (United States)

Parmar, Suresh; Khodasevych, Iryna; Troynikov, Olga

2017-08-21

The recent use of graduated compression therapy for treatment of chronic venous disorders such as leg ulcers and oedema has led to considerable research interest in flexible and low-cost force sensors. Properly applied low pressure during compression therapy can substantially improve the treatment of chronic venous disorders. However, achievement of the recommended low pressure levels and its accurate determination in real-life conditions is still a challenge. Several thin and flexible force sensors, which can also function as pressure sensors, are commercially available, but their real-life sensing performance has not been evaluated. Moreover, no researchers have reported information on sensor performance during static and dynamic loading within the realistic test conditions required for compression therapy. This research investigated the sensing performance of five low-cost commercial pressure sensors on a human-leg-like test apparatus and presents quantitative results on the accuracy and drift behaviour of these sensors in both static and dynamic conditions required for compression therapy. Extensive experimental work on this new human-leg-like test setup demonstrated its utility for evaluating the sensors. Results showed variation in static and dynamic sensing performance, including accuracy and drift characteristics. Only one commercially available pressure sensor was found to reliably deliver accuracy of 95% and above for all three test pressure points of 30, 50 and 70 mmHg.

Memory Flexibility training (MemFlex) to reduce depressive symptomatology in individuals with major depressive disorder: study protocol for a randomised controlled trial.

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Hitchcock, Caitlin; Hammond, Emily; Rees, Catrin; Panesar, Inderpal; Watson, Peter; Werner-Seidler, Aliza; Dalgleish, Tim

2015-11-03

Major depressive disorder (MDD) is associated with chronic biases in the allocation of attention and recollection of personal memories. Impaired flexibility in attention and autobiographical memory retrieval is seen to both maintain current symptoms and predict future depression. Development of innovative interventions to reduce maladaptive cognitive patterns and improve cognitive flexibility in the domain of memory may therefore advance current treatment approaches for depression. Memory specificity training and cognitive bias modification techniques have both shown some promise in improving cognitive flexibility. Here we outline plans for a trial of an innovative memory flexibility training programme, MemFlex, which advances current training techniques with the aim of improving flexibility of autobiographical memory retrieval. This trial seeks to estimate the efficacy of MemFlex, provide data on feasibility, and begin to explore mechanisms of change. We plan a single-blind, randomised, controlled, patient-level trial in which 50 individuals with MDD will complete either psychoeducation (n = 25) or MemFlex (n = 25). After completing pre-treatment measures and an orientation session, participants complete eight workbook-based sessions at home. Participants will then be assessed at post-treatment and at 3 month follow-up. The co-primary outcomes are depressive symptoms and diagnostic status at 3 month follow-up. The secondary outcomes are memory flexibility at post-treatment and number of depression free days at 3 month follow-up. Other process outcomes and mediators of any treatment effects will also be explored. This trial will establish the efficacy of MemFlex in improving memory flexibility, and reducing depressive symptoms. Any effects on process measures related to relapse may also indicate whether MemFlex may be helpful in reducing vulnerability to future depressive episodes. The low-intensity and workbook-based format of the programme may improve

Differential responsiveness to a parenting intervention for mothers in substance abuse treatment.

Science.gov (United States)

Paris, Ruth; Herriott, Anna; Holt, Melissa; Gould, Karen

2015-12-01

This study examines the relationship between levels of psychological distress in substance-dependent mothers and their differential response to a dyadic parent-child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social-emotional development. Additionally, clinicians provided assessments of the parent-child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal-Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women with moderately elevated levels of psychological distress did not. Women who were most distressed at baseline showed increased levels of parental reflective functioning post-treatment while women with moderate and lower levels of baseline psychological distress showed improvements on clinician-rated assessments of parent-child relationships. Chi Square analyses showed that parents who endorsed the highest levels of distress at baseline reported that their children's risk status regarding social-emotional development decreased post-treatment. Despite similarities in substance dependence, mothers in this sample had different needs and outcomes in the context of this parenting intervention due to variation in mental health. Given this variation, parenting interventions for substance-dependent mothers need to account for the individual differences in levels of psychological distress. Copyright © 2015 Elsevier Ltd. All rights reserved.

Flexible working conditions and their effects on employee health and wellbeing.

Science.gov (United States)

Joyce, Kerry; Pabayo, Roman; Critchley, Julia A; Bambra, Clare

2010-02-17

Flexible working conditions are increasingly popular in developed countries but the effects on employee health and wellbeing are largely unknown. To evaluate the effects (benefits and harms) of flexible working interventions on the physical, mental and general health and wellbeing of employees and their families. Our searches (July 2009) covered 12 databases including the Cochrane Public Health Group Specialised Register, CENTRAL; MEDLINE; EMBASE; CINAHL; PsycINFO; Social Science Citation Index; ASSIA; IBSS; Sociological Abstracts; and ABI/Inform. We also searched relevant websites, handsearched key journals, searched bibliographies and contacted study authors and key experts. Randomised controlled trials (RCT), interrupted time series and controlled before and after studies (CBA), which examined the effects of flexible working interventions on employee health and wellbeing. We excluded studies assessing outcomes for less than six months and extracted outcomes relating to physical, mental and general health/ill health measured using a validated instrument. We also extracted secondary outcomes (including sickness absence, health service usage, behavioural changes, accidents, work-life balance, quality of life, health and wellbeing of children, family members and co-workers) if reported alongside at least one primary outcome. Two experienced review authors conducted data extraction and quality appraisal. We undertook a narrative synthesis as there was substantial heterogeneity between studies. Ten studies fulfilled the inclusion criteria. Six CBA studies reported on interventions relating to temporal flexibility: self-scheduling of shift work (n = 4), flexitime (n = 1) and overtime (n = 1). The remaining four CBA studies evaluated a form of contractual flexibility: partial/gradual retirement (n = 2), involuntary part-time work (n = 1) and fixed-term contract (n = 1). The studies retrieved had a number of methodological limitations including short follow-up periods

Biobank participant support of newborn screening for disorders with variable treatment and intervention options.

Science.gov (United States)

Bunnell, Megan E; Tarini, Beth A; Petros, Michael; Goldenberg, Aaron J; Arjunan, Aishwarya; Wicklund, Catherine

2016-10-01

We aimed to better understand biobank participant opinions of the benefits of newborn screening (NBS) for certain disorder types and how terminology used in NBS discourse might impact stakeholder opinion. We conducted a between-subjects randomized survey of 5840 members of the Northwestern University Biobank. The survey contained 12 scenarios, each describing a disorder and its treatment. For each scenario, we varied the terminology used to describe treatment options. One survey version used the term intervention and the other treatment. The outcome measured for each scenario was perceived benefit (for the infant) and importance of testing (for participants). Comparisons were made between participants and between scenarios. Ratings of benefit and importance were not influenced by the use of the term intervention versus treatment within scenarios. Nuances existed in ratings of benefit to the infant and importance to participants amongst scenarios. Participants were most likely to perceive benefit and importance in screening for a disorder if treatment/intervention offered a high chance of improved outcomes. While participants perceived benefit to the infant and importance to themselves in screening for most disorders, nuances in inter-scenario ratings suggest participants weighed availability and type of treatment/intervention in consideration of the benefits of NBS.

Predictors of adherence to exercise interventions during and after cancer treatment : A systematic review

NARCIS (Netherlands)

Ormel, H L; van der Schoot, G G F; Sluiter, W J; Jalving, M; Gietema, J A; Walenkamp, A M E

Objective: Exercise interventions benefit cancer patients. However, only low numbers of patients adhere to these interventions. This review aimed to identify predictors of exercise intervention adherence in patients with cancer, during and after multimodality cancer treatment. Methods: A literature

Mechanisms of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys.

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Burke, Jeffrey D; Loeber, Rolf

2016-01-01

Evidence for effective treatment for behavioral problems continues to grow, yet evidence about the effective mechanisms underlying those interventions has lagged behind. The Stop Now and Plan (SNAP) program is a multicomponent intervention for boys between 6 and 11. This study tested putative treatment mechanisms using data from 252 boys in a randomized controlled trial of SNAP versus treatment as usual. SNAP includes a 3 month group treatment period followed by individualized intervention, which persisted through the 15 month study period. Measures were administered in four waves: at baseline and at 3, 9 and 15 months after baseline. A hierarchical linear modeling strategy was used. SNAP was associated with improved problem-solving skills, prosocial behavior, emotion regulation skills, and reduced parental stress. Prosocial behavior, emotion regulation skills and reduced parental stress partially mediated improvements in child aggression. Improved emotion regulation skills partially mediated treatment-related child anxious-depressed outcomes. Improvements in parenting behaviors did not differ between treatment conditions. The results suggest that independent processes may drive affective and behavioral outcomes, with some specificity regarding the mechanisms related to differing treatment outcomes.

Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

Science.gov (United States)

Karim, Rushmia; Sykakis, Evripidis; Lightman, Susan; Fraser-Bell, Samantha

2013-01-01

Background Uveitic macular edema is the major cause of reduced vision in eyes with uveitis. Objectives To assess the effectiveness of interventions in the treatment of uveitic macular edema. Search strategy Cochrane Central Register of Controlled Trials, Medline, and Embase. There were no language or data restrictions in the search for trials. The databases were last searched on December 1, 2011. Reference lists of included trials were searched. Archives of Ophthalmology, Ophthalmology, Retina, the British Journal of Ophthalmology, and the New England Journal of Medicine were searched for clinical trials and reviews. Selection criteria Participants of any age and sex with any type of uveitic macular edema were included. Early, chronic, refractory, or secondary uveitic macular edema were included. We included trials that compared any interventions of any dose and duration, including comparison with another treatment, sham treatment, or no treatment. Data collection and analysis Best-corrected visual acuity and central macular thickness were the primary outcome measures. Secondary outcome data including adverse effects were collected. Conclusion More results from randomized controlled trials with long follow-up periods are needed for interventions for uveitic macular edema to assist in determining the overall long-term benefit of different treatments. The only intervention with sufficiently robust randomized controlled trials for a meta-analysis was acetazolamide, which was shown to be ineffective in improving vision in eyes with uveitic macular edema, and is clinically now rarely used. Interventions showing promise in this disease include dexamethasone implants, immunomodulatory drugs and anti-vascular endothelial growth-factor agents. When macular edema has become refractory after multiple interventions, pars plana vitrectomy could be considered. The disease pathophysiology is uncertain and the course of disease unpredictable. As there are no clear guidelines from

Parent-only interventions in the treatment of childhood obesity: a systematic review of randomized controlled trials

OpenAIRE

Ewald, H.; Kirby, J.; Rees, K.; Robertson, W.

2017-01-01

Background An effective and cost-effective treatment is required for the treatment of childhood obesity. Comparing parent-only interventions with interventions including the child may help determine this. Methods A systematic review of published and ongoing studies until 2013, using electronic database and manual searches. Inclusion criteria: randomized controlled trials, overweight/obese children aged 5-12 years, parent-only intervention compared with an intervention that included the child,...

Minimum housing spaces, flexibility and sustainability: a reflection on the basis of ergonomics intervention.

Science.gov (United States)

Oliveira, Rayssa Cristiane; Elali, Gleice Azambuja

2012-01-01

This article discusses the quality of internal life space in apartments of residential buildings in the northeast region of Brazil, especially the possibility to adapt environments with small areas (according to local building codes) to the needs of different arrangements of families (considering 4 members per family). The research had a gradual approach and used multimethod strategy: (a) studying the universe of residential buildings whose apartment's inner area is between 50 and 60 m2 and were constructed in Natal-RN between 1998 and 2008, as well as not linked to social housing programs and occupied for more than one year; (b) selecting a building to do a Post Occupation Evaluation (POE), using walkthrough, technical observation and questionnaires; (c) choosing of two housing units to do an ergonomic intervention (based in interviews and detailed measurements). The results show the technical possibility to modify the units, but these modifications have a high (social, economic and environmental) price, because in general the space of units projected is not flexible. So, the paper concludes that this type of enterprise needs to be rethought, since part of them is (social and ecologically) unsustainable.

Brief Interventions in the Treatment of Alcohol Use Disorders: Definition and Overview.

Science.gov (United States)

Osburn, Cynthia J.

2001-01-01

Reviews the literature and describes the nature and feasibility of brief interventions in the treatment of alcohol use disorders. Attention is given to the promising results of outcome studies, and recommendations are provided for the implementation of brief interventions with a heterogeneous clientele. (Contains 39 references.) (GCP)

Colorectal-Cancer Incidence and Mortality with Screening Flexible Sigmoidoscopy

Science.gov (United States)

Schoen, Robert E.; Pinsky, Paul F.; Weissfeld, Joel L.; Yokochi, Lance A.; Church, Timothy; Laiyemo, Adeyinka O.; Bresalier, Robert; Andriole, Gerald L.; Buys, Saundra S.; Crawford, E. David; Fouad, Mona N.; Isaacs, Claudine; Johnson, Christine C.; Reding, Douglas J.; O'Brien, Barbara; Carrick, Danielle M.; Wright, Patrick; Riley, Thomas L.; Purdue, Mark P.; Izmirlian, Grant; Kramer, Barnett S.; Miller, Anthony B.; Gohagan, John K.; Prorok, Philip C.; Berg, Christine D.

2013-01-01

Background The benefits of endoscopic testing for colorectal-cancer screening are uncertain. We evaluated the effect of screening with flexible sigmoidoscopy on colorectal-cancer incidence and mortality. Methods From 1993 through 2001, we randomly assigned 154,900 men and women 55 to 74 years of age either to screening with flexible sigmoidoscopy, with a repeat screening at 3 or 5 years, or to usual care. Cases of colorectal cancer and deaths from the disease were ascertained. Results Of the 77,445 participants randomly assigned to screening (intervention group), 83.5% underwent baseline flexible sigmoidoscopy and 54.0% were screened at 3 or 5 years. The incidence of colorectal cancer after a median follow-up of 11.9 years was 11.9 cases per 10,000 person-years in the intervention group (1012 cases), as compared with 15.2 cases per 10,000 person-years in the usual-care group (1287 cases), which represents a 21% reduction (relative risk, 0.79; 95% confidence interval [CI], 0.72 to 0.85; Pcolorectal cancer (479 cases in the intervention group vs. 669 cases in the usual-care group; relative risk, 0.71; 95% CI, 0.64 to 0.80; Pcolorectal cancer (512 cases vs. 595 cases; relative risk, 0.86; 95% CI, 0.76 to 0.97; P = 0.01). There were 2.9 deaths from colorectal cancer per 10,000 person-years in the intervention group (252 deaths), as compared with 3.9 per 10,000 person-years in the usual-care group (341 deaths), which represents a 26% reduction (relative risk, 0.74; 95% CI, 0.63 to 0.87; Pcolorectal cancer was reduced by 50% (87 deaths in the intervention group vs. 175 in the usual-care group; relative risk, 0.50; 95% CI, 0.38 to 0.64; Pcolorectal cancer was unaffected (143 and 147 deaths, respectively; relative risk, 0.97; 95% CI, 0.77 to 1.22; P = 0.81). Conclusions Screening with flexible sigmoidoscopy was associated with a significant decrease in colorectal-cancer incidence (in both the distal and proximal colon) and mortality (distal colon only). (Funded by the

Interventional treatment of emergent hepatic artery thrombosis after liver transplantation

International Nuclear Information System (INIS)

Liu Fengyong; Wang Maoqiang; Wang Zhijun; Wang Zhongpu; Shi Xianjie; Zhou Ningxin

2006-01-01

Objective: To evaluate the safety and efficacy of the endovascular interventional techniques for the management of emergent hepatic artery thrombosis (HAT) after orthotopic liver transplantation (OLT). Methods: Ten patients (8 men and 2 women with mean age of 47 years) diagnosed with HAT after OLT were treated with interventional procedures. All patients presented with elevation of liver enzymes and bilirubin levels. The diagnosis of the HAT was suggested by doppler ultrasonography and confirmed by angiography at 16 hours to 10 days (mean, 4.5 days) after OLT. Interventional techniques consisted of indwelling transcatheter hepatic arterial thrombolysis with a low dose of urokinase monitored under ultrasonography every 6-12 hours and stent placement in the stenotic segment of the hepatic artery was undertaken. Systemic intravenous low dose of heparin was given contemporaneously. Results: Complete occlusion of the proper HA was achieved in 10 patients. Hepatic arterial flow was re-established in 8 of the 10 patients (80%) at 12 hours to 9 days (mean, 4.8 days) after the intra-arterial thrombolysis, with significant improvement of liver function. Hepatic artery stenosis at the anastomosis was found in the 8 patients, and a stent placement in the stenotic segment was performed successfully in 7 patients with degree of stenosis over 90%.Intra-arterial thrombolysis was failed in 2 cases. Intraperitoneal hemorrhage from the anastomosis occurred in 1 patient at 12 hours after the treatment, and was emergently taken for the graft revision with reanastomosis. One patient with complete occlusion of the hepatic artery at 7 days after the treatment, but having collateral flow of the liver for maintaining liver function and thus sparing further intervention. 8 patients with successful hepatic arterial recanalization carried along a good clinical course with normal graft function at a median 12 months (range, 4 to 20 months), and patent hepatic arterial flow was identified by

Developing and implementing a positive behavioral reinforcement intervention in prison-based drug treatment: Project BRITE.

Science.gov (United States)

Burdon, William M; St De Lore, Jef; Prendergast, Michael L

2011-09-01

Within prison settings, the reliance on punishment for controlling inappropriate or noncompliant behavior is self-evident. What is not so evident is the similarity between this reliance on punishment and the use of positive reinforcements to increase desired behaviors. However, seldom do inmates receive positive reinforcement for engaging in prosocial behaviors or, for inmates receiving drug treatment, behaviors that are consistent with or support their recovery. This study provides an overview of the development and implementation of a positive behavioral reinforcement intervention in male and female prison-based drug treatment programs. The active involvement of institutional staff, treatment staff, and inmates enrolled in the treatment programs in the development of the intervention along with the successful branding of the intervention were effective at promoting support and participation. However, these factors may also have ultimately impacted the ability of the randomized design to reliably demonstrate the effectiveness of the intervention.

Psychological comorbidities and compliance to interventional treatment of patients with cutaneous vascular malformations.

Science.gov (United States)

Kenny, Stephanie A; Majeed, Nevin; Zhand, Naista; Glikstein, Rafael; Agid, Ronit; Dos Santos, Marlise P

2016-08-01

The aim of this study was to assess qualitatively the psychological stressors affecting patients with cutaneous vascular malformations and hemangiomas (CVM-H) and their impact on compliance to interventional treatment. A retrospective chart review was conducted of all patients with CVM-H treated by interventional neuroradiology at a single academic institution during a five-year period (2009-2014). Psychological complaints were documented during each clinic visit by a neuroradiologist. Compliance to interventional treatment was defined by adherence to the scheduled treatment sessions. Fisher's exact test was used to assess for associations between psychological complaints and compliance. Seventy-five patients were assessed, of whom 49 (65.3%) were female, with an age range of 2-78 years (mean age 30.2 years). All except one patient older than seven years of age (n = 71; 94.6%) had a psychological complaint, including fear of negative appearance (n = 53; 70.6%), dissatisfaction with appearance (n = 46; 61.3%), low self-esteem (n = 35; 46.6%), anxiety (n = 16; 21.3%), stress (n = 13; 17.3%), bullying (n = 5; 6.6%), and low mood (n = 4; 5.3%). Twenty-three (31%) patients were non-compliant. Low self-esteem was significantly associated with non-compliance (p = 0.0381). There is a high prevalence of psychological comorbidities among patients treated for CVM-H. This has potential implications for interventional treatment, as it was found that low self-esteem is significantly associated with non-compliance. These results suggest the need for early psychological support in these patients in order to maximize compliance to interventional treatment. © The Author(s) 2016.

Effective Mental Health Interventions and Treatments for Young Children with Diverse Needs

Science.gov (United States)

Osofsky, Joy; Wieder, Serena; Noroña, Carmen Rosa; Lowell, Darcy; Worthy, D'Lisa Ramsey

2018-01-01

Infant and early childhood mental health interventions and treatment take place in many different settings including clinics serving adults and children, primary care centers, pediatric clinics, private practice offices, homes, early intervention offices, and child care centers. In addition, the types of evaluations and services offered in these…

Return-to-work intervention during cancer treatment - The providers' experiences

DEFF Research Database (Denmark)

Petersen, K S; Momsen, A H; Stapelfeldt, C M

2018-01-01

To explore in-depth understanding of providers' experiences when involved in a return-to-work (RTW) intervention offered during cancer treatment. Semi-structured individual interviews and participant observations at a hospital department and two municipal job centers were carried out, including ten...... providers (physicians, nurses and social workers). A phenomenological-hermeneutic approach was applied, involving coding, identification of themes and interpretation of findings. Three major themes were identified: Treatment first, Work as an integrated component in cancer rehabilitation, and Challenges...... in bringing up work issues. Differences in providers' experiences of the RTW intervention offered to cancer patients were found: in the hospital setting RTW was a second priority, whereas in the municipality job centers it was an integrated component. Further studies are needed to investigate how and when...

Interventional recanalization combined with chinese traditional medicine in the treatment of fallopian tube obstruction

International Nuclear Information System (INIS)

Sun Lizhe; Liu Hui; He Zhao; Wei Feng; Ma Xuanpeng

2004-01-01

Objective: To observe the curative effect of interventional recanalization combined with chinese traditional medicine in treatment of fallopian tube obstruction. Methods: There were 200 cases in treatment group and 120 cases in control group. In the treatment group patients were given chinese herbal medicine after the intervention. In sixth month a follow up imaging was performed assessing the patency. The follow up also included the pregnancy rate 1 year later. Results: The patency rate was 83% in treatment group, and 81.5% in control group (P>0.05). Re-conjunction rate was 7.6% in the study group and 22% in control group (P<0.01). The pregnancy rate was 67% in study group and 42% in control group (P<0.01). Conclusion: With interventional recanalization combined with chinese traditional medicine, good curative effect obtained in treatment of fallopian tube obstructive infertility. Combined with Chinese traditional medicine, the post-procedure re-conjunction rate is decreased, especially in the case of short fallopian tube obstruction

Flexible input, dazzling output with IBM i

CERN Document Server

Victória-Pereira, Rafael

2014-01-01

Link your IBM i system to the modern business server world! This book presents easier and more flexible ways to get data into your IBM i system, along with rather surprising methods to export and present the vital business data it contains. You'll learn how to automate file transfers, seamlessly connect PC applications with your RPG programs, and much more. Input operations will become more flexible and user-proof, with self-correcting import processes and direct file transfers that require a minimum of user intervention. Also learn novel ways to present information: your DB2 data will look gr

The effect of Pilates method on elderly flexibility

Directory of Open Access Journals (Sweden)

Adriana Coutinho de Azevedo Guimarães

Full Text Available Introduction Pilates as physical exercise practice brings countless benefits, such as improvement of motor aptitudes and skills.Objective To look into the effect of the Pilates method on the hip and shoulder girdle flexibility levels in the elderly.Methods Experimental study composed of 30 elderly subjects of the control group and 30 of the Pilates group within a 12 week training time. A form was used to characterize the sample and to assess hip flexibility and shoulder girdle. Descriptive and inferential statistics were used, under a significance level of p < 0.05.Results On hip flexibility, the 30 elderly individuals from the control group remained under normal and inferior classification, not presenting any differences between the variables (p = 0.180 from the pretest to the retest. In the intervention group, 60% of the elderly subjects were assessed as normal. In the retest, such percentage increased to 66.7%. In the pretest, 10% of the elderly subjects were given the superior classification, and in the retest, it increased to 33%, not presenting significance between the variables (p = 0.180. On shoulder flexibility in the intervention group, 63% of the elderly subjects were graded as normal, and 17% as superior. In the shoulder retest the number of elderly individuals decreased to 47% in the normal classification, and increased to 33% in the superior classification, presenting a significant difference (p = 0.001.Conclusion The elderly subjects who did not take part into the Pilates method presented a lower flexibility degree, considering that, the latter reduces in aging. As a preventive way of improving such limitation, the practice of the Pilates method is suggested.

Systematic review and meta-analysis of music interventions in hypertension treatment: a quest for answers.

Science.gov (United States)

Kühlmann, Anne Y R; Etnel, Jonathan R G; Roos-Hesselink, Jolien W; Jeekel, Johannes; Bogers, Ad J J C; Takkenberg, Johanna J M

2016-04-19

Adverse effects, treatment resistance and high costs associated with pharmacological treatment of hypertension have led to growing interest in non-pharmacological complementary therapies such as music interventions. This meta-analysis aims to provide an overview of reported evidence on the efficacy of music interventions in the treatment of hypertension. A systematic literature search was conducted for publications on the effect of music interventions on blood pressure in adult hypertensive subjects published between January 1990-June 2014. Randomized controlled trials with a follow-up duration ≥28 days were included. Blood pressure measures were pooled using inverse variance weighting. Of the 1689 abstracts reviewed, 10 randomized controlled trials were included. Random-effects pooling of the music intervention groups showed a trend toward a decrease in mean systolic blood pressure (SBP) from 144 mmHg(95 % CI:137-152) to 134 mmHg(95 % CI:124-144), and in mean diastolic blood pressure (DBP) from 84 mmHg(95 % CI:78-89) to 78 mmHg(95 % CI:73-84). Fixed-effect analysis of a subgroup of 3 trials with valid control groups showed a significant decrease in pooled mean SBP and DBP in both intervention and control groups. A comparison between music intervention groups and control groups was not possible due to unavailable measures of dispersion. This systematic review and meta-analysis revealed a trend towards a decrease in blood pressure in hypertensive patients who received music interventions, but failed to establish a cause-effect relationship between music interventions and blood pressure reduction. Considering the potential value of this safe, low-cost intervention, well-designed, high quality and sufficiently powered randomized studies assessing the efficacy of music interventions in the treatment of hypertension are warranted.

Flexible workspace design and ergonomics training: impacts on the psychosocial work environment, musculoskeletal health, and work effectiveness among knowledge workers.

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Robertson, Michelle M; Huang, Yueng-Hsiang; O'Neill, Michael J; Schleifer, Lawrence M

2008-07-01

A macroergonomics intervention consisting of flexible workspace design and ergonomics training was conducted to examine the effects on psychosocial work environment, musculoskeletal health, and work effectiveness in a computer-based office setting. Knowledge workers were assigned to one of four conditions: flexible workspace (n=121), ergonomics training (n=92), flexible workspace+ergonomics training (n=31), and a no-intervention control (n=45). Outcome measures were collected 2 months prior to the intervention and 3 and 6 months post-intervention. Overall, the study results indicated positive, significant effects on the outcome variables for the two intervention groups compared to the control group, including work-related musculoskeletal discomfort, job control, environmental satisfaction, sense of community, ergonomic climate, communication and collaboration, and business process efficiency (time and costs). However, attrition of workers in the ergonomics training condition precluded an evaluation of the effects of this intervention. This study suggests that a macroergonomics intervention is effective among knowledge workers in office settings.

Educational interventions for knowledge on the disease, treatment adherence and control of diabetes mellitus.

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Figueira, Ana Laura Galhardo; Boas, Lilian Cristiane Gomes Villas; Coelho, Anna Claudia Martins; Freitas, Maria Cristina Foss de; Pace, Ana Emilia

2017-04-20

to assess the effect of educational interventions for knowledge on the disease, medication treatment adherence and glycemic control of diabetes mellitus patients. evaluation research with "before and after" design, developed in a sample of 82 type 2 diabetes mellitus patients. To collect the data, the Brazilian version of the Diabetes Knowledge Scale (DKN-A), the Measure of Adherence to Treatments and the electronic system at the place of study were used. The data were collected before and after the end of the educational interventions. The educational activities were developed within 12 months, mediated by the Diabetes Conversation Maps, using the Cognitive Social Theory to conduct the interventions. the knowledge on the disease (pknowledge about diabetes mellitus, the medication treatment adherence and the glycated hemoglobin rates.

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Long Version)

DEFF Research Database (Denmark)

Dietrich, Christoph F; Lorentzen, T.; Appelbaum, L.

2016-01-01

The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound (INVUS) assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice ar...

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Short Version)

DEFF Research Database (Denmark)

Dietrich, Christoph F; Lorentzen, T.; Appelbaum, L.

2016-01-01

The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice are presen...

Systematic Review of Interventions Supported by ICT for the Prevention Treatment of Occupational Stress.

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Narváez, Santiago; Tobar, Angela M; López, Diego M

2014-01-01

Stress-related disorders have become one of the main problems of public health in many countries and of worldwide organizations, and they are expected to become more common in the forthcoming decades. This article aims at providing a systematic review and a descriptive evaluation of the interventions supported by ICT for the prevention and treatment of occupational stress. A systematic review of five databases (EBSCO, The Cochrane Library, PubMed, ScienceDirect and IEEEXplorer) was carried out. This article provides a quantitative and qualitative description of 21 studies about occupational stress interventions supported by ICT. The following factors were considered for the analysis: impact of the intervention, design of the study, type of intervention, purpose of the intervention, type of instrument for the measurement of occupational stress, and type of ICT used. The systematic review demonstrated that interventions supported by ICT for the prevention and treatment of occupational stress are scarce but effective.

The Flexibility of Pusher Furnace Grate

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Słowik J.A.

2016-12-01

Full Text Available The lifetime of guide grates in pusher furnaces for heat treatment could be increased by raising the flexibility of their structure through, for example, the replacement of straight ribs, parallel to the direction of grate movement, with more flexible segments. The deformability of grates with flexible segments arranged in two orientations, i.e. crosswise (perpendicular to the direction of compression and lengthwise (parallel to the direction of compression, was examined. The compression process was simulated using SolidWorks Simulation program. Relevant regression equations were also derived describing the dependence of force inducing the grate deformation by 0.25 mm ‒ modulus of grate elasticity ‒ on the number of flexible segments in established orientations. These calculations were made in Statistica and Scilab programs. It has been demonstrated that, with the same number of segments, the crosswise orientation of flexible segments increases the grate structure flexibility in a more efficient way than the lengthwise orientation. It has also been proved that a crucial effect on the grate flexibility has only the quantity and orientation of segments (crosswise / lengthwise, while the exact position of segments changes the grate flexibility by less than 1%.

Interventional radiological treatment of renal transplant complications: A pictorial review

Energy Technology Data Exchange (ETDEWEB)

Lezzi, Roberto; La, Torre Michele fabio; Santoro, Marco; Dattesi, Robrta; Nestola, Massimiliano; Posa, Alessandro; Romagnoli, Jacopo; CItterio, Franco; Bonomo, Lorenzo [' A. Gemelli' Hospital - Catholic University, Rome (Italy)

2015-06-15

Renal transplantation is the treatment of choice for patients with chronic renal failure, which produces a dramatic improvement in the quality of life and survival rates, in comparison to long-term dialysis. Nowadays, new imaging modalities allow early diagnosis of complications, and thanks to the recent developments of interventional techniques, surgery may be avoided in most cases. Knowledge in the types of renal transplant complications is fundamental for a correct pre-operative planning. In this article, we described the most common or clinically relevant renal transplant complications and explained their interventional management.

The Effectiveness of Group Spiritual Intervention on Self-esteem and Happiness among Men Undergoing Methadone Maintenance Treatment.

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Jalali, Amir; Behrouzi, Mahvash Kashkouli; Salari, Nader; Bazrafshan, Mohammad-Rafi; Rahmati, Mahmoud

2018-05-10

Drug dependence or substance use disorder not only affects a person's life but also brings a lot of challenges for families and communities and imposes heavy burdens on them. There are various therapies in the domain of addiction whose main purposes are to reduce or to cut down substance abuse. This study aimed to determine the effectiveness of group spiritual intervention on self-esteem and happiness among male clients undergoing methadone maintenance treatment. This study was an intervention study in which 60 clients affected with substance abuse and undergoing methadone maintenance treatment were recruited. The study samples were selected through convenience sampling method and then divided randomly into two groups of 30 individuals: intervention and control. The intervention group attended group spiritual interventions for 10 sessions. Self-esteem and happiness among the study participants were also measured through Coopersmith Self-Esteem Inventory and Oxford Happiness Questionnaire before and after the intervention. The results showed a significant difference between both intervention and control groups in terms of self-esteem and happiness (P˂0.05); so that the participants in the intervention group demonstrated a significant improvement in their self-esteem and happiness. It was concluded that group spiritual intervention as a useful method could be effective in enhancing self-esteem and happiness among addicted individuals undergoing methadone maintenance treatment. The given treatment could be also used as a complementary therapy beside methadone maintenance treatment to reduce the likelihood of people returning to substance abuse. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Parent-only interventions in the treatment of childhood obesity: a systematic review of randomized controlled trials.

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Ewald, H; Kirby, J; Rees, K; Robertson, W

2014-09-01

An effective and cost-effective treatment is required for the treatment of childhood obesity. Comparing parent-only interventions with interventions including the child may help determine this. A systematic review of published and ongoing studies until 2013, using electronic database and manual searches. randomized controlled trials, overweight/obese children aged 5-12 years, parent-only intervention compared with an intervention that included the child, 6 months or more follow-up. Outcomes included measures of overweight. Ten papers from 6 completed studies, and 2 protocols for ongoing studies, were identified. Parent-only groups are either more effective than or similarly effective as child-only or parent-child interventions, in the change in degree of overweight. Most studies were at unclear risk of bias for randomization, allocation concealment and blinding of outcome assessors. Two trials were at high risk of bias for incomplete outcome data. Four studies showed higher dropout from parent-only interventions. One study examined programme costs and found parent-only interventions to be cheaper. Parent-only interventions appear to be as effective as parent-child interventions in the treatment of childhood overweight/obesity, and may be less expensive. Reasons for higher attrition rates in parent-only interventions need further investigation. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Preferences for Depression Treatment Including Internet-Based Interventions: Results From a Large Sample of Primary Care Patients

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Marie Dorow

2018-05-01

Full Text Available Background: To date, little is known about treatment preferences for depression concerning new media. This study aims to (1 investigate treatment preferences for depression including internet-based interventions and (2 examine subgroup differences concerning age, gender and severity of depression as well as patient-related factors associated with treatment preferences.Methods: Data were derived from the baseline assessment of the @ktiv-trial. Depression treatment preferences were assessed from n = 641 primary care patients with mild to moderate depression regarding the following treatments: medication, psychotherapy, combined treatment, alternative treatment, talking to friends and family, exercise, self-help literature, and internet-based interventions. Depression severity was specified by GPs according to ICD-10 criteria. Ordinal logistic regression models were conducted to identify associated factors of treatment preferences.Results: Patients had a mean age of 43.9 years (SD = 13.8 and more than two thirds (68.6% were female. About 43% of patients had mild depression while 57% were diagnosed with moderate depression. The majority of patients reported strong preferences for psychotherapy, talking to friends and family, and exercise. About one in five patients was very likely to consider internet-based interventions in case of depression. Younger patients expressed significantly stronger treatment preferences for psychotherapy and internet-based interventions than older patients. The most salient factors associated with treatment preferences were the patients' education and perceived self-efficacy.Conclusions: Patients with depression report individually different treatment preferences.Our results underline the importance of shared decision-making within primary care. Future studies should investigate treatment preferences for different types of internet-based interventions.

Clinical evaluation of interventional treatment for Budd-Chiari syndrome

International Nuclear Information System (INIS)

Zhong Hongshan; Xu Ke; Xiao Liang

2009-01-01

Objective: To evaluate the interventional treatment of Budd-Chiari syndrome (BCS) with regard to different types of the disease. Methods: One hundred and fifty-nine consecutive cases with BCS underwent interventional treatments with regard to different types of the diseases, including percutaneous angioplasty (PTA), transcatheter thrombolysis, endovascular stent implantation and modified transjugular intrahepatic portosystemic shunt (MTIPS). Among them, 147 cases that underwent complete follow-up were enrolled in this study. Simple obstruction of HV, membranous obstruction of IVC, membranous obstruction of IVC combined with thrombosis in the distal lumen and segmental obstruction of IVC constituted 13.6% (20), 66.0% (97), 6.1% (9)and 14.3% (21/147), respectively. The technical success rate of each type was determined. They were followed up for (67.3±9.0) months (16 h-104 months). Overall primary patency rate was evaluated. The late effect on liver function was analyzed according to the Child-Pugh score. Results: The primary patency rate of PTA was 65.6% (86/131) and the secondary, patency rate was 96.9% (124/128). The primary patency rate of stent implantation was 78.9% (15/19) and the secondary patency rate was 92.3% (24/26). One patient of type IIIa that received recanalization, catheter-directed thrombolysis and PTA in IVC died of hemoptysis 72 h after the procedure. One patients of type I b who received MTIPS died of DIC 16 hrs after the procedure. And one patient of type Ib who received MTIPS died of liver failure 13 months after the procedure. Twelve patients died in 7-79 months after the interventional procedure due to unrelated causes. At the end of follow-up, the liver function of the patients was improved. Conclusions: Optimal application of various vascular interventional techniques has a satisfactory primary and secondary patency rate and improves the long-term liver function. (authors)

Using the Medical Research Council framework for development and evaluation of complex interventions in a low resource setting to develop a theory-based treatment support intervention delivered via SMS text message to improve blood pressure control.

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Bobrow, Kirsten; Farmer, Andrew; Cishe, Nomazizi; Nwagi, Ntobeko; Namane, Mosedi; Brennan, Thomas P; Springer, David; Tarassenko, Lionel; Levitt, Naomi

2018-01-23

Several frameworks now exist to guide intervention development but there remains only limited evidence of their application to health interventions based around use of mobile phones or devices, particularly in a low-resource setting. We aimed to describe our experience of using the Medical Research Council (MRC) Framework on complex interventions to develop and evaluate an adherence support intervention for high blood pressure delivered by SMS text message. We further aimed to describe the developed intervention in line with reporting guidelines for a structured and systematic description. We used a non-sequential and flexible approach guided by the 2008 MRC Framework for the development and evaluation of complex interventions. We reviewed published literature and established a multi-disciplinary expert group to guide the development process. We selected health psychology theory and behaviour change techniques that have been shown to be important in adherence and persistence with chronic medications. Semi-structured interviews and focus groups with various stakeholders identified ways in which treatment adherence could be supported and also identified key features of well-regarded messages: polite tone, credible information, contextualised, and endorsed by identifiable member of primary care facility staff. Direct and indirect user testing enabled us to refine the intervention including refining use of language and testing of interactive components. Our experience shows that using a formal intervention development process is feasible in a low-resource multi-lingual setting. The process enabled us to pre-test assumptions about the intervention and the evaluation process, allowing the improvement of both. Describing how a multi-component intervention was developed including standardised descriptions of content aimed to support behaviour change will enable comparison with other similar interventions and support development of new interventions. Even in low

The effectiveness of non-surgical interventions in the treatment of Charcot foot.

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Smith, Caroline; Kumar, Saravana; Causby, Ryan

2007-12-01

Background  Charcot neuropathic osteoarthropathy is commonly known as 'Charcot foot'. It is a serious foot complication of diabetes mellitus that can frequently lead to foot ulceration, gangrene, hospital admission and foot amputation. A multidisciplinary approach to the management of Charcot foot is taken involving medical and allied health professionals. The management approach may also differ between different countries. To date, there is no systematic review of the literature undertaken to identify the clinical effectiveness of non-operative interventions in the treatment of acute Charcot foot. Objective  The objective of this review was to identify the effectiveness of non-surgical interventions with reducing lesions, ulceration, the rate of surgical intervention, reducing hospital admissions and improve the quality of life of subjects with Charcot foot. Search strategy  A comprehensive search strategy was undertaken on databases available from University of South Australia from their inception to November 2006. Selection criteria  Randomised controlled trials or clinical controlled trials were primarily sought. Critical appraisal of study quality and data extraction was undertaken using Joanna Briggs Institute instruments. Review Manager software was used to calculate comparative statistics. Results  This review identified 11 trials and five trials were included in the review. Three trials involved the use of bisphosphonate, a pharmacological agent. Two experimental treatments were also included, evaluating palliative radiology and magnetic fields. No trials were found using immobilisation and off-loading interventions for acute Charcot foot. The overall methodological quality score of the five studies was moderate. Owing to heterogeneous data, meta-analysis could not be performed. The trials did not report on reducing lesions, ulceration, rate of surgical intervention, hospital admissions and the quality of life of subjects with Charcot foot. The

Interventional treatment of arterial complications in post renal transplantation

International Nuclear Information System (INIS)

Qian Xiaojun; Dai Dingke; Zhai Renyou

2004-01-01

Objective: To report our experience of interventional procedure for arterial complications in post renal transplantation and to evaluate its clinical value. Methods: In a retrospective analysis of renal transplantations in our center, 52 cases of renal allograft artery abnormalities had taken angiography. Interventional procedure included transluminal angioplasty of arterial stenoses, treatment of arterial occlusion, and embolization of pseudoaneurysm. Results: Renal allograft artery abnormalities included artery stenosis (n=21), artery thrombosis (n=13) and embolision (n=1), renal artery pseudoaneurysms (n=2), and decrease of renal artery flow (n=3). Of the 21 artery stenosis, 2 grafts with artery stenosis were lost because the stenosis could not be corrected, and 3 with mild stenosis received no treatment. Another 16 accepted renal artery angioplasty (balloon dilation, n=12, and stent implantation, n=4). 14 achieved long-term allograft function. 1 graft was lost because renal function failed to recover. Restenosis occurred in one stent implantation, and lost the allograft function after secondary dilation. 13 cases received thrombolytic therapy through artery catheter for thrombosis and 9 achieved long-term allograft function. Thrombolyses failed in 3 cases, and renal function failed to recover in 1 case. One pseudoaneurysm received stent implantation after embolization, and got a short-term allograft function. The other one received allograft excision. Conclusion: Intravascular interventional therapy will be the first-line therapy for any indications of complication in post renal transplantation, and it can surely save the kidney in a majority of instances. (authors)

Treatment Expectations for CAM Interventions in Pediatric Chronic Pain Patients and their Parents

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Jennie C. I. Tsao

2005-01-01

Full Text Available Patient expectations regarding complementary and alternative medicine (CAM interventions have important implications for treatment adherence, attrition and clinical outcome. Little is known, however, about parent and child treatment expectations regarding CAM approaches for pediatric chronic pain problems. The present study examined ratings of the expected benefits of CAM (i.e. hypnosis, massage, acupuncture, yoga and relaxation and conventional medicine (i.e. medications, surgery interventions in 45 children (32 girls; mean age = 13.8 years ± 2.5 and parents (39 mothers presenting for treatment at a specialty clinic for chronic pediatric pain. Among children, medications and relaxation were expected to be significantly more helpful than the remaining approaches (P < 0.01. However, children expected the three lowest rated interventions, acupuncture, surgery and hypnosis, to be of equal benefit. Results among parents were similar to those found in children but there were fewer significant differences between ratings of the various interventions. Only surgery was expected by parents to be significantly less helpful than the other approaches (P < 0.01. When parent and child perceptions were compared, parents expected hypnosis, acupuncture and yoga, to be more beneficial than did children, whereas children expected surgery to be more helpful than did parents (P < 0.01. Overall, children expected the benefits of CAM to be fairly low with parents' expectations only somewhat more positive. The current findings suggest that educational efforts directed at enhancing treatment expectations regarding CAM, particularly among children with chronic pain, are warranted.

[Non pharmacological treatment for Alzheimer's disease: comparison between musical and non-musical interventions].

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Narme, Pauline; Tonini, Audrey; Khatir, Fatiha; Schiaratura, Loris; Clément, Sylvain; Samson, Séverine

2012-06-01

On account of the limited effectiveness of pharmacological treatments in Alzheimer's disease (AD), there is a growing interest on nonpharmacological treatments, including musical intervention. Despite the large number of studies showing the multiple benefits of music on behavioral, emotional and cognitive disorders of patients with AD, only a few of them used a rigorous method. Finally, the specificity of musical as compared to non-musical and pleasant interventions has rarely been addressed. To investigate this issue, two randomized controlled trials were conducted contrasting the effects of musical to painting (Study 1) or cooking (Study 2) interventions on emotional state of 33 patients with AD. The patients' emotional state was assessed by analyzing professional caregivers' judgments of the patient's mood, then facial expressions and valence of the discourse from short-filmed interviews. In the first study (n=22), each intervention lasted 3 weeks (two sessions per week) and the patients' emotional state was assessed before, during and after intervention periods. After the interventions, the results showed that facial expression, discourse content and mood assessment improved (more positive than negative expressions) as compared to pre-intervention assessment. However, musical intervention was more effective and had longer effects as compared with painting. In the second study (n=11), we further examined long lasting effects of music as compared to cooking by adding evaluation of the patients' emotional state 2 and 4 weeks after the last intervention. Again, music was more effective to improve the emotional state. Music had positive effects that remained significant up to 4 weeks after the intervention, while cooking only produced short-term effect on mood. In both studies, benefits were significant in more than 80% of patients. Taken together, these findings show that music intervention has specific effects on patients' emotional well being, offering promising

Effects of Video Modeling on Treatment Integrity of Behavioral Interventions

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DiGennaro-Reed, Florence D.; Codding, Robin; Catania, Cynthia N.; Maguire, Helena

2010-01-01

We examined the effects of individualized video modeling on the accurate implementation of behavioral interventions using a multiple baseline design across 3 teachers. During video modeling, treatment integrity improved above baseline levels; however, teacher performance remained variable. The addition of verbal performance feedback increased…

Iatrogenic effects of psychosocial interventions: treatment, life context, and personal risk factors.

Science.gov (United States)

Moos, Rudolf H

2012-01-01

Between 7% and 15% of individuals who participate in psychosocial interventions for substance use disorders may be worse off after treatment than before. Intervention-related predictors of iatrogenic effects include lack of bonding; lack of goal direction and monitoring; confrontation, criticism, and high emotional arousal; models and norms for substance use; and stigma and inaccurate expectations. Life context and personal predictors include lack of support, criticism, and more severe substance use and psychological problems. Ongoing monitoring and safety standards are needed to identify and counteract adverse consequences of intervention programs.

Comparison of short-term effects between interventional embolization treatment and iodine-131 therapy for graves'hyperthyroidism

International Nuclear Information System (INIS)

Zhu Gaohong; Zhao Wei; Yuan Weihong; Wang Bailing; Yi Gengfa; Yang Shumin

2010-01-01

Objective: To compare the short-term effects between interventional arterial embolization and iodine-131 therapy in treating Graves' disease. Methods: A total of 84 patients with Graves' disease (GD), confirmed by clinical data and laboratory tests, were divided into two groups: interventional group (n = 42) receiving arterial embolization and iodine-131 group (n = 42)receiving iodine-131 therapy. Before and after the treatment thyroid angiography and SPECT / CT imaging were performed to determine the shape and size of the thyroid, and radioimmunoassay method was used to measure serum levels of FT3, FT4, TSH and TRAb at 3, 6 and 12 months after the therapy. The results were compared and statistically analyzed. The occurrence of complications was observed. Results: No statistically significant difference in short-term therapeutic effects was found between interventional group and iodine-131 group. The occurrence of early severe complication was much higher in interventional group than that in iodine-131 group, while the occurrence of hypothyroidism was obviously higher in iodine-131 group than that in interventional group. Conclusion: Both interventional embolization and iodine-131 therapy have reliable effect for the treatment of Graves' disease. Iodine-131 therapy may be used in patients who plan to receive initial treatment or in patients who failed to effectively respond to other kinds of therapies, while interventional embolization may be employed in patients who are not able to receive surgery or in patients who have failed to respond to anti-thyroid drug treatment, or in patients whose iodine-131 intake rate is too low to undergo iodine-131 therapy, especially in patients with refractory and intractable hyperthyroidism. Interventional embolization can be regarded as an alternative treatment for Graves' disease. (authors)

Pericardial tamponade complicated by interventional management for Budd-Chiari syndrome: clinical analysis and treatment

International Nuclear Information System (INIS)

Zhang Luxi; Zu Maoheng; Wu Jinping; Xu Hao; Jiao Xudong; Chen Zhengkan

2011-01-01

Objective: To discuss the cases and treatment of pericardial tamponade (PT) occurred in the interventional management for Budd-Chiari syndrome (BCS). Methods: During the period from 1990 to 2006, interventional treatment was performed in 812 patients with BCS. Pericardial tamponade occurred in nine patients during the period of interventional treatment. The clinical data, including angiographic findings, clinical symptoms, management and outcomes, of the nine patients were retrospectively analyzed. The possible causes of pericardial tamponade were discussed. Results: Of the nine patients occurring pericardial tamponade, successful treatment was obtained in eight and death occurred in one. The lesions of BCS in the nine cases included inferior vena cava obstruction type (n=7), hepatic venous obstruction type (n=1) and mixed type (n=1). Pericardial tamponade was caused by mistakenly puncturing into pericardium (n=5), mistakenly puncturing together with laceration of pericardium by balloon (n=3), and breaking of pericardium by displaced stent (n=1). Conventional pericardicentesis was employed in one case, surgery was carried out in three cases, and infra-xiphoid catheterization and drainage using Seldinger technique was performed in two cases. Conservative treatment was adopted in one case and aspiration through the wrongly inserted catheter was tried in one case. In the remaining one case, aspiration through the wrongly inserted catheter together with infra-xiphoid catheterization and drainage by using Seldinger technique was carried out. Conclusion: The pericardial tamponade is an severe complication occurred in the interventional management for Budd-Chiari syndrome, although it is rarely seen. Preoperative prevention, prompt detection and rational treatment are the keys avoid serious consequences. (authors)

Community intervention to promote rational treatment of acute respiratory infection in rural Nepal.

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Holloway, Kathleen A; Karkee, Shiba B; Tamang, Ashalal; Gurung, Yam Bahadur; Kafle, Kumud K; Pradhan, Ramesh; Reeves, Barnaby C

2009-01-01

To evaluate a community education program about treatment of acute respiratory infection (ARI). First, community case definitions for severe and mild ARI were developed. The intervention was then evaluated using a controlled before-and-after design. Household surveys collected data about ARI treatment in 20 clusters, each based around a school and health facility. Treatment indicators included percentages of cases attending health facilities and receiving antibiotics. The intervention consisted of an education program in schools culminating in street theater performances, discussions with mothers after performances and training for community leaders and drug retailers by paramedics. The intervention was conducted in mid-2003. Indicators were measured before the intervention in Nov/Dec 2002 and again in Dec 2003/Jan 2004. Two thousand and seven hundred and nineteen households were surveyed and 3654 under-fives were identified, of whom 377 had severe ARI. After implementing the intervention, health post (HP) attendance rose by 13% in under-fives with severe ARI and fell by 9% in under-fives with mild ARI (test of interaction, P = 0.01). Use of prescribed antibiotics increased in under-fives with severe ARI by 21% but only by 1% in under-fives with mild ARI (test of interaction, P = 0.38). Irrespective of ARI severity, the use of non-prescribed antibiotics dropped by 5% (P = 0.002), and consultation with female community health volunteers (FCHVs)and use of safe home remedies increased by 6.7% (P not estimated) and 5.7% (P = 0.008) respectively. The intervention was implemented using local structures and in difficult circumstances, yet had a moderate impact. Thus it has the potential to effect large scale changes in behaviour and merits replication elsewhere.

The Flexibility of Ectopic Lipids

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Hannah Loher

2016-09-01

Full Text Available In addition to the subcutaneous and the visceral fat tissue, lipids can also be stored in non-adipose tissue such as in hepatocytes (intrahepatocellular lipids; IHCL, skeletal (intramyocellular lipids; IMCL or cardiac muscle cells (intracardiomyocellular lipids; ICCL. Ectopic lipids are flexible fuel stores that can be depleted by physical exercise and repleted by diet. They are related to obesity and insulin resistance. Quantification of IMCL was initially performed invasively, using muscle biopsies with biochemical and/or histological analysis. 1H-magnetic resonance spectroscopy (1H-MRS is now a validated method that allows for not only quantifying IMCL non-invasively and repeatedly, but also assessing IHCL and ICCL. This review summarizes the current available knowledge on the flexibility of ectopic lipids. The available evidence suggests a complex interplay between quantitative and qualitative diet, fat availability (fat mass, insulin action, and physical exercise, all important factors that influence the flexibility of ectopic lipids. Furthermore, the time frame of the intervention on these parameters (short-term vs. long-term appears to be critical. Consequently, standardization of physical activity and diet are critical when assessing ectopic lipids in predefined clinical situations.

Response expectancies, treatment credibility, and hypnotic suggestibility: mediator and moderator effects in hypnotic and cognitive-behavioral pain interventions.

Science.gov (United States)

Milling, Leonard S; Shores, Jessica S; Coursen, Elizabeth L; Menario, Deanna J; Farris, Catherine D

2007-04-01

Several studies have shown that response expectancies are an important mechanism of popular psychological interventions for pain. However, there has been no research on whether response expectancies and treatment credibility independently mediate hypnotic and cognitive-behavioral pain interventions and whether the pattern of mediation is affected by experience with the interventions. Also, past research has indicated that hypnotic pain interventions may be moderated by hypnotic suggestibility. However, these studies have typically failed to measure the full range of suggestibility and have assessed pain reduction and suggestibility in the same experimental context, possibly inflating the association between these variables. To clarify the mediator role of response expectancies and treatment credibility, and the moderator role of hypnotic suggestibility in the hypnotic and cognitive-behavioral reduction of pain. Approximately 300 participants were assessed for suggestibility. Then, as part of an apparently unrelated experiment, 124 of these individuals received analogue cognitive-behavioral, hypnotic, or placebo control pain interventions. Response expectancies and credibility independently mediated treatment. The extent of mediation increased as participants gained more experience with the interventions. Suggestibility moderated treatment and was associated with relief only from the hypnotic intervention. Response expectancies and treatment credibility are unique mechanisms of hypnotic and cognitive-behavioral pain interventions. Hypnotic suggestibility predicts relief from hypnotic pain interventions and this association is not simply an artifact of measuring suggestibility and pain reduction in the same experimental context. The relationship between suggestibility and hypnotic pain reduction appears to be linear in nature.

Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Karim R

2013-06-01

Full Text Available Rushmia Karim,1 Evripidis Sykakis,2 Susan Lightman,3 Samantha Fraser-Bell4 1Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia; 2Department of Ophthalmology, Whipps Cross University Hospital, 3UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, UK; 4University of Sydney, Clinical Ophthalmology and Eye Health, Sydney Adventist Hospital Clinical School, Sydney, NSW, Australia Background: Uveitic macular edema is the major cause of reduced vision in eyes with uveitis. Objectives: To assess the effectiveness of interventions in the treatment of uveitic macular edema. Search strategy: Cochrane Central Register of Controlled Trials, Medline, and Embase. There were no language or data restrictions in the search for trials. The databases were last searched on December 1, 2011. Reference lists of included trials were searched. Archives of Ophthalmology, Ophthalmology, Retina, the British Journal of Ophthalmology, and the New England Journal of Medicine were searched for clinical trials and reviews. Selection criteria: Participants of any age and sex with any type of uveitic macular edema were included. Early, chronic, refractory, or secondary uveitic macular edema were included. We included trials that compared any interventions of any dose and duration, including comparison with another treatment, sham treatment, or no treatment. Data collection and analysis: Best-corrected visual acuity and central macular thickness were the primary outcome measures. Secondary outcome data including adverse effects were collected. Conclusion: More results from randomized controlled trials with long follow-up periods are needed for interventions for uveitic macular edema to assist in determining the overall long-term benefit of different treatments. The only intervention with sufficiently robust randomized controlled trials for a meta-analysis was acetazolamide, which was shown to be ineffective in improving vision in eyes with uveitic

Efficacy of “Attachment-Based Compassion Therapy” in the Treatment of Fibromyalgia: A Randomized Controlled Trial

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Jesús Montero-Marín

2018-01-01

Full Text Available ObjectiveThere is a growing interest in evaluating the effectiveness of compassion interventions for treating psychological disorders. The present study evaluated the effectiveness of “attachment-based compassion therapy” (ABCT in the treatment of fibromyalgia (FM, and the role of psychological flexibility as a mediator of improvements.MethodsA total of 42 patients with FM were randomly assigned to ABCT or relaxation (active control group. Both the intervention and control condition were combined with treatment as usual (TAU. The primary outcome was functional status (FIQ, and the secondary outcomes were clinical severity (CGI-S, pain catastrophizing (PCS, anxiety (HADS-A, depression (HADS-D, quality of life (EQ-5D, and psychological flexibility (AAQ-II. Differences between the groups were estimated using mixed-effects models, and mediation assessments were conducted using path analyses.ResultsThe ABCT group demonstrated superior outcomes compared to the relaxation group, including better FIQ values after treatment (B = −3.01; p = 0.003. Differences in FIQ were maintained at 3-month follow-up (B = −3.33; p = 0.001. The absolute risk reduction in ABCT compared to relaxation increased by 40.0%, with an NNT = 3 based on criteria of ≥50% FIQ reduction after treatment. Psychological flexibility had a significant mediating effect on improvements.ConclusionThese results suggest that ABCT combined with TAU appears to be effective in the treatment of FM symptoms.Clinical Trial Registrationhttp://ClinicalTrials.gov, identifier NCT02454244.

Treatment of radiodermatitis in cancer patients: support for nursing intervention

International Nuclear Information System (INIS)

Blecha, Flavio Peixoto; Guedes, Maria Teresa dos Santos

2006-01-01

Radiation therapy is a locoregional treatment modality aimed at cure, remission, prophylaxis, or palliation and is indicated singly or in association (neoadjuvant, concomitant, or adjuvant) with treatments like chemotherapy and surgery. One of the complications arising from ionizing radiation involves skin lesions referred to as radiodermatitis, which can involve acute or late reactions. Radiodermatitis affects the individual's quality of life, with altered body image, self-image, and self-esteem, leading to social isolation. The nurse's role is important in prevention and especially in intervention in such reactions. The objective of the current study was to review the state of the art, identify the products and dressings used, and contribute to evidence-based nursing interventions based on treatment of radiodermatitis. A systematic literature review was performed without meta-analysis using the Lilacs, Medline, PubMed, and CINAHL databases from 1993 to 2004. The results identified in the review failed to demonstrate the frequent use of a product that could be recommended for nursing practice. The majority of the products identified are not available in Brazil. The principal publications were in nursing journals in which the nurse was the research coordinator or consultant. The current study revealed a knowledge gap and the need for controlled clinical research led by nurses as the basis for treatment of radiodermatitis. (author)

Mediation and moderation of treatment effects in randomised controlled trials of complex interventions.

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Emsley, Richard; Dunn, Graham; White, Ian R

2010-06-01

Complex intervention trials should be able to answer both pragmatic and explanatory questions in order to test the theories motivating the intervention and help understand the underlying nature of the clinical problem being tested. Key to this is the estimation of direct effects of treatment and indirect effects acting through intermediate variables which are measured post-randomisation. Using psychological treatment trials as an example of complex interventions, we review statistical methods which crucially evaluate both direct and indirect effects in the presence of hidden confounding between mediator and outcome. We review the historical literature on mediation and moderation of treatment effects. We introduce two methods from within the existing causal inference literature, principal stratification and structural mean models, and demonstrate how these can be applied in a mediation context before discussing approaches and assumptions necessary for attaining identifiability of key parameters of the basic causal model. Assuming that there is modification by baseline covariates of the effect of treatment (i.e. randomisation) on the mediator (i.e. covariate by treatment interactions), but no direct effect on the outcome of these treatment by covariate interactions leads to the use of instrumental variable methods. We describe how moderation can occur through post-randomisation variables, and extend the principal stratification approach to multiple group methods with explanatory models nested within the principal strata. We illustrate the new methodology with motivating examples of randomised trials from the mental health literature.

Treatment expectations for CAM interventions in pediatric chronic pain patients and their parents.

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Tsao, Jennie C I; Meldrum, Marcia; Bursch, Brenda; Jacob, Margaret C; Kim, Su C; Zeltzer, Lonnie K

2005-12-01

Patient expectations regarding complementary and alternative medicine (CAM) interventions have important implications for treatment adherence, attrition and clinical outcome. Little is known, however, about parent and child treatment expectations regarding CAM approaches for pediatric chronic pain problems. The present study examined ratings of the expected benefits of CAM (i.e. hypnosis, massage, acupuncture, yoga and relaxation) and conventional medicine (i.e. medications, surgery) interventions in 45 children (32 girls; mean age = 13.8 years +/- 2.5) and parents (39 mothers) presenting for treatment at a specialty clinic for chronic pediatric pain. Among children, medications and relaxation were expected to be significantly more helpful than the remaining approaches (P CAM to be fairly low with parents' expectations only somewhat more positive. The current findings suggest that educational efforts directed at enhancing treatment expectations regarding CAM, particularly among children with chronic pain, are warranted.

A meta-analysis of cognitive intervention, parent management training, and psychopharmacological intervention in the treatment of conduct disorder

OpenAIRE

Anderson, David W.

1996-01-01

Conduct disorder in children and adolescents has developed into a very costly problem with severe negative consequences to individuals, families, and communities. A void exists in the literature in that no summaries have been found which compare the effectiveness of the leading treatment modalities for conduct disorder. The purpose of this study is to conduct a meta-analysis comparing three psychotherapeutic interventions for the treatment of conduct disorders in c...

Psychosocial interventions in opiate substitution treatment services: does the evidence provide a case for optimism or nihilism?

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Day, Ed; Mitcheson, Luke

2017-08-01

Clinical guidelines from around the world recommend the delivery of psychosocial interventions as part of routine care in opiate substitution treatment (OST) programmes. However, although individual studies demonstrate benefit for structured psychosocial interventions, meta-analytical reviews find no benefit for manual-based treatments beyond 'routine counselling'. We consider the question of whether OST medication alone is sufficient to produce the required outcomes, or whether greater efforts should be made to provide high-quality psychosocial treatment alongside medication. In so doing, we consider the nuances and limitations of the evidence and the organizational barriers to transferring it into routine practice. The evidence base for psychosocial interventions in opiate substitution treatment (OST) services can be interpreted both positively and negatively. Steering a path between overly optimistic or nihilistic interpretations of the value of psychosocial treatment in OST programmes is the most pragmatic approach. Greater attention should be paid to elements common to all psychological treatments (such as therapeutic alliance), but also to the sequencing and packaging of psychosocial elements and their linkage to peer-led interventions. © 2017 Society for the Study of Addiction.

Efficacy and safety of a flexible extended regimen of ethinylestradiol/drospirenone for the treatment of dysmenorrhea: a multicenter, randomized, open-label, active-controlled study

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Momoeda M

2017-05-01

disease severity reported in both treatment groups. According to the investigators, 64.8% and 59.4% of women in the flexible-regimen and 28d-regimen treatment groups had “very much improved” or “much improved” disease, while 54.3% and 50.9% of patients reported being “very much satisfied” or “much satisfied” with their treatment, respectively. Conclusion: In Japanese women with dysmenorrhea, a flexible extended regimen of ethinylestradiol/drospirenone decreased the number of days with dysmenorrheic pain versus the traditional 28d regimen. Keywords: oral contraceptive, dysmenorrhea, ethinylestradiol/drospirenone, flexible extended regimen, pain relief 

Increasing body image flexibility in a residential eating disorder facility: Correlates with symptom improvement.

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Lee, Eric B; Ong, Clarissa W; Twohig, Michael P; Lensegrav-Benson, Tera; Quakenbush-Roberts, Benita

2018-01-01

The purpose of this study was to examine the effects of changes in body image psychological flexibility over the course of treatment on various outcome variables. Participants included 103 female, residential patients diagnosed with an eating disorder. Pretreatment and posttreatment data were collected that examined body image psychological flexibility, general psychological flexibility, symptom severity, and other outcome variables. Changes in body image psychological flexibility significantly predicted changes in all outcome measures except for obsessive-compulsive symptoms after controlling for body mass index, depression, and anxiety. Additionally, these results were maintained after controlling for general psychological flexibility, contributing to the incremental validity of the BI-AAQ. This study suggests that changes in body image psychological flexibility meaningfully predict changes in various treatment outcomes of interest, including eating disorder risk, quality of life, and general mental health. Findings indicate that body image psychological flexibility might be a viable target for eating disorder treatment.

Maintaining Treatment Fidelity of Mindfulness-Based Relapse Prevention Intervention for Alcohol Dependence: A Randomized Controlled Trial Experience

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Aleksandra E. Zgierska

2017-01-01

Full Text Available Background. Treatment fidelity is essential to methodological rigor of clinical trials evaluating behavioral interventions such as Mindfulness Meditation (MM. However, procedures for monitoring and maintenance of treatment fidelity are inconsistently applied, limiting the strength of such research. Objective. To describe the implementation and findings related to fidelity monitoring of the Mindfulness-Based Relapse Prevention for Alcohol Dependence (MBRP-A intervention in a 26-week randomized controlled trial. Methods. 123 alcohol dependent adults were randomly assigned to MM (MBRP-A and home practice, adjunctive to usual care; N=64 or control (usual care alone; N=59. Treatment fidelity assessment strategies recommended by the National Institutes of Health Behavior Change Consortium for study/intervention design, therapist training, intervention delivery, and treatment receipt and enactment were applied. Results. Ten 8-session interventions were delivered. Therapist adherence and competence, assessed using the modified MBRP Adherence and Competence Scale, were high. Among the MM group participants, 46 attended ≥4 sessions; over 90% reported at-home MM practice at 8 weeks and 72% at 26 weeks. They also reported satisfaction with and usefulness of MM for maintaining sobriety. No adverse events were reported. Conclusions. A systematic approach to assessment of treatment fidelity in behavioral clinical trials allows determination of the degree of consistency between intended and actual delivery and receipt of intervention.

The diagnosis and treatment of two kinds of pulmonary embolism complications after interventional therapy

International Nuclear Information System (INIS)

Su Hongying; Xiao Liang; Zhong Hongshan; Xu Ke; Zheng Yanbo; Lu Zaiming

2008-01-01

Objective: To summarize the different types, clinical manifestation, treatment and prognosis of pulmonary embolism after interventional therapy in order to promote the diagnosis and treatment for the severe complication. Methods: The cases of pulmonary embolism complications after interventional therapy were collected from three hospitals between 1998 and 2005. The patients were divided into two types of iodized oil and thrombus pulmonary embolism according to the different types of the embolus. The experience of the clinical manifestation, diagnosis and treatment were summarized. Results: Ten patients with pulmonary embolism complication after interventional therapy were collected, including five with thrombus pulmonary embolism and four with iodized oil pulmonary embolism. All 5 cases of the thrombus pulmonary embolism suffered burst dyspnea and apsychia, two died and the others recovered or turned better. Aggravating dyspnea without shock occurred in the five iodized oil pulmonary embolism cases, 1 to 3 days after interventional therapy. The symptoms disappeared 15 to 50 days after combined therapy including majorly oxygen supply therapy. Conclusion: Pulmonary embolism is an emergent and severe complication after interventional therapy including acute thrombus pulmonary embolism without deep vein thrombosis which can be effectively treated be effectively treated with maintaining effective circulation and thrombolysis; and iodized oil pulmonary embolism with slow onsets could disappear within 1 month after combined therapy with mainly oxygen supplying therapy. The diagnosis and antidiastole mainly rely on enhancement of CT scan. (authors)

Interventional radiology in pain treatment

International Nuclear Information System (INIS)

Kastler, B.

2007-01-01

Disease whether it is acute, chronic, or at end stage, is all too regularly accompanied by pain. Pain is often difficult to control, in malignant disease in particular, even by using appropriate medications. Anesthesiologists and pain therapists have developed new invasive therapies including nerve block, sympatholysis, and neurolysis useful for both diagnosis and pain management. To insure the efficiency and safety of these procedures, and furthermore for elaborate techniques such as vertebroplasty, cementoplasty, and radio frequency bone ablation, imaging guidance becomes mandatory. This state-of-the-art book describes the techniques elaborated by interventional radiologists in the treatment and palliation of a variety of benign and malignant painful conditions. Each chapter written by an expert in the field concentrates on a particular aspect of pain management, with emphasis on practical issues. This book will serve as an invaluable source of information for the radiologist willing to learn about new pain therapy techniques aimed at optimizing or replacing more invasive traditional methods. (orig.)

Protocol for a systematic review of psychological interventions for cancer-related fatigue in post-treatment cancer survivors.

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Corbett, Teresa; Devane, Declan; Walsh, Jane C; Groarke, AnnMarie; McGuire, Brian E

2015-12-04

Fatigue is a common symptom in cancer patients that can persist beyond the curative treatment phase. Some evidence has been reported for interventions for fatigue during active treatment. However, to date, there is no systematic review on psychological interventions for fatigue after the completion of curative treatment for cancer. This is a protocol for a systematic review that aims to evaluate the effectiveness of psychological interventions for cancer-related fatigue in post-treatment cancer survivors. This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database. We will search the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library), PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, and relevant sources of grey literature. Randomised controlled trials (RCTs) which have evaluated psychological interventions in adult cancer patients after the completion of treatment, with fatigue as an outcome measure, will be included. Two review authors will independently extract data from the selected studies and assess the methodological quality using the Cochrane Collaboration Risk of Bias Tool. Most existing evidence on cancer-related fatigue is from those in active cancer treatment. This systematic review and meta-analysis will build upon previous evaluations of psychological interventions in people during and after cancer treatment. With the growing need for stage-specific research in cancer, this review seeks to highlight a gap in current practice and to strengthen the evidence base of randomised controlled trials in the area. PROSPERO CRD42014015219.

A Clinical Pilot Study of Individual and Group Treatment for Adolescents with Chronic Pain and Their Parents: Effects of Acceptance and Commitment Therapy on Functioning

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Marie Kanstrup

2016-11-01

Full Text Available Pediatric chronic pain is common and can result in substantial long-term disability. Previous studies on acceptance and commitment therapy (ACT have shown promising results in improving functioning in affected children, but more research is still urgently needed. In the current clinical pilot study, we evaluated an ACT-based interdisciplinary outpatient intervention (14 sessions, including a parent support program (four sessions. Adolescents were referred to the clinic if they experienced disabling chronic pain. They were then randomized, along with their parents, to receive group (n = 12 or individual (n = 18 treatment. Adolescent pain interference, pain reactivity, depression, functional disability, pain intensity and psychological flexibility, along with parent anxiety, depression, pain reactivity and psychological flexibility were assessed using self-reported questionnaires. There were no significant differences in outcomes between individual and group treatment. Analyses illustrated significant (p < 0.01 improvements (medium to large effects in pain interference, depression, pain reactivity and psychological flexibility post-treatment. Additionally, analyses showed significant (p < 0.01 improvements (large effects in parent pain reactivity and psychological flexibility post-treatment. On all significant outcomes, clinically-significant changes were observed for 21%–63% of the adolescents across the different outcome measures and in 54%–76% of the parents. These results support previous findings and thus warrant the need for larger, randomized clinical trials evaluating the relative utility of individual and group treatment and the effects of parental interventions.

Analysis of operators' surface doses in the common endovascular and on-vascular interventional diagnosis and treatment

International Nuclear Information System (INIS)

Zhang Lin; Zhu Jianguo; Min Nan; Lu Feng

2011-01-01

Objective: To contrast the level of radiation doses of Lead protective clothing both inside and outside in different parts of the body of the first and second operators and touring nurse in common endovascular and non-vascular interventional diagnosis and treatment. Methods: We choose the common endovascular interventional diagnosis and treatment in the head, thorax, abdomen, such as Cerebral angiography, Coronary angiography, Transcatheter arterial chemoembolization and non-vascular interventional diagnosis and treatment such as Endoscopic Retrograde Cholangio-Pancreatography and Percutaneous transhepatic cholangial drainage as experiment objects. Put the thermoluminescence dosimeter on the different spots of Lead protective clothing of subjects (Inside and outside the lead cap and the lead collar, inside and outside of the lead protective clothing in chest and abdomen, left upper arm outside of lead protective clothing, back of the left hand) and X-ray machine outgoing port when the operation was going on. After that, measure the thermoluminescence dosimeter, calculate and analyze exposure doses inside and outside of the lead protective clothing. Results: The skin doses of operators in different types of interventional diagnosis and treatment are listed in Table 1to Table 4; exposure doses of touring nurses are very low; the doses of X-ray machine outgoing port are mostly over the measuring range. Conclusion: The protection of Lead clothes plays a significant role in these two types of interventional diagnosis and treatment based on the conclusion that the dose of inside of Lead clothes is less than that of outside. We should enhance the operators' protection and administration in the process of intervention and arise the conscious of self-protection, to avoid the unnecessary radiation exposure. (authors)

Flexible removable partial dentures: a basic overview.

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Hill, Edward E; Rubel, Barry; Smith, John B

2014-01-01

For many years, flexible resin materials have been available for fabricating removable partial denture (RPD) prostheses. Using a nonrigid material for the major connector or other components of an RPD may be a consideration for certain patients. Except for the promotional literature that has been written for flexible resin dentures, there is very little information available in the dental literature concerning nonrigid RPDs. As a result, the decision to use this treatment option depends on the judgment and experience of the dentist and fabricating laboratory. This article summarizes clinically pertinent information about flexible, nonrigid partial dentures.

Psychological flexibility and mindfulness explain intuitive eating in overweight adults.

Science.gov (United States)

Sairanen, Essi; Tolvanen, Asko; Karhunen, Leila; Kolehmainen, Marjukka; Järvelä, Elina; Rantala, Sanni; Peuhkuri, Katri; Korpela, Riitta; Lappalainen, Raimo

2015-07-01

The current study investigated whether mindfulness and psychological flexibility, independently and together, explain intuitive eating. The participants were overweight or obese persons (N = 306) reporting symptoms of perceived stress and enrolled in a psychological lifestyle intervention study. Participants completed self-report measures of psychological flexibility; mindfulness including the subscales observe, describe, act with awareness, non-react, and non-judgment; and intuitive eating including the subscales unconditional permission to eat, eating for physical reasons, and reliance on hunger/satiety cues. Psychological flexibility and mindfulness were positively associated with intuitive eating factors. The results suggest that mindfulness and psychological flexibility are related constructs that not only account for some of the same variance in intuitive eating, but they also account for significant unique variances in intuitive eating. The present results indicate that non-judgment can explain the relationship between general psychological flexibility and unconditional permission to eat as well as eating for physical reasons. However, mindfulness skills-acting with awareness, observing, and non-reacting-explained reliance on hunger/satiety cues independently from general psychological flexibility. These findings suggest that mindfulness and psychological flexibility are interrelated but not redundant constructs and that both may be important for understanding regulation processes underlying eating behavior. © The Author(s) 2015.

One-day behavioral intervention in depressed migraine patients: effects on headache.

Science.gov (United States)

Dindo, Lilian; Recober, Ana; Marchman, James; O'Hara, Michael W; Turvey, Carolyn

2014-03-01

To determine whether a 1-day behavioral intervention, aimed at enhancing psychological flexibility, improves headache outcomes of migraine patients with comorbid depression. Migraine is often comorbid with depression, with each disorder increasing the risk for onset and exacerbation of the other. Managing psychological triggers, such as stress and depression, may result in greater success of headache management. Sixty patients with comorbid migraine and depression were assigned to a 1-day Acceptance and Commitment Training plus Migraine Education workshop (ACT-ED; N = 38) or to treatment as usual (TAU; N = 22). Patients completed a daily headache diary prior to, and for 3 months following, the intervention. Clinical variables examined included headache frequency/severity, medication use, disability, and visit to a health care professional. Comparisons were made between baseline findings and findings at the 3-month follow up. Participants assigned to the ACT-ED condition exhibited significant improvements in headache frequency, headache severity, medication use, and headache-related disability. In contrast, the TAU group did not exhibit improvements. The difference in headache outcomes between ACT-ED and TAU was not statistically significant over time (ie, the treatment by time interaction was nonsignificant). These results complement those of a previous report showing effects of ACT-ED vs TAU on depression and disability. A 1-day ACT-ED workshop targeting psychological flexibility may convey benefit for patients with comorbid migraine and depression.These pilot study findings merit further investigation using a more rigorously designed large-scale trial.

Adding evidence-based interventions to assertive community treatment : a feasibility study

NARCIS (Netherlands)

Sytema, Sjoerd; Jörg, Frederike; Nieboer, Roeline; Wunderink, Lex

OBJECTIVE: This 24-month study, conducted in The Netherlands, examined the feasibility of enhancing the effectiveness of assertive community treatment (ACT) by adding evidence-based interventions. METHODS: A total of 159 patients were randomly assigned to two ACT teams, one providing standard ACT

Drug interventions for the treatment of obesity in children and adolescents

NARCIS (Netherlands)

Mead, Emma; Atkinson, Greg; Richter, Bernd; Metzendorf, Maria-Inti; Baur, Louise; Finer, Nicholas; Corpeleijn, Eva; O'Malley, Claire; Ells, Louisa J.

2016-01-01

BACKGROUND: Child and adolescent obesity has increased globally, and can be associated with significant short- and long-term health consequences. OBJECTIVES: To assess the efficacy of drug interventions for the treatment of obesity in children and adolescents. SEARCH METHODS: We searched CENTRAL,

Pharmacological interventions for pain relief during orthodontic treatment.

Science.gov (United States)

Monk, Aoife B; Harrison, Jayne E; Worthington, Helen V; Teague, Annabel

2017-11-28

Pain is a common side effect of orthodontic treatment. It increases in proportion to the amount of force applied to the teeth, and the type of orthodontic appliance used can affect the intensity of the pain. Pain during orthodontic treatment has been shown to be the most common reason for people wanting to discontinue treatment, and has been ranked as the worst aspect of treatment. Although pharmacological methods of pain relief have been investigated, there remains some uncertainty among orthodontists about which painkillers are most suitable and whether pre-emptive analgesia is beneficial. We conducted this Cochrane Review to assess and summarize the international evidence relating to the effectiveness of analgesics for preventing this unwanted side effect associated with orthodontic treatment. The objectives of this review are to determine:- the effectiveness of drug interventions for pain relief during orthodontic treatment; and- whether there is a difference in the analgesic effect provided by different types, forms and doses of analgesia taken during orthodontic treatment. Cochrane Oral Health's Information Specialist searched the following databases: the Cochrane Oral Health Trials Register (to 19 June 2017), the Cochrane Central Register of Controlled Trials (CENTRAL;the Cochrane Library 2016, Issue 7), MEDLINE Ovid (1946 to 19 June 2017), Embase Ovid (1980 to 19 June 2017) and CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 19 June 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched on the 19 June 2017 for ongoing studies. We placed no restrictions on language or date of publication when searching the electronic databases. We included randomized controlled trials (RCTs) relating to pain control during orthodontic treatment. Pain could be measured on a visual analogue scale (VAS), numerical

Changes of plasma VEGF levels and liver function in patients with liver cancer before and after interventional treatment

International Nuclear Information System (INIS)

Li Jia; Qi Jun; Gao Jia

2011-01-01

To explore the effect of the interventional treatment for the angiogenesis and liver function in patients with liver cancer within short time, enzyme linked immunosorbent assay was used to determine the level of VEGF in plasma. The level of liver function was measured through automatic biochemistry analyzer. The results indicated that the level of VEGF in patients with liver cancer decreased after interventional treatment than that of before treatment (P<0.05). The level of total protein, albumin, alkaline phosphatase and total bile acid decreased after interventional treatment (P<0.05). The level of alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin and indirect bilirubin were increased than before (P<0.05). The interventional treatment inhibit the expression of the VEGF in the tumor tissue and limited the angiogenesis within short time, but to some extent may caused the injury of the hepatocytes and the synthetic and excremental function in patients with liver cancer. (authors)

Surgical treatment of atrial and ventricular septal defects after unsuccessful interventional therapy: a retrospective analysis

International Nuclear Information System (INIS)

Han Hongguang; Zhang Nanbin; Wang Zengwei; Wang Huishan; Zhu Hongyu; Li Xinmin

2010-01-01

Objective: To investigate the causes of failure in treating atrial septal defect (ASD) and ventricular septal defect (VSD) with interventional procedures and to evaluate the clinical efficacy of surgical treatment in order to increase the successful rate. Methods: A total of 13 patients, who underwent surgical therapy because of unsuccessful interventional treatment for ASD or VSD during the period of January 2001-December 2007, were selected,and the clinical data were retrospectively analyzed. The surgical indications included the occluder abscission (n=7), III degree atrioventricular conduction block (n=3), valvular regurgitation (n=2), residual shunt (n=1) and interventional failure (n=1). The cardiac surgeries, including removal of the displaced occluder and / or the repair of atrioventricular septal defects, were performed with the help of cardiopulmonary bypass in all 13 cases. After surgical treatment, all patients were transferred into ICU for further supervision and treatment. Results: The average diameter of ASD on surgical exploration was 31 mm, which was greater than the preoperative average diameter (26 mm), with a significant difference (P 0.05). The III degree atrioventricular conduction block in 3 cases restored sinus rhythm after operation. All the procedures were successfully completed in all patients. No death occurred during the hospitalization period. Conclusion: Proper and timely cardiac surgery is an effective and safe measure for the treatment of the complications due to unsuccessful interventional therapy as well as the atrioventricular septal defect itself. (authors)

Ovarian tumor-initiating cells display a flexible metabolism

International Nuclear Information System (INIS)

Anderson, Angela S.; Roberts, Paul C.; Frisard, Madlyn I.; Hulver, Matthew W.; Schmelz, Eva M.

2014-01-01

An altered metabolism during ovarian cancer progression allows for increased macromolecular synthesis and unrestrained growth. However, the metabolic phenotype of cancer stem or tumor-initiating cells, small tumor cell populations that are able to recapitulate the original tumor, has not been well characterized. In the present study, we compared the metabolic phenotype of the stem cell enriched cell variant, MOSE-L FFLv (TIC), derived from mouse ovarian surface epithelial (MOSE) cells, to their parental (MOSE-L) and benign precursor (MOSE-E) cells. TICs exhibit a decrease in glucose and fatty acid oxidation with a concomitant increase in lactate secretion. In contrast to MOSE-L cells, TICs can increase their rate of glycolysis to overcome the inhibition of ATP synthase by oligomycin and can increase their oxygen consumption rate to maintain proton motive force when uncoupled, similar to the benign MOSE-E cells. TICs have an increased survival rate under limiting conditions as well as an increased survival rate when treated with AICAR, but exhibit a higher sensitivity to metformin than MOSE-E and MOSE-L cells. Together, our data show that TICs have a distinct metabolic profile that may render them flexible to adapt to the specific conditions of their microenvironment. By better understanding their metabolic phenotype and external environmental conditions that support their survival, treatment interventions can be designed to extend current therapy regimens to eradicate TICs. - Highlights: • Ovarian cancer TICs exhibit a decreased glucose and fatty acid oxidation. • TICs are more glycolytic and have highly active mitochondria. • TICs are more resistant to AICAR but not metformin. • A flexible metabolism allows TICs to adapt to their microenvironment. • This flexibility requires development of specific drugs targeting TIC-specific changes to prevent recurrent TIC outgrowth

Ovarian tumor-initiating cells display a flexible metabolism

Energy Technology Data Exchange (ETDEWEB)

Anderson, Angela S. [Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA (United States); Roberts, Paul C. [Biomedical Science and Pathobiology, Virginia Tech, Blacksburg, VA (United States); Frisard, Madlyn I. [Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA (United States); Hulver, Matthew W., E-mail: hulvermw@vt.edu [Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA (United States); Schmelz, Eva M., E-mail: eschmelz@vt.edu [Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA (United States)

2014-10-15

An altered metabolism during ovarian cancer progression allows for increased macromolecular synthesis and unrestrained growth. However, the metabolic phenotype of cancer stem or tumor-initiating cells, small tumor cell populations that are able to recapitulate the original tumor, has not been well characterized. In the present study, we compared the metabolic phenotype of the stem cell enriched cell variant, MOSE-L{sub FFLv} (TIC), derived from mouse ovarian surface epithelial (MOSE) cells, to their parental (MOSE-L) and benign precursor (MOSE-E) cells. TICs exhibit a decrease in glucose and fatty acid oxidation with a concomitant increase in lactate secretion. In contrast to MOSE-L cells, TICs can increase their rate of glycolysis to overcome the inhibition of ATP synthase by oligomycin and can increase their oxygen consumption rate to maintain proton motive force when uncoupled, similar to the benign MOSE-E cells. TICs have an increased survival rate under limiting conditions as well as an increased survival rate when treated with AICAR, but exhibit a higher sensitivity to metformin than MOSE-E and MOSE-L cells. Together, our data show that TICs have a distinct metabolic profile that may render them flexible to adapt to the specific conditions of their microenvironment. By better understanding their metabolic phenotype and external environmental conditions that support their survival, treatment interventions can be designed to extend current therapy regimens to eradicate TICs. - Highlights: • Ovarian cancer TICs exhibit a decreased glucose and fatty acid oxidation. • TICs are more glycolytic and have highly active mitochondria. • TICs are more resistant to AICAR but not metformin. • A flexible metabolism allows TICs to adapt to their microenvironment. • This flexibility requires development of specific drugs targeting TIC-specific changes to prevent recurrent TIC outgrowth.

Effects of lyric analysis interventions on treatment motivation in patients on a detoxification unit: a randomized effectiveness study.

Science.gov (United States)

Silverman, Michael J

2015-01-01

Treatment motivation is a key component in the early rehabilitative stages for people with substance use disorders. To date, no music therapy researcher has studied how lyric analysis interventions might affect motivation in a randomized controlled design. The primary purpose of this study was to determine the effect of lyric analysis interventions on treatment motivation in patients on a detoxification unit using a single-session wait-list control design. A secondary purpose was to determine if there were between-group differences concerning two contrasting songs used for the lyric analyses. Participants (N=104) were cluster randomized to a group lyric analysis condition or a wait-list control condition. Participants received either a "Hurt" or a "How to Save a Life" lyric analysis treatment. The Texas Christian University Treatment Motivation Scale-Client Evaluation of Self at Intake (CESI) (Simpson, 2008[2005]) was used to measure aspects of treatment motivation: problem recognition, desire for help, treatment readiness, pressures for treatment, and total motivation. Results indicated significant between-group differences in measures of problem recognition, desire for help, treatment readiness, and total motivation, with experimental participants having higher treatment motivation means than control participants. There was no difference between the two lyric analysis interventions. Although the song used for lyric analysis interventions did not affect outcome, a single group-based music therapy lyric analysis session can be an effective psychosocial treatment intervention to enhance treatment motivation in patients on a detoxification unit. Limitations, implications for clinical practice, and suggestions for future research are provided. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

STARS experiential group intervention: a complex trauma treatment approach for survivors of human trafficking.

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Hopper, Elizabeth K; Azar, Naomi; Bhattacharyya, Sriya; Malebranche, Dominique A; Brennan, Kelsey E

2018-01-01

This is the abstract that was submitted online with the paper: Despite the fact that many survivors of human trafficking have experienced complex trauma, there are no established interventions designed to specifically address these impacts. Leaders in the field of complex trauma have advocated for the need for somatic approaches to intervention. This paper presents STARS Experiential Group treatment, the first structured bodybased group intervention that has been designed to address complex trauma in survivors of human trafficking. Three pilot groups were run in residential settings with adolescent and adult survivors of sex trafficking. Two adaptations were utilized, with one focusing on application of expressive arts modalities and the other incorporating theater games. Qualitative results, using thematic analysis, identified several themes related to challenges and potential benefits of these groups. Potential benefits of the STARS groups were found in the areas of Interpersonal Relationships, Regulation, and Self/ Identity, with fourteen sub-themes further describing positive impacts. Challenges within these areas are explored, to inform the development of group interventions for trafficking survivors. The results of this paper suggest that experiential, somatically-oriented group treatment shows promise as an important element of holistic intervention with trafficking survivors.

Considerations for a Human Rights Impact Assessment of a Population Wide Treatment for HIV Prevention Intervention.

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Hanefeld, Johanna; Bond, Virginia; Seeley, Janet; Lees, Shelley; Desmond, Nicola

2015-12-01

Increasing attention is being paid to the potential of anti-retroviral treatment (ART) for HIV prevention. The possibility of eliminating HIV from a population through a universal test and treat intervention, where all people within a population are tested for HIV and all positive people immediately initiated on ART, as part of a wider prevention intervention, was first proposed in 2009. Several clinical trials testing this idea are now in inception phase. An intervention which relies on universally testing the entire population for HIV will pose challenges to human rights, including obtaining genuine consent to testing and treatment. It also requires a context in which people can live free from fear of stigma, discrimination and violence, and can access services they require. These challenges are distinct from the field of medical ethics which has traditionally governed clinical trials and focuses primarily on patient researcher relationship. This paper sets out the potential impact of a population wide treatment as prevention intervention on human rights. It identifies five human right principles of particular relevance: participation, accountability, the right to health, non-discrimination and equality, and consent and confidentiality. The paper proposes that explicit attention to human rights can strengthen a treatment as prevention intervention, contribute to mediating likely health systems challenges and offer insights on how to reach all sections of the population. © 2013 John Wiley & Sons Ltd.

Flexibility.

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Humphrey, L. Dennis

1981-01-01

Flexibility is an important aspect of all sports and recreational activities. Flexibility can be developed and maintained by stretching exercises. Exercises designed to develop flexibility in ankle joints, knees, hips, and the lower back are presented. (JN)

Interventional bronchoscopy for treatment of tracheal obstruction secondary to benign or malignant thyroid disease.

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Noppen, Marc; Poppe, Kris; D'Haese, Jan; Meysman, Marc; Velkeniers, Brigitte; Vincken, Walter

2004-02-01

Surgery is the treatment of choice for symptomatic tracheal obstruction due to benign or malignant thyroid disease. In case of inoperability, or when surgery is refused, few therapeutic alternatives are available. Interventional bronchoscopic procedures have only been reported anecdotally. The objective of this study is to evaluate the results of interventional bronchoscopic procedures in the treatment of severe tracheal obstruction due to thyroid disease. Retrospective cohort analysis. University hospital, tertiary referral center. Thirty consecutive patients referred for bronchoscopic treatment of benign (n = 17) or malignant (n = 13) thyroid-related upper airway obstruction due to tracheomalacia, extrinsic compression, and/or tracheal ingrowth. Indications for bronchoscopic treatment were medical or surgical inoperability, prevention or treatment of tracheomalacia, and refusal of surgery. There were no procedure-related complications. Rigid bronchoscopy with dilatation, stenting and/or Nd-YAG laser treatment, and clinical follow-up. Subjective improvement, pulmonary function tests, early and late complications, and survival. In the benign group, immediate (100% relief of dyspnea) and long-term (88% relief of dyspnea) results were excellent after airway stenting (21 stents used in 17 patients). There was one unrelated death 1 week after stenting in a 98-year-old patient. There were 6% and 30% short-term and long-term complications, respectively, that could be managed endoscopically. In the malignant group, Nd-YAG laser treatment (n = 3) and stenting (n = 13) yielded immediate and long-term success in 92% of patients. There were 15% short-term and 8% long-term complications. Median survival time was 540 days. Interventional bronchoscopic procedures including Nd-YAG laser treatment and stenting are valuable alternatives to surgery in inoperable thyroid-induced tracheal obstruction, or when surgery is refused.

Hot-compress: A new postdeposition treatment for ZnO-based flexible dye-sensitized solar cells

Energy Technology Data Exchange (ETDEWEB)

Haque Choudhury, Mohammad Shamimul, E-mail: shamimul129@gmail.com [Department of Frontier Material, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555 (Japan); Department of Electrical and Electronic Engineering, International Islamic University Chittagong, b154/a, College Road, Chittagong 4203 (Bangladesh); Kishi, Naoki; Soga, Tetsuo [Department of Frontier Material, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555 (Japan)

2016-08-15

Highlights: • A new postdeposition treatment named hot-compress is introduced. • Hot-compression gives homogeneous compact layer ZnO photoanode. • I-V and EIS analysis data confirms the efficacy of this method. • Charge transport resistance was reduced by the application of hot-compression. - Abstract: This article introduces a new postdeposition treatment named hot-compress for flexible zinc oxide–base dye-sensitized solar cells. This postdeposition treatment includes the application of compression pressure at an elevated temperature. The optimum compression pressure of 130 Ma at an optimum compression temperature of 70 °C heating gives better photovoltaic performance compared to the conventional cells. The aptness of this method was confirmed by investigating scanning electron microscopy image, X-ray diffraction, current-voltage and electrochemical impedance spectroscopy analysis of the prepared cells. Proper heating during compression lowers the charge transport resistance, longer the electron lifetime of the device. As a result, the overall power conversion efficiency of the device was improved about 45% compared to the conventional room temperature compressed cell.

The antibiotic prevention and interventional treatment as well as medical imaging manifestations of rabbit discitis

International Nuclear Information System (INIS)

Sun Gang; Yuang Cheng; Huang Deqing; Dong Zhengjun

1999-01-01

Objective: To assess the role of antibiotic and interventional radiology in prevention and treatment of discitis and analyze the imaging manifestations of discitis. Methods: 24 rabbits were used to make discitis models, and were classified into 4 groups randomly, 6 cases per group: non-treatment group, prophylactic antibiotic group, therapeutic antibiotic group and interventional treatment group. In prophylactic antibiotics group, intravenous clindamycin was administered 3 day before inoculation of bacteria to disc. In therapeutic antibiotics group, 4-week course of intravenous antibiotics was commenced 1 week after the bacterial inoculation. In interventional treatment group, PLD were performed 1 week after the inoculation, with simultaneous intravenous antibiotics for a period of 1 week, 2 or 4 weeks after inoculation. The lumbar spines of all rabbits were examined by X-ray, CT, and MRI respectively. Needle biopsy of nuclear pulpous was obtained and experimental region of lumbar spine were removed for pathological examination. Results: In non-treatment group and therapeutic antibiotics group, all of the discs inoculated with bacteria developed radiographic and pathological evidence of discitis, including intervertebral space narrowing, inflammatory changes of disc tissue, and destruction of end-plates. In prophylactic antibiotics group, none of the discs developed radiographic and pathological evidences of discitis, the bacterial culture was negative. In interventional treatment group, disc narrowing was observed in medical image and fibrosis was found in nucleus region. There was no evidence of destruction of end-plate, the bacteria culture was negative. Conclusion: MRI is a relative sensitive method to detect discitis. Prophylactic antibiotics is a key measure to prevent discitis. The PLD treatment could hold back the pathological process of discitis. Once developed, intravenous antibiotic is unable to affect the course of discitis

Bronchoscopic Treatment in the Management of Benign Tracheal Stenosis: Choices for Simple and Complex Tracheal Stenosis.

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Dalar, Levent; Karasulu, Levent; Abul, Yasin; Özdemir, Cengiz; Sökücü, Sinem Nedime; Tarhan, Merve; Altin, Sedat

2016-04-01

Bronchoscopic treatment is 1 of the treatment choices for both palliative and definitive treatment of benign tracheal stenosis. There is no consensus on the management of these patients, however, especially patients having complex stenoses. The aim of the present study was to assess, in the largest group of patients with complex stenoses yet reported, which types of tracheal stenosis are amenable to optimal management by bronchoscopic treatment. The present study was a retrospective cohort study including 132 consecutive patients with benign tracheal stenoses diagnosed between August 2005 and January 2013. The mean age of the study population was 52 ± 18 years; 62 (47%) were women and 70 (53%) were men. Their lesions were classified as simple and complex stenoses. Simple stenoses (n = 6) were treated with 12 rigid and flexible bronchoscopic procedures (mean of 2 per patient); 5 stents were placed. The total success rate was 100%. Among the 124 complex stenoses, 4 were treated directly with surgical intervention. In total, 481 rigid and 487 flexible bronchoscopic procedures were performed in these patients. In this group, the success rate was 69.8%. From the present study, we propose that after accurate classification, interventional bronchoscopic management may have an important role in the treatment of benign tracheal stenosis. Bronchoscopic treatment should be considered as first-line therapy for simple stenoses, whereas complex stenoses need a multidisciplinary approach and often require surgical intervention. However, bronchoscopic treatment may be a valid conservative approach in the management of patients with complex tracheal stenosis who are not eligible for operative treatment. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Wearable and flexible electronics for continuous molecular monitoring.

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Yang, Yiran; Gao, Wei

2018-04-03

Wearable biosensors have received tremendous attention over the past decade owing to their great potential in predictive analytics and treatment toward personalized medicine. Flexible electronics could serve as an ideal platform for personalized wearable devices because of their unique properties such as light weight, low cost, high flexibility and great conformability. Unlike most reported flexible sensors that mainly track physical activities and vital signs, the new generation of wearable and flexible chemical sensors enables real-time, continuous and fast detection of accessible biomarkers from the human body, and allows for the collection of large-scale information about the individual's dynamic health status at the molecular level. In this article, we review and highlight recent advances in wearable and flexible sensors toward continuous and non-invasive molecular analysis in sweat, tears, saliva, interstitial fluid, blood, wound exudate as well as exhaled breath. The flexible platforms, sensing mechanisms, and device and system configurations employed for continuous monitoring are summarized. We also discuss the key challenges and opportunities of the wearable and flexible chemical sensors that lie ahead.

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

International Nuclear Information System (INIS)

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

2006-01-01

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

[Interventional radiology in treatment of biliodigestive anastomoses strictures].

Science.gov (United States)

Okhotnikov, O I; Yakovleva, M V; Grigoriev, S N

2016-01-01

To analyze efficacy of interventional methods via antegrade transhepatic approach in treatment of patients with strictures of biliodigestive anastomoses. 24 patients aged 47.2 years were treated for the period 2002-2015. Average time from extrahepatic biliary reconstruction using transhepatic stented tubes to strictures appearance varied from 9 months to 12 years. One- and double-sided percutaneous transhepatic cholangiostomy was performed to abort biliary hypertension. Stricture recanalization was achieved using «catheter-wire» system. Antegrade dilatation of stricture was made using balloon catheter 8 mm and pressure up to 6 atm and stage exposition up to 10 minutes. Balloon repair of anastomosis was supplemented by stented outer-inner drainage of the area of stricture. Restoration of patency of stricture area using antegrade interventional methods was effective in 22 patients. Recurrent stricture occurred in 2 cases within 1.5 years that required repeated biliary reconstruction including antegrade extraction of blocked uncovered stent in 1 patient. There were no major postoperative complications and deaths. Maximal recurrence-free follow-up after stent installation was 11 years.

The Relationship between Treatment Integrity and Acceptability of Reading Interventions for Children with Attention-Deficit/Hyperactivity Disorder

Science.gov (United States)

Mautone, Jennifer A.; DuPaul, George J.; Jitendra, Asha K.; Tresco, Katy E.; Junod, Rosemary Vile; Volpe, Robert J.

2009-01-01

This study examined the relationship between treatment integrity and acceptability for reading interventions across two consultation models, intensive data-based academic intervention (IDAI) and traditional data-based academic intervention (TDAI). Participants included 83 first- through fourth-grade students who met research criteria for…

Interventions for post-infectious irritable bowel syndrome: a systematic review of treatment efficacy.

Science.gov (United States)

Torbicki, Emma; Oh, Justin; Mishra, Sharmistha; Page, Andrea V; Boggild, Andrea K

2015-01-01

Post-infectious irritable bowel syndrome (PI-IBS) due to traveler's diarrhea is the second most common illness seen in post-travel clinics, yet its optimal management remains unknown. We performed a systematic review to evaluate treatment efficacy in PI-IBS. We searched Medline, EMBASE, LILACS, CINAHL, CAB abstracts, and the Cochrane Library to February 3, 2014 for intervention studies of the pharmacologic and non-pharmacologic management of PI-IBS and examined the evidence according to a modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scale. Of 336 records, 9 studies were included. Eight studies of pharmacologic interventions examined 5 agents (mesalazine or mesalamine, ondansetron, prednisolone, cholestyramine, and metronidazole). One study examined the non-pharmacologic intervention of different infant nutritional formulas following acute gastroenteritis. The quality of the evidence to date was low, with small sample size (fewer than 50 participants) and short duration of follow-up. Overall, the efficacy of pharmacological treatment ranged from no benefit (ondansetron and prednisolone) to moderately beneficial (cholestyramine and metronidazole). The evidence for mesalazine was equivocal: one study showed benefit, two others showed none. Heterogeneity in outcome measures and low strength of evidence preclude recommendations on the optimal management of PI-IBS by a specific agent. More comparative intervention research into PI-IBS treatment is needed for consistent best practice in PI-IBS management. Clinicians may elect to pursue therapeutic trials of mesalazine, cholestyramine, or metronidazole in individual patients, but should be aware that data supporting the efficacy of these agents is limited.

Improvements in musculoskeletal health and computing behaviors: Effects of a macroergonomics office workplace and training intervention.

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Robertson, Michelle M; Huang, Yueng Hsiang; Lee, Jin

2017-07-01

Computer use and its association with musculoskeletal and visual symptoms is an escalating concern. Organizations are shifting to a more proactive injury prevention perspective. Accordingly, a macroergonomics intervention consisting of flexible workplace design and office ergonomics training was designed to examine the effects on worker's computing behaviors, postures, and musculoskeletal discomfort, and their relationship to psychosocial factors. Participants were assigned to either group: 1) no-intervention control 2) flexible Workplace-only (WP-only), and 3) flexible Workplace + Training (WP+T). Observational findings indicate both intervention groups experienced positive, significant changes in improved workstation arrangements and computing postures, with the WP+T intervention group exhibiting a higher, significant change of behavioral translation. Also, significant, positive relationships between observed postures and musculoskeletal discomfort/pain were found. The intervention effect was stronger when management was responsive to workers' ergonomics needs. This study suggests that a macroergonomics intervention can produce beneficial effects for office and computer workers and organizations. Copyright © 2017 Elsevier Ltd. All rights reserved.

A review of evidence-based early intervention for behavioural problems in children with autism spectrum disorder: the core components of effective programs, child-focused interventions and comprehensive treatment models.

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Tonge, Bruce J; Bull, Kerry; Brereton, Avril; Wilson, Rebecca

2014-03-01

This article reviews recent evidence and other earlier relevant articles regarding early intervention studies for children with autism spectrum disorder (ASD). There is a well-established body of empirical evidence for the effectiveness of Early Intensive Behavioural Intervention (EIBI) with young children with ASD. The importance of parent skills training, education and positive behaviour support is also a key factor in influencing outcomes. Drug treatment is of short-term benefit for disruptive behaviour but long-term outcome and metabolic side-effects have not been studied. Few studies have measured the long-term value and effectiveness of early intervention treatments, and currently there are no articles published on effects into adulthood of such treatments. Such research would indicate whether early intervention results in reduced reliance on health services into adulthood.

Atraumatic restorative treatment and minimal intervention dentistry.

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Frencken, J E

2017-08-11

Too many people worldwide suffer from the consequences of untreated dentine carious lesions. This finding reflects the inability of the currently used traditional mode of treatments to manage such lesions. A change is needed. Dental training institutions should depart from the traditional 'drill and fill' treatments and embrace the holistic oral healthcare approach that is minimal intervention dentistry (MID) and includes within it minimally invasive operative skills. Dental caries is, after all, a preventable disease. The atraumatic restorative treatment (ART) concept is an example of MID. ART consists of a preventive (ART sealant) and a restorative (ART restoration) component. ART sealants using high-viscosity glass-ionomer (HVGIC) have a very high dentine carious lesion preventive effect. The survival rate of these sealants is not significantly different from that of sealants produced with resin. The survival rate of ART/HVGIC restorations matches those of amalgam and resin composite in single- and multiple-surface cavities in primary teeth and in single-surface cavities in permanent teeth. The principles of carious tissue removal within a cavity recommended by the International Caries Consensus Collaboration are in line with those of treating a cavity using ART. Owing to its good performance and the low levels of discomfort/pain and dental anxiety associated with it, ART and/or other evidence-based atraumatic care procedures should be the first treatment for a primary dentine carious lesion. Only if the use of ART is not indicated should other more invasive and less-atraumatic care procedures be used in both primary and permanent dentitions.

Reducing Stress Among Mothers in Drug Treatment: A Description of a Mindfulness Based Parenting Intervention.

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Short, Vanessa L; Gannon, Meghan; Weingarten, Wendy; Kaltenbach, Karol; LaNoue, Marianna; Abatemarco, Diane J

2017-06-01

Background Parenting women with substance use disorder could potentially benefit from interventions designed to decrease stress and improve overall psychosocial health. In this study we assessed whether a mindfulness based parenting (MBP) intervention could be successful in decreasing general and parenting stress in a population of women who are in treatment for substance use disorder and who have infants or young children. Methods MBP participants (N = 59) attended a two-hour session once a week for 12 weeks. Within-group differences on stress outcome measures administered prior to the beginning of the MBP intervention and following the intervention period were investigated using mixed-effects linear regression models accounting for correlations arising from the repeated-measures. Scales assessed for pre-post change included the Perceived Stress Scale-10 (PSS) and the Parenting Stress Index-Short Form (PSI). Results General stress, as measured by the PSS, decreased significantly from baseline to post-intervention. Women with the highest baseline general stress level experienced the greatest change in total stress score. A significant change also occurred across the Parental Distress PSI subscale. Conclusions Findings from this innovative interventional study suggest that the addition of MBP within treatment programs for parenting women with substance use disorder is an effective strategy for reducing stress within this at risk population.

Identifying Critical Elements of Treatment: Examining the Use of Turn Taking in Autism Intervention

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Reith, Sarah R.; Stahmer, Aubyn C.; Suhrheinrich, Jessica; Schreibman, Laura; Kennedy, Joanna; Ross, Benjamin

2014-01-01

Evidence-based treatments for autism spectrum disorders (ASD) are comprised of components that identify therapist behavior necessary to implement the treatment with integrity. Some components are shared across approaches from diverse theoretical backgrounds. One component included in several interventions that has not been researched in isolation…

Hospitalization, frequency of interventions, and quality of life after endoscopic, surgical, or conservative treatment in patients with chronic pancreatitis.

Science.gov (United States)

Rutter, Karoline; Ferlitsch, A; Sautner, T; Püspök, A; Götzinger, P; Gangl, A; Schindl, M

2010-11-01

Patients with chronic pancreatitis usually have a long and debilitating history of disease with frequent hospital admissions, episodes of intractable pain and multiple interventions. The sequences of treatment at initial presentation, endoscopy, surgery, or conservative treatment may affect the time course and admissions needed for disease control, thereby determining quality of life and overall outcome. A total of 292 patients with initial endoscopic, surgical, or conservative pharmacological treatment were retrospectively analyzed regarding frequency of interventions, days in hospital, symptom-free intervals, morbidity, and mortality. Quality of life (QoL) at the latest follow-up was measured by two standardized quality of life questionnaires (EORTC C30 and PAN26). Endoscopic treatment was initially performed in 150 (51.4%) patients, whereas 99 (33.9%) underwent surgery and 43 (14.7%) patients were treated conservatively at their initial presentation. Patients who underwent surgery had a significantly shorter time in the hospital (25.3 ± 24.6, 34.4 ± 35.1, 61.1 ± 37.9; P surgical treatment (P ≤ 0.001), whereas patients after endoscopic intervention developed acute or chronic pancreatitis or pseudocyst formation (P = 0.023). Patients who undergo surgery as their initial treatment for chronic pancreatitis require less consecutive interventions, a shorter hospital stay, and have a better quality of life compared with any other treatment. Surgery should therefore be considered early for the treatment of chronic pancreatitis, when endoscopic or conservative treatment fails and patients require further intervention.

A Comprehensive Examination of Changes in Psychological Flexibility Following Acceptance and Commitment Therapy for Chronic Pain.

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Scott, Whitney; Hann, Katie E J; McCracken, Lance M

Acceptance and commitment therapy (ACT) for chronic pain aims to improve patient functioning by fostering greater psychological flexibility. While promising, ACT treatment process research in the context of chronic pain so far has only focused on a few of the processes of psychological flexibility. Therefore, this study aimed to more comprehensively examine changes in processes of psychological flexibility following an ACT-based treatment for chronic pain, and to examine change in these processes in relation to improvements in patient functioning. Individuals with chronic pain attending an interdisciplinary ACT-based rehabilitation program completed measures of pain, functioning, depression, pain acceptance, cognitive fusion, decentering, and committed action at pre- and post-treatment and during a nine-month follow-up. Significant improvements were observed from pre- to post-treatment and pre-treatment to follow-up on each of the treatment outcome and process variables. Regression analyses indicated that change in psychological flexibility processes cumulatively explained 6-27 % of the variance in changes in functioning and depression over both assessment periods, even after controlling for changes in pain intensity. Further research is needed to maximize the effectiveness of ACT for chronic pain, and to determine whether larger improvements in the processes of psychological flexibility under study will produce better patient outcomes, as predicted by the psychological flexibility model.

Flexible Bronchoscopy.

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Miller, Russell J; Casal, Roberto F; Lazarus, Donald R; Ost, David E; Eapen, George A

2018-03-01

Flexible bronchoscopy has changed the course of pulmonary medicine. As technology advances, the role of the flexible bronchoscope for both diagnostic and therapeutic indications is continually expanding. This article reviews the historical development of the flexible bronchoscopy, fundamental uses of the flexible bronchoscope as a tool to examine the central airways and obtain diagnostic tissue, and the indications, complications, and contraindications to flexible bronchoscopy. Copyright © 2017 Elsevier Inc. All rights reserved.

The effect of flexible cognitive-behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees: pragmatic randomised controlled clinical trial.

Science.gov (United States)

Buhmann, Caecilie Böck; Nordentoft, Merete; Ekstroem, Morten; Carlsson, Jessica; Mortensen, Erik Lykke

2016-03-01

Little evidence exists on the treatment of traumatised refugees. To estimate treatment effects of flexible cognitive-behavioural therapy (CBT) and antidepressants (sertraline and mianserin) in traumatised refugees. Randomised controlled clinical trial with 2 × 2 factorial design (registered with Clinicaltrials.gov, NCT00917397, EUDRACT no. 2008-006714-15). Participants were refugees with war-related traumatic experiences, post-traumatic stress disorder (PTSD) and without psychotic disorder. Treatment was weekly sessions with a physician and/or psychologist over 6 months. A total of 217 of 280 patients completed treatment (78%). There was no effect on PTSD symptoms, no effect of psychotherapy and no interaction between psychotherapy and medicine. A small but significant effect of treatment with antidepressants was found on depression. In a pragmatic clinical setting, there was no effect of flexible CBT and antidepressants on PTSD, and there was a small-to-moderate effect of antidepressants and psychoeducation on depression in traumatised refugees. © The Royal College of Psychiatrists 2016.

Interventional cardiology and diabetes mellitus: age of effective coronary heart disease treatment

Directory of Open Access Journals (Sweden)

Victor Yur'evich Kalashnikov

2011-03-01

Full Text Available Introduction into clinical practice of coronary angioplasty has provided new possibilities for treatment of coronary heart disease (CHD in patientswith diabetes mellitus. The indications for endovascular interventions and principles of coronary stenting in such patients are described in this article.

Modeling social transmission dynamics of unhealthy behaviors for evaluating prevention and treatment interventions on childhood obesity.

Science.gov (United States)

Frerichs, Leah M; Araz, Ozgur M; Huang, Terry T-K

2013-01-01

Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2) to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively). Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence) than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally, targeting adults may

Modeling social transmission dynamics of unhealthy behaviors for evaluating prevention and treatment interventions on childhood obesity.

Directory of Open Access Journals (Sweden)

Leah M Frerichs

Full Text Available Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1 to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2 to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively. Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally

Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum.

Science.gov (United States)

Kenworthy, Lauren; Anthony, Laura Gutermuth; Naiman, Daniel Q; Cannon, Lynn; Wills, Meagan C; Luong-Tran, Caroline; Werner, Monica Adler; Alexander, Katie C; Strang, John; Bal, Elgiz; Sokoloff, Jennifer L; Wallace, Gregory L

2014-04-01

Unstuck and On Target (UOT) is an executive function (EF) intervention for children with autism spectrum disorders (ASD) targeting insistence on sameness, flexibility, goal-setting, and planning through a cognitive-behavioral program of self-regulatory scripts, guided/faded practice, and visual/verbal cueing. UOT is contextually-based because it is implemented in school and at home, the contexts in which a child uses EF skills. To evaluate the effectiveness of UOT compared with a social skills intervention (SS), 3rd-5th graders with ASD (mean IQ = 108; UOT n = 47; SS n = 20) received interventions delivered by school staff in small group sessions. Students were matched for gender, age, race, IQ, ASD symptomotolgy, medication status, and parents' education. Interventions were matched for 'dose' of intervention and training. Measures of pre-post change included classroom observations, parent/teacher report, and direct child measures of problem-solving, EF, and social skills. Schools were randomized and evaluators, but not parents or teachers, were blinded to intervention type. Interventions were administered with high fidelity. Children in both groups improved with intervention, but mean change scores from pre- to postintervention indicated significantly greater improvements for UOT than SS groups in: problem-solving, flexibility, and planning/organizing. Also, classroom observations revealed that participants in UOT made greater improvements than SS participants in their ability to follow rules, make transitions, and be flexible. Children in both groups made equivalent improvements in social skills. These data support the effectiveness of the first contextually-based EF intervention for children with ASD. UOT improved classroom behavior, flexibility, and problem-solving in children with ASD. Individuals with variable background/training in ASD successfully implemented UOT in mainstream educational settings. © 2013 The Authors. Journal of Child Psychology and

Acute effect of different stretching methods on flexibility and jumping performance in competitive artistic gymnasts.

Science.gov (United States)

Dallas, G; Smirniotou, A; Tsiganos, G; Tsopani, D; Di Cagno, A; Tsolakis, Ch

2014-12-01

The purpose of this study was to investigate the acute effects of 3 different warm up methods of stretching (static, proprioceptive neuromuscular facilitation, and stretching exercises on a Vibration platform) on flexibility and legs power-jumping performance in competitive artistic gymnasts. Eighteen competitive artistic gymnasts were recruited to participate in this study. Subjects were exposed to each of 3 experimental stretching conditions: static stretching (SS), proprioceptive neuromuscular facilitation stretching (PNF), and stretching exercises on a Vibration platform (S+V). Flexibility assessed with sit and reach test (S & R) and jumping performance with squat jump (SJ) and counter movement jump (CMJ) and were measured before, immediately after and 15 min after the interventions. Significant differences were observed for flexibility after all stretching conditions for S+V (+1.1%), SS (+5.7%) and PNF (+6.8%) (P=0.000), which remained higher 15 min after interventions (S+V (1.1%), SS (5.3%) and PNF (5.5%), respectively (P=0.000). PNF stretching increased flexibility in competitive gymnasts, while S+V maintained jumping performance when both methods were used as part of a warm-up procedure.

Systematic review and meta-analysis of music interventions in hypertension treatment: A quest for answers

NARCIS (Netherlands)

A.Y.R. Kühlmann (Anne Y.R.); J.R.G. Etnel (Jonathan R.G.); J.W. Roos-Hesselink (Jolien); J. Jeekel (Hans); A.J.J.C. Bogers (Ad); J.J.M. Takkenberg (Hanneke)

2016-01-01

textabstractBackground: Adverse effects, treatment resistance and high costs associated with pharmacological treatment of hypertension have led to growing interest in non-pharmacological complementary therapies such as music interventions. This meta-analysis aims to provide an overview of reported

Interventional Radiological Treatment of Perihepatic Vascular Stenosis or Occlusion in Pediatric Patients After Liver Transplantation

International Nuclear Information System (INIS)

Uller, Wibke; Knoppke, Birgit; Schreyer, Andreas G.; Heiss, Peter; Schlitt, Hans J.; Melter, Michael; Stroszczynski, Christian; Zorger, Niels; Wohlgemuth, Walter A.

2013-01-01

Purpose: Evaluation of the efficacy and safety of percutaneous treatment of vascular stenoses and occlusions in pediatric liver transplant recipients. Methods: Fifteen children (mean age 8.3 years) underwent interventional procedures for 18 vascular complications after liver transplantation. Patients had stenoses or occlusions of portal veins (n = 8), hepatic veins (n = 3), inferior vena cava (IVC; n = 2) or hepatic arteries (n = 5). Technical and clinical success rates were evaluated. Results: Stent angioplasty was performed in seven cases (portal vein, hepatic artery and IVC), and sole balloon angioplasty was performed in eight cases. One child underwent thrombolysis (hepatic artery). Clinical and technical success was achieved in 14 of 18 cases of vascular stenoses or occlusions (mean follow-up 710 days). Conclusion: Pediatric interventional radiology allows effective and safe treatment of vascular stenoses after pediatric liver transplantation (PLT). Individualized treatment with special concepts for each pediatric patient is necessary. The variety, the characteristics, and the individuality of interventional management of all kinds of possible vascular stenoses or occlusions after PLT are shown

Orthographically sensitive treatment for dysprosody in children with childhood apraxia of speech using ReST intervention.

Science.gov (United States)

McCabe, Patricia; Macdonald-D'Silva, Anita G; van Rees, Lauren J; Ballard, Kirrie J; Arciuli, Joanne

2014-04-01

Impaired prosody is a core diagnostic feature of Childhood Apraxia of Speech (CAS) but there is limited evidence of effective prosodic intervention. This study reports the efficacy of the ReST intervention used in conjunction with bisyllabic pseudo word stimuli containing orthographic cues that are strongly associated with either strong-weak or weak-strong patterns of lexical stress. Using a single case AB design with one follow-up and replication, four children with CAS received treatment of four one-hour sessions per week for three weeks. Sessions contained 100 randomized trials of pseudo word treatment stimuli. Baseline measures were taken of treated and untreated behaviors; retention was measured at one day and four weeks post-treatment. Children's production of lexical stress improved from pre to post-treatment. Treatment effects and maintenance varied among participants. This study provides support for the treatment of prosodic deficits in CAS.

Analysis of the complications in interventional treatment for Budd-Chiari syndrome

International Nuclear Information System (INIS)

Niu Zhike; Lv Guanghua; Du Fei; Guo Yanxia; Guan Lan

2010-01-01

Objective: To discuss the causes and the prevention measures of the complications occurred after interventional therapy for different type of Budd-Chiari syndrome (BCS). Methods: Based on the type of BCS, the corresponding interventional management was adopted in 204 patients with BCS. The interventional procedures included PTA and stent placement of inferior vena cava (IVC), percutaneous transhepatic recanalization and dilation (PTRD) of hepatic vein, percutaneous trans jugular or trans inferior vena cava recanalization, dilation and stent placement of hepatic vein and trans jugular intrahepatic portal-systemic stenting shunt (TIPSS). Results: The successful rate of interventional therapy was 95.5% (21 / 22) for type Ia, 81.8% (9/11) for type Ib, 97.3% (109/112) for type IIa, 92.9% (13/14) for type IIb, 88.9% (8/9) for type IIIa, 100% (2/2) type IIIb, 92% (23/25) for type IVa and 88.9% (8/9) for type IVb BCS. The main complications occurred during or after the operation included acute cardiac insufficiency (n=2), pulmonary arterial embolization (n=4), disseminated intravascular coagulation (n=1), extravasation of contrast medium (n=3), arrhythmia (n=2), and cardiac tamponade (n=1). Conclusion: Interventional therapy is simple, safe and effective for the treatment of BCS, but its indications should be strictly considered and all kinds of effective prevention measures should be taken to avoid or to reduce the possible complications. (authors)

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

Science.gov (United States)

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

2016-12-01

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

Design, Prototyping and Control of a Flexible Cystoscope for Biomedical Applications

Science.gov (United States)

Sozer, Canberk; Ghorbani, Morteza; Alcan, Gokhan; Uvet, Huseyin; Unel, Mustafa; Kosar, Ali

2017-07-01

Kidney stone and prostate hyperplasia are very common urogenital diseases all over the world. To treat these diseases, one of the ESWL (Extracorporeal Shock Wave Lithotripsy), PCNL (Percutaneous Nephrolithotomy), cystoscopes or open surgery techniques can be used. Cystoscopes named devices are used for in-vivo intervention. A flexible or rigid cystoscope device is inserted into human body and operates on interested area. In this study, a flexible cystoscope prototype has been developed. The prototype is able to bend up to ±40°in X and Y axes, has a hydrodynamic cavitation probe for rounding sharp edges of kidney stone or resection of the filled prostate with hydrodynamic cavitation method and contains a waterproof medical camera to give visual feedback to the operator. The operator steers the flexible end-effector via joystick toward target region. This paper presents design, manufacturing, control and experimental setup of the tendon driven flexible cystoscope prototype. The prototype is 10 mm in outer diameter, 70 mm in flexible part only and 120 mm in total length with flexible part and rigid tube. The experimental results show that the prototype bending mechanism, control system, manufactured prototype parts and experimental setup function properly. A small piece of real kidney stone was broken in targeted area.

The SCIDOTS Project: Evidence of benefits of an integrated tobacco cessation intervention in tuberculosis care on treatment outcomes

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Syed Sulaiman Syed Azhar

2011-09-01

Full Text Available Abstract Background There is substantial evidence to support the association between tuberculosis (TB and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. Methods An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group or conventional TB DOTS alone (comparison or DOTS group. At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. Results A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when

The SCIDOTS Project: evidence of benefits of an integrated tobacco cessation intervention in tuberculosis care on treatment outcomes.

Science.gov (United States)

Awaisu, Ahmed; Nik Mohamed, Mohamad Haniki; Mohamad Noordin, Noorliza; Abd Aziz, Noorizan; Syed Sulaiman, Syed Azhar; Muttalif, Abdul Razak; Ahmad Mahayiddin, Aziah

2011-09-23

There is substantial evidence to support the association between tuberculosis (TB) and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS) providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group) or conventional TB DOTS alone (comparison or DOTS group). At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when compared with those who received the conventional TB

Behavioral interventions as a treatment for epilepsy: A multicenter randomized controlled trial.

Science.gov (United States)

Haut, Sheryl R; Lipton, Richard B; Cornes, Susannah; Dwivedi, Alok K; Wasson, Rachel; Cotton, Sian; Strawn, Jeffrey R; Privitera, Michael

2018-03-13

To evaluate the effect of a stress-reduction intervention in participants with medication-resistant epilepsy. Adults with medication-resistant focal epilepsy (n = 66) were recruited from 3 centers and randomized to 1 of 2 interventions: (1) progressive muscle relaxation (PMR) with diaphragmatic breathing, or (2) control focused-attention activity with extremity movements. Following an 8-week baseline period, participants began 12 weeks of double-blind treatment. Daily self-reported mood and stress ratings plus seizure counts were completed by participants using an electronic diary, and no medication adjustments were permitted. The primary outcome was percent reduction in seizure frequency per 28 days comparing baseline and treatment; secondary outcomes included stress reduction and stress-seizure interaction. In the 66 participants in the intention-to-treat analysis, seizure frequency was reduced from baseline in both treatment groups (PMR: 29%, p < 0.05; focused attention: 25%, p < 0.05). PMR and focused attention did not differ in seizure reduction ( p = 0.38), although PMR was associated with stress reduction relative to focused attention ( p < 0.05). Daily stress was not a predictor of seizures. Both PMR and the focused-attention groups showed reduced seizure frequency compared to baseline in participants with medication-resistant focal seizures, although the 2 treatments did not differ. PMR was more effective than focused attention in reducing self-reported stress. NCT01444183. © 2018 American Academy of Neurology.

Flexible ACT & Resource-group ACT: Different Working Procedures Which Can Supplement and Strengthen Each Other. A Response.

Science.gov (United States)

van Veldhuizen, Remmers; Delespaul, Philippe; Kroon, Hans; Mulder, Niels

2015-01-01

This article is a response to Nordén and Norlander's 'Absence of Positive Results for Flexible Assertive Community Treatment. What is the next approach?'[1], in which they assert that 'at present [there is] no evidence for Flexible ACT and… that RACT might be able to provide new impulses and new vitality to the treatment mode of ACT'. We question their analyses and conclusions. We clarify Flexible ACT, referring to the Flexible Assertive Community Treatment Manual (van Veldhuizen, 2013) [2] to rectify misconceptions. We discuss Nordén and Norlander's interpretation of research on Flexible ACT. The fact that too little research has been done and that there are insufficient positive results cannot serve as a reason to propagate RACT. However, the Resource Group method does provide inspiration for working with clients to involve their networks more effectively in Flexible ACT.

Retrograde placement of double-J ureteral stent with interventional therapy for the treatment of ureteral stricture

International Nuclear Information System (INIS)

Kong Jian; Xu Linfeng; Liang Huimin; Zheng Chuansheng; Zheng Jinlong; Feng Gansheng

2000-01-01

Objective: To evaluate the retrograde placement of Double-J ureteral stent with interventional therapy for the treatment of ureteral stricture. Methods: Twenty patients with ureteral stricture of various causes were treated with retrograde placing Double-J ureteral stent by interventional therapy. Results: The Double-J stent was successfully performed in all twenty patients. The successful rate of placing stent was 100%. The cure rate was 90% (18/20). The complications such as urinary leakage, wound infection, and bleeding were markedly decreased. The indication, duration of indwelling and complication of the indwelling stent were discussed. Conclusion: Retrograde placing Double-J stent with interventional therapy is simple and less invasive. It is believed to be a safe and effective method for the treatment of ureteral stricture

Current approaches to treatments for schizophrenia spectrum disorders, part II: psychosocial interventions and patient-focused perspectives in psychiatric care

Directory of Open Access Journals (Sweden)

Chien WT

2013-09-01

Full Text Available Wai Tong Chien, Sau Fong Leung, Frederick KK Yeung, Wai Kit Wong School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Abstract: Schizophrenia is a disabling psychiatric illness associated with disruptions in cognition, emotion, and psychosocial and occupational functioning. Increasing evidence shows that psychosocial interventions for people with schizophrenia, as an adjunct to medications or usual psychiatric care, can reduce psychotic symptoms and relapse and improve patients' long-term outcomes such as recovery, remission, and illness progression. This critical review of the literature was conducted to identify the common approaches to psychosocial interventions for people with schizophrenia. Treatment planning and outcomes were also explored and discussed to better understand the effects of these interventions in terms of person-focused perspectives such as their perceived quality of life and satisfaction and their acceptability and adherence to treatments or services received. We searched major healthcare databases such as EMBASE, MEDLINE, and PsycLIT and identified relevant literature in English from these databases. Their reference lists were screened, and studies were selected if they met the criteria of using a randomized controlled trial or systematic review design, giving a clear description of the interventions used, and having a study sample of people primarily diagnosed with schizophrenia. Five main approaches to psychosocial intervention had been used for the treatment of schizophrenia: cognitive therapy (cognitive behavioral and cognitive remediation therapy, psychoeducation, family intervention, social skills training, and assertive community treatment. Most of these five approaches applied to people with schizophrenia have demonstrated satisfactory levels of short- to medium-term clinical efficacy in terms of symptom control or reduction, level of

Flexible Synthetic Semiconductor Applied in Optoelectronic Organic Sensor

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Andre F. S. Guedes

2017-06-01

Full Text Available The synthesis and application of new nanostructured organic materials, for the development of technology based on organic devices, have taken great interest from the scientific community. The greatest interest in studying organic semiconductor materials has been connected to its already known potential applications, such as: batteries, organic solar cells, flexible organic solar cells, organic light emitting diodes, organic sensors and others. Phototherapy makes use of different radiation sources, and the treatment of hyperbilirubinemia the most common therapeutic intervention occurs in the neonatal period. In this work we developed an organic optoelectronic sensor capable of detecting and determining the radiation dose rate emitted by the radiation source of neonatal phototherapy equipment. The sensors were developed using optically transparent substrate with Nanostructured thin film layers of Poly(9-Vinylcarbazole covered by a layer of Poly(P-Phenylene Vinylene. The samples were characterized by UV-Vis Spectroscopy, Electrical Measurements and SEM. With the results obtained from this study can be developed dosimeters organics to the neonatal phototherapy equipment.

Effect of short-term intensive atorvastatin treatment on interventional treatment effect and cardiac function of patients with acute coronary syndrome

Directory of Open Access Journals (Sweden)

Yu Lei

2016-06-01

Full Text Available Objective: To study the effect of short-term intensive atorvastatin treatment on interventional treatment effect and cardiac function of patients with acute coronary syndrome. Methods: A total of 104 cases of patients with acute coronary syndrome who received PCI treatment in Emergency Department of our hospital from May 2014 to November 2015 were retrospectively analyzed and divided into intensive group and routine group according to different atorvastatin treatment methods, and then biochemical indexes, cardiac ultrasound indicators and inflammatory indexes of two groups were compared. Results: Serum TG, TC, LDL-C, hs- CRP, LDH, α-HBDH, CK and CK-MB content of intensive group were significantly lower than those of routine group while HDL-C content was higher than that of routine group; E/ A ratio and LVEF of intensive group were higher than those of routine group while Tei index, systolic index and diastolic index were lower than those of routine group; TLR4 and NF-kB expression levels in peripheral blood as well as TNF-α and IL-6 content in serum of intensive group were significantly lower than those of routine group. Conclusion: Short-term intensive atorvastatin treatment improves the interventional treatment effect of patients with acute coronary syndrome, and can reduce myocardial injury, improve cardiac diastolic and systolic function and inhibit the inflammation mediated by TLR4/NF-kB.

Storytelling in community intervention research: lessons learned from the walk your heart to health intervention.

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LeBron, Alana M; Schulz, Amy J; Bernal, Cristina; Gamboa, Cindy; Wright, Conja; Sand, Sharon; Valerio, Melissa; Caver, Deanna

2014-01-01

Contextually and culturally congruent interventions are urgently needed to reduce racial, ethnic, and socioeconomic inequities in physical activity and cardiovascular disease. To examine a community-based participatory research (CBPR) process that incorporated storytelling into a physical activity intervention, and consider implications for reducing health inequities. We used a CBPR process to incorporate storytelling in an existing walking group intervention. Stories conveyed social support and problem-solving intervention themes designed to maintain increases in physical activity over time, and were adapted to the walking group context, group dynamics, challenges, and traditions. After describing of the CBPR process used to adapt stories to walking group sites, we discuss challenges and lessons learned regarding the adaptation and implementation of stories to convey key intervention themes. A CBPR approach to incorporating storytelling to convey intervention themes offers an innovative and flexible strategy to promote health toward the elimination of health inequities.

Blending Face-to-Face and Internet-Based Interventions for the Treatment of Mental Disorders in Adults: Systematic Review.

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Erbe, Doris; Eichert, Hans-Christoph; Riper, Heleen; Ebert, David Daniel

2017-09-15

Many studies have provided evidence for the effectiveness of Internet-based stand-alone interventions for mental disorders. A newer form of intervention combines the strengths of face-to-face (f2f) and Internet approaches (blended interventions). The aim of this review was to provide an overview of (1) the different formats of blended treatments for adults, (2) the stage of treatment in which these are applied, (3) their objective in combining face-to-face and Internet-based approaches, and (4) their effectiveness. Studies on blended concepts were identified through systematic searches in the MEDLINE, PsycINFO, Cochrane, and PubMed databases. Keywords included terms indicating face-to-face interventions ("inpatient," "outpatient," "face-to-face," or "residential treatment"), which were combined with terms indicating Internet treatment ("internet," "online," or "web") and terms indicating mental disorders ("mental health," "depression," "anxiety," or "substance abuse"). We focused on three of the most common mental disorders (depression, anxiety, and substance abuse). We identified 64 publications describing 44 studies, 27 of which were randomized controlled trials (RCTs). Results suggest that, compared with stand-alone face-to-face therapy, blended therapy may save clinician time, lead to lower dropout rates and greater abstinence rates of patients with substance abuse, or help maintain initially achieved changes within psychotherapy in the long-term effects of inpatient therapy. However, there is a lack of comparative outcome studies investigating the superiority of the outcomes of blended treatments in comparison with classic face-to-face or Internet-based treatments, as well as of studies identifying the optimal ratio of face-to-face and Internet sessions. Several studies have shown that, for common mental health disorders, blended interventions are feasible and can be more effective compared with no treatment controls. However, more RCTs on effectiveness and

A randomized controlled trial comparing Circle of Security Intervention and treatment as usual as interventions to increase attachment security in infants of mentally ill mothers: Study Protocol.

Science.gov (United States)

Ramsauer, Brigitte; Lotzin, Annett; Mühlhan, Christine; Romer, Georg; Nolte, Tobias; Fonagy, Peter; Powell, Bert

2014-01-30

Psychopathology in women after childbirth represents a significant risk factor for parenting and infant mental health. Regarding child development, these infants are at increased risk for developing unfavorable attachment strategies to their mothers and for subsequent behavioral, emotional and cognitive impairments throughout childhood. To date, the specific efficacy of an early attachment-based parenting group intervention under standard clinical outpatient conditions, and the moderators and mediators that promote attachment security in infants of mentally ill mothers, have been poorly evaluated. This randomized controlled clinical trial tests whether promoting attachment security in infancy with the Circle of Security (COS) Intervention will result in a higher rate of securely attached children compared to treatment as usual (TAU). Furthermore, we will determine whether the distributions of securely attached children are moderated or mediated by variations in maternal sensitivity, mentalizing, attachment representations, and psychopathology obtained at baseline and at follow-up. We plan to recruit 80 mother-infant dyads when infants are aged 4-9 months with 40 dyads being randomized to each treatment arm. Infants and mothers will be reassessed when the children are 16-18 months of age. Methodological aspects of the study are systematic recruitment and randomization, explicit inclusion and exclusion criteria, research assessors and coders blinded to treatment allocation, advanced statistical analysis, manualized treatment protocols and assessments of treatment adherence and integrity. The aim of this clinical trial is to determine whether there are specific effects of an attachment-based intervention that promotes attachment security in infants. Additionally, we anticipate being able to utilize data on maternal and child outcome measures to obtain preliminary indications about potential moderators of the intervention and inform hypotheses about which intervention

The intervention research on treatment by Xianchen to rabbits model of chemotherapeutic phlebitis.

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Zhang, Jing; Shen, Juan; Yin, Weiwei; Wei, Xiaoyu; Wu, Ligao; Liu, Hao

2016-08-01

To develop a chemotherapeutics induced phlebitis and explore the effects of Xianchen on the phlebitis treatment. Forty-eight rabbits were divided into two series. Phlebitis model induced by vincristine was established at each series. The first series had 24 rabbits, which were divided into four groups (6 hours, 12 hours, 18 hours, 24 hours) after vincristine infusion. The grades of phlebitis through visual observation and histopathological examination were observed. The second series had also 24 rabbits. Interventions were performed 12 hours after vincristine infusion. These rabbits were randomly divided into four groups, according to treatment: Hirudoid (bid), Xianchen (daily), Xianchen (tid), Xianchen (five times a day). Four days after intervention, the venous injury through visual observation and histopathological examination were evaluated. Series 1: Phlebitis appeared 12 hours after infusion of vincristine through visual observation. There was a significant difference (pphlebitis appeared early. Xianchen can treat vincristine induced phlebitis, as well as Hirudoid. It is particularly effective in the treatment of edema, and there is a remarkable dose-response relationship.

The effects of static stretch duration on the flexibility of hamstring ...

African Journals Online (AJOL)

The effects of static stretch duration on the flexibility of hamstring muscles. NA Odunaiya, TK Hamzat, OF Ajayi. Abstract. The effects of duration of a static stretching protocol (Intervention) on hamstrings tightness were evaluated. Sixty purposively sampled subjects with unilateral hamstring tightness that had no history of low ...

Evaluation of a physiotherapeutic treatment intervention in "Bell's" facial palsy.

Science.gov (United States)

Cederwall, Elisabet; Olsén, Monika Fagevik; Hanner, Per; Fogdestam, Ingemar

2006-01-01

The aim of this study was to evaluate a physiotherapeutic treatment intervention in Bell's palsy. A consecutive series of nine patients with Bell's palsy participated in the study. The subjects were enrolled 4-21 weeks after the onset of facial paralysis. The study had a single subject experimental design with a baseline period of 2-6 weeks and a treatment period of 26-42 weeks. The patients were evaluated using a facial grading score, a paresis index and a written questionnaire created for this study. Every patient was taught to perform an exercise program twice daily, including movements of the muscles surrounding the mouth, nose, eyes and forehead. All the patients improved in terms of symmetry at rest, movement and function. In conclusion, patients with remaining symptoms of Bell's palsy appear to experience positive effects from a specific training program. A larger study, however, is needed to fully evaluate the treatment.

Sensitivity of disease parameters to flexible budesonide/formoterol treatment in an allergic rat model.

Science.gov (United States)

Brange, Charlotte; Smailagic, Amir; Jansson, Anne-Helene; Middleton, Brian; Miller-Larsson, Anna; Taylor, John D; Silberstein, David S; Lal, Harbans

2009-02-01

Clinical studies show that flexible dosing (maintenance and symptom-driven dose adjustments) of budesonide and formoterol (BUD/FORM) improves control of asthma exacerbations as compared to fixed maintenance dosing protocols (maintenance therapy) even when the latter utilize higher BUD/FORM doses. This suggests that dose-response relationships for certain pathobiologic mechanisms in asthma shift over time. Here, we have conducted animal studies to address this issue. (1) To test in an animal asthma-like model whether it is possible to achieve the same or greater pharmacological control over bronchoconstriction and airway/lung inflammation, and with less total drug used, by flexible BUD/FORM dosing (upward adjustment of doses) in association with allergen challenges. (2) To determine whether the benefit requires adjustment of both drug components. Rats sensitized on days 0 and 7 were challenged intratracheally with ovalbumin on days 14 and 21. On days 13-21, rats were treated intratracheally with fixed maintenance or flexible BUD/FORM combinations. On day 22, rats were challenged with methacholine and lungs were harvested for analysis. A flexible BUD/FORM dosing regimen (using 3.3 times less total drug than the fixed maintenance high dose regimen), delivered the same or greater reductions of excised lung gas volume (a measure of gas trapped in lung by bronchoconstriction) and lung weight (a measure of inflammatory oedema). When either BUD or FORM alone was increased on days of challenge, the benefit of the flexible dose upward adjustment was lost. Flexible dosing of the BUD/FORM combination improves the pharmacological inhibition of allergen-induced bronchoconstriction and an inflammatory oedema in an allergic asthma-like rat model.

Ensuring treatment fidelity in a multi-site behavioral intervention study: implementing NIH Behavior Change Consortium recommendations in the SMART trial.

Science.gov (United States)

Robb, Sheri L; Burns, Debra S; Docherty, Sharron L; Haase, Joan E

2011-11-01

The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies. Copyright © 2010 John Wiley & Sons, Ltd.

Flexible ACT & Resource-group ACT: Different Working Procedures Which Can Supplement and Strengthen Each Other. A Response#

Science.gov (United States)

van Veldhuizen, Remmers; Delespaul, Philippe; Kroon, Hans; Mulder, Niels

2015-01-01

This article is a response to Nordén and Norlander’s ‘Absence of Positive Results for Flexible Assertive Community Treatment. What is the next approach?’[1], in which they assert that ‘at present [there is] no evidence for Flexible ACT and… that RACT might be able to provide new impulses and new vitality to the treatment mode of ACT’. We question their analyses and conclusions. We clarify Flexible ACT, referring to the Flexible Assertive Community Treatment Manual (van Veldhuizen, 2013) [2] to rectify misconceptions. We discuss Nordén and Norlander’s interpretation of research on Flexible ACT. The fact that too little research has been done and that there are insufficient positive results cannot serve as a reason to propagate RACT. However, the Resource Group method does provide inspiration for working with clients to involve their networks more effectively in Flexible ACT. PMID:25767558

Web-based interventions in nursing.

Science.gov (United States)

Im, Eun-Ok; Chang, Sun Ju

2013-02-01

With recent advances in computer and Internet technologies and high funding priority on technological aspects of nursing research, researchers at the field level began to develop, use, and test various types of Web-based interventions. Despite high potential impacts of Web-based interventions, little is still known about Web-based interventions in nursing. In this article, to identify strengths and weaknesses of Web-based nursing interventions, a literature review was conducted using multiple databases with combined keywords of "online," "Internet" or "Web," "intervention," and "nursing." A total of 95 articles were retrieved through the databases and sorted by research topics. These articles were then analyzed to identify strengths and weaknesses of Web-based interventions in nursing. A strength of the Web-based interventions was their coverage of various content areas. In addition, many of them were theory-driven. They had advantages in their flexibility and comfort. They could provide consistency in interventions and require less cost in the intervention implementation. However, Web-based intervention studies had selected participants. They lacked controllability and had high dropouts. They required technical expertise and high development costs. Based on these findings, directions for future Web-based intervention research were provided.

Clinical and Cognitive Insight in a Compensatory Cognitive Training Intervention

Science.gov (United States)

Burton, Cynthia Z.; Vella, Lea; Twamley, Elizabeth W.

2013-01-01

The impact of limited insight is a crucial consideration in the treatment of individuals with psychiatric illness. In the context of psychosis, both clinical and cognitive insight have been described. This study aimed to evaluate the relationships between clinical and cognitive insight and neuropsychological functioning, psychiatric symptom severity, and everyday functioning in patients with a primary psychotic disorder participating in a compensatory cognitive training (CT) intervention. Sixty-nine individuals diagnosed with a primary psychotic disorder were randomized to a 3-month CT intervention or to standard pharmacotherapy, and they completed a comprehensive neuropsychological, clinical, and functional battery at baseline, 3 months, and 6 months. The CT intervention focused on habit formation and compensatory strategy learning in four domains: prospective memory, attention and vigilance, learning and memory, and problem-solving/cognitive flexibility. At baseline, better clinical insight was significantly related to better executive functioning and less severe negative symptoms. There was no significant association between cognitive insight and cognitive functioning, symptom severity, or everyday functioning ability. The CT intervention did not have an effect on clinical or cognitive insight, but better cognitive insight prior to participation in CT significantly predicted decreased positive and depressive symptom severity posttreatment, and better clinical insight predicted improved self-reported quality of life. Although clinical insight is related to executive functioning, the correlates of cognitive insight remain elusive. Intact insight appears to be beneficial in ameliorating clinical symptomatology like positive symptoms and depression, rather than augmenting cognition. It may be valuable to develop brief interventions aimed at improving clinical and cognitive insight prior to other psychosocial rehabilitation in order to maximize the benefit of

Interventional treatment of transplanted renal artery stenosis

International Nuclear Information System (INIS)

Zhang Zefu; Liang Huiming; Feng Gansheng; Zheng Chuansheng; Wu Hanpin; Zhou Guofeng

2008-01-01

Objective: To evaluate the treatment of transplanted renal artery stenosis (TRAS) by pereutaneous transluminal angioplasty (PTA)and stentplacement. Methods: The averange time from trans- plantation to the symptom occurrence of TRAS was 5.5 months (4-15 months)in 12 TRAS patients. All of them received the interventional therapy through femoral approach. Average BP, creatinine level and stenosis before and after the procedure were taken as the judgement standards. Results: PTA was performed with balloon (length 20-40 mm, diameter 5-7 mm)in 4 patients, stenting after PTA in 5, including 3 of direct stenting. Two cases (17%)occurred restenosis after PTA and restenting was undertaken. Three ases (25%)with restenosis after stentplacement were undergone PTA. One self-expandable stent and 9 balloon- dilatation stent were released in 10 eases. Stenosis significantly decreased from 65%-95% preoperatively to 15%-25% postoperatively, together with average BP decreased from 175/105 mmHg to 140/80 mmHg and creatinine level decreased from 475.5 μmol/L to 118.5 μmol/L. Among 12 cases included 4 healed, melioration (5), improvement (2), and inefficiency (1) during follow-up of 9 months (3-24 months). No complication occurred. Conclusion: The interventional therapy is effective and safe for TRAS with high rates of procedure success and efficacy. The proper selection of the adapted approach combined with PTA and stenting may effectively raise the long term efficacy for TRAS and success rate of the procedure. (authors)

Interventional radiology and endovascular surgery in the treatment of ectopic pregnancies

Energy Technology Data Exchange (ETDEWEB)

Fornazari, Vinicius Adami Vayego; Szejnfeld, Denis; Elito, Julio Júnior; Goldman, Suzan Menasce [Universidade Federal de São Paulo, São Paulo, SP (Brazil)

2015-07-01

The advent of interventional radiology enabled remarkable advances in diagnosis and treatment of several situations in obstetrics and gynecology. In the field of obstetrics, these advances include temporary occlusion of the iliac arteries to the management of placenta accreta and/or prior, arteriovenous fistulas after embolization of uterine curettage and management of ectopic uterine and extra-uterine pregnancies. The non-tubal ectopic pregnancy, either cervical, abdominal, ovarian or in a cesarean scar, often represents major therapeutic challenge, especially when exists a desire to maintain fertility. Despite the systemic methotrexate therapy and surgical resection of the ectopic gestational sac be the most used therapeutic options, the interventionist approach of non-tubal ectopic pregnancies, direct injection of methotrexate in the gestational sac and intra-arterial chemoembolization of uterine arteries constitute in the currently literature viable, safe, effective modalities with low morbidity, shorter hospital stay, and rapid clinical recovery. Because of little variety of materials used, and the increase in training of specialists in the area, the radiological intervention as a treatment option in ectopic pregnancies is financially viable and present considerable accessibility in the world and at most of Brazilian medical centers.

A pilot feasibility randomised controlled trial of an adjunct brief social network intervention in opiate substitution treatment services.

Science.gov (United States)

Day, Ed; Copello, Alex; Seddon, Jennifer L; Christie, Marilyn; Bamber, Deborah; Powell, Charlotte; Bennett, Carmel; Akhtar, Shabana; George, Sanju; Ball, Andrew; Frew, Emma; Goranitis, Ilias; Freemantle, Nick

2018-01-15

Approximately 3% of people receiving opioid substitution therapy (OST) in the UK manage to achieve abstinence from prescribed and illicit drugs within three years of commencing treatment. Involvement of families and wider social networks in supporting psychological treatment may be an effective strategy in facilitating recovery, and this pilot study aimed to evaluate the impact of a social network-focused intervention for patients receiving OST. A two-site, open feasibility trial randomised patients receiving OST for at least 12 months but still reporting illicit opiate use in the past 28 days to one of three treatments: 1) treatment as usual (TAU), 2) Brief Social Behaviour and Network Therapy (B-SBNT) + TAU, or 3) Personal Goal Setting (PGS) + TAU. The two active interventions consisted of 4 sessions. There were 3 aims: 1) test the feasibility of recruiting OST patients to a trial of B-SBNT, and following them up over 12 months; 2) test the feasibility of training clinicians to deliver B-SBNT; 3) test whether B-SBNT reduces heroin use 3 and 12 months after treatment, and to explore potential mediating factors. The primary outcome for aim 3 was number of days of heroin use in the past month, and a range of secondary outcome measures were specified in advance (level of drug dependence, mental health, social satisfaction, therapist rapport, treatment satisfaction, social network size and support). A total of 83 participants were randomised, and 70 (84%) were followed-up at 12 months. Fidelity analysis of showed that B-SBNT sessions were clearly distinguishable from PGS and TAU sessions, suggesting it was possible to train clinical staff to an adequate level of competence. No significant differences were found between the 3 intervention arms in the primary or secondary outcome measures. Attendance at psychosocial treatment intervention sessions was low across all three arms (44% overall). Patients receiving OST can be recruited into a trial of a social

Mobile diabetes intervention study: testing a personalized treatment/behavioral communication intervention for blood glucose control.

Science.gov (United States)

Quinn, Charlene C; Gruber-Baldini, Ann L; Shardell, Michelle; Weed, Kelly; Clough, Suzanne S; Peeples, Malinda; Terrin, Michael; Bronich-Hall, Lauren; Barr, Erik; Lender, Dan

2009-07-01

National data find glycemic control is within target (A1ccommunication system, using mobile phones and patient/physician portals to allow patient-specific treatment and communication. All physicians receive American Diabetes Association (ADA) Guidelines for diabetes care. Patients with poor diabetes control (A1c> or =7.5%) at baseline (n=260) are enrolled in study groups based on PCP randomization. All study patients receive blood glucose (BG) meters and a year's supply of testing materials. Patients in three treatment groups select one of two mobile phone models, receive one-year unlimited mobile phone data and service plan, register on the web-based individual patient portal and receive study treatment phone software based on study assignment. Control group patients receive usual care from their PCP. The primary outcome is mean change in A1c over a 12-month intervention period. Traditional methods of disease management have not achieved adequate control for BG and other conditions important to persons with diabetes. Tools to improve communication between patients and PCPs may improve patient outcomes and be satisfactory to patients and physicians. This RCT is ongoing.

Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective

Directory of Open Access Journals (Sweden)

Dejan V. Radenkovic

2016-01-01

Full Text Available Abdominal compartment syndrome (ACS in patients with severe acute pancreatitis (SAP is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment.

Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective.

Science.gov (United States)

Radenkovic, Dejan V; Johnson, Colin D; Milic, Natasa; Gregoric, Pavle; Ivancevic, Nenad; Bezmarevic, Mihailo; Bilanovic, Dragoljub; Cijan, Vladimir; Antic, Andrija; Bajec, Djordje

2016-01-01

Abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment.

Interventions for Increasing Alcohol Treatment Utilization Among Patients with Alcohol Use Disorders from Emergency Departments: A Systematic Review.

Science.gov (United States)

Simioni, Nicolas; Rolland, Benjamin; Cottencin, Olivier

2015-11-01

Alcohol use disorders (AUDs) are characterized by low treatment coverage. Emergency departments (EDs) have great potential to increase alcohol treatment coverage. While ED-based brief interventions (BIs) are rarely effective for reducing alcohol use and related consequences in people with AUDs, utilization of formal alcohol treatment has been demonstrated to be useful. Thus we conducted a systematic review to determine efficacious interventions for increasing subsequent alcohol treatment from EDs. A systematic search of the literature up to 31 December 2013 was undertaken in three electronic databases: PubMed, PsycINFO and The Cochrane Library. Only randomized controlled trials (RCTs), controlled clinical trials (CCTs) and non-randomized controlled trials (NRCTs) were included. A meta-analysis was judged inappropriate because of substantial discrepancies in term of interventions' characteristics across studies. From the 2182 identified records, 7 studies (4RCTs, 2 CCTs, 1NRCT) met inclusion criteria. Onsite brief advice (BA) was found efficacious in comparison to no active control condition, but no evidence of efficacy was found when compared to active control conditions. Referral to post-discharge BIs was not found efficacious either used alone or in addition to onsite BA. There is evidence, albeit limited, suggesting that more intensive interventions, such as referral to extended post-discharge interventions and onsite extended BI, might be useful. Based on the available evidence, onsite BA with leaflets appears to be the minimum level of intervention since it enables to actively intervene while fitting in the time concerns experienced in EDs. Further research is needed to confirm these findings given the limited quantity and quality of existing data and to determine whether more intensive interventions could actually be useful. Copyright © 2015 Elsevier Inc. All rights reserved.

Interventional and surgical therapeutic strategies for pulmonary arterial hypertension: Beyond palliative treatments.

Science.gov (United States)

Sandoval, Julio; Gomez-Arroyo, Jose; Gaspar, Jorge; Pulido-Zamudio, Tomas

2015-10-01

Despite significant advances in pharmacological treatments, pulmonary arterial hypertension remains an incurable disease with an unreasonably high morbidity and mortality. Although specific pharmacotherapies have shifted the survival curves of patients and improved exercise endurance as well as quality of life, it is also true that these pharmacological interventions are not always accessible (particularly in developing countries) and, perhaps most importantly, not all patients respond similarly to these drugs. Furthermore, many patients will continue to deteriorate and will eventually require an additional, non-pharmacological, intervention. In this review we analyze the role of atrial septostomy and Potts anastomosis in the management of patients with pulmonary arterial hypertension, we summarize the current worldwide clinical experience (case reports and case series), and discuss why these interventional/surgical strategies might have a therapeutic role beyond that of a "bridge" to transplantation. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

On flexibility

OpenAIRE

Weiss, Christoph R.; Briglauer, Wolfgang

2000-01-01

By building on theoretical work by Mills and Schumann (1985) and Ungern-Sternberg (1990) this paper provides evidence on the determinants of two dimensions of flexibility, the flexibility in adjusting aggregate output over time (tactical flexibility) as well as the ability to switch quickly between products (operational flexibility). Econometric analysis of a sample of 40.000 farms in Upper-Austria for the period 1980 to 1990 suggests that larger full-time farms operated by younger, better ed...

Effectiveness of social work intervention with a systematic approach to improve general health in opioid addicts in addiction treatment centers.

Science.gov (United States)

Raheb, Ghoncheh; Khaleghi, Esmat; Moghanibashi-Mansourieh, Amir; Farhoudian, Ali; Teymouri, Robab

2016-01-01

This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. A covariance analysis test and independent and dependent t -test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients' self-understanding and self-recognition, and enhancing social functioning.

The angiographic findings and interventional treatment of the iatrogenic hemobilia

International Nuclear Information System (INIS)

Wen feng; Lu Zaiming; Sun Wei; Li Wei; Guo Qiyong

2012-01-01

Objective: To evaluate the angiography and interventional embolization in diagnosing and treating the iatrogenic hemobilia. Methods: A total of 21 patients with iatrogenic hemobilia were enrolled in this study. The clinical data were retrospectively analyzed. Percutaneous selective superior mesenteric artery angiography, celiac angiography and common hepatic artery angiography were carried out in all patients. After the bleeding sites were clarified, selective or super-selective catheterization and embolization were performed. The clinical results were analyzed. Results: Active bleeding was confirmed by angiography in all the 21 cases. Angiographic findings included pseudoaneurysm (n=17, 81.0%) and extravasation of contrast medium (n=4, 19.0%). The embolic agents used in this study included polyvinyl alcohol particles (n=2), pure coils (n=8) or Gelfoam particles plus coils (n=11). The success rate of hemostasis after single embolization was 85.7% (18/21), and second embolization procedure had to be carried out in three patients as recurrent massive bleeding occurred in them. All the patients were followed up for 5 to 28 months, and no recurrent hemobilia was observed. No serious complications such as non-targeted vessel embolization, liver function failure, embolization-related infection, etc. occurred. Conclusion: For the treatment of iatrogenic hemobilia, percutaneous selective angiography together with interventional embolization is safe, minimally-invasive, reliable and effective, and this technique should be regarded as the treatment of first choice. (authors)

A Qualitative Comparative Analysis of sustainable household water treatment interventions in developing countries

Science.gov (United States)

Sihombing, Daniel; Pande, Saket; Rietveld, Luuk

2017-04-01

One of the sub-goals of United Nations Sustainable Development Goal 6 is to achieve universal and equitable access to safe and affordable drinking water for all by 2030. Household water treatment (HWT; such as boiling, chlorination, solar or UV disinfection with lamps, etc.) is one of the technologies that can be used to reach this target. However, there is a big challenge to scale up the widespread implementation of this technology. Even though there are many HWT products on the market, sustainable uptake of this method (compliance) is unsatisfying. Researchers have shown that its compliance rate has often declined over time. Since there are many factors that influence the compliance rate, it is desirable to know the best combination of causal factors (pathway) that give the highest compliance based on the success stories reported in the literature. The motivation of this research is to find the pathways characteristic of local people that influence the compliance rate of HWT, using QCA (Qualitative Comparative Analysis). The comparative analysis is essentially a meta-analysis of HWT interventions and factors, possibly, behind successful or unsuccessful HWT uptake reported in literature. This thus helps to identify the characteristics of target communities that are willing to adopt HWT intervention, irrespective of the type of HWT. Out of 102 case studies reported in literature, 36 are selected from developing countries where an HWT intervention lasted for at least 12 months were selected and analyzed. Factors such as education level, perception about water quality, local beliefs, sanitation coverage, existing water treatment, type of water source, ability to pay, willingness to pay, existing local supply chain, and accessibility to water treatment were examined. Preliminary results show that 1) a combination of no prior HWT intervention in the community with a general perception of water quality being poor often leads to uptake of HWT technology, 2) education

[Expert consensus statement on interventional renal sympathetic denervation for hypertension treatment].

Science.gov (United States)

Mahfoud, F; Vonend, O; Bruck, H; Clasen, W; Eckert, S; Frye, B; Haller, H; Hausberg, M; Hoppe, U C; Hoyer, J; Hahn, K; Keller, T; Krämer, B K; Kreutz, R; Potthoff, S A; Reinecke, H; Schmieder, R; Schwenger, V; Kintscher, U; Böhm, M; Rump, L C

2011-11-01

This commentary summarizes the expert consensus and recommendations of the working group 'Herz und Niere' of the German Society of Cardiology (DGK), the German Society of Nephrology (DGfN) and the German Hypertension League (DHL) on renal denervation for antihypertensive treatment. Renal denervation is a new, interventional approach to selectively denervate renal afferent and efferent sympathetic fibers. Renal denervation has been demonstrated to reduce office systolic and diastolic blood pressure in patients with resistant hypertension, defined as systolic office blood pressure ≥ 160 mm Hg and ≥ 150 mm Hg in patients with diabetes type 2, which should currently be used as blood pressure thresholds for undergoing the procedure. Exclusion of secondary hypertension causes and optimized antihypertensive drug treatment is mandatory in every patient with resistant hypertension. In order to exclude pseudoresistance, 24-hour blood pressure measurements should be performed. Preserved renal function was an inclusion criterion in the Symplicity studies, therefore, renal denervation should be only considered in patients with a glomerular filtration rate > 45 ml/min. Adequate centre qualification in both, treatment of hypertension and interventional expertise are essential to ensure correct patient selection and procedural safety. Long-term follow-up after renal denervation and participation in the German Renal Denervation (GREAT) Registry are recommended to assess safety and efficacy after renal denervation over time. © Georg Thieme Verlag KG Stuttgart · New York.

Scaled-Up Mobile Phone Intervention for HIV Care and Treatment: Protocol for a Facility Randomized Controlled Trial.

Science.gov (United States)

L'Engle, Kelly L; Green, Kimberly; Succop, Stacey M; Laar, Amos; Wambugu, Samuel

2015-01-23

Adherence to prevention, care, and treatment recommendations among people living with HIV (PLHIV) is a critical challenge. Yet good clinical outcomes depend on consistent, high adherence to antiretroviral therapy (ART) regimens. Mobile phones offer a promising means to improve patient adherence and health outcomes. However, limited information exists on the impact that mobile phones for health (mHealth) programs have on ART adherence or the behavior change processes through which such interventions may improve patient health, particularly among ongoing clients enrolled in large public sector HIV service delivery programs and key populations such as men who have sex with men (MSM) and female sex workers (FSW). Our aim is to evaluate an mHealth intervention where text message reminders are used as supportive tools for health providers and as motivators and reminders for ART clients to adhere to treatment and remain linked to care in Ghana. Using an implementation science framework, we seek to: (1) evaluate mHealth intervention effects on patient adherence and health outcomes, (2) examine the delivery of the mHealth intervention for improving HIV care and treatment, and (3) assess the cost-effectiveness of the mHealth intervention. The 36-month study will use a facility cluster randomized controlled design (intervention vs standard of care) for evaluating the impact of mHealth on HIV care and treatment. Specifically, we will look at ART adherence, HIV viral load, retention in care, and condom use at 6 and 12-month follow-up. In addition, participant adoption and satisfaction with the program will be measured. This robust methodology will be complemented by qualitative interviews to obtain feedback on the motivational qualities of the program and benefits and challenges of delivery, especially for key populations. Cost-effectiveness will be assessed using incremental cost-effectiveness ratios, with health effects expressed in terms of viral load suppression and costs

Submucosal surgery: novel interventions in the third space.

Science.gov (United States)

Teitelbaum, Ezra N; Swanstrom, Lee L

2018-02-01

Traditional surgeries involve accessing body cavities, such as the abdomen and thorax, via incisions that divide skin and muscle. These operations result in postoperative pain and convalescence, and a risk of complications such as wound infection and hernia. The development of flexible endoscopy allowed diseases as varied as gastrointestinal bleeding and colon adenomas to be treated without incisions, but this technique is restricted by its endoluminal nature. A novel category of surgical endoscopic procedures has recently been developed that uses flexible endoscopic techniques to enter and access the submucosa of the gastrointestinal tract. Through this approach, the advantages of incisionless endoscopy can be applied to areas of the body that previously could only be reached with surgery. This Review introduces this new class of interventions by describing two examples of such submucosal surgeries for the treatment of benign gastrointestinal disease: per-oral endoscopic myotomy and per-oral pyloromyotomy. The approach to pre-procedure patient evaluation, operative technique, and the published outcomes are discussed, as well as potential future applications of similar techniques and procedures in this so-called third space. Copyright © 2018 Elsevier Ltd. All rights reserved.

Balance and flexibility.

Science.gov (United States)

2003-12-01

The 'work-life balance' and flexible working are currently key buzz terms in the NHS. Those looking for more information on these topics should visit Flexibility at www.flexibility.co.uk for a host of resources designed to support new ways of working, including information on flexible workers and flexible rostering, the legal balancing act for work-life balance and home working.

Printable Transparent Conductive Films for Flexible Electronics.

Science.gov (United States)

Li, Dongdong; Lai, Wen-Yong; Zhang, Yi-Zhou; Huang, Wei

2018-03-01

Printed electronics are an important enabling technology for the development of low-cost, large-area, and flexible optoelectronic devices. Transparent conductive films (TCFs) made from solution-processable transparent conductive materials, such as metal nanoparticles/nanowires, carbon nanotubes, graphene, and conductive polymers, can simultaneously exhibit high mechanical flexibility, low cost, and better photoelectric properties compared to the commonly used sputtered indium-tin-oxide-based TCFs, and are thus receiving great attention. This Review summarizes recent advances of large-area flexible TCFs enabled by several roll-to-roll-compatible printed techniques including inkjet printing, screen printing, offset printing, and gravure printing using the emerging transparent conductive materials. The preparation of TCFs including ink formulation, substrate treatment, patterning, and postprocessing, and their potential applications in solar cells, organic light-emitting diodes, and touch panels are discussed in detail. The rational combination of a variety of printed techniques with emerging transparent conductive materials is believed to extend the opportunities for the development of printed electronics within the realm of flexible electronics and beyond. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Lower limb strength and flexibility in athletes with and without patellar tendinopathy.

Science.gov (United States)

Scattone Silva, Rodrigo; Nakagawa, Theresa H; Ferreira, Ana Luisa G; Garcia, Luccas C; Santos, José E M; Serrão, Fábio V

2016-07-01

To compare the hip, knee and ankle torques, as well as knee and ankle flexibility between athletes with patellar tendinopathy and asymptomatic controls. Cross-sectional study. Laboratory setting. Fourteen male volleyball, basketball or handball athletes, divided into 2 groups, patellar tendinopathy group (TG; n = 7) and asymptomatic control group (CG; n = 7). Hip, knee and ankle isometric torques were measured with a handheld dynamometer. Weight-bearing ankle dorsiflexion, hamstring and quadriceps flexibility were measured with a gravity inclinometer. The TG had 27% lower hip extensor torque when compared to the CG (P = 0.031), with no group differences in knee and ankle torques (P > 0.05). Also, the TG had smaller weight-bearing ankle dorsiflexion (P = 0.038) and hamstring flexibility (P = 0.006) when compared to the CG. Regarding quadriceps flexibility, no group differences were found (P = 0.828). Strength and flexibility deficits might contribute to a greater overload on the knee extensor mechanism, possibly contributing to the origin/perpetuation of patellar tendinopathy. Interventions aiming at increasing hip extensors strength as well as ankle and knee flexibility might be important for the rehabilitation of athletes with patellar tendinopathy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Service evaluation of the GOALS family-based childhood obesity treatment intervention during the first 3 years of implementation

Science.gov (United States)

Watson, Paula M; Dugdill, Lindsey; Pickering, Katie; Owen, Stephanie; Hargreaves, Jackie; Staniford, Leanne J; Murphy, Rebecca C; Knowles, Zoe; Cable, N Timothy

2015-01-01

Objectives To evaluate the impact of the GOALS (Getting Our Active Lifestyles Started) family-based childhood obesity treatment intervention during the first 3 years of implementation. Design Single-group repeated measures with qualitative questionnaires. Setting Community venues in a socioeconomically deprived, urban location in the North-West of England. Participants 70 overweight or obese children (mean age 10.5 years, 46% boys) and their parents/carers who completed GOALS between September 2006 and March 2009. Interventions GOALS was a childhood obesity treatment intervention that drew on social cognitive theory to promote whole family lifestyle change. Sessions covered physical activity (PA), diet and behaviour change over 18 2 h weekly group sessions (lasting approximately 6 months). A Template for Intervention Description and Replication (TIDieR) checklist of intervention components is provided. Primary and secondary outcome measures The primary outcome measure was child body mass index (BMI) z-score, collected at baseline, post-intervention and 12 months. Secondary outcome measures were child self-perceptions, parent/carer BMI and qualitative changes in family diet and PA (parent/carer questionnaire). Results Child BMI z-score reduced by 0.07 from baseline to post-intervention (pGOALS. Conclusions GOALS completion was associated with small improvements in child BMI z-score and improved family PA and dietary behaviours. Several intervention modifications were necessary during the implementation period and it is suggested childhood obesity treatment interventions need time to embed before a definitive evaluation is conducted. Researchers are urged to use the TIDieR checklist to ensure transparent reporting of interventions and facilitate the translation of evidence to practice. PMID:25652799

A four-session acceptance and commitment therapy based intervention for depressive symptoms delivered by masters degree level psychology students: a preliminary study.

Science.gov (United States)

Kohtala, Aino; Lappalainen, Raimo; Savonen, Laura; Timo, Elina; Tolvanen, Asko

2015-05-01

Depressive symptoms are one of the main reasons for seeking psychological help. Shorter interventions using briefly trained therapists could offer a solution to the ever-rising need for early and easily applicable psychological treatments. The current study examines the effectiveness of a four-session Acceptance and Commitment Therapy (ACT) based treatment for self-reported depressive symptoms administered by Masters level psychology students. This paper reports the effectiveness of a brief intervention compared to a waiting list control (WLC) group. Participants were randomized into two groups: ACT (n = 28) and waiting list (n = 29). Long-term effects were examined using a 6-month follow-up. The treatment group's level of depressive symptoms (Beck Depression Inventory) decreased by an average of 47%, compared to an average decrease of 4% in the WLC group. Changes in psychological well-being in the ACT group were better throughout, and treatment outcomes were maintained after 6 months. The posttreatment "between-group" and follow-up "with-in group" effect sizes (Cohen's d) were large to medium for depressive symptoms and psychological flexibility. The results support the brief ACT-based intervention for sub-clinical depressive symptoms when treatment was conducted by briefly trained psychology students. It also contributes to the growing body of evidence on brief ACT-based treatments and inexperienced therapists.

Role of Interventional Radiology in the Treatment of Biliary Strictures Following Orthotopic Liver Transplantation

International Nuclear Information System (INIS)

Righi, Dorico; Cesarani, Federico; Muraro, Emanuele; Gazzera, Carlo; Salizzoni, Mauro; Gandini, Giovanni

2002-01-01

Purpose: To evaluate the efficacy and safety of percutaneous treatment of biliary strictures complicating orthotopic liver transplantation (OLT). Methods: Between October 1990 and May 2000, 619 patients underwent 678 liver transplants. Seventy of the 619 (11%) patients were found to be affected by biliary strictures by July 2000. Bilioplasty was performed in 51 of these 70 (73%) patients. A cohort of 33 of 51 (65%) patients were clinically followed for more than 12 months after the last percutaneous treatment and included in the survey results. Results: After one to three treatments 24 of 33 (73%)patients were stricture-free on ultrasound and MR cholangiography follow-up. A delayed stricture recurrence required a fourth percutaneous bilioplasty in two of 33 (6%) patients. A surgical bilioenteric anastomosis was performed in six of 33 (18%) patients.Retransplantation was performed due to ischemic damage in one of 33(3%) patients. Conclusion: Interventional radiology is an effective therapeutic alternative for the treatment of most biliary strictures complicating OLT. It has a high success rate and should be considered before surgical interventions. Elective surgery may be necessary in a few failed cases or those with more severe and extensive biliary strictures

Improving communication after ended adjuvant treatment - experiences of a coaching intervention

DEFF Research Database (Denmark)

Timmermann, Connie; Ammentorp, Jette; Birkelund, Regner

Background: Cancer is a potential life-threatening illness likely to trigger existential concerns related to the meaning of life, hope or faith. Such concerns have shown to influence patients’ perception of their identity and have also proven to worsen physical symptoms related to their cancer...... illness. To improve the conditions for cancer survivors the objective of this study was to develop and evaluate a coaching intervention aimed to improve the communication with the patients. Methods & Materials: Three nurses participated in a two-day training program focusing on coaching methods. A total...... of participating in the intervention were collected through qualitative interviews. Data were analyzed in accordance with the phenomenological-hermeneutic tradition. Results: The patients described a comprehensive process of regaining mental as well as physical strength and well-being after ended treatment...

Unhealthy smokers: scopes for prophylactic intervention and clinical treatment.

Science.gov (United States)

Prasad, Shikha; Kaisar, Mohammad Abul; Cucullo, Luca

2017-10-04

Globally, tobacco use causes approximately 6 million deaths per year, and predictions report that with current trends; more than 8 million deaths are expected annually by 2030. Cigarette smokings is currently accountable for more than 480,000 deaths each year in United States (US) and is the leading cause of preventable death in the US. On average, smokers die 10 years earlier than nonsmokers and if smoking continues at its current proportion among adolescents, one in every 13 Americans aged 17 years or younger is expected to die prematurely from a smoking-related illness. Even though there has been a marginal smoking decline of around 5% in recent years (2005 vs 2015), smokers still account for 15% of the US adult population. What is also concerning is that 41,000 out of 480,000 deaths results from secondhand smoke (SHS) exposure. Herein, we provide a detailed review of health complications and major pathological mechanisms including mutation, inflammation, oxidative stress, and hemodynamic and plasma protein changes associated with chronic smoking. Further, we discuss prophylactic interventions and associated benefits and provide a rationale for the scope of clinical treatment. Considering these premises, it is evident that much detailed translational and clinical studies are needed. Factors such as the length of smoking cessation for ex-smokers, the level of smoke exposure in case of SHS, pre-established health conditions, genetics (and epigenetics modification caused by chronic smoking) are few of the criteria that need to be evaluated to begin assessing the prophylactic and/or therapeutic impact of treatments aimed at chronic and former smokers (especially early stage ex-smokers) including those frequently subjected to second hand tobacco smoke exposure. Herein, we provide a detailed review of health complications and major pathological mechanisms including mutation, inflammation, oxidative stress, and hemodynamic and plasma protein changes associated with

Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions.

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Pelham, William E; Fabiano, Gregory A; Waxmonsky, James G; Greiner, Andrew R; Gnagy, Elizabeth M; Pelham, William E; Coxe, Stefany; Verley, Jessica; Bhatia, Ira; Hart, Katie; Karch, Kathryn; Konijnendijk, Evelien; Tresco, Katy; Nahum-Shani, Inbal; Murphy, Susan A

2016-01-01

Behavioral and pharmacological treatments for children with attention deficit/hyperactivity disorder (ADHD) were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first and, in case of insufficient response to initial treatment, whether increasing dose of initial treatment or adding the other treatment modality is superior. Children with ADHD (ages 5-12, N = 146, 76% male) were treated for 1 school year. Children were randomized to initiate treatment with low doses of either (a) behavioral parent training (8 group sessions) and brief teacher consultation to establish a Daily Report Card or (b) extended-release methylphenidate (equivalent to .15 mg/kg/dose bid). After 8 weeks or at later monthly intervals as necessary, insufficient responders were rerandomized to secondary interventions that either increased the dose/intensity of the initial treatment or added the other treatment modality, with adaptive adjustments monthly as needed to these secondary treatments. The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations (the primary outcome) at study endpoint and tended to have fewer out-of-class disciplinary events. Further, adding medication secondary to initial behavior modification resulted in better outcomes on the primary outcomes and parent/teacher ratings of oppositional behavior than adding behavior modification to initial medication. Normalization rates on teacher and parent ratings were generally high. Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication. Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication.

Parameter trajectory analysis to identify treatment effects of pharmacological interventions.

Directory of Open Access Journals (Sweden)

Christian A Tiemann

Full Text Available The field of medical systems biology aims to advance understanding of molecular mechanisms that drive disease progression and to translate this knowledge into therapies to effectively treat diseases. A challenging task is the investigation of long-term effects of a (pharmacological treatment, to establish its applicability and to identify potential side effects. We present a new modeling approach, called Analysis of Dynamic Adaptations in Parameter Trajectories (ADAPT, to analyze the long-term effects of a pharmacological intervention. A concept of time-dependent evolution of model parameters is introduced to study the dynamics of molecular adaptations. The progression of these adaptations is predicted by identifying necessary dynamic changes in the model parameters to describe the transition between experimental data obtained during different stages of the treatment. The trajectories provide insight in the affected underlying biological systems and identify the molecular events that should be studied in more detail to unravel the mechanistic basis of treatment outcome. Modulating effects caused by interactions with the proteome and transcriptome levels, which are often less well understood, can be captured by the time-dependent descriptions of the parameters. ADAPT was employed to identify metabolic adaptations induced upon pharmacological activation of the liver X receptor (LXR, a potential drug target to treat or prevent atherosclerosis. The trajectories were investigated to study the cascade of adaptations. This provided a counter-intuitive insight concerning the function of scavenger receptor class B1 (SR-B1, a receptor that facilitates the hepatic uptake of cholesterol. Although activation of LXR promotes cholesterol efflux and -excretion, our computational analysis showed that the hepatic capacity to clear cholesterol was reduced upon prolonged treatment. This prediction was confirmed experimentally by immunoblotting measurements of SR-B1

Screening, brief intervention, and referral to treatment for opioid and other substance use during infertility treatment.

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Wright, Tricia E

2017-08-01

Opioid use and misuse have reached epidemic proportions in the United States, especially in women of childbearing age, some of whom seek infertility treatments. Substance use is much more common than many of the conditions routinely screened for during the preconception period, and it can have devastating consequences for the woman and her family. Substance use can worsen infertility, complicate pregnancy, increase medical problems, and lead to psychosocial difficulties for the woman and her family. The reproductive endocrinologist thus has an ethical and medical duty to screen for substance use, provide initial counseling, and refer to specialized treatment as needed. This article provides an overview of screening, brief intervention, and referral to treatment (SBIRT), a public health approach shown to be effective in ameliorating the harms of substance use. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Illustrating idiographic methods for translation research: moderation effects, natural clinical experiments, and complex treatment-by-subgroup interactions.

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Ridenour, Ty A; Wittenborn, Andrea K; Raiff, Bethany R; Benedict, Neal; Kane-Gill, Sandra

2016-03-01

A critical juncture in translation research involves the preliminary studies of intervention tools, provider training programs, policies, and other mechanisms used to leverage knowledge garnered at one translation stage into another stage. Potentially useful for such studies are rigorous techniques for conducting within-subject clinical trials, which have advanced incrementally over the last decade. However, these methods have largely not been utilized within prevention or translation contexts. The purpose of this manuscript is to demonstrate the flexibility, wide applicability, and rigor of idiographic clinical trials for preliminary testing of intervention mechanisms. Specifically demonstrated are novel uses of state-space modeling for testing intervention mechanisms of short-term outcomes, identifying heterogeneity in and moderation of within-person treatment mechanisms, a horizontal line plot to refine sampling design during the course of a clinic-based experimental study, and the need to test a treatment's efficacy as treatment is administered along with (e.g., traditional 12-month outcomes).

Nonstent Combination Interventional Therapy for Treatment of Benign Cicatricial Airway Stenosis

OpenAIRE

Xiao-Jian Qiu; Jie Zhang; Ting Wang; Ying-Hua Pei; Min Xu

2015-01-01

Background: Benign cicatricial airway stenosis (BCAS) is a life-threatening disease. While there are numerous therapies, all have their defects, and stenosis can easily become recurrent. This study aimed to investigate the efficacy and complications of nonstent combination interventional therapy (NSCIT) when used for the treatment of BCAS of different causes and types. Methods: This study enrolled a cohort of patients with BCAS resulting from tuberculosis, intubation, tracheotomy, and othe...

Effectiveness of Acceptance and Commitment Therapy on Interpersonal Problems and Psychological Flexibility in Female High School Students With Social Anxiety Disorder.

Science.gov (United States)

Azadeh, Sayedeh Monireh; Kazemi-Zahrani, Hamid; Besharat, Mohammad Ali

2015-07-12

Social anxiety is a psychological disorder which has devastative and pernicious effects on interpersonal relationships and one's psychological flexibility. The aim of this research was to determine the effectiveness of Acceptance and Commitment Therapy on interpersonal problems and psychological flexibility in female high school students with social anxiety disorder. With a semi-experimental design, the subjects were assessed using the Social Anxiety Scale and clinical interview. The statistical population of the research was high school female students studying in 5 areas of Isfahan. 30 individuals were purposively selected as the sample. The subjects of the research were randomly assigned to the experimental and control groups. Acceptance and Commitment Therapy was given in 10 sessions of 90 minutes in the experimental group and the control group did not receive any treatment. Pre-test and post-test scores of Inventory of Interpersonal Problems, and Acceptance and Action Questionnaire were analyzed using multivariate analysis of variance & the results showed that after the intervention, there was a significant difference between the scores of the subjects in the experimental and control groups. This means that Acceptance and Commitment Therapy can influence interpersonal problems and their six dimensions and psychological flexibility as well.

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

Science.gov (United States)

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

2015-05-23

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

[Psychosocial Interventions in Acute and Maintenance Treatment of Adult Patients Diagnosed With Schizophrenia].

Science.gov (United States)

Ahunca Velásquez, Luisa Fernanda; García Valencia, Jenny; Bohórquez Peñaranda, Adriana Patricia; Gómez-Restrepo, Carlos; Jaramillo González, Luis Eduardo; Palacio Acosta, Carlos

2014-01-01

To determine the effectiveness of the psychosocial strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of the disorder. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia. A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The psychoeducation and family intervention showed higher efficacy, compared with the usual treatment, to prevent relapses and hospital readmissions, to reduce family burden and to improve adherence to treatment. The social skill training was effective to improve symptoms, social functioning and quality of life. However, the quality of evidence was low. There was not enough evidence about the efficacy of occupational therapy, but considering patients preferences and its wide clinical utilization, the GDG suggested its inclusion. Psychoeducation, family intervention and social skill training are recommended to be offered for the treatment of schizophrenia. Furthermore, occupational therapy is suggested for inpatients and outpatients with the disorder. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Flexible Ureterorenoscopy versus Mini-Percutaneous Nephrolithotomy for the Treatment of Renal Stones.

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Ergin, Giray; Kirac, Mustafa; Kopru, Burak; Ebiloglu, Turgay; Biri, Hasan

2018-04-22

To compare the pain status and stone free rates of flexible ureterorenoscopy (F-URS) versus mini-percutaneousnephrolithotomy (mini-PNL) for the treatment of 1-to 2-cm renal stones. This study was retrospectively designed with match paired method. Between January 2013 and December 2016, 387 patients underwent stone surgery for renal stones, 45 patients underwent FURS and 45 patients underwent mini-PNL. 90 patients were divided into two groups according to the surgical procedures. Group 1 patients underwent F-URS, and Group 2 patients underwent mini-PNL. During the intraoperative andpostoperative periods, pain management for all patients was standardized. Pain scores were determined using a visual analogue scale (VAS) completed at 2, 6, 12 and 24 hours postoperatively. The stone free status, hemoglobin levels, fluoroscopy time (FT), operation time (OT), hospitalization time (HT), return to work time (RWT), and complications were noted for each patient. Of all patients, the mean age was 41.1 ± 12.1 years and the mean stone size was 13.9 ± 2.9 mm. The VAS scores were significantly higher in the mini-PNL group at 2, 6, 12 and 24 hours (P .05); however, the hemoglobin decreases and the fluoroscopy, operation, hospitalization and return to work times were higher in the mini-PNL group than in the F-URS group (P work duration. We think that F-URS is more comfortable and less painful than mini-PNL and achieves a similar stone free rate for the treatment of 1- to 2-cm renal stones.

Service evaluation of the GOALS family-based childhood obesity treatment intervention during the first 3 years of implementation.

Science.gov (United States)

Watson, Paula M; Dugdill, Lindsey; Pickering, Katie; Owen, Stephanie; Hargreaves, Jackie; Staniford, Leanne J; Murphy, Rebecca C; Knowles, Zoe; Cable, N Timothy

2015-02-04

To evaluate the impact of the GOALS (Getting Our Active Lifestyles Started) family-based childhood obesity treatment intervention during the first 3 years of implementation. Single-group repeated measures with qualitative questionnaires. Community venues in a socioeconomically deprived, urban location in the North-West of England. 70 overweight or obese children (mean age 10.5 years, 46% boys) and their parents/carers who completed GOALS between September 2006 and March 2009. GOALS was a childhood obesity treatment intervention that drew on social cognitive theory to promote whole family lifestyle change. Sessions covered physical activity (PA), diet and behaviour change over 18 2 h weekly group sessions (lasting approximately 6 months). A Template for Intervention Description and Replication (TIDieR) checklist of intervention components is provided. The primary outcome measure was child body mass index (BMI) z-score, collected at baseline, post-intervention and 12 months. Secondary outcome measures were child self-perceptions, parent/carer BMI and qualitative changes in family diet and PA (parent/carer questionnaire). Child BMI z-score reduced by 0.07 from baseline to post-intervention (pchildhood obesity treatment interventions need time to embed before a definitive evaluation is conducted. Researchers are urged to use the TIDieR checklist to ensure transparent reporting of interventions and facilitate the translation of evidence to practice. 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.

Treatment Integrity of Literacy Interventions for Students with Emotional and/or Behavioral Disorders: A Review of Literature

Science.gov (United States)

Griffith, Annette K.; Hurley, Kristin Duppong; Hagaman, Jessica L.

2009-01-01

This review examines the treatment integrity data of literacy interventions for students with emotional and/or behavioral disorders (EBD). Forty-four studies published between 1977 and 2005 were examined. Findings indicate that studies focusing on literacy interventions for students with EBD included clear operational definitions and data on…

Differential ethnic associations between maternal flexibility and play sophistication in toddlers born very low birth weight

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Erickson, Sarah J.; Montague, Erica Q.; Maclean, Peggy C.; Bancroft, Mary E.; Lowe, Jean R.

2013-01-01

Children born very low birth weight (development of self-regulation and effective functional skills, and play serves as an important avenue of early intervention. The current study investigated associations between maternal flexibility and toddler play sophistication in Caucasian, Spanish speaking Hispanic, English speaking Hispanic, and Native American toddlers (18-22 months adjusted age) in a cross-sectional cohort of 73 toddlers born VLBW and their mothers. We found that the association between maternal flexibility and toddler play sophistication differed by ethnicity (F(3,65) = 3.34, p = .02). In particular, Spanish speaking Hispanic dyads evidenced a significant positive association between maternal flexibility and play sophistication of medium effect size. Results for Native Americans were parallel to those of Spanish speaking Hispanic dyads: the relationship between flexibility and play sophistication was positive and of small-medium effect size. Findings indicate that for Caucasians and English speaking Hispanics, flexibility evidenced a non-significant (negative and small effect size) association with toddler play sophistication. Significant follow-up contrasts revealed that the associations for Caucasian and English speaking Hispanic dyads were significantly different from those of the other two ethnic groups. Results remained unchanged after adjusting for the amount of maternal language, an index of maternal engagement and stimulation; and after adjusting for birth weight, gestational age, gender, test age, cognitive ability, as well maternal age, education, and income. Our results provide preliminary evidence that ethnicity and acculturation may mediate the association between maternal interactive behavior such as flexibility and toddler developmental outcomes, as indexed by play sophistication. Addressing these association differences is particularly important in children born VLBW because interventions targeting parent interaction strategies such as

Parent cognitive-behavioral intervention for the treatment of childhood anxiety disorders: a pilot study.

Science.gov (United States)

Smith, Allison M; Flannery-Schroeder, Ellen C; Gorman, Kathleen S; Cook, Nathan

2014-10-01

Strong evidence supports cognitive-behavioral therapy (CBT) for the treatment of childhood anxiety. Many studies suggest that parents play an etiological role in the development and maintenance of child anxiety. This pilot study examined the efficacy of a cognitive-behavioral intervention delivered to the parents of 31 anxious children (ages 7-13). Parents were randomly assigned to an individual parent-only CBT intervention (PCBT, n = 18) or wait-list control (WL, n = 13). PCBT demonstrated significant reductions in children's number of anxiety disorder diagnoses, parent-rated interference and clinician-rated severity of anxiety, and maternal protective behaviors at post-treatment, which were maintained at 3-months. WL did not demonstrate significant changes. There were no significant differences between conditions in child self-reported or parent-report of child anxiety symptoms. Findings were replicated in a combined sample of treated participants, as well as in an intent-to-treat sample. Parent-only CBT may be an effective treatment modality for child anxiety, though future research is warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

Implementation of Treatment Integrity Procedures An Analysis of Outcome Studies of Youth Interventions Targeting Externalizing Behavioral Problems

NARCIS (Netherlands)

Goense, Pauline; Boendermaker, Leonieke; van Yperen, Tom; Stams, Geert-Jan; van Laar, Jose

2014-01-01

This systematic review evaluates the implementation of treatment integrity procedures in outcome studies of youth interventions targeting behavioral problems. The Implementation of Treatment Integrity Procedures Scale (ITIPS), developed by Perepletchikova, Treat, and Kazdin (2007), was adapted

Acute effect of whole body vibration on isometric strength, squat jump, and flexibility in well-trained combat athletes

Directory of Open Access Journals (Sweden)

Cem Kurt

2015-02-01

Full Text Available The purpose of this study was to investigate the effect of whole body vibration (WBV training on maximal strength, squat jump, and flexibility of well-trained combat athletes. Twelve female and 8 male combat athletes (age: 22.8 ± 3.1 years, mass: 65.4 ± 10.7 kg, height: 168.8 ± 8.8 cm, training experience: 11.6 ± 4.7 years, training volume: 9.3 ± 2.8 hours/week participated in this study. The study consisted of three sessions separated by 48 hours. The first session was conducted for familiarization. In the subsequent two sessions, participants performed WBV or sham intervention in a randomized, balanced order. During WBV intervention, four isometric exercises were performed (26 Hz, 4 mm. During the sham intervention, participants performed the same WBV intervention without vibration treatment (0 Hz, 0 mm. Hand grip, squat jump, trunk flexion, and isometric leg strength tests were performed after each intervention. The results of a two-factor (pre-post[2] × intervention[2] repeated measures ANOVA revealed a significant interaction (p = 0.018 of pre-post × intervention only for the hand grip test, indicating a significant performance increase of moderate effect (net increase of 2.48%, d = 0.61 after WBV intervention. Squat jump, trunk flexion, and isometric leg strength performances were not affected by WBV. In conclusion, the WBV protocol used in this study potentiated hand grip performance, but did not enhance squat jump, trunk flexion, or isometric leg strength in well-trained combat athletes.

Acute effect of whole body vibration on isometric strength, squat jump, and flexibility in well-trained combat athletes.

Science.gov (United States)

Kurt, C; Pekünlü, E

2015-06-01

The purpose of this study was to investigate the effect of whole body vibration (WBV) training on maximal strength, squat jump, and flexibility of well-trained combat athletes. Twelve female and 8 male combat athletes (age: 22.8 ± 3.1 years, mass: 65.4 ± 10.7 kg, height: 168.8 ± 8.8 cm, training experience: 11.6 ± 4.7 years, training volume: 9.3 ± 2.8 hours/week) participated in this study. The study consisted of three sessions separated by 48 hours. The first session was conducted for familiarization. In the subsequent two sessions, participants performed WBV or sham intervention in a randomized, balanced order. During WBV intervention, four isometric exercises were performed (26 Hz, 4 mm). During the sham intervention, participants performed the same WBV intervention without vibration treatment (0 Hz, 0 mm). Hand grip, squat jump, trunk flexion, and isometric leg strength tests were performed after each intervention. The results of a two-factor (pre-post[2] × intervention[2]) repeated measures ANOVA revealed a significant interaction (p = 0.018) of pre-post × intervention only for the hand grip test, indicating a significant performance increase of moderate effect (net increase of 2.48%, d = 0.61) after WBV intervention. Squat jump, trunk flexion, and isometric leg strength performances were not affected by WBV. In conclusion, the WBV protocol used in this study potentiated hand grip performance, but did not enhance squat jump, trunk flexion, or isometric leg strength in well-trained combat athletes.

[Effectiveness comparison of flexible fixation and rigid fixation in treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis].

Science.gov (United States)

Li, Yuewei; Zhang, Minghui; Li, Xiaorong; Chen, Xiaoyong; Deng, Jianlong

2017-07-01

To compare the effectiveness of flexible fixation and rigid fixation in the treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis. A retrospective analysis was made on the clinical data of 50 patients with ankle pronation-external rotation fractures and distal tibiofibular syndesmosis treated between January 2013 and December 2015. Suture-button fixation was used in 23 patients (flexible fixation group) and cortical screw fixation in 27 patients (rigid fixation group). There was no significant difference in age, gender, weight, side, fracture type, and time from trauma to surgery between 2 groups ( P >0.05). The operation time, medial clear space (MCS), tibiofibular clear space (TFCS), tibiofibular overlap (TFO), American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Disability Index (FADI) score were compared between 2 groups. The operation time was (83.0±9.1) minutes in the flexible fixation group and was (79.6±13.1) minutes in the rigid fixation group, showing no significant difference ( t =1.052, P =0.265). All patients achieved healing of incision by first intention. The patients were followed up 12-20 months (mean, 14 months). The X-ray films showed good healing of fracture in 2 groups. There was no screw fracture, delayed union or nounion. The fracture healing time was (12.1±2.5) months in the flexible fixation group and was (11.3±3.2) months in the rigid fixation group, showing no significant difference between 2 groups ( t =1.024, P =0.192). Reduction loss occurred after removal of screw in 2 cases of the rigid fixation group. At last follow-up, there was no significant difference in MCS, TFCS, TFO, AOFAS score and FADI score between 2 groups ( P >0.05). Suture-button fixation has similar effectiveness to screw fixation in ankle function and imaging findings, and flexible fixation has lower risk of reduction loss of distal tibiofibular syndesmosis than rigid fixation.

Motivation and treatment engagement intervention trial (MotivaTe-IT: the effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness

Directory of Open Access Journals (Sweden)

Jochems Eline C

2012-11-01

Full Text Available Abstract Background Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1 to determine whether a feedback intervention based on the patients’ motivation for treatment is effective at improving treatment engagement (TE of severe mentally ill patients in outpatient psychiatric treatment, 2 to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM and TE in this patient population and 3 to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. Methods/design The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients’ treatment motivation upon the patients’ TE. The primary outcome is the patients’ TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. Discussion The current study can provide important insights regarding motivational processes and the way in which motivation

Motivation and treatment engagement intervention trial (MotivaTe-IT): the effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness.

Science.gov (United States)

Jochems, Eline C; Mulder, Cornelis L; van Dam, Arno; Duivenvoorden, Hugo J; Scheffer, Sylvia C M; van der Spek, Willem; van der Feltz-Cornelis, Christina M

2012-11-24

Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients' motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM) and TE in this patient population and 3) to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT) is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients' treatment motivation upon the patients' TE. The primary outcome is the patients' TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual) will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician) and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. The current study can provide important insights regarding motivational processes and the way in which motivation influences the treatment engagement and clinical outcomes. The

Motivation and treatment engagement intervention trial (MotivaTe-IT): the effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness

Science.gov (United States)

2012-01-01

Background Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients’ motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM) and TE in this patient population and 3) to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. Methods/design The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT) is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients’ treatment motivation upon the patients’ TE. The primary outcome is the patients’ TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual) will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician) and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. Discussion The current study can provide important insights regarding motivational processes and the way in which motivation influences the treatment

Technology-Enhanced Maintenance of Treatment Gains in Eating Disorders: Efficacy of an Intervention Delivered via Text Messaging

Science.gov (United States)

Bauer, Stephanie; Okon, Eberhard; Meermann, Rolf; Kordy, Hans

2012-01-01

Objective: Given the lack of maintenance interventions for eating disorders, a program delivered via the short message service (SMS) and text messaging was developed to support patients after their discharge from inpatient treatment. Method: The efficacy of the intervention was studied in a randomized controlled trial. Additionally, its impact on…

The upper extremity deep venous thrombosis and its interventional treatment

International Nuclear Information System (INIS)

Yang Chao; Ni Caifang

2011-01-01

Upper extremity deep vein thrombosis (UEDVT) was once regarded as a kind of disorder that was not serious. With the development of medical knowledge and research, it is now has been well recognized that UEDVT is an important risk factor that can bring about the pulmonary embolus, even cause death in severe patients. This article aims to make a comprehensive review of UEDVT, focusing on the etiology, epidemiology, the clinical features, the diagnosis, the interventional treatment options, the nursing care, the complications as well as prevention strategies, etc. (authors)

The effect of flexible cognitive-behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees

DEFF Research Database (Denmark)

Buhmann, Caecilie Böck; Nordentoft, Merete; Ekstrøm, Morten

2016-01-01

design (registered with Clinicaltrials.gov, NCT00917397, EUDRACT no. 2008-006714-15). Participants were refugees with war-related traumatic experiences, post-traumatic stress disorder (PTSD) and without psychotic disorder. Treatment was weekly sessions with a physician and/or psychologist over 6 months....... RESULTS: A total of 217 of 280 patients completed treatment (78%). There was no effect on PTSD symptoms, no effect of psychotherapy and no interaction between psychotherapy and medicine. A small but significant effect of treatment with antidepressants was found on depression. CONCLUSIONS: In a pragmatic...... clinical setting, there was no effect of flexible CBT and antidepressants on PTSD, and there was a small-to-moderate effect of antidepressants and psychoeducation on depression in traumatised refugees....

Office flexible cystoscopy.

Science.gov (United States)

Kavoussi, L R; Clayman, R V

1988-11-01

Since the development of the first purpose-built flexible cystoscope in 1984, flexible cystoscopy has become an accepted diagnostic and therapeutic modality. Indeed, it is estimated that more than 10 per cent of practicing urologists are already familiar with this technology. The flexible cystoscope has markedly extended the urologist's ability to examine the bladder, and it has become a valuable adjunct to the rigid cystoscope. Although the operation of this instrument is vastly different from that of its rigid counterpart, with practice, the technique can be learned. After experience is obtained with diagnostic flexible cystoscopy, the urologist will likely prefer this new instrument for bladder inspection, as it provides for a more thorough yet less morbid and less expensive examination. In the future, the development of improved and smaller instrumentation will further extend the therapeutic indications for flexible cystoscopy. Indeed, advances in laser technology are already providing the urologist with 300- to 600-micron (0.9 to 1.8F) flexible probes capable of incision (KTP laser), fulguration (Nd:YAG laser), and stone disintegration (tunable dye laser). Lastly, the skills obtained in using the flexible cystoscope are all readily applicable to the development of dexterity with the already available flexible nephroscope and the more recently developed flexible ureteroscope.

[Study of Flexible Doses of Paliperidone ER in Pacients with Schizophrenia who Have Undergone Inefficient Treatment with other Antipsychotics].

Science.gov (United States)

Córdoba, Rodrigo; Cano, Juan Fernando; Arango-Dávila, César Augusto; Miranda, Carlos; Holguín, Jorge; Fernández, Darío; Márquez, Miguel; Lupo, Christian; Gargoloff, Pedro; Petracca, Gustavo; Lucchetti, César

2012-06-01

Extended-release (ER) paliperidone is an innovative atypical antipsychotic that allows minimal peak-to-through fluctuations with once-daily dosing. To evaluate effectiveness, safety and tolerability of flexible, once-daily doses of paliperidone ER (3-12 mg/day) in patients with schizophrenia from Argentina and Colombia who had previously failed treatment with other antipsychotic agents. The authors conducted a 6-month, open-label, prospective and multicentric study. Effectiveness was assessed with Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance scale (PSP). Other measures of effectiveness, safety and tolerability, were also conducted. Paliperidone ER 3-12 mg/day improved Positive and Negative Syndrome Scale (PANSS) total scores (primary endpoint) from baseline to study end (p < 0,001). In the PANSS total score, the mean change from baseline (83, 9 units) to end point (53,7 units) was significant (p < 0,001). Flexible doses of paliperidone ER demonstrated a ≥20% reduction in the PANSS total score (p<0.001) in almost two-thirds of patients. PSP mean change from baseline (52 units) to end point (85 units) was significant (p < 0,001). Secondary effectiveness assessments, as well as safety and tolerability measures, demonstrated favourable results throughout the study. Flexible doses of paliperidone ER over 6 months were effective, safe and well tolerated in patients with schizophrenia from Argentina and Colombia. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Novel Nano-Materials and Nano-Fabrication Techniques for Flexible Electronic Systems

Directory of Open Access Journals (Sweden)

Kyowon Kang

2018-05-01

Full Text Available Recent progress in fabricating flexible electronics has been significantly developed because of the increased interest in flexible electronics, which can be applied to enormous fields, not only conventional in electronic devices, but also in bio/eco-electronic devices. Flexible electronics can be applied to a wide range of fields, such as flexible displays, flexible power storages, flexible solar cells, wearable electronics, and healthcare monitoring devices. Recently, flexible electronics have been attached to the skin and have even been implanted into the human body for monitoring biosignals and for treatment purposes. To improve the electrical and mechanical properties of flexible electronics, nanoscale fabrications using novel nanomaterials are required. Advancements in nanoscale fabrication methods allow the construction of active materials that can be combined with ultrathin soft substrates to form flexible electronics with high performances and reliability. In this review, a wide range of flexible electronic applications via nanoscale fabrication methods, classified as either top-down or bottom-up approaches, including conventional photolithography, soft lithography, nanoimprint lithography, growth, assembly, and chemical vapor deposition (CVD, are introduced, with specific fabrication processes and results. Here, our aim is to introduce recent progress on the various fabrication methods for flexible electronics, based on novel nanomaterials, using application examples of fundamental device components for electronics and applications in healthcare systems.

Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies.

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Janket, S-J; Wightman, A; Baird, A E; Van Dyke, T E; Jones, J A

2005-12-01

Previous analyses regarding effects of periodontal treatment on glycemic control included studies where causal association might not be assumed, or the results were reported non-quantitatively. We initiated this meta-analysis of 10 intervention studies to quantify the effects of periodontal treatment on HbA1c level among diabetic patients, to explore possible causes for the discrepant reports, and to make recommendations for future studies. Data sources were MEDLINE (January, 1980, to January, 2005), the EBMR, Cochrane Register, and bibliographies of the published articles. Three investigators extracted data regarding intervention, outcomes, and effect size. A total of 456 patients was included in this analysis, with periodontal treatment as predictor and the actual change in hemoglobin A1c level as the outcome. The weighted average decrease in actual HbA1c level was 0.38% for all studies, 0.66% when restricted to type 2 diabetic patients, and 0.71% if antibiotics were given to them. However, none was statistically significant.

Early interventional treatment with intranasal corticosteroids compared with postonset treatment in pollinosis.

Science.gov (United States)

Higaki, Takaya; Okano, Mitsuhiro; Makihara, Seiichiro; Fujiwara, Tazuko; Haruna, Takenori; Noda, Yohei; Kariya, Shin; Nishizaki, Kazunori

2012-12-01

The usefulness of early interventional treatment (EIT) with intranasal corticosteroids (INSs) compared with postonset treatment (POT) has not been clarified. To study the efficacy and safety of EIT with INSs compared with POT and placebo in Japanese cedar/cypress pollinosis. We designed a 3-armed, double-blinded, randomized, placebo-controlled trial. Patients received mometasone furoate nasal spray (EIT group: n = 25), placebo (n = 25), or 4 weeks of placebo followed by 8 weeks of mometasone (POT group: n = 25) for a 12-week period starting on February 1, 2011. The primary end point was the comparison of the total nasal symptom score (TNSS) among the 3 groups. Total ocular symptom score (TOSS), total naso-ocular symptom score (TSS), Allergic Rhinitis and Its Impact (ARIA) on Asthma classification, and safety were the main secondary end points. The placebo and POT groups, but not the EIT group, had a significant exacerbation of TNSS and TOSS soon after the start of pollen counts being high on consecutive days. The 12-week mean TSS in the EIT group (score, 2.3) was significantly lower than in the placebo (5.0; P INSs is superior to POT in controlling pollinosis. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Application of flexible endoscopy-based biopsy in the diagnosis of tumour pathologies in otorhinolaryngology.

Science.gov (United States)

Saga, Carlos; Olalde, Manuel; Larruskain, Ekhiñe; Álvarez, Leire; Altuna, Xabier

Interventional endoscopy allows us to act on the pathology of the patient with minimal discomfort, low costs and high efficiency. We assessed the validity of flexible endoscopic biopsies in our hospital, in lesions suspected of malignancy in the rhino-pharyngo-laryngeal space. Retrospective study of patients with a pathology suspected of malignancy assessed between 2006-2016 in our centre. We evaluated the effectiveness, the tolerance and the number of complications. We calculated the cost reduction in comparison with direct laryngoscopy in the operating room. We compared our sample with others of similar characteristics described in the literature. Thirty patients were studied with a flexible endoscopic biopsy during that period. Nineteen patients obtained positive results which allowed them to start treatment for their pathology. Seven cases had no evidence of malignancy and required another biopsy under general anaesthesia, which confirmed the carcinoma diagnosis. Two samples ruled out malignancy which was confirmed by laryngeal microsurgery. One case showed inflammation and the lesion was cured after antibiotherapy. It was impossible to collect the sample in one case. Thus, we obtained sensitivity levels of 73% with a specificity of 100%. There were no complications. The cost reduction in our sample was above 80%. Flexible endoscopic biopsy has advantages over direct laryngoscopy that are relevant in the diagnosis of oncological pathology in otorhinolaryngology. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Kind of blue: A systematic review and meta-analysis of music interventions in cancer treatment.

Science.gov (United States)

Bro, Margrethe Langer; Jespersen, Kira Vibe; Hansen, Julie Bolvig; Vuust, Peter; Abildgaard, Niels; Gram, Jeppe; Johansen, Christoffer

2018-02-01

Music may be a valuable and low-cost coping strategy for cancer patients. We conducted a systematic review and meta-analysis to identify the psychological and physical effects of music interventions in cancer treatment. We included randomized, controlled trials with adult patients in active cancer treatment exposed to different music interventions versus control conditions. Qualitative studies and systematic reviews were excluded. We identified a total of 2624 records through 2 systematic searches (June 2015 and September 2016) in PubMed, Scopus, EMBASE, Cinahl, Web of Science, Cochrane, and PsycINFO and used Risk of Bias Assessment, GRADE and Checklist for Reporting Music-Based Interventions to evaluate the music applied and quality of the studies. We conducted meta-analyses using Review Manager (version 5.3). PROSPERO reg. no. CRD42015026024. We included 25 RCT's (N = 1784) of which 20 were eligible for the meta-analysis (N = 1565). Music reduced anxiety (SMD -0·80 [95% CI, -1.35 to -0.25]), pain (SMD -0.88 [95% CI -1.45 to -0.32]), and improved mood (SMD -0.55 [95% CI, -0.98 to -0.13]). However, studies were hampered by heterogeneity with I 2 varying between 54% and 96%. Quality of the studies ranged from very low to low. The most effective mode of music intervention appeared to be passive listening to self-selected, recorded music in a single session design. Music may be a tool in reducing anxiety, pain, and improving mood among patients with cancer in active treatment. However, methodological limitations in the studies conducted so far prevent firm conclusions. Copyright © 2017 John Wiley & Sons, Ltd.

Outcomes of a pilates-based intervention for individuals with lateral epicondylosis: A pilot study.

Science.gov (United States)

Dale, Lucinda M; Mikuski, Connie; Miller, Jacqueline

2015-01-01

Core stability and flexibility, features of Pilates exercise, can reduce loads to the upper extremities. Reducing loads is essential to improve symptoms for individuals with lateral epicondylosis. Although Pilates exercise has gained popularity in healthy populations, it has not been studied for individuals with lateral epicondylosis. The purpose of this study was to determine if adding Pilates-based intervention to standard occupational therapy intervention improved outcomes as measured by the Patient-Rated Tennis Elbow Evaluation (PRTEE) more than standard intervention for individuals with lateral epicondylosis. Participants (N= 17) were randomized to the standard intervention group or Pilates-based intervention group. All participants received standard intervention. The Pilates-based intervention group additionally completed abdominal strengthening, postural correction, and flexibility. For both groups, paired t-tests showed significantly improved PRTEE scores, 38.1 for the Pilates-based intervention group, and 22.9 for the standard intervention group. Paired t-test showed significantly improved provocative grip strength and pain for both groups. Independent t-tests showed no significant difference between groups in improved scores of PRTEE, pain, and provocative grip. Although the Pilates-based intervention group showed greater improvement in PRTEE outcome, provocative grip, and pain, scores were not significantly better than those of the standard intervention group, warranting further research.

Flexible structured high-frequency film bulk acoustic resonator for flexible wireless electronics

International Nuclear Information System (INIS)

Zhou, Changjian; Shu, Yi; Yang, Yi; Ren, Tian-Ling; Jin, Hao; Dong, Shu-Rong; Chan, Mansun

2015-01-01

Flexible electronics have inspired many novel and very important applications in recent years and various flexible electronic devices such as diodes, transistors, circuits, sensors, and radiofrequency (RF) passive devices including antennas and inductors have been reported. However, the lack of a high-performance RF resonator is one of the key bottlenecks to implement flexible wireless electronics. In this study, for the first time, a novel ultra-flexible structured film bulk acoustic resonator (FBAR) is proposed. The flexible FBAR is fabricated on a flexible polyimide substrate using piezoelectric thin film aluminum nitride (AlN) for acoustic wave excitation. Both the shear wave and longitudinal wave can be excited under the surface interdigital electrodes configuration we proposed. In the case of the thickness extension mode, a flexible resonator with a working frequency as high as of 5.2325 GHz has been realized. The resonators stay fully functional under bending status and after repeated bending and re-flattening operations. This flexible high-frequency resonator will serve as a key building block for the future flexible wireless electronics, greatly expanding the application scope of flexible electronics. (paper)

The value of three-dimensional helical computed tomography for the retrograde flexible ureteronephroscopy in the treatment of lower pole calyx stones

Directory of Open Access Journals (Sweden)

Yan Xu

2016-03-01

Full Text Available Objective: The aim of our study was to determine if there is any advantage of three-dimensional helical computed tomography (3D-HCT over intravenous urogram (IVU for the retrograde flexible ureteronephroscopy in the treatment of lower pole calyx stones. Methods: From June 2012 to January 2014, a total of 52 cases of lower pole renal stones underwent retrograde intrarenal surgery (RIRS in our center. All patients underwent a preoperative IVU and three-dimensional helical computed tomography urography (3D-CTU program to define the collecting system anatomy, manly concerning the following lower pole features; infundibu-lopelvic angle (IPA, infundibular length (IL, and infundibular width (IW. The examinations were performed in the same center of reference with a standardized method and with 3D-HCT Siemens Somaton Plus equipment. The measurements were performed by the same researcher, using a ruler and a square. Results: Based on clinical threshold difference of the anatomic factors on an IVU image to compare the difference between an IVU image and a 3D-CT image of 52 patients, the IPA was <30° when measured on intravenous pyelography (IVP for 21 patients. We found that with the IPA of <30° measured with IVP only 19% (4/21 were correctly classified in the same size category using 3D-HCT, whereas 81% (17/21 were upgraded to 40–50° on 3D-CT. This difference was significant between IVP and 3D-HCT. Conclusions: 3D-HCT has advantages over IVU when analyzing the morphometric and the morphological features of kidney lower pole spatial anatomy for the retrograde flexible ureteronephroscopy in the treatment of lower pole calyx stones. Keywords: Intravenous urogram, Computed tomography urography, Flexible ureterorenoscopy, Lower pole, Renal stones

A Systematic Review on the Use of Psychosocial Interventions in Conjunction With Medications for the Treatment of Opioid Addiction.

Science.gov (United States)

Dugosh, Karen; Abraham, Amanda; Seymour, Brittany; McLoyd, Keli; Chalk, Mady; Festinger, David

2016-01-01

Opioid use and overdose rates have risen to epidemic levels in the United States during the past decade. Fortunately, there are effective medications (ie, methadone, buprenorphine, and oral and injectable naltrexone) available for the treatment of opioid addiction. Each of these medications is approved for use in conjunction with psychosocial treatment; however, there is a dearth of empirical research on the optimal psychosocial interventions to use with these medications. In this systematic review, we outline and discuss the findings of 3 prominent prior reviews and 27 recent publications of empirical studies on this topic. The most widely studied psychosocial interventions examined in conjunction with medications for opioid addiction were contingency management and cognitive behavioral therapy, with the majority focusing on methadone treatment. The results generally support the efficacy of providing psychosocial interventions in combination with medications to treat opioid addictions, although the incremental utility varied across studies, outcomes, medications, and interventions. The review highlights significant gaps in the literature and provides areas for future research. Given the enormity of the current opioid problem in the United States, it is critical to gain a better understanding of the most effective ways to deliver psychosocial treatments in conjunction with these medications to improve the health and well-being of individuals suffering from opioid addiction.

Teaching Intuitive Eating and Acceptance and Commitment Therapy Skills Via a Web-Based Intervention: A Pilot Single-Arm Intervention Study

Science.gov (United States)

Boucher, Sara; Edwards, Olivia; Gray, Andrew; Nada-Raja, Shyamala; Lillis, Jason; Tylka, Tracy L

2016-01-01

Background Middle-aged women are at risk of weight gain and associated comorbidities. Deliberate restriction of food intake (dieting) produces short-term weight loss but is largely unsuccessful for long-term weight management. Two promising approaches for the prevention of weight gain are intuitive eating (ie, eating in accordance with hunger and satiety signals) and the development of greater psychological flexibility (ie, the aim of acceptance and commitment therapy [ACT]). Objectives This pilot study investigated the usage, acceptability, and feasibility of “Mind, Body, Food,” a Web-based weight gain prevention intervention prototype that teaches intuitive eating and psychological flexibility skills. Methods Participants were 40 overweight women (mean age 44.8 [standard deviation, SD, 3.06] years, mean body mass index [BMI] 32.9 [SD 6.01] kg/m2, mean Intuitive Eating Scale [IES-1] total score 53.4 [SD 7.46], classified as below average) who were recruited from the general population in Dunedin, New Zealand. Module completion and study site metrics were assessed using Google Analytics. Use of an online self-monitoring tool was determined by entries saved to a secure online database. Intervention acceptability was assessed postintervention. BMI, intuitive eating, binge eating, psychological flexibility, and general mental and physical health were assessed pre- and postintervention and 3-months postintervention. Results Of the 40 women enrolled in the study, 12 (30%) completed all 12 modules (median 7.5 [interquartile range, IQR, 2-12] modules) and 4 (10%) used the self-monitoring tool for all 14 weeks of the intervention period (median 3 [IQR 1-9] weeks). Among 26 women who completed postintervention assessments, most women rated “Mind, Body, Food” as useful (20/26, 77%), easy to use (17/25, 68%) and liked the intervention (22/25, 88%). From pre- to postintervention, there were statistically significant within-group increases in intuitive eating (IES-2

Interventional treatment of common congenital heart diseases: the common view of Chinese medical experts. Part Five-transcatheter intervention for the treatment of compound congenital cardiac anomalies

International Nuclear Information System (INIS)

Committee on Congenital Heart Diseases, Internal Medicine Branch of Cadiovascular Diseases of China Physicians' Association

2011-01-01

Compound congenital cardiac anomalies refer to two or more congenital cardiovascular defects coexisting in the same patient. Transcatheter intervention for compound congenital cardiac anomalies has got satisfactory results in recent years. However, the percutaneous closure procedure used for compound congenital cardiac defects does not mean the simple addition of single interventional technique. Clinically, it needs more specialist expertise to deal with such complex defects. This chapter will briefly describe the pathophysiology and clinical features of the following compound congenital cardiac anomalies: the ventricular septal defect (VSD) with coexistence of atrial septal defect (ASD), patent ductus arteriosus (PDA) or pulmonary valve stenosis (PS), the ASD coexistence of PDA, PS or mitral stenosis (Lutembacher's syndrome), and coarctation of aorta compound with PDA. The indications and contraindications, the therapeutic principles, the matters needing attention, the postoperative management, the judgment of curative effect, etc. of using transcatheter for the treatment of such compound anomalies will also be discussed. (authors)

Interventional treatment of common congenital heart diseases: the common view of Chinese medical experts. Part Five-transcatheter intervention for the treatment of compound congenital cardiac anomalies

Energy Technology Data Exchange (ETDEWEB)

Committee on Congenital Heart Diseases, Internal Medicine Branch of Cadiovascular Diseases of China Physicians' Association

2011-05-15

Compound congenital cardiac anomalies refer to two or more congenital cardiovascular defects coexisting in the same patient. Transcatheter intervention for compound congenital cardiac anomalies has got satisfactory results in recent years. However, the percutaneous closure procedure used for compound congenital cardiac defects does not mean the simple addition of single interventional technique. Clinically, it needs more specialist expertise to deal with such complex defects. This chapter will briefly describe the pathophysiology and clinical features of the following compound congenital cardiac anomalies: the ventricular septal defect (VSD) with coexistence of atrial septal defect (ASD), patent ductus arteriosus (PDA) or pulmonary valve stenosis (PS), the ASD coexistence of PDA, PS or mitral stenosis (Lutembacher's syndrome), and coarctation of aorta compound with PDA. The indications and contraindications, the therapeutic principles, the matters needing attention, the postoperative management, the judgment of curative effect, etc. of using transcatheter for the treatment of such compound anomalies will also be discussed. (authors)

Operability and flexibility of a milk production line

DEFF Research Database (Denmark)

Cheng, Hongyuan; Friis, Alan

2007-01-01

The operability and flexibility of an existing milk treatment process are investigated through flowsheet modelling and simulation. From the flowsheet simulation, a process operating region was determined using incoming milk flow viscosity and heat exchanger pressure drop as characteristic...

Immediate Effects of Neurodynamic Sliding versus Muscle Stretching on Hamstring Flexibility in Subjects with Short Hamstring Syndrome

Science.gov (United States)

Castellote-Caballero, Yolanda; Valenza, Maríe C.; Puentedura, Emilio J.; Fernández-de-las-Peñas, César; Alburquerque-Sendín, Francisco

2014-01-01

Background. Hamstring injuries continue to affect active individuals and although inadequate muscle extensibility remains a commonly accepted factor, little is known about the most effective method to improve flexibility. Purpose. To determine if an isolated neurodynamic sciatic sliding technique would improve hamstring flexibility to a greater degree than stretching or a placebo intervention in asymptomatic subjects with short hamstring syndrome (SHS). Study Design. Randomized double-blinded controlled trial. Methods. One hundred and twenty subjects with SHS were randomized to 1 of 3 groups: neurodynamic sliding, hamstring stretching, and placebo control. Each subject's dominant leg was measured for straight leg raise (SLR) range of motion (ROM) before and after interventions. Data were analyzed with a 3 × 2 mixed model ANOVA followed by simple main effects analyses. Results. At the end of the study, more ROM was observed in the Neurodynamic and Stretching groups compared to the Control group and more ROM in the Neurodynamic group compared to Stretching group. Conclusion. Findings suggest that a neurodynamic sliding technique will increase hamstring flexibility to a greater degree than static hamstring stretching in healthy subjects with SHS. Clinical Relevance. The use of neurodynamic sliding techniques to improve hamstring flexibility in sports may lead to a decreased incidence in injuries; however, this needs to be formally tested. PMID:26464889

Culturally sensitive substance abuse intervention for Hispanic and African American adolescents: empirical examples from the Alcohol Treatment Targeting Adolescents in Need (ATTAIN) Project.

Science.gov (United States)

Gil, Andrés G; Wagner, Eric F; Tubman, Jonathan G

2004-11-01

This study presents preliminary analyses examining the effects of an alcohol and other drug use (AOD) intervention with minority juvenile offenders. Furthermore, the study investigates the impact of cultural factors on baseline AOD use among Hispanic and African American youth, as well as on treatment outcome. Participants were 213 juvenile offenders referred for treatment (mean age = 15.7 years), 97 of whom have completed treatment to date. The intervention was carried out in clinics placed within the neighborhoods in which the participants resided. Intervention Alcohol Treatment Targeting Adolescents in Need (ATTAIN) is a controlled clinical trial evaluating the effectiveness of a brief motivational, cognitive behavioral intervention, guided self-change (GSC). Participants are assigned randomly to the individual format of guided self-change (I-GSC), the family involved format of guided self-Change (F-GSC), choice of one of these two, or a waiting list control condition. Only participants involved in active intervention are included in the present report. Data were collected via structured face-to-face interviews. Alcohol and marijuana use measures were collected using the Time-line Follow-back interview (TLFB). There were significant reductions in alcohol and marijuana use for all ethnic groups from baseline to post-intervention. Cultural factors (discrimination, acculturation, ethnic pride and cultural mistrust) were associated with pre-intervention levels of alcohol and marijuana use. Among Hispanics, pre-intervention level of substance use were higher among foreign-born than US-born youth. Analyses conducted with the US-born Hispanic group showed that ethnic orientation and ethnic pride were associated positively with greater reductions in alcohol use. The intervention provided through ATTAIN appears to be effective with a multi-ethnic population of juvenile delinquents. Cultural factors, such as ethnic orientation and ethnic mistrust, appear to constitute

A clinical study on the interventional treatment of acute pulmonary embolism

International Nuclear Information System (INIS)

Yu Xixiang; Zhang Minghua; Ci Xiao; Wang Chunmei; Lin Xiaojie; Si Tongguo; Huang Linfen; Feng Xiaofeng

2004-01-01

Objective: To evaluate the effectiveness of interventional procedures in the treatment of acute pulmonary embolism (PE). Methods: Pulmonary arterial thrombolytic therapy, suction and fragmentation of thromhi, anti-spasm, and balloon dilation were performed in eighteen cases with clinically highly suspected PE confirmed by emergent pulmonary artery angiography beforehand. Wedged pulmonary arterial pressure, pulmonary recanalization rate, the display ratio of distal pulmonary capillary net, blood gas analysis, blood oxygen saturation, and the improvement of clinical symptoms and signs were used for evaluation of the effectiveness. Seventeen of the alive cases with dislodgement of deep vein thrombi of the lower extremities were confirmed for the formation of PE and then thrombolytic treatment of the thrombotic deep vein was performed after the placement of inferior vena cava filter. Results: Pulmanory artery angiographies showed embolism of the pulmonary arterial trunks or more than two of the branches. The post-treatment pulmonary patency reached 80%-90% in three cases, 90%-95% in eleven cases and 100% in five cases. The display ratio of distal pulmonary capillary net was over 90% in all the cases. Wedged pulmonary arterial pressure decreased to below 25 mmHg in thirteen cases, and to 25-30 mmHg in five cases. Blood oxygen saturation rate improved immediately to 90%-95% in ten cases and to 95%-100% in eight cases. Cough, hemoptysis, dyspnea, and chest pain were completely relieved in thirteen cases and significantly relieved in five cases. Digestive track bleeding was complicated in one case. Conclusions: Pulmonary artery angiography is the golden standard for the diagnosis of pulmonary embolism. Interventional therapy is very effective for acute pulmonary embolism, which can significantly reduce the mortality rate. (authors)

Mindfulness-Based Interventions for the Treatment of Substance and Behavioral Addictions: A Systematic Review

Directory of Open Access Journals (Sweden)

Marta Sancho

2018-03-01

Full Text Available BackgroundEmotion (dysregulation as well as the interventions for improving these difficulties are receiving a growing attention in the literature. The aim of the present paper was to conduct a systematic review about the efficacy of mindfulness-based interventions (MBIs in both substance and behavioral addictions (BAs.MethodA literature search was conducted using Cochrane, PubMed, and Web of Science. Fifty-four randomized controlled trials published in English since 2009 to April 2017 were included into a narrative synthesis.ResultsMindfulness-based interventions were applied in a wide range of addictions, including substance use disorders (from smoking to alcohol, among others and BAs (namely, gambling disorder. These treatments were successful for reducing dependence, craving, and other addiction-related symptoms by also improving mood state and emotion dysregulation. The most commonly used MBI approaches were as follows: Mindfulness-Based Relapse Prevention, Mindfulness Training for Smokers, or Mindfulness-Oriented Recovery Enhancement, and the most frequent control group in the included studies was Treatment as Usual (TAU. The most effective approach was the combination of MBIs with TAU or other active treatments. However, there is a lack of studies showing the maintenance of the effect over time. Therefore, studies with longer follow-ups are needed.ConclusionThe revised literature shows support for the effectiveness of the MBIs. Future research should focus on longer follow-up assessments as well as on adolescence and young population, as they are a vulnerable population for developing problems associated with alcohol, drugs, or other addictions.

Thoracoscopic CO laser coagulation shrinkage of blebs in treatment of spontaneous pneumothorax

Science.gov (United States)

Sensaki, Koji; Arai, Tsunenori; Kikuchi, Keiichi; Takagi, Keigo; Tanaka, Susumu; Kikuchi, Makoto

1992-06-01

Spontaneous pneumothorax is a common disease in young people. Operative intervention has been done in most of the recurrent cases. Recently thoracoscopic treatment has been tested as a less invasive treatment modarity. We adopted carbon monoxide (CO) laser for thoracoscopic treatment of recurrent spontaneous pneumothorax. CO laser (wavelength; 5.4 micrometers ) could be delivered by chalcogenide glass (As - S) covered with a teflon sheath and ZnSe fiber tip. The sterilized flexible bronchoscope was inserted through the thoracoscopic outer sheath under local anesthesia. Shrinkage of blebs was obtained by non-contact method of CO laser irradiation. Laser power at the tip was 2.5 - 5 W and irradiation duration was 0.5 s each. Excellent shrinkage of bleb and bulla could be obtained by CO laser without perforation complication. Advantages of CO laser as a thoracoscopic treatment were: (1) capability of fiber delivery (flexible thoracoscopy was easy to operate and clear to visualize the blebs which were frequently found at the apical portion of the lung, and (2) shallow extinction length (good shrinkage of blebs, low risk of perforation, and thin layer of carbonization). In conclusion, our new technique of thoracoscopic CO laser irradiation was found to be a safe and effective treatment of spontaneous pneumothorax.

Interventional radiology of malignant biliary obstruction complication and treatment

International Nuclear Information System (INIS)

Zhai Renyou; Huang Qiang

2007-01-01

Intervetional therapy as an important therapeutic method for malignant biliary obstruction has been used extensively, but there still remain some problems worthy for our emphasis and research. We retrospectively reviewed more than 800 patients with malignant obstructive jaundice during 12 years. Indications, contraindications, complications and corresponding treatment methods were studied. Furthermore, discussion including methods of biliary drainage, proper time of stent implantation, methods of anesthesia, usage of antibiotics and haemostat were also carded out. Use of analgesics (pain-suppressal) pre- and post procedure, development of acute pancreatitis and its management, and peri-operative mortality were further investigated in detail. We hope our experiences and lessons would give interventional doctors some help in their career. (authors)

Obstruction of hepatic vein or inferior vena cava after liver transplantation: the diagnosis and interventional treatment

International Nuclear Information System (INIS)

Zhu Kangshun; Qian Jiesheng; Meng Xiaochun; Yi Shuhong; Pang Pengfei; He Keke; Jiang Zaibo; Lu Minqiang; Shan Hong

2010-01-01

Objective: To investigate the diagnosis and interventional therapeutic technology for the obstruction of hepatic vein (HV) or inferior vena cava (IVC) after liver transplantation. Methods: In the 831 patients who received orthotopic liver transplantation (OLT) and 26 patients who received living donor liver transplantation (LDLT), 11 cases were confirmed with HV or IVC obstruction by venography and received interventional treatment from 2 to 111 days after liver transplantation. Of the 11 patients, five had the obstruction of HV anastomosis, five had the obstruction of IVC anastomosis, and one had the obstruction of HV and IVC anastomosis. In the eleven patients, five patients underwent OLT, four patients underwent LDLT, and two pediatric patients underwent reduced-size OLT. Before interventional treatment, 9 patients function tests, clinical sympatom, and monitoring of HV or IVC flow. Pressure gradients before and after therapeutic technology of 11 cases were retrospectively analyzed. Results: In all 11 patients, CT or MRI could clearly show congested areas of the liver, and the location and degree of HV or IVC obstruction. Of the 11 patients, four with HV obstruction and five with IVC obstruction were treated with stent placement, one with HV obstruction was treated with percutaneous transluminal angioplasty (PTA), one with HV and IVC obstruction was treated with HV PTA and IVC stent placement. Interventional technical success was achieved in all patients. The venous pressure gradient across obstruction was significantly reduced from (16.5 ± 4.1) mm Hg (1 mm Hg =0.133 kPa) before the procedure to (2.9 ± 1.7) mm Hg after the procedure (t=11.5, P<0.01). Clinical improvement was noted in 10 patients except one pediatric patient who died of multiple-organs failure at the 9 th day after the treatment. During the follow-up period of 9 to 672 days, two patients with PTA treatment had recurrent HV stenosis within one month after treatment, no patient with stent

Flexibility@Work 2013: yearly report on flexible labor and employment

NARCIS (Netherlands)

Berkhout, E.; Heyma, A.; Prins, J.

2013-01-01

There is no clear evidence that the strong growth in the share of flexible labor relations between 2002 and 2007 points at a worldwide trend towards a larger share of flexible labor at the expense of traditional open-ended labor contracts. The growth in flexible labor varies too much between

Psychosocial and pharmacological interventions for the treatment of cannabis use disorder [version 1; referees: 3 approved

Directory of Open Access Journals (Sweden)

Pamela Sabioni

2018-02-01

Full Text Available Cannabis use has been continuously increasing, and cannabis use disorder (CUD has become a public health issue. Some psychosocial interventions have demonstrated the ability to reduce cannabis use; however, there are no pharmacotherapies approved for the treatment of CUD. Some drugs have shown limited positive effects on use and withdrawal symptoms, but no controlled studies have been able to show strong and persistent effects on clinically meaningful outcomes. The aim of this review is to synthesize the evidence from the available literature regarding the effectiveness of psychosocial and pharmacological treatments for CUD among adults (that is, 18 years old or older. An analysis of the evidence shows that the current best psychosocial intervention to reduce cannabis use is the combination of motivational enhancement therapy and cognitive-behavioral therapy, preferably accompanied by a contingency management approach. In regard to pharmacological interventions, there are mostly unclear findings. Some drugs, such as CB1 agonists, gabapentin, and N-acetylcysteine, have been shown to produce improvements in some symptoms of CUD in single studies, but these have not been replicated. Other classes of medications, including antidepressants and antipsychotics, have been unsuccessful in producing such effects. There is an imminent need for more clinical trials to develop more effective treatments for CUD.

Effectiveness of social work intervention with a systematic approach to improve general health in opioid addicts in addiction treatment centers

Directory of Open Access Journals (Sweden)

Raheb G

2016-11-01

Full Text Available Ghoncheh Raheb,1,2 Esmat Khaleghi,1 Amir Moghanibashi-Mansourieh,1 Ali Farhoudian,2 Robab Teymouri3 1Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 2Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 3Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Purpose: This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. Patients and methods: This is an experimental plan (pretest to posttest with a control group; the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30 and control (30 groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. Results: A covariance analysis test and independent and dependent t-test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Conclusion: Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients’ self-understanding and self-recognition, and enhancing social functioning. Keywords: social work, intervention, systematic approach, general health, opioid addicts

Addressing the service linkage problem. Increasing substance abuse treatment engagement using personalized feedback interventions in heavy-using female domestic violence shelter residents.

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Ogle, Richard L; Baer, John S

2003-11-01

Two personalized substance abuse assessment and feedback interventions were tested for effectiveness in engaging female domestic violence shelter residents in substance abuse treatment. One hundred forty-seven residents were assessed for quantity andfrequency of substance use, negative consequences due to use, motivation to change substance use behavior, and psychopathological symptoms related to substance abuse. Assessment identified (33) 22% of participants as heavy substance users. Twenty of the 33 heavy-using residents received one of two personalized substance use feedback interventions:face-to-face feedback or writtenfeedbackplaced in shelter mailboxes. Treatment engagement was defined as attending at least one substance abuse treatment session within 30 days after the intervention. Results showed a significant difference in treatment engagement rates in favor of the face-to-face feedback group (60% vs. 0%). The results provide preliminary data suggesting that substance abuse assessment can be effectively accomplished in the shelter environment and that the face-to-face feedback procedure may be an effective intervention to bridge the service linkage problem between domestic violence services and substance abuse treatment.

The role and progress of interventional therapy in the prevention and treatment of postoperative hepatocellular carcinoma recurrence

International Nuclear Information System (INIS)

Xiao Yunping; Xiao Enhua

2008-01-01

The articles concerning intensive effect and progress of interventional therapy for hepatocellular carcinoma (HCC) recurrence were comprehensively reviewed. Along with unceasing abundance of all interventional methods (including transcatheter arterial chemoemblization (TACE), percutaneous dehydrated ethanol injection, radio frequency ablation, percutaneous microwave therapy, argon-helium cryoablation, high-intensity focused ultrasound and radionuclide interventional therapy, etc), combined interventional therapies mainly TACE were increasingly appreciated in postoperative HCC recurrence, but still have to be further standardized. With further emerging and maturing of new technologies, such as antiangiogenesis, gene therapy and targeted therapy on HCC metastatic and recurrence specific cycle; the effect of combined therapy will be further promoted. Interventional therapy will play an important role in the prevention and treatment of postoperative HCC recurrence in the foreseen furture. (authors)

Effectiveness of a clinical practice change intervention in increasing the provision of nicotine dependence treatment in inpatient psychiatric facilities: an implementation trial.

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Wye, Paula M; Stockings, Emily A; Bowman, Jenny A; Oldmeadow, Chris; Wiggers, John H

2017-02-07

Despite clinical practice guidelines recommending the routine provision of nicotine dependence treatment to smokers in inpatient psychiatric facilities, the prevalence of such treatment provision is low. The aim of this study was to examine the effectiveness of a clinical practice change intervention in increasing clinician recorded provision of nicotine dependence treatment to patients in inpatient psychiatric facilities. We undertook an interrupted time series analysis of nicotine dependence treatment provision before, during and after a clinical practice change intervention to increase clinician recorded provision of nicotine dependence treatment for all hospital discharges (aged >18 years, N = 4175) over a 19 month period in two inpatient adult psychiatric facilities in New South Wales, Australia. The clinical practice change intervention comprised six key strategies: leadership and consensus, enabling systems and procedures, training and education, information and resources, audit and feedback and an on-site practice change support officer. Systematic medical record audit and segmented logistic regression was used to determine differences in proportions for each nicotine dependence treatment outcome measure between the 'pre', 'during' and 'post-intervention' periods. The prevalence of all five outcome measures increased significantly between the pre and post-intervention periods, including clinician recorded: assessment of patient smoking status (36.43 to 51.95%; adjusted odds ratio [AOR] = 2.39, 99% Confidence Interval [CI]: 1.23 to 4.66); assessment of patient nicotine dependence status (4.74 to 11.04%; AOR = 109.67, 99% CI: 35.35 to 340.22); provision of brief advice to quit (0.85 to 8.81%; AOR = 97.43, 99% CI: 31.03 to 306.30); provision of nicotine replacement therapy (8.06 to 26.25%; AOR = 19.59, 99% CI: 8.17 to 46.94); and provision of nicotine dependence treatment on discharge (8.82 to 13.45%, AOR = 12.36; 99% CI: 6.08 to 25

Clinical analysis of interventional treatment for avascular necrosis of femoral head in adults

International Nuclear Information System (INIS)

Cao Dianbo; Yang Haishan; Zhao Yongsheng; Cheng Tilong

2001-01-01

Objective: To study the method and efficacy of interventional therapy for avascular necrosis of femoral head. Methods: A 5.0 F Cobra duct was first super selected into circumflex artery by applying Seldinger's technique and vasoactive drugs were perfused, then into inferior gluteal or obturator artery that are the branches of internal iliac artery. Dissolving and dilative drugs were perfused through micro-artery pump linked to the duct for three days on 30 cases (total 51 heads of femur). Results: Following interventional treatment, there were marked improvement of clinical symptoms, with relief or disappearance of pain (92.2%) and functional improvement in hip joint (87.5%). Increase of vessel numbers, disappearance of blank space, richness of parenchymal staining and establishment of collateral circulations were found around the hip joint. Repair of osteonecrosis at different degrees was observed on regular reexamination. Conclusion: Interventional therapy for ANFH had a significantly therapeutic effect after short-term follow-up

The effect of duration of untreated psychosis and treatment delay on the outcomes of prolonged early intervention in psychotic disorders

DEFF Research Database (Denmark)

Albert, Nikolai; Melau, Marianne; Jensen, Heidi

2017-01-01

to the prolonged treatment with regards to disorganized and negative dimension. For participants with short duration from first symptom until start of SEI treatment there was a significant difference on the negative dimension favoring the prolonged OPUS treatment. The finding of an effect of prolonged treatment......The duration of untreated psychosis (DUP) has been shown to have an effect on outcome after first-episode psychosis. The premise of specialized early intervention (SEI) services is that intervention in the early years of illness can affect long-term outcomes. In this study, we investigate whether...... DUP affects treatment response after 5 years of SEI treatment compared to 2 years of SEI treatment. As part of a randomized controlled trial testing the effect of prolonged SEI treatment 400 participants diagnosed within the schizophrenia spectrum were recruited. For this specific study participants...

Responding to Requests of Families for Unproven Interventions in Neurodevelopmental Disorders: Hyperbaric Oxygen "Treatment" and Stem Cell "Therapy" in Cerebral Palsy

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Bell, Emily; Wallace, Tessa; Chouinard, Isabelle; Shevell, Michael; Racine, Eric

2011-01-01

Faced with the limitations of currently available mainstream medical treatments and interventions, parents of children with neurodevelopmental disorders often seek information about unproven interventions. These interventions frequently have undetermined efficacy and uncertain safety profiles. In this article, we present a general background and…

The effect of duration of untreated psychosis and treatment delay on the outcomes of prolonged early intervention in psychotic disorders.

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Albert, Nikolai; Melau, Marianne; Jensen, Heidi; Hastrup, Lene Halling; Hjorthøj, Carsten; Nordentoft, Merete

2017-09-26

The duration of untreated psychosis (DUP) has been shown to have an effect on outcome after first-episode psychosis. The premise of specialized early intervention (SEI) services is that intervention in the early years of illness can affect long-term outcomes. In this study, we investigate whether DUP affects treatment response after 5 years of SEI treatment compared to 2 years of SEI treatment. As part of a randomized controlled trial testing the effect of prolonged SEI treatment 400 participants diagnosed within the schizophrenia spectrum were recruited. For this specific study participants were dichotomized based on DUP, treatment delay, and time from first symptom until start of SEI treatment. The groups were analyzed with regard to treatment response on psychopathology, level of functioning, and cognitive functioning. The participants with a short DUP had a tendency to respond better to the prolonged treatment with regards to disorganized and negative dimension. For participants with short duration from first symptom until start of SEI treatment there was a significant difference on the negative dimension favoring the prolonged OPUS treatment. The finding of an effect of prolonged treatment for participants with a short total treatment delay could mean that prolonged SEI treatment is more beneficial than treatment as usual (TAU) so long as it is provided in the early years of illness and not just in the early years after diagnosis. THE EARLIER THE BETTER: The duration of untreated psychosis influences the long-term outcomes of treatment. Nikolai Albert, at the Copenhagen Mental Health Centre, and a team of Danish researchers have investigated the effects of a specialized early intervention program (OPUS) in 400 patients diagnosed with schizophrenia spectrum disorders and compared the effects of OPUS after two and five years. Their findings suggest that five years of specialized early intervention was most beneficial when the total duration from symptom start to

School-based programs aimed at the prevention and treatment of obesity: evidence-based interventions for youth in Latin America.

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Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K; Nagle, Brian J; Arredondo, Elva M; Barquera, Simón; Elder, John P

2013-09-01

Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be gathered from such interventions. We performed a systematic review of papers published between 1965 and December 2010. Interventions were considered eligible if they had a school-based component, were done in Latin America, evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z-score), and compared youth exposed vs not exposed. Ten studies were identified as having a school-based component. Most interventions had a sample of normal and overweight children. The most successful interventions focused on prevention rather than treatment, had longer follow-ups, a multidisciplinary team, and fewer limitations in execution. Three prevention and 2 treatment interventions found sufficient improvements in obesity-related outcomes. We found sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America. Evidence-based interventions in the school setting should be promoted as an important component for integrated programs, policies, and monitoring frameworks designed to reverse the childhood obesity in the region. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Complications and nursing care in interventional treatment of diabetic foot via radial artery access

International Nuclear Information System (INIS)

Liu Lingyun; Zhou Xiaoxiang; Zeng Yongmei; Chen Junfei; Lai Lisha; Pang Pengfei; Zhu Kangshun

2009-01-01

Objective: To evaluate the therapeutic effect of interventional treatment via radial artery access for diabetic foot and to summarize its complications and nursing care. Methods: The interventional treatment via radial artery access was performed in twenty patients with diabetic foot. The preoperative psychological nursing care, the nursing of the punctured site of radial artery and the indwelling catheter, the complications of the puncture site and thrombolytic therapy were reviewed and retrospectively analyzed. Results: Some complications occurred in eight cases, including hematoma at puncture site (n= 1), oozing of blood (n=3), gingival bleeding (n=1) and pain (n=3). No retention of urine or infection occurred. Conclusion: It is very important to pay enough attention to the nursing care of puncture site and indwelling catheter sheath and to make a close observation of patient's condition in order to reduce the occurrence of complications. Rich clinical experience and careful observation after the operation can definitely reduce the occurrence of thrombolytic complications and improve the patient's living quality. (authors)

Autism Treatment and Family Support Models Review

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Mehrnoush Esbati

2009-04-01

Full Text Available Autism is a lifelong neurological disability of unknown etiology. The criteria for a diagnosis of autism are based on a triad of impairments in social interaction, communication and a lack of flexibility in thinking and behavior There are several factors which are likely to contribute to this variation including the definition of autism and variability in diagnosis amongst professionals, however anecdotally there appears to have been a steadily increasing demand for services. The purpose of this review of research literature relating to the management and treatment of children with autism is to identify the most effective models of best practice. The review includes Comparative evidence supporting a range of treatment and intervention models, across the range of individuals included within autism spectrum disorders, psychodynamic treatment/management which are based on the assumption that autism is the result of emotional damage to the child, usually because of failure to develop a close attachment to parents, especially the mother, biological treatments, educational and behavioral interventions, communication therapies, cost benefits and supporting families.The research is examined for evidence to support best practice models in supporting families at the time of diagnosis and assessment and an overview of the nature of comprehensive supports that help reduce stresses that may be experienced by families of a child with autism and promote inclusion in community activities.

ediatric femoral shaft fractures treated by flexible intramedullary nailing.

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Kapil Mani, K C; Dirgha Raj, R C; Parimal, Acharya

2015-01-01

Nowadays pediatric femoral fractures are more commonly managed with operative treatment rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization. Children between the ages of 5-13 years are treated either by traction plus hip spica and flexible/elastic stable retrograde intramedullary nail, or external fixators in the case of open fractures. The aim of this study is to evaluate the outcome of pediatric femoral shaft fractures treated by stainless steel flexible intramedullary nail in children between 5 and 13 years of age. There were 32 cases of femoral shaft fractures which were all fixed with stainless steel flexible intramedullary nail under fluoroscopy. Long leg cast was applied at the time of fixation. Partial weight bearing was started 2 weeks after surgery. Patients were evaluated in follow-up study to observe the alignment of fracture, infection, delayed union, nonunion, limb length discrepancy, motion of knee joint, and time to unite the fracture. We were able to follow up 28 out of 32 patients. The patients were 8.14 years of age on average. The mean hospital stay after operation was 4 days and fracture union time was 9.57 weeks. There were 3 cases of varus angulation, 2 cases of anterior angulation, and 4 cases of limb lengthening. Patients aged between 5 and 13 years treated with flexible intramedullary nail for closed femoral shaft fracture have rapid union and recovery, short rehabilitation period, less immobilization and psychological impact, and cost-effective.

Effects of repeated treatment with MDMA on working memory and behavioural flexibility in mice.

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Viñals, Xavier; Maldonado, Rafael; Robledo, Patricia

2013-03-01

Repeated administration of 3,4-methylenedioxymethamphetamine (MDMA) produces dopaminergic neurotoxicity in mice. However, it is still not clear whether this exposure induces deficits in cognitive processing related to specific subsets of executive functioning. We evaluated the effects of neurotoxic and non-neurotoxic doses of MDMA (0, 3 and 30 mg/kg, twice daily for 4 days) on working memory and attentional set-shifting in mice, and changes in extracellular levels of dopamine (DA) in the striatum. Treatment with MDMA (30 mg/kg) disrupted performance of acquired operant alternation, and this impairment was still apparent 5 days after the last drug administration. Decreased alternation was not related to anhedonia because no differences were observed between groups in the saccharin preference test under similar experimental conditions. Correct responding on delayed alternation was increased 1 day after repeated treatment with MDMA (30 mg/kg), probably because of general behavioural quiescence. Notably, the high dose regimen of MDMA impaired attentional set-shifting related to an increase in total perseveration errors. Finally, basal extracellular levels of DA in the striatum were not modified in mice repeatedly treated with MDMA with respect to controls. However, an acute challenge with MDMA (10 mg/kg) failed to increase DA outflow in mice receiving the highest MDMA dose (30 mg/kg), corroborating a decrease in the functionality of DA transporters. Seven days after this treatment, the effects of MDMA on DA outflow were recovered. These results suggest that repeated neurotoxic doses of MDMA produce lasting impairments in recall of alternation behaviour and reduce cognitive flexibility in mice. © 2012 The Authors, Addiction Biology © 2012 Society for the Study of Addiction.

Interventions to treat mental disorders during pregnancy: A systematic review and multiple treatment meta-analysis.

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Leontien M van Ravesteyn

Full Text Available For women suffering from an antepartum mental disorder (AMD, there is lack of evidence-based treatment algorithms due to the complicated risk-benefit analysis for both mother and unborn child. We aimed to provide a comprehensive overview of pharmacological and non-pharmacological interventions to treat AMD and performed a meta-analysis of the estimated treatment effect on the psychiatric symptoms during pregnancy.MedLine, PsycINFO and Embase databases were searched by two independent reviewers for clinical trials with a control condition on treatment of women with AMD, i.e. major depressive (MDD, anxiety, psychotic, eating, somatoform and personality disorders. We inventoried the effect of the treatment, i.e. decrease of psychiatric symptoms at the end of the treatment or postpartum. We adhered to the PRISMA-protocol.Twenty-nine trials were found involving 2779 patients. Trials studied patients with depressive disorders (k = 28, and anxiety disorders (k = 1. No pharmacological trials were detected. A form of psychotherapy, like Cognitive Behavioural Therapy (g = -0.61; 95%CI:-0.73 to -0.49, I2 = 0%; k = 7 or Interpersonal Psychotherapy (g = -0.67; 95%CI:-1.27 to -0.07; I2 = 79%; k = 4, holds robust benefit for pregnant women with MDD. Body-oriented interventions (g = -0.43; 95%CI:-0.61 to -0.25; I2 = 17%; k = 7 and acupuncture (g = -0.43; 95%CI:-0.80 to -0.06; I2 = 0%; k = 2 showed medium sized reduction of depressive symptoms. Bright light therapy (g = -0.59; 95%CI:-1.25 to 0.06; I2 = 0%; k = 2, and food supplements (g = -0.51; 95%CI:-1.02 to 0.01; I2 = 20%; k = 3 did not show significant treatment effects. One study was found on Integrative Collaborative Care.This meta-analysis found a robust moderate treatment effect of CBT for MDD during pregnancy, and to a lesser extent for IPT. As an alternative, positive results were found for body-oriented interventions and acupuncture. No evidence was found for bright light therapy and food supplements

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

Science.gov (United States)

Aust, Birgit; Flyvholm, Mari-Ann

2015-01-01

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

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

Directory of Open Access Journals (Sweden)

Louise Hardman Smith

2015-01-01

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

Review of interventions to reduce ultraviolet tanning: Need for treatments targeting excessive tanning, an emerging addictive behavior.

Science.gov (United States)

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

2017-12-01

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

The treatment of pharyngoesophageal perforation following anterior cervical spine intervention.

Science.gov (United States)

Aslıer, Mustafa; Doğan, Ersoy; Ecevit, Mustafa Cenk; Erdağ, Taner Kemal; Ikiz, Ahmet Omer

2016-06-01

We aimed to investigate the diagnostic and therapeutic approaches in pharyngoesophageal perforation (PEP) following anterior cervical spine intervention (ACSI). We reviewed the records of four patients with PEP after ACSI. Symptoms, physical examination findings, imaging results, treatment, and follow-up characteristics were evaluated. All four patients had undergone ACSI for either cervical trauma or cervical disc herniation with cervical cage reconstruction. Symptoms developed within the first 10 days of the postoperative period in three patients, and in the eighth month in one patient. Mucosal defects were detected during neck exploration in three patients. Reconstruction with primary suture and a local muscle flap was utilized in two patients. Three patients were discharged 3-8 weeks after surgical treatment. In cases of PEP after ACSI, a good prognosis can be achieved when symptoms are detected in the early period and reconstruction with local muscle flap is applied. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Organizational-skills interventions in the treatment of ADHD.

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Langberg, Joshua M; Epstein, Jeffery N; Graham, Amanda J

2008-10-01

Children with attention-deficit/hyperactivity disorder (ADHD) often experience problems with temporal and materials organization. These difficulties remain prominent throughout development. For children, organizational problems are most apparent in the school setting and result in impairments such as lost and forgotten homework assignments and inadequate planning for tests. Temporal aspects of organization tend to be most salient for adults with ADHD and manifest as procrastination and missed appointments and deadlines. Skills and strategy training interventions have been developed to address the organizational problems of children and adults with ADHD. Patients are taught systems for managing their time and materials more effectively. Contingency management is often used in conjunction with organizational skills training to promote the use of organizational skills and their generalization. Organizational skills interventions have been evaluated as standalone interventions and part of multicomponent interventions for children, adolescents and adults with ADHD. These interventions are associated with significant improvements in the organization of materials, homework management, time management and planning. There is also some evidence to suggest that organizational improvements lead to reductions in ADHD symptoms and gains in academic functioning. Additional research using randomized controlled research designs and long-term follow-up evaluation is necessary before organizational interventions may be considered established evidence-based interventions for patients with ADHD.

Factors affecting ambulance utilization for asthma attack treatment: understanding where to target interventions.

Science.gov (United States)

Raun, L H; Ensor, K B; Campos, L A; Persse, D

2015-05-01

Asthma is a serious, sometimes fatal condition, in which attacks vary in severity, potentially requiring emergency medical services (EMS) ambulance treatment. A portion of asthma attacks requiring EMS ambulance treatment may be prevented with improved education and access to care. The aim of this study was to identify areas of the city with high rates of utilization of EMS ambulance for treatment, and the demographics, socio-economic status, and time of day associated with these rates, to better target future interventions to prevent emergencies and reduce cost. A cross-sectional study was conducted on individuals in Houston, TX (USA) requiring ambulance treatment for asthma attacks from 2004 to 2011. 12,155 EMS ambulance-treated asthma attack cases were linked to census tracts. High rate treatment areas were identified with geospatial mapping. Census tract demographic characteristics of these high rate areas were compared with the remainder of the city using logistic regression. The association between case level demographics and the time of day of asthma attack within the high rate area was also assessed with logistic regression. EMS ambulance-treated high rate areas were identified and found to have a utilization incidence rate over six times higher per 100,000 people than the remainder of the city. There is an increased risk of location in this high rate area with a census tract level increase of percent of population: earning less than $10,000 yearly income (RR 1.21, 1.16-1.26), which is black (RR 1.08, 1.07-1.10), which is female (RR 1.34, 1.20-1.49) and have obtained less than a high school degree (RR 1.02, 1.01-1.03). Within the high rate area, case level data indicates an increased risk of requiring an ambulance after normal doctor office hours for men compared with women (RR 1.13, 1.03-1.22), for black compared with Hispanic ethnicity (RR 1.31, 1.08-1.59), or for adults (less than 41 and greater than 60) compared with children. Interventions to prevent

Dynamic Model of a Rotating Flexible Arm-Flexible Root Mechanism Driven by a Shaft Flexible in Torsion

Directory of Open Access Journals (Sweden)

S.Z. Ismail

2006-01-01

Full Text Available This paper presents a dynamic model of a rotating flexible beam carrying a payload at its tip. The model accounts for the driving shaft and the arm root flexibilities. The finite element method and the Lagrangian dynamics are used in deriving the equations of motion with the small deformation theory assumptions and the Euler-Bernoulli beam theory. The obtained model is a nonlinear-coupled system of differential equations. The model is simulated for different combinations of shaft and root flexibilities and arm properties. The simulation results showed that the root flexibility is an important factor that should be considered in association with the arm and shaft flexibilities, as its dynamics influence the motor motion. Moreover, the effect of system non-linearity on the dynamic behavior is investigated by simulating the equivalent linearized system and it was found to be an important factor that should be considered, particularly when designing a control strategy for practical implementation.

Psychological flexibility and catastrophizing as associated change mechanisms during online Acceptance & Commitment Therapy for chronic pain

NARCIS (Netherlands)

Trompetter, H.R.; Bohlmeijer, Ernst Thomas; Fox, Gerardus J.A.; Schreurs, Karlein Maria Gertrudis

2015-01-01

The underlying mechanisms of the effectiveness of cognitive behavioural interventions for chronic pain need further clarification. The role of, and associations between, pain-related psychological flexibility (PF) and pain catastrophizing (PC) were examined during a randomized controlled trial on

Pediatric interventional radiology: vascular interventions

International Nuclear Information System (INIS)

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

2016-01-01

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

Treatment of Aphasia Combining Neuromodulation and Behavioral Intervention: Taking an Impairment and Functional Approach

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Elizabeth E. Galletta

2014-04-01

Baseline measures of naming nouns and verbs in single words, and sentences, were obtained. While there was no improvement in production of nouns or verbs in single words or sentence production after sham tDCS, and no improvement of noun production after anodal tDCS and speech-language treatment, production of verbs in sentences improved after a 10-session treatment block of anodal tDCS and behavioral therapy. Conclusion Administering a behavioral treatment that is impairment-based as well as functionally-based in conjunction with tDCS is both feasible and promising. Anodal tDCS in conjunction with behavioral intervention is a treatment approach that warrants continued investigation. The results will be discussed in relation to the tDCS and aphasia literature.

The Effects of Cryotherapy and PNF Stretching Techniques on Hip Extensor Flexibility in Elderly Females.

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Rosenberg, Beth S.; And Others

1990-01-01

Study determined whether three proprioceptive neuromuscular facilitation flexibility maneuvers (to increase hamstring length) were as effective in 31 older females as in younger subjects. Cryotherapy intervention was also employed. Results indicated contract-relax and slow-reversal-hold-relax procedures were superior to static stretching;…

Integrated Specialized Early-Course Psychosis Treatment Services - University Psychiatric Hospital Vrapce Model.

Science.gov (United States)

Ostojić, DraŽenka; Čulo, Ilaria; Silić, Ante; Kos, Suzana; Savić, Aleksandar

2018-06-01

First episode of psychosis presents a critical period in terms of numerous associated risks, but also possibilities for effective therapeutic interventions. There is a continued focus on early interventions in prodromal states and early course of frank psychosis, aimed at ensuring faster remission, reducing relapses, achieving better long-term functioning, and preventing adverse outcomes linked to untreated psychosis and chronic psychotic disorders. A number of different specialized treatment models and services exist trying to close knowledge gaps and provide clinical interventions to first-episode psychosis (FEP) patients, but there is still no generally accepted standard of care informing our every-day practice. FEP and early-course psychosis specialized treatment model developed in 2004 in University Psychiatric Hospital Vrapce rests on integration of care across different organization units and clinical presentation acuity levels and patient needs (intensive care, FEP inpatient unit, FEP outpatient services including day hospital). Such integration of FEP services allows for flexible entry point on multiple levels, earlier structuring of therapeutic alliance for those requiring inpatient care, reduction of risks associated with FEP, quicker formation of long-term treatment plans, reduction of delay in accessing specialized services, and a more coordinated diagnostic process and recruitment of FEP patient population. Detailed evaluations of outcomes and comparisons with different treatment models are necessary in order to assess strengths and weaknesses of each specific model and inform modifications to current practice models.

Global Sourcing Flexibility

DEFF Research Database (Denmark)

Ørberg Jensen, Peter D.; Petersen, Bent

2013-01-01

the higher costs (but decreased risk for value chain disruption) embedded in a more flexible global sourcing model that allows the firm to replicate and/or relocate activities across multiple locations. We develop a model and propositions on facilitating and constraining conditions of global sourcing...... sourcing flexibility. Here we draw on prior research in the fields of organizational flexibility, international business and global sourcing as well as case examples and secondary studies. In the second part of the paper, we discuss the implications of global sourcing flexibility for firm strategy...... and operations against the backdrop of the theory-based definition of the construct. We discuss in particular the importance of global sourcing flexibility for operational performance stability, and the trade-off between specialization benefits, emerging from location and service provider specialization, versus...

Timing-based business models for flexibility creation in the electric power sector

International Nuclear Information System (INIS)

Helms, Thorsten; Loock, Moritz; Bohnsack, René

2016-01-01

Energy policies in many countries push for an increase in the generation of wind and solar power. Along these developments, the balance between supply and demand becomes more challenging as the generation of wind and solar power is volatile, and flexibility of supply and demand becomes valuable. As a consequence, companies in the electric power sector develop new business models that create flexibility through activities of timing supply and demand. Based on an extensive qualitative analysis of interviews and industry research in the energy industry, the paper at hand explores the role of timing-based business models in the power sector and sheds light on the mechanisms of flexibility creation through timing. In particular we distill four ideal-type business models of flexibility creation with timing and reveal how they can be classified along two dimensions, namely costs of multiplicity and intervention costs. We put forward that these business models offer ‘coupled services’, combining resource-centered and service-centered perspectives. This complementary character has important implications for energy policy. - Highlights: •Explores timing-based business models providing flexibility in the energy industry. •Timing-based business models can be classified on two dimensions. •Timing-based business models offer ‘coupled services’. • ‘Coupled services’ couple timing as a service with supply- or demand side valuables. •Policy and managerial implications for energy market design.

Immediate Effects of Neurodynamic Sliding versus Muscle Stretching on Hamstring Flexibility in Subjects with Short Hamstring Syndrome

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Yolanda Castellote-Caballero

2014-01-01

Full Text Available Background. Hamstring injuries continue to affect active individuals and although inadequate muscle extensibility remains a commonly accepted factor, little is known about the most effective method to improve flexibility. Purpose. To determine if an isolated neurodynamic sciatic sliding technique would improve hamstring flexibility to a greater degree than stretching or a placebo intervention in asymptomatic subjects with short hamstring syndrome (SHS. Study Design. Randomized double-blinded controlled trial. Methods. One hundred and twenty subjects with SHS were randomized to 1 of 3 groups: neurodynamic sliding, hamstring stretching, and placebo control. Each subject’s dominant leg was measured for straight leg raise (SLR range of motion (ROM before and after interventions. Data were analyzed with a 3×2 mixed model ANOVA followed by simple main effects analyses. Results. At the end of the study, more ROM was observed in the Neurodynamic and Stretching groups compared to the Control group and more ROM in the Neurodynamic group compared to Stretching group. Conclusion. Findings suggest that a neurodynamic sliding technique will increase hamstring flexibility to a greater degree than static hamstring stretching in healthy subjects with SHS. Clinical Relevance. The use of neurodynamic sliding techniques to improve hamstring flexibility in sports may lead to a decreased incidence in injuries; however, this needs to be formally tested.

Can reinforcement-based interventions to reduce drug use successfully be adapted to routine opioid maintenance treatment?

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Michael Specka

2013-12-01

Full Text Available INTRODUCTION: Comorbid substance related disorders are a major health problem for patients in opioid maintenance treatment (OMT. It was investigated whether a reinforcement scheme adapted to the regulatory and financial restrictions of routine treatment reduces concomitant drug use. METHODS: OMT patients from 7 clinics who were using cocaine, benzodiazepines, heroin or amphetamines were randomly allocated to either treatment as usual (n = 64 or treatment with an additional escalating reinforcement scheme (n = 72 in which a patient's number of weekly take-home dosages was increased after 1, 4, 8 and 12 consecutive weeks with drug-free urine specimens. Trial duration was 26 weeks. RESULTS: Completion rates were 64% for controls and 62.5% in the experimental group. Mean number of drug-free weeks was 11.3 (SD 8.5 for the control group and 9.8 (8.9 for the experimental group (p = 0.30. CONCLUSION: The intervention was not effective compared to routine treatment. Additional features might be necessary to achieve an effect, e.g. a higher frequency of urine sampling or use of other reinforcers. It has to be further investigated how interventions which have been proven effective in experimental studies can successfully be adapted to routine care conditions.

Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review.

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Lee, Eleanor W; Denison, Fiona C; Hor, Kahyee; Reynolds, Rebecca M

2016-02-29

Perinatal depression is strikingly common with a prevalence of 10-15%. The adverse effects of perinatal depression on maternal and child health are profound with considerable costs. Despite this, few women seek medical attention. E-health, providing healthcare via the Internet is an accessible and effective solution for the treatment of depression in the general population. We aimed to conduct a systematic review of web-based interventions for the prevention and treatment of mood disorders in the perinatal period, defined as the start of pregnancy to 1 year post-partum. Six databases were searched until 26(th) March 2015. Two researchers independently screened articles for eligibility. Of the 547 screened articles, four met the inclusion criteria. These included three randomised-controlled trials and one feasibility trial, with total data from 1274 participants. MOOSE and PRISMA guidelines were adhered to for the conduct and reporting of the systematic review. All studies were conducted in the post-partum period. All reported an improvement in maternal mood following intervention. A significant improvement in depressive symptoms was measured using validated rating scales, such as the Edinburgh Postnatal Depression Scale (EPDS), either at post-treatment or follow-up which ranged from 3 to 12 months post study completion. For the two RCTs utilising the EPDS, the EPDS score reductions were (mean ± SEM) 8.52 ± 0.22 (Range 19.46 to10.94) and 9.19 ± 0.63 (Range, 20.24 to 11.05) for treatment groups and 5.16 ± 0.25 (Range 19.44 to 14.28) and 6.81 ± 0.71 (Range 21.07 to 14.26) for comparator groups. However attrition within studies ranged from 13 to 61%. One study was rated as 'good' quality. Preliminary data suggests web-based therapies for perinatal depression delivered in the post-partum period may play a role in improving maternalmood but more studies are needed, particularly with interventions delivered antenatally. Further research is needed

Effect of dietary intervention and lipid-lowering treatment on brachial vasoreactivity in patients with ischemic heart disease and hypercholesterolemia

DEFF Research Database (Denmark)

Søndergaard, Eva; Møller, Jacob E; Egstrup, Kenneth

2003-01-01

BACKGROUND: The "Mediterranean" diet and statin treatment have both independently been shown to improve survival and reduce the risk of cardiovascular events in patients with ischemic heart disease (IHD), but no studies have evaluated the effect of this combination on endothelial function. We...... factors and vessel size (P =.02; beta = -2.66 [-4.91; -0.41]). CONCLUSION: Dietary intervention with the Mediterranean diet and statin treatment improve FMD in the brachial artery in patients with IHD and hypercholesterolemia to a greater degree than statin treatment alone....... therefore sought to evaluate the effect of the combination dietary intervention and lipid-lowering treatment on brachial vasoreactivity. METHODS: A total of 131 consecutive patients with documented IHD and a serum cholesterol level > or =5 mmol/L (193 mg/dL) were randomized to receive Mediterranean dietary...

An intervention program to promote health-related physical fitness in nurses.

Science.gov (United States)

Yuan, Su-Chuan; Chou, Ming-Chih; Hwu, Lien-Jen; Chang, Yin-O; Hsu, Wen-Hsin; Kuo, Hsien-Wen

2009-05-01

To assess the effects of exercise intervention on nurses' health-related physical fitness. Regular exercise that includes gymnastics or aerobics has a positive effect on fitness. In Taiwan, there are not much data which assess the effects of exercise intervention on nurses' health-related physical fitness. Many studies have reported the high incidence of musculoskeletal disorders (MSDs) in nurses However, there has been limited research on intervention programs that are designed to improve the general physical fitness of nurses. A quasi-experimental study was conducted at a medical centre in central Taiwan. Ninety nurses from five different units of a hospital volunteered to participate in this study and participated in an experimental group and a control group. The experimental group engaged in a three-month intervention program consisting of treadmill exercise. Indicators of the health-related physical fitness of both groups were established and assessed before and after the intervention. Before intervention, the control group had significantly better grasp strength, flexibility and durability of abdominal muscles than the experimental group (p work duration, regular exercise and workload and found that the experimental group performed significantly better (p flexibility, durability of abdominal and back muscles and cardiopulmonary function. This study demonstrates that the development and implementation of an intervention program can promote and improve the health-related physical fitness of nurses. It is suggested that nurses engage in an exercise program while in the workplace to lower the risk of MSDs and to promote working efficiency.

Mapping the Barriers and Facilitators of HCV Treatment Initiation in Methadone Maintenance Therapy Patients: Implications for Intervention Development.

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Bass, Sarah Bauerle; Jessop, Amy; Maurer, Laurie; Gashat, Muhamed; Al Hajji, Mohammed; Gutierrez, Mercedes

2018-01-01

An estimated 70-90% of current methadone users have Hepatitis C (HCV). Current treatments have few side effects and can cure infection in 8-12 weeks, but less than 10% of methadone patients initiate treatment. Engaging this group in treatment is an important strategy to lower both morbidity and mortality from liver disease and eliminate a significant reservoir of HCV in communities. To understand how to address this treatment gap we used commercial marketing techniques called perceptual mapping and vector message modeling to analyze survey data from 100 HCV+ methadone patients from four centers in Philadelphia. Results were used to understand barriers and facilitators to treatment initiation and to devise targeted message strategies to adapt to a mobile health communication intervention. Results indicate that focusing on how treatment can make one feel "in charge", positive interactions with healthcare providers, the positive attributes of the new vs. old HCV treatments, and providing strategies to address tangible barriers to getting treatment, would be important to address in a communication intervention. These marketing methods allow for focusing on specific variables to "move" the group toward a treatment decision, making them an innovative technique to use in developing highly targeted health communication messages.

Pharmacological interventions in the treatment of the acute effects of cannabis: a systematic review of literature

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Crippa José AS

2012-01-01

Full Text Available Abstract Background Cannabis intoxication is related to a number of physical and mental health risks with ensuing social costs. However, little attention has been given to the investigation of possible pharmacological interactions in this condition. Objective To review the available scientific literature concerning pharmacological interventions for the treatment of the acute effects of cannabis. Methods A search was performed on the Pubmed, Lilacs, and Scielo online databases by combining the terms cannabis, intoxication, psychosis, anxiety, and treatment. The articles selected from this search had their reference lists checked for additional publications related to the topic of the review. Results The reviewed articles consisted of case reports and controlled clinical trials and are presented according to interventions targeting the physiological, psychiatric, and cognitive symptoms provoked by cannabis. The pharmacological interventions reported in these studies include: beta-blockers, antiarrhythmic agents, antagonists of CB-1 and GABA-benzodiazepine receptors, antipsychotics, and cannabidiol. Conclusion Although scarce, the evidence on pharmacological interventions for the management of cannabis intoxication suggests that propanolol and rimonabant are the most effective compounds currently available to treat the physiological and subjective effects of the drug. Further studies are necessary to establish the real effectiveness of these two medications, as well as the effectiveness of other candidate compounds to counteract the effects of cannabis intoxication, such as cannabidiol and flumazenil.

Implementing trials of complex interventions in community settings: the USC-Rancho Los Amigos pressure ulcer prevention study (PUPS).

Science.gov (United States)

Clark, Florence; Pyatak, Elizabeth A; Carlson, Mike; Blanche, Erna Imperatore; Vigen, Cheryl; Hay, Joel; Mallinson, Trudy; Blanchard, Jeanine; Unger, Jennifer B; Garber, Susan L; Diaz, Jesus; Florindez, Lucia I; Atkins, Michal; Rubayi, Salah; Azen, Stanley Paul

2014-04-01

Randomized trials of complex, non-pharmacologic interventions implemented in home and community settings, such as the University of Southern California (USC)-Rancho Los Amigos National Rehabilitation Center (RLANRC) Pressure Ulcer Prevention Study (PUPS), present unique challenges with respect to (1) participant recruitment and retention, (2) intervention delivery and fidelity, (3) randomization and assessment, and (4) potential inadvertent treatment effects. We describe the methods employed to address the challenges confronted in implementing PUPS. In this randomized controlled trial, we are assessing the efficacy of a complex, preventive intervention in reducing the incidence of, and costs associated with, the development of medically serious pressure ulcers in people with spinal cord injury. Individuals with spinal cord injury recruited from RLANRC were assigned to either a 12-month preventive intervention group or a standard care control group. The primary outcome is the incidence of serious pressure ulcers with secondary endpoints including ulcer-related surgeries, medical treatment costs, and quality of life. These outcomes are assessed at 12 and 24 months after randomization. Additionally, we are studying the mediating mechanisms that account for intervention outcomes. PUPS has been successfully implemented, including recruitment of the target sample size of 170 participants, assurance of the integrity of intervention protocol delivery with an average 90% treatment adherence rate, and enactment of the assessment plan. However, implementation has been replete with challenges. To meet recruitment goals, we instituted a five-pronged approach customized for an underserved, ethnically diverse population. In intervention delivery, we increased staff time to overcome economic and cultural barriers to retention and adherence. To ensure treatment fidelity and replicability, we monitored intervention protocol delivery in accordance with a rigorous plan. Finally, we

Conflicting flexibility

NARCIS (Netherlands)

De Jong, P.; Schaap, A.

2011-01-01

New buildings are designed for first users. For a sustainable approach there are many advantages in designing in flexibility and adjustability in order to enable and facilitate the other sequential users. For the first investor this flexibility is translated into improved exit values due to

Effectiveness of the Costa Rican Central Bank forex intervention

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Julio César Espinoza Rodríguez

2016-03-01

Full Text Available This paper represents an empirical approach to assess the effectiveness of foreign exchange interventions following the criteria by K. Domínguez (1998 using a GARCH model based on the work by C. Broto (2012. Analyses are conducted to evaluate the FOREX rules of intervention followed by the BCCR, and the probability of occurrence of an intervention is estimated using a LOGIT model.  In addition, the paper attempts to analyze what happened to the exchange arrangements applied in Costa Rica as a result of the 2006 exchange rate flexibility and transition to inflation targets.

Three-Year Outcomes of Bariatric Surgery vs Lifestyle Intervention for Type 2 Diabetes Mellitus Treatment: A Randomized Clinical Trial.

Science.gov (United States)

Courcoulas, Anita P; Belle, Steven H; Neiberg, Rebecca H; Pierson, Sheila K; Eagleton, Jessie K; Kalarchian, Melissa A; DeLany, James P; Lang, Wei; Jakicic, John M

2015-10-01

Questions remain about the role and durability of bariatric surgery for type 2 diabetes mellitus (T2DM). To compare the remission of T2DM following surgical and nonsurgical treatments. In this 3-arm randomized clinical trial conducted at the University of Pittsburgh Medical Center from October 1, 2009, to June 26, 2014, in Pittsburgh, Pennsylvania, outcomes were assessed 3 years after treating 61 obese participants aged 25 to 55 years with T2DM. Analysis was conducted with an intent-to-treat population. Participants were randomized to either an intensive lifestyle weight loss intervention for 1 year followed by a low-level lifestyle intervention for 2 years or surgical treatments (Roux-en-Y gastric bypass [RYGB] or laparoscopic adjustable gastric banding [LAGB]) followed by low-level lifestyle intervention in years 2 and 3. Primary end points were partial and complete T2DM remission and secondary end points included diabetes medications and weight change. Body mass index (calculated as weight in kilograms divided by height in meters squared) was less than 35 for 26 participants (43%), 50 (82%) were women, and 13 (21%) were African American. Mean (SD) values were 100.5 (13.7) kg for weight, 47.3 (6.6) years for age, 7.8% (1.9%) for hemoglobin A1c level, and 171.3 (72.5) mg/dL for fasting plasma glucose level. Partial or complete T2DM remission was achieved by 40% (n = 8) of RYGB, 29% (n = 6) of LAGB, and no intensive lifestyle weight loss intervention participants (P = .004). The use of diabetes medications was reduced more in the surgical groups than the lifestyle intervention-alone group, with 65% of RYGB, 33% of LAGB, and none of the intensive lifestyle weight loss intervention participants going from using insulin or oral medication at baseline to no medication at year 3 (P lifestyle treatment at 5.7% (2.4%) (P lifestyle intervention resulted in more disease remission than did lifestyle intervention alone. clinicaltrials.gov Identifier: NCT

Usefulness of flexible covered stent in malignant colorectal obstruction

Energy Technology Data Exchange (ETDEWEB)

Kang, Jee Hee; Kang, Sung Gwon; Kim, Hyung Jin; Noh, Hong Gi; Woo, Jae Hong; Suh, Chang Hae [Inha Univ. Hospital, Inchon (Korea, Republic of)

1998-07-01

To evaluate the usefulness of flexible covered stent in the treatment of acute colorectal obstruction secondary to colorectal carcinoma. Materials and Methods : Flexible covered stents were placed in 11 patients with clinical and radiologic signs of acute colonic obstruction secondary to colorectal carcinoma. The purposes of stent insertion were pre-operative bowel preparation in seven patients and palliative treatment in four. A fistula was present in two;in one this was between the proximal jejunum and colon, and the other was rectovaginal. The usefulness of stent insertion for the purpose of preoperative bowel preparation was evaluated according to the feasibility and status of bowel preparation, as decided by the operator. Palliative treatment for the relief of symptoms of acute bowel obstruction was evaluated according to the number and amount of defecation,bowel dilatation in simple abdomen radiography, and the presence of complications. Results : Bowel preparation for the purpose of preoperative bowel cleansing was easy in seven patients;the fecal materials remaining in the colon presented no problems during surgery. In one of four patients palliative treatment involved a colostomy;this was due to recurrent stent obstruction by fecal materials after three months, and in two other patients there was stent obstruction after two and five months, respectively. The stent in one of four patients who underwent palliative treatment was removed because of stent migration three days after insertion;the stents in two patients with fistulas covered the fistulas successfully. Complications after stent insertion were anal pain in three patients, anal bleeding in three and stent migration in one. Conclusion : The flexible covered stent was an effective device for the relief of acute colonic obstruction secondary to malignant rectosigmoid neoplasia. It allowed for single-stage operation and covered the fistula. We believe however that for further evaluation of the

Inter-vertebral flexibility of the ostrich neck: implications for estimating sauropod neck flexibility.

Science.gov (United States)

Cobley, Matthew J; Rayfield, Emily J; Barrett, Paul M

2013-01-01

The flexibility and posture of the neck in sauropod dinosaurs has long been contentious. Improved constraints on sauropod neck function will have major implications for what we know of their foraging strategies, ecology and overall biology. Several hypotheses have been proposed, based primarily on osteological data, suggesting different degrees of neck flexibility. This study attempts to assess the effects of reconstructed soft tissues on sauropod neck flexibility through systematic removal of muscle groups and measures of flexibility of the neck in a living analogue, the ostrich (Struthio camelus). The possible effect of cartilage on flexibility is also examined, as this was previously overlooked in osteological estimates of sauropod neck function. These comparisons show that soft tissues are likely to have limited the flexibility of the neck beyond the limits suggested by osteology alone. In addition, the inferred presence of cartilage, and varying the inter-vertebral spacing within the synovial capsule, also affect neck flexibility. One hypothesis proposed that flexibility is constrained by requiring a minimum overlap between successive zygapophyses equivalent to 50% of zygapophyseal articular surface length (ONP50). This assumption is tested by comparing the maximum flexibility of the articulated cervical column in ONP50 and the flexibility of the complete neck with all tissues intact. It is found that this model does not adequately convey the pattern of flexibility in the ostrich neck, suggesting that the ONP50 model may not be useful in determining neck function if considered in isolation from myological and other soft tissue data.

Inter-vertebral flexibility of the ostrich neck: implications for estimating sauropod neck flexibility.

Directory of Open Access Journals (Sweden)

Matthew J Cobley

Full Text Available The flexibility and posture of the neck in sauropod dinosaurs has long been contentious. Improved constraints on sauropod neck function will have major implications for what we know of their foraging strategies, ecology and overall biology. Several hypotheses have been proposed, based primarily on osteological data, suggesting different degrees of neck flexibility. This study attempts to assess the effects of reconstructed soft tissues on sauropod neck flexibility through systematic removal of muscle groups and measures of flexibility of the neck in a living analogue, the ostrich (Struthio camelus. The possible effect of cartilage on flexibility is also examined, as this was previously overlooked in osteological estimates of sauropod neck function. These comparisons show that soft tissues are likely to have limited the flexibility of the neck beyond the limits suggested by osteology alone. In addition, the inferred presence of cartilage, and varying the inter-vertebral spacing within the synovial capsule, also affect neck flexibility. One hypothesis proposed that flexibility is constrained by requiring a minimum overlap between successive zygapophyses equivalent to 50% of zygapophyseal articular surface length (ONP50. This assumption is tested by comparing the maximum flexibility of the articulated cervical column in ONP50 and the flexibility of the complete neck with all tissues intact. It is found that this model does not adequately convey the pattern of flexibility in the ostrich neck, suggesting that the ONP50 model may not be useful in determining neck function if considered in isolation from myological and other soft tissue data.

eHealth interventions for the prevention and treatment of overweight and obesity in adults: a systematic review with meta-analysis.

Science.gov (United States)

Hutchesson, M J; Rollo, M E; Krukowski, R; Ells, L; Harvey, J; Morgan, P J; Callister, R; Plotnikoff, R; Collins, C E

2015-05-01

A systematic review of randomized controlled trials was conducted to evaluate the effectiveness of eHealth interventions for the prevention and treatment of overweight and obesity in adults. Eight databases were searched for studies published in English from 1995 to 17 September 2014. Eighty-four studies were included, with 183 intervention arms, of which 76% (n = 139) included an eHealth component. Sixty-one studies had the primary aim of weight loss, 10 weight loss maintenance, eight weight gain prevention, and five weight loss and maintenance. eHealth interventions were predominantly delivered using the Internet, but also email, text messages, monitoring devices, mobile applications, computer programs, podcasts and personal digital assistants. Forty percent (n = 55) of interventions used more than one type of technology, and 43.2% (n = 60) were delivered solely using eHealth technologies. Meta-analyses demonstrated significantly greater weight loss (kg) in eHealth weight loss interventions compared with control (MD -2.70 [-3.33,-2.08], P eHealth weight loss interventions with extra components or technologies (MD 1.46 [0.80, 2.13], P eHealth programmes. The findings support the use of eHealth interventions as a treatment option for obesity, but there is insufficient evidence for the effectiveness of eHealth interventions for weight loss maintenance or weight gain prevention. © 2015 World Obesity.

Treatment Effects of a Primary Care Intervention on Parenting Behaviors: Sometimes It's Relative.

Science.gov (United States)

Shaffer, Anne; Lindhiem, Oliver; Kolko, David

2017-04-01

The goal of this brief report is to demonstrate the utility of quantifying parental discipline practices as relative frequencies in measuring changes in parenting behavior and relations to child behavior following intervention. We explored comparisons across methodological approaches of assessing parenting behavior via absolute and relative frequencies in measuring improvements in parent-reported disciplinary practices (increases in positive parenting practices in response to child behavior; decreases in inconsistent discipline and use of corporal punishment) and child behavior problems. The current study was conducted as part of a larger clinical trial to evaluate the efficacy of a collaborative care intervention for behavior problems, ADHD, and anxiety in pediatric primary care practices (Doctor Office Collaborative Care; DOCC). Participants were 321 parent-child dyads (M child age = 8.00, 65 % male children) from eight pediatric practices that were cluster randomized to DOCC or enhanced usual care (EUC). Parents reported on their own discipline behaviors and child behavior problems. While treatment-related decreases in negative parenting were found using both the absolute and relative frequencies of parenting behaviors, results were different for positive parenting behaviors, which showed decreases when measured as absolute frequencies but increases when measured as relative frequencies. In addition, positive parenting was negatively correlated with child behavior problems when using relative frequencies, but not absolute frequencies, and relative frequencies of positive parenting mediated relations between treatment condition and outcomes. Our findings indicate that the methods used to measure treatment-related change warrant careful consideration.

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

Science.gov (United States)

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

2017-11-01

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

Robust path planning for flexible needle insertion using Markov decision processes.

Science.gov (United States)

Tan, Xiaoyu; Yu, Pengqian; Lim, Kah-Bin; Chui, Chee-Kong

2018-05-11

Flexible needle has the potential to accurately navigate to a treatment region in the least invasive manner. We propose a new planning method using Markov decision processes (MDPs) for flexible needle navigation that can perform robust path planning and steering under the circumstance of complex tissue-needle interactions. This method enhances the robustness of flexible needle steering from three different perspectives. First, the method considers the problem caused by soft tissue deformation. The method then resolves the common needle penetration failure caused by patterns of targets, while the last solution addresses the uncertainty issues in flexible needle motion due to complex and unpredictable tissue-needle interaction. Computer simulation and phantom experimental results show that the proposed method can perform robust planning and generate a secure control policy for flexible needle steering. Compared with a traditional method using MDPs, the proposed method achieves higher accuracy and probability of success in avoiding obstacles under complicated and uncertain tissue-needle interactions. Future work will involve experiment with biological tissue in vivo. The proposed robust path planning method can securely steer flexible needle within soft phantom tissues and achieve high adaptability in computer simulation.

Process and Product in Cross-Cultural Treatment Research: Development of a Culturally Sensitive Women-Centered Substance Use Intervention in Georgia

Directory of Open Access Journals (Sweden)

Hendrée E. Jones

2014-01-01

Full Text Available Women who inject drugs (WID are highly marginalized and stigmatized and experience ongoing discrimination in Georgia. Few opportunities exist for WID to receive publicly funded treatment for substance use disorders. The IMEDI (Investigating Methods for Enhancing Development in Individuals project was developed in response to the need for women-specific and women-centered treatment services. This paper described our approach to understanding the Georgian culture—and WID within that culture—so that we could integrate two interventions for substance use found effective in other Western and non-Western cultures and to outline how we refined and adapted our integrated intervention to yield a comprehensive women-centered intervention for substance use. Reinforcement Based Treatment (RBT and the Women’s CoOp (WC were adapted and refined based on in-depth interviews with WID (N=55 and providers of health services (N=34 to such women and focus groups [2 with WID (N=15 and 2 with health service providers (N=12]. The resulting comprehensive women-centered intervention, RBT+WC, was then pretested and further refined in a sample of 20 WID. Results indicated positive pre-post changes in urine screening results and perceived needs for both RBT+WC and a case management control condition. The approach to treatment adaptation and the revised elements of RBT+WC are presented and discussed.

Partial Treatment Requests and Underlying Motives of Applicants for Gender Affirming Interventions.

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Beek, Titia F; Kreukels, Baudewijntje P C; Cohen-Kettenis, Peggy T; Steensma, Thomas D

2015-11-01

Historically, only individuals with a cross-gender identity who wanted to receive a full treatment, were eligible for "complete sex reassignment" consisting of feminizing/masculinizing hormone treatment and several surgical interventions including genital surgery (full treatment). Currently, it is unclear what motives underlie a request for hormones only or surgery only or a combination of hormones and surgery (e.g., a mastectomy), but no genital surgery (partial treatment). The aims of this study were (i) to describe treatment requests of applicants at a specialized gender identity clinic in the Netherlands; and (ii) to explore the motives underlying a partial treatment request, including the role of (non-binary) gender identity. Information was collected on all 386 adults who applied for treatment at the Center of Expertise on Gender Dysphoria of the VU University Medical Center in Amsterdam, the Netherlands, in the year 2013. Treatment requests were available for 360 individuals: 233 natal men (64.7%) and 127 natal women (35.3%). Treatment requests were systematically collected during assessment. Individuals were classified as either desiring a full or partial treatment. The motives behind a partial treatment request were collected and categorized as well. The majority of applicants at our gender identity clinic requested full treatment. Among those who requested partial treatment, the most reported underlying motive was surgical risks/outcomes. Only a small number of applicants requested partial treatment to bring their body into alignment with their non-binary gender identity. It becomes clear that partial treatment is requested by a substantial number of applicants. This emphasizes the need for gender identity clinics to provide information about the medical possibilities and limitations, and careful introduction and evaluation of non-standard treatment options. © 2015 International Society for Sexual Medicine.

Aptitude-treatment interactions revisited: effect of metacognitive intervention on subtypes of written expression in elementary school students.

Science.gov (United States)

Hooper, Stephen R; Wakely, Melissa B; de Kruif, Renee E L; Swartz, Carl W

2006-01-01

We examined the effectiveness of a metacognitive intervention for written language performance, based on the Hayes model of written expression, for 73 fourth-grade (n = 38) and fifth-grade (n = 35) students. The intervention consisted of twenty 45-min writing lessons designed to improve their awareness of writing as a problem-solving process. Each of the lessons addressed some aspect of planning, translating, and reflecting on written products; their self-regulation of these processes; and actual writing practice. All instruction was conducted in intact classrooms. Prior to the intervention, all students received a battery of neurocognitive tests measuring executive functions, attention, and language. In addition, preintervention writing samples were obtained and analyzed holistically and for errors in syntax, semantics, and spelling. Following the intervention, the writing tasks were readministered and cluster analysis of the neurocognitive data was conducted. Cluster analytic procedures yielded 7 reliable clusters: 4 normal variants, 1 Problem Solving weakness, 1 Problem Solving Language weaknesses, and 1 Problem Solving strength. The response to the single treatment by these various subtypes revealed positive but modest findings. Significant group differences were noted for improvement in syntax errors and spelling, with only spelling showing differential improvement for the Problem Solving Language subtype. In addition, there was a marginally significant group effect for holistic ratings. These findings provide initial evidence that Writing Aptitude (subtype) x Single Treatment interactions exist in writing, but further research is needed with other classification schemes and interventions.

Combination of docetaxel and cisplatin in the interventional treatment of advanced non-small cell lung cancer

International Nuclear Information System (INIS)

He Zhijiang; Liu Yunjun; Li Ezhen

2004-01-01

Objective: To evaluate the efficacy and toxicity of the combination of docetaxel and cisplatin in the interventional treatment of patients with advanced non-small cell lung cancer (NSCLC). Methods: Thirty patients with locally advanced (stage III) or metastatic (stage IV) NSCLC were enrolled into the study. The patients received docetaxel 75 mg/m 2 per day by bronchial artery and vein, and cisplatin 40 mg 2 on day 1-3 of a 21-day cycle. Each patient should complete two cycles. Results: An objective response rate was obtained in 46.7% of 30 patients (one complete and 13 partial response), whereas 10 patients had stable disease and 6 patients were progressive. The response rate was 60% (9/15) in the initial patients, and 33.3% (5/15) in the retreated patients. The main toxicities were leukopenia (26.7% in grade III + IV) and thrombocytopenia (10% in grade III + IV). Conclusion: The combination of docetaxel and cisplatin by interventional treatment is a feasible, well-tolerated and active scheme in the treatment of advanced NSCLC. (authors)

Contingency Management interventions for non-prescribed drug use during treatment for opiate addiction: A systematic review and meta-analysis.

Science.gov (United States)

Ainscough, Tom S; McNeill, Ann; Strang, John; Calder, Robert; Brose, Leonie S

2017-09-01

Use of non-prescribed drugs during treatment for opiate addiction reduces treatment success, creating a need for effective interventions. This review aimed to assess the efficacy of contingency management, a behavioural treatment that uses rewards to encourage desired behaviours, for treating non-prescribed drug use during opiate addiction treatment. A systematic search of the databases Embase, PsychInfo, PsychArticles and Medline from inception to March 2015 was performed. Random effects meta-analysis tested the use of contingency management to treat the use of drugs during opiate addiction treatment, using either longest duration of abstinence (LDA) or percentage of negative samples (PNS). Random effects moderator analyses were performed for six potential moderators: drug targeted for intervention, decade in which the study was carried out, study quality, intervention duration, type of reinforcer, and form of opiate treatment. The search returned 3860 papers; 22 studies met inclusion criteria and were meta-analysed. Follow-up data was only available for three studies, so all analyses used end of treatment data. Contingency management performed significantly better than control in reducing drug use measured using LDA (d=0.57, 95% CI: 0.42-0.72) or PNS (d=0.41) (95% CI: 0.28-0.54). This was true for all drugs other than opiates. The only significant moderator was drug targeted (LDA: Q=10.75, p=0.03). Contingency management appears to be efficacious for treating most drug use during treatment for opiate addiction. Further research is required to ascertain the full effects of moderating variables, and longer term effects. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Pilot study of a social network intervention for heroin users in opiate substitution treatment: study protocol for a randomized controlled trial.

Science.gov (United States)

Day, Edward; Copello, Alex; Seddon, Jennifer L; Christie, Marilyn; Bamber, Deborah; Powell, Charlotte; George, Sanju; Ball, Andrew; Frew, Emma; Freemantle, Nicholas

2013-08-19

Research indicates that 3% of people receiving opiate substitution treatment (OST) in the UK manage to achieve abstinence from all prescribed and illicit drugs within 3 years of commencing treatment, and there is concern that treatment services have become skilled at engaging people but not at helping them to enter a stage of recovery and drug abstinence. The National Treatment Agency for Substance Misuse recommends the involvement of families and wider social networks in supporting drug users' psychological treatment, and this pilot randomized controlled trial aims to evaluate the impact of a social network-focused intervention for patients receiving OST. In this two-site, early phase, randomized controlled trial, a total of 120 patients receiving OST will be recruited and randomized to receive one of three treatments: 1) Brief Social Behavior and Network Therapy (B-SBNT), 2) Personal Goal Setting (PGS) or 3) treatment as usual. Randomization will take place following baseline assessment. Participants allocated to receive B-SBNT or PGS will continue to receive the same treatment that is routinely provided by drug treatment services, plus four additional sessions of either intervention. Outcomes will be assessed at baseline, 3 and 12 months. The primary outcome will be assessment of illicit heroin use, measured by both urinary analysis and self-report. Secondary outcomes involve assessment of dependence, psychological symptoms, social satisfaction, motivation to change, quality of life and therapeutic engagement. Family members (n = 120) of patients involved in the trial will also be assessed to measure the level of symptoms, coping and the impact of the addiction problem on the family member at baseline, 3 and 12 months. This study will provide experimental data regarding the feasibility and efficacy of implementing a social network intervention within routine drug treatment services in the UK National Health Service. The study will explore the impact of the

A control systems engineering approach for adaptive behavioral interventions: illustration with a fibromyalgia intervention.

Science.gov (United States)

Deshpande, Sunil; Rivera, Daniel E; Younger, Jarred W; Nandola, Naresh N

2014-09-01

The term adaptive intervention has been used in behavioral medicine to describe operationalized and individually tailored strategies for prevention and treatment of chronic, relapsing disorders. Control systems engineering offers an attractive means for designing and implementing adaptive behavioral interventions that feature intensive measurement and frequent decision-making over time. This is illustrated in this paper for the case of a low-dose naltrexone treatment intervention for fibromyalgia. System identification methods from engineering are used to estimate dynamical models from daily diary reports completed by participants. These dynamical models then form part of a model predictive control algorithm which systematically decides on treatment dosages based on measurements obtained under real-life conditions involving noise, disturbances, and uncertainty. The effectiveness and implications of this approach for behavioral interventions (in general) and pain treatment (in particular) are demonstrated using informative simulations.

Flexible Carbon Aerogels

Directory of Open Access Journals (Sweden)

Marina Schwan

2016-09-01

Full Text Available Carbon aerogels are highly porous materials with a large inner surface area. Due to their high electrical conductivity they are excellent electrode materials in supercapacitors. Their brittleness, however, imposes certain limitations in terms of applicability. In that context, novel carbon aerogels with varying degree of flexibility have been developed. These highly porous, light aerogels are characterized by a high surface area and possess pore structures in the micrometer range, allowing for a reversible deformation of the aerogel network. A high ratio of pore size to particle size was found to be crucial for high flexibility. For dynamic microstructural analysis, compression tests were performed in-situ within a scanning electron microscope allowing us to directly visualize the microstructural flexibility of an aerogel. The flexible carbon aerogels were found to withstand between 15% and 30% of uniaxial compression in a reversible fashion. These findings might stimulate further research and new application fields directed towards flexible supercapacitors and batteries.

Implementing trials of complex interventions in community settings: The USC – Rancho Los Amigos Pressure Ulcer Prevention Study (PUPS)

Science.gov (United States)

Clark, Florence; Pyatak, Elizabeth A.; Carlson, Mike; Blanche, Erna Imperatore; Vigen, Cheryl; Hay, Joel; Mallinson, Trudy; Blanchard, Jeanine; Unger, Jennifer B.; Garber, Susan L.; Diaz, Jesus; Florindez, Lucia I.; Atkins, Michal; Rubayi, Salah; Azen, Stanley Paul

2014-01-01

Background Randomized trials of complex, non-pharmacologic interventions implemented in home and community settings, such as the University of Southern California (USC)–Rancho Los Amigos National Rehabilitation Center (RLANRC) Pressure Ulcer Prevention Study (PUPS), present unique challenges with respect to: (a) participant recruitment and retention, (b) intervention delivery and fidelity, (c) randomization and assessment, and (d) potential inadvertent treatment effects. Purpose We describe the methods employed to address the challenges confronted in implementing PUPS. In this randomized controlled trial, we are assessing the efficacy of a complex, preventive intervention in reducing the incidence of, and costs associated with, the development of medically serious pressure ulcers in people with spinal cord injury. Method Individuals with spinal cord injury recruited from RLANRC were assigned to either a 12-month preventive intervention group or a standard care control group. The primary outcome is the incidence of serious pressure ulcers with secondary endpoints including ulcer-related surgeries, medical treatment costs, and quality of life. These outcomes are assessed at 12 and 24 months after randomization. Additionally, we are studying the mediating mechanisms that account for intervention outcomes. Results PUPS has been successfully implemented, including recruitment of the target sample size of 170 participants, assurance of the integrity of intervention protocol delivery with an average 90% treatment adherence rate, and enactment of the assessment plan. However, implementation has been replete with challenges. To meet recruitment goals, we instituted a five-pronged approach customized for an underserved, ethnically diverse population. In intervention delivery, we increased staff time to overcome economic and cultural barriers to retention and adherence. To ensure treatment fidelity and replicability, we monitored intervention protocol delivery in accord

The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment

OpenAIRE

Battaglini,Claudio; Bottaro,Martim; Dennehy,Carolyn; Rae,Logan; Shields,Edgar; Kirk,David; Hackney,Anthony

2007-01-01

CONTEXT AND OBJECTIVE: Changes in metabolism have been reported in the majority of patients undergoing cancer treatment, and these are usually characterized by progressive change in body composition. The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects, which include the negative changes in body composition, have been extensively reported in the literature. However, few resistance exercise intervention studies have hypothesized that breast ca...

Flexible intramedullary nailing for femoral diaphyseal fractures in children

Directory of Open Access Journals (Sweden)

Rojan Tamrakar

2017-12-01

Full Text Available Background & Objectives: Although various treatment options are available for the treatment of femoral diaphyesal fractures in children, the titanium flexible nailing has gained popularity because it is safe, easy procedure with rapid recovery and high success rate. The aim of this study was to evaluate the outcome of titanium elastic nails in treating paediatric femoral diaphyesal fractures at Patan Hospital.Materials & Methods: There were 35 cases which were all fixed with titanium flexible intramedullary nail under image intensifier at the Patan hospital from January 2013 and December 2015. Patients were evaluated in follow-ups to observe the alignment of fracture, infection, delayed union, nonunion, limb length discrepancy, implant failure, range of movement of hip and knee joints, and time to unite the fracture. The final results were evaluated using criteria of titanium elastic nail (TEN outcome score described by Flynn et al.Results: The mean age of the patients was 8.51 years. Among 35 patients (22 boys and 13 girls, there were 19 mid-shaft fractures, nine proximal third fractures and seven distal third fractures. Fracture patterns were transverse (22, oblique (10, spiral (2, and comminuted (2. The mean time for fracture union was 8.17 weeks radiologically whereas 9.83 weeks clinically. According to TEN outcome score, excellent and good results were in 28 cases (80% and seven cases (20% respectively.Conclusion: Flexible titanium nailing is a safe and satisfactory treatment for diaphyseal femoral fractures in children, because it provides rapid recovery, short rehabilitation and immobilization as well as very high union rate with few complications.

Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO): protocol for an educational intervention study.

Science.gov (United States)

Sanchez, Katherine; Eghaneyan, Brittany H; Trivedi, Madhukar H

2016-07-29

Barriers to depression treatment among Hispanic populations include persistent stigma, inadequate doctor patient communication (DPC) and resultant sub-optimal use of anti-depressant medications. Stigma is primarily perpetuated due to inadequate disease literacy and cultural factors. Common concerns about depression treatments among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications. The current manuscript presents the study protocol for the Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO) study funded by the Center for Medicare and Medicaid Services (CMS) Grants to Support the Hispanic Health Services Research Grant Program. DESEO will implement universal screening with a self-report depression screening tool (the 9-item Patient Health Questionnaire (PHQ-9)) that is presented through a customized web application and a Depression Education Intervention (DEI) designed to increase disease literacy, and dispel myths about depression and its treatment among Hispanic patients thus reducing stigma and increasing treatment engagement. This project will be conducted at one community health center whose patient population is majority Hispanic. The target enrollment for recruitment is 350 patients over the 24-month study period. A one-group, pretest-posttest design will be used to asses knowledge of depression and its treatment and related stigma before, immediately after, and one month post intervention. Primary care settings often are the gateway to identifying undiagnosed mental health disorders, particularly for people with comorbid physical health conditions. This study is unique in that it aims to examine the specific role of patient education as an intervention to increase engagement in depression treatment. By participating in the DEI, it is expected that patients will have time to understand treatment

Video-enabled cue-exposure-based intervention improves postdischarge drinking outcomes among alcohol-dependent men: A prospective study at a government addiction treatment setting in India.

Science.gov (United States)

Nattala, Prasanthi; Murthy, Pratima; Leung, Kit Sang; Rentala, Sreevani; Ramakrishna, Jayashree

2017-04-25

Returning to alcohol use following inpatient treatment occurs due to various real life cues/triggers. It is a challenge to demonstrate to patients how to deal with these triggers during inpatient treatment. Aims of the current study were (a) to evaluate the effectiveness of video-enabled cue-exposure-based intervention (VE-CEI) in influencing treatment outcomes in alcohol dependence, (b) to identify postdischarge predictors of intervention failure (returning to ≥50% of baseline alcohol consumption quantity/day). The VE-CEI comprises live action videos in which human characters model various alcohol use cues and strategies to deal with them effectively. The VE-CEI was administered to an inpatient alcohol-dependent sample (n = 43) and compared with treatment as usual (TAU) (n = 42) at a government addiction treatment setting in India. Patients were followed up over 6 months postdischarge to evaluate effectiveness of the VE-CEI on specific drinking outcomes. Over 6-month follow-up, VE-CEI group (vs. TAU) reported significantly lesser alcohol consumption quantity, fewer drinking days, and lower intervention failure rates. Results of multivariate Cox regression showed that participants who did not receive VE-CEI had an elevated risk of intervention failure (hazards ratio: 11.14; 95% confidence interval [4.93, 25.15]), other intervention failure predictors being early-onset dependence and increased baseline drinking. Findings provide evidence from India for effectiveness of cue-exposure-based intervention delivered using video technology in improving postdischarge treatment outcomes.

The muscular flexibility training and the range of movement improvement: a critical literature review

Directory of Open Access Journals (Sweden)

L.F. Coelho

2008-01-01

Full Text Available The muscular flexibility training put in evidence a train of neurophysiological principals and an intricate amount of muscular and viscous-elastic properties. There are a lot of stretching methods, used on the clinical and sport contexts. Despite its common utilization, it isn’t usual the health and educational professionals reflect about the compounds and efficacy of the diverse stretching methods. In this article, we realize a critical review about the diverse methods used on the flexibility training, as the principles and parameters related with that. We will done special emphasis to the principles of the proprioceptive neuromuscular facilitation and the diverse local relaxation methods, like warming. We will also have in count the revealing data relating to the Elasticity Coefficient paradox, witch can help to conceive an intervention philosophy of the flexibility training different from what it have being defended and practiced.

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

Science.gov (United States)

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

2017-12-01

Osteoporosis interventions targeting older Australians and clinicians were conducted in 2008 and 2011 as part of a national quality improvement program underpinned by behavioural theory and stakeholder engagement. Uptake of bone mineral density (BMD) tests among targeted men and women increased after both interventions and sustained increases in osteoporosis treatment were observed among men targeted in 2008. Educational interventions incorporating patient-specific prescriber feedback have improved osteoporosis screening and treatment among at-risk patients in clinical trials but have not been evaluated nationally. This study assessed uptake of BMD testing and osteoporosis medicines following two national Australian quality improvement initiatives targeting women (70-79 years) and men (75-85 years) at risk of osteoporosis. Administrative health claims data were used to determine monthly rates of BMD testing and initiation of osteoporosis medicines in the 9-months post-intervention among targeted men and women compared to older cohorts of men and women. Log binomial regression models were used to assess differences between groups. In 2008 91,794 patients were targeted and 52,427 were targeted in 2011. There was a twofold increase in BMD testing after each intervention among targeted patients compared to controls (p theory and stakeholder engagement that target both primary care clinicians and patients can improve osteoporosis screening and management at the national level.

Reversibly Bistable Flexible Electronics

KAUST Repository

Alfaraj, Nasir

2015-05-01

Introducing the notion of transformational silicon electronics has paved the way for integrating various applications with silicon-based, modern, high-performance electronic circuits that are mechanically flexible and optically semitransparent. While maintaining large-scale production and prototyping rapidity, this flexible and translucent scheme demonstrates the potential to transform conventionally stiff electronic devices into thin and foldable ones without compromising long-term performance and reliability. In this work, we report on the fabrication and characterization of reversibly bistable flexible electronic switches that utilize flexible n-channel metal-oxide-semiconductor field-effect transistors. The transistors are fabricated initially on rigid (100) silicon substrates before they are peeled off. They can be used to control flexible batches of light-emitting diodes, demonstrating both the relative ease of scaling at minimum cost and maximum reliability and the feasibility of integration. The peeled-off silicon fabric is about 25 µm thick. The fabricated devices are transferred to a reversibly bistable flexible platform through which, for example, a flexible smartphone can be wrapped around a user’s wrist and can also be set back to its original mechanical position. Buckling and cyclic bending of such host platforms brings a completely new dimension to the development of flexible electronics, especially rollable displays.

Assessment and comparison of the effects of two techniques on hamstring flexibility

Directory of Open Access Journals (Sweden)

Marcelo Tavella Navega

Full Text Available Introduction There are several stretching techniques that help increase flexibility, however, there are still questions regarding which method leads to the most effective gains. Objectives To assess and compare the effects of two stretching techniques, namely proprioceptive neuromuscular facilitation (PNF and static stretching on the flexibility of hamstring muscles of young women. Methods The study sample consisted of 45 young women, mean age 20.45 (± 1.66,assigned to one of three groups: static stretching group (SSG, n = 15, proprioceptive neuromuscular facilitation group (PNFG, n = 15 and control group (CG, n = 15. Both SSG and PNFG carried out three weekly stretching sessions over a four-week period. The sit and reach and popliteal angle tests were used at the beginning and end of the intervention. Normally distributed data were analyzed using Student’s t-test, whereas data with non-normal distribution were analyzed using the Wilcoxon test, to compare initial and end measurements for each technique. Finally, we used the Mann-Whitney U test to compare both techniques with each other. A significance level of 5% (p < 0.05 was adopted. Results There was a significant increase in hamstring flexibility when analyzing the assessments and reassessments of both stretching protocols. Conclusions Both techniques were effective in increasing hamstring flexibility and there were no significant differences to indicate which one is better in increasing the flexibility of this muscle group.

A Contextual Behavior Science Framework for Understanding How Behavioral Flexibility Relates to Anxiety.

Science.gov (United States)

Palm Reed, Kathleen M; Cameron, Amy Y; Ameral, Victoria E

2017-09-01

There is a growing literature focusing on the emerging idea that behavioral flexibility, rather than particular emotion regulation strategies per se, provides greater promise in predicting and influencing anxiety-related psychopathology. Yet this line of research and theoretical analysis appear to be plagued by its own challenges. For example, middle-level constructs, such as behavioral flexibility, are difficult to define, difficult to measure, and difficult to interpret in relation to clinical interventions. A key point that some researchers have made is that previous studies examining flexible use of emotion regulation strategies (or, more broadly, coping) have failed due to a lack of focus on context. That is, examining strategies in isolation of the context in which they are used provides limited information on the suitability, rigid adherence, or effectiveness of a given strategy in that situation. Several of these researchers have proposed the development of new models to define and measure various types of behavioral flexibility. We would like to suggest that an explanation of the phenomenon already exists and that we can go back to our behavioral roots to understand this phenomenon rather than focusing on defining and capturing a new process. Indeed, thorough contextual behavioral analyses already yield a useful account of what has been observed. We will articulate a model explaining behavioral flexibility using a functional, contextual framework, with anxiety-related disorders as an example.

Computer-based information management system for interventional radiology

International Nuclear Information System (INIS)

Forman, B.H.; Silverman, S.G.; Mueller, P.R.; Hahn, P.F.; Papanicolaou, N.; Tung, G.A.; Brink, J.A.; Ferrucci, J.T.

1989-01-01

The authors authored and implemented a computer-based information management system (CBIMS) for the integrated analysis of data from a variety of abdominal nonvascular interventional procedures. The CBIMS improved on their initial handwritten-card system (which listed only patient name, hospital number, and type of procedure) by capturing relevant patient data in an organized fashion and integrating information for meaningful analysis. Advantages of CBIMS include enhanced compilation of monthly census, easy access to a patient's interventional history, and flexible querying capability that allows easy extraction of subsets of information from the patient database

Sustained Uptake of a Hospital-Based Handwashing with Soap and Water Treatment Intervention (Cholera-Hospital-Based Intervention for 7 Days [CHoBI7]): A Randomized Controlled Trial.

Science.gov (United States)

George, Christine Marie; Jung, Danielle S; Saif-Ur-Rahman, K M; Monira, Shirajum; Sack, David A; Mahamud-ur Rashid; Mahmud, Md Toslim; Mustafiz, Munshi; Rahman, Zillur; Bhuyian, Sazzadul Islam; Winch, Peter J; Leontsini, Elli; Perin, Jamie; Begum, Farzana; Zohura, Fatema; Biswas, Shwapon; Parvin, Tahmina; Sack, R Bradley; Alam, Munirul

2016-02-01

Diarrhea is the second leading cause of death in children under 5 years of age globally. The time patients and caregivers spend at a health facility for severe diarrhea presents the opportunity to deliver water, sanitation, and hygiene (WASH) interventions. We recently developed Cholera-Hospital-Based Intervention for 7 days (CHoBI7), a 1-week hospital-based handwashing with soap and water treatment intervention, for household members of cholera patients. To investigate if this intervention could lead to sustained WASH practices, we conducted a follow-up evaluation of 196 intervention household members and 205 control household members enrolled in a randomized controlled trial of the CHoBI7 intervention 6 to 12 months post-intervention. Compared with the control arm, the intervention arm had four times higher odds of household members' handwashing with soap at a key time during 5-hour structured observation (odds ratio [OR]: 4.71, 95% confidence interval [CI]: 2.61, 8.49) (18% versus 50%) and a 41% reduction in households in the World Health Organization very high-risk category for stored drinking water (OR: 0.38, 95% CI: 0.15, 0.96) (58% versus 34%) 6 to 12 months post-intervention. Furthemore, 71% of observed handwashing with soap events in the intervention arm involved the preparation and use of soapy water, which was promoted during the intervention, compared to 9% of control households. These findings demonstrate that the hospital-based CHoBI7 intervention can lead to significant increases in handwashing with soap practices and improved stored drinking water quality 6 to 12 months post-intervention. © The American Society of Tropical Medicine and Hygiene.

Carbon nanotube yarns as strong flexible conductive capacitive electrodes

NARCIS (Netherlands)

Liu, F.; Wagterveld, R.M.; Gebben, B.; Otto, M.J.; Biesheuvel, P.M.; Hamelers, H.V.M.

2015-01-01

Carbon nanotube (CNT) yarn, consisting of 23 µm diameter CNT filaments, can be used as capacitive electrodes that are long, flexible, conductive and strong, for applications in energy and electrochemical water treatment. We measure the charge storage capacity as function of salt concentration, and

Flexible thermoplastic denture base materials for aesthetical removable partial denture framework.

Science.gov (United States)

Singh, Kunwarjeet; Aeran, Himanshu; Kumar, Narender; Gupta, Nidhi

2013-10-01

Conventional fixed partial dentures, implant supported Fixed Partial Dentures (FDPs) and removable partial dentures are the most common treatment modalities for the aesthetic and functional rehabilitation of partially edentulous patients. Although implants and FDP have certain advantages over removable partial dentures, in some cases, removable partial dentures may be the only choice which is available. Removable cast partial dentures are used as definitive removable prostheses when indicated, but location of clasps may affect aesthetics. So, when patient is concerned about aesthetics, flexible partial dentures which is aesthetically superior to flipper and cast partial dentures, may be considered. But for the success of flexible removable partial denture, proper diagnosis, treatment planning and insertion technique of this prosthesis is very important, which have been thoroughly described in this article.

Flexible MEMS: A novel technology to fabricate flexible sensors and electronics

Science.gov (United States)

Tu, Hongen

This dissertation presents the design and fabrication techniques used to fabricate flexible MEMS (Micro Electro Mechanical Systems) devices. MEMS devices and CMOS(Complementary Metal-Oxide-Semiconductor) circuits are traditionally fabricated on rigid substrates with inorganic semiconductor materials such as Silicon. However, it is highly desirable that functional elements like sensors, actuators or micro fluidic components to be fabricated on flexible substrates for a wide variety of applications. Due to the fact that flexible substrate is temperature sensitive, typically only low temperature materials, such as polymers, metals, and organic semiconductor materials, can be directly fabricated on flexible substrates. A novel technology based on XeF2(xenon difluoride) isotropic silicon etching and parylene conformal coating, which is able to monolithically incorporate high temperature materials and fluidic channels, was developed at Wayne State University. The technology was first implemented in the development of out-of-plane parylene microneedle arrays that can be individually addressed by integrated flexible micro-channels. These devices enable the delivery of chemicals with controlled temporal and spatial patterns and allow us to study neurotransmitter-based retinal prosthesis. The technology was further explored by adopting the conventional SOI-CMOS processes. High performance and high density CMOS circuits can be first fabricated on SOI wafers, and then be integrated into flexible substrates. Flexible p-channel MOSFETs (Metal-Oxide-Semiconductor Field-Effect-Transistors) were successfully integrated and tested. Integration of pressure sensors and flow sensors based on single crystal silicon has also been demonstrated. A novel smart yarn technology that enables the invisible integration of sensors and electronics into fabrics has been developed. The most significant advantage of this technology is its post-MEMS and post-CMOS compatibility. Various high

Cognitive intervention therapy as treatment for behaviour disorders in Alzheimer disease: evidence on efficacy and neurobiological correlations.

Science.gov (United States)

García-Alberca, J M

2015-01-01

The prevalence of behavioural and psychological symptoms (BPS) is very high among patients with Alzheimer disease (AD); more than 90% of AD patients will present such symptoms during the course of the disease. These symptoms result in poorer quality of life for both patients and caregivers and increased healthcare costs. BPS are the main factors involved in increases to the caregiver burden, and they often precipitate the admission of patients to residential care centres. Current consensus holds that intervention models combining pharmacological and non-pharmacological treatments are the most effective for AD patients. Several studies have shown cholinesterase inhibitors and memantine combined with cognitive intervention therapy (CIT) to be effective for improving patients' cognitive function and functional capacity for undertaking daily life activities. However, the efficacy of CIT as a treatment for BPS has not yet been clearly established, which limits its use for this purpose in clinical practice. The objective of this review is to gather available evidence on the efficacy of cognitive intervention therapy (CIT) on BPS in patients with AD. The results of this review suggest that CIT may have a beneficial effect on BPS in patients with AD and should therefore be considered a treatment option for patients with AD and BPS. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Interventions to Improve the Treatment of Malaria in an Acute Teaching Hospital in Ireland

LENUS (Irish Health Repository)

O’Connor, R

2017-11-01

Malaria is the most serious parasitic infection. At our institution over a two year period there were treatment errors in 18% (n=3) of cases. The aim of this multidisciplinary study was to ensure appropriate and timely treatment of malaria by implementation of a cluster of interventions: reconfiguration of existing guidelines, provision of prescribing information; delivery of education sessions to front-line staff and enabling rapid access to medication. Staff feedback was assessed through a questionnaire. Perceived benefits gained included awareness of guidelines (91%, n= 39), how to diagnose (81%, n =35), how to treat (86%, n=37), that treatment must be prompt (77%, n=33) and where to find treatment out of hours (84%, n=36). ‘Others’ perceived benefits (5% n= 2) noted referred to treatment in pregnancy. Going forward, a programme of on-going staff education, repeated audits of guideline compliance and promotion of reporting of medication errors should help ensure that these benefits are sustained

[Surgical treatment of Marfan syndrome; analysis of the patients required multiple surgical interventions].

Science.gov (United States)

Yamazaki, F; Shimamoto, M; Fujita, S; Nakai, M; Aoyama, A; Chen, F; Nakata, T; Yamada, T

2002-07-01

Without treatment, the life expectancy of patients with Marfan syndrome is reduced by the associated cardiovascular abnormalities. In this study, we reviewed our experience of the patients with Marfan syndrome who required multiple surgical interventions to identify the optimal treatment for these patients. Between January 1986 and December 2000, 44 patients with Marfan syndrome were operated on at Shizuoka City Hospital (SCH). Among them, 10 patients (22.7%) underwent multiple surgical interventions. There were 5 male and 5 female patients with a mean age of 40.6 +/- 16.1 years at the initial surgery. Only one patient was operated on at another hospital for his first, second, and third operations. His fourth operation was carried out at SCH. The remaining 9 patients underwent a total of 14 additional surgical procedures at SCH. Computed tomography (CT) scans were taken every 6 months postoperatively, and aortic diameter greater than 60 mm was considered as the indication for the additional surgery. There were no early death and one late death. The causes of additional surgery were enlargement of true aneurysm in 6, enlargement of residual dissection in 4, new dissection in 4, false aneurysm at the coronary anastomosis of Bentall procedure in 1. In 9 patients, both ascending and descending aorta were replaced. Among these 9 patients, only 3 patients underwent total arch replacement, and remaining 6 patients had their arch left in place with or without dissection. Our current strategy of the treatment of Marfan patients with acute type A dissection is total arch replacement with an elephant trunk at the initial emergent surgery.

Flexible Carpooling: Exploratory Study

OpenAIRE

Dorinson, Diana; Gay, Deanna; Minett, Paul; Shaheen, Susan

2009-01-01

Energy consumption could be reduced if more people shared rides rather than driving alone yet carpooling represents a small proportion of all potential carpoolers. Prior research has found that many who might carpool were concerned about reduced flexibility with carpooling. If flexibility is one of the barriers how could carpooling be organized to be more flexible? In Northern Virginia a flexible system has evolved where there are 3,500 single-use carpools per day. In another example there ...

Interventions for Posttraumatic Stress With Children Exposed to Violence: Factors Associated With Treatment Success.

Science.gov (United States)

Miller-Graff, Laura E; Campion, Karen

2016-03-01

In the past 15 years, there have been a substantial number of rigorous studies examining the effectiveness of various treatments for child trauma and posttraumatic stress disorder (PTSD). Although a number of review articles exist, many have focused on randomized controlled trials or specific treatment methodologies, both of which limit the ability to draw conclusions across studies and the statistical power to test the effect of particular treatment characteristics on treatment outcomes. The current study is a review and meta-analysis of 74 studies examining treatments for children exposed to violence. After reviewing the literature, we examined the relationship of a variety of treatment characteristics (e.g., group or individual treatments) and sample characteristics (e.g., average age) on treatment effect sizes. Results indicated that individual therapies and those with exposure paradigms within a cognitive-behavioral therapy or skills-building framework show the most promise, but treatment is somewhat less effective for those with more severe symptomology and for younger children. Future treatments should consider the developmental and social contexts that may impede treatment progress for young children and consider how best to develop the effectiveness of group interventions that can be readily delivered in settings of mass trauma. © 2015 Wiley Periodicals, Inc.

Manufacturing and testing flexible microfluidic devices with optical and electrical detection mechanisms

OpenAIRE

Ivan, M.G.; Vivet, F.; Meinders, E.R.

2010-01-01

Flexible microfluidic devices made of poly(dimethylsiloxane) (PDMS) were manufactured by soft lithography, and tested in detection of ionic species using optical absorption spectroscopy and electrical measurements. PDMS was chosen due to its flexibility and ease of surface modification by exposure to plasma and UV treatment, its transparency in UV-Vis regions of the light spectrum, and biocompatibility. The dual-detection mechanism allows the user more freedom in choosing the detection tool, ...

Local Flexibility Market Design for Aggregators Providing Multiple Flexibility Services at Distribution Network Level

Directory of Open Access Journals (Sweden)

Pol Olivella-Rosell

2018-04-01

Full Text Available This paper presents a general description of local flexibility markets as a market-based management mechanism for aggregators. The high penetration of distributed energy resources introduces new flexibility services like prosumer or community self-balancing, congestion management and time-of-use optimization. This work is focused on the flexibility framework to enable multiple participants to compete for selling or buying flexibility. In this framework, the aggregator acts as a local market operator and supervises flexibility transactions of the local energy community. Local market participation is voluntary. Potential flexibility stakeholders are the distribution system operator, the balance responsible party and end-users themselves. Flexibility is sold by means of loads, generators, storage units and electric vehicles. Finally, this paper presents needed interactions between all local market stakeholders, the corresponding inputs and outputs of local market operation algorithms from participants and a case study to highlight the application of the local flexibility market in three scenarios. The local market framework could postpone grid upgrades, reduce energy costs and increase distribution grids’ hosting capacity.

[Inspecting the cochlear scala tympanic with flexible and semi-flexible micro-endoscope].

Science.gov (United States)

Zhang, Daoxcing; Zhang, Yankun

2006-02-01

Flexible and semi-flexible micro-endoscopes were used in cochlear scala tympani inspection , to explore their application in inner ear examination. Fifteen profound hearing loss patients preparing for cochlear implant were included in this study. During the operation, micro-endoscopy was performed after opening the cochlear scala tympani. And 1 mm diameter semi-flexible micro-endoscope could go as deep as 9 mm into the cochlear scala tympani, while 0. 5 mm diameter flexible micro-endoscope could go as deep as 25 mm. The inspecting results were compared with video recording. Using 0.5 mm flexible micro-endoscope, we canould check cochlear scala tympani with depth range of 15-25 mm, but the video imaging was not clear enough to examine the microstructure in the cochlear. With 1 mm diameter semi-flexible micro-endoscope, we could reach 9 mm deep into the cochlear. During the examination, we found 3 cases with calcification deposit in osseous spiral lamina, l case with granulation tissue in the lateral wall of scala tympani, no abnormal findings in the other 11 cases. Inspecting the cochlear scala tympani with 0.5 mm flexible micro-endoscope, even though we can reach the second circuit of the cochlear, it is difficult to find the pathology in the cochlear because of the poor video imaging. With 1 mm semi-flexible micro-endoscope, we can identify the microstructure of the cochlear clearly and find the pathologic changes, but the inserting depth was limited to 9 mm with limitation to examine the whole cochlear.

Interventions for replacing missing teeth: treatment of perimplantitis.

Science.gov (United States)

Esposito, Marco; Grusovin, Maria Gabriella; Tzanetea, Eleni; Piattelli, Adriano; Worthington, Helen V

2010-06-16

One of the key factors for the long-term success of oral implants is the maintenance of healthy tissues around them. Bacterial plaque accumulation induces inflammatory changes in the soft tissues surrounding oral implants and it may lead to their progressive destruction (perimplantitis) and ultimately to implant failure. Different treatment strategies for perimplantitis have been suggested, however it is unclear which are the most effective. To identify the most effective interventions for treating perimplantitis around osseointegrated dental implants. We searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of the identified randomised controlled trials (RCTs) and relevant review articles for studies outside the handsearched journals. We wrote to authors of all identified RCTs, to more than 55 dental implant manufacturers and an Internet discussion group to find unpublished or ongoing RCTs. No language restrictions were applied. The last electronic search was conducted on 7th January 2010. All RCTs comparing agents or interventions for treating perimplantitis around dental implants. Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. We contacted the authors for missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals (CI). Heterogeneity was to be investigated including both clinical and methodological factors. Twelve eligible trials were identified, but five were excluded. The following procedures were tested: (1) use of local antibiotics versus ultrasonic debridement; (2) benefits of adjunctive local antibiotics to debridement; (3) different techniques of subgingival debridement; (4) laser versus manual

Development of Flexible Pneumatic Cylinder with Built-in Flexible Linear Encoder and Flexible Bending Sensor

Science.gov (United States)

Akagi, Tetsuya; Dohta, Shujiro; Matsushita, Hisashi; Fukuhara, Akimasa

The purpose of this study is to develop a lightweight and intelligent soft actuator which can be safely attached to the human body. A novel flexible pneumatic cylinder that can be used even if it is deformed by external force had been proposed. The cylinder can realize both pushing and pulling motions even if the cylinder bends. In this paper, a flexible pneumatic cylinder with a built-in flexible linear encoder is proposed and tested. The encoder can detect the cylinder displacement even if the cylinder bends. In the next step, to realize an intelligent flexible cylinder, it is essential to recognize the angle of deflection of the cylinder to estimate the direction of the external force. Therefore, a flexible bending sensor that can measure the directional angle by attaching it to the end of the cylinder is also proposed and tested. The tested bending sensor also consists of four inexpensive photo-reflectors set on the circumferential surface to the cylinder tube every 90 degrees from the center of the tube. By measuring the distance between the photo reflector and the surface of the tube at each point, the bending directional angle of the cylinder can be obtained. A low cost measuring system using a micro-computer incorporating a programmed Up/Down counter to measure the displacement of the cylinder is also developed. As a result, it was confirmed that the measuring accuracy of the bending directional angle was good, less than 0.7 degrees as a standard deviation.

Successful management of Barth syndrome: a systematic review highlighting the importance of a flexible and multidisciplinary approach

Directory of Open Access Journals (Sweden)

Reynolds S

2015-07-01

Full Text Available Stacey Reynolds Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA, USA Abstract: This review describes and summarizes the available evidence related to the treatment and management of Barth syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA standards were used to identify articles published between December 2004 and January 2015. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS approach was used to guide the article selection and evaluation process. Of the 128 articles screened, 28 articles matched the systematic review inclusion criteria. The results of this review indicate the need for a flexible and multidisciplinary approach to manage the symptoms most commonly associated with Barth syndrome. It is recommended that a comprehensive care team should include individuals with Barth syndrome, their family members and caregivers, as well as medical, rehabilitative, nutritional, psychological, and educational professionals. The evidence for specific treatments, therapies, and techniques for individuals with Barth syndrome is currently lacking in both quality and quantity. Keywords: Barth syndrome, rare disorders, rehabilitation, cardiac, systematic review

Cognitive Flexibility Training: A Large-Scale Multimodal Adaptive Active-Control Intervention Study in Healthy Older Adults

Directory of Open Access Journals (Sweden)

Jessika I. V. Buitenweg

2017-11-01

Full Text Available As aging is associated with cognitive decline, particularly in the executive functions, it is essential to effectively improve cognition in older adults. Online cognitive training is currently a popular, though controversial method. Although some changes seem possible in older adults through training, far transfer, and longitudinal maintenance are rarely seen. Based on previous literature we created a unique, state-of-the-art intervention study by incorporating frequent sessions and flexible, novel, adaptive training tasks, along with an active control group. We created a program called TAPASS (Training Project Amsterdam Seniors and Stroke, a randomized controlled trial. Healthy older adults (60–80 y.o. were assigned to a frequent- (FS or infrequent switching (IS experimental condition or to the active control group and performed 58 half-hour sessions over the course of 12 weeks. Effects on executive functioning, processing- and psychomotor speed, planning, verbal long term memory, verbal fluency, and reasoning were measured on four time points before, during and after the training. Additionally, we examined the explorative question which individual aspects added to training benefit. Besides improvements on the training, we found significant time effects on multiple transfer tasks in all three groups that likely reflected retest effects. No training-specific improvements were detected, and we did not find evidence of additional benefits of individual characteristics. Judging from these results, the therapeutic value of using commercially available training games to train the aging brain is modest, though any apparent effects should be ascribed more to expectancy and motivation than to the elements in our training protocol. Our results emphasize the importance of using parallel tests as outcome measures for transfer and including both active and passive control conditions. Further investigation into different training methods is advised

Interventional Treatment of a Symptomatic Neonatal Hepatic Cavernous Hemangioma Using the Amplatzer Vascular Plug

International Nuclear Information System (INIS)

Kretschmar, Oliver; Knirsch, Walter; Bernet, Vera

2008-01-01

Percutaneous intervention is one treatment option for symptomatic hepatic hemangioma in infants. We report the case of a newborn (birth weight 4060 g) with a large hepatic cavernous hemangioma, which presented early with high cardiac output failure due to arteriovenous shunting and signs of incipient Kasabach-Merritt syndrome. We performed a successful superselective transcatheter coil embolization of three feeding arteries on the seventh day of life. Because of remaining diffuse very small arteries causing a relevant residual shunt, additional occlusion of the three main draining veins was necessary with three Amplatzer vascular plugs. Cardiac failure resolved immediately. Without any additional therapy the large venous cavities disappeared within the following months. The tumor continues to regress in size 8 months after the intervention

Online and social networking interventions for the treatment of depression in young people: a systematic review.

Science.gov (United States)

Rice, Simon M; Goodall, Joanne; Hetrick, Sarah E; Parker, Alexandra G; Gilbertson, Tamsyn; Amminger, G Paul; Davey, Christopher G; McGorry, Patrick D; Gleeson, John; Alvarez-Jimenez, Mario

2014-09-16

Major depression accounts for the greatest burden of all diseases globally. The peak onset of depression occurs between adolescence and young adulthood, and for many individuals, depression displays a relapse-remitting and increasingly severe course. Given this, the development of cost-effective, acceptable, and population-focused interventions for depression is critical. A number of online interventions (both prevention and acute phase) have been tested in young people with promising results. As these interventions differ in content, clinician input, and modality, it is important to identify key features (or unhelpful functions) associated with treatment outcomes. A systematic review of the research literature was undertaken. The review was designed to focus on two aspects of online intervention: (1) standard approaches evaluating online intervention content in randomized controlled designs (Section 1), and (2) second-generation online interventions and services using social networking (eg, social networking sites and online support groups) in any type of research design (Section 2). Two specific literature searches were undertaken. There was no date range specified. The Section 1 search, which focused on randomized controlled trials, included only young people (12-25 years) and yielded 101 study abstracts, of which 15 met the review inclusion criteria. The Section 2 search, which included all study design types and was not restricted in terms of age, yielded 358 abstracts, of which 22 studies met the inclusion criteria. Information about the studies and their findings were extracted and tabulated for review. The 15 studies identified in Section 1 described 10 trials testing eight different online interventions, all of which were based on a cognitive behavioral framework. All but one of the eight identified studies reported positive results; however, only five of the 15 studies used blinded interviewer administered outcomes with most trials using self-report data

Instability of a cantilevered flexible plate in viscous channel flow

Science.gov (United States)

Balint, T. S.; Lucey, A. D.

2005-10-01

The stability of a flexible cantilevered plate in viscous channel flow is studied as a representation of the dynamics of the human upper airway. The focus is on instability mechanisms of the soft palate (flexible plate) that cause airway blockage during sleep. We solve the Navier Stokes equations for flow with Reynolds numbers up to 1500 fully coupled with the dynamics of the plate motion solved using finite-differences. The study is 2-D and based upon linearized plate mechanics. When both upper and lower airways are open, the plate is found to lose its stability through a flutter mechanism and a critical Reynolds number exists. When one airway is closed, the plate principally loses its stability through a divergence mechanism and a critical flow speed exists. However, below the divergence-onset flow speed, flutter can exist for low levels of structural damping in the flexible plate. Our results serve to extend understanding of flow-induced instability of cantilevered flexible plates and will ultimately improve the diagnosis and treatment of upper-airway disorders.

mHealth based interventions for the assessment and treatment of psychotic disorders: a systematic review.

Science.gov (United States)

Gire, Nadeem; Farooq, Saeed; Naeem, Farooq; Duxbury, Joy; McKeown, Mick; Kundi, Pardeep Singh; Chaudhry, Imran Bashir; Husain, Nusrat

2017-01-01

The relative burden of mental health disorders is increasing globally, in terms of prevalence and disability. There is limited data available to guide treatment choices for clinicians in low resourced settings, with mHealth technologies being a potentially beneficial avenue to bridging the large mental health treatment gap globally. The aim of the review was to search the literature systematically for studies of mHealth interventions for psychosis globally, and to examine whether mHealth for psychosis has been investigated. A systematic literature search was completed in Embase, Medline, PsychINFO and Evidence Based Medicine Reviews databases from inception to May 2016. Only studies with a randomised controlled trial design that investigated an mHealth intervention for psychosis were included. A total of 5690 records were identified with 7 studies meeting the inclusion criteria. The majority of included studies, were conducted across Europe and the United Sates with one being conducted in China. The 7 included studies examined different parameters, such as Experiential Sampling Methodology (ESM), medication adherence, cognitive impairment, social functioning and suicidal ideation in veterans with schizophrenia. Considering the increasing access to mobile devices globally, mHealth may potentially increase access to appropriate mental health care. The results of this review show promise in bridging the global mental health treatment gap, by enabling individuals to receive treatment via their mobile phones, particularly for those individuals who live in remote or rural areas, areas of high deprivation and for those from low resourced settings.

Energy Flexibility in Retail Buildings

DEFF Research Database (Denmark)

Ma, Zheng; Billanes, Joy Dalmacio; Kjærgaard, Mikkel Baun

2017-01-01

Retail buildings has an important role for demand side energy flexibility because of their high energy consumption, variety of energy flexibility resources, and centralized control via building control systems. Energy flexibility requires agreements and collaborations among different actors......), with the discussion of the stakeholders’ roles and their interrelation in delivering energy flexibility with the influential factors to the actual implementation of energy flexible operation of their buildings. Based on a literature analysis, the results cover stakeholders’ types and roles, perceptions (drivers......, barriers, and benefits), energy management activities and technology adoptions, and the stakeholders’ interaction for the energy flexibility in retail buildings....

Psychogenic nonepileptic seizures: a treatment review. What have we learned since the beginning of the millennium?

Directory of Open Access Journals (Sweden)

Baslet G

2012-12-01

reprocessing may deserve exploration. Flexible delivery of treatment that considers the heterogeneous backgrounds of patients is emphasized as necessary for successful outcomes in clinical practice.Keywords: conversion disorder, therapeutics, clinical trials, psychotherapeutic interventions, psychopharmacological interventions

Flexible Word Classes

DEFF Research Database (Denmark)

• First major publication on the phenomenon • Offers cross-linguistic, descriptive, and diverse theoretical approaches • Includes analysis of data from different language families and from lesser studied languages This book is the first major cross-linguistic study of 'flexible words', i.e. words...... that cannot be classified in terms of the traditional lexical categories Verb, Noun, Adjective or Adverb. Flexible words can - without special morphosyntactic marking - serve in functions for which other languages must employ members of two or more of the four traditional, 'specialised' word classes. Thus......, flexible words are underspecified for communicative functions like 'predicating' (verbal function), 'referring' (nominal function) or 'modifying' (a function typically associated with adjectives and e.g. manner adverbs). Even though linguists have been aware of flexible world classes for more than...

Position of the Academy of Nutrition and Dietetics: interventions for the prevention and treatment of pediatric overweight and obesity.

Science.gov (United States)

Hoelscher, Deanna M; Kirk, Shelley; Ritchie, Lorrene; Cunningham-Sabo, Leslie

2013-10-01

It is the position of the Academy of Nutrition and Dietetics that prevention and treatment of pediatric overweight and obesity require systems-level approaches that include the skills of registered dietitians, as well as consistent and integrated messages and environmental support across all sectors of society to achieve sustained dietary and physical-activity behavior change. This position paper provides guidance and recommendations for levels of intervention targeting overweight and obesity prevention and treatment from preschool age through adolescence. Methods included a review of the literature from 2009 to April 2012, including the Academy's 2009 evidence analysis school-based reviews. Multicomponent interventions show the greatest impact for primary prevention; thus, early childhood and school-based interventions should integrate behavioral and environmental approaches that focus on dietary intake and physical activity using a systems-level approach targeting the multilevel structure of the socioecological model as well as interactions and relationships between levels. Secondary prevention and tertiary prevention/treatment should emphasize sustained family-based, developmentally appropriate approaches that include nutrition education, dietary counseling, parenting skills, behavioral strategies, and physical-activity promotion. For obese youth with concomitant serious comorbidities, structured dietary approaches and pharmacologic agents should be considered, and weight-loss surgery can be considered for severely obese adolescents. Policy and environmental interventions are recommended as feasible and sustainable ways to support healthful lifestyles for children and families. The Academy supports commitment of resources for interventions, policies, and research that promote healthful eating and physical-activity behaviors to ensure that all youth have the opportunity to achieve and maintain a weight that is optimal for health. Copyright © 2013 Academy of

Flexible Textile-Based Organic Transistors Using Graphene/Ag Nanoparticle Electrode

Science.gov (United States)

Kim, Youn; Kwon, Yeon Ju; Lee, Kang Eun; Oh, Youngseok; Um, Moon-Kwang; Seong, Dong Gi; Lee, Jea Uk

2016-01-01

Highly flexible and electrically-conductive multifunctional textiles are desirable for use in wearable electronic applications. In this study, we fabricated multifunctional textile composites by vacuum filtration and wet-transfer of graphene oxide films on a flexible polyethylene terephthalate (PET) textile in association with embedding Ag nanoparticles (AgNPs) to improve the electrical conductivity. A flexible organic transistor can be developed by direct transfer of a dielectric/semiconducting double layer on the graphene/AgNP textile composite, where the textile composite was used as both flexible substrate and conductive gate electrode. The thermal treatment of a textile-based transistor enhanced the electrical performance (mobility = 7.2 cm2·V−1·s−1, on/off current ratio = 4 × 105, and threshold voltage = −1.1 V) due to the improvement of interfacial properties between the conductive textile electrode and the ion-gel dielectric layer. Furthermore, the textile transistors exhibited highly stable device performance under extended bending conditions (with a bending radius down to 3 mm and repeated tests over 1000 cycles). We believe that our simple methods for the fabrication of graphene/AgNP textile composite for use in textile-type transistors can potentially be applied to the development of flexible large-area electronic clothes. PMID:28335276

Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis.

Science.gov (United States)

Harris, Leanne; Hamilton, Sharon; Azevedo, Liane B; Olajide, Joan; De Brún, Caroline; Waller, Gillian; Whittaker, Vicki; Sharp, Tracey; Lean, Mike; Hankey, Catherine; Ells, Louisa

2018-02-01

To examine the effectiveness of intermittent energy restriction in the treatment for overweight and obesity in adults, when compared to usual care treatment or no treatment. Intermittent energy restriction encompasses dietary approaches including intermittent fasting, alternate day fasting, and fasting for two days per week. Despite the recent popularity of intermittent energy restriction and associated weight loss claims, the supporting evidence base is limited. This review included overweight or obese (BMI ≥25 kg/m) adults (≥18 years). Intermittent energy restriction was defined as consumption of ≤800 kcal on at least one day, but no more than six days per week. Intermittent energy restriction interventions were compared to no treatment (ad libitum diet) or usual care (continuous energy restriction ∼25% of recommended energy intake). Included interventions had a minimum duration of 12 weeks from baseline to post outcome measurements. The types of studies included were randomized and pseudo-randomized controlled trials. The primary outcome of this review was change in body weight. Secondary outcomes included: i) anthropometric outcomes (change in BMI, waist circumference, fat mass, fat free mass); ii) cardio-metabolic outcomes (change in blood glucose and insulin, lipoprotein profiles and blood pressure); and iii) lifestyle outcomes: diet, physical activity, quality of life and adverse events. A systematic search was conducted from database inception to November 2015. The following electronic databases were searched: MEDLINE, Embase, CINAHL, Cochrane Library, ClinicalTrials.gov, ISRCTN registry, and anzctr.org.au for English language published studies, protocols and trials. Two independent reviewers evaluated the methodological quality of included studies using the standardized critical appraisal instruments from the Joanna Briggs Institute. Data were extracted from papers included in the review by two independent reviewers using the standardized data

Effectiveness of passive stretching versus hold relax technique in flexibility of hamstring muscle

Directory of Open Access Journals (Sweden)

Gauri Shankar

2010-10-01

Full Text Available Aim: To compare the effectiveness of passive stretching and hold relax technique in the flexibility of hamstring muscle. Methods: A total of 80 normal healthy female subjects between age group 20-30 years referred to the department of physiotherapy, Sumandeep Vidyapeeth University, sampling method being convenient sampling. The subjects were randomly divided in two groups i.e. passive stretching group (n=40 and PNF group (n=40 and given passive stretching and proprioceptive neuromuscular facilitation technique respectively. Active knee extension range was measured before and after the intervention by goniometer. Results: t test showed a highly significant (p=0.000 increase in range of motion in PNF group. Conclusion: Proprioceptive neuromuscular facilitation technique is more effective in increasing hamstring flexibility than the passive stretching.

The effect of an expressive writing intervention (EWI) on stress in infertile couples undergoing assisted reproductive technlogy (ART) treatment: A randomized controlled pilot study

DEFF Research Database (Denmark)

Matthiesen, Signe Maria Schneevoigt; Klonoff-Cohen, Hillary; Zachariae, Robert

2012-01-01

Objectives. Infertile couples undergoing fertility treatments may experience stress and could benefit from psychological intervention. Expressive Writing Intervention (EWI) has shown promising results on various psychological outcomes, yet only one study has applied the method to infertility......-related stress. Our aim was to assess feasibility and effectiveness of EWI for patients in treatment with Assisted Reproductive Technology (ART). Design and participants. Patients enrolling in their first ART treatment at the fertility clinic, Aarhus University Hospital, Denmark were offered to participate....... A total of 82 participants (45 women, 37 men), mean age: 33.17, were randomized to home-based EWI or neutral writing control group and completed an infertility-related stress questionnaire at treatment enrollment, 3 weeks later (at the time of down regulation), and 6 weeks after the intervention...

Effect of a brief outreach educational intervention on the translation of acute poisoning treatment guidelines to practice in rural Sri Lankan hospitals: a cluster randomized controlled trial.

Science.gov (United States)

Senarathna, Lalith; Buckley, Nick A; Dibley, Michael J; Kelly, Patrick J; Jayamanna, Shaluka F; Gawarammana, Indika B; Dawson, Andrew H

2013-01-01

In developing countries, including Sri Lanka, a high proportion of acute poisoning and other medical emergencies are initially treated in rural peripheral hospitals. Patients are then usually transferred to referral hospitals for further treatment. Guidelines are often used to promote better patient care in these emergencies. We conducted a cluster randomized controlled trial (ISRCTN73983810) which aimed to assess the effect of a brief educational outreach ('academic detailing') intervention to promote the utilization of treatment guidelines for acute poisoning. This cluster RCT was conducted in the North Central Province of Sri Lanka. All peripheral hospitals in the province were randomized to either intervention or control. All hospitals received a copy of the guidelines. The intervention hospitals received a brief out-reach academic detailing workshop which explained poisoning treatment guidelines and guideline promotional items designed to be used in daily care. Data were collected on all patients admitted due to poisoning for 12 months post-intervention in all study hospitals. Information collected included type of poison exposure, initial investigations, treatments and hospital outcome. Patients transferred from peripheral hospitals to referral hospitals had their clinical outcomes recorded. There were 23 intervention and 23 control hospitals. There were no significant differences in the patient characteristics, such as age, gender and the poisons ingested. The intervention hospitals showed a significant improvement in administration of activated charcoal [OR 2.95 (95% CI 1.28-6.80)]. There was no difference between hospitals in use of other decontamination methods. This study shows that an educational intervention consisting of brief out-reach academic detailing was effective in changing treatment behavior in rural Sri Lankan hospitals. The intervention was only effective for treatments with direct clinician involvement, such as administering activated

Mindfulness Is Associated With Treatment Response From Nonpharmacologic Exercise Interventions in Knee Osteoarthritis.

Science.gov (United States)

Lee, Augustine C; Harvey, William F; Price, Lori Lyn; Han, Xingyi; Driban, Jeffrey B; Wong, John B; Chung, Mei; McAlindon, Timothy E; Wang, Chenchen

2017-11-01

To examine the association between baseline mindfulness and response from exercise interventions in knee osteoarthritis (OA). Cohort study; responder analysis of a clinical trial subset. Urban tertiary care academic hospital. Participants with symptomatic, radiographic knee OA (N=86; mean age, 60y; 74% female; 48% white). Twelve weeks (twice per week) of Tai Chi or physical therapy exercise. Treatment response was defined using Osteoarthritis Research Society International criteria indicating meaningful improvements in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, WOMAC function, or Patient Global Assessment scores. At baseline, participants completed the Five Facet Mindfulness Questionnaire (mean total score, 142±17) and were grouped into 3 categories of total mindfulness: higher, medium, or lower. Relative risk (RR) ratios were used to compare treatment response across groups. Participants with higher total mindfulness were 38% (95% confidence interval [CI], 1.05-1.83) more likely to meet responder criteria than those with lower mindfulness. We found no significant difference between medium and lower mindfulness groups (RR=1.0; 95% CI, 0.69-1.44). Among the 5 mindfulness facets, medium acting-with-awareness was 46% (95% CI, 1.09-1.96) more likely to respond than lower acting-with-awareness, and higher acting-with-awareness was 34% more likely to respond, but this did not reach significance (95% CI, 0.97-1.86). In this study, higher mindfulness, primarily driven by its acting-with-awareness facet, was significantly associated with a greater likelihood of response to nonpharmacologic exercise interventions in knee OA. This suggests that mindfulness-cultivating interventions may increase the likelihood of response from exercise. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

China in search of 'legitimate' great power intervention

DEFF Research Database (Denmark)

Sørensen, Camilla T. N.

2016-01-01

Thanks to Beijing’s expanding global role and interests, it is no longer possible for China to follow its traditional ‘lay low’ [tao guang yang hui] strategy and the traditionally rather strict interpretation of the principle of non-intervention. Consequently, among Chinese International Relations...... (IR) scholars there is an intense debate on how China can protect and promote its global presence and interests while at the same time continuing to ‘stay within’ the principle of non-intervention. New concepts and approaches are developing as the debate progresses. Current Chinese foreign...... and security policy reflects a more flexible and pragmatic Chinese interpretation – and implementation – of the principle of non-intervention. This chapter examines the search for ‘legitimate’ great-power intervention that characterizes both the debate among Chinese IR scholars and current Chinese foreign...

Comparison between static stretching and the Pilates method on the flexibility of older women.

Science.gov (United States)

Oliveira, Laís Campos de; Oliveira, Raphael Gonçalves de; Pires-Oliveira, Deise Aparecida de Almeida

2016-10-01

Flexibility decreases with advancing age and some forms of exercise, such as static stretching and Pilates, can contribute to the improvement of this physical ability. To compare the effects of static stretching and Pilates on the flexibility of healthy older women, over the age of 60 years. Thirty-two volunteers were randomized into two groups (Static stretching or Pilates) to perform exercises for 60 min, twice a week, for three months. Evaluations to analyze the movements of the trunk (flexion and extension), hip flexion and plantar and dorsiflexion of the ankle were performed before and after the intervention, using a fleximeter. The static stretching exercises improved the trunk flexion and hip flexion movements, while the Pilates improved all evaluated movements. However, over time, the groups presented differences only for the trunk extension movement. For some body segments, Pilates may be more effective for improving flexibility in older women compared to static stretching. Copyright © 2016 Elsevier Ltd. All rights reserved.

Child involvement, alliance, and therapist flexibility: process variables in cognitive-behavioural therapy for anxiety disorders in childhood.

Science.gov (United States)

Hudson, Jennifer L; Kendall, Philip C; Chu, Brian C; Gosch, Elizabeth; Martin, Erin; Taylor, Alan; Knight, Ashleigh

2014-01-01

This study examined the relations between treatment process variables and child anxiety outcomes. Independent raters watched/listened to taped therapy sessions of 151 anxiety-disordered (6-14 yr-old; M = 10.71) children (43% boys) and assessed process variables (child alliance, therapist alliance, child involvement, therapist flexibility and therapist functionality) within a manual-based cognitive-behavioural treatment. Latent growth modelling examined three latent variables (intercept, slope, and quadratic) for each process variable. Child age, gender, family income and ethnicity were examined as potential antecedents. Outcome was analyzed using factorially derived clinician, mother, father, child and teacher scores from questionnaire and structured diagnostic interviews at pretreatment, posttreatment and 12-month follow-up. Latent growth models demonstrated a concave quadratic curve for child involvement and therapist flexibility over time. A predominantly linear, downward slope was observed for alliance, and functional flexibility remained consistent over time. Increased alliance, child involvement and therapist flexibility showed some albeit inconsistent, associations with positive treatment outcome. Findings support the notion that maintaining the initial high level of alliance or involvement is important for clinical improvement. There is some support that progressively increasing alliance/involvement also positively impacts on treatment outcome. These findings were not consistent across outcome measurement points or reporters. Copyright © 2013 Elsevier Ltd. All rights reserved.

Short-term cognitive behavioral partial hospital treatment: a pilot study.

Science.gov (United States)

Neuhaus, Edmund C; Christopher, Michael; Jacob, Karen; Guillaumot, Julien; Burns, James P

2007-09-01

Brief, cost-contained, and effective psychiatric treatments benefit patients and public health. This naturalistic pilot study examined the effectiveness of a 2-week, cognitive-behavioral therapy (CBT) oriented partial hospital program. Study participants were 57 patients with mood, anxiety, and/or personality disorders receiving treatment in a private psychiatric partial hospital (PH) setting. A flexible treatment model was used that adapts evidence-based CBT treatment interventions to the PH context with emphases on psychoeducation and skills training. Participants completed self-report measures at admission and after 1 and 2 weeks, to assess stabilization and functional improvements, with added attention to the acquisition of cognitive and behavioral skills. The data were analyzed using repeated measures analyses of variance and correlation. Participants reported a decrease in symptoms and negative thought patterns, improved satisfaction with life, and acquisition and use of cognitive and behavioral skills. Skill acquisition was correlated with symptom reduction, reduced negative thought patterns, and improved satisfaction with life. Results of this pilot study suggest that a 2-week PH program can be effective for a heterogeneous patient population with mood, anxiety, and/or personality disorders. These findings are promising given the prevalence of treatments of such brief duration in private sector PH programs subject to the managed care marketplace. Future studies are planned to test this flexible PH treatment model, with particular attention to the effectiveness of the CBT approach for the treatment of different disorders and to whether effectiveness is sustained at follow-up. Further study should also examine whether skill acquisition is a mechanism of change for symptom reduction and functional improvements.

Interventions for post-infectious irritable bowel syndrome: a systematic review of treatment efficacy

OpenAIRE

Torbicki, Emma; Oh, Justin; Mishra, Sharmistha; Page, Andrea V.; Boggild, Andrea K.

2015-01-01

Background Post-infectious irritable bowel syndrome (PI-IBS) due to traveler?s diarrhea is the second most common illness seen in post-travel clinics, yet its optimal management remains unknown. We performed a systematic review to evaluate treatment efficacy in PI-IBS. Methods We searched Medline, EMBASE, LILACS, CINAHL, CAB abstracts, and the Cochrane Library to February 3, 2014 for intervention studies of the pharmacologic and non-pharmacologic management of PI-IBS and examined the evidence...

Low intensity interventions for Obsessive-Compulsive Disorder (OCD): a qualitative study of mental health practitioner experiences.

Science.gov (United States)

Gellatly, Judith; Pedley, Rebecca; Molloy, Christine; Butler, Jennifer; Lovell, Karina; Bee, Penny

2017-02-22

Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder that can substantially impact upon quality of life and everyday functioning. Guidelines recommend pharmacological and psychological treatments, using a cognitive behaviour therapy approach (CBT) including exposure and response prevention, but access has generally been poor. Low intensity psychological interventions have been advocated. The evidence base for these interventions is emerging but there is a paucity of information regarding practitioners' perceptions and experiences of supporting individuals with OCD using this approach. Qualitative interviews were undertaken with psychological wellbeing practitioners (PWPs) (n = 20) delivering low intensity psychological interventions for adults with OCD within the context of a large pragmatic effectiveness trial. Interviews explored the feasibility and acceptability of delivering two interventions; guided self-help and supported computerised cognitive behaviour therapy (cCBT), within Improving Access to Psychological Therapies (IAPT) services in NHS Trusts. Interviews were recorded with consent, transcribed and analysed using thematic analysis. PWPs acknowledged the benefits of low intensity psychological interventions for individuals experiencing OCD symptoms on an individual and population level. Offering low intensity support provided was perceived to have the opportunity to overcome existing service barriers to access treatment, improve patient choice and flexibility. Professional and service relevant issues were also recognised including self-beliefs about supporting people with OCD and personal training needs. Challenges to implementation were recognised in relation to practitioner resistance and intervention delivery technical complications. This study has provided insight into the implementation of new low intensity approaches to the management of OCD within existing mental health services. Benefits from a practitioner, service

Flexible magnetoimpedance sensor

KAUST Repository

Li, Bodong; Kavaldzhiev, Mincho; Kosel, Jü rgen

2015-01-01

Flexible magnetoimpedance (MI) sensors fabricated using a NiFe/Cu/NiFe tri-layer on Kapton substrate have been studied. A customized flexible microstrip transmission line was employed to investigate the MI sensors's magnetic field and frequency

Retroflex Versus Bunched in Treatment for Rhotic Misarticulation: Evidence From Ultrasound Biofeedback Intervention

Science.gov (United States)