Classification via Clustering for Predicting Final Marks Based on Student Participation in Forums

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Lopez, M. I.; Luna, J. M.; Romero, C.; Ventura, S.

2012-01-01

This paper proposes a classification via clustering approach to predict the final marks in a university course on the basis of forum data. The objective is twofold: to determine if student participation in the course forum can be a good predictor of the final marks for the course and to examine whether the proposed classification via clustering…

Validity of resting energy expenditure predictive equations before and after an energy-restricted diet intervention in obese women.

Directory of Open Access Journals (Sweden)

Jonatan R Ruiz

Full Text Available BACKGROUND: We investigated the validity of REE predictive equations before and after 12-week energy-restricted diet intervention in Spanish obese (30 kg/m(2>BMI<40 kg/m(2 women. METHODS: We measured REE (indirect calorimetry, body weight, height, and fat mass (FM and fat free mass (FFM, dual X-ray absorptiometry in 86 obese Caucasian premenopausal women aged 36.7±7.2 y, before and after (n = 78 women the intervention. We investigated the accuracy of ten REE predictive equations using weight, height, age, FFM and FM. RESULTS: At baseline, the most accurate equation was the Mifflin et al. (Am J Clin Nutr 1990; 51: 241-247 when using weight (bias:-0.2%, P = 0.982, 74% of accurate predictions. This level of accuracy was not reached after the diet intervention (24% accurate prediction. After the intervention, the lowest bias was found with the Owen et al. (Am J Clin Nutr 1986; 44: 1-19 equation when using weight (bias:-1.7%, P = 0.044, 81% accurate prediction, yet it provided 53% accurate predictions at baseline. CONCLUSIONS: There is a wide variation in the accuracy of REE predictive equations before and after weight loss in non-morbid obese women. The results acquire especial relevance in the context of the challenging weight regain phenomenon for the overweight/obese population.

Predictive factors for final outcome of severely traumatized eyes with no light perception

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Agrawal Rupesh

2012-06-01

Full Text Available Abstract Background An eye injury that causes no light perception (NLP typically carries an unfavorable prognosis, and NLP because of trauma is a common indication for enucleation. With advances in vitreoretinal surgical techniques, however, the indication for enucleation is no longer determined by posttrauma NLP vision alone. There are limited studies in the literature to analyse the outcome of NLP eyes following open globe injury. The current study was aimed to evaluate the outcome of surgical repair of severely traumatized eyes with no light perception vision as preoperative visual acuity. Secondary objective was to possibly predict the factors affecting the final vision outcome in this eyes. Methods Retrospective case analysis of patients with surgical repair of open globe injury over last ten years at a tertiary referral eye care centre in Singapore. Results Out of one hundred and seventy two eyes with open globe injury 27 (15.7% eyes had no light perception (NLP. After surgical repair, final visual acuity remained NLP in 18 (66.7% eyes. Final vision improved to Light perception/ Hand movement (LP/HM in 2(7.4% eyes, 1/200 to 19/200(11.1% in 3 eyes and 20/50-20/200(14.8% in 4 eyes. The median follow up was 18.9 months (range: 4–60 months. The factors contributing to poor postoperative outcome were presence of RAPD (p = 0.014, wound extending into zone III (p = 0.023 and associated vitreoretinal trauma (p = 0.008. Conclusions One third of eyes had ambulatory vision or better though two third of eyes still remained NLP. Pre-operative visual acuity of NLP should not be an indication for primary enucleation or evisceration for severely traumatized eyes. Presence of afferent papillary defect, wound extending posterior to rectus insertion and associated vitreoretinal trauma can adversely affect the outcome in severely traumatized eyes with NLP. Timely intervention and state of art surgery may restore useful vision in severely

Gut Microbiota Signatures Predict Host and Microbiota Responses to Dietary Interventions in Obese Individuals

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Korpela, Katri; Flint, Harry J.; Johnstone, Alexandra M.; Lappi, Jenni; Poutanen, Kaisa; Dewulf, Evelyne; Delzenne, Nathalie; de Vos, Willem M.; Salonen, Anne

2014-01-01

Background Interactions between the diet and intestinal microbiota play a role in health and disease, including obesity and related metabolic complications. There is great interest to use dietary means to manipulate the microbiota to promote health. Currently, the impact of dietary change on the microbiota and the host metabolism is poorly predictable and highly individual. We propose that the responsiveness of the gut microbiota may depend on its composition, and associate with metabolic changes in the host. Methodology Our study involved three independent cohorts of obese adults (n = 78) from Belgium, Finland, and Britain, participating in different dietary interventions aiming to improve metabolic health. We used a phylogenetic microarray for comprehensive fecal microbiota analysis at baseline and after the intervention. Blood cholesterol, insulin and inflammation markers were analyzed as indicators of host response. The data were divided into four training set – test set pairs; each intervention acted both as a part of a training set and as an independent test set. We used linear models to predict the responsiveness of the microbiota and the host, and logistic regression to predict responder vs. non-responder status, or increase vs. decrease of the health parameters. Principal Findings Our models, based on the abundance of several, mainly Firmicute species at baseline, predicted the responsiveness of the microbiota (AUC  =  0.77–1; predicted vs. observed correlation  =  0.67–0.88). Many of the predictive taxa showed a non-linear relationship with the responsiveness. The microbiota response associated with the change in serum cholesterol levels with an AUC of 0.96, highlighting the involvement of the intestinal microbiota in metabolic health. Conclusion This proof-of-principle study introduces the first potential microbial biomarkers for dietary responsiveness in obese individuals with impaired metabolic health, and reveals the potential of

Interactive Visual Intervention Planning: Interactive Visualization for Intervention Planning in Particle Accelerator Environments with Ionizing Radiation

CERN Document Server

Fabry, Thomas; Feral, Bruno

2013-01-01

Intervention planning is crucial for maintenance operations in particle accelerator environments with ionizing radiation, during which the radiation dose contracted by maintenance workers should be reduced to a minimum. In this context, we discuss the visualization aspects of a new software tool, which integrates interactive exploration of a scene depicting an accelerator facility augmented with residual radiation level simulations, with the visualization of intervention data such as the followed trajectory and maintenance tasks. The visualization of each of these aspects has its effect on the final predicted contracted radiation dose. In this context, we explore the possible benefits of a user study, with the goal of enhancing the visual conditions in which the intervention planner using the software tool is minimizing the radiation dose.

Pre-trial Intervention: The Manhattan Court Employment Project of the Vera Institute of Justice. Final Report.

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Vera Inst. of Justice, New York, NY.

The final report of an experimental pre-trial intervention program of intensive manpower services (individual and group counseling and job, training, or academic placement with the help of career developers) for selected defendants in Manhattan covers the period November 1967 through October 1970. After three years and 1,300 participants,…

Model-on-Demand Predictive Control for Nonlinear Hybrid Systems With Application to Adaptive Behavioral Interventions

Science.gov (United States)

Nandola, Naresh N.; Rivera, Daniel E.

2011-01-01

This paper presents a data-centric modeling and predictive control approach for nonlinear hybrid systems. System identification of hybrid systems represents a challenging problem because model parameters depend on the mode or operating point of the system. The proposed algorithm applies Model-on-Demand (MoD) estimation to generate a local linear approximation of the nonlinear hybrid system at each time step, using a small subset of data selected by an adaptive bandwidth selector. The appeal of the MoD approach lies in the fact that model parameters are estimated based on a current operating point; hence estimation of locations or modes governed by autonomous discrete events is achieved automatically. The local MoD model is then converted into a mixed logical dynamical (MLD) system representation which can be used directly in a model predictive control (MPC) law for hybrid systems using multiple-degree-of-freedom tuning. The effectiveness of the proposed MoD predictive control algorithm for nonlinear hybrid systems is demonstrated on a hypothetical adaptive behavioral intervention problem inspired by Fast Track, a real-life preventive intervention for improving parental function and reducing conduct disorder in at-risk children. Simulation results demonstrate that the proposed algorithm can be useful for adaptive intervention problems exhibiting both nonlinear and hybrid character. PMID:21874087

ST peak during primary percutaneous coronary intervention predicts final infarct size, left ventricular function, and clinical outcome

DEFF Research Database (Denmark)

Lønborg, Jacob Thomsen; Kelbæk, Henning Skov; Holmvang, Lene

2012-01-01

One third of patients treated with primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction develop a secondary increase in electrocardiographic ST segment (ST peak) during reperfusion. The purpose was to determine the clinical importance of ST peak during primary PCI....

Using behavioral theories of choice to predict drinking outcomes following a brief intervention.

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Murphy, James G; Correia, Christopher J; Colby, Suzanne M; Vuchinich, Rudy E

2005-05-01

Behavioral theories of choice predict that substance use is partly a function of the relative value of drugs in relation to other available reinforcers. This study evaluated this hypothesis in the context of predicting drinking outcomes following an alcohol abuse intervention. Participants (N = 54, 69% female, 31% male) were college student heavy drinkers who completed a single-session motivational intervention. Students completed a baseline measure of substance-related and substance-free activity participation and enjoyment. Only women showed a significant reduction in drinking at the 6-month follow-up, and the ratio of substance-related to substance-free reinforcement accounted for unique variance in their drinking outcomes. Women who at baseline derived a smaller proportion of their total reinforcement from substance use showed lower levels of follow-up drinking, even after the authors controlled for baseline drinking level. Male and female participants who reduced their drinking showed increased proportional reinforcement from substance-free activities. Copyright 2005 APA, all rights reserved.

Environmental Contamination as an Important Route for the Transmission of the Hospital Pathogen VRE: Modeling and Prediction of Classical Interventions

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M Wolkewitz

2008-01-01

Full Text Available Background In addition to the close contact between patients and medical staff, the contamination of surfaces plays an important role in the transmission of pathogens such as vancomycin-resistant enterococci (VRE. Mathematical modeling is a very convenient tool for hospital infection control as it allows the quantitative prediction of the effects of special hygiene and control interventions. Methods We present a compartmental model which describes the dynamics of transmission from patient to patient, also taking into account the interaction with medical staff and environmental contamination. Empirical data from a VRE outbreak in the onco-haematological unit at the University Medical Center Freiburg (Germany were collected with 100 consecutive admissions being followed up for 90 days. Stochastical simulations were used to predict the prevalence of patients colonised with VRE at the time when at least one of the following interventions were introduced: hand hygiene, disinfection of surfaces, cohorting, screening and antibiotic reduction. Results Graphical figures show the temporal dynamics of several simulation scenarios. If no prevention or intervention is present, simulations based on transmission models predict an expected endemic prevalence per ward of 0.83 (95% CI:0.66, 1.00 after the first infected person enters the unit. Interventions may reduce this prevalence, but only the combination of several interventions can control a VRE outbreak. Conclusions The model predicts that only the combination of several interventions can control an VRE outbreak in this setting. The inclusion of environmental contamination improves the compartmental model and allows a prediction of the efficacy of the disinfection of surfaces. These results can be applied to other settings and will therefore help to understand and control the spread of nosocomial pathogens.

Predicting success in an online parenting intervention: the role of child, parent, and family factors.

Science.gov (United States)

Dittman, Cassandra K; Farruggia, Susan P; Palmer, Melanie L; Sanders, Matthew R; Keown, Louise J

2014-04-01

The present study involved an examination of the extent to which a wide range of child, parent, family, and program-related factors predicted child behavior and parenting outcomes after participation in an 8-session online version of the Triple P-Positive Parenting Program. Participants were mothers and fathers of 97 children aged between 3 and 8 years displaying elevated levels of disruptive behavior problems. For both mothers and fathers, poorer child behavior outcomes at postintervention were predicted by the number of sessions of the intervention completed by the family. For mothers, postintervention child behavior was also predicted by the quality of the mother-child relationship at baseline; for fathers, baseline child behavior severity was an additional predictor. Mothers' postintervention ineffective parenting was predicted by session completion and preintervention levels of ineffective parenting, whereas the only predictor of fathers' ineffective parenting at postintervention was preintervention levels of ineffective parenting. Socioeconomic risk, parental adjustment, and father participation in the intervention were not significant predictors of mother- or father-reported treatment outcomes. The implications of the findings for the provision of online parenting support are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Prediction of fruit and vegetable intake from biomarkers using individual participant data of diet-controlled intervention studies

DEFF Research Database (Denmark)

Souverein, Olga W; de Vries, Jeanne H M; Freese, Riitta

2015-01-01

concentrations. Furthermore, a prediction model of fruit and vegetable intake based on these biomarkers and subject characteristics (i.e. age, sex, BMI and smoking status) was established. Data from twelve diet-controlled intervention studies were obtained to develop a prediction model for fruit and vegetable...

Comparison of biometric predictability and final refraction expected in phacoemulsification surgery with and without trabeculectomy

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Fernanda Guedes Oliveira

Full Text Available Abstract Objective: The main purpose of this article is to compare the predictability of biometric results and final refractive outcomes expected in patients undergoing cataract surgery through phacoemulsification with and without associated trabeculectomy. Methods: Cataract patients who have undergone phacoemulsification surgery alone (control group or associated with trabeculectomy (study group screened. All surgeries were performed following standard protocol. For enrollment, biometrics calculated by IOL Master (Carl Zeiss Meditec, Inc. biometry, refraction and intraocular pressure (IOP before and after surgery were required. Data was compared between groups in addition to the correlation between variation of IOP and final refraction. Results: Thirty eyes per group were enrolled. Only prior IOP (p <0.001, IOP post-surgery (p = 0.01 and the difference in IOP (p <0.001 were statistically significant. Axial length, IOL diopter used, expected spherical refraction by biometrics and astigmatism pre- and post-surgery were similar in both groups (p=0.1; 0.4; 0.4; 0.5 and 0.3, respectively. Spherical predictability by biometrics within 0.25 diopters was noted in both the control group (range 0.06 ± 0.45 and study group (range 0.25 ± 0.97, p = 0.3. There was no statistical significance between groups for the difference between final cylinder and corneal astigmatism (p = 0.9, and the difference between axis of refractive and corneal astigmatism (p = 0.7. Conclusion: The biometric predictability in phacoemulsification surgery and the expected final refraction are significant, andare not modified by trabeculectomy in the combined surgeries.

Workflow and intervention times of MR-guided focused ultrasound - Predicting the impact of new techniques.

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Loeve, Arjo J; Al-Issawi, Jumana; Fernandez-Gutiérrez, Fabiola; Langø, Thomas; Strehlow, Jan; Haase, Sabrina; Matzko, Matthias; Napoli, Alessandro; Melzer, Andreas; Dankelman, Jenny

2016-04-01

Magnetic resonance guided focused ultrasound surgery (MRgFUS) has become an attractive, non-invasive treatment for benign and malignant tumours, and offers specific benefits for poorly accessible locations in the liver. However, the presence of the ribcage and the occurrence of liver motion due to respiration limit the applicability MRgFUS. Several techniques are being developed to address these issues or to decrease treatment times in other ways. However, the potential benefit of such improvements has not been quantified. In this research, the detailed workflow of current MRgFUS procedures was determined qualitatively and quantitatively by using observation studies on uterine MRgFUS interventions, and the bottlenecks in MRgFUS were identified. A validated simulation model based on discrete events simulation was developed to quantitatively predict the effect of new technological developments on the intervention duration of MRgFUS on the liver. During the observation studies, the duration and occurrence frequencies of all actions and decisions in the MRgFUS workflow were registered, as were the occurrence frequencies of motion detections and intervention halts. The observation results show that current MRgFUS uterine interventions take on average 213min. Organ motion was detected on average 2.9 times per intervention, of which on average 1.0 actually caused a need for rework. Nevertheless, these motion occurrences and the actions required to continue after their detection consumed on average 11% and up to 29% of the total intervention duration. The simulation results suggest that, depending on the motion occurrence frequency, the addition of new technology to automate currently manual MRgFUS tasks and motion compensation could potentially reduce the intervention durations by 98.4% (from 256h 5min to 4h 4min) in the case of 90% motion occurrence, and with 24% (from 5h 19min to 4h 2min) in the case of no motion. In conclusion, new tools were developed to predict how

Discrete event simulation model of sudden cardiac death predicts high impact of preventive interventions.

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Andreev, Victor P; Head, Trajen; Johnson, Neil; Deo, Sapna K; Daunert, Sylvia; Goldschmidt-Clermont, Pascal J

2013-01-01

Sudden Cardiac Death (SCD) is responsible for at least 180,000 deaths a year and incurs an average cost of $286 billion annually in the United States alone. Herein, we present a novel discrete event simulation model of SCD, which quantifies the chains of events associated with the formation, growth, and rupture of atheroma plaques, and the subsequent formation of clots, thrombosis and on-set of arrhythmias within a population. The predictions generated by the model are in good agreement both with results obtained from pathological examinations on the frequencies of three major types of atheroma, and with epidemiological data on the prevalence and risk of SCD. These model predictions allow for identification of interventions and importantly for the optimal time of intervention leading to high potential impact on SCD risk reduction (up to 8-fold reduction in the number of SCDs in the population) as well as the increase in life expectancy.

Final Technical Report: Increasing Prediction Accuracy.

Energy Technology Data Exchange (ETDEWEB)

King, Bruce Hardison [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hansen, Clifford [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Stein, Joshua [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2015-12-01

PV performance models are used to quantify the value of PV plants in a given location. They combine the performance characteristics of the system, the measured or predicted irradiance and weather at a site, and the system configuration and design into a prediction of the amount of energy that will be produced by a PV system. These predictions must be as accurate as possible in order for finance charges to be minimized. Higher accuracy equals lower project risk. The Increasing Prediction Accuracy project at Sandia focuses on quantifying and reducing uncertainties in PV system performance models.

Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: background, design and conceptual model of FINALE.

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Holtermann, Andreas; Jørgensen, Marie B; Gram, Bibi; Christensen, Jeanette R; Faber, Anne; Overgaard, Kristian; Ektor-Andersen, John; Mortensen, Ole S; Sjøgaard, Gisela; Søgaard, Karen

2010-03-09

A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers) characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence. A novel approach of the FINALE programme is that the interventions, i.e. 3 randomized controlled trials (RCT) and 1 exploratory case-control study are tailored to the physical work demands, physical capacities and health profile of workers in each job-group. The RCT among cleaners, characterized by repetitive work tasks and musculoskeletal disorders, aims at making the cleaners less susceptible to musculoskeletal disorders by physical coordination training or cognitive behavioral theory based training (CBTr). Because health-care workers are reported to have high prevalence of overweight and heavy lifts, the aim of the RCT is long-term weight-loss by combined physical exercise training, CBTr and diet. Construction work, characterized by heavy lifting, pushing and pulling, the RCT aims at improving physical capacity and promoting musculoskeletal and cardiovascular health. At the industrial work-place characterized by repetitive work tasks, the intervention aims at reducing physical exertion and musculoskeletal disorders by combined physical exercise training, CBTr and participatory ergonomics. The overall aim of the FINALE programme is to improve the safety margin between individual resources (i.e. physical capacities, and cognitive and behavioral skills) and physical work demands

Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions

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Ferreira Isabel

2005-04-01

Full Text Available Abstract Background The present paper intends to contribute to the debate on the usefulness and barriers in applying theories in diet and physical activity behavior-change interventions. Discussion Since behavior theory is a reflection of the compiled evidence of behavior research, theory is the only foothold we have for the development of behavioral nutrition and physical activity interventions. Application of theory should improve the effectiveness of interventions. However, some of the theories we use lack a strong empirical foundation, and the available theories are not always used in the most effective way. Furthermore, many of the commonly-used theories provide at best information on what needs to be changed to promote healthy behavior, but not on how changes can be induced. Finally, many theories explain behavioral intentions or motivation rather well, but are less well-suited to explaining or predicting actual behavior or behavior change. For more effective interventions, behavior change theory needs to be further developed in stronger research designs and such change-theory should especially focus on how to promote action rather than mere motivation. Since voluntary behavior change requires motivation, ability as well as the opportunity to change, further development of behavior change theory should incorporate environmental change strategies. Conclusion Intervention Mapping may help to further improve the application of theories in nutrition and physical activity behavior change.

Prediction impact curve is a new measure integrating intervention effects in the evaluation of risk models.

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Campbell, William; Ganna, Andrea; Ingelsson, Erik; Janssens, A Cecile J W

2016-01-01

We propose a new measure of assessing the performance of risk models, the area under the prediction impact curve (auPIC), which quantifies the performance of risk models in terms of their average health impact in the population. Using simulated data, we explain how the prediction impact curve (PIC) estimates the percentage of events prevented when a risk model is used to assign high-risk individuals to an intervention. We apply the PIC to the Atherosclerosis Risk in Communities (ARIC) Study to illustrate its application toward prevention of coronary heart disease. We estimated that if the ARIC cohort received statins at baseline, 5% of events would be prevented when the risk model was evaluated at a cutoff threshold of 20% predicted risk compared to 1% when individuals were assigned to the intervention without the use of a model. By calculating the auPIC, we estimated that an average of 15% of events would be prevented when considering performance across the entire interval. We conclude that the PIC is a clinically meaningful measure for quantifying the expected health impact of risk models that supplements existing measures of model performance. Copyright © 2016 Elsevier Inc. All rights reserved.

Motivational impairment predicts functional remission in first-episode psychosis: 3-Year follow-up of the randomized controlled trial on extended early intervention.

Science.gov (United States)

Chang, Wing Chung; Kwong, Vivian Wing Yan; Or Chi Fai, Philip; Lau, Emily Sin Kei; Chan, Gloria Hoi Kei; Jim, Olivia Tsz Ting; Hui, Christy Lai Ming; Chan, Sherry Kit Wa; Lee, Edwin Ho Ming; Chen, Eric Yu Hai

2018-02-01

Functional remission represents an intermediate functional milestone toward recovery. Differential relationships of negative symptom sub-domains with functional remission in first-episode psychosis are understudied. We aimed to examine rate and predictors of functional remission in people with first-episode psychosis in the context of a 3-year follow-up of a randomized controlled trial comparing 1-year extension of early intervention (i.e. 3-year early intervention) with step-down psychiatric care (i.e. 2-year early intervention). A total of 160 participants were recruited upon completion of a 2-year specialized early intervention program for first-episode psychosis in Hong Kong and underwent a 1-year randomized controlled trial comparing 1-year extended early intervention with step-down care. Participants were followed up and reassessed 3 years after inclusion to the trial (i.e. 3-year follow-up). Functional remission was operationalized as simultaneous fulfillment of attaining adequate functioning (measured by Social and Occupational Functioning Scale and Role Functioning Scale) at 3-year follow-up and sustained employment in the last 6 months of 3-year study period. Negative symptom measure was delineated into amotivation (i.e. motivational impairment) and diminished expression (i.e. reduced affect and speech output). Data analysis was based on 143 participants who completed follow-up functional assessments. A total of 31 (21.7%) participants achieved functional remission status at 3-year follow-up. Multivariate regression analysis showed that lower levels of amotivation ( p = 0.010) and better functioning at study intake ( p = 0.004) independently predicted functional remission (Final model: Nagelkerke R 2  = 0.40, χ 2  = 42.9, p amotivation may represent a critical therapeutic target for functional remission attainment in early psychosis.

Patterns, incidence and predictive factors for pain after interventional radiology

International Nuclear Information System (INIS)

England, A.; Tam, C.L.; Thacker, D.E.; Walker, A.L.; Parkinson, A.S.; DeMello, W.; Bradley, A.J.; Tuck, J.S.; Laasch, H.-U.; Butterfield, J.S.; Ashleigh, R.J.; England, R.E.; Martin, D.F.

2005-01-01

AIM: To evaluate prospectively the pattern, severity and predictive factors of pain after interventional radiological procedures. MATERIALS AND METHODS: All patients undergoing non-arterial radiological interventional procedures were assessed using a visual-analogue scale (VAS) for pain before and at regular intervals for 24 h after their procedure. RESULTS: One hundred and fifty patients (87 men, mean age 62 years, range 18-92 years) were entered into the study. Significant increases in VAS score occurred 8 h after percutaneous biliary procedures (+47.7 mm, SD 14.9 mm; p=0.001), 6 h after central venous access and gastrostomy insertion (+23.7 mm, SD 19.5 mm; p=0.001 and +28.4 mm, SD 9.7 mm; p=0.007, respectively) and 4 h after oesophageal stenting (+27.8 mm, SD 20.2 mm, p=0.001). Non-significant increases in VAS pain score were observed after duodenal and colonic stenting (duodenal: +5.13 mm, SD 7.47 mm; p=0.055, colonic: +23.3 mm, SD 13.10 mm, p=0.250) at a mean of 5 h (range 4-6 h). Patients reported a significant reduction in pain score for nephrostomy insertion (-28.4 mm, SD 7.11 mm, p=0.001). Post-procedural analgesia was required in 99 patients (69.2%), 40 (28.0%) requiring opiates. Maximum post-procedural VAS pain score was significantly higher in patients who had no pre-procedural analgesia (p=0.003). CONCLUSION: Post-procedural pain is common and the pattern and severity of pain between procedures is variable. Pain control after interventional procedures is often inadequate, and improvements in pain management are required

Evaluation of scoring models for identifying the need for therapeutic intervention of upper gastrointestinal bleeding: A new prediction score model for Japanese patients.

Science.gov (United States)

Iino, Chikara; Mikami, Tatsuya; Igarashi, Takasato; Aihara, Tomoyuki; Ishii, Kentaro; Sakamoto, Jyuichi; Tono, Hiroshi; Fukuda, Shinsaku

2016-11-01

Multiple scoring systems have been developed to predict outcomes in patients with upper gastrointestinal bleeding. We determined how well these and a newly established scoring model predict the need for therapeutic intervention, excluding transfusion, in Japanese patients with upper gastrointestinal bleeding. We reviewed data from 212 consecutive patients with upper gastrointestinal bleeding. Patients requiring endoscopic intervention, operation, or interventional radiology were allocated to the therapeutic intervention group. Firstly, we compared areas under the curve for the Glasgow-Blatchford, Clinical Rockall, and AIMS65 scores. Secondly, the scores and factors likely associated with upper gastrointestinal bleeding were analyzed with a logistic regression analysis to form a new scoring model. Thirdly, the new model and the existing model were investigated to evaluate their usefulness. Therapeutic intervention was required in 109 patients (51.4%). The Glasgow-Blatchford score was superior to both the Clinical Rockall and AIMS65 scores for predicting therapeutic intervention need (area under the curve, 0.75 [95% confidence interval, 0.69-0.81] vs 0.53 [0.46-0.61] and 0.52 [0.44-0.60], respectively). Multivariate logistic regression analysis retained seven significant predictors in the model: systolic blood pressure upper gastrointestinal bleeding. © 2016 Japan Gastroenterological Endoscopy Society.

Physical characteristics that predict final basal insulin dose in type 2 diabetes mellitus, with a special focus on BMI

NARCIS (Netherlands)

Simon, A. C. R.; Bolli, G. B.; Dain, M.-P.; Wang, E.; Holleman, F.

2014-01-01

The possibility to predict final insulin dose based on patient's characteristics would allow for efficient titration for patients with higher dose needs. The primary aim of this post-hoc analysis of the L2T3 study was to determine predictors for final dose. Specifically, we focused on the

Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: Background, design and conceptual model of FINALE

Directory of Open Access Journals (Sweden)

Mortensen Ole S

2010-03-01

Full Text Available Abstract Background A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence. Methods/Design A novel approach of the FINALE programme is that the interventions, i.e. 3 randomized controlled trials (RCT and 1 exploratory case-control study are tailored to the physical work demands, physical capacities and health profile of workers in each job-group. The RCT among cleaners, characterized by repetitive work tasks and musculoskeletal disorders, aims at making the cleaners less susceptible to musculoskeletal disorders by physical coordination training or cognitive behavioral theory based training (CBTr. Because health-care workers are reported to have high prevalence of overweight and heavy lifts, the aim of the RCT is long-term weight-loss by combined physical exercise training, CBTr and diet. Construction work, characterized by heavy lifting, pushing and pulling, the RCT aims at improving physical capacity and promoting musculoskeletal and cardiovascular health. At the industrial work-place characterized by repetitive work tasks, the intervention aims at reducing physical exertion and musculoskeletal disorders by combined physical exercise training, CBTr and participatory ergonomics. The overall aim of the FINALE programme is to improve the safety margin between individual resources (i.e. physical capacities, and

Internet interventions: Past, present and future

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Gerhard Andersson

2018-06-01

Full Text Available Internet interventions have been around now for about 20 years. While the field still suffers from a scattered terminology a large number of programs and studies exist. In the present paper I present an overview of my experiences of studying internet-supported cognitive-behaviour therapy (ICBT, but also mention other approaches including the use of smartphones. The paper covers the history of ICBT, short-term effects in controlled trials for a range of conditions, long-term effects, comparisons against face-to-face therapy, effectiveness studies, prediction studies, how the treatment is perceived, critique, and finally future directions. I conclude that we have now reached a stage in which we have numerous evidence-based treatments and procedures, and increasingly internet interventions including ICBT are disseminated. Keywords: Internet treatment, Therapist guidance, Anxiety, Mood disorders, Somatic disorders

Harnessing Facebook for Smoking Reduction and Cessation Interventions: Facebook User Engagement and Social Support Predict Smoking Reduction

Science.gov (United States)

Marsch, Lisa A; Brunette, Mary F; Dallery, Jesse

2017-01-01

Background Social media technologies offer a novel opportunity for scalable health interventions that can facilitate user engagement and social support, which in turn may reinforce positive processes for behavior change. Objective By using principles from health communication and social support literature, we implemented a Facebook group–based intervention that targeted smoking reduction and cessation. This study hypothesized that participants’ engagement with and perceived social support from our Facebook group intervention would predict smoking reduction. Methods We recruited 16 regular smokers who live in the United States and who were motivated in quitting smoking at screening. We promoted message exposure as well as engagement and social support systems throughout the intervention. For message exposure, we posted prevalidated, antismoking messages (such as national antismoking campaigns) on our smoking reduction and cessation Facebook group. For engagement and social support systems, we delivered a high degree of engagement and social support systems during the second and third week of the intervention and a low degree of engagement and social support systems during the first and fourth week. A total of six surveys were conducted via Amazon Mechanical Turk (MTurk) at baseline on a weekly basis and at a 2-week follow-up. Results Of the total 16 participants, most were female (n=13, 81%), white (n=15, 94%), and between 25 and 50 years of age (mean 34.75, SD 8.15). There was no study attrition throughout the 6-time-point baseline, weekly, and follow-up surveys. We generated Facebook engagement and social support composite scores (mean 19.19, SD 24.35) by combining the number of likes each participant received and the number of comments or wall posts each participant posted on our smoking reduction and cessation Facebook group during the intervention period. The primary outcome was smoking reduction in the past 7 days measured at baseline and at the two

Accuracy of pre-operative hysteroscopic guided biopsy for predicting final pathology in uterine malignancies.

Science.gov (United States)

Martinelli, Fabio; Ditto, Antonino; Bogani, Giorgio; Signorelli, Mauro; Chiappa, Valentina; Lorusso, Domenica; Haeusler, Edward; Raspagliesi, Francesco

2017-07-01

To evaluate concordance (C) between pre-operative hysteroscopic-directed sampling and final pathology in uterine cancers. A retrospective cross-sectional evaluation of prospectively collected data of women who underwent hysterectomy for uterine malignancies and a previous hysteroscopic-guided biopsy was performed. Diagnostic concordance between pre-operative (hysteroscopic biopsy) and postoperative (uterine specimen) histology was evaluated. In endometrioid-endometrial cancers cases Kappa (k) statistics was applied to evaluate agreement for grading (G) between the preoperative and final pathology. A total 101 hysterectomies for uterine malignancies were evaluated. There were 23 non-endometrioid cancers: 7 serous (C:5/7, 71.4%); 10 carcinosarcomas (C:7/10, 70%, remaining 3 cases only epithelial component diagnosed); 3 clear cell (C:3/3, 100%); 3 sarcomas (C:3/3, 100%). In 78 cases an endometrioid endometrial cancer was found. In 63 cases there was a histological C (63/78, 80.8%) between hysteroscopic-guided biopsy and final pathology, while in 15 cases (19.2%) only hyperplasia (with/without atypia) was found preoperatively. Overall accuracy to detect endometrial cancer was 80.2%. In 50 out of 63 endometrial cancers (79.4%) grading was concordant. The overall level of agreement between preoperative and postoperative grading was "substantial" according to Kappa (k) statistics (k 0.64; 95% CI: 0.449-0.83; p < 0.001), as well as for G1 (0.679; 95% CI: 0.432-0.926; p < 0.001) and G3 (0.774; 94% CI: 0.534-1; p < 0.001), while for G2 (0.531; 95% CI: 0.286-0.777; p < 0.001) it was moderate. In our series we found an 80% C between pre-operative hysteroscopic-guided biopsy and final pathology, in uterine malignancies. Moreover, hysteroscopic biopsy accurately predicted endometrial cancer in 80% of cases and "substantially" predicted histological grading. Hysteroscopic-guided uterine sampling could be a useful tool to tailor treatment in patients with uterine

Interventions for the prediction and management of chronic postsurgical pain after total knee replacement: systematic review of randomised controlled trials.

Science.gov (United States)

Beswick, Andrew D; Wylde, Vikki; Gooberman-Hill, Rachael

2015-05-12

Total knee replacement can be a successful operation for pain relief. However, 10-34% of patients experience chronic postsurgical pain. Our aim was to synthesise evidence on the effectiveness of applying predictive models to guide preventive treatment, and for interventions in the management of chronic pain after total knee replacement. We conducted a systematic review of randomised controlled trials using appropriate search strategies in the Cochrane Library, MEDLINE and EMBASE from inception to October 2014. No language restrictions were applied. Adult patients receiving total knee replacement. Predictive models to guide treatment for prevention of chronic pain. Interventions for management of chronic pain. Reporting of specific outcomes was not an eligibility criterion but we sought outcomes relating to pain severity. No studies evaluated the effectiveness of predictive models in guiding treatment and improving outcomes after total knee replacement. One study evaluated an intervention for the management of chronic pain. The trial evaluated the use of a botulinum toxin A injection with antinociceptive and anticholinergic activity in 49 patients with chronic postsurgical pain after knee replacement. A single injection provided meaningful pain relief for about 40 days and the authors acknowledged the need for a large trial with repeated injections. No trials of multidisciplinary interventions or individualised treatments were identified. Our systematic review highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. 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.

Schedulability Analysis for Java Finalizers

DEFF Research Database (Denmark)

Bøgholm, Thomas; Hansen, Rene Rydhof; Søndergaard, Hans

2010-01-01

Java finalizers perform clean-up and finalisation of objects at garbage collection time. In real-time Java profiles the use of finalizers is either discouraged (RTSJ, Ravenscar Java) or even disallowed (JSR-302), mainly because of the unpredictability of finalizers and in particular their impact...... on the schedulability analysis. In this paper we show that a controlled scoped memory model results in a structured and predictable execution of finalizers, more reminiscent of C++ destructors than Java finalizers. Furthermore, we incorporate finalizers into a (conservative) schedulability analysis for Predictable Java...... programs. Finally, we extend the SARTS tool for automated schedulability analysis of Java bytecode programs to handle finalizers in a fully automated way....

Harnessing Facebook for Smoking Reduction and Cessation Interventions: Facebook User Engagement and Social Support Predict Smoking Reduction.

Science.gov (United States)

Kim, Sunny Jung; Marsch, Lisa A; Brunette, Mary F; Dallery, Jesse

2017-05-23

Social media technologies offer a novel opportunity for scalable health interventions that can facilitate user engagement and social support, which in turn may reinforce positive processes for behavior change. By using principles from health communication and social support literature, we implemented a Facebook group-based intervention that targeted smoking reduction and cessation. This study hypothesized that participants' engagement with and perceived social support from our Facebook group intervention would predict smoking reduction. We recruited 16 regular smokers who live in the United States and who were motivated in quitting smoking at screening. We promoted message exposure as well as engagement and social support systems throughout the intervention. For message exposure, we posted prevalidated, antismoking messages (such as national antismoking campaigns) on our smoking reduction and cessation Facebook group. For engagement and social support systems, we delivered a high degree of engagement and social support systems during the second and third week of the intervention and a low degree of engagement and social support systems during the first and fourth week. A total of six surveys were conducted via Amazon Mechanical Turk (MTurk) at baseline on a weekly basis and at a 2-week follow-up. Of the total 16 participants, most were female (n=13, 81%), white (n=15, 94%), and between 25 and 50 years of age (mean 34.75, SD 8.15). There was no study attrition throughout the 6-time-point baseline, weekly, and follow-up surveys. We generated Facebook engagement and social support composite scores (mean 19.19, SD 24.35) by combining the number of likes each participant received and the number of comments or wall posts each participant posted on our smoking reduction and cessation Facebook group during the intervention period. The primary outcome was smoking reduction in the past 7 days measured at baseline and at the two-week follow-up. Compared with the baseline

The New York State risk score for predicting in-hospital/30-day mortality following percutaneous coronary intervention.

Science.gov (United States)

Hannan, Edward L; Farrell, Louise Szypulski; Walford, Gary; Jacobs, Alice K; Berger, Peter B; Holmes, David R; Stamato, Nicholas J; Sharma, Samin; King, Spencer B

2013-06-01

This study sought to develop a percutaneous coronary intervention (PCI) risk score for in-hospital/30-day mortality. Risk scores are simplified linear scores that provide clinicians with quick estimates of patients' short-term mortality rates for informed consent and to determine the appropriate intervention. Earlier PCI risk scores were based on in-hospital mortality. However, for PCI, a substantial percentage of patients die within 30 days of the procedure after discharge. New York's Percutaneous Coronary Interventions Reporting System was used to develop an in-hospital/30-day logistic regression model for patients undergoing PCI in 2010, and this model was converted into a simple linear risk score that estimates mortality rates. The score was validated by applying it to 2009 New York PCI data. Subsequent analyses evaluated the ability of the score to predict complications and length of stay. A total of 54,223 patients were used to develop the risk score. There are 11 risk factors that make up the score, with risk factor scores ranging from 1 to 9, and the highest total score is 34. The score was validated based on patients undergoing PCI in the previous year, and accurately predicted mortality for all patients as well as patients who recently suffered a myocardial infarction (MI). The PCI risk score developed here enables clinicians to estimate in-hospital/30-day mortality very quickly and quite accurately. It accurately predicts mortality for patients undergoing PCI in the previous year and for MI patients, and is also moderately related to perioperative complications and length of stay. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Historical maintenance relevant information road-map for a self-learning maintenance prediction procedural approach

Science.gov (United States)

Morales, Francisco J.; Reyes, Antonio; Cáceres, Noelia; Romero, Luis M.; Benitez, Francisco G.; Morgado, Joao; Duarte, Emanuel; Martins, Teresa

2017-09-01

A large percentage of transport infrastructures are composed of linear assets, such as roads and rail tracks. The large social and economic relevance of these constructions force the stakeholders to ensure a prolonged health/durability. Even though, inevitable malfunctioning, breaking down, and out-of-service periods arise randomly during the life cycle of the infrastructure. Predictive maintenance techniques tend to diminish the appearance of unpredicted failures and the execution of needed corrective interventions, envisaging the adequate interventions to be conducted before failures show up. This communication presents: i) A procedural approach, to be conducted, in order to collect the relevant information regarding the evolving state condition of the assets involved in all maintenance interventions; this reported and stored information constitutes a rich historical data base to train Machine Learning algorithms in order to generate reliable predictions of the interventions to be carried out in further time scenarios. ii) A schematic flow chart of the automatic learning procedure. iii) Self-learning rules from automatic learning from false positive/negatives. The description, testing, automatic learning approach and the outcomes of a pilot case are presented; finally some conclusions are outlined regarding the methodology proposed for improving the self-learning predictive capability.

Longitudinal predictive ability of mapping models: examining post-intervention EQ-5D utilities derived from baseline MHAQ data in rheumatoid arthritis patients.

Science.gov (United States)

Kontodimopoulos, Nick; Bozios, Panagiotis; Yfantopoulos, John; Niakas, Dimitris

2013-04-01

The purpose of this methodological study was to to provide insight into the under-addressed issue of the longitudinal predictive ability of mapping models. Post-intervention predicted and reported utilities were compared, and the effect of disease severity on the observed differences was examined. A cohort of 120 rheumatoid arthritis (RA) patients (60.0% female, mean age 59.0) embarking on therapy with biological agents completed the Modified Health Assessment Questionnaire (MHAQ) and the EQ-5D at baseline, and at 3, 6 and 12 months post-intervention. OLS regression produced a mapping equation to estimate post-intervention EQ-5D utilities from baseline MHAQ data. Predicted and reported utilities were compared with t test, and the prediction error was modeled, using fixed effects, in terms of covariates such as age, gender, time, disease duration, treatment, RF, DAS28 score, predicted and reported EQ-5D. The OLS model (RMSE = 0.207, R(2) = 45.2%) consistently underestimated future utilities, with a mean prediction error of 6.5%. Mean absolute differences between reported and predicted EQ-5D utilities at 3, 6 and 12 months exceeded the typically reported MID of the EQ-5D (0.03). According to the fixed-effects model, time, lower predicted EQ-5D and higher DAS28 scores had a significant impact on prediction errors, which appeared increasingly negative for lower reported EQ-5D scores, i.e., predicted utilities tended to be lower than reported ones in more severe health states. This study builds upon existing research having demonstrated the potential usefulness of mapping disease-specific instruments onto utility measures. The specific issue of longitudinal validity is addressed, as mapping models derived from baseline patients need to be validated on post-therapy samples. The underestimation of post-treatment utilities in the present study, at least in more severe patients, warrants further research before it is prudent to conduct cost-utility analyses in the context

Low Transvalvular Flow Rate Predicts Mortality in Patients With Low-Gradient Aortic Stenosis Following Aortic Valve Intervention.

Science.gov (United States)

Vamvakidou, Anastasia; Jin, Wenying; Danylenko, Oleksandr; Chahal, Navtej; Khattar, Rajdeep; Senior, Roxy

2018-03-09

This study aimed to assess the value of low transvalvular flow rate (FR) for the prediction of mortality compared with low stroke volume index (SVi) in patients with low-gradient (mean gradient: gradient AS who had undergone valve intervention. We retrospectively followed prospectively assessed consecutive patients with low-gradient, low aortic valve area AS who underwent aortic valve intervention between 2010 and 2014 for all-cause mortality. Of the 218 patients with mean age 75 ± 12 years, 102 (46.8%) had low stroke volume index (SVi) (gradient, low valve area aortic stenosis undergoing aortic valve intervention, low FR, not low SVi, was an independent predictor of medium-term mortality. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: background, design and conceptual model of FINALE

DEFF Research Database (Denmark)

Holtermann, Andreas; Jørgensen, Marie B; Gram, Bibi

2010-01-01

physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers) characterized by high......A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high...... physical work demands, musculoskeletal disorders, poor work ability and sickness absence....

Multiphasic perfusion CT in acute middle cerebral artery ischemic stroke: prediction of final infarct volume and correlation with clinical outcome

International Nuclear Information System (INIS)

Yi, Chin A; Na, Dong Gyu; Ryoo, Jae Wook; Moon, Chan Hong; Byun, Hong Sik; Roh, Hong Gee; Moon, Won Jin; Lee, Kwang Ho; Lee, Soo Joo

2002-01-01

To assess the utility of multiphasic perfusion CT in the prediction of final infarct volume, and the relationship between lesion volume revealed by CT imaging and clinical outcome in acute ischemic stroke patients who have not undergone thrombolytic therapy. Thirty-five patients underwent multiphasic perfusion CT within six hours of stroke onset. After baseline unenhanced helical CT scanning, contrast-enhanced CT scans were obtained 20, 34, 48, and 62 secs after the injection of 90 mL contrast medium at a rate of 3 mL/sec. CT peak and total perfusion maps were obtained from serial CT images, and the initial lesion volumes revealed by CT were compared with final infarct volumes and clinical scores. Overall, the lesion volumes seen on CT peak perfusion maps correlated most strongly with final infarct volumes (R2=0.819, p<0.001, slope of regression line=1.016), but individual data showed that they were less than final infarct volume in 31.4% of patients. In those who showed early clinical improvement (n=6), final infarct volume tended to be overestimated by CT peak perfusion mapping and only on total perfusion maps was there significant correlation between lesion volume and final infarct volume (R2=0.854, p=0.008). The lesion volumes depicted by CT maps showed moderate correlation with baseline clinical scores and clinical outcomes (R=0.445-0.706, p≤0.007). CT peak perfusion maps demonstrate strong correlation between lesion volume and final infarct volume, and accurately predict final infarct volume in about two-thirds of the 35 patients. The lesion volume seen on CT maps shows moderate correlation with clinical outcome

cardiovascular disease intervention programme

African Journals Online (AJOL)

... trial was conducted as part of a coronary risk factor intervention study in three rural ... habits, which was defined as the residual change in the intervention areas after ... finally to change behaviour in such a way that modified lifestyles would ...

A predictive mathematical model for the calculation of the final mass of Graves' disease thyroids treated with 131I

Science.gov (United States)

Traino, Antonio C.; Di Martino, Fabio; Grosso, Mariano; Monzani, Fabio; Dardano, Angela; Caraccio, Nadia; Mariani, Giuliano; Lazzeri, Mauro

2005-05-01

Substantial reductions in thyroid volume (up to 70-80%) after radioiodine therapy of Graves' hyperthyroidism are common and have been reported in the literature. A relationship between thyroid volume reduction and outcome of 131I therapy of Graves' disease has been reported by some authors. This important result could be used to decide individually the optimal radioiodine activity A0 (MBq) to administer to the patient, but a predictive model relating the change in gland volume to A0 is required. Recently, a mathematical model of thyroid mass reduction during the clearance phase (30-35 days) after 131I administration to patients with Graves' disease has been published and used as the basis for prescribing the therapeutic thyroid absorbed dose. It is well known that the thyroid volume reduction goes on until 1 year after therapy. In this paper, a mathematical model to predict the final mass of Graves' diseased thyroids submitted to 131I therapy is presented. This model represents a tentative explanation of what occurs macroscopically after the end of the clearance phase of radioiodine in the gland (the so-called second-order effects). It is shown that the final thyroid mass depends on its basal mass, on the radiation dose absorbed by the gland and on a constant value α typical of thyroid tissue. α has been evaluated based on a set of measurements made in 15 reference patients affected by Graves' disease and submitted to 131I therapy. A predictive equation for the calculation of the final mass of thyroid is presented. It is based on macroscopic parameters measurable after a diagnostic 131I capsule administration (0.37-1.85 MBq), before giving the therapy. The final mass calculated using this equation is compared to the final mass of thyroid measured 1 year after therapy administration in 22 Graves' diseased patients. The final masses calculated and measured 1 year after therapy are in fairly good agreement (R = 0.81). The possibility, for the physician, to decide a

A predictive mathematical model for the calculation of the final mass of Graves' disease thyroids treated with 131I

International Nuclear Information System (INIS)

Traino, Antonio C; Martino, Fabio Di; Grosso, Mariano; Monzani, Fabio; Dardano, Angela; Caraccio, Nadia; Mariani, Giuliano; Lazzeri, Mauro

2005-01-01

Substantial reductions in thyroid volume (up to 70-80%) after radioiodine therapy of Graves' hyperthyroidism are common and have been reported in the literature. A relationship between thyroid volume reduction and outcome of 131 I therapy of Graves' disease has been reported by some authors. This important result could be used to decide individually the optimal radioiodine activity A 0 (MBq) to administer to the patient, but a predictive model relating the change in gland volume to A 0 is required. Recently, a mathematical model of thyroid mass reduction during the clearance phase (30-35 days) after 131 I administration to patients with Graves' disease has been published and used as the basis for prescribing the therapeutic thyroid absorbed dose. It is well known that the thyroid volume reduction goes on until 1 year after therapy. In this paper, a mathematical model to predict the final mass of Graves' diseased thyroids submitted to 131 I therapy is presented. This model represents a tentative explanation of what occurs macroscopically after the end of the clearance phase of radioiodine in the gland (the so-called second-order effects). It is shown that the final thyroid mass depends on its basal mass, on the radiation dose absorbed by the gland and on a constant value α typical of thyroid tissue. α has been evaluated based on a set of measurements made in 15 reference patients affected by Graves' disease and submitted to 131 I therapy. A predictive equation for the calculation of the final mass of thyroid is presented. It is based on macroscopic parameters measurable after a diagnostic 131 I capsule administration (0.37-1.85 MBq), before giving the therapy. The final mass calculated using this equation is compared to the final mass of thyroid measured 1 year after therapy administration in 22 Graves' diseased patients. The final masses calculated and measured 1 year after therapy are in fairly good agreement (R = 0.81). The possibility, for the physician, to

Monitoring and regulation of learning in medical education: the need for predictive cues.

Science.gov (United States)

de Bruin, Anique B H; Dunlosky, John; Cavalcanti, Rodrigo B

2017-06-01

Being able to accurately monitor learning activities is a key element in self-regulated learning in all settings, including medical schools. Yet students' ability to monitor their progress is often limited, leading to inefficient use of study time. Interventions that improve the accuracy of students' monitoring can optimise self-regulated learning, leading to higher achievement. This paper reviews findings from cognitive psychology and explores potential applications in medical education, as well as areas for future research. Effective monitoring depends on students' ability to generate information ('cues') that accurately reflects their knowledge and skills. The ability of these 'cues' to predict achievement is referred to as 'cue diagnosticity'. Interventions that improve the ability of students to elicit predictive cues typically fall into two categories: (i) self-generation of cues and (ii) generation of cues that is delayed after self-study. Providing feedback and support is useful when cues are predictive but may be too complex to be readily used. Limited evidence exists about interventions to improve the accuracy of self-monitoring among medical students or trainees. Developing interventions that foster use of predictive cues can enhance the accuracy of self-monitoring, thereby improving self-study and clinical reasoning. First, insight should be gained into the characteristics of predictive cues used by medical students and trainees. Next, predictive cue prompts should be designed and tested to improve monitoring and regulation of learning. Finally, the use of predictive cues should be explored in relation to teaching and learning clinical reasoning. Improving self-regulated learning is important to help medical students and trainees efficiently acquire knowledge and skills necessary for clinical practice. Interventions that help students generate and use predictive cues hold the promise of improved self-regulated learning and achievement. This framework is

Predictive value of clinical risk indicators in child development: final results of a study based on psychoanalytic theory

Directory of Open Access Journals (Sweden)

Maria Cristina Machado Kupfer

2010-03-01

Full Text Available We present the final results of a study using the IRDI (Clinical Risk Indicators in Child Development. Based on a psychoanalytic approach, 31 risk signs for child development were constructed and applied to 726 children between the ages of 0 and 18 months. One sub-sample was evaluated at the age of three. The results showed a predictive capacity of IRDIs to indicate developmental problems; 15 indicators for the IRDI were also highlighted that predict psychic risk for the constitution of the subject.

Toward a better understanding of what makes positive psychology interventions work: predicting happiness and depression from the person × intervention fit in a follow-up after 3.5 years.

Science.gov (United States)

Proyer, René T; Wellenzohn, Sara; Gander, Fabian; Ruch, Willibald

2015-03-01

Robust evidence exists that positive psychology interventions are effective in enhancing well-being and ameliorating depression. Comparatively little is known about the conditions under which they work best. Models describing characteristics that impact the effectiveness of positive interventions typically contain features of the person, of the activity, and the fit between the two. This study focuses on indicators of the person × intervention fit in predicting happiness and depressive symptoms 3.5 years after completion of the intervention. A sample of 165 women completed measures for happiness and depressive symptoms before and about 3.5 years after completion of a positive intervention (random assignment to one out of nine interventions, which were aggregated for the analyses). Four fit indicators were assessed: Preference; continued practice; effort; and early reactivity. Three out of four person × intervention fit indicators were positively related to happiness or negatively related to depression when controlled for the pretest scores. Together, they explained 6 per cent of the variance in happiness, and 10 per cent of the variance of depressive symptoms. Most tested indicators of a person × intervention fit are robust predictors of happiness and depressive symptoms-even after 3.5 years. They might serve for an early estimation of the effectiveness of a positive intervention. © 2014 The International Association of Applied Psychology.

Can we predict final outcome of internal medicine residents with in-training evaluation.

Science.gov (United States)

Chierakul, Nitipatana; Pongprasobchai, Supot; Boonyapisit, Kanokwan; Chinthammitr, Yingyong; Pithukpakorn, Manop; Maneesai, Adisak; Srivijitkamol, Apiradee; Koomanachai, Pornpan; Koolvisoot, Ajchara; Tanwandee, Tawesak; Shayakul, Chairat; Kachintorn, Udom

2011-02-01

To assess the predictive value of in-training evaluation for determining future success in the internal medicine board certifying examination. Ninety-seven internal medicine residents from Faculty of Medicine Siriraj Hospital who undertake the Thai Board examination during the academic year 2006-2008 were enrolled. Correlation between the scores during internal medicine rotation and final scores in board examination were then examined. Significant positive linear correlation was found between scores from both written and clinical parts of board certifying examination and scores from the first-year summative written and clinical examinations and also the second-year formative written examination (r = 0.43-0.68, p evaluation by attending staffs was less well correlated (r = 0.29-0.36) and the evaluation by nurses or medical students demonstrated inverse relationship (r = -0.2, p = 0.27 and r = -0.13, p = 0.48). Some methods of in-training evaluation can predict successful outcome of board certifying examination. Multisource assessments cannot well extrapolate some aspects of professional competences and qualities.

Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention)

Energy Technology Data Exchange (ETDEWEB)

Goffette, Pierre P. [Department of Medical Imaging, Saint-Luc University Hospital-Louvain Medical School, Brussels (Belgium); Laterre, Pierre-Francois [Department of Emergency and Critical Care, Saint-Luc University Hospital-Louvain Medical School, Brussels (Belgium)

2002-05-01

The nonoperative management (NOM) of abdominal trauma has gained increasing acceptance over the past decade. This approach has been extended to severe trauma patients previously considered as candidates for surgery. Consequently, the incidence of delayed and uncommonly encountered complications has increased. Causes of delayed complications are multiple and include: (a) abnormal or insufficient injury healing process; (b) retention of necrotic tissue; (c) secondary infection of initially sterile collections; and (d) underestimation of injury severity. The purpose of this review article is to explain the role of various imaging modalities in detecting post-traumatic delayed complications and to highlight the usefulness of minimally invasive techniques, including laparoscopy, biliary endoscopy, therapeutic angiography and image-guided drainage. Subsequent complications, which do not necessarily negatively influence the final outcome, are often predictable, virtually obligatory consequences of the successful NOM of high-grade or complex abdominal injuries. Between 50 and 60% of those patients with grade-IV or grade-V liver or splenic lacerations require some type of interventional treatment; therefore, indiscriminate discharge of patients with solid organ injury managed conservatively may be potentially harmful. As the incidence of complications is higher for more severe grade-IV or grade-V liver, spleen, or kidney injuries, scheduled follow-up CT scans may be rational in this subset of patients to identify potential complications amenable to early application of interventional techniques. Follow-up CT scans are unnecessary in stable adults or children with low-grade injury. Delayed splenic or hepatic rupture is one of the major concerns because this type of complication remains difficult to predict and historically often requires emergent surgery. (orig.) (orig.)

Predicting subscriber dissatisfaction and improving retention in the wireless telecommunications industry.

Science.gov (United States)

Mozer, M C; Wolniewicz, R; Grimes, D B; Johnson, E; Kaushansky, H

2000-01-01

Competition in the wireless telecommunications industry is fierce. To maintain profitability, wireless carriers must control churn, which is the loss of subscribers who switch from one carrier to another.We explore techniques from statistical machine learning to predict churn and, based on these predictions, to determine what incentives should be offered to subscribers to improve retention and maximize profitability to the carrier. The techniques include logit regression, decision trees, neural networks, and boosting. Our experiments are based on a database of nearly 47,000 U.S. domestic subscribers and includes information about their usage, billing, credit, application, and complaint history. Our experiments show that under a wide variety of assumptions concerning the cost of intervention and the retention rate resulting from intervention, using predictive techniques to identify potential churners and offering incentives can yield significant savings to a carrier. We also show the importance of a data representation crafted by domain experts. Finally, we report on a real-world test of the techniques that validate our simulation experiments.

Imagining life with an ostomy: Does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?☆

Science.gov (United States)

Angott, Andrea M.; Comerford, David A.; Ubel, Peter A.

2014-01-01

Objective To test a video intervention as a way to improve predictions of mood and quality-of-life with an emotionally evocative medical condition. Such predictions are typically inaccurate, which can be consequential for decision making. Method In Part 1, people presently or formerly living with ostomies predicted how watching a video depicting a person changing his ostomy pouch would affect mood and quality-of-life forecasts for life with an ostomy. In Part 2, participants from the general public read a description about life with an ostomy; half also watched a video depicting a person changing his ostomy pouch. Participants’ quality-of-life and mood forecasts for life with an ostomy were assessed. Results Contrary to our expectations, and the expectations of people presently or formerly living with ostomies, the video did not reduce mood or quality-of-life estimates, even among participants high in trait disgust sensitivity. Among low-disgust participants, watching the video increased quality-of-life predictions for ostomy. Conclusion Video interventions may improve mood and quality-of-life forecasts for medical conditions, including those that may elicit disgust, such as ostomy. Practice implications Video interventions focusing on patients’ experience of illness continue to show promise as components of decision aids, even for emotionally charged health states such as ostomy. PMID:23177398

Machine learning for outcome prediction of acute ischemic stroke post intra-arterial therapy.

Directory of Open Access Journals (Sweden)

Hamed Asadi

Full Text Available INTRODUCTION: Stroke is a major cause of death and disability. Accurately predicting stroke outcome from a set of predictive variables may identify high-risk patients and guide treatment approaches, leading to decreased morbidity. Logistic regression models allow for the identification and validation of predictive variables. However, advanced machine learning algorithms offer an alternative, in particular, for large-scale multi-institutional data, with the advantage of easily incorporating newly available data to improve prediction performance. Our aim was to design and compare different machine learning methods, capable of predicting the outcome of endovascular intervention in acute anterior circulation ischaemic stroke. METHOD: We conducted a retrospective study of a prospectively collected database of acute ischaemic stroke treated by endovascular intervention. Using SPSS®, MATLAB®, and Rapidminer®, classical statistics as well as artificial neural network and support vector algorithms were applied to design a supervised machine capable of classifying these predictors into potential good and poor outcomes. These algorithms were trained, validated and tested using randomly divided data. RESULTS: We included 107 consecutive acute anterior circulation ischaemic stroke patients treated by endovascular technique. Sixty-six were male and the mean age of 65.3. All the available demographic, procedural and clinical factors were included into the models. The final confusion matrix of the neural network, demonstrated an overall congruency of ∼ 80% between the target and output classes, with favourable receiving operative characteristics. However, after optimisation, the support vector machine had a relatively better performance, with a root mean squared error of 2.064 (SD: ± 0.408. DISCUSSION: We showed promising accuracy of outcome prediction, using supervised machine learning algorithms, with potential for incorporation of larger multicenter

The Large Scale Machine Learning in an Artificial Society: Prediction of the Ebola Outbreak in Beijing

Directory of Open Access Journals (Sweden)

Peng Zhang

2015-01-01

Full Text Available Ebola virus disease (EVD distinguishes its feature as high infectivity and mortality. Thus, it is urgent for governments to draw up emergency plans against Ebola. However, it is hard to predict the possible epidemic situations in practice. Luckily, in recent years, computational experiments based on artificial society appeared, providing a new approach to study the propagation of EVD and analyze the corresponding interventions. Therefore, the rationality of artificial society is the key to the accuracy and reliability of experiment results. Individuals’ behaviors along with travel mode directly affect the propagation among individuals. Firstly, artificial Beijing is reconstructed based on geodemographics and machine learning is involved to optimize individuals’ behaviors. Meanwhile, Ebola course model and propagation model are built, according to the parameters in West Africa. Subsequently, propagation mechanism of EVD is analyzed, epidemic scenario is predicted, and corresponding interventions are presented. Finally, by simulating the emergency responses of Chinese government, the conclusion is finally drawn that Ebola is impossible to outbreak in large scale in the city of Beijing.

Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs.

Science.gov (United States)

McCarthy, John F; Bossarte, Robert M; Katz, Ira R; Thompson, Caitlin; Kemp, Janet; Hannemann, Claire M; Nielson, Christopher; Schoenbaum, Michael

2015-09-01

The Veterans Health Administration (VHA) evaluated the use of predictive modeling to identify patients at risk for suicide and to supplement ongoing care with risk-stratified interventions. Suicide data came from the National Death Index. Predictors were measures from VHA clinical records incorporating patient-months from October 1, 2008, to September 30, 2011, for all suicide decedents and 1% of living patients, divided randomly into development and validation samples. We used data on all patients alive on September 30, 2010, to evaluate predictions of suicide risk over 1 year. Modeling demonstrated that suicide rates were 82 and 60 times greater than the rate in the overall sample in the highest 0.01% stratum for calculated risk for the development and validation samples, respectively; 39 and 30 times greater in the highest 0.10%; 14 and 12 times greater in the highest 1.00%; and 6.3 and 5.7 times greater in the highest 5.00%. Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions.

Network discovery, characterization, and prediction : a grand challenge LDRD final report.

Energy Technology Data Exchange (ETDEWEB)

Kegelmeyer, W. Philip, Jr.

2010-11-01

This report is the final summation of Sandia's Grand Challenge LDRD project No.119351, 'Network Discovery, Characterization and Prediction' (the 'NGC') which ran from FY08 to FY10. The aim of the NGC, in a nutshell, was to research, develop, and evaluate relevant analysis capabilities that address adversarial networks. Unlike some Grand Challenge efforts, that ambition created cultural subgoals, as well as technical and programmatic ones, as the insistence on 'relevancy' required that the Sandia informatics research communities and the analyst user communities come to appreciate each others needs and capabilities in a very deep and concrete way. The NGC generated a number of technical, programmatic, and cultural advances, detailed in this report. There were new algorithmic insights and research that resulted in fifty-three refereed publications and presentations; this report concludes with an abstract-annotated bibliography pointing to them all. The NGC generated three substantial prototypes that not only achieved their intended goals of testing our algorithmic integration, but which also served as vehicles for customer education and program development. The NGC, as intended, has catalyzed future work in this domain; by the end it had already brought in, in new funding, as much funding as had been invested in it. Finally, the NGC knit together previously disparate research staff and user expertise in a fashion that not only addressed our immediate research goals, but which promises to have created an enduring cultural legacy of mutual understanding, in service of Sandia's national security responsibilities in cybersecurity and counter proliferation.

Persuasive system design does matter: a systematic review of adherence to web-based interventions.

Science.gov (United States)

Kelders, Saskia M; Kok, Robin N; Ossebaard, Hans C; Van Gemert-Pijnen, Julia E W C

2012-11-14

). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence. Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adhere.

Risk prediction models for major adverse cardiac event (MACE) following percutaneous coronary intervention (PCI): A review

Science.gov (United States)

Manan, Norhafizah A.; Abidin, Basir

2015-02-01

Five percent of patients who went through Percutaneous Coronary Intervention (PCI) experienced Major Adverse Cardiac Events (MACE) after PCI procedure. Risk prediction of MACE following a PCI procedure therefore is helpful. This work describes a review of such prediction models currently in use. Literature search was done on PubMed and SCOPUS database. Thirty literatures were found but only 4 studies were chosen based on the data used, design, and outcome of the study. Particular emphasis was given and commented on the study design, population, sample size, modeling method, predictors, outcomes, discrimination and calibration of the model. All the models had acceptable discrimination ability (C-statistics >0.7) and good calibration (Hosmer-Lameshow P-value >0.05). Most common model used was multivariate logistic regression and most popular predictor was age.

Predicting sugar-sweetened behaviours with theory of planned behaviour constructs: Outcome and process results from the SIPsmartER behavioural intervention.

Science.gov (United States)

Zoellner, Jamie M; Porter, Kathleen J; Chen, Yvonnes; Hedrick, Valisa E; You, Wen; Hickman, Maja; Estabrooks, Paul A

2017-05-01

Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology. Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants. Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models. TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13-20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6-38%) and behaviour (average 30%, range 6-55%) were significant. Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases.

Predicting sugar-sweetened behaviours with theory of planned behaviour constructs: Outcome and process results from the SIPsmartER behavioural intervention

Science.gov (United States)

Zoellner, Jamie M.; Porter, Kathleen J.; Chen, Yvonnes; Hedrick, Valisa E.; You, Wen; Hickman, Maja; Estabrooks, Paul A.

2017-01-01

Objective Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology. Design Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants. Main Outcome Measures Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models. Results TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13–20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6–38%) and behaviour (average 30%, range 6–55%) were significant. Conclusion Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases. PMID:28165771

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

Science.gov (United States)

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

2011-01-01

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

Recruitable collateral blood flow index predicts coronary instent restenosis after percutaneous coronary intervention

DEFF Research Database (Denmark)

Jensen, Lisette Okkels; Thayssen, Per; Lassen, Jens Flensted

2007-01-01

AIMS: Collateral flow may influence long-term results after percutaneous coronary intervention (PCI) because of haemodynamic forces compete with the antegrade flow through the dilated lesion. The aim of the study was to assess the influence of recruitable collateral blood flow on restenosis...... in patients undergoing PCI with bare metal stents and using optimal antithrombotic treatment. METHODS AND RESULTS: In 95 patients, 95 de novo lesions were treated with PCI and a bare metal stent. Fractional flow reserve (FFR) at maximum hyperaemia induced by intravenous adenosine was determined. The pressure.......02-1.12, P = 0.016). CONCLUSION: Recruitable collateral blood flow measured during balloon inflation predicts angiographic instent restenosis in PCI patients treated with bare metal stents. Udgivelsesdato: 2007-Aug...

Does Personality Predict Depression and Use of an Internet-Based Intervention for Depression among Adolescents?

Directory of Open Access Journals (Sweden)

Hans Christian B. Vangberg

2012-01-01

Full Text Available Background. Focus upon depression and prevention of its occurrence among adolescents is increasing. Novel ways of dealing with this serious problem have become available especially by means of internet-based prevention and treatment programs of depression and anxiety. The use of Internet-based intervention programs among adolescents has revealed some difficulties in implementation that need to be further elucidated. The aim of this study is to investigate the association between personality and adolescent depression and the characteristics of users of an Internet-based intervention program. Method. The Junior Temperament and Character Inventory (JTCI, the General Self-Efficacy scale (GSE and the Centre for Epidemiological Studies-Depression scale (CES-D have been administered to a sample (=1234 of Norwegian senior high-school students. Results. Multiple regression analysis revealed associations between depression and gender, and several JTCI domains and facets. In line with previous findings in adults, high Harm Avoidance and low Self-Directedness emerged as the strongest predictors of adolescent depressive symptoms. Further, in logistic regression analysis with the covariates JTCI, GSE and CES-D, the only significant variables predicting use/non-use were the CES-D and the temperament domain Reward Dependence. Conclusion. The results in this study revealed level of depressive symptoms as the strongest predictor of the use of the Internet based intervention and that personality might provide useful information about the users.

Comparison of classification methods for voxel-based prediction of acute ischemic stroke outcome following intra-arterial intervention

Science.gov (United States)

Winder, Anthony J.; Siemonsen, Susanne; Flottmann, Fabian; Fiehler, Jens; Forkert, Nils D.

2017-03-01

Voxel-based tissue outcome prediction in acute ischemic stroke patients is highly relevant for both clinical routine and research. Previous research has shown that features extracted from baseline multi-parametric MRI datasets have a high predictive value and can be used for the training of classifiers, which can generate tissue outcome predictions for both intravenous and conservative treatments. However, with the recent advent and popularization of intra-arterial thrombectomy treatment, novel research specifically addressing the utility of predictive classi- fiers for thrombectomy intervention is necessary for a holistic understanding of current stroke treatment options. The aim of this work was to develop three clinically viable tissue outcome prediction models using approximate nearest-neighbor, generalized linear model, and random decision forest approaches and to evaluate the accuracy of predicting tissue outcome after intra-arterial treatment. Therefore, the three machine learning models were trained, evaluated, and compared using datasets of 42 acute ischemic stroke patients treated with intra-arterial thrombectomy. Classifier training utilized eight voxel-based features extracted from baseline MRI datasets and five global features. Evaluation of classifier-based predictions was performed via comparison to the known tissue outcome, which was determined in follow-up imaging, using the Dice coefficient and leave-on-patient-out cross validation. The random decision forest prediction model led to the best tissue outcome predictions with a mean Dice coefficient of 0.37. The approximate nearest-neighbor and generalized linear model performed equally suboptimally with average Dice coefficients of 0.28 and 0.27 respectively, suggesting that both non-linearity and machine learning are desirable properties of a classifier well-suited to the intra-arterial tissue outcome prediction problem.

Epidemiology of Mild Traumatic Brain Injury with Intracranial Hemorrhage: Focusing Predictive Models for Neurosurgical Intervention.

Science.gov (United States)

Orlando, Alessandro; Levy, A Stewart; Carrick, Matthew M; Tanner, Allen; Mains, Charles W; Bar-Or, David

2017-11-01

To outline differences in neurosurgical intervention (NI) rates between intracranial hemorrhage (ICH) types in mild traumatic brain injuries and help identify which ICH types are most likely to benefit from creation of predictive models for NI. A multicenter retrospective study of adult patients spanning 3 years at 4 U.S. trauma centers was performed. Patients were included if they presented with mild traumatic brain injury (Glasgow Coma Scale score 13-15) with head CT scan positive for ICH. Patients were excluded for skull fractures, "unspecified hemorrhage," or coagulopathy. Primary outcome was NI. Stepwise multivariable logistic regression models were built to analyze the independent association between ICH variables and outcome measures. The study comprised 1876 patients. NI rate was 6.7%. There was a significant difference in rate of NI by ICH type. Subdural hematomas had the highest rate of NI (15.5%) and accounted for 78% of all NIs. Isolated subarachnoid hemorrhages had the lowest, nonzero, NI rate (0.19%). Logistic regression models identified ICH type as the most influential independent variable when examining NI. A model predicting NI for isolated subarachnoid hemorrhages would require 26,928 patients, but a model predicting NI for isolated subdural hematomas would require only 328 patients. This study highlighted disparate NI rates among ICH types in patients with mild traumatic brain injury and identified mild, isolated subdural hematomas as most appropriate for construction of predictive NI models. Increased health care efficiency will be driven by accurate understanding of risk, which can come only from accurate predictive models. Copyright © 2017 Elsevier Inc. All rights reserved.

Value of MDCT and Clinical and Laboratory Data for Predicting the Need for Surgical Intervention in Suspected Small-Bowel Obstruction.

Science.gov (United States)

Scrima, Andrew; Lubner, Meghan G; King, Scott; Pankratz, Joshua; Kennedy, Gregory; Pickhardt, Perry J

2017-04-01

The purpose of this article is to assess the value of a large panel of clinical and MDCT variables in patients with suspected small-bowel obstruction (SBO) for predicting urgent surgical intervention (data were abstracted from electronic medical record review. Univariate and multivariate analyses were performed. Among all 179 patients with suspected SBO, 56 (31.3%) underwent surgical intervention within 72 hours, 10 (5.6%) had ischemia at surgery, and nine (5.0%) required small-bowel resection. On univariate analysis, multiple CT findings were highly significant (p < 0.01) for predicting the main surgical outcomes, including degree of obstruction, 5-point radiology likelihood scores, and the presence of a transition point, closed loop, and mesenteric congestion. None of the objective clinical or laboratory variables (including serum lactate level) reached this level of significance. At multivariate analysis, forward stepwise logistic regression with 0.05 significance level cutoff included both degree of obstruction (p < 0.001) and closed loop (p < 0.01), with the presence of a transition point showing a trend toward significance (p = 0.081). A number of findings at abdominal MDCT are associated with the need for surgery and other important surgical outcomes in patients with suspected SBO. Overall radiologist impression of need for surgical intervention was a better predictor than any clinical or laboratory parameter.

Child-Level Predictors of Responsiveness to Evidence-Based Mathematics Intervention.

Science.gov (United States)

Powell, Sarah R; Cirino, Paul T; Malone, Amelia S

2017-07-01

We identified child-level predictors of responsiveness to 2 types of mathematics (calculation and word-problem) intervention among 2nd-grade children with mathematics difficulty. Participants were 250 children in 107 classrooms in 23 schools pretested on mathematics and general cognitive measures and posttested on mathematics measures. We assigned classrooms randomly assigned to calculation intervention, word-problem intervention, or business-as-usual control. Intervention lasted 17 weeks. Path analyses indicated that scores on working memory and language comprehension assessments moderated responsiveness to calculation intervention. No moderators were identified for responsiveness to word-problem intervention. Across both intervention groups and the control group, attentive behavior predicted both outcomes. Initial calculation skill predicted the calculation outcome, and initial language comprehension predicted word-problem outcomes. These results indicate that screening for calculation intervention should include a focus on working memory, language comprehension, attentive behavior, and calculations. Screening for word-problem intervention should focus on attentive behavior and word problems.

The development of an adolescent smoking cessation intervention--an Intervention Mapping approach to planning.

Science.gov (United States)

Dalum, Peter; Schaalma, Herman; Kok, Gerjo

2012-02-01

The objective of this project was to develop a theory- and evidence-based adolescent smoking cessation intervention using both new and existing materials. We used the Intervention Mapping framework for planning health promotion programmes. Based on a needs assessment, we identified important and changeable determinants of cessation behaviour, specified change objectives for the intervention programme, selected theoretical change methods for accomplishing intervention objectives and finally operationalized change methods into practical intervention strategies. We found that guided practice, modelling, self-monitoring, coping planning, consciousness raising, dramatic relief and decisional balance were suitable methods for adolescent smoking cessation. We selected behavioural journalism, guided practice and Motivational Interviewing as strategies in our intervention. Intervention Mapping helped us to develop as systematic adolescent smoking cessation intervention with a clear link between behavioural goals, theoretical methods, practical strategies and materials and with a strong focus on implementation and recruitment. This paper does not present evaluation data.

Bone age estimation and prediction of final height in patients with {beta}-thalassaemia major: a comparison between the two most common methods

Energy Technology Data Exchange (ETDEWEB)

Christoforidis, Athanasios; Katzos, George; Athanassiou-Metaxa, Miranda [Aristotle University of Thessaloniki, 1st Paediatric Department, Thessaloniki (Greece); Badouraki, Maria [Ippokratio Hospital, Paediatric Radiology Department, Thessaloniki (Greece)

2007-12-15

Thalassaemic patients are in need of frequent assessment of bone age because of growth failure and pubertal disorders. To compare the ''rapid'' Greulich and Pyle (G and P) method with the third edition of the Tanner and Whitehouse (TW3) method for determining skeletal maturity and predicting final height in thalassaemic patients. A total of 191 radiographs from 58 patients (28 male, 30 female) were retrospectively evaluated by two investigators, one for each method. In 47 radiographs from 15 patients having attained their adult height, predicted final height was calculated according to each method. The mean bone ages determined by both the G and P and TW3 methods were lower than mean chronological age, although the differences were not statistically significant (10.04 {+-} 3.69 years and 9.98 {+-} 3.39 years vs. 10.78 {+-} 3.96 years, respectively). Both methods had a tendency to over-estimate final height. Overall, the TW3 method seemed to be more accurate than the G and P method (mean absolute error 3.21 {+-} 2.51 years vs. 3.99 {+-} 2.99 years, respectively, P=0.048). The same method should be used when serial assessments are performed, as both methods provide similarly reliable, although not equivalent, results. The TW3 height prediction method seemed to be more accurate in patients with {beta}-thalassaemia major than the G and P method, albeit with a large confidence interval. (orig.)

Bone age estimation and prediction of final height in patients with β-thalassaemia major: a comparison between the two most common methods

International Nuclear Information System (INIS)

Christoforidis, Athanasios; Katzos, George; Athanassiou-Metaxa, Miranda; Badouraki, Maria

2007-01-01

Thalassaemic patients are in need of frequent assessment of bone age because of growth failure and pubertal disorders. To compare the ''rapid'' Greulich and Pyle (G and P) method with the third edition of the Tanner and Whitehouse (TW3) method for determining skeletal maturity and predicting final height in thalassaemic patients. A total of 191 radiographs from 58 patients (28 male, 30 female) were retrospectively evaluated by two investigators, one for each method. In 47 radiographs from 15 patients having attained their adult height, predicted final height was calculated according to each method. The mean bone ages determined by both the G and P and TW3 methods were lower than mean chronological age, although the differences were not statistically significant (10.04 ± 3.69 years and 9.98 ± 3.39 years vs. 10.78 ± 3.96 years, respectively). Both methods had a tendency to over-estimate final height. Overall, the TW3 method seemed to be more accurate than the G and P method (mean absolute error 3.21 ± 2.51 years vs. 3.99 ± 2.99 years, respectively, P=0.048). The same method should be used when serial assessments are performed, as both methods provide similarly reliable, although not equivalent, results. The TW3 height prediction method seemed to be more accurate in patients with β-thalassaemia major than the G and P method, albeit with a large confidence interval. (orig.)

Prediction of postpercutaneous coronary intervention myocardial infarction: insights from intravascular imaging, coronary flow, and biomarker evaluation.

Science.gov (United States)

Hoole, Stephen P; Hernández-Sánchez, Jules; Brown, Adam J; Giblett, Joel P; Bennett, Martin R; West, Nick E J

2018-05-01

Percutaneous coronary intervention-induced myocardial infarction (PMI) has prognostic significance. Identifying patients at high risk for PMI is desirable as it may alter strategy and facilitate early preventative therapy. We therefore sought to establish whether preprocedural demographic, interventional (plaque characteristics and coronary microcirculatory function), and inflammatory, endothelial damage, and platelet-derived biomarker data could predict the risk of PMI. We performed target vessel pressure wire to assess fractional flow reserve, index of microcirculatory resistance (IMR) and coronary flow reserve, plaque characterization by virtual histology intravascular ultrasound, and assayed peripheral biomarkers before uncomplicated PCI in 88 patients. We then analyzed post-PCI cardiac troponin level to adjudicate PMI based on the third universal definition of myocardial infarction. Overall incidence of PMI was 27%. Women [10/15 (66%) vs. 14/73 (19%), PPMI. Preprocedural coronary flow reserve was lower in individuals with a subsequent PMI (1.8±1.2 vs. 2.1±1.3. P=0.03), and patients with higher pre-PCI IMR were more likely to sustain PMI [IMR>22: 10/23 (44%) vs. ≤22: 14/65 (22%), P=0.04], although neither was predictive after multivariate analysis. Plaque characterization by virtual histology intravascular ultrasound did not discriminate those at risk of PMI. However, peripheral venous interleukin (IL)-18 and IL-8 levels were independently negatively and positively associated with PMI, respectively. Women and those with low BMI, particularly when associated with high IL-8 and low IL-18 levels, appear to be at increased risk of PMI.

Reliability of steam-turbine rotors. Task 1. Lifetime prediction analysis system. Final report

International Nuclear Information System (INIS)

Nair, P.K.; Pennick, H.G.; Peters, J.E.; Wells, C.H.

1982-12-01

Task 1 of RP 502, Reliability of Steam Turbine Rotors, resulted in the development of a computerized lifetime prediction analysis system (STRAP) for the automatic evaluation of rotor integrity based upon the results of a boresonic examination of near-bore defects. Concurrently an advanced boresonic examination system (TREES), designed to acquire data automatically for lifetime analysis, was developed and delivered to the maintenance shop of a major utility. This system and a semi-automated, state-of-the-art system (BUCS) were evaluated on two retired rotors as part of the Task 2 effort. A modified nonproprietary version of STRAP, called SAFER, is now available for rotor lifetime prediction analysis. STRAP and SAFER share a common fracture analysis postprocessor for rapid evaluation of either conventional boresonic amplitude data or TREES cell data. The final version of this postprocessor contains general stress intensity correlations for elliptical cracks in a radial stress gradient and provision for elastic-plastic instability of the ligament between an imbedded crack and the bore surface. Both linear elastic and ligament rupture models were developed for rapid analysis of linkup within three-dimensional clusters of defects. Bore stress-rupture criteria are included, but a creep-fatigue crack growth data base is not available. Physical and mechanical properties of air-melt 1CrMoV forgings are built into the program; however, only bounding values of fracture toughness versus temperature are available. Owing to the lack of data regarding the probability of flaw detection for the boresonic systems and of quantitative verification of the flaw linkup analysis, automatic evlauation of boresonic results is not recommended, and the lifetime prediction system is currently restricted to conservative, deterministic analysis of specified flaw geometries

Whole-brain perfusion CT using a toggling table technique to predict final infarct volume in acute ischemic stroke.

Science.gov (United States)

Schrader, I; Wilk, D; Jansen, O; Riedel, C

2013-09-01

To evaluate how accurately final infarct volume in acute ischemic stroke can be predicted with perfusion CT (PCT) using a 64-MDCT unit and the toggling table technique. Retrospective analysis of 89 patients with acute ischemic stroke who underwent CCT, CT angiography (CTA) and PCT using the "toggling table" technique within the first three hours after symptom onset. In patients with successful thrombolytic therapy (n = 48) and in those without effective thrombolytic therapy (n = 41), the infarct volume and the volume of the penumbra on PCT were compared to the infarct size on follow-up images (CT or MRI) performed within 8 days. The feasibility of complete infarct volume prediction by 8 cm cranio-caudal coverage was evaluated. The correlation between the volume of hypoperfusion on PCT defined by cerebral blood volume reduction and final infarct volume was strongest in patients with successful thrombolytic therapy with underestimation of the definite infarct volume by 8.5 ml on average. The CBV map had the greatest prognostic value. In patients without successful thrombolytic therapy, the final infarct volume was overestimated by 12.1 ml compared to the MTT map on PCT. All infarcts were detected completely. There were no false-positive or false-negative results. Using PCT and the "toggling table" technique in acute stroke patients is helpful for the rapid and accurate quantification of the minimal final infarct and is therefore a prognostic parameter which has to be evaluated in further studies to assess its impact on therapeutic decision. ▶ Using PCT and the “toggling table technique” allows accurate quantification of the infarct core and penumbra. ▶ It is possible to record dynamic perfusion parameters quickly and easily of almost the entire supratentorial brain volume on a 64-slice MDCT unit. ▶ The technique allows identification of those patients who could profit from thrombolytic therapy outside the established time intervals. © Georg Thieme Verlag

Household water treatment in developing countries: comparing different intervention types using meta-regression.

Science.gov (United States)

Hunter, Paul R

2009-12-01

Household water treatment (HWT) is being widely promoted as an appropriate intervention for reducing the burden of waterborne disease in poor communities in developing countries. A recent study has raised concerns about the effectiveness of HWT, in part because of concerns over the lack of blinding and in part because of considerable heterogeneity in the reported effectiveness of randomized controlled trials. This study set out to attempt to investigate the causes of this heterogeneity and so identify factors associated with good health gains. Studies identified in an earlier systematic review and meta-analysis were supplemented with more recently published randomized controlled trials. A total of 28 separate studies of randomized controlled trials of HWT with 39 intervention arms were included in the analysis. Heterogeneity was studied using the "metareg" command in Stata. Initial analyses with single candidate predictors were undertaken and all variables significant at the P Risk and the parameter estimates from the final regression model. The overall effect size of all unblinded studies was relative risk = 0.56 (95% confidence intervals 0.51-0.63), but after adjusting for bias due to lack of blinding the effect size was much lower (RR = 0.85, 95% CI = 0.76-0.97). Four main variables were significant predictors of effectiveness of intervention in a multipredictor meta regression model: Log duration of study follow-up (regression coefficient of log effect size = 0.186, standard error (SE) = 0.072), whether or not the study was blinded (coefficient 0.251, SE 0.066) and being conducted in an emergency setting (coefficient -0.351, SE 0.076) were all significant predictors of effect size in the final model. Compared to the ceramic filter all other interventions were much less effective (Biosand 0.247, 0.073; chlorine and safe waste storage 0.295, 0.061; combined coagulant-chlorine 0.2349, 0.067; SODIS 0.302, 0.068). A Monte Carlo model predicted that over 12 months

Endovascular image-guided interventions (EIGIs)

International Nuclear Information System (INIS)

Rudin, Stephen; Bednarek, Daniel R.; Hoffmann, Kenneth R.

2008-01-01

Minimally invasive interventions are rapidly replacing invasive surgical procedures for the most prevalent human disease conditions. X-ray image-guided interventions carried out using the insertion and navigation of catheters through the vasculature are increasing in number and sophistication. In this article, we offer our vision for the future of this dynamic field of endovascular image-guided interventions in the form of predictions about (1) improvements in high-resolution detectors for more accurate guidance, (2) the implementation of high-resolution region of interest computed tomography for evaluation and planning, (3) the implementation of dose tracking systems to control patient radiation risk, (4) the development of increasingly sophisticated interventional devices, (5) the use of quantitative treatment planning with patient-specific computer fluid dynamic simulations, and (6) the new expanding role of the medical physicist. We discuss how we envision our predictions will come to fruition and result in the universal goal of improved patient care.

Predictive-property-ranked variable reduction in partial least squares modelling with final complexity adapted models: comparison of properties for ranking.

Science.gov (United States)

Andries, Jan P M; Vander Heyden, Yvan; Buydens, Lutgarde M C

2013-01-14

The calibration performance of partial least squares regression for one response (PLS1) can be improved by eliminating uninformative variables. Many variable-reduction methods are based on so-called predictor-variable properties or predictive properties, which are functions of various PLS-model parameters, and which may change during the steps of the variable-reduction process. Recently, a new predictive-property-ranked variable reduction method with final complexity adapted models, denoted as PPRVR-FCAM or simply FCAM, was introduced. It is a backward variable elimination method applied on the predictive-property-ranked variables. The variable number is first reduced, with constant PLS1 model complexity A, until A variables remain, followed by a further decrease in PLS complexity, allowing the final selection of small numbers of variables. In this study for three data sets the utility and effectiveness of six individual and nine combined predictor-variable properties are investigated, when used in the FCAM method. The individual properties include the absolute value of the PLS1 regression coefficient (REG), the significance of the PLS1 regression coefficient (SIG), the norm of the loading weight (NLW) vector, the variable importance in the projection (VIP), the selectivity ratio (SR), and the squared correlation coefficient of a predictor variable with the response y (COR). The selective and predictive performances of the models resulting from the use of these properties are statistically compared using the one-tailed Wilcoxon signed rank test. The results indicate that the models, resulting from variable reduction with the FCAM method, using individual or combined properties, have similar or better predictive abilities than the full spectrum models. After mean-centring of the data, REG and SIG, provide low numbers of informative variables, with a meaning relevant to the response, and lower than the other individual properties, while the predictive abilities are

Final state predictions for J2 gravity perturbed motion of the Earth’s artificial satellites using Bispherical coordinates

Directory of Open Access Journals (Sweden)

M.A. Sharaf

2013-06-01

Full Text Available In this paper, initial value problem for dynamical astronomy will be established using Bispherical coordinates. A computational algorithm is developed for the final state predictions for J2 gravity perturbed motion of the Earth’s artificial satellites. This algorithm is important in targeting, rendezvous maneuvers as well for scientific researches. The applications of the algorithm are illustrated by numerical examples of some test orbits of different eccentricities. The numerical results are extremely accurate and efficient.

Barriers to Mindfulness: a Path Analytic Model Exploring the Role of Rumination and Worry in Predicting Psychological and Physical Engagement in an Online Mindfulness-Based Intervention.

Science.gov (United States)

Banerjee, Moitree; Cavanagh, Kate; Strauss, Clara

2018-01-01

Little is known about the factors associated with engagement in mindfulness-based interventions (MBIs). Moreover, engagement in MBIs is usually defined in terms of class attendance ('physical engagement') only. However, in the psychotherapy literature, there is increasing emphasis on measuring participants' involvement with interventions ('psychological engagement'). This study tests a model that rumination and worry act as barriers to physical and psychological engagement in MBIs and that this in turn impedes learning mindfulness. One hundred and twenty-four participants were given access to a 2-week online mindfulness-based self-help (MBSH) intervention. Self-report measures of mindfulness, rumination, worry, positive beliefs about rumination, positive beliefs about worry and physical and psychological engagement were administered. A path analysis was used to test the linear relationships between the variables. Physical and psychological engagement were identified as two distinct constructs. Findings were that rumination and worry both predicted psychological disengagement in MBSH. Psychological engagement predicted change in the describe, act with awareness, non-judge and non-react facets of mindfulness while physical engagement only predicted changes in the non-react facet of mindfulness. Thus, rumination and worry may increase risk of psychological disengagement from MBSH which may in turn hinder cultivating mindfulness. Future suggestions for practice are discussed.

Calcification remodeling index characterized by cardiac CT as A novel parameter to predict the use of rotational atherectomy for coronary intervention of lesions with moderate to severe calcification

International Nuclear Information System (INIS)

Yu, Meng Meng; Li, Yue Hua; Li, Wen Bin; Lu, Zhi Gang; Wei, Meng; Zhang, Jia Yin

2017-01-01

To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation.

Calcification Remodeling Index Characterized by Cardiac CT as a Novel Parameter to Predict the Use of Rotational Atherectomy for Coronary Intervention of Lesions with Moderate to Severe Calcification

Science.gov (United States)

Yu, Mengmeng; Li, Yuehua; Li, Wenbin; Lu, Zhigang; Wei, Meng

2017-01-01

Objective To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Materials and Methods Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. Results A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Conclusion Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation. PMID:28860893

Calcification remodeling index characterized by cardiac CT as A novel parameter to predict the use of rotational atherectomy for coronary intervention of lesions with moderate to severe calcification

Energy Technology Data Exchange (ETDEWEB)

Yu, Meng Meng; Li, Yue Hua; Li, Wen Bin; Lu, Zhi Gang; Wei, Meng; Zhang, Jia Yin [Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai (China)

2017-09-15

To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation.

Prediction of crime and early interventions

DEFF Research Database (Denmark)

Christoffersen, Mogens

This paper presents a prospective longitudinal study that attempts to predict juvenile delinquency measured by first contact with the police (arrest, pre-trial detention or charges of crimes) taking a complete cohort of all children born in Denmark in 1984 (N=54,458). The children are followed from...

Estimating the Costs of Preventive Interventions

Science.gov (United States)

Foster, E. Michael; Porter, Michele M.; Ayers, Tim S.; Kaplan, Debra L.; Sandler, Irwin

2007-01-01

The goal of this article is to improve the practice and reporting of cost estimates of prevention programs. It reviews the steps in estimating the costs of an intervention and the principles that should guide estimation. The authors then review prior efforts to estimate intervention costs using a sample of well-known but diverse studies. Finally,…

Can Rheumatologists Predict Eventual Need for Orthopaedic Intervention in Patients with Rheumatoid Arthritis? Results of a Systematic Review and Analysis of Two UK Inception Cohorts

OpenAIRE

Nikiphorou, E.; Carpenter, L.; Norton, S.; Morris, S.; MacGregor, A.; Dixey, J.; Williams, P.; Kiely, P.; Walsh, D. A.; Young, A.

2017-01-01

PURPOSE OF REVIEW: The structural damage caused by rheumatoid arthritis (RA) can often be mitigated by orthopaedic surgery in late disease. This study evaluates the value of predictive factors for orthopaedic intervention. METHODS: A systematic review of literature was undertaken to identify papers describing predictive factors for orthopaedic surgery in RA. Manuscripts were selected if they met inclusion criteria of cohort study design, diagnosis of RA, follow-up duration/disease...

THE LIMITS OF POSITIVE INTERVENTIONS

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Gonzalo Hervás

2017-01-01

Full Text Available Positive interventions have been developed extensively in recent years and they have been tested and applied in very diverse settings. Despite the fact that most of the findings regarding their efficacy can be considered from positive to very positive, the possibility that, in some cases, positive interventions may have unexpected or even iatrogenic effects cannot be discarded. In this article, research from several sources is reviewed in order to inform decisions about what interventions might be inadequate for cases with specific characteristics or vulnerability traits. Finally, the importance of using positive interventions with caution and rigor even when working with individuals who do not have overt problems or psychological disorders is discussed.

Balance of Autonomic Nervous System Predicts Who Benefits from a Self-management Intervention Program for Irritable Bowel Syndrome.

Science.gov (United States)

Jarrett, Monica E; Cain, Kevin C; Barney, Pamela G; Burr, Robert L; Naliboff, Bruce D; Shulman, Robert; Zia, Jasmine; Heitkemper, Margaret M

2016-01-31

To determine if potential biomarkers can be used to identify subgroups of people with irritable bowel syndrome (IBS) who will benefit the most or the least from a comprehensive self-management (CSM) intervention. In a two-armed randomized controlled trial a CSM (n = 46) was compared to a usual care (n = 46) group with follow-up at 3 and 6 months post randomization. Biomarkers obtained at baseline included heart rate variability, salivary cortisol, interleukin-10 produced by unstimulated peripheral blood mononuclear cells, and lactulose/mannitol ratio. Linear mixed models were used to test whether these biomarkers predicted improvements in the primary outcomes including daily abdominal pain, Gastrointestinal Symptom score and IBS-specific quality of life. The nurse-delivered 8-session CSM intervention is more effective than usual care in reducing abdominal pain, reducing Gastrointestinal Symptom score, and enhancing quality of life. Participants with lower nighttime high frequency heart rate variability (vagal modulation) and increased low frequency/high frequency ratio (sympathovagal balance) had less benefit from CSM on abdominal pain. Salivary cortisol, IL-10, and lactulose/mannitol ratio were not statistically significant in predicting CSM benefit. Baseline symptom severity interacts with treatment, namely the benefit of CSM is greater in those with higher baseline symptoms. Cognitively-focused therapies may be less effective in reducing abdominal pain in IBS patients with higher sympathetic tone. Whether this a centrally-mediated patient characteristic or related to heightened arousal remains to be determined.

EFFECT OF EDUCATIONAL INTERVENTION MEASURES ON KNOWLEDGE ABOUT RABIES AND ITS PREVENTIVE MEASURES AMONG FINAL YEAR NURSING STUDENTS OF A TERTIARY CARE HOSPITAL IN CENTRAL INDIA

Directory of Open Access Journals (Sweden)

Sanjay Dixit

2012-03-01

Full Text Available Background: Rabies continues to be a major public health challenge with around 55,000 deaths every year. Amongst the health care providers nursing personnel are often the first point of contact and hence need to be well trained in the management of rabies cases. Methods: The present study was an educational intervention study conducted among 100 final year nursing students of a Medical College Hospital to assess the knowledge regarding rabies and its transmission, first aid measures undertaken, and pre and post exposure prophylaxis measures employed to prevent the infection. Results: 66% of the students knew about the signs and symptoms of the disease, post intervention this increased to 87%. Knowledge regarding animal bites which transmit rabies improved by 86 % mode of transmission by 49 % and first aid measures undertaken following an animal bite by 12%. 15% of the students knew about the correct site and route of PEP; post intervention 91% knew about it, 87% increase was observed as regards the dose of vaccine to be administered and 73% students correctly knew about the PEP schedule post educational intervention. Knowledge regarding groups / individuals who need to receive pre-exposure prophylaxis increased by 33% and that of the schedule of pre-exposure prophylaxis by 53%. The mean pre-intervention score was 6.95 and mean post-intervention score was 13.51; the results being statistically significant. Conclusion: Substantial improvement in knowledge about the disease was noted amongst the nursing students following the educational intervention session.

Early diagnosis and early intervention in cerebral palsy

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Mijna eHadders-Algra

2014-09-01

Full Text Available This paper reviews the opportunities and challenges for early diagnosis and early intervention in cerebral palsy (CP. CP describes a group of disorders of the development of movement and posture, causing activity limitation, that are attributed to disturbances that occurred in the fetal or infant brain. Therefore the paper starts with a summary of relevant information from developmental neuroscience. Most lesions underlying CP occur in the second half of gestation, when developmental activity in the brain reaches its summit. Variations in timing of the damage not only result in different lesions, but also in different neuroplastic reactions and different associated neuropathologies. This turns CP into a heterogeneous entity. This may mean that the best early diagnostics and the best intervention methods may differ for various subgroups of children with CP. Next, the paper addresses possibilities for early diagnosis. It discusses the predictive value of neuromotor and neurological exams, neuro-imaging techniques and neurophysiological assessments. Prediction is best when complementary techniques are used in longitudinal series. Possibilities for early prediction of CP differ for infants admitted to neonatal intensive care and other infants. In the former group best prediction is achieved with the combination of neuro-imaging and the assessment of general movements, in the latter group best prediction is based on carefully documented milestones and neurological assessment. The last part reviews early intervention in infants developing CP. Most knowledge on early intervention is based on studies in high risk infants without CP. In these infants early intervention programs promote cognitive development until preschool age; motor development profits less. The few studies on early intervention in infants developing CP suggest that programs that stimulate all aspects of infant development by means of family coaching are most promising. More research is

The role of preschool teacher-child interactions in academic adjustment: An intervention study with Playing-2-gether.

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Van Craeyevelt, Sanne; Verschueren, Karine; Vancraeyveldt, Caroline; Wouters, Sofie; Colpin, Hilde

2017-09-01

Social relationships can serve as important risk or protective factors for child development in general, and academic adjustment in particular. This study investigated the role of teacher-child interactions in academic adjustment among preschool boys at risk of externalizing behaviour, using a randomized controlled trial study with Playing-2-gether (P2G), a 12-week indicated two-component intervention aimed at improving the affective quality of the teacher-child relationship and teacher behaviour management. In a sample of 175 preschool boys showing signs of externalizing behaviour (M age  = 4 years, 9 months, SD age  = 7 months) and their teachers, we investigated P2G effects on academic engagement as well as on language achievement. Academic engagement was rated by teachers at three occasions within one school year (T1 = pretest, T3 = post-test, and T2 = in-between intervention components). Language achievement was assessed by researchers at pre- and post-test, using a standardized test. Cross-lagged path analyses revealed a direct intervention effect of P2G on academic engagement at Time 2. In addition, a significant indirect intervention effect was found on academic engagement at Time 3 through academic engagement at Time 2. Finally, academic engagement at Time 2 was found to predict language achievement at post-test. A marginally significant indirect intervention effect was found on language achievement at Time 3, through academic engagement at Time 2. This intervention study suggests that teacher-child interactions predict academic engagement over time, which in turn improves language achievement among preschool boys at risk of externalizing behaviour. © 2017 The British Psychological Society.

Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention

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Aoun-Bacha Zeina

2008-06-01

Full Text Available Abstract Background This study evaluated the benefits and impact of ICU therapeutic interventions on the survival and functional ability of severe cerebrovascular accident (CVA patients. Methods Sixty-two ICU patients suffering from severe ischemic/haemorrhagic stroke were evaluated for CVA severity using APACHE II and the Glasgow coma scale (GCS. Survival was determined using Kaplan-Meier survival tables and survival prediction factors were determined by Cox multivariate analysis. Functional ability was assessed using the stroke impact scale (SIS-16 and Karnofsky score. Risk factors, life support techniques and neurosurgical interventions were recorded. One year post-CVA dependency was investigated using multivariate analysis based on linear regression. Results The study cohort constituted 6% of all CVA (37.8% haemorrhagic/62.2% ischemic admissions. Patient mean(SD age was 65.8(12.3 years with a 1:1 male: female ratio. During the study period 16 patients had died within the ICU and seven in the year following hospital release. The mean(SD APACHE II score at hospital admission was 14.9(6.0 and ICU mean duration of stay was 11.2(15.4 days. Mechanical ventilation was required in 37.1% of cases. Risk ratios were; GCS at admission 0.8(0.14, (p = 0.024, APACHE II 1.11(0.11, (p = 0.05 and duration of mechanical ventilation 1.07(0.07, (p = 0.046. Linear coefficients were: type of CVA – haemorrhagic versus ischemic: -18.95(4.58 (p = 0.007, GCS at hospital admission: -6.83(1.08, (p = 0.001, and duration of hospital stay -0.38(0.14, (p = 0.40. Conclusion To ensure a better prognosis CVA patients require ICU therapeutic interventions. However, as we have shown, where tests can determine the worst affected patients with a poor vital and functional outcome should treatment be withheld?

Behind the scenes of the PRIME intervention: designing a complex intervention to improve malaria care at public health centres in Uganda

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Deborah D. DiLiberto

2015-10-01

Full Text Available Background: In Uganda, health system challenges limit access to good quality healthcare and contribute to slow progress on malaria control. We developed a complex intervention (PRIME, which was designed to improve quality of care for malaria at public health centres. Objective: Responding to calls for increased transparency, we describe the PRIME intervention's design process, rationale, and final content and reflect on the choices and challenges encountered during the design of this complex intervention. Design: To develop the intervention, we followed a multistep approach, including the following: 1 formative research to identify intervention target areas and objectives; 2 prioritization of intervention components; 3 review of relevant evidence; 4 development of intervention components; 5 piloting and refinement of workshop modules; and 6 consolidation of the PRIME intervention theories of change to articulate why and how the intervention was hypothesized to produce desired outcomes. We aimed to develop an intervention that was evidence-based, grounded in theory, and appropriate for the study context; could be evaluated within a randomized controlled trial; and had the potential to be scaled up sustainably. Results: The process of developing the PRIME intervention package was lengthy and dynamic. The final intervention package consisted of four components: 1 training in fever case management and use of rapid diagnostic tests for malaria (mRDTs; 2 workshops in health centre management; 3 workshops in patient-centred services; and 4 provision of mRDTs and antimalarials when stocks ran low. Conclusions: The slow and iterative process of intervention design contrasted with the continually shifting study context. We highlight the considerations and choices made at each design stage, discussing elements we included and why, as well as those that were ultimately excluded. Reflection on and reporting of ‘behind the scenes’ accounts of intervention

Comparison of Perfusion CT Software to Predict the Final Infarct Volume After Thrombectomy.

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Austein, Friederike; Riedel, Christian; Kerby, Tina; Meyne, Johannes; Binder, Andreas; Lindner, Thomas; Huhndorf, Monika; Wodarg, Fritz; Jansen, Olav

2016-09-01

Computed tomographic perfusion represents an interesting physiological imaging modality to select patients for reperfusion therapy in acute ischemic stroke. The purpose of our study was to determine the accuracy of different commercial perfusion CT software packages (Philips (A), Siemens (B), and RAPID (C)) to predict the final infarct volume (FIV) after mechanical thrombectomy. Single-institutional computed tomographic perfusion data from 147 mechanically recanalized acute ischemic stroke patients were postprocessed. Ischemic core and FIV were compared about thrombolysis in cerebral infarction (TICI) score and time interval to reperfusion. FIV was measured at follow-up imaging between days 1 and 8 after stroke. In 118 successfully recanalized patients (TICI 2b/3), a moderately to strongly positive correlation was observed between ischemic core and FIV. The highest accuracy and best correlation are shown in early and fully recanalized patients (Pearson r for A=0.42, B=0.64, and C=0.83; P<0.001). Bland-Altman plots and boxplots demonstrate smaller ranges in package C than in A and B. Significant differences were found between the packages about over- and underestimation of the ischemic core. Package A, compared with B and C, estimated more than twice as many patients with a malignant stroke profile (P<0.001). Package C best predicted hypoperfusion volume in nonsuccessfully recanalized patients. Our study demonstrates best accuracy and approximation between the results of a fully automated software (RAPID) and FIV, especially in early and fully recanalized patients. Furthermore, this software package overestimated the FIV to a significantly lower degree and estimated a malignant mismatch profile less often than other software. © 2016 American Heart Association, Inc.

Features predicting weight loss in overweight or obese participants in a web-based intervention: randomized trial.

Science.gov (United States)

Brindal, Emily; Freyne, Jill; Saunders, Ian; Berkovsky, Shlomo; Smith, Greg; Noakes, Manny

2012-12-12

at week 12 (P = .01). The average number of days that each site was used varied significantly (P = .02) and was higher for the supportive site at 5.96 (SD 11.36) and personalized-supportive site at 5.50 (SD 10.35), relative to the information-based site at 3.43 (SD 4.28). In total, 435 participants provided a valid final weight at the 12-week follow-up. Intention-to-treat analyses (using multiple imputations) revealed that there were no statistically significant differences in weight loss between sites (P = .42). On average, participants lost 2.76% (SE 0.32%) of their initial body weight, with 23.7% (SE 3.7%) losing 5% or more of their initial weight. Within supportive conditions, the level of use of the online weight tracker was predictive of weight loss (model estimate = 0.34, P frequency of use of the weight tracker. Relative to a static control, inclusion of social networking features and personalized meal planning recommendations in a web-based weight loss program did not demonstrate additive effects for user weight loss or retention. These features did, however, increase the average number of days that a user engaged with the system. For users of the supportive websites, greater use of the weight tracker tool was associated with greater weight loss.

Academic procrastination and academic performance: An initial basis for intervention.

Science.gov (United States)

Goroshit, Marina

2018-01-01

Academic procrastination is a prevalent phenomenon with a range of negative outcomes. Many studies focused on causes and correlates of academic procrastination; however, the study of interventions for academic procrastination is scarce. The present study is an initial effort to study the relationship between academic procrastination, online course participation, and achievement, as a basis for developing an intervention for academic procrastination. Findings indicated that studying procrastination was negatively associated with final exam grade as well as with the three online course participation measures. Final exam grade was positively associated with two of the online course participation measures, and they positively correlated with each other. In addition, results indicated that studying procrastination, in combination with online course participation measures, explained about 50% of variance in final exam's grade. Frequency of activities in course Web site had the strongest positive effect on final exam's grade. These findings strengthen the notion that studying procrastination is an impediment to students' academic performance and outcomes and clarifies the need to develop and study academic interventions for academic procrastination as a means to decrease its prevalence in academic settings.

Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling.

Science.gov (United States)

Fang, Wei; Li, Jiu-Ke; Jin, Xiao-Hong; Dai, Yuan-Min; Li, Yu-Min

2016-01-01

To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment (RRD) after sclera buckling (SB). Totally 48 patients (51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy (PVR), posterior vitreous detachment (PVD), baseline best corrected visual acuity (BCVA), operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student's t-test, Wilcoxon two-sample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR. Primary surgical success rate was 92.16% (47/51). Correlation analyses revealed shorter symptoms duration (r=0.3850, P=0.0053), less detached area (r=0.5489, Ppredictive factors were better baseline BCVA [partial R-square (PR(2))=0.5316, Ppredictive factors for better vision improvement were better baseline vision [odds ratio (OR) =50.369, P=0.0041] and longer follow up duration (OR=1.144, P=0.0067). Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA, shorter symptoms duration, shorter operative duration and longer follow up duration, while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.

Educational intervention for liver transplantation candidates

OpenAIRE

Mendes,Karina Dal Sasso; Silva Junior,Orlando de Castro e; Ziviani,Luciana da Costa; Rossin,Fabiana Murad; Zago,Márcia Maria Fontão; Galvão,Cristina Maria

2013-01-01

OBJECTIVE: The objective in this study was to analyze candidates' knowledge on the liver transplantation process before and after putting in practice an educational intervention. METHOD: A quasi-experimental, one-group pretest-posttest research design was adopted. The final sample included 15 subjects. Research data were collected between January and March 2010 in three phases, which were: pretest, implementation of the educational intervention (two meetings) and posttest. RESULTS: The result...

Predictive models of long-term anatomic outcome in age-related macular degeneration treated with as-needed Ranibizumab.

Science.gov (United States)

Gonzalez-Buendia, Lucia; Delgado-Tirado, Santiago; Sanabria, M Rosa; Fernandez, Itziar; Coco, Rosa M

2017-08-18

To analyze predictors and develop predictive models of anatomic outcome in neovascular age-related macular degeneration (AMD) treated with as-needed ranibizumab after 4 years of follow-up. A multicenter consecutive case series non-interventional study was performed. Clinical, funduscopic and OCT characteristics of 194 treatment-naïve patients with AMD treated with as-needed ranibizumab for at least 2 years and up to 4 years were analyzed at baseline, 3 months and each year until the end of the follow-up. Baseline demographic and angiographic characteristics were also evaluated. R Statistical Software was used for statistical analysis. Main outcome measure was final anatomic status. Factors associated with less probability of preserved macula were diagnosis in 2009, older age, worse vision, presence of atrophy/fibrosis, pigment epithelium detachment, and geographic atrophy/fibrotic scar/neovascular AMD in the fellow eye. Factors associated with higher probability of GA were presence of atrophy and greater number of injections, whereas male sex, worse vision, lesser change in central macular thickness and presence of fibrosis were associated with less probability of GA as final macular status. Predictive model of preserved macula vs. GA/fibrotic scar showed sensibility of 77.78% and specificity of 69.09%. Predictive model of GA vs. fibrotic scar showed sensibility of 68.89% and specificity of 72.22%. We identified predictors of final macular status, and developed two predictive models. Predictive models that we propose are based on easily harvested variables, and, if validated, could be a useful tool for individual patient management and clinical research studies.

A plane-wave final-state theory of ATI

International Nuclear Information System (INIS)

Parker, J.S.; Clark, C.W.

1993-01-01

A Fermi Golden Rule calculation of ionization cross-sections provides us with the simplest example of a plane-wave final-state theory. In this method the final (unbound) state is modeled as a plane wave, an approximation that generally gives best results in the high energy limit in which the affect of the atomic potential on the final state can be neglected. A cross-section is then calculated from the matrix element connecting the bound initial state with the final state. The idea of generalizing this method to model transitions among unbound states is credited to L.V. Keldysh, and a number of related formalisms have been proposed that are consistent with the general features of experimental data. Here we describe a plane-wave final-state model of ATI that is in the spirit of these theories, but differs significantly in its implementation and predictions. We will present a comparison of the predictions of the plane-wave model with those of a full numerical integration of the time-dependent Schrodinger equation for atomic hydrogen in a radiation field. The theory and the numerical integration give good qualitative agreement in their predictions of photoelectron spectra over about 14 orders of magnitude

Interventional magnetic resonance imaging

International Nuclear Information System (INIS)

Debatin, J.F.; Adam, G.

1998-01-01

With the advent of open configuration MR imaging systems, the vision of MRI-based guidance, control, and monitoring of minimally invasive interventions has evolved from a hypothetical concept to a practical possibility. This book provides a comprehensive overview of the very exciting emerging field of interventional MRI. The international authorship provides firsthand experience of all relevant topics. This book will familiarize the reader with the basic principles underlying currently available hardware and software configurations. In addition, technical aspects of thermosensitive imaging, techniques for instrument visualization, and safety aspects are covered. Finally, the book emphasizes both existing and future clinical applications. (orig.)

Patient Dose Optimization in Fluoroscopically Guided Interventional Procedures. Final Report of a Coordinated Research Project

International Nuclear Information System (INIS)

2010-01-01

In recent years, many surgical procedures have increasingly been replaced by interventional procedures that guide catheters into the arteries under X ray fluoroscopic guidance to perform a variety of operations such as ballooning, embolization, implantation of stents etc. The radiation exposure to patients and staff in such procedures is much higher than in simple radiographic examinations like X ray of chest or abdomen such that radiation induced skin injuries to patients and eye lens opacities among workers have been reported in the 1990's and after. Interventional procedures have grown both in frequency and importance during the last decade. This Coordinated Research Project (CRP) and TECDOC were developed within the International Atomic Energy Agency's (IAEA) framework of statutory responsibility to provide for the worldwide application of the standards for the protection of people against exposure to ionizing radiation. The CRP took place between 2003 and 2005 in six countries, with a view of optimizing the radiation protection of patients undergoing interventional procedures. The Fundamental Safety Principles and the International Basic Safety Standards for Protection against Ionizing Radiation (BSS) issued by the IAEA and co-sponsored by the Food and Agriculture Organization of the United Nations (FAO), the International Labour Organization (ILO), the World Health Organization (WHO), the Pan American Health Organization (PAHO) and the Nuclear Energy Agency (NEA), among others, require the radiation protection of patients undergoing medical exposures through justification of the procedures involved and through optimization. In keeping with its responsibility on the application of standards, the IAEA programme on Radiological Protection of Patients encourages the reduction of patient doses. To facilitate this, it has issued specific advice on the application of the BSS in the field of radiology in Safety Reports Series No. 39 and the three volumes on Radiation

Can bone scintigraphy predict the final outcome of pasteurized autografts?

International Nuclear Information System (INIS)

Eid, Ahmed Shawky; Jeon, Dae-Geun; Cho, Wan Hyeong

2010-01-01

As pasteurization is becoming more widely used in limb salvage reconstruction, more study is required to understand about host-graft junction healing, graft revascularization and incorporation, and the incidence and type of complications among pasteurized autografts. This was mainly achieved by follow-up radiography. We aimed to clarify whether Tc99m bone scanning can be considered a reliable method in determining these three parameters. Twenty-seven osteosarcoma patients with pasteurized autograft reconstructions were retrospectively reviewed using available scintigraphic and radiographic follow-up every 6 months postoperatively for 36 months. Follow-up of the unhealed cases was continued for the maximum follow-up period available for each case beyond the original study period, ranging from 1 to 15 months. Tc99m uptake was classified as cold, faint, moderate and high uptake. Junction healing was classified as none, partial and complete healing. Seventy percent of junctions united with a mean of 22 months. Ninety to 100% of junctions showed increased uptake (high or moderate) at one time of the study regardless of final outcome. 85% of the pasteurized grafts showed the characteristic ''tramline appearance''. Four grafts (15%) were complicated: pseudoarthrosis and implant failure (1), fractured plate (1), intramedullary nail (IMN) fracture (1), and prosthesis stem loosening in the host bone (1), with underlying unhealed junctions in all cases. Bone scanning can determine the stages of the graft's rim revascularization and incorporation; however, it cannot detect or predict junction healing or occurrence of complications. Supplementary treatment of unhealed junctions showing either decreased junctional uptake or graft quiescence may be warranted. Otherwise, detection of distant metastasis and early local recurrence remains the main application of Tc99m scanning in the management of bone sarcomas. (orig.)

Can bone scintigraphy predict the final outcome of pasteurized autografts?

Energy Technology Data Exchange (ETDEWEB)

Eid, Ahmed Shawky [Ain Shams University, Department of Orthopedic Surgery, Cairo (Egypt); Jeon, Dae-Geun; Cho, Wan Hyeong [Korea Cancer Center Hospital, Department of Orthopedic Surgery, Seoul (Korea)

2010-10-15

As pasteurization is becoming more widely used in limb salvage reconstruction, more study is required to understand about host-graft junction healing, graft revascularization and incorporation, and the incidence and type of complications among pasteurized autografts. This was mainly achieved by follow-up radiography. We aimed to clarify whether Tc99m bone scanning can be considered a reliable method in determining these three parameters. Twenty-seven osteosarcoma patients with pasteurized autograft reconstructions were retrospectively reviewed using available scintigraphic and radiographic follow-up every 6 months postoperatively for 36 months. Follow-up of the unhealed cases was continued for the maximum follow-up period available for each case beyond the original study period, ranging from 1 to 15 months. Tc99m uptake was classified as cold, faint, moderate and high uptake. Junction healing was classified as none, partial and complete healing. Seventy percent of junctions united with a mean of 22 months. Ninety to 100% of junctions showed increased uptake (high or moderate) at one time of the study regardless of final outcome. 85% of the pasteurized grafts showed the characteristic ''tramline appearance''. Four grafts (15%) were complicated: pseudoarthrosis and implant failure (1), fractured plate (1), intramedullary nail (IMN) fracture (1), and prosthesis stem loosening in the host bone (1), with underlying unhealed junctions in all cases. Bone scanning can determine the stages of the graft's rim revascularization and incorporation; however, it cannot detect or predict junction healing or occurrence of complications. Supplementary treatment of unhealed junctions showing either decreased junctional uptake or graft quiescence may be warranted. Otherwise, detection of distant metastasis and early local recurrence remains the main application of Tc99m scanning in the management of bone sarcomas. (orig.)

Designing a Minimal Intervention Strategy to Control Taenia solium.

Science.gov (United States)

Lightowlers, Marshall W; Donadeu, Meritxell

2017-06-01

Neurocysticercosis is an important cause of epilepsy in many developing countries. The disease is a zoonosis caused by the cestode parasite Taenia solium. Many potential intervention strategies are available, however none has been able to be implemented and sustained. Here we predict the impact of some T. solium interventions that could be applied to prevent transmission through pigs, the parasite's natural animal intermediate host. These include minimal intervention strategies that are predicted to be effective and likely to be feasible. Logical models are presented which reflect changes in the risk that age cohorts of animals have for their potential to transmit T. solium. Interventions that include a combined application of vaccination, plus chemotherapy in young animals, are the most effective. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Results of a large-scale randomized behavior change intervention on road safety in Kenya.

Science.gov (United States)

Habyarimana, James; Jack, William

2015-08-25

Road accidents kill 1.3 million people each year, most in the developing world. We test the efficacy of evocative messages, delivered on stickers placed inside Kenyan matatus, or minibuses, in reducing road accidents. We randomize the intervention, which nudges passengers to complain to their drivers directly, across 12,000 vehicles and find that on average it reduces insurance claims rates of matatus by between one-quarter and one-third and is associated with 140 fewer road accidents per year than predicted. Messages promoting collective action are especially effective, and evocative images are an important motivator. Average maximum speeds and average moving speeds are 1-2 km/h lower in vehicles assigned to treatment. We cannot reject the null hypothesis of no placebo effect. We were unable to discern any impact of a complementary radio campaign on insurance claims. Finally, the sticker intervention is inexpensive: we estimate the cost-effectiveness of the most impactful stickers to be between $10 and $45 per disability-adjusted life-year saved.

The relationship between formative and summative examinations and PANCE scores; can the past predict the future?

Science.gov (United States)

Massey, Scott; Stallman, John; Lee, Louise; Klingaman, Kathy; Holmerud, David

2011-01-01

This paper describes how a systematic analysis of students at risk for failing the Physician Assistant National Certifying Examination (PANCE) may be used to identify which students may benefit from intervention prior to taking the PANCE and thus increase the likelihood of successful completion of the PANCE. The intervention developed and implemented uses various formative and summative examinations to predict students' PANCE scores with a high degree of accuracy. Eight end-of-rotation exams (EOREs) based upon discipline-specific diseases and averaging 100 questions each, a 360-question PANCE simulation (SUMM I), the PACKRAT, and a 700-question summative cognitive examination based upon the NCCPA blueprint (SUMM II) were administered to all students enrolled in the program during the clinical year starting in January 2010 and concluding in December 2010. When the PACKRAT, SUMM I, SUMM II, and the surgery, women's health, and pediatrics EOREs were combined in a regression model, an Rvalue of 0.87 and an R2 of 0.75 were obtained. A predicted score was generated for the class of 2009. The predicted PANCE score based upon this model had a final correlation of 0.790 with the actual PANCE score. This pilot study demonstrated that valid predicted scores could be generated from formative and summative examinations to provide valuable feedback and to identify students at risk of failing the PANCE.

Osteoprotegerin predicts long-term outcome in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

DEFF Research Database (Denmark)

Pedersen, Sune Folke; Bjerre, Mette; Mogelvang, Rasmus

2012-01-01

: 1.03-1.59; p = 0.03), repeat myocardial infarction (HR: 1.30; CI: 1.00-1.68; p = 0.05) and admission with heart failure (HR: 1.50; CI: 1.18-1.90; p = 0.001). Conclusion: This study shows that OPG independently predicts long-term outcome in STEMI patients treated with pPCI. Eventually, this knowledge...... in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods: We included 716 consecutive STEMI patients admitted to a single high-volume invasive heart center from September 2006 to December 2008. Endpoints were all...

Predictive Utility of Brief AUDIT for HIV Antiretroviral Medication Nonadherence

Science.gov (United States)

Broyles, Lauren Matukaitis; Gordon, Adam J.; Sereika, Susan M.; Ryan, Christopher M.; Erlen, Judith A.

2012-01-01

Alcohol use negatively affects adherence to antiretroviral therapy (ART), thus HIV/AIDS providers need accurate, efficient assessments of alcohol use. Using existing data from an efficacy trial of two cognitive-behavioral ART adherence interventions, we sought to determine if results on two common alcohol screening tests (Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) and its binge-related question (AUDIT-3)) predict ART nonadherence. Twenty seven percent of the sample (n=308) were positive on the AUDIT-C and 34% were positive on the AUDIT-3. In multivariate analyses, AUDIT-C positive status predicted ART nonadherence after controlling for race, age, conscientiousness, and self-efficacy (p=.036). While AUDIT-3 positive status was associated with ART nonadherence in unadjusted analyses, this relationship was not maintained in the final multivariate model. The AUDIT-C shows potential as an indirect screening tool for both at-risk drinking and ART nonadherence, underscoring the relationship between alcohol and chronic disease management. PMID:22014256

Final report on reliability and lifetime prediction.

Energy Technology Data Exchange (ETDEWEB)

Gillen, Kenneth T; Wise, Jonathan; Jones, Gary D.; Causa, Al G.; Terrill, Edward R.; Borowczak, Marc

2012-12-01

This document highlights the important results obtained from the subtask of the Goodyear CRADA devoted to better understanding reliability of tires and to developing better lifetime prediction methods. The overall objective was to establish the chemical and physical basis for the degradation of tires using standard as well as unique models and experimental techniques. Of particular interest was the potential application of our unique modulus profiling apparatus for assessing tire properties and for following tire degradation. During the course of this complex investigation, extensive relevant information was generated, including experimental results, data analyses and development of models and instruments. Detailed descriptions of the findings are included in this report.

Predictive Value of Plasma Glucose Level on Admission for Short and Long Term Mortality in Patients With ST-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

NARCIS (Netherlands)

Hoebers, Loes P.; Damman, Peter; Claessen, Bimmer E.; Vis, Marije M.; Baan, Jan; van Straalen, Jan P.; Fischer, Johan; Koch, Karel T.; Tijssen, Jan G. P.; de Winter, Robbert J.; Piek, Jan J.; Henriques, Jose P. S.

2012-01-01

Published reports describe a strong association between plasma glucose levels on admission and mortality in patients who undergo primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. The aim of this study was to assess the predictive value of admission glucose

INDIVIDUO: Results from a patient-centered lifestyle intervention for obesity surgery candidates.

Science.gov (United States)

Camolas, José; Santos, Osvaldo; Moreira, Pedro; do Carmo, Isabel

Preoperative nutritional counseling provides an opportunity to ameliorate patients' clinical condition and build-up adequate habits and perception of competence. Study aimed to evaluate: (a) the effect of INDIVIDUO on weight and metabolic control; (b) the impact of INDIVIDUO on psychosocial variables associated with successful weight-control. Two-arms randomised controlled single-site study, with six-month duration. Patients were recruited from an Obesity Treatment Unit's waiting list. For the intervention group (IG), an operating procedure manual was used, nutritionists received training/supervision regarding INDIVIDUO's procedures. Control group (CG) received health literacy-promoting intervention. Intention-to-treat and per-control analysis were used. Outcomes included weight, metabolic control variables (blood pressure, glycemia, insulinemia, triglycerides, cholesterol), measures of eating and physical activity patterns, hedonic hunger, autonomous/controlled regulation, perceived competence for diet (PCS-diet) and quality of life. Primary outcomes were weight and metabolic control. Effect size was estimated by odds ratio and Cohens'd coefficient. Overall, 94 patients participated (IG:45; CG:49) and 60 completed the study (IG:29; CG:31). Intervention patients lost an excess 9.68% body weight (%EWL), vs. 0.51% for CG. Adjusting for age and baseline BMI, allocation group remained an independent predictor of %EWL (B=8.43, 95%CI: 2.79-14.06). IG had a six-fold higher probability (OR: 6.35, 95%CI: 1.28-31.56) of having adequate/controlled fasting glycemia at final evaluation. PCS-diet at final evaluation was independently predicted by baseline PCS-diet (B=0.31, 95%CI: 0.06-0.64), variation in autonomous regulation (B=0.43, 95%CI: 0.15-0.71) and allocation group (B=0.26, 95%CI: 0.04-1.36). Results on weight and metabolic control support INDIVIDUO as a valuable clinical tool for obesity surgery candidates counseling. Additionally, intervention associated with perceived

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.

Risk Prediction Models in Psychiatry: Toward a New Frontier for the Prevention of Mental Illnesses.

Science.gov (United States)

Bernardini, Francesco; Attademo, Luigi; Cleary, Sean D; Luther, Charles; Shim, Ruth S; Quartesan, Roberto; Compton, Michael T

2017-05-01

We conducted a systematic, qualitative review of risk prediction models designed and tested for depression, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, and psychotic disorders. Our aim was to understand the current state of research on risk prediction models for these 5 disorders and thus future directions as our field moves toward embracing prediction and prevention. Systematic searches of the entire MEDLINE electronic database were conducted independently by 2 of the authors (from 1960 through 2013) in July 2014 using defined search criteria. Search terms included risk prediction, predictive model, or prediction model combined with depression, bipolar, manic depressive, generalized anxiety, posttraumatic, PTSD, schizophrenia, or psychosis. We identified 268 articles based on the search terms and 3 criteria: published in English, provided empirical data (as opposed to review articles), and presented results pertaining to developing or validating a risk prediction model in which the outcome was the diagnosis of 1 of the 5 aforementioned mental illnesses. We selected 43 original research reports as a final set of articles to be qualitatively reviewed. The 2 independent reviewers abstracted 3 types of data (sample characteristics, variables included in the model, and reported model statistics) and reached consensus regarding any discrepant abstracted information. Twelve reports described models developed for prediction of major depressive disorder, 1 for bipolar disorder, 2 for generalized anxiety disorder, 4 for posttraumatic stress disorder, and 24 for psychotic disorders. Most studies reported on sensitivity, specificity, positive predictive value, negative predictive value, and area under the (receiver operating characteristic) curve. Recent studies demonstrate the feasibility of developing risk prediction models for psychiatric disorders (especially psychotic disorders). The field must now advance by (1) conducting more large

Predictive Manufacturing: A Classification Strategy to Predict Product Failures

DEFF Research Database (Denmark)

Khan, Abdul Rauf; Schiøler, Henrik; Kulahci, Murat

2018-01-01

manufacturing analytics model that employs a big data approach to predicting product failures; third, we illustrate the issue of high dimensionality, along with statistically redundant information; and, finally, our proposed method will be compared against the well-known classification methods (SVM, K......-nearest neighbor, artificial neural networks). The results from real data show that our predictive manufacturing analytics approach, using genetic algorithms and Voronoi tessellations, is capable of predicting product failure with reasonable accuracy. The potential application of this method contributes...... to accurately predicting product failures, which would enable manufacturers to reduce production costs without compromising product quality....

Bio-Energy during Finals: Stress Reduction for a University Community.

Science.gov (United States)

Running, Alice; Hildreth, Laura

2016-01-01

To re-examine the effectiveness of a bio-energy intervention on self-reported stress for a convenience sample of university students during dead week, a quasi-experimental, single-group pretest-posttest design was used. Thirty-three students participated, serving as their own controls. After participants had consented, a 15-min Healing Touch intervention followed enrollment. Self-reported stress was significantly reduced after the bio-energy (Healing Touch) intervention. Bio-energy therapy has shown to be beneficial in reducing stress for students during dead week, the week before final examinations. Further research is needed.

Targeted intervention: Computational approaches to elucidate and predict relapse in alcoholism.

Science.gov (United States)

Heinz, Andreas; Deserno, Lorenz; Zimmermann, Ulrich S; Smolka, Michael N; Beck, Anne; Schlagenhauf, Florian

2017-05-01

Alcohol use disorder (AUD) and addiction in general is characterized by failures of choice resulting in repeated drug intake despite severe negative consequences. Behavioral change is hard to accomplish and relapse after detoxification is common and can be promoted by consumption of small amounts of alcohol as well as exposure to alcohol-associated cues or stress. While those environmental factors contributing to relapse have long been identified, the underlying psychological and neurobiological mechanism on which those factors act are to date incompletely understood. Based on the reinforcing effects of drugs of abuse, animal experiments showed that drug, cue and stress exposure affect Pavlovian and instrumental learning processes, which can increase salience of drug cues and promote habitual drug intake. In humans, computational approaches can help to quantify changes in key learning mechanisms during the development and maintenance of alcohol dependence, e.g. by using sequential decision making in combination with computational modeling to elucidate individual differences in model-free versus more complex, model-based learning strategies and their neurobiological correlates such as prediction error signaling in fronto-striatal circuits. Computational models can also help to explain how alcohol-associated cues trigger relapse: mechanisms such as Pavlovian-to-Instrumental Transfer can quantify to which degree Pavlovian conditioned stimuli can facilitate approach behavior including alcohol seeking and intake. By using generative models of behavioral and neural data, computational approaches can help to quantify individual differences in psychophysiological mechanisms that underlie the development and maintenance of AUD and thus promote targeted intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

Surrogate inaccuracy in predicting older adults' desire for life-sustaining interventions in the event of decisional incapacity: is it due in part to erroneous quality-of-life assessments?

Science.gov (United States)

Bravo, Gina; Sene, Modou; Arcand, Marcel

2017-07-01

Family members are often called upon to make decisions for an incapacitated relative. Yet they have difficulty predicting a loved one's desire to receive treatments in hypothetical situations. We tested the hypothesis that this difficulty could in part be explained by discrepant quality-of-life assessments. The data come from 235 community-dwelling adults aged 70 years and over who rated their quality of life and desire for specified interventions in four health states (current state, mild to moderate stroke, incurable brain cancer, and severe dementia). All ratings were made on Likert-type scales. Using identical rating scales, a surrogate chosen by the older adult was asked to predict the latter's responses. Linear mixed models were fitted to determine whether differences in quality-of-life ratings between the older adult and surrogate were associated with surrogates' inaccuracy in predicting desire for treatment. The difference in quality-of-life ratings was a significant predictor of prediction inaccuracy for the three hypothetical health states (p quality of life compared to the older adult, the more he or she overestimated the older adult's desire to be treated. Discrepant quality-of-life ratings are associated with surrogates' difficulty in predicting desire for life-sustaining interventions in hypothetical situations. This finding underscores the importance of discussing anticipated quality of life in states of cognitive decline, to better prepare family members for making difficult decisions for their loved ones. ISRCTN89993391.

Characterization of the radon source in North-Central Florida. Final report part 1 -- Final project report; Final report part 2 -- Technical report

International Nuclear Information System (INIS)

1997-01-01

This report contains two separate parts: Characterization of the Radon Source in North-Central Florida (final report part 1 -- final project report); and Characterization of the Radon Source in North-Central Florida (technical report). The objectives were to characterize the radon 222 source in a region having a demonstrated elevated indoor radon potential and having geology, lithology, and climate that are different from those in other regions of the U.S. where radon is being studied. Radon availability and transport in this region were described. Approaches for predicting the radon potential of lands in this region were developed

PRIME – PRocess modelling in ImpleMEntation research: selecting a theoretical basis for interventions to change clinical practice

Directory of Open Access Journals (Sweden)

Pitts Nigel

2003-12-01

Full Text Available Abstract Background Biomedical research constantly produces new findings but these are not routinely translated into health care practice. One way to address this problem is to develop effective interventions to translate research findings into practice. Currently a range of empirical interventions are available and systematic reviews of these have demonstrated that there is no single best intervention. This evidence base is difficult to use in routine settings because it cannot identify which intervention is most likely to be effective (or cost effective in a particular situation. We need to establish a scientific rationale for interventions. As clinical practice is a form of human behaviour, theories of human behaviour that have proved useful in other similar settings may provide a basis for developing a scientific rationale for the choice of interventions to translate research findings into clinical practice. The objectives of the study are: to amplify and populate scientifically validated theories of behaviour with evidence from the experience of health professionals; to use this as a basis for developing predictive questionnaires using replicable methods; to identify which elements of the questionnaire (i.e., which theoretical constructs predict clinical practice and distinguish between evidence compliant and non-compliant practice; and on the basis of these results, to identify variables (based on theoretical constructs that might be prime targets for behaviour change interventions. Methods We will develop postal questionnaires measuring two motivational, three action and one stage theory to explore five behaviours with 800 general medical and 600 general dental practitioners. We will collect data on performance for each of the behaviours. The relationships between predictor variables (theoretical constructs and outcome measures (data on performance in each survey will be assessed using multiple regression analysis and structural equation

Admission hyperglycemia predicts inhospital mortality and major adverse cardiac events after primary percutaneous coronary intervention in patients without diabetes mellitus.

Science.gov (United States)

Ekmekci, Ahmet; Cicek, Gokhan; Uluganyan, Mahmut; Gungor, Baris; Osman, Faizel; Ozcan, Kazim Serhan; Bozbay, Mehmet; Ertas, Gokhan; Zencirci, Aycan; Sayar, Nurten; Eren, Mehmet

2014-02-01

Admission hyperglycemia is associated with high inhospital and long-term adverse events in patients that undergo primary percutaneous coronary intervention (PCI). We aimed to evaluate whether hyperglycemia predicts inhospital mortality. We prospectively analyzed 503 consecutive patients. The patients were divided into tertiles according to the admission glucose levels. Tertile I: glucose 145 mg/dL (n = 169). Inhospital mortality was 0 in tertile I, 2 in tertile II, and 9 in tertile III (P < .02). Cardiogenic shock occurred more frequently in tertile III compared to tertiles I and II (10% vs 4.1% and 0.6%, respectively, P = .01). Multivariate logistic regression analysis revealed that patients in tertile III had significantly higher risk of inhospital major adverse cardiac events compared to patients in tertile I (odds ratio: 9.55, P < .02). Admission hyperglycemia predicts inhospital adverse cardiac events in mortality and acute ST-segment elevation myocardial infarction in patients that underwent primary PCI.

Perioperative Care and the Importance of Continuous Quality Improvement--A Controlled Intervention Study in Three Tanzanian Hospitals.

Science.gov (United States)

Bosse, Goetz; Abels, Wiltrud; Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus-Dieter; Spies, Claudia

2015-01-01

Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, pcontrol group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (pcontrol group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach.

Refusal to medical interventions.

Science.gov (United States)

Palacios, G; Herreros, B; Pacho, E

2014-10-01

Refusal to medical interventions is the not acceptance, voluntary and free, of an indicated medical intervention. What the physician should do in case of refusal? It is understandable that the rejection of a validated medical intervention is difficult to accept by the responsible physician when raises the conflict protection of life versus freedom of choice. Therefore it is important to follow some steps to incorporate the most relevant aspects of the conflict. These steps include: 1) Give complete information to patients, informing on possible alternatives, 2) determine whether the patient can decide (age, competency and level of capacity), 3) to ascertain whether the decision is free, 4) analyze the decision with the patient, 5) to persuade, 6) if the patient kept in the rejection decision, consider conscientious objection, 7) take the decision based on the named criteria, 8) finally, if the rejection is accepted, offer available alternatives. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

How learning analytics can early predict under-achieving students in a blended medical education course.

Science.gov (United States)

Saqr, Mohammed; Fors, Uno; Tedre, Matti

2017-07-01

Learning analytics (LA) is an emerging discipline that aims at analyzing students' online data in order to improve the learning process and optimize learning environments. It has yet un-explored potential in the field of medical education, which can be particularly helpful in the early prediction and identification of under-achieving students. The aim of this study was to identify quantitative markers collected from students' online activities that may correlate with students' final performance and to investigate the possibility of predicting the potential risk of a student failing or dropping out of a course. This study included 133 students enrolled in a blended medical course where they were free to use the learning management system at their will. We extracted their online activity data using database queries and Moodle plugins. Data included logins, views, forums, time, formative assessment, and communications at different points of time. Five engagement indicators were also calculated which would reflect self-regulation and engagement. Students who scored below 5% over the passing mark were considered to be potentially at risk of under-achieving. At the end of the course, we were able to predict the final grade with 63.5% accuracy, and identify 53.9% of at-risk students. Using a binary logistic model improved prediction to 80.8%. Using data recorded until the mid-course, prediction accuracy was 42.3%. The most important predictors were factors reflecting engagement of the students and the consistency of using the online resources. The analysis of students' online activities in a blended medical education course by means of LA techniques can help early predict underachieving students, and can be used as an early warning sign for timely intervention.

The value of independent specialty designation for interventional cardiology.

Science.gov (United States)

Blankenship, James C; Powell, Wayne A; Gray, Dawn R; Duffy, Peter L

2017-01-01

Interventional cardiology has finally completed, after 26 years of advocacy, a professional hat trick: independent board certification, membership as a unique specialty in the American Medical Association House of Delegates (AMA HOD), and recognition by the Centers for Medicaid and Medicare Services (CMS) as a separate medical specialty. This article points out how these distinctions for interventional cardiology and its professional society, the Society for Cardiovascular Angiography and Interventions (SCAI), have led to clear and definite benefits for interventional cardiologists and their patients. We focus on the least understood of these three-recognition by CMS and its implications for reimbursement and quality assessment for interventional cardiologists. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A new, accurate predictive model for incident hypertension.

Science.gov (United States)

Völzke, Henry; Fung, Glenn; Ittermann, Till; Yu, Shipeng; Baumeister, Sebastian E; Dörr, Marcus; Lieb, Wolfgang; Völker, Uwe; Linneberg, Allan; Jørgensen, Torben; Felix, Stephan B; Rettig, Rainer; Rao, Bharat; Kroemer, Heyo K

2013-11-01

Data mining represents an alternative approach to identify new predictors of multifactorial diseases. This work aimed at building an accurate predictive model for incident hypertension using data mining procedures. The primary study population consisted of 1605 normotensive individuals aged 20-79 years with 5-year follow-up from the population-based study, that is the Study of Health in Pomerania (SHIP). The initial set was randomly split into a training and a testing set. We used a probabilistic graphical model applying a Bayesian network to create a predictive model for incident hypertension and compared the predictive performance with the established Framingham risk score for hypertension. Finally, the model was validated in 2887 participants from INTER99, a Danish community-based intervention study. In the training set of SHIP data, the Bayesian network used a small subset of relevant baseline features including age, mean arterial pressure, rs16998073, serum glucose and urinary albumin concentrations. Furthermore, we detected relevant interactions between age and serum glucose as well as between rs16998073 and urinary albumin concentrations [area under the receiver operating characteristic (AUC 0.76)]. The model was confirmed in the SHIP validation set (AUC 0.78) and externally replicated in INTER99 (AUC 0.77). Compared to the established Framingham risk score for hypertension, the predictive performance of the new model was similar in the SHIP validation set and moderately better in INTER99. Data mining procedures identified a predictive model for incident hypertension, which included innovative and easy-to-measure variables. The findings promise great applicability in screening settings and clinical practice.

Predicting non-familial major physical violent crime perpetration in the US Army from administrative data.

Science.gov (United States)

Rosellini, A J; Monahan, J; Street, A E; Heeringa, S G; Hill, E D; Petukhova, M; Reis, B Y; Sampson, N A; Bliese, P; Schoenbaum, M; Stein, M B; Ursano, R J; Kessler, R C

2016-01-01

Although interventions exist to reduce violent crime, optimal implementation requires accurate targeting. We report the results of an attempt to develop an actuarial model using machine learning methods to predict future violent crimes among US Army soldiers. A consolidated administrative database for all 975 057 soldiers in the US Army in 2004-2009 was created in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Of these soldiers, 5771 committed a first founded major physical violent crime (murder-manslaughter, kidnapping, aggravated arson, aggravated assault, robbery) over that time period. Temporally prior administrative records measuring socio-demographic, Army career, criminal justice, medical/pharmacy, and contextual variables were used to build an actuarial model for these crimes separately among men and women using machine learning methods (cross-validated stepwise regression, random forests, penalized regressions). The model was then validated in an independent 2011-2013 sample. Key predictors were indicators of disadvantaged social/socioeconomic status, early career stage, prior crime, and mental disorder treatment. Area under the receiver-operating characteristic curve was 0.80-0.82 in 2004-2009 and 0.77 in the 2011-2013 validation sample. Of all administratively recorded crimes, 36.2-33.1% (male-female) were committed by the 5% of soldiers having the highest predicted risk in 2004-2009 and an even higher proportion (50.5%) in the 2011-2013 validation sample. Although these results suggest that the models could be used to target soldiers at high risk of violent crime perpetration for preventive interventions, final implementation decisions would require further validation and weighing of predicted effectiveness against intervention costs and competing risks.

A Systematic Review of Interventions to Follow-Up Test Results Pending at Discharge.

Science.gov (United States)

Darragh, Patrick J; Bodley, T; Orchanian-Cheff, A; Shojania, K G; Kwan, J L; Cram, P

2018-05-01

Patients are frequently discharged from the hospital before all test results have been finalized. Thirty to 40% of tests pending at discharge (TPADs) return potentially actionable results that could necessitate change in the patients' management, often unbeknownst to their physicians. Delayed follow-up of TPADs can lead to patient harm. We sought to synthesize the existing literature on interventions intended to improve the management of TPADs, including interventions designed to enhance documentation of TPADs, increase physician awareness when TPAD results finalize post-discharge, decrease adverse events related to missed TPADs, and increase physician satisfaction with TPAD management. We searched Medline, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Database of Controlled Clinical Trials and Medline (January 1, 2000-November 10, 2016) for randomized controlled trials and prospective, controlled observational studies that evaluated interventions to improve follow-up of TPADs for adult patients discharged from acute care hospitals or emergency department settings. From each study we extracted characteristics of the intervention being evaluated and its impact on TPAD management. Nine studies met the criteria for inclusion. Six studies evaluated electronic discharge summary templates with a designated field for documenting TPADs, and three of six of these studies reported a significant improvement in documentation of TPADs in discharge summaries in pre- and post-intervention analysis. One study reported that auditing discharge summaries and providing feedback to physicians were associated with improved TPAD documentation in discharge summaries. Two studies found that email alerts when TPADs were finalized improved physicians' awareness of the results and documentation of their follow-up actions. Of the four studies that assessed patient morbidity, two showed a positive effect; however, none specifically measured the impact of their interventions

Conducting Organizational-level occupational health interventions: What works?

DEFF Research Database (Denmark)

Nielsen, Karina; Randall, Raymond; Holten, Ann-Louise

2010-01-01

In recent years, there has been an increasing interest in how organizational-level occupational health interventions aimed at improving psychosocial working conditions and employee health and well-being may be planned, implemented and evaluated. It has been claimed that such interventions have...... the alteration of the way in which work is designed, organized and managed. The methods identified are the Risk Management approach and the Management Standards from Great Britain, the German Health Circles approach, Work Positive from Ireland and Prevenlab from Spain. Comparative analyses reveal...... their appropriateness in conducting organizationallevel occupational health interventions. Finally, we discuss where we still need more research to determine the working ingredients of organizational-level occupational health interventions....

Cardiovascular and interventional radiology

International Nuclear Information System (INIS)

White, R.I. Jr.

1985-01-01

A symposium of eight short but complete papers giving an overview of interventional radiology is presented. Organized by Dr. William Casarella, this symposium is certainly the most current review of the subject available. This year's cardiovascular section is again heavily weighted toward interventional radiology. Abrams and Doubilet's article on the underutilization of angioplasty is important because it describes the cost effectiveness of this method. Most health planners, right or wrong, have complained about overutilization of diagnostic radiology procedures. In general, the opposite is true for interventional procedures - they are underutilized. If the authors draw the attention of their hospital administrators to these approaches and also produce the data on long-term follow-up for our medical colleagues, interventional radiology may realize its full potential. Articles on cardiac magnetic resonance imaging are beginning to appear and this technique seems to have great potential. An important article, which is the first prospective study comparing lung scintigraphy and pulmonary angiography in the diagnosis of pulmonary embolism, supports the increased use of pulmonary angiography. Finally, an article on complications of percutaneous biliary drainage provokes some discussion of its value for routine preoperative use

Socioeconomic predictors of cognition in Ugandan children: implications for community interventions.

Directory of Open Access Journals (Sweden)

Paul Bangirana

2009-11-01

Full Text Available Several interventions to improve cognition in at risk children have been suggested. Identification of key variables predicting cognition is necessary to guide these interventions. This study was conducted to identify these variables in Ugandan children and guide such interventions.A cohort of 89 healthy children (45 females aged 5 to 12 years old were followed over 24 months and had cognitive tests measuring visual spatial processing, memory, attention and spatial learning administered at baseline, 6 months and 24 months. Nutritional status, child's educational level, maternal education, socioeconomic status and quality of the home environment were also measured at baseline. A multivariate, longitudinal model was then used to identify predictors of cognition over the 24 months.A higher child's education level was associated with better memory (p = 0.03, attention (p = 0.005 and spatial learning scores over the 24 months (p = 0.05; higher nutrition scores predicted better visual spatial processing (p = 0.002 and spatial learning scores (p = 0.008; and a higher home environment score predicted a better memory score (p = 0.03.Cognition in Ugandan children is predicted by child's education, nutritional status and the home environment. Community interventions to improve cognition may be effective if they target multiple socioeconomic variables.

Adapting Behavioral Interventions for Social Media Delivery

Science.gov (United States)

Waring, Molly E; May, Christine N; Ding, Eric Y; Kunz, Werner H; Hayes, Rashelle; Oleski, Jessica L

2016-01-01

Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals—a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality. PMID:26825969

Adapting Behavioral Interventions for Social Media Delivery.

Science.gov (United States)

Pagoto, Sherry; Waring, Molly E; May, Christine N; Ding, Eric Y; Kunz, Werner H; Hayes, Rashelle; Oleski, Jessica L

2016-01-29

Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals--a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality.

On intervention levels for nuclear or radiological emergency and decision-making on protective measures

International Nuclear Information System (INIS)

Wang Hengde; Nakashima, Y.

1999-01-01

The intervention principles and intervention levels newly recommended by ICRP and IAEA are introduced, the necessarily of determining site specific intervention levels is discussed, the method of estimating intervention levels with human capital approach by an example of Japan case is described, and finally decision-making issues are discussed and a decision-making chain is given

[Effective interventions to reduce absenteeism among hospital nurses].

Science.gov (United States)

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

2013-01-01

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

Predicting dropout using student- and school-level factors: An ecological perspective.

Science.gov (United States)

Wood, Laura; Kiperman, Sarah; Esch, Rachel C; Leroux, Audrey J; Truscott, Stephen D

2017-03-01

High school dropout has been associated with negative outcomes, including increased rates of unemployment, incarceration, and mortality. Dropout rates vary significantly depending on individual and environmental factors. The purpose of our study was to use an ecological perspective to concurrently explore student- and school-level predictors associated with dropout for the purpose of better understanding how to prevent it. We used the Education Longitudinal Study of 2002 dataset. Participants included 14,106 sophomores across 684 public and private schools. We identified variables of interest based on previous research on dropout and implemented hierarchical generalized linear modeling. In the final model, significant student-level predictors included academic achievement, retention, sex, family socioeconomic status (SES), and extracurricular involvement. Significant school-level predictors included school SES and school size. Race/ethnicity, special education status, born in the United States, English as first language, school urbanicity, and school region did not significantly predict dropout after controlling for the aforementioned predictors. Implications for prevention and intervention efforts within a multitiered intervention model are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Preprocedural Prediction Model for Contrast-Induced Nephropathy Patients.

Science.gov (United States)

Yin, Wen-Jun; Yi, Yi-Hu; Guan, Xiao-Feng; Zhou, Ling-Yun; Wang, Jiang-Lin; Li, Dai-Yang; Zuo, Xiao-Cong

2017-02-03

Several models have been developed for prediction of contrast-induced nephropathy (CIN); however, they only contain patients receiving intra-arterial contrast media for coronary angiographic procedures, which represent a small proportion of all contrast procedures. In addition, most of them evaluate radiological interventional procedure-related variables. So it is necessary for us to develop a model for prediction of CIN before radiological procedures among patients administered contrast media. A total of 8800 patients undergoing contrast administration were randomly assigned in a 4:1 ratio to development and validation data sets. CIN was defined as an increase of 25% and/or 0.5 mg/dL in serum creatinine within 72 hours above the baseline value. Preprocedural clinical variables were used to develop the prediction model from the training data set by the machine learning method of random forest, and 5-fold cross-validation was used to evaluate the prediction accuracies of the model. Finally we tested this model in the validation data set. The incidence of CIN was 13.38%. We built a prediction model with 13 preprocedural variables selected from 83 variables. The model obtained an area under the receiver-operating characteristic (ROC) curve (AUC) of 0.907 and gave prediction accuracy of 80.8%, sensitivity of 82.7%, specificity of 78.8%, and Matthews correlation coefficient of 61.5%. For the first time, 3 new factors are included in the model: the decreased sodium concentration, the INR value, and the preprocedural glucose level. The newly established model shows excellent predictive ability of CIN development and thereby provides preventative measures for CIN. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Imaging in percutaneous musculoskeletal interventions

International Nuclear Information System (INIS)

Gangi, Afshin; Guth, Stephane; Guermazi, Ali

2009-01-01

This is one of the first books to deal specifically with imaging in percutaneous musculoskeletal interventions. The use of different imaging modalities during these procedures is well described. In the first chapter, the basic procedures and different guidance techniques are presented and discussed. The ensuing chapters describe in exhaustive detail the abilities and uses of imaging in guiding procedures ranging from biopsy and joint injection to management of pain and tumors. These procedures are extensively documented in adults as well as in the pediatric population. The third part of the book describes the different indications for vascular interventions in musculoskeletal lesions. The final chapter focuses on ultrasound-guided interventions, as they are more common and tend to be fashionable. The book is well illustrated with carefully chosen and technically excellent images. Each of the 18 chapters is written by an expert of international repute, making this book the most current and complete treatment of the subject available. It should be of great interest to interventional radiologists and also musculoskeletal and general radiologists. (orig.)

The role of cognition in cost-effectiveness analyses of behavioral interventions

Directory of Open Access Journals (Sweden)

Prenger Rilana

2012-03-01

Full Text Available Abstract Background Behavioral interventions typically focus on objective behavioral endpoints like weight loss and smoking cessation. In reality, though, achieving full behavior change is a complex process in which several steps towards success are taken. Any progress in this process may also be considered as a beneficial outcome of the intervention, assuming that this increases the likelihood to achieve successful behavior change eventually. Until recently, there has been little consideration about whether partial behavior change at follow-up should be incorporated in cost-effectiveness analyses (CEAs. The aim of this explorative review is to identify CEAs of behavioral interventions in which cognitive outcome measures of behavior change are analyzed. Methods Data sources were searched for publications before May 2011. Results Twelve studies were found eligible for inclusion. Two different approaches were found: three studies calculated separate incremental cost-effectiveness ratios for cognitive outcome measures, and one study modeled partial behavior change into the final outcome. Both approaches rely on the assumption, be it implicitly or explicitly, that changes in cognitive outcome measures are predictive of future behavior change and may affect CEA outcomes. Conclusion Potential value of cognitive states in CEA, as a way to account for partial behavior change, is to some extent recognized but not (yet integrated in the field. In conclusion, CEAs should consider, and where appropriate incorporate measures of partial behavior change when reporting effectiveness and hence cost-effectiveness.

Psychosocial Intervention Model

DEFF Research Database (Denmark)

Singla, Rashmi

2007-01-01

The article is based on a research project drawing upon survey data (N=628) and qualitative interviews (N=60) of youth and their parents belonging to the five largest ethnic minority groups in Denmark i.e. Turkey, former Yugoslavia, Pakistan, Lebanon and Somalia, along with the experiences of psy.......K. as well as Nordic countries. Finally a model for psychosocial intervention is presented which directs attention to the issues of ageism, sexism as well as racism at personal, interpersonal and structural levels....

Using the Intervention Mapping Protocol to develop an online video intervention for parents to prevent childhood obesity: Movie Models.

Science.gov (United States)

De Lepeleere, Sara; Verloigne, Maïté; Brown, Helen Elizabeth; Cardon, Greet; De Bourdeaudhuij, Ilse

2016-08-08

The increasing prevalence of childhood overweight/obesity caused by an unhealthy diet, insufficient physical activity (PA) and high levels of sedentary behaviour (SB) is a prominent public health concern. Parenting practices may contribute to healthy behaviour change in children, but well-researched examples are limited. The aim of this study is to describe the systematic development of an intervention for parents to prevent childhood overweight/obesity through the improvement of parenting practices. The six steps of the Intervention Mapping Protocol (IMP), a theory- and evidence-based tool to develop health-related interventions, were used as a framework to develop the 'Movie Models' programme. In Step 1, a needs assessment was performed to better understand the health problem of overweight/obesity in children and its association with diet, PA and SB. In Step 2, the programme goal (increasing the adoption of effective parenting practices) was sub-divided into performance objectives. Change objectives, which specify explicit actions required to accomplish the performance objectives, were also identified. Step 3 included the selection of theoretical methods (e.g. 'modelling' and 'images'), which were then translated into the practical strategy of online parenting videos. Step 4 comprised the development of a final intervention framework, and Step 5 included the planning of programme adoption and implementation. The final phase, Step 6, included the development of an effect- and process-evaluation plan. The IMP was used to structure the development of 'Movie Models', an intervention targeting specific parenting practices related to children's healthy diet, PA, SB, and parental self-efficacy. A clear framework for process analyses is offered, which aims to increase the potential effectiveness of an intervention and can be useful for those developing health promotion programmes. © The Author(s) 2016.

Characterizing Social Networks and Communication Channels in a Web-Based Peer Support Intervention.

Science.gov (United States)

Owen, Jason E; Curran, Michaela; Bantum, Erin O'Carroll; Hanneman, Robert

2016-06-01

Web and mobile (mHealth) interventions have promise for improving health outcomes, but engagement and attrition may be reducing effect sizes. Because social networks can improve engagement, which is a key mechanism of action, understanding the structure and potential impact of social networks could be key to improving mHealth effects. This study (a) evaluates social network characteristics of four distinct communication channels (discussion board, chat, e-mail, and blog) in a large social networking intervention, (b) predicts membership in online communities, and (c) evaluates whether community membership impacts engagement. Participants were 299 cancer survivors with significant distress using the 12-week health-space.net intervention. Social networking attributes (e.g., density and clustering) were identified separately for each type of network communication (i.e., discussion board, blog, web mail, and chat). Each channel demonstrated high levels of clustering, and being a community member in one communication channel was associated with being in the same community in each of the other channels (φ = 0.56-0.89, ps < 0.05). Predictors of community membership differed across communication channels, suggesting that each channel reached distinct types of users. Finally, membership in a discussion board, chat, or blog community was strongly associated with time spent engaging with coping skills exercises (Ds = 1.08-1.84, ps < 0.001) and total time of intervention (Ds = 1.13-1.80, ps < 0.001). mHealth interventions that offer multiple channels for communication allow participants to expand the number of individuals with whom they are communicating, create opportunities for communicating with different individuals in distinct channels, and likely enhance overall engagement.

Characterizing Social Networks and Communication Channels in a Web-Based Peer Support Intervention

Science.gov (United States)

Curran, Michaela; Bantum, Erin O'Carroll; Hanneman, Robert

2016-01-01

Abstract Web and mobile (mHealth) interventions have promise for improving health outcomes, but engagement and attrition may be reducing effect sizes. Because social networks can improve engagement, which is a key mechanism of action, understanding the structure and potential impact of social networks could be key to improving mHealth effects. This study (a) evaluates social network characteristics of four distinct communication channels (discussion board, chat, e-mail, and blog) in a large social networking intervention, (b) predicts membership in online communities, and (c) evaluates whether community membership impacts engagement. Participants were 299 cancer survivors with significant distress using the 12-week health-space.net intervention. Social networking attributes (e.g., density and clustering) were identified separately for each type of network communication (i.e., discussion board, blog, web mail, and chat). Each channel demonstrated high levels of clustering, and being a community member in one communication channel was associated with being in the same community in each of the other channels (φ = 0.56–0.89, ps < 0.05). Predictors of community membership differed across communication channels, suggesting that each channel reached distinct types of users. Finally, membership in a discussion board, chat, or blog community was strongly associated with time spent engaging with coping skills exercises (Ds = 1.08–1.84, ps < 0.001) and total time of intervention (Ds = 1.13–1.80, ps < 0.001). mHealth interventions that offer multiple channels for communication allow participants to expand the number of individuals with whom they are communicating, create opportunities for communicating with different individuals in distinct channels, and likely enhance overall engagement. PMID:27327066

Prediction of Outcome in Acute Lower Gastrointestinal Bleeding Using Gradient Boosting.

Directory of Open Access Journals (Sweden)

Lakshmana Ayaru

Full Text Available There are no widely used models in clinical care to predict outcome in acute lower gastro-intestinal bleeding (ALGIB. If available these could help triage patients at presentation to appropriate levels of care/intervention and improve medical resource utilisation. We aimed to apply a state-of-the-art machine learning classifier, gradient boosting (GB, to predict outcome in ALGIB using non-endoscopic measurements as predictors.Non-endoscopic variables from patients with ALGIB attending the emergency departments of two teaching hospitals were analysed retrospectively for training/internal validation (n=170 and external validation (n=130 of the GB model. The performance of the GB algorithm in predicting recurrent bleeding, clinical intervention and severe bleeding was compared to a multiple logic regression (MLR model and two published MLR-based prediction algorithms (BLEED and Strate prediction rule.The GB algorithm had the best negative predictive values for the chosen outcomes (>88%. On internal validation the accuracy of the GB algorithm for predicting recurrent bleeding, therapeutic intervention and severe bleeding were (88%, 88% and 78% respectively and superior to the BLEED classification (64%, 68% and 63%, Strate prediction rule (78%, 78%, 67% and conventional MLR (74%, 74% 62%. On external validation the accuracy was similar to conventional MLR for recurrent bleeding (88% vs. 83% and therapeutic intervention (91% vs. 87% but superior for severe bleeding (83% vs. 71%.The gradient boosting algorithm accurately predicts outcome in patients with acute lower gastrointestinal bleeding and outperforms multiple logistic regression based models. These may be useful for risk stratification of patients on presentation to the emergency department.

Modelling household responses to energy efficiency interventions ...

African Journals Online (AJOL)

2010-11-01

Nov 1, 2010 ... to interventions aimed at reducing energy consumption (specifically the use of .... 4 A system dynamics model of electricity consumption ...... to base comparisons on overly detailed quantitative predictions of behaviour.

Appropriate Use Criteria for Fluoroscopically Guided Diagnostic and Therapeutic Sacroiliac Interventions: Results from the Spine Intervention Society Convened Multispecialty Collaborative.

Science.gov (United States)

MacVicar, John; Kreiner, D Scott; Duszynski, Belinda; Kennedy, David J

2017-11-01

To provide an overview of a multisociety effort to formulate appropriate use criteria for image-guided injections and radiofrequency procedures in the diagnosis and treatment of sacroiliac joint and posterior sacroiliac complex pain. The Spine Intervention Society convened a multisociety effort to guide physicians and define for payers the appropriate use of image-guided injections and radiofrequency procedures. An evidence panel was established to write systematic reviews, define key terms and assumptions, and develop clinical scenarios to be addressed. The rating panel considered the evidence presented in the systematic reviews, carefully reviewed the definitions and assumptions, and rated the clinical scenarios. Final median ratings, in combination with the level of agreement, determined the final ratings for the appropriate use of sacroiliac injections and radiofrequency neurotomy. More than 10,000 scenarios were addressed in the appropriate use criteria and are housed within five modules in the portal, available on the Spine Intervention Society website: Module 1: Clinical Indications and Imaging; Module 2: Anticoagulants; Module 3: Timing of Injections; Module 4: Number of Injections; and Module 5: Lateral Branch Radiofrequency Neurotomy. Within several of these modules, several issues of interest are identified and discussed. Physicians and payers can access the appropriate use criteria portal on the Spine Intervention Society's website and select specific clinical indications for a particular patient in order to learn more about the appropriateness of the intervention(s) under consideration. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Assessing the Availability of Users to Engage in Just-in-Time Intervention in the Natural Environment.

Science.gov (United States)

Sarker, Hillol; Sharmin, Moushumi; Ali, Amin Ahsan; Rahman, Md Mahbubur; Bari, Rummana; Hossain, Syed Monowar; Kumar, Santosh

Wearable wireless sensors for health monitoring are enabling the design and delivery of just-in-time interventions (JITI). Critical to the success of JITI is to time its delivery so that the user is available to be engaged. We take a first step in modeling users' availability by analyzing 2,064 hours of physiological sensor data and 2,717 self-reports collected from 30 participants in a week-long field study. We use delay in responding to a prompt to objectively measure availability. We compute 99 features and identify 30 as most discriminating to train a machine learning model for predicting availability. We find that location, affect, activity type, stress, time, and day of the week, play significant roles in predicting availability. We find that users are least available at work and during driving, and most available when walking outside. Our model finally achieves an accuracy of 74.7% in 10-fold cross-validation and 77.9% with leave-one-subject-out.

Distinct lipid profiles predict improved glycemic control in obese, nondiabetic patients after a low-caloric diet intervention

DEFF Research Database (Denmark)

Valsesia, Armand; Saris, Wim Hm; Astrup, Arne

2016-01-01

BACKGROUND: An aim of weight loss is to reduce the risk of type 2 diabetes (T2D) in obese subjects. However, the relation with long-term glycemic improvement remains unknown. OBJECTIVE: We evaluated the changes in lipid composition during weight loss and their association with long-term glycemic...... improvement. DESIGN: We investigated the plasma lipidome of 383 obese, nondiabetic patients within a randomized, controlled dietary intervention in 8 European countries at baseline, after an 8-wk low-caloric diet (LCD) (800-1000 kcal/d), and after 6 mo of weight maintenance. RESULTS: After weight loss......: In this study, we report a lipid signature of LCD success (for weight and glycemic outcome) in obese, nondiabetic patients. Lipid changes during an 8-wk LCD allowed us to predict insulin-resistant patients after 6 mo of weight maintenance. The determination of the lipid composition during an LCD enables...

Early identification and interventions for dyslexia: a contemporary view

OpenAIRE

Snowling, Margaret J.

2013-01-01

This paper reviews current proposals concerning the definition of dyslexia and contrasts it with reading comprehension impairment. We then discuss methods for early identification and review evidence that teacher assessments and ratings may be valid screening tools. Finally, we argue that interventions should be theoretically motivated and evidence based. We conclude that early identification of children at risk of dyslexia followed by the implementation of intervention is a realistic aim for...

Pilot European Regional Interventions for Smart Childhood Obesity Prevention in Early age

DEFF Research Database (Denmark)

Sansolios, Sanne; Mikkelsen, Mette Vang

2010-01-01

The intervention carried out in Denmark included a foodintervention in four kindergartens over at four weeks baseline period and a two weeks intervention period, also a tasteworkshop were carried out introducing a new boardgame using the Sapere method and finally a foodtale book and an activity f...

Pilot European Regional Interventions for Smart Childhood Obesity Prevention in Early age

DEFF Research Database (Denmark)

Sansolios, Sanne; Storm Slumstrup, Camilla

2010-01-01

The intervention carried out in Denmark included a foodintervention in four kindergartens over at four weeks baseline period and a two weeks intervention period, also a tasteworkshop were carried out introducing a new boardgame using the Sapere method and finally a foodtale book and an activity...

Interventional Application of Shape Memory Polymer Foam Final Report CRADA No. TC-02067-03

Energy Technology Data Exchange (ETDEWEB)

Maitland, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Metzger, M. F. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2017-09-27

This was a collaborative effort between The Regents of the University of California, Lawrence Livermore National Laboratory (LLNL) and Sierra Interventions, LLC, to develop shape memory polymer foam devices for treating hemorrhagic stroke.

ENHANCED IMMUNIZATION COVERAGE THROUGH INTERVENTIONS FOR CHILDHOOD CLUSTER DISEASES IN DEVELOPING COUNTRIES.

Science.gov (United States)

Mureed, Sheh; Somronghtong, Ratana; Kumar, Ramesh; Ghaffar, Abdul; Chapman, Robert S

2015-01-01

Globally immunisation has to be considered as a most effective and efficient public health intervention to reduce morbidity and mortality among children. Most of the children from developing countries are still not fully immunized due to multiple factors including lack of interventions, awareness, and financial constraints and due to limited resource. Conversely, this review has identified the effectiveness of interventions to increase the immunisation coverage among children of developing countries. Systematic review by using PRISMA statement ("preferred reporting items for systematic reviews and meta-analyses") has been conducted in English. published articles on Pub Med, Scopus, Cochrane, Medline and ISI by searching keywords like immunizations, childhood vaccination and developing countries has been accessed. Only randomised controlled trial and quasi-experimental studies designs were included in the final analysis based on quality assessment by adopting the Down and Black checklist and finally pooled analysis was done by random effect model. This systematic review has been approved and registered by University of York. A total of 16,570 published articles were accessed and finally 10 fulfilled our criteria that were analysed and interpreted. It demonstrated that the interventions has shown significantly increase vaccine coverage for childhood cluster diseases (OR 2.136 and p 0.05) and full vaccination schedule (OR 1.342 and p>0.05). Systematic review has concluded that the professional interventions are an effective while in improving the child immunisation coverage for cluster diseases in developing countries, major effect on DTP an.d measles.

Mind-body interventions during pregnancy.

Science.gov (United States)

Beddoe, Amy E; Lee, Kathryn A

2008-01-01

To examine published evidence on the effectiveness of mind-body interventions during pregnancy on perceived stress, mood, and perinatal outcomes. Computerized searches of PubMed, Cinahl, PsycINFO, and the Cochrane Library. Twelve out of 64 published intervention studies between 1980 and February 2007 of healthy, adult pregnant women met criteria for review. Studies were categorized by type of mind-body modality used. Progressive muscle relaxation was the most common intervention. Other studies used a multimodal psychoeducation approach or a yoga and meditation intervention. The research contained methodological problems, primarily absence of a randomized control group or failure to adequately control confounding variables. Nonetheless, there was modest evidence for the efficacy of mind-body modalities during pregnancy. Treatment group outcomes included higher birthweight, shorter length of labor, fewer instrument-assisted births, and reduced perceived stress and anxiety. There is evidence that pregnant women have health benefits from mind-body therapies used in conjunction with conventional prenatal care. Further research is necessary to build on these studies in order to predict characteristics of subgroups that might benefit from mind-body practices and examine cost effectiveness of these interventions on perinatal outcomes.

The optimal definition of contrast-induced acute kidney injury for prediction of inpatient mortality in patients undergoing percutaneous coronary interventions.

Science.gov (United States)

Parsh, Jessica; Seth, Milan; Briguori, Carlo; Grossman, Paul; Solomon, Richard; Gurm, Hitinder S

2016-05-01

It is unknown which definition of contrast-induced acute kidney injury (CI-AKI) in the setting of percutaneous coronary interventions is best associated with inpatient mortality and whether this association is stable across patients with various preprocedural serum creatinine (SCr) values. We applied logistic regression models to multiple CI-AKI definitions used by the Kidney Disease Improving Global Outcomes guidelines and previously published studies to examine the impact of preprocedural SCr on a candidate definition's correlation with the adverse outcome of inpatient mortality. We used likelihood ratio tests to examine candidate definitions and identify those where association with inpatient mortality remained constant regardless of preprocedural SCr. These definitions were assessed for specificity, sensitivity, and positive and negative predictive values to identify an optimal definition. Our study cohort included 119,554 patients who underwent percutaneous coronary intervention in Michigan between 2010 and 2014. Most commonly used definitions were not associated with inpatient mortality in a constant fashion across various preprocedural SCr values. Of the 266 candidate definitions examined, 16 definition's association with inpatient mortality was not significantly altered by preprocedural SCr. Contrast-induced acute kidney injury defined as an absolute increase of SCr ≥0.3 mg/dL and a relative SCr increase ≥50% was selected as the optimal candidate using Perkins and Shisterman decision theoretic optimality criteria and was highly predictive of and specific for inpatient mortality. We identified the optimal definition for CI-AKI to be an absolute increase in SCr ≥0.3 mg/dL and a relative SCr increase ≥50%. Further work is needed to validate this definition in independent studies and to establish its utility for clinical trials and quality improvement efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

Improving student success using predictive models and data visualisations

Directory of Open Access Journals (Sweden)

Hanan Ayad

2012-08-01

Full Text Available The need to educate a competitive workforce is a global problem. In the US, for example, despite billions of dollars spent to improve the educational system, approximately 35% of students never finish high school. The drop rate among some demographic groups is as high as 50–60%. At the college level in the US only 30% of students graduate from 2-year colleges in 3 years or less and approximately 50% graduate from 4-year colleges in 5 years or less. A basic challenge in delivering global education, therefore, is improving student success. By student success we mean improving retention, completion and graduation rates. In this paper we describe a Student Success System (S3 that provides a holistic, analytical view of student academic progress.1 The core of S3 is a flexible predictive modelling engine that uses machine intelligence and statistical techniques to identify at-risk students pre-emptively. S3 also provides a set of advanced data visualisations for reaching diagnostic insights and a case management tool for managing interventions. S3's open modular architecture will also allow integration and plug-ins with both open and proprietary software. Powered by learning analytics, S3 is intended as an end-to-end solution for identifying at-risk students, understanding why they are at risk, designing interventions to mitigate that risk and finally closing the feedback look by tracking the efficacy of the applied intervention.

Target motion predictions for pre-operative planning during needle-based interventions

NARCIS (Netherlands)

op den Buijs, J.; Abayazid, Momen; de Korte, Chris L.; Misra, Sarthak

During biopsies, breast tissue is subjected to displacement upon needle indentation, puncture, and penetration. Thus, accurate needle placement requires pre-operative predictions of the target motions. In this paper, we used ultrasound elastography measurements to non-invasively predict elastic

Age at disease onset and peak ammonium level rather than interventional variables predict the neurological outcome in urea cycle disorders.

Science.gov (United States)

Posset, Roland; Garcia-Cazorla, Angeles; Valayannopoulos, Vassili; Teles, Elisa Leão; Dionisi-Vici, Carlo; Brassier, Anaïs; Burlina, Alberto B; Burgard, Peter; Cortès-Saladelafont, Elisenda; Dobbelaere, Dries; Couce, Maria L; Sykut-Cegielska, Jolanta; Häberle, Johannes; Lund, Allan M; Chakrapani, Anupam; Schiff, Manuel; Walter, John H; Zeman, Jiri; Vara, Roshni; Kölker, Stefan

2016-09-01

Patients with urea cycle disorders (UCDs) have an increased risk of neurological disease manifestation. Determining the effect of diagnostic and therapeutic interventions on the neurological outcome. Evaluation of baseline, regular follow-up and emergency visits of 456 UCD patients prospectively followed between 2011 and 2015 by the E-IMD patient registry. About two-thirds of UCD patients remained asymptomatic until age 12 days [i.e. the median age at diagnosis of patients identified by newborn screening (NBS)] suggesting a potential benefit of NBS. In fact, NBS lowered the age at diagnosis in patients with late onset of symptoms (>28 days), and a trend towards improved long-term neurological outcome was found for patients with argininosuccinate synthetase and lyase deficiency as well as argininemia identified by NBS. Three to 17 different drug combinations were used for maintenance therapy, but superiority of any single drug or specific drug combination above other combinations was not demonstrated. Importantly, non-interventional variables of disease severity, such as age at disease onset and peak ammonium level of the initial hyperammonemic crisis (cut-off level: 500 μmol/L) best predicted the neurological outcome. Promising results of NBS for late onset UCD patients are reported and should be re-evaluated in a larger and more advanced age group. However, non-interventional variables affect the neurological outcome of UCD patients. Available evidence-based guideline recommendations are currently heterogeneously implemented into practice, leading to a high variability of drug combinations that hamper our understanding of optimised long-term and emergency treatment.

Comparison of Predictive Modeling Methods of Aircraft Landing Speed

Science.gov (United States)

Diallo, Ousmane H.

2012-01-01

Expected increases in air traffic demand have stimulated the development of air traffic control tools intended to assist the air traffic controller in accurately and precisely spacing aircraft landing at congested airports. Such tools will require an accurate landing-speed prediction to increase throughput while decreasing necessary controller interventions for avoiding separation violations. There are many practical challenges to developing an accurate landing-speed model that has acceptable prediction errors. This paper discusses the development of a near-term implementation, using readily available information, to estimate/model final approach speed from the top of the descent phase of flight to the landing runway. As a first approach, all variables found to contribute directly to the landing-speed prediction model are used to build a multi-regression technique of the response surface equation (RSE). Data obtained from operations of a major airlines for a passenger transport aircraft type to the Dallas/Fort Worth International Airport are used to predict the landing speed. The approach was promising because it decreased the standard deviation of the landing-speed error prediction by at least 18% from the standard deviation of the baseline error, depending on the gust condition at the airport. However, when the number of variables is reduced to the most likely obtainable at other major airports, the RSE model shows little improvement over the existing methods. Consequently, a neural network that relies on a nonlinear regression technique is utilized as an alternative modeling approach. For the reduced number of variables cases, the standard deviation of the neural network models errors represent over 5% reduction compared to the RSE model errors, and at least 10% reduction over the baseline predicted landing-speed error standard deviation. Overall, the constructed models predict the landing-speed more accurately and precisely than the current state-of-the-art.

Using kaizen to improve employee well-being: Results from two organizational intervention studies

Science.gov (United States)

von Thiele Schwarz, Ulrica; Nielsen, Karina M; Stenfors-Hayes, Terese; Hasson, Henna

2016-01-01

Participatory intervention approaches that are embedded in existing organizational structures may improve the efficiency and effectiveness of organizational interventions, but concrete tools are lacking. In the present article, we use a realist evaluation approach to explore the role of kaizen, a lean tool for participatory continuous improvement, in improving employee well-being in two cluster-randomized, controlled participatory intervention studies. Case 1 is from the Danish Postal Service, where kaizen boards were used to implement action plans. The results of multi-group structural equation modeling showed that kaizen served as a mechanism that increased the level of awareness of and capacity to manage psychosocial issues, which, in turn, predicted increased job satisfaction and mental health. Case 2 is from a regional hospital in Sweden that integrated occupational health processes with a pre-existing kaizen system. Multi-group structural equation modeling revealed that, in the intervention group, kaizen work predicted better integration of organizational and employee objectives after 12 months, which, in turn, predicted increased job satisfaction and decreased discomfort at 24 months. The findings suggest that participatory and structured problem-solving approaches that are familiar and visual to employees can facilitate organizational interventions. PMID:28736455

Using kaizen to improve employee well-being: Results from two organizational intervention studies.

Science.gov (United States)

von Thiele Schwarz, Ulrica; Nielsen, Karina M; Stenfors-Hayes, Terese; Hasson, Henna

2017-08-01

Participatory intervention approaches that are embedded in existing organizational structures may improve the efficiency and effectiveness of organizational interventions, but concrete tools are lacking. In the present article, we use a realist evaluation approach to explore the role of kaizen, a lean tool for participatory continuous improvement, in improving employee well-being in two cluster-randomized, controlled participatory intervention studies. Case 1 is from the Danish Postal Service, where kaizen boards were used to implement action plans. The results of multi-group structural equation modeling showed that kaizen served as a mechanism that increased the level of awareness of and capacity to manage psychosocial issues, which, in turn, predicted increased job satisfaction and mental health. Case 2 is from a regional hospital in Sweden that integrated occupational health processes with a pre-existing kaizen system. Multi-group structural equation modeling revealed that, in the intervention group, kaizen work predicted better integration of organizational and employee objectives after 12 months, which, in turn, predicted increased job satisfaction and decreased discomfort at 24 months. The findings suggest that participatory and structured problem-solving approaches that are familiar and visual to employees can facilitate organizational interventions.

Influence of ST-segment recovery on infarct size and ejection fraction in patients with ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention

DEFF Research Database (Denmark)

Hallén, Jonas; Ripa, Maria Sejersten; Johanson, Per

2010-01-01

percutaneous coronary intervention. Three methods for calculating and categorizing ST-segment recovery were used: (1) summed ST-segment deviation (STD) resolution analyzed in 3 categories (> or = 70%, > or = 30% to or = 2 mm). Infarct size and ejection fraction were assessed at 4 months by cardiac magnetic...... resonance imaging. All 3 ST-segment recovery algorithms predicted the final infarct size and cardiac function. Worst-lead residual STD performed the same as, or better than, the more complex methods and identified large subgroups at either end of the risk spectrum (median infarct size from the lowest...

Caregiver Responsiveness to the Family Bereavement Program: What predicts responsiveness? What does responsiveness predict?

OpenAIRE

Schoenfelder, Erin N.; Sandler, Irwin N.; Millsap, Roger E.; Wolchik, Sharlene A.; Berkel, Cady; Ayers, Timothy S.

2013-01-01

The study developed a multi-dimensional measure to assess participant responsiveness to a preventive intervention, and applied this measure to study how participant baseline characteristics predict responsiveness and how responsiveness predicts program outcomes. The study was conducted with caregivers who participated in the parenting-focused component of the Family Bereavement Program (FBP), a prevention program for families that have experienced parental death. The sample consisted of 89 ca...

Using predictive analytics and big data to optimize pharmaceutical outcomes.

Science.gov (United States)

Hernandez, Inmaculada; Zhang, Yuting

2017-09-15

The steps involved, the resources needed, and the challenges associated with applying predictive analytics in healthcare are described, with a review of successful applications of predictive analytics in implementing population health management interventions that target medication-related patient outcomes. In healthcare, the term big data typically refers to large quantities of electronic health record, administrative claims, and clinical trial data as well as data collected from smartphone applications, wearable devices, social media, and personal genomics services; predictive analytics refers to innovative methods of analysis developed to overcome challenges associated with big data, including a variety of statistical techniques ranging from predictive modeling to machine learning to data mining. Predictive analytics using big data have been applied successfully in several areas of medication management, such as in the identification of complex patients or those at highest risk for medication noncompliance or adverse effects. Because predictive analytics can be used in predicting different outcomes, they can provide pharmacists with a better understanding of the risks for specific medication-related problems that each patient faces. This information will enable pharmacists to deliver interventions tailored to patients' needs. In order to take full advantage of these benefits, however, clinicians will have to understand the basics of big data and predictive analytics. Predictive analytics that leverage big data will become an indispensable tool for clinicians in mapping interventions and improving patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

An evaluation of community assessment tools (CATs in predicting use of clinical interventions and severe outcomes during the A(H1N1pdm09 pandemic.

Directory of Open Access Journals (Sweden)

Malcolm G Semple

Full Text Available During severe influenza pandemics healthcare demand can exceed clinical capacity to provide normal standards of care. Community Assessment Tools (CATs could provide a framework for triage decisions for hospital referral and admission. CATs have been developed based on evidence that supports the recognition of severe influenza and pneumonia in the community (including resource limited settings for adults, children and infants, and serious feverish illness in children. CATs use six objective criteria and one subjective criterion, any one or more of which should prompt urgent referral and admission to hospital. A retrospective evaluation of the ability of CATs to predict use of hospital-based interventions and patient outcomes in a pandemic was made using the first recorded routine clinical assessment on or shortly after admission from 1520 unselected patients (800 female, 480 children <16 years admitted with PCR confirmed A(H1N1pdm09 infection (the FLU-CIN cohort. Outcome measures included: any use of supplemental oxygen; mechanical ventilation; intravenous antibiotics; length of stay; intensive or high dependency care; death; and "severe outcome" (combined: use of intensive or high dependency care or death during admission. Unadjusted and multivariable analyses were conducted for children (age <16 years and adults. Each CATs criterion independently identified both use of clinical interventions that would in normal circumstances only be provided in hospital and patient outcome measures. "Peripheral oxygen saturation ≤ 92% breathing air, or being on oxygen" performed well in predicting use of resources and outcomes for both adults and children; supporting routine measurement of peripheral oxygen saturation when assessing severity of disease. In multivariable analyses the single subjective criterion in CATs "other cause for clinical concern" independently predicted death in children and in adults predicted length of stay, mechanical ventilation

Patient survival and surgical re-intervention predictors for intracapsular hip fractures.

Science.gov (United States)

González Quevedo, David; Mariño, Iskandar Tamimi; Sánchez Siles, Juan Manuel; Escribano, Esther Romero; Granero Molina, Esther Judith; Enrique, David Bautista; Smoljanović, Tomislav; Pareja, Francisco Villanueva

2017-08-01

Choosing between total hip replacement (THR) and partial hip replacement (PHR) for patients with intracapsular hip fractures is often based on subjective factors. Predicting the survival of these patients and risk of surgical re-intervention is essential to select the most adequate implant. We conducted a retrospective cohort study on mortality of patients over 70 years with intracapsular hip fractures who were treated between January 2010 and December 2013, with either PHR or THR. Patients' information was withdrawn from our local computerized database. The age-adjusted Charlson comorbidity index (ACCI) and American Society of Anesthesiologists (ASA) score were calculated for all patients. The patients were followed for 2 years after surgery. Survival and surgical re-intervention rates were compared between the two groups using a Multivariate Cox proportional hazard model. A total of 356 individuals were included in this study. At 2 years of follow-up, 221 (74.4%) of the patients with ACCI score≤7 were still alive, in contrast to only 20 (29.0%) of those with ACCI score>7. In addition, 201 (76.2%) of the patients with ASA score≤3 were still alive after 2 years, compared to 30 (32.6%) of individuals with ASA >3. Patients with the ACCI score>7, and ASA score>3 had a significant increase in all-cause 2-year mortality (adjusted hazard ratio of 3.2, 95% CI 2.2-4.6; and 3.12, 95% CI 2.2-4.5, respectively). Patients with an ASA score>3 had a quasi-significant increase in the re-intervention risk (adjusted hazard ratio 2.2, 95% CI 1.0-5.1). The sensitivity, specificity, positive predictive value and negative predictive values of ACCI in predicting 2-year mortality were 39.2%, 91.1%, 71%, and 74.4%, respectively. On the other hand, the sensitivity, specificity, positive predictive value and negative predictive values of ASA score in predicting 2-year mortality were 49.6%, 79.1%, 67.4%, and 76.1%, respectively. Both ACCI and ASA scales were able to predict the 2-year

Factors Predicting Sustainability of the Schoolwide Positive Behavior Intervention Support Model

Science.gov (United States)

Chitiyo, Jonathan; May, Michael E.

2018-01-01

The Schoolwide Positive Behavior Intervention Support model (SWPBIS) continues to gain widespread use across schools in the United States and abroad. Despite its widespread implementation, little research has examined factors that influence its sustainability. Informed by Rogers's diffusion theory, this study examined school personnel's…

The design of patient decision support interventions: addressing the theory-practice gap.

Science.gov (United States)

Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky

2011-08-01

Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards

CNNcon: improved protein contact maps prediction using cascaded neural networks.

Directory of Open Access Journals (Sweden)

Wang Ding

Full Text Available BACKGROUNDS: Despite continuing progress in X-ray crystallography and high-field NMR spectroscopy for determination of three-dimensional protein structures, the number of unsolved and newly discovered sequences grows much faster than that of determined structures. Protein modeling methods can possibly bridge this huge sequence-structure gap with the development of computational science. A grand challenging problem is to predict three-dimensional protein structure from its primary structure (residues sequence alone. However, predicting residue contact maps is a crucial and promising intermediate step towards final three-dimensional structure prediction. Better predictions of local and non-local contacts between residues can transform protein sequence alignment to structure alignment, which can finally improve template based three-dimensional protein structure predictors greatly. METHODS: CNNcon, an improved multiple neural networks based contact map predictor using six sub-networks and one final cascade-network, was developed in this paper. Both the sub-networks and the final cascade-network were trained and tested with their corresponding data sets. While for testing, the target protein was first coded and then input to its corresponding sub-networks for prediction. After that, the intermediate results were input to the cascade-network to finish the final prediction. RESULTS: The CNNcon can accurately predict 58.86% in average of contacts at a distance cutoff of 8 Å for proteins with lengths ranging from 51 to 450. The comparison results show that the present method performs better than the compared state-of-the-art predictors. Particularly, the prediction accuracy keeps steady with the increase of protein sequence length. It indicates that the CNNcon overcomes the thin density problem, with which other current predictors have trouble. This advantage makes the method valuable to the prediction of long length proteins. As a result, the effective

British Military Intervention into Sierra Leone: A Case Study

National Research Council Canada - National Science Library

Roberson, Walter G

2007-01-01

.... The successful British intervention led to the defeat of the Revolutionary United Front (RUF) and final peace accords, restored order to a failed state, and allowed the democratic restoration of the government of Sierra Leone...

Development of a Colorectal Cancer Screening Intervention for Iranian Adults: Appling Intervention Mapping

Science.gov (United States)

Besharati, Fereshteh; Karimi-Shahanjarini, Akram; Hazavehei, Seyed Mohammad Mehdi; Bashirian, Saeid; Bagheri, Fahimeh; Faradmal, Javad

2017-08-27

Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population. The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews (n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral outcome and theoretical methods and their practical applications were identified to guide intervention development and implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems, fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation, group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and control (Pintervention addressing CRC screening among Iranian population. Creative Commons Attribution License

Development of an Evidence-Informed Blog to Promote Healthy Eating Among Mothers: Use of the Intervention Mapping Protocol.

Science.gov (United States)

Dumas, Audrée-Anne; Lemieux, Simone; Lapointe, Annie; Provencher, Véronique; Robitaille, Julie; Desroches, Sophie

2017-05-19

Low adherence to dietary guidelines and a concurrent rise of obesity-related chronic diseases emphasize the need for effective interventions to promote healthy eating. There is growing recognition that behavior change interventions should draw on theories of behavior change. Online interventions grounded in theory lead to increased effectiveness for health behavior change; however, few theory-driven social media-based health promotion interventions have been described in the literature. The objective of this study was to describe the application of the Intervention Mapping (IM) protocol to develop an evidence-informed blog to promote healthy eating among French-Canadian mothers of preschool and school-aged children. The following six steps of the IM protocol were performed. In Step 1, a preliminary needs assessment included a literature search on theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults (ie, knowledge, beliefs about capabilities, beliefs about consequences, intention/goals) and a qualitative study including focus groups to identify female Internet users' perceptions of their use of healthy eating blogs. In Step 2, two behavioral outcomes were selected (ie, increase daily intakes of Vegetables and Fruits and Milk and Alternatives of mothers to reach Canadian dietary recommendations) and subsequently divided into six performance objectives inspired by national and international dietary recommendations such as planning for healthy meals. A matrix of change objectives was then created by crossing performance objectives with theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults. Step 3 consisted of selecting theory-based intervention methods (eg, modeling and goal setting) and translating them into practical applications for the context of a dietary intervention delivered through a blog. A 6-month intervention was developed in Step 4 in which we aimed to

Predicting final extent of ischemic infarction using artificial neural network analysis of multi-parametric MRI in patients with stroke.

Directory of Open Access Journals (Sweden)

Hassan Bagher-Ebadian

Full Text Available In hemispheric ischemic stroke, the final size of the ischemic lesion is the most important correlate of clinical functional outcome. Using a set of acute-phase MR images (Diffusion-weighted--DWI, T(1-weighted--T1WI, T(2-weighted--T2WI, and proton density weighted--PDWI for inputs, and the chronic T2WI at 3 months as an outcome measure, an Artificial Neural Network (ANN was trained to predict the 3-month outcome in the form of a voxel-by-voxel forecast of the chronic T2WI. The ANN was trained and tested using 12 subjects (with 83 slices and 140218 voxels using a leave-one-out cross-validation method with calculation of the Area Under the Receiver Operator Characteristic Curve (AUROC for training, testing and optimization of the ANN. After training and optimization, the ANN produced maps of predicted outcome that were well correlated (r = 0.80, p<0.0001 with the T2WI at 3 months for all 12 patients. This result implies that the trained ANN can provide an estimate of 3-month ischemic lesion on T2WI in a stable and accurate manner (AUROC = 0.89.

What do people living in deprived communities in the UK think about household energy efficiency interventions?

International Nuclear Information System (INIS)

Scott, Fiona L.; Jones, Christopher R.; Webb, Thomas L.

2014-01-01

While physical interventions such as external wall cladding can improve the energy efficiency of domestic properties, how residents think about and respond to such interventions can influence both their uptake and impact on the household’s energy use. The present research investigated what residents living within deprived communities in Yorkshire and the Humber (United Kingdom) thought about a number of household energy efficiency interventions proposed as part of a project known as “The BIG Energy Upgrade”. The Theory of Planned Behaviour was used as a framework for investigating residents' beliefs. Residents generally felt positive about the proposed interventions and expected that they would lead to financial savings, improve the appearance and warmth of their homes, and sense of pride in the local community. However, while residents intended to adopt energy efficiency interventions if offered them, they were less willing to personally invest in them. Home ownership and the belief in humans' ability to tackle climate change were found to predict willingness to invest. These findings help to understand responses to initiatives that seek to improve the energy efficiency of hard-to-treat homes. - Highlights: • We investigate beliefs about energy efficiency interventions in deprived areas. • Residents felt positive and predicted considerable financial savings. • Improved appearance, warmth and pride in place were important for residents • Home ownership predicted willingness to invest in interventions • Belief in humans' ability to tackle climate change predicted willingness to invest

When it comes to lifestyle recommendations, more is sometimes less: a meta-analysis of theoretical assumptions underlying the effectiveness of interventions promoting multiple behavior domain change.

Science.gov (United States)

Wilson, Kristina; Senay, Ibrahim; Durantini, Marta; Sánchez, Flor; Hennessy, Michael; Spring, Bonnie; Albarracín, Dolores

2015-03-01

A meta-analysis of 150 research reports summarizing the results of multiple behavior domain interventions examined theoretical predictions about the effects of the included number of recommendations on behavioral and clinical change in the domains of smoking, diet, and physical activity. The meta-analysis yielded 3 main conclusions. First, there is a curvilinear relation between the number of behavioral recommendations and improvements in behavioral and clinical measures, with a moderate number of recommendations producing the highest level of change. A moderate number of recommendations is likely to be associated with stronger effects because the intervention ensures the necessary level of motivation to implement the recommended changes, thereby increasing compliance with the goals set by the intervention, without making the intervention excessively demanding. Second, this curve was more pronounced when samples were likely to have low motivation to change, such as when interventions were delivered to nonpatient (vs. patient) populations, were implemented in nonclinic (vs. clinic) settings, used lay community (vs. expert) facilitators, and involved group (vs. individual) delivery formats. Finally, change in behavioral outcomes mediated the effects of number of recommended behaviors on clinical change. These findings provide important insights that can help guide the design of effective multiple behavior domain interventions. PsycINFO Database Record (c) 2015 APA, all rights reserved.

When It Comes to Lifestyle Recommendations, More is Sometimes Less: A Meta-Analysis of Theoretical Assumptions Underlying the Effectiveness of Interventions Promoting Multiple Behavior Domain Change

Science.gov (United States)

Wilson, Kristina; Senay, Ibrahim; Durantini, Marta; Sánchez, Flor; Hennessy, Michael; Spring, Bonnie; Albarracín, Dolores

2016-01-01

A meta-analysis of 150 research reports summarizing the results of multiple behavior domain interventions examined theoretical predictions about the effects of the included number of recommendations on behavioral and clinical change in the domains of smoking, diet, and physical activity. The meta-analysis yielded three main conclusions. First, there is a curvilinear relation between the number of behavioral recommendations and improvements in behavioral and clinical measures, with a moderate number of recommendations producing the highest level of change. A moderate number of recommendations is likely to be associated with stronger effects because the intervention ensures the necessary level of motivation to implement the recommended changes, thereby increasing compliance with the goals set by the intervention, without making the intervention excessively demanding. Second, this curve was more pronounced when samples were likely to have low motivation to change, such as when interventions were delivered to non-patient (vs. patient) populations, were implemented in non-clinic (vs. clinic) settings, used lay community (vs. expert) facilitators, and involved group (vs. individual) delivery formats. Finally, change in behavioral outcomes mediated the effects of number of recommended behaviors on clinical change. These findings provide important insights that can help guide the design of effective multiple behavior domain interventions. PMID:25528345

A timeline for predicting durable medical equipment needs and interventions for amyotrophic lateral sclerosis patients.

Science.gov (United States)

Bromberg, Mark B; Brownell, Alexander A; Forshew, Dallas A; Swenson, Michael

2010-01-01

ALS is progressive with increasing patient needs for durable medical equipment (DME) and interventions (gastric feeding tube - PEG, and non-invasive ventilation - NIV). We performed a chart review of deceased patients to determine the time-course of needs and their estimated costs. A timeline of needs was based on when clinic personnel felt an item was necessary. The point in time when an item or intervention was needed was expressed as a percentage of a patient's total disease duration. A wide range of DME and interventions was needed irrespective of site of ALS symptom onset (bulbar, upper, lower extremity), beginning at 10% of disease duration of lower extremity onset and increasing thereafter for all sites. The cumulative probability of costs of items and interventions began at 25%-50% of disease duration and increased to between $18,000 and $32,000 (USD), highest for lower extremity onset due to the cost of wheelchairs. We conclude that a high percentage of ALS patients will need a full spectrum of major DME items and interventions during the second half of disease duration. This results in a linear rise in costs over the second half of the disease duration.

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

Directory of Open Access Journals (Sweden)

Bergman Howard

2009-04-01

insight of healthcare professionalnd managers and emphasizes the need to intervene at different levels. Further research will be needed in order to develop a more thorough understanding of the impacts of such strategies on the final outcomes of intervention implementations.

Interventions to tackle malnutrition and its risk factors in children living in slums: a scoping review.

Science.gov (United States)

Goudet, Sophie; Griffiths, Paula; Bogin, Barry; Madise, Nyovani

2017-02-01

Children living in slums are at high risk of being malnourished. There are no published reviews on existing interventions promoting better nutrition for children living in slums and the risk factors for children's malnutrition. Improved understanding of the risk factors for malnutrition in slums communities and the impact of interventions on children's health can provide guidance to practitioners and decision-makers. The present review is designed to provide this information. The search included 30 electronic bibliographic databases and relevant eligible studies published up to December 2013. The search located 1512 citations. Full text relevance screening was conducted on 226 studies and on abstracts for 16 studies. The final 58 unique studies included 22 on interventions and 38 on risk. All of the interventions were nutrition-specific, with nutritional intervention being the most dominant type. Seventy-three per cent of the interventions were assessed effective. The findings stressed the gaps in knowledge in terms of quality assessment and programmatic recommendations to identify children who are the most at risk of malnutrition to appropriately target interventions. Finally, the review helped to inform a systematic review (Cochrane Systematic review protocol 2015) that will examine the impact of interventions on outcome measures.

A contemporary risk model for predicting 30-day mortality following percutaneous coronary intervention in England and Wales.

Science.gov (United States)

McAllister, Katherine S L; Ludman, Peter F; Hulme, William; de Belder, Mark A; Stables, Rodney; Chowdhary, Saqib; Mamas, Mamas A; Sperrin, Matthew; Buchan, Iain E

2016-05-01

The current risk model for percutaneous coronary intervention (PCI) in the UK is based on outcomes of patients treated in a different era of interventional cardiology. This study aimed to create a new model, based on a contemporary cohort of PCI treated patients, which would: predict 30 day mortality; provide good discrimination; and be well calibrated across a broad risk-spectrum. The model was derived from a training dataset of 336,433 PCI cases carried out between 2007 and 2011 in England and Wales, with 30 day mortality provided by record linkage. Candidate variables were selected on the basis of clinical consensus and data quality. Procedures in 2012 were used to perform temporal validation of the model. The strongest predictors of 30-day mortality were: cardiogenic shock; dialysis; and the indication for PCI and the degree of urgency with which it was performed. The model had an area under the receiver operator characteristic curve of 0.85 on the training data and 0.86 on validation. Calibration plots indicated a good model fit on development which was maintained on validation. We have created a contemporary model for PCI that encompasses a range of clinical risk, from stable elective PCI to emergency primary PCI and cardiogenic shock. The model is easy to apply and based on data reported in national registries. It has a high degree of discrimination and is well calibrated across the risk spectrum. The examination of key outcomes in PCI audit can be improved with this risk-adjusted model. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Data-driven background predictions for a search of direct gluino pair production in the single-lepton final state using 13 TeV pp-collisions at the CMS experiment

Energy Technology Data Exchange (ETDEWEB)

Lobanov, Artur; Seitz, Claudia; Melzer-Pellmann, Isabell [DESY, Hamburg (Germany)

2016-07-01

We present a search for direct gluino-pair production in events with a single lepton using 13 TeV pp-collisions at the CMS experiment. This final state is characterised by high multiplicities of jets and b-quark jets, as well as a large scalar sum of all jet transverse momenta, and a large scalar sum of the transverse missing momentum and the lepton transverse momentum, called L{sub T}. The dominating Standard Model backgrounds in this phase-space are tt+jets and W+jets production. A data-driven method is used to estimate the background in the search regions. All backgrounds except for QCD in the (high ΔΦ(W,l)) signal regions are predicted by from the number of events in the low ΔΦ(W,l) region, with transfer factors determined also from data, while for the multi-jet events a fake-lepton enriched side-band is used. We conclude by showing predictions and final results from data corresponding to 2.1 fb{sup -1} integrated luminosity recorded with the CMS detector during the LHC Run2 in 2015.

Vibration and wear prediction for steam generator tubes: Final report

International Nuclear Information System (INIS)

Rao, M.S.M.; Gupta, G.D.; Eisinger, F.L.

1988-06-01

As part of the overall EPRI program to develop a mechanistic model for tube fretting and wear prediction, Foster Wheeler Development Corporation undertook the responsibility of developing analytical models to predict structural response and wear in a multispan tube. The project objective was to develop the analytical capability to simulate the time-dependent motion of a multispan steam generator tube in the presence of the clearance gaps at each tube baffle or support. The models developed were to simulate nonlinear tube-to-tube support interaction by determining the impact force, the sliding distance, and the resultant tube wear. Other objectives of the project included: validate the models by comparing the analytical results with the EPRI tests done at Combustion Engineering (C-E) on single multispan tubes; test the models for simulating the U-bend region of the steam generator tube, including the antivibration bars; and develop simplified methods to treat the nonlinear dynamic problem of a multispan tube so that computing costs could be minimized. 15 refs., 53 figs., 27 tabs

Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions

Science.gov (United States)

Kok, Robin N; Ossebaard, Hans C; Van Gemert-Pijnen, Julia EWC

2012-01-01

Background Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. Objective This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. Methods We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. Results We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p = .004), setup (p persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are

'Whatever happened to the class of 2000?' An outcome survey of potential interventional radiologists

International Nuclear Information System (INIS)

Nicholson, A.A.; Adam, A.

2006-01-01

Objectives: To find out what final career choices were made by trainee doctors who had indicated a strong interest in pursuing a career in interventional radiology and to establish the reasons behind their final career choice. Methods: Eighty-eight doctors who attended a meeting in 2000 designed to promote interventional radiology as a career were questioned as to whether the meeting influenced their potential career choices and then further surveyed via postal questionnaire 5 years later to find out their eventual career choices. Of the 88 doctors who attended, 56 were radiology trainees and 32 were training in either medical or surgical specialties. There were 25 women and 63 men. Results: Five years after the meeting, six are now interventional radiologists (6.8%) though four of these are still in a 6th year interventional radiology fellowship. A further 12 (13.6%) are systems based, predominantly diagnostic radiologists with an interest in intervention. Thirty-two (43.2%) are diagnostic radiologists who undertake little or no therapeutic intervention. Of the 32 non-radiologists who attended the meeting only three entered radiology and are still in training. Conclusions: Interventional radiology is a popular initial career choice amongst trainee doctors. However, only a small number eventually pursue the specialty. If the manpower shortage of interventional radiologists is to be addressed, there needs to be improvements in training, accreditation, career opportunities and working conditions

The Utility of Home-Practice in Mindfulness-Based Group Interventions: A Systematic Review.

Science.gov (United States)

Lloyd, Annette; White, Ross; Eames, Catrin; Crane, Rebecca

2018-01-01

A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.

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

Science.gov (United States)

Harackiewicz, Judith M; Priniski, Stacy J

2018-01-04

Many theoretically based interventions have been developed over the past two decades to improve educational outcomes in higher education. Based in social-psychological and motivation theories, well-crafted interventions have proven remarkably effective because they target specific educational problems and the processes that underlie them. In this review, we evaluate the current state of the literature on targeted interventions in higher education with an eye to emerging theoretical and conceptual questions about intervention science. We review three types of interventions, which focus on the value students perceive in academic tasks, their framing of academic challenges, and their personal values, respectively. We consider interventions that (a) target academic outcomes (e.g., grades, major or career plans, course taking, retention) in higher education, as well as the pipeline to college, and (b) have been evaluated in at least two studies. Finally, we discuss implications for intervention science moving forward.

Predictive value of ocular trauma score in open globe combat eye injuries

International Nuclear Information System (INIS)

Islam, Q.

2016-01-01

Prediction of final visual outcome in ocular injuries is of paramount importance and various prognostic models have been proposed to predict final visual outcome. The objective of this study was to validate the predictive value of ocular trauma score (OTS) in patients with combat related open globe injuries and to evaluate the factors affecting the final visual outcome. Methods: Data of 93 patients admitted in AFIO Rawalpindi between Jan 2010 to June 2014 with combat related open globe ocular injuries was analysed. Initial and final best corrected visual acuity (BCVA) was categorized as No Light Perception (NLP), Light Perception (LP) to Hand Movement (HM), 1/200-19/200, 20/200-20/50, and =20/40. OTS was calculated for each eye by assigning numerical raw points to six variables and then scores were stratified into five OTS categories. Results: Mean age of study population was 28.77 ± 8.37 years. Presenting visual acuity was <20/200 (6/60) in 103 (96.23%) eyes. However, final BCVA of =20/40 (6/12) was achieved in 18 (16.82%) eyes, while 72 (67.28%) eyes had final BCVA of <20/200 (6/60). Final visual outcome in our study were similar to those in OTS study, except for NLP in category 1 (81% vs. 74%) and =20/40 in category 3 (30% vs. 41%). The OTS model predicted visual survival (LP or better) with a sensitivity of 94.80% and predicted no vision (NLP) with a specificity of 100%. Conclusion: OTS is a reliable tool for assessment of ocular injuries and predicting final visual outcome at the outset. (author)

Platelet density per monocyte predicts adverse events in patients after percutaneous coronary intervention.

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Rutten, Bert; Roest, Mark; McClellan, Elizabeth A; Sels, Jan W; Stubbs, Andrew; Jukema, J Wouter; Doevendans, Pieter A; Waltenberger, Johannes; van Zonneveld, Anton-Jan; Pasterkamp, Gerard; De Groot, Philip G; Hoefer, Imo E

2016-01-01

Monocyte recruitment to damaged endothelium is enhanced by platelet binding to monocytes and contributes to vascular repair. Therefore, we studied whether the number of platelets per monocyte affects the recurrence of adverse events in patients after percutaneous coronary intervention (PCI). Platelet-monocytes complexes with high and low median fluorescence intensities (MFI) of the platelet marker CD42b were isolated using cell sorting. Microscopic analysis revealed that a high platelet marker MFI on monocytes corresponded with a high platelet density per monocyte while a low platelet marker MFI corresponded with a low platelet density per monocyte (3.4 ± 0.7 vs 1.4 ± 0.1 platelets per monocyte, P=0.01). Using real-time video microscopy, we observed increased recruitment of high platelet density monocytes to endothelial cells as compared with low platelet density monocytes (P=0.01). Next, we classified PCI scheduled patients (N=263) into groups with high, medium and low platelet densities per monocyte and assessed the recurrence of adverse events. After multivariate adjustment for potential confounders, we observed a 2.5-fold reduction in the recurrence of adverse events in patients with a high platelet density per monocyte as compared with a low platelet density per monocyte [hazard ratio=0.4 (95% confidence interval, 0.2-0.8), P=0.01]. We show that a high platelet density per monocyte increases monocyte recruitment to endothelial cells and predicts a reduction in the recurrence of adverse events in patients after PCI. These findings may imply that a high platelet density per monocyte protects against recurrence of adverse events.

Family intervention for schizophrenia.

Science.gov (United States)

Pharoah, F M; Mari, J J; Streiner, D

2000-01-01

It has been showed that people with schizophrenia from families that express high levels of criticism, hostility, or over involvement, have more frequent relapses than people with similar problems from families that tend to be less expressive of their emotions. Psychosocial interventions designed to reduce these levels of expressed emotions within families now exist for mental health workers. These interventions are proposed as adjuncts rather than alternatives to drug treatments, and their main purpose is to decrease the stress within the family and also the rate of relapse. To estimate the effects of family psychosocial interventions in community settings for the care of those with schizophrenia or schizophrenia-like conditions compared to standard care. Electronic searches of the Cochrane Library (Issue 2, 1998), the Cochrane Schizophrenia Group's Register (June 1998), EMBASE (1981-1995) and MEDLINE (1966-1995) were undertaken and supplemented with reference searching of the identified literature. Randomised or quasi-randomised studies were selected if they focused on families of people with schizophrenia or schizoaffective disorder and compared community-orientated family-based psychosocial intervention of more than five sessions to standard care. Data were reliably extracted, and, where appropriate and possible, summated. Peto odds ratios (OR), their 95% confidence intervals (CI) and number needed to treat (NNT) were estimated. The reviewers assume that people who died or dropped out had no improvement and tested the sensitivity of the final results to this assumption. Family intervention may decrease the frequency of relapse (one year OR 0.57 CI 0.4-0.8, NNT 6.5 CI 4-14). The trend over time of this main finding is towards the null and some small but negative studies may not have been identified by the search. Family intervention may decrease hospitalisation and encourage compliance with medication but data are few and equivocal. Family intervention does not

Improved final predicted height with the injection of leuprolide in children with earlier puberty: A retrospective cohort study.

Directory of Open Access Journals (Sweden)

Yi-Chun Lin

Full Text Available The adult height of children with early onset puberty is limited by the premature maturation of hypothalamic-pituitary-gonadal axis. To evaluate the effects of gonadotropin-releasing hormone analog (GnRHa treatment on the final height (FH and bone maturation rate (BMR in girls with early puberty (EP or idiopathic central precocious puberty (ICPP, we examined data from girls who were diagnosed with EP or ICPP and underwent GnRHa (Leuplin Depot: 3.75 mg/month at China Medical University Hospital, in Taiwan, between 2006 and 2015. Patients were observed until the achievement of FH and divided into an "EP group" (T-ep and "ICPP group" (T-icpp according to the age of onset of puberty. Eighty-seven patients were enrolled (T-ep, N = 44, puberty onset at 8-10 years; T-icpp, N = 43, puberty onset before 8 years. The demographic data of girls with EP or IPP was characterized. BMR, change in predicted final height (PFH after GnRHa treatment, target height (TH and FH were measured. After GnRHa treatment, the study groups (T-ep: 160.24±6.18 cm, T-icpp: 158.99±5.92 cm both had higher PFH than at initiation (T-ep: 159.83±7.19 cm, T-icpp: 158.58±5.93 cm. There was deceleration of BMR in both groups (T-ep: 0.57±0.39; T-icpp: 0.97±0.97 and a significant difference between the groups (p = 0.027. The gap in FH standard deviation scores (SDS and TH SDS had a significant difference in T-ep (p = 0.045 but not in T-icpp. Moreover, there was no difference in the gap of PFH SDS between the 1st and final treatment in both groups. We concluded that GnRHa decelerated BMR in girls with earlier puberty. Further prospective clinical studies are warranted.

Protection of staff in interventional radiology

International Nuclear Information System (INIS)

Melkamu, M. A.

2013-04-01

This project focuses on the interventional radiology. The main objective of this project work was to provide a guidance and advice for occupational exposure and hospital management to optimize radiation protection safety and endorse safety culture. It provides practical information on how to minimize occupational exposure in interventional radiology. In the literature review all considerable parameters to reduce dose to the occupationally exposed are well discussed. These parameters include dose limit, risk estimation, use of dosimeter, personal dose record keeping, analysis of surveillance of occupational dose, investigation levels, and proper use of radiation protection tools and finally about scatter radiation dose rate. In addition the project discusses the ways to reduce occupational exposure in interventional radiology. The methods for dose reduction are minimizing fluoroscopic time, minimizing the number of fluoroscopic image, use of patient dose reduction technologies, use of collimation, planning interventional procedures, positioning in low scattered areas, use of protective shielding, use of appropriate fluoroscopic imaging equipment, giving training for the staff, wearing the dosimeters and know their own dose regularly, and management commitment to quality assurance and quality control system and optimization of radiation protection of safety. (author)

Implementing a complex intervention to support personal recovery: a qualitative study nested within a cluster randomised controlled trial.

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Leamy, Mary; Clarke, Eleanor; Le Boutillier, Clair; Bird, Victoria; Janosik, Monika; Sabas, Kai; Riley, Genevieve; Williams, Julie; Slade, Mike

2014-01-01

To investigate staff and trainer perspectives on the barriers and facilitators to implementing a complex intervention to help staff support the recovery of service users with a primary diagnosis of psychosis in community mental health teams. Process evaluation nested within a cluster randomised controlled trial (RCT). 28 interviews with mental health care staff, 3 interviews with trainers, 4 focus groups with intervention teams and 28 written trainer reports. 14 community-based mental health teams in two UK sites (one urban, one semi-rural) who received the intervention. The factors influencing the implementation of the intervention can be organised under two over-arching themes: Organisational readiness for change and Training effectiveness. Organisational readiness for change comprised three sub-themes: NHS Trust readiness; Team readiness; and Practitioner readiness. Training effectiveness comprised three sub-themes: Engagement strategies; Delivery style and Modelling recovery principles. Three findings can inform future implementation and evaluation of complex interventions. First, the underlying intervention model predicted that three areas would be important for changing practice: staff skill development; intention to implement; and actual implementation behaviour. This study highlighted the importance of targeting the transition from practitioners' intent to implement to actual implementation behaviour, using experiential learning and target setting. Second, practitioners make inferences about organisational commitment by observing the allocation of resources, Knowledge Performance Indicators and service evaluation outcome measures. These need to be aligned with recovery values, principles and practice. Finally, we recommend the use of organisational readiness tools as an inclusion criteria for selecting both organisations and teams in cluster RCTs. We believe this would maximise the likelihood of adequate implementation and hence reduce waste in research

Evaluation of a physical activity intervention for new parents: protocol paper for a randomized trial

Directory of Open Access Journals (Sweden)

Alison Quinlan

2017-11-01

Full Text Available Abstract Background Identifying critical life transitions in people’s physical activity behaviors may illuminate the most opportune intervention apertures for chronic disease prevention. A substantive evidence base now indicates that parenthood is one of these critical transition points for physical activity decline. This study will examine whether a brief theory-based intervention can prevent a decline in physical activity among new parents over 6 months following intervention. This study protocol represents the first dyad-based physical activity initiative in the parenthood literature involving both mothers and fathers; prior research has focused on only mothers or only fathers (albeit limited, and has shown only short-term changes in physical activity. This study will be investigating whether a theory-based physical activity intervention can maintain or improve moderate to vigorous intensity physical activity measured via accelerometry of new parents over a 6 month period following intervention compared to a control group. Methods This study is a 6-month longitudinal randomized controlled trial. Parents are measured at baseline (2 months postpartum with two assessment points at 6 weeks (3.5 months postpartum and 3 months (5 months postpartum and a final follow-up assessment at 6 months (8 months postpartum. The content of the theory-based intervention was derived from the results of our prior longitudinal trial of new parents using an adapted theory of planned behavior framework to predict changes in physical activity. Results A total of 152 couples have been recruited to date. Sixteen couples dropped out after baseline and a total of 88 couples have completed their 6-month measures. Discussion If the intervention proves successful, couple-based physical activity promotion efforts among parents could be a promising avenue to pursue to help mitigate the declines of physical activity levels during parenthood. These findings could inform

Evaluation of a physical activity intervention for new parents: protocol paper for a randomized trial.

Science.gov (United States)

Quinlan, Alison; Rhodes, Ryan E; Beauchamp, Mark R; Symons Downs, Danielle; Warburton, Darren E R; Blanchard, Chris M

2017-11-09

Identifying critical life transitions in people's physical activity behaviors may illuminate the most opportune intervention apertures for chronic disease prevention. A substantive evidence base now indicates that parenthood is one of these critical transition points for physical activity decline. This study will examine whether a brief theory-based intervention can prevent a decline in physical activity among new parents over 6 months following intervention. This study protocol represents the first dyad-based physical activity initiative in the parenthood literature involving both mothers and fathers; prior research has focused on only mothers or only fathers (albeit limited), and has shown only short-term changes in physical activity. This study will be investigating whether a theory-based physical activity intervention can maintain or improve moderate to vigorous intensity physical activity measured via accelerometry of new parents over a 6 month period following intervention compared to a control group. This study is a 6-month longitudinal randomized controlled trial. Parents are measured at baseline (2 months postpartum) with two assessment points at 6 weeks (3.5 months postpartum) and 3 months (5 months postpartum) and a final follow-up assessment at 6 months (8 months postpartum). The content of the theory-based intervention was derived from the results of our prior longitudinal trial of new parents using an adapted theory of planned behavior framework to predict changes in physical activity. A total of 152 couples have been recruited to date. Sixteen couples dropped out after baseline and a total of 88 couples have completed their 6-month measures. If the intervention proves successful, couple-based physical activity promotion efforts among parents could be a promising avenue to pursue to help mitigate the declines of physical activity levels during parenthood. These findings could inform public health materials and practitioners. This trial has been

Evaluation of composting in the intervention of waste management

International Nuclear Information System (INIS)

Diaz, F. J.; Claver, F.; Moraleda, M.; Vazquez, C.

1998-01-01

Decontamination countermeasures may generate high amounts of wastes. The management of wastes (meaning all those actions to be carried out until its final disposal) should be taking into account during the selection of the optimum restoration strategy. TEMAS Project (Techniques and Management Strategies for environmental restoration and their ecological consequences) considers waste management in the selection of optimized intervention. The management of wastes can follow an stepped process (disposal route) from the origin of waste to its final disposal. Each potential waste can be managed throughout one or more of these disposal routes. These processes must be characterized in the following terms: cost (machinery; manpower and consumables) and added dose for workers. This work deals with the obtention of this type of information required to evaluate the applicability of disposal routes including composting as one step in the management of organic wastes generated during the intervention. (Author) 11 refs

Photon final states at the Tevatron

Energy Technology Data Exchange (ETDEWEB)

Campanelli, Mario; /University Coll. London

2008-04-01

The authors present here several recent measurements involving associate production of photons and jets at the Tevatron. In particular, inclusive photon + met from D0, and photon + b-jets and photon + b-jet + leptons + MET from CDF are described in some detail. These measurements offer a good test of QCD predictions in rather complex final states.

The "Som la Pera" intervention: sustainability capacity evaluation of a peer-led social-marketing intervention to encourage healthy lifestyles among adolescents.

Science.gov (United States)

Llauradó, Elisabet; Aceves-Martins, Magaly; Tarro, Lucia; Papell-Garcia, Ignasi; Puiggròs, Francesc; Prades-Tena, Jordi; Kettner, Helle; Arola, Lluis; Giralt, Montse; Solà, Rosa

2018-02-10

Sustainability capacity, always considered a challenge, is the ability to maintain effective long-term intervention in a community. The aim of the study was to improve the sustainability capacity of effective "Som la Pera," a school-based, peer-led, social-marketing intervention that encourages healthy diet and physical activity, in low socioeconomic adolescents from Spain. The sustainability capacity was analyzed by a "programme sustainability assessment tool (PSAT)" comprising eight domains: political support, funding stability, partnerships, organizational capacity, programme evaluation, programme adaptation, communications, and strategic planning. Each domain was evaluated from 1 (no or to a small extent) to 7 points (to a great extent). The final score for sustainability capacity was the mean of the eight domain scores. The PSAT was assessed by nine professionals (researchers, staff members, and stakeholders) at two periods during intervention implementation: end of the first year (January 2015) and end of the second year (September 2015). At the end of the first year, strategic planning (4.43 ± 1.98) and funding stability (4.38 ± 1) were considered deficient domains, and at the end of the second year, these domains had improved by 1.67 points (p =.043) and 0.59 points (p = .159), respectively. The funding stability increase was not significant because only one of the five specific items, "policies implemented to ensure sustained funding," improved by 1.08 points (p = .036). The sustainability capacity final score was 5.93 ± 1.13. The sustainability capacity assessment during the intervention allows its improvement before the programme expires, ensuring the long-term implementation of the "Som la Pera" intervention programme to encourage healthy lifestyles in adolescents. © Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PREDICTION OF SPORT ADHERENCE THROUGH THE INFLUENCE OF AUTONOMY-SUPPORTIVE COACHING AMONG SPANISH ADOLESCENT ATHLETES

Directory of Open Access Journals (Sweden)

Bartolomé J. Almagro

2010-03-01

Full Text Available The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key words: Autonomy support, perceived autonomy, intrinsic motivation, sport adherence

Psychosocial interventions for cannabis use disorder

Science.gov (United States)

Gates, Peter J; Sabioni, Pamela; Copeland, Jan; Le Foll, Bernard; Gowing, Linda

2016-01-01

nature of the interventions provided, participant blinding was not possible, and reports of researcher blinding often were unclear or were not provided. Half of the reviewed studies included collateral verification or urinalysis to confirm self report data, leading to concern about performance and detection bias. Finally, concerns of other bias were based on relatively consistent lack of assessment of non-cannabis substance use or use of additional treatments before or during the trial period. A subset of studies provided sufficient detail for comparison of effects of any intervention versus inactive control on primary outcomes of interest at early follow-up (median, four months). Results showed moderate-quality evidence that approximately seven out of 10 intervention participants completed treatment as intended (effect size (ES) 0.71, 95% confidence interval (CI) 0.63 to 0.78, 11 studies, 1424 participants), and that those receiving psychosocial intervention used cannabis on fewer days compared with those given inactive control (mean difference (MD) 5.67, 95% CI 3.08 to 8.26, six studies, 1144 participants). In addition, low-quality evidence revealed that those receiving intervention were more likely to report point-prevalence abstinence (risk ratio (RR) 2.55, 95% CI 1.34 to 4.83, six studies, 1166 participants) and reported fewer symptoms of dependence (standardised mean difference (SMD) 4.15, 95% CI 1.67 to 6.63, four studies, 889 participants) and cannabis-related problems compared with those given inactive control (SMD 3.34, 95% CI 1.26 to 5.42, six studies, 2202 participants). Finally, very low-quality evidence indicated that those receiving intervention reported using fewer joints per day compared with those given inactive control (SMD 3.55, 95% CI 2.51 to 4.59, eight studies, 1600 participants). Notably, subgroup analyses found that interventions of more than four sessions delivered over longer than one month (high intensity) produced consistently improved

Psychosocial interventions for cannabis use disorder.

Science.gov (United States)

Gates, Peter J; Sabioni, Pamela; Copeland, Jan; Le Foll, Bernard; Gowing, Linda

2016-05-05

researcher blinding often were unclear or were not provided. Half of the reviewed studies included collateral verification or urinalysis to confirm self report data, leading to concern about performance and detection bias. Finally, concerns of other bias were based on relatively consistent lack of assessment of non-cannabis substance use or use of additional treatments before or during the trial period.A subset of studies provided sufficient detail for comparison of effects of any intervention versus inactive control on primary outcomes of interest at early follow-up (median, four months). Results showed moderate-quality evidence that approximately seven out of 10 intervention participants completed treatment as intended (effect size (ES) 0.71, 95% confidence interval (CI) 0.63 to 0.78, 11 studies, 1424 participants), and that those receiving psychosocial intervention used cannabis on fewer days compared with those given inactive control (mean difference (MD) 5.67, 95% CI 3.08 to 8.26, six studies, 1144 participants). In addition, low-quality evidence revealed that those receiving intervention were more likely to report point-prevalence abstinence (risk ratio (RR) 2.55, 95% CI 1.34 to 4.83, six studies, 1166 participants) and reported fewer symptoms of dependence (standardised mean difference (SMD) 4.15, 95% CI 1.67 to 6.63, four studies, 889 participants) and cannabis-related problems compared with those given inactive control (SMD 3.34, 95% CI 1.26 to 5.42, six studies, 2202 participants). Finally, very low-quality evidence indicated that those receiving intervention reported using fewer joints per day compared with those given inactive control (SMD 3.55, 95% CI 2.51 to 4.59, eight studies, 1600 participants). Notably, subgroup analyses found that interventions of more than four sessions delivered over longer than one month (high intensity) produced consistently improved outcomes (particularly in terms of cannabis use frequency and severity of dependence) in the short term

Evaluating prediction uncertainty

International Nuclear Information System (INIS)

McKay, M.D.

1995-03-01

The probability distribution of a model prediction is presented as a proper basis for evaluating the uncertainty in a model prediction that arises from uncertainty in input values. Determination of important model inputs and subsets of inputs is made through comparison of the prediction distribution with conditional prediction probability distributions. Replicated Latin hypercube sampling and variance ratios are used in estimation of the distributions and in construction of importance indicators. The assumption of a linear relation between model output and inputs is not necessary for the indicators to be effective. A sequential methodology which includes an independent validation step is applied in two analysis applications to select subsets of input variables which are the dominant causes of uncertainty in the model predictions. Comparison with results from methods which assume linearity shows how those methods may fail. Finally, suggestions for treating structural uncertainty for submodels are presented

Elevated T-wave alternans predicts nonsustained ventricular tachycardia in association with percutaneous coronary intervention in ST-segment elevation myocardial infarction (STEMI) patients.

Science.gov (United States)

Verrier, Richard L; Nearing, Bruce D; Ghanem, Raja N; Olson, Rachel E; Garberich, Ross F; Katsiyiannis, William T; Gornick, Charles C; Tang, Chuen Y; Henry, Timothy D

2013-06-01

Successful reperfusion with primary percutaneous coronary intervention (PCI) can paradoxically elicit temporary vulnerability to ventricular arrhythmia. We examined whether T-wave alternans (TWA) level is correlated with nonsustained ventricular tachycardia (NSVT) incidence in association with PCI in patients with acute ST-segment elevation myocardial infarction (STEMI). We analyzed continuous 24-hour ambulatory electrocardiograms in 48 STEMI patients during and after successful primary PCI, achieving Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow. TWA was measured using modified moving average method. Maximum TWA was elevated in patients with (N = 22) compared to without (N = 26) NSVT (75.1 ± 6.3 vs 49.9 ± 3.6 μV, P < 0.005) during the 22-hour monitoring period. TWA ≥ 60μV predicted NSVT with sensitivity of 77%; specificity, 73%; positive predictive value, 71%; and negative predictive value, 79%. Area under receiver operator characteristic curve (AUC) was 0.87 for maximum TWA in predicting NSVT. By comparison, ST-segment levels did not differ in patients with versus without NSVT and were not predictive (AUC = 0.52). TWA was elevated prior to PCI and remained elevated at 30 minutes after balloon inflation despite restoration of TIMI grade 3 flow in all patients, declining by 22 hours (P < 0.05). Maximum ST-segment levels decreased from before PCI to 30 minutes after balloon inflation. TWA is regionally specific, with higher values prior to PCI in precordial lead V5 than in V1 for left coronary lesions. TWA may be useful in identifying individuals at heightened risk for arrhythmia in association with primary PCI and can potentially signal time-dependent changes in arrhythmia vulnerability. © 2013 Wiley Periodicals, Inc.

Intervention principles: Theory and practice

International Nuclear Information System (INIS)

Jensen, P.H.; Crick, M.J.

2000-01-01

conditions and the circumstances of the accident. Only with suitable models can they be accurately interpreted in terms of avertable individual or collective doses. This paper will discuss the application of the basic radiation protection principles for intervention to develop generic intervention levels for different protection actions and how these levels can be converted to specific operational intervention levels reflecting site and accident specific factors. In addition, the factors entering the optimisation process will be discussed and also how the uncertainty associated with these factors will influence the optimised intervention levels. Finally, the use of intervention levels in the decision-making process after an accident is discussed. (author)

The association between adherence and outcome in an Internet intervention for depression.

Science.gov (United States)

Fuhr, Kristina; Schröder, Johanna; Berger, Thomas; Moritz, Steffen; Meyer, Björn; Lutz, Wolfgang; Hohagen, Fritz; Hautzinger, Martin; Klein, Jan Philipp

2018-03-15

Adherence to Internet interventions is often reported to be rather low and this might adversely impact the effectiveness of these interventions. We investigated if patient characteristics are associated with adherence, and if adherence is associated with treatment outcome in a large RCT of an Internet intervention for depression, the EVIDENT trial. Patients were randomized to either care as usual (CAU) or CAU plus the Internet intervention Deprexis. A total of 509 participants with mild to moderate depressive symptoms were included in the intervention group and of interest for the present study. We assessed depression symptoms pre and post intervention (12 weeks). Patient characteristics, a self-rating screening for mental disorders, attitudes towards online interventions, and quality of life were assessed before randomization. Adherence in this study was good with on average seven hours of usage time and eight number of sessions spent with the intervention. Some of the patient characteristics (age, sex, depressive symptoms, and confidence in the effectiveness of the program) predicted higher number of sessions in different models (explaining in total between 15 and 25% of variance). Older age (β = .16) and higher depressive symptoms (β = .15) were associated with higher usage duration. Higher adherence to the program predicted a greater symptom reduction in depressive symptoms over 12 weeks (number of sessions: β = .13, usage duration: β = .14), however, this prediction could mostly be explained by receiving guidance (β = .27 and .26). Receiving guidance and symptom severity at baseline were confounded since only participants with a moderate symptom severity at baseline received e-mail support. Therefore no firm conclusions can be drawn from the association we observed between baseline symptom severity and usage intensity. We conclude that older age was associated with adherence and adherence was positively associated with outcome. The effects we have found

Event-rate and delta inflation when evaluating mortality as a primary outcome from randomized controlled trials of nutritional interventions during critical illness: a systematic review.

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Summers, Matthew J; Chapple, Lee-anne S; McClave, Stephen A; Deane, Adam M

2016-04-01

There is a lack of high-quality evidence that proves that nutritional interventions during critical illness reduce mortality. We evaluated whether power calculations for randomized controlled trials (RCTs) of nutritional interventions that used mortality as the primary outcome were realistic, and whether overestimation was systematic in the studies identified to determine whether this was due to overestimates of event rate or delta. A systematic review of the literature between 2005 and 2015 was performed to identify RCTs of nutritional interventions administered to critically ill adults that had mortality as the primary outcome. Predicted event rate (predicted mortality during the control), predicted mortality during intervention, predicted delta (predicted difference between mortality during the control and intervention), actual event rate (observed mortality during control), observed mortality during intervention, and actual delta (difference between observed mortality during the control and intervention) were recorded. The event-rate gap (predicted event rate minus observed event rate), the delta gap (predicted delta minus observed delta), and the predicted number needed to treat were calculated. Data are shown as median (range). Fourteen articles were extracted, with power calculations provided for 10 studies. The predicted event rate was 29.9% (20.0–52.4%), and the predicted delta was 7.9% (3.0–20.0%). If the study hypothesis was proven correct then, on the basis of the power calculations, the number needed to treat would have been 12.7 (5.0–33.3) patients. The actual event rate was 25.3% (6.1–50.0%), the observed mortality during the intervention was 24.4% (6.3–39.7%), and the actual delta was 0.5% (−10.2–10.3%), such that the event-rate gap was 2.6% (−3.9–23.7%) and delta gap was 7.5% (3.2–25.2%). Overestimates of delta occur frequently in RCTs of nutritional interventions in the critically ill that are powered to determine a mortality

Prediction of sport adherence through the influence of autonomy-supportive coaching among spanish adolescent athletes.

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Almagro, Bartolomé J; Sáenz-López, Pedro; Moreno, Juan A

2010-01-01

The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years) completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key pointsImportance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes.Interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation.Intrinsic motivation predicted the intention to be physically active in the future.

Use and Effectiveness of a Video- and Text-Driven Web-Based Computer-Tailored Intervention: Randomized Controlled Trial.

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Walthouwer, Michel Jean Louis; Oenema, Anke; Lechner, Lilian; de Vries, Hein

2015-09-25

Many Web-based computer-tailored interventions are characterized by high dropout rates, which limit their potential impact. This study had 4 aims: (1) examining if the use of a Web-based computer-tailored obesity prevention intervention can be increased by using videos as the delivery format, (2) examining if the delivery of intervention content via participants' preferred delivery format can increase intervention use, (3) examining if intervention effects are moderated by intervention use and matching or mismatching intervention delivery format preference, (4) and identifying which sociodemographic factors and intervention appreciation variables predict intervention use. Data were used from a randomized controlled study into the efficacy of a video and text version of a Web-based computer-tailored obesity prevention intervention consisting of a baseline measurement and a 6-month follow-up measurement. The intervention consisted of 6 weekly sessions and could be used for 3 months. ANCOVAs were conducted to assess differences in use between the video and text version and between participants allocated to a matching and mismatching intervention delivery format. Potential moderation by intervention use and matching/mismatching delivery format on self-reported body mass index (BMI), physical activity, and energy intake was examined using regression analyses with interaction terms. Finally, regression analysis was performed to assess determinants of intervention use. In total, 1419 participants completed the baseline questionnaire (follow-up response=71.53%, 1015/1419). Intervention use declined rapidly over time; the first 2 intervention sessions were completed by approximately half of the participants and only 10.9% (104/956) of the study population completed all 6 sessions of the intervention. There were no significant differences in use between the video and text version. Intervention use was significantly higher among participants who were allocated to an

Response to Intervention as a Predictor of Long-Term Reading Outcomes in Children with Dyslexia.

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van der Kleij, Sanne W; Segers, Eliane; Groen, Margriet A; Verhoeven, Ludo

2017-08-01

The goal of this study was to investigate how growth during a phonics-based intervention, as well as reading levels at baseline testing, predicted long-term reading outcomes of children with dyslexia. Eighty Dutch children with dyslexia who had completed a 50-week phonics-based intervention in grade 4 were tested in grade 5 on both word and pseudoword (following regular Dutch orthographic patterns) reading efficiency and compared to 93 typical readers. In grade 5 the children with dyslexia were still significantly slower in word and pseudoword reading than their typically developing peers. Results showed that long-term pseudoword reading in the group with dyslexia was predicted by pseudoword reading at pretest and growth in pseudoword reading during the intervention, which was itself predicted by pseudoword reading at pretest. This was not the case for word reading. We found that long-term word reading was directly predicted from pretest word reading, and indirectly via pretest pseudoword reading, via growth in pseudoword and word reading. It can be concluded that pseudoword reading is not only a good indicator of severity of reading difficulties in children with dyslexia, it is also an indicator of who will profit from intervention in the long-term. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Enhanced immunization coverage through interventions for childhood cluster diseases in developing countries

International Nuclear Information System (INIS)

Mureed, S.; Somronghtong, R.; Kumar, R.

2015-01-01

Globally immunisation has to be considered as a most effective and efficient public health intervention to reduce morbidity and mortality among children. Most of the children from developing countries are still not fully immunized due to multiple factors including lack of interventions, awareness, and financial constraints and due to limited resource. Conversely, this review has identified the effectiveness of interventions to increase the immunisation coverage among children of developing countries. Methods: Systematic review by using PRISMA statement (preferred reporting items for systematic reviews and meta-analyses) has been conducted in English published articles on Pub Med, Scopus, Cochrane, Medline and ISI by searching keywords like immunizations, childhood vaccination and developing countries has been accessed. Only randomised controlled trial and quasi-experimental studies designs were included in the final analysis based on quality assessment by adopting the Down and Black checklist and finally pooled analysis was done by random effect model. This systematic review has been approved and registered by University of York. Results: A total of 16,570 published articles were accessed and finally 10 fulfilled our criteria that were analysed and interpreted. It demonstrated that the interventions has shown significantly increase vaccine coverage for childhood cluster diseases (OR 2.136 and p <0.05).Furthermore, it has been proved that an effect was more prominent for DTP (OR 2.397 and p<0.05) and measles (OR 2.628 and p<0.05), not as much for polio (OR 2.284 and p>0.05) and full vaccination schedule (OR 1.342 and p>0.05). Conclusions: Systematic review has concluded that the professional interventions are an effective while in improving the child immunisation coverage for cluster diseases in developing countries, major effect on DTP and measles. (author)

Parental feeding practices predict authoritative, authoritarian, and permissive parenting styles.

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Hubbs-Tait, Laura; Kennedy, Tay Seacord; Page, Melanie C; Topham, Glade L; Harrist, Amanda W

2008-07-01

Our goal was to identify how parental feeding practices from the nutrition literature link to general parenting styles from the child development literature to understand how to target parenting practices to increase effectiveness of interventions. Stand-alone parental feeding practices could be targeted independently. However, parental feeding practices linked to parenting styles require interventions treating underlying family dynamics as a whole. To predict parenting styles from feeding practices and to test three hypotheses: restriction and pressure to eat are positively related whereas responsibility, monitoring, modeling, and encouraging are negatively related to an authoritarian parenting style; responsibility, monitoring, modeling, and encouraging are positively related whereas restriction and pressure to eat are negatively related to an authoritative parenting style; a permissive parenting style is negatively linked with all six feeding practices. Baseline data of a randomized-controlled intervention study. Two hundred thirty-nine parents (93.5% mothers) of first-grade children (134 boys, 105 girls) enrolled in rural public schools. Parental responses to encouraging and modeling questionnaires and the Child Feeding Questionnaire, as well as parenting styles measured by the Parenting Styles and Dimensions Questionnaire. Correlation and regression analyses. Feeding practices explained 21%, 15%, and 8% of the variance in authoritative, authoritarian, and permissive parenting, respectively. Restriction, pressure to eat, and monitoring (negative) significantly predicted an authoritarian style (Hypothesis 1); responsibility, restriction (negative), monitoring, and modeling predicted an authoritative style (Hypothesis 2); and modeling (negative) and restriction significantly predicted a permissive style (Hypothesis 3). Parental feeding practices with young children predict general parenting styles. Interventions that fail to address underlying parenting styles

Brain Implants for Prediction and Mitigation of Epileptic Seizures - Final CRADA Report

Energy Technology Data Exchange (ETDEWEB)

Gopalsami, Nachappa

2016-09-29

This is a CRADA final report on C0100901 between Argonne National Laboratory and Flint Hills Scientific, LLC of Lawrence, Kansas. Two brain implantable probes, a surface acoustic wave probe and a miniature cooling probe, were designed, built, and tested with excellent results.

Early Identification and Interventions for Dyslexia: A Contemporary View

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Snowling, Margaret J.

2013-01-01

This paper reviews current proposals concerning the definition of dyslexia and contrasts it with reading comprehension impairment. We then discuss methods for early identification and review evidence that teacher assessments and ratings may be valid screening tools. Finally, we argue that interventions should be theoretically motivated and…

Simulation of the Press Hardening Process and Prediction of the Final Mechanical Material Properties

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Hochholdinger, Bernd; Hora, Pavel; Grass, Hannes; Lipp, Arnulf

2011-08-01

Press hardening is a well-established production process in the automotive industry today. The actual trend of this process technology points towards the manufacturing of parts with tailored properties. Since the knowledge of the mechanical properties of a structural part after forming and quenching is essential for the evaluation of for example the crash performance, an accurate as possible virtual assessment of the production process is more than ever necessary. In order to achieve this, the definition of reliable input parameters and boundary conditions for the thermo-mechanically coupled simulation of the process steps is required. One of the most important input parameters, especially regarding the final properties of the quenched material, is the contact heat transfer coefficient (IHTC). The CHTC depends on the effective pressure or the gap distance between part and tool. The CHTC at different contact pressures and gap distances is determined through inverse parameter identification. Furthermore a simulation strategy for the subsequent steps of the press hardening process as well as adequate modeling approaches for part and tools are discussed. For the prediction of the yield curves of the material after press hardening a phenomenological model is presented. This model requires the knowledge of the microstructure within the part. By post processing the nodal temperature history with a CCT diagram the quantitative distribution of the phase fractions martensite, bainite, ferrite and pearlite after press hardening is determined. The model itself is based on a Hockett-Sherby approach with the Hockett-Sherby parameters being defined in function of the phase fractions and a characteristic cooling rate.

Cost-Benefit Analysis and Assessment of Ergonomic Interventions Effects: Case Study Boiler and Equipment Engineering and Manufacturing Company

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Iraj Mohammad faam

2015-12-01

Full Text Available Background & Objectives: In Economic and competitive world today,cost-benefit analysis is one of the most important parameters for any intervention.The purpose of thisstudy was cost-benefit analysis of ergonomic interventions effects in Boiler and Equipment Engineering and Manufacturing Company. Methods:At first all workstations of the company assessed using QEC. Thenthose earned more than 70% in QEC assessed by OWAS. By analyzing the results of these two methods, the “Haarp welding” workstation selected as the critical one. After presentation of possible solutions in specialized committee, the final solution selected and cost-benefit analysis done by CyberManS tool. Finally after implementing the intervention workstation reassessed. Findings:The results of the survey showed that the final score of assessment using QEC, OWAS and NASA-TLX before the intervention was 84.7%, 3 and 75.4, respectively and after the intervention was 47.5%, 1 and 42.7 that witnesses a significant reduction in all three methods of assessment. Also the result of cost-benefit analysis by CyberManS showed that by spending 110 million rials after 1.5 years the investment returned and profitability initiated. Conclusion:In addition to reducing the risk of musculoskeletal disorders, ergonomic interventions have financial benefits by increasing the productivity and production, reducing the compensation and the lost work days can also cause financial benefits.

[A Group Cognitive-Behavioural Intervention to Prevent Depression Relapse in Individuals Having Recently Returned to Work: Protocol and Feasibility].

Science.gov (United States)

Lecomte, Tania; Corbière, Marc

Workplace depression is one of the major causes for sick leave and loss of productivity at work. Many studies have investigated factors predicting return to work for people with depression, including studies evaluating return to work programs and organizational factors. Yet, a paucity of studies have targeted the prevention of depressive relapses at work, even though more than half of those having had a depression will have a depressive relapse in the near future.Objectives This article describes a research protocol involving a novel group intervention based on cognitive behavioural principles with the aim to optimize return to work and diminish risk of depressive relapses.Method This pilot study follows a randomized controlled trial design, with half the participants (N=25) receiving the group intervention and the other half (N=25) receiving usual services. The theoretical and empirical underpinnings of the intervention are described, along with a detailed presentation of the intervention and of the study's objectives. The group intervention consists of 8 sessions whereby Cognitive behavioural therapy (CBT) principles and techniques are applied to the following themes: (1) Coping with stress at work; (2) Recognizing and modifying my dysfunctional beliefs linked to work; (3) Overcoming obstacles linked to work functioning and maintaining work; (4) Negotiating needed work adjustments with the support of the immediate supervisor; (5) Finding my strengths and competencies related to work; (6) Accepting criticism and asserting myself appropriately at work; (7) Uncovering my best coping strategies for work.Results Qualitative information pertaining to the first two cohorts' participants' subjective appreciation of the group experience revealed that the intervention was perceived as very useful by all, with group support, namely harmony and interpersonal support, as well as CBT strategies being mentioned specifically.Conclusion Finally, the potential relevance of the

How health leaders can benefit from predictive analytics.

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Giga, Aliyah

2017-11-01

Predictive analytics can support a better integrated health system providing continuous, coordinated, and comprehensive person-centred care to those who could benefit most. In addition to dollars saved, using a predictive model in healthcare can generate opportunities for meaningful improvements in efficiency, productivity, costs, and better population health with targeted interventions toward patients at risk.

Do Motivational Interviewing Behaviors Predict Reductions in Partner Aggression for Men and Women?

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Woodin, Erica M.; Sotskova, Alina; O’Leary, K. Daniel

2011-01-01

Motivational interviewing is a directive, non-confrontational intervention to promote behavior change. The current study examined therapist behaviors during a successful brief motivational interviewing intervention for physically aggressive college dating couples (Woodin & O’Leary, 2010). Forty-five minute motivational interviews with each partner were videotaped and coded using the Motivational Interviewing Treatment Integrity scale (MITI; Moyers, Martin, Manuel, & Miller, 2003). Hierarchical modeling analyses demonstrated that therapist behaviors consistent with motivational interviewing competency predicted significantly greater reductions in physical aggression perpetration following the intervention. Specifically, greater reflection to question ratios by the therapists predicted reductions in aggression for both men and women, greater percentages of open versus closed questions predicted aggression reductions for women, and there was a trend for greater levels of global therapist empathy to predict aggression reductions for women. These findings provide evidence that motivational interviewing seems to have an effect on behavior change through therapist behaviors consistent with the theoretical underpinnings of motivational interviewing. PMID:22119133

Investigation of key interventions for shigellosis outbreak control in China.

Directory of Open Access Journals (Sweden)

Tianmu Chen

Full Text Available Shigellosis is a major public health concern in China, where waterborne disease outbreaks are common. Shigellosis-containing strategies, mostly single or multiple interventions, are implemented by primary-level health departments. Systematic assessment of the effectiveness of these measures is scarce. To estimate the efficacy of commonly used intervention strategies, we developed a Susceptible-Exposed-Infectious/Asymptomatic-Recovered-Water model. No intervention was predicted to result in a total attack rate (TAR of 90% of the affected population (95% confidence interval [CI]: 86.65-92.80 and duration of outbreak (DO of 89 days, and the use of single-intervention strategies can be futile or even counter-productive. Prophylactics and water disinfection did not improve TAR or DO. School closure for up to 3 weeks did not help but only increased DO. Isolation alone significantly increased DO. Only antibiotics treatment could shorten the DO to 35 days with TAR unaffected. We observed that these intervention effects were additive when in combined usage under most circumstances. Combined intervention "Isolation+antibiotics+prophylactics+water disinfection" was predicted to result in the lowest TAR (41.9%, 95%CI: 36.97-47.04% and shortest DO (28 days. Our actual Shigellosis control implementation that also included school closure for 1 week, attained comparable results and the modeling produced an epidemic curve of Shigellosis highly similar to our actual outbreak data. This lends a strong support to the reality of our model that provides a possible reference for public health professionals to evaluate their strategies towards Shigellosis control.

Models and criteria for prediction of Deflagration-to-Detonation Transition (DDT) in hydrogen-air-steam systems under severe accident conditions. Final report

International Nuclear Information System (INIS)

Klein, R.; Rehm, W.

1999-01-01

The European Commission in Brussels supported a joint project on Deflagration-to-Detonation Transition (DDT) studies for hydrogen safety within the framework programme on nuclear fission safety. The project was initiated by the Forschungszentrum Juelich based on the results of a pilot project. The following main project was coordinated by the Freie Universitaet Berlin involving seven european partners. The partners came from universities, research centers and industry, as follows: FU-Berlin, RWTH-Aachen, CNRS-Marseille, IPSN-Saclay, FZ-Juelich, FZ-Karlsruhe, and NNC-Knutsford, which worked closely together. The working period was two years (1997-1998). The aim of the project was to develop models and criteria for prediction of deflagration-to-detonation transition (DDT) in hydrogen-air-steam systems under severe accident conditions. The results obtained are documented in this final report, which was finished in 1999. The report consists of seven chapters, concerning: - Introduction - Experimental Investigations - Modelling and Numerics - Validation - Mitigation - Further Deliverables - Summary and Conclusion. The final report presents special experimental, theoretical, and computational aspects of the complex DDT phenomena for hydrogen safety studies, and it should be a solid basis for end user applications and further developments. (orig.)

Predictive Utility of Brief Alcohol Use Disorders Identification Test (AUDIT) for human immunodeficiency virus antiretroviral medication nonadherence.

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Broyles, Lauren Matukaitis; Gordon, Adam J; Sereika, Susan M; Ryan, Christopher M; Erlen, Judith A

2011-10-01

Alcohol use negatively affects adherence to antiretroviral therapy (ART), thus human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) care providers need accurate, efficient assessments of alcohol use. Using existing data from an efficacy trial of 2 cognitive-behavioral ART adherence interventions, the authors sought to determine if results on 2 common alcohol screening tests (Alcohol Use Disorders Identification Test--Consumption [AUDIT-C] and its binge-related question [AUDIT-3]) predict ART nonadherence. Twenty-seven percent of the sample (n = 308) were positive on the AUDIT-C and 34% were positive on the AUDIT-3. In multivariate analyses, AUDIT-C-positive status predicted ART nonadherence after controlling for race, age, conscientiousness, and self-efficacy (P = .036). Although AUDIT-3-positive status was associated with ART nonadherence in unadjusted analyses, this relationship was not maintained in the final multivariate model. The AUDIT-C shows potential as an indirect screening tool for both at-risk drinking and ART nonadherence, underscoring the relationship between alcohol and chronic disease management.

Cell phone intervention for you (CITY): A randomized, controlled trial of behavioral weight loss intervention for young adults using mobile technology.

Science.gov (United States)

Svetkey, Laura P; Batch, Bryan C; Lin, Pao-Hwa; Intille, Stephen S; Corsino, Leonor; Tyson, Crystal C; Bosworth, Hayden B; Grambow, Steven C; Voils, Corrine; Loria, Catherine; Gallis, John A; Schwager, Jenifer; Bennett, Gary G; Bennett, Gary B

2015-11-01

To determine the effect on weight of two mobile technology-based (mHealth) behavioral weight loss interventions in young adults. Randomized, controlled comparative effectiveness trial in 18- to 35-year-olds with BMI ≥ 25 kg/m(2) (overweight/obese), with participants randomized to 24 months of mHealth intervention delivered by interactive smartphone application on a cell phone (CP); personal coaching enhanced by smartphone self-monitoring (PC); or Control. The 365 randomized participants had mean baseline BMI of 35 kg/m(2) . Final weight was measured in 86% of participants. CP was not superior to Control at any measurement point. PC participants lost significantly more weight than Controls at 6 months (net effect -1.92 kg [CI -3.17, -0.67], P = 0.003), but not at 12 and 24 months. Despite high intervention engagement and study retention, the inclusion of behavioral principles and tools in both interventions, and weight loss in all treatment groups, CP did not lead to weight loss, and PC did not lead to sustained weight loss relative to Control. Although mHealth solutions offer broad dissemination and scalability, the CITY results sound a cautionary note concerning intervention delivery by mobile applications. Effective intervention may require the efficiency of mobile technology, the social support and human interaction of personal coaching, and an adaptive approach to intervention design. © 2015 The Obesity Society.

Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands

DEFF Research Database (Denmark)

Holtermann, Andreas; Jørgensen, Marie B; Gram, Bibi

2010-01-01

) characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence. METHODS/DESIGN: A novel approach of the FINALE programme is that the interventions, i.e. 3 randomized controlled trials (RCT) and 1 exploratory case-control study are tailored to the physical work......BACKGROUND: A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job...... groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers...

Symposium: Organizational Health Intervention Research: Current Empirical Developments

DEFF Research Database (Denmark)

Ipsen, Christine; Jenny, Gregor

2014-01-01

or networks of employees. The intervention process is designed to involve the most effective set of stakeholders (leaders, management, experts, co-workers) and connect them to an efficient network of change agents. For this, the current interventions offer models, handbooks and indicators that inform...... Health Index”. The study, conducted in Switzerland, shows that the index predicts sick leave, stress symptoms, work engagement and self-rated productivity. • The fourth contribution Torsten Holstad and his colleagues present their summative evaluation of a tailor-made training program focusing on health...

The association between expressive grammar intervention and social and emergent literacy outcomes for preschoolers with SLI.

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Washington, Karla N

2013-02-01

To determine whether (a) expressive grammar intervention facilitated social and emergent literacy outcomes better than no intervention and (b) expressive grammar gains and/or initial expressive grammar level predicted social and emergent literacy outcomes. This investigation was a follow-up to a recently published study exploring the impact of grammatical language intervention on expressive grammar outcomes for preschoolers with specific language impairment (SLI). Twenty-two 3- to 5-year-old preschoolers received ten 20-minute intervention sessions addressing primary deficits in grammatical morphology. Participants' social and emergent literacy skills were not targeted. Twelve children awaiting intervention, chosen from the same selection pool as intervention participants, served as controls. Blind assessments of social and emergent literacy outcomes were completed at preintervention, immediately postintervention, and 3 months postintervention. Only intervention participants experienced significant gains in social and emergent literacy outcomes and maintained these gains for 3 months postintervention. Expressive grammar gains was the only single significant predictor of these outcomes. Expressive grammar intervention was associated with broad impacts on social and emergent literacy outcomes that were maintained beyond the intervention period. Gains in expressive grammar predicted these outcomes. Social and emergent literacy skills were positively affected for preschoolers with SLI during a grammatical language intervention program.

Analyzing transmission dynamics of cholera with public health interventions.

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Posny, Drew; Wang, Jin; Mukandavire, Zindoga; Modnak, Chairat

2015-06-01

Cholera continues to be a serious public health concern in developing countries and the global increase in the number of reported outbreaks suggests that activities to control the diseases and surveillance programs to identify or predict the occurrence of the next outbreaks are not adequate. These outbreaks have increased in frequency, severity, duration and endemicity in recent years. Mathematical models for infectious diseases play a critical role in predicting and understanding disease mechanisms, and have long provided basic insights in the possible ways to control infectious diseases. In this paper, we present a new deterministic cholera epidemiological model with three types of control measures incorporated into a cholera epidemic setting: treatment, vaccination and sanitation. Essential dynamical properties of the model with constant intervention controls which include local and global stabilities for the equilibria are carefully analyzed. Further, using optimal control techniques, we perform a study to investigate cost-effective solutions for time-dependent public health interventions in order to curb disease transmission in epidemic settings. Our results show that the basic reproductive number (R0) remains the model's epidemic threshold despite the inclusion of a package of cholera interventions. For time-dependent controls, the results suggest that these interventions closely interplay with each other, and the costs of controls directly affect the length and strength of each control in an optimal strategy. Copyright © 2015 Elsevier Inc. All rights reserved.

Implementation of brief alcohol interventions by nurses in primary care: do non-clinical factors influence practice?

Science.gov (United States)

Lock, Catherine A; Kaner, Eileen F S

2004-06-01

In the UK, GPs and practice nurses selectively provide brief alcohol interventions to risk drinkers. GPs' provision of a brief alcohol intervention can be predicted by patient characteristics, practitioner characteristics and structural factors such as the features of the practice and how it is organized. However, much less is known about possible modifiers of nurse practice. Our aim was to investigate if patient characteristics, nurse characteristics and practice factors influence provision of a brief alcohol intervention by practice nurses in primary health care. One hundred and twenty-eight practice nurses who had implemented a brief alcohol intervention programme in a previous trial based in the North of England were requested to screen adults presenting to their surgery and follow a structured protocol to give a brief intervention (5 min of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of 5541 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires were collected after a 3-month implementation period and analysed by logistic regression analysis. Although AUDIT identified 1500 'risk' drinkers, only 926 (62%) received a brief intervention. Logistic regression modelling showed that patients' risk status as measured by AUDIT score was the most influential predictor of a brief intervention by practice nurses. However, risk drinkers who were most likely to receive a brief intervention were male. Patients' age or social class did not independently predict a brief intervention. The multilevel model was unable to identify any independent nurse characteristics that could predict a brief intervention, but indicated significant variation between nurses in their tendency to offer the intervention to patients. No structural factors were found to be positively associated with selective provision. Patient and nurse factors contributed to the selective provision of a brief intervention in primary care. If

Advanced medical interventions in pleural disease

Directory of Open Access Journals (Sweden)

Rahul Bhatnagar

2016-06-01

Full Text Available The burden of a number of pleural diseases continues to increase internationally. Although many pleural procedures have historically been the domain of interventional radiologists or thoracic surgeons, in recent years, there has been a marked expansion in the techniques available to the pulmonologist. This has been due in part to both technological advancements and a greater recognition that pleural disease is an important subspecialty of respiratory medicine. This article summarises the important literature relating to a number of advanced pleural interventions, including medical thoracoscopy, the insertion and use of indwelling pleural catheters, pleural manometry, point-of-care thoracic ultrasound, and image-guided closed pleural biopsy. We also aim to inform the reader regarding the latest updates to more established procedures such as chemical pleurodesis, thoracentesis and the management of chest drains, drawing on contemporary data from recent randomised trials. Finally, we shall look to explore the challenges faced by those practicing pleural medicine, especially relating to training, as well as possible future directions for the use and expansion of advanced medical interventions in pleural disease.

Sectoral job training as an intervention to improve health equity.

Science.gov (United States)

Tsui, Emma K

2010-04-01

A growing literature on the social determinants of health strongly suggests the value of examining social policy interventions for their potential links to health equity. I investigate how sectoral job training, an intervention favored by the Obama administration, might be conceptualized as an intervention to improve health equity. Sectoral job training programs ideally train workers, who are typically low income, for upwardly mobile job opportunities within specific industries. I first explore the relationships between resource redistribution and health equity. Next, I discuss how sectoral job training theoretically redistributes resources and the ways in which these resources might translate into improved health. Finally, I make recommendations for strengthening the link between sectoral job training and improved health equity.

Positive psychology interventions in breast cancer. A systematic review.

Science.gov (United States)

Casellas-Grau, Anna; Font, Antoni; Vives, Jaume

2014-01-01

Positive psychology is an emerging area of empirical study, not only in clinical, but also in health psychology. The present systematic review aims to synthesize the evidence about the positive psychology interventions utilized in breast cancer. Relevant studies were identified via Pubmed, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, Wiley Online Library, TDX, and DIALNET databases (up to April 2013). Only those papers focused on interventions related to positive psychology and carried out on breast cancer patients were included. Of the 7266 articles found through databases, 16 studies were finally included in this review. Five groups of therapies were found: mindfulness-based approaches, expression of positive emotions, spiritual interventions, hope therapy, and meaning-making interventions. These specific interventions promoted positive changes in breast cancer participants, such as enhanced quality of life, well-being, hope, benefit finding, or optimism. However, the disparity of the interventions and some methodological issues limit the outcomes. Some studies provided relevant evidence about the clear development of positive aspects from the breast cancer experience. Positive interventions applied to patients and survivors of breast cancer were found to be able to promote positive aspects. A global consensus of a positive therapies classification is needed to take one more step in structuring positive psychology. Copyright © 2013 John Wiley & Sons, Ltd.

Improving attitudes towards children with disabilities in a school context: a cluster randomized intervention study.

Science.gov (United States)

Godeau, Emmanuelle; Vignes, Céline; Sentenac, Mariane; Ehlinger, Virginie; Navarro, Félix; Grandjean, Hélène; Arnaud, Catherine

2010-10-01

although inclusive education of disabled children is now an accepted practice, it is often challenged by negative peer attitudes. We undertook an interventional study aimed at improving students' attitudes towards their disabled peers. the participants were students from the 7th grade of twelve paired schools (1509 students from 62 classes; age 12-13y), randomly allocated to an intervention group (205 males, 285 females) or a control group (132 males, 165 females). The intervention consisted of a mandatory comprehensive educational project on disability. The Chedoke-McMaster Attitudes Towards Children with Handicaps Scale (CATCH) was used to assess children's attitudes before (T0) and after (T1) intervention. The hierarchical structure of the data was taken into account by adjusting standard deviations and using linear multilevel models. seven hundred and eighty-four students had at least one score on the three domains (cognitive, affective, behavioural) of the CATCH at T0 and T1. The final scores were higher than baseline scores (total scores, intervention group: baseline score 25.6 (SD=5.4), final score 26.8 (5.9), pattitudes was found in students from schools with special units for their peers with cognitive impairment for total (p=0.013), affective (pattitudes in the intervention and control groups that could be a result of the nature of the scales and questionnaires the students had to complete before the intervention.

Impact of the Occlusion Duration on the Performance of J-CTO Score in Predicting Failure of Percutaneous Coronary Intervention for Chronic Total Occlusion.

Science.gov (United States)

de Castro-Filho, Antonio; Lamas, Edgar Stroppa; Meneguz-Moreno, Rafael A; Staico, Rodolfo; Siqueira, Dimytri; Costa, Ricardo A; Braga, Sergio N; Costa, J Ribamar; Chamié, Daniel; Abizaid, Alexandre

2017-06-01

The present study examined the association between Multicenter CTO Registry in Japan (J-CTO) score in predicting failure of percutaneous coronary intervention (PCI) correlating with the estimated duration of chronic total occlusion (CTO). The J-CTO score does not incorporate estimated duration of the occlusion. This was an observational retrospective study that involved all consecutive procedures performed at a single tertiary-care cardiology center between January 2009 and December 2014. A total of 174 patients, median age 59.5 years (interquartile range [IQR], 53-65 years), undergoing CTO-PCI were included. The median estimated occlusion duration was 7.5 months (IQR, 4.0-12.0 months). The lesions were classified as easy (score = 0), intermediate (score = 1), difficult (score = 2), and very difficult (score ≥3) in 51.1%, 33.9%, 9.2%, and 5.7% of the patients, respectively. Failure rate significantly increased with higher J-CTO score (7.9%, 20.3%, 50.0%, and 70.0% in groups with J-CTO scores of 0, 1, 2, and ≥3, respectively; PJ-CTO score predicted failure of CTO-PCI independently of the estimated occlusion duration (P=.24). Areas under receiver-operating characteristic curves were computed and it was observed that for each occlusion time period, the discriminatory capacity of the J-CTO score in predicting CTO-PCI failure was good, with a C-statistic >0.70. The estimated duration of occlusion had no influence on the J-CTO score performance in predicting failure of PCI in CTO lesions. The probability of failure was mainly determined by grade of lesion complexity.

Implementing a complex intervention to support personal recovery: a qualitative study nested within a cluster randomised controlled trial.

Directory of Open Access Journals (Sweden)

Mary Leamy

Full Text Available OBJECTIVE: To investigate staff and trainer perspectives on the barriers and facilitators to implementing a complex intervention to help staff support the recovery of service users with a primary diagnosis of psychosis in community mental health teams. DESIGN: Process evaluation nested within a cluster randomised controlled trial (RCT. PARTICIPANTS: 28 interviews with mental health care staff, 3 interviews with trainers, 4 focus groups with intervention teams and 28 written trainer reports. SETTING: 14 community-based mental health teams in two UK sites (one urban, one semi-rural who received the intervention. RESULTS: The factors influencing the implementation of the intervention can be organised under two over-arching themes: Organisational readiness for change and Training effectiveness. Organisational readiness for change comprised three sub-themes: NHS Trust readiness; Team readiness; and Practitioner readiness. Training effectiveness comprised three sub-themes: Engagement strategies; Delivery style and Modelling recovery principles. CONCLUSIONS: Three findings can inform future implementation and evaluation of complex interventions. First, the underlying intervention model predicted that three areas would be important for changing practice: staff skill development; intention to implement; and actual implementation behaviour. This study highlighted the importance of targeting the transition from practitioners' intent to implement to actual implementation behaviour, using experiential learning and target setting. Second, practitioners make inferences about organisational commitment by observing the allocation of resources, Knowledge Performance Indicators and service evaluation outcome measures. These need to be aligned with recovery values, principles and practice. Finally, we recommend the use of organisational readiness tools as an inclusion criteria for selecting both organisations and teams in cluster RCTs. We believe this would

Factors Predicting the Provision of Smoking Cessation Services Among Occupational Health Nurses in Thailand.

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Chatdokmaiprai, Kannikar; Kalampakorn, Surintorn; McCullagh, Marjorie; Lagampan, Sunee; Keeratiwiriyaporn, Sansanee

2017-06-01

The purpose of this study was to identify factors predicting occupational health nurses' provision of smoking cessation services. Data were collected via a self-administered questionnaire distributed to 254 occupational health nurses in Thailand. Analysis by structural equation modeling revealed that self-efficacy directly and positively influenced smoking cessation services, and mediated the relationship between workplace factors, nurse factors, and smoking cessation services. The final model had good fit to the data, accounting for 20.4% and 38.0% of the variance in self-efficacy and smoking cessation services, respectively. The findings show that self-efficacy is a mediator that influences provision of smoking cessation services by occupational health nurses. Interventions to enhance nurses' self-efficacy in providing smoking cessation services are expected to promote provision of smoking cessation services to workers.

Response to intervention in math

CERN Document Server

Riccomini, Paul J

2010-01-01

Boost academic achievement for all students in your mathematics classroom! This timely resource leads the way in applying RTI to mathematics instruction. The authors describe how the three tiers can be implemented in specific math areas and illustrate RTI procedures through case studies. Aligned with the NMAP final report and IES practice guide, this book includes: Intervention strategies for number sense, fractions, problem solving, and more Procedures for teaching math using systematic and explicit instruction for assessment, instructional planning, and evaluation Essential components to con

Supporting Families through Early Intervention

Directory of Open Access Journals (Sweden)

Roy McConkey

2003-09-01

Full Text Available Internationally early intervention programmes for infants and preschoolers with disabilities have proved to be remarkably successful. In many countries, they began with teachers for visually impaired or hearing impaired children visiting the family home to teach parents how they could overcome the child's impairments. The logic of early intervention was inequitable. For example, the sooner children with visual impairments learnt to be independently mobile, then the greater their potential to learn and to kad an ordinary life. In time, this philosophy was extended to children with neurological and developmental delays, such as mental retardation, although success could be variable. In part, many different factors contributed to this variability: the form the interventions took, the extent of family involvement in the intervention and the lack of sensitivity of the measures used to assess a child's progress, to name but three. Perhaps the most extensive and intensive Early intervention schemes have been in the United States with their Head Start programmes. They were aimed at promoting the educational potential of preschoolers from deprived socio - economic backgrounds. Although the first phase of programmes had varying success, those in the second phase yielded impressive results which were mainly attributed to a greater focus on parental participation and links forged with the school system. Recently in developing countries, priority has been given to establishing early intervention as a means of creating new styles of family-based and community-based service in these countries in contrast to the hospital or institutional-services that were a legacy from a previous generation. Although formal evaluations are largely lacking, informal reports have been broadly enthusiastic. In sum, early intervention is no longer a new approach to developmental disabilities. It is an approach of proven effectiveness with children who have different impairments

Wavelet bidomain sample entropy analysis to predict spontaneous termination of atrial fibrillation

International Nuclear Information System (INIS)

Alcaraz, Raúl; Rieta, José Joaquín

2008-01-01

The ability to predict if an atrial fibrillation (AF) episode terminates spontaneously or not through non-invasive techniques is a challenging problem of great clinical interest. This fact could avoid useless therapeutic interventions and minimize the risks for the patient. The present work introduces a robust AF prediction methodology carried out by estimating, through sample entropy (SampEn), the atrial activity (AA) organization increase prior to AF termination from the surface electrocardiogram (ECG). This regularity variation appears as a consequence of the decrease in the number of reentries wandering throughout the atrial tissue. AA was obtained from surface ECG recordings by applying a QRST cancellation technique. Next, a robust and reliable classification process for terminating and non-terminating AF episodes was developed, making use of two different wavelet decomposition strategies. Finally, the AA organization both in time and wavelet domains (bidomain) was estimated via SampEn. The methodology was validated using a training set consisting of 20 AF recordings with known termination properties and a test set of 30 recordings. All the training signals and 93.33% of the test set were correctly classified into terminating and sustained AF, obtaining 93.75% sensitivity and 92.86% specificity. It can be concluded that spontaneous AF termination can be reliably and noninvasively predicted by applying wavelet bidomain sample entropy

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

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Vergidis, Paschalis I; Falagas, Matthew E

2009-06-01

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

Specific attitudes which predict psychology students' intentions to seek help for psychological distress.

Science.gov (United States)

Thomas, Susan J; Caputi, Peter; Wilson, Coralie J

2014-03-01

Although many postgraduate psychology programs address students' mental health, there are compelling indications that earlier, undergraduate, interventions may be optimal. We investigated specific attitudes that predict students' intentions to seek treatment for psychological distress to inform targeted interventions. Psychology students (N = 289; mean age = 19.75 years) were surveyed about attitudes and intentions to seek treatment for stress, anxiety, or depression. Less than one quarter of students reported that they would be likely to seek treatment should they develop psychological distress. Attitudes that predicted help-seeking intentions related to recognition of symptoms and the benefits of professional help, and openness to treatment for emotional problems. The current study identified specific attitudes which predict help-seeking intentions in psychology students. These attitudes could be strengthened in undergraduate educational interventions promoting well-being and appropriate treatment uptake among psychology students. © 2013 Wiley Periodicals, Inc.

Reactive transport predictions for an Olkiluoto. Final repository tunnel unit

International Nuclear Information System (INIS)

Luukkonen, A.; Nordman, H.

2007-09-01

The presented hydrogeochemical reactive transport calculations concentrate to a defined unit piece (unit cell) of the planned Olkiluoto repository that is under design for spent nuclear fuel. The material properties assigned to the tunnel unit are based on literature as far as possible. Calculations make up geochemical future scenarios on the repository evolution. Most recent predictions on the potential future climate at Olkiluoto are utilised together with estimates how future hydraulic conditions affect the repository. Two climate scenarios are considered in detail. The Weichselian-R scenario is based on the repetition of the last glacial cycle, while the Emissions-M scenario attempts to predict the future groundwater conditions at Olkiluoto in the situation where the atmospheric greenhouse gasses delay the next glacial cycle at least for 100,000 years. The groundwater compositions, considered active at the repository depth in future, are judged in this study. Several geochemical processes are considered active at the repository depth. Calculations concentrate on the changes occurring with time within the tunnel unit. All simulations are done in geochemically reducing conditions. It turns out that sulphur cycling in these conditions is in central role considering the safety assessment studies of Olkiluoto repository. Furthermore, groundwater salinity and cation occupancy within the exchange sites of montmorillonite contributes to sealing properties of the engineered barrier system. Calculations attempt to estimate effects of possible future scenarios for the Olkiluoto repository. The results indicate that the buffer capacities assigned to the tunnel unit are large enough, at least to next 100,000 years, to maintain dissolved sulphide contents low in the groundwater infiltrating through the tunnel engineered barrier system. Geochemical reactions raise the bicarbonate levels within the groundwater. This is a useful buffer if low pH conditions emerge in the

LDRD Final Report: Capabilities for Uncertainty in Predictive Science.

Energy Technology Data Exchange (ETDEWEB)

Phipps, Eric Todd; Eldred, Michael S; Salinger, Andrew G.; Webster, Clayton G.

2008-10-01

Predictive simulation of systems comprised of numerous interconnected, tightly coupled com-ponents promises to help solve many problems of scientific and national interest. Howeverpredictive simulation of such systems is extremely challenging due to the coupling of adiverse set of physical and biological length and time scales. This report investigates un-certainty quantification methods for such systems that attempt to exploit their structure togain computational efficiency. The traditional layering of uncertainty quantification aroundnonlinear solution processes is inverted to allow for heterogeneous uncertainty quantificationmethods to be applied to each component in a coupled system. Moreover this approachallows stochastic dimension reduction techniques to be applied at each coupling interface.The mathematical feasibility of these ideas is investigated in this report, and mathematicalformulations for the resulting stochastically coupled nonlinear systems are developed.3

Perioperative Care and the Importance of Continuous Quality Improvement—A Controlled Intervention Study in Three Tanzanian Hospitals

Science.gov (United States)

Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus–Dieter; Spies, Claudia

2015-01-01

Introduction Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. Methods All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Results Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, pimproved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Conclusion Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach. PMID:26327392

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

Science.gov (United States)

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.

Provision of Early Intervention and Special Education Services to Eligible DoD Dependents. Final rule.

Science.gov (United States)

2015-06-25

This rule reissues the current regulations and: Establishes policy, assigns responsibilities, and implements the non-funding and non-reporting provisions in DoD for: Provision of early intervention services (EIS) to infants and toddlers with disabilities and their families, as well as special education and related services to children with disabilities entitled under this part to receive education services from the DoD; implementation of a comprehensive, multidisciplinary program of EIS for infants and toddlers with disabilities and their families who, but for age, are eligible to be enrolled in DoD schools; provision of a free appropriate public education (FAPE), including special education and related services, for children with disabilities, as specified in their individualized education programs (IEP), who are eligible to enroll in DoD schools; and monitoring of DoD programs providing EIS, and special education and related services for compliance with this part. This rule also establishes a DoD Coordinating Committee to recommend policies and provide compliance oversight for early intervention and special education.

Crisis Intervention in Early Adolescence. First Annual Report.

Science.gov (United States)

Adolescence Resources Center, Sumter, SC.

The basic premise under investigation is that systematic intervention in a predictable, natural occurring stress situation for population groups: (1) can promote acquisition of competence and coping skills; and (2) minimize pathological response to stress and eventual need for treatment. This study is an exploration of preadolescent development of…

Final amplifier design and mercury

International Nuclear Information System (INIS)

Rose, E.A.; Hanson, D.E.

1991-01-01

The final amplifier for the Mercury KrF excimer facility is being designed. The design exercise involves extensive modeling to predict amplifier performance. Models of the pulsed-power system, including a Child-Langmuir diode with closure, electron-beam energy deposition, KrF laser kinetics, amplified spontaneous emission (ASE), a time-dependent laser extraction in the presence of ASE are presented as a design package. The design exercise indicates that the energy objective of Phase I -- 100 joules -- will be met

Responsiveness to Intervention in Children with Dyslexia.

Science.gov (United States)

Tilanus, Elisabeth A T; Segers, Eliane; Verhoeven, Ludo

2016-08-01

We examined the responsiveness to a 12-week phonics intervention in 54 s-grade Dutch children with dyslexia, and compared their reading and spelling gains to a control group of 61 typical readers. The intervention aimed to train grapheme-phoneme correspondences (GPCs), and word reading and spelling by using phonics instruction. We examined the accuracy and efficiency of grapheme-phoneme correspondences, decoding words and pseudowords, as well as the accuracy of spelling words before and after the intervention. Moreover, responsiveness to intervention was examined by studying to what extent scores at posttest could directly or indirectly be predicted from precursor measures. Results showed that the children with dyslexia were significantly behind in all reading and spelling measures at pretest. During the intervention, the children with dyslexia made more progress on GPC, (pseudo)word decoding accuracy and efficiency, and spelling accuracy than the typical reading group. Furthermore, we found a direct effect of the precursor measures rapid automatized naming, verbal working memory and phoneme deletion on the dyslexic children's progress in GPC speed, and indirect effects of rapid automatized naming and phoneme deletion on word and pseudoword efficiency and word decoding accuracy via the scores at pretest. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Basic principles for intervention after a nuclear or radiological emergency

International Nuclear Information System (INIS)

Per Hedemann Jensen

1996-01-01

The current status of internationally agreed principles for intervention after a nuclear accident or radiological emergency and the international development of intervention guidance since the Chernobyl accident are reviewed. The experience gained after the Chernobyl accident indicates that the international advice on intervention existing at the time of the Chernobyl accident was not fully understood by decision makers neither in Western Europe nor in the former USSR and that the guidance failed to address adequately the difficult social problems which can arise after a serious nuclear accident. The radiation protection philosophy of today distinguishes between practices and interventions. The radiological protection system of intervention includes justification of the protective action and optimization of the level of protection achieved by that action. Dose limits do not apply in intervention situations. The inputs to justification and optimization studies include factors that are related to radiological protection, whereas the final decisions on introduction of countermeasures would also depend on other factors. The basic principles for intervention as recommended by international organisations are discussed in detail and the application of the principles on a generic basis is illustrated for long-term protective actions. The concepts of intervention level, operational intervention level and action level are presented and the relation between these quantities is illustrated. The numerical guidance on intervention in a nuclear accident or radiological emergency or a chronic exposure situation given by ICRP, IAEA and in the Basic Safety Standards is presented. (author)

DYNAMICS OF POLYMERS AT INTERFACES; FINAL

International Nuclear Information System (INIS)

SMITH, G.S.; MAJEWSKI, J.

1999-01-01

This is the final report of a three-year, Laboratory-Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). This project addresses fundamental questions concerning the behavior of polymers at interfaces: (1) What processes control the formation of an adsorbed layer on a clean surface? (2) What processes control the displacement of preadsorbed polymers? (3) Can one accurately predict the structure of polymer layers? To answer these questions, using neutron reflectivity, we have studied adsorbed layers of the polymer poly(methyl methacrylate) (PMMA) onto a quartz substrate. The polymer density profiles were derived from the neutron reflectivity data. We have shown that dry films exhibit behavior predicted by mean-field theory in that the equilibrated layer thickness scales with the molecular weight of the polymer. Also, we find that the profiles of the polymers in solution qualitatively agree with those predicted by reflected random walk (RRW) theories, yet the profiles are not in quantitative agreement

Written Emotional Expression as an Intervention for Asthma

Science.gov (United States)

Bray, Melissa A.; Theodore, Lea A.; Patwa, Shamim S.; Margiano, Suzanne G.; Alric, Jolie M.; Peck, Heather L.

2003-01-01

This investigation employed a multiple baseline design across five participants to examine written emotional expression as an intervention to improve lung function in high school-aged students, college students, and adults with asthma. The predicted forced expiratory volume in 1 second (FEV[subscript 1] measure of large airway functioning) and…

Implicit Learning Abilities Predict Treatment Response in Autism Spectrum Disorders

Science.gov (United States)

2015-09-01

early behavioral interventions are the most effective treatment for Autism Spectrum Disorder (ASD), but almost half of the children do not make...behavioral intervention . 2. KEYWORDS Autism Spectrum Disorder , implicit learning, associative learning, individual differences, functional Magnetic...2 AWARD NUMBER: W81XWH-14-1-0261 TITLE: Implicit Learning Abilities Predict Treatment Response in Autism Spectrum Disorders PRINCIPAL

Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention

NARCIS (Netherlands)

S.S. Pedersen (Susanne); J. Denollet (Johan); R.A.M. Erdman (Ruud); P.W.J.C. Serruys (Patrick); R.T. van Domburg (Ron)

2009-01-01

textabstractWe examined the impact of co-occurring diabetes and hopelessness on 3-year prognosis in percutaneous coronary intervention patients. Consecutive patients (n = 534) treated with the paclitaxel-eluting stent completed a set of questionnaires at baseline and were followed up for 3-year

The Abdominal Aortic Aneurysm Statistically Corrected Operative Risk Evaluation (AAA SCORE) for predicting mortality after open and endovascular interventions.

Science.gov (United States)

Ambler, Graeme K; Gohel, Manjit S; Mitchell, David C; Loftus, Ian M; Boyle, Jonathan R

2015-01-01

Accurate adjustment of surgical outcome data for risk is vital in an era of surgeon-level reporting. Current risk prediction models for abdominal aortic aneurysm (AAA) repair are suboptimal. We aimed to develop a reliable risk model for in-hospital mortality after intervention for AAA, using rigorous contemporary statistical techniques to handle missing data. Using data collected during a 15-month period in the United Kingdom National Vascular Database, we applied multiple imputation methodology together with stepwise model selection to generate preoperative and perioperative models of in-hospital mortality after AAA repair, using two thirds of the available data. Model performance was then assessed on the remaining third of the data by receiver operating characteristic curve analysis and compared with existing risk prediction models. Model calibration was assessed by Hosmer-Lemeshow analysis. A total of 8088 AAA repair operations were recorded in the National Vascular Database during the study period, of which 5870 (72.6%) were elective procedures. Both preoperative and perioperative models showed excellent discrimination, with areas under the receiver operating characteristic curve of .89 and .92, respectively. This was significantly better than any of the existing models (area under the receiver operating characteristic curve for best comparator model, .84 and .88; P AAA repair. These models were carefully developed with rigorous statistical methodology and significantly outperform existing methods for both elective cases and overall AAA mortality. These models will be invaluable for both preoperative patient counseling and accurate risk adjustment of published outcome data. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

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)

A Systematic Review of Predictors of, and Reasons for, Adherence to Online Psychological Interventions.

Science.gov (United States)

Beatty, Lisa; Binnion, Claire

2016-12-01

A key issue regarding the provision of psychological therapy in a self-guided online format is low rates of adherence. The aim of this systematic review was to assess both quantitative and qualitative data on the predictors of adherence, as well as participant reported reasons for adhering or not adhering to online psychological interventions. Database searches of PsycINFO, Medline, and CINAHL identified 1721 potentially relevant articles published between 1 January 2000 and 25 November 2015. A further 34 potentially relevant articles were retrieved from reference lists. Articles that reported predictors of, or reasons for, adherence to an online psychological intervention were included. A total of 36 studies met the inclusion criteria. Predictors assessed included demographic, psychological, characteristics of presenting problem, and intervention/computer-related predictors. Evidence suggested that female gender, higher treatment expectancy, sufficient time, and personalized intervention content each predicted higher adherence. Age, baseline symptom severity, and control group allocation had mixed findings. The majority of assessed variables however, did not predict adherence. Few clear predictors of adherence emerged overall, and most results were either mixed or too preliminary to draw conclusions. More research of predictors associated with adherence to online interventions is warranted.

A random forest based risk model for reliable and accurate prediction of receipt of transfusion in patients undergoing percutaneous coronary intervention.

Directory of Open Access Journals (Sweden)

Hitinder S Gurm

Full Text Available BACKGROUND: Transfusion is a common complication of Percutaneous Coronary Intervention (PCI and is associated with adverse short and long term outcomes. There is no risk model for identifying patients most likely to receive transfusion after PCI. The objective of our study was to develop and validate a tool for predicting receipt of blood transfusion in patients undergoing contemporary PCI. METHODS: Random forest models were developed utilizing 45 pre-procedural clinical and laboratory variables to estimate the receipt of transfusion in patients undergoing PCI. The most influential variables were selected for inclusion in an abbreviated model. Model performance estimating transfusion was evaluated in an independent validation dataset using area under the ROC curve (AUC, with net reclassification improvement (NRI used to compare full and reduced model prediction after grouping in low, intermediate, and high risk categories. The impact of procedural anticoagulation on observed versus predicted transfusion rates were assessed for the different risk categories. RESULTS: Our study cohort was comprised of 103,294 PCI procedures performed at 46 hospitals between July 2009 through December 2012 in Michigan of which 72,328 (70% were randomly selected for training the models, and 30,966 (30% for validation. The models demonstrated excellent calibration and discrimination (AUC: full model  = 0.888 (95% CI 0.877-0.899, reduced model AUC = 0.880 (95% CI, 0.868-0.892, p for difference 0.003, NRI = 2.77%, p = 0.007. Procedural anticoagulation and radial access significantly influenced transfusion rates in the intermediate and high risk patients but no clinically relevant impact was noted in low risk patients, who made up 70% of the total cohort. CONCLUSIONS: The risk of transfusion among patients undergoing PCI can be reliably calculated using a novel easy to use computational tool (https://bmc2.org/calculators/transfusion. This risk prediction

Earthquake prediction with electromagnetic phenomena

Energy Technology Data Exchange (ETDEWEB)

Hayakawa, Masashi, E-mail: hayakawa@hi-seismo-em.jp [Hayakawa Institute of Seismo Electomagnetics, Co. Ltd., University of Electro-Communications (UEC) Incubation Center, 1-5-1 Chofugaoka, Chofu Tokyo, 182-8585 (Japan); Advanced Wireless & Communications Research Center, UEC, Chofu Tokyo (Japan); Earthquake Analysis Laboratory, Information Systems Inc., 4-8-15, Minami-aoyama, Minato-ku, Tokyo, 107-0062 (Japan); Fuji Security Systems. Co. Ltd., Iwato-cho 1, Shinjyuku-ku, Tokyo (Japan)

2016-02-01

Short-term earthquake (EQ) prediction is defined as prospective prediction with the time scale of about one week, which is considered to be one of the most important and urgent topics for the human beings. If this short-term prediction is realized, casualty will be drastically reduced. Unlike the conventional seismic measurement, we proposed the use of electromagnetic phenomena as precursors to EQs in the prediction, and an extensive amount of progress has been achieved in the field of seismo-electromagnetics during the last two decades. This paper deals with the review on this short-term EQ prediction, including the impossibility myth of EQs prediction by seismometers, the reason why we are interested in electromagnetics, the history of seismo-electromagnetics, the ionospheric perturbation as the most promising candidate of EQ prediction, then the future of EQ predictology from two standpoints of a practical science and a pure science, and finally a brief summary.

The basic reproduction number R0 and effectiveness of reactive interventions during dengue epidemics: the 2002 dengue outbreak in Easter Island, Chile.

Science.gov (United States)

Chowell, Gerardo; Fuentes, R; Olea, A; Aguilera, X; Nesse, H; Hyman, J M

2013-01-01

We use a stochastic simulation model to explore the effect of reactive intervention strategies during the 2002 dengue outbreak in the small population of Easter Island, Chile. We quantified the effect of interventions on the transmission dynamics and epidemic size as a function of the simulated control intensity levels and the timing of initiation of control interventions. Because no dengue outbreaks had been reported prior to 2002 in Easter Island, the 2002 epidemic provided a unique opportunity to estimate the basic reproduction number R0 during the initial epidemic phase, prior to the start of control interventions. We estimated R0 at 27.2 (95%CI: 14.8, 49.3). We found that the final epidemic size is highly sensitive to the timing of start of interventions. However, even when the control interventions start several weeks after the epidemic onset, reactive intervention efforts can have a significant impact on the final epidemic size. Our results indicate that the rapid implementation of control interventions can have a significant effect in reducing the epidemic size of dengue epidemics.

Characterize and Model Final Waste Formulations and Offgas Solids from Thermal Treatment Processes - FY-98 Final Report for LDRD 2349

Energy Technology Data Exchange (ETDEWEB)

Kessinger, Glen Frank; Nelson, Lee Orville; Grandy, Jon Drue; Zuck, Larry Douglas; Kong, Peter Chuen Sun; Anderson, Gail

1999-08-01

The purpose of LDRD #2349, Characterize and Model Final Waste Formulations and Offgas Solids from Thermal Treatment Processes, was to develop a set of tools that would allow the user to, based on the chemical composition of a waste stream to be immobilized, predict the durability (leach behavior) of the final waste form and the phase assemblages present in the final waste form. The objectives of the project were: • investigation, testing and selection of thermochemical code • development of auxiliary thermochemical database • synthesis of materials for leach testing • collection of leach data • using leach data for leach model development • thermochemical modeling The progress toward completion of these objectives and a discussion of work that needs to be completed to arrive at a logical finishing point for this project will be presented.

Animal-Assisted Intervention and Dementia: A Systematic Review.

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Yakimicki, Michelle L; Edwards, Nancy E; Richards, Elizabeth; Beck, Alan M

2018-02-01

This review discusses the relationship between animal-assisted interventions (AAI) and behavioral and psychological symptoms of dementia (BPSD). A systematic search was conducted within CINAHL, Web of Science CAB Abstracts, PubMed, Abstracts in Social Gerontology, Google Scholar, and PsycINFO for primary research articles. A total of 32 studies were included in the final review. Variation was noted in study designs and in study setting. Twenty-seven of 32 studies used dogs as the intervention. Agitation/aggression showed a significant decrease in nine of 15 studies. Eleven of 12 studies demonstrated increased social interaction with AAI. Mood had mixed results in nine studies. Quality of life was increased in three of four studies. Resident activity and nutritional intake were each increased in two studies. Animal assisted activities/interventions showed a strong positive effect on social behaviors, physical activity, and dietary intake in dementia patients and a positive effect on agitation/aggression and quality of life.

Mind-set interventions are a scalable treatment for academic underachievement.

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Paunesku, David; Walton, Gregory M; Romero, Carissa; Smith, Eric N; Yeager, David S; Dweck, Carol S

2015-06-01

The efficacy of academic-mind-set interventions has been demonstrated by small-scale, proof-of-concept interventions, generally delivered in person in one school at a time. Whether this approach could be a practical way to raise school achievement on a large scale remains unknown. We therefore delivered brief growth-mind-set and sense-of-purpose interventions through online modules to 1,594 students in 13 geographically diverse high schools. Both interventions were intended to help students persist when they experienced academic difficulty; thus, both were predicted to be most beneficial for poorly performing students. This was the case. Among students at risk of dropping out of high school (one third of the sample), each intervention raised students' semester grade point averages in core academic courses and increased the rate at which students performed satisfactorily in core courses by 6.4 percentage points. We discuss implications for the pipeline from theory to practice and for education reform. © The Author(s) 2015.

Support to Military or Humanitarian Counterterrorism Interventions: The Effect of Interpersonal and Intergroup Attitudes

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Stefano Passini

2014-01-01

Full Text Available Recently, new interest in terrorism and psychological factors related to supporting the war on terrorism has been growing in the field of psychology. The aim of this study was to examine the effect of various socio-political attitudes on the level of agreement with military and humanitarian counterterrorism interventions. 270 Italian participants responded to a news article concerning measures against terrorism. Half of the participants read an article regarding a military intervention while the other half read about a humanitarian intervention. They then evaluated the other type of intervention. Results showed that military intervention was supported by people with high authoritarian, dominant, ethnocentric attitudes and by people who attach importance to both positive and negative reciprocity norms. Instead, none of these variables was correlated with humanitarian intervention. Finally, there was a considerable influence of media on the acceptance of both interventions.

Predicting performance at medical school: can we identify at-risk students?

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Shaban S

2011-05-01

Full Text Available Sami Shaban, Michelle McLeanDepartment of Medical Education, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab EmiratesBackground: The purpose of this study was to examine the predictive potential of multiple indicators (eg, preadmission scores, unit, module and clerkship grades, course and examination scores on academic performance at medical school, with a view to identifying students at risk.Methods: An analysis was undertaken of medical student grades in a 6-year medical school program at the Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates, over the past 14 years.Results: While high school scores were significantly (P < 0.001 correlated with the final integrated examination, predictability was only 6.8%. Scores for the United Arab Emirates university placement assessment (Common Educational Proficiency Assessment were only slightly more promising as predictors with 14.9% predictability for the final integrated examination. Each unit or module in the first four years was highly correlated with the next unit or module, with 25%–60% predictability. Course examination scores (end of years 2, 4, and 6 were significantly correlated (P < 0.001 with the average scores in that 2-year period (59.3%, 64.8%, and 55.8% predictability, respectively. Final integrated examination scores were significantly correlated (P < 0.001 with National Board of Medical Examiners scores (35% predictability. Multivariate linear regression identified key grades with the greatest predictability of the final integrated examination score at three stages in the program.Conclusion: This study has demonstrated that it may be possible to identify “at-risk” students relatively early in their studies through continuous data archiving and regular analysis. The data analysis techniques used in this study are not unique to this institution.Keywords: at-risk students, grade

Mathematical approaches for complexity/predictivity trade-offs in complex system models : LDRD final report.

Energy Technology Data Exchange (ETDEWEB)

Goldsby, Michael E.; Mayo, Jackson R.; Bhattacharyya, Arnab (Massachusetts Institute of Technology, Cambridge, MA); Armstrong, Robert C.; Vanderveen, Keith

2008-09-01

The goal of this research was to examine foundational methods, both computational and theoretical, that can improve the veracity of entity-based complex system models and increase confidence in their predictions for emergent behavior. The strategy was to seek insight and guidance from simplified yet realistic models, such as cellular automata and Boolean networks, whose properties can be generalized to production entity-based simulations. We have explored the usefulness of renormalization-group methods for finding reduced models of such idealized complex systems. We have prototyped representative models that are both tractable and relevant to Sandia mission applications, and quantified the effect of computational renormalization on the predictive accuracy of these models, finding good predictivity from renormalized versions of cellular automata and Boolean networks. Furthermore, we have theoretically analyzed the robustness properties of certain Boolean networks, relevant for characterizing organic behavior, and obtained precise mathematical constraints on systems that are robust to failures. In combination, our results provide important guidance for more rigorous construction of entity-based models, which currently are often devised in an ad-hoc manner. Our results can also help in designing complex systems with the goal of predictable behavior, e.g., for cybersecurity.

Engaging Mexican Origin Families in a School-Based Preventive Intervention

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Mauricio, Anne M.; Gonzales, Nancy A.; Millsap, Roger E.; Meza, Connie M.; Dumka, Larry E.; Germán, Miguelina; Genalo, M. Toni

2009-01-01

This study describes a culturally sensitive approach to engage Mexican origin families in a school-based, family-focused preventive intervention trial. The approach was evaluated via assessing study enrollment and intervention program participation, as well as examining predictors of engagement at each stage. Incorporating traditional cultural values into all aspects of engagement resulted in participation rates higher than reported rates of minority-focused trials not emphasizing cultural sensitivity. Family preferred language (English or Spanish) or acculturation status predicted engagement at all levels, with less acculturated families participating at higher rates. Spanish-language families with less acculturated adolescents participated at higher rates than Spanish-language families with more acculturated adolescents. Other findings included two-way interactions between family language and the target child’s familism values, family single- vs. dual-parent status, and number of hours the primary parent worked in predicting intervention participation. Editors’ Strategic Implications: The authors present a promising approach—which requires replication—to engaging and retaining Mexican American families in a school-based prevention program. The research also highlights the importance of considering acculturation status when implementing and studying culturally tailored aspects of prevention models. PMID:18004659

The effectiveness of a pressure ulcer intervention program on the prevalence of hospital acquired pressure ulcers: controlled before and after study.

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Mallah, Zeinab; Nassar, Nada; Kurdahi Badr, Lina

2015-05-01

Pressure Ulcers (PUs) are associated with high mortality, morbidity, and health care costs. In addition to being costly, PrUs cause pain, suffering, infection, a lower quality of life, extended hospital stay and even death. Although several nursing interventions have been advocated in the literature, there is a paucity of research on what constitutes the most effective nursing intervention. To determine the efficacy of multidisciplinary intervention and to assess which component of the intervention was most predictive of decreasing the prevalence of Hospital acquired pressure ulcers (HAPU) in a tertiary setting in Lebanon. An evaluation prospective research design was utilized with data before and after the intervention. The sample consisted of 468 patients admitted to the hospital from January 2012 to April 2013. The prevalence of HAPU was significantly reduced from 6.63% in 2012 to 2.47. Sensitivity of the Braden scale in predicting a HAPU was 92.30% and specificity was 60.04%. A logistic multiple regression equation found that two factors significantly predicted the development of a HAPU; skin care and Braden scores. The multidisciplinary approach was effective in decreasing the prevalence of HAPUs. Skin care management which was a significant predictor of PUs should alert nurses to the cost effectiveness of this intervention. Lower Braden scores also were predictive of HAPUs. Published by Elsevier Inc.

Playing Active Video Games may not develop movement skills: An intervention trial

Science.gov (United States)

Barnett, Lisa M.; Ridgers, Nicola D.; Reynolds, John; Hanna, Lisa; Salmon, Jo

2015-01-01

Background: To investigate the impact of playing sports Active Video Games on children's actual and perceived object control skills. Methods: Intervention children played Active Video Games for 6 weeks (1 h/week) in 2012. The Test of Gross Motor Development-2 assessed object control skill. The Pictorial Scale of Perceived Movement Skill Competence assessed perceived object control skill. Repeated measurements of object control and perceived object control were analysed for the whole sample, using linear mixed models, which included fixed effects for group (intervention or control) and time (pre and post) and their interaction. The first model adjusted for sex only and the second model also adjusted for age, and prior ball sports experience (yes/no). Seven mixed-gender focus discussions were conducted with intervention children after programme completion. Results: Ninety-five Australian children (55% girls; 43% intervention group) aged 4 to 8 years (M 6.2, SD 0.95) participated. Object control skill improved over time (p = 0.006) but there was no significant difference (p = 0.913) between groups in improvement (predicted means: control 31.80 to 33.53, SED = 0.748; intervention 30.33 to 31.83, SED = 0.835). A similar result held for the second model. Similarly the intervention did not change perceived object control in Model 1 (predicted means: control: 19.08 to 18.68, SED = 0.362; intervention 18.67 to 18.88, SED = 0.406) or Model 2. Children found the intervention enjoyable, but most did not perceive direct equivalence between Active Video Games and ‘real life’ activities. Conclusions: Whilst Active Video Game play may help introduce children to sport, this amount of time playing is unlikely to build skill. PMID:26844136

Playing Active Video Games may not develop movement skills: An intervention trial

Directory of Open Access Journals (Sweden)

Lisa M. Barnett

2015-01-01

Full Text Available Background: To investigate the impact of playing sports Active Video Games on children's actual and perceived object control skills. Methods: Intervention children played Active Video Games for 6 weeks (1 h/week in 2012. The Test of Gross Motor Development-2 assessed object control skill. The Pictorial Scale of Perceived Movement Skill Competence assessed perceived object control skill. Repeated measurements of object control and perceived object control were analysed for the whole sample, using linear mixed models, which included fixed effects for group (intervention or control and time (pre and post and their interaction. The first model adjusted for sex only and the second model also adjusted for age, and prior ball sports experience (yes/no. Seven mixed-gender focus discussions were conducted with intervention children after programme completion. Results: Ninety-five Australian children (55% girls; 43% intervention group aged 4 to 8 years (M 6.2, SD 0.95 participated. Object control skill improved over time (p = 0.006 but there was no significant difference (p = 0.913 between groups in improvement (predicted means: control 31.80 to 33.53, SED = 0.748; intervention 30.33 to 31.83, SED = 0.835. A similar result held for the second model. Similarly the intervention did not change perceived object control in Model 1 (predicted means: control: 19.08 to 18.68, SED = 0.362; intervention 18.67 to 18.88, SED = 0.406 or Model 2. Children found the intervention enjoyable, but most did not perceive direct equivalence between Active Video Games and ‘real life’ activities. Conclusions: Whilst Active Video Game play may help introduce children to sport, this amount of time playing is unlikely to build skill.

Playing Active Video Games may not develop movement skills: An intervention trial.

Science.gov (United States)

Barnett, Lisa M; Ridgers, Nicola D; Reynolds, John; Hanna, Lisa; Salmon, Jo

2015-01-01

To investigate the impact of playing sports Active Video Games on children's actual and perceived object control skills. Intervention children played Active Video Games for 6 weeks (1 h/week) in 2012. The Test of Gross Motor Development-2 assessed object control skill. The Pictorial Scale of Perceived Movement Skill Competence assessed perceived object control skill. Repeated measurements of object control and perceived object control were analysed for the whole sample, using linear mixed models, which included fixed effects for group (intervention or control) and time (pre and post) and their interaction. The first model adjusted for sex only and the second model also adjusted for age, and prior ball sports experience (yes/no). Seven mixed-gender focus discussions were conducted with intervention children after programme completion. Ninety-five Australian children (55% girls; 43% intervention group) aged 4 to 8 years (M 6.2, SD 0.95) participated. Object control skill improved over time (p = 0.006) but there was no significant difference (p = 0.913) between groups in improvement (predicted means: control 31.80 to 33.53, SED = 0.748; intervention 30.33 to 31.83, SED = 0.835). A similar result held for the second model. Similarly the intervention did not change perceived object control in Model 1 (predicted means: control: 19.08 to 18.68, SED = 0.362; intervention 18.67 to 18.88, SED = 0.406) or Model 2. Children found the intervention enjoyable, but most did not perceive direct equivalence between Active Video Games and 'real life' activities. Whilst Active Video Game play may help introduce children to sport, this amount of time playing is unlikely to build skill.

Predicting and Evaluating the Epidemic Trend of Ebola Virus Disease in the 2014-2015 Outbreak and the Effects of Intervention Measures.

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Zuiyuan Guo

Full Text Available We constructed dynamic Ebola virus disease (EVD transmission models to predict epidemic trends and evaluate intervention measure efficacy following the 2014 EVD epidemic in West Africa. We estimated the effective vaccination rate for the population, with basic reproduction number (R0 as the intermediate variable. Periodic EVD fluctuation was analyzed by solving a Jacobian matrix of differential equations based on a SIR (susceptible, infective, and removed model. A comprehensive compartment model was constructed to fit and predict EVD transmission patterns, and to evaluate the effects of control and prevention measures. Effective EVD vaccination rates were estimated to be 42% (31-50%, 45% (42-48%, and 51% (44-56% among susceptible individuals in Guinea, Liberia and Sierra Leone, respectively. In the absence of control measures, there would be rapid mortality in these three countries, and an EVD epidemic would be likely recur in 2035, and then again 8~9 years later. Oscillation intervals would shorten and outbreak severity would decrease until the periodicity reached ~5.3 years. Measures that reduced the spread of EVD included: early diagnosis, treatment in isolation, isolating/monitoring close contacts, timely corpse removal, post-recovery condom use, and preventing or quarantining imported cases. EVD may re-emerge within two decades without control and prevention measures. Mass vaccination campaigns and control and prevention measures should be instituted to prevent future EVD epidemics.

Prediction of motivational impairment: 12-month follow-up of the randomized-controlled trial on extended early intervention for first-episode psychosis.

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Chang, W C; Kwong, V W Y; Chan, G H K; Jim, O T T; Lau, E S K; Hui, C L M; Chan, S K W; Lee, E H M; Chen, E Y H

2017-03-01

Amotivation is prevalent in first-episode psychosis (FEP) patients and is a major determinant of functional outcome. Prediction of amotivation in the early stage of psychosis, however, is under-studied. We aimed to prospectively examine predictors of amotivation in FEP patients in a randomized-controlled trial comparing a 1-year extension of early intervention (Extended EI, 3-year EI) with step-down psychiatric care (SC, 2-year EI). One hundred sixty Chinese patents were recruited from a specialized EI program for FEP in Hong Kong after they have completed this 2-year EI service, randomly allocated to Extended EI or SC, and followed up for 12 months. Assessments on premorbid adjustment, onset profiles, baseline symptom severity and treatment characteristics were conducted. Data analysis was based on 156 subjects who completed follow-up assessments. Amotivation at 12-month follow-up was associated with premorbid adjustment, allocated treatment condition, and levels of positive symptoms, disorganization, amotivation, diminished expression (DE) and depression at study intake. Hierarchical multiple regression analysis revealed that Extended EI and lower levels of DE independently predicted better outcome on 12-month amotivation. Our findings indicate a potentially critical therapeutic role of an extended specialized EI on alleviating motivational impairment in FEP patients. The longer-term effect of Extended EI on amotivation merits further investigation. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Brief cognitive interventions for burn pain.

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Haythronthwaite, J A; Lawrence, J W; Fauerbach, J A

2001-01-01

This study tested the efficacy of 2 brief cognitive interventions in supplementing regular medical treatment for pain during burn dressing change. Forty-two burn inpatients were randomly assigned to 3 groups: sensory focusing, music distraction, and usual care. Patients reported pain, pain relief satisfaction with pain control, and pain coping strategies. The sensory focusing group reported greater pain relief compared to the music distraction group and a reduction in remembered pain compared to the usual care group, although group differences were not observed on serial pain ratings. In addition, after controlling for burn size and relevant covariates, regression analyses indicated that catastrophizing predicted pain, memory for pain, and satisfaction with pain control. Refinement of the sensory focusing intervention is warranted to reduce catastrophic thinking and improve pain relief

Insights into workplace bullying: psychosocial drivers and effective interventions

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Escartín, Jordi

2016-01-01

on grounded theoretical and methodological approaches. Finally, this systematic review highlights future directions for enhancing the adoption, high-quality implementation, and dissemination of evidence-based workplace bullying prevention and intervention programs. PMID:27382343

Achieving an optimal allocation of resources for animal health surveillance, intervention and disease mitigation.

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Hasler, B; Delabouglise, A; Babo Martins, S

2017-04-01

The primary role of animal health economics is to inform decision-making by determining optimal investments for animal health. Animal health surveillance produces information to guide interventions. Consequently, investments in surveillance and intervention must be evaluated together. This article explores the different theoretical frameworks and methods developed to assess and optimise the spending of resources in surveillance and intervention and their technical interdependence. The authors present frameworks that define the relationship between health investment and losses due to disease, and the relationship between surveillance and intervention resources. Surveillance and intervention are usually considered as technical substitutes, since increased investments in surveillance reduce the level of intervention resources required to reach the same benefit. The authors also discuss approaches used to quantify externalities and non-monetary impacts. Finally, they describe common economic evaluation types, including optimisation, acceptability and least-cost studies.

Predicting child maltreatment: A meta-analysis of the predictive validity of risk assessment instruments.

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

2017-11-01

Risk assessment is crucial in preventing child maltreatment since it can identify high-risk cases in need of child protection intervention. Despite widespread use of risk assessment instruments in child welfare, it is unknown how well these instruments predict maltreatment and what instrument characteristics are associated with higher levels of predictive validity. Therefore, a multilevel meta-analysis was conducted to examine the predictive accuracy of (characteristics of) risk assessment instruments. A literature search yielded 30 independent studies (N=87,329) examining the predictive validity of 27 different risk assessment instruments. From these studies, 67 effect sizes could be extracted. Overall, a medium significant effect was found (AUC=0.681), indicating a moderate predictive accuracy. Moderator analyses revealed that onset of maltreatment can be better predicted than recurrence of maltreatment, which is a promising finding for early detection and prevention of child maltreatment. In addition, actuarial instruments were found to outperform clinical instruments. To bring risk and needs assessment in child welfare to a higher level, actuarial instruments should be further developed and strengthened by distinguishing risk assessment from needs assessment and by integrating risk assessment with case management. Copyright © 2017 Elsevier Ltd. All rights reserved.

Causality and prediction: differences and points of contact

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Luis Carlos Silva Ayçaguer, PhD

2014-09-01

Full Text Available This contribution presents the differences between those variables that might play a causal role in a certain process and those only valuable for predicting the outcome. Some considerations are made about the core intervention of the association and the temporal precedence and biases in both cases, the study of causality and predictive modeling. In that context, several relevant aspects related to the design of the corresponding studies are briefly reviewed and some of the mistakes that are often committed in handling both, causality and prediction, are illustrated.

[Individual, community, regulatory, and systemic approaches to tobacco control interventions].

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Gorini, Giuseppe

2011-01-01

During the 60s and the 70s strategies for decreasing initiation or quitting have been developed, in order to find those with high success rates. Unfortunately, interventions with an individual approach involved few smokers, so their impact in decreasing smoking prevalence was limited. The socio-ecological model offers a theoretical framework to community interventions for smoking cessation developed during the 80s, in which smoking was considered not only an individual, but also a social problem. In the 80s and the 90s smoking cessation community trials were developed, such as the Community Intervention Trial for Smoking Cessation (COMMIT). Afterwards, policy interventions (price policy; smoking bans in public places; advertising bans; bans of sales to minors) were developed, such as the American Stop Smoking Intervention Study for Cancer Prevention (ASSIST). California has been the first State all over the world to develop a comprehensive Tobacco Control Program in 1988, becoming the place for an ever-conducted natural experiment. All policy interventions in tobacco control have been finally grouped together in the World Health Organization - Framework Convention on Tobacco Control (WHO-FCTC), the first Public Health Treaty. Study designs have changed, according to the individual, community, or regulatory approaches: the classical randomized controlled trials (RCTs), in which the sampling unit is the individual, have been carried out for the evaluation of smoking cessation treatments, whereas cluster RCTs, in which the sampling unit is the community, have been conducted for evaluating community interventions, such as COMMIT. Finally, quasi-experimental studies (before/after study; prospective cohorts, both with a control group), in which the observational unit is a State, have been used for evaluating tobacco control policies, such as ASSIST and the International Tobacco Control Policy Evaluation Project. Although the successes of the last 20 years, tobacco

Economic evaluation of targeted cancer interventions: critical review and recommendations.

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Elkin, Elena B; Marshall, Deborah A; Kulin, Nathalie A; Ferrusi, Ilia L; Hassett, Michael J; Ladabaum, Uri; Phillips, Kathryn A

2011-10-01

Scientific advances have improved our ability to target cancer interventions to individuals who will benefit most and spare the risks and costs to those who will derive little benefit or even be harmed. Several approaches are currently used for targeting interventions for cancer risk reduction, screening, and treatment, including risk prediction algorithms for identifying high-risk subgroups and diagnostic tests for tumor markers and germline genetic mutations. Economic evaluation can inform decisions about the use of targeted interventions, which may be more costly than traditional strategies. However, assessing the impact of a targeted intervention on costs and health outcomes requires explicit consideration of the method of targeting. In this study, we describe the importance of this principle by reviewing published cost-effectiveness analyses of targeted interventions in breast cancer. Few studies we identified explicitly evaluated the relationships among the method of targeting, the accuracy of the targeting test, and outcomes of the targeted intervention. Those that did found that characteristics of targeting tests had a substantial impact on outcomes. We posit that the method of targeting and the outcomes of a targeted intervention are inextricably linked and recommend that cost-effectiveness analyses of targeted interventions explicitly consider costs and outcomes of the method of targeting.

Response to intervention as a predictor of long-term reading outcomes in children with dyslexia

NARCIS (Netherlands)

Kleij, S.W. van der; Segers, P.C.J.; Groen, M.A.; Verhoeven, L.T.W.

2017-01-01

The goal of this study was to investigate how growth during a phonics-based intervention, as well as reading levels at baseline testing, predicted long-term reading outcomes of children with dyslexia. Eighty Dutch children with dyslexia who had completed a 50-week phonics-based intervention in grade

Conditional prediction intervals of wind power generation

DEFF Research Database (Denmark)

Pinson, Pierre; Kariniotakis, Georges

2010-01-01

A generic method for the providing of prediction intervals of wind power generation is described. Prediction intervals complement the more common wind power point forecasts, by giving a range of potential outcomes for a given probability, their so-called nominal coverage rate. Ideally they inform...... on the characteristics of prediction errors for providing conditional interval forecasts. By simultaneously generating prediction intervals with various nominal coverage rates, one obtains full predictive distributions of wind generation. Adapted resampling is applied here to the case of an onshore Danish wind farm...... to the case of a large number of wind farms in Europe and Australia among others is finally discussed....

Prediction, Regression and Critical Realism

DEFF Research Database (Denmark)

Næss, Petter

2004-01-01

This paper considers the possibility of prediction in land use planning, and the use of statistical research methods in analyses of relationships between urban form and travel behaviour. Influential writers within the tradition of critical realism reject the possibility of predicting social...... phenomena. This position is fundamentally problematic to public planning. Without at least some ability to predict the likely consequences of different proposals, the justification for public sector intervention into market mechanisms will be frail. Statistical methods like regression analyses are commonly...... seen as necessary in order to identify aggregate level effects of policy measures, but are questioned by many advocates of critical realist ontology. Using research into the relationship between urban structure and travel as an example, the paper discusses relevant research methods and the kinds...

Neurosurgical intervention in patients with mild traumatic brain injury and its effect on neurological outcomes.

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Tierney, Kevin James; Nayak, Natasha V; Prestigiacomo, Charles J; Sifri, Ziad C

2016-02-01

The object of this study was to determine the mortality and neurological outcome of patients with mild traumatic brain injury (mTBI) who require neurosurgical intervention (NSI), identify clinical predictors of a poor outcome, and investigate the effect of failed nonoperative management and delayed NSI on outcome. A cross-sectional study of 10 years was performed, capturing all adults with mTBI and NSI. Primary outcome variables were mortality and Glasgow Outcome Scale (GOS) score. Patients were divided into an immediate intervention group, which received an NSI after the initial cranial CT scan, and a delayed intervention group, which had failed nonoperative management and received an NSI after 2 or more cranial CT scans. The mortality rate in mTBI patients requiring NSI was 13%, and the mean GOS score was 3.6 ± 1.2. An age > 60 years was independently predictive of a worse outcome, and epidural hematoma was independently predictive of a good outcome. Logistic regression analysis using independent variables was calculated to create a model for predicting poor neurological outcomes in patients with mTBI undergoing NSI and had 74.1% accuracy. Patients in the delayed intervention group had worse mortality (25% vs 9%) and worse mean GOS scores (2.9 ± 1.3 vs 3.7 ± 1.2) than those in the immediate intervention group. Data in this study demonstrate that patients with mTBI requiring NSI have higher mortality rates and worse neurological outcomes and should therefore be classified separately from mTBI patients not requiring NSI. Additionally, mTBI patients requiring NSI after the failure of nonoperative management have worse outcomes than those receiving immediate intervention and should be considered separately.

Matching adherence interventions to patient determinants using the Theoretical Domains Framework

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Samuel Sebastian Allemann

2016-11-01

Full Text Available IntroductionDespite much research, interventions to improve medication adherence report disappointing and inconsistent results. Tailored approaches that match interventions and patient determinants of non-adherence were seldom used in clinical trials. The presence of a multitude of theoretical frameworks and models to categorize interventions and patient determinants complicated the development of common categories shared by interventions and determinants. We retrieved potential interventions and patient determinants from published literature on medication adherence, matched them like locks and keys, and categorized them according to the Theoretical Domains Framework (TDF.MethodsWe identified the most relevant literature reviews on interventions and determinants in a pragmatic literature search, extracted all interventions and determinants, grouped similar concepts to umbrella terms and assigned them to TDF categories. All steps were finalized in consensus discussion between the authors.ResultsSixteen articles (5 with determinants, 11 with interventions were included for analysis. We extracted 103 interventions and 42 determinants that we divided in 26 modifiable and 16 unmodifiable determinants. All interventions and modifiable determinants were matched within 11 categories (Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Beliefs about consequences; Intentions; Memory, Attention and decision processes; Environmental context and resources; Social influences; Emotion; and Behavioral regulation.ConclusionIn published trials on medication adherence, the congruence between interventions and determinants can be assessed with matching interventions to determinants. To be successful, interventions in medication adherence should target current modifiable determinants and be tailored to the unmodifiable determinants. Modifiable and unmodifiable determinants need to be assessed at inclusion of intervention studies to

Matching Adherence Interventions to Patient Determinants Using the Theoretical Domains Framework.

Science.gov (United States)

Allemann, Samuel S; Nieuwlaat, Robby; van den Bemt, Bart J F; Hersberger, Kurt E; Arnet, Isabelle

2016-01-01

Introduction: Despite much research, interventions to improve medication adherence report disappointing and inconsistent results. Tailored approaches that match interventions and patient determinants of non-adherence were seldom used in clinical trials. The presence of a multitude of theoretical frameworks and models to categorize interventions and patient determinants complicated the development of common categories shared by interventions and determinants. We retrieved potential interventions and patient determinants from published literature on medication adherence, matched them like locks and keys, and categorized them according to the Theoretical Domains Framework (TDF). Methods: We identified the most relevant literature reviews on interventions and determinants in a pragmatic literature search, extracted all interventions and determinants, grouped similar concepts to umbrella terms and assigned them to TDF categories. All steps were finalized in consensus discussion between the authors. Results: Sixteen articles (5 with determinants, 11 with interventions) were included for analysis. We extracted 103 interventions and 42 determinants that we divided in 26 modifiable and 16 unmodifiable determinants. All interventions and modifiable determinants were matched within 11 categories (Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Beliefs about consequences; Intentions; Memory, Attention and decision processes; Environmental context and resources; Social influences; Emotion; and Behavioral regulation). Conclusion: In published trials on medication adherence, the congruence between interventions and determinants can be assessed with matching interventions to determinants. To be successful, interventions in medication adherence should target current modifiable determinants and be tailored to the unmodifiable determinants. Modifiable and unmodifiable determinants need to be assessed at inclusion of intervention studies to

Predictive Value of CHA2DS2-VASC Score for Contrast-Induced Nephropathy After Percutaneous Coronary Intervention for Acute Coronary Syndrome.

Science.gov (United States)

Kurtul, Alparslan; Yarlioglues, Mikail; Duran, Mustafa

2017-03-15

The CHA2DS2-VASC score, used for embolic risk stratification in atrial fibrillation (AF), has been reported recently to predict adverse clinical outcomes in patients with acute coronary syndrome (ACS), regardless of having AF. We investigated the correlation between the CHA2DS2-VASC score and contrast-induced nephropathy (CIN) in patients with ACS who underwent urgent percutaneous coronary intervention (PCI). A total of 1,408 patients were enrolled in the study. The CHA2DS2-VASC score was calculated for each patient. Based on the receiver operating characteristic analysis, the study population was divided into 2 groups: CHA2DS2-VASC score ≤3 group (n = 944) and CHA2DS2-VASC score ≥4 group (n = 464). Patients were then reallocated to 2 groups according to the presence or absence of CIN. CIN was defined as a rise in serum creatinine >0.5 mg/dl or >25% increase in baseline within 72 hours after PCI. Overall, 159 cases (11.3%) of CIN were diagnosed. Receiver operating characteristic curve analysis revealed good diagnostic value of CHA2DS2-VASC score in predicting CIN (area under the curve 0.769, 95% confidence interval 0.733 to 0.805; p high score had a higher frequency of CIN (23.9% vs 5.1%; p <0.001), and multivariate analysis identified the CHA2DS2-VASC score of ≥4 as an independent predictor of CIN. In conclusion, CHA2DS2-VASC score can be used as a new, simple, and reliable tool to predict CIN in patients with ACS who underwent urgent PCI. Copyright © 2016 Elsevier Inc. All rights reserved.

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

It's Your Place: Development and Evaluation of an Evidence-Based Bystander Intervention Campaign.

Science.gov (United States)

Sundstrom, Beth; Ferrara, Merissa; DeMaria, Andrea L; Gabel, Colby; Booth, Kathleen; Cabot, Jeri

2017-06-28

Preventing sexual assault on college campuses is a national priority. Bystander intervention offers a promising approach to change social norms and prevent sexual misconduct. This study presents the implementation and evaluation of a theory-based campaign to promote active bystander intervention. The theory of planned behavior (TPB) served as a conceptual framework throughout campaign development and evaluation. Formative research published elsewhere was used to develop campaign strategies, communication channels, and messages, including "It is your place to prevent sexual assault: You're not ruining a good time." The It's Your Place multi-media campaign fosters a culture of bystander intervention through peer-to-peer facilitation and training, as well as traditional and new media platforms. A cross-sectional post-test only web-based survey was designed to evaluate the campaign and test the TPB's ability to accurately predict intention to intervene. Survey data were collected from 1,505 currently enrolled students. The TPB model predicted intention to intervene. There was a significant effect of campaign exposure on attitude, subjective norms, and perceived behavioral intention. This theory-based communication campaign offers implications for promoting active bystander intervention and reducing sexual assault.

School Based Multicomponent Intervention for Obese Children in Udupi District, South India - A Randomized Controlled Trial.

Science.gov (United States)

Nayak, Baby S; Bhat, Vinod H

2016-12-01

Childhood obesity and overweight is a global epidemics and has been increasing in the developing countries. Childhood obesity is linked with increased mortality and morbidity independent of adult obesity. Declining physical activity, access to junk food and parenting style are the major determinants of overweight in children. Thus, there is a need for increasing the physical activity of children, educating the parents as well as the children on lifestyle modification. This can be achieved through implementation of multicomponent intervention. To evaluate the effectiveness of multicomponent intervention on improving the lifestyle practices, reducing the body fat and improving the self esteem of obese children from selected schools of Udupi District, South India. A sample of 120 obese children were enrolled for multicomponent intervention. The components of multicomponent intervention were: education provided to the obese children on lifestyle modification, education of the parents and increasing the physical education activity of these children in the form of aerobics under the supervision of physical education teacher. There was an attrition of 25% in the intervention group. Thus the final sample in the intervention group was 90. Total sample of 131 overweight/ obese children enrolled as controls. There was an attrition of 20.61% in the control group. Thus, the final sample in the control group was 104. Intervention group received the multicomponent intervention for six month. Mixed Method Repeated measures Ananlysis of Variance (ANOVA) was applied for analysis of data. Results indicated that the intervention was effective in reducing the Body Mass Index (BMI), triceps, biceps, subscapular skin fold thickness of obese children. The intervention was also effective in improving the lifestyle practices and self-esteem of obese children. Overweight/obese children need to control diet and perform vigorous exercise at least for 20 minutes a day to reduce the excess fat

General predictive control using the delta operator

DEFF Research Database (Denmark)

Jensen, Morten Rostgaard; Poulsen, Niels Kjølstad; Ravn, Ole

1993-01-01

This paper deals with two-discrete-time operators, the conventional forward shift-operator and the δ-operator. Both operators are treated in view of construction of suitable solutions to the Diophantine equation for the purpose of prediction. A general step-recursive scheme is presented. Finally...... a general predictive control (GPC) is formulated and applied adaptively to a continuous-time plant...

PWR [pressurized water reactor] pressurizer transient response: Final report

International Nuclear Information System (INIS)

Murphy, S.I.

1987-08-01

To predict PWR pressurizer transients, Ahl proposed a three region model with a universal coefficient to represent condensation on the water surface. Specifically, this work checks the need for three regions and the modeling of the interfacial condensation coefficient. A computer model has been formulated using the basic mass and energy conservation laws. A two region vapor and liquid model was first used to predict transients run on a one-eleventh scale Freon pressurizer. These predictions verified the need for a second liquid region. As a result, a three region model was developed and used to predict full-scale pressurizer transients at TMI-2, Shippingport, and Stade. Full-scale pressurizer predictions verified the three region model and pointed out the shortcomings of Ahl's universal condensation coefficient. In addition, experiments were run using water at low pressure to study interface condensation. These experiments showed interface condensation to be significant only when spray flow is turned on; this result was incorporated in the final three region model

Understanding predictability and exploration in human mobility

DEFF Research Database (Denmark)

Cuttone, Andrea; Jørgensen, Sune Lehmann; González, Marta C.

2018-01-01

Predictive models for human mobility have important applications in many fields including traffic control, ubiquitous computing, and contextual advertisement. The predictive performance of models in literature varies quite broadly, from over 90% to under 40%. In this work we study which underlying...... strong influence on the accuracy of prediction. Finally we reveal that the exploration of new locations is an important factor in human mobility, and we measure that on average 20-25% of transitions are to new places, and approx. 70% of locations are visited only once. We discuss how these mechanisms...... are important factors limiting our ability to predict human mobility....

The effects of practice on movement distance and final position reproduction: implications for the equilibrium-point control of movements.

Science.gov (United States)

Jaric, S; Corcos, D M; Gottlieb, G L; Ilic, D B; Latash, M L

1994-01-01

Predictions of two views on single-joint motor control, namely programming of muscle force patterns and equilibrium-point control, were compared with the results of experiments with reproduction of movement distance and final location during fast unidirectional elbow flexions. Two groups of subjects were tested. The first group practiced movements over a fixed distance (36 degrees), starting from seven different initial positions (distance group, DG). The second group practiced movements from the same seven initial positions to a fixed final location (location group, LG). Later, all the subjects were tested at the practiced task with their eyes closed, and then, unexpectedly for the subjects, they were tested at the other, unpracticed task. In both groups, the task to reproduce final position had lower indices of final position variability than the task to reproduce movement distance. Analysis of the linear regression lines between initial position and final position (or movement distance) also demonstrated a better (more accurate) performance during final position reproduction than during distance reproduction. The data are in a good correspondence with the predictions of the equilibrium-point hypothesis, but not with the predictions of the force-pattern control approach.

"Teacher, I Can Read!" The Marvels of Early Intervention Strategies

Science.gov (United States)

Murphy, Jean C.; Hernandez, Leonor

2011-01-01

"Teacher, I can read!" exclaimed Saree, a fourth-quarter second grader who was placed in the lowest of reading groups at a southwest side elementary school in Chicago. This was her proud announcement after three weeks of intensive intervention with Ms. Gomez, a student teacher in her final semester at Chicago State University. "Ms.…

Prediction of paroxysmal atrial fibrillation using recurrence plot-based features of the RR-interval signal

International Nuclear Information System (INIS)

Mohebbi, Maryam; Ghassemian, Hassan

2011-01-01

Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke. Predicting the onset of paroxysmal AF (PAF), based on noninvasive techniques, is clinically important and can be invaluable in order to avoid useless therapeutic intervention and to minimize risks for the patients. In this paper, we propose an effective PAF predictor which is based on the analysis of the RR-interval signal. This method consists of three steps: preprocessing, feature extraction and classification. In the first step, the QRS complexes are detected from the electrocardiogram (ECG) signal and then the RR-interval signal is extracted. In the next step, the recurrence plot (RP) of the RR-interval signal is obtained and five statistically significant features are extracted to characterize the basic patterns of the RP. These features consist of the recurrence rate, length of longest diagonal segments (L max  ), average length of the diagonal lines (L mean ), entropy, and trapping time. Recurrence quantification analysis can reveal subtle aspects of dynamics not easily appreciated by other methods and exhibits characteristic patterns which are caused by the typical dynamical behavior. In the final step, a support vector machine (SVM)-based classifier is used for PAF prediction. The performance of the proposed method in prediction of PAF episodes was evaluated using the Atrial Fibrillation Prediction Database (AFPDB) which consists of both 30 min ECG recordings that end just prior to the onset of PAF and segments at least 45 min distant from any PAF events. The obtained sensitivity, specificity, positive predictivity and negative predictivity were 97%, 100%, 100%, and 96%, respectively. The proposed methodology presents better results than other existing approaches

Implementation and testing of the travel time prediction system (TIPS)

OpenAIRE

PANT, Prahlad D; UNIVERSITY OF CINCINNATI

2001-01-01

RAPPORT DE RECHERCHE FINAL The Travel Time Prediction System (TIPS) is a portable automated system for predicting and displaying travel time for motorists in advance of and through freeway construction work zones,on a real-time basis

Healthcare in the Pocket: Mapping the Space of Mobile-Phone Health Interventions

Science.gov (United States)

Klasnja, Predrag; Pratt, Wanda

2011-01-01

Mobile phones are becoming an increasingly important platform for the delivery of health interventions. In recent years, researchers have used mobile phones as tools for encouraging physical activity and healthy diets, for symptom monitoring in asthma and heart disease, for sending patients reminders about upcoming appointments, for supporting smoking cessation, and for a range of other health problems. This paper provides an overview of this rapidly growing body of work. We describe the features of mobile phones that make them a particularly promising platform for health interventions, and we identify five basic intervention strategies that have been used in mobile-phone health applications across different health conditions. Finally, we outline the directions for future research that could increase our understanding of functional and design requirements for the development of highly effective mobile-phone health interventions. PMID:21925288

Manned underwater intervention during deep-water operations

Energy Technology Data Exchange (ETDEWEB)

Lothe, Mikal Sjur

2010-07-01

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

Quality prediction and mistake proofing: An LDRD final report

Energy Technology Data Exchange (ETDEWEB)

McDonald, M.J.

1998-03-01

Sandia National Laboratories is responsible for assuring that the US nuclear deterrent remains credible and that the one in a billion disaster of unintended nuclear detonation never occurs. Letting mistake-generated defects into the stockpile would undermine its mission. The current era of shrinking stockpiles is shrinking Sandia`s opportunities to discover and correct mistakes and fine tune processes over long production runs. In response, Sandia has chosen to develop and use a science-based, life cycle systems engineering practices that, in part, require understanding the design to manufacturing issues in enough detail to tune processes and eliminate mistakes before ever making a part. Defect prevention is a key area of concern that currently lacks sufficient theoretical understanding. This report is the result of a scoping study in the application of best-practice quality techniques that could address Sandia`s stockpile mission. The study provides detail on sources and control of mistakes, poka-yoke or mistake-proofing techniques, the Toyota Production system, and design theory in relation to manufacturing quality prediction. Scoping experiments are described and areas for future research are identified.

Iterative development of MobileMums: a physical activity intervention for women with young children

Directory of Open Access Journals (Sweden)

Fjeldsoe Brianna S

2012-12-01

Full Text Available Abstract Background To describe the iterative development process and final version of ‘MobileMums’: a physical activity intervention for women with young children ( Methods MobileMums development followed the five steps outlined in the mHealth development and evaluation framework: 1 conceptualization (critique of literature and theory; 2 formative research (focus groups, n= 48; 3 pre-testing (qualitative pilot of intervention components, n= 12; 4 pilot testing (pilot RCT, n= 88; and, 5 qualitative evaluation of the refined intervention (n= 6. Results Key findings identified throughout the development process that shaped the MobileMums program were the need for: behaviour change techniques to be grounded in Social Cognitive Theory; tailored SMS content; two-way SMS interaction; rapport between SMS sender and recipient; an automated software platform to generate and send SMS; and, flexibility in location of a face-to-face delivered component. Conclusions The final version of MobileMums is flexible and adaptive to individual participant’s physical activity goals, expectations and environment. MobileMums is being evaluated in a community-based randomised controlled efficacy trial (ACTRN12611000481976.

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

Science.gov (United States)

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.

Short-Term Wind Speed Prediction Using EEMD-LSSVM Model

Directory of Open Access Journals (Sweden)

Aiqing Kang

2017-01-01

Full Text Available Hybrid Ensemble Empirical Mode Decomposition (EEMD and Least Square Support Vector Machine (LSSVM is proposed to improve short-term wind speed forecasting precision. The EEMD is firstly utilized to decompose the original wind speed time series into a set of subseries. Then the LSSVM models are established to forecast these subseries. Partial autocorrelation function is adopted to analyze the inner relationships between the historical wind speed series in order to determine input variables of LSSVM models for prediction of every subseries. Finally, the superposition principle is employed to sum the predicted values of every subseries as the final wind speed prediction. The performance of hybrid model is evaluated based on six metrics. Compared with LSSVM, Back Propagation Neural Networks (BP, Auto-Regressive Integrated Moving Average (ARIMA, combination of Empirical Mode Decomposition (EMD with LSSVM, and hybrid EEMD with ARIMA models, the wind speed forecasting results show that the proposed hybrid model outperforms these models in terms of six metrics. Furthermore, the scatter diagrams of predicted versus actual wind speed and histograms of prediction errors are presented to verify the superiority of the hybrid model in short-term wind speed prediction.

Insights into workplace bullying: psychosocial drivers and effective interventions

Directory of Open Access Journals (Sweden)

Escartín J

2016-06-01

antibullying interventions must flourish and be improved, requiring close cooperation between practitioners and academics to design, implement, and evaluate effective interventions based on grounded theoretical and methodological approaches. Finally, this systematic review highlights future directions for enhancing the adoption, high-quality implementation, and dissemination of evidence-based workplace bullying prevention and intervention programs. Keywords: evaluation, intervention programs, systematic review, training, violence prevention, workplace bullying 

Predictive modelling of Ross River virus notifications in southeastern Australia.

Science.gov (United States)

Cutcher, Z; Williamson, E; Lynch, S E; Rowe, S; Clothier, H J; Firestone, S M

2017-02-01

Ross River virus (RRV) is a mosquito-borne virus endemic to Australia. The disease, marked by arthritis, myalgia and rash, has a complex epidemiology involving several mosquito species and wildlife reservoirs. Outbreak years coincide with climatic conditions conducive to mosquito population growth. We developed regression models for human RRV notifications in the Mildura Local Government Area, Victoria, Australia with the objective of increasing understanding of the relationships in this complex system, providing trigger points for intervention and developing a forecast model. Surveillance, climatic, environmental and entomological data for the period July 2000-June 2011 were used for model training then forecasts were validated for July 2011-June 2015. Rainfall and vapour pressure were the key factors for forecasting RRV notifications. Validation of models showed they predicted RRV counts with an accuracy of 81%. Two major RRV mosquito vectors (Culex annulirostris and Aedes camptorhynchus) were important in the final estimation model at proximal lags. The findings of this analysis advance understanding of the drivers of RRV in temperate climatic zones and the models will inform public health agencies of periods of increased risk.

Pre-treatment amygdala volume predicts electroconvulsive therapy response

NARCIS (Netherlands)

ten Doesschate, Freek; van Eijndhoven, Philip; Tendolkar, Indira; van Wingen, Guido A.; van Waarde, Jeroen A.

2014-01-01

Electroconvulsive therapy (ECT) is an effective treatment for patients with severe depression. Knowledge on factors predicting therapeutic response may help to identify patients who will benefit most from the intervention. Based on the neuroplasticity hypothesis, volumes of the amygdala and

Baseline Gray- and White Matter Volume Predict Successful Weight Loss in the Elderly

Science.gov (United States)

Mokhtari, Fatemeh; Paolini, Brielle M.; Burdette, Jonathan H.; Marsh, Anthony P.; Rejeski, W. Jack; Laurienti, Paul J.

2016-01-01

Objective The purpose of this study is to investigate if structural brain phenotypes can be used to predict weight loss success following behavioral interventions in older adults that are overweight or obese and have cardiometabolic dysfunction. Methods A support vector machine (SVM) with a repeated random subsampling validation approach was used to classify participants into the upper and lower halves of the weight loss distribution following 18 months of a weight loss intervention. Predictions were based on baseline brain gray matter (GM) and white matter (WM) volume from 52 individuals that completed the intervention and a magnetic resonance imaging session. Results The SVM resulted in an average classification accuracy of 72.62 % based on GM and WM volume. A receiver operating characteristic analysis indicated that classification performance was robust based on an area under the curve of 0.82. Conclusions Our findings suggest that baseline brain structure is able to predict weight loss success following 18 months of treatment. The identification of brain structure as a predictor of successful weight loss is an innovative approach to identifying phenotypes for responsiveness to intensive lifestyle interventions. This phenotype could prove useful in future research focusing on the tailoring of treatment for weight loss. PMID:27804273

Life prediction methodology for ceramic components of advanced vehicular heat engines: Volume 1. Final report

Energy Technology Data Exchange (ETDEWEB)

Khandelwal, P.K.; Provenzano, N.J.; Schneider, W.E. [Allison Engine Co., Indianapolis, IN (United States)

1996-02-01

One of the major challenges involved in the use of ceramic materials is ensuring adequate strength and durability. This activity has developed methodology which can be used during the design phase to predict the structural behavior of ceramic components. The effort involved the characterization of injection molded and hot isostatic pressed (HIPed) PY-6 silicon nitride, the development of nondestructive evaluation (NDE) technology, and the development of analytical life prediction methodology. Four failure modes are addressed: fast fracture, slow crack growth, creep, and oxidation. The techniques deal with failures initiating at the surface as well as internal to the component. The life prediction methodology for fast fracture and slow crack growth have been verified using a variety of confirmatory tests. The verification tests were conducted at room and elevated temperatures up to a maximum of 1371 {degrees}C. The tests involved (1) flat circular disks subjected to bending stresses and (2) high speed rotating spin disks. Reasonable correlation was achieved for a variety of test conditions and failure mechanisms. The predictions associated with surface failures proved to be optimistic, requiring re-evaluation of the components` initial fast fracture strengths. Correlation was achieved for the spin disks which failed in fast fracture from internal flaws. Time dependent elevated temperature slow crack growth spin disk failures were also successfully predicted.

Prediction model of critical weight loss in cancer patients during particle therapy.

Science.gov (United States)

Zhang, Zhihong; Zhu, Yu; Zhang, Lijuan; Wang, Ziying; Wan, Hongwei

2018-01-01

The objective of this study is to investigate the predictors of critical weight loss in cancer patients receiving particle therapy, and build a prediction model based on its predictive factors. Patients receiving particle therapy were enroled between June 2015 and June 2016. Body weight was measured at the start and end of particle therapy. Association between critical weight loss (defined as >5%) during particle therapy and patients' demographic, clinical characteristic, pre-therapeutic nutrition risk screening (NRS 2002) and BMI were evaluated by logistic regression and decision tree analysis. Finally, 375 cancer patients receiving particle therapy were included. Mean weight loss was 0.55 kg, and 11.5% of patients experienced critical weight loss during particle therapy. The main predictors of critical weight loss during particle therapy were head and neck tumour location, total radiation dose ≥70 Gy on the primary tumour, and without post-surgery, as indicated by both logistic regression and decision tree analysis. Prediction model that includes tumour locations, total radiation dose and post-surgery had a good predictive ability, with the area under receiver operating characteristic curve 0.79 (95% CI: 0.71-0.88) and 0.78 (95% CI: 0.69-0.86) for decision tree and logistic regression model, respectively. Cancer patients with head and neck tumour location, total radiation dose ≥70 Gy and without post-surgery were at higher risk of critical weight loss during particle therapy, and early intensive nutrition counselling or intervention should be target at this population. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Current Controversies in the Prediction, Diagnosis, and Management of Cerebral Vasospasm: Where Do We Stand?

Directory of Open Access Journals (Sweden)

Young Lee

2013-01-01

Full Text Available Aneurysmal subarachnoid hemorrhage occurs in approximately 30,000 persons in the United States each year. Around 30 percent of patients with aneurysmal subarachnoid hemorrhage suffer from cerebral ischemia and infarction due to cerebral vasospasm, a leading cause of treatable death and disability following aneurysmal subarachnoid hemorrhage. Methods used to predict, diagnose, and manage vasospasm are the topic of recent active research. This paper utilizes a comprehensive review of the recent literature to address controversies surrounding these topics. Evidence regarding the effect of age, smoking, and cocaine use on the incidence and outcome of vasospasm is reviewed. The abilities of different computed tomography grading schemes to predict vasospasm in the aftermath of subarachnoid hemorrhage are presented. Additionally, the utility of different diagnostic methods for the detection and visualization of vasospasm, including transcranial Doppler ultrasonography, CT angiography, digital subtraction angiography, and CT perfusion imaging is discussed. Finally, the recent literature regarding interventions for the prophylaxis and treatment of vasospasm, including hyperdynamic therapy, albumin, calcium channel agonists, statins, magnesium sulfate, and endothelin antagonists is summarized. Recent studies regarding each topic were reviewed for consensus recommendations from the literature, which were then presented.

Current controversies in the prediction, diagnosis, and management of cerebral vasospasm: where do we stand?

Science.gov (United States)

Lee, Young; Zuckerman, Scott L; Mocco, J

2013-01-01

Aneurysmal subarachnoid hemorrhage occurs in approximately 30,000 persons in the United States each year. Around 30 percent of patients with aneurysmal subarachnoid hemorrhage suffer from cerebral ischemia and infarction due to cerebral vasospasm, a leading cause of treatable death and disability following aneurysmal subarachnoid hemorrhage. Methods used to predict, diagnose, and manage vasospasm are the topic of recent active research. This paper utilizes a comprehensive review of the recent literature to address controversies surrounding these topics. Evidence regarding the effect of age, smoking, and cocaine use on the incidence and outcome of vasospasm is reviewed. The abilities of different computed tomography grading schemes to predict vasospasm in the aftermath of subarachnoid hemorrhage are presented. Additionally, the utility of different diagnostic methods for the detection and visualization of vasospasm, including transcranial Doppler ultrasonography, CT angiography, digital subtraction angiography, and CT perfusion imaging is discussed. Finally, the recent literature regarding interventions for the prophylaxis and treatment of vasospasm, including hyperdynamic therapy, albumin, calcium channel agonists, statins, magnesium sulfate, and endothelin antagonists is summarized. Recent studies regarding each topic were reviewed for consensus recommendations from the literature, which were then presented.

The Association between Expressive Grammar Intervention and Social and Emergent Literacy Outcomes for Preschoolers with SLI

Science.gov (United States)

Washington, Karla N.

2013-01-01

Purpose: To determine whether (a) expressive grammar intervention facilitated social and emergent literacy outcomes better than no intervention and (b) expressive grammar gains and/or initial expressive grammar level predicted social and emergent literacy outcomes. Method: This investigation was a follow-up to a recently published study exploring…

Structure strategy interventions: Increasing reading comprehension of expository text

Directory of Open Access Journals (Sweden)

Bonnie J. F. MEYER

2011-11-01

Full Text Available In this review of the literature we examine empirical studies designed to teach the structure strategy to increase reading comprehension of expository texts. First, we review the research that has served as a foundation for many of the studies examining the effects of text structure instruction. Text structures generally can be grouped into six categories: comparison, problem-and solution, causation, sequence, collection, and description. Next, we provide a historical look at research of structure strategyinterventions. Strategy interventions employ modeling, practice, and feedback to teach students how to use text structure strategically and eventually automatically. Finally, we review recent text structure interventions for elementary school students. We present similarities and differences among these studies and applications for instruction. Our review of intervention research suggests that direct instruction, modeling, scaffolding, elaborated feedback, and adaptation of instruction to student performance are keys in teaching students to strategically use knowledge about text structure.

A GROUP INTERVENTION PROGRAMME FOR ADULT SURVIVORS OF CHILDHOOD SEXUAL ABUSE

Directory of Open Access Journals (Sweden)

Fouché, Ansie

2016-10-01

Full Text Available This study reports on the core components of the Survivor to Thriver strengths-based group intervention programme for women who experienced childhood sexual abuse. It advocates a balanced approach and draws on an eclectic mix of theories, and has been field tested with two groups of women. An exposition of the philosophical and theoretical underpinnings, a description of the context, the role of the expert companion, outcomes and activities of the programme, evaluation methods and standard of care is provided. Finally, critical reflections on the intervention are discussed as well as limitations and the way forward.

Poverty, Stress, and Brain Development: New Directions for Prevention and Intervention

Science.gov (United States)

Blair, Clancy; Raver, C. Cybele

2018-01-01

We review some of the growing evidence of the costs of poverty to children’s neuroendocrine function, early brain development, and cognitive ability. We underscore the importance of addressing the negative consequences of poverty-related adversity early in children’s lives, given evidence supporting the plasticity of executive functions and associated physiologic processes in response to early intervention and the importance of higher order cognitive functions for success in school and in life. Finally, we highlight some new directions for prevention and intervention that are rapidly emerging at the intersection of developmental science, pediatrics, child psychology and psychiatry, and public policy. PMID:27044699

Predicting visibility of aircraft.

Directory of Open Access Journals (Sweden)

Andrew Watson

Full Text Available Visual detection of aircraft by human observers is an important element of aviation safety. To assess and ensure safety, it would be useful to be able to be able to predict the visibility, to a human observer, of an aircraft of specified size, shape, distance, and coloration. Examples include assuring safe separation among aircraft and between aircraft and unmanned vehicles, design of airport control towers, and efforts to enhance or suppress the visibility of military and rescue vehicles. We have recently developed a simple metric of pattern visibility, the Spatial Standard Observer (SSO. In this report we examine whether the SSO can predict visibility of simulated aircraft images. We constructed a set of aircraft images from three-dimensional computer graphic models, and measured the luminance contrast threshold for each image from three human observers. The data were well predicted by the SSO. Finally, we show how to use the SSO to predict visibility range for aircraft of arbitrary size, shape, distance, and coloration.

Nonpharmaceutical Interventions for Military Populations During Pandemic Influenza

Directory of Open Access Journals (Sweden)

Selim Kilic

2007-08-01

Full Text Available Influenza causes substantial illness and loss of work days among young adults, and outbreaks can affect the preparedness of military units. In an influenza pandemic, people who live in confined settings have greater risk of infection. Military trainees are at particularly high risk. Because of likely unavailability of vaccines and antiviral drugs at the start of a pandemic and for many months thereafter, nonpharmaceutical interventions may be very important. During a pandemic, it seems prudent that military public health officials employ at least several nonpharmaceutical interventions. For example frequent handwashing and respiratory hygiene/cough etiquette should be strongly encouraged among soldiers. Head-to-toe sleeping, a “no-cost” intervention should be for crowded berthing areas. Isolation of patients with influenza and quarantine of their close contacts should be employed. Masks and alcohol-based hand rubs may be employed among those at highest risk. Finally, whenever possible military planners should, reduce crowding and limit the interaction of training cohorts to reduce risk of influenza virus transmission. [TAF Prev Med Bull. 2007; 6(4: 285-290

Immediate outcome indicators in perioperative care: a controlled intervention study on quality improvement in hospitals in Tanzania.

Science.gov (United States)

Bosse, Goetz; Mtatifikolo, Ferdinand; Abels, Wiltrud; Strosing, Christian; Breuer, Jan-Philipp; Spies, Claudia

2013-01-01

Outcome assessment is the standard for evaluating the quality of health services worldwide. In this study, outcome has been divided into immediate and final outcome. Aim was to compare an intervention hospital with a Continuous Quality Improvement approach to a control group using benchmark assessments of immediate outcome indicators in surgical care. Results were compared to final outcome indicators. Surgical care quality in six hospitals in Tanzania was assessed from 2006-2011, using the Hospital Performance Assessment Tool. Independent observers assessed structural, process and outcome quality using checklists based on evidence-based guidelines. The number of surgical key procedures over the benchmark of 80% was compared between the intervention hospital and the control group. Results were compared to Case Fatality Rates. In the intervention hospital, in 2006, two of nine key procedures reached the benchmark, one in 2009, and four in 2011. In the control group, one of nine key procedures reached the benchmark in 2006, one in 2009, and none in 2011. Case Fatality Rate for all in-patients in the intervention hospital was 5.5% (n = 12,530) in 2006, 3.5% (n = 21,114) in 2009 and 4.6% (n = 18,840) in 2011. In the control group it was 3.1% (n = 17,827) in 2006, 4.2% (n = 13,632) in 2009 and 3.8% (n = 17,059) in 2011. Results demonstrated that quality assurance improved performance levels in both groups. After the introduction of Continuous Quality Improvement, performance levels improved further in the intervention hospital while quality in the district hospital did not. Immediate outcome indicators appeared to be a better steering tool for quality improvement compared to final outcome indicators. Immediate outcome indicators revealed a need for improvement in pre- and postoperative care. Quality assurance programs based on immediate outcome indicators can be effective if embedded in Continuous Quality Improvement. Nevertheless, final outcome

Effect of Repeated/Spaced Formative Assessments on Medical School Final Exam Performance

Directory of Open Access Journals (Sweden)

Edward K. Chang

2017-06-01

Discussion: Performance on weekly formative assessments was predictive of final exam scores. Struggling medical students will benefit from extra cumulative practice exams while students who are excelling do not need extra practice.

Designing and Undertaking a Health Economics Study of Digital Health Interventions.

Science.gov (United States)

McNamee, Paul; Murray, Elizabeth; Kelly, Michael P; Bojke, Laura; Chilcott, Jim; Fischer, Alastair; West, Robert; Yardley, Lucy

2016-11-01

This paper introduces and discusses key issues in the economic evaluation of digital health interventions. The purpose is to stimulate debate so that existing economic techniques may be refined or new methods developed. The paper does not seek to provide definitive guidance on appropriate methods of economic analysis for digital health interventions. This paper describes existing guides and analytic frameworks that have been suggested for the economic evaluation of healthcare interventions. Using selected examples of digital health interventions, it assesses how well existing guides and frameworks align to digital health interventions. It shows that digital health interventions may be best characterized as complex interventions in complex systems. Key features of complexity relate to intervention complexity, outcome complexity, and causal pathway complexity, with much of this driven by iterative intervention development over time and uncertainty regarding likely reach of the interventions among the relevant population. These characteristics imply that more-complex methods of economic evaluation are likely to be better able to capture fully the impact of the intervention on costs and benefits over the appropriate time horizon. This complexity includes wider measurement of costs and benefits, and a modeling framework that is able to capture dynamic interactions among the intervention, the population of interest, and the environment. The authors recommend that future research should develop and apply more-flexible modeling techniques to allow better prediction of the interdependency between interventions and important environmental influences. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study.

Science.gov (United States)

Chatterjee, Sudeshna; Ray, Krishnangshu; Das, Anup Kumar

2016-01-01

1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. Comparative, cross-sectional and non-interventional study. It is retrospective, record-based study conducted upon inpatients ( n = 200) of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. Comparative analysis of specific and selective gaps were estimated in terms of percentage (%). Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care.

Executive function processes predict mobility outcomes in older adults.

Science.gov (United States)

Gothe, Neha P; Fanning, Jason; Awick, Elizabeth; Chung, David; Wójcicki, Thomas R; Olson, Erin A; Mullen, Sean P; Voss, Michelle; Erickson, Kirk I; Kramer, Arthur F; McAuley, Edward

2014-02-01

To examine the relationship between performance on executive function measures and subsequent mobility outcomes in community-dwelling older adults. Randomized controlled clinical trial. Champaign-Urbana, Illinois. Community-dwelling older adults (N = 179; mean age 66.4). A 12-month exercise trial with two arms: an aerobic exercise group and a stretching and strengthening group. Established cognitive tests of executive function (flanker task, task switching, and a dual-task paradigm) and the Wisconsin card sort test. Mobility was assessed using the timed 8-foot up and go test and times to climb up and down a flight of stairs. Participants completed the cognitive tests at baseline and the mobility measures at baseline and after 12 months of the intervention. Multiple regression analyses were conducted to determine whether baseline executive function predicted postintervention functional performance after controlling for age, sex, education, cardiorespiratory fitness, and baseline mobility levels. Selective baseline executive function measurements, particularly performance on the flanker task (β = 0.15-0.17) and the Wisconsin card sort test (β = 0.11-0.16) consistently predicted mobility outcomes at 12 months. The estimates were in the expected direction, such that better baseline performance on the executive function measures predicted better performance on the timed mobility tests independent of intervention. Executive functions of inhibitory control, mental set shifting, and attentional flexibility were predictive of functional mobility. Given the literature associating mobility limitations with disability, morbidity, and mortality, these results are important for understanding the antecedents to poor mobility function that well-designed interventions to improve cognitive performance can attenuate. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Gender differences in condom use prediction with Theory of Reasoned Action and Planned Behaviour: the role of self-efficacy and control.

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Muñoz-Silva, A; Sánchez-García, M; Nunes, C; Martins, A

2007-10-01

There is much evidence that demonstrates that programs and interventions based on the theoretical models of the Theory of Reasoned Action (TRA) and the Theory of Planned Behaviour (TPB) have been effective in the prevention of the sexual transmission of HIV. The objective of this work is to compare the effectiveness of both models in the prediction of condom use, distinguishing two components inside the variable Perceived Behavioural Control of the TPB model: self-efficacy and control. The perspective of gender differences is also added. The study was carried out in a sample of 601 Portuguese and Spanish university students. The results show that the females have a higher average in all the TPB variables than males, except in the frequency of condom use: females request the use of condoms less frequently than males. On the other hand, for both females and males the TPB model predicts better condom-use intention than the TRA. However there are no differences between the two models in relation to the prediction of condom-use behaviour. For prediction of intention, the most outstanding variable among females is attitude, while among males they are subjective norm and self-efficacy. Finally, we analyze the implications of these data from a theoretical and practical point of view.

Applications of contact predictions to structural biology

Directory of Open Access Journals (Sweden)

Felix Simkovic

2017-05-01

methods. Finally, predicted contacts can distinguish between biologically relevant interfaces and mere lattice contacts in a final crystal structure, and have potential in the identification of functionally important regions and in foreseeing the consequences of mutations.

Simultaneous 3D–2D image registration and C-arm calibration: Application to endovascular image-guided interventions

Energy Technology Data Exchange (ETDEWEB)

Mitrović, Uroš [Faculty of Electrical Engineering, University of Ljubljana, Tržaška 25, Ljubljana 1000, Slovenia and Cosylab, Control System Laboratory, Teslova ulica 30, Ljubljana 1000 (Slovenia); Pernuš, Franjo [Faculty of Electrical Engineering, University of Ljubljana, Tržaška 25, Ljubljana 1000 (Slovenia); Likar, Boštjan; Špiclin, Žiga, E-mail: ziga.spiclin@fe.uni-lj.si [Faculty of Electrical Engineering, University of Ljubljana, Tržaška 25, Ljubljana 1000, Slovenia and Sensum, Computer Vision Systems, Tehnološki Park 21, Ljubljana 1000 (Slovenia)

2015-11-15

Purpose: Three-dimensional to two-dimensional (3D–2D) image registration is a key to fusion and simultaneous visualization of valuable information contained in 3D pre-interventional and 2D intra-interventional images with the final goal of image guidance of a procedure. In this paper, the authors focus on 3D–2D image registration within the context of intracranial endovascular image-guided interventions (EIGIs), where the 3D and 2D images are generally acquired with the same C-arm system. The accuracy and robustness of any 3D–2D registration method, to be used in a clinical setting, is influenced by (1) the method itself, (2) uncertainty of initial pose of the 3D image from which registration starts, (3) uncertainty of C-arm’s geometry and pose, and (4) the number of 2D intra-interventional images used for registration, which is generally one and at most two. The study of these influences requires rigorous and objective validation of any 3D–2D registration method against a highly accurate reference or “gold standard” registration, performed on clinical image datasets acquired in the context of the intervention. Methods: The registration process is split into two sequential, i.e., initial and final, registration stages. The initial stage is either machine-based or template matching. The latter aims to reduce possibly large in-plane translation errors by matching a projection of the 3D vessel model and 2D image. In the final registration stage, four state-of-the-art intrinsic image-based 3D–2D registration methods, which involve simultaneous refinement of rigid-body and C-arm parameters, are evaluated. For objective validation, the authors acquired an image database of 15 patients undergoing cerebral EIGI, for which accurate gold standard registrations were established by fiducial marker coregistration. Results: Based on target registration error, the obtained success rates of 3D to a single 2D image registration after initial machine-based and

Influence of year-on-year performance on final degree classification in a chiropractic master's degree program.

Science.gov (United States)

Dewhurst, Philip; Rix, Jacqueline; Newell, David

2016-03-01

We explored if any predictors of success could be identified from end-of-year grades in a chiropractic master's program and whether these grades could predict final-year grade performance and year-on-year performance. End-of-year average grades and module grades for a single cohort of students covering all academic results for years 1-4 of the 2013 graduating class were used for this analysis. Analysis consisted of within-year correlations of module grades with end-of-year average grades, linear regression models for continuous data, and logistic regression models for predicting final degree classifications. In year 1, 140 students were enrolled; 85.7% of students completed the program 4 years later. End-of-year average grades for years 1-3 were correlated (Pearson r values ranging from .75 to .87), but the end-of-year grades for years 1-3 were poorly correlated with clinic internship performance. In linear regression, several modules were predictive of end-of-year average grades for each year. For year 1, logistic regression showed that the modules Physiology and Pharmacology and Investigative Imaging were predictive of year 1 performance (odds ratio [OR] = 1.15 and 0.9, respectively). In year 3, the modules Anatomy and Histopathology 3 and Problem Solving were predictors of the difference between a pass/merit or distinction final degree classification (OR = 1.06 and 1.12, respectively). Early academic performance is weakly correlated with final-year clinic internship performance. The modules of Anatomy and Histopathology year 3 and Problem Solving year 3 emerged more consistently than other modules as being associated with final-year classifications.

Evaluating health effects of transport interventions methodologic case study.

Science.gov (United States)

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

2006-08-01

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

Final-state interactions and relativistic effects in the quasielastic (e,e') reaction

International Nuclear Information System (INIS)

Chinn, C.R.; Physics Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545); Picklesimer, A.; Van Orden, J.W.

1989-01-01

The longitudinal and transverse response functions for the inclusive quasielastic (e,e') reaction are analyzed in detail. A microscopic theoretical framework for the many-body reaction provides a clear conceptual (nonrelativistic) basis for treating final-state interactions and goes far beyond simple plane-wave or Hermitean potential models. The many-body physics of inelastic final-state channels as described by optical and multiple scattering theories is properly included by incorporating a full complex optical potential. Explicit nonrelativistic and relativistic momentum-space calculations quantitatively demonstrate the importance of such a treatment of final-state interactions for both the transverse and longitudinal response. Nonrelativistic calculations are performed using final-state interactions based on phenomenology, local density models, and microscopic multiple scattering theory. Relativistic calculations span a similar range of models and employ Dirac bound-state wave functions. The theoretical extension to relativistic dynamics is of course not clear, but is done in obvious parallel to elastic proton scattering. Extensive calculations are performed for 40 Ca at momentum transfers of 410, 550, and 700 MeV/c. A number of interesting physical effects are observed, including significant relativistic suppressions (especially for R L ), large off-shell and virtual pair effects, enhancement of the tails of the response by the final-state interactions, and large qualitative and even shape distinctions between the predictions of the various models of the final-state interactions. None of the models is found to be able to simultaneously predict the data for both response functions. This strongly suggests that additional physical mechanisms are of qualitative importance in inclusive quasielastic electron scattering

Predictive maintenance: A new approach in maintenance of nuclear power plants

International Nuclear Information System (INIS)

Benvenuto, F.; Ferrari, L.

2005-01-01

The maintenance services for a Nuclear Power Plant are in general aimed at reaching the following goals: - Increase component availability and consequently decrease intervention frequency; - Reduce unexpected costs from unexpected repairs; - Progressively decrease the time of each intervention; - Improve the spare parts supply efficiency; - Improve spare parts and consumable warehouse managing; - Decrease maintenance costs. Most of the currently used maintenance activities refer to run-to-failure or preventive approaches: - Run-to-failure or Corrective Maintenance means that work is only carried out when a component or system is faulty and unable to perform its critical function. Non critical components such as filters or components with spare may be maintained in this way; - Preventive or Scheduled Maintenance involves a regular pre-set schedule programme of maintenance work. Programme outlined by the manufacturer of the component in question based on the design life of the component and based on past experience by operation. One step further than Preventive Maintenance is represented by Predictive Maintenance. Whereas Preventive Maintenance bases its schedules on past performance data, a predictive system acquires condition data from the machine to be maintained whilst the machine is in operation. The information obtained from this analysis indicates the condition in real time, provides a diagnosis of wear and shows any trend towards critical conditions. Predictive maintenance mainly consists of the following interventions: - Lubricant analysis; - Collection / analysis of functional parameters, such as motor absorption, flow rate, pressure, temperature, noise, vibration of rotating equipment, thermal efficiency, etc; - Periodical test of lifting systems; - Other operations to acquire sensitive equipment parameters. Predictive Maintenance can reduce the accidental intervention and extend the components life, and, in the end, is increasing the global availability

Development of Virtual Traveller: A behaviour change intervention to increase physical activity during primary school lessons

Directory of Open Access Journals (Sweden)

Emma Norris

2015-09-01

Three sources of data were used to inform the intervention development process: the existing research literature on school-based physical activity interventions, teacher interviews (N=12 and pupil focus groups (N=18 and an experimental feasibility study (N=85; Norris, Shelton, Dunsmuir, Duke-Williams, & Stamatakis, 2015b. The Behaviour Change Wheel was used as a framework to guide synthesis of evidence into the resulting intervention. Potential appropriate Behaviour Change Techniques were reviewed and embedded within the intervention. Conclusions The resulting 6-week Virtual Traveller programme with a 3-month follow-up period is currently in its final stages of evaluation in ten Greater London primary schools. Using the Behaviour Change Wheel and Behaviour Change Techniques allows development of replicable health interventions in applied settings such as schools.

Prediction of Tissue Outcome and Assessment of Treatment Effect in Acute Ischemic Stroke Using Deep Learning

DEFF Research Database (Denmark)

Nielsen, Anne; Hansen, Mikkel Bo; Tietze, Anna

2018-01-01

of automatically identifying and combining acute imaging features to accurately predict final lesion volume. METHODS: Using acute magnetic resonance imaging, we developed and trained a deep convolutional neural network (CNNdeep) to predict final imaging outcome. A total of 222 patients were included, of which 187...

Psychotherapeutic and work-oriented interventions: employment outcomes among young adults with work disability due to a mental disorder.

Science.gov (United States)

Mattila-Holappa, Pauliina; Joensuu, Matti; Ahola, Kirsi; Koskinen, Aki; Tuisku, Katinka; Ervasti, Jenni; Virtanen, Marianna

2016-01-01

We examined the extent to which psychotherapeutic and work-oriented interventions were included in a medical treatment and rehabilitation plan and whether they predicted future employment among young adults with work disability due to a mental disorder. Data were obtained from the treatment and rehabilitation plans of 1163 young adults aged 18‒34 years, who in 2008 were granted fixed-term work disability compensation due to a mental disorder and were followed for 5 years. Forty-six percent had no proposal for psychotherapy or a work-oriented intervention in their treatment and rehabilitation plan, 22 % had a plan for only a psychotherapeutic intervention, 23 % had a plan for only a work-oriented intervention, and 10 % had both types of interventions planned. Having a planned psychotherapeutic intervention (HR = 1.35, 95 % CI 1.07-1.69) and of the work-oriented interventions, planned rehabilitative courses and training (HR = 1.34, 95 % CI 1.03-1.70) predicted quicker entry into competitive employment. Having a plan for both a psychotherapeutic and work-oriented intervention was associated with being employed at the end of the follow-up (OR = 1.77, 95 % CI 1.07-2.95). Young adults with a long-term psychiatric work disability episode rarely have a recorded plan for rehabilitation in their treatment and rehabilitation plan although psychotherapeutic interventions and a combination of a psychotherapeutic and work-oriented intervention might help them gain employment.

Mindfulness Interventions.

Science.gov (United States)

Creswell, J David

2017-01-03

Mindfulness interventions aim to foster greater attention to and awareness of present moment experience. There has been a dramatic increase in randomized controlled trials (RCTs) of mindfulness interventions over the past two decades. This article evaluates the growing evidence of mindfulness intervention RCTs by reviewing and discussing (a) the effects of mindfulness interventions on health, cognitive, affective, and interpersonal outcomes; (b) evidence-based applications of mindfulness interventions to new settings and populations (e.g., the workplace, military, schools); (c) psychological and neurobiological mechanisms of mindfulness interventions; (d) mindfulness intervention dosing considerations; and (e) potential risks of mindfulness interventions. Methodologically rigorous RCTs have demonstrated that mindfulness interventions improve outcomes in multiple domains (e.g., chronic pain, depression relapse, addiction). Discussion focuses on opportunities and challenges for mindfulness intervention research and on community applications.

Digital Behaviour Change Interventions for Osteoarthritis - A Systematic Literature Review

Directory of Open Access Journals (Sweden)

Alice Berry

2015-10-01

•\tTo examine how uptake and usage of digital interventions has been reported Methods: A pre-defined search was carried out using databases including: AMED, CINAHL Plus, Cochrane Library, Embase, Medline, Psycinfo, Pubmed, SPORTDiscus and Web of Science. Articles were included if: they reported PA data; included people with OA; and if the intervention was accessed via a digital platform. Results: The database searches generated 2132 published papers. After applying selection criteria, eight studies were included in the final review. 5 out of the 8 included studies showed a statistically significant increase in self-reported levels of PA for up to 12 months. A number of outcome measures were used but were predominantly self-reported. BCTs used included: goal setting, action planning, problem solving, feedback, shaping knowledge, self-talk, and self-monitoring. Most studies (n=6 were based on social cognitive theory. A variety of methods were employed to report uptake and usage of digital interventions, making it difficult for comparisons to be made. Discussion and Conclusions: There is limited evidence supporting the effectiveness of internet based interventions to increase PA in OA. Most studies rely on self-report to determine change in levels of PA; objective measurement may be beneficial. Interventions were generally based on Social Cognitive Theory; other constructs may increase effectiveness. Clearer reporting of BCTs and intervention usage is needed.

A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar.

Science.gov (United States)

Murray, Jennifer; Williams, Brian; Hoskins, Gaylor; Skar, Silje; McGhee, John; Treweek, Shaun; Sniehotta, Falko F; Sheikh, Aziz; Brown, Gordon; Hagen, Suzanne; Cameron, Linda; Jones, Claire; Gauld, Dylan

2016-01-01

Visualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma. We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing. Our final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions. We have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However

Portrayal of medical decision making around medical interventions life-saving encounters on three medical television shows.

Science.gov (United States)

Schwei, Rebecca J; Jacobs, Elizabeth A; Wingert, Katherine; Montague, Enid

2015-07-01

Previous literature has shown that patients obtain information about the medical system from television shows. Additionally, shared decision making is regularly cited as the ideal way to make decisions during a medical encounter. Little information exists surrounding the characteristics of medical decision-making, such as who makes the decision, on medical television shows. We evaluate the characteristics of medical decisions in lifesaving encounters on medical television shows and evaluate if these characteristics were different on staged and reality television shows. We coded type of medical intervention, patient's ability to participate in decision, presence of patient advocate during decision, final decision maker, decision to use intervention, and controversy surrounding decision on three television shows. Frequencies by show were calculated and differences across the three television shows and between staged (ER) and reality ( BostonMed and Hopkins ) television shows were assessed with chi-square tests. The final data set included 37 episodes, 137 patients and 593 interventions. On ER, providers were significantly more likely to make the decision about the medical intervention without informing the patient when a patient was capable of making a decision compared to BostonMed or Hopkins (ptelevision shows we analyzed. It is possible that what patients see on television influences their expectations surrounding the decision making process and the use of medical interventions in everyday healthcare encounters.

Provocative diskography: safety and predictive value in the outcome of spinal fusion or pain intervention for chronic low-back pain

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Willems PC

2014-12-01

Full Text Available Paul C Willems Department of Orthopedic Surgery, CAPHRI Research School, Maastricht University Medical Center, Maastricht, the Netherlands Abstract: There is still no clear definition of diskogenic low-back pain and no consensus on a generally agreed test, such as provocative diskography (PD, to diagnose painful disk degeneration, and probably more importantly, to predict the outcome of therapy intended to reduce pain that is presumed to be diskogenic in nature. Nevertheless, PD is the most specific procedure to diagnose diskogenic low-back pain. Its accuracy, however, is rather low or at best unknown. Although rare, the most prevalent complication, postdiskography diskitis, can be devastating for the individual patient, so all measures, like strict sterile conditions and antibiotic prophylaxis, should be taken to avoid this complication. It is advised to perform the procedure in a pressure-controlled way with a constant low flow, and optionally computed tomography imaging. PD should not be performed in morphologically normal disks. A standardized execution of the test should be established in order to perform high-quality studies to determine its accuracy to lead to meaningful interventions, and find best practices for diagnosis and treatment of diskogenic back pain. Possibly, PD may have detrimental effects on the disk, causing early degeneration, although it is unknown whether this will be related to clinical symptoms. Especially with these possible adverse side effects in mind, the risk–benefit ratio with the lack of clear benefits from treatments provided, and possible complications of disk puncture, the rationale for PD is questionable, which should be stressed to patients in the process of shared decision making. Diskography as a stand-alone test is not recommended in clinical decision making for patients with chronic low-back pain. Keywords: provocative diskography, chronic low-back pain, prognostic accuracy, spinal fusion, pain

Life prediction methodology for ceramic components of advanced heat engines. Phase 1: Volume 1, Final report

Energy Technology Data Exchange (ETDEWEB)

Cuccio, J.C.; Brehm, P.; Fang, H.T. [Allied-Signal Aerospace Co., Phoenix, AZ (United States). Garrett Engine Div.] [and others

1995-03-01

Emphasis of this program is to develop and demonstrate ceramics life prediction methods, including fast fracture, stress rupture, creep, oxidation, and nondestructive evaluation. Significant advancements were made in these methods and their predictive capabilities successfully demonstrated.

Évaluation d'une intervention intégrée visant à convaincre les ...

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

Extrants. Rapports. ASSIST Pakistan : Action to Stop Smoking In Suspected Tuberculosis in Pakistan; an intervention to stop tobacco use among patients suspected of TB - evaluation of an integrated approach (final technical report). Téléchargez le PDF ...

Lessons learned: the effect of prior technology use on Web-based interventions.

Science.gov (United States)

Carey, Joanne C; Wade, Shari L; Wolfe, Christopher R

2008-04-01

This study examined the role of regular prior technology use in treatment response to an online family problem-solving (OFPS) intervention and an Internet resource intervention (IRI) for pediatric traumatic brain injury (TBI). Participants were 150 individuals in 40 families of children with TBI randomly assigned to OFPS intervention or an IRI. All families received free computers and Internet access to TBI resources. OFPS families received Web-based sessions and therapist-guided synchronous videoconferences focusing on problem solving, communication skills, and behavior management. All participants completed measures of depression, anxiety, and computer usage. OFPS participants rated treatment satisfaction, therapeutic alliance, and Web site and technology comfort. With the OFPS intervention, depression and anxiety improved significantly more among technology using parents (n = 14) than nontechnology users (n = 6). Technology users reported increasing comfort with technology over time, and this change was predictive of depression at followup. Satisfaction and ease-of-use ratings did not differ by technology usage. Lack of regular prior home computer usage and nonadherence were predictive of anxiety at followup. The IRI was not globally effective. However, controlling for prior depression, age, and technology at work, there was a significant effect of technology at home for depression. Families with technology experience at home (n = 11) reported significantly greater improvements in depression than families without prior technology experience at home (n = 8). Although Web-based OFPS was effective in improving caregiver functioning, individuals with limited computer experience may benefit less from an online intervention due to increased nonadherence.

Earthquake prediction the ory and its relation to precursors

International Nuclear Information System (INIS)

Negarestani, A.; Setayeshi, S.; Ghannadi-Maragheh, M.; Akasheh, B.

2001-01-01

Since we don't have enough knowledge about the Physics of earthquakes. therefore. the study of seismic precursors plays an important role in earthquake prediction. Earthquake prediction is a science which discusses about precursory phenomena during seismogenic process, and then investigates the correlation and association among them and the intrinsic relation between precursors and the seismogenic process. ar the end judges comprehensively the seismic status and finally makes earthquake prediction. There are two ways for predicting earthquake prediction. The first is to study the physics of seismogenic process and to determine the parameters in the process based on the source theories and the second way is to use seismic precursors. In this paper the theory of earthquake is reviewed. We also study theory of earthquake using models of earthquake origin, the relation between seismogenic process and various accompanying precursory phenomena. The earthquake prediction is divided into three categories: long-term, medium-term and short-term. We study seismic anomalous behavior. electric field, crustal deformation, gravity. magnetism of earth. change of groundwater variation. groundwater geochemistry and change of Radon gas emission. Finally, it is concluded the there is a correlation between Radon gas emission and earthquake phenomena. Meanwhile, there are some samples from actual processing in this area

Iris-fixated phakic intraocular lens implantation to correct myopia and a predictive model of endothelial cell loss.

Science.gov (United States)

Bouheraoua, Nacim; Bonnet, Clemence; Labbé, Antoine; Sandali, Otman; Lecuen, Nicolas; Ameline, Barbara; Borderie, Vincent; Laroche, Laurent

2015-11-01

To report long-term results of Artisan phakic intraocular lens (pIOL) to correct myopia and to propose a model predicting endothelial cell loss after pIOL implantation. Quinze-Vingts National Ophthalmology Hospital, Paris, France. Retrospective, interventional case series. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and central endothelial cell count (ECC) were determined before and at yearly intervals up to 5 years after pIOL implantation. Linear model analysis was performed to present a model that describes endothelial cell loss as a linear decrease and an additional decrease depending on postoperative loss. A total of 49 patients (68 eyes) implanted with pIOLs from January 2000 to January 2009 were evaluated. The mean preoperative and final spherical equivalent (SE) were -13 ± 4.10 and -0.75 ± 0.74 diopters (D), respectively. The mean preoperative and final central ECC were 2629 ± 366 and 2250 ± 454 cells/mm(2), respectively. There were no intraoperative complications for any of the eyes. One eye required surgery for repositioning the pIOL, and 1 eye required pIOL exchange for postoperative refractive error. The model predicted that for patients with preoperative ECC of 3000, 2500, and 2000 cells/mm(2), a critical ECC of 1500 cells/mm(2) will be reached at 39, 28, and 15 years after implantation, respectively. Implantation of the pIOL was an effective and stable procedure after 5 years of follow-up. The presented model predicted EC loss after pIOL implantation, which can assist ophthalmologists in patient selection and follow-up. The authors report no conflict of interest. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

EDUCATIONAL INTERVENTION FOR THE CARDIOVASCULAR PREVENTION IN ADOLESCENTS OF SECONDARY BASIC.

Directory of Open Access Journals (Sweden)

Yuri Arnold Domínguez

2011-08-01

Full Text Available Background: Healthy lifestyles incorporated in early ages could influence the most important behaviours and risk factors for atherosclerotic vascular disease in order to reduce the incidence of this condition during adulthood. Objective: To assess the effectiveness of the educational-participatory intervention on students' knowledge as to cardiovascular risk factors. Material: An educational intervention with a quasi-experimental design was conducted from April 2007 to October 2008 in eighth grade junior high school students from Old Havana (the intervention group and Center Havana (the control group. The nonparametric Chi square tests from McNemar and Mantel-Haenszel were used. Results: There were significant statistical associations with a confidence limit of 95% between initial and final state of knowledge in relation to cardiovascular risk factors in the intervention group (p = 0.0001, in the control group (p = 0.035 and between the study group versus the control group after the intervention (p = 0.0001. Conclusions: An educational-participatory program for health promotion and prevention of major risk factors of cardiovascular disease (inadequate dietary habits, smoking and physical inactivity among adolescents, contributes to increase their knowledge and encourages the adoption of healthy daily habits and lifestyles.

Psychosocial intervention for children with narcolepsy: Parents' expectations and perceived support.

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Kippola-Pääkkönen, Anu; Härkäpää, Kristiina; Valkonen, Jukka; Tuulio-Henriksson, Annamari; Autti-Rämö, Ilona

2016-04-18

The study focuses on the parents of children who were affected by narcolepsy after a pandemic influenza and vaccination campaign in Finland. The main aim of the study was to clarify parents' expectations and perceived support from the intervention and to assess their need for additional support. The data were gathered using questionnaires. Fifty-eight parents answered the baseline questionnaire and 40 parents the final questionnaire. Parents' expectations of and perceived support from the intervention mainly related to peer support. The intervention offered an arena for sharing information and experiences and provided encouragement for coping in everyday life. Many expectations were not met, especially those concerning information about needed services, financial benefits and availability of local support. The results highlight that for persons with rare disorders and their families, an inpatient psychosocial intervention can offer an important arena to receive both informal and professionally led peer support. Comprehensive psychosocial and other support services are also needed in the community. Listening to parents' perspectives on the intervention and perceived support can help to establish multiform family-centred support for families with children affected by a rare chronic disabling condition. © The Author(s) 2016.

Beyond discrimination: A comparison of calibration methods and clinical usefulness of predictive models of readmission risk.

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Walsh, Colin G; Sharman, Kavya; Hripcsak, George

2017-12-01

Prior to implementing predictive models in novel settings, analyses of calibration and clinical usefulness remain as important as discrimination, but they are not frequently discussed. Calibration is a model's reflection of actual outcome prevalence in its predictions. Clinical usefulness refers to the utilities, costs, and harms of using a predictive model in practice. A decision analytic approach to calibrating and selecting an optimal intervention threshold may help maximize the impact of readmission risk and other preventive interventions. To select a pragmatic means of calibrating predictive models that requires a minimum amount of validation data and that performs well in practice. To evaluate the impact of miscalibration on utility and cost via clinical usefulness analyses. Observational, retrospective cohort study with electronic health record data from 120,000 inpatient admissions at an urban, academic center in Manhattan. The primary outcome was thirty-day readmission for three causes: all-cause, congestive heart failure, and chronic coronary atherosclerotic disease. Predictive modeling was performed via L1-regularized logistic regression. Calibration methods were compared including Platt Scaling, Logistic Calibration, and Prevalence Adjustment. Performance of predictive modeling and calibration was assessed via discrimination (c-statistic), calibration (Spiegelhalter Z-statistic, Root Mean Square Error [RMSE] of binned predictions, Sanders and Murphy Resolutions of the Brier Score, Calibration Slope and Intercept), and clinical usefulness (utility terms represented as costs). The amount of validation data necessary to apply each calibration algorithm was also assessed. C-statistics by diagnosis ranged from 0.7 for all-cause readmission to 0.86 (0.78-0.93) for congestive heart failure. Logistic Calibration and Platt Scaling performed best and this difference required analyzing multiple metrics of calibration simultaneously, in particular Calibration

The Times They Are a-Changin': Clock Drawing and Prediction of Dementia.

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Amodeo, Sean; Mainland, Brian J; Herrmann, Nathan; Shulman, Kenneth I

2015-06-01

Identification of individuals who will eventually develop dementia is critical for early intervention, treatment, and care planning. The clock drawing test (CDT) is a widely used cognitive screening tool that has been well accepted among clinicians and patients for its ease of use and short administration time. This review explores the value of the CDT for predicting the later development of dementia in cognitively intact older adults and patients with mild cognitive impairment (MCI). Additionally, we reviewed studies that examined the ability of the CDT to monitor declines in cognitive functioning over time. A PubMed literature search for articles that included a longitudinal analysis of the CDT was conducted. The search included articles published up to June 2013 and manual cross-referencing of bibliographies. Relevant studies were categorized, summarized, and critiqued. The consensus from the studies reviewed suggests that the CDT is a useful measure of cognitive decline over time. Conceptual clock drawing errors (eg, misrepresentation of time) detected this decline most effectively. In addition, the CDT appears to differentiate at baseline between cognitively intact older adults who will develop dementia up to 2 years postbaseline. Finally, the CDT has been found to differentiate between patients with MCI who will progress to dementia up to 6 years postbaseline. The CDT appears useful for the longitudinal assessment of cognitive impairment and together with other validated measures may be helpful for predicting conversion to dementia. Cost-effective and practical ways of predicting risk of dementia will become increasingly critical as we develop disease-modifying treatments. © The Author(s) 2014.

Vitality training-A mindfulness- and acceptance-based intervention for chronic pain.

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Zangi, Heidi A; Haugli, Liv

2017-11-01

Chronic non-malign pain has a substantial impact on all parts of an individual's life. Mindfulness- and acceptance- based interventions are increasingly offered to help people manage their pain and strengthening their health promoting resources. In this paper, we present a mindfulness- and acceptance-based intervention, the Vitality Training Programme (VTP), to mitigating pain and accompanying symptoms and increasing pain coping abilities. Based on a clinical case presentation, we discuss how the VTP can help individuals to live a better life with pain. The VTP has been evaluated in two randomised controlled trials and two qualitative studies. Existing evidence is presented. Finally, based on a recently published theoretical model, we present some possible common explanatory mechanisms across various mindfulness- and acceptance-based interventions that might also apply to the VTP. Copyright © 2017 Elsevier B.V. All rights reserved.

Deep Visual Attention Prediction

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Wang, Wenguan; Shen, Jianbing

2018-05-01

In this work, we aim to predict human eye fixation with view-free scenes based on an end-to-end deep learning architecture. Although Convolutional Neural Networks (CNNs) have made substantial improvement on human attention prediction, it is still needed to improve CNN based attention models by efficiently leveraging multi-scale features. Our visual attention network is proposed to capture hierarchical saliency information from deep, coarse layers with global saliency information to shallow, fine layers with local saliency response. Our model is based on a skip-layer network structure, which predicts human attention from multiple convolutional layers with various reception fields. Final saliency prediction is achieved via the cooperation of those global and local predictions. Our model is learned in a deep supervision manner, where supervision is directly fed into multi-level layers, instead of previous approaches of providing supervision only at the output layer and propagating this supervision back to earlier layers. Our model thus incorporates multi-level saliency predictions within a single network, which significantly decreases the redundancy of previous approaches of learning multiple network streams with different input scales. Extensive experimental analysis on various challenging benchmark datasets demonstrate our method yields state-of-the-art performance with competitive inference time.

Preferences for Early Intervention Mental Health Services: A Discrete-Choice Conjoint Experiment.

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Becker, Mackenzie P E; Christensen, Bruce K; Cunningham, Charles E; Furimsky, Ivana; Rimas, Heather; Wilson, Fiona; Jeffs, Lisa; Bieling, Peter J; Madsen, Victoria; Chen, Yvonne Y S; Mielko, Stephanie; Zipursky, Robert B

2016-02-01

Early intervention services (EISs) for mental illness may improve outcomes, although treatment engagement is often a problem. Incorporating patients' preferences in the design of interventions improves engagement. A discrete-choice conjoint experiment was conducted in Canada to identify EIS attributes that encourage treatment initiation. Sixteen four-level attributes were formalized into a conjoint survey, completed by patients, family members, and mental health professionals (N=562). Participants were asked which EIS option people with mental illness would contact. Latent-class analysis identified respondent classes characterized by shared preferences. Randomized first-choice simulations predicted which hypothetical options, based on attributes, would result in maximum utilization. Participants in the conventional-service class (N=241, 43%) predicted that individuals would contact traditional services (for example, hospital location and staffed by psychologists or psychiatrists). Membership was associated with being a patient or family member and being male. Participants in the convenient-service class (N=321, 57%) predicted that people would contact services promoting easy access (for example, self-referral and access from home). Membership was associated with being a professional. Both classes predicted that people would contact services that included short wait times, direct contact with professionals, patient autonomy, and psychological treatment information. The convenient-service class predicted that people would use an e-health model, whereas the conventional-service class predicted that people would use a primary care or clinic-hospital model. Provision of a range of services may maximize EIS use. Professionals may be more apt to adopt EISs in line with their beliefs regarding patient preferences. Considering several perspectives is important for service design.

Criteria for prediction of plastic instabilities for hot working processes. (Part I: Theoretical review)

International Nuclear Information System (INIS)

Al Omar, A.; Prado, J. M.

2010-01-01

Hot working processes often induce high levels of deformation at high strain rates, and impose very complex multiaxial modes of solicitation. These processes are essentially limited by apparition and development of plastic instabilities. These may be the direct cause of rapid crack propagation, which lead to a possible final rupture. The complexity of deformation modes and the simultaneous intervention of several parameters have led many researchers to develop various criteria, with different approaches, to predict the occurrence of defects and to optimize process control parameters. The aim of the present paper is to summarize the general characteristics of some instability criteria, widely used in the literature, for the prediction of plastic instabilities during hot working. It was considered appropriate to divide the work into two parts: part I presents the phenomenological criteria for the prediction of plastic instabilities, based on descriptive observation of microscopic phenomena of the deformation (strain hardening and strain rate sensitivity), and discusses the continuum criteria based on the principle of maximum rate of entropy production of irreversible thermodynamics applied to continuum mechanics of large plastic flow. Also, this part provides a bibliographical discussion among several authors with regard to the physical foundations of dynamic materials model. In part II, of the work, a comparative study has been carried out to characterize the flow instability during a hot working process of a medium carbon microalloyed using phenomenological and continuum criteria. (Author) 83 refs.

Interventions for confusion and dementia. 5: Changing cultures.

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Woodrow, P

Previous articles in this series (Vol 7(15): 891-94; Vol 7(17): 1018-20; Vol 7(19): 1145-49; Vol 7(20): 1247-50) have explored the promotion of quality of life for people with dementia and how this can be achieved through existing interventions. This final article moves from discussing specific interventions to cover wider issues around healthcare beliefs and values. A brief historical overview of dementia care is given, outlining the inherited structures and values. Much valuable work has been carried out by the Bradford Dementia Group, who has described changes in dementia care as moving from an 'old' to a 'new' culture. This 'new culture', offering a comprehensive person-centred approach to holistic care, is explored with reference to the work of Kitwood, who has done much to promote quality of life for people suffering from dementia.

Impact of a social network-based intervention promoting diabetes self-management in socioeconomically deprived patients: a qualitative evaluation of the intervention strategies.

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Vissenberg, C; Stronks, K; Nijpels, G; Uitewaal, P J M; Middelkoop, B J C; Kohinor, M J E; Hartman, M A; Nierkens, V

2016-04-13

There is a need for effective interventions that improve diabetes self-management (DSM) among socioeconomically deprived patients with type 2 diabetes. The group-based intervention Powerful Together with Diabetes (PTWD) aimed to increase social support for DSM and decrease social influences hindering DSM (eg, peer pressure, social norms) in patients living in deprived neighbourhoods. Through a qualitative process evaluation, this paper aims to study whether this intervention changed social support and social influences, and which elements of the intervention contributed to this. The intervention group (IG) was compared with a standard group-based educational intervention (control group, CG). 27 qualitative in-depth interviews with participants (multiethnic sample) and 24 interviews with group leaders were conducted. Interviews were coded and analysed using MAXQDA according to framework analysis. Patients in the IG experienced more emotional support from group members and more instrumental and appraisal support from relatives than those in the CG. Also, they were better able to recognise and cope with influences that hinder their DSM, exhibited more positive norms towards DSM and increased their priority regarding DSM and their adherence. Finally, the engagement in DSM by relatives of participants increased. Creating trust between group members, skills training, practising together and actively involving relatives through action plans contributed to these changes. A group-based intervention aimed at creating trust, practising together and involving relatives has the potential to increase social support and diminish social influences hindering DSM in socioeconomically deprived patients with diabetes. Promising elements of the intervention were skills training and providing feedback using role-playing exercises in group sessions with patients, as well as the involvement of patients' significant others in self-management tasks, and actively involving them in making an

76 FR 60139 - Early Intervention Program for Infants and Toddlers With Disabilities

Science.gov (United States)

2011-09-28

... intervention services under certain circumstances. Additionally, many commenters requested that music therapy... the Education of Children With Disabilities; Final Rule and Proposed Rule #0;#0;Federal Register / Vol...) and new Sec. 303.321(a)(5) and (a)(6) clarify that in the case of a child who is limited English...

A comparison of two short-term intensive physical activity interventions: methodological considerations

Directory of Open Access Journals (Sweden)

Norton Lynda H

2011-12-01

Full Text Available Abstract Background Increases in chronic illness due to sedentary lifestyles and poor metabolic fitness have led to numerous intervention strategies to promote physical activity (PA. This paper describes the methodological strategies of two short-term PA interventions. Outcome measures reported are PA adherence and compliance rates during the intervention and at 3, 6 and 12-month follow-up. Methods The 40-day interventions were: a pedometer-based walking program (n = 251 and a group-based intensive program (n = 148. There was also an active control group (n = 135. Intervention subjects were prescribed PA each day and required to record all activity sessions (pedometer steps or energy expenditure from heart rate monitors. Results Compliance (≥ 150 min/wk PA was highest post-intervention (81.1% and 64.5% for the group and pedometer subjects, respectively and then progressively decreased across the 12-month follow-up period (final compliance rates were 53.5% and 46.6%, respectively although they remained significantly higher than pre-intervention rates (zero %. There was significantly higher adherence to 6 months (75.0% and 64.9%, and compliance to 3 months (64.9% and 51.0%, for group versus pedometer subjects. The active control group maintained the highest adherence and compliance rates across the study. Conclusions The group-based program resulted in higher adherence and compliance rates post-intervention although both types of interventions showed long-term effectiveness to increase activity patterns.

Regression models for predicting peak and continuous three-dimensional spinal loads during symmetric and asymmetric lifting tasks.

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Fathallah, F A; Marras, W S; Parnianpour, M

1999-09-01

Most biomechanical assessments of spinal loading during industrial work have focused on estimating peak spinal compressive forces under static and sagittally symmetric conditions. The main objective of this study was to explore the potential of feasibly predicting three-dimensional (3D) spinal loading in industry from various combinations of trunk kinematics, kinetics, and subject-load characteristics. The study used spinal loading, predicted by a validated electromyography-assisted model, from 11 male participants who performed a series of symmetric and asymmetric lifts. Three classes of models were developed: (a) models using workplace, subject, and trunk motion parameters as independent variables (kinematic models); (b) models using workplace, subject, and measured moments variables (kinetic models); and (c) models incorporating workplace, subject, trunk motion, and measured moments variables (combined models). The results showed that peak 3D spinal loading during symmetric and asymmetric lifting were predicted equally well using all three types of regression models. Continuous 3D loading was predicted best using the combined models. When the use of such models is infeasible, the kinematic models can provide adequate predictions. Finally, lateral shear forces (peak and continuous) were consistently underestimated using all three types of models. The study demonstrated the feasibility of predicting 3D loads on the spine under specific symmetric and asymmetric lifting tasks without the need for collecting EMG information. However, further validation and development of the models should be conducted to assess and extend their applicability to lifting conditions other than those presented in this study. Actual or potential applications of this research include exposure assessment in epidemiological studies, ergonomic intervention, and laboratory task assessment.

Hyper-attenuating brain lesions on CT after ischemic stroke and thrombectomy are associated with final brain infarction.

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Cabral, F B; Castro-Afonso, L H; Nakiri, G S; Monsignore, L M; Fábio, Src; Dos Santos, A C; Pontes-Neto, O M; Abud, D G

2017-12-01

Purpose Hyper-attenuating lesions, or contrast staining, on a non-contrast brain computed tomography (NCCT) scan have been investigated as a predictor for hemorrhagic transformation after endovascular treatment of acute ischemic stroke (AIS). However, the association of hyper-attenuating lesions and final ischemic areas are poorly investigated in this setting. The aim of the present study was to assess correlations between hyper-attenuating lesions and final brain infarcted areas after thrombectomy for AIS. Methods Data from patients with AIS of the anterior circulation who underwent endovascular treatment were retrospectively assessed. Images of the brain NCCT scans were analyzed in the first hours and late after treatment. The hyper-attenuating areas were compared to the final ischemic areas using the Alberta Stroke Program Early CT Score (ASPECTS). Results Seventy-one of the 123 patients (65.13%) treated were included. The association between the hyper-attenuating region in the post-thrombectomy CT scan and final brain ischemic area were sensitivity (58.3% to 96.9%), specificity (42.9% to 95.6%), positive predictive values (71.4% to 97.7%), negative predictive values (53.8% to 79.5%), and accuracy values (68% to 91%). The highest sensitivity values were found for the lentiform (96.9%) and caudate nuclei (80.4%) and for the internal capsule (87.5%), and the lowest values were found for the M1 (58.3%) and M6 (66.7%) cortices. Conclusions Hyper-attenuating lesions on head NCCT scans performed after endovascular treatment of AIS may predict final brain infarcted areas. The prediction appears to be higher in the deep brain regions compared with the cortical regions.

Lung protection: an intervention for tidal volume reduction in a teaching intensive care unit

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Briva, Arturo; Gaiero, Cristina

2016-01-01

Objective To determine the effect of feedback and education regarding the use of predicted body weight to adjust tidal volume in a lung-protective mechanical ventilation strategy. Methods The study was performed from October 2014 to November 2015 (12 months) in a single university polyvalent intensive care unit. We developed a combined intervention (education and feedback), placing particular attention on the importance of adjusting tidal volumes to predicted body weight bedside. In parallel, predicted body weight was estimated from knee height and included in clinical charts. Results One hundred fifty-nine patients were included. Predicted body weight assessed by knee height instead of visual evaluation revealed that the delivered tidal volume was significantly higher than predicted. After the inclusion of predicted body weight, we observed a sustained reduction in delivered tidal volume from a mean (standard error) of 8.97 ± 0.32 to 7.49 ± 0.19mL/kg (p < 0.002). Furthermore, the protocol adherence was subsequently sustained for 12 months (delivered tidal volume 7.49 ± 0.54 versus 7.62 ± 0.20mL/kg; p = 0.103). Conclusion The lack of a reliable method to estimate the predicted body weight is a significant impairment for the application of a worldwide standard of care during mechanical ventilation. A combined intervention based on education and repeated feedbacks promoted sustained tidal volume education during the study period (12 months). PMID:27925055

Identification of factors that affect the adoption of an ergonomic intervention among Emergency Medical Service workers.

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Weiler, Monica R; Lavender, Steven A; Crawford, J Mac; Reichelt, Paul A; Conrad, Karen M; Browne, Michael W

2012-01-01

This study explored factors contributing to intervention adoption decisions among Emergency Medical Service (EMS) workers. Emergency Medical Service workers (n = 190), from six different organisations, participated in a two-month longitudinal study following the introduction of a patient transfer-board (also known as slide-board) designed to ease lateral transfers of patients to and from ambulance cots. Surveys administered at baseline, after one month and after two months sampled factors potentially influencing the EMS providers' decision process. 'Ergonomics Advantage' and 'Patient Advantage' entered into a stepwise regression model predicting 'intention to use' at the end of month one (R (2 )= 0.78). After the second month, the stepwise regression indicated only two factors were predictive of intention to use: 'Ergonomics Advantage,' and 'Endorsed by Champions' (R (2 )= 0.58). Actual use was predicted by: 'Ergonomics Advantage' and 'Previous Tool Experience.' These results relate to key concepts identified in the diffusion of innovation literature and have the potential to further ergonomics intervention adoption efforts. Practitioner Summary. This study explored factors that potentially facilitate the adoption of voluntarily used ergonomics interventions. EMS workers were provided with foldable transfer-boards (slideboards) designed to reduce the physical demands when laterally transferring patients. Factors predictive of adoption measures included perceived ergonomics advantage, the endorsement by champions, and prior tool experience.

The comparison of available data on PWR assembly thermal behavior with analytical predictions. Topical report (final)

International Nuclear Information System (INIS)

Liu, J.; Todreas, N.

1979-02-01

The comparison of available data with analytical predictions has been illustrated in this report. Since few data on the cross flow are available, a study of parameters in the transverse momentum equation was performed to assess the sensitivity of results to their assumed values. It is confirmed that effects of these parameters on the overall results are not significant under PWR operating conditions. Data on subchannel properties of quality and mass flux were also assessed. From the data comparisons, it is evident that COBRA can successfully predict the PWR normal operating conditions but cannot predict the trend under bulk quality conditions

Diagnoses, Intervention Strategies, and Rates of Functional Improvement in Integrated Behavioral Health Care Patients

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Bridges, Ana J.; Gregus, Samantha J.; Rodriguez, Juventino Hernandez; Andrews, Arthur R.; Villalobos, Bianca T.; Pastrana, Freddie A.; Cavell, Timothy A.

2016-01-01

Objective Compared with more traditional mental health care, integrated behavioral health care (IBHC) offers greater access to services and earlier identification and intervention of behavioral and mental health difficulties. The current study examined demographic, diagnostic, and intervention factors that predict positive changes for IBHC patients. Method Participants were 1,150 consecutive patients (mean age = 30.10 years, 66.6% female, 60.1% Hispanic, 47.9% uninsured) seen for IBHC services at 2 primary care clinics over a 34-month period. Patients presented with depressive (23.2%), anxiety (18.6%), adjustment (11.3%), and childhood externalizing (7.6%) disorders, with 25.7% of patients receiving no diagnosis. Results The most commonly delivered interventions included behavioral activation (26.1%), behavioral medicine-specific consultation (14.6%), relaxation training (10.3%), and parent-management training (8.5%). There was high concordance between diagnoses and evidence-based intervention selection. We used latent growth curve modeling to explore predictors of baseline global assessment of functioning (GAF) and improvements in GAF across sessions, utilizing data from a subset of 117 patients who attended at least 3 behavioral health visits. Hispanic ethnicity and being insured predicted higher baseline GAF, while patients with an anxiety disorder had lower baseline GAF than patients with other diagnoses. Controlling for primary diagnosis, patients receiving behavioral activation or exposure therapy improved at faster rates than patients receiving other interventions. Demographic variables did not relate to rates of improvement. Conclusion Results suggest even brief IBHC interventions can be focused, targeting specific patient concerns with evidence-based treatment components. PMID:25774786

Effects of a combined dietary, exercise and behavioral intervention and sympathetic system on body weight maintenance after intended weight loss: results of a randomized controlled trial.

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Mai, Knut; Brachs, Maria; Leupelt, Verena; Schwartzenberg, Reiner Jumpertz-von; Maurer, Lukas; Grüters-Kieslich, Annette; Ernert, Andrea; Bobbert, Thomas; Krude, Heiko; Spranger, Joachim

2018-01-19

Lifestyle based weight loss interventions are hampered by long-term inefficacy. Prediction of individuals successfully reducing body weight would be highly desirable. Although sympathetic activity is known to contribute to energy homeostasis, its predictive role in body weight maintenance has not yet been addressed. We investigated, whether weight regain could be modified by a weight maintenance intervention and analyzed the predictive role of weight loss-induced changes of the sympathetic system on long-term weight regain. 156 subjects (age > 18; BMI ≥ 27 kg/m 2 ) participated in a 12-week weight reduction program. After weight loss (T0), 143 subjects (weight loss >8%) were randomized to a 12-month lifestyle intervention or a control group. After 12 months (T12) no further intervention was performed until month 18 (T18). Weight regain at T18 (regain BMI ) was the primary outcome. Evaluation of systemic and tissue specific estimates of sympathetic system was a pre-defined secondary outcome. BMI was reduced by 4.67 ± 1.47 kg/m 2 during the initial weight loss period. BMI maintained low in subjects of the intervention group until T12 (+0.07 ± 2.98 kg/m 2 ; p = 0.58 compared to T0), while control subjects regained +0.98 ± 1.93 kg/m 2 (p predicted regain BMI (R 2  = 0.138; p Predictive sympathetic activity was not persistently modified by the intervention, which may partially explain the lack of long-term success of such interventions. Copyright © 2018. Published by Elsevier Inc.

Climate Change as a Predictable Surprise

International Nuclear Information System (INIS)

Bazerman, M.H.

2006-01-01

In this article, I analyze climate change as a 'predictable surprise', an event that leads an organization or nation to react with surprise, despite the fact that the information necessary to anticipate the event and its consequences was available (Bazerman and Watkins, 2004). I then assess the cognitive, organizational, and political reasons why society fails to implement wise strategies to prevent predictable surprises generally and climate change specifically. Finally, I conclude with an outline of a set of response strategies to overcome barriers to change

Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015.

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Mehmandar, Mohammadreza; Soori, Hamid; Mehrabi, Yadolah

2016-01-01

Predicting the trend in traffic accidents deaths and its analysis can be a useful tool for planning and policy-making, conducting interventions appropriate with death trend, and taking the necessary actions required for controlling and preventing future occurrences. Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015. It was a cross-sectional study. All the information related to fatal traffic accidents available in the database of Iran Legal Medicine Organization from 2004 to the end of 2013 were used to determine the change points (multi-variable time series analysis). Using autoregressive integrated moving average (ARIMA) model, traffic accidents death rates were predicted for 2014 and 2015, and a comparison was made between this rate and the predicted value in order to determine the efficiency of the model. From the results, the actual death rate in 2014 was almost similar to that recorded for this year, while in 2015 there was a decrease compared with the previous year (2014) for all the months. A maximum value of 41% was also predicted for the months of January and February, 2015. From the prediction and analysis of the death trends, proper application and continuous use of the intervention conducted in the previous years for road safety improvement, motor vehicle safety improvement, particularly training and culture-fostering interventions, as well as approval and execution of deterrent regulations for changing the organizational behaviors, can significantly decrease the loss caused by traffic accidents.

Predicting the Initial Lapse Using a Mobile Health Application after Alcohol Detoxification

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Chih, Ming-Yuan

2013-01-01

The prediction and prevention of the initial lapse--which is defined as the first lapse after a period of abstinence--is important because the initial lapse often leads to subsequent lapses (within the same lapse episode) or relapse. The prediction of the initial lapse may allow preemptive intervention to be possible. This dissertation reports on…

Wind Power Prediction Considering Nonlinear Atmospheric Disturbances

Directory of Open Access Journals (Sweden)

Yagang Zhang

2015-01-01

Full Text Available This paper considers the effect of nonlinear atmospheric disturbances on wind power prediction. A Lorenz system is introduced as an atmospheric disturbance model. Three new improved wind forecasting models combined with a Lorenz comprehensive disturbance are put forward in this study. Firstly, we define the form of the Lorenz disturbance variable and the wind speed perturbation formula. Then, different artificial neural network models are used to verify the new idea and obtain better wind speed predictions. Finally we separately use the original and improved wind speed series to predict the related wind power. This proves that the corrected wind speed provides higher precision wind power predictions. This research presents a totally new direction in the wind prediction field and has profound theoretical research value and practical guiding significance.

Further understanding of the complications after orthotopic liver transplantation and their interventional management

International Nuclear Information System (INIS)

Shan Hong; Jiang Zaibo

2009-01-01

The majority of complications due to orthotopic liver transplantation (OLT)need interventional treatment. For arterial and venous complications after OLT, we have established clear and definite interventional therapeutic mode. However, it has been the difficult point as well as the weak point for interventional radiologists to treat the biliary complications. With the technical improvement and deep-going understanding, a part of biliary complications of OLT can be relieved or even finally be cured with percutaneous biliary drainage (PTBD) and endoscopic nasobiliary drainage (ENBD). For some patients, PTBD and ENBD seem to be the main palliative therapeutic means, which might accompany the patients for a lifetime. Now, it is an urgent demand to formulate the clinical therapeutic guidelines for the treatment of biliary complications after OLT. (authors)

Application of Machine Learning to Predict Dietary Lapses During Weight Loss.

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Goldstein, Stephanie P; Zhang, Fengqing; Thomas, John G; Butryn, Meghan L; Herbert, James D; Forman, Evan M

2018-05-01

Individuals who adhere to dietary guidelines provided during weight loss interventions tend to be more successful with weight control. Any deviation from dietary guidelines can be referred to as a "lapse." There is a growing body of research showing that lapses are predictable using a variety of physiological, environmental, and psychological indicators. With recent technological advancements, it may be possible to assess these triggers and predict dietary lapses in real time. The current study sought to use machine learning techniques to predict lapses and evaluate the utility of combining both group- and individual-level data to enhance lapse prediction. The current study trained and tested a machine learning algorithm capable of predicting dietary lapses from a behavioral weight loss program among adults with overweight/obesity (n = 12). Participants were asked to follow a weight control diet for 6 weeks and complete ecological momentary assessment (EMA; repeated brief surveys delivered via smartphone) regarding dietary lapses and relevant triggers. WEKA decision trees were used to predict lapses with an accuracy of 0.72 for the group of participants. However, generalization of the group algorithm to each individual was poor, and as such, group- and individual-level data were combined to improve prediction. The findings suggest that 4 weeks of individual data collection is recommended to attain optimal model performance. The predictive algorithm could be utilized to provide in-the-moment interventions to prevent dietary lapses and therefore enhance weight losses. Furthermore, methods in the current study could be translated to other types of health behavior lapses.

Improving the prediction of the final part geometry in high strength steels U drawing by means of advanced material and friction models

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de Argandoña, Eneko Saenz; Mendiguren, Joseba; Otero, Irune; Mugarra, Endika; Otegi, Nagore; Galdos, Lander

2018-05-01

Steel has been used in vehicles from the automotive industry's inception. Different steel grades are continually being developed in order to satisfy new fuel economy requirements. For example, advanced high strength steel grades (AHSS) are widely used due to their good strength/weight ratio. Because each steel grade has a different microstructure composition and hardness, they show different behaviors when they are subjected to different strain paths. Similarly, the friction behavior when using different contact pressures is considerably altered. In the present paper, four different steel grades, ZSt380, DP600, DP780 and Fortiform 1050 materials are deeply characterized using uniaxial and cyclic tension-compression tests. Coefficient of friction (COF) is also obtained using strip drawing tests. These results have been used to calibrate mixed kinematic-hardening material models as well as pressure dependent friction models. Finally, the geometrical accuracy of the different material and friction models has been evaluated by comparing the numerical predictions with experimental demonstrators obtained using a U-Drawing tester.

Comparison report of the OECD/CSNI international standard problem 21 (Piper-one experiment PO-SB-7). Volume 1 comparison report. Volume 2 evaluation of code accuracy in the prediction of ISP 21

International Nuclear Information System (INIS)

1989-11-01

The present report deals with the comparison of 6 blind predictions, submitted by 5 participants, and the experimental results measured during the test PO-SB-7 performed in PIPER-ONE facility. The PIPER-ONE apparatus is an experimental simulator of a General Electric BWR. The test PO-SB-7 simulates a SB-LOCA originated by a break in one recirculation line of the reference BWR-6 plant, without intervention of high pressure ECCS. The overall activity constitutes the CSNI ISP-21. The main parts of the report are: a) outline of the test facility and of the PO-SB-7 experiment; b) overview of input models used by participants; c) evaluation of participant predictions on the basis of one-by-one comparison with selected experimental trends; d) evaluation of present code capabilities and accuracy, on the basis of the overall comparison between measured data and participants double blind predictions. Finally, a judgement is given in relation to the overall value of the activity

Predictors of Response and Mechanisms of Change in an Organizational Skills Intervention for Students with ADHD.

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Langberg, Joshua M; Becker, Stephen P; Epstein, Jeffery N; Vaughn, Aaron J; Girio-Herrera, Erin

2013-10-01

The purpose of the study was to evaluate predictors of response and mechanisms of change for the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with Attention-Deficit/Hyperactivity Disorder (ADHD). Twenty-three middle school students with ADHD (grades 6-8) received the HOPS intervention implemented by school mental health providers and made significant improvements in parent-rated materials organization and planning skills, impairment due to organizational skills problems, and homework problems. Predictors of response examined included demographic and child characteristics, such as gender, ethnicity, intelligence, ADHD and ODD symptom severity, and ADHD medication use. Mechanisms of change examined included the therapeutic alliance and adoption of the organization and planning skills taught during the HOPS intervention. Participant implementation of the HOPS binder materials organization system and the therapeutic alliance as rated by the student significantly predicted post-intervention outcomes after controlling for pre-intervention severity. Adoption of the binder materials organization system predicted parent-rated improvements in organization, planning, and homework problems above and beyond the impact of the therapeutic alliance. These findings demonstrate the importance of teaching students with ADHD to use a structured binder organization system for organizing and filing homework and classwork materials and for transferring work to and from school.

Behavioral economics strategies for promoting adherence to sleep interventions.

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Stevens, Jack

2015-10-01

Cognitive-behavioral treatment for insomnia and continuous positive airway pressure therapy for obstructive sleep apnea are among the most efficacious sleep interventions. Unfortunately, adherence levels are disappointingly low for these interventions. Behavioral economics offers a promising framework for promoting adherence, often through relatively brief and straightforward strategies. The assumptions, goals, and key strategies of behavioral economics will be introduced. These strategies include providing social norms information, changing defaults, using the compromise effect, utilizing commitment devices, and establishing lottery-based systems. Then, this review will highlight specific behavioral economic approaches to promote patient adherence for three major sleep interventions: 1) behavioral treatment for pediatric insomnia, 2) cognitive-behavioral treatment for adult insomnia, and 3) continuous positive airway pressure for obstructive sleep apnea. Next, behavioral economic strategies will be discussed as ways to improve health care provider adherence to clinical practice guidelines regarding appropriate prescribing of hypnotics and ordering sleep-promoting practices for hospitalized inpatients. Finally, possible concerns that readers may have about behavioral economics strategies, including their efficacy, feasibility, and sustainability, will be addressed. Copyright © 2014 Elsevier Ltd. All rights reserved.

The value of computed tomography-urography in predicting the ...

African Journals Online (AJOL)

Background The natural course of pelviureteric junction (PUJ) obstruction is variable. Of those who require surgical intervention, there is no definite reliable preoperative predictor of the likely postoperative outcome. We evaluated the value of preoperative computed tomography (CT)-urography in predicting the ...

Addressing Adolescent Substance Abuse: An Evaluation of Washington's Prevention and Intervention Services Program. 2001-03 Final Report.

Science.gov (United States)

Deck, Dennis D.

2004-01-01

To directly address the state of Washington's concerns regarding student alcohol and other drug use, in 1989 the state Legislature passed the Omnibus Alcohol and Controlled Substances Act (ESSHB 1793). One part of this act called for the creation of a school-based alcohol and other dug abuse prevention and early intervention program. The Office of…

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

International Nuclear Information System (INIS)

Thomas, G.; Kumar, K.S.

2006-01-01

public from a practice is relatively small, the intervention level based on averted dose may have to be high, as significant reduction in exposure is required to justify the intervention. For intervention after a major nuclear / radiological accident, the non-radiological risk could be much larger, particularly if it is necessary to evacuate a large number of people. The variation between intervention levels for different nuclear/ radiological emergency situation could also differ quite significantly. In case of intervention, the doses received before the countermeasures are implemented should not be counted for balancing the detriment and benefit as these doses will be received whether or not the intervention is carried out. At the same time, applying the concept of averted dose involves lot of uncertainty in predicting and advising the time of intervention. The initial planning for various emergencies should include a choice of intervention levels, as discussed in this paper, in terms of averted doses, that will be justified and reasonably well optimized. Each protective action should therefore be considered on its own merits and the doses that would be incurred via all relevant pathways of exposure should also be assessed. (authors)

Digital storytelling: an innovative legacy-making intervention for children with cancer.

Science.gov (United States)

Akard, Terrah Foster; Dietrich, Mary S; Friedman, Debra L; Hinds, Pamela S; Given, Barbara; Wray, Sarah; Gilmer, Mary Jo

2015-04-01

This study examined the feasibility of a legacy-making intervention in children with cancer and the preliminary effects on outcomes related to quality of life. Children (N = 28) ages 7-17 years completed a baseline QOL questionnaire (PedsQL) at T1. After baseline, the intervention group (n = 15) completed a randomized intervention that guided children to answer questions about legacy-making and create a digital story about themselves. A final copy of the digital story was provided to the families. A control group (n = 13) received customary care. Children repeated the questionnaire at T2. Parents (N = 22) of children who completed the intervention completed follow-up survey questions regarding intervention effects. Feasibility was strong (78% participation; 1 attrition). While differences between the groups in physical, emotional, social, or school functioning change was not statistically significant, the intervention group showed slightly better emotional and school functioning compared to controls. Parents reported that their child's digital story provided emotional comfort to them (n = 11, 46%), facilitated communication between parents and children (n = 9, 38%), and was a coping strategy for them (n = 4, 17%). Parents reported that the intervention helped children express their feelings (n = 19, 79%), cope (n = 6, 27%), and feel better emotionally (n = 5, 23%). Our intervention is feasible for children with cancer, is developmentally appropriate for children 7-17 years of age, and demonstrates promise to improve quality of life outcomes for children with cancer and their parents. © 2015 Wiley Periodicals, Inc.

Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study

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Sudeshna Chatterjee

2016-01-01

Full Text Available Aims: 1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. Settings and Design: Comparative, cross-sectional and non-interventional study. Methods and Material: It is retrospective, record-based study conducted upon inpatients (n = 200 of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. Statistical Analysis Used: Comparative analysis of specific and selective gaps were estimated in terms of percentage (%. Results: Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. Conclusions: The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care.

Predictions for the decays of radially-excited baryons

International Nuclear Information System (INIS)

Carlson, C.E.

2001-01-01

We consider decays of the lowest-lying radially excited baryons. Assuming a single-quark decay approximation, and negligible configuration mixing, we make model-independent predictions for the partial decay widths to final states with a single meson. Masses of unobserved states are predicted using an old mass formula rederived using large-N c QCD. The momentum dependence of the one-body decay amplitude is determined phenomenologically by fitting to observed decays. Comparison of these predictions to experiment may shed light on whether the Roper resonance can be interpreted as a three-quark state. (author)

Ergonomics Intervention in Unit Blast Furnace of a Typical Steel Company

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Majid Mo'tamed-Zadeh

2013-10-01

Full Text Available Objective: Musculoskeletal disorders are a major part of occupational diseases in working environments. Prevention of the occurrence of these problems requires the use of ergonomic assessment techniques and intervention to improve working conditions. The purpose of this study was to investigate the prevalence of musculoskeletal disorders in workers in the blast furnace unit and the intervention to reduce the prevalence of these disorders. Materials & Methods: This study conducted on 24 people working in the furnace unit. Medical records of furnace workers were reviewed and Nordic Musculoskeletal Questionnaires (NMQ was completed. Drilling operation and oxygenation task were assessed by using Rapid Entire Body Assessment (REBA and workers were given the necessary training. Work stations of oxygenation for 24 workers were redesign and Drilling operation was mechanized. And employed workers with musculoskeletal disorders were changed. REBA and NMQ were used to reassess the intervention effects. Results: According to medical records and results of NMQ about 37.5 percent of workers had musculoskeletal disorders. REBA final score was 11 and 10 for the drilling and oxygenation tasks respectively. After redesigning the workstation, REBA final score was 5 for the oxygenation task and the drilling operation removed by mechanized. With the amendment procedures of musculoskeletal disorders was reduced 17.5 percent. Conclusion: According to REBA Score, the risk of musculoskeletal disorders was reduced by implementing amendments to the furnace unit and prevalence of musculoskeletal disorders also significantly reduced. Keyword: Ergonomic, MSDs, REBA, NMQ, Steel

C-reactive protein response to a vegan lifestyle intervention.

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Sutliffe, Jay T; Wilson, Lori D; de Heer, Hendrik D; Foster, Ray L; Carnot, Mary Jo

2015-02-01

This brief lifestyle intervention, including a vegan diet rich in fresh fruits and vegetables, whole grains and various legumes, nuts and seeds, significantly improved health risk factors and reduced systemic inflammation as measured by circulating CRP. The degree of improvement was associated with baseline CRP such that higher levels predicted greater decreases. The interaction between gender and baseline CRP was significant and showed that males with higher baseline CRP levels appeared to have a more robust decrease in CRP due to the intervention than did their female counterparts. It is likely that the vegetable and high fiber content of a vegan diet reduces CRP in the presences of obesity. Neither the quantity of exercise nor the length of stay was significant predictors of CRP reduction. Additionally, those participants who had a vegan diet prior to the intervention had the lowest CRP risk coming into the program. Direct measure of body fat composition, estrogen and other inflammatory mediators such as IL-6 and TNF-alpha would enhance current understanding of the specific mechanisms of CRP reduction related to lifestyle interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Applications of Temperament: A Review of Caregiver-Focused Temperament-Driven Interventions

Science.gov (United States)

Iverson, Sydney L.; Gartstein, Maria A.

2018-01-01

Research Findings: Temperament, often defined in terms of reactive and regulatory tendencies, has been shown to predict child outcomes over and above other risk factors and represents a critical aspect of social-emotional development. The present article is a systematic review of temperament-based interventions targeting caregivers, wherein the…

Die Casting Part Distortion: Prediction and Attenuation; FINAL

International Nuclear Information System (INIS)

Allen Miller, R.

2002-01-01

The goal of this research was to predict the part deformation and residual stresses after ejection from the die and cooling to room temperature. A finite element model was built to achieve this goal and several modeling techniques were investigated throughout this research. Die-casting is a very complex process and the researchers are faced with a large number of hard to solve physical problems when modeling the process. Several assumptions are made in our simulation model. The first significant assumption is the instantaneous cavity filling. This means that the cavity filling stage is not considered in our model. Considering the cavity filling stage increases the modeling complexity as a result of different flow patterns. expected in the shot sleeve, gate, runner and different cavity features. The flow of gas from the cavity through the vents is another problem that is ignored in our model as a result of this assumption. Our second assumption is that the cast metal has uniform temperature distribution inside the cavity, at the starting point of simulation. This temperature is assumed to be over liquidus limit, i.e. the solid fraction is 0.0% of the cast metal. The third assumption is due to ABAQUS (commercial software used in this research) limitations. ABAQUS cannot deal with multi-phase models; therefore we use solid elements to define the casting instead of multi-phase (liquid/solid) elements. Liquid elements can carry the hydrostatic pressure from the shot sleeve and apply it on the cavity surfaces, while the solid elements do not have this capability. To compensate for this assumption we add the cavity pressure as a boundary condition and apply it on the cavity surface separately from the part. Another issue with this assumption is that, liquid casting can follow the cavity shape when it distorts. With the use of solid elements to represent the casting during its liquid state, it loses this capability to follow the cavity. Several techniques were tested to

Predicting healthcare trajectories from medical records: A deep learning approach.

Science.gov (United States)

Pham, Trang; Tran, Truyen; Phung, Dinh; Venkatesh, Svetha

2017-05-01

Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, stored in electronic medical records are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network that reads medical records, stores previous illness history, infers current illness states and predicts future medical outcomes. At the data level, DeepCare represents care episodes as vectors and models patient health state trajectories by the memory of historical records. Built on Long Short-Term Memory (LSTM), DeepCare introduces methods to handle irregularly timed events by moderating the forgetting and consolidation of memory. DeepCare also explicitly models medical interventions that change the course of illness and shape future medical risk. Moving up to the health state level, historical and present health states are then aggregated through multiscale temporal pooling, before passing through a neural network that estimates future outcomes. We demonstrate the efficacy of DeepCare for disease progression modeling, intervention recommendation, and future risk prediction. On two important cohorts with heavy social and economic burden - diabetes and mental health - the results show improved prediction accuracy. Copyright © 2017 Elsevier Inc. All rights reserved.

Genomic prediction of complex human traits: relatedness, trait architecture and predictive meta-models

Science.gov (United States)

Spiliopoulou, Athina; Nagy, Reka; Bermingham, Mairead L.; Huffman, Jennifer E.; Hayward, Caroline; Vitart, Veronique; Rudan, Igor; Campbell, Harry; Wright, Alan F.; Wilson, James F.; Pong-Wong, Ricardo; Agakov, Felix; Navarro, Pau; Haley, Chris S.

2015-01-01

We explore the prediction of individuals' phenotypes for complex traits using genomic data. We compare several widely used prediction models, including Ridge Regression, LASSO and Elastic Nets estimated from cohort data, and polygenic risk scores constructed using published summary statistics from genome-wide association meta-analyses (GWAMA). We evaluate the interplay between relatedness, trait architecture and optimal marker density, by predicting height, body mass index (BMI) and high-density lipoprotein level (HDL) in two data cohorts, originating from Croatia and Scotland. We empirically demonstrate that dense models are better when all genetic effects are small (height and BMI) and target individuals are related to the training samples, while sparse models predict better in unrelated individuals and when some effects have moderate size (HDL). For HDL sparse models achieved good across-cohort prediction, performing similarly to the GWAMA risk score and to models trained within the same cohort, which indicates that, for predicting traits with moderately sized effects, large sample sizes and familial structure become less important, though still potentially useful. Finally, we propose a novel ensemble of whole-genome predictors with GWAMA risk scores and demonstrate that the resulting meta-model achieves higher prediction accuracy than either model on its own. We conclude that although current genomic predictors are not accurate enough for diagnostic purposes, performance can be improved without requiring access to large-scale individual-level data. Our methodologically simple meta-model is a means of performing predictive meta-analysis for optimizing genomic predictions and can be easily extended to incorporate multiple population-level summary statistics or other domain knowledge. PMID:25918167

Impact of clinical pharmacy interventions on medication error nodes.

Science.gov (United States)

Chamoun, Nibal R; Zeenny, Rony; Mansour, Hanine

2016-12-01

Background Pharmacists' involvement in patient care has improved the quality of care and reduced medication errors. However, this has required a lot of work that could not have been accomplished without documentation of interventions. Several means of documenting errors have been proposed in the literature but without a consistent comprehensive process. Recently, the American College of Clinical Pharmacy (ACCP) recognized that pharmacy practice lacks a consistent process for direct patient care and discussed several options for a pharmaceutical care plan, essentially encompassing medication therapy assessment, development and implementation of a pharmaceutical care plan and finally evaluation of the outcome. Therefore, as per the recommendations of ACCP, we sought to retrospectively analyze interventions by grouping them according to medication related problems (MRP) and their nodes such as prescribing; administering; monitoring; documenting and dispensing. Objective The aim of this study is to report interventions according to medication error (ME) nodes and show the impact of pharmacy interventions in reducing MRPs. Setting The study was conducted at the cardiology and infectious diseases services at a teaching hospital located in Beirut, Lebanon. Methods Intervention documentation was completed by pharmacy students on infectious diseases and cardiology rotations then reviewed by clinical pharmacists with respective specialties. Before data analysis, a new pharmacy reporting sheet was developed in order to link interventions according to MRP. Then, MRPs were grouped in the five ME nodes. During the documentation process, whether MRP had reached the patient or not may have not been reported which prevented the classification to the corresponding medication error nodes as ME. Main outcome Reduction in medication related problems across all ME nodes. Results A total of n = 1174 interventions were documented. N = 1091 interventions were classified as MRPs

A narrative review on cervical interventions in adults with chronic whiplash-associated disorder

Science.gov (United States)

Yeung, Euson; Tong, Tiffany; Reed, Nick

2018-01-01

Introduction Whiplash injuries are common in society, but clinical interventions are inconclusive on the most effective treatment. Research and reviews have been completed with the goal of determining clinical interventions that are effective for whiplash injuries and disorders, but literature has not recently been summarised on best practices for cervical spine interventions for adults with chronic whiplash. Purpose The objective of this narrative review is to update and expand on previous works, to provide recommendations for clinical interventions and future research in the area of cervical spine rehabilitation for adults with chronic whiplash-associated disorder. Method The Arskey and O’Malley methodology was used for this narrative review. CINHAL, EMBASE, Medline, PsychInfo, Scopus, Web of Science, as well as grey literature, were searched from 2003 to April 2017. Two reviewers screened titles and abstracts for relevance to the review, and content analysis summarised the study findings. A total of 14 citations were included in the final review. Findings Exercise-based interventions targeted at the cervical spine appear most beneficial for adults with chronic whiplash-associated disorder (WAD). Invasive interventions still require more rigorous studies to deem their effectiveness for this population. Conclusion Further research is required to investigate and determine clinically relevant results for cervical spine intervention in patients with chronic WAD. PMID:29719724

The hadronic final state in the deep inelastic electron-proton scattering. A comparison between the ZEUS data measured 1992 and theoretical models

International Nuclear Information System (INIS)

Schneider, J.L.

1993-12-01

The hadronic final state in deep inelastic e - P collisions has been studied with the 1992 data from the ZEUS detector at HERA. The hadronic final state is described by event topology variables like thrust and sphericity and also by variables like multiplicity and transverse momentum. These quantities require the reconstruction of the particle four moments which are calculated from calorimeter cell clusters (condensates). A detailed Monte-Carlo comparison between final state particles and condensates is presented. ZEUS data and model predictions are compared in the γ * P system. Good agreement between data and models is found in the x-Feynman and transverse momentum spectra and in the seagull plot. Mean thrust and sphericity are measured as functions of the invariant mass W of the hadronic final state. They significantly deviate from the model predictions, as do the mean multiplicities, which exceed the model predictions by about 1 unit. (orig.)

Healthy work revisited: do changes in time strain predict well-being?

Science.gov (United States)

Moen, Phyllis; Kelly, Erin L; Lam, Jack

2013-04-01

Building on Karasek and Theorell (R. Karasek & T. Theorell, 1990, Healthy work: Stress, productivity, and the reconstruction of working life, New York, NY: Basic Books), we theorized and tested the relationship between time strain (work-time demands and control) and seven self-reported health outcomes. We drew on survey data from 550 employees fielded before and 6 months after the implementation of an organizational intervention, the results only work environment (ROWE) in a white-collar organization. Cross-sectional (wave 1) models showed psychological time demands and time control measures were related to health outcomes in expected directions. The ROWE intervention did not predict changes in psychological time demands by wave 2, but did predict increased time control (a sense of time adequacy and schedule control). Statistical models revealed increases in psychological time demands and time adequacy predicted changes in positive (energy, mastery, psychological well-being, self-assessed health) and negative (emotional exhaustion, somatic symptoms, psychological distress) outcomes in expected directions, net of job and home demands and covariates. This study demonstrates the value of including time strain in investigations of the health effects of job conditions. Results encourage longitudinal models of change in psychological time demands as well as time control, along with the development and testing of interventions aimed at reducing time strain in different populations of workers.

Neuropsychiatric symptoms and quality of life in patients in the final phase of dementia.

Science.gov (United States)

Koopmans, Raymond T C M; van der Molen, Marloes; Raats, Monique; Ettema, Teake P

2009-01-01

To assess neuropsychiatric symptoms and quality of life in a group of patients in the final phase of dementia. All patients with dementia (n = 216) residing on dementia special care units of two Dutch nursing homes were included in the study provided they met the criteria for the final phase of dementia. Neuropsychiatric symptoms were assessed with the Neuropsychiatric Inventory Nursing Home version (NPI-NH) and the Cohen Mansfield Agitation Inventory (CMAI). Quality of life was assessed with the QUALIDEM. Of the 216 dementia patients 39 met the criteria for the final phase of dementia. The patients showed a specific pattern of behaviours with a high prevalence of apathy, agitation and behaviours that were mainly observed during morning care such as making strange noises, grabbing, performing repetitious mannerism, spitting, hitting, screaming and pushing. Overall quality of life of these patients in the final phase of dementia was moderate. In this small sample, patients in the final phase of dementia show specific behavioural problems, that mainly should be addressed with psychosocial interventions. (c) 2008 John Wiley & Sons, Ltd.

YOUTH HOMELESSNESS: PREVENTION AND INTERVENTION EFFORTS IN PSYCHOLOGY

Directory of Open Access Journals (Sweden)

JHON J. SANABRIA

2006-01-01

Full Text Available In this paper, I review the prevention and intervention efforts addressing youth homelessness in the fieldof psychology between 1994 and 2004. Analyses of the literature revealed that the majority of papersincluding homeless youth as a population for study have focused on issues other than homelessness.These issues include HIV/AIDS and substance abuse prevention. Eleven journal articles addressing youthhomelessness were reviewed. These articles focused on outcomes, interventions, and recommendationsfor clinical practice. Literature findings revealed that demographic variables did not predict outcomesfor homeless youth; youth returning home with their parents have more positive outcomes than youthmoving into other locations, emergency shelter services improve youth’s mental health and social condition,and services should be comprehensive and move beyond the individuals. Implications for communitypsychology, policy makers, and shelters are discussed.

[The CHILT I project (Children's Health Interventional Trial). A multicomponent intervention to prevent physical inactivity and overweight in primary schools].

Science.gov (United States)

Graf, C; Dordel, S

2011-03-01

Child and juvenile obesity is increasing worldwide; therefore, effective preventive strategies are warranted. The stepwise project CHILT (Children's Health Interventional Trial) was initiated in 2000 and combines in its multicomponent school-based arm CHILT I health education and physical activity for primary school children to prevent physical inactivity and overweight. The effect on obesity and physical performance was studied in 12 primary schools (intervention schools, IS) compared with 5 control schools (CS). Anthropometric data were recorded. Physical performance was measured by a coordination test for children (the "Körperkoordinationstest für Kinder", KTK) and the 6-minute run. Anthropometric and motoric data of 436 children in IS (55.0% of the population) and 179 children in CS (62.8%) were available at baseline and at follow-up. No difference in the incidence of overweight was found between the IS and CS after 4 years of intervention. Remission of overweight was higher in IS (23.2% versus 19.2%), but not significant. The increase in BMI was significantly lower in IS, in which the program was regularly performed. There was an improvement in selected items of the KTK in IS. In particular, endurance performance tended to be higher at final examination. School-based preventive intervention seems to have a positive influence on physical motor skills and the remission of overweight. To optimize the effects, a consistent and quality assured implementation and the integration of the children's whole environment are warranted.

Predicting epileptic seizures in advance.

Directory of Open Access Journals (Sweden)

Negin Moghim

Full Text Available Epilepsy is the second most common neurological disorder, affecting 0.6-0.8% of the world's population. In this neurological disorder, abnormal activity of the brain causes seizures, the nature of which tend to be sudden. Antiepileptic Drugs (AEDs are used as long-term therapeutic solutions that control the condition. Of those treated with AEDs, 35% become resistant to medication. The unpredictable nature of seizures poses risks for the individual with epilepsy. It is clearly desirable to find more effective ways of preventing seizures for such patients. The automatic detection of oncoming seizures, before their actual onset, can facilitate timely intervention and hence minimize these risks. In addition, advance prediction of seizures can enrich our understanding of the epileptic brain. In this study, drawing on the body of work behind automatic seizure detection and prediction from digitised Invasive Electroencephalography (EEG data, a prediction algorithm, ASPPR (Advance Seizure Prediction via Pre-ictal Relabeling, is described. ASPPR facilitates the learning of predictive models targeted at recognizing patterns in EEG activity that are in a specific time window in advance of a seizure. It then exploits advanced machine learning coupled with the design and selection of appropriate features from EEG signals. Results, from evaluating ASPPR independently on 21 different patients, suggest that seizures for many patients can be predicted up to 20 minutes in advance of their onset. Compared to benchmark performance represented by a mean S1-Score (harmonic mean of Sensitivity and Specificity of 90.6% for predicting seizure onset between 0 and 5 minutes in advance, ASPPR achieves mean S1-Scores of: 96.30% for prediction between 1 and 6 minutes in advance, 96.13% for prediction between 8 and 13 minutes in advance, 94.5% for prediction between 14 and 19 minutes in advance, and 94.2% for prediction between 20 and 25 minutes in advance.

Predicting the Impact of Intervention Strategies for Sleeping Sickness in Two High-Endemicity Health Zones of the Democratic Republic of Congo.

Directory of Open Access Journals (Sweden)

Kat S Rock

2017-01-01

Full Text Available Two goals have been set for Gambian human African trypanosomiasis (HAT, the first is to achieve elimination as a public health problem in 90% of foci by 2020, and the second is to achieve zero transmission globally by 2030. It remains unclear if certain HAT hotspots could achieve elimination as a public health problem by 2020 and, of greater concern, it appears that current interventions to control HAT in these areas may not be sufficient to achieve zero transmission by 2030. A mathematical model of disease dynamics was used to assess the potential impact of changing the intervention strategy in two high-endemicity health zones of Kwilu province, Democratic Republic of Congo. Six key strategies and twelve variations were considered which covered a range of recruitment strategies for screening and vector control. It was found that effectiveness of HAT screening could be improved by increasing effort to recruit high-risk groups for screening. Furthermore, seven proposed strategies which included vector control were predicted to be sufficient to achieve an incidence of less than 1 reported case per 10,000 people by 2020 in the study region. All vector control strategies simulated reduced transmission enough to meet the 2030 goal, even if vector control was only moderately effective (60% tsetse population reduction. At this level of control the full elimination threshold was expected to be met within six years following the start of the change in strategy and over 6000 additional cases would be averted between 2017 and 2030 compared to current screening alone. It is recommended that a two-pronged strategy including both enhanced active screening and tsetse control is implemented in this region and in other persistent HAT foci to ensure the success of the control programme and meet the 2030 elimination goal for HAT.

Guided interventions in musculoskeletal ultrasound: what's the evidence?

International Nuclear Information System (INIS)

Davidson, J.; Jayaraman, S.

2011-01-01

Increasing histological and radiological understanding of the processes involved in soft-tissue injury is leading to novel targeted treatments. A number of reviews have recommended that these treatments should be performed with image guidance. This review describes current ultrasound-guided interventions and injections, together with the level of evidence for these. Discussion of guided interventions will include; percutaneous lavage (barbotage), brisement, dry needling, electrocoagulation, and of guided injections; corticosteroids, autologous substances (blood and platelet rich plasma), sclerosants, and prolotherapy (hyperosmolar dextrose). Representative imaging illustrating some of these techniques is included for correlation with the methods described. As these procedures are often performed in sportspeople, it is essential that the radiologist is aware of prohibited substances and methods outlined in an annual publication from the World Anti-Doping Association (WADA). Finally, future directions, including the use of autologous substances, mesenchymal and stem cells will be discussed.

A model to predict the beginning of the pollen season

DEFF Research Database (Denmark)

Toldam-Andersen, Torben Bo

1991-01-01

for fruit trees are generally applicable, and give a reasonable description of the growth processes of other trees. This type of model can therefore be of value in predicting the start of the pollen season. The predicted dates were generally within 3-5 days of the observed. Finally the possibility of frost...

Customer Churn Prediction for Broadband Internet Services

Science.gov (United States)

Huang, B. Q.; Kechadi, M.-T.; Buckley, B.

Although churn prediction has been an area of research in the voice branch of telecommunications services, more focused studies on the huge growth area of Broadband Internet services are limited. Therefore, this paper presents a new set of features for broadband Internet customer churn prediction, based on Henley segments, the broadband usage, dial types, the spend of dial-up, line-information, bill and payment information, account information. Then the four prediction techniques (Logistic Regressions, Decision Trees, Multilayer Perceptron Neural Networks and Support Vector Machines) are applied in customer churn, based on the new features. Finally, the evaluation of new features and a comparative analysis of the predictors are made for broadband customer churn prediction. The experimental results show that the new features with these four modelling techniques are efficient for customer churn prediction in the broadband service field.

Predicting the duration of the Syrian insurgency

Directory of Open Access Journals (Sweden)

Ulrich Pilster

2014-08-01

Full Text Available While there were several relatively short uprisings in Northern Africa and the Middle East during the Arab Spring, the dispute between the rebels and government forces in Syria has evolved into a full-scale civil war. We try to predict the length of the Syrian insurgency with a three-stage technique. Using out-of-sample techniques, we first assess the predictive capacity of 69 explanatory variables for insurgency duration. After determining the model with the highest predictive power, we categorize Syria according to the variables in this final model. Based on in-sample approaches, we then predict the duration of the Syrian uprising for three different scenarios. The most realistic point prediction is 5.12 years from the insurgency’s start, which suggests an end date between the end of 2016 and early 2017.

A Parent-Mediated Intervention to Increase Responsive Parental Behaviors and Child Communication in Children with ASD: A Randomized Clinical Trial

Science.gov (United States)

Siller, Michael; Hutman, Ted; Sigman, Marian

2013-01-01

Longitudinal research has demonstrated that responsive parental behaviors reliably predict subsequent language gains in children with autism spectrum disorder. To investigate the underlying causal mechanisms, we conducted a randomized clinical trial of an experimental intervention (Focused Playtime Intervention, FPI) that aims to enhance…

Poverty, Stress, and Brain Development: New Directions for Prevention and Intervention.

Science.gov (United States)

Blair, Clancy; Raver, C Cybele

2016-04-01

We review some of the growing evidence of the costs of poverty to children's neuroendocrine function, early brain development, and cognitive ability. We underscore the importance of addressing the negative consequences of poverty-related adversity early in children's lives, given evidence supporting the plasticity of executive functions and associated physiologic processes in response to early intervention and the importance of higher order cognitive functions for success in school and in life. Finally, we highlight some new directions for prevention and intervention that are rapidly emerging at the intersection of developmental science, pediatrics, child psychology and psychiatry, and public policy. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Preventive interventions in families with parental depression: children's psychosocial symptoms and prosocial behaviour.

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Solantaus, Tytti; Paavonen, E Juulia; Toikka, Sini; Punamäki, Raija-Leena

2010-12-01

The aim is to document the effectiveness of a preventive family intervention (Family Talk Intervention, FTI) and a brief psychoeducational discussion with parents (Let's Talk about the Children, LT) on children's psychosocial symptoms and prosocial behaviour in families with parental mood disorder, when the interventions are practiced in psychiatric services for adults in the finnish national health service. Patients with mood disorder were invited to participate with their families. Consenting families were randomized to the two intervention groups. The initial sample comprised 119 families and their children aged 8-16. Of these, 109 completed the interventions and the baseline evaluation. Mothers and fathers filled out questionnaires including standardized rating scales for children's symptoms and prosocial behaviour at baseline and at 4, 10 and 18 months post-intervention. The final sample consisted of parental reports on 149 children with 83 complete data sets. Both interventions were effective in decreasing children's emotional symptoms, anxiety, and marginally hyperactivity and in improving children's prosocial behaviour. The FTI was more effective than the LT on emotional symptoms particularly immediately after the intervention, while the effect of the LT emerged after a longer interval. The study supports the effectiveness of both interventions in families with depressed parents. The FTI is applicable in cultural settings other than the USA. Our findings provide support for including preventive child mental health measures as part of psychiatric services for mentally ill parents.

Do Psychosocial Factors Predict Readmission among Diabetic Elderly Patients?

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Alavi, Mousa; Baharlooei, Omeleila; AdelMehraban, Marzieh

2017-01-01

Despite advances in diabetes treatment, the rate of readmission is still relatively high among these patients, especially in older population. Various factors may predict readmission in these patients; hence, the aim of this study was to assess the role of psychosocial factors in predicting readmission among diabetic elderly hospitalized in selected hospitals of Isfahan. In this cross-sectional study conducted from January to September 2016, 150 diabetic elderly hospitalized in selected hospitals affiliated with Isfahan University of medical sciences were chosen using a convenient sampling method. The initial information was collected by a three-part questionnaire consisting of (a) demographic characteristics, (b) 21-item depression, anxiety, and stress scale (DASS-21), and (c) multidimensional scale of perceived social support (MSPSS). Further information about readmission was gathered 3 months after completing the questionnaires through a phone call follow-up. Descriptive and inferential statistics (discriminant function analysis test) were used to analyze the data. During 3 months after discharge, 44% of hospitalized diabetic elderly were readmitted. Analytical model predicted the readmission status of 109 individuals (of total 150 persons) in the studied units (success rate of 72.2%). Among predicting factors, depression and social support had the most and the least important roles in predicting readmission rate, respectively. Interventions to improve mental status (i.e., decreasing levels of depression, anxiety, and stress) and develop social support are suggested to reduce the risk of readmission among diabetic elderly patients. Nevertheless, future studies are needed to verify the value of such interventions.

Evaluation of interventions on road traffic injuries in Peru: a qualitative approach

Science.gov (United States)

2012-01-01

Background Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru. Methods We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention. Results Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks. Conclusions Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru. PMID:22269578

Effect of information, education and communication intervention on awareness about rational pharmacy practice in pharmacy students.

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Gharpure, Kunda; Thawani, Vijay; Sontakke, Smita; Chaudhari, Kiran; Bankar, Mangesh; Diwe, Rajendra

2011-07-01

There is a growing indifference among the pharmacy practitioners towards their duty as information providers to the patients. The patients do not always get enough desired information about proper use of medicines from the prescribers also. This contributes to improper use of medicines by the patients. To bring about awareness about rational pharmacy practice in pharmacy students for better service to the patients. The final year students of Bachelor of Pharmacy (B. Pharm) from four colleges of Nagpur were enrolled for the study after informed consent. Their base knowledge was assessed through a written test which comprised of 27 objective questions related to rational pharmacy practice. This was followed by a series of seven articles on rational medicine use, published in leading local English news daily. The participants were reminded to read them on the day of publication of each article. As a backup, the articles were displayed on the notice board of respective colleges. Second intervention was a half day interactive session where series of six lectures were delivered to the participants on the right and wrong approaches in pharmacy practice. Posters about the do's and dont's of rational pharmacy practice were also displayed at the venue. The session was followed by a repeat test using the same pre-test to assess the change. Pre and post intervention data was compared using Fisher's Exact test. It was observed that the intervention did bring about a positive change in the attitude and knowledge of the final year Pharmacy students about rational pharmacy practice. The role of a pharmacist in health care provision is usually overlooked in India. Hence there is strong need for reinforcement in final year B. Pharm when most of the students go in for community service. Such interventions will be helpful in bringing about a positive change towards rational practice of pharmacy. This study showed that a properly timed and meticulously implemented intervention brings

Using physiologically based models for clinical translation: predictive modelling, data interpretation or something in-between?

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Niederer, Steven A; Smith, Nic P

2016-12-01

Heart disease continues to be a significant clinical problem in Western society. Predictive models and simulations that integrate physiological understanding with patient information derived from clinical data have huge potential to contribute to improving our understanding of both the progression and treatment of heart disease. In particular they provide the potential to improve patient selection and optimisation of cardiovascular interventions across a range of pathologies. Currently a significant proportion of this potential is still to be realised. In this paper we discuss the opportunities and challenges associated with this realisation. Reviewing the successful elements of model translation for biophysically based models and the emerging supporting technologies, we propose three distinct modes of clinical translation. Finally we outline the challenges ahead that will be fundamental to overcome if the ultimate goal of fully personalised clinical cardiac care is to be achieved. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

Return to Work After Lumbar Microdiscectomy - Personalizing Approach Through Predictive Modeling.

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Papić, Monika; Brdar, Sanja; Papić, Vladimir; Lončar-Turukalo, Tatjana

2016-01-01

Lumbar disc herniation (LDH) is the most common disease among working population requiring surgical intervention. This study aims to predict the return to work after operative treatment of LDH based on the observational study including 153 patients. The classification problem was approached using decision trees (DT), support vector machines (SVM) and multilayer perception (MLP) combined with RELIEF algorithm for feature selection. MLP provided best recall of 0.86 for the class of patients not returning to work, which combined with the selected features enables early identification and personalized targeted interventions towards subjects at risk of prolonged disability. The predictive modeling indicated at the most decisive risk factors in prolongation of work absence: psychosocial factors, mobility of the spine and structural changes of facet joints and professional factors including standing, sitting and microclimate.

An Application of the Reasoned Action Approach to Bystander Intervention for Sexual Assault.

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Lukacena, Kaylee M; Reynolds-Tylus, Tobias; Quick, Brian L

2017-10-25

The high prevalence of sexual assault in US college campuses has led to a widespread implementation of bystander intervention programs aimed at preventing sexual assault. The current study examines predictors of college students' intentions to engage in bystander intervention through the theoretical lens of the reasoned action approach. An online survey with college students (N = 186) was conducted at a large Midwestern university. Our results indicated experiential attitudes, instrumental attitudes, descriptive norms, autonomy, and capacity, each positively associated with participants' intentions to intervene to stop a sexual assault. Against expectations, injunctive norms were unrelated to bystander intervention intentions. Finally, in addition to these main effects, an experiential attitude by autonomy interaction was also observed. The results are discussed with a focus on the theoretical and practical implications of our findings.

Aggression and social withdrawal as viewed by children's peers: conceptual issues in assessment and implications for intervention.

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Younger, A J; Schneider, B H; Daniels, T

1991-01-01

Children's peer assessments of aggressive and withdrawn behavior are fundamentally related to developmental changes in their understanding of others. This article synthesizes research relevant to the thesis that peer assessments are dependent on children's ability both to recall the previous behavior of their peers and to predict their likely future behavior. Social schema theory, borrowed from adult social psychology, is highly relevant to such recall and prediction. Age differences, affective biases, and gender roles may color children's assessments of their peers' social behavior. Such influences should be taken into account when conceptualizing interventions aimed at enhancing children's peer status, and in measuring the success of these interventions. PMID:1958647

Early-Life Obesity Prevention: Critique of Intervention Trials During the First One Thousand Days.

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Reilly, John J; Martin, Anne; Hughes, Adrienne R

2017-06-01

To critique the evidence from recent and ongoing obesity prevention interventions in the first 1000 days in order to identify evidence gaps and weaknesses, and to make suggestions for more informative future intervention trials. Completed and ongoing intervention trials have had fairly modest effects, have been limited largely to high-income countries, and have used relatively short-term interventions and outcomes. Comparison of the evidence from completed prevention trials with the evidence from systematic reviews of behavioral risk factors shows that some life-course stages have been neglected (pre-conception and toddlerhood), and that interventions have neglected to target some important behavioral risk factors (maternal smoking during pregnancy, infant and child sleep). Finally, while obesity prevention interventions aim to modify body composition, few intervention trials have used body composition measures as outcomes, and this has limited their sensitivity to detect intervention effects. The new WHO Healthy Lifestyles Trajectory (HeLTI) initiative should address some of these weaknesses. Future early obesity prevention trials should be much more ambitious. They should, ideally: extend their interventions over the first 1000 days; have longer-term (childhood) outcomes, and improved outcome measures (body composition measures in addition to proxies for body composition such as the BMI for age); have greater emphasis on maternal smoking and child sleep; be global.

Dynamic fMRI networks predict success in a behavioral weight loss program among older adults.

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Mokhtari, Fatemeh; Rejeski, W Jack; Zhu, Yingying; Wu, Guorong; Simpson, Sean L; Burdette, Jonathan H; Laurienti, Paul J

2018-06-01

More than one-third of adults in the United States are obese, with a higher prevalence among older adults. Obesity among older adults is a major cause of physical dysfunction, hypertension, diabetes, and coronary heart diseases. Many people who engage in lifestyle weight loss interventions fail to reach targeted goals for weight loss, and most will regain what was lost within 1-2 years following cessation of treatment. This variability in treatment efficacy suggests that there are important phenotypes predictive of success with intentional weight loss that could lead to tailored treatment regimen, an idea that is consistent with the concept of precision-based medicine. Although the identification of biochemical and metabolic phenotypes are one potential direction of research, neurobiological measures may prove useful as substantial behavioral change is necessary to achieve success in a lifestyle intervention. In the present study, we use dynamic brain networks from functional magnetic resonance imaging (fMRI) data to prospectively identify individuals most likely to succeed in a behavioral weight loss intervention. Brain imaging was performed in overweight or obese older adults (age: 65-79 years) who participated in an 18-month lifestyle weight loss intervention. Machine learning and functional brain networks were combined to produce multivariate prediction models. The prediction accuracy exceeded 95%, suggesting that there exists a consistent pattern of connectivity which correctly predicts success with weight loss at the individual level. Connectivity patterns that contributed to the prediction consisted of complex multivariate network components that substantially overlapped with known brain networks that are associated with behavior emergence, self-regulation, body awareness, and the sensory features of food. Future work on independent datasets and diverse populations is needed to corroborate our findings. Additionally, we believe that efforts can begin to

Nutritional Intervention as part of Functional Rehabilitation in Older People with reduced functional ability

DEFF Research Database (Denmark)

Beck, Anne Marie; Dent, Elsa; Baldwin, Christine

2016-01-01

body weight, hand-grip strength or muscle strength. There was no difference between groups in the critical outcomes; balance, cognition, activities of daily living and mortality at long-term follow-up. Nutritional intervention given with functional rehabilitation was associated with an increased...... studies considered to be clinical homogenous were combined in a meta-analysis Results Of the 788 studies screened, five were identified for inclusion. Nutritional intervention given with functional rehabilitation improved energy and protein intake, although it failed to provide any improvement in final....... Conclusions This meta-analysis highlights concerns regarding the quality of the randomisation of participants at baseline. Future high-quality research is essential to establish whether older people with loss of functional abilities can benefit from nutritional intervention....

Group interventions for patients with cancer and HIV disease: part IV. Clinical and policy recommendations.

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Leszcz, Molyn; Sherman, Allen; Mosier, Julie; Burlingame, Gary M; Cleary, Trish; Ulman, Kathleen Hubbs; Simonton, Stephanie; Latif, Umaira; Strauss, Bernhard; Hazelton, Lara

2004-10-01

Group interventions have assumed a growing role in primary prevention and supportive care for cancer and HIV disease. Earlier sections of this Special Report examined empirical findings for these interventions and provided recommendations for future research. The current section offers brief recommendations for service providers, policymakers, and stakeholders. Group services now occupy an increasingly prominent place in primary prevention programs and medical settings. In previous sections of this Special Report (Sherman, Leszcz et al., 2004; Sherman, Mosier et al., 2004a, 2004b) we examined the efficacy of different group interventions at different phases of cancer or HIV disease, considered characteristics of the intervention and the participants that might influence outcomes, and discussed mechanisms of action. Methodological challenges and priorities for future research were highlighted. In this, the final section, we offer brief recommendations for service providers, policymakers, and other stakeholders. We consider some of the barriers that constrain use of empirically-based group interventions and note how these programs might be implemented more widely and effectively.

Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study.

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Wang, Chao; Hua, Yujie; Fu, Hua; Cheng, Longfeng; Qian, Wen; Liu, Junyang; Crawford, Paul; Dai, Junming

2017-01-03

The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai. Recruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237) into either the intervention group (3 communities, n = 105) or to a wait-list control group (3 communities, n = 132). All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15). From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1), before intervention at 24 weeks (T2), and immediately after intervention at 32 weeks (T3). Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5) and the Self-administered Sleep Questionnaire (SSQ). Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects. There was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there was no significant difference within the groups

Costs of the 'Hartslag Limburg' community heart health intervention

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Ruland Erik

2006-03-01

Full Text Available Abstract Background Little is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution. Methods Hartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000. Special attention was paid to reach persons with a low socio-economic status. Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004. Results The economic costs of the interventions that were implemented within the five-year community programme (n = 180,000 were calculated to be about €900,000. €555,000 was spent on interventions to change people's exercise patterns, €250,000 on improving nutrition, €50,000 on smoking cessation, and €45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs. Conclusion The current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very

Exploring workplace TB interventions with foreign-born Latino workers.

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Eggerth, Donald E; Keller, Brenna M; Flynn, Michael A

2018-05-15

Persons born outside the United States are more likely to be diagnosed with tuberculosis disease (TB) than native-born individuals. Foreign-born Latinos at risk of TB may be difficult to reach with public health interventions due to cultural and institutional barriers. Workplaces employing large concentrations of foreign-born Latinos may be useful locations for TB interventions targeting this high-risk population. This study used a two-phase approach to investigate the feasibility of workplace TB interventions. The first phase investigated employer knowledge of TB and receptiveness to allowing TB interventions in their businesses through 5 structured interviews. The second phase investigated foreign-born workers' knowledge of TB and their receptiveness to receiving TB interventions in their places of employment through 12 focus groups stratified by gender and education. Phase 1: Only 1 of the 5 employers interviewed had a high level of knowledge about TB, and three had no knowledge other than that TB was a disease that involved coughing. They were receptive to workplace TB interventions, but were concerned about lost productivity and customers finding out if an employee had TB. Phase 2: There was no observed differences in responses between gender and between the bottom two education groups, so the final analysis took place between a gender-combined lower education group and higher education group. The higher education group tended to have knowledge that was more accurate and to view TB as a disease associated with poverty. The lower education group tended to have more misconceptions about TB and more often expressed concern that their employers would not support worksite interventions. The results from both phases indicate that more TB education is needed among both foreign-born Latino workers and their employers. Obstacles to implementing workplace TB interventions include knowledge, potential productivity loss, employer liability, and perceived customer response

Adapting a couple-based intimacy enhancement intervention to breast cancer: A developmental study.

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Reese, Jennifer Barsky; Porter, Laura S; Casale, Kristen E; Bantug, Elissa T; Bober, Sharon L; Schwartz, Sharon C; Smith, Katherine Clegg

2016-10-01

Sexual concerns continue to be poorly addressed for women treated for breast cancer and evidence-based interventions that adequately address these concerns are scarce. The objective of this study was to adapt a telephone-based intimacy enhancement intervention, previously tested in couples facing colorectal cancer, to the needs of women with breast cancer through qualitative focus groups, cognitive interviews, and expert review. Three semistructured qualitative focus groups in partnered posttreatment breast cancer survivors (n = 15) reporting sexual concerns were conducted to investigate experiences of breast cancer-related sexual concerns and intervention preferences. Focus group data were coded using the framework approach to qualitative analysis; 8 key themes were identified and used to develop the content and format of the intervention. Feedback from cognitive interviews with study-naïve breast cancer survivors (n = 4) and expert review of materials were also incorporated in finalizing the intervention materials. Qualitative findings centered on the impact of breast cancer and its treatment on women's sexuality and on the intimate relationship, experiences of helpful and unhelpful coping methods, and explicit intervention preferences. Focus group data were particularly helpful in identifying the scope of educational topics and in determining how to structure intervention skills practice (e.g., intimacy-related communication) to be optimally relevant and helpful for both women and their partners. Cognitive interview feedback helped refine intervention materials. An intimacy enhancement intervention was adapted for women with breast cancer and their partners. This intervention offers a promising, potentially disseminable approach to addressing breast cancer-related sexual concerns. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Predictors of Response to Intervention of Word Reading Fluency in Dutch

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Scheltinga, Femke; van der Leij, Aryan; Struiksma, Chris

2010-01-01

The objective of this study was to investigate the contribution of rapid digit naming, phonological memory, letter sound naming, and orthographic knowledge to the prediction of responsiveness to a school-based, individual intervention of word reading fluency problems of 122 Dutch second and third graders whose reading scores were below the 10th…

A Self-Regulation-Based eHealth Intervention to Promote a Healthy Lifestyle: Investigating User and Website Characteristics Related to Attrition.

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Van der Mispel, Celien; Poppe, Louise; Crombez, Geert; Verloigne, Maïté; De Bourdeaudhuij, Ilse

2017-07-11

eHealth interventions can reach large populations and are effective in increasing physical activity (PA) and fruit and vegetable intake. Nevertheless, the effects of eHealth interventions are overshadowed by high attrition rates. Examining more closely when users decide to leave the intervention can help eHealth developers to make informed decisions about which intervention components should be reshaped or simply removed. Investigating which users are more likely to quit an intervention can inform developers about whether and how their intervention should be adapted to specific subgroups of users. This study investigated the pattern of attrition in a Web-based intervention to increase PA, fruit, and vegetable intake. The first aim was to describe attrition rates according to different self-regulation components. A second aim was to investigate whether certain user characteristics are predictors for start session completion, returning to a follow-up session and intervention completion. The sample consisted of 549 adults who participated in an online intervention, based on self-regulation theory, to promote PA and fruit and vegetable intake, called "MyPlan 1.0." Using descriptive analysis, attrition was explored per self-regulation component (eg, action planning and coping planning). To identify which user characteristics predict completion, logistic regression analyses were conducted. At the end of the intervention program, there was an attrition rate of 78.2% (330/422). Attrition rates were very similar for the different self-regulation components. However, attrition levels were higher for the fulfillment of questionnaires (eg, to generate tailored feedback) than for the more interactive components. The highest amount of attrition could be observed when people were asked to make their own action plan. There were no significant predictors for first session completion. Yet, two subgroups had a lower chance to complete the intervention, namely male users (OR: 2.24, 95

The trickle-down effect of predictability: Secondary task performance benefits from predictability in the primary task.

Directory of Open Access Journals (Sweden)

Magdalena Ewa Król

Full Text Available Predictions optimize processing by reducing attentional resources allocation to expected or predictable sensory data. Our study demonstrates that these saved processing resources can be then used on concurrent stimuli, and in consequence improve their processing and encoding. We illustrate this "trickle-down" effect with a dual task, where the primary task varied in terms of predictability. The primary task involved detection of a pre-specified symbol that appeared at some point of a short video of a dot moving along a random, semi-predictable or predictable trajectory. The concurrent secondary task involved memorization of photographs representing either emotionally neutral or non-neutral (social or threatening content. Performance in the secondary task was measured by a memory test. We found that participants allocated more attention to unpredictable (random and semi-predictable stimuli than to predictable stimuli. Additionally, when the stimuli in the primary task were more predictable, participants performed better in the secondary task, as evidenced by higher sensitivity in the memory test. Finally, social or threatening stimuli were allocated more "looking time" and a larger number of saccades than neutral stimuli. This effect was stronger for the threatening stimuli than social stimuli. Thus, predictability of environmental input is used in optimizing the allocation of attentional resources, which trickles-down and benefits the processing of concurrent stimuli.

The trickle-down effect of predictability: Secondary task performance benefits from predictability in the primary task.

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Król, Magdalena Ewa; Król, Michał

2017-01-01

Predictions optimize processing by reducing attentional resources allocation to expected or predictable sensory data. Our study demonstrates that these saved processing resources can be then used on concurrent stimuli, and in consequence improve their processing and encoding. We illustrate this "trickle-down" effect with a dual task, where the primary task varied in terms of predictability. The primary task involved detection of a pre-specified symbol that appeared at some point of a short video of a dot moving along a random, semi-predictable or predictable trajectory. The concurrent secondary task involved memorization of photographs representing either emotionally neutral or non-neutral (social or threatening) content. Performance in the secondary task was measured by a memory test. We found that participants allocated more attention to unpredictable (random and semi-predictable) stimuli than to predictable stimuli. Additionally, when the stimuli in the primary task were more predictable, participants performed better in the secondary task, as evidenced by higher sensitivity in the memory test. Finally, social or threatening stimuli were allocated more "looking time" and a larger number of saccades than neutral stimuli. This effect was stronger for the threatening stimuli than social stimuli. Thus, predictability of environmental input is used in optimizing the allocation of attentional resources, which trickles-down and benefits the processing of concurrent stimuli.

Long-term outcome of social skills intervention based on interactive LEGO play.

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Legoff, Daniel B; Sherman, Michael

2006-07-01

LEGO building materials have been adapted as a therapeutic modality for increasing motivation to participate in social skills intervention, and providing a medium through which children with social and communication handicaps can effectively interact. A 3 year retrospective study of long-term outcome for autistic spectrum children participating in LEGO therapy (N = 60) compared Vineland Adaptive Behavior Scale socialization domain (VABS-SD) and Gilliam Autism Rating Scale social interaction subscale (GARS-SI) scores preand post-treatment with a matched comparison sample (N = 57) who received comparable non-LEGO therapy. Although both groups made significant gains on the two outcome measures, LEGO participants improved significantly more than the comparison subjects. Diagnosis and pre-treatment full-scale IQ scores did not predict outcome scores; however, Vineland adaptive behavior composite, Vineland communication domain, and verbal IQ all predicted outcome on the VABS-SD, especially for the LEGO therapy group. Results are discussed in terms of implications for methods of social skills intervention for autistic spectrum disorders.

Informing early intervention: preschool predictors of anxiety disorders in middle childhood.

Directory of Open Access Journals (Sweden)

Jennifer L Hudson

Full Text Available BACKGROUND: To inform early intervention practice, the present research examines how child anxiety, behavioural inhibition, maternal overinvolvement, maternal negativity, mother-child attachment and maternal anxiety, as assessed at age four, predict anxiety at age nine. METHOD: 202 children (102 behaviourally inhibited and 100 behaviourally uninhibited aged 3-4 years were initially recruited and the predictors outlined above were assessed. Diagnostic assessments, using the Anxiety Disorders Interview Schedule, were then conducted five years later. RESULTS: Behavioural inhibition, maternal anxiety, and maternal overinvolvement were significant predictors of clinical anxiety, even after controlling for baseline anxiety (p.1. CONCLUSIONS: Preschool children who show anxiety, are inhibited, have overinvolved mothers and mothers with anxiety disorders are at increased risk for anxiety in middle childhood. These factors can be used to identify suitable participants for early intervention and can be targeted within intervention programs.

Modeling Dynamic Food Choice Processes to Understand Dietary Intervention Effects.

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Marcum, Christopher Steven; Goldring, Megan R; McBride, Colleen M; Persky, Susan

2018-02-17

Meal construction is largely governed by nonconscious and habit-based processes that can be represented as a collection of in dividual, micro-level food choices that eventually give rise to a final plate. Despite this, dietary behavior intervention research rarely captures these micro-level food choice processes, instead measuring outcomes at aggregated levels. This is due in part to a dearth of analytic techniques to model these dynamic time-series events. The current article addresses this limitation by applying a generalization of the relational event framework to model micro-level food choice behavior following an educational intervention. Relational event modeling was used to model the food choices that 221 mothers made for their child following receipt of an information-based intervention. Participants were randomized to receive either (a) control information; (b) childhood obesity risk information; (c) childhood obesity risk information plus a personalized family history-based risk estimate for their child. Participants then made food choices for their child in a virtual reality-based food buffet simulation. Micro-level aspects of the built environment, such as the ordering of each food in the buffet, were influential. Other dynamic processes such as choice inertia also influenced food selection. Among participants receiving the strongest intervention condition, choice inertia decreased and the overall rate of food selection increased. Modeling food selection processes can elucidate the points at which interventions exert their influence. Researchers can leverage these findings to gain insight into nonconscious and uncontrollable aspects of food selection that influence dietary outcomes, which can ultimately improve the design of dietary interventions.

Enteric disease episodes and the risk of acquiring a future sexually transmitted infection: a prediction model in Montreal residents.

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Caron, Melissa; Allard, Robert; Bédard, Lucie; Latreille, Jérôme; Buckeridge, David L

2016-11-01

The sexual transmission of enteric diseases poses an important public health challenge. We aimed to build a prediction model capable of identifying individuals with a reported enteric disease who could be at risk of acquiring future sexually transmitted infections (STIs). Passive surveillance data on Montreal residents with at least 1 enteric disease report was used to construct the prediction model. Cases were defined as all subjects with at least 1 STI report following their initial enteric disease episode. A final logistic regression prediction model was chosen using forward stepwise selection. The prediction model with the greatest validity included age, sex, residential location, number of STI episodes experienced prior to the first enteric disease episode, type of enteric disease acquired, and an interaction term between age and male sex. This model had an area under the curve of 0.77 and had acceptable calibration. A coordinated public health response to the sexual transmission of enteric diseases requires that a distinction be made between cases of enteric diseases transmitted through sexual activity from those transmitted through contaminated food or water. A prediction model can aid public health officials in identifying individuals who may have a higher risk of sexually acquiring a reportable disease. Once identified, these individuals could receive specialized intervention to prevent future infection. The information produced from a prediction model capable of identifying higher risk individuals can be used to guide efforts in investigating and controlling reported cases of enteric diseases and STIs. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Adaptive intervention design in mobile health: Intervention design and development in the Cell Phone Intervention for You trial.