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the pre-therapy patients (P-0.05). There was no significant change in the Hct, total WBC count platelet count and reticulocyte count in both the pre-therapy and post-therapy patients. The monocytosis observed in patients, especially those on antimalaria therapy, may be indicative of an anti-malaria effect by monocytes.

Gestalt Therapy Interventions for Group Counseling

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Passons, William R.

1972-01-01

The author offers a brief introduction to some of the basic tenets of Gestalt therapy, noting goals that are similar to those in counseling theories. He also suggests several interventions from Gestalt therapy to be considered for group counseling and discusses their applications. (Author)

Orbitofrontal cortex, emotional decision-making and response to cognitive behavioural therapy for psychosis.

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Premkumar, Preethi; Fannon, Dominic; Sapara, Adegboyega; Peters, Emmanuelle R; Anilkumar, Anantha P; Simmons, Andrew; Kuipers, Elizabeth; Kumari, Veena

2015-03-30

Grey matter volume (GMV) in the orbitofrontal cortex (OFC) may relate to better response to cognitive behavioural therapy for psychosis (CBTp) because of the region׳s role in emotional decision-making and cognitive flexibility. This study aimed to determine the relation between pre-therapy OFC GMV or asymmetry, emotional decision-making and CBTp responsiveness. Emotional decision-making was measured by the Iowa Gambling task (IGT). Thirty patients received CBTp+standard care (CBTp+SC; 25 completers) for 6-8 months. All patients (before receiving CBTp) and 25 healthy participants underwent structural magnetic resonance imaging. Patients׳ symptoms were assessed before and after therapy. Pre-therapy OFC GMV was measured using a region-of-interest approach, and IGT performance was measured as overall learning, attention to reward, memory for past outcomes and choice consistency. Both these measures, were comparable between patient and healthy groups. In the CBTp+SC group, greater OFC GMV correlated with positive symptom improvement, specifically hallucinations and persecution. Greater rightward OFC asymmetry correlated with improvement in several negative and general psychopathology symptoms. Greater left OFC GMV was associated with lower IGT attention to reward. The findings suggest that greater OFC volume and rightward asymmetry, which maintain the OFC׳s function in emotional decision-making and cognitive flexibility, are beneficial for CBTp responsiveness. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Occupational Therapy intervention for patiens with COPD, Rehabilitation at home

DEFF Research Database (Denmark)

Larsen, Stina Meyer; Petersen, Anne Karin

Describe and demonstrate Occupational Therapy (OT) intervention for patients with Chronic Obstructive Pulmonary Disease (COPD).......Describe and demonstrate Occupational Therapy (OT) intervention for patients with Chronic Obstructive Pulmonary Disease (COPD)....

The interventional therapy of lung abscess

International Nuclear Information System (INIS)

Huang Changcen

2000-01-01

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

Clinical pharmacist interventions to support adherence to thrombopreventive therapy

DEFF Research Database (Denmark)

Hedegaard, Ulla

The three papers in the thesis were based on two randomised controlled trials (RCTs) on in-hospital clinical pharmacist interventions for improvement of adherence to thrombopreventive therapy in two different populations: outpatients with hypertension and patients with acute stroke/transient isch......The three papers in the thesis were based on two randomised controlled trials (RCTs) on in-hospital clinical pharmacist interventions for improvement of adherence to thrombopreventive therapy in two different populations: outpatients with hypertension and patients with acute stroke...... individualised interventions and team-based care, e.g. integrating a clinical pharmacist with particular focus on patients’ drug-related problems. One approach with growing evidence of improving medication adherence is motivational interviewing (MI). So far, no clinical pharmacist intervention using MI has...... targeted patients with hypertension or stroke in a hospital care setting. Thus, the aim of this thesis was to develop and evaluate in-hospital pharmacist interventions including MI to improve adherence to primary and secondary thrombopreventive therapy. The first study was a RCT, which investigated...

Interventional therapy for congenital urinary obstruction in children

International Nuclear Information System (INIS)

Qin Zenhui; Huang Sui; Liu Fan; Yang Jinyuan

2005-01-01

Objective: To investigate the interventional therapy in children's congenital urinary obstruction and its efficacy. Methods: Thirty-three children with congenital obstruction of ureteropelvic junction were treated through percutaneous dilation and/or stent placement, and 42 cases with posterior urethral valves were treated through trans-urethra dilation. Results: Thirty-three cases with upper urinary obstruction were improved with symptoms disappeared and stable efficacy on long-term follow-up of 1-7 years. Another 2 cases with the upper urethral obstruction had not been relieved of symptoms and resorted to surgical operation. For patients with posterior urethral valves, the lower urethral obstruction was totally got rid of after interventional therapy with stable efficacy on long-term follow-up of 1-10 years. Conclusions: Interventional therapy is safe , micro-invasive and efficient in treating congenital urinary obstruction with stable efficacy on long-term follow-up. (authors)

A clinical treatment intervention for dysphoria: externalizing metaphors therapy.

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

2014-01-01

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

Attach importance to intervention therapy of acute abdomen

International Nuclear Information System (INIS)

Li Xuan

2006-01-01

Acute abdomen means a set of clinical emergency with acute abdominalgia as the primary characteristic symptom of onset, including others as the acute onset, quick symptom changes, severe illness, and oftenly need surgical treatment; therefore, acute abdomen ought to be designated within surgery domain. As interventional therapy is extensively applied in clinical medicine, now a days many victims of acute abdomen, especially those with ambiguous clinical diagnosis requiring an initial invasive examination (angiography, PTC, etc), should be referred to interventional therapy before taking an item of invasive measures. This new concept management has achieved good clinical curative effect and become one of the remarkable achievements in acute abdomen therapeutics. Such predominance finds proper expression in the following two aspects: (1) The evolution of contemporary medical iconography has made it possible to duly and accurately diagnose acute abdomen, and thus created a diagnostic predominance for us-interventionalists; (2) Intervention therapy is featured with its unique minimal invasion and massive effectiveness, and thus provides high leading edge than conventional surgical operation. The authors believe that intervention management ought to become the first-choice for treating the above mentioned acute abdomen. (authors)

Coaching as a Family-Centred, Occupational Therapy Intervention for Autism: A Literature Review

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Simpson, Desley

2015-01-01

Occupational therapy interventions for autism spectrum disorder (ASD) require a sound evidence-base. In the context of emerging evidence on coaching interventions in paediatric occupational therapy practice, a review of the occupational therapy literature was conducted to investigate the use of coaching interventions for children and adolescents…

Interventional therapy of atherosclerotic renal artery occlusion

International Nuclear Information System (INIS)

Li Jian; Xu Ke; Xiao Liang

2009-01-01

Objective: To investigate the effectiveness of interventional therapy for the atherosclerotic renal artery occlusion (ARAO). Methods: During the period of June 2001-Dec. 2007, 16 patients with ARAO (total of 16 occluded arteries) underwent interventional managements, including percutaneous endovascular renal artery revascularization, balloon dilatation angioplasty and stent placement. Follow-up survey was made at regular intervals. The patent condition of the renal artery was evaluated with ultrasonography and digital subtraction angiography. The blood pressure and the renal function were determined and the data were statistically analyzed in order to assess the intermediate and long-term effect of the interventional therapy. Results: Of 16 patients, technical success was achieved in 15 (93.8%) and failure occurred in one. During a follow-up period of 9 - 24 months, 3 patients died. According to the data obtained at each patient's last follow-up survey, the hypertension fell to normal in 3 (25.0%), was improved in 7 (58.3%) and showed no marked change in 2 patients (16.7%), with a clinical efficacy of 83.3% (10 / 12). The renal function was improved in 2 (16.7%), stabilized in 6 (50%) and deteriorated in 4 patients (33.3%), with an effective rate of 66.7% (8 / 12). Conclusion: For the treatment of atherosclerotic renal artery occlusion, the interventional therapy carries high successful rate and can effectively lower the blood pressure level, in addition, it can also protect the renal function in a certain degree. (authors)

Effectiveness of Occupational Therapy Interventions for Lower-Extremity Musculoskeletal Disorders: A Systematic Review.

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Dorsey, Julie; Bradshaw, Michelle

Lower-extremity (LE) musculoskeletal disorders (MSDs) can have a major impact on the ability to carry out daily activities. The effectiveness of interventions must be examined to enable occupational therapy practitioners to deliver the most appropriate services. This systematic review examined the literature published between 1995 and July 2014 that investigated the effectiveness of occupational therapy interventions for LE MSDs. Forty-three articles met the criteria and were reviewed. Occupational therapy interventions varied on the basis of population subgroup: hip fracture, LE joint replacement, LE amputation or limb loss, and nonsurgical osteoarthritis and pain. The results indicate an overall strong role for occupational therapy in treating clients with LE MSDs. Activity pacing is an effective intervention for nonsurgical LE MSDs, and multidisciplinary rehabilitation is effective for LE joint replacement and amputation. Further research on specific occupational therapy interventions in this important area is needed. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Value of whole body 123I scan for detection of metastasis in patients with well-differentiated thyroid carcinoma

International Nuclear Information System (INIS)

Takahashi, Naoya; Odano, Ikuo; Sugita, Tadashi; Sato, Yoko; Sakai, Kunio

1995-01-01

To evaluate the utility of 123 I whole body scan for detection of metastasis in patients with well-differentiated thyroid carcinoma, post-therapy whole body 131 I images in 55 cases were compared with pre-therapy 123 I images using diagnostic dose (74 MBq). The post-therapy studies were performed 7 days after administration of therapeutic doses (3.33-7.77 GBq) of 131 I. The pre-therapy scans showed 30 lesions (71.4%) of 42 lesions which were shown by 131 I post-therapy scans. The diagnostic accuracy of 123 I whole body scans was considered to be nearly the same as the images obtained by 131 I using diagnostic dose. 123 I has short-life and an optimum gamma ray energy for scintigraphy. It makes radiation dose to patients lower than that of 131 I. Therefore, we recommend pre-therapy 131 I image using diagnostic dose is replaced by 123 I image. (author)

“Putting the Occupation Back in Occupational Therapy:” A Survey of Occupational Therapy Practitioners’ Use of Gardening as an Intervention

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Amy Wagenfeld

2014-10-01

Full Text Available Background. This study examines how and why occupational therapy practitioners across practice areas use gardening as an intervention. Respondents’ interpretation of the best and least desirable aspects of their facility’s garden and whether they contributed to its design was also examined. Method. A description and link to a 15-question online survey about gardening as an occupational therapy intervention was emailed to Western Michigan University Occupational Therapy alumni and posted on four OT Connections groups and the AOTA LinkedIn site. Results. Gardening as an occupational therapy intervention is meaningful and purposeful (93.66%, n = 56, motivating (80%, n = 48, fun 61.67% (n = 37, and client-centered (31.67%, n =19. Frequency of gardening as a therapeutic intervention and practitioner involvement in designing the garden was significant (p = .007, suggesting that for respondents, environmental context supports engagement and heightens the meaningfulness and purposefulness of gardening. Conclusion. Based on results of this study, a suggested next step is evidence-based translational and intervention research to validate the efficacy of gardening as an occupational therapy intervention and occupational therapy practitioners’ professional value as implementers of such intervention. Assessing the effectiveness of the role of occupational therapy practitioners in facility garden design is also important to consider.

External radiation therapy in early stage prostate cancer

International Nuclear Information System (INIS)

Sandler, Howard M.

1996-01-01

Optimal therapy for adenocarcinoma of the prostate is controversial. Numerous options are available, however, comparison of results is difficult in view of the insufficiency of phase III randomized trials comparing alternative treatment strategies. These options include such strategies as no curative therapy (so-called watchful waiting), radiotherapy (external and/or internal), cryotherapy, or radical prostatectomy. Clearly, a broad spectrum of clinical approaches. When reported experiences involving radiation therapy and radical prostatectomy are compared, surgical patients tend to be younger, of earlier stage, of higher performance status, and have lower pre-therapy PSA. These prognostic factors influence the probability of disease control, and since patient selection can have a profound impact on results reporting, these issues need to be carefully controlled. A review of patients who are potentially candidates for surgery at the University of Michigan treated with conformal therapy external beam treatment, indicates that these relatively early patients are doing well. These issues will be elaborated upon further during the presentation

Interventional therapy for nutcracker syndrome (report of 6 cases)

International Nuclear Information System (INIS)

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

2008-01-01

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

Therapy interventions for children with neurodisabilities: a qualitative scoping study.

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Beresford, Bryony; Clarke, Susan; Maddison, Jane

2018-01-01

Therapy interventions emerged four times in the top 10 research priorities in a James Lind Alliance research prioritisation exercise for children with neurodisabilities (Morris C, Simkiss D, Busk M, Morris M, Allard A, Denness J, et al. Setting research priorities to improve the health of children and young people with neurodisability: a British Academy of Childhood Disability-James Lind Alliance Research Priority Setting Partnership. BMJ Open 2015; 5 :e006233). The National Institute for Health Research (NIHR) commissioned this study as part of an information-gathering exercise in response to this. The objectives were to (1) describe the current practice, approaches and schools of thought in relation to physiotherapy, occupational therapy and speech and language therapy for children with neurodisability; (2) explore clinical decision-making; (3) investigate views on outcomes and their measurement, particularly participation as an outcome, that is, the child's ability to have the opportunity to be involved in life situations and activities (e.g. communication, mobility, interpersonal interactions, self-care, learning and applying knowledge); (4) seek views on the aspects of therapy interventions that have an impact on outcomes; and (5) elicit stakeholder views on research needs and priorities. More than 70 professionals (therapists, service leads, paediatricians and education staff) and 25 parents participated in a qualitative interview (either individually or as part of a focus group). Professional thinking and models of service delivery are in a state of flux and development. There is a move towards goals-focused, family-centred approaches. Work tends to be highly individualised, with few protocols. Parents are certain of the value of therapies, although they may experience difficulties with provision and may seek (additional) private provision. Therapy interventions are conceived as three components: the therapist, the procedures/equipment, etc., and the wider

Research advances in traditional Chinese medicine combined with interventional therapy for hepatocellular carcinoma

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LIU Yang

2015-01-01

Full Text Available Interventional therapy has become the first choice of non-surgical treatment for hepatocellular carcinoma (HCC due to its advantages such as little trauma and marked local effect. However, the clinical efficiency is less than expected. One of the possibilities is the resistance of cancer cells to anti-cancer drugs. Increasing attention has been paid to the combination of traditional Chinese medicine (TCM and interventional therapy in HCC treatment. This paper reviews the progress in TCM combined with interventional therapy for HCC at animal experiment and clinical study levels in recent ten years. It is pointed out that the combination therapy with TCM and intervention for HCC has a unique advantage.

Clinical study of interventional therapy for acute cerebral infarction

International Nuclear Information System (INIS)

Xiang Guangze; Xiao Yiming; Wen Zhilin

2004-01-01

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

Doll therapy: an intervention for nursing home residents with dementia.

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Shin, Juh Hyun

2015-01-01

The use of dolls as a therapeutic intervention for nursing home residents with dementia is relatively new. The current article describes a research study implemented with nursing home residents in Korea to examine the effects of doll therapy on their mood, behavior, and social interactions. A one-group, pretest-posttest design was used to measure the impact of doll therapy on 51 residents with dementia. Linear regression demonstrated statistically significant differences in aggression, obsessive behaviors, wandering, negative verbalization, negative mood, and negative physical appearance after introduction of the doll therapy intervention. Interactions with other individuals also increased over time. Findings support the benefits of doll therapy for nursing home residents with dementia; however, further research is needed to provide more empirical evidence and explore ethical considerations in the use of doll therapy in this vulnerable population. Copyright 2015, SLACK Incorporated.

The percutaneous interventional therapy of lung abscess and pyothorax under the CT guidance

International Nuclear Information System (INIS)

Gao Xinghan; Zhu Zhenfang; Lv Fanzhen; Yan Dejun; Su Baomin

2003-01-01

Objective: To study the indication, the procedure, the necessity and feasibility of the percutaneous interventional therapy of lung abscess and pyothorax under the CT guidance. Methods: The group included 18 patients who received percutaneous interventional therapy of lung abscess and pyothorax. Results: 13 patients were cured by a single procedure, 3 patients received twice intervention. Triple therapies were done in 2 patients. 2 cases out of 18 were eventually diagnosed as peripheral lung cancer. The body temperature and the WBC count returned to normal range after the procedures. 16 patients completely recovered in 1-5 weeks after the therapies. Conclusion: The interventional therapy under CT guidance not only helps the diagnosis and differential diagnosis of chronic or acute lung abscess and pyothorax, but also shortens the course of treatment and avoids the open surgery. It is a safe, simple and convenient method

The efficacy discussion of interventional therapy for advanced pancreatic carcinoma

International Nuclear Information System (INIS)

Song Tian; Yin Shimeng; Sun Rongyue; Shen Lan; Qian Yu

2008-01-01

Objective: To evaluate the efficacy of interventional therapy for advanced pancreatic carcinoma. Methods: 33 cases of advanced pancreatic carcinoma accepted interventional therapy from April 2005 were retrospectively analyzed. All patients were unoperable and accepted one or more times of celiac and superior mesenteric arterial chemotheraputics perfusion with dosage of 2:1. The embolization was further introduced with the addition of liver invasion. The repetition interval was kept at 6 weeks with no severe complications. Results: The one with follow-up CT imagings showed obvious decrease of the lesion size, together with release or disappearance of the sensation of abdominal pain and abdominal distention. The life span prolonged with average survival of 13 months, including the longest of 22 months and the life quality improved. Conclusions: The interventional therapy could be the first method of choice in the management of advanced pancreatic carcinoma. (authors)

Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional biopsy or interventional therapy

International Nuclear Information System (INIS)

Li Zhen; Han Xinwei; Jiao Dechao; Ren Jianzhuang; Su Yu; Ye Hui

2011-01-01

Objective: to investigate the clinical value of C-arm CT-guided targeted puncturing technique in performing non, vascular interventional biopsy or interventional therapy. Methods: Thirty, one patients, who were encountered in authors' hospital during the period from July 2010 to September 2010, were involved in this study. C-arm CT-guided percutaneous targeted puncturing biopsy or interventional therapy was performed in all 31 patients. All patients had complete clinical data. The complications and positive rate of biopsy were recorded and analyzed. Results: Under C-arm CT-guidance, percutaneous interventional therapy was carried out in 13 patients. The interventional procedures included radiofrequency ablation therapy for hepatic cellular carcinoma (n=2), pelvic abscess draining (n=1), hepatic abscess draining (n=1), ethanol injection for liver cancer (n=4), sclerotic therapy with ethanol injection for renal cyst (n=2), sclerotic therapy with ethanol injection for liver cyst (n=2) and catheter-indwelling drainage for pancreatic pseudocyst (n=1). percutaneous interventional biopsy was performed in the remaining 18 cases, including liver (n=4), lung (n=7), mediastinum (n=2), bone and soft tissue (n=4) and neck mass (n=1). All the procedures were successfully accomplished, no technique, related complications occurred during the operation. For biopsy examination in 18 cases, the positive rate was 94.4% (17/18) and false, negative results was seen in one case with lung lesion. Conclusion: The percutaneous targeted puncturing technique with C, arm CT-guidance combines the advantages of both CT scanning and fluoroscopy. The use of real, time road, mapping function can effectively guide the puncturing and therapeutic management, which can not only optimize the workflow, save the operation time, but also improve the success rate and technical safety. Therefore, it is of great value to popularize this targeted puncturing technique. (authors)

Interventional MRI of the breast: minimally invasive therapy

International Nuclear Information System (INIS)

Hall-Craggs, M.A.

2000-01-01

In recent years a variety of minimally invasive therapies have been applied to the treatment of breast lesions. These therapies include thermal treatments (interstitial laser coagulation, focused ultrasound, radiofrequency and cryotherapy), percutaneous excision, and interstitial radiotherapy. Magnetic resonance has been used in these treatments to visualize lesions before, during and after therapy and to guide interventions. ''Temperature-sensitive'' sequences have shown changes with thermal ablation which broadly correlate with areas of tumour necrosis. Consequently, MR has the potential to monitor treatment at the time of therapy. To date, experience in the treatment of breast cancer has been restricted to small studies. Large controlled studies are required to validate the efficacy and safety of these therapies in malignant disease. (orig.)

Laughter therapy as an intervention to promote psychological well ...

African Journals Online (AJOL)

The study explores the experiences of volunteer community care workers working with HIV-affected families, participating in laughter therapy. Laughter therapy is being used as an intervention to positively influence individuals experiencing various forms of emotional distress. Community care workers play a vital role in the ...

Occupational therapy intervention in a subject with Parkinson disease

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Gustavo Artur Monzeli

2016-04-01

Full Text Available Introduction: Parkinson disease-PD has affected an increasing number of individuals, compromising their functional skills progressively and irreversibly, requiring preventive and rehabilitative actions. Objective: To present and discuss the effect of occupational therapy intervention with a 70-year old patient diagnosed with PD. Method: This is an experience report with a single subject. An intervention plan including an exercise program for extra-care activities and home visits for observation of possible difficulties and risk of falls in the environment has been prepared. The measurement of independence was performed using the Functional Independence Measure-FIM. The intervention occurred during six months. Results: It was identified improvement in eating and writing activities. There was one score of improvement documented in FIM. Conclusion: The importance of the intervention of occupational therapy is enforced, which in this context improved the occupational performance of this subject in the daily life activities, contributing for maintaining functional performance.

Neuroradiological diagnosis and interventional therapy of carotid cavernous fistulas

International Nuclear Information System (INIS)

Struffert, T.; Engelhorn, T.; Doelken, M.; Doerfler, A.; Holbach, L.

2008-01-01

Carotid cavernous fistulas are pathologic connections between the internal and/or external carotid artery and the cavernous sinus. According to Barrow one can distinguish between direct (high flow) and indirect (low flow) fistulas, whereby direct fistulas are often traumatic while indirect fistulas more frequently occur spontaneously in postmenopausal women. Diagnosis can easily be established using MRI and angiography, which allow exact visualization of the anatomy of fistulas to plan the interventional neurological therapy that in recent years has replaced surgical therapy. This article provides an overview on imaging findings, diagnosis using MRI and angiography as well as interventional treatment strategies. (orig.) [de

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Interventional MRI of the breast: minimally invasive therapy

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Hall-Craggs, M.A. [MR Unit, Middlesex Hospital, London (United Kingdom)

2000-01-01

In recent years a variety of minimally invasive therapies have been applied to the treatment of breast lesions. These therapies include thermal treatments (interstitial laser coagulation, focused ultrasound, radiofrequency and cryotherapy), percutaneous excision, and interstitial radiotherapy. Magnetic resonance has been used in these treatments to visualize lesions before, during and after therapy and to guide interventions. ''Temperature-sensitive'' sequences have shown changes with thermal ablation which broadly correlate with areas of tumour necrosis. Consequently, MR has the potential to monitor treatment at the time of therapy. To date, experience in the treatment of breast cancer has been restricted to small studies. Large controlled studies are required to validate the efficacy and safety of these therapies in malignant disease. (orig.)

TU-F-BRF-03: Effect of Radiation Therapy Planning Scan Registration On the Dose in Lung Cancer Patient CT Scans

International Nuclear Information System (INIS)

Cunliffe, A; Contee, C; White, B; Justusson, J; Armato, S; Malik, R; Al-Hallaq, H

2014-01-01

Purpose: To characterize the effect of deformable registration of serial computed tomography (CT) scans on the radiation dose calculated from a treatment planning scan. Methods: Eighteen patients who received curative doses (≥60Gy, 2Gy/fraction) of photon radiation therapy for lung cancer treatment were retrospectively identified. For each patient, a diagnostic-quality pre-therapy (4–75 days) CT scan and a treatment planning scan with an associated dose map calculated in Pinnacle were collected. To establish baseline correspondence between scan pairs, a researcher manually identified anatomically corresponding landmark point pairs between the two scans. Pre-therapy scans were co-registered with planning scans (and associated dose maps) using the Plastimatch demons and Fraunhofer MEVIS deformable registration algorithms. Landmark points in each pretherapy scan were automatically mapped to the planning scan using the displacement vector field output from both registration algorithms. The absolute difference in planned dose (|ΔD|) between manually and automatically mapped landmark points was calculated. Using regression modeling, |ΔD| was modeled as a function of the distance between manually and automatically matched points (registration error, E), the dose standard deviation (SD-dose) in the eight-pixel neighborhood, and the registration algorithm used. Results: 52–92 landmark point pairs (median: 82) were identified in each patient's scans. Average |ΔD| across patients was 3.66Gy (range: 1.2–7.2Gy). |ΔD| was significantly reduced by 0.53Gy using Plastimatch demons compared with Fraunhofer MEVIS. |ΔD| increased significantly as a function of E (0.39Gy/mm) and SD-dose (2.23Gy/Gy). Conclusion: An average error of <4Gy in radiation dose was introduced when points were mapped between CT scan pairs using deformable registration. Dose differences following registration were significantly increased when the Fraunhofer MEVIS registration algorithm was used

Preliminary design of the database and registration system for the national malignant tumor interventional therapy

International Nuclear Information System (INIS)

Hu Di; Zeng Jinjin; Wang Jianfeng; Zhai Renyou

2010-01-01

Objective: This research is one of the sub-researches of 'The comparative study of the standards of interventional therapies and the evaluation of the long-term and middle-term effects for common malignant tumors', which is one of the National Key Technologies R and D Program in the eleventh five-year plan. Based on the project,the authors need to establish an international standard in order to set up the national tumor interventional therapy database and registration system. Methods: By using the computing programs of downloading software, self-management and automatic integration, the program was written by the JAVA words. Results: The database and registration system for the national tumor interventional therapy was successfully set up, and it could complete both the simple and complex inquiries. The software worked well through the initial debugging. Conclusion: The national tumor interventional therapy database and registration system can not only precisely tell the popularizing rate of the interventional therapy nationwide, compare the results of different methods, provide the latest news concerning the interventional therapy, subsequently promote the academic exchanges between hospitals, but also help us get the information about the distribution of the interventional physicians, the consuming quantity and variety of the interventional materials, so the medical costs can be reduced. (authors)

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

International Nuclear Information System (INIS)

Xiao Yunping; Xiao Enhua

2008-01-01

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

The contribution of conceptual frameworks to knowledge translation interventions in physical therapy.

Science.gov (United States)

Hudon, Anne; Gervais, Mathieu-Joël; Hunt, Matthew

2015-04-01

There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions are identified, and limits related to their use are considered. A sample of 5 conceptual frameworks is evaluated, and how they address common barriers to knowledge translation in physical therapy is assessed. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Finally, the use of a conceptual framework is illustrated through a case example. Increased use of conceptual frameworks can have a positive impact on the field of knowledge translation in physical therapy and support the development and implementation of robust and effective knowledge translation interventions that help span the research-practice gap. © 2015 American Physical Therapy Association.

Contextual emotion regulation therapy: a developmentally based intervention for pediatric depression.

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Kovacs, Maria; Lopez-Duran, Nestor L

2012-04-01

For this special issue about child and adolescent depression, the authors were asked to describe contextual emotion regulation therapy as an example of a developmentally informed psychosocial intervention. The article begins with the authors' definition of the elements that should comprise such an intervention. A succinct summary of this contextual emotion regulation therapy is then provided, including its explanatory paradigm of depression, followed by an exposition of how it addresses the various definitional criteria of a developmentally informed intervention. The article concludes with a brief overview of the challenges of implementing a developmentally sensitive psychotherapy for depressed children and adolescents.

Manualization of Occupational Therapy Interventions: Illustrations from the Pressure Ulcer Prevention Research Program

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Blanche, Erna Imperatore; Fogelberg, Donald; Diaz, Jesus; Carlson, Mike; Clark, Florence

2011-01-01

The manualization of a complex occupational therapy intervention is a crucial step in ensuring treatment fidelity for both clinical application and research purposes. Towards this latter end, intervention manuals are essential for assuring trustworthiness and replicability of randomized controlled trials (RCT’s) that aim to provide evidence of the effectiveness of occupational therapy. In this paper, literature on the process of intervention manualization is reviewed. The prescribed steps are then illustrated through our experience in implementing the University of Southern California/Rancho Los Amigos National Rehabilitation Center’s collaborative Pressure Ulcer Prevention Project (PUPP). In this research program, qualitative research provided the initial foundation for manualization of a multifaceted occupational therapy intervention designed to reduce incidence of medically serious pressure ulcers in people with SCI. PMID:22214116

Interventional therapy of hilar cholangiocarcinoma in type III and IV

International Nuclear Information System (INIS)

Fan Weijun; Wu Peihong; Zhang Liang; Huang Jinhua; Zhang Fujun; Gu Yangkui; Zhao Ming; Huang Xianglong; Guo Changyu

2005-01-01

Objective: To explore the role of synthetic interventional therapy for hilar cholangiocarcinoma in type III and IV. Methods: Twenty-one patients with obstructive cholestasis were pathological confirmed as cholangioadenocarcinoma, and they were classified as type III and IV cholangioadenocarcinoma by CT, MRCP, and percutaneous transhepatic cholangiography. Percutaneous transhepatic cholangiography with internal and external drainage (PTCD), multipolar radiofrequency (RF) ablation, biliary stent endoprosthesis, and interventional adjuvant chemotherapy were applied sequentially. Results: All masses presented with density diminution in CT one month after RF ablation, in which 13 masses had about 30% reduction in size, 4 masses had about 20% reduction in size, and 4 masses remained unchanged. All the masses presented with size reduction with an average of 37% in follow-up CT after 6 months, and the most remarkable size reduction was 60%. The direct and indirect bilirubin levels prompt returned to normal range in 17 cases one month after synthetic interventional therapy and returned to normal range in all cases 6 months later. All patients survived with the follow-up period ranging from 9 to 24 months, with the mean survival time of 14 months. Conclusion: Synthetic interventional therapy is a micro-invasive and effective treatment for type III and IV cholangiocarcinoma. (authors)

Integrated Trauma-Focused Cognitive-Behavioural Therapy for Post-traumatic Stress and Psychotic Symptoms: A Case-Series Study Using Imaginal Reprocessing Strategies

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Nadine Keen

2017-06-01

Full Text Available Despite high rates of trauma in individuals with psychotic symptoms, post-traumatic stress symptoms are frequently overlooked in clinical practice. There is also reluctance to treat post-traumatic symptoms in case the therapeutic procedure of reprocessing the trauma exacerbates psychotic symptoms. Recent evidence demonstrates that it is safe to use reprocessing strategies in this population. However, most published studies have been based on treating post-traumatic symptoms in isolation from psychotic symptoms. The aims of the current case series were to assess the acceptability, feasibility, and preliminary effectiveness of integrating cognitive-behavioural approaches for post-traumatic stress and psychotic symptoms into a single protocol. Nine participants reporting distressing psychotic and post-traumatic symptoms were recruited from a specialist psychological therapies service for psychosis. Clients were assessed at five time points (baseline, pre, mid, end of therapy, and at 6+ months of follow-up by an independent assessor on measures of current symptoms of psychosis, post-traumatic stress, emotional problems, and well-being. Therapy was formulation based and individualised, depending on presenting symptoms and trauma type. It consisted of five broad, flexible phases, and included imaginal reprocessing strategies (reliving and/or rescripting. The intervention was well received, with positive post-therapy feedback and satisfaction ratings. Unusually for this population, no-one dropped out of therapy. Post therapy, all but one (88% of participants achieved a reliable improvement compared to pre-therapy on at least one outcome measure: post-traumatic symptoms (63%, voices (25%, delusions (50%, depression (50%, anxiety (36%, and well-being (40%. Follow-up assessments were completed by 78% (n = 7 of whom 86% (n = 6 maintained at least one reliable improvement. Rates of improvements following therapy (average of 44% across measures post

Developing Home-Based Virtual Reality Therapy Interventions.

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Lin, Janice; Kelleher, Caitlin L; Engsberg, Jack R

2013-02-01

Stroke is one of the leading causes of serious long-term disability. However, home exercise programs given at rehabilitation often lack in motivational aspects. The purposes of this pilot study were (1) create individualized virtual reality (VR) games and (2) determine the effectiveness of VR games for improving movement in upper extremities in a 6-week home therapy intervention for persons with stroke. Participants were two individuals with upper extremity hemiparesis following a stroke. VR games were created using the Looking Glass programming language and modified based on personal interests, goals, and abilities. Participants were asked to play 1 hour each day for 6 weeks. Assessments measured upper extremity movement (range of motion and Action Research Arm Test [ARAT]) and performance in functional skills (Canadian Occupational Performance Measure [COPM] and Motor Activity Log [MAL]). Three VR games were created by a supervised occupational therapist student. The participants played approximately four to six times a week and performed over 100 repetitions of movements each day. Participants showed improvement in upper extremity movement and participation in functional tasks based on results from the COPM, ARAT, and MAL. Further development in the programming environment is needed to be plausible in a rehabilitation setting. Suggestions include graded-level support and continuation of creating a natural programming language, which will increase the ability to use the program in a rehabilitation setting. However, the VR games were shown to be effective as a home therapy intervention for persons with stroke. VR has the potential to advance therapy services by creating a more motivating home-based therapy service.

Exploring Animal-Assisted Therapy as a Reading Intervention Strategy

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Kaymen, Maria S.

2005-01-01

This study is an examination of animal-assisted therapy in an attempt to explore the ways it may serve as reading intervention program for struggling readers. Due to the low rate of literacy in the U.S., children are often put into reading intervention programs where they are required to read to an adult; potentially creating anxiety that may act…

Intervention group as a resource of Occupational Therapy: an experience with menopausal women

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Soraya Diniz Rosa

2013-08-01

Full Text Available Intervention group as a resource of Occupational Therapy is the main theme of this study. Herein we present an experience carried out in two universities in the areas of occupational therapy, pharmacy and medicine, more specifically in the field of gynecology regarding the care of climacteric woman. The first intervention occurred in 2004 with trainees of the occupational therapy course and medical school residents. However, the study was restarted in 2010 with expansion to the human resources and knowledge areas. The methodology was based on the transcripts of the remarks made after each group meeting, which was coordinated by the Occupational Therapy. Results showed that the intervention group process has helped participants in the understanding of this stage of life and has interfered in the changing of habits and attitudes, with great improvement in daily life organization. We concluded that the use of intervention group as a resource of Occupational Therapy and the liaison with other areas are of great importance because they enable the construction of a unique treatment plan for the group, given the contribution from each clinical area.

The Contribution of Conceptual Frameworks to Knowledge Translation Interventions in Physical Therapy

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Gervais, Mathieu-Joël; Hunt, Matthew

2015-01-01

There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions are identified, and limits related to their use are considered. A sample of 5 conceptual frameworks is evaluated, and how they address common barriers to knowledge translation in physical therapy is assessed. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Finally, the use of a conceptual framework is illustrated through a case example. Increased use of conceptual frameworks can have a positive impact on the field of knowledge translation in physical therapy and support the development and implementation of robust and effective knowledge translation interventions that help span the research-practice gap. PMID:25060959

Urine Culture in Uncomplicated UTI: Interpretation and Significance.

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Stapleton, Ann E

2016-05-01

Acute uncomplicated urinary tract infection (UTI) is a common clinical problem, accounting for millions of outpatient visits in the USA annually. Although routinely obtaining urine cultures in UTI is not recommended, there are circumstances in which obtaining a pre-therapy culture may be warranted or chosen by clinicians, such as when indicated by the need for careful antimicrobial stewardship. This review focuses on understanding reasons for obtaining a pre-therapy culture, methods of collection, and appropriately interpreting urine culture data.

Occupational Therapy Interventions for People With Alzheimer's Disease.

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Piersol, Catherine Verrier; Jensen, Lou; Lieberman, Deborah; Arbesman, Marian

Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Project. In this Evidence Connection article, we describe a case report of a person with Alzheimer's disease. The occupational therapy assessment and intervention process in the home setting is described. Findings from the systematic reviews on this topic were published in the November/December 2017 issue of the American Journal of Occupational Therapy and in AOTA's Occupational Therapy Practice Guidelines for Adults With Alzheimer's Disease and Related Major Neurocognitive Disorders. Each article in this series summarizes the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. Evidence Connection articles illustrate how the research evidence from the reviews can be used to inform and guide clinical reasoning. Copyright © 2018 by the American Occupational Therapy Association, Inc.

Evaluation of an Anger Therapy Intervention for Incarcerated Adult Males

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Vannoy, Steven D.; Hoyt, William T.

2004-01-01

An anger therapy intervention was developed for incarcerated adult males. The therapy was an extension of cognitive-behavioral approaches, incorporating principles and practices drawn from Buddhist psychology. Adult males from a Midwestern low-security prison were randomly assigned to either a treatment group (n= 16) or a waiting list control…

Occupational Therapy Interventions Effect on Mathematical Problems in Students with Special Learning Disorders

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Rogaieh Mohammadi

2009-10-01

Full Text Available Objectives: Dyscalculia is specific learning disabilities affecting the acquisition of mathematic skills in an otherwise normal child. The aim of this study was investigation of occupational therapy interventions effect on mathematical problems in students with special learning disorders. Methods: 40 students with dyscalculia (2-5 grades were selected and divided through randomized permuted blocks method into two groups 20 persons as intervention group and the others as the control group. Initially both of groups were administered by the "Iran Key math Test". Then intervention group received occupational therapy interventions for 20 sessions individually and two groups were administered by the Test again. Data was analyzed by using Paired and Independent t-tests. Results: By the paired sample t-test the mean of total marks of Iran Key math Test demonstrated statistically significant difference in both of groups (P<0.05, but the measure of difference in intervention group was more than control group. The mean of marks of Basic Concepts, Operations and Applications demonstrated statistically significant difference at intervention group. Discussion: Occupational therapy interventions had clinical effect on mathematical problems in students with special learning disorders.

Nursing care of patients receiving interventional therapy for hepatic artery stenosis after liver transplantation

International Nuclear Information System (INIS)

Wei Lin; Liu Shiguang

2009-01-01

Objective: To discuss the perioperative nursing care of patients who is going to receive interventional therapy for hepatic artery stenosis after liver transplantation and to provide useful reference for reducing surgery-related complication and for improving the prognosis of patients. Methods: Based on the patient's condition and operative requirement,we provided effective nursing care for 20 patients who were admitted to receive the interventional therapy for hepatic artery stenosis after liver transplantation. The nursing care included preoperative preparation,postoperative nursing and medical guidance at the time of discharge. Results: Interventional therapy was successfully performed in all 20 cases, and no hemorrhagic tendency or acute thrombosis occurred. Marked symptomatic improvement was obtained in all patients. Conclusion: The interventional therapy is an effective treatment for hepatic artery stenosis after liver transplantation. Intensive perioperative nursing care can well prevent the occurrence of surgery-related complications and can surely improve the therapeutic results. (authors)

Laughter therapy as an intervention to promote psychological well ...

African Journals Online (AJOL)

2017-11-23

Nov 23, 2017 ... Laughter therapy is being used as an intervention to positively influence individuals experiencing various forms of .... to facilitate healing or coping, whether physical, emotional, cognitive, social or ...... Geriatrics & Geron-.

Indirect vs Direct Voice Therapy for Children With Vocal Nodules: A Randomized Clinical Trial.

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Hartnick, Christopher; Ballif, Catherine; De Guzman, Vanessa; Sataloff, Robert; Campisi, Paolo; Kerschner, Joseph; Shembel, Adrianna; Reda, Domenic; Shi, Helen; Sheryka Zacny, Elinore; Bunting, Glenn

2018-02-01

Benign vocal fold nodules affect 12% to 22% of the pediatric population, and 95% of otolaryngologists recommend voice therapy as treatment. However, no randomized clinical trials that we are aware of have shown its benefits. To determine the impact of voice therapy in children with vocal fold nodules according to pretherapy and posttherapy scores on the Pediatric Voice-Related Quality of Life (PVRQOL) survey; secondary objectives included changes in phonatory parameters. For this multicenter randomized clinical trial, 114 children ages 6 to 10 years with vocal fold nodules, PVRQOL scores less than 87.5, and dysphonia for longer than 12 weeks were recruited from outpatient voice and speech clinics. This age range was identified because these patients have not experienced pubertal changes of the larynx, tolerate stroboscopy, and cooperate with voice therapy. Participants were blinded to treatment arm. Participants received either indirect or direct therapy for 8 to 12 weeks. Indirect therapy focused on education and discussion of voice principles, while direct treatment used the stimulus, response, antecedent paradigm. The primary outcome measure was PVRQOL score change before and after treatment. Secondary phonatory measures were also compared. Overall, 114 children were recruited for study (mean [SD] age, 8 [1.4] years; 83 males [73%]); with 57 randomized to receive either indirect or direct therapy. Both direct and indirect therapy approaches showed significant differences in PVRQOL scores pretherapy to posttherapy. The mean increase in PVRQOL score for direct therapy was 19.2, and 14.7 for indirect therapy (difference, 4.5; 95.3% CI, -10.8 to 19.8). Of 44 participants in the direct therapy group, 27 (61%) achieved a clinically meaningful PVRQOL improvement, compared with 26 of 49 (53%) for indirect therapy (difference, 8%; 95% CI, -12 to 28). Post hoc stratification showed robust effects in the direct therapy group for older children (Cohen d = 0.50) and the

Occupational Therapy Interventions Effect on Visual-Motor Skills in Children with Learning Disorders

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Batoul Mandani

2007-07-01

Full Text Available Objective: Visual-motor skill is a part of visual perception which can integrate visual processing skills to fine movements. Visual-motor dysfunction is often to cause problems in copying and writing. The purpose of this study is investigation of occupational therapy interventions effect on the visual-motor skill in children with learning disorders. Materials & Methods: In this interventional and experimental study, 23 students with learning disorders (2nd, 3rd, 4th grade were selected and they were divided (through Randomized Block Method into two groups, 11 persons as intervention group and the others as the control group (12 people. Both groups were administered the “Test of Visual-Motor Skills- Revised” (TVMS-R. Then case group received occupational therapy interventions for 16 sessions and two groups were administered by TVMS-R again. Data was analyzed by using paired T-test and independent T-test. Results: Total mark of TVMS-R demonstrated statistically significant difference in visual-motor skills between case and control groups (P<0/001. This test has 8 categories. Total mark of 1, 3,4,6,8 categories demonstrated that occupational therapy had significant effect on visual analysis skills (P<0/005. Total mark of 2, 5, 7 categories demonstrated that occupational therapy had significant effect on visual-spatial skills (P<0/001. Conclusion: Occupational therapy interventions had significant effect on the visual-motor skills and its items (visual-spatial, visual analysis, visual-motor integration and eye fixation skills.

Image-guided interventions and computer-integrated therapy: Quo vadis?

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Peters, Terry M; Linte, Cristian A

2016-10-01

Significant efforts have been dedicated to minimizing invasiveness associated with surgical interventions, most of which have been possible thanks to the developments in medical imaging, surgical navigation, visualization and display technologies. Image-guided interventions have promised to dramatically change the way therapies are delivered to many organs. However, in spite of the development of many sophisticated technologies over the past two decades, other than some isolated examples of successful implementations, minimally invasive therapy is far from enjoying the wide acceptance once envisioned. This paper provides a large-scale overview of the state-of-the-art developments, identifies several barriers thought to have hampered the wider adoption of image-guided navigation, and suggests areas of research that may potentially advance the field. Copyright © 2016. Published by Elsevier B.V.

Interpersonal Accuracy of Interventions and the Outcome of Cognitive and Interpersonal Therapies for Depression

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Crits-Christoph, Paul; Gibbons, Mary Beth Connolly; Temes, Christina M.; Elkin, Irene; Gallop, Robert

2010-01-01

Objective: The purpose of the current investigation was to examine the interpersonal accuracy of interventions in cognitive therapy and interpersonal therapy as a predictor of the outcome of treatment for patients with major depressive disorder. Method: The interpersonal accuracy of interventions was rated using transcripts of treatment sessions…

Clinical study of the improvement of butylphthalide combined with edaravone therapy on neural functional recovery in acute cerebral infarction after interventional therapy

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Juan-Li Jiang

2016-08-01

Full Text Available Objective: To study the improvement value of butylphthalide combined with edaravone therapy on neural functional recovery in acute cerebral infarction after interventional therapy. Methods: Patients with acute cerebral infarction who received interventional therapy in our hospital from May 2012 to May 2015 were randomly divided into antioxidant group and control group, control group received conventional anti-platelet and lipid-lowering therapy, antioxidant group received butylphthalide and edaravone on the basis of conventional treatment, and the levels of serum oxygen free radicals, oxidation products, antioxidants and S100β were determined. Results: 3 d after treatment, serum •OH, •O2, NO• and •ONOO- content of both antioxidant group and control group were lower than those instantly after interventional therapy, and serum •OH, •O2, NO• and •ONOO- content of antioxidant group 3 d after treatment were lower than those of control group; 3 d after treatment, serum MDA and AOPP content of antioxidant group were significantly lower than those of control group while SOD and GSH content were significantly higher than those of control group; 3 d, 5 d and 7 d after treatment, serum S100β levels of both antioxidant group and control group were lower than those instantly after interventional therapy, and serum S100β levels of antioxidant group 3 d, 5 d and 7 d after treatment were lower than those of control group. Conclusion: Butylphthalide combined with edaravone therapy for acute cerebral infarction after interventional therapy can improve neural functional recovery, and the functioning molecular target of the treatment is to remove oxygen free radicals.

Group Play Therapy with Sexually Abused Preschool Children: Group Behaviors and Interventions

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Jones, Karyn Dayle

2002-01-01

Group play therapy is a common treatment modality for children who have been sexually abused. Sexually abused preschoolers exhibit different group play therapy behaviors than do nonabused children. Group workers need to be aware of these differences and know the appropriate group interventions. This article describes group play therapy with…

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

International Nuclear Information System (INIS)

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

2009-01-01

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

[At-home music therapy intervention using video phone (Skype) for elderly people with dementia].

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Hori, Miyako; Iizuka, Mieko; Nakamura, Michikazu; Aiba, Ikuko; Saito, Yufuko; Kubota, Masakazu; Urabe, Mie; Kinoshita, Ayae

2014-12-01

There are various nonpharmacological therapies available for elderly people with dementia, and these can improve quality of life and the behavioral and psychological symptoms of dementia (BPSD) that appear throughout the progression of the disease. Since a substantial number of effects have been reported for music therapy, we focused on this nonpharmacological intervention. Generally, musical therapy is provided collectively in facilities. However, the music used in this context may not consider the preferences and music abilities of each person. Therefore, in this study we created made-to-order music CDs that accounted for each participant's musical preferences and abilities. Utilizing the CDs, we conducted an intervention study of music therapy using a video phone (Skype) that elderly people with dementia can use at home. An advantage of conducting music therapy for individuals with dementia using a video phone is that those who have difficulty going to the hospital or participating in dementia-related therapy groups can participate in therapy in a familiar place. The results of this intervention showed that participants demonstrated signs of improvement as measured by the smile degree(Smile scan)and Behavior Pathology in Alzheimer's Disease (BEHAVE-AD) scale.

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

International Nuclear Information System (INIS)

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

2010-01-01

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

Current Perspectives on Therapy Dog Welfare in Animal-Assisted Interventions

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Glenk, Lisa Maria

2017-01-01

Simple Summary In animal-assisted interventions (AAIs) animals are used as adjuncts to therapy to positively affect human health. The practice of implementing dogs into therapeutic environments is emerging and as a result, there has been a growing scientific interest on human health outcomes over the past decades. Research efforts into the canine perspective of AAIs have been scarce. Accordingly, there is little consensus on the impact of such interventions on the animals involved. This paper aimed to contribute to the limited body of knowledge by reviewing available studies on therapy dogs’ welfare during AAIs. Moreover, discussion of theoretical and methodological issues, implications for practice and suggestions for future research are provided. Abstract Research into the effects of animal-assisted interventions (AAIs) has primarily addressed human health outcomes. In contrast, only few publications deal with the therapy dog experience of AAIs. This paper provides an overview on potential welfare threats that therapy dogs may encounter and presents the results of a review of available studies on welfare indicators for therapy dogs during AAIs. Previous investigations used physiological and behavioral welfare indicators and dog handler surveys to identify work-related stress. Research outcomes are discussed in the light of strengths and weaknesses of the methods used. Study results suggest that frequency and duration of AAI sessions, novelty of the environment, controllability, age and familiarity of recipients modulate animal welfare indicators. However, this review reveals that currently, clear conclusions on how the well-being of dogs is influenced by the performance in AAIs are lacking due to the heterogeneity of programs, recipient and session characteristics, small dog sample sizes and methodological limitations. This paper further aimed to identify unresolved difficulties in previous research to pave the way for future investigations supporting the

Reiki therapy: a nursing intervention for critical care.

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Toms, Robin

2011-01-01

Complementary and alternative medicine (CAM) is not generally associated with the complexity and intensity of critical care. Most CAM therapies involve slow, calming techniques that seem to be in direct contrast with the fast-paced, highly technical nature of critical care. However, patients in critical care often find themselves coping with the pain and stress of their illness exacerbated by the stress of the critical care environment. Complementary and alternative medicine-related research reveals that complementary therapies, such as Reiki, relieve pain and anxiety and reduce symptoms of stress such as elevated blood pressure and pulse rates. Patients and health care professionals alike have become increasingly interested in complementary and alternative therapies that do not rely on expensive, invasive technology, and are holistic in focus. Reiki is cost-effective, noninvasive, and can easily be incorporated into patient care. The purpose of this article is to examine the science of Reiki therapy and to explore Reiki as a valuable nursing intervention.

Transuterinal artery interventional therapy for fallopian tubal pregnancy

International Nuclear Information System (INIS)

Jiang Zaibo; Shan Hong; Guan Shouhai; Ma Zhuang; Huang Mingsheng; Li Zhengran; Zhu Kangshun; Chen Hanwei; Xiao Jibo; Mu Yongsheng

2001-01-01

Objective: To study the methods and clinical effect of transuterinal artery interventional therapy of fallopian tubal pregnancy. Methods: The authors cured 34 cases of fallopian tubal pregnancy by interventional methods. In the procedure, 4.1 - 5.0 F catheters were used for performing super selective angiography in uterine artery and then infusing Methotrexate 50-100 mg. Finally gelfoam particles or stripes were used to embolise uterine artery. Before and after the procedure, patients showed changes of clinical symptom, physical signs. Value of urine β-hCG and size of pregnancy cyst were studied. Results: 31 cases were succeeded. The successful rate was 91%. 37 fallopian tubal arteries were displayed in 40 uterine arterial angiographies. The stain of ovary was shown done in 21 cases, the appearance rate was 68%. The stain of pregnant cyst was in six cases, the appearance rate was 18%. Conclusion: It is safe and efficient in performing transuterine artery chemo-embolization for therapy of fallopian tubal pregnancy. It could prevent and control fatal bleeding induced by pregnancy cyst rupture

Role of 3T multiparametric-MRI with BOLD hypoxia imaging for diagnosis and post therapy response evaluation of postoperative recurrent cervical cancers

International Nuclear Information System (INIS)

Mahajan, Abhishek; Engineer, Reena; Chopra, Supriya; Mahanshetty, Umesh; Juvekar, S.L.; Shrivastava, S.K.; Desekar, Naresh; Thakur, M.H.

2015-01-01

•In operated cervix cancer, the accuracy of diagnosing vaginal vault/local recurrent lesions was higher at combined multiparametric MR imaging and conventional MR imaging (100%) than at conventional MR imaging (70%) or multiparametric MR imaging (96.7%) alone.•We found a significant correlation between percentage tumor regression and pre-treatment parameters: NEI (p = 0.02), the maximum slope (p = 0.04), mADC value (p = 0.001) and amount of hypoxic fraction present in the pretherapy MRI (p = 0.01).•Multiparametric and BOLD hypoxia MR Imaging are feasible and reliable in diagnosing post-operative recurrence in cervical cancer and should be applied when there is clinical suspicion of post-operative recurrence.•Quantitative image features obtained at multiparametric-MRI with BOLD hypoxia imaging has potential to be an appropriate and reliable biologic target for radiation dose painting to optimize therapy in future. In operated cervix cancer, the accuracy of diagnosing vaginal vault/local recurrent lesions was higher at combined multiparametric MR imaging and conventional MR imaging (100%) than at conventional MR imaging (70%) or multiparametric MR imaging (96.7%) alone. We found a significant correlation between percentage tumor regression and pre-treatment parameters: NEI (p = 0.02), the maximum slope (p = 0.04), mADC value (p = 0.001) and amount of hypoxic fraction present in the pretherapy MRI (p = 0.01). Multiparametric and BOLD hypoxia MR Imaging are feasible and reliable in diagnosing post-operative recurrence in cervical cancer and should be applied when there is clinical suspicion of post-operative recurrence. Quantitative image features obtained at multiparametric-MRI with BOLD hypoxia imaging has potential to be an appropriate and reliable biologic target for radiation dose painting to optimize therapy in future. To assess the diagnostic value of multiparametric-MRI (MPMRI) with hypoxia imaging as a functional marker for characterizing and detecting

The Application of Nursing Interventions: Generalist Therapy to Against Hopelessness on Elderly

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Ike Mardiati Agustin

2015-10-01

Full Text Available Introduction: An increasing number of elderly people followed the emergence of mental health problems. One of mental health problem that arises is hopelesness. Nursing action to hopelesness in elderly people in society is not to optimals. The aimed of this paper was gave an overview about the application of nursing intervention: generalist therapy to against hopelesness on elderly. Method: This research was used descriptive analytic design. Population were elders who lived at RW 3 and RW 4, Kelurahan Ciwaringin, Kota Bogor. Samples were 10 respondents, taken according to purposive sampling technique. Independent variable was generalist therapy, while dependent variables were sign and symptoms of hopelessness and ability to cope with hopelessness. Data were collected by using questionnaire, then analyzed by using frequency distribution. Result: The results showed that generalist therapy can decrease elder’s sign and symptoms of hopelessness (21% and increase their ability to cope with hopelessness (72%. Discussion: It can be concluded that generalist therapy can be used as one of nursing intervention to against hopelesness in the elderly. Keywords: hopelesness, elderly, generalist therapy

The application of sacral block anesthesia in pediatric interventional therapy

International Nuclear Information System (INIS)

Zhong Liang; Qin Zenghui

2009-01-01

Objective: To discuss the management and feasibility of sacral block anesthesia in pediatric interventional therapy. Methods: A total of 80 pediatric patients were randomly and equally divided into two groups. Patients in group A received sacral block anesthesia together with basic anesthesia with propofol, while patients in group B received intravenous anesthesia with propofol. Small amount of ketamine as maintaining dose was used in both groups when needed. Results: The interventional management was successfully completed in all patients. A marked decrease in blood pressure occurred in three patients of group A receiving sacral block anesthesia. In group B receiving intravenous anesthesia, a decrease of SpO 2 to below 90 percent was seen in 8 cases, and obvious bradycardia developed in 12 cases. All these patients were treated with intravenous medication or by reducing the dose of propofol. Additional small dose of ketamine was needed in 4 patients during the procedure. Conclusion: Sacral block anesthesia combined with intravenous anesthesia is one of the effective anesthesia management schemes for pediatric interventional therapy. (authors)

Cognitive behavioural therapy attenuates the enhanced early facial stimuli processing in social anxiety disorders: an ERP investigation.

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Cao, Jianqin; Liu, Quanying; Li, Yang; Yang, Jun; Gu, Ruolei; Liang, Jin; Qi, Yanyan; Wu, Haiyan; Liu, Xun

2017-07-28

Previous studies of patients with social anxiety have demonstrated abnormal early processing of facial stimuli in social contexts. In other words, patients with social anxiety disorder (SAD) tend to exhibit enhanced early facial processing when compared to healthy controls. Few studies have examined the temporal electrophysiological event-related potential (ERP)-indexed profiles when an individual with SAD compares faces to objects in SAD. Systematic comparisons of ERPs to facial/object stimuli before and after therapy are also lacking. We used a passive visual detection paradigm with upright and inverted faces/objects, which are known to elicit early P1 and N170 components, to study abnormal early face processing and subsequent improvements in this measure in patients with SAD. Seventeen patients with SAD and 17 matched control participants performed a passive visual detection paradigm task while undergoing EEG. The healthy controls were compared to patients with SAD pre-therapy to test the hypothesis that patients with SAD have early hypervigilance to facial cues. We compared patients with SAD before and after therapy to test the hypothesis that the early hypervigilance to facial cues in patients with SAD can be alleviated. Compared to healthy control (HC) participants, patients with SAD had more robust P1-N170 slope but no amplitude effects in response to both upright and inverted faces and objects. Interestingly, we found that patients with SAD had reduced P1 responses to all objects and faces after therapy, but had selectively reduced N170 responses to faces, and especially inverted faces. Interestingly, the slope from P1 to N170 in patients with SAD was flatter post-therapy than pre-therapy. Furthermore, the amplitude of N170 evoked by the facial stimuli was correlated with scores on the interaction anxiousness scale (IAS) after therapy. Our results did not provide electrophysiological support for the early hypervigilance hypothesis in SAD to faces, but

The study of patient controlled analgesia undergoing interventional therapy for gynecology and obstetrics ailment

International Nuclear Information System (INIS)

She Shouzhang

2006-01-01

Uterine artery embolism is widely used for interventional therapy of gynecology and obstetrics ailment, but immediate incidence of pain occurs in 90% to 100% after uterine artery embolism and postoperative incidence of pain takes place from 80% to 90%. Patient controlled epidural analgesia (PCEA) could be adopted to treat pain with obviously outweighed effects over the traditional drug regimen or patient intravenous analgesia during the period of interventional therapy of uterine artery embolization. PCEA possesses good effect of analgesia and less adverse reaction and furthermore could eliminate or lessen the sufferings of patient and thus improve rehabilitation quality. Adding droperidol (0.005%) into the preparation of PCEA could decrease adverse effect incidence of nausea and vomiting; so it deserves recommendation for extending application in clinical interventional therapy. (authors)

Comparative Effectiveness of Three Occupational Therapy Sleep Interventions: A Randomized Controlled Study.

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Gutman, Sharon A; Gregory, Kristin A; Sadlier-Brown, Megan M; Schlissel, Marcy A; Schubert, Allison M; Westover, Lee Ann; Miller, Richard C

2017-01-01

Although sleep intervention is within the domain of occupational therapy, few studies exist supporting practice. Effectiveness of three sleep interventions was compared: Dreampad Pillow®, iRest® meditation, and sleep hygiene. Twenty-nine participants were randomly assigned to the Dreampad Pillow® ( n = 10), iRest® meditation ( n = 9), and sleep hygiene ( n = 10) groups. In Phase 1, all participants used a 7-day sleep hygiene regimen to reduce poor sleep habits. In Phase 2 (14 days), 10 participants used the Dreampad Pillow® and sleep hygiene, nine used the iRest meditation and sleep hygiene, and 10 continued sleep hygiene only. At intervention-end, the iRest meditation group experienced statistically greater time asleep than both the Dreampad Pillow® ( p meditation ( p occupational therapy's domain.

A Cognitive Behavioral Therapy-Based Text Messaging Intervention for Methamphetamine Dependence

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Keoleian, Victoria; Stalcup, S. Alex; Polcin, Douglas L.; Brown, Michelle; Galloway, Gantt

2013-01-01

Psychosocial treatments for methamphetamine dependence are of limited effectiveness. Thus, a significant need exists for add-on therapy for this substance user disorder. The aim of this study was to develop and test a novel text messaging intervention for use as an adjunct to cognitive behavioral group therapy for methamphetamine users. Text messaging has the potential to support patients in real-time, around the clock. We convened 2 meetings of an expert panel, held 3 focus groups in current and former users, and conducted 15 semi-structured interviews with in-treatment users in order to develop a fully-automated, cognitive behavioral therapy-based text messaging intervention. We then conducted a randomized, crossover pre-test in 5 users seeking treatment. Participants’ ratings of ease of use and functionality of the system were high. During the pre-test we performed real-time assessments via text messaging on daily methamphetamine use, craving levels, and the perceived usefulness of messages; 79% of scheduled assessments were collected. The odds of messages being rated as “very” or “extremely” useful were 6.6 times [95% CI: 2.2, 19.4] higher in the active vs. placebo periods. The intervention is now ready for testing in randomized clinical trials. PMID:24592670

Music Therapy as a Caring Intervention: Swedish Musicians Learning a New Professional Field

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Petersson, Gunnar; Nystrom, Maria

2011-01-01

The question of competence in providing music therapy has rarely been the focus of interest in empirical research, as most music therapy research aims at measuring outcomes. Therefore, the aim of this study is to analyse and describe musicians' learning processes when they study music therapy as a caring intervention. An initial presumption is…

Association between Leptin and Complement in Hepatitis C Patients with Viral Clearance: Homeostasis of Metabolism and Immunity.

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Chang, Ming-Ling; Kuo, Chia-Jung; Huang, Hsin-Chih; Chu, Yin-Yi; Chiu, Cheng-Tang

2016-01-01

The association between leptin and complement in hepatitis C virus (HCV) infection remains unknown. A prospective study was conducted including 474 (250 genotype 1, 224 genotype 2) consecutive chronic hepatitis C (CHC) patients who had completed an anti-HCV therapy course and undergone pre-therapy and 24-week post-therapy assessments of interferon λ3-rs12979860 and HCV RNA/genotypes, anthropometric measurements, metabolic and liver profiles, and complement component 3 (C3), C4, and leptin levels. Of the 474 patients, 395 had a sustained virological response (SVR). Pre-therapy leptin levels did not differ between patients with and without an SVR. Univariate and multivariate analyses showed that sex (pre- and post-therapy, pimmune and metabolic homeostasis through association with C4 and TC. Positive alterations in C4 and TC levels reflect viral clearance after therapy in CHC patients.

Multidisciplinary approach to identification and remedial intervention for adverse late effects of cancer therapy

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McCalla, J.L.

1985-01-01

Because of advances in surgical technique, radiation therapy, and combined chemotherapy regimens, there has been a dramatic improvement in the survival of children with pediatric malignancies. All treatment modalities are associated with adverse effects that may be manifested months to years after therapy. This article has provided an overview of the physiologic and psychologic adverse effects of antineoplastic therapy and described the multidisciplinary approach used by one institution to identify and initiate appropriate remedial intervention. Nurses can learn to assist in the identification of adverse late effects, provide support to the family, and facilitate appropriate intervention

Occupational Therapy Home Safety Intervention via Telehealth

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BREEDEN, LORI E.

2016-01-01

Photography can be an effective addition for education-based telehealth services delivered by an occupational therapist. In this study, photography was used as antecedent to telehealth sessions delivered by an occupational therapist focused on narrative learning about home safety. After taking photographs of past home safety challenges, six participants experienced three web-based occupational therapy sessions. Sessions were recorded and transcribed. Data were examined using content analysis. The content analysis identified the following themes: the value of photos to support learning; the value of narrative learning related to home safety education; and abstract versus concrete learners. Procedural findings are included to support future endeavors. Findings indicate that within a wellness context, home safety education for older adults can be delivered effectively via telehealth when using photography as a part of an occupational therapy intervention. PMID:27563389

Contributions to clinical Occupational Therapy in the area of early intervention in interdisciplinary team

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Dani Laura Peruzzolo

2015-07-01

Full Text Available Introduction: Specialized care for infants considers that the sooner the intervention in risk and symptoms occurs, the greater the possibility of obtaining better results. Aims: To describe the process of early intervention provided by an extension program of graduate studies in Occupational Therapy and Hearing, Speech and Languages Science courses and also discuss the theoretical and practical paths in the care for infants and in the Occupational Therapy area. Method: Case report with convenience sample. The study was carried out through an assessment interpreted in light of psychomotor, occupational therapeutic, and speech, hearing and language contributions. The intervention was under the responsibility of an occupational therapist supported by an interdisciplinary team. It occurred once a week from August 2011 to January 2012 and from March 2012 to July 2012. Data analysis was carried out by comparing the entry assessment test and the final assessment test. Results: The boy had not developed concepts of body schema and body image that could sustain his relationship with objects, space and other persons. He presented little linguistic evolution. Considering the contributions of occupational therapy in psychomotor clinic, the boy reconstructed his family place in early intervention. The possibility of language functioning connected to the boy’s demands allowed access to symbolism. Conclusion: The proposal of early occupational therapy intervention with a single therapist supported by an interdisciplinary team was able to overcome the structural and instrumental obstacles to the boy’s development.

Early Intervention for Borderline Personality Disorder: Psychodynamic Therapy in Adolescents.

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Salzer, Simone; Cropp, Carola; Streeck-Fischer, Annette

2014-01-01

Borderline personality disorder (BPD) should be understood as a disorder of development (Streeck-Fischer 2008, 2013) that has its first manifestation in late childhood and adolescence. There are only few treatment studies of adolescents meeting the diagnostic criteria of borderline personality disorder, although early interventions for these patients are urgently needed (see Chanen & McCutcheon 2013). We examined the effectiveness of an inpatient psychodynamic therapy (PDT). Twenty-eight adolescents fulfilling the DSM-IV diagnostic criteria of borderline personality disorder were treated with psychodynamic therapy. The mean duration of treatment was 29.87 weeks (SD = 15.88). Outcomes were remission rates, GAF, GSI, SDQ, IIP and BPI scores. Assessments were made at admission and after treatment. Pre-post comparisons and comparisons with normative data were conducted. At the end of treatment 39.29% of the patients were remitted. We found significant improvements for the GAF, GSI, SDQ, IIP (all p0.001) and the BPI (p = 0.006). These clinically relevant improvements demonstrate the effectiveness of psychodynamic therapy in adolescents with borderline personality disorder and stress the usefulness of an early intervention for these patients.

The DSA findings and interventional therapy of hepatic alveolar echinococcus

International Nuclear Information System (INIS)

Ren Weixin; Xiao Xiangsheng; Chen Peng; Ma Jun

2004-01-01

Objective: To analyse the DSA findings of hepatic alveolar echinococcus (HAE) and evaluate the feasibility of the interventional therapy. Methods: Eight patients with HAE were all examined by DSA, CT and lab test. Three of them were performed the transcatheter arterial embolization by iodized oil. All of them were confirmed by surgical operation and followed-up for three months. Results: The DSA findings of HAE included hepatic arterial curling and enlargement with hypertrophied circled encircling as typical 'handed ball'. Eight cases presented the ring stain during the capillary stage. After embolization, the retention of iodized oil was revealed by DSA in 3 cases. CT three months later showed fine iodized oil retention and the enlarged necrosis. Ischemic necrosis around the lesion and the cut margins were clearly seen in operation biopsy. Conclusions: HAE possesses special DSA findings and interventional therapy is a new therapeutic method of choice. (authors)

Effectiveness of a positive psychology intervention combined with cognitive behavioral therapy in university students

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Rosario-Josefa Marrero

Full Text Available The aim of this study was to design and implement a positive intervention combined with cognitive-behavioral therapy to enhance subjective and psychological well-being and other positive functioning constructs in a convenience sample. Participants analysed were 48 university students (mean age 22.25, 25 assigned nonrandomized to intervention condition and 23 to no-treatment waiting-list control condition. All participants were assessed pre- and post-intervention to test the treatment program effectiveness. Repeated-measures ANCOVAs, controlling baseline differences between the two groups, indicated that the intervention group reported greater social support after the intervention period than the waiting-list control group. Within-group differences were found for happiness, selfacceptance, positive relations with others, optimism, and self-esteem in the intervention group; these differences did not appear in the waiting-list control group. These findings suggest the limited capacity of this intervention program for improving well-being through positive activities combined with cognitive-behavioral therapy. Future research should analyse what kind of activities could be more effective in promoting well-being depending on the characteristics of participants.

Nonstent Combination Interventional Therapy for Treatment of Benign Cicatricial Airway Stenosis

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

2015-01-01

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

The diagnostic imaging and interventional therapy of hepatic angiomyolipoma associated with tuberous sclerosis

International Nuclear Information System (INIS)

You Jian; Xu Wei; Zhu Jiehui

2001-01-01

Objective: To evaluate imaging diagnosis, differential diagnosis, surgery and interventional therapy of hepatic angiomyolipoma associated with tuberous sclerosis. Methods: Clinical features, imaging appearances and interventional therapy for 2 cases of HAML in TS were retrospectively analyzed. Results: The features of HAML in TS are as following: (1) Two cases were female with no history of hepatitis and hepatocirrhosis, liver function test and alpha fetoprotein were normal: (2) the tumor was shown as a multiple hyper-echoic mass with sharp margin on ultrasonography; well defined, fat density and intensity mass on computerized tomography (CT); hypervascular mass with early drainage of hepatic vein and tumor staining on angiography. (3) One case underwent interventional therapy. After 42 month follow up, the tumor was found to be diminished in size. Another case was under monitored with only the enucleating of left renal mass. The hepatic tumor showed no change after 10 months. Conclusions: The imaging appearances of HAML in TS are relatively characteristic. Super selective arterial embolization is an effective treatment for HAML in TS

Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions

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Franz MJ

2018-06-01

Full Text Available Marion J Franz,1 Janice MacLeod2 1Nutrition Concepts by Franz, Minneapolis, MN, 2Clinical Innovation, WellDoc, Columbia, MD, USA Abstract: A systematic review was conducted by the Academy of Nutrition and Dietetics to determine the evidence for the effectiveness of individualized nutrition therapy provided by a dietitian nutritionist and evidence-based (EB nutrition-therapy interventions in adults with diabetes. This article briefly reviews the systematic process used and summarizes the effectiveness evidence and intervention recommendations. In persons with type 2 diabetes (T2D, 18 studies met study criteria for the effectiveness question. A 0.3%–2.0% decrease from baseline in glycated hemoglobin was reported at 3 months in 13 study arms, a 0.3%–1.8% decrease at 6 months in 12 study arms, a 0.3%–1.6% decrease at 12 months with ongoing support in six study arms, and a 0.6%–1.8% decrease at >12 months in four study arms. An initial series of encounters with follow-up visits and implementation of a variety of nutrition-therapy interventions, all of which reduced energy intake, were reported. Nutrition therapy also significantly decreased doses or number of glucose-lowering medications used and resulted in improvements in quality of life. Mixed effects on cardiovascular risk factors and body weight were reported. Fourteen questions were identified related to nutrition-therapy interventions. A total of 38 studies met study criteria for the nutrition-intervention questions, from which 30 conclusion statements and 19 nutrition-practice guideline recommendations for T2D were written. Three additional NPG recommendations for T2D were written based on evidence reviewed by the American Diabetes Association. The 22 nutrition-intervention recommendations for T2D are summarized. How to implement nutrition-practice guideline recommendations effectively by health care providers and individuals with T2D remains challenging. Of importance, it is

Occupational Therapy Contributions in Early Intervention: Implications for Personnel Preparation and Interprofessional Practice

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Muhlenhaupt, Mary; Pizur-Barnekow, Kris; Schefkind, Sandra; Chandler, Barbara; Harvison, Neil

2015-01-01

Occupational therapy provides a unique contribution in early intervention programs for families and their children from birth to 3 years old who are at risk for, or who have, identified disabilities. This article describes occupational therapy's distinct value and presents the profession's perspective on services to enhance families' caregiving…

Is mindfulness-based therapy an effective intervention for obsessive-intrusive thoughts: a case series.

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Wilkinson-Tough, Megan; Bocci, Laura; Thorne, Kirsty; Herlihy, Jane

2010-01-01

Despite the efficacy of cognitive-behavioural interventions in improving the experience of obsessions and compulsions, some people do not benefit from this approach. The present research uses a case series design to establish whether mindfulness-based therapy could benefit those experiencing obsessive-intrusive thoughts by targeting thought-action fusion and thought suppression. Three participants received a relaxation control intervention followed by a six-session mindfulness-based intervention which emphasized daily practice. Following therapy all participants demonstrated reductions in Yale-Brown Obsessive-Compulsive Scale scores to below clinical levels, with two participants maintaining this at follow-up. Qualitative analysis of post-therapy feedback suggested that mindfulness skills such as observation, awareness and acceptance were seen as helpful in managing thought-action fusion and suppression. Despite being limited by small participant numbers, these results suggest that mindfulness may be beneficial to some people experiencing intrusive unwanted thoughts and that further research could establish the possible efficacy of this approach in larger samples. Copyright (c) 2009 John Wiley & Sons, Ltd.

Preliminary studies of plasma growth hormone releasing activity during medical therapy of acromegaly

International Nuclear Information System (INIS)

Hagen, T.C.; Lawrence, A.M.; Kirsteins, L.

1978-01-01

The in vitro growth hormone releasing activity of plasma obtained from six acromegalic subjects was measured before and during therapy. In five subjects, plasmas were obtained before and during successful medical therapy with medroxyprogesterone acetate (MPA). The sixth subject was sampled before and after transphenoidal Sr 90 -induced hypopituitarism. All subjects had a decrement in fasting growth hormone levels with respective therapies (29-88%). The in vitro growth hormone released from Rhesus monkey anterior pituitaries was assessed after incubating one lateral half in control plasma (pre-therapy) and the contralateral pituitary half in plasma obtained during or after therapy. Studies with plasmas obtained from the five patients successfully treated with MPA showed a decrease in growth hormone releasing activity during therapy in all (18-57%). Plasma obtained after Sr 90 pituitary ablation in the sixth subject had 35% more growth hormone releasing activity than obtained before therapy. These results suggest that active acromegalics who respond to MPA with significantly lowered growth hormone levels may actually achieve this response because of a decrease in growth hormone releasing factor measured peripherally. The opposite response in one acromegalic subject, following Sr 90 pituitary ablation and hypopituitarism, suggests that growth hormone releasing factor secretion may increase when growth hormone levels are lowered by ablative therapy. (orig.) [de

Occupational Therapy Home Safety Intervention via Telehealth

Directory of Open Access Journals (Sweden)

Lori E. Breeden

2016-07-01

Full Text Available Photography can be an effective addition for education-based telehealth services delivered by an occupational therapist.  In this study, photography was used as antecedent to telehealth sessions delivered by an occupational therapist focused on narrative learning about home safety.  After taking photographs of past home safety challenges, six participants experienced three web-based occupational therapy sessions each.  Sessions were recorded and transcribed.  Data were examined using content analysis.  A content analysis identified the following themes as well as an understanding of the learning process.  Analyses yielded themes of: the value of photos to support learning, the value of narrative learning related to home safety education, abstract versus concrete learners.  Procedural findings are included to support future endeavors.  Findings indicate that within a wellness context, home safety education for older adults can be delivered effectively via telehealth when using photography as a part of an occupational therapy intervention.

Core journals that publish clinical trials of physical therapy interventions.

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Costa, Leonardo Oliveira Pena; Moseley, Anne M; Sherrington, Catherine; Maher, Christopher G; Herbert, Robert D; Elkins, Mark R

2010-11-01

The objective of this study was to identify core journals in physical therapy by identifying those that publish the most randomized controlled trials of physical therapy interventions, provide the highest-quality reports of randomized controlled trials, and have the highest journal impact factors. This study was an audit of a bibliographic database. All trials indexed in the Physiotherapy Evidence Database (PEDro) were analyzed. Journals that had published at least 80 trials were selected. The journals were ranked in 4 ways: number of trials published; mean total PEDro score of the trials published in the journal, regardless of publication year; mean total PEDro score of the trials published in the journal from 2000 to 2009; and 2008 journal impact factor. The top 5 core journals in physical therapy, ranked by the total number of trials published, were Archives of Physical Medicine and Rehabilitation, Clinical Rehabilitation, Spine, British Medical Journal (BMJ), and Chest. When the mean total PEDro score was used as the ranking criterion, the top 5 journals were Journal of Physiotherapy, Journal of the American Medical Association (JAMA), Stroke, Spine, and Clinical Rehabilitation. When the mean total PEDro score of the trials published from 2000 to 2009 was used as the ranking criterion, the top 5 journals were Journal of Physiotherapy, JAMA, Lancet, BMJ, and Pain. The most highly ranked physical therapy-specific journals were Physical Therapy (ranked eighth on the basis of the number of trials published) and Journal of Physiotherapy (ranked first on the basis of the quality of trials). Finally, when the 2008 impact factor was used for ranking, the top 5 journals were JAMA, Lancet, BMJ, American Journal of Respiratory and Critical Care Medicine, and Thorax. There were no significant relationships among the rankings on the basis of trial quality, number of trials, or journal impact factor. Physical therapists who are trying to keep up-to-date by reading the best

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

International Nuclear Information System (INIS)

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

2000-01-01

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

Possibilities of Occupational Therapy Intervention for Cancer Patients

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Bejdlová, Dagmar

2016-01-01

The aim of this thesis is to approach the issue of cancer patients and to present occupational therapy intervention in oncology. The theoretical part of the thesis is an overview of the most important concepts from the field of oncology. It outlines different types of treatments in oncology, including their side effects. There are also the most frequent cancer diagnoses in the Czech Republic and abroad. Furthermore, the work describes the general possibilities of rehabilitation for people wit...

Comparing Active and Passive Distraction-Based Music Therapy Interventions on Preoperative Anxiety in Pediatric Patients and Their Caregivers.

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Millett, Christopher R; Gooding, Lori F

2018-01-13

Young children who experience high levels of preoperative anxiety often exhibit distress behaviors, experience more surgical complications, and are at a higher risk for developing a variety of negative postoperative consequences. A significant factor in pediatric preoperative anxiety is the level of anxiety present in their caregivers. Active and passive music therapy interventions addressing anxiety prior to invasive procedures have been met with success. The purpose of this study was to investigate the comparative effectiveness of two distraction-based music therapy interventions on reducing preoperative anxiety in young pediatric surgical patients and their caregivers. A total of 40 pediatric patient and caregiver dyads undergoing ambulatory surgery were included in this study. Pediatric preoperative anxiety was measured pre- and post-intervention using the modified Yale Pediatric Anxiety Scale, while caregiver anxiety was measured through self-report using the short-form Strait-Trait Anxiety Inventory-Y6. Participants were randomized to either an active or passive intervention group for a preoperative music therapy session. Results indicated a significant reduction in preoperative anxiety for both patients and their caregivers regardless of intervention type. Neither active nor passive music therapy interventions were significantly more effective than the other. For future studies, the researchers recommend an increased sample size, controlling for various factors such as sedative premedication use, and testing interventions with patients in various stages of development. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Game-based digital interventions for depression therapy: a systematic review and meta-analysis.

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Li, Jinhui; Theng, Yin-Leng; Foo, Schubert

2014-08-01

The aim of this study was to review the existing literature on game-based digital interventions for depression systematically and examine their effectiveness through a meta-analysis of randomized controlled trials (RCTs). Database searching was conducted using specific search terms and inclusion criteria. A standard meta-analysis was also conducted of available RCT studies with a random effects model. The standard mean difference (Cohen's d) was used to calculate the effect size of each study. Nineteen studies were included in the review, and 10 RCTs (eight studies) were included in the meta-analysis. Four types of game interventions-psycho-education and training, virtual reality exposure therapy, exercising, and entertainment-were identified, with various types of support delivered and populations targeted. The meta-analysis revealed a moderate effect size of the game interventions for depression therapy at posttreatment (d=-0.47 [95% CI -0.69 to -0.24]). A subgroup analysis showed that interventions based on psycho-education and training had a smaller effect than those based on the other forms, and that self-help interventions yielded better outcomes than supported interventions. A higher effect was achieved when a waiting list was used as the control. The review and meta-analysis support the effectiveness of game-based digital interventions for depression. More large-scale, high-quality RCT studies with sufficient long-term data for treatment evaluation are needed.

Study on the improvement effect of edaravone combined with Ginkgo biloba extract on neurological function after interventional therapy of cerebral infarction

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Xiang-Yang Hu1

2017-05-01

Full Text Available Objective: To study the effect of edaravone combined with Ginkgo biloba extract on neurological function after interventional therapy of cerebral infarction. Methods: A total of 152 cases of patients with acute cerebral infarction who received interventional therapy in Mianyang Central Hospital between May 2013 and September 2016 were retrospectively analyzed and divided into intervention group and control group, intervention group received routine treatment combined with edaravone and Ginkgo biloba extract treatment after interventional therapy, and control group received routine medical treatment after interventional therapy. 3 d, 7 d, 14 d after therapy, serum was separated, and the levels of neural function injury markers, oxidative stress products, antioxidant enzymes and platelet activation indexes were determined. Results: 3 d, 7 d and 14 d after treatment, serum UCH-L1, GFAP, NSE, S100B, ROS, GMP-140, PAC-1 and CD62p contents of intervention group were significantly lower than those of control group while CAT, SOD and GSH-PX contents were significantly higher than those of control group. Conclusion: Edaravone combined with Ginkgo biloba extract can reduce neurological injury and promote neurological function recovery after interventional therapy of cerebral infarction, and this effect is related to the reduction of oxidative stress and inhibition of platelet activation.

Interventional therapy for gastrointestinal hemorrhage induced by Dieulafoy disease

International Nuclear Information System (INIS)

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

2008-01-01

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

Roles of posttherapy 18F-FDG PET/CT in patients with advanced squamous cell carcinoma of the uterine cervix receiving concurrent chemoradiotherapy.

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Liu, Feng-Yuan; Su, Tzu-Pei; Wang, Chun-Chieh; Chao, Angel; Chou, Hung-Hsueh; Chang, Yu-Chen; Yen, Tzu-Chen; Lai, Chyong-Huey

2018-07-01

To assess the clinical roles of [ 18 F]fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) performed 2-3 months after completion of concurrent chemoradiotherapy (CCRT), along with pretherapy characteristics, in patients with advanced squamous cell carcinoma of the uterine cervix enrolled in a prospective randomized clinical trial. Posttherapy PET/CT in patients with advanced FIGO stage or positive pelvic or para-aortic lymph node (PALN) defined on pretherapy PET/CT was classified as positive, equivocal, or negative. Overall survival (OS) rates between patients with different PET/CT results are compared. Pretherapy characteristics are examined for association with posttherapy PET/CT results and for prognostic significance in patients with equivocal or negative PET/CT. PET/CT scans (n = 55) were positive, equivocal and negative in 9, 13 and 33 patients, respectively. All patients with positive scans were confirmed to have residual or metastatic disease and died despite salvage therapies. There is a significant OS difference between patients with positive and equivocal scans (P PET/CT (P = .033) and predicts a poorer survival in patients with equivocal or negative posttherapy PET/CT (P PET/CT 2-3 months posttherapy implies treatment failure and novel therapy is necessary to improve outcomes for such patients. A more intense posttherapy surveillance may be warranted in patients with positive pretherapy PALN.

Review of Occupational Therapy Intervention Research in the Practice Area of Children and Youth 2009–2013

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Bendixen, Roxanna M.; Huang, Yu Yun; Lim, Yoonjeong

2014-01-01

PURPOSE. We conducted a systematic review examining the extent to which pediatric intervention research recently published in the American Journal of Occupational Therapy reflects occupational therapy’s holistic occupation-based tenets. METHOD. We surveyed 10 systematic reviews and analyzed 38 single effectiveness studies for intervention approach, type, level of environmental targeting, level of occupational task and participation practice, and measures used. RESULTS. Of the 38 single effectiveness studies, 12 (32%) explicitly incorporated both environmental targets of intervention and practice of complex or in vivo occupational tasks, with steady increases during the 2009–2013 time frame. CONCLUSION. In the area of children and youth, occupational therapy is making steady gains in reflecting and demonstrating the effectiveness of the profession’s holistic, occupation-based tenets. Occupational therapy researchers must be mindful to ensure that despite the reductionist nature of intervention research, interventions reflect the profession’s holistic understanding of the interplay between the child, environment, and occupations. PMID:24581415

Composite Configuration Interventional Therapy Robot for the Microwave Ablation of Liver Tumors

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Cao, Ying-Yu; Xue, Long; Qi, Bo-Jin; Jiang, Li-Pei; Deng, Shuang-Cheng; Liang, Ping; Liu, Jia

2017-11-01

The existing interventional therapy robots for the microwave ablation of liver tumors have a poor clinical applicability with a large volume, low positioning speed and complex automatic navigation control. To solve above problems, a composite configuration interventional therapy robot with passive and active joints is developed. The design of composite configuration reduces the size of the robot under the premise of a wide range of movement, and the robot with composite configuration can realizes rapid positioning with operation safety. The cumulative error of positioning is eliminated and the control complexity is reduced by decoupling active parts. The navigation algorithms for the robot are proposed based on solution of the inverse kinematics and geometric analysis. A simulation clinical test method is designed for the robot, and the functions of the robot and the navigation algorithms are verified by the test method. The mean error of navigation is 1.488 mm and the maximum error is 2.056 mm, and the positioning time for the ablation needle is in 10 s. The experimental results show that the designed robot can meet the clinical requirements for the microwave ablation of liver tumors. The composite configuration is proposed in development of the interventional therapy robot for the microwave ablation of liver tumors, which provides a new idea for the structural design of medical robots.

Occupational therapy interventions in the treatment of people with severe mental illness.

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Höhl, Werner; Moll, Sandra; Pfeiffer, Andreas

2017-07-01

Life expectancy of people with severe mental illness is considerably shortened and their risk for cardiovascular and metabolic disorders is increased. They spend more time in solitary and less time in structured activities than the general population.Engagement in healthy patterns of activity, including active, meaningful participation in the community can, therefore, be critical to recovery from severe mental illness. Occupational therapy is a profession that focuses on time use, activity patterns and occupational engagement, and the links to health and well-being. In this study, we review research evidence regarding approaches to occupational engagement, including behavioural activation, time use, and activity promotion. We also will review studies that specifically evaluate the impact of occupational therapy interventions. There is a growing body of evidence regarding the value of interventions addressing occupational engagement of individuals with severe mental illness, including a range of activation strategies and approaches. There is a need, however, for documentation of theoretically informed approaches that are supported by fidelity measures to ensure standardization. Larger-scale studies are needed, including consistent outcome measures to document engagement and changes in activity patterns as well as health-related outcomes. High-quality randomized clinical trials are important to establish effectiveness. As occupational therapy interventions are complex and embedded within a range of multidisciplinary approaches, new models of pragmatic trials within the naturalistic context of psychiatric rehabilitation are also needed.

Effects of a music therapy group intervention on enhancing social skills in children with autism.

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LaGasse, A Blythe

2014-01-01

Research indicates that music therapy can improve social behaviors and joint attention in children with Autism Spectrum Disorder (ASD); however, more research on the use of music therapy interventions for social skills is needed to determine the impact of group music therapy. To examine the effects of a music therapy group intervention on eye gaze, joint attention, and communication in children with ASD. Seventeen children, ages 6 to 9, with a diagnosis of ASD were randomly assigned to the music therapy group (MTG) or the no-music social skills group (SSG). Children participated in ten 50-minute group sessions over a period of 5 weeks. All group sessions were designed to target social skills. The Social Responsiveness Scale (SRS), the Autism Treatment Evaluation Checklist (ATEC), and video analysis of sessions were used to evaluate changes in social behavior. There were significant between-group differences for joint attention with peers and eye gaze towards persons, with participants in the MTG demonstrating greater gains. There were no significant between-group differences for initiation of communication, response to communication, or social withdraw/behaviors. There was a significant interaction between time and group for SRS scores, with improvements for the MTG but not the SSG. Scores on the ATEC did not differ over time between the MTG and SSG. The results of this study support further research on the use of music therapy group interventions for social skills in children with ASD. Statistical results demonstrate initial support for the use of music therapy social groups to develop joint attention. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Short term efficacy of interventional therapy for hilar biliary obstruction

International Nuclear Information System (INIS)

Zhai Renyou; Dai Dingke; Wang Jianfeng; Yu Ping; Wei Baojie

2006-01-01

Objective: To analyze the method and short term efficacy of interventional therapy for hilar biliary obstructive jaundice. Methods: 100 consecutive patients with perihilar biliary obstruction admitted before May 2004 were treated with percutaneous transhepatic biliary drainage (PTBD) or placement of metallic stents. Among them, 39 patients were found with bile duct cancer, 6 with adenocarcinoma of gallbladder, 22 with metastatic carcinoma, 15 with primary liver carcinoma and 18 with bile duct strait after liver transplantation. Serum total bilirubin before operation and 3-7 days, 8-14 days after procedure were analysed by t test. Results: 79 patients with PTBD (including simple external drainage and combined internal and external drainage), and 21 patients with stents placement (including 31 stents of 4 different kinds) were all carried out successfully. There were significant differences in serum total bilirubin before and 3-7 days, 8-14 days after the procedure, P<0.05 vs P<0.01. Conclusion: Interventional therapy is simple, safe, and effective for hilar biliary obstruction, the latter showed more significance than the former with short term satisfaction. (authors)

Interventional therapy for priapism caused by arteriovenous fistula of penis: the nursing experience in two patients

International Nuclear Information System (INIS)

Peng Jinxia; Liu Ping; Jia Hongtao

2010-01-01

Objective: To discuss the perioperative nursing measures for interventional treatment of priapism caused by arteriovenous fistula of penis in order to reduce the operation-related complications and to promote rehabilitation. Methods: A series of nursing steps were carried out in 2 patients who suffered from priapism caused by arteriovenous fistula of penis and received interventional therapy. The nursing measures included preoperative psychological nursing,routine preoperative examinations, promotion of friendly relations between nurse and patient, preparation for the operation method, the preparation of skin, postoperative nursing of patient's position, observation of penis erection and vital signs, postoperative psychological nursing, and the health guidance at the time of discharge. Results: After the interventional therapy two patients were successfully cured at the time of discharge. No complications related to the operation occurred. Three months after the operation the erect function of the penis remained normal. Conclusion: The interventional therapy is a safe and reliable technique for priapism caused by arteriovenous fistula of penis. The proper and effective perioperative and postoperative nursing measures can surely improve the successful rate of interventional treatment as well as prevent the occurrence of complications. (authors)

Evaluation of genome-wide expression profiles of blood and sputum neutrophils in cystic fibrosis patients before and after antibiotic therapy.

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Massimo Conese

Full Text Available In seeking more specific biomarkers of the cystic fibrosis (CF lung inflammatory disease that would be sensitive to antibiotic therapy, we sought to evaluate the gene expression profiles of neutrophils in CF patients before treatment in comparison with non-CF healthy individuals and after antibiotic treatment. Genes involved in neutrophil-mediated inflammation, i.e. chemotaxis, respiratory burst, apoptosis, and granule exocytosis, were the targets of this study. Microarray analysis was carried out in blood and airway neutrophils from CF patients and in control subjects. A fold change (log threshold of 1.4 and a cut-off of p<0.05 were utilized to identify significant genes. Community networks and principal component analysis were used to distinguish the groups of controls, pre- and post-therapy patients. Control subjects and CF patients before therapy were readily separated, whereas a clear distinction between patients before and after antibiotic therapy was not possible. Blood neutrophils before therapy presented 269 genes down-regulated and 56 up-regulated as compared with control subjects. Comparison between the same patients before and after therapy showed instead 44 genes down-regulated and 72 up-regulated. Three genes appeared to be sensitive to therapy and returned to "healthy" condition: phorbol-12-myristate-13-acetate-induced protein 1 (PMAIP1, hydrogen voltage-gated channel 1 (HVCN1, and β-arrestin 1 (ARRB1. The up-regulation of these genes after therapy were confirmed by real time PCR. In airway neutrophils, 1029 genes were differentially expressed post- vs pre-therapy. Of these, 30 genes were up-regulated and 75 down-regulated following antibiotic treatment. However, biological plausibility determined that only down-regulated genes belonged to the gene classes studied for blood neutrophils. Finally, it was observed that commonly expressed genes showed a greater variability in airway neutrophils than that found in blood neutrophils

Evaluation of genome-wide expression profiles of blood and sputum neutrophils in cystic fibrosis patients before and after antibiotic therapy.

Science.gov (United States)

Conese, Massimo; Castellani, Stefano; Lepore, Silvia; Palumbo, Orazio; Manca, Antonio; Santostasi, Teresa; Polizzi, Angela Maria; Copetti, Massimiliano; Di Gioia, Sante; Casavola, Valeria; Guerra, Lorenzo; Diana, Anna; Montemurro, Pasqualina; Mariggiò, Maria Addolorata; Gallo, Crescenzio; Maffione, Angela Bruna; Carella, Massimo

2014-01-01

In seeking more specific biomarkers of the cystic fibrosis (CF) lung inflammatory disease that would be sensitive to antibiotic therapy, we sought to evaluate the gene expression profiles of neutrophils in CF patients before treatment in comparison with non-CF healthy individuals and after antibiotic treatment. Genes involved in neutrophil-mediated inflammation, i.e. chemotaxis, respiratory burst, apoptosis, and granule exocytosis, were the targets of this study. Microarray analysis was carried out in blood and airway neutrophils from CF patients and in control subjects. A fold change (log) threshold of 1.4 and a cut-off of p<0.05 were utilized to identify significant genes. Community networks and principal component analysis were used to distinguish the groups of controls, pre- and post-therapy patients. Control subjects and CF patients before therapy were readily separated, whereas a clear distinction between patients before and after antibiotic therapy was not possible. Blood neutrophils before therapy presented 269 genes down-regulated and 56 up-regulated as compared with control subjects. Comparison between the same patients before and after therapy showed instead 44 genes down-regulated and 72 up-regulated. Three genes appeared to be sensitive to therapy and returned to "healthy" condition: phorbol-12-myristate-13-acetate-induced protein 1 (PMAIP1), hydrogen voltage-gated channel 1 (HVCN1), and β-arrestin 1 (ARRB1). The up-regulation of these genes after therapy were confirmed by real time PCR. In airway neutrophils, 1029 genes were differentially expressed post- vs pre-therapy. Of these, 30 genes were up-regulated and 75 down-regulated following antibiotic treatment. However, biological plausibility determined that only down-regulated genes belonged to the gene classes studied for blood neutrophils. Finally, it was observed that commonly expressed genes showed a greater variability in airway neutrophils than that found in blood neutrophils, both before and

Decreased Serum Hepatocyte Growth Factor (HGF in Individuals with Bipolar Disorder Normalizes after Zinc and Anti-oxidant Therapy

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A.J. Russo

2010-01-01

Full Text Available Aim To assess serum HGF concentration in individuals with bipolar disorder and investigate the efficacy of zinc therapy on these levels. Subjects and Methods Serum from 35 individuals diagnosed with bipolar disorder and 19 age and gender similar controls were tested for HGF concentration using ELISAs, and copper and zinc plasma levels using inductively-coupled plasma-mass spectrometry. Results HGF serum levels of individuals with bipolar disorder were significantly lower than age and gender similar controls ( P = 0.0021. HGF serum concentration was significantly lower in Bipolar patients pre-therapy ( P = 0.0009 and HGF levels normalized post-therapy. Zinc levels in these same individuals also normalized ( P = 0.0046 and patient's perceived severity of Bipolar symptoms significantly decreased after therapy ( P = 0.0003. We also found a significant direct correlation between Zinc and HGF serum concentration in the bipolar patients ( P = 0.04. Discussion These results suggest an association between low HGF levels and bipolar disorder and also demonstrate that zinc therapy may be associated with the normalization of HGF levels and decrease in severity of disease.

Measuring Supportive Music and Imagery Interventions: The Development of the Music Therapy Self-Rating Scale.

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Meadows, Anthony; Burns, Debra S; Perkins, Susan M

2015-01-01

Previous research has demonstrated modest benefits from music-based interventions, specifically music and imagery interventions, during cancer care. However, little attention has been paid to measuring the benefits of music-based interventions using measurement instruments specifically designed to account for the multidimensional nature of music-imagery experiences. The purpose of this study was to describe the development of, and psychometrically evaluate, the Music Therapy Self-Rating Scale (MTSRS) as a measure for cancer patients engaged in supportive music and imagery interventions. An exploratory factor analysis using baseline data from 76 patients who consented to participate in a music-based intervention study during chemotherapy. Factor analysis of 14 items revealed four domains: Awareness of Body, Emotionally Focused, Personal Resources, and Treatment Specific. Internal reliability was excellent (Cronbach alphas ranging from 0.75 to 0.88) and construct and divergent-discriminant validity supported. The MTSRS is a psychometrically sound, brief instrument that captures essential elements of patient experience during music and imagery interventions. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pre-operative assessment of residual disease in locally advanced breast cancer patients: A sequential study by quantitative diffusion weighted MRI as a function of therapy.

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Agarwal, Khushbu; Sharma, Uma; Sah, Rani G; Mathur, Sandeep; Hari, Smriti; Seenu, Vurthaluru; Parshad, Rajinder; Jagannathan, Naranamangalam R

2017-10-01

The potential of diffusion weighted imaging (DWI) in assessing pathologic response and surgical margins in locally advanced breast cancer patients (n=38) undergoing neoadjuvant chemotherapy was investigated. DWI was performed at pre-therapy (Tp0), after I (Tp1) and III (Tp3) NACT at 1.5T. Apparent diffusion coefficient (ADC) of whole tumor (ADC WT ), solid tumor (ADC ST ), intra-tumoral necrosis (ADC Nec ) was determined. Further, ADC of 6 consecutive shells (5mm thickness each) including tumor margin to outside tumor margins (OM1 to OM5) was calculated and the data analyzed to define surgical margins. Of 38 patients, 6 were pathological complete responders (pCR), 19 partial responders (pPR) and 13 were non-responders (pNR). Significant increase was observed in ADC ST and ADC WT in pCR and pPR following therapy. Pre-therapy ADC was significantly lower in pCR compared to pPR and pNR indicating the heterogeneous nature of tumor which may affect drug perfusion and consequently the response. ADC of outside margins (OM1, OM2, and OM3) was significantly different among pCR, pPR and pNR at Tp3 which may serve as response predictive parameter. Further, at Tp3, ADC of outside margins (OM1, OM2, and OM3) was significantly lower compared to that seen at Tp0 in pCR, indicating the presence of residual disease in these shells. Pre-surgery information may serve as a guide to define cancer free margins and the extent of residual disease which may be useful in planning breast conservation surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Beta blocker therapy is associated with reduced depressive symptoms 12 months post percutaneous coronary intervention

NARCIS (Netherlands)

Battes, L.C.; Pedersen, S.S.; Oemrawsingh, R.M.; van Geuns, R.-J.M.; Al Amri, I.; Regar, E.; de Jaegere, P.T.; Serruys, P.W.; van Domburg, R.T.

2012-01-01

Background Beta blocker therapy may induce depressive symptoms, although current evidence is conflicting. We examined the association between beta blocker therapy and depressive symptoms in percutaneous coronary intervention (PCI) patients and the extent to which there is a dose–response

[Effects of magnesium valproate on endocrine system and reproductive functions of female epileptics].

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Xiang, Li; Ding, Jun-Qing; Huang, Xi-Shun

2011-08-09

To explore the effects of valproate (VPA) on endocrine system in adolescent and reproductive female patients with epilepsy. A total of 30 adolescent and reproductive female patients with a diagnosis of epilepsy at our hospital during July 2009 to March 2010 were recruited. All cases with magnesium VPA alone were included. The levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2), progesterone (P) and testosterone (T) were detected respectively at pre-therapy and 3, 6 and 12 months post-therapy. And the changes of menstruation and ovaries were recorded. The serum concentration of PRL was lower at 3 and 6 months post-therapy than that at pre-therapy. There was significant difference (P = 0.010 and 0.014). The serum concentration of E2 significantly decreased after a 3-month therapy of valproate (P endocrine system and hormonal levels, but also induce such endocrine dysfunction syndromes as menstrual suspension and polycystic ovary. It eventually causes polycystic ovary syndrome.

Computer-based radiological longitudinal evaluation of meningiomas following stereotactic radiosurgery.

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Shimol, Eli Ben; Joskowicz, Leo; Eliahou, Ruth; Shoshan, Yigal

2018-02-01

Stereotactic radiosurgery (SRS) is a common treatment for intracranial meningiomas. SRS is planned on a pre-therapy gadolinium-enhanced T1-weighted MRI scan (Gd-T1w MRI) in which the meningioma contours have been delineated. Post-SRS therapy serial Gd-T1w MRI scans are then acquired for longitudinal treatment evaluation. Accurate tumor volume change quantification is required for treatment efficacy evaluation and for treatment continuation. We present a new algorithm for the automatic segmentation and volumetric assessment of meningioma in post-therapy Gd-T1w MRI scans. The inputs are the pre- and post-therapy Gd-T1w MRI scans and the meningioma delineation in the pre-therapy scan. The output is the meningioma delineations and volumes in the post-therapy scan. The algorithm uses the pre-therapy scan and its meningioma delineation to initialize an extended Chan-Vese active contour method and as a strong patient-specific intensity and shape prior for the post-therapy scan meningioma segmentation. The algorithm is automatic, obviates the need for independent tumor localization and segmentation initialization, and incorporates the same tumor delineation criteria in both the pre- and post-therapy scans. Our experimental results on retrospective pre- and post-therapy scans with a total of 32 meningiomas with volume ranges 0.4-26.5 cm[Formula: see text] yield a Dice coefficient of [Formula: see text]% with respect to ground-truth delineations in post-therapy scans created by two clinicians. These results indicate a high correspondence to the ground-truth delineations. Our algorithm yields more reliable and accurate tumor volume change measurements than other stand-alone segmentation methods. It may be a useful tool for quantitative meningioma prognosis evaluation after SRS.

Medication Therapy Management and Preconception Care: Opportunities for Pharmacist Intervention

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Natalie A. DiPietro

2014-01-01

Full Text Available As medication therapy management (MTM continues to grow in the profession of pharmacy, careful consideration as to areas for positive patient impact is warranted. Given the current gaps in preconception care in the United States, and the accessibility and expertise of the pharmacist, MTM interventions related to preconception care may be valuable. This paper describes potential for pharmacist intervention in several different areas of preconception care. Notably, targeted medication reviews may be appropriate for interventions such as folic acid recommendations, teratogenic/category X medication management, immunizations, and disease state management. Comprehensive medication reviews may be warranted for selected disease states due to complexity of interventions, such the management of diabetes. Comprehensive medication reviews may also be warranted if several targeted interventions are necessary, or if there are a several medications or disease states requiring intervention. Pharmacists also have important roles in screening, support, and referrals needed for preconception care in the context of MTM. Patients may benefit substantially from pharmacist-directed MTM services related to preconception care. In addition, depending on clinical pharmacy service contracts and billing opportunities, pharmacists may be reimbursed for providing these services, generating sustainable revenue while fulfilling an important public health need.   Type: Idea Paper

Context Therapy: A New Intervention Approach for Children with Cerebral Palsy

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Darrah, Johanna; Law, Mary C.; Pollock, Nancy; Wilson, Brenda; Russell, Dianne J.; Walter, Stephen D.; Rosenbaum, Peter; Galuppi, Barb

2011-01-01

Aim: To describe the development of context therapy, a new intervention approach designed for a randomized controlled trial. Method: Therapists were trained to change task and environmental factors to achieve parent-identified functional goals for children with cerebral palsy. Therapists did not provide any remediation strategies to change the…

The application of comprehensive nursing measures in interventional therapy for deep vein thrombosis of lower extremities

International Nuclear Information System (INIS)

Huang Linfen; Guo Yanxue; Nan Yi; Pan Xiaohui

2009-01-01

Objective: To discuss the effective nursing measures in interventional therapy for deep vein thrombosis (DVT) of lower extremities in order to improve the successful rate of the procedure and to decrease the occurrence of complications. Methods: Comprehensive nursing measures, including general nursing care, specific nursing care and emergency nursing care, were employed in 63 DVT patients receiving interventional therapy. Clinical response and complications were observed. Results: After the treatment, the disorder was cured in 31 cases, while excellent result was seen in 26 cases and obvious improvement in 6 cases. During the procedure, bleeding at puncture site occurred in 16 cases, pulmonary embolism in 2 cases and cerebral hemorrhage in one case. No death occurred. Conclusion: Comprehensive nursing measures can effectively prevent or reduce the occurrence of complications, decrease the mortality rate. Therefore, Comprehensive nursing measures are the most helpful nursing care for DVT patients receiving interventional therapy. (authors)

Dual antiplatelet therapy with prasugrel or ticagrelor versus clopidogrel in interventional cardiology

DEFF Research Database (Denmark)

Clemmensen, Peter; Dridi, Nadia Paarup; Holmvang, Lene

2013-01-01

For several years, clopidogrel plus aspirin has been the dual antiplatelet therapy (DAPT) of choice for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) with stent implantation. More recently, prasugrel and ticagrelor have demonstrated greater effica...

A review of "music and movement" therapies for children with autism: embodied interventions for multisystem development.

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Srinivasan, Sudha M; Bhat, Anjana N

2013-01-01

The rising incidence of Autism Spectrum Disorders (ASDs) has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Musical training impacts various forms of development including communication, social-emotional, and motor development in children with ASDs and other developmental disorders as well as typically developing children. In this review, we will highlight the multisystem impairments of ASDs, explain why music and movement therapies are a powerful clinical tool, as well as describe mechanisms and offer evidence in support of music therapies for children with ASDs. We will support our claims by reviewing results from brain imaging studies reporting on music therapy effects in children with autism. We will also discuss the critical elements and the different types of music therapy approaches commonly used in pediatric neurological populations including autism. We provide strong arguments for the use of music and movement interventions as a multisystem treatment tool for children with ASDs. Finally, we also make recommendations for assessment and treatment of children with ASDs, and provide directions for future research.

Beta blocker therapy is associated with reduced depressive symptoms 12 months post percutaneous coronary intervention

DEFF Research Database (Denmark)

Battes, Linda C; Pedersen, Susanne S.; Oemrawsingh, Rohit M

2012-01-01

Beta blocker therapy may induce depressive symptoms, although current evidence is conflicting. We examined the association between beta blocker therapy and depressive symptoms in percutaneous coronary intervention (PCI) patients and the extent to which there is a dose-response relationship between...... beta blocker dose and depressive symptoms....

The functional manual therapy intervention in infants with nonsynostotic plagiocephaly: a pilot study.

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Billi, Mariangela; Greco, Angelo; Colonneli, Paola; Volpi, Giordana; Valente, Donatella; Galeoto, Giovanni

2017-10-25

To document the evolution of cranial asymmetries in infants with signs of nonsynostotic occipital plagiocephaly (NSOP) who were undergo to many functional manual therapy treatments (in addition to the standard positioning recommendations) as well as to determine the feasibility of this methodology to conduct an outcome research investigating the impact of this intervention for infants with NSOP. Pilot clinical standardization project using pre-post design in which 10 infants participated. Nine infants presented an initial Oblique Diameter Difference Index (ODDI) over 104%, three an initial Ear Deviation Index (EDI) over 4%, and three a Cranial Proportional Index (CPI) over 90%. Infants received three functional manual therapy treatments for week during the first month of intervention and two ones for week during the second month. Plagiocephalometric measurememts were administered at the first assessment pre-intervention (T0), after 30 days (+/-5) (T1) and at a third time after 60 days (+/5) of treatment (T2). 9/10 participants showed a significant decrease in ODDI under 104% between T0 and T2 assessments. 5/10 infants showed an EDI under 4%, and 3/10 showed a value about 0%. 3/10 maintained their CPI over 90% with a considerable decrease. These clinical findings support the hypothesis that functional manual therapy treatments contribute to the improvement of cranial asymmetries in infants younger than 6.5 months old presenting with NSOP.

Perioperative nursing for patients with diabetic foot receiving endovascular interventional therapy

International Nuclear Information System (INIS)

Yang Yang; Wang Feng; Li Ke; Li Cheng; Ji Donghua

2010-01-01

Objective: To study the effect of perioperative nursing on the living quality of patients with diabetic foot who are treated with endovascular interventional therapy. Methods: Specific perioperative nursing care plan was accordingly designed for 43 patients with diabetic foot. Endovascular balloon angioplasty and stent implantation were formed in these patients to treat their diabetic foot. The clinical results were observed. Results: Perioperative nursing effectively improved patient's limb blood supply, enhanced the healing of diabetic foot ulceration and increased the possibility of limb preservation. Conclusion: Endovascular therapy combined with corresponding perioperative nursing care can benefit more patients with diabetic foot. (authors)

Compositional stability of a salivary bacterial population against supragingival microbiota shift following periodontal therapy.

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Wataru Yamanaka

Full Text Available Supragingival plaque is permanently in contact with saliva. However, the extent to which the microbiota contributes to the salivary bacterial population remains unclear. We compared the compositional shift in the salivary bacterial population with that in supragingival plaque following periodontal therapy. Samples were collected from 19 patients with periodontitis before and after periodontal therapy (mean sample collection interval, 25.8 ± 2.6 months, and their bacterial composition was investigated using barcoded pyrosequencing analysis of the 16S rRNA gene. Phylogenetic community analysis using the UniFrac distance metric revealed that the overall bacterial community composition of saliva is distinct from that of supragingival plaque, both pre- and post-therapy. Temporal variation following therapy in the salivary bacterial population was significantly smaller than in the plaque microbiota, and the post-therapy saliva sample was significantly more similar to that pre-therapy from the same individual than to those from other subjects. Following periodontal therapy, microbial richness and biodiversity were significantly decreased in the plaque microbiota, but not in the salivary bacterial population. The operational taxonomic units whose relative abundances changed significantly after therapy were not common to the two microbiotae. These results reveal the compositional stability of salivary bacterial populations against shifts in the supragingival microbiota, suggesting that the effect of the supragingival plaque microbiota on salivary bacterial population composition is limited.

COPING SKILLS IN CHILDREN WITH EPILEPSY--EVALUATION OF COGNITIVE BEHAVIORAL THERAPY INTERVENTION.

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Batista, Maja; Mestrović, Antonela; Vekić, Ana Marija; Malenical, Masa; Kukuruzović, Monika; Begovac, Ivan

2015-12-01

A pilot study was conducted to examine the efficiency and satisfaction of cognitive behavioral therapy (CBT) intervention in youth with epilepsy regarding coping strategies. The CBT intervention was based on the main principles and empirically supported cognitive-behavioral techniques. The intervention consists of epilepsy education, stress education, and coping skill strategies. Seventeen children and adolescents aged 9-17 diagnosed with epilepsy for at least one year, with at least average intelligence and no history of serious mental illness completed the CBT intervention during summer camp, providing data on the efficiency of and satisfaction with CBT intervention. Upon completion of the CBT intervention, study subjects achieved significantly higher scores on the following Scale of Coping with Stress subscales: Problem solving; Seeking for social support from friends; Seeking for social support from family; and Cognitive restructuring, for both measures of usage frequency and effectiveness of each subscale. The participants reported a high level of satisfaction with the CBT intervention. This study provided explanation of research limitations and recommendations for future clinical trials.

The consensus among Chinese interventional experts on the standard of interventional therapy for deep venous thrombosis of lower extremity

International Nuclear Information System (INIS)

Academic Group of Interventional Radiology, Radiology Branch of Chinese Medical Association

2011-01-01

This paper aims to introduce the indications and contraindications of catheter-directed thrombolysis, percutaneous mechanical thrombectomy, balloon angioplasty and stent implantation for deep venous thrombosis of lower extremity, and also aims to summarize and to illustrate the manipulating procedure, the points for attention, the perioperative complications and preventions in performing different kind of interventional technique. Great importance is attached to the interventional therapy for both acute and subacute deep venous thrombosis of lower extremity in order to effectively reduce the occurrence of post-thrombosis syndrome. (authors)

Interventional radiological therapy of benign low back pain syndromes

International Nuclear Information System (INIS)

Huegli, R.W.; Jacob, A.L.; Steinbrich, W.

2007-01-01

Spinal affections belong to the most widespread sources of back pain. Beside medical history and clinical examination, the radiological investigation plays an important rote in the clinical workup especially with the modern Cross sectional imaging methods such as computed and magnetic resonance tomography. After exclusion of a malignant disease usually a conservative therapeutic approach is the first line treatment option. If the conservative treatment approach falls a minimalinvasive image guided diagnostic or therapeutic infiltration may be considered. Thereby the interventional radiologist should be a member of the team which decides the clinical strategy. This article describes epidemiology and pathophysiology, common pre-interventional diagnostic strategies, drugs, indications, possible complications and the impact of diagnostic and therapeutic minimally invasive image guided techniques in low back pain. In this context facet joint blockade, periradicular and peridural therapy as well as sacroiliac joint blockades are discussed

Incorporating Internet-based Interventions into Couple Therapy: Available Resources and Recommended Uses.

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Cicila, Larisa N; Georgia, Emily J; Doss, Brian D

2014-12-01

Although there are a number of highly efficacious in-person treatments designed to ameliorate relationship distress, only a small proportion of distressed couples seek out in-person treatment. Recently developed internet-based interventions based on these in-person treatments are a promising way to circumvent common barriers to in-person treatment and give more distressed couples access to these efficacious interventions. The overarching aims of this review are to provide couple and family therapists with a broad overview of the available internet-based interventions and provide suggestions about how these interventions might be utilized before, during, or after in-person treatment. First, we review internet-based interventions targeting individual psychopathology (e.g. anxiety and depression). These interventions would be particularly useful as an adjunctive resource for in-person couple or family therapy when referrals for a concurrent in-person individual therapist are not feasible (because of time, financial, or geographic constraints). The majority of the review centers on internet-based interventions for distressed couples and covers four distinct types of resources: relationship advice websites, assessment/feedback interventions, enrichment interventions for satisfied couples, and interventions targeting at-risk or distressed couples. We close with a case study of one couple's journey through a newly developed intervention targeting at-risk couples, OurRelationship.com, and provide two appendices with information on currently available internet-based interventions.

Survival of nonsurgically staged patients with negative lymphangiograms who had Stage IIB carcinoma of the cervix treated by pelvic radiation plus hydroxyurea

International Nuclear Information System (INIS)

Piver, M.S.; Krishnamsetty, R.M.; Emrich, L.J.

1985-01-01

Twenty patients with Stage IIB carcinoma of the cervix who did not undergo pretherapy para-aortic lymphadenectomy, but who had negative preradiation therapy lymphangiograms, were treated with pelvic radiation plus hydroxyurea. Patients received a median of 5020 rads of pelvic radiation plus 4000 rads of radium to point A. During radiation therapy and for a total of 12 weeks, patients received hydroxyurea administered at a dose of 80 mg/kg of body weight every 3 days if the white blood cell count was greater than or equal to 2,500/mm3 and platelets were greater than or equal to 75,000/mm3. The median follow-up time was 28 months (6 to 83 months). The estimated 5-year survival rate was 92%. Seventeen patients are alive with no evidence of disease (median, 28 months); one died of intercurrent disease with no evidence of disease (17 months); one is alive with no evidence of disease after recurrence (18 months); and one died of cervical cancer (22 months). The survival rate of patients with nonsurgically staged negative pretherapy lymphangiograms who had Stage IIB cervical cancer treated by pelvic radiation therapy plus hydroxyurea approximated the improved survival rate reported for patients with negative pretherapy para-aortic lymphadenectomy who were treated with pelvic radiation therapy plus hydroxyurea. Both studies would suggest that pelvic radiation plus hydroxyurea improves the rate of survival in patients with Stage IIB cervical cancer

Group Cognitive-Behavior Therapy and Supportive Art and Sport Interventions on Bam Earthquake Related Post Traumatic Stress Symptoms in Children: A Field Trial

Directory of Open Access Journals (Sweden)

Narges Joshaghani

2009-12-01

Full Text Available "n Objective: "n "nThe main objective of this study is to evaluate the effect of psychological therapies and art/sport supportive interventions separately,and in combination on post traumatic stress symptoms in children and compare them with a control group . "nMethods: In a field trial, we evaluated the efficacy of group behavioral therapy, art and sport supportive interventions in Bam earthquake children survivors with PTSD symptoms and compared it with a control group. Before and after interventions we evaluated the PTSD symptoms using K-SADS-PL semi-structural interview for each group and compared them using appropriate statistical methods. "nResults: The participants were 200 individuals who were randomized in four groups according to an intervention program including: Group behavioral therapy; Group behavioral therapy plus art and sport interventions; Art and sport interventions; and control group. During the interventions, 39 individuals were excluded. None of the participants had severed PTSD or other psychiatry disorders that needed pharmacological interventions. In interventional groups, the reduction of total PTSD symptoms and the symptoms of re-experience, avoidance and hyper arousal was not statistically significant. However, in the control group, the PTSD symptoms increased during the study which was statistically significant. "nConclusion: Group behavior therapy and supportive interventions (art and sport may have preventive effects on PTSD symptoms.

Primary Prevention Programme for Burnout-Endangered Teachers: Follow-Up Effectiveness of a Combined Group and Individual Intervention of AFA Breathing Therapy

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Katja Goetz

2013-01-01

Full Text Available Background. Early retirement of teachers due to burnout is frequent in Germany. In this study short- and medium-term effects of AFA breathing therapy were evaluated. Methods. This study was designed as a longitudinal controlled intervention design with four points of measurements: before assessment (T1, after intervention (T2, three months (follow up 1 (T3 after intervention, and six months (follow up 2 after intervention (T4. The intervention lasted a total of 11 weeks (weekly group therapy for eight weeks and three weeks of individual breathing session. The effects of intervention were measured with the questionnaire “work-related behaviour and experience Patterns” (AVEM at four times. Results. In the intervention group 64 teachers and in the self-selected control group 27 teachers were included. The AVEM scales “subjective significance of work” and “professional ambition” changed over time and within both groups (interaction effect. Significant improvements over the four measurements were observed in the intervention group in two AVEM scales: “emotional distancing” (F=6.3; P<0.01 and “balance and mental stability” (F=4.4; P<0.02. Conclusions. AFA breathing therapy showed short- and medium-term effects in the intervention group over four points of measurements. It may be assumed that breath therapy supports teachers in resisting occupational demand.

The normalization of nursing supervision in the comprehensive interventional therapy and diagnosis center

International Nuclear Information System (INIS)

Li Xue; Chen Jinhua; Zhang Weiguo; Wang Yi

2009-01-01

Objective: To discuss the normalization of nursing supervision in the comprehensive interventional therapy and diagnosis center in order to improve the nursing quality and work-efficiency. Methods: The following normalization measures were established: to formulate a new system of administration, to consummate interventional rules and regulations, to normalize various operation process and nursing norms, to design interventional nursing record, to cultivate professional interventional nurses, to establish the transversal connecting interventional nursing model, to enhance the interventional quality control of care, to consummate quality evaluation criterion and to enact unified management of the interventional consumed material by computer. Results: The expertise and skill of nursing personnel was significantly raised. The nursing personnel could assume the assistance and salvage in various large and complicate interventional operation. The nursing quality could meet the professional requirements. The administration of the interventional center gained the cohesive force and the nursing supervision became on the right track, right procedure and scientific principle. The nursing quality and work-efficiency was greatly improved. Conclusion: It is necessary to establish comprehensive interventional center and enforce the normalization of the nursing supervision for the development of the subject of interventional radiology. (authors)

Non-vascular interventional therapy for respiratory diseases

International Nuclear Information System (INIS)

Ji Hongjian; Chen Liping; Wang Hui; Cheng Yongde

2009-01-01

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

A novel bilateral lower extremity mirror therapy intervention for individuals with stroke

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Lucas D. Crosby

2016-12-01

Full Text Available Despite improvements made in stroke rehabilitation, motor impairment and gait deficits persist at discharge. New interventions are needed. Mirror therapy has promise as one element of a rehabilitation program. The primary objectives were to 1 describe a bilateral, lower extremity mirror therapy (LE-MT device and training protocol and 2 investigate the feasibility of LE-MT. A LE-MT device was constructed to train bilateral LE movements for 30 min, 3 times/week for 4 weeks, as an adjunct to physiotherapy in three individuals post-stroke. Sessions were digitally recorded and reviewed to extract feasibility measures; repetitions, rests and session duration. Pre and post measures of gait and motor impairment were taken. Two participants completed 100% of the sessions and a third completed 83% due to a recurrence of pre-existing back pain. Repetitions increased and session duration was maintained. Number of rests decreased for two participants and increased for one participant. Participants reported fatigue and mild muscle soreness but also that the intervention was tolerable. Positive gait changes included increased velocity and decreased variability. LE motor impairment also improved. A bilateral LE-MT adjunct intervention for stroke is feasible and may have positive effects. A history of low back pain should be a precaution.

Interventional therapy of hepatic arterial hemorrhage occurred after percutaneous transhepatic biliary drainage

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Liang Songnian; Feng Bo; Su Hongying; Xu Ke

2011-01-01

Objective: To analyze the causes and clinical manifestations of hepatic arterial hemorrhage which occurred after percutaneous transhepatic biliary drainage and to summarize the practical experience in its diagnosis and treatment in order to decrease its incidence and mortality. Methods: During the period from June 2007 to June 2010, percutaneous transhepatic biliary drainage was carried out in 622 cases, of which DSA-proved postoperative hepatic arterial hemorrhage occurred in 11, including bile duct hemorrhage (n=6), abdominal cavity bleeding (n=3) and combination of bile duct and abdominal cavity (n=2). Interventional embolization of the bleeding branches of hepatic artery with Gelfoam and coils was carried out in all 11 patients. The clinical data such as clinical manifestations and therapeutic results were retrospectively analyzed. Results: After interventional embolization therapy for postoperative hepatic arterial hemorrhage the bleeding stopped in ten patients, who were discharged from hospital when the clinical conditions were alleviated. The remaining one patient died of sustained deterioration in hepatic and renal functions although the bleeding was ceased. Conclusion: Though hepatic arterial hemorrhage occurred after percutaneous transhepatic biliary drainage is a rare complication, it is dangerous and fatal. Hepatic arterial angiography together with interventional embolization is a sate and effective therapy for hepatic arterial hemorrhage. (authors)

A review of “music and movement” therapies for children with autism: embodied interventions for multisystem development

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Srinivasan, Sudha M.; Bhat, Anjana N.

2013-01-01

The rising incidence of Autism Spectrum Disorders (ASDs) has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Musical training impacts various forms of development including communication, social-emotional, and motor development in children with ASDs and other developmental disorders as well as typically developing children. In this review, we will highlight the multisystem impairments of ASDs, explain why music and movement therapies are a powerful clinical tool, as well as describe mechanisms and offer evidence in support of music therapies for children with ASDs. We will support our claims by reviewing results from brain imaging studies reporting on music therapy effects in children with autism. We will also discuss the critical elements and the different types of music therapy approaches commonly used in pediatric neurological populations including autism. We provide strong arguments for the use of music and movement interventions as a multisystem treatment tool for children with ASDs. Finally, we also make recommendations for assessment and treatment of children with ASDs, and provide directions for future research. PMID:23576962

Clinical significance of combined determination of the changes of serum IGF-II, CA19-9 and AFP levels after intervention therapy in patients with primary hepatic cancer

International Nuclear Information System (INIS)

Wang Zhong

2007-01-01

Objective: To investigate the clinical significance of changes of serum IGF-II, CA19-9 and AFP levels after intervention therapy in patients with primary hepatic cancer. Methods: Serum levels of IGF-II, CA19-9 and AFP (with RIA) were repeatedly determined in 35 patients with primary hepatic cancer before intervention therapy, 1 month after intervention therapy and 6 months after intervention therapy as well as in 30 controls. Results: Before intervention therapy, serum levels of IGF-II, CA19-9 and AFP in the patients were significantly higher than those in the controls (P <0.01 ). One month after intervention therapy, all the serum levels were approaching normal. Six months later, the levels in the patients without recurrence remained normal. However, the levels in the 6 patients with recurrence returued to those before intervention therapy again. Conclusion: Changes of serum IGF-II, CA19-9 and AFP levels are closely related to the tumor burden and may reflect the presence of recurrence. (authors)

Cardiological-interventional therapy of coronary artery disease today

International Nuclear Information System (INIS)

Reynen, K.; Henssge, R.

1999-01-01

The current importance of the interventional therapy of coronary artery disease may be deduced from the exponential increase in procedures performed in Germany in the last decade - at least 125,840 in 1996. Today, by improved catheter and balloon materials as well as by growing experience of the cardiologists, even complex lesions may be treated. Limitations of balloon angioplasty include acute vessel closure and restenosis - newer angioplasty devices like directional or rotational atherectomy or excimer-laser angioplasty did not overcome these limitations; only by coronary stenting, acute vessel closure could be managed and the likelihood of restenosis - at least in particular groups of patients - could be reduced. For a few years, intracoronary brachytherapy of the segments dilated with beta- or gamma-emitters has been seeking to reduce restenosis rate; the department of cardiology of the Dresden Cardiovascular Institute is participating in such a multicentre study using the beta-emitter 188 renium. Further main topics of our department represent primary angioplasty in patients with acute myocardial infarction and invasive diagnostic or interventional procedures by the transradial approach. (orig.)

Vascular Complications of Pancreatitis: Role of Interventional Therapy

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Barge, Jaideep U.; Lopera, Jorge E. [University of Texas Health Science Center, San Antonio (United States)

2012-02-15

Major vascular complications related to pancreatitis can cause life-threatening hemorrhage and have to be dealt with as an emergency, utilizing a multidisciplinary approach of angiography, endoscopy or surgery. These may occur secondary to direct vascular injuries, which result in the formation of splanchnic pseudoaneurysms, gastrointestinal etiologies such as peptic ulcer disease and gastroesophageal varices, and post-operative bleeding related to pancreatic surgery. In this review article, we discuss the pathophysiologic mechanisms, diagnostic modalities, and treatment of pancreatic vascular complications, with a focus on the role of minimally-invasive interventional therapies such as angioembolization, endovascular stenting, and ultrasound-guided percutaneous thrombin injection in their management.

Interventional radiological therapy of benign low back pain syndromes; Interventionell radiologische Therapie benigner lumbaler Schmerzsyndrome

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Huegli, R.W.; Jacob, A.L.; Steinbrich, W. [Universitaetsspital Basel (Switzerland). Interventionelle Radiologie

2007-03-15

Spinal affections belong to the most widespread sources of back pain. Beside medical history and clinical examination, the radiological investigation plays an important rote in the clinical workup especially with the modern Cross sectional imaging methods such as computed and magnetic resonance tomography. After exclusion of a malignant disease usually a conservative therapeutic approach is the first line treatment option. If the conservative treatment approach falls a minimalinvasive image guided diagnostic or therapeutic infiltration may be considered. Thereby the interventional radiologist should be a member of the team which decides the clinical strategy. This article describes epidemiology and pathophysiology, common pre-interventional diagnostic strategies, drugs, indications, possible complications and the impact of diagnostic and therapeutic minimally invasive image guided techniques in low back pain. In this context facet joint blockade, periradicular and peridural therapy as well as sacroiliac joint blockades are discussed.

Borderline personality disorder: nursing interventions using dialectical behavioral therapy.

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Osborne, Unda L; McComish, Judith Fry

2006-06-01

Psychotherapeutic treatment of people with borderline personality disorder (BPD) is one of the greatest challenges confronting mental health professionals today. Clients with BPD are often difficult for nurses to work with, perhaps due to a lack of understanding of the underlying dynamics of the disorder. This article describes effective treatment strategies for BPD with a central focus on dialectical behavioral therapy (DBT). In typical mental health settings, nurses can effectively implement interventions using the concepts of DBT to help people with BPD build effective coping strategies and skillful behavioral responses for improved quality of life.

A methodological approach to speech therapy intervention disorders in children (as 6th year of the degree preschool

Directory of Open Access Journals (Sweden)

María Cristina García Benítez

2003-03-01

Full Text Available This article addresses issues related to the results of a master's thesis in which the importance of educational game addressed during speech therapy intervention to meet the communication needs of children of preschool age. The alternative is in line with the activities proposed in degree programs, responding to the current demands of the integral for-mation of students and constituting a resource, to develop an efficient speech therapy intervention.

Current Perspectives on Therapy Dog Welfare in Animal-Assisted Interventions.

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Glenk, Lisa Maria

2017-02-01

Research into the effects of animal-assisted interventions (AAIs) has primarily addressed human health outcomes. In contrast, only few publications deal with the therapy dog experience of AAIs. This paper provides an overview on potential welfare threats that therapy dogs may encounter and presents the results of a review of available studies on welfare indicators for therapy dogs during AAIs. Previous investigations used physiological and behavioral welfare indicators and dog handler surveys to identify work-related stress. Research outcomes are discussed in the light of strengths and weaknesses of the methods used. Study results suggest that frequency and duration of AAI sessions, novelty of the environment, controllability, age and familiarity of recipients modulate animal welfare indicators. However, this review reveals that currently, clear conclusions on how the well-being of dogs is influenced by the performance in AAIs are lacking due to the heterogeneity of programs, recipient and session characteristics, small dog sample sizes and methodological limitations. This paper further aimed to identify unresolved difficulties in previous research to pave the way for future investigations supporting the applicability of scientific findings in practice.

Technology-enhanced writing therapy for people with aphasia: results of a quasi-randomized waitlist controlled study.

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Marshall, Jane; Caute, Anna; Chadd, Katie; Cruice, Madeline; Monnelly, Katie; Wilson, Stephanie; Woolf, Celia

2018-05-10

Acquired writing impairment, or dysgraphia, is common in aphasia. It affects both handwriting and typing, and may recover less well than other aphasic symptoms. Dysgraphia is an increasing priority for intervention, particularly for those wishing to participate in online written communication. Effective dysgraphia treatment studies have been reported, but many did not target, or did not achieve, improvements in functional writing. Functional outcomes might be promoted by therapies that exploit digital technologies, such as voice recognition and word prediction software. This study evaluated the benefits of technology-enhanced writing therapy for people with acquired dysgraphia. It aimed to explore the impact of therapy on a functional writing activity, and to examine whether treatment remediated or compensated for the writing impairment. The primary question was: Does therapy improve performance on a functional assessment of writing; and, if so, do gains occur only when writing is assisted by technology? Secondary measures examined whether therapy improved unassisted written naming, functional communication, mood and quality of life. The study employed a quasi-randomized waitlist controlled design. A total of 21 people with dysgraphia received 12 h of writing therapy either immediately or after a 6-week delay. The primary outcome measure was a functional assessment of writing, which was administered in handwriting and on a computer with assistive technology enabled. Secondary measures were: The Boston Naming Test (written version), Communication Activities of Daily Living-2, Visual Analogue Mood Scales (Sad question), and the Assessment of Living with Aphasia. Analyses of variance (ANOVA) were used to examine change on the outcome measures over two time points, between which the immediate group had received therapy but the delayed group had not. Pre-therapy, post-therapy and follow-up scores on the measures were also examined for all participants. Time × group

Mapping the Maze: An Art Therapy Intervention following Disclosure of Sexual Abuse

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Pifalo, Terry

2009-01-01

Disclosures of child sexual abuse create an immediate crisis within the child's family unit. Reactions of nonoffending caregivers in particular may prevent them from being emotionally available to respond immediately to the needs of the child victim. This article describes an art therapy intervention of visual mapping used in a support group of…

[Theories of behavior change through preventive and health promotion interventions in occupational therapy].

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Filiatrault, Johanne; Richard, Lucie

2005-02-01

Community occupational therapy practice challenges therapists in their health educator role and incites them to implement preventive strategies with their clients. Working in the community also provides an interesting context for the implementation of strategies targeting health promotion at the community level. This article describes some of the theories that are used in the public health and health promotion fields to explain health-related behaviour change. It also highlights their potential for community practice in occupational therapy. The theories presented in this paper are the health belief model, social cognitive theory, theory of reasoned action and theory of planned behavior. They are among the most widely used for health-related behaviour analysis and intervention. Since these theories emphasize a set of factors that influence health behaviours, reviewing these theories could contribute to enhance the effectiveness of educational interventions with regards to clients'adherence to their prevention and health promotion recommendations.

Clinical observation on scores of anxiety, depression and quality of life for advanced gastrointestinal carcinoma patients with palliation intervention therapy

International Nuclear Information System (INIS)

Chen Yue; Jiang Tinghui; Jiang Yongxing; Sun Xianjun

2007-01-01

Objective: To evaluate the influence of palliative intervention therapy on advanced gastrointestinal carcinoma patients with depression and anxiety before and after the treatment. Methods: 56 advanced gastrointestinal carcinoma patients were selected and treated with intra-arterial perfusion chemotherapy or intra-arterial perfusion chemotherapy with embolization. Curative effects were assessed with the SDS, SAS and FACT-G before and after the treatment. In addition, all patients took self-assessment with SCL-90, comparing with the Chinese norms. Results: SCL-90 scores including the somatization agent, depression agent, and anxiety agent scores of the advanced gastrointestinal carcinoma were higher than those of Chinese norms, with significant difference (P<0.05). After palliative intervention therapy, the scores of SDS and SAS were lower than those before the palliative intervention therapy with significant difference (P< 0.05); and furthermore with an obvious improvement in the scores of FACT-G (P<0.05). Conclusion: Palliative intervention therapy for advanced gastrointestinal carcinoma patients can improve the complaints of depression anxiety and quality of life. (authors)

Emergency interventional therapy of peripheral arterial stenosis and thrombosis

International Nuclear Information System (INIS)

Cai Fengquan; Yu Xixiang

2004-01-01

Objective: To evaluate the clinical value of emergency interventional therapy of stenosis and thrombosis of peripheral arteries. Methods: 26 patients suffered from stenosis and thrombosis of peripheral arteries including, 3 subclavical arteries, 5 iliac arteries, 7 femoral arteries, 4 popliteal arteries, 4 posterior or anterior tibial arteries, 2 graft vessels and 1 instent restenosis were undertaken interventional ATD or urokinase infusion thrombolysis, percutanous transluminal angioplasty (PTA) and stent placement. Results: The stenotic arteries were recanalized after PTA or stent placement and the thrombosis vanished after thrombolysis with distal flowes improved or resumed. Clinical symptom was ameliorated. No more complication occurred except one patient with alimentary hemorrhage after thrombolysis. The patients were followed up from 1 to 20 months with all the involved arteries keeping in constant patency without any amputation. Conclusions: Emergency thrombolysis by machine or drug along with PTA or stent placement can effectively cure the stenosis or thrombosis of peripheral artery with recanalization and no amputation. (authors)

The effects of cognitive therapy versus 'no intervention' for major depressive disorder

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Jakobsen, Janus Christian; Hansen, Jane Lindschou; Storebø, Ole Jakob

2011-01-01

BACKGROUND: Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Cognitive therapy may be an effective treatment option for major depressive disorder, but the effects have only had limited assessment in systematic reviews....... METHODS/PRINCIPAL FINDINGS: We used The Cochrane systematic review methodology with meta-analyses and trial sequential analyses of randomized trials comparing the effects of cognitive therapy versus 'no intervention' for major depressive disorder. Participants had to be older than 17 years with a primary...... diagnosis of major depressive disorder to be eligible. Altogether, we included 12 trials randomizing a total of 669 participants. All 12 trials had high risk of bias. Meta-analysis on the Hamilton Rating Scale for Depression showed that cognitive therapy significantly reduced depressive symptoms (four...

Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review

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Anttila, Heidi; Autti-Rämö, Ilona; Suoranta, Jutta

2008-01-01

BACKGROUND: To assess the effectiveness of physical therapy (PT) interventions on functioning in children with cerebral palsy (CP). METHODS: A search was made in Medline, Cinahl, PEDro and the Cochrane library for the period 1990 to February 2007. Only randomized controlled trials (RCTs) on PT...... interventions in children with diagnosed CP were included. Two reviewers independently assessed the methodological quality and extracted the data. The outcomes measured in the trials were classified using the International Classification of Functioning, Disability and Health (ICF). RESULTS: Twenty-two trials...

Focal Therapy: Patients, Interventions, and Outcomes—A Report from a Consensus Meeting

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Donaldson, Ian A.; Alonzi, Roberto; Barratt, Dean; Barret, Eric; Berge, Viktor; Bott, Simon; Bottomley, David; Eggener, Scott; Ehdaie, Behfar; Emberton, Mark; Hindley, Richard; Leslie, Tom; Miners, Alec; McCartan, Neil; Moore, Caroline M.; Pinto, Peter; Polascik, Thomas J.; Simmons, Lucy; van der Meulen, Jan; Villers, Arnauld; Willis, Sarah; Ahmed, Hashim U.

2015-01-01

Background Focal therapy as a treatment option for localized prostate cancer (PCa) is an increasingly popular and rapidly evolving field. Objective To gather expert opinion on patient selection, interventions, and meaningful outcome measures for focal therapy in clinical practice and trial design. Design, setting, and participants Fifteen experts in focal therapy followed a modified two-stage RAND/University of California, Los Angeles (UCLA) Appropriateness Methodology process. All participants independently scored 246 statements prior to rescoring at a face-to-face meeting. The meeting occurred in June 2013 at the Royal Society of Medicine, London, supported by the Wellcome Trust and the UK Department of Health. Outcome measurements and statistical analysis Agreement, disagreement, or uncertainty were calculated as the median panel score. Consensus was derived from the interpercentile range adjusted for symmetry level. Results and limitations Of 246 statements, 154 (63%) reached consensus. Items of agreement included the following: patients with intermediate risk and patients with unifocal and multifocal PCa are eligible for focal treatment; magnetic resonance imaging–targeted or template-mapping biopsy should be used to plan treatment; planned treatment margins should be 5 mm from the known tumor; prostate volume or age should not be a primary determinant of eligibility; foci of indolent cancer can be left untreated when treating the dominant index lesion; histologic outcomes should be defined by targeted biopsy at 1 yr; residual disease in the treated area of ≤3 mm of Gleason 3 + 3 did not need further treatment; and focal retreatment rates of ≤20% should be considered clinically acceptable but subsequent whole-gland therapy deemed a failure of focal therapy. All statements are expert opinion and therefore constitute level 5 evidence and may not reflect wider clinical consensus. Conclusions The landscape of PCa treatment is rapidly evolving with new

Developing a Manualized Occupational Therapy Diabetes Management Intervention: Resilient, Empowered, Active Living With Diabetes.

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Pyatak, Elizabeth A; Carandang, Kristine; Davis, Shain

2015-07-01

This article reports on the development of a manualized occupational therapy intervention for diabetes management. An initial theoretical framework and core content areas for a Stage I intervention manual were developed based on an in-depth needs assessment and review of existing literature. After evaluation by a panel of experts and completion of a feasibility study, the intervention was revised into a Stage 2 manual in preparation for a randomized study evaluating the intervention's efficacy. In developing the initial manual, we delineated core theoretical principles to allow for flexible application and tailoring of the intervention's content areas. Expert panel feedback and feasibility study results led to changes to the intervention structure and content as we developed the Stage 2 manual. Through describing this process, we illustrate the dynamic evolution of intervention manuals, which undergo revisions due to both theoretical and practical considerations at each stage of the research-to-clinical practice pipeline.

The preventive effect of statin therapy on new-onset and recurrent atrial fibrillation in patients not undergoing invasive cardiac interventions ☆

DEFF Research Database (Denmark)

Bang, Casper Niels Furbo; Greve, Anders M; Abdulla, Jawdat

2013-01-01

BACKGROUND: Previous meta-analyses suggest that pre-procedural use of statin therapy may reduce atrial fibrillation (AF) following invasive cardiac interventions (coronary artery by-pass grafting and percutaneous coronary intervention). However, the current evidence on the benefit of statins...... unrelated to invasive cardiac interventions has not been clarified systematically. METHODS: Through a systematic literature search, trials examining the effect of statin therapy on AF were selected. Trials using statins before any percutaneous or surgical cardiac interventions were excluded. RESULTS......: The search identified 11 randomized and 16 observational eligible studies, totaling 106,640 patients receiving statin therapy and 129,305 serving as controls. Fourteen studies investigated the effect of statins on new-onset AF, 13 studies investigated the effect of statins on recurrent AF and one in both new...

[An Occupational Therapy Intervention for People With Dementia].

Science.gov (United States)

Ke, Hung-Hsun

2018-02-01

The percentage of individuals with dementia worldwide is increasing with the continued trend toward global trend overall. As options for the medical treatment of dementia remain limited, combined, non-pharmacological interventions are necessary to maintain and slow the degeneration of functional capabilities. Additionally, there is a need to help caregivers develop better patterns of care and methods to reduce the burden of care. Therefore, occupational therapists play an important role in the dementia care team. This article introduces how occupational therapists help dementia patient maintain their functional capabilities and delay degeneration and help caregivers reduce their burden of care. Both activities are based on the concept of occupational therapy, which includes three important components: people, activities, and the environment.

First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents.

Science.gov (United States)

Letourneau, Elizabeth J; McCart, Michael R; Sheidow, Ashli J; Mauro, Pia M

2017-01-01

There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N=45) or usual services (US; N=60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

Group Music Therapy as a Preventive Intervention for Young People at Risk: Cluster-Randomized Trial.

Science.gov (United States)

Gold, Christian; Saarikallio, Suvi; Crooke, Alexander Hew Dale; McFerran, Katrina Skewes

2017-07-01

Music forms an important part of the lives and identities of adolescents and may have positive or negative mental health implications. Music therapy can be effective for mental disorders such as depression, but its preventive potential is unknown. The aim of this study was to examine whether group music therapy (GMT) is an effective intervention for young people who may be at risk of developing mental health problems, as indicated via unhealthy music use. The main question was whether GMT can reduce unhealthy uses of music and increase potentials for healthy uses of music, compared to self-directed music listening (SDML). We were also interested in effects of GMT on depressive symptoms, psychosocial well-being, rumination, and reflection. In an exploratory cluster-randomized trial in Australian schools, 100 students with self-reported unhealthy music use were invited to GMT (weekly sessions over 8 weeks) or SDML. Changes in the Healthy-Unhealthy Music Scale (HUMS) and mental health outcomes were measured over 3 months. Both interventions were well accepted. No effects were found between GMT and SDML (all p > 0.05); both groups tended to show small improvements over time. Younger participants benefited more from GMT, and older ones more from SDML (p = 0.018). GMT was associated with similar changes as SDML. Further research is needed to improve the processes of selecting participants for targeted interventions; to determine optimal dosage; and to provide more reliable evidence of effects of music-based interventions for adolescents. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

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

2014-01-01

This study examined vocabulary intervention-in terms of targets and techniques-for children with language impairment receiving speech-language therapy in public schools (i.e., non-fee-paying schools) in the United States. Vocabulary treatments and targets were examined with respect to their alignment with the empirically validated practice of rich vocabulary intervention. Participants were forty-eight 5-7-year-old children participating in kindergarten or the first-grade year of school, all of whom had vocabulary-specific goals on their individualized education programmes. Two therapy sessions per child were coded to determine what vocabulary words were being directly targeted and what techniques were used for each. Study findings showed that the majority of words directly targeted during therapy were lower-level basic vocabulary words (87%) and very few (1%) were academically relevant. On average, three techniques were used per word to promote deep understanding. Interpreting findings against empirical descriptions of rich vocabulary intervention indicates that children were exposed to some but not all aspects of this empirically supported practice. © 2013 Royal College of Speech and Language Therapists.

Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head-and-neck cancer

International Nuclear Information System (INIS)

Eisbruch, Avraham; Lyden, Teresa; Bradford, Carol R.; Dawson, Laura A.; Haxer, Marc J.; Miller, Amy E.; Teknos, Theodoros N.; Chepeha, Douglas B.; Hogikyan, Norman D.; Terrell, Jeffrey E.; Wolf, Gregory T.

2002-01-01

Purpose:To objectively assess swallowing function after an intensive chemoradiation regimen for locally advanced head-and-neck cancer and to assess the clinical implications of swallowing dysfunction. Patients and Methods:Twenty-nine patients with nonresectable Stage IV head-and-neck cancer participated in a Phase I study of radiation, 70 Gy/7 weeks, concurrent with weekly gemcitabine. Because of a high rate of mucosal toxicity, reduced drug doses were delivered to subsequent patient groups: 300, 150, 50, and 10 mg/m 2 /week. Twenty-six of these patients underwent prospective evaluation of swallowing function with videofluoroscopy and esophagogram. Studies were performed pretherapy, early post-therapy (1-3 months), and late post-therapy (6-12 months). Results:Complete tests were performed pretherapy in 22 patients, early post-therapy in 20, and late post-therapy in 13. Twenty-five patients had at least one post-therapy study. Post-therapy dysfunction was characterized by reduced inversion of the epiglottis, delayed swallow initiation and uncoordinated timing of the propulsion of the bolus, opening of the cricopharyngeal muscle, and closure of the larynx, all of which promoted aspiration during and after the swallow. In addition, reduced base-of-tongue retraction with reduced contact to the posterior pharyngeal wall and incomplete cricopharyngeal relaxation resulted in pooling in the pyriform sinuses and vallecula of residue, which was frequently aspirated after the swallow. Post-therapy aspirations were typically ''silent,'' eliciting no cough reflex, or the cough was delayed and noneffective in expelling the residue. Aspiration was observed in 3 patients (14%) in the pretherapy studies, in 13 (65%) in the early post-therapy studies, and in 8 (62%) in the late post-therapy studies (aspiration rates post-therapy vs. pretherapy: p=0.0002). Six patients had pneumonia requiring hospitalization 1-14 months after therapy (median: 2.5 months), being the likely cause of

Music therapy for prisoners: pilot randomised controlled trial and implications for evaluating psychosocial interventions.

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Gold, Christian; Assmus, Jörg; Hjørnevik, Kjetil; Qvale, Liv Gunnhild; Brown, Fiona Kirkwood; Hansen, Anita Lill; Waage, Leif; Stige, Brynjulf

2014-12-01

Mental health problems are common among prison inmates. Music therapy has been shown to reduce mental health problems. It may also be beneficial in the rehabilitation of prisoners, but rigorous outcome research is lacking. We compared group music therapy with standard care for prisoners in a pilot randomised controlled trial that started with the establishment of music therapy services in a prison near Bergen in 2008. In all, 113 prisoners agreed to participate. Anxiety (STAI-State [State-Trait Anxiety Inventory], STAI-Trait), depression (HADS-D [Hospital Anxiety and Depression Scale]), and social relationships (Quality of Life Enjoyment and Satisfaction Questionnaire [Q-LES-Q]) were assessed at baseline; every 2 weeks in the experimental group; after 1, 3, and 6 months in the control group; and at release. No restrictions were placed on the frequency, duration, or contents of music therapy. Duration of stay in the institution was short (62% stayed less than 1 month). Only a minority reached clinical cutoffs for anxiety and depression at baseline. Between-group analyses of effects were not possible. Music therapy was well accepted and attractive among the prisoners. Post hoc analysis of within-group changes suggested a reduction of state anxiety after 2 weeks of music therapy (d = 0.33, p = .025). Short sentences and low baseline levels of psychological disturbance impeded the examination of effects in this study. Recommendations for planning future studies are given, concerning the careful choice of participants, interventions and settings, comparison condition and design aspects, choice of outcomes, and integration of research approaches. Thus, the present study has important implications for future studies evaluating interventions for improving prisoners' mental health. ISRCTN22518605. © The Author(s) 2013.

Strategy and clinical significance of interventional management before surgical therapy for massive hemorrhage of gastrointestinal tract

International Nuclear Information System (INIS)

Hu Tingyang; Yu Wenqiang; Mao Yingmin; Yuan Jianhua; CChen Fanghong; Luo Zuyan; Ding Xiaonan; Zhou Bing; Ding Zhongxiang

2009-01-01

Objective: To discuss the clinical value of interventional management before surgical therapy for massive gastrointestinal hemorrhage, and to compare the clinical efficacy and re-bleeding rate between hypophysin infusion group and embolization group. Methods: During the period of June 1998-Apr. 2009, 31 patients with massive gastrointestinal hemorrhage in our institution underwent preoperative interventional managements before they received surgical treatment. According to DSA manifestations, the patients underwent transarterial hypophysin infusion or transcatheter embolization as interventional management. The clinical efficacy of interventional procedures and its influence on the surgery were evaluated, and the hemostasis rate and re-bleeding rate were compared the two kind of intervention managements. The numeration data were analyzed with Fisher's exact test, and the SPSS 11.0 was used as statistical software. Results: The interventional managements were successfully performed in all the 31 patients, with a total hemostasis rate of 83.9% (26/31) and a total re-bleeding rate 30.7% (8/26). The hemostasis rate and re-bleeding rate of hypophysin infusion group and embolization group were 69.2% (9/ 13), 94.4% (17/18) and 44.4% (4/9), 23.7% (4/17), respectively. All the 31 patients received surgery after interventional therapy, of which selective operation was carried out in 20. Neither surgery-related or intervention-related serious complications nor death occurred. Conclusion: Preoperative interventional managements can provide patients with massive gastrointestinal hemorrhage with valuable chance of a successful surgery, enable the physician to take a selective operation to replace an emergency one,as a result, the surgical risk will be greatly reduced. Therefore, it is worth popularizing the preoperative interventional managements in clinical practice. (authors)

The clinical evaluation of double intervention therapy for advanced lung carcinoma by bronchial and pulmonary arterial approach

International Nuclear Information System (INIS)

Shi Yue; Gao Congjing

2002-01-01

Objective: Seeking a better way of PAI and BAI double intervention therapy for mid and advanced lung carcinoma, to observe the clinical effect. Methods: 60 patients with double intervention therapy through bronchial and pulmonary arterial (BAI and PAI) approaches were analyzed. Results: The effective rates of BAI and PAI as CR, PR and NC were 9 cases (15%), 45% cases (75%), 6 cases (10%) with mean survival spans of 10.8 and 12.4 months respectively. Conclusions: The combined treatment effects of BAI and PAI were better than BAI alone in advanced lung carcinoma with operation

Current Perspectives on Therapy Dog Welfare in Animal-Assisted Interventions

Directory of Open Access Journals (Sweden)

Lisa Maria Glenk

2017-02-01

Full Text Available Research into the effects of animal-assisted interventions (AAIs has primarily addressed human health outcomes. In contrast, only few publications deal with the therapy dog experience of AAIs. This paper provides an overview on potential welfare threats that therapy dogs may encounter and presents the results of a review of available studies on welfare indicators for therapy dogs during AAIs. Previous investigations used physiological and behavioral welfare indicators and dog handler surveys to identify work-related stress. Research outcomes are discussed in the light of strengths and weaknesses of the methods used. Study results suggest that frequency and duration of AAI sessions, novelty of the environment, controllability, age and familiarity of recipients modulate animal welfare indicators. However, this review reveals that currently, clear conclusions on how the well-being of dogs is influenced by the performance in AAIs are lacking due to the heterogeneity of programs, recipient and session characteristics, small dog sample sizes and methodological limitations. This paper further aimed to identify unresolved difficulties in previous research to pave the way for future investigations supporting the applicability of scientific findings in practice.

A critical realist evaluation of a music therapy intervention in palliative care.

Science.gov (United States)

Porter, Sam; McConnell, Tracey; Clarke, Mike; Kirkwood, Jenny; Hughes, Naomi; Graham-Wisener, Lisa; Regan, Joan; McKeown, Miriam; McGrillen, Kerry; Reid, Joanne

2017-12-08

Music therapy is increasingly used as an adjunct therapy to support symptom management in palliative care. However, studies to date have paid little attention to the processes that lead to changes in patient outcomes. To fill this gap, we examined the processes and experiences involved in the introduction of music therapy as an adjunct complementary therapy to palliative care in a hospice setting in the United Kingdom (UK). Using a realistic evaluation approach, we conducted a qualitative study using a variety of approaches. These consisted of open text answers from patients (n = 16) on how music therapy helped meet their needs within one hospice in Northern Ireland, UK. We also conducted three focus groups with a range of palliative care practitioners (seven physicians, seven nursing staff, two social workers and three allied health professionals) to help understand their perspectives on music therapy's impact on their work setting, and what influences its successful implementation. This was supplemented with an interview with the music therapist delivering the intervention. Music therapy contains multiple mechanisms that can provide physical, psychological, emotional, expressive, existential and social support. There is also evidence that the hospice context, animated by a holistic approach to healthcare, is an important facilitator of the effects of music therapy. Examination of patients' responses helped identify specific benefits for different types of patients. There is a synergy between the therapeutic aims of music therapy and those of palliative care, which appealed to a significant proportion of participants, who perceived it as effective.

Indirect language therapy for children with persistent language impairment in mainstream primary schools: outcomes from a cohort intervention.

Science.gov (United States)

McCartney, Elspeth; Boyle, James; Ellis, Sue; Bannatyne, Susan; Turnbull, Mary

2011-01-01

A manualized language therapy developed via a randomized controlled trial had proved efficacious in the short-term in developing expressive language for mainstream primary school children with persistent language impairment. This therapy had been delivered to a predetermined schedule by speech and language therapists or speech and language therapy assistants to children individually or in groups. However, this model of service delivery is no longer the most common model in UK schools, where indirect consultancy approaches with intervention delivered by school staff are often used. A cohort study was undertaken to investigate whether the therapy was equally efficacious when delivered to comparable children by school staff, rather than speech and language therapists or speech and language therapy assistants. Children in the cohort study were selected using the same criteria as in the randomized controlled trial, and the same manualized therapy was used, but delivered by mainstream school staff using a consultancy model common in the UK. Outcomes were compared with those of randomized controlled trial participants. The gains in expressive language measured in the randomized controlled trial were not replicated in the cohort study. Less language-learning activity was recorded than had been planned, and less than was delivered in the randomized controlled trial. Implications for 'consultancy' speech and language therapist service delivery models in mainstream schools are outlined. At present, the more efficacious therapy is that delivered by speech and language therapists or speech and language therapy assistants to children individually or in groups. This may be related to more faithful adherence to the interventions schedule, and to a probably greater amount of language-learning activity undertaken. Intervention delivered via school-based 'consultancy' approaches in schools will require to be carefully monitored by schools and SLT services. © 2010 Royal College of

Ultrasound-guided interventional therapy for recurrent ovarian chocolate cysts.

Science.gov (United States)

Wang, Lu-Lu; Dong, Xiao-Qiu; Shao, Xiao-Hui; Wang, Si-Ming

2011-10-01

The aim of this study was to determine the effectiveness of ultrasound-guided interventional therapy in the treatment of postoperative recurrent chocolate cysts. The 198 patients enrolled in this study were divided into three groups. In group 1, the saline washing group, the cavity of the cyst was washed thoroughly with warm saline. In group 2, the ethanol short-time retention group, after washing with saline, the cyst was injected with 95% ethanol with a volume of half of the fluid aspirated from the cyst. Ten minutes later, the rest of the ethanol was aspirated. In group 3, the ethanol retention group, the procedures were the same as with the ethanol short-time retention group, except that 95% of the ethanol was retained in the cyst. An ultrasound examination was performed in the third, sixth and 12th months after therapy. The chocolate cyst cure rate was significantly higher in the ethanol retention group (96%, 66/69) than in the ethanol short-time retention group (82%, 56/68) and no case was cured in the first group (saline washing). We conclude that ultrasound-guided injection and 95% ethanol retention are an effective therapy for the treatment of postoperative recurrent chocolate cysts. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

A descriptive study of a manual therapy intervention within a randomised controlled trial for hamstring and lower limb injury prevention

Directory of Open Access Journals (Sweden)

Hoskins Wayne

2010-08-01

Full Text Available Abstract Background There is little literature describing the use of manual therapy performed on athletes. It was our purpose to document the usage of a sports chiropractic manual therapy intervention within a RCT by identifying the type, amount, frequency, location and reason for treatment provided. This information is useful for the uptake of the intervention into clinical settings and to allow clinicians to better understand a role that sports chiropractors offer. Methods All treatment rendered to 29 semi-elite Australian Rules footballers in the sports chiropractic intervention group of an 8 month RCT investigating hamstring and lower-limb injury prevention was recorded. Treatment was pragmatically and individually determined and could consist of high-velocity, low-amplitude (HVLA manipulation, mobilization and/or supporting soft tissue therapies. Descriptive statistics recorded the treatment rendered for symptomatic or asymptomatic benefit, delivered to joint or soft tissue structures and categorized into body regions. For the joint therapy, it was recorded whether treatment consisted of HVLA manipulation, HVLA manipulation and mobilization, or mobilization only. Breakdown of the HVLA technique was performed. Results A total of 487 treatments were provided (mean 16.8 consultations/player with 64% of treatment for asymptomatic benefit (73% joint therapies, 57% soft tissue therapies. Treatment was delivered to approximately 4 soft tissue and 4 joint regions each consultation. The most common asymptomatic regions treated with joint therapies were thoracic (22%, knee (20%, hip (19%, sacroiliac joint (13% and lumbar (11%. For soft tissue therapies it was gluteal (22%, hip flexor (14%, knee (12% and lumbar (11%. The most common symptomatic regions treated with joint therapies were lumbar (25%, thoracic (15% and hip (14%. For soft tissue therapies it was gluteal (22%, lumbar (15% and posterior thigh (8%. Of the joint therapy, 56% was HVLA

[Organ-preserving interventions in combined therapy of children and adolescents with osteosarcoma].

Science.gov (United States)

Punanov, Iu A; Gafton, G I; Gudz', Iu V; Nabokov, V V; Ivanova, T V; Safonova, S A; Levchenko, E V; Kupatadze, D D; Novik, V I; Lazareva, Iu R; Krzhivitskiĭ, P I; Petrov, V G

2012-01-01

An analyzed cohort consists of 50 pediatric patients with osteosarcoma receiving combined therapy in N. N. Petrov Research Institute for Oncology (1999-2010). Thirty nine of them had localized disease, 11 patients had distant metastases. The treatment scheme included neoadjuvant therapy with cisplatin and doxorubicin, surgical treatment and adjuvant therapy depended on initial response and could include cisplatin, doxorubicin, high-dose methotrexate, ifosfamide, etoposide. Four-year overall and relapse-free survival in children with localized disease was 74.3% and 69.2% accordingly. In 62% of patients were performed organ-preserving surgical interventions, in 22 patients was performed endoprosthetics, in 4 patients the defect was replaced by a bone autograft on a vascular bundle. The effectiveness of initial treatment and secondary endoprosthetics were analyzed. Six patients with lung metastases received normotermic lung chemoperfusion, 4 of them are alive and disease-free for 8 to 24 months.

Catching moving targets: cancer stem cell hierarchies, therapy-resistance & considerations for clinical intervention.

LENUS (Irish Health Repository)

Gasch, Claudia

2017-01-01

It is widely believed that targeting the tumour-initiating cancer stem cell (CSC) component of malignancy has great therapeutic potential, particularly in therapy-resistant disease. However, despite concerted efforts, CSC-targeting strategies have not been efficiently translated to the clinic. This is partly due to our incomplete understanding of the mechanisms underlying CSC therapy-resistance. In particular, the relationship between therapy-resistance and the organisation of CSCs as Stem-Progenitor-Differentiated cell hierarchies has not been widely studied. In this review we argue that modern clinical strategies should appreciate that the CSC hierarchy is a dynamic target that contains sensitive and resistant components and expresses a collection of therapy-resisting mechanisms. We propose that the CSC hierarchy at primary presentation changes in response to clinical intervention, resulting in a recurrent malignancy that should be targeted differently. As such, addressing the hierarchical organisation of CSCs into our bench-side theory should expedite translation of CSC-targeting to bed-side practice. In conclusion, we discuss strategies through which we can catch these moving clinical targets to specifically compromise therapy-resistant disease.

Clinical application of interventional therapy for avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Han Xu; Jin Kesi; Liu Wei; Ma Jun; Shen Jianming; Aziken

2004-01-01

Objective: To evaluate the possibility of interventional therapy for avascular necrosis of the femoral head, with different curing methods, way of introduction and cultural heritages. Methods: Vasodilator, thrombolytics and promoting microcirculatory drug were directly injected into the feeding arteries of the avascular necrotic femoral heads, under the condition of applying the blood stoppage belt at the root of thigh with pressure before the drug injection into the femoral pronator and extension arteries. The treatment was repeated 45 d later. Urokinase 10 5 unite/d x 10 were administrated with venous infusion ipsilaterally on the 15th day after the beginning of the therapy. Imaging features and clinical symptoms were recorded and correlatively studied before and after the treament. Results: Symptoms relief especially the pain reached 100% after the treatment with various degrees of bony repair and new bone formation. Furthermore, increase caliber of feeding small arteries for femoral head and multiplicity of microvasculature, shortening of opacification time were revealed by DSA. IV stage bony change showed mild or inconspicuous. Conclusions: Interventional catheterization treatment for avascular femoral head necrosis, especially the patients of fore III stage, is safe and effective. (authors)

[Astronauts, asteroids and the universe of antithrombotic therapies in primary percutaneous coronary intervention].

Science.gov (United States)

De Luca, Leonardo; Granatelli, Antonino

2017-06-01

A sensation of self-awareness on the relativity of our certainties comes over looking to the huge amount of data on antithrombotic therapies assessed in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). This sensation can be compared to the so-called "overview effect", a cognitive shift in awareness reported by some astronauts during spaceflight, often while viewing the Earth from orbit. In this review we will mention drugs floated like meteors in the Universe of STEMI treatment and we will discuss the body of evidence on oral and intravenous antithrombotic therapies for patients undergoing pPCI.

The effect of outpatient physical therapy intervention on pelvic floor muscles in women with urinary incontinence.

Science.gov (United States)

Knorst, Mara R; Resende, Thais L; Santos, Thaís G; Goldim, José R

2013-01-01

To assess the effect of a weekly, short-term physical therapy intervention on the pelvic floor muscles and urinary incontinence (UI) among patients of the public health system. Quasi-experimental before-and-after study. Clinical history and function evaluation were performed using perineal bidigital maneuvers and perineometry. The intervention consisted of transvaginal electrical stimulation and pelvic floor kinesiotherapy. Data were analyzed using the paired t test or Wilcoxon signed-rank test, Pearson product-moment correlation coefficient or Spearman's rank correlation coefficient. A value of Pphysical therapy sessions were held on average. There was no difference in perineometry measurements following the intervention (40.6±24.1 versus 41.7±25.4, P=0.098). Muscle function significantly increased (P<0.01) in the bidigital maneuver. The patients reported being continent or satisfied with the treatment in 88.9% of cases. The results demonstrated an increase in muscle function and the attainment of urinary continence or treatment satisfaction in most cases.

Supporting Adults With Alzheimer's Disease and Related Major Neurocognitive Disorders and Their Caregivers: Effective Occupational Therapy Interventions.

Science.gov (United States)

Smallfield, Stacy

Occupational therapy practitioners play a significant role in supporting adults with Alzheimer's disease and related major neurocognitive disorders, as well as their caregivers, through all phases of the disease process. This editorial highlights the systematic reviews completed in collaboration with the American Occupational Therapy Association's Evidence-Based Practice Project that summarize the evidence for the effectiveness of interventions within the scope of occupational therapy practice for this population. Readers are encouraged to translate and integrate this updated knowledge into everyday practice. Copyright © 2017 by the American Occupational Therapy Association, Inc.

The influence of saliva flow stimulation on the absorbed radiation dose to the salivary glands during radioiodine therapy of thyroid cancer using 124I PET(/CT) imaging

International Nuclear Information System (INIS)

Jentzen, Walter; Schmitz, Jochen; Freudenberg, Lutz; Eising, Ernst; Bockisch, Andreas; Stahl, Alexander; Balschuweit, Dorothee; Hilbel, Thomas

2010-01-01

A serious side effect of high-activity radioiodine therapy in the treatment of differentiated thyroid cancer is radiogenic salivary gland damage. This damage may be diminished by lemon-juice-induced saliva flow immediately after 131 I administration. The aim of this study was to assess the effect of chewing lemon slices on the absorbed (radiation) doses to the salivary glands. Ten patients received (pretherapy) 124 I PET(/CT) dosimetry before their first radioiodine therapy. The patients underwent a series of six PET scans at 0.5, 1, 2, 4, 48 and ≥96 h and one PET/CT scan at 24 h after administration of 27 MBq 124 I. Blood samples were also collected at about 2, 4, 24, 48, and 96 h. Contrary to the standard radioiodine therapy protocol, the patients were not stimulated with lemon juice. Specifically, the patients chewed no lemon slices during the pretherapy procedure and neither ate food nor drank fluids until after completion of the last PET scan on the first day. Organ absorbed doses per administered 131 I activity (ODpAs) as well as gland and blood uptake curves were determined and compared with published data from a control patient group, i.e. stimulated per the standard radioiodine therapy protocol. The calculations for both groups used the same methodology. A within-group comparison showed that the mean ODpA for the submandibular glands was not significantly different from that for the parotid glands. An intergroup comparison showed that the mean ODpA in the nonstimulation group averaged over both gland types was reduced by 28% compared to the mean ODpA in the stimulation group (p=0.01). Within each gland type, the mean ODpA reductions in the nonstimulation group were statistically significant for the parotid glands (p=0.03) but not for the submandibular glands (p=0.23). The observed ODpAs were higher in the stimulation group because of increased initial gland uptake rather than group differences in blood kinetics. The 124 I PET(/CT) salivary gland

Paving the way to personalized medicine. Production of some theragnostic radionuclides at Brookhaven National Laboratory

International Nuclear Information System (INIS)

Srivastava, S.C.

2011-01-01

This paper introduces a relatively novel paradigm that involves specific individual radionuclides or radionuclide pairs that have emissions that allow pre-therapy low-dose imaging plus higher-dose therapy in the same patient. We have made an attempt to sort out and organize a number of such theragnostic radionuclides and radionuclide pairs that may potentially bring us closer to the age-long dream of personalized medicine for performing tailored low-dose molecular imaging (SPECT/CT or PET/CT) to provide the necessary pre-therapy information on biodistribution, dosimetry, the limiting or critical organ or tissue, and the maximum tolerated dose (MTD), etc. If the imaging results then warrant it, it would be possible to perform higher-dose targeted molecular therapy in the same patient with the same radiopharmaceutical. A major problem that remains yet to be fully resolved is the lack of availability, in sufficient quantities, of a majority of the best candidate theragnostic radionuclides in a no-carrier-added (NCA) form. A brief description of the recently developed new or modified methods at BNL for the production of four theragnostic radionuclides, whose nuclear, physical, and chemical characteristics seem to show great promise for personalized cancer therapy are described.

Physical therapy interventions for knee pain secondary to osteoarthritis: a systematic review.

Science.gov (United States)

Wang, Shi-Yi; Olson-Kellogg, Becky; Shamliyan, Tatyana A; Choi, Jae-Young; Ramakrishnan, Rema; Kane, Robert L

2012-11-06

Osteoarthritis is a leading cause of disability. Nonsurgical treatment is a key first step. Systematic literature review of physical therapy (PT) interventions for community-dwelling adults with knee osteoarthritis. MEDLINE, the Cochrane Library, the Physiotherapy Evidence Database, Scirus, Allied and Complementary Medicine, and the Health and Psychosocial Instruments bibliography database. 193 randomized, controlled trials (RCTs) published in English from 1970 to 29 February 2012. Means of outcomes, PT interventions, and risk of bias were extracted to pool standardized mean differences. Disagreements between reviewers abstracting and checking data were resolved through discussion. Meta-analyses of 84 RCTs provided evidence for 13 PT interventions on pain (58 RCTs), physical function (36 RCTs), and disability (29 RCTs). Meta-analyses provided low-strength evidence that aerobic (11 RCTs) and aquatic (3 RCTs) exercise improved disability and that aerobic exercise (19 RCTs), strengthening exercise (17 RCTs), and ultrasonography (6 RCTs) reduced pain and improved function. Several individual RCTs demonstrated clinically important improvements in pain and disability with aerobic exercise. Other PT interventions demonstrated no sustained benefit. Individual RCTs showed similar benefits with aerobic, aquatic, and strengthening exercise. Adverse events were uncommon and did not deter participants from continuing treatment. Variability in PT interventions and outcomes measures hampered synthesis of evidence. Low-strength evidence suggested that only a few PT interventions were effective. Future studies should compare combined PT interventions (which is how PT is generally administered for pain associated with knee osteoarthritis). Agency for Healthcare Research and Quality.

Impact of region contouring variability on image-based focal therapy evaluation

Science.gov (United States)

Gibson, Eli; Donaldson, Ian A.; Shah, Taimur T.; Hu, Yipeng; Ahmed, Hashim U.; Barratt, Dean C.

2016-03-01

Motivation: Focal therapy is an emerging low-morbidity treatment option for low-intermediate risk prostate cancer; however, challenges remain in accurately delivering treatment to specified targets and determining treatment success. Registered multi-parametric magnetic resonance imaging (MPMRI) acquired before and after treatment can support focal therapy evaluation and optimization; however, contouring variability, when defining the prostate, the clinical target volume (CTV) and the ablation region in images, reduces the precision of quantitative image-based focal therapy evaluation metrics. To inform the interpretation and clarify the limitations of such metrics, we investigated inter-observer contouring variability and its impact on four metrics. Methods: Pre-therapy and 2-week-post-therapy standard-of-care MPMRI were acquired from 5 focal cryotherapy patients. Two clinicians independently contoured, on each slice, the prostate (pre- and post-treatment) and the dominant index lesion CTV (pre-treatment) in the T2-weighted MRI, and the ablated region (post-treatment) in the dynamic-contrast- enhanced MRI. For each combination of clinician contours, post-treatment images were registered to pre-treatment images using a 3D biomechanical-model-based registration of prostate surfaces, and four metrics were computed: the proportion of the target tissue region that was ablated and the target:ablated region volume ratio for each of two targets (the CTV and an expanded planning target volume). Variance components analysis was used to measure the contribution of each type of contour to the variance in the therapy evaluation metrics. Conclusions: 14-23% of evaluation metric variance was attributable to contouring variability (including 6-12% from ablation region contouring); reducing this variability could improve the precision of focal therapy evaluation metrics.

The influence of saliva flow stimulation on the absorbed radiation dose to the salivary glands during radioiodine therapy of thyroid cancer using {sup 124}I PET(/CT) imaging

Energy Technology Data Exchange (ETDEWEB)

Jentzen, Walter; Schmitz, Jochen; Freudenberg, Lutz; Eising, Ernst; Bockisch, Andreas; Stahl, Alexander [Universitaet Duisburg-Essen, Klinik fuer Nuklearmedizin, Essen (Germany); Balschuweit, Dorothee; Hilbel, Thomas [Fachhochschule Gelsenkirchen, Fachbereich Physikalische Technik, Gelsenkirchen (Germany)

2010-12-15

A serious side effect of high-activity radioiodine therapy in the treatment of differentiated thyroid cancer is radiogenic salivary gland damage. This damage may be diminished by lemon-juice-induced saliva flow immediately after {sup 131}I administration. The aim of this study was to assess the effect of chewing lemon slices on the absorbed (radiation) doses to the salivary glands. Ten patients received (pretherapy) {sup 124}I PET(/CT) dosimetry before their first radioiodine therapy. The patients underwent a series of six PET scans at 0.5, 1, 2, 4, 48 and {>=}96 h and one PET/CT scan at 24 h after administration of 27 MBq {sup 124}I. Blood samples were also collected at about 2, 4, 24, 48, and 96 h. Contrary to the standard radioiodine therapy protocol, the patients were not stimulated with lemon juice. Specifically, the patients chewed no lemon slices during the pretherapy procedure and neither ate food nor drank fluids until after completion of the last PET scan on the first day. Organ absorbed doses per administered {sup 131}I activity (ODpAs) as well as gland and blood uptake curves were determined and compared with published data from a control patient group, i.e. stimulated per the standard radioiodine therapy protocol. The calculations for both groups used the same methodology. A within-group comparison showed that the mean ODpA for the submandibular glands was not significantly different from that for the parotid glands. An intergroup comparison showed that the mean ODpA in the nonstimulation group averaged over both gland types was reduced by 28% compared to the mean ODpA in the stimulation group (p=0.01). Within each gland type, the mean ODpA reductions in the nonstimulation group were statistically significant for the parotid glands (p=0.03) but not for the submandibular glands (p=0.23). The observed ODpAs were higher in the stimulation group because of increased initial gland uptake rather than group differences in blood kinetics. The {sup 124}I PET

Importance of imaging diagnostics and interventional therapy for diseases of the lacrimal drainage canals

International Nuclear Information System (INIS)

Bink, A.; Berkefeld, J.; Luechtenberg, M.

2008-01-01

Epiphora (continuous watering of the eyes) is frequently caused by obstruction of the lacrimal draining system. Radiographic imaging of the tear ducts after contrast injection with the DSA (digital subtraction angiography) dacryocystography technique is still the gold standard in patients with severe epiphora which does not respond to conservative therapy. Recent techniques, such as 3D rotational dacryocystography, MRI and CT are able to show the anatomic surroundings in addition to the ductal structures and are especially useful for planning endoscopic operations. Dacryocystographically assisted interventions, such as balloon dilatation or stenting of tear duct stenoses are technically feasible. Balloon dacryocystoplasty is especially successful in patients with incomplete or short distance obstructions of the nasolacrimal duct. Stenting may improve procedural success and patency rates. Minimally invasive interventional therapy is useful as an initial treatment in selected cases, however, long-term success rates may be limited and operative dacryocystorhinostomy still plays an important role. Comparative studies for evaluation of different therapeutic options are necessary. (orig.) [de

Physiotherapy and occupational therapy interventions for people with benign joint hypermobility syndrome: a systematic review of clinical trials.

Science.gov (United States)

Smith, Toby O; Bacon, Holly; Jerman, Emma; Easton, Vicky; Armon, Kate; Poland, Fiona; Macgregor, Alex J

2014-01-01

This study assessed the literature to determine the efficacy and effectiveness of physiotherapy and occupational therapy interventions in the treatment of people with benign joint hypermobility syndrome (BJHS). Published literature databases including: AMED, CINAHL, MEDLINE, EMBASE, PubMed and the Cochrane Library, in addition to unpublished databases and trial registries were searched to October 2012. All clinical trials comparing the clinical outcomes of Occupational Therapy and Physiotherapy interventions compared to non-treatment or control intervention for people with BJHS were included. Of the 126 search results, 3 clinical studies satisfied the eligibility criteria. The data provides limited support for the use of wrist/hand splints for school children. While there is some support for exercise-based intervention, there is insufficient research to determine the optimal mode, frequency, dosage or type of exercise which should be delivered. The current evidence-base surrounding Occupational Therapy and Physiotherapy in the management of BJHS is limited in size and quality. There is insufficient research exploring the clinical outcomes of a number of interventions including sensory integration, positioning and posture management and education. Longer term, rigorous multi-centre randomised controlled trials are warranted to begin to assess the clinical and cost-effectiveness of interventions for children and adults with BJHS. Implications for Rehabilitation There is an evidence-base to support clinician's use of proprioceptive-based exercises in adults, and either tailored or generalised physiotherapy regimes for children with BJHS. Clinicians should be cautious when considering the prescription of hand/wrist splints for school age children with BJHS, based on the current research. Until further multi-centre trials are conducted assessing the clinical and cost-effectiveness of interventions for children and adult with BJHS, clinical decision-making should be

A review of music and movement therapies for children with autism: Embodied interventions for multisystem development

Directory of Open Access Journals (Sweden)

Anjana Narayan Bhat

2013-04-01

Full Text Available The rising incidence of Autism Spectrum Disorders (ASDs has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Evidence suggests that musical training significantly impacts various forms of development including communication, social-emotional, motor, and behavioral development, in children with ASDs, typically developing individuals, and children with other neurological disabilities such as dyslexia and intellectual disabilities. In this review, we first highlight mechanisms and evidence for how music and movement interventions can enhance communication, social-emotional, behavioral, and motor skills in individuals with autism. We will support our claims by reviewing results from brain imaging studies in children with autism that provide neuroanatomical evidence for the effects of music therapies in autism. We will also discuss the critical elements and the different types of music therapy approaches commonly used in pediatric neurological populations including autism. We provide strong arguments for the use of music and movement interventions as a multisystem treatment tool for children with ASDs. Finally, we also make recommendations for assessment and treatment of children with ASDs, and provide directions for future research.

Record of Occupational Therapy interventional practice in inclusive education

Directory of Open Access Journals (Sweden)

Tatiana Barbieri Bombarda

2015-07-01

Full Text Available Considering the importance of records in the professional practice of occupational therapy, it is necessary to instill a more insightful look at the effectiveness of practitioners’ notes, as well as encourage the development of research–oriented documentary practice. The preparation of records arises from the need to have information from the service as a means of guidance and oversight of the service provided and on the adopted technical responsibility, as well as from the fact that the notes are a valuable data providing resource for research. The present study sought to identify and characterize occupational therapists in the state of Sao Paulo who work in inclusive education and how the records of their interventional practices are performed. A structured questionnaire as a tool available on the website for specific predetermined time was used as the study instrument, and the obtained data were analyzed using descriptive statistics. Participants were 55 occupational therapists working in the inclusive education process registered in the 3rd region of the Regional Council of Physical Therapy and Occupational Therapy. The results demonstrated that free narrative was the most commonly used registration model and that information related to the process of custody of notes was fragmented. These data showed weakness in the systematization of records, which is believed to result in improvement of the profession, a factor that demonstrates the necessity and temporality of the scientific production on this issue.

Cardiological-interventional therapy of coronary artery disease today; Kardiologisch-interventionelle Therapie der koronaren Herzerkrankung heute

Energy Technology Data Exchange (ETDEWEB)

Reynen, K.; Henssge, R. [Technische Univ. Dresden (Germany). Klinik fuer Kardiologie

1999-07-01

The current importance of the interventional therapy of coronary artery disease may be deduced from the exponential increase in procedures performed in Germany in the last decade - at least 125,840 in 1996. Today, by improved catheter and balloon materials as well as by growing experience of the cardiologists, even complex lesions may be treated. Limitations of balloon angioplasty include acute vessel closure and restenosis - newer angioplasty devices like directional or rotational atherectomy or excimer-laser angioplasty did not overcome these limitations; only by coronary stenting, acute vessel closure could be managed and the likelihood of restenosis - at least in particular groups of patients - could be reduced. For a few years, intracoronary brachytherapy of the segments dilated with beta- or gamma-emitters has been seeking to reduce restenosis rate; the department of cardiology of the Dresden Cardiovascular Institute is participating in such a multicentre study using the beta-emitter {sup 188}renium. Further main topics of our department represent primary angioplasty in patients with acute myocardial infarction and invasive diagnostic or interventional procedures by the transradial approach. (orig.)

A quality improvement project sustainably decreased time to onset of active physical therapy intervention in patients with acute lung injury.

Science.gov (United States)

Dinglas, Victor D; Parker, Ann M; Reddy, Dereddi Raja S; Colantuoni, Elizabeth; Zanni, Jennifer M; Turnbull, Alison E; Nelliot, Archana; Ciesla, Nancy; Needham, Dale M

2014-10-01

Rehabilitation started early during an intensive care unit (ICU) stay is associated with improved outcomes and is the basis for many quality improvement (QI) projects showing important changes in practice. However, little evidence exists regarding whether such changes are sustainable in real-world practice. To evaluate the sustained effect of a quality improvement project on the timing of initiation of active physical therapy intervention in patients with acute lung injury (ALI). This was a pre-post evaluation using prospectively collected data involving consecutive patients with ALI admitted pre-quality improvement (October 2004-April 2007, n = 120) versus post-quality improvement (July 2009-July 2012, n = 123) from a single medical ICU. The primary outcome was time to first active physical therapy intervention, defined as strengthening, mobility, or cycle ergometry exercises. Among ICU survivors, more patients in the post-quality improvement versus pre-quality improvement group received physical therapy in the ICU (89% vs. 24%, P quality improvement versus pre-quality improvement group, there was a shorter median (interquartile range) time to first physical therapy (4 [2, 6] vs. 11 d [6, 29], P quality improvement period was associated with shorter time to physical therapy (adjusted hazard ratio [95% confidence interval], 8.38 [4.98, 14.11], P quality improvement period. The following variables were independently associated with a longer time to physical therapy: higher Sequential Organ Failure Assessment score (0.93 [0.89, 0.97]), higher FiO2 (0.86 [0.75, 0.99] for each 10% increase), use of an opioid infusion (0.47 [0.25, 0.89]), and deep sedation (0.24 [0.12, 0.46]). In this single-site, pre-post analysis of patients with ALI, an early rehabilitation quality improvement project was independently associated with a substantial decrease in the time to initiation of active physical therapy intervention that was sustained over 5 years. Over the entire pre

Impact of a Child Life and Music Therapy Procedural Support Intervention on Parental Perception of Their Child's Distress During Intravenous Placement.

Science.gov (United States)

Ortiz, Gabriela S; OʼConnor, Todd; Carey, Jessa; Vella, Adam; Paul, Audrey; Rode, Diane; Weinberg, Alan

2017-02-21

Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department. The aim of this study was to investigate the efficacy of this collaborative intervention by evaluating parental perception of their child's distress. This study was a prospective analysis investigating the impact of a child life and music therapy intervention on children aged 4 to 11 years old receiving an IV placement in the pediatric emergency department. Efficacy was evaluated by comparing scores between a 4-question pretest and subsequent 4-question posttest that asked the child's parent to evaluate how they anticipated their child would respond to the procedure, and then to evaluate how they perceived their child to have responded after the procedure. Qualitative data were collected in the form of open-ended comments, which were accommodated at the end of the posttest. Data were analyzed by the Cochran-Mantel-Haenszel method for testing repeated ordinal responses and the PROC GENMOD procedure in the SAS system software. A total of 41 participants were enrolled in this study. Results of the statistical analysis revealed significant differences between all pre- and posttest scores (P music therapy intervention. Improvement was demonstrated across all 4 questions, suggesting that the child life and music therapy intervention supported healthy, adaptive coping and helped to minimize distress experienced by patients during IV placement. These results underscore the importance and potential clinical

Interventional therapy for tubal pregnancy (report of 20 cases)

International Nuclear Information System (INIS)

Cao Xusheng; Gu Tongxiao; Liu Huisheng; Zhang Junfeng; Huang Jinyou; Hu Xiumin

2000-01-01

Objective: To search an approach to treat tubal pregnancy in a safe and economic way. Methods: 20 cases of tubal pregnancy were studied. Under fluoroscopic guidance, a 3F catheter was introduced to the site of tubal gestation through the uterine cavity, and methotrexate 30 mg in 10 ml saline was injected. Results: On the 5th day after operation, the level of serum hCG began to decline reaching the normal value on the 21 st-28 th day. The gestation sac was absorbed after 2-2.5 months. In 6 cases the fallopian tube was re-canalized after 3 months. Conclusion: Interventional therapy is a valuable and practical method for tubal pregnancy

The interventional diagnosis and therapy for thyroid disease should be studied deeply and developed prudently

International Nuclear Information System (INIS)

Zhao Wei; Cheng Yongde

2007-01-01

Many details concerning the interventional diagnosis and therapy of thyroid disease need to be studied deeply and carefully; for example, the thyroid applied anatomy, especially the anatomical imageology study of the thyroid arterial anastomosis involving the therapeutic effects and complications, the thyroid artery embolization treatment, presently as a substitution or the supplement therapy for the traditional classical therapy of Graves disease. There are many exploration to extend the indication scope, the therapeutic effect, embolization scope in intervention for Graves disease due to having no accurate individual quantification standard, and so on. The thyroid arterial embolization for Graves disease is to reduce the main cause of thyroxin secretion. Simultaneously, the comprehensive therapeutic effects might have possibly produce the thyroidcytic apoptosis and immune adjustments. Serious complications such as the cerebral infarction, the hyperthyroidism crisis, the hypocalcemia, the periodic paralysis, and so on commonly occured in thyroid arterial embolization. It is necessary to keep strictly the procedure rule and the indication. The mid-and long- term therapeutic effect of thyroid artery embolization for Graves disease is good, but still need more extensive and prudent research for the prospective achievement. (authors)

[Interventional therapy of acute myocardial infarction].

Science.gov (United States)

Zahn, R; Zeymer, U

2008-09-01

Currently an acute myocardial infarction has to be differentiated into ST-elevation myocardial infarction (STEMI) or non ST-elevation myocardial infarction (NSTEMI). However, there exists another definition of acute coronary syndromes (ACS), which is more important in clinical practice, for all recommendations from the guidelines of the cardiac societies concerning the invasive strategies rely on this one. Here one has to differentiate an ACS with ST-elevation (STE-ACS = STEMI) from an ACS without ST-elevation (NSTE-ACS). The last one is further divided into an NSTE-ACS with or without high risk. In patients with an NSTE-ACS with high risk an early invasive strategy is recommended within 72 h after the diagnosis. In patients with an NSTE-ACS without high risk a more conservative approach can be pursued. In STE-ACS patients primary angioplasty is the reperfusion therapy of choice, if it can be performed in a timely fashion within 2 h after diagnosis at an interventional centre with experienced interventionalists and short "door-to-balloon" times. In Germany this goal is achievable almost everywhere. Therefore it is currently the most important task to establish local networks to reach this goal.

Nonsurgical interventional therapies for low back pain: a review of the evidence for an American Pain Society clinical practice guideline.

Science.gov (United States)

Chou, Roger; Atlas, Steven J; Stanos, Steven P; Rosenquist, Richard W

2009-05-01

Systematic review. To systematically assess benefits and harms of nonsurgical interventional therapies for low back and radicular pain. Although use of certain interventional therapies is common or increasing, there is also uncertainty or controversy about their efficacy. Electronic database searches on Ovid MEDLINE and the Cochrane databases were conducted through July 2008 to identify randomized controlled trials and systematic reviews of local injections, botulinum toxin injection, prolotherapy, epidural steroid injection, facet joint injection, therapeutic medial branch block, sacroiliac joint injection, intradiscal steroid injection, chemonucleolysis, radiofrequency denervation, intradiscal electrothermal therapy, percutaneous intradiscal radiofrequency thermocoagulation, Coblation nucleoplasty, and spinal cord stimulation. All relevant studies were methodologically assessed by 2 independent reviewers using criteria developed by the Cochrane Back Review Group (for trials) and by Oxman (for systematic reviews). A qualitative synthesis of results was performed using methods adapted from the US Preventive Services Task Force. For sciatica or prolapsed lumbar disc with radiculopathy, we found good evidence that chemonucleolysis is moderately superior to placebo injection but inferior to surgery, and fair evidence that epidural steroid injection is moderately effective for short-term (but not long-term) symptom relief. We found fair evidence that spinal cord stimulation is moderately effective for failed back surgery syndrome with persistent radiculopathy, though device-related complications are common. We found good or fair evidence that prolotherapy, facet joint injection, intradiscal steroid injection, and percutaneous intradiscal radiofrequency thermocoagulation are not effective. Insufficient evidence exists to reliably evaluate other interventional therapies. Few nonsurgical interventional therapies for low back pain have been shown to be effective in

Use of recombinant, human TSH radioiodine therapy in patients with differentiated thyroid carcinoma; Radioiodtherapie des differenzierten Schilddruesenkarzinoms nach Vorbehandlung mit rekombinantem, humanem TSH

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Luster, M. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

2001-12-01

We describe the use of recombinant human TSH (rhTSH) in conjunction with ablative radioiodine therapy (RIT) in 11 patients (16 total treatments) with advanced and/or recurrent DTC (5 papillary, 6 follicular) for whom withdrawal of thyroid hormone suppressive therapy (THST) to increase serum TSH was not an option. Indications for rhTSH use in these patients included inability to tolerate withdrawal of thyroid hormones due to poor physical condition or inability to achieve sufficient serum TSH levels after THST withdrawal. All patients had undergone thyroidectomy and most (9/11) had received prior radioablative therapy after THST withdrawal. In 7 cases (5 patients), post-therapy Tg levels assessed at a mean of 4.3 months (range 2-10 months) after I-131 therapy were decreased by at least 30% compared to pre-therapy levels. In an additional 3 patients, whole body scans performed at follow-up indicated decreased or stabilized tumor burden compared to pre-therapy scans or marked clinical improvement was found. Three patients died of progressive disease within 2 months of therapy before follow-up assessments occurred. No adverse events were reported among the 8 surviving patients. The results suggest that rhTSH offers a promising alternative to THST withdrawal to allow radioablative therapy under maximal TSH stimulation in patients with advanced recurrent DTC who would not otherwise be able to receive this treatment. This therapeutic indication extends the clinical potential of the new agent, already demonstrated to be effective for use with I-131 for diagnostic purposes. However in some patients suffering from highly aggressive tumors the poor prognosis will not be improved. (orig.) [German] An unserer Klinik liegen bislang Erfahrungen mit 16 Radioiodtherapien (RIT) (z.T. mehrfache Anwendung) unter rhTSH vor. Die ueberwiegende Mehrzahl der Patienten wurde wegen einer fortgeschrittenen Tumorerkrankung mit dem Risiko einer lebensbedrohlichen Verschlechterung in

Diagnosis and interventional neuroradiology in cranial emergencies. Neuroradiologische Notfalldiagnostik und -therapie kranieller Erkrankungen

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Wakhloo, A.K.; Schumacher, M. (Freiburg Univ. (Germany, F.R.). Sektion Neuroradiologie)

1991-01-01

The most efficient diagnostic procedures are described for cases of intracranial mass, cerebral sinus and venous thrombosis, thrombosis of vertebral and basilar arteries, subarachnoid hemorrhage, carotid-cavernous fistulas, intractable epistaxis, Wernicke's encephalopathy and inflammatory cranial diseases. The importance of CT, MRI and angiography is discussed for these cranial emergencies. The different forms of interventional therapy possible are specified. (orig.).

Impact of educational outreach intervention on enhancing health care providers' knowledge about statin therapy prescribing in Malaysian patients with type 2 diabetes mellitus.

Science.gov (United States)

Elnaem, Mohamed Hassan; Nik Mohamed, Mohamad Haniki; Zaman Huri, Hasniza; Azarisman, Shah M

2018-03-06

Previous research reported underutilization of statin therapy among patients with type 2 diabetes mellitus. Improving health care providers' awareness and understanding of the benefits and risks of statin treatment could be of assistance in optimizing the statin prescribing process. This study aimed to assess health care providers' knowledge related to statin therapy and the impact of educational outreach intervention based on the perceived knowledge. This was a cross-sectional study based on educational outreach intervention targeting physicians and pharmacists in 1 major tertiary hospital in the state of Pahang, Malaysia. Participants responded to a 12-item, validated questionnaire both prior to and after the outreach educational program. Two sessions were conducted separately for 2 cohorts of pharmacists and physicians. The knowledge scores prior to and after the educational intervention were calculated and compared using a paired-samples t-test. The response rate to both pre-and post-educational outreach questionnaires was 91% (40/44). Prior to the intervention, around 84% (n37) of the participants decided to initiate statin therapy for both pre-assessment clinical case scenarios; however, only 27% (n12) could state the clinical benefits of statin therapy. Forty-five percent (n20) could state the drug to drug interactions, and 52.3% (n23) could identify the statin therapy that can be given at any time day/evening. The educational outreach program increased participants' knowledge scores of 1.450 (95% CI, 0.918 to 1.982) point, P health care providers' knowledge and beliefs about statin therapy. This type of intervention is considered effective for short-term knowledge enhancement. Further research is needed to test the long-term efficacy of such intervention. © 2018 John Wiley & Sons, Ltd.

State-trait anxiety levels during pregnancy and foetal parameters following intervention with music therapy.

Science.gov (United States)

Garcia-Gonzalez, J; Ventura-Miranda, M I; Requena-Mullor, M; Parron-Carreño, T; Alarcon-Rodriguez, R

2018-05-01

Research indicates that anxiety during pregnancy may be a risk factor for the development of alterations in the mental health of the pregnant woman and of obstetric complications. to investigate the effect of music therapy on maternal anxiety, before and after a non-stress test (NST), and the effect of maternal anxiety on the birthing process and birth size. 409 nulliparous women coming for routine prenatal care were randomized in the third trimester to receive either music therapy (n = 204) or no music therapy (n = 205) during an NST. Maternal anxiety was assessed using the Spielberger State-Trait Anxiety Inventory before and after the NST. After the NST, the women from the music group showed significantly lower scores in state anxiety (OR = 0.87; p < 0.001) as well as trait anxiety (p < 0.001) than the control group. Furthermore, the pregnant women from the music group presented lower levels of state-trait anxiety than the control group in relation to the variables of birth process, and higher birth weight and chest circumference in the newborn (OR = 3.5 and OR = 0.81, respectively; p < 0.05). This study was limited by the fact that it was a single-centre study; the observers conducting the NST were not blinded to the allocation, although neither midwife had any knowledge of the maternal anxiety scores, and we could not apply the double-blind method due to the nature of the observation. Our findings confirm that music therapy intervention during pregnancy could reduce elevated state-trait anxiety levels during the third trimester. Further research into the influence of music therapy as intervention on maternal anxiety and on the birthing process and birth size is required during pregnancy. Copyright © 2018 Elsevier B.V. All rights reserved.

COMBINATION THERAPIES OR STANDALONE INTERVENTIONS? INNOVATION OPTIONS FOR PHARMACEUTICAL FIRMS FIGHTING CANCER

OpenAIRE

GUNJAN BHARDWAJ; ANSHIT AGRAWAL; RUPESH TYAGI

2015-01-01

Innovation is key to the pharma model, from an initial discovery to the final development of a marketable drug. Here, we explore the innovation options in the fiercely contested therapeutic area of Oncology. We studied clinical development of drugs targeting PD-1 and PD-L1 pathway. In this interesting contest, companies seem to be focusing on standalone interventions (exploratory innovation) and combination therapy (exploitative innovation) in clinical development. Merck Sharp and Dohme, havi...

Mindfulness-based cognitive therapy in the intervention of psychiatric disorders: A review

Directory of Open Access Journals (Sweden)

Jian-Fei Xie

2014-06-01

Full Text Available Mindfulness-based cognitive therapy (MBCT is frequently used for psychiatric disorders. Despite MBCT's considerable potential for improving psychological health for patients, there is little empirical evidence to support its practical application in Chinese. This review will define meditation and mindfulness, provide an overview of the development of MBCT, identify the evidence for the effectiveness of MBCT, and offer recommendations to medical personnels on how to provide support for patients receiving mindfulness intervention.

Visceral artery aneurysms and pseudoaneurysms. Retrospective analysis of interventional endovascular therapy of 43 aneurysms; Aneurysmen und Pseudoaneurysmen viszeraler Arterien. Retrospektive Analyse der interventionellen radiologischen Therapie von 43 Aneurysmen

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Ruhnke, Hannes; Kroencke, Thomas J. [Klinikum Augsburg (Germany). Dept. of Diagnostic and Interventional Radiology and Neuroradiology

2017-07-15

To evaluate the results of interventional endovascular therapy of incidental and symptomatic visceral artery aneurysms in the elective and emergency situation. 43 aneurysms in 38 patients (19 female, 19 male, mean age: 57 ± 16 years [18-82]) were treated between 2011 and 2015. The characteristics of the aneurysms (true vs. false aneurysm, size, etiology, location, symptoms) were considered. Furthermore, we evaluated the intervention with respect to technical success, embolic/occlusive agents used, therapy-associated complications and post-interventional follow-up. 23 true aneurysms (maximum diameter: 22 ± 18 mm [11 - 67mm]) and 20 false aneurysms (maximum diameter: 9 ± 33 mm [3 - 150 mm]) were evaluated. The splenic (n = 14) and renal arteries (n = 18) were most frequently affected. The etiology was most commonly degenerative-atherosclerotic (47%) or iatrogenic post-operative (19%). 18/48 interventions were performed due to active bleeding. False aneurysms were associated significantly more often with active bleeding (63 vs. 25%, p = 0.012). 41/48 treatments were technically successful. Re-intervention was necessary 6 times. In 2 cases the endovascular approach did not succeed. There was a complication rate of 10%, whereby only 4 minor and 1 major complications occurred. No patient suffered from permanent sequelae. Aneurysms were primarily treated by using coils and if necessary additional embolic agents (liquid embolic agent or vascular plugs) (75%). In the follow-up period, reperfusion of treated aneurysms occurred at a rate of 7% (n = 3). Interventional endovascular therapy of visceral artery aneurysms is safe and effective in the elective treatment of incidental aneurysms as well as in significantly more frequent hemorrhaging false aneurysms in the emergency situation.

Barriers and facilitators of interventions for improving antiretroviral therapy adherence: a systematic review of global qualitative evidence.

Science.gov (United States)

Ma, Qingyan; Tso, Lai Sze; Rich, Zachary C; Hall, Brian J; Beanland, Rachel; Li, Haochu; Lackey, Mellanye; Hu, Fengyu; Cai, Weiping; Doherty, Meg; Tucker, Joseph D

2016-01-01

Qualitative research on antiretroviral therapy (ART) adherence interventions can provide a deeper understanding of intervention facilitators and barriers. This systematic review aims to synthesize qualitative evidence of interventions for improving ART adherence and to inform patient-centred policymaking. We searched 19 databases to identify studies presenting primary qualitative data on the experiences, attitudes and acceptability of interventions to improve ART adherence among PLHIV and treatment providers. We used thematic synthesis to synthesize qualitative evidence and the CERQual (Confidence in the Evidence from Reviews of Qualitative Research) approach to assess the confidence of review findings. Of 2982 references identified, a total of 31 studies from 17 countries were included. Twelve studies were conducted in high-income countries, 13 in middle-income countries and six in low-income countries. Study populations focused on adults living with HIV (21 studies, n =1025), children living with HIV (two studies, n =46), adolescents living with HIV (four studies, n =70) and pregnant women living with HIV (one study, n =79). Twenty-three studies examined PLHIV perspectives and 13 studies examined healthcare provider perspectives. We identified six themes related to types of interventions, including task shifting, education, mobile phone text messaging, directly observed therapy, medical professional outreach and complex interventions. We also identified five cross-cutting themes, including strengthening social relationships, ensuring confidentiality, empowerment of PLHIV, compensation and integrating religious beliefs into interventions. Our qualitative evidence suggests that strengthening PLHIV social relationships, PLHIV empowerment and developing culturally appropriate interventions may facilitate adherence interventions. Our study indicates that potential barriers are inadequate training and compensation for lay health workers and inadvertent disclosure of

Emotion-Focused Family Therapy for Eating Disorders Across the Lifespan: A Pilot Study of a 2-Day Transdiagnostic Intervention for Parents.

Science.gov (United States)

Lafrance Robinson, Adèle; Dolhanty, Joanne; Stillar, Amanda; Henderson, Katherine; Mayman, Shari

2016-01-01

Emotion-focused family therapy is a transdiagnostic approach that affords parents and caregivers a significant role in their loved one's recovery from an eating disorder. A 2-day intervention was developed on the basis of emotion-focused family therapy principles and delivered to 33 parents of adolescent and adult children. Data were collected pre- and post-intervention. Through education and skills practice, parents were taught strategies with respect to meal support and symptom interruption as well as emotion coaching. Parents were also supported to identify and work through their own emotional blocks that could interfere with their supportive efforts. Analyses revealed a significant increase in parental self-efficacy, a positive shift in parents' attitudes regarding their role as emotion coach and a reduction in the fears associated with their involvement in treatment, including a decrease in self-blame. Overall, this broad-based, low-cost intervention shows promise, and future research is warranted. Copyright © 2014 John Wiley & Sons, Ltd. A low-cost, intensive emotion-focused family therapy intervention shows promise for parents of individuals with an eating disorder, regardless of their loved one's age, symptom profile or involvement in treatment. Working with parents' emotions and emotional reactions to their child's struggles has the potential to improve supportive efforts. An emotion-focused family therapy intervention for parents yields high satisfaction rates, improves parental self-efficacy and reduces fears regarding their involvement, including self-blame. Copyright © 2014 John Wiley & Sons, Ltd.

The management of primary lymphoma of bone

International Nuclear Information System (INIS)

Mendenhall, N.P.; Jones, J.J.; Kramer, B.S.; Carter, R.L.; Enneking, W.F.; Marcus, R.B. Jr.; Million, R.R.; Hudson, T.M.

1987-01-01

From October 1962 through to April 1982, 21 patients with the diagnosis of primary lymphoma of bone (18 monostotic, stages I E and II E ; 3 polyostotic) were treated with curative intent. A combination of chemotherapy and radiation therapy was used in 11 patients, local treatment alone in 9 patients, and chemotherapy alone in one patient. Overall 5-year survival for the patients treated with curative intent was 56%. Standard work-up has changed over the 20-year study period. Five-year survival for the subset of eight stage I and II patients with full pretherapy staging was 83%. Prognosis was significantly correlated with extent of pretherapy staging. Treatment parameters that also seemed to predict outcome were the aggressiveness of chemotherapy and the use of irradiation or surgery for local-regional disease; the only local failure occurred in the patient who received chemotherapy alone. Complications of radiation therapy alone and in combination with chemotherapy are discussed and correlated with irradiation dose. Radiation therapy techniques are described, and a management approach is recommended. (Auth.)

Dosimetric model for antibody targeted radionuclide therapy of tumor cells in cerebrospinal fluid

International Nuclear Information System (INIS)

Millar, W.T.; Barrett, A.

1990-01-01

Although encouraging results have been obtained using systemic radioimmunotherapy in the treatment of cancer, it is likely that regional applications may prove more effective. One such strategy is the treatment of central nervous system leukemia in children by intrathecal instillation of targeting or nontargeting beta particle emitting radionuclide carriers. The beta particle dosimetry of the spine is assessed, assuming that the spinal cord and the cerebrospinal fluid compartment can be adequately represented by a cylindrical annulus. The radionuclides investigated were 90 Y, 131 I, 67 Cu, and 199 Au. It is shown that the radiation dose to the cord can be significantly reduced using short range beta particle emitters and that there is little advantage in using targeting carriers with these radionuclides. 199 Au and 67 Cu also have the advantage of having a suitable gamma emission for imaging, permitting pretherapy imaging and dosimetric calculations to be undertaken prior to therapy. If these methods prove successful, it may be possible to replace the external beam component used in the treatment of central nervous system leukemia in children by intrathecal radionuclide therapy, thus reducing or avoiding side effects such as growth and intellectual impairment

Analysis of interventional therapy for progressing stage gastric cancer

International Nuclear Information System (INIS)

Zhu Mingde; Zhang Zijing; Ji Hongsheng; Ge Chenlin; Hao Gang; Wei Kongming; Yuan Yuhou; Zhao Xiuping

2008-01-01

Objective: To investigate the interventional therapy and its curative effect for progressing stage gastric cancer. Methods: two hundred and twelve patients with progressing stage gastric cancer were treated with arterial perfusion and arterial embolization. Gastric cardia cancer was treated through the left gastric artery and the left inferior phrenic artery or splenic artery. Cancers of lesser and greater gastric curvature was treated either through the left and right gastric arteries or common hepatic artery or through gastroduodenal artery, right gastroomental artery or splenic artery. Gastric antrum cancers were perfused through gastroduodenal artery or after the middle segmental embolization of right gastroomental artery. Results: One hundred and ninety three cases undergone interventional management were followed up. The CR + PR of gastric cardia cancer was 53.13%; gastric body cancer 44.44%; gastric antrum cancer 10%; recurrent cancer and remnant gastric cancer 0. There was no significant difference in outcome between gastric cardia cancer and gastric body cancer (P>0.05) but significant differences were shown both between gastric cardia cancer and gastric antrum cancer, and between gastric body cancer and gastric antrum cancer (P<0.05), with 1 year and 2 years survival rates of 81% and 56% respectively. Conclusion: The interventional therapeutic effect of progressing stage gastric cancers is different due to the different sites of the lesions in the gastric tissue. The curative effect of gastric cardia cancer and gastric body cancer is better than that of gastric antrum cancer, recurrent cancer and remnant gastric cancer. (authors)

Using Videoconferencing to Deliver Individual Therapy and Pediatric Psychology Interventions with Children and Adolescents.

Science.gov (United States)

Nelson, Eve-Lynn; Patton, Susana

2016-04-01

Because of the widening access gap between need for individual and pediatric psychology services and child specialist availability, secure videoconferencing options are more needed than ever to address access challenges across underserved settings. The authors summarize real-time videoconferencing evidence to date across individual therapy with children and pediatric psychology interventions using videoconferencing. The authors summarize emerging guidelines that inform best practices for individual child therapy over videoconferencing. The authors present three case examples to illustrate best practices. The first behavioral pediatrics case summarizes evidence-based approaches in treating a rural young adolescent with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and hearing impairment. The second pediatric psychology case describes similarities and difference between on-site and videoconferencing services in treating a rural child with toileting concerns. The third adolescent case describes treatment of an urban honors student with depression. Videoconferencing is an effective approach to improving access to individual and pediatric psychology interventions for children and adolescents. Videoconferencing approaches are well accepted by families and show promise for disseminating evidence-based treatments to underserved communities.

Value of 201Tl imaging in predicting therapeutic 131I uptake in patients with thyroglobulin-positive but 131I scan-negative differentiated thyroid carcinoma

International Nuclear Information System (INIS)

Conlu, R.A.O.; Obaldo, J.M.

2004-01-01

Background: Serum thyroglobulin assay and 131Iodine (1311) whole body scan are considered complementary in detecting malignant thyroid tissue or metastases. A large number of patients, however, are encountered presenting with scan-negative, thyroglobulin-positive differentiated thyroid carcinoma posing a dilemma in therapeutic management. One of the first alternative scanning agents to be employed is 201Thallium (201Tl). Recent studies have demonstrated its usefulness in identifying lesions that are not visualized with traditional 131I whole body scan. It is not clear, however, whether 201Tl scan helps in the decision-making for subsequent 131I therapy. This study was conducted to determine if 201Tl scan can predict therapeutic 131I uptake and to define the clinical role of 201Tl scanning in these patients. Methods and results: A total of 12 patients (20-63 y/o), 5 males and 7 females, underwent surgery for differentiated thyroid cancer and all had serum thyroglobulin values above 10 ng/ml and normal TPO autoantibodies. Pre-therapy 131I scan using 111 MBq (3mCi) of 131I were obtained. As required for inclusion, all patients had negative pre-therapy scan and negative TPO autoantibody results and underwent 20lTl scanning within 3 weeks. All patients were given 131I therapy (3.7-5.5 GBq or 100-150 mCi) between one to two months after 201Tl scanning. Within a week after therapy, all patients underwent whole body 1311 scanning. 201Tl imaging demonstrated thyroid remnants in 9 out of 12 patients having positive 201Tl scan but negative pre-therapy 1311 scan. However, only 2 of the positive 201Tl scans showed 131I uptake post-therapy (positive predictive value of 20%). None of the subjects presented with a negative 201Tl scan and a positive post-therapy 131I scan. Conclusion: Our study suggests that evidence of remnants or metastases on 201Tl scanning may be an inappropriate basis for the decision to proceed with 131I therapy. The role of 20lTl imaging in this subset of

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

International Nuclear Information System (INIS)

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

2010-01-01

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

Initial application of a ACI-rat model of hepatocellular carcinoma in the experiments of interventional therapy

International Nuclear Information System (INIS)

Qian Jun; Feng Gansheng

2003-01-01

Objective: To evaluate the therapeutic efficiency of various methods of interventional therapy in the ACI-rat model of hepatocellular carcinoma, and to assess the value of this model in the experiments of interventional therapy. Methods: The subcapsular implantation of a solid Morris Hepatoma 3924A (1 mm 3 ) in the livers was carried out in 58 male ACI-rats. 13 days after the implantation, the tumor volume (V 1 ) was measured by using magnetic resonance tomography (MRT). After laparotomy and retrograde placement of catheter into the gastroduodenal artery (14 d), the following protocols of interventional therapy were performed: (A) Mitomycin C (n = 4); (B) Degradable starch microspheres (DSM) (n = 4); (C) Lipiodol (n = 5); (D) Ligation (n = 4); (E) Mitomycin C + DSM (n = 4); (F) Mitomycin C + ligation (n = 5); (G) Mitomycin C + Lipiodol (n = 5); (H) DSM + ligation (n = 4); (I) Lipiodol + ligation (n = 4); (J) Mitomycin C + Poly-lactide-coglycollide-microspheres (Plcg) (n = 4); (K) Mitomycin C + Lipiodol + ligation (n = 4); (L) Mitomycin C + DSM + ligation (n = 4); (M) 0.9% NaCl (control group, n = 7). 13 days after these therapies the change of the tumor volume (V 2 ) was determined by MRT again. Results: The rate of implantation was 100%. V 2 /V 1 was 4.50 in group A, 12.73 in group B, 15.84 in group C, 10.17 in group D, 90.20 in group E, 7.16 in group F, 4.08 in group G, 3.45 in group H, 9.99 in group I, 2.86 in group J, 3.76 in group K, 7.71 in group L, and 27.12 in group M, respectively. Compared to the control group, groups A, G, H, J and K showed significant reduced tumor growth (χ 2 = 5.238, 8.571, 5.238, 5.238, 5.238, P = 0.045, 0.008, 0.045, 0.045, 0.045) in the period of observation, whereas the other groups showed no statistical significant differences by the tumor growth [χ 2 = 1.016(B), 3.086(C), 1.016(D), 2.213(E), 3.086(F), 1.061(I), 1.061(L), P = 0.348 (B), 0.121 (C), 0.348 (D), 0.199 (E), 0.121 (F), 0.348 (I), 0.348(L)]. Conclusion: This model of

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

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

2017-12-01

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

Subgroup effects of occupational therapy-based intervention for people with advanced cancer.

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Sampedro Pilegaard, Marc; Oestergaard, Lisa Gregersen; la Cour, Karen; Thit Johnsen, Anna; Brandt, Åse

2018-03-23

Many people with advanced cancer have decreased ability to perform activities of daily living (ADL). We recently performed a randomized, controlled trial (RCT) assessing the efficacy of an occupational therapy-based program, the 'Cancer Home-Life Intervention' in people with advanced cancer (N = 242) and found no overall effects on ADL ability. However, heterogeneity of treatment effect may disguise subgroup differences. To investigate whether subgroups of people with advanced cancer gain positive effects from the 'Cancer Home-Life Intervention' on ADL ability. An exploratory subgroup analysis including 191 participants from a RCT. The outcome was ADL motor ability measured by the Assessment of Motor and Process Skills (AMPS). Subgroups were defined by age, gender, years of education, type of primary tumor, functional level, and activity problems. The 'Cancer Home-Life Intervention' had no statistically significant effect in the six subgroups. Modifying effects of age (0.30 [95% CI: -0.05 to 0.64]) and gender (0.23 [95% CI: -0.11 to 0.57]) were not found. There were no subgroup effects of the 'Cancer Home-Life Intervention'on ADL motor ability. Some indications suggest greater effects for those aged below 69 years; however, this result should be interpreted with caution.

Comparing the acceptability of a positive psychology intervention versus a cognitive behavioural therapy for clinical depression.

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Lopez-Gomez, Irene; Chaves, Covadonga; Hervas, Gonzalo; Vazquez, Carmelo

2017-09-01

There is growing evidence on the efficacy of positive psychology interventions (PPI) to treat clinical disorders. However, very few studies have addressed their acceptability. The present study aimed to analyse 2 key components of acceptability (i.e., client satisfaction and adherence to treatment) of a new PPI programme, the Integrative Positive Psychological Intervention for Depression (IPPI-D), in comparison to a standard cognitive behavioural therapy (CBT) programme in the treatment of clinical depression. One hundred twenty-eight women with a DSM-IV diagnosis of major depression or dysthymia were allocated to a 10-session IPPI-D or CBT group intervention condition. Results showed that both interventions were highly acceptable for participants. Attendance rates were high, and there were no significant differences between conditions. However, the IPPI-D condition showed significantly higher client satisfaction than the CBT condition. Moreover, acceptability did not differ based on participants' severity of symptoms, regardless of condition. These findings encourage further investigations of the applicability of PPI in clinical settings in order to broaden the range of acceptable and suitable therapies for depressed patients. Key Practitioner Message This study sheds light on the client satisfaction and adherence to a positive intervention. For participants, positive psychology interventions (PPI) may be more satisfactory than CBT as PPI are framed within a positive mental health model and, consequently, may reduce the risk of stigmatization Because acceptability of treatments and preferences may affect the efficacy of treatments, this study provides an excellent opportunity to offer professionals more therapeutic options to tailor treatments to clients' needs and expectations. Copyright © 2017 John Wiley & Sons, Ltd.

The efficacy of Motivational Intervention and Cognitive-Behavioral Therapy for Pathological Gambling.

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Garcia-Caballero, Anna; Torrens-Lluch, Marina; Ramírez-Gendrau, Isabel; Garrido, Gemma; Vallès, Vicenç; Aragay, Núria

2018-01-15

The aim of the current study is to determine the effectiveness of an individual psychological intervention based on the motivational interview and cognitive-behavioral therapy for the treatment of pathological gambling. A sample of 18 participants, diagnosed of pathological gambling and without any other associated comorbidity, were assessed, attended at the publicly-funded Gambling and Behavioral Addictions Unit (Consorci Sanitari de Terrassa). Median age was 46 years (SD = 12). All the patients achieved abstinence and completed follow-up. The Screen for Gambling Problems (NODS), Quality of Life Enjoyment and Satisfaction (Q-LES-Q), Impulsive Behavior Scale (UPPS-P), Sheehan Disability Inventory (SDI), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were administered pre- and posttreatment. Results showed that patients significantly reduced the problems related to gambling behavior according to the NODS score (p < .000). Regarding impulsive behavior (UPPS-P), we found significant differences in negative urgency (p < .001), positive urgency (p < .001), (lack of) premeditation (p < .029) and (lack of) perseverance (p < .048). Some relevant aspects of quality of life as assessed by the Q-LES-Q had improved. In conclusion, the study shows that psychological intervention based on the motivational interview and cognitive-behavioral therapy not only significantly reduces gambling-related behavior problems but also leads to improvements in impulsivity and quality of life. .

Theoretical Issues in Clinical Social Group Work.

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Randall, Elizabeth; Wodarski, John S.

1989-01-01

Reviews relevant issues in clinical social group practice including group versus individual treatment, group work advantages, approach rationale, group conditions for change, worker role in group, group composition, group practice technique and method, time as group work dimension, pretherapy training, group therapy precautions, and group work…

Progression of puberty after initiation of androgen therapy in patients with idiopathic hypogonadotropic hypogonadism

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Bindu Kulshreshtha

2013-01-01

Full Text Available Background: Onset of puberty in boys usually occurs by 14 years of age. Some boys may exhibit delayed sexual maturation till about 17-18 years of age. However, pubertal onset beyond 18 years of age is exceedingly rare. Materials and Methods: Patients diagnosed as idiopathic hypogonadotropic hypogonadism (IHH who had onset of puberty (increase in testicular volume >10 ml while on androgen therapy were studied. These patients were evaluated prospectively. Results: There were nine subjects that were included in the study. The pre-therapy testicular volumes ranged from 3 to 6 ml. Luteinizing hormone (LH levels increased from 1.2 ± 0.96 to 2.8 ± 1.0 IU/L, follicular stimulating hormone (FSH levels increased from 1.5 ± 0.79 to 3.5 ± 1.9 IU/L, and testosterone increased from 0.36 ± 0.16 to 3.4 ± 2.1 ng/ml. Three out of nine patients had testosterone levels below 3 ng/ml. Conclusion: Our present study indicates that pubertal development can occur in patients presenting with hypogonadotropic hypogonadism after 18 years of age. However, acquired pubertal status may be subnormal

The importance of therapy motivation for patients with substance use disorders.

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Philips, Björn; Wennberg, Peter

2014-12-01

The present study aimed to examine whether patients' pretherapy motivation was related to other patient characteristics and whether it predicted retention in psychotherapy. Data were collected within a naturalistic outcome study of various forms of psychotherapy for patients (N = 172) with substance use disorders (SUD). Therapy motivation was measured using the Client Motivation for Therapy Scale (CMOTS), including the variables autonomous motivation, controlled motivation, and amotivation. Female patients had higher levels of autonomous motivation (d = .53), lower levels of controlled motivation (d = -.32), and lower levels of amotivation (d = -.62). Level of symptoms and impairment was significantly positively correlated with controlled motivation (r = .31). Autonomous motivation was positively correlated with four expectation subscales associated with constructive therapeutic work, whereas amotivation was negatively correlated with three of these subscales. Controlled motivation was positively correlated with the subscales external orientation, defensiveness, and support. In a logistic regression, amotivation stood out as a negative predictor of retention, in terms of starting in psychotherapy after assessment or not. Quite surprisingly, autonomous motivation was not a significant predictor of retention. The present study indicates that amotivation is a risk factor for early dropout among SUD patients. More efforts should be directed at preparing patients for psychotherapy through strengthening motivation.

Measuring psychological change during cognitive behaviour therapy in primary care: a Polish study using 'PSYCHLOPS' (Psychological Outcome Profiles.

Directory of Open Access Journals (Sweden)

Slawomir Czachowski

Full Text Available BACKGROUND: Psychological outcome measures are evolving into measures that depict progress over time. Interval measurement during therapy has not previously been reported for a patient-generated measure in primary care. We aimed to determine the sensitivity to change throughout therapy, using 'PSYCHLOPS' (Psychological Outcome Profiles, and to determine if new problems appearing during therapy diminish overall improvement. METHODS: Responses to PSYCHLOPS, pre-, during- and post-therapy were compared. SETTING: patients offered brief cognitive behaviour therapy in primary care in Poland. RESULTS: 238 patients completed the pre-therapy questionnaire, 194 (81.5% the during-therapy questionnaire and 142 the post-therapy questionnaire (59.7%. For those completing all three questionnaires (n = 135, improvement in total scores produced an overall Effect Size of 3.1 (2.7 to 3.4. We estimated change using three methods for dealing with missing values. Single and multiple imputation did not significantly change the Effect Size; 'Last Value Carried Forward', the most conservative method, produced an overall Effect Size of 2.3 (1.9 to 2.6. New problems during therapy were reported by 81 patients (60.0%: new problem and original problem scores were of similar magnitude and change scores were not significantly different when compared to patients who did not report new problems. CONCLUSION: A large proportion of outcome data is lost when outcome measures depend upon completed end of therapy questionnaires. The use of a during-therapy measure increases data capture. Missing data still produce difficulties in interpreting overall effect sizes for change. We found no evidence that new problems appearing during therapy hampered overall recovery.

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

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

2016-01-01

The use of fall risk-increasing drugs (FRIDs) by older adults is one factor associated with falling, and FRID use is common among older adults. A targeted medication therapy management intervention focused on FRID use that included prescription and over-the-counter (OTC) medications, along with follow-up telephone calls was designed. The purpose of this pilot study was to examine preliminary effects of a medication therapy management (MTM) intervention focused on FRIDs provided by a community pharmacist to older adults. Randomized, controlled trial. One community pharmacy. Eighty older adults who completed a fall prevention workshop. The main outcome measures were the rate of discontinuing FRIDs, the proportion of older adults falling, and the number of falls. A secondary outcome was the acceptance rate of medication recommendations by patients and prescribers. Thirty-eight older adults received the targeted MTM intervention. Of the 31 older adults using a FRID, a larger proportion in the intervention group had FRID use modified relative to controls (77% and 28%, respectively; P FRID use among older adults was effective in modifying FRID use. This result supports the preliminary conclusion that community pharmacists can play an important role in modifying FRID use among older adults. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Post-Admission Cognitive Therapy: A Brief Intervention for Psychiatric Inpatients Admitted After a Suicide Attempt

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Ghahramanlou-Holloway, Marjan; Cox, Daniel W.; Greene, Farrah N.

2012-01-01

To date, no empirically based inpatient intervention for individuals who have attempted suicide exists. We present an overview of a novel psychotherapeutic approach, Post-Admission Cognitive Therapy (PACT), currently under development and empirical testing for inpatients who have been admitted for a recent suicide attempt. PACT is adapted from an…

Psychological flexibility mediates change in intuitive eating regulation in acceptance and commitment therapy interventions.

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Sairanen, Essi; Tolvanen, Asko; Karhunen, Leila; Kolehmainen, Marjukka; Järvelä-Reijonen, Elina; Lindroos, Sanni; Peuhkuri, Katri; Korpela, Riitta; Ermes, Miikka; Mattila, Elina; Lappalainen, Raimo

2017-06-01

Despite the promising results related to intuitive eating, few studies have attempted to explain the processes encouraging this adaptive eating behaviour. The focus of the present study was on exploring mechanisms of change in intuitive eating and weight in acceptance and commitment therapy (ACT) interventions. Mediation provides important information regarding the treatment processes and theoretical models related to specific treatment approaches. The study investigates whether psychological flexibility, mindfulness skills and sense of coherence mediated the interventions' effect on intuitive eating and weight. Secondary analysis of a randomized control trial. Mediation analysis compared two ACT interventions - face-to-face (in a group) and mobile (individually) - with a control group using a latent difference score model. Settings Data were collected in three Finnish towns. The participants were overweight or obese (n 219), reporting symptoms of perceived stress. The effect of the interventions on participants' (i) BMI, (ii) intuitive eating and its subscales, (iii) eating for physical rather than emotional reasons and (iv) reliance on internal hunger and satiety cues was mediated by changes in weight-related psychological flexibility in both ACT groups. These findings suggest that ACT interventions aiming for lifestyle changes mediate the intervention effects through the enhanced ability to continue with valued activities even when confronted with negative emotions and thoughts related to weight.

TU-EF-210-04: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy

Energy Technology Data Exchange (ETDEWEB)

Farahani, K. [National Cancer Institute (United States)

2015-06-15

The use of therapeutic ultrasound to provide targeted therapy is an active research area that has a broad application scope. The invited talks in this session will address currently implemented strategies and protocols for both hyperthermia and ablation applications using therapeutic ultrasound. The role of both ultrasound and MRI in the monitoring and assessment of these therapies will be explored in both pre-clinical and clinical applications. Katherine Ferrara: High Intensity Focused Ultrasound, Drug Delivery, and Immunotherapy Rajiv Chopra: Translating Localized Doxorubicin Delivery to Pediatric Oncology using MRI-guided HIFU Elisa Konofagou: Real-time Ablation Monitoring and Lesion Quantification using Harmonic Motion Imaging Keyvan Farahani: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy Learning Objectives: Understand the role of ultrasound in localized drug delivery and the effects of immunotherapy when used in conjunction with ultrasound therapy. Understand potential targeted drug delivery clinical applications including pediatric oncology. Understand the technical requirements for performing targeted drug delivery. Understand how radiation-force approaches can be used to both monitor and assess high intensity focused ultrasound ablation therapy. Understand the role of AAPM task groups in ultrasound imaging and therapies. Chopra: Funding from Cancer Prevention and Research Initiative of Texas (CPRIT), Award R1308 Evelyn and M.R. Hudson Foundation; Research Support from Research Contract with Philips Healthcare; COI are Co-founder of FUS Instruments Inc Ferrara: Supported by NIH, UCDavis and California (CIRM and BHCE) Farahani: In-kind research support from Philips Healthcare.

TU-EF-210-04: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy

International Nuclear Information System (INIS)

Farahani, K.

2015-01-01

The use of therapeutic ultrasound to provide targeted therapy is an active research area that has a broad application scope. The invited talks in this session will address currently implemented strategies and protocols for both hyperthermia and ablation applications using therapeutic ultrasound. The role of both ultrasound and MRI in the monitoring and assessment of these therapies will be explored in both pre-clinical and clinical applications. Katherine Ferrara: High Intensity Focused Ultrasound, Drug Delivery, and Immunotherapy Rajiv Chopra: Translating Localized Doxorubicin Delivery to Pediatric Oncology using MRI-guided HIFU Elisa Konofagou: Real-time Ablation Monitoring and Lesion Quantification using Harmonic Motion Imaging Keyvan Farahani: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy Learning Objectives: Understand the role of ultrasound in localized drug delivery and the effects of immunotherapy when used in conjunction with ultrasound therapy. Understand potential targeted drug delivery clinical applications including pediatric oncology. Understand the technical requirements for performing targeted drug delivery. Understand how radiation-force approaches can be used to both monitor and assess high intensity focused ultrasound ablation therapy. Understand the role of AAPM task groups in ultrasound imaging and therapies. Chopra: Funding from Cancer Prevention and Research Initiative of Texas (CPRIT), Award R1308 Evelyn and M.R. Hudson Foundation; Research Support from Research Contract with Philips Healthcare; COI are Co-founder of FUS Instruments Inc Ferrara: Supported by NIH, UCDavis and California (CIRM and BHCE) Farahani: In-kind research support from Philips Healthcare

A miniature, wearable activity/fall monitor to assess the efficacy of mobility therapy for children with cerebral palsy during everyday living.

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Smith, Warren D; Bagley, Anita

2010-01-01

Children with cerebral palsy may have difficulty walking and may fall frequently, resulting in a decrease in their participation in school and community activities. It is desirable to assess the effectiveness of mobility therapies for these children on their functioning during everyday living. Over 50 hours of tri-axial accelerometer and digital video recordings from 35 children with cerebral palsy and 51 typically-developing children were analyzed to develop algorithms for automatic real-time processing of the accelerometer signals to monitor a child's level of activity and to detect falls. The present fall-detection algorithm has 100% specificity and a sensitivity of 100% for falls involving trunk rotation. Sensitivities for drops to the knees and to the bottom are 72% and 78%, respectively. The activity and fall-detection algorithms were implemented in a miniature, battery-powered microcontroller-based activity/fall monitor that the child wears in a small fanny pack during everyday living. The monitor continuously logs 1-min. activity levels and the occurrence and characteristics of each fall for two-week recording sessions. Pre-therapy and post-therapy recordings from these monitors will be used to assess the efficacies of alternative treatments for gait abnormalities.

Cognitive and Emotion Regulation Change Processes in Cognitive Behavioural Therapy for Social Anxiety Disorder.

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O'Toole, Mia S; Mennin, Douglas S; Hougaard, Esben; Zachariae, Robert; Rosenberg, Nicole K

2015-01-01

The objective of the study was to investigate variables, derived from both cognitive and emotion regulation conceptualizations of social anxiety disorder (SAD), as possible change processes in cognitive behaviour therapy (CBT) for SAD. Several proposed change processes were investigated: estimated probability, estimated cost, safety behaviours, acceptance of emotions, cognitive reappraisal and expressive suppression. Participants were 50 patients with SAD, receiving a standard manualized CBT program, conducted in groups or individually. All variables were measured pre-therapy, mid-therapy and post-therapy. Lower level mediation models revealed that while a change in most process measures significantly predicted clinical improvement, only changes in estimated probability and cost and acceptance of emotions showed significant indirect effects of CBT for SAD. The results are in accordance with previous studies supporting the mediating role of changes in cognitive distortions in CBT for SAD. In addition, acceptance of emotions may also be a critical component to clinical improvement in SAD during CBT, although more research is needed on which elements of acceptance are most helpful for individuals with SAD. The study's lack of a control condition limits any conclusion regarding the specificity of the findings to CBT. Change in estimated probability and cost, and acceptance of emotions showed an indirect effect of CBT for SAD. Cognitive distortions appear relevant to target with cognitive restructuring techniques. Finding acceptance to have an indirect effect could be interpreted as support for contemporary CBT approaches that include acceptance-based strategies. Copyright © 2014 John Wiley & Sons, Ltd.

The Stoplight Program: A Proactive Physical Therapy Intervention for Children With Acute Lymphoblastic Leukemia.

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Tanner, Lynn; Sencer, Susan; Hooke, Mary C

Chemotherapy may cause neuromuscular impairments that can have life-long effects. The Stoplight Program (SLP) was developed as a proactive physical therapy (PT) intervention directed at impairments in children with acute lymphoblastic leukemia (ALL). In this program evaluation, we assessed the feasibility of the SLP delivered as part of standard care and identified body function and activity patterns in patients who received the intervention. Children ages 1 to 22 years, diagnosed with ALL, received an assessment by a physical therapist as part of usual care. The SLP intervention used 3 levels to categorize the impairment levels and intensity of PT. Of the children (n = 135) screened, 46% completed 5 intervention visits and 32% completed the program and met discharge criteria. At initial assessment, 46% of children ages 1 to 5 years and 67% of children ages 6 to 22 years had abnormal motor function. Those completing the program tested within the healthy norms. Research is needed on variables that influence adherence to a PT program and the range of functional impairment and activity limitations in this population.

Social recovery therapy in combination with early intervention services for enhancement of social recovery in patients with first-episode psychosis (SUPEREDEN3): a single-blind, randomised controlled trial.

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Fowler, David; Hodgekins, Jo; French, Paul; Marshall, Max; Freemantle, Nick; McCrone, Paul; Everard, Linda; Lavis, Anna; Jones, Peter B; Amos, Tim; Singh, Swaran; Sharma, Vimal; Birchwood, Max

2018-01-01

Provision of early intervention services has increased the rate of social recovery in patients with first-episode psychosis; however, many individuals have continuing severe and persistent problems with social functioning. We aimed to assess the efficacy of early intervention services augmented with social recovery therapy in patients with first-episode psychosis. The primary hypothesis was that social recovery therapy plus early intervention services would lead to improvements in social recovery. We did this single-blind, phase 2, randomised controlled trial (SUPEREDEN3) at four specialist early intervention services in the UK. We included participants who were aged 16-35 years, had non-affective psychosis, had been clients of early intervention services for 12-30 months, and had persistent and severe social disability, defined as engagement in less than 30 h per week of structured activity. Participants were randomly assigned (1:1), via computer-generated randomisation with permuted blocks (sizes of four to six), to receive social recovery therapy plus early intervention services or early intervention services alone. Randomisation was stratified by sex and recruitment centre (Norfolk, Birmingham, Lancashire, and Sussex). By necessity, participants were not masked to group allocation, but allocation was concealed from outcome assessors. The primary outcome was time spent in structured activity at 9 months, as measured by the Time Use Survey. Analysis was by intention to treat. This trial is registered with ISRCTN, number ISRCTN61621571. Between Oct 1, 2012, and June 20, 2014, we randomly assigned 155 participants to receive social recovery therapy plus early intervention services (n=76) or early intervention services alone (n=79); the intention-to-treat population comprised 154 patients. At 9 months, 143 (93%) participants had data for the primary outcome. Social recovery therapy plus early intervention services was associated with an increase in structured

Effects of rational emotive occupational health therapy intervention on the perceptions of organizational climate and occupational risk management practices among electronics technology employees in Nigeria.

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Ogbuanya, Theresa Chinyere; Eseadi, Chiedu; Orji, Chibueze Tobias; Ede, Moses Onyemaechi; Ohanu, Ifeanyi Benedict; Bakare, Jimoh

2017-05-01

Improving employees' perception of organizational climate, and coaching them to remain steadfast when managing occupational risks associated with their job, might have an important effect on their psychosocial wellbeing and occupational health. This study examined the effects of a rational emotive occupational health therapy intervention program on the perceptions of organizational climate and occupational risk management practices. The participants were 77 electronics technology employees in the south-east of Nigeria. The study used a pretest-posttest control group design. The rational emotive occupational health therapy intervention program significantly improved perceptions of the organizational climate for the people in the treatment group compared to those in the waitlist control group at post-intervention and follow-up assessments. Occupational risk management practices of the employees in the treatment group were also significantly better than those in the waitlist control group at the same 2 assessments. Corporate application of a rational emotive behavior therapy as an occupational health therapy intervention program is essential for improving the perceptions of organizational climate and promoting the adoption of feasible occupational risk management strategies in the workplace.

Systematic reviews of randomised clinical trials examining the effects of psychotherapeutic interventions versus "no intervention" for acute major depressive disorder and a randomised trial examining the effects of "third wave" cognitive therapy versus mentalization-based treatment for acute major

DEFF Research Database (Denmark)

Jakobsen, Janus Christian

2014-01-01

systematic reviews with meta-analyses and trial sequential analyses using The Cochrane Collaboration methodology examining the effects of cognitive therapy and psycho-dynamic therapy for major depressive disorder. We developed a thorough treatment protocol for a randomised trial with low risks of bias...... therapy versus mentalisation-based treatment for major depressive disorder. The first systematic review included five randomised trials examining the effects of psychodynamic therapy versus "no intervention' for major depressive disorder. Altogether the five trials randomised 365 participants who in each...... this result. The second systematic review included 12 randomised trials examining the effects of cognitive therapy versus "no intervention" for major depressive disorder. Altogether a total of 669 participants were randomised. All trials had high risk of bias. Meta-analysis showed that cognitive therapy...

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

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Solomon, Susan; Simiyon, Manjula; Vedachalam, Ahalya

2016-04-01

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

The effectiveness of a short-term group music therapy intervention for parents who have a child with a disability.

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Williams, Kate E; Berthelsen, Donna; Nicholson, Jan M; Walker, Sue; Abad, Vicky

2012-01-01

The positive relationship between parent-child interactions and optimal child development is well established. Families of children with disabilities may face unique challenges in establishing positive parent-child relationships; yet, there are few studies examining the effectiveness of music therapy interventions to address these issues. In particular, these studies have been limited by small sample size and the use of measures of limited reliability and validity. This study examined the effectiveness of a short-term group music therapy intervention for parents of children with disabilities and explored factors associated with better outcomes for participating families. Participants were 201 mother-child dyads, where the child had a disability. Pre- and post-intervention parental questionnaires and clinician observation measures were completed to examine outcomes of parental wellbeing, parenting behaviors, and child development. Descriptive data, t-tests for repeated measures and a predictive model tested via logistic regression are presented. Significant improvements pre to post intervention were found for parent mental health, child communication and social skills, parenting sensitivity, parental engagement with child and acceptance of child, child responsiveness to parent, and child interest and participation in program activities. There was also evidence for high parental satisfaction and that the program brought social benefits to families. Reliable change on six or more indicators of parent or child functioning was predicted by attendance and parent education. This study provides positive evidence for the effectiveness of group music therapy in promoting improved parental mental health, positive parenting and key child developmental areas.

Physical Therapy Intervention to Augment Outcomes Of Lymph Node Transfer Surgery for a Breast Cancer Survivor with Secondary Upper Extremity Lymphedema: A Case Report.

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McKey, Katelyn P; Alappattu, Meryl J

Lymphedema is an incurable complication of breast cancer treatment that affects roughly 20 percent of women. It is often managed via complete decongestive therapy, which includes manual lymph drainage, therapeutic compression, skin care, and exercise. Lymph node transfer is a new and expensive surgical intervention that uses one's own lymph nodes and implants them in the affected upper extremity. Previous research has investigated augmenting lymph node transfer surgery with complete decongestive therapy, but there is a lack of evidence regarding the success of focusing lymph drainage against the normal pressure gradient toward a surgical flap located on the wrist. The patient's main motivation for the surgical intervention was to alleviate her daily burden of complete decongestive therapy. The purpose of this case report was to compare the methods and results of pre-surgical complete decongestive physical therapy to a post-operation modified approach that directed lymph fluid away from the major lymphatic ducts and instead toward a surgical flap on the wrist of a patient with lymphedema. A 65-year-old female presented with secondary upper extremity lymphedema following breast cancer treatment. Her circumferential measurements and L-Dex score corroborated this diagnosis, and she had functional deficits in upper extremity range of motion. She was seen for 10 visits of traditional complete decongestive therapy prior to her lymph node transfer surgery and 24 treatments of modified complete decongestive therapy over the course of six months following surgery. At six months, the patient had minor improvements in the Functional Assessment of Chronic Illness Therapy-Fatigue, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion, and upper extremity strength. However, her circumferential measurements and L-Dex scores showed a meaningful increase in limb girth. The patient's smallest upper extremity volumes were documented before the operation after two

Systematic reviews of randomised clinical trials examining the effects of psychotherapeutic interventions versus "no intervention" for acute major depressive disorder and a randomised trial examining the effects of "third wave" cognitive therapy versus mentalization-based treatment for acute major depressive disorder.

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Jakobsen, Janus Christian

2014-10-01

Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Cognitive therapy and psychodynamic therapy may be effective treatment options for major depressive disorder, but the effects have only had limited assessment in systematic reviews. The two modern forms of psychotherapy, "third wave" cognitive therapy and mentalization-based treatment, have both gained some ground as treatments of psychiatric disorders. No randomised trial has compared the effects of these two interventions for major depressive disorder. We performed two systematic reviews with meta-analyses and trial sequential analyses using The Cochrane Collaboration methodology examining the effects of cognitive therapy and psycho-dynamic therapy for major depressive disorder. We developed a thorough treatment protocol for a randomised trial with low risks of bias (systematic error) and low risks of random errors ("play of chance") examining the effects of third wave' cognitive therapy versus mentalization-based treatment for major depressive disorder. We conducted a randomised trial according to good clinical practice examining the effects of "third wave" cognitive therapy versus mentalisation-based treatment for major depressive disorder. The first systematic review included five randomised trials examining the effects of psychodynamic therapy versus "no intervention' for major depressive disorder. Altogether the five trials randomised 365 participants who in each trial received similar antidepressants as co-interventions. All trials had high risk of bias. Four trials assessed "interpersonal psychotherapy" and one trial "short psychodynamic supportive psychotherapy". Both of these interventions are different forms of psychodynamic therapy. Meta-analysis showed that psychodynamic therapy significantly reduced depressive symptoms on the Hamilton Depression Rating Scale (HDRS) compared with "no intervention" (mean difference -3.01 (95

Internet-based self-help therapy with FearFighter™ versus no intervention for anxiety disorders in adults

DEFF Research Database (Denmark)

Fenger, Morten; Lindschou, Jane; Gluud, Christian

2016-01-01

BACKGROUND: Internet-based self-help psychotherapy (IBT) could be an important alternative or supplement to ordinary face-to-face therapy. The findings of randomised controlled trials indicate that the effects of various IBT programmes for anxiety disorders seem better than no intervention...... and in some instances are equivalent to usual therapy. In Denmark, IBT is part of future treatment plans in mental health care services, but the verification level of the current clinical scientific knowledge is insufficient. The objective of this trial is feasibility assessment of benefits and harms...

Interventional therapy of hyperthyroidism

International Nuclear Information System (INIS)

Liang Jun; Yang Shibin; Yue Yu; Chen Tingcong

2001-01-01

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

Variation of hepatic artery on arteriogram and its clinical significance in interventional therapy for hepatic cancer

International Nuclear Information System (INIS)

Wang Xiaodong; Yang Renjie

2009-01-01

Objective: To investigate the variations of hepatic artery and its extrahepatic arteries on hepatic arteriogram and to provide benefit for transhepatic arterical chemoemblization. Methods: The hepatic arteriograms of 200 cases with unresectable hepatic malignant tumor before interventional therapy were analysed. Two interventional radiologists in common reviewed the incidences of various types according to Michels' classification, the absence of proper hepatic artery, and the variations of extrahepatic arteries originating from hepatic artery. Results: The most common hepatic artery variation was Michels type III(n=17,8.5%), followed by type II(n=10,5.0%) and V(n=9,4.5%). Proper hepatic absence was found in 25 cases and appeared as 5 subtypes. 5 kinds of extrahepatic arteries were found. The most common extrahepatic artery was the right gastric artery (n=156,78.0%), followed by cystic artery (n=126,63.0%), accessory left gastric artery (n=19,9.5%), the hepatic falciform artery (n=5,2.5%), and accessory left inferior phrenic artery (n=4,2.0%). Conclusion: There are some other variations of hepatic artery beside Michels' classification,and there are many variations of extrahepatic arteries originating from hepatic artery, it is important to assure interventional therapy effect for hepatic cancer and prevent complication. (authors)

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

NARCIS (Netherlands)

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

2011-01-01

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

The causes and the nursing interventions of the complications due to repeated embolization therapy for huge cerebral arteriovenous malformations

International Nuclear Information System (INIS)

Sun Lingfang; Sun Ge

2010-01-01

Objective: To investigate the causes of the complications occurred after repeated embolization therapy for huge cerebral arteriovenous malformations and to discuss their nursing interventions. Methods: A total of 54 embolization procedures were performed in 17 patients with huge cerebral arteriovenous malformations. The clinical data were retrospectively analyzed. The causes of complications were carefully examined and the preventive measures were discussed. The prompt and necessary nursing interventions were formulated in order to prevent the complications or serious consequences. Results: Among the total 17 patients, one patient gave up the treatment because of the cerebral hemorrhage which occurred two months after receiving 3 times of embolization therapy. One patient experienced cerebral vascular spasm during the procedure, which was relieved after antispasmodic medication and no neurological deficit was left behind. Two patients developed transient dizziness and headache, which were alleviated spontaneously. One patient presented with nervousness, fear and irritability, which made him hard to cooperate with the operation and the basis intravenous anesthesia was employed. No complications occurred in the remaining cases. Conclusion: The predictive nursing interventions for the prevention of complications are very important for obtaining a successful repeated embolization therapy for huge cerebral arteriovenous malformations, which will ensure that the patients can get the best treatment and the complications can be avoided. (authors)

Behaviour therapy for obesity treatment considering approved drug therapy

Directory of Open Access Journals (Sweden)

Wasem, Jürgen

2008-05-01

interventions of media alone as well as through the intervention of media in conjunction with personal support within the groups. However, analyses of the inter-group comparisons offer no statistically significant difference. However, analyses of the inter-group comparisons offer no statistically significant difference. Comparative analyses confirm the effectiveness of behaviour therapy in combination with additional drug treatment when compared to behaviour therapy alone.In all the studies presented here, relevant changes in weight of -5% to -10% are only partially achieved. High weight losses of less than -10% were found among the intervention group in two of the studies. One study reported a weight loss of -11.4% with the “group therapy” intervention method, while another study reported a weight loss of -11.2% with the “behaviour therapy plus drug treatment” intervention method. Studies with a subsequent follow-up period indicate a clear weight loss at the end of the intervention followed by a renewed weight gain towards the end of the follow-up period.For the evaluation of economic, social-ethical or legal aspects we could not identify any studies. Discussion: A comparative assessment among the studies proved difficult due to their heterogeneous nature. Little conformity can be detected in either the contents of the behaviour therapy or in the treatment plans. The length of the follow-up periods also varies from study to study. Many studies only analyze weight changes within one group or for the entire study population. However, the results of these analyses all indicate a significant weight loss at the end of the intervention. Conclusion: Some effects of behaviour therapy on a reduction in weight can be shown. However, relevant weight changes of -5% to -10% are only achieved to a certain extent. The extremely heterogeneous nature of the interventions makes a comparison of the study results very difficult. A trend can be detected indicates that those treatments

Using Contact Work in Interactions with Adults with Learning Disabilities and Autistic Spectrum Disorders

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Brooks, Sharon; Paterson, Gail

2011-01-01

This article describes a project about using contact work with people with learning disabilities and autistic spectrum disorder. People with learning disabilities and additional autistic spectrum disorder are at risk of becoming socially isolated because of their difficulties in interacting with others. Contact work is a form of Pre-Therapy, which…

Anger management in substance abuse based on cognitive behavioral therapy: an interventional study.

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Zarshenas, Ladan; Baneshi, Mehdi; Sharif, Farkhondeh; Moghimi Sarani, Ebrahim

2017-11-23

Anger and aggression have been developing notably in societies, especially among patients depending on substance abuse. Therefore, this study aimed to investigate the effect of anger management based on group education among patients depending on substances according to Patrick Reilly's cognitive behavioral approach. In a quasi- experimental study, all patients who met the inclusion criteria were evaluated regarding their aggression level. The participants were assigned to 12 educational sessions based on group therapy and Patrick-Reilly's anger management by focusing on using a combination of cognitive intervention, relaxation, and communication skills. The data were analyzed using the SPSS statistical software, version 16. The findings showed a significant difference between the two groups regarding aggression level after the intervention (p = 0.001). No significant relationship was observed between aggression level and demographic variables (p > 0.05). The intervention of this study can be used for establishing self-management and decreasing anger among patients depending on substances. They can also be used as a therapeutic program in addition to pharmacotherapy. IRCT2016102030398N1 .

Disability and recovery in schizophrenia: a systematic review of cognitive behavioral therapy interventions.

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Nowak, Izabela; Sabariego, Carla; Świtaj, Piotr; Anczewska, Marta

2016-07-11

Schizophrenia is a disabling disease that impacts all major life areas. There is a growing need for meeting the challenge of disability from a perspective that extends symptomatic reduction. Therefore, this study aimed to systematically review the extent to which traditional and "third wave" cognitive - behavioral (CBT) interventions address the whole scope of disabilities experienced by people with lived experience of schizophrenia using the WHO's International Classification of Functioning, Disability and Health (ICF) as a frame of reference. It also explores if current CBT interventions focus on recovery and what is their impact on disability domains. Medline and PsycINFO databases were searched for studies published in English between January 2009 and December 2015. Abstracts and full papers were screened against pre-defined selection criteria by two reviewers. Methodological quality of included studies was assessed by two independent raters using the Effective Public Health Practice Project Quality assessment tool for quantitative studies (EPHPP) guidelines. A total of 50 studies were included, 35 studies evaluating traditional CBT interventions and 15 evaluating "third wave" approaches. Overall, traditional CBT interventions addressed more disability domains than "third wave" approaches and mostly focused on mental functions reflecting schizophrenia psychopathology. Seven studies met the inclusion criteria of recovery-oriented interventions. The majority of studies evaluating these interventions had however a high risk of bias, therefore evidence on their effectiveness is inconclusive. Traditional CBT interventions address more disability domains than "third wave" therapies, however both approaches focus mostly on mental functions that reflect schizophrenia psychopathology. There are also few interventions that focus on recovery. These results indicate that CBT interventions going beyond symptom reduction are still needed. Recovery-focused CBT interventions

PACS for surgery and interventional radiology: features of a Therapy Imaging and Model Management System (TIMMS).

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Lemke, Heinz U; Berliner, Leonard

2011-05-01

Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the "image-centric world view" of the classical PACS technology is complemented by an IT "model-centric world view". Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve

PACS for surgery and interventional radiology: Features of a Therapy Imaging and Model Management System (TIMMS)

International Nuclear Information System (INIS)

Lemke, Heinz U.; Berliner, Leonard

2011-01-01

Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the 'image-centric world view' of the classical PACS technology is complemented by an IT 'model-centric world view'. Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve

Effects of a Cognitive Behavioral Therapy Intervention Trial to Improve Disease Outcomes in Children with Inflammatory Bowel Disease.

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Levy, Rona L; van Tilburg, Miranda A L; Langer, Shelby L; Romano, Joan M; Walker, Lynn S; Mancl, Lloyd A; Murphy, Tasha B; Claar, Robyn L; Feld, Shara I; Christie, Dennis L; Abdullah, Bisher; DuPen, Melissa M; Swanson, Kimberly S; Baker, Melissa D; Stoner, Susan A; Whitehead, William E

2016-09-01

Studies testing the efficacy of behavioral interventions to modify psychosocial sequelae of inflammatory bowel disease in children are limited. This report presents outcomes through a 6-month follow-up from a large randomized controlled trial testing the efficacy of a cognitive behavioral intervention for children with inflammatory bowel disease and their parents. One hundred eighty-five children aged 8 to 17 years with a diagnosis of Crohn's disease or ulcerative colitis and their parents were randomized to one of two 3-session conditions: (1) a social learning and cognitive behavioral therapy condition or (2) an education support condition designed to control for time and attention. There was a significant overall treatment effect for school absences due to Crohn's disease or ulcerative colitis (P cognitive behavioral therapy condition experienced a greater reduction in flares after treatment. This trial suggests that a brief cognitive behavioral intervention for children with inflammatory bowel disease and their parents can result in improved child functioning and quality of life, and for some children may decrease disease activity.

Feasibility Study of a Mobile Health Intervention for Older Adults on Oral Anticoagulation Therapy

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Jung-Ah Lee PhD, RN

2016-10-01

Full Text Available Background: Oral anticoagulation treatment (OAT such as warfarin therapy is recommended for older adults with atrial fibrillation, heart failure, or who are at risk for venous thromboembolism. Despite its proven benefits, older adults report both dissatisfaction with OAT and reduced quality of life that can potentially lead to low adherence to OAT and decreased treatment efficacy. Objective: To test the feasibility of Mobile Applications for Seniors to enhance Safe anticoagulation therapy (MASS, a mobile-based health technology intervention designed to promote independence and self-care. Method s: This pilot study used a single-arm experimental pre–post design to test the feasibility of a 3-month intervention using MASS in 18 older adults (male: n = 14; White: n = 9; Hispanic: n = 7; Other: n = 2; M age = 67. MASS was available in English or Spanish. Participants completed surveys about their OAT knowledge, attitudes, quality of life with OAT, and adherence at baseline and at a 3-month follow-up. Satisfaction with the MASS intervention was also assessed at follow-up. Results: Anticoagulation knowledge significantly improved from baseline to follow-up ( M base = 12.5 ± 5.51, M follow-up = 14.78 ± 3.93, p = .007. Other outcomes were not different, pre- and post-tests. Participants reported they were generally satisfied with MASS, its ease of use and its usefulness. Conclusion: The results showed use of MASS improved older adults’ knowledge of OAT. Using mHealth apps may enhance self-care among older adults with chronic conditions who are also taking oral anticoagulants.

LEGO therapy and the social use of language programme: an evaluation of two social skills interventions for children with high functioning autism and Asperger Syndrome.

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Owens, Gina; Granader, Yael; Humphrey, Ayla; Baron-Cohen, Simon

2008-11-01

LEGO therapy and the Social Use of Language Programme (SULP) were evaluated as social skills interventions for 6-11 year olds with high functioning autism and Asperger Syndrome. Children were matched on CA, IQ, and autistic symptoms before being randomly assigned to LEGO or SULP. Therapy occurred for 1 h/week over 18 weeks. A no-intervention control group was also assessed. Results showed that the LEGO therapy group improved more than the other groups on autism-specific social interaction scores (Gilliam Autism Rating Scale). Maladaptive behaviour decreased significantly more in the LEGO and SULP groups compared to the control group. There was a non-significant trend for SULP and LEGO groups to improve more than the no-intervention group in communication and socialisation skills.

Electroconvulsive Therapy Intervention for Parkinson's Disease.

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Narang, Puneet; Glowacki, Anna; Lippmann, Steven

2015-01-01

Electroconvulsive therapy is an established means to improve function in a variety of psychiatric and neurologic conditions, particularly for patients who remain treatment-refractory. Parkinson's disease is a neurodegenerative disorder that sometimes does not respond well to conventional pharmacotherapies. Reports have indicated that electroconvulsive therapy may be an effective and safe treatment for those patients with Parkinson's disease who are not optimally responding to first-line treatments. Despite these reports, however, electroconvulsive therapy is not often used by clinicians in patients with treatment-resistant Parkinson's disease, perhaps due to stigma, lack of knowledge regarding its safety and efficacy, and/or inability to predict the duration of therapeutic benefit. Our objective was to determine if the available literature on ECT supports it as a safe and effective treatment option in patients with treatment-refractory Parkinson's disease. Motoric improvement induced by electroconvulsive therapy has been documented for decades in persons with Parkinson's disease. Efficacy and safety are reported following electroconvulsive therapy in people with Parkinson's disease who have sub-optimal response to medicines or experience the "on/off" phenomenon to L-dopa. Electroconvulsive therapy is an effective option for acute and maintenance treatment of Parkinson's disease in select patients. Inability to predict how long the beneficial effects of ECT therapy will last in patients with Parkinson's disease may be a reason why this treatment is underutilized by clinicians. More research is warranted to clarify parameters for application and duration of therapeutic benefit in individuals with difficult-to-treat Parkinson's disease.

Effect of Cognitive Behavior Therapy (CBT Intervention on Serum Cortisol Level and Pain Score of Patients with Advanced-Stage Cervical Cancer

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. Soetrisno

2016-12-01

Full Text Available ABSTRACT Cervical cancer is the most frequent cause of death related gynecology malignancy in Indonesia. Recent management of advanced-stage cervical cancer has still not been able to improve the prognosis. Chemotherapy and radiation intervention, as well as therapy may resulting pain and cause psychological stress for some patient, furthermore it could effect on the quality of life. Cortisol is a hormone of adrenal cortex, it secretes due to increased production of ACTH by anterior pituitary which is associated with stressful condition. To analyze the effect of Cognitive Behavior Therapy (CBT intervention on serum cortisol levels and pain score of patients with advanced-stage cervical cancer. This experimental study was a double blind non-randomized clinical trial post-test group design. It was using two groups in this study, each group consisting of 15 subjects, the treatment group were given CBT and standard therapy, while the control group were only given a standard therapy. The study was conducted in the gynecology oncology ward and the gynecology oncology clinic of Dr. Moewardi Hospital Surakarta and Prodia Laboratory, from January - March 2015. Cortisol level of the treatment group was 1.03 ± 0.71 mg / dL, and the control group was 11.41 ± 7.34 mg / dL. Pain score in the treatment group was 4.46 ± 0.83, and the control group was 7.34 ± 0.74. There are significant differences in serum cortisol level decrease (p = 0.00 and pain score (p = 0.00 between the CBT intervention with standard therapy group compared and the standard therapy only group

Effects of rational emotive occupational health therapy intervention on the perceptions of organizational climate and occupational risk management practices among electronics technology employees in Nigeria

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Ogbuanya, Theresa Chinyere; Eseadi, Chiedu; Orji, Chibueze Tobias; Ede, Moses Onyemaechi; Ohanu, Ifeanyi Benedict; Bakare, Jimoh

2017-01-01

Abstract Background: Improving employees’ perception of organizational climate, and coaching them to remain steadfast when managing occupational risks associated with their job, might have an important effect on their psychosocial wellbeing and occupational health. This study examined the effects of a rational emotive occupational health therapy intervention program on the perceptions of organizational climate and occupational risk management practices. Methods: The participants were 77 electronics technology employees in the south-east of Nigeria. The study used a pretest–posttest control group design. Results: The rational emotive occupational health therapy intervention program significantly improved perceptions of the organizational climate for the people in the treatment group compared to those in the waitlist control group at post-intervention and follow-up assessments. Occupational risk management practices of the employees in the treatment group were also significantly better than those in the waitlist control group at the same 2 assessments. Conclusions: Corporate application of a rational emotive behavior therapy as an occupational health therapy intervention program is essential for improving the perceptions of organizational climate and promoting the adoption of feasible occupational risk management strategies in the workplace. PMID:28471971

Integrative Music Therapy: A Healing Intervention.

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Barnes, Thomas Bryan

Music plays a significant role in the lives of individuals across the lifespan. Some healthcare providers may not appreciate music therapy and the positive benefits it can have on the environment, patients, caregivers, and healthcare staff. Integrative Music Therapy (IMT) has proven to be effective in multiple settings, offering therapy for behavioral, emotional, physiological, psychological, and psychosocial needs. IMT, performed by a trained, certified professional (MT-BC), does not seek to replace medication or other procedures, but works synergistically with provided healthcare.

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

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Alejandrina Alucema

2015-02-01

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

Superwellness Program: a cognitive-behavioral therapy-based group intervention to reduce weight gain in patients treated with antipsychotic drugs

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Laura R. Magni

2017-03-01

Full Text Available Objective: To assess the effectiveness of a cognitive-behavioral therapy-based intervention (Superwellness Program on weight gain compared with a treatment-as-usual (TAU approach in patients treated with antipsychotics, and to evaluate the relationship between body mass index (BMI variation and clinical variables. Method: Eighty-five patients treated with antipsychotics were allocated across two groups, experimental (n=59 and control (n=26. The Superwellness Program (experimental group consisted of 32 twice-weekly 1-hour sessions, conducted by a psychologist and a nutritionist/nurse, concurrently with moderate food intake and moderate physical activity plans. Sociodemographic, clinical, and biological variables were collected at baseline, at the end of intervention (16 weeks, and after 6 months. Results: BMI change from baseline differed significantly between the experimental and control groups, with a larger decrease in the experimental group (F = 5.5, p = 0.021. Duration of illness moderated the effect of treatment on BMI (p = 0.026. No significant (p = 0.499 effect of intervention during the follow-up period was found. Interestingly, the intervention indirectly induced a significant (p = 0.024 reduction in metabolic risk by reducing BMI. Conclusion: A cognitive-behavioral therapy-based intervention could be useful in reducing weight in a clinical population taking antipsychotics, with consequent benefit to physical and mental health.

Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 2. Impact of Multidisciplinary Rehabilitation and Psychosocial, Sexuality, and Return-to-Work Interventions.

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Hunter, Elizabeth G; Gibson, Robert W; Arbesman, Marian; D'Amico, Mariana

This article is the second part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the use of multidisciplinary rehabilitation and interventions that address psychosocial outcomes, sexuality, and return to work. Strong evidence indicates that multidisciplinary rehabilitation benefits cancer survivors and that psychosocial strategies can reduce anxiety and depression. Moderate evidence indicates that interventions can support survivors in returning to the level of sexuality desired and help with return to work. Part 1 of the review also appears in this issue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Helping Older Adults Sustain Their Physical Therapy Gains: A Theory-Based Intervention to Promote Adherence to Home Exercise Following Rehabilitation.

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Gallagher, Kristel M

2016-01-01

The benefits of exercise gained by older adults during physical therapy are often not maintained once the program is over. This lack of sustained benefits is thought to be partially the result of poor adherence to the prescribed home exercise program to be continued once therapy is completed. Most of what is known about older adults' adherence to physical therapy and home exercise comes from research seeking to identify and understand predictors of adherence, rather than trying to enhance adherence explicitly. The purpose of this study was to test a theoretically grounded approach to promoting adherence to home exercise programs in older adults. Sixty older adults (M age = 69.3 (6.87) years) in a program of physical therapy received 1 of 2 print messages and magnets promoting adherence to home exercise. The content of the messages was informed by the goal-specific tenets of socioemotional selectivity theory-one message described the emotional and meaningful benefits of home exercise, such as time with loved ones and independence, and one message described facts and information about physiological benefits, such as balance and strength. Adherence to home exercise was measured 2 weeks after participants were discharged from physical therapy by calculating the percentage of the prescribed exercises participants reported completing at home. An analysis of covariance indicated that there was no statistically significant difference in adherence rates between participants receiving either message. However, a 2×2 analysis of covariance did reveal a significant interaction between the type of message participants received and the time at which they received that message. Post hoc analyses separately examined the rates of adherence in participants who received the intervention message with time remaining in their therapy program and participants who received the intervention message on the day of discharge. In the subset of participants who received their intervention

The effect of outpatient physical therapy intervention on pelvic floor muscles in women with urinary incontinence

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Mara R. Knorst

2013-10-01

Full Text Available OBJECTIVE: To assess the effect of a weekly, short-term physical therapy intervention on the pelvic floor muscles and urinary incontinence (UI among patients of the public health system. METHOD: Quasi-experimental before-and-after study. Clinical history and function evaluation were performed using perineal bidigital maneuvers and perineometry. The intervention consisted of transvaginal electrical stimulation and pelvic floor kinesiotherapy. Data were analyzed using the paired t test or Wilcoxon signed-rank test, Pearson product-moment correlation coefficient or Spearman's rank correlation coefficient. A value of P<0.05 was considered significant. RESULTS: Eight-two women 55.1±10.9 years-old were evaluated. Mixed urinary incontinence (MUI, stress urinary incontinence (SUI and urge urinary incontinence (UUI were observed in 52.4%, 36.6% and 11%, respectively. The length of UI was 6.0 years (3.0-10. Approximately 13.64 physical therapy sessions were held on average. There was no difference in perineometry measurements following the intervention (40.6±24.1 versus 41.7±25.4, P=0.098. Muscle function significantly increased (P<0.01 in the bidigital maneuver. The patients reported being continent or satisfied with the treatment in 88.9% of cases. CONCLUSIONS: The results demonstrated an increase in muscle function and the attainment of urinary continence or treatment satisfaction in most cases.

Medical therapy, percutaneous coronary intervention and prognosis in patients with chronic total occlusions.

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Ladwiniec, Andrew; Allgar, Victoria; Thackray, Simon; Alamgir, Farquad; Hoye, Angela

2015-12-01

There is little published data reporting outcomes for those found to have a chronic total coronary occlusion (CTO) that is electively treated medically versus those treated by percutaneous coronary intervention (PCI). We sought to compare long-term clinical outcomes between patients treated by PCI and elective medical therapy in a consecutive cohort of patients with an identified CTO. Patients found to have a CTO on angiography between January 2002 and December 2007 in a single tertiary centre were identified using a dedicated database. Those undergoing CTO PCI and elective medical therapy to the CTO were propensity matched to adjust for baseline clinical and angiographic differences. In total, 1957 patients were identified, a CTO was treated by PCI in 405 (20.7%) and medical therapy in 667 (34.1%), 885 (45.2%) patients underwent coronary artery bypass graft surgery. Of those treated by PCI or medical therapy, propensity score matching identified 294 pairs of patients, PCI was successful in 177 patients (60.2%). All-cause mortality at 5 years was 11.6% for CTO PCI and 16.7% for medical therapy HR 0.63 (0.40 to 1.00, p=0.052). The composite of 5-year death or myocardial infarction occurred in 13.9% of the CTO PCI group and 19.6% in the medical therapy group, HR 0.64 (0.42 to 0.99, p=0.043). Among the CTO PCI group, if the CTO was revascularised by any means during the study period, 5-year mortality was 10.6% compared with 18.3% in those not revascularised in the medical therapy group, HR 0.50 (0.28-0.88, p=0.016). Revascularisation, but not necessarily PCI of a CTO, is associated with improved long-term survival relative to medical therapy alone. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The use of exercise interventions to overcome adverse effects of androgen deprivation therapy

DEFF Research Database (Denmark)

Østergren, Peter Busch; Kistorp, Caroline; Bennedbæk, Finn Noe

2016-01-01

Androgen deprivation therapy (ADT) induces severe hypogonadism and is associated with several adverse effects that negatively affect health and quality of life in patients with prostate cancer. ADT changes body composition characterized by an increase in fat mass and a reduction in muscle mass....... Some studies also indicate that exercise might moderate ADT-related changes in body composition. However, beneficial effects of exercise interventions on other ADT-related conditions have not been conclusively proven. Trials investigating the effects of ADT on fracture risk and development of diabetes...

[Therapy-resistant and therapy-refractory arterial hypertension].

Science.gov (United States)

Wallbach, M; Koziolek, M J

2018-05-02

Therapy-resistant and therapy-refractory arterial hypertension differ in prevalence, pathogenesis, prognosis and therapy. In both cases, a structured approach is required, with the exclusion of pseudoresistance and, subsequently, secondary hypertension. Resistant hypertension has been reported to be more responsive to intensified diuretic therapy, whereas refractory hypertension is presumed to require sympathoinhibitory therapy. Once the general measures and the drug-based step-up therapy have been exhausted, interventional procedures are available.

Results Of A Lifestyle Intervention Involving Healthy Diet, Exercise and Cognitive Behavioral Therapy In Polycystic Ovary Syndrome (PCOS)

NARCIS (Netherlands)

L.G. Jiskoot (Geranne); R. Timman (Reinier); A. Beerthuizen (Annemerle); Dietz de Loos, A (Alexandra); J.J. van Busschbach (Jan); J.S.E. Laven (Joop)

2018-01-01

markdownabstract_Context_ Long-term weight loss is important for women with polycystic ovary syndrome. Although no protocol exist for effective and long-term weight loss in this population. Three-component interventions including diet, exercise, and cognitive behavioral therapy (CBT) have shown

Early Intervention in Children (0–6 Years with a Rare Developmental Disability: The Occupational Therapy Role

Directory of Open Access Journals (Sweden)

Lucy Dall'Alba

2014-12-01

Conclusion: Family-centred practice, play therapy, and individually tailored programmes are identified as key practice areas for this population. The important role occupational therapists play in early intervention teams is highlighted; however, further research is needed to develop the evidence base for best practice with particular rare developmental conditions.

Predictors of receiving therapy among very low birth weight 2-year olds eligible for Part C early intervention in Wisconsin.

Science.gov (United States)

McManus, Beth Marie; Robert, Stephanie; Albanese, Aggie; Sadek-Badawi, Mona; Palta, Mari

2013-07-11

The Individuals with Disabilities Education Act (Part C) authorizes states to establish systems to provide early intervention services (e.g., therapy) for children at risk, with the incentive of federal financial support. This study examines family and neighborhood characteristics associated with currently utilizing physical, occupational, or speech therapy among very low birthweight (VLBW) 2-year-old children who meet Wisconsin eligibility requirements for early intervention services (EI) due to developmental delay. This cross-sectional analysis used data from the Newborn Lung Project, a regional cohort study of VLBW infants hospitalized in Wisconsin's newborn intensive care units during 2003-2004. We included the 176 children who were age two at follow-up, and met Wisconsin state eligibility requirements for EI based on developmental delay. Exact logistic regression was used to describe child and neighborhood socio-demographic correlates of parent-reported receipt of therapy. Among VLBW children with developmental delay, currently utilizing therapy was higher among children with Medicaid (aOR = 5.3, 95% CI: 1.3, 28.3) and concomitant developmental disability (aOR = 5.2, 95% CI: 2.1, 13.3) and lower for those living in a socially more disadvantaged neighborhood (aOR=0.48, 95% CI: 0.21, 0.98, per tertile). Among a sample of VLBW 2-year olds with developmental delays who are EI-eligible in WI, 4 out of 5 were currently receiving therapy, per parent report. Participation in Medicaid positively influences therapy utilization. Children with developmental difficulties who live in socially disadvantaged neighborhoods are at highest risk for not receiving therapy.

Parent-Child Interaction Therapy (PCIT) in school-aged children with specific language impairment.

Science.gov (United States)

Allen, Jessica; Marshall, Chloë R

2011-01-01

Parents play a critical role in their child's language development. Therefore, advising parents of a child with language difficulties on how to facilitate their child's language might benefit the child. Parent-Child Interaction Therapy (PCIT) has been developed specifically for this purpose. In PCIT, the speech-and-language therapist (SLT) works collaboratively with parents, altering interaction styles to make interaction more appropriate to their child's level of communicative needs. This study investigates the effectiveness of PCIT in 8-10-year-old children with specific language impairment (SLI) in the expressive domain. It aimed to identify whether PCIT had any significant impact on the following communication parameters of the child: verbal initiations, verbal and non-verbal responses, mean length of utterance (MLU), and proportion of child-to-parent utterances. Sixteen children with SLI and their parents were randomly assigned to two groups: treated or delayed treatment (control). The treated group took part in PCIT over a 4-week block, and then returned to the clinic for a final session after a 6-week consolidation period with no input from the therapist. The treated and control group were assessed in terms of the different communication parameters at three time points: pre-therapy, post-therapy (after the 4-week block) and at the final session (after the consolidation period), through video analysis. It was hypothesized that all communication parameters would significantly increase in the treated group over time and that no significant differences would be found in the control group. All the children in the treated group made language gains during spontaneous interactions with their parents. In comparison with the control group, PCIT had a positive effect on three of the five communication parameters: verbal initiations, MLU and the proportion of child-to-parent utterances. There was a marginal effect on verbal responses, and a trend towards such an effect

Occupational Therapy Intervention in a child with Cri-du-Chat Syndrome: a case study

Directory of Open Access Journals (Sweden)

Gabriela Caseiro

2013-04-01

Full Text Available Cri-du-Chat syndrome is a chromosomal abnormality that can result in several damages including developmental delay and intellectual disability of the affected child. This case study describes the occupational therapy intervention in a child with Cri-du-chat syndrome that was followed from two to four years old, in weekly sessions, at a school hospital in the state of São Paulo. Data from medical records, family reports, and occupational therapy sessions were used for case description. The initial assessment showed that the child was hypotonic, stood up only with support, and explored objects by taking them to the mouth. Occupational Therapy assistance aimed to stimulate sensorimotor performance skills (perceptual, neuromuscleskeletal and motor processing and cognitive integration and components (attention spectrum, sequencing, and learning, through make-believe activities and participation in the activities of daily living (ADL. Moreover, it was also necessary to intervene directly in the school context and the child’s family, advising parents to avoid overprotection. Through the jointffort of the multidisciplinary team and the child’s family, it was possible to contribute to the improvement of bodily functions, allowing an increase in activities and participation, considering the child’s personal factors and environmental conditions, with consequent discharge from ambulatory attendance of occupational therapy.

The Effects of Music Therapy on the Physiological Response of Asthmatic Children Receiving Inhalation Therapy.

Science.gov (United States)

Roslita, Riau; Nurhaeni, Nani; Wanda, Dessie

The clinical manifestation of asthma in children can interfere with their daily activities. Music therapy may become one of the alternative approaches to making children feel comfortable during inhalation therapy. The aim of the study was to identify the effects of music therapy on the physiological response of asthmatic preschool and school-age children receiving inhalation therapy. This study used a quasi-experimental, nonequivalent control group with a pre-test-post-test design. The 44 respondents consisted of preschool and school-age children assigned to intervention and control groups. The results showed a significant difference in average oxygen saturation, heart rate, and respiratory rate between the control and intervention groups before and after intervention (p Music therapy can be used as a nursing intervention to improve the physiological response of children with breathing problems.

Cerebral blood flow in hypothyroidism: Response to therapy and associated cognitive performance

International Nuclear Information System (INIS)

Ilgin, N.; Akdemir, U.O.; Yetkin, I.; Eroglu, A.

2002-01-01

Hypothyroidism is often associated with defective memory, psychomotor slowing and depression. However, the relationship between thyroid status, related cognitive state and associated cerebral circulatory and/or metabolic abnormalities have not been elucidated. Purpose: The aim of this study was to evaluate pre-and post-therapy brain perfusion patterns in 9 hypothyroid patients presenting with Hashimoto thyroiditis. Method: Patients were referred on the basis of abnormal levels of anti-thyroglobulin and anti-microsomal antibodies, hypothyroidism and symptoms of cognitive dysfunction. Cognitive performance was tested using Raven's Coloured Progressive Matrices and Bender Gestalt Test. Functional evaluation of the brain was also performed via the methods of electroencephalography (EEG) and single photon emission tomography (SPECT). An initial SPECT study was carried out after I.V. injection of Tc99m-HMPAO and semiquantitative rCBF analysis was performed by drawing irregular regions of interest (ROIs) in three slices. A total number of 12 sector regions of interest placed on the two hemispheres and regional cerebral blood flow (rCBF) was determined using cortical region/cerebellum ratios obtained in each hemisphere. A repeat SPECT study was undertaken in 5 subjects 3-6 months after the initiation of medical therapy. Results: Pre-therapy perfusion data in four patients showed that the cortical ratios were globally depressed at the levels of 0.65-0.85 where these ratios improved quickly to the near normal-above normal levels (range of rCBF improvement as % difference from baseline 25%-45%) within 3-4 months of therapy. Conclusion: These results indicate that brain activity was globally decreased in severe hypothyroidism of short duration which normalized steadily as the hypothyroid state is corrected

A randomized trial of a cognitive-behavioral therapy and hypnosis intervention on positive and negative affect during breast cancer radiotherapy

OpenAIRE

Schnur, Julie B.; David, Daniel; Kangas, Maria; Green, Sheryl; Bovbjerg, Dana H.; Montgomery, Guy H.

2009-01-01

Breast cancer radiotherapy can be an emotionally difficult experience. Despite this, few studies have examined the effectiveness of psychological interventions to reduce negative affect, and none to date have explicitly examined interventions to improve positive affect among breast cancer radiotherapy patients. The present study examined the effectiveness of a multimodal psychotherapeutic approach, combining cognitive-behavioral therapy and hypnosis (CBTH), to reduce negative affect and incre...

The "Robustness" of Vocabulary Intervention in the Public Schools: Targets and Techniques Employed in Speech-Language Therapy

Science.gov (United States)

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

2014-01-01

This study examined vocabulary intervention--in terms of targets and techniques--for children with language impairment receiving speech-language therapy in public schools (i.e., non-fee-paying schools) in the United States. Vocabulary treatments and targets were examined with respect to their alignment with the empirically validated practice of…

Attribution Theory and Crisis Intervention Therapy.

Science.gov (United States)

Skilbeck, William M.

It was proposed that existing therapeutic procedures may influence attributions about emotional states. Therefore an attributional analysis of crisis intervention, a model of community-based, short-term consultation, was presented. This analysis suggested that crisis intervention provides attributionally-relevant information about both the source…

Evidence-based interventions of dichotic listening training, compensatory strategies and combined therapies in managing pupils with auditory processing disorders.

Science.gov (United States)

Osisanya, Ayo; Adewunmi, Abiodun T

2018-02-01

The need to develop a measure of managing children with a single profile of auditory processing disorders (APDs), and differentiate between true and artefactual improvements necessitated the study. The study also sought to determine the efficacy of interventions - both single and combined on APD, against no-treatment. A randomised controlled trial of interventions (RCT) was adopted. Participants were randomly allocated to each of the intervention groups or the no intervention group. The 10 weeks intervention included 45 minutes three times a week therapeutic intervention on listening with noise and sound localisation ability in the home and school environments. 80 pupils (7-11 years) with a single profile of APD participated in the study. Treatments were effective on the cocktail party and sound localisation. The best result was realised with the combined therapy (CT), and there was no significant difference in performance in the remaining treatment groups. The intervention groups were beneficial to pupils with APD and should be adopted by clinicians.

Does an online psychological intervention improve self-efficacy and disability in people also receiving Multimodal Manual Therapy for chronic low back pain compared to Multimodal Manual Therapy alone? Design of a randomized controlled trial

NARCIS (Netherlands)

Petrozzi, M.J.; Leaver, A.; Jones, M.K.; Ferreira, P.H.; Rubinstein, S.M.; Mackey, M.G.

2015-01-01

Background: Various interventions are available for the treatment of chronic low back pain (LBP), including Manual Therapy and Cognitive Behavioural Therapy (CBT). The purpose of this study is to evaluate whether the addition of an internet-based CBT program leads to better outcomes in patients who

Interventional therapy for acute myocardial infarction associated with postinfarction ventricular septal rupture: report of 6 cases

International Nuclear Information System (INIS)

Zhou Ling; Xie Dujiang; Dong Jing; Wu Chengquan; Tian Nailiang; Li Xiaobo; Wang Rong; Chen Shaoliang

2014-01-01

Objective: To evaluate the curative effect of interventional therapy in treating acute myocardial infarction (AMI) associated with postinfarction ventricular septal rupture (VSR). Methods: Transcatheter closure was performed in 6 patients with VSR which was caused by AMI. Percutaneous coronary intervention (PCI) was also carried out according to patient's clinical condition. The results were analyzed. Results: The interval between the occurrence of VSR and the performance of transcatheter closure ranged from 3 to 30 days. Of the six patients, transcatheter closure failed in two, who died from cardiogenic shock during hospitalization. The remaining 4 patients experienced a successful transcatheter closure procedure, and their cardiac function was improved during the follow-up period lasting for 0.5-4 years. Conclusion: Interventional transcatheter treatment is safe and feasible for acute myocardial infarction complicated by postinfarction ventricular septal rupture. (authors)

Therapeutic interventions in cerebral palsy.

Science.gov (United States)

Patel, Dilip R

2005-11-01

Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy.

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

Directory of Open Access Journals (Sweden)

Flávia Cristina Zago

2013-08-01

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

Cognitive stimulation therapy as a low-resource intervention for dementia in sub-Saharan Africa (CST-SSA): Adaptation for rural Tanzania and Nigeria.

Science.gov (United States)

Mkenda, Sarah; Olakehinde, Olaide; Mbowe, Godfrey; Siwoku, Akeem; Kisoli, Aloyce; Paddick, Stella-Maria; Adediran, Babatunde; Gray, William K; Dotchin, Catherine L; Adebiyi, Akinpelumi; Walker, Richard W; Mushi, Declare; Ogunniyi, Adesola

2016-06-21

Cognitive stimulation therapy is a non-pharmacological intervention for people with dementia. Its use has been associated with substantial improvements in cognition and quality of life in studies from high-income countries, equivalent to those achieved by pharmacological treatments. Cognitive stimulation therapy may be particularly suited to low resource settings, such as sub-Saharan Africa, because it requires little specialist equipment and can be delivered by non-specialist health workers. The aim of this study was to adapt cognitive stimulation therapy for use in sub-Saharan Africa taking into account socio-cultural differences and resource implications. Cognitive stimulation therapy is a structured programme, originally developed in the United Kingdom. Substantial adaptations were required for use in sub-Saharan Africa. The formative method for adapting psychotherapy was used as a framework for the adaption process. The feasibility of using the adapted cognitive stimulation therapy programme to manage dementia was assessed in Tanzania and Nigeria in November 2013. Further adaptations were made following critical appraisal of feasibility. The adapted cognitive stimulation therapy intervention appeared feasible and acceptable to participants and carers. Key adaptations included identification of suitable treatment settings, task adaptation to accommodate illiteracy and uncorrected sensory impairment, awareness of cultural differences and usage of locally available materials and equipment to ensure sustainability. Cognitive stimulation therapy was successfully adapted for use in sub-Saharan Africa. Future work will focus on a trial of cognitive stimulation therapy in each setting. © The Author(s) 2016.

Physical therapy interventions for gross motor skills in people with an intellectual disability aged 6 years and over: a systematic review.

Science.gov (United States)

Hocking, Judith; McNeil, Julian; Campbell, Jared

2016-12-01

The systematic review was undertaken to investigate the effectiveness of physical therapy interventions for improving gross motor skills (GMSs) in people with an intellectual disability aged 6 years and older. There is a lack of physical therapy research for GMSs in this population, and no prior systematic review. People with an intellectual disability may require specific teaching approaches within therapy interventions to accommodate their cognitive and learning needs. People with an intellectual disability who suffer from GMS deficits can benefit from physical therapy to help improve their GMSs. Data sources were PubMed, CINAHL, Embase, and ProQuest. Reference lists of relevant identified articles were also hand searched. Papers published in English from 1 January 2008 to 22 October 2014 were considered for inclusion. This start date was chosen to reflect the tenets of the United Nations Convention on the Rights of Persons with Disabilities which was ratified in 2008.Eligible study designs for inclusion were randomized controlled trial (RCT), pseudo-RCT, repeated measures, and case report. Overall, 887 potential articles were identified, of which 42 were retrieved for full-text review, and seven were finally included. Critical appraisal was independently conducted by two reviewers using the Joanna Briggs Institute appraisal checklists; no articles were excluded following critical appraisal. Data extraction was performed using Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument data extraction instruments. High heterogeneity between the studies precluded meta-analysis of the results; a narrative synthesis was completed instead. Two RCTs, two pseudo-RCTs, two repeated measures studies, and one case report were included. Studies varied in regard to participants' intellectual disability, and the clinical interventions used. Interventions were well tolerated with negligible adverse effects. Significant improvements were reported for

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

OpenAIRE

Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel FGJ; Hendriks, Erik JM; Kremers, Stef PJ; van Peppen, Roland PS; Rutten, Steven TJ; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob AB

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. ...

Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial

NARCIS (Netherlands)

Dewilde, Willem J. M.; Oirbans, Tom; Verheugt, Freek W. A.; Kelder, Johannes C.; de Smet, Bart J. G. L.; Herrman, Jean-Paul; Adriaenssens, Tom; Vrolix, Mathias; Heestermans, Antonius A. C. M.; Vis, Marije M.; Tijsen, Jan G. P.; van 't Hof, Arnoud W.; ten Berg, Jurriën M.; Schölzel, B. E.; van den Branden, B. J.; Plokker, H. W. M.; Bosschaert, M. A.; Slagboom, T.; Vos, J.; Brueren, B. R. G.; Breet, N. J.; Sheikjoesoef, K.; Aarnoudse, W.; Rasoul, S.; van Mieghem, C.; Vandendriessche, T.; Cornelis, K.

2013-01-01

If percutaneous coronary intervention (PCI) is required in patients taking oral anticoagulants, antiplatelet therapy with aspirin and clopidogrel is indicated, but such triple therapy increases the risk of serious bleeding. We investigated the safety and efficacy of clopidogrel alone compared with

[Music-based intervention in children].

Science.gov (United States)

Kiese-Himmel, Christiane

2012-01-01

Music-based interventions with children are an effective method in health and sickness treatment and in education systems. The engagement with music enables positive transfer effects on extra-musical developmental domains. Music therapy was applied primarily as a practically-oriented scientific discipline both within the framework of a multi-modal therapy approach as one treatment component and focused specifically on children with emotional disorders within a somatic therapy concept and in rehabilitation. The following narrative overview will present music therapy's working basis, treatment goals, and select outcome research in children from 2005-2010. There currently exists a substantial lack, even within empirical research, in relation to the application of music therapy to children. This is an opportunity to initiate a broad range of study for the future. Current challenges and opportunities in scientific, music-based intervention in the paediatric population lie in the concretization of differential indications (both in intervention approach and duration), replicable comparative therapy (alternated treatment-design), the application of a music-therapeutic placebo requirement, as well as in the verification and analysis of specific music therapeutic mechanisms.

The role of interventional radiology in the management of deep venous thrombosis: advanced therapy.

LENUS (Irish Health Repository)

O'Sullivan, Gerard J

2011-06-01

Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This "usual treatment" is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases. Interventional radiologists are now using advanced endovascular techniques to achieve thrombus removal in a minimally invasive manner in a very short treatment time, thereby quickly restoring patency, relieving acute symptoms, and potentially limiting the subsequent development of postthrombotic syndrome when followed with anticoagulation and compression regimens. This article provides an overview of the interventions available for treating DVT. One of the newer "single-session" techniques is isolated pharmacomechanical thrombolysis, which is described here in detail with supporting cases.

The Role of Interventional Radiology in the Management of Deep Venous Thrombosis: Advanced Therapy

International Nuclear Information System (INIS)

O’Sullivan, Gerard J.

2011-01-01

Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This “usual treatment” is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases. Interventional radiologists are now using advanced endovascular techniques to achieve thrombus removal in a minimally invasive manner in a very short treatment time, thereby quickly restoring patency, relieving acute symptoms, and potentially limiting the subsequent development of postthrombotic syndrome when followed with anticoagulation and compression regimens. This article provides an overview of the interventions available for treating DVT. One of the newer “single-session” techniques is isolated pharmacomechanical thrombolysis, which is described here in detail with supporting cases.

TU-A-12A-04: Quantitative Texture Features Calculated in Lung Tissue From CT Scans Demonstrate Consistency Between Two Databases From Different Institutions

International Nuclear Information System (INIS)

Cunliffe, A; Armato, S; Castillo, R; Pham, N; Guerrero, T; Al-Hallaq, H

2014-01-01

Purpose: To evaluate the consistency of computed tomography (CT) scan texture features, previously identified as stable in a healthy patient cohort, in esophageal cancer patient CT scans. Methods: 116 patients receiving radiation therapy (median dose: 50.4Gy) for esophageal cancer were retrospectively identified. For each patient, diagnostic-quality pre-therapy (0-183 days) and post-therapy (5-120 days) scans (mean voxel size: 0.8mm×0.8mm×2.5mm) and a treatment planning scan and associated dose map were collected. An average of 501 32x32-pixel ROIs were placed randomly in the lungs of each pre-therapy scan. ROI centers were mapped to corresponding locations in post-therapy and planning scans using the displacement vector field output by demons deformable registration. Only ROIs with mean dose <5Gy were analyzed, as these were expected to contain minimal post-treatment damage. 140 texture features were calculated in pre-therapy and post-therapy scan ROIs and compared using Bland-Altman analysis. For each feature, the mean feature value change and the distance spanned by the 95% limits of agreement were normalized to the mean feature value, yielding normalized range of agreement (nRoA) and normalized bias (nBias). Using Wilcoxon signed rank tests, nRoA and nBias were compared with values computed previously in 27 healthy patient scans (mean voxel size: 0.67mm×0.67mm×1mm) acquired at a different institution. Results: nRoA was significantly (p<0.001) larger in cancer patients than healthy patients. Differences in nBias were not significant (p=0.23). The 20 features identified previously as having nRoA<20% for healthy patients had the lowest nRoA values in the current database, with an average increase of 5.6%. Conclusion: Despite differences in CT scanner type, scan resolution, and patient health status, the same 20 features remained stable (i.e., low variability and bias) in the absence of disease changes for databases from two institutions. Identification of

Effects of a Dyadic Music Therapy Intervention on Parent-Child Interaction, Parent Stress, and Parent-Child Relationship in Families with Emotionally Neglected Children

DEFF Research Database (Denmark)

Jacobsen, Stine Lindahl; H. McKinney, Cathy; Holck, Ulla

2014-01-01

of this study was to investigate the effect of a dyadic music therapy intervention on observed parent-child interaction (mutual attunement, nonverbal communication, emotional parental response), self-reported parenting stress, and self-reported parent-child relationship in families at risk and families...... significantly improved their nonverbal communication and mutual attunement. Similarly, parents who participated in dyadic music therapy reported themselves to be significantly less stressed by the mood of the child and to significantly improve their parent-child relationship in terms of being better at talking......-perceived autonomy, attachment, and parental competence. Conclusions: The dyadic music therapy intervention examined in this study improved emotional communication between parent and child and interaction after 6 to 10 sessions and can be considered as a viable treatment alternative or supplement for families...

Cognitive intervention therapy as treatment for behaviour disorders in Alzheimer disease: evidence on efficacy and neurobiological correlations.

Science.gov (United States)

García-Alberca, J M

2015-01-01

The prevalence of behavioural and psychological symptoms (BPS) is very high among patients with Alzheimer disease (AD); more than 90% of AD patients will present such symptoms during the course of the disease. These symptoms result in poorer quality of life for both patients and caregivers and increased healthcare costs. BPS are the main factors involved in increases to the caregiver burden, and they often precipitate the admission of patients to residential care centres. Current consensus holds that intervention models combining pharmacological and non-pharmacological treatments are the most effective for AD patients. Several studies have shown cholinesterase inhibitors and memantine combined with cognitive intervention therapy (CIT) to be effective for improving patients' cognitive function and functional capacity for undertaking daily life activities. However, the efficacy of CIT as a treatment for BPS has not yet been clearly established, which limits its use for this purpose in clinical practice. The objective of this review is to gather available evidence on the efficacy of cognitive intervention therapy (CIT) on BPS in patients with AD. The results of this review suggest that CIT may have a beneficial effect on BPS in patients with AD and should therefore be considered a treatment option for patients with AD and BPS. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

An evaluation of the effectiveness of psychological therapy in reducing general psychological distress for adults with autism spectrum conditions and comorbid mental health problems.

Science.gov (United States)

Blainey, Sarah H; Rumball, Freya; Mercer, Louise; Evans, Lauren Jayne; Beck, Alison

2017-11-01

To investigate the effectiveness of psychological therapy in reducing psychological distress for adults with autism spectrum conditions (ASC) and co-morbid mental health conditions in routine clinical practice. To explore the effect of individual characteristics and service factors on change in general distress. In a specialist psychological therapies service for adults with ASC, the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) self-report questionnaire of psychological distress is completed by clients at start and end of therapy. Change over time and reliable and clinical change was assessed for 81 of a total of 122 clients (66.4%). Factors which may influence change over time were explored using available clinical information. Overall, there was a significant reduction in CORE-OM score during therapy with a small effect size. Most clients showed an improvement in psychological distress over therapy (75.4% improved, with 36.9% of these showing reliable changes). Significant and comparable reductions from pre-therapy to post-therapy were seen across the sample, showing that individual differences did not mediate therapy effectiveness. CORE-OM scores mediate the association between age of ASD diagnosis and hours of therapeutic input required, with greater age at diagnosis and higher distress associated with longer therapy duration. Our preliminary findings suggest that psychological therapy may be effective in reducing general distress for clients with ASC and co-morbid mental health conditions and should be routinely offered. Individuals who are diagnosed with ASD in adulthood are likely to require a longer course of therapy when their general distress scores are high. Copyright © 2017 John Wiley & Sons, Ltd.

Safety of combination therapy with milrinone and esmolol for heart protection during percutaneous coronary intervention in acute myocardial infarction.

Science.gov (United States)

Poh, Kian-Keong; Xu, Xin; Chan, Mark Y; Lee, Chi-Hang; Tay, Edgar L; Low, Adrian F; Chan, Koo Hui; Sia, Winnie; Tang, Liang-Qiu; Tan, Huay Cheem; Lui, Charles Y; Nguyen, Vincent; Fujise, Kenichi; Huang, Ming-He

2014-05-01

Ischemia/reperfusion injury remains an untreated clinical problem in patients with acute myocardial infarction (AMI) despite significant advances in emergent revascularization through percutaneous coronary intervention (PCI). Pharmacological intervention for infarct size reduction is unavailable. We have identified that the medications milrinone and esmolol, when administered together at the beginning of the reperfusion, significantly decrease infarct size via reducing reperfusion injury in an experimental model. The present study tested the safety of combination therapy of milrinone and esmolol (M + E) in patients with AMI. Sixteen subjects with AMI requiring PCI were consecutively recruited. M + E was intravenously infused simultaneously for 10 min started at 5 min before anticipated angioplasty balloon inflation. Another 16 consecutively recruited AMI patients requiring PCI served as a placebo arm treated per routine clinical protocol. Blood pressure (BP) and heart rate (HR) were monitored continuously during PCI. M + E combination therapy resulted in a trend of non-significant reduction in BP compared with a control group. There was a modest but significant increase in HR at the later phase of M + E infusion compared with a control group. No significant cardiac arrhythmia was induced during M + E infusion. The combination therapy with M + E produces a minimal change in hemodynamics and appears safe as an adjunctive therapy to PCI in AMI patients. Further studies are warranted.

Masivukeni: Development of a Multimedia Based Antiretroviral Therapy Adherence Intervention for Counselors and Patients in South Africa

Science.gov (United States)

Remien, Robert H; Mellins, Claude A.; Robbins, Reuben N.; Kelsey, Ryan; Rowe, Jessica; Warne, Patricia; Chowdhury, Jenifar; Lalkhen, Nuruneesa; Hoppe, Lara; Abrams, Elaine J.; El-Bassel, Nabila; Witte, Susan; Stein, Dan J.

2013-01-01

Effective medical treatment for HIV/AIDS requires patients’ optimal adherence to antiretroviral therapy (ART). In resource-constrained settings, lack of adequate standardized counseling for patients on ART remains a significant barrier to adherence. Masivukeni (“Lets Wake Up” in Xhosa) is an innovative multimedia-based intervention designed to help people living with HIV in resource-limited settings achieve and maintain high levels of ART adherence. Adapted from a couples-based intervention tested in the United States (US), Masivukeni was developed through community-based participatory research with US and South African partners and informed by Ewart’s Social Action Theory. Innovative computer-based multimedia strategies were used to translate a labor- and training-intensive intervention into one that could be readily and widely used by lay counselors with relatively little training with low-literacy patients. In this paper, we describe the foundations of this new intervention, the process of its development, and the evidence of its high acceptability and feasibility. PMID:23468079

Long-term pain relief with optimized medical treatment including antioxidants and step-up interventional therapy in patients with chronic pancreatitis.

Science.gov (United States)

Shalimar; Midha, Shallu; Hasan, Ajmal; Dhingra, Rajan; Garg, Pramod Kumar

2017-01-01

Abdominal pain is difficult to treat in patients with chronic pancreatitis (CP). Medical therapy including antioxidants has been shown to relieve pain of CP in the short-term. Our aim was to study the long-term results of optimized medical and interventional therapy for pain relief in patients with CP with a step-up approach. All consecutive patients with CP were included prospectively in the study. They were treated medically with a well-balanced diet, pancreatic enzymes, and antioxidants (9000 IU beta-carotene, 0.54 g vitamin C, 270 IU vitamin E, 600 µg organic selenium, and 2 g methionine). Endoscopic therapy and/or surgery were offered if medical therapy failed. Pain relief was the primary outcome measure. A total of 313 patients (mean age 26.16 ± 12.17; 244 males) with CP were included; 288 (92%) patients had abdominal pain. The etiology of CP was idiopathic in 224 (71.6%) and alcohol in 82 (26.2%). At 1-year follow-up, significant pain relief was achieved in 84.7% of patients: 52.1% with medical therapy, 16.7% with endoscopic therapy, 7.6% with surgery, and 8.3% spontaneously. The mean pain score decreased from 6.36 ± 1.92 to 1.62 ± 2.10 (P pain free at those follow-up periods. Significant pain relief is achieved in the majority of patients with optimized medical and interventional treatment. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Prospective study of exercise intervention in prostate cancer patients on androgen deprivation therapy

International Nuclear Information System (INIS)

Beydoun, Nadine; Bucci, Joseph A.; Chin, Yaw S.; Spry, Nigel; Newton, Robert; Galvão, Daniel A.

2014-01-01

Androgen deprivation therapy (ADT) is an important component of modern prostate cancer treatment. Survival benefits from neo-adjuvant and adjuvant hormones may take years to manifest, and balancing this with potential morbidity of therapy can be challenging. This study aimed to assess whether education and short-term combined aerobic and resistance exercises could help to ameliorate the adverse side effects of ADT. Eight hundred fifty-nine patients with relapsed or metastatic prostate cancer on leuprorelin acetate were allocated to three interventional streams based on patient preference and medical fitness: supervised group (Face-to-Face) exercise sessions, home-based (At Home) exercise or a support programme for those incapable of exercising (Support). Patients enrolled onto Face to Face underwent measurement of body composition and cardiorespiratory fitness variables at baseline and programme completion. Patients in the exercise streams were surveyed to determine the programme's impact on physical fitness and well-being. Statistically significant improvements (p<0.001) were seen in all measured cardiorespiratory fitness and strength variables. Programme attrition rates were low (75/859; 8.7%), the primary reason for withdrawal being discontinuation of hormones (70%). Programme satisfaction was high, with 98% of surveyed patients reporting a positive impact on fitness and 97% planning to continue exercising after programme completion. At 6 months, improved physical and emotional well-being was reported by 93 and 79% of patients, respectively. A short-term structured exercise intervention results in high compliance and significant improvements in muscle strength and cardiorespiratory fitness in prostate cancer patients on ADT.

Atorvastatin in the management of tinnitus with hyperlipidemias

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Hameed, M. K.; Sheikh, Z. A.; Ahmed, A. [Armed Forces Inst. of Pathology, Rawalpindi (Pakistan). Dept. of Pathology

2014-12-15

To determine the role of atorvastatin in management of tinnitus in patients with hyperlipidemia. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Department, Combined Military Hospital, Rawalpindi, from July 2011 to August 2012. Methodology: Ninety eight patients of tinnitus with sensorineural hearing loss having hyperlipidemia were included in the study. Their pre-therapy serum cholesterols were measured, and tinnitus scores were recorded on a 'Tinnitus handicap questionnaire'. They were administered tablet atorvastatin 40 mg once daily with low fat diet for 8 months. After 8 months of therapy, patients were purposefully divided into responsive and unresponsive group depending on serum cholesterol levels. Post therapy serum cholesterol levels and tinnitus scores were also recorded after 8 months and compared with pre-therapy records. Results: Serum cholesterol came to within normal limits in 51 (52%) patients (responsive group), while it remained high in 47 (48%) patients (unresponsive group). Improvement in tinnitus score in the responsive group was seen in 36 (70.5%) patients and in 2 (4.2%) patients of the unresponsive group. Improvement in tinnitus scores was compared in the two groups using Fisher's exact test and were found to be statistically better in the responsive group (p < 0.001). Conclusion: Tinnitus, in patients having hyperlipidemia, can be successfully dealt with by treating hyperlipidemia with lipid lowering agent atorvastatin. (author)

Atorvastatin in the management of tinnitus with hyperlipidemias

International Nuclear Information System (INIS)

Hameed, M.K.; Sheikh, Z.A.; Ahmed, A.

2014-01-01

To determine the role of atorvastatin in management of tinnitus in patients with hyperlipidemia. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Department, Combined Military Hospital, Rawalpindi, from July 2011 to August 2012. Methodology: Ninety eight patients of tinnitus with sensorineural hearing loss having hyperlipidemia were included in the study. Their pre-therapy serum cholesterols were measured, and tinnitus scores were recorded on a 'Tinnitus handicap questionnaire'. They were administered tablet atorvastatin 40 mg once daily with low fat diet for 8 months. After 8 months of therapy, patients were purposefully divided into responsive and unresponsive group depending on serum cholesterol levels. Post therapy serum cholesterol levels and tinnitus scores were also recorded after 8 months and compared with pre-therapy records. Results: Serum cholesterol came to within normal limits in 51 (52%) patients (responsive group), while it remained high in 47 (48%) patients (unresponsive group). Improvement in tinnitus score in the responsive group was seen in 36 (70.5%) patients and in 2 (4.2%) patients of the unresponsive group. Improvement in tinnitus scores was compared in the two groups using Fisher's exact test and were found to be statistically better in the responsive group (p < 0.001). Conclusion: Tinnitus, in patients having hyperlipidemia, can be successfully dealt with by treating hyperlipidemia with lipid lowering agent atorvastatin. (author)

Effect of radioiodine therapy on thyroid nodule size in patients with toxic adenomas

International Nuclear Information System (INIS)

Rajkovaca, Z.; Mijatovic, J.; Skrobis, M.; Kovacevic, P.

2005-01-01

Full text: Autonomously functioning toxic adenomas are a common cause of hyperthyroidism. Surgery, radioiodine and percutaneous ethanol injection into the nodule are effective therapies. Radioiodine therapy is increasingly used as first line therapy especially in elderly patients. Radioactive iodine I-131 seems to be a good therapeutic option with low incidence of post-therapy hypothyroidism. The important therapeutic effect has also been the regression in nodule size. The aim of this study was to investigate the effect of radioiodine therapy on the size of toxic adenomas. Forty-six patients with age range of 37-76 years (Mean age=60.9 years) were followed up for a period of 12 months after I-131 therapy for toxic adenomas. Thyroid hormone levels (T3, T4 and TSH) were determined. Each patient was subjected to ultrasound and radionuclide scanning of thyroid gland at 3,6 and 12 months following I-131 therapy. Successful treatment was defined as control of hyperthyroidism and reappearance of extra-glandular thyroid tissue on Thyroid scan, which were suppressed by the hyperactive nodule prior to therapy. The volumes of the thyroid pre and post-therapy were estimated by US using the formula of ellipsoid model (δ/2π6 x length x width x depth). The therapeutic dose of I-131 was calculated for each patient by the following formula: 12 mCi x 100/24 hrs RAIU. Patients received a single dose of I-131 and the range of administered I-131 dose was 825 1221 MBq. Results revealed that 42 patients (91%) became euthyroid in three months after I-131. All patients became euthyroid in 6 months. The adenomas were reduced in size from a mean of 18.23+11.21 ml to 7.38+3.48 ml during the 12 months follow up. This was highly significant (p<0.05, t=3.408). The extra-nodular thyroid volume did not change following therapy (12.2+7.4 ml pre-therapy vs. 11.8+7.1 ml post therapy at 12 months). The results of our study showed that I-131 can successfully treat not only the functional state of

Occupational Therapy Interventions for Adults With Cancer.

Science.gov (United States)

Braveman, Brent; Hunter, Elizabeth G; Nicholson, Jennifer; Arbesman, Marian; Lieberman, Deborah

This Evidence Connection describes a case report of a man with non-Hodgkin's lymphoma who underwent an allogenic stem cell transplant. The occupational therapy assessment and treatment processes for an outpatient rehabilitation setting are described. Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Project. Copyright © 2017 by the American Occupational Therapy Association, Inc.

A 9-week randomized trial comparing a chronotherapeutic intervention (wake and light therapy) to exercise in major depressive disorder patients treated with duloxetine

DEFF Research Database (Denmark)

Martiny, Klaus; Refsgaard, Else; Lund, Vibeke

2012-01-01

The onset of action of antidepressants often takes 4 to 6 weeks. The antidepressant effect of wake therapy (sleep deprivation) comes within hours but carries a risk of relapse. The objective of this study was to investigate whether a new chronotherapeutic intervention combining wake therapy...... with bright light therapy and sleep time stabilization could induce a rapid and sustained augmentation of response and remission in major depressive disorder....

Effects of a program of cognitive-behavioural group therapy, vestibular rehabilitation, and psychoeducational explanations on patients with dizziness and no quantified balance deficit, compared to patients with dizziness and a quantified balance deficit.

Science.gov (United States)

Schmid, D A; Allum, J H J; Sleptsova, M; Gross, S; Gaab, J; Welge-Lüssen, A; Schaefert, R; Langewitz, W

2018-02-01

We examined whether a program combining cognitive-behavioural therapy (CBT), vestibular rehabilitation (VR) and psychoeducation is equally effective in improving psychometric measures in patients with dizziness independent of a balance deficit. Measures of patients with dizziness only (DO) were compared to those of patients also having a quantified balance deficit (QBD). 32 patients (23 female, 9 male) with persistent dizziness were analysed as 2 groups based on stance and gait balance control: those with QBD (pathological balance) or DO (normal balance). Dizziness Handicap Inventory (DHI) and Brief Symptom Inventory (BSI) questionnaires were used pre- and post-therapy to assess psychometric measures. Patients then received the same combination therapy in a group setting. The QBD group mean age was 60.6, SD 8.3, and DO group mean age 44.8, SD 12.1, years. Pre-therapy, questionnaire scores were pathological but not different between groups. Balance improved significantly for the QBD group (p=0.003) but not for the DO group. DHI and BSI scores improved significantly in the DO group (0.001balance control improving to near normal. Possibly, greater focus on phobic anxiety during the group therapy program would have improved psychological measures of QBD patient. Copyright © 2017 Elsevier Inc. All rights reserved.

A Bioecological Framework to Evaluate Communicative Participation Outcomes for Preschoolers Receiving Speech-Language Therapy Interventions in Ontario, Canada

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Cunningham, Barbara J.; Rosenbaum, Peter L.

2015-01-01

Background: The Preschool Speech and Language Program (PSLP) in Ontario, Canada, is a publicly funded intervention service for children from birth to 5 years with communication disorders. It has begun a population-level programme evaluation of children's communicative participation outcomes following therapy. Data are currently being collected for…

Comparative analysis of hepatopulmonary shunt obtained from pretherapy 99mTc MAA scintigraphy and post-therapy 90Y Bremsstrahlung imaging in 90Y microsphere therapy.

Science.gov (United States)

Jha, Ashish Kumar A; Zade, Anand A; Rangarajan, Venkatesh; Purandare, Nilendu; Shah, Sneha A; Agrawal, Archi; Kulkarni, Suyash S; Shetty, Nitin

2012-05-01

(99m)Tc macroaggregate albumin (MAA) scintigraphy is routinely used to estimate the hepatopulmonary shunt (HPS) of (90)Y microspheres because of their comparable average particle sizes (20-30 µm). However, the MAA particle size can vary from 10 to 90 µm. Therefore, HPS computed from (99m)Tc MAA scintigraphy may not accurately represent the HPS of (90)Y microspheres. In view of this, the present study was undertaken to investigate the accuracy of (99m)Tc MAA scintigraphy in estimating the HPS of (90)Y microspheres. Nineteen sessions of transarterial radioembolization using (90)Y therasphere were carried out in 17 patients for hepatic malignancies (both primary and secondary). For each session of therapy, a pretherapeutic (99m)Tc MAA scintigraphy and post-therapeutic (90)Y Bremsstrahlung scintigraphy were performed. The HPSs obtained from these images were compared. The mean HPS fractions calculated from the pretherapeutic (99m)Tc MAA study and the post-therapeutic (90)Y Bremsstrahlung images were 4.77 ± 2.81 and 4.52 ± 2.5%, respectively. The coefficient of correlation (r) was 0.96. (99m)Tc MAA scintigraphy accurately predicts the HPS of (90)Y microspheres.

Combination therapy efficacy of catgut embedding acupuncture and diet intervention on interleukin-6 levels and body mass index in obese patients

Science.gov (United States)

Tjan, P. M.; Srilestari, A.; Abdurrohim, K.; Kresnawan, T.

2017-08-01

Obesity is a major health problem worldwide, affecting more than 500 million adults with an additional 1.5 billion adults classified as overweight. Acupuncture has been recognized as an adjunctive therapy for obesity, and recent evidence suggests its potential to reduce the inflammatory response in adipose tissue, a condition believed to be responsible for obesity-related health problems. Interleukin-6 (IL-6) has been proposed as an important mediator of the inflammatory response in adipose tissue, but the number of studies addressing the issue is still limited. A double-blind, randomized, placebo-controlled trial was conducted with36 obese patients currently receiving dietary intervention. The patients were randomly allocated into the catgut embedding acupuncture group with diet intervention or the sham (placebo) embedding acupuncture group with diet intervention. Catgut embedding therapy was given twice at CV12 Zhongwan, ST25 Tianshu, CV6 Qihai, and SP6 Sanyinjiao acupoints with two week intervals between procedures. The study endpoints were the IL-6 levels in the blood plasma and body mass index (BMI), measured before and after the intervention. We observed a reduction in the IL-6 levels (mean reduction 0.13 pg/mL, 95% CI: 0.03-0.23) and BMI (mean reduction 0.66, 95% CI 0.43-0.88) in the accupuncture group. The average difference in mean reduction of BMI between the accupuncture and sham groups was 0.34 (95% CI: 0.17-0.52). No difference was found in mean IL-6 reduction between the two groups (95% CI: -0.17 to 0.06). The results suggest that acupoint catgut embedding therapy may help reduce IL-6 levels and BMI in obese patients receiving dietary intervention.

Impact of Triple Therapy in Elderly Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention.

Directory of Open Access Journals (Sweden)

Antonia Sambola

Full Text Available Selecting an ideal antithrombotic therapy for elderly patients with atrial fibrillation (AF undergoing percutaneous coronary intervention (PCI can be challenging since they have a higher thromboembolic and bleeding risk than younger patients. The current study aimed to assess the efficacy and safety of triple therapy (TT: oral anticoagulation plus dual antiplatelet therapy: aspirin plus clopidogrel in patients ≥75 years of age with atrial fibrillation (AF undergoing percutaneous coronary intervention (PCI.A prospective multicenter study was conducted from 2003 to 2012 at 6 Spanish teaching hospitals. A cohort study of consecutive patients with AF undergoing PCI and treated with TT or dual antiplatelet therapy (DAPT was analyzed. All outcomes were evaluated at 1-year of follow-up.Five hundred and eighty-five patients, 289 (49% of whom were ≥75 years of age (79.6±3.4 years; 33% women were identified. TT was prescribed in 55.9% of patients at discharge who had a higher thromboembolic risk (CHA2DS2VASc score: 4.23±1.51 vs 3.76±1.40, p = 0.007 and a higher bleeding risk (HAS-BLED ≥3: 88.6% vs 79.2%, p = 0.02 than those on DAPT. Therefore, patients on TT had a lower rate of thromboembolism than those on DAPT (0.6% vs 6.9%, p = 0.004; HR 0.08, 95% CI: 0.01-0.70, p = 0.004. Major bleeding events occurred more frequently in patients on TT than in those on DAPT (11.7% vs 2.4%, p = 0.002; HR 5.2, 95% CI: 1.53-17.57, p = 0.008. The overall mortality rate was similar in both treatment groups (11.9% vs 13.9%, p = 0.38; however, after adjustment for confounding variables, TT was associated with a reduced mortality rate (HR 0.33, 95% CI: 0.12-0.86, p = 0.02.In elderly patients with AF undergoing PCI, the use of TT compared to DAPT was associated with reduced thromboembolism and mortality rates, although a higher rate of major bleeding.

The singing nurse?! Music therapy, interdisciplinarity and an overview of research in psychosocial interventions

DEFF Research Database (Denmark)

Ridder, Hanne Mette Ochsner

Conference: Music Therapy and Dementia Care in the 21st Century Dementia is one of the major causes of disability and dependency among older people, with agitation in dementia as the most significant symptom causing patient distress and caregiver burden in later stages of the disease. Music...... in various forms (e.g. caregiver singing or music listening) is widely used in nursing homes for people with dementia; however these practices are generally little informed by music therapy theory and research. In this presentation, an overview of research in non- pharmacological approaches is given.......g. in dyads with caregivers or relatives and the person with dementia. The aim is to provide and develop psychosocial interventions in the interdisciplinary team, and to support staff and caregivers in their use of music as part of the daily culture of care. References Bunt, L. & Stige, B. (2014). Music...

A Combined Pharmacokinetic and Radiologic Assessment of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Predicts Response to Chemoradiation in Locally Advanced Cervical Cancer

International Nuclear Information System (INIS)

Semple, Scott; Harry, Vanessa N. MRCOG.; Parkin, David E.; Gilbert, Fiona J.

2009-01-01

Purpose: To investigate the combination of pharmacokinetic and radiologic assessment of dynamic contrast-enhanced magnetic resonance imaging (MRI) as an early response indicator in women receiving chemoradiation for advanced cervical cancer. Methods and Materials: Twenty women with locally advanced cervical cancer were included in a prospective cohort study. Dynamic contrast-enhanced MRI was carried out before chemoradiation, after 2 weeks of therapy, and at the conclusion of therapy using a 1.5-T MRI scanner. Radiologic assessment of uptake parameters was obtained from resultant intensity curves. Pharmacokinetic analysis using a multicompartment model was also performed. General linear modeling was used to combine radiologic and pharmacokinetic parameters and correlated with eventual response as determined by change in MRI tumor size and conventional clinical response. A subgroup of 11 women underwent repeat pretherapy MRI to test pharmacokinetic reproducibility. Results: Pretherapy radiologic parameters and pharmacokinetic K trans correlated with response (p < 0.01). General linear modeling demonstrated that a combination of radiologic and pharmacokinetic assessments before therapy was able to predict more than 88% of variance of response. Reproducibility of pharmacokinetic modeling was confirmed. Conclusions: A combination of radiologic assessment with pharmacokinetic modeling applied to dynamic MRI before the start of chemoradiation improves the predictive power of either by more than 20%. The potential improvements in therapy response prediction using this type of combined analysis of dynamic contrast-enhanced MRI may aid in the development of more individualized, effective therapy regimens for this patient group.

Effects of Group Counseling Programs, Cognitive Behavioral Therapy, and Sports Intervention on Internet Addiction in East Asia: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Liu, Jun; Nie, Jing; Wang, Yafeng

2017-11-28

To evaluate the effects of group counseling programs, cognitive behavioral therapy (CBT), and sports intervention on Internet addiction (IA), a systematic search in ten databases was performed to identify eligible studies without language restrictions up to January 2017. A meta-analysis and trial sequential analysis (TSA) was performed, respectively. A total of 58 randomized controlled trials (RCTs), which included 2871 participants, were incorporated into our meta-analysis. The results showed that group counseling programs, CBT, and sports intervention could significantly reduce IA levels (group counseling program: standardized mean difference (SMD), -1.37; 95% confidence interval (CI), -1.89 to -0.85; CBT: SMD, -1.88; 95% CI, -2.53 to -1.23; sports intervention: SMD, -1.70; 95% CI, -2.14 to -1.26). For group counseling programs, this treatment was more effective in four dimensions of IA, including time management, interpersonal and health issues, tolerance, and compulsive Internet use. For CBT, this treatment yielded a positive change in depression, anxiousness, aggressiveness, somatization, social insecurity, phobic anxiety, paranoid ideation, and psychoticism. For sports intervention, the significant effects were also observed in all dimensions of the IA scale. Each of group counseling programs, cognitive behavioral therapy, and sports intervention had a significant effect on IA and psychopathological symptoms. Sports intervention could improve withdrawal symptoms especially.

Mindfulness Interventions in Physical Rehabilitation: A Scoping Review.

Science.gov (United States)

Hardison, Mark E; Roll, Shawn C

2016-01-01

A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association's Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners. Copyright © 2016 by the American Occupational Therapy Association, Inc.

The efficacy of hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency.

Science.gov (United States)

Zhai, Hongxia; Li, Liang; Yin, Yaxin; Zhang, Jinjin; Chen, Haiwei; Liu, Runmei; Xia, Yun-feng

2016-01-01

The aim of this study was to explore the efficacy and safety of hemodialysis in interventional therapy for patients with coronary artery disease combined with chronic renal insufficiency. With the aging and social development, the number of coronary artery disease patients with chronic renal insufficiency gradually increased. Total 58 coronary heart disease patients with chronic renal dysfunction were selected. These patients were characterized with typical angina symptoms and typical electrocardiogram (ECG) changes of onset angina. Continuous oral administration of sodium bicarbonate tablets 1 g 3/day × 3 days and slow intravenous input sodium chloride 1000 ∼1500 mL 3-12 h before operation were given. By this way, all patients were treated by hydration and alkalization. After percutaneous coronary intervention (PCI) treatment, patients were immediately transferred to undergo 4 h of dialysis treatment without removing indwelling of femoral artery puncture sheath tube to protect renal function. Changes in renal function including serum creatinine, glomerular filtration rate, and urine were observed and recorded. All patients were successfully underwent PCI treatment. Within one month after PCI, there were no obvious complication and no stent thrombosis occurred. Among of 58 patients, 56 cases showed no significant increase in serum creatinine levels compared with those before operation. However, serum creatinine level of one patient increased to 251 umol/L and one patient still required permanent dialysis. Using hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency could significantly improve the prognosis of the patients.

A systematic review of physical therapy interventions for patients with anorexia and bulemia nervosa.

Science.gov (United States)

Vancampfort, Davy; Vanderlinden, Johan; De Hert, Marc; Soundy, Andrew; Adámkova, Milena; Skjaerven, Liv Helvik; Catalán-Matamoros, Daniel; Lundvik Gyllensten, Amanda; Gómez-Conesa, Antonia; Probst, Michel

2014-01-01

The purpose of this systematic review was to summarise the evidence from randomised controlled trials examining the effectiveness of physical therapy compared with care as usual or a wait-list condition on eating pathology and on physiological and psychological parameters in patients with anorexia and bulimia nervosa. EMBASE, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and The Cochrane Library were searched from their inception until February, 2013. Articles were eligible if they utilised a randomised controlled trial design, compared physical therapy with a placebo condition, control intervention, or standard care and included patients with anorexia and bulimia nervosa. The methodological quality was assessed with the Jadad scale. Eight randomised controlled trials involving 213 patients (age range: 16-36 years) met all selection criteria. Three of the 8 included studies were of strong methodological quality (Jadad score≥3). Major methodological weaknesses were attrition and selection bias. The main results demonstrate that aerobic and resistance training result in significantly increased muscle strength, body mass index and body fat percentage in anorexia patients. In addition, aerobic exercise, yoga, massage and basic body awareness therapy significantly lowered scores of eating pathology and depressive symptoms in both anorexia and bulimia nervosa patients. No adverse effects were reported. The paucity and heterogeneity of available studies limits overall conclusions and highlights the need for further research. Implications for Rehabilitation Supervised physical therapy might increase weight in anorexia nervosa patients. Aerobic exercise, massage, basic body awareness therapy and yoga might reduce eating pathology in patients with anorexia and bulimia nervosa. Aerobic exercise, yoga and basic body awareness therapy might improve mental and physical quality of life in patients with an eating

Can integrating the Memory Support Intervention into cognitive therapy improve depression outcome? Study protocol for a randomized controlled trial.

Science.gov (United States)

Harvey, Allison G; Dong, Lu; Lee, Jason Y; Gumport, Nicole B; Hollon, Steven D; Rabe-Hesketh, Sophia; Hein, Kerrie; Haman, Kirsten; McNamara, Mary E; Weaver, Claire; Martinez, Armando; Notsu, Haruka; Zieve, Garret; Armstrong, Courtney C

2017-11-14

The Memory Support Intervention was developed in response to evidence showing that: (1) patient memory for treatment is poor, (2) poor memory for treatment is associated with poorer adherence and poorer outcome, (3) the impact of memory impairment can be minimized by the use of memory support strategies and (4) improved memory for treatment improves outcome. The aim of this study protocol is to conduct a confirmatory efficacy trial to test whether the Memory Support Intervention improves illness course and functional outcomes. As a "platform" for the next step in investigating this approach, we focus on major depressive disorder (MDD) and cognitive therapy (CT). Adults with MDD (n = 178, including 20% for potential attrition) will be randomly allocated to CT + Memory Support or CT-as-usual and will be assessed at baseline, post treatment and at 6 and 12 months' follow-up (6FU and 12FU). We will compare the effects of CT + Memory Support vs. CT-as-usual to determine if the new intervention improves the course of illness and reduces functional impairment (aim 1). We will determine if patient memory for treatment mediates the relationship between treatment condition and outcome (aim 2). We will evaluate if previously reported poor treatment response subgroups moderate target engagement (aim 3). The Memory Support Intervention has been developed to be "transdiagnostic" (relevant to a broad range of mental disorders) and "pantreatment" (relevant to a broad range of types of treatment). This study protocol describes a "next step" in the treatment development process by testing the Memory Support Intervention for major depressive disorder (MDD) and cognitive therapy (CT). If the results are promising, future directions will test the applicability to other kinds of interventions and disorders and in other settings. ClinicalTrials.gov, ID: NCT01790919 . Registered on 6 October 2016.

Promoting interventional radiology in clinical practice of emergency medicine

International Nuclear Information System (INIS)

Zhou Bing; Yuan Jianhua

2009-01-01

Interventional radiology has lot of advantages in dealing with various emergencies. The technique is minimally-invasive, highly-effective and immediately-efficient, moreover, it integrates the diagnosis with the therapy perfectly. Besides, the interventional techniques applied in emergency medicine include not only the vascular interventions,such as embolization, embolectomy, etc, but also the nonvascular interventions, such as tracheal s tent implantation, percutaneous vertebroplasty and so forth. However, importance has not been attached to the clinical use of interventional therapy in emergency medicine so far. It is imperative for us to promote the acceptance of interventional therapy in emergency medicine as well as to popularize the technique in clinical practice. (authors)

Radiofrequency (thermal) ablation versus no intervention or other interventions for hepatocellular carcinoma

DEFF Research Database (Denmark)

Weis, Sebastian; Franke, Annegret; Mössner, Joachim

2013-01-01

Hepatocellular carcinoma is the fifth most common cancer worldwide. Percutaneous interventional therapies, such as radiofrequency (thermal) ablation (RFA), have been developed for early hepatocellular carcinoma. RFA competes with other interventional techniques such as percutaneous ethanol...

The 'Cancer Home-Life Intervention': A randomised controlled trial evaluating the efficacy of an occupational therapy-based intervention in people with advanced cancer.

Science.gov (United States)

Pilegaard, Marc Sampedro; la Cour, Karen; Gregersen Oestergaard, Lisa; Johnsen, Anna Thit; Lindahl-Jacobsen, Line; Højris, Inger; Brandt, Åse

2018-04-01

People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the 'Cancer Home-Life Intervention'. To evaluate the efficacy of the 'Cancer Home Life-Intervention' compared with usual care with regard to patients' performance of, and participation in, everyday activities, and their health-related quality of life. A randomised controlled trial ( ClinicalTrials.gov NCT02356627). The 'Cancer Home-Life Intervention' is a brief, tailored, occupational therapy-based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities. Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were assessed at baseline, and at 6 and 12 weeks of follow-up. The primary outcome was activities of daily living motor ability. Secondary outcomes were activities of daily living process ability, difficulty performing prioritised everyday activities, participation restrictions and health-related quality of life. A total of 242 participants were randomised either to the intervention group ( n = 121) or the control group ( n = 121). No effect was found on the primary outcome (between-group mean change: -0.04 logits (95% confidence interval: -0.23 to 0.15); p = 0.69). Nor was any effect on the secondary outcomes observed. In most cases, the 'Cancer Home-Life Intervention' was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants' everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing.

Short-term group schema therapy for mixed personality disorders: A pilot study

Directory of Open Access Journals (Sweden)

Sally Ann Skewes

2015-01-01

Full Text Available Schema Therapy has shown promising results for personality disorders but there is a limited evidence base for group Schema Therapy (ST-g with mixed personality disorders. The aim of this study was to explore the feasibility, acceptability and preliminary effectiveness of ST-g in a sample of eight participants with mixed personality disorders (with a predominant diagnosis of avoidant personality disorder and high levels of comorbidity. Treatment was comprised of 20 sessions which included cognitive, behavioural, and experiential techniques. Specific schema-based strategies were chosen for a diagnostically mixed group of personality disorder clients. Six participants attended until end of treatment and two dropped-out before mid-treatment. All outcome measures showed changes with large effect sizes in avoidant personality disorder symptom severity, depression and anxiety levels between pre-therapy and follow-up. Four participants achieved a loss of personality disorder diagnosis at the end of therapy. By follow-up, five participants had achieved a loss of diagnosis, suggesting that participants derived ongoing benefits from the group even after treatment ended. Six participants no longer met criteria for depression at the end of treatment and this was maintained for all participants at six-month follow-up. At follow-up, the majority of participants showed clinically significant change on the GSI. For the SMI maladaptive modes, the majority of participants showed improvement at follow-up. At follow-up 40% of participants showed clinically significant change on the SMI adaptive modes. Qualitative feedback indicates that the group helps to normalize participants’ psychological experiences and difficulties and promotes self-expression and self-disclosure, while reducing disinhibition. Preliminary results suggest that short-term ST-g may benefit those with mixed personality disorders, but generalizability is limited by the small sample size and lack

Group of family companions of hospitalized patients: an occupational therapy intervention strategy in a general hospital

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Daniel Ferreira Dahdah

2013-08-01

Full Text Available There is a consensus in the literature that the company of a family member during the hospitalization period increases patient recovery. However, this can have some negative effects on the caregiver’s health. With the purpose of reducing these negatives effects, it is useful to let family members express themselves. The State Hospital of Ribeirão Preto created a Group of Family Companions coordinated by the Occupational Therapy and Social Service. This study focuses on the assistance offered in a general hospital to families that undergo the whole illness and hospitalization process of their family member, suffering the impacts of this process in their daily lives, and on the intervention of Occupational Therapy in these cases.

Mirror therapy: A potential intervention for pain management

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Priscilla G. Wittkopf

Full Text Available Summary The consequences of chronic pain and associated disabilities to the patient and to the health care system are well known. Medication is often the first treatment of choice for chronic pain, although side effects and high costs restrict long-term use. Inexpensive, safe and easy to self-administer non-pharmacological therapies, such as mirror therapy, are recommended as adjuncts to pain treatment. The purpose of this review is to describe the principles of use of mirror therapy so it can be incorporated into a health care delivery. The physiological rationale of mirror therapy for the management of pain and the evidence of clinical efficacy based on recent systematic reviews are also discussed. Mirror therapy, whereby a mirror is placed in a position so that the patient can view a reflection of a body part, has been used to treat phantom limb pain, complex regional pain syndrome, neuropathy and low back pain. Research evidence suggests that a course of treatment (four weeks of mirror therapy may reduce chronic pain. Contraindications and side effects are few. The mechanism of action of mirror therapy remains uncertain, with reintegration of motor and sensory systems, restored body image and control over fear-avoidance likely to influence outcome. The evidence for clinical efficacy of mirror therapy is encouraging, but not yet definitive. Nevertheless, mirror therapy is inexpensive, safe and easy for the patient to self-administer.

Interventions for vaginismus.

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Melnik, Tamara; Hawton, Keith; McGuire, Hugh

2012-12-12

Vaginismus is an involuntary contraction of the vaginal muscles which makes sexual intercourse difficult or impossible. It is one of the more common female psychosexual problems. Various therapeutic strategies for vaginismus, such as sex therapy and desensitisation, have been proposed, and uncontrolled case series appear promising. To assess the effects of different interventions for vaginismus. We searched the Cochrane Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR-Studies and CCDANCTR-References) to August 2012. This register contains relevant randomised controlled trials from: The Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date) and PsycINFO (1967 to date). We searched reference lists and conference abstracts. We contacted experts in the field regarding unpublished material. Controlled trials comparing treatments for vaginismus with another treatment, a placebo treatment, treatment as usual or waiting list control. The review authors extracted data which we verified with the trial investigator where possible. Five studies were included, of which four with a total of 282 participants provided data. No meta-analysis was possible due to heterogeneity of comparisons within included studies as well as inadequate reporting of data. All studies were considered to be at either moderate or high risk of bias. The results of this systematic review indicate that there is no clinical or statistical difference between systematic desensitisation and any of the control interventions (either waiting list control, systematic desensitisation combined with group therapy or in vitro (with women under instruction by the therapist) desensitisation) for the treatment of vaginismus. The drop-out rates were higher in the waiting list groups. A clinically relevant effect of systematic desensitisation when compared with any of the control interventions cannot be ruled out. None of the included trials compared other behaviour therapies (e

Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol.

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Beck, Alison K; Baker, Amanda; Jones, Steven; Lobban, Fiona; Kay-Lambkin, Frances; Attia, John; Banfield, Michelle

2018-01-31

Improving accessible, acceptable recovery-oriented service provision for people with bipolar disorder (BD) is an important priority. Mindfulness and acceptance-based cognitive and behavioural therapies (or 'third -wave' CBT) may prove fruitful due to the considerable overlap between these approaches and key features of personal recovery. Groups also confer therapeutic benefits consistent with personal recovery and may improve recovery-oriented service provision by adding another modality for accessing support. The primary objective of this trial is to explore the feasibility and acceptability of a new recovery-focused group therapy (RfGT) intervention for adults with BD. This is the first published feasibility assessment of a time-limited RfGTrecovery-focused group therapy intervention for BD. This protocol describes an open feasibility study, utilising a pre-treatment design versus post- treatment design and nested qualitative evaluation. Participants will be recruited from the Central Coast region of New South Wales, Australia, from primary care providers, specialist mental health services, non-government organisations and via self-referral. The primary outcomes are feasibility and acceptability as indexed by recruitment, retention, intervention adherence, adverse events (if any) and detailed consumer feedback. Clinical outcomes and process measures will be assessed to inform future research. Primary outcome data will utiliseuse descriptive statistics (eg, summarizingsummarising recruitment, demographics, attendance, attrition and intervention adherence). Secondary outcomes will be assessed using repeated-measures analysis of covariance across all time points (including change, effect size and variability). Ethical approval has been granted by the Northern Sydney Local Health District HREChuman research ethics committee (HREC) (HREC/16/HAWKE/69) and The University of Newcastle HREC (H-2016-0107). The Ffindings will be used to improve the intervention per user

Alternative Therapeutic Intervention for Individuals with Rett Syndrome

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Meir Lotan

2007-01-01

Full Text Available The individual with Rett syndrome (RS displays an array of challenging difficulties in all areas of daily living. Since there is no cure for the disorder at this moment, parents of the individual with Rett search for different interventional modalities that will improve the condition and quality of life for their child. During the last few years, many individuals with RS have experienced different kinds of interventions. This paper presents these methods with relevant case stories for others to share the possibilities. This paper reviews the following interventions: animal-assisted therapy, such as dolphin therapy and dog-assisted therapy; auditory integration training; hyperbaric chamber; manual therapy, such as acupuncture/acupressure, aromatherapy, craniosacral therapy, Mayo facial release, Treager massage, chiropractor, and Reiki; mental modification techniques, such as Lovas and cognitive rehabilitation; motoric interventions, such as advanced biomechanical rehabilitation, patterning/Doman-DeLacato approach, and yoga. The present paper is not a recommendation for any of the above-mentioned techniques, but merely a review of different interventions available for the inquisitive parent of the individual with RS.

Treatment of Neck Pain: Noninvasive Interventions

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Carragee, Eugene J.; van der Velde, Gabrielle; Carroll, Linda J.; Nordin, Margareta; Guzman, Jaime; Peloso, Paul M.; Holm, Lena W.; Côté, Pierre; Hogg-Johnson, Sheilah; Cassidy, J. David; Haldeman, Scott

2008-01-01

Study Design. Best evidence synthesis. Objective. To identify, critically appraise, and synthesize literature from 1980 through 2006 on noninvasive interventions for neck pain and its associated disorders. Summary of Background Data. No comprehensive systematic literature reviews have been published on interventions for neck pain and its associated disorders in the past decade. Methods. We systematically searched Medline and screened for relevance literature published from 1980 through 2006 on the use, effectiveness, and safety of noninvasive interventions for neck pain and associated disorders. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our best evidence synthesis. Results. Of the 359 invasive and noninvasive intervention articles deemed relevant, 170 (47%) were accepted as scientifically admissible, and 139 of these related to noninvasive interventions (including health care utilization, costs, and safety). For whiplash-associated disorders, there is evidence that educational videos, mobilization, and exercises appear more beneficial than usual care or physical modalities. For other neck pain, the evidence suggests that manual and supervised exercise interventions, low-level laser therapy, and perhaps acupuncture are more effective than no treatment, sham, or alternative interventions; however, none of the active treatments was clearly superior to any other in either the short-or long-term. For both whiplash-associated disorders and other neck pain without radicular symptoms, interventions that focused on regaining function as soon as possible are relatively more effective than interventions that do not have such a focus. Conclusion. Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain; this was also true of therapies which include educational interventions

Metacognition in speech and language therapy for children with social (pragmatic) communication disorders: implications for a theory of therapy.

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Gaile, Jacqueline; Adams, Catherine

2018-01-01

Metacognition is a significant component of complex interventions for children who have developmental language disorders. Research into how metacognition operates in the content or process of developmental language therapy delivery is limited. Identification and description of proposed active therapy components, such as metacognition, may contribute to our understanding of how to deliver complex communication interventions in an optimal manner. To analyse aspects of metacognition during therapy derived from a manualized speech and language intervention (the Social Communication Intervention Programme-SCIP) as delivered to children who have social (pragmatic) communication disorder (SPCD) and to examine the dynamic process of delivering therapy. A purposive sample of eight filmed therapy sessions was selected from the video data corpus of intervention-arm participants within a randomized controlled trial. The child-therapist interactions during therapy sessions from five children (aged between 5;11 and 10;3) in the SCIP trial were transcribed. Filmed sessions represented a variety of communication profiles and SCIP therapy content. Starting from existing theory on metacognition, cycles of iterative analysis were performed using a mixed inductive-deductive qualitative analysis. A preliminary list of metacognitive content embedded in the intervention was developed into a metacognitive coding framework (MCF). A thematic analysis of the identified metacognitive content of the intervention was then carried out across the whole sample. Thematic analysis revealed the presence of metacognition in the content and delivery of SCIP intervention. Four main themes of metacognitive person, task and strategy knowledge, and monitoring/control were identified. Metacognition was a feature of how children's ability to monitor language, pragmatic and social interaction skills, in themselves and other people, was developed. Task design and delivery methods were found to play a

Guidelines for radiological interventions

International Nuclear Information System (INIS)

Kauffmann, G.W.

1998-01-01

The German Radiological Society, in cooperation with other German professional bodies, set up draft Guidelines for Radiological Interventions and submitted them to the professional community for discussion. The Guidelines are meant to assess the potential of radiological interventions as treatment alternatives to surgery or aggressive therapy such as chemotherapy. In fact, technical practicability on its own is insufficient to warrant intervention. The Guidelines are systematically compiled notions and recommendations whose aim it is to provide support to physicians and patients in choosing suitable medical care provisions (prevention, diagnosis, therapy, aftertreatment) in specific circumstances. A complete Czech translation of the Guidelines is given. (P.A.)

Music therapy is a potential intervention for cognition of Alzheimer?s Disease: a mini-review

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Fang, Rong; Ye, Shengxuan; Huangfu, Jiangtao; Calimag, David P.

2017-01-01

Alzheimer?s Disease (AD) is a global health issue given the increasing prevalence rate and the limitations of drug effects. As a consequent, non-pharmacological interventions are of importance. Music therapy (MT) is a non-pharmacological way with a long history of use and a fine usability for dementia patients. In this review, we will summarize different techniques, diverse clinical trials, and the mechanisms of MT as it is helpful to the cognition in AD, providing reference for future resear...

Extension of a Coronary Intramural Hematoma as a Complication of Early Percutaneous Coronary Intervention after Thrombolytic Therapy

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Mohamed El-Mawardy

2013-01-01

Full Text Available The optimal treatment approach for coronary intramural hematomas has not been well defined, and discussion is limited to scarce data. In addition, the impact of prior thrombolytic therapy in the setting of coronary artery dissections with possible development and/or extension of an intramural hematoma is not well understood. We describe a case of iatrogenic periprocedural dissection of the left anterior descending artery (LAD with development of an intramural hematoma and the extension of this hematoma to the left main (LM and left circumflex (LCX arteries in a middle-aged female, where prior recent thrombolytic therapy may have played a role in its triggering or facilitation of its extension. This case highlights the importance of facilitation of bleeding complications by prior use of thrombolytic therapy not only peripherally but intracoronary too and the use of intravascular ultrasound for both diagnosis, followup, and percutaneous coronary intervention (PCI guidance.

The effectiveness of manual physical therapy interventions in pediatric patients with anterior hip pain: a retrospective study.

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Galleher, Mindy; Crowe, Briana; Selhorst, Mitchell

2017-12-01

The purposes of this study were to: (1) assess the benefit of adding manual therapy (MT) to physical therapy care in pediatric patients with anterior hip pain; (2) assess the relative risk of adverse reactions when MT is used; and (3) report the types of MT used. This study was a retrospective chart review of patients treated in a hospital-based sports medicine clinic. The charts of 201 patients (mean age = 14.23 ± 2.15 years) met the inclusion criteria and were reviewed. Patients were grouped into those who received MT during their episode of care, and those who did not. Pain efficiency (change in pain/number of visits), number and type of adverse reactions, as well as frequency and type of manual therapy interventions used, were the outcomes of interest. The mean pain efficiency was significantly less if manual therapy was performed (MT = 0.60 [95% CI 0.47-0.72], no MT = 0.80 [95% CI 0.71-0.90] p  = 0.01). There was no significant difference between groups in risk of adverse reactions (MT = 5, no MT = 5). The number of visits was significantly different between groups (MT = 9.43 ± 3.9 sessions, and no MT = 7.6 ± 5.2 sessions). MT did not increase the risk of an adverse reaction in pediatric patients with anterior hip pain. While it appears to be a safe intervention, it did not improve pain efficiency or patient adherence. Future research should be performed to assess the effectiveness of MT, when performed by skilled therapists, in pediatric patients with hip pain in a controlled manner. Level of Evidence: 3b.

Music therapy is a potential intervention for cognition of Alzheimer's Disease: a mini-review.

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Fang, Rong; Ye, Shengxuan; Huangfu, Jiangtao; Calimag, David P

2017-01-01

Alzheimer's Disease (AD) is a global health issue given the increasing prevalence rate and the limitations of drug effects. As a consequent, non-pharmacological interventions are of importance. Music therapy (MT) is a non-pharmacological way with a long history of use and a fine usability for dementia patients. In this review, we will summarize different techniques, diverse clinical trials, and the mechanisms of MT as it is helpful to the cognition in AD, providing reference for future research. Many articles have demonstrated that MT can reduce cognitive decline especially in autobiographical and episodic memories, psychomotor speed, executive function domains, and global cognition. MT is a promising intervention for strategy of dementia especially of AD and it must be started as early as possible. However, more evidences with prospective, randomized, blinded, uniform and rigorous methodological investigations are needed. And we should consider to combine MT with other cognitive stimulations such as dance, physical exercise, video game, art and so on.

Cultural adaptation of a cognitive-behavioural intervention to improve adherence to antiretroviral therapy among people living with HIV/AIDS in Zimbabwe: Nzira Itsva.

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Bere, Tarisai; Nyamayaro, Primrose; Magidson, Jessica F; Chibanda, Dixon; Chingono, Alfred; Munjoma, Ronald; Macpherson, Kirsty; Ndhlovu, Chiratidzo Ellen; O'Cleirigh, Conall; Kidia, Khameer; Safren, Steven A; Abas, Melanie

2017-09-01

Few evidence-based interventions to improve adherence to antiretroviral therapy have been adapted for use in Africa. We selected, culturally adapted and tested the feasibility of a cognitive-behavioural intervention for adherence and for delivery in a clinic setting in Harare, Zimbabwe. The feasibility of the intervention was evaluated using a mixed-methods assessment, including ratings of provider fidelity of intervention delivery, and qualitative assessments of feasibility using individual semi-structured interviews with counsellors (n=4) and patients (n=15). The intervention was feasible and acceptable when administered to 42 patients and resulted in improved self-reported adherence in a subset of 15 patients who were followed up after 6months.

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

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

2016-01-01

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

Effects of Group Counseling Programs, Cognitive Behavioral Therapy, and Sports Intervention on Internet Addiction in East Asia: A Systematic Review and Meta-Analysis

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Jun Liu

2017-11-01

Full Text Available To evaluate the effects of group counseling programs, cognitive behavioral therapy (CBT, and sports intervention on Internet addiction (IA, a systematic search in ten databases was performed to identify eligible studies without language restrictions up to January 2017. A meta-analysis and trial sequential analysis (TSA was performed, respectively. A total of 58 randomized controlled trials (RCTs, which included 2871 participants, were incorporated into our meta-analysis. The results showed that group counseling programs, CBT, and sports intervention could significantly reduce IA levels (group counseling program: standardized mean difference (SMD, −1.37; 95% confidence interval (CI, −1.89 to −0.85; CBT: SMD, −1.88; 95% CI, −2.53 to −1.23; sports intervention: SMD, −1.70; 95% CI, −2.14 to −1.26. For group counseling programs, this treatment was more effective in four dimensions of IA, including time management, interpersonal and health issues, tolerance, and compulsive Internet use. For CBT, this treatment yielded a positive change in depression, anxiousness, aggressiveness, somatization, social insecurity, phobic anxiety, paranoid ideation, and psychoticism. For sports intervention, the significant effects were also observed in all dimensions of the IA scale. Each of group counseling programs, cognitive behavioral therapy, and sports intervention had a significant effect on IA and psychopathological symptoms. Sports intervention could improve withdrawal symptoms especially.

Percutaneous coronary intervention and antiplatelet therapy in patients with atrial fibrillation receiving apixaban or warfarin: Insights from the ARISTOTLE trial

NARCIS (Netherlands)

Kopin, D.; Jones, W.S.; Sherwood, M.W.; Wojdyla, D.M.; Wallentin, L.; Lewis, B.S.; Verheugt, F.W.A.; Vinereanu, D.; Bahit, M.C.; Halvorsen, S.; Huber, K.; Parkhomenko, A.; Granger, C.B.; Lopes, R.D.; Alexander, J.H.

2018-01-01

BACKGROUND: We assessed antiplatelet therapy use and outcomes in patients undergoing percutaneous coronary intervention (PCI) during the ARISTOTLE trial. METHODS: Patients were categorized based on the occurrence of PCI during follow-up (median 1.8 years); PCI details and outcomes post-PCI are

Recent advances in pediatric interventional cardiology.

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Kim, Seong-Ho

2017-08-01

During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.

Aquatic Therapy: A Viable Therapeutic Recreation Intervention.

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Broach, Ellen; Dattilo, John

1996-01-01

Reviews literature on the effects of aquatic therapy (swimming and exercise) to improve function. Research shows that aquatic therapy has numerous psychological and physical benefits, and it supports the belief that participation can provide a realistic solution to maintaining physical fitness and rehabilitation goals while engaging in enjoyable…

Cognitive behavioural therapy (CBT), third-wave CBT and interpersonal therapy (IPT) based interventions for preventing depression in children and adolescents.

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Hetrick, Sarah E; Cox, Georgina R; Witt, Katrina G; Bir, Julliet J; Merry, Sally N

2016-08-09

Depression is common in young people. It has a marked negative impact and is associated with self-harm and suicide. Preventing its onset would be an important advance in public health. This is an update of a Cochrane review that was last updated in 2011. To determine whether evidence-based psychological interventions (including cognitive behavioural therapy (CBT), interpersonal therapy (IPT) and third wave CBT)) are effective in preventing the onset of depressive disorder in children and adolescents. We searched the specialised register of the Cochrane Common Mental Disorders Group (CCMDCTR to 11 September 2015), which includes relevant randomised controlled trials from the following bibliographic databases: The Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date) and PsycINFO (1967 to date). We searched conference abstracts and reference lists of included trials and reviews, and contacted experts in the field. We included randomised controlled trials of an evidence-based psychological prevention programme compared with any comparison control for young people aged 5 to 19 years, who did not currently meet diagnostic criteria for depression. Two authors independently assessed trials for inclusion and rated their risk of bias. We adjusted sample sizes to take account of cluster designs and multiple comparisons. We contacted trial authors for additional information where needed. We assessed the quality of evidence for the primary outcomes using GRADE. We included 83 trials in this review. The majority of trials (67) were carried out in school settings with eight in colleges or universities, four in clinical settings, three in the community and four in mixed settings. Twenty-nine trials were carried out in unselected populations and 53 in targeted populations.For the primary outcome of depression diagnosis at medium-term follow-up (up to 12 months), there were 32 trials with 5965 participants and the risk of having a diagnosis of depression was

Unraveling the Mechanisms of Manual Therapy: Modeling an Approach.

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Bialosky, Joel E; Beneciuk, Jason M; Bishop, Mark D; Coronado, Rogelio A; Penza, Charles W; Simon, Corey B; George, Steven Z

2018-01-01

Synopsis Manual therapy interventions are popular among individual health care providers and their patients; however, systematic reviews do not strongly support their effectiveness. Small treatment effect sizes of manual therapy interventions may result from a "one-size-fits-all" approach to treatment. Mechanistic-based treatment approaches to manual therapy offer an intriguing alternative for identifying patients likely to respond to manual therapy. However, the current lack of knowledge of the mechanisms through which manual therapy interventions inhibit pain limits such an approach. The nature of manual therapy interventions further confounds such an approach, as the related mechanisms are likely a complex interaction of factors related to the patient, the provider, and the environment in which the intervention occurs. Therefore, a model to guide both study design and the interpretation of findings is necessary. We have previously proposed a model suggesting that the mechanical force from a manual therapy intervention results in systemic neurophysiological responses leading to pain inhibition. In this clinical commentary, we provide a narrative appraisal of the model and recommendations to advance the study of manual therapy mechanisms. J Orthop Sports Phys Ther 2018;48(1):8-18. doi:10.2519/jospt.2018.7476.

A pilot study: the effects of music therapy interventions on middle school students' ESL skills.

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Kennedy, Roy; Scott, Amanda

2005-01-01

The purpose of this study was to investigate the effects of music therapy techniques on the story retelling and speaking skills of English as a Second Language (ESL) middle school students. Thirty-four middle school students of Hispanic heritage, ages 10-12, in high and low-functioning groups participated in the study for 12 weeks. Pretest to posttest data yielded significant differences on the story retelling skills between the experimental and control groups. Chi Square comparisons on English speaking skills also yielded significant results over 3 months of music therapy intervention. A variety of music therapy techniques were used including music and movement, active music listening, group chanting and singing, musical games, rhythmic training, music and sign language, and lyric analysis and rewrite activities as supplemental activities to the ESL goals and objectives. Comparisons of individual subjects' scores indicated that all of the students in the experimental groups scored higher than the control groups on story retelling skills (with the exception of 1 pair of identical scores), regardless of high and low functioning placement. Monthly comparisons of the high and low functioning experimental groups indicated significant improvements in English speaking skills as well.

Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial

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Ørner Roderick

2009-01-01

Full Text Available Abstract Background Sleep problems are common, affecting over a third of adults in the United Kingdom and leading to reduced productivity and impaired health-related quality of life. Many of those whose lives are affected seek medical help from primary care. Drug treatment is ineffective long term. Psychological methods for managing sleep problems, including cognitive behavioural therapy for insomnia (CBTi have been shown to be effective and cost effective but have not been widely implemented or evaluated in a general practice setting where they are most likely to be needed and most appropriately delivered. This paper outlines the protocol for a pilot study designed to evaluate the effectiveness and cost-effectiveness of an educational intervention for general practitioners, primary care nurses and other members of the primary care team to deliver problem focused therapy to adult patients presenting with sleep problems due to lifestyle causes, pain or mild to moderate depression or anxiety. Methods and design This will be a pilot cluster randomised controlled trial of a complex intervention. General practices will be randomised to an educational intervention for problem focused therapy which includes a consultation approach comprising careful assessment (using assessment of secondary causes, sleep diaries and severity and use of modified CBTi for insomnia in the consultation compared with usual care (general advice on sleep hygiene and pharmacotherapy with hypnotic drugs. Clinicians randomised to the intervention will receive an educational intervention (2 × 2 hours to implement a complex intervention of problem focused therapy. Clinicians randomised to the control group will receive reinforcement of usual care with sleep hygiene advice. Outcomes will be assessed via self-completion questionnaires and telephone interviews of patients and staff as well as clinical records for interventions and prescribing. Discussion Previous studies in adults

Occupational Therapy in the Intensive Care Unit: A Systematic Review.

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Weinreich, Mark; Herman, Jennifer; Dickason, Stephanie; Mayo, Helen

2017-07-01

This paper is a synthesis of the available literature on occupational therapy interventions performed in the adult intensive care unit (ICU). The databases of Ovid MEDLINE, Embase, the Cochrane Library, ClinicalTrials.gov and CINAHL databases were systematically searched from inception through August 2016 for studies of adults who received occupational therapy interventions in the ICU. Of 1,938 citations reviewed, 10 studies met inclusion criteria. Only one study explicitly discussed occupational therapy interventions performed and only one study specifically tested the efficacy of occupational therapy. Future research is needed to clarify the specific interventions and role of occupational therapy in the ICU and the efficacy of these interventions.

Acute deep venous thrombosis of lower extremity: anatomical distribution, comparison of anticoagulation, thrombolysis and interventional therapy

International Nuclear Information System (INIS)

Zhuang; Naijun; Che Guoping; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Su Haobo; Song Jinhua; Wang Tao; Xu Ke

2011-01-01

Objective: To investigate the anatomical distribution of acute deep venous thrombosis (DVT) of the lower extremity, and compare different therapeutic methods including anticoagulation alone, thrombolysis through dorsal vein and interventional therapy. Methods: The clinical data, venography and therapies of 204 acute DVT patients were retrospectively studied According to the distribution, DVT were classified into three types including peripheral, central and mixed types. According to the difference of the therapeutic method, each type of DVT was divided into three groups, Group A (37 patients) anticoagulation alone: Group B (55 patients) thrombolysis through dorsal vein: and Group C (112 patients) interventional therapy. The results of different kind of treatment method in each type of DVT were evaluated before the patients were discharged and the Chi-square test was used for statistical analysis. Results: There were 132 patients with DVT in the left lower extremity, 62 in right lower extremity, and 10 in both extremities.. The complication of pulmonary embolism (PE) occurred in 4, 5 and 2 cases respectively, and the morbidity was 3.0%, 8.1% and 20.0% (χ 2 =6.494, P=0.039) respectively. There was significant statistical difference among them. There were 23 cases of peripheral type of DVT, 48 central type and 133 mixed type. The complication of PE were observed in 2, 5 and 4 cases respectively in each type. The morbidity was 8.7%, 10.4% and 3.0% respectively (χ 2 =4.350, P=0.114). There were no statistical significance among them. In the 23 cases of peripheral type DVTs, 2 of 5 in group A and 11 of 18 in group B had excellent therapeutic response. In the 48 cases of central type of DVTs, 1 of 10 in group A, 2 of 5 in in group B and 26 of 33 in group C had excellent therapeutic response. There were statistically significant differences among groups A, B and C (χ 2 =16.157, P=0.000). In the 133 cases of mixed type DVTs, 1 of 22 in group A, 10 of 32 in group B and 65

The perfect marriage: Solution-focused therapy and motivational interviewing in medical family therapy

Directory of Open Access Journals (Sweden)

Gage Stermensky

2014-01-01

Full Text Available Medical family therapy has many potential uses in behavioral medicine and primary care. Current research was reviewed to determine the most advantageous way to apply solution-focused therapy and motivational interviewing as a perfect marriage in medical family therapy. An extensive literature review was done in the following databases for medical family therapy: Proquest, EBSCO, Medline, and PsychInfo. The search resulted in 86 relevant articles, of which 46 of the most recent were selected for review. Medical family therapy lacks current research that supports solution-focused therapy or motivational interviewing. However, evidence supports the use of solution-focused therapy as a brief format, as well as the closely related intervention, motivational interviewing. While medical family therapy presents many hopeful possibilities in the fields of behavioral medicine, psychology, and marriage and family therapy, little evidence currently exists for the most effective implementation. This review found evidence supporting solution-focused therapy and motivational interviewing as the perfect marriage of the collaborative team approaches for the future implementation and use of specific interventions in medical family therapy.

Using a Response to Intervention (RtI) Framework with 1st Grade Students: A Model for Occupational Therapy Practitioners

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McGuire, Beatriz

2012-01-01

The most recent reauthorization of the Individual's with Disabilities Education Improvement Act (IDEA, 2004) allows for the expansion of occupational therapy's role in school-based practice to include students who have not been identified for special education through early intervening services such as response to intervention (RtI).…

Effects of a live educational music therapy intervention on acute psychiatric inpatients' perceived social support and trust in the therapist: a four-group randomized effectiveness study.

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Silverman, Michael J

2014-01-01

Social support is associated with enhanced illness management and recovery in persons with mental illness, making it an important topic addressed through acute inpatient psychoeducational programs. In addition, trust in the therapist may mediate clinical outcomes in this patient population. To date, few studies have examined the effect of music-based psychoeducational programs on these variables. The purpose of this study was to isolate and examine the component parts of a live educational music therapy intervention, and its effect on acute psychiatric inpatients' perceived social support from significant others, family, and friends and trust in the therapist. This study also explored whether trust in therapist varied across conditions, but did not examine it as a mediator for social support. Participants (N = 96) were cluster-randomized in a single-session posttest-only design to one of four conditions: live educational music therapy, recorded educational music therapy, education without music, or recreational music therapy without education. Conditions were designed to isolate the following intervention components: live vs. recorded music, educational vs. non-educational content, and music vs. nonmusic modality. Dependent measures were assessed post intervention via established self-report instruments evaluating perceived social support and trust in the therapist. There were no significant between-group differences for social support or trust in therapist total scores. However, subscale score analyses revealed two significant between-group differences: (a) participants in the Live Educational Music Therapy condition reported significantly higher perceived therapist competence compared with the Recorded Educational Music Therapy condition; (b) participants in the Live Educational Music Therapy condition reported significantly higher perceived support from friends compared with the Recreational Music Therapy condition. Live educational music therapy may be a way to

The applicability of normalisation process theory to speech and language therapy: a review of qualitative research on a speech and language intervention.

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James, Deborah M

2011-08-12

The Bercow review found a high level of public dissatisfaction with speech and language services for children. Children with speech, language, and communication needs (SLCN) often have chronic complex conditions that require provision from health, education, and community services. Speech and language therapists are a small group of Allied Health Professionals with a specialist skill-set that equips them to work with children with SLCN. They work within and across the diverse range of public service providers. The aim of this review was to explore the applicability of Normalisation Process Theory (NPT) to the case of speech and language therapy. A review of qualitative research on a successfully embedded speech and language therapy intervention was undertaken to test the applicability of NPT. The review focused on two of the collective action elements of NPT (relational integration and interaction workability) using all previously published qualitative data from both parents and practitioners' perspectives on the intervention. The synthesis of the data based on the Normalisation Process Model (NPM) uncovered strengths in the interpersonal processes between the practitioners and parents, and weaknesses in how the accountability of the intervention is distributed in the health system. The analysis based on the NPM uncovered interpersonal processes between the practitioners and parents that were likely to have given rise to successful implementation of the intervention. In previous qualitative research on this intervention where the Medical Research Council's guidance on developing a design for a complex intervention had been used as a framework, the interpersonal work within the intervention had emerged as a barrier to implementation of the intervention. It is suggested that the design of services for children and families needs to extend beyond the consideration of benefits and barriers to embrace the social processes that appear to afford success in embedding

Animal-assisted interventions: A national survey of health and safety policies in hospitals, eldercare facilities, and therapy animal organizations.

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Linder, Deborah E; Siebens, Hannah C; Mueller, Megan K; Gibbs, Debra M; Freeman, Lisa M

2017-08-01

Animal-assisted intervention (AAI) programs are increasing in popularity, but it is unknown to what extent therapy animal organizations that provide AAI and the hospitals and eldercare facilities they work with implement effective animal health and safety policies to ensure safety of both animals and humans. Our study objective was to survey hospitals, eldercare facilities, and therapy animal organizations on their AAI policies and procedures. A survey of United States hospitals, eldercare facilities, and therapy animal organizations was administered to assess existing health and safety policies related to AAI programs. Forty-five eldercare facilities, 45 hospitals, and 27 therapy animal organizations were surveyed. Health and safety policies varied widely and potentially compromised human and animal safety. For example, 70% of therapy animal organizations potentially put patients at risk by allowing therapy animals eating raw meat diets to visit facilities. In general, hospitals had stricter requirements than eldercare facilities. This information suggests that there are gaps between the policies of facilities and therapy animal organizations compared with recent guidelines for animal visitation in hospitals. Facilities with AAI programs need to review their policies to address recent AAI guidelines to ensure the safety of animals and humans involved. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Effects of lifestyle intervention using patient-centered cognitive behavioral therapy among patients with cardio-metabolic syndrome: a randomized, controlled trial.

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Zhang, Ying; Mei, Songli; Yang, Rui; Chen, Ling; Gao, Hang; Li, Li

2016-11-18

Cardio-metabolic syndrome (CMS) is a highly prevalent condition. There is an urgent need to identify effective and integrated multi-disciplinary approaches that can reduce risk factors for CMS. Sixty-two patients with a history of CMS were randomized 1:1 into two groups: a standard information -only group (control), or a self-regulated lifestyle waist circumference (patient-centered cognitive behavioral therapy) intervention group. A pretest and posttest, controlled, experimental design was used. Outcomes were measured at the baseline (week 0) and at the end of intervention (week 12). Comparisons were drawn between groups and over time. The mean (standard deviation) age of the subjects was 48.6 (5.8) years ranging from 32 to 63, and 56.9% of the participants were female. Both groups showed no significant differences in Demographic variables and the metabolic syndrome indicators at baseline. While the control group only showed modest improvement after 12 weeks, compared to baseline, the intervention group demonstrated significant improvement from baseline. This study controlled for patients' demographics and baseline characteristics when assessing the effects of intervention. After adjusting for age, education and baseline level, the experimental group and the control group were statistically significant different in the following post-treatment outcomes: WC (F = 35.96, P cognitive behavioral therapy can improve the physical and mental health conditions among individuals reporting a history of cardio-metabolic syndrome, and possibly provided preliminary benefits for the treatment of CMS. Chinese Clinical Trial Register #, ChiCTR15006148 .

A blended intervention for patients with knee and hip osteoarthritis in the physical therapy practice: development and a pilot study.

NARCIS (Netherlands)

Bossen, D.; Kloek, C.; Snippe, H.W.; Dekker, J.; Bakker, D. de; Veenhof, C.

2016-01-01

Background Exercise therapy in patients with hip and/or knee osteoarthritis is effective in reducing pain, increasing physical activity and physical functioning, but costly and a burden for the health care budget. A web-based intervention is cheap in comparison to face-to-face