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Control Interventions (control + intervention)
Selected AbstractsStatistical Inference in a Stochastic Epidemic SEIR Model with Control Intervention: Ebola as a Case StudyBIOMETRICS, Issue 4 2006Phenyo E. Lekone Summary A stochastic discrete-time susceptible-exposed-infectious-recovered (SEIR) model for infectious diseases is developed with the aim of estimating parameters from daily incidence and mortality time series for an outbreak of Ebola in the Democratic Republic of Congo in 1995. The incidence time series exhibit many low integers as well as zero counts requiring an intrinsically stochastic modeling approach. In order to capture the stochastic nature of the transitions between the compartmental populations in such a model we specify appropriate conditional binomial distributions. In addition, a relatively simple temporally varying transmission rate function is introduced that allows for the effect of control interventions. We develop Markov chain Monte Carlo methods for inference that are used to explore the posterior distribution of the parameters. The algorithm is further extended to integrate numerically over state variables of the model, which are unobserved. This provides a realistic stochastic model that can be used by epidemiologists to study the dynamics of the disease and the effect of control interventions. [source] Healthy weight control and dissonance-based eating disorder prevention programs: Results from a controlled trialINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2003Eric Stice Abstract Objective Because universal psychoeducational eating disorder prevention programs have had little success, we developed and evaluated two interventions for high-risk populations: a healthy weight control intervention and a dissonance-based intervention. Method Adolescent girls (N = 148) with body image concerns were randomized to one of these interventions or to a waitlist control group. Participants completed baseline, termination, and 1, 3, and 6-month follow-up surveys. Results Participants in both interventions reported decreased thin-ideal internalization, negative affect, and bulimic symptoms at termination and follow-up relative to controls. However, no effects were observed for body dissatisfaction or dieting and effects diminished over time. Discussion Results provide evidence that both interventions effectively reduce bulimic pathology and risk factors for eating disturbances. © 2002 by Wiley Periodicals, Inc. Int J Eat Disord 33: 10,21, 2003. [source] Does the experimental design capture the effects of complementary therapy?JOURNAL OF CLINICAL NURSING, Issue 4 2007A study using reflexology for patients undergoing coronary artery bypass graft surgery Aim., Our purpose was to pilot test whether reflexology may reduce anxiety in patients undergoing Coronary Artery Bypass Graft Surgery in Iceland. Background., Nurses need to study the effects of complementary therapies in general and particularly those that may be beneficial to decrease patients' anxiety. It has been assumed that reflexology lessens anxiety, but research is needed to substantiate such expectations. Design., A pilot study using randomized design with experimental and control groups. Methods., Nine patients were recruited and randomly assigned into groups with five patients assigned into an experimental group receiving reflexology for 30 minutes and four patients into control group which rested for 30 minutes. Anxiety and physiological variables were measured pre- and post-reflexology sessions once a day over five days. Results., The anxiety scores were lower for patients in the control group on all measures. Systolic blood pressure lowered significantly more in the control group than in the treatment group. No significant changes were observed for other variables. Patients' comments and responses overwhelmingly suggested increased well-being due to both experimental and control intervention. Conclusion., This study showed little evidence to support reflexology as a mean of reducing anxiety in CABG patients. Several methodological problems were identified that need to be considered further. Relevance to clinical practice., It is suggested that reflexology should be tailored to individual needs and research methods used that allow for capturing its holistic nature. Further scholarly work is warranted to explore several methodological issues in studying complementary therapies in a highly complex treatment situation. [source] Brief Motivational Interviewing for DWI Recidivists Who Abuse Alcohol and Are Not Participating in DWI Intervention: A Randomized Controlled TrialALCOHOLISM, Issue 2 2010Thomas G. Brown Background:, Driving while impaired (DWI) recidivists with unresolved alcohol use problems pose an ongoing risk for traffic safety. Following conviction, many do not participate in mandated alcohol evaluation and intervention programs, or continue to drink problematically after being relicensed. This study investigated if, in DWI recidivists with alcohol problems and not currently involved in DWI intervention, Brief Motivational Interviewing (BMI) produced greater reductions in risky drinking at 6- and 12-month follow-up compared to an information-advice control condition. Additional analyses explored whether BMI was associated with greater readiness to change, subsequent substance abuse treatment service utilization, and satisfaction compared to the control condition. Methods:, Male and female recidivists with drinking problems and not currently engaged in DWI intervention were recruited, evaluated, and then randomly assigned to receive 1 of 2 manualized interventions: 30-minute BMI session or information-advice. Participants, interviewers, researchers, and statisticians were blind to assignment. Outcomes were changed in: percent of risky drinking days (i.e., ,3 standard drinks/d for males; ,2 for females) in the previous 6 months derived from the Timeline Followback, biomarkers of alcohol abuse (GGT, AST, ALT, MCV) by blood assay, and alcohol abuse-related behaviors using the MMPI-Mac scale. Data from the Readiness to Change Questionnaire, a substance abuse service utilization questionnaire, and the Client Satisfaction Scale were also collected. Results:, Analyses revealed significant declines in risky drinking with both interventions. BMI (n = 92) resulted in a 25% reduction in risky drinking days at 12-month follow-up, which compared to the control intervention (n = 92) represented a significant decline from 6-month levels. Exposure to BMI also produced significantly greater improvement at 6-month follow-up in a biomarker of alcohol abuse and a behavioral measure related to recidivism risk. Exploration of readiness to change, substance abuse service utilization, and satisfaction with intervention indicated a perception of BMI being more useful in coping with problems. Conclusions:, Brief MI approaches warrant further implementation and effectiveness research as an opportunistic DWI intervention strategy to reduce risks associated with alcohol use outside of clinical and DWI relicensing settings. [source] A further comparison of external control and problem-solving interventions to teach social skills to adults with intellectual disabilitiesBEHAVIORAL INTERVENTIONS, Issue 3 2004Mark F. O'Reilly We compared the effectiveness of a problem-solving and an external control intervention to teach social skills to two adults with mild intellectual disabilities. Each participant received the problem-solving intervention with one social skill and the external control intervention with another social skill. The comparative effectiveness of the social skill training protocols was evaluated using individual participant alternating treatment designs. Overall, there seemed to be little difference between the interventions in terms of acquisition, generalization, or maintenance of social skills with either participant. Limitations of the current study and issues for future research are discussed. Copyright © 2004 John Wiley & Sons, Ltd. [source] A randomized clinical trial of energy conservation for patients with cancer-related fatigueCANCER, Issue 6 2004Andrea M. Barsevick D.N.Sc. Abstract BACKGROUND The efficacy of energy conservation and activity management (ECAM) for fatigue reduction and maintenance of functional performance has never been evaluated in adults with cancer who are undergoing treatment. METHODS A randomized clinical trial compared an ECAM intervention with a control intervention focused on nutrition. Individuals initiating chemotherapy, radiotherapy, or concurrent therapy for cancer were randomized to receive either the semistructured ECAM intervention (n = 200) or the control intervention (n = 196). Participants in each group participated in 3 telephone sessions with an oncology nurse during the first 5 weeks of treatment. Data on fatigue and limitation of functioning were obtained before cancer treatment and at two follow-up points that coincided with times of high fatigue for each type of treatment. The outcomes of interest included perception of fatigue and functional performance. RESULTS A repeated-measures analysis of covariance using the type of cancer treatment as a covariate revealed a significant study group,by-time interaction indicating that the ECAM group experienced a greater decrease in fatigue over time compared with the control group (F2,544 = 4.5; P = 0.01). The intervention was not associated with changes in overall functional performance. CONCLUSIONS Individuals who received the ECAM intervention derived a modest but significant benefit from it. To achieve a more robust clinical benefit from the intervention, it may be necessary to manage other key symptoms in addition to fatigue. Research is needed to examine symptom clusters or combinations associated with negative outcomes as well as combination strategies for symptom management. Cancer 2004. © 2004 American Cancer Society. [source] Maximizing help for dissonant smokersADDICTION, Issue 1s1 2000Michael Kunze 'Consonant' smokers know and accept the risks associated with tobacco consumption, and do not wish to change their smoking, whereas 'dissonant' smokers are tobacco consumers whose attitudes differ from their behaviour. Dissonant smokers have several options: to quit smoking (the optimal solution), reduce their smoking, switch products or brands, or do nothing. To date, nicotine replacement therapy (NRT) is the best-established medical aid to smoking cessation, but several important factors impact on NRT use. As smokers constitute a diverse group there is a need for various different formulations, some of which will suit certain smokers better than others. Smokers should be allowed to select their preferred products in order to increase compliance, and should also be permitted to combine various products if desired. Adequate dosage regimens should be stressed in order to avoid under-dosing, which is common with NRT. It is also essential that the medical system focuses increasingly on the diagnosis and treatment of those smokers who are unable or unwilling to quit smoking. High nicotine dependence correlates with a high risk of pulmonary and cardiovascular disease; because these smokers cannot quit, cessation efforts have little impact on the incidence of tobacco-related diseases in this population. Additional smoking control interventions, such as smoking reduction therapy, are therefore required to treat this group. Our experience in Vienna shows that these smokers can be targeted through approaches that utilize new messages offering alternatives to cessation. [source] Effective Methods to Improve Recruitment and Retention in School-Based Substance Use Prevention StudiesJOURNAL OF SCHOOL HEALTH, Issue 9 2009Jean-Marie Bruzzese PhD ABSTRACT BACKGROUND: Poor recruitment and high attrition may invalidate results of research studies. This paper describes successful recruitment and retention strategies in a school-based substance use prevention trial and explores factors associated with intervention attendance and retention. METHODS: A total of 384 parent-child dyads from 15 schools in the New York Metropolitan area participated in a control trial, testing the efficacy of parent-training to prevent youth substance use. Assessments were completed immediately post-intervention and 6-, 12-, and 24-month postintervention. Logistic regression analyses were used to determine which familial and study characteristics predicted attendance in the intervention and retention by parents and youth. RESULTS: 84% of intervention parents attended 4 of the 5 workshops; 83% of control parents attended their single workshop. Intervention attendance was predicted by parent job status, but this was not significant after controlling for other family factors. Retention rates ranged from 87% to 91% over the 2 years. No family characteristics predicted retention, but time since baseline and attendance at treatment workshops and the control workshop did. For children, age at baseline and ethnicity predicted retention, but this did not remain significant in the adjusted model. CONCLUSION: Intervention attendance was high and retention rates far exceeded the minimum standard of 70% retention in behavioral studies. Recruitment and retention strategies were effective for different family constellations. Efforts to maximize participation in both treatment and control interventions are critical to retention in longitudinal trials. [source] Seasonal variations in active dispersal of natural populations of Triatoma infestans in rural north-western ArgentinaMEDICAL AND VETERINARY ENTOMOLOGY, Issue 3 2006G. M. VAZQUEZ-PROKOPEC Abstract The flight dispersal of Triatoma infestans Klug (Hemiptera: Reduviidae) is one of the main mechanisms determining community re-infestation after control interventions. An empirical model of flight initiation coupled with data from a longitudinal study predicted that the flight dispersal of T. infestans would peak in summer. To test this prediction, longitudinal light trap collections were conducted during 3,8 nights in March (late summer), July (winter) and November (spring) 2003, and in March 2004 in a rural community in north-west Argentina. Following each light-trapping collection date, all peridomestic sites around light traps were inspected to assess the relative abundance and nutritional status of T. infestans at each site. A total of 21 adult and five nymph T. infestans, six Triatoma guasayana Wygodzinsky & Abalos, and nine Triatoma garciabesi Carcavallo et al. were collected in 96 light-trapping nights, whereas 696 T. infestans were collected from the peridomestic sites that surrounded the light traps. The arrival of T. infestans in the light traps occurred in 64% of catch stations and peaked in the summer surveys (10,14 bugs) compared with spring and winter surveys. When winds were < 5 km/h, the arrival of adult T. infestans at the light traps was significantly associated with maximum temperature and relative humidity. This is the first field report of seasonal variations in the flight dispersal activity of T. infestans. [source] Treatment, management, and control: Improving outcomes through more treatment and less controlNEW DIRECTIONS FOR YOUTH DEVELOPMENT, Issue 88 2000Richard H. Hunter President Outcomes in psychiatric care are improved by expanding treatment options and reducing dependence on management and control interventions. [source] Practitioner Review: Bridging the gap between research and clinical practice in pediatric obesityTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 2 2007Elissa Jelalian Background:, Pediatric obesity is a significant public health concern, with rising prevalence rates in both developed and developing countries. This is of particular significance given that overweight children and adolescents are at increased risk for multiple medical comorbidities, as well as psychosocial and behavioral difficulties. The current review highlights findings from the empirical pediatric obesity treatment literature, with particular attention to diet, physical activity, and behavior interventions. Evaluation and treatment considerations relevant to working with overweight children and adolescents with psychiatric comorbidities are reviewed. Methods:, Review of the relevant treatment literature, with a focus on randomized clinical trials, was conducted. Recommendations regarding treatment of children and adolescents with psychiatric comorbidities are based on relevant prospective studies of the relationship between weight status and psychological variables and studies with adult populations. Results:, Well-established pediatric weight control interventions have been conducted in research settings. These studies provide a starting point, but are limited by homogeneous samples that may exclude participants with psychiatric comorbidities. Practitioners treating obese children and adolescents with psychiatric disorders are encouraged to assess individual, familial, and contextual variables specific to weight (e.g., motivation and existing support to change current eating and physical activity patterns, extent of weight-related conflict within family, impact of weight on current functioning) in order to prioritize treatment objectives. Conclusions:, The review concludes with a discussion of current empirical and practical challenges, including explicitly targeting obese children and adolescents with psychiatric concerns and determining appropriateness of pursuing weight control interventions in this population. [source] Lessons for Aboriginal tobacco control in remote communities: an evaluation of the Northern Territory ,Tobacco Project'AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010David Thomas Abstract Objective: To evaluate a Northern Territory (NT) government-led pilot ,Tobacco Project' in six remote communities. Methods: Monthly surveys of staff, semi-structured interviews with staff and community members, observation of the delivery of tobacco control interventions, review of Project documents, and monitoring of tobacco consumption using sales (or wholesale orders) of tobacco. Results: There was a substantive amount of tobacco control activity delivered in three of the Project communities. In two of these locations, the majority of work was primarily driven and undertaken by resident staff. Overall, most of the Project's efforts related to community education and awareness-raising. There was variable impact of the Project on tobacco consumption across the six communities. More tobacco control activity was consistently associated with a greater reduction in tobacco consumption. An important predictor of local activity was the presence of strong community drivers. A significant obstacle to the Project was the lack of new resources. Conclusions: Despite the minimal impact of this Project on tobacco consumption overall, there was a consistent association between on-the-ground tobacco control activity and reductions in tobacco consumption. Implications: New initiatives will not only need to provide new funding, but identify and then support local staff, who are central to improving local tobacco control activity and so reducing smoking and smoking-related illnesses and deaths. [source] Statistical Inference in a Stochastic Epidemic SEIR Model with Control Intervention: Ebola as a Case StudyBIOMETRICS, Issue 4 2006Phenyo E. Lekone Summary A stochastic discrete-time susceptible-exposed-infectious-recovered (SEIR) model for infectious diseases is developed with the aim of estimating parameters from daily incidence and mortality time series for an outbreak of Ebola in the Democratic Republic of Congo in 1995. The incidence time series exhibit many low integers as well as zero counts requiring an intrinsically stochastic modeling approach. In order to capture the stochastic nature of the transitions between the compartmental populations in such a model we specify appropriate conditional binomial distributions. In addition, a relatively simple temporally varying transmission rate function is introduced that allows for the effect of control interventions. We develop Markov chain Monte Carlo methods for inference that are used to explore the posterior distribution of the parameters. The algorithm is further extended to integrate numerically over state variables of the model, which are unobserved. This provides a realistic stochastic model that can be used by epidemiologists to study the dynamics of the disease and the effect of control interventions. [source] Surveillance of antibiotic use in hospitals: methods, trends and targetsCLINICAL MICROBIOLOGY AND INFECTION, Issue 8 2006E. I. Kritsotakis Abstract A standardised antibiotic surveillance system is an essential requirement of all antibiotic control strategies. Antibiotic use can be quantified accurately using patient-level surveillance, although this is not feasible for most hospitals. Instead, population-level surveillance is a more realistic alternative for ongoing and systematic monitoring of antibiotic use. Monitoring of aggregate, ward-supply data on a monthly basis, stratification by patient care area, and analysis by the anatomical therapeutic chemical/defined daily dose (ATC/DDD) system, adjusting for bed-occupancy, provides a clear picture of antibiotic consumption density and time-trends within a hospital. When usage rates are supplemented and interpreted according to changes in hospital resource indicators, benchmarking is facilitated. This provides an efficient tool for triggering and targeting antibiotic control interventions. [source] |