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Active Intervention (active + intervention)
Selected AbstractsPassive Acceptance or Active Intervention, a Choice With ConsequencesACADEMIC EMERGENCY MEDICINE, Issue 7 2009Charlene Babcock Irvin MD No abstract is available for this article. [source] Consequences of soil compaction for seedling establishment: Implications for natural regeneration and restorationAUSTRAL ECOLOGY, Issue 8 2005I. E. BASSETT Abstract Soil compaction can affect seedling root development by decreasing oxygen availability and increasing soil strength. However, little quantitative information is available on the compaction tolerances of non-crop native species. We investigated the effects of soil compaction on establishment and development of two New Zealand native species commonly used in restoration programmes; Cordyline australis (Agavaceae) (cabbage tree) a fleshy rooted species, and Leptospermum scoparium (Myrtaceae) (manuka) a very finely rooted species. Seedlings were grown in a range of soil compaction levels in growth cabinet experiments. Low levels of soil compaction (0.6 MPa) reduced both the number and speed of C. australis seedlings penetrating the soil surface. In contrast, L. scoparium seedlings showed improved establishment at an intermediate compaction level. Root and shoot growth of both species decreased with increasing soil strength, with L. scoparium seedlings tolerating higher soil strengths than did C. australis. Despite these results, soil strength accounted for only a small amount of variation in root length (R2 < 0.25), due to greater variability in growth at low soil strengths. Soil strengths of 0.6 MPa are likely to pose a barrier to C. australis regeneration. This is consistent with adaptation to organic and/or soft, waterlogged soils. Active intervention may be necessary to establish C. australis from seed on many sites previously in farmland. [source] Testing mechanisms of action for intensive case managementADDICTION, Issue 3 2008Jon Morgenstern ABSTRACT Aim This study identified factors that predict, mediate or moderate the effects of intensive case management (ICM) on longer-term drug abstinence outcomes in women on welfare. Design In a parent study women were assigned randomly to usual care (UC) or intensive case manangement (ICM). Treatment was provided for 12 weeks and follow-up continued for 15 months after study intake. A set of hypothesized mediators was assessed at month 3 and a rigorous four-step mediational model was tested using outcomes in months 4,15. Participants Participants were 302 drug-dependent women applying and eligible for federal welfare and not currently in drug abuse treatment. Interventions ICM provided intensive treatment engagement including voucher incentives for treatment attendance and case management services; UC provided primarily referral to community treatment programs. Measurement Substance use outcomes were assessed using the time-line follow-back interview and confirmed using biological and collateral measures. Findings Participants in ICM had more case manager contacts, better treatment engagement and more self-help attendance than did those in UC. Each of these variables predicted, and was shown to be a mediator of outcome, but case management contact was an especially robust mediator. Further, ICM effects were strongest for those who attended treatment least. Contrary to prediction, greater psychopathology and environmental stressors did not predict worse outcomes. Conclusions Findings suggest that case management is an active intervention that may both facilitate and substitute for formal drug abuse treatment. [source] Health Professionals' Attitudes toward Acute Diarrhea ManagementJOURNAL OF TRAVEL MEDICINE, Issue 2 2001Iain B. McIntosh Background: Travelers' diarrhea is the most frequent health problem in those participating in international journeys, and is responsible for many consultations abroad and on return home. Methods: A questionnaire assessing attitudes toward treatment and management of travel-related and nontravel-related diarrhea was administered to 542 GPs, nurses and pharmacists. Results: Health professionals' attitudes to management of acute diarrhea are variable, with marked divergence regarding adherence to published "good practice" guidelines and recommendations. Inconsistencies exist in stated attitudes toward prescribing antispasmodics and antimotility agents and actual prescribing behavior. Conclusion: Current treatment guidelines may be outdated. Inappropriate or delayed treatment disadvantages the patient. Limiting the use of antidiarrheal agents can deny access, for those inflicted with diarrhea, to a medication which may shorten symptomatology and morbidity, and speed the return to normality. Review of guidelines for diarrhea management in adults is overdue, as is standardization of treatment response. Educational initiatives are required to encourage active intervention and improved provision of care. [source] Pediatric moyamoya disease: An analysis of 410 consecutive casesANNALS OF NEUROLOGY, Issue 1 2010Seung-Ki Kim MD Objective Moyamoya disease (MMD) is a cerebrovascular occlusive disease of the bilateral internal carotid arteries that causes a compensatory abnormal vascular network at the base of brain. The rare incidence and various surgical techniques applied have limited the clinical research on MMD. Methods We conducted a retrospective analysis of the surgical outcome of 410 pediatric MMD patients. All patients were treated in a relatively uniform scheme at a single institution. The surgical procedures consisted of bilateral encephaloduroarteriosynangiosis augmented by bifrontal encephalogaleo-/periosteal synangiosis. Logistic regression analyses were applied to reveal the prognostic factors for surgical outcome. Results The overall clinical outcome was excellent in 66%, good in 15%, fair in 15%, and poor in 4% of the patients. Therefore, 81% of the patients had a favorable clinical outcome (excellent and good). Multivariate analyses revealed that infarction on presentation was associated with unfavorable clinical outcome (odds ratio [OR], 2.85; 95% confidence interval [CI], 1.49,5.46; p < 0.01) and decreased vascular reserve only on single-photon emission computerized tomography (OR, 0.07; 95% CI, 0.01,0.52; p < 0.01), with favorable clinical outcome. Interpretation Our results indicate that an early diagnosis and active intervention before establishment of irreversible hemodynamic change are essential to achieve a favorable clinical outcome in children with MMD. ANN NEUROL 2010;68:92,101 [source] COLONIALISM AND INDUSTRIALISATION: FACTORY LABOUR PRODUCTIVITY OF COLONIAL KOREA, 1913,37AUSTRALIAN ECONOMIC HISTORY REVIEW, Issue 1 2008Duol Kim colonial Korea; colonialism; entrepreneurship; factory labour productivity; industrialisation Unlike other colonial economies, Korea industrialised rapidly during its colonial period, which past scholars attributed to the industrialisation policy directed by the Japanese colonial government between 1930 and 1945. Our analysis of factory labour productivity from 1913 to 1937 suggests significant revisions to this claim. Factory labour productivity as well as total production grew rapidly before the active intervention of the colonial government. In addition, Korean entrepreneurs invested heavily in their firms and successfully competed with Japanese entrepreneurs. We conjecture that the pre-war experience of Korean entrepreneurs provided a critical foundation for the post-colonial economic growth. [source] Conservative management of vestibular schwannomas: third review of a 10-year prospective studyCLINICAL OTOLARYNGOLOGY, Issue 3 2008D. Hajioff Keypoints ,,Seventy-two patients with a unilateral vestibular schwannoma have been treated conservatively for a median of 121 months. They have been followed prospectively by serial clinical examination, MRI scans and audiometry. ,,Twenty-five patients (35%, 95% CI: 24,47) failed conservative management and required active intervention during the study. No factors predictive of tumour growth or failure of conservative management could be identified. Seventy-five per cent of failures occurred in the first half of the 10-year study. ,,The median growth rate for all tumours at 10 years was 1 mm/year (range ,0.53,7.84). Cerebellopontine angle tumours grew faster (1.4 mm/year) than intracanalicular tumours (0 mm/year, P < 0.01); 92% had growth rates under 2 mm/year. ,,Hearing deteriorated substantially even in tumours that did not grow, but did so faster in tumours that grew significantly (mean deterioration in pure tone average at 0.5, 1, 2 and 3 kHz was 36 dB; speech discrimination scores deteriorated by 40%). ,,Patients who failed conservative management had clinical outcomes that were not different from those who underwent primary treatment without a period of conservative management. [source] Self-help treatments for disorders of recurrent binge eating: a systematic reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2006S. C. Stefano Objective:, To evaluate self-help interventions for patients with binge eating disorder (BED) and bulimia nervosa (BN), tested in randomized controlled trials, and compared with waiting list or any other type of control group. Methods:, A systematic review including quality appraisal was conducted of randomized controlled trials, using self-help techniques in patients with BED and/or BN. Six databases were searched during the period between January 1994 and June 2004. Results:, A total of 2686 articles were identified, 1701 abstracts were evaluated in detail and, nine studies fulfilled the inclusion criteria for this review. All studies indicated that patients treated with active interventions had a reduced number of binge eating episodes at end of treatment. Conclusion:, The results support self-help interventions but shall be interpreted with caution. Because of the small number of studies using self-help techniques for BED and BN, further larger randomized, multi-center controlled studies that apply standardized inclusion criteria, evaluation instruments and self-help materials, are needed. [source] Preventing heavy alcohol use in adolescents (PAS): cluster randomized trial of a parent and student intervention offered separately and simultaneouslyADDICTION, Issue 10 2009Ina M. Koning ABSTRACT Aims To evaluate the effectiveness of two preventive interventions to reduce heavy drinking in first- and second-year high school students. Design and setting Cluster randomized controlled trial using four conditions for comparing two active interventions with a control group from 152 classes of 19 high schools in the Netherlands. Participants A total of 3490 first-year high school students (mean 12.68 years, SD = 0.51) and their parents. Intervention conditions (i) Parent intervention (modelled on the Swedish Örebro Prevention Program) aimed at encouraging parental rule-setting concerning their children's alcohol consumption; (ii) student intervention consisting of four digital lessons based on the principles of the theory of planned behaviour and social cognitive theory; (iii) interventions 1 and 2 combined; and (iv) the regular curriculum as control condition. Main outcome measures Incidence of (heavy) weekly alcohol use and frequency of monthly drinking at 10 and 22 months after baseline measurement. Findings A total of 2937 students were eligible for analyses in this study. At first follow-up, only the combined student,parent intervention showed substantial and statistically significant effects on heavy weekly drinking, weekly drinking and frequency of drinking. At second follow-up these results were replicated, except for the effects of the combined intervention on heavy weekly drinking. These findings were consistent across intention-to-treat and completers-only analyses. Conclusions Results suggest that adolescents as well as their parents should be targeted in order to delay the onset of drinking, preferably prior to onset of weekly drinking. [source] Industry sponsorship and selection of comparators in randomized clinical trialsEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 2 2010D. N. Lathyris Eur J Clin Invest 2010; 40 (2): 172,182 Abstract Background, Most clinical trials on medical interventions are sponsored by the industry. The choice of comparators shapes the accumulated evidence. We aimed to assess how often major companies sponsor trials that involve only their own products. Methods, Studies were identified by searching ClinicalTrials.gov for trials registered in 2006. We focused on randomized trials involving the 15 companies that had sponsored the largest number of registered trials in ClinicalTrials.gov in that period. Results, Overall, 577 randomized trials were eligible for analysis and 82% had a single industry sponsor [89% (166/187) of the placebo-control trials, 87% (91/105) of trials comparing different doses or ways of administration of the same intervention, and 78% (221/285) of other active control trials]. The compared intervention(s) belonged to a single company in 67% of the trials (89%, 81% and 47% in the three categories respectively). All 15 companies strongly preferred to run trials where they were the only industry sponsor or even the only owner of the assessed interventions. Co-sponsorship typically reflected co-ownership of the same intervention by both companies. Head-to-head comparison of different active interventions developed by different companies occurred in only 18 trials with two or more industry sponsors. Conclusions, Each company generates a clinical research agenda that is strongly focused on its own products, while comparisons involving different interventions from different companies are uncommon. This diminishes the ability to understand the relative merits of different interventions for the same condition. [source] | ||||||||||