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Intervention Need (intervention + need)
Selected AbstractsA Comparison of CV-Catheters (CV) Grafts (GR) and Fistulae (FI) in Quotidian HemodialysisHEMODIALYSIS INTERNATIONAL, Issue 1 2003C Kjellstrand We studied longevity and complications from CV, GR, and FI in 23 patients on quotidian hemodialysis. There were a total of 409 patient months, mean 18,10 months observation and a total of 9209 dialyses. There were 14 FI, 5 GR and 4 CV. 1, 1 and 2 replacements were necessary during a total observation time of 254, 105 and 50 patient months, respectively. For fistulae there were 0.02 replacements/year vs. 0.30 for GR and 0.41 for CV. P = 0.042 FI vs. other. The cumulative survival at 15 months was 100% for FI, 80% for GR and 20% for CV. P = 0.041. The cumulative survival at 3 years were 80% for fistulae and grafts, no CV lasted beyond 15 months. P = 0.013. There were 27 events requiring hospitalization or outpatient intervention. FI: 0.42/patient year, GR 1.22/patient year and CV 1.36/patient year. P = 0.080, FI vs. Other. Patients reported more problems between dialysis for FI, 3.2% of the days and least on GR (0.2%), CV (0.4%). P < 0.0001. Of the problems 85% were pain and redness. To the contrary there were more problems during dialysis with CV, 9.1% vs. FI 2.7%, and GR 0.9%. P < 0.0001. The complications and survival data are similar to those reported by others for quotidian hemodialysis and no different from reports on conventional 3 times per week dialyses. Conclusion: Daily hemodialysis does not adversely affect the different types of blood access. The survival and intervention need of accesses is best for fistulae, worst for CV, but GR, when functioning, have fewer problems between and during dialyses. [source] Brief Intervention for Female Heavy Drinkers in Routine General Practice: A 3-Year Randomized, Controlled StudyALCOHOLISM, Issue 11 2000Mauri Aalto Background: Today, heavy drinking is a common health hazard among women. The evidence in favor of providing some kind of brief intervention to reduce drinking is quite convincing. However, we do not know if intervention works in a natural environment of routine health care. The purpose of this study was to evaluate the effectiveness of long-lasting, brief alcohol intervention counseling for women in a routine general practice setting. Methods: In five primary care outpatient clinics in a Finnish town, 118 female early-phase heavy drinkers who consulted their general practitioners for various reasons were given brief alcohol intervention counseling. Intervention groups A (n= 40) and B (n= 38) were offered seven and three brief intervention sessions, respectively, over a 3-yr period. The control group C (n= 40) was advised to reduce drinking at baseline. Main outcome measures were self-reported weekly alcohol consumption, carbohydrate-deficient transferrin, mean corpuscular volume (MCV), aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase. Results: Depending on the outcome measure and the study group, clinically meaningful reduction of drinking was found in 27% to 75% of the heavy drinkers. Within all the groups, MCV significantly decreased. However, there were no statistically significant differences between study groups A, B, and C in the mean changes between the beginning and endpoint in the main outcome measures. Conclusions: The present study indicated that minimal advice, as offered to group C, was associated with reduced drinking as much as the brief intervention, as offered to groups A and B, given over a 3-yr period. Furthermore, in the routine setting of the general practice office, the effectiveness of the brief intervention may not be as good as in special research conditions. The factors possibly reducing the effectiveness in a routine setting are unknown. Thus, different methods of implementing brief intervention need to be evaluated to find better ways to support general practice personnel in their efforts to help heavy-drinking female patients to reduce their drinking. [source] Betting on the evidence: Reported gambling problems among the Indigenous population of the Northern TerritoryAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2009Matthew Stevens Abstract Objectives: To address a shortfall in evidence with which to justify gambling-specific interventions for the Indigenous population, we analysed two surveys (2002 National Aboriginal and Torres Strait Islander Social Survey and General Social Survey) that contain information on reported gambling problems for the NT. Methods: Estimates of reported gambling problems are presented for each state and territory by remoteness for the Indigenous and total population for 2002. Factor analysis was used to identify the relationship between gambling problems and other negative life events for the NT Indigenous and total population. Results: High levels of reported gambling problems were apparent for the Indigenous population particularly in the remote parts of the NT and Queensland. Gambling problems were associated with other stressors relating to social transgressions. Among the NT Indigenous population, gambling problems were correlated with levels of crowding, community involvement, personal and community violence and self-assessed health status. Conclusions: The high levels of reported gambling problems suggest that gambling is causing significant problems for Indigenous people. The multivariable adjusted associations indicate that gambling-related problems are intimately connected to a range of community contexts. Implications: Policies of intervention need to address broader social and environmental contexts that are intrinsically associated with gambling (and associated problems), in addition to public education in harm associated with gambling and provision of counselling services to assist problem gamblers. [source] Criteria for evaluating interventionsDYSLEXIA, Issue 4 2007T. R. Miles Abstract By common consent there is a ,gold standard' in reference to which the efficacy of medical interventions needs to be evaluated. It is suggested in this paper that in educational research achievement of this gold standard is rarely possible. It does not follow, however, that research that falls short of this standard is therefore valueless; there may be many different kinds of good (and less good) reasons for accepting particular conclusions. Copyright © 2007 John Wiley & Sons, Ltd. [source] |