Home About us Contact
|
Home About us Contact | ||
|
|
||
Interventions Used (intervention + used)
Selected AbstractsNursing Diagnoses and Interventions Used in Home Care in KoreaINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2000Hea Kung Hur PhD, RN Assistant Professor First page of article [source] A best-evidence synthesis review of the administration of psychotropic pro re nata (PRN) medication in in-patient mental health settingsJOURNAL OF CLINICAL NURSING, Issue 9 2008John A Baker BNurs, MPhil Aims and objectives., This paper aims to synthesise published literature of drug use/administration studies of pro re nata psychotropic medications in mental health wards. Design., The study employed a best-evidence synthesis review design. Background., The administration of psychotropic pro re nata medications is a frequently used clinical intervention in mental health wards. Pro re nata contributes to exposing patients to high doses of antipsychotic medication. Despite the frequent use of pro re nata, there is limited evidence of their effectiveness. Methods., A best-evidence synthesis review. Results., Six major themes emerged from the literature: (i) frequency of administration; (ii) administration during the 24-hour day; (iii) administration associated with length and stage of admission; (iv) rationales for administration; (v) medicines administered (including route of administration); and (vi) effects and side effects of the medicines administered. Conclusions., Overall findings indicate that the administration of psychotropic pro re nata varies radically and appears to be influenced by many variables. Relevance to clinical practice., Patients are most likely to receive a benzodiazepine or typical antipsychotic as pro re nata. Pro re nata is an important and under-researched clinical intervention used in mental health wards. [source] Building strong communities: an evaluation of a neighborhood leadership program in a diverse urban areaJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 8 2009Cecilia Ayón The purpose of this study was to describe and evaluate an intervention used to train neighborhood leaders about community organizing and to enhance leadership skills. A mixed-method design was used which included (a) a pre- and posttest assessment of 83 participants, and (b) qualitative descriptive interviews of 33 participants. Over half of the participants in the study were from ethnic minority groups (Latino or Cambodian). At posttest assessment, the participants improved in leadership skills (p=.001) and experience (p=.001) subscales. The qualitative interviews revealed that participants continued to be active in their communities by implementing neighborhood programs or starting community organizations. It is recommended that community practitioners and activists support neighborhood leadership programs to foster growth and enrichment in communities, and researchers/practitioners evaluate these projects with multiple methods to broaden scholarship in this important arena. © 2009 Wiley Periodicals, Inc. [source] Suppression of growth of pancreatic cancer cell and expression of vascular endothelial growth factor by gene silencing with RNA interferenceJOURNAL OF DIGESTIVE DISEASES, Issue 4 2008Jian WANG OBJECTIVE: To explore the anti-angiogenesis and tumor cell growth suppressive effects resulted from gene silencing by RNAi in BxPC-3 human pancreatic cancer cells. METHODS: The designation and transfection of vascular endothelial growth factor (VEGF)-siRNA lentivirus was carried out in vitro. Real-time PCR and western blot were conducted to measure the expression levels of VEGF mRNA and protein. Flow cytometry was employed to evaluate cell apoptosis and cell death. A lactate dehydrogenase (LDH) assay was used to assess the cytotoxicity of VEGF-siRNA. A 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay was used to picture the cellular growth. For the in vivo study, BxPC-3 cells were injected subcutaneously into nude mice to form xenografts. The mice were divided into three groups according to the intervention used. The control group, the negative control group and the knockdown group of mice were injected with saline, an empty lentivirus vehicle and lentivirus carrying VEGF-siRNA, respectively. None of the mice died during the study. When these mice were killed, the xenografts were collected and the tumor sizes of the different groups were compared. Finally, immunohistochemistry was used to assess the VEGF expression level and microvascular density. RESULTS: After the transfection of VEGF-siRNA lentivirus, the cellular expression of VEGF mRNA decreased to 50% of the control and the VEGF protein in the BxPC-3 cells decreased to 30% of the control. Apoptosis and cell death increased after transfection of the VEGF-siRNA lentivirus. The LDH assay showed high cytotoxicity induced by VEGF-siRNA lentivirus transfection. The MTT assay showed slower cellular growth in the knockdown cells. Tumor growth suppression was observed in nude mice that had received the VEGF-siRNA lentivirus transfection, and the tumor sizes of the xenografts in this group were clearly smaller than those in other two groups. VEGF expression and microvascular density were significantly decreased. CONCLUSION: Vascular endothelial growth factor gene silencing via VEGF-siRNA can effectively inhibit the production of VEGF and exert an anti-angiogenesis and tumor cell growth suppressive effect both in vitro and in vivo. [source] An examination of frequent nursing interventions and outcomes in an adolescent psychiatric inpatient unitINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 5 2009Candace Bobier ABSTRACT:, Little is known about which nursing interventions used in adolescent psychiatric inpatient treatment demonstrate improvements in outcome in the ,real world' setting, despite an increase in external outcomes reporting requirements. This paper examines nursing and other multidisciplinary interventions commonly used at the Youth Inpatient Unit, Christchurch, New Zealand, in relation to improvements in outcomes as measured by the Health of the Nation Outcome Scales for Children and Adolescents, utilizing data gathered prospectively as part of an ongoing quality assurance and outcomes project. We found the majority of interventions investigated were utilized equally across diagnostic groups, although stress management and problem-solving education was used more for patients with mixed affective disorders. Further, the results contribute to growing evidence toward the value of providing medication and problem-solving education to this population. Mental health nurses working with children and adolescents should be supported to utilize and develop their unique skill set to offer targeted interventions and to examine their practice to identify the most valuable interventions for their patients within this developmental context. [source] Improving geriatric mental health nursing care: Making a case for going beyond psychotropic medicationsINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2003Philippe Voyer ABSTRACT Providing high-quality mental health nursing care should be an important and continuous preoccupation in the gerontological nursing field. As the proportion of elderly people in our society is growing, the emphasis on high-quality care will receive increasing attention from administrators, politicians, organized groups, researchers and clinical nurses. Recent findings illustrate unequivocally the important contribution of nurses to achieving the goal of high-quality geriatric care. However, the quality of care for the elderly with psychological difficulties has not been addressed. The objective of this article is to illustrate that while nurses can accomplish much to improve the well-being and mental health of the elderly, their skills are often underutilized. Psychotropic drugs are often the first-line interventions used by health-care professionals to treat mental health concerns of elderly persons. Alternative therapies that could be implemented and evaluated, such as psychological counselling, supportive counselling, education and life review, are infrequently used. Nevertheless, current scientific data suggest that it would be very advantageous if nurses were to play a dominant role in the care of elderly people who are depressed or experiencing sleep pattern disturbances. The same can be said about elderly chronic users of benzodiazepines, as well as those with cognitive impairment. Evidence for the use of psychotropic medications as a viable treatment option for the elderly both in the community and in the long-term care setting who are experiencing mental health challenges is examined. Alternative non-pharmacological approaches that nurses can use to augment care are also briefly discussed. [source] Comparison of Nursing Interventions Performed by Medical-Surgical Nurses in Korea and the United StatesINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2006Eunjoo Lee PhD PURPOSE.,To compare the Nursing Interventions Classification (NIC) interventions used in two countries, Korea and the United States. METHODS.,Data were collected from 167 nurses working in eight hospitals in Korea and analyzed with descriptive statistics. FINDINGS.,Korean nurses selected 202 interventions, nine of which were used by more than 50% of nurses surveyed. In comparison, the Academy of Medical-Surgical Nurses (AMSN) in the United States identified 68 interventions as core interventions. Among the top ranked 68 interventions selected by Korean nurses, 29 (43%) matched those selected by U.S. nurses. CONCLUSION.,The nursing interventions selected by Korean nurses were more heavily focused on the physiologic domain than those selected by the U.S. nurses. PRACTICE IMPLICATIONS.,The identified intervention lists can be used to develop nursing information systems, staff education, competency evaluation, referral networks, certification and licensing exams, and educational curricula for nursing students. Comparaison des interventions réalisées par les infirmières de Médecine-Chirurgie en Corée et aux Etats-Unis BUTS.,Comparer les interventions (tirées de la Classification des Interventions) utilisées dans deux pays: La Corée et les Etats-Unis. MÉTHODES.,Les données furent collectées auprès de 167 infirmières travaillant dans huit hôpitaux Coréens et furent analysées à l'aide de statistiques descriptives. RÉSULTATS.,Les infirmières Coréennes ont choisi 202 interventions, neuf d'entre elles furent utilisées par plus de 50% des infirmières incluses dans l'étude. En comparaison, l'Académie des Infirmières en Médecine-Chirurgie (E.U.) ont identifié 68 interventions clés. Parmi les 68 premières interventions choisies par les infirmières Coréennes, 29 (43%) correspondent à celles qui ont été choisies par les infirmières Américaines. CONCLUSION.,Les interventions de soins choisies par les infirmières Coréennes furent plus fortement centrées sur les domaines physiologiques que celles choisies par leurs collègues Américaines. IMPLICATIONS POUR LA PRATIQUE.,Les listes d'interventions identifées peuvent être utilisées pour développer des systèmes d'information, la formation du personnel, l'évaluation de la compétence, les réseaux de soin, les examens de certification et les programmes de formation des étudiantes infirmières. Translation by Cécile Boisvert, MSN, RN Comparação das Intervenções Realizadas por Enfermeiras Médico-Cirúrgicas na Coréia e nos Estados Unidos OBJETIVO.,Comparar as intervenções contidas na classificação de intervenções de Enfermagem (NIC) usadas nos dois paises, Coréia e Estados Unidos. MÉTODOS.,Os dados foram coletados com 167 enfermeiras que trabalhavam em oito hospitais na Coréia e analisadas com estaticista descritiva. RESULTADOS.,As enfermeiras coreanas selecionaram 202 intervenções, nas quais foram usadas por mais de 50% das enfermeiras entrevistadas. Em comparação, a Academia de enfermeiras médico-cirúrgicas (AMSN) nos Estados Unidos identificaram 68 intervenções como principais. Dentre as 68 intervenções como principais. Dentre as 68 intervenções mais importantes selecionadas pelas enfermeiras coreanas, 29 (43%) coincidiram com aquelas selecionadas pelas enfermeiras americanas. CONCLUSÃO.,As intervenções selecionadas pelas enfermeiras coreanas foram mais fortemente focadas no domínio fisiológico do que aquelas selecionadas pelas enfermeiras americanas. IMPLICAÇÕES PARA A PRÁTICA.,As listas das intervenções identificadas pode ser usada para o desenvolvimento de sistemas de informação de enfermagem, educação-permanente da equipe, avaliação da competência, rede de referências, exames de certificação e licença e currículo educacional para estudantes de enfermagem. Translation by Alba Leite de Barros, PhD, RN Estudio Comparativo de las Intervenciones Enfermeras Realizadas por Enfermeras Especialistas Médico-Quirúrgicas en Korea y Estados Unidos (EUA) PROPÓSITO.,Realizar un estudio comparativo entre las intervenciones enfermeras de la taxonomía NIC (Clasificación de las Intervenciones Enfermeras) utilizadas en dos países, Korea y EUA. METODOLOGÍA.,Los datos fueron recogidos entre 167 enfermeras que trabajaban en ocho hospitales de Korea y fueron analizadas utilizando medidas estadísticas descriptivas. HALLAZGOS.,Las enfermeras koreanas seleccionaron 202 intervenciones, nueve de las cuales fueron utilizadas por más del 50% de las enfermeras estudiadas. A diferencia, la Academia de Enfermeras especialistas Médico-quirúrgicas (AMSN) de los EUA, había identificado 68 intervenciones enfermeras. Entre las 68 intervenciones seleccionadas más frecuentemente por las enfermeras koreanas, 29 (43%) coincidían con las seleccionadas por las enfermeras americanas. CONCLUSIÓN.,Las intervenciones seleccionadas por las enfermeras koreanas estaban más centradas en el dominio fisiológico que las seleccionadas por las enfermeras americanas. IMPLICACIONES PARA LA PRÁCTICA.,La lista de intervenciones identificadas puede ser utilizada para desarrollar sistemas de información enfermeros, programas de formación, evaluación de la competencia, redes de enfermeras de referencia, exámenes de certificación y obtención de licencias, y currícula de formación para los estudiantes de enfermería. Translation by Adolf Guirao, RN [source] Use of Nursing Diagnoses and Interventions in Public Health Nursing PracticeINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2002Jennifer C. Rivera MSN PURPOSE. To determine the frequency of use of NANDA diagnoses and the Nursing Interventions Classification in care plans written by public health nurses (PHNs) in Orange County, CA. METHODS.Retrospective chart review. FINDINGS. The frequency pattern of nursing diagnoses and nursing interventions used in care plans is consistent with the scope of practice of the PHN, whose emphasis is on health promotion and disease prevention. CONCLUSIONS. The most commonly used diagnoses and interventions provide evidence of a core set of interventions useful for PHN practice. IMPLICATIONS FOR PRACTICE.Linking diagnoses and interventions allow PHNs to build a body of knowledge based on patient care and improve clinical decision-making process. Search terms:Interventions, nursing diagnosis, public health nursing Utilisation des diagnostics infirmiers et interventions en santé publique BUT.Déterminer la fréquence des diagnostics infirmiers (ANADI) et des interventions (NIC) dans les plans de soins rédigés par les infirmières de santé publique dans le Comté d'Orange, CA. METHODE.Étude rétrospective des dossiers. RÉSULTATS.La répartition des diagnostics infirmiers et des interventions utilisés dans les plans de soin est cohérente avec la pratique des infirmières en santé publique, c'est-à-dire qu'elle souligne l'importance de la promotion de la santé et la prévention de la maladie. CONCLUSIONS.Les diagnostics et interventions les plus fréquemment utilisés permettent d'identifier le groupe d'interventions au centre de la pratique des soins en santé publique. IMPLICATIONS POUR LA PRATIQUE.L'articulation des diagnostics et interventions de soins permet de construire un corpus de connaissances en santé publique basée sur le soin des patients et d'améliorer le processus de décision clinique. Mots-clés:Diagnostics infirmiers, interventions, soins infirmiers en santé publique Utilización de los diagnósticos e intervenciones de enfermería en la práctica de enfermería de salud pública PROPÓSITO.Determinar la frecuencia del uso de los diagnósticos de la NANDA y de la clasificación de las intervenciones enfermeras (NIC), en planes del cuidados escritos por enfermeras de salud pública en el Condado de Orange, California. MÉTODOS.Revisión retrospectiva de gráficos. RESULTADOS. El patrón de frecuencia de diagnósticos de enfermería y de intervenciones enfermeras utilizados en los planes del cuidados, es consistente con el ámbito asistencial de las enfermeras de salud pública, cuyo énfasis está en la promoción de salud y la prevención de la enfermedad. CONCLUSIÓN.Los diagnósticos e intervenciones más comúnmente utilizados, proporcionan evidencia de un grupo nuclear de intervenciones útiles a la práctica de enfermería de salud pública. IMPLICACIONES PARA LA PRÁCTICA.Conectar los diagnósticos y las intervenciones permite a las Enfermeras de Salud Pública construir un cuerpo de conocimientos basado en el cuidado de los pacientes y mejorar el proceso de toma de decisiones en la práctica clínica. Términos de búsqueda:Diagnóstico enfermero, enfermería de salud pública, intervenciones Uso de diagnósticos e intervenções de enfermagem na prótica de enfermagem em Saúde Pública OBJETIVO.Determinar a freqüência de uso dos diagnósticos da NANDA e da Classificação de Intervenções de Enfermagem (NIC) em planos de cuidados escritos por enfermeiras da área de Saúde Pública no Condado de Orange, Califórnia. MÉTODO.Revisão retrospectiva de fichas. ACHADOS.O padrão de freqüência de diagnósticos de enfermagem e intervenções de enfermagem utilizados em planos de cuidados é compatível com o escopo da prática das enfermeiras da área de Saúde Pública, cuja ênfase está na promoção da saúde e prevenção de doenças. CONCLUSãO.Os diagnósticos e intervenções mais comumente utilizados evidenciam a existência de um conjunto de intervenções principais, que éútil para a prática destas enfermeiras. IMPLICAÇõES PARA A PRÁTICA. A ligação entre diagnósticos e intervenções permite às enfermeiras da área de saúde pública construírem um corpo de conhecimentos baseado no cuidado do paciente e melhora o processo de tomada de decisão. Palavras para busca:Diagnóstico de enfermagem, enfermagem em saúde publica, intervenções [source] Characteristics of and interventions for fever in JapanINTERNATIONAL NURSING REVIEW, Issue 4 2004Y. Ikematsu rn Abstract Purpose:, As part of a larger multinational validation study of the International Classification for Nursing Practice (ICNP®) alpha version, a survey was conducted in Japan to determine characteristics of ,fever' and interventions to treat febrile patients. Sample:, Three hundred and fifty-six acute and critical care Japanese nurses participated in this study. Method:, The major and minor characteristics of ,fever' perceived by Japanese nurses and interventions used by the nurses in managing febrile patients were identified using the Diagnostic Content Validity (DCV) model. Results:, Two characteristics, ,increased body temperature' and ,chills' were selected as major characteristics from the standardized list of the ICNP® alpha version validation study. Nine characteristics among the standardized list of characteristics were rated as minor characteristics, and six of the ICNP® characteristics were rejected. ,Shivering' and ,infectious lab data' were added with a level of representativeness similar to a major characteristic by nine of the nurses. A variety of interventions to treat fever were reported. The most frequently reported intervention was cooling, followed by warming and medication. Nine dimensions were derived from all reported interventions. Discussion:, As well as perceived characteristics of fever, these interventions may have aspects unique to Japanese nursing practice and to the acute and critical care settings. These results can be compared to those of other populations in future studies. [source] Screening of domestic violence against women in the perinatal setting: A systematic reviewJAPAN JOURNAL OF NURSING SCIENCE, Issue 2 2004Yaeko KATAOKA Abstract Aim:, To review published studies focusing on the screening of domestic violence (DV) against women, in particular, the instruments, the screening methods and the interventions used to help abused women after screening. Based on the results of the review, the suitability of introducing routine screening for DV in the perinatal setting in Japan would be assessed. Methods:, National Guideline Clearinghouse database, HSTAT, PubMed, CINAHL, the Cochrane Library and the Ichushi-Web were all used to searched from when records were first held until February 2003 for eligible primary studies and systematic reviews for this literature review. Each selected article was independently read and appraised by two reviewers who finally selected 12 primary studies and three systematic reviews that fulfilled the criteria for inclusion. Results:, Three studies evaluated screening instruments for DV (i.e. Abuse Assessment Screen, Partner Violence Screen and Violence Against Women Screen) and of these, the Violence Against Women Screen was the most valid, reliable and suitable for use in the clinical setting in Japan. The three studies that examined the screening method had differing results, but the one conducted in Japan showed a significantly higher rate of identification in the self-administered questionnaire group compared with the interview group. The six studies that tested the effectiveness of interventions for abused women showed that counseling sessions after screening and the advocacy program for postsheltered women were effective in reducing DV. Conclusion:, Routine screening of all pregnant women in Japan for DV should be introduced, considering the high burden of suffering that women expose to DV experience, and the existence of both acceptable screening instruments and effective interventions. [source] Postdischarge nursing interventions for stroke survivors and their familiesJOURNAL OF ADVANCED NURSING, Issue 2 2004Kelly L. McBride MSc RN Background. The physical, cognitive, and emotional sequelae of stroke underscore the need for nursing interventions across the continuum of care. Although there are several published studies evaluating community interventions for stroke survivors, the nursing role has not been clearly articulated. Aim. The aim of this paper is to report a study to describe, using a standardized classification system, the nursing interventions used with stroke survivors during the initial 6 weeks following discharge home. Methods. In the context of a randomized controlled trial, two nurse case managers provided care to 90 community-dwelling stroke survivors who were assigned to the intervention arm of the trial. The nursing documentation was analysed, using the Nursing Intervention Classification (NIC) system, to identify and quantify the interventions that were provided. Findings. Stroke survivors received, on average, six different interventions. There was a trend for those who were older, more impaired, and who lived alone to receive more interventions. The most commonly reported interventions included those directed towards ensuring continuity of care between acute and community care, family care, and modifying stroke risk factors. The study was limited to the nursing documentation, which may represent an underestimation of the care delivered. Conclusions. The NIC system was useful in capturing the interventions delivered by the nurse case managers. Nursing interventions are often not clearly articulated and less often use standardized terminology. Describing nursing activities in a standard manner will contribute to an increase in nursing knowledge and to evidence-based practice. [source] Psychiatric nurses' attitudes towards patient autonomy in depot clinicsJOURNAL OF ADVANCED NURSING, Issue 4 2001Bodil Svedberg RPN Psychiatric nurses' attitudes towards patient autonomy in depot clinics Aim.,The aim of this qualitative study was to explore how psychiatric nurses experience patient autonomy in relation to their professional role in depot clinics. Background.,The administration of depot neuroleptics at outpatient clinics is a common task for psychiatric nurses in many countries. The procedure is characterized by brief contacts often allowing little opportunity for adequate monitoring of the treatment and a dialog between nurses and patients. As nurses have an important role in involving patients in decision-making, there is a need to analyse the nurses' attitudes towards giving depot neuroleptics from the perspective of autonomy. Method.,Nine experienced psychiatric nurses were interviewed using open-ended questions. The steps of a phenomenological descriptive method guided the data analysis. Findings.,The structure describes how benevolent attitudes towards patient autonomy motivated the nurses' interventions in relation to how they experienced their own professional authority. The structure consists of four variations: (1) Beneficent interventions used with patients perceived as co-operative when the nurses experienced a high degree of professional authority. (2) Paternalistic interventions used with patients perceived as ambiguous towards medication when the nurses experienced an arbitrary professional authority in collaboration with team members. (3) Weak paternalistic interventions used with patients perceived as unwilling when the nurses experienced having sufficient professional authority in the treatment situation. (4) Nonmaleficent interventions used with patients perceived as being resigned when the nurses experienced a low degree of professional authority within the team. Conclusions.,The findings indicate that psychiatric nurses' experience of their professional authority is closely related to the organization of the depot treatment and that brief contacts do not favour the establishment of collaborative relationships with patients. When injection-giving nurses, as patients' key workers, have overall responsibility for co-ordinating the patients' treatment they can encourage patient autonomy by helping patients understand the meaning of depot medication and its benefits. Further clinical research regarding the involvement of nurses in the treatment as well as patients' experiences of treatment with depot neuroleptics is needed to allow suggestions about improvements of the organization of the treatment. [source] Learning sobriety together: behavioural couples therapy for alcoholism and drug abuseJOURNAL OF FAMILY THERAPY, Issue 2 2009William Fals-Stewart Among the various types of partner- and family-involved interventions used to treat adults with substance use disorders, Behavioural Couples Therapy (BCT) has garnered the strongest empirical support for its efficacy. During the past thirty years, multiple studies have consistently found married or cohabiting substance-abusing patients who engage in BCT, compared to traditional individual-based counselling or partner-involved attention control treatments, report significantly greater (1) reductions in substance use, (2) levels of relationship satisfaction, and (3) greater improvements in other areas of relationship and family adjustment (e.g. reductions in partner violence, improvements in custodial children's adjustment). In addition to discussing the theoretical rationale for BCT as a treatment of substance abuse, this article describes specific therapeutic techniques used as part of this intervention and summarizes the relevant evaluative empirical literature. [source] Weight Management Practices Among Primary Care ProvidersJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2000Gayle M. Timmerman RN ABSTRACT This pilot study examined how primary care providers manage patients with weight problems, an important component of primary care. A convenience sample of 17 nurse practitioners and 15 physicians were surveyed about assessments and interventions used in practice for weight management along with perceived barriers to providing effective weight management. Practice patterns between gender, profession and practice setting of the nurse practitioners were compared. [source] Systematic review: self-management support interventions for irritable bowel syndromeALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2010S. D. Dorn Aliment Pharmacol Ther 2010; 32: 513,521 Summary Background, Irritable bowel syndrome is an extremely common and costly condition. Because there is no cure, patients must be supported to manage their own condition. Aim, To assess systematically the interventions used to support irritable bowel syndrome patient self-management. Methods, A search of PubMed, EMBASE, CINAHL and PsycINFO was performed to identify all studies that involved self-management support interventions for irritable bowel syndrome. Studies that compared the self-management-related intervention to a control group were included. Results, Eleven studies that involved a total of 1657 patients were included. For nearly all studies, the intervention was associated with statistically significant benefits. However, across studies there was significant heterogeneity in terms of sample size, diagnostic criteria, study setting, study design, primary outcome, statistical analyses and study quality. Therefore, individual study results could not be statistically combined. Conclusions, Many self-management support interventions appear benefit patients with irritable bowel syndrome. However, studies were limited by methodological flaws. Furthermore, feasibility in ,real world' clinical practice is uncertain. Thus, practical self-management interventions that can be applied across various clinical settings should be developed, and then tested in well-designed clinical trials. [source] An integrative review of Canadian childhood obesity prevention programmesOBESITY REVIEWS, Issue 1 2007S. Conroy Summary To examine successful Canadian nursing and health promotion intervention programmes for childhood obesity prevention during gestation and infancy, an integrative review was performed of the literature from 1980 to September 2005. The following databases were used: PubMed; Cochrane Database of Systematic Reviews; Cochrane Controlled Trials Register; Database of Abstracts of Reviews of Effects; ACP Journal Club; MEDLINE; EMBASE; CINAHL; Web of Science; Scopus; Sociological Abstracts; Sport Discus; PsycInfo; ERIC and HealthStar. MeSH headings included: infancy (0,24 months), gestation, gestational diabetes, nutrition, prenatal care, pregnancy, health education, pregnancy outcome, dietary services with limits of Canadian, term birth. Of 2028 articles found, six Canadian childhood obesity prevention programmes implemented during gestation and/or infancy were found; three addressed gestational diabetes with five targeting low-income Canadian urban and/or Aboriginal populations. No intervention programmes specifically aimed to prevent childhood obesity during gestation or infancy. This paucity suggests that such a programme would be innovative and much needed in an effort to stem the alarming increase in obesity in children and adults. Any attempts either to develop new approaches or to replicate interventions used with obese adults or even older children need careful evaluation and pilot testing prior to sustained use within the perinatal period. [source] Acute Myocardial Infarction and Acute Coronary Syndrome: Then and Now (1950,2005)PREVENTIVE CARDIOLOGY, Issue 4 2006Monte Malach MD Advances in the prevention, diagnosis, and treatment of acute myocardial infarction (AMI) and acute coronary syndrome (ACS) have been remarkable since the mid-20th century. Even the clinical terminology used to describe some of the various components of ACS have undergone change, while the latter term itself represents a fairly recent addition to the medical lexicon. Although there have been dramatic changes in the diagnostic and therapeutic interventions used and impressive declines in morbidity and mortality, the differential diagnosis and complications of AMI and ACS remain as challenging now as they were a half century ago. This article presents in detail the medical understanding of AMI in the mid-20th century and how physicians of that era managed it and its complications, and contrasts this with current evidence-based knowledge and interventions. [source] Annotation: Tourette syndrome: a relentless drumbeat , driven by misguided brain oscillationsTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 6 2006James F. Leckman Objective:, This annotation reviews recent evidence that points to the likely role of aberrant neural oscillations in the pathogenesis of Tourette syndrome (TS). Methods:, The available anatomic and electrophysiological findings in TS are reviewed in the context of an emerging picture of the crucial role that neural oscillations play in maintaining normal central nervous system (CNS) function. Results:, Neurons form behavior-dependent oscillating networks of various sizes and frequencies that bias input selection and facilitate synaptic plasticity, mechanisms that cooperatively support temporal representation as well as the transfer and long-term consolidation of information. Coherent network activity is likely to modulate sensorimotor gating as well as focused motor actions. When these networks are dysrhythmic, there may be a loss of control of sensory information and motor action. The known electrophysiological effects of medications and surgical interventions used to treat TS likely have an ameliorative effect on these aberrant oscillations. Similarly, a strong case can be made that successful behavioral treatments involve the willful training regions of the prefrontal cortex to engage in tic suppression and the performance of competing motor responses to unwanted sensory urges such that these prefrontal regions become effective modulators of aberrant thalamocortical rhythms. Conclusions:, A deeper understanding of neural oscillations may illuminate the complex, challenging, enigmatic, internal world that is TS. [source] Platelets Influence Vascularized Organ Transplants from Start to FinishAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2009A. D. Kirk This review relates the basic functions of platelets to specific aspects of organ allograft rejection. Platelet activation can occur in the donor or recipient before transplantation as well as during antibody- and cell-mediated rejection. Biopsies taken during organ procurement from cadaver donors have documented that activated platelets are attached to vascular endothelial cells or leukocytes. In addition, many patients waiting for transplants have activated platelets due to the diseases that lead to organ failure or as a result of interventions used to support patients before and during transplantation. The contribution of platelets to hyperacute rejection of both allografts and xenografts is well recognized. Intravascular aggregates of platelets can also be prominent in experimental and clinical transplants that undergo acute antibody or cell-mediated rejection. In acute rejection, platelets can recruit mononuclear cells by secretion of chemokines. After contact, monocytes, macrophages and T cells interact with platelets through receptor/ligand pairs, including P-selectin/PSGL-1 and CD40/CD154. There is a potential for therapy to inhibit platelet mediated immune stimulation, but it is counterbalanced by the need to maintain coagulation in the perioperative period. [source] MANAGEMENT OF POPLITEAL ARTERY ANEURYSMSANZ JOURNAL OF SURGERY, Issue 10 2006Maher Hamish Background: Popliteal artery aneurysms (PAA) are the most common peripheral aneurysm and are recognized as ,the silent killer of the leg circulation'. The timing and type of interventions used in their treatment is still controversial. This review examines the published data on the natural history, epidemiology, clinical presentation and management options available. The aim of this study is to try and reach a consensus with regards to the best management of PAA. Method: A systematic review of data in the English published works since 1980. Results: The authors include 53 studies containing 2854 patients with 4291 PAA. Most published data involves retrospective studies and personal experience, with one multicentre study. No randomized controlled studies exist regarding the management of PAA. Conclusions: 1. Although most PAA are of atherosclerotic origin in old patients, trauma, infection and family history are the main causes in young patients. 2. Great vigilance is needed for diagnosis as only approximately five patients are seen each year by a major vascular centre. There is no place for screening programmes to detect PAA. 3. Approximately 45% of patients are asymptomatic at the time of initial diagnosis. Aortic aneurysms are found in 40% and bilateral PAA in 50% of patients. More than 95% of patients are men with a mean age of 65 years and 45% have hypertension. 4. Surgical reconstruction is recommended for all symptomatic and asymptomatic aneurysms larger than 2 cm. Five-year graft patency rates after surgical repair range from 30 to 97%, with 5-year limb salvage ranging from 70 to 98%. Patient survival rates at 5 and 10 years are 75 and 46%, respectively. 5. If carried out carefully, intra-arterial thrombolysis can safely prepare patients presenting with acute ischaemia from occluded PAA, for surgical revascularization to restore distal run-off. 6. Endovascular repair of a PAA is a feasible option, although little evidence is yet available. 7. Lifelong, careful patient surveillance is essential to detect and treat new aneurysms at other sites. [source] CURRENT CONTROVERSIES IN THE MANAGEMENT OF PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURYANZ JOURNAL OF SURGERY, Issue 3 2006Alexios A. Adamides Background: Traumatic brain injury is a major cause of mortality and morbidity, particularly among young men. The efficacy and safety of most of the interventions used in the management of patients with traumatic brain injury remain unproven. Examples include the ,cerebral perfusion pressure-targeted' and ,volume-targeted' management strategies for optimizing cerebrovascular haemodynamics and specific interventions, such as hyperventilation, osmotherapy, cerebrospinal fluid drainage, barbiturates, decompressive craniectomy, therapeutic hypothermia, normobaric hyperoxia and hyperbaric oxygen therapy. Methods: A review of the literature was performed to examine the evidence base behind each intervention. Results: There is no class I evidence to support the routine use of any of the therapies examined. Conclusion: Well-designed, large, randomized controlled trials are needed to determine therapies that are safe and effective from those that are ineffective or harmful. [source] | |||||||||||||