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Key Interventions (key + intervention)
Selected AbstractsModifiable Risk Factors for Migraine Progression (or for Chronic Daily Headaches),Clinical LessonsHEADACHE, Issue 2006Marcelo E. Bigal MD Herein we summarize clinical issues gleaned from a full peer-reviewed article on modifiable risk factors for migraine. Since migraine is progressive in some but not in most individuals, identifying patients at risk for progression is crucial. Key interventions include: (1) Decrease headache frequency with behavioral and pharmacologic interventions; (2) Monitor the body mass index and encourage maintenance of normal weight; (3) Avoid medication overuse; (4) Avoid caffeine overuse; (5) Investigate and treat sleep problems and snoring; (6) Screen and treat depression and other psychiatric comorbidities. These recommendations have not been demonstrated to improve outcomes in longitudinal studies. [source] Post-Conditionality Politics and Administrative Reform: Reflections on the Cases of Uganda and TanzaniaDEVELOPMENT AND CHANGE, Issue 4 2001Graham Harrison This article contributes to the discussion of the nature of external intervention in the reform processes of indebted states. Looking at administrative reform in Uganda and Tanzania, it is argued that external involvement in sub-Saharan Africa is becoming increasingly differentiated. For some states , including the two cases dealt with here , a key set of continuities and changes allows us to conceptualize a regime of post-conditionality. Post-conditionality regimes exist where extreme external dependence and economic growth produce a set of political dynamics in which external,national distinctions become less useful, in which there emerge a set of unequal mutual dependencies, and in which donor/creditor involvement in reform becomes qualitatively more intimate, pervading the form and processes of the state. Details of this dispensation are provided in an analysis of key ministries and key interventions by donors/creditors. The article finishes by considering the contradictions of the post-conditionality regime, and its prospects. [source] An overview of environmental issues in Southern AfricaAFRICAN JOURNAL OF ECOLOGY, Issue 2009Michael Bernard Kwesi Darkoh Abstract This paper provides an overview of some of the significant environmental problems in the Southern African region. The key problems highlighted are global warming and climate variability, loss of biodiversity, deforestation, desertification-land degradation, waste and littering, population growth, urbanization, pollution, poverty and health hazards. These problems present a challenge to governments and other players within and outside Southern Africa to seek for long-term solutions by addressing the root causes of these problems. The paper notes that although the environmental problems facing the Southern African region are being tackled at national, regional and international levels, there is more that can be done. At the national level, the different agencies and players, both within and outside government need to strengthen coordination and implementation of key interventions in different sectors in both rural and urban areas. At the African regional and international levels, there is a need to address geopolitical forces and issues that contribute to the underdevelopment of the African region. Among the major issues are poor terms of international trade, political instability, poverty, declining economic performance and international debt. [source] Evaluation of a postgraduate training programme for community mental health practitionersJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2005A. N. GAUNTLETT rmn bsc msc Government guidelines on mental health care in England have considerable implications for the level of competency required by the mental health workforce. Implementing these changes requires the widespread introduction of training initiatives whose effectiveness in improving staff performance need to be demonstrated through programme evaluation. This exploratory study evaluates the impact of a 2-year mental health training programme by measuring skill acquisition and skill application, by identifying the key ingredients for facilitating the transfer of learning into practice, and by examining differences in outcome between the academic and the non-academic students. High skill acquisition and application was reported in the majority of interventions, however, low skill application was reported for some key interventions (assertive outreach, dual diagnosis). Statistically significant differences were found between student cohorts in one intervention for skill acquisition (crisis intervention) and two interventions for skill application (client strengths model; medication management). The main ingredients for facilitating transfer were found to be the credibility of the trainers and training alongside colleagues from their own workplace. Some of the possible explanatory factors for these findings are discussed. [source] Implementing the severe sepsis care bundles outside the ICU by outreachNURSING IN CRITICAL CARE, Issue 5 2007Chris Carter Abstract Sepsis is not a new challenge facing the health care team, it remains a complex disease, which is difficult to identify and treat. Mortality from sepsis remains high and continues to be a common cause of death among critically ill patients, despite advances in critical care. Sepsis accounts for an estimated 27% of all intensive care admissions in England, Wales and Northern Ireland, and accounted for 46% of all intensive care bed days. Recent research studies and the surviving sepsis campaign have shown that identifying and providing key interventions to patients with severe sepsis and septic shock prior to their admission to the intensive care unit significantly improve outcomes. The aim of this paper was to identify how the Critical Care Outreach Team at one local hospital implemented the severe sepsis resuscitation care bundle for patients in the emergency department (ED) and on the general wards. It will include a presentation on the various ways the team raised the profile of severe sepsis and the care bundle at hospital and at national level. It also includes audit data that have been collected. The results showed that if the resuscitation care bundle was implemented within the first 24 h of hospital admission, mortality was 29%, whereas if the care bundle was instigated after this time mortality was more than at 49%. Audit data showed that the commonest sign of severe sepsis seen in patients in the ED and on wards was tachypnoea. This article discusses the successful implementation of the severe sepsis resuscitation care bundle and the positive impact an Outreach team can have in changing practice in the way patients are managed with severe sepsis. The audit data support the need for regular physiological observations and the use of a Patient At Risk Trigger scoring tool to identify patients at risk of deterioration. This allows referral to the Outreach team, who assess the patient and if appropriate initiate the care bundle. [source] Improving survival disparities in cervical cancer between M,ori and non-M,ori women in New Zealand: a national retrospective cohort studyAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2010Melissa McLeod Abstract Objective: M,ori women in New Zealand have higher incidence of and mortality from cervical cancer than non-M,ori women, however limited research has examined differences in treatment and survival between these groups. This study aims to determine if ethnic disparities in treatment and survival exist among a cohort of M,ori and non-M,ori women with cervical cancer. Methods: A retrospective cohort study of 1911 women (344 M,ori and 1567 non-M,ori) identified from the New Zealand Cancer Register with cervical cancer (adenocarcinoma, adenosquamous or squamous cell carcinoma) between 1 January 1996 and 31 December 2006. Results: M,ori women with cervical cancer had a higher receipt of total hysterectomies, and similar receipt of radical hysterectomies and brachytherapy as primary treatment, compared to non-M,ori women (age and stage adjusted). Over the cohort period, M,ori women had poorer cancer specific survival than non-M,ori women (mortality hazard ratio (HR) 2.07, 95% confidence interval (CI): 1.63,2.62). From 1996 to 2005, the survival for M,ori improved significantly relative to non-M,ori. Conclusion: M,ori continue to have higher incidence and mortality than non-M,ori from cervical cancer although disparities are improving. Survival disparities are also improving. Treatment (as measured) by ethnicity is similar. Implications: Primary prevention and early detection remain key interventions for addressing M,ori needs and reducing inequalities in cervical cancer in New Zealand. [source] | ||||||||||