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Many Interventions (many + intervention)
Selected AbstractsImportance of arterial stiffness as cardiovascular risk factor for future development of new type of drugsFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 3 2008Pierre Boutouyrie Abstract Cardiovascular risk prediction relies on classical risk factors such as age, gender, lipids, hypertension, smoking and diabetes. Although the value of such scales of risk is high for populations, its value for individual is reduced and too much influenced by non-modifiable risk factors (age and gender). Biomarkers of risk have been deceiving and genome wide scan approach is too recent. Target organ damage may help in selecting patients at high risk and in determining intervention. Aortic pulse wave velocity, an index of aortic stiffness, has been widely validated as providing additional risk predictions beyond and above classical risk factors, and has now entered into official guidelines. Many interventions (dietary, behaviour, drug treatment) were shown to influence arterial stiffness positively, but little evidence of a direct effect of intervention on arterial stiffness independent of blood pressure is available. New pharmacological targets and new drugs need to be identified. To become a surrogate endpoint for drug development, there is a need to demonstrate that regression arterial stiffness is associated with improved outcome. In parallel to this demonstration, points to be improved are the homogenization and spreading of the technique of measurement, the establishment of a reference value database. [source] A systematic review of intervention studies about anxiety in caregivers of people with dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2007Claudia Cooper Abstract Background There is considerable literature on managing depression, burden and psychological morbidity in caregivers of people with dementia (CG). Anxiety has been a relatively neglected outcome measure but may require specific interventions. Objective To synthesise evidence regarding interventions that reduce anxiety in CGs. Methods Twenty-four studies met our inclusion criteria. We rated the methodology of studies, and awarded grades of recommendation (GR) for each type of intervention according to Centre for Evidence Based Medicine guidelines, from A (highest level of evidence) to D. Results Anxiety level was the primary outcome measure in only one study and no studies were predicated on a power calculation for anxiety level. There was little evidence of efficacy for any intervention. The only RCT to report significantly reduced anxiety involved a CBT and relaxation-based intervention specifically devised to treat anxiety, and there was preliminary evidence (no randomised controlled trials) that caregiver groups involving yoga and relaxation without CBT were effective. There was grade B evidence that behavioural management, exercise therapies and respite were ineffective. Limitations Many interventions were heterogeneous, so there is some overlap between groups. Lack of evidence of efficacy is not evidence of lack of efficacy. Conclusions CBT and other therapies developed primarily to target depression did not effectively treat anxiety. Good RCTs are needed to specifically target anxiety which might include relaxation techniques. Some of the interventions focussed on reducing contact with the care recipients but caregivers may want to cope with caring and preliminary evidence suggests strategies to help CGs manage caring demands may be more effective. Copyright © 2006 John Wiley & Sons, Ltd. [source] Cognitive therapy with people with intellectual disabilities: a selective review and critiqueCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 4 2004Peter Sturmey The literature on cognitive therapy with people with intellectual disabilities was selectively reviewed, including application to problems such as anger management, depression and offending. The literature on anger management showed the most promise. The literature on depression was weak. Research on offenders was promising, but no controlled trials were found. Much of the literature incorrectly identified behavioral interventions as cognitive interventions. Many interventions, such as anger management, were in fact packages that included many behavioral interventions, such as relaxation and social skills training, alongside cognitive methods, such as cognitive restructuring. Hence, evaluations of anger management packages can not tell us anything about the effectiveness of cognitive therapy, since cognitive therapy is confounded with behavior therapy. Future directions for research include well controlled experimental trials to evaluate the effectiveness of these packages and the contribution of cognitive therapy to treatment outcome.,Copyright © 2004 John Wiley & Sons, Ltd. [source] Adolescent quality of life: A school-based cohort study in Western AustraliaPEDIATRICS INTERNATIONAL, Issue 6 2003Lynn B. Meuleners AbstractBackground:,Quality of life (QOL) has received increasing attention in pediatrics medicine recently. Improving QOL is the primary justification for many interventions, medications and therapies. The present study is a school-based longitudinal study which aims to investigate the factors affecting QOL of adolescents in Western Australia over a 6-month period. Methods:,A generic self-reported questionnaire was administered twice to participants from 20 schools in Perth at 6 months apart. In addition to QOL scores and physical health status, demographic and other information was also collected. For the cohort of 363 students who participated in the initial survey, 300 of them completed the second questionnaire. Results:,A significant change in QOL score between baseline and 6 months was observed. Results from fitting a hierarchical mixed regression model indicated that 55% of the variation in QOL was due to differences between individuals, and was significantly associated with age, control, opportunities and perceptions of physical health, while the remaining variance component could be attributed to within-individual changes. Improved control and opportunities appeared to have a significant positive impact on QOL, whereas increasing age and deterioration in physical health had the opposite effect. Conclusions:,The hierarchical regression analysis has enabled valid inferences to be made based on the observed longitudinal data. Perceptions of physical health, age, control and opportunities available are related to adolescent QOL. The findings have implications on evidence-based practices and childhood health issues. [source] | ||||||||||