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Planning Intervention (planning + intervention)
Selected AbstractsEffect of a Disease-Specific Planning Intervention on Surrogate Understanding of Patient Goals for Future Medical TreatmentJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2010Karin T. Kirchhoff PhD OBJECTIVES: To determine whether a disease-specific planning process can improve surrogate understanding of goals of patients with life-limiting illnesses for future medical treatments. DESIGN: A multisite randomized controlled trial conducted between January 1, 2004 and July 31, 2007. SETTING: Six outpatient clinics of large community or university health systems in three Wisconsin cities. PARTICIPANTS: Competent, English-speaking adults aged 18 and older with chronic congestive heart failure or chronic renal disease and their surrogate decision-makers. INTERVENTION: Trained health professionals conducted a structured, patient-centered interview intended to promote informed decision-making and to result in the completion of a document clarifying the goals of the patient with regard to four disease-specific health outcome situations and the degree of decision-making latitude granted to the surrogate. MEASUREMENTS: Surrogate understanding of patient goals for care with regard to four expected, disease-specific outcomes situations and of the degree of surrogate latitude in decision-making. RESULTS: Three hundred thirteen patient,surrogate pairs completed the study. As measured according to kappa scores and in all four situations and in the degree of latitude, intervention group surrogates demonstrated a significantly higher degree of understanding of patient goals than control group surrogates. Intervention group kappa scores ranged from 0.61 to 0.78, whereas control group kappa scores ranged from 0.07 to 0.28. CONCLUSION: Surrogates in the intervention group had a significantly better understanding of patient goals and preferences than surrogates in the control group. This finding is the first step toward ensuring that patient goals for care are known and honored. [source] Safeguarding Children Living with Trauma and Family Violence: Evidence-based Assessment, Analysis and Planning InterventionsCHILD & FAMILY SOCIAL WORK, Issue 2 2010John Frederick No abstract is available for this article. [source] Computational cardiac atlases: from patient to population and backEXPERIMENTAL PHYSIOLOGY, Issue 5 2009Alistair A. Young Integrative models of cardiac physiology are important for understanding disease and planning intervention. Multimodal cardiovascular imaging plays an important role in defining the computational domain, the boundary/initial conditions, and tissue function and properties. Computational models can then be personalized through information derived from in vivo and, when possible, non-invasive images. Efforts are now established to provide Web-accessible structural and functional atlases of the normal and pathological heart for clinical, research and educational purposes. Efficient and robust statistical representations of cardiac morphology and morphodynamics can thereby be obtained, enabling quantitative analysis of images based on such representations. Statistical models of shape and appearance can be built automatically from large populations of image datasets by minimizing manual intervention and data collection. These methods facilitate statistical analysis of regional heart shape and wall motion characteristics across population groups, via the application of parametric mathematical modelling tools. These parametric modelling tools and associated ontological schema also facilitate data fusion between different imaging protocols and modalities as well as other data sources. Statistical priors can also be used to support cardiac image analysis with applications to advanced quantification and subject-specific simulations of computational physiology. [source] Dietary Planning as a Mediator of the Intention,Behavior Relation: An Experimental-Causal-Chain DesignAPPLIED PSYCHOLOGY, Issue 2008Tabea Reuter Health behavior change is seen as a self-regulatory process that consists of a motivation phase of goal setting and a volition phase of goal pursuit. Previous studies suggest that the intention,behavior association is mediated by planning. However, evidence is based on observational studies rather than on experimental designs. To validate the causal assumptions, an experimental-causal-chain design was employed. Study 1 (n= 145) examined whether changing dietary intentions by a motivational intervention engenders changes in planning activities 1 month later. Study 2 (n= 115) examined, in a different sample, whether a volitional planning intervention engenders changes in dietary behavior 1 month later. In both studies, repeated measures ANOVAs revealed a significant Time × Condition interaction. Changes in intention mediated the effects of the motivational intervention on planning activities (Study 1). Changes in planning mediated the effect of a planning intervention on dietary behavior (Study 2). Previous observational findings on planning as a mediator in the intention,behavior association were supported by the two experiments. The findings might help to identify points of intervention in the process underlying health behavior change. Le changement de comportement au plan de la santé est considéré comme un processus d'auto-régulation qui se compose d'une phase de motivation (fixation des buts) et d'une phase de volition (poursuite des buts). Des études précédentes suggèrent que le passage de l'intention au comportement est médiatisé par la planification. Ces résultats sont obtenus par voie d'observations plutôt que par expérimentations. Pour valider les hypothèses de causalité, un modèle de chaîne-causale-expérimentale a été employé. L'étude 1 examine si, en changeant les intentions alimentaires par une intervention motivationnelle, on obtient des changements dans la planification des activités un mois après (n= 145). L'étude 2 examine, sur un échantillon différent, si la planification d'une intervention engendre des changements du comportement alimentaire un mois plus tard (n= 115). Pour ces deux études, des ANOVA à mesures répétées révèlent une interaction significative entre le temps et la condition étudiée. Les changements de l'intention influencent les effets de l'intervention motivationnelle sur la planification des activités (étude 1). Les changements de la planification influencent les effets de l'intervention de la volition sur le comportement alimentaire (Etude 2). Les résultats obtenus par observation sur la planification comme lien entre l'intention et le comportement sont confirmés par les expérimentations. Les résultats peuvent permettre d'identifier les modalités d'interventions relatives au processus sous-tendant le changement du comportement de santé. [source] Predicting Patterns of Mammography Use: A Geographic Perspective on National Needs for Intervention ResearchHEALTH SERVICES RESEARCH, Issue 4 2002Julie Legler Objective. To introduce a methodology for planning preventive health service research that takes into account geographic context. Data Sources. National Health Interview Survey (NHIS) self-reports of mammography within the past two years, 1987, and 1993,94. Area Resource File (ARF), 1990. Database of mammography intervention research studies conducted from 1984 to 1994. Design. Bayesian hierarchical modeling describes mammography as a function of county-level socioeconomic data and explicitly estimates the geographic variation unexplained by the county-level data. This model produces county use estimates (both NHIS-sampled and unsampled), which are aggregated for entire states. The locations of intervention research studies are examined in light of the statewide mammography utilization estimates. Data Extraction. Individual level NHIS data were merged with county-level data from the ARF. Principal Findings. State maps reveal the estimated distribution of mammography utilization and intervention research. Eighteen states with low mammography use reported no intervention research activity. County-level occupation and education were important predictors for younger women in 1993,94. In 1987, they were not predictive for any demographic group. Conclusions. Opportunities exist to improve the planning of future intervention research by considering geographic context. Modeling results suggest that the choice of predictors be tailored to both the population and the time period under study when planning interventions. [source] Trophic mass balanced models and dynamic simulations of benthic communities from La Rinconada Marine Reserve off northern Chile: network properties and multispecies harvest scenario assessmentsAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 1 2010Marco Ortiz Abstract 1.Mass balanced trophic models and dynamic simulations of two benthic ecological systems from La Rinconada Marine Reserve (Antofagasta Bay, SE Pacific) were constructed. 2.The scallop Argopecten purpuratus is the most important benthic resource in La Rinconada Marine Reserve, followed by the carnivorous snail Thais chocolata, and the filter-feeder bivalves Tagelus dombeii and Transennella pannosa. 3.Information on biomass, P/B ratios, catches, food spectrum, consumption, and dynamics of commercial and non-commercial species was obtained and examined using Ecopath with an Ecosim software package. 4.The bivalves A. purpuratus and T. dombeii represented the most abundant compartments in the studied subsystems. Of the carnivores, the snail T. chocolata was dominant, followed by the crabs Cancer spp. and the functional group of large epifauna. 5.The two subsystems presented similar values of system throughput. The mean trophic level of their fisheries also reached similar magnitudes (2.0), showing that the harvests in each system concentrated on secondary producers. Likewise, both subsystems presented similar A/C ratios (29.9 and 30.3), suggesting that they were immature. 6.The results obtained using mixed trophic impact (MTI) and Ecosim (increasing the fishing mortality Fi by four times) showed that only four species propagated the highest direct and indirect effects. Coincidentally, these species are the most economically important and the changes produced by the scallop A. purpuratus are noteworthy. 7.With regard to the system recovery time (SRT) estimates, only three species or functional groups presented the highest magnitudes, from highest to lowest: the sea star Luidia magallanica, the scallop A. purpuratus, and the crabs Cancer spp. 8.The topological keystone indexes of Jordán and Libralato had divergent results. According to Jordán's index, the keystone species were L. magallanica, Cancer spp., and detritus; whereas Libralato's index showed phytoplankton to be the keystone species. 9.Based on the results obtained, it is concluded that trophic mass balanced models and simulated management scenarios have considerable value for planning interventions and manipulations or for planning more sustainable management strategies in La Rinconada Marine Reserve. Copyright © 2009 John Wiley & Sons, Ltd. [source] Psycho-social issues in long-term survivors of testicular cancer: Directions for future researchASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 3 2008Tim LUCKETT Abstract Testicular cancer is the most common non-skin cancer in young men and among the most curable of all neoplasms, making patients' long-term physical, psychological and social well-being of major concern. To date, research on outcomes has been restricted almost entirely to survivors in Europe and the USA. The current article reviews the international literature with a view to developing directions for future research in the Asia,Pacific region. We conclude that planning interventions to improve outcomes awaits further, prospective, controlled studies aimed at establishing the predictive value not only of socio-demographic, disease and treatment variables but also of psycho-social variables underlying adjustment and recovery. Ideally, research of this kind would: (i) highlight aspects of the experience of testicular cancer and its treatment that might be targeted by changes to patterns of care, and (ii) identify groups at risk of poor outcomes who could be identified for early intervention through screening. Planning of prospective research would itself benefit from further, large-scale, cross-sectional research aimed at identifying those variables that would prove most informative when tracked over time. Exploratory research of this kind should be aimed at providing a snapshot of men's well-being in the context of a comprehensive range of variables that include patterns of care, unmet needs, satisfaction with treatment and social support as well as disease and treatment variables. Outcome variables should include disease-specific concerns such as psycho-sexual problems as well as general physical, psychological and social well-being. [source] | |||||||||||||