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Preventive Interventions (preventive + intervention)
Kinds of Preventive Interventions Selected AbstractsIs Sure Start an Effective Preventive Intervention?CHILD AND ADOLESCENT MENTAL HEALTH, Issue 1 2007Jon Davies No abstract is available for this article. [source] Is Sure Start an Effective Preventive Intervention?CHILD AND ADOLESCENT MENTAL HEALTH, Issue 3 2006Michael Rutter Background:, Sure Start was established with the aim of eliminating child poverty and social exclusion. Method:, The findings from the reports of the National Evaluation of Sure Start Team, published in November 2005, are reviewed and critiqued. Results:, The family and child functioning after 3 years of Sure Start, as compared with Sure Start-to-be areas, showed very few significant differences, with some indication of adverse effects in the most disadvantaged families. Conclusions:, These findings are discussed in relation to their service, research and policy implications,with the conclusion that the research evaluation was well conducted, but the findings are inconclusive. There are lessons on how to improve Sure Start and what should have been done differently. [source] Childhood predictors of adult criminality: are all risk factors reflected in childhood aggressiveness?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2002L. Rowell Huesmann Background Early aggressive behaviour is one of the best predictors of adult criminality. Aim To assess the degree to which family background variables, parental beliefs and behaviour and child intelligence predict child aggression and adult criminality. Method Data were used from the Colombia County Longitudinal Study, a longitudinal study of 856 children in third grade in New York, in 1959,60. Adult measures of criminal behaviour, child measures taken at age eight, child peer-nominated aggression, child's peer-nominated popularity, child's IQ and parental measures at eight years were used. Results Aggressive children were less intelligent, less popular, rejected more by their parents, had parents who believed in punishment, were less identified with their parents' self-image and were less likely to express guilt. As adults, more aggressive children with parents who were less well educated, experienced more marital disharmony and who seldom attended church were most at risk for arrest. However, after the effect of early aggression was controlled, most effects disappeared and only parents having a strong belief in punishment added significantly to risk of arrest by age 30; the only fact that then reduced the risk of arrest was having parents who attended church often. Both parental authoritarianism and child IQ reduced the risk of conviction for arrested children. Discussion Level of aggression at age eight is the best predictor of criminal events over the next 22 years. A clear implication is that the risk for criminality is affected by much that happens to a boy before he is eight years old. Preventive interventions need to target risk factors that appear to influence the development of early aggression. Copyright © 2002 Whurr Publishers Ltd. [source] The development of pressure ulcers in patients with hip fractures: inadequate nursing documentation is still a problemJOURNAL OF ADVANCED NURSING, Issue 5 2000Lena Gunningberg MSC RN The aims of the study were to investigate, on a daily basis: (i] the development and progress of pressure ulcers, (ii) the documented nursing interventions for prevention and treatment of pressure ulcers, and (iii) when nursing interventions regarding prevention and treatment of pressure ulcers were documented, in relation to patient risk status and the development of pressure ulcers. The study design was prospective, comparative and descriptive. A total of 55 patients with hip fracture were included. To facilitate the nurse's assessment, a ,pressure ulcer card' was developed, consisting of the Modified Norton Scale (MNS) and descriptions of the four stages of pressure ulcers. The incidence of pressure ulcers was 55%. The mean rank of the lowest MNS score was significantly lower for patients who developed pressure ulcers than for patients without pressure ulcers. The majority of the pressure ulcers occurred between admission to the ward and the fourth day after surgery. Documented interventions regarding prevention and treatment were: repositioning, overlays, cushions, use of lotion and observation. The mean number of interventions per patient was 2·2 for patients who developed pressure ulcers during their hospital stay. The comprehensiveness and quality of the nursing record was unsatisfactory, and only three nursing records reached the level required by Swedish law. Preventive interventions such as repositioning were documented when the pressure ulcer had already occurred. The lack of nursing documentation regarding prevention and treatment of pressure ulcers may indicate that nurses did not identify pressure ulcers as a prioritized nursing problem for this patient group. The Modified Norton Scale could be a valuable tool for nurses, both identifying the patient at risk and acting as a guide for nursing interventions. The study was approved by the ethics committee of the Faculty of Medicine at Uppsala University. [source] Preventive interventions among children exposed to trauma of armed conflict: a literature reviewAGGRESSIVE BEHAVIOR, Issue 2 2010Kirsi Peltonen Abstract Increasing research is available on the preconditions for child mental health and optimal development in traumatic conditions, whereas less is known how to translate the findings into effective interventions to help traumatized children. This literature review analyses the effectiveness of psychosocial preventive interventions and treatments and their theoretical bases among children traumatized in the context of armed conflicts (war, military violence, terrorism and refugee). The first aim is to evaluate the effectiveness of preventive interventions in preventing emotional distress and impairment and promoting optimal emotional-cognitive and social development. The second task is to analyze the nature of the underlying mechanisms for the success of preventive interventions, and the theoretical premises of the choice of intervention techniques, procedures and tools. We found 16 relevant published studies, but an examination of them revealed that only four of them had experimental designs strong enough that they could be included in the meta-analysis. While the subjective reports of the researchers suggested that systematic preventive interventions were effective in decreasing PTSD and depressive symptoms among children traumatized due to armed conflict, the more objective results of the meta-analysis and the weaknesses in designs uncovered during the meta-analysis undermine such a conclusion. Additionally, a majority of the reported preventive interventions focused only on children's biased cognitive processes and negative emotions, while only a few aimed at influencing multiple domains of child development and improving developmental functioning on emotional, social and psychophysiological levels. It is concluded that substantial additional work needs to be done in developing effective preventive interventions and treatments for children traumatized by exposure to war and violence. Aggr. Behav. 36:95,116, 2010. © 2009 Wiley-Liss, Inc. [source] Depression and anxiety symptoms: onset, developmental course and risk factors during early childhoodTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 10 2009Sylvana M. Côté Background:, Depressive and anxiety disorders are among the top ten leading causes of disabilities. We know little, however, about the onset, developmental course and early risk factors for depressive and anxiety symptoms (DAS). Objective:, Model the developmental trajectories of DAS during early childhood and to identify risk factors for atypically high DAS. Method:, Group-based developmental trajectories of DAS conditional on risk factors were estimated from annual maternal ratings (1½ to 5 years) in a large population sample (n = 1759). Results:, DAS increased substantially in two of the three distinct trajectory groups identified: High-Rising (14.7%); Moderate-Rising (55.4%); and Low (29.9%). Two factors distinguished the High-Rising group from the other two: Difficult temperament at 5 months (High-Rising vs Moderate-Rising: OR = 1.32; 95% CI = 1.13,1.55; High-Rising vs Low: OR = 1.31, CI = 1.12,1.54) and maternal lifetime major depression (High-Rising vs Moderate-Rising: OR = 1.10; CI = 1.01,1.20; High-Rising vs Low: OR = 1.19; CI = 1.08,1.31). Two factors distinguished the High-Rising group from the Low group: High family dysfunction (OR = 1.24; CI = 1.03,1.5) and Low parental self-efficacy (OR = .71; CI = .54,.94). Conclusions:, DAS tend to increase in frequency over the first 5 years of life. Atypically high level can be predicted from mother and child characteristics present before 6 months of age. Preventive interventions should be experimented with at risk infants and parents. [source] Mediator effects in the social development model: an examination of constituent theoriesCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2005Eric C. Brown Background The social development model (SDM) provides an explanatory framework for the progression of antisocial behaviour in children and adolescents. Although previous research has assessed the predictive validity of the model, alternative associations based on the SDM's constituent theories have not been examined. Method Using structural equation modelling, a series of direct paths was examined for mediation by SDM constructs. Data for the study consisted of teacher-, parent- and self-report of 1016 fourth- and fifth-grade students from the Raising Healthy Children project, a longitudinal etiological study with an embedded preventive intervention. Results Four of the seven paths examined were partially or totally mediated by SDM constructs. Specifically, the relationship between prosocial bonding and adolescent antisocial behaviour, as hypothesized by social control theory, was fully mediated by prosocial beliefs. As hypothesized by social learning theory, students' socioemotional and cognitive skills significantly predicted antisocial behaviour, independent of partial mediation through rewards, bonding and beliefs. As hypothesized by differential association theory, involvement with both prosocial and antisocial persons was directly associated with respective prosocial and antisocial beliefs, independent of partial mediation through rewards and bonding. Conclusions These findings suggest additional associations that are not currently specified in the SDM and underscore the importance of re-examining hypotheses from constituent theories when integrating developmental models of antisocial behaviour. Copyright © 2005 John Wiley & Sons, Ltd. [source] The nurse,family partnership: An evidence-based preventive interventionINFANT MENTAL HEALTH JOURNAL, Issue 1 2006David L. Olds Pregnancy and the early years of the child's life offer an opportune time to prevent a host of adverse maternal, child, and family outcomes that are important in their own right, but that also reflect biological, behavioral, and social substrates in the child and family that affect family formation and future life trajectories. This article summarizes a 27-year program of research that has attempted to improve early maternal and child health and future life options with prenatal and infancy home visiting by nurses. The program is designed for low-income mothers who have had no previous live births. The home-visiting nurses have three major goals: to improve the outcomes of pregnancy by helping women improve their prenatal health, to improve the child's health and development by helping parents provide more sensitive and competent care of the child, and to improve parental life course by helping parents plan future pregnancies, complete their education, and find work. The program has been tested in three separate large-scale, randomized controlled trials with different populations living in different contexts. Results from these trials indicate that the program has been successful in achieving two of its most important goals: (a) the improvement of parental care of the child as reflected in fewer injuries and ingestions that may be associated with child abuse and neglect and better infant emotional and language development; and (b) the improvement of maternal life course, reflected in fewer subsequent pregnancies, greater work-force participation, and reduced dependence on public assistance and food stamps. The impact on pregnancy outcomes is equivocal. In the first trial, the program also produced long-term effects on the number of arrests, convictions, emergent substance use, and promiscuous sexual activity of 15-year-old children whose nurse-visited mothers were low-income and unmarried when they registered in the study during pregnancy. In general, the impact of the program was greater on those segments of the population at greater risk for the particular outcome domain under examination. Since 1996, the program has been offered for public investment outside of research contexts. Careful attention has been given to ensuring that organizational and community contexts are favorable for development of the program, to providing excellent training and guidance to the nurses in their use of the program's visit-by-visit guidelines, to monitoring the functioning of the program with a comprehensive clinical information system, and to improving the performance of the programs over time with continuous improvement strategies. [source] Testing the developmental distinctiveness of male proactive and reactive aggression with a nested longitudinal experimental interventionAGGRESSIVE BEHAVIOR, Issue 2 2010Edward D. Barker Abstract An experimental preventive intervention nested into a longitudinal study was used to test the developmental distinctiveness of proactive and reactive aggression. The randomized multimodal preventive intervention targeted a subsample of boys rated disruptive by their teachers. These boys were initially part of a sample of 895 boys, followed from kindergarten to 17 years of age. Semiparametric analyses of developmental trajectories for self-reported proactive and reactive aggression (between 13 and 17 years of age) indicated three trajectories for each type of aggression that varied in size and shape (Low, Moderate, and High Peaking). Intent-to-treat comparisons between the boys in the prevention group and the control group confirmed that the preventive intervention between 7 and 9 years of age, which included parenting skills and social skills training, could impact the development of reactive more than proactive aggression. The intervention effect identified in reactive aggression was related to a reduction in self-reported coercive parenting. The importance of these results for the distinction between subtypes of aggressive behaviors and the value of longitudinal-experimental studies from early childhood onward is discussed. Aggr. Behav. 36:127,140, 2010. © 2010 Wiley-Liss, Inc. [source] Two studies of proximal outcomes and implementation quality of universal preventive interventions in a community,university collaboration contextJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 5 2002Richard Spoth Here we present the results from two longitudinal studies of competency-training interventions that entailed community,university collaboration intended to enhance implementation quality. In Study 1, 22 rural schools were randomly assigned to a family-focused intervention or a minimal contact control group. In Study 2, 36 rural schools were randomly assigned to a family-focused preventive intervention combined with a school-based intervention, the school-based intervention alone, or a minimal contact control group. In both studies, observers rated adherence to intervention protocols. Results showed that, on average, high levels of observer-rated adherence were attained in both studies. Analyses of the relationship between observer-rated adherence scores and proximal outcomes showed limited evidence of poorer outcomes associated with lower-adherence groups. Overall, findings highlight the benefits of community,university collaboration intended to facilitate high levels of intervention adherence. The need for a framework guiding a collaborative implementation research agenda is discussed. © 2002 Wiley Periodicals, Inc. [source] Who joins a preventive intervention?JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 4 2001How risk status predicts enrollment The objective of this study was to identify social, psychological, and health-related variables that predict mothers' refusals to join a prevention program for families of children with chronic illnesses. A two-step recruitment process was used with 193 families of children with chronic illnesses. First, families were recruited for a longitudinal research survey. Then, mothers were given the opportunity to randomly receive one of two programs. Mothers who refused the opportunity to participate in either program continued in the research project. Data were collected through structured interviews at baseline and 12 months later. Compared to mothers who agreed to participate in one of the programs, those who refused reported more confidence, more support, and less depression and higher functional status and better adjustment in their child. Mothers who agree to participate in a longitudinal research effort but refuse to participate in an intervention program are likely to be functioning well, and may perceive no need for a program designed to prevent mental health problems. © 2001 John Wiley & Sons, Inc. [source] Oral Health of Young Children in Mississippi Delta Child Care Centers: A Second Look at Early Childhood Caries Risk AssessmentJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2008Linda H. Southward PhD Abstract Objectives: To identify the predictors of early childhood caries and urgent dental treatment need among primarily African-American children in child care centers in the Delta region of Mississippi. The purpose of this study was to replicate predictors of caries and urgent dental treatment needs that were identified in an earlier study conducted in Delta child care centers and to assess additional caries risk factors not collected in the original study. Methods: Children in 19 child care centers were examined by the dentists, and the parents provided data on oral health practices, oral health history, and on children's oral health-related quality of life (QOL). The dentists also assessed visible plaque and tested levels of mutans streptococci. Predictors of caries and treatment need among children 24 to 71 months of age were examined using logistic regression. Results: Two parent predictors of caries identified in the earlier study (parent flossing and soft/sugary drink consumption) were not predictive in the current study. Parent history of abscess continued to predict their child's urgent need for treatment. Young children's level of salivary mutans streptococci, maxillary incisor visible plaque, and parents' reports of child oral health-related QOL measures predicted the presence of both caries and urgent treatment need. Some expected predictors, such as frequency of child's toothbrushing, were not predictive of caries. Conclusions: Parental abscess and parent's report of the child's oral health-related QOL are risk indicators for poor oral health outcomes that could be used by nondental personnel to identify young children in need of early preventive intervention and dental referral. [source] Linking Changes in Parenting to Parent,Child Relationship Quality and Youth Self-Control: The Strong African American Families ProgramJOURNAL OF RESEARCH ON ADOLESCENCE, Issue 1 2005Gene H. Brody A randomized prevention trial was conducted contrasting families who took part in the Strong African American Families Program (SAAF), a preventive intervention for rural African American mothers and their 11-year-olds, with control families. SAAF is based on a conceptual model positing that changes in intervention-targeted parenting behaviors would enhance responsive-supportive parent,child relationships and youths' self-control, which protect rural African American youths from substance use and early sexual activity. Parenting variables included involvement-vigilance, racial socialization, communication about sex, and clear expectations for alcohol use. Structural equation modeling analyses indicated that intervention-induced changes in parenting were linked with changes in responsive,supportive parent,child relationships and youth self-control. [source] Perceptual, motor and cognitive performance components of Bedouin children in IsraelOCCUPATIONAL THERAPY INTERNATIONAL, Issue 4 2000Shula Parush PhD Abstract The purpose of this study was to evaluate the perceptual, motor and cognitive performance abilities of Bedouin children as compared with mainstream Israeli children of the same age. The study population comprised two age groups (6,8 year olds and 10,12 year olds) living in two different types of settlements (rural and town). Participants included 20 children in each group. The Test of Visual-Perceptual Skills (TVPS), the Developmental Test of Visual-Motor Integration (VMI), selected subtests from the Bruininks-Oseretsky Test of Motor Proficiency and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were used. Older participants in all three groups performed better than the younger subjects. There were no significant differences between the two Bedouin groups in either age category. The mainstream Israeli subjects scored significantly higher than the two Bedouin groups on most variables tested. The lack of differences between the two Bedouin groups may indicate that the transition from nomadic communities to urban communities is mainly external and has not caused a significant change in perception, perceptual-motor and cognitive performance abilities. The results of this study may be used as a base for developing preventive intervention programmes to meet the specific needs of Bedouin children. A limitation of this study was the classification of the Bedouin population according to their dwelling place and not according to their sociodemographic background, such as parents' economic status, parents' education and so on. Recommendations for future research include expanding the number of participants, including children from additional rural schools of various distant tribes and incorporating more detailed cognitive assessments. Copyright © 2000 Whurr Publishers Ltd. [source] Cumulative Adversity and Posttraumatic Stress Disorder: Evidence From a Diverse Community Sample of Young AdultsAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 4 2003Donald A. Lloyd PhD The authors hypothesized that a history of adversities, whether they were objectively traumatic or not, predicts risk for 1st onset of PTSD. Survival analysis in a community sample of 1,803 young adults revealed that risk is associated with retrospectively reported adverse experiences that occurred in years prior to the focal traumatic event. Analyses control for clustering of events proximal to onset. Implications for etiology and preventive intervention are noted. [source] Structured extracurricular activities among adolescents: Findings and implications for school psychologistsPSYCHOLOGY IN THE SCHOOLS, Issue 1 2004Rich Gilman One factor that contributes to adolescent positive mental health is active engagement. Engagement is defined as any activity that is initiated to attain an outcome. In general, two forms of activities exist that correspond with engagement: solitary, non-structured, and non-cooperative pursuits, often without adult supervision (e.g., playing video games, watching television) and highly structured, collaborative activities that are under the guidance of a competent set of adults (i.e., structured extracurricular activities, or SEAs). Although large amounts of time spent in unstructured activities is related to negative psychosocial outcomes, participation in SEAs has been related to a variety of positive outcomes for students. This paper reviews current research regarding adolescent participation in SEAs and its effects on academic and personal-social variables (i.e., self-concept, life satisfaction), as well as potential preventive effects for youths considered to be "at-risk" for negative developmental outcomes. The paper also examines research investigating the potential benefits and shortcomings of different types of SEAs. Finally, suggestions for future research and school-based preventive intervention are presented. © 2004 Wiley Periodicals, Inc. Psychol Schs 41: 31,41, 2004. [source] Antisocial behavior and the prediction of violence: A meta-analysisPSYCHOLOGY IN THE SCHOOLS, Issue 2 2001James H. Derzon Youthful antisocial behavior is often viewed as a precursor to later violent and threatening behavior. Olweus (1979) reported aggressive reaction patterns in males that over time approached the stability of intelligence. While Olweus did not examine violent behavior directly, his study is often cited as evidence for the stability of violence. To examine the evidence for this assertion, this study synthesized the evidence from 82 reports of 58 prospective studies that followed individuals over some period of their life span. After correcting effect sizes for exogenous study features, the grand mean correlation of antisocial and substance misusing behaviors with later crimes against persons was estimated to be r = .33, a far cry from the stability of intelligence. Because these predictors are often used to select people into intervention, this study estimated the conditional error rates associated with identification for preventive intervention. Overall, selection failed to identify 66% of those who displayed later violence, while on average, 60% of those engaging in antisocial or substance-using behavior were not later violent. © 2001 John Wiley & Sons, Inc. [source] Subjective quality of life aspects predict depressive symptoms over time: results from a three-wave longitudinal studyACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009C. Kuehner Objective:, Little is known about predictive effects of quality of life aspects on the course of depressive symptoms in clinical and non-clinical settings. This study examines longitudinal associations between depressive symptoms and subjective quality of life (QOL) dimensions using a parallel sample of depressed patients and community controls. Method:, Eighty-two depressed patients were investigated 1, 6, and 42 months after hospital discharge together with 76 community controls regarding depressive symptoms measured by Montgomery Asberg Depression Rating Scale (MADRS) and QOL (WHOQOL-BREF). Data analysis included time-lagged linear models. Results:, Physical, psychological, environmental and overall QOL, controlled for depressive symptoms, predicted future depression levels. Group status did not moderate these associations. Depressive symptoms predicted future QOL levels only regarding social relations. Conclusion:, Our study suggests that subjective QOL domains have prognostic value for the course of depressive symptoms over time, both in patient and community samples. Respective self-perceptions should therefore be directly addressed by therapeutic and preventive interventions. [source] The quantitative risk of violent crime and criminal offending: a case-control study among the offspring of recidivistic Finnish homicide offendersACTA PSYCHIATRICA SCANDINAVICA, Issue 2002A. Putkonen Objective: To study if later risk of violent offending and criminality among high-risk children can be estimated quantitatively on the basis of parental crimes. Method:, The criminal and prison records of the offspring (N=11) of homicide recidivists (N=36) were compared with data from controls (N=220) who were matched for sex, domicile of birth and date of birth and death. Results:, The risk (odds ratio) was increased up to 24-fold for violent crimes (P=0.01), and up to 17-fold for criminality (P=0.0008) among the offspring of homicide recidivists. Conclusion:, The quantitative risk of a child for later violent offending and criminality can be estimated on the basis of parental homicide recidivism. This kind of method could be used to choose target groups for early preventive interventions, and to study the effectiveness of prevention. [source] Cost-effectiveness of interventions to prevent alcohol-related disease and injury in AustraliaADDICTION, Issue 10 2009Linda Cobiac ABSTRACT Aims To evaluate cost-effectiveness of eight interventions for reducing alcohol-attributable harm and determine the optimal intervention mix. Methods Interventions include volumetric taxation, advertising bans, an increase in minimum legal drinking age, licensing controls on operating hours, brief intervention (with and without general practitioner telemarketing and support), drink driving campaigns, random breath testing and residential treatment for alcohol dependence (with and without naltrexone). Cost-effectiveness is modelled over the life-time of the Australian population in 2003, with all costs and health outcomes evaluated from an Australian health sector perspective. Each intervention is compared with current practice, and the most cost-effective options are then combined to determine the optimal intervention mix. Measurements Cost-effectiveness is measured in 2003 Australian dollars per disability adjusted life year averted. Findings Although current alcohol intervention in Australia (random breath testing) is cost-effective, if the current spending of $71 million could be invested in a more cost-effective combination of interventions, more than 10 times the amount of health gain could be achieved. Taken as a package of interventions, all seven preventive interventions would be a cost-effective investment that could lead to substantial improvement in population health; only residential treatment is not cost-effective. Conclusions Based on current evidence, interventions to reduce harm from alcohol are highly recommended. The potential reduction in costs of treating alcohol-related diseases and injuries mean that substantial improvements in population health can be achieved at a relatively low cost to the health sector. [source] Preventing heavy alcohol use in adolescents (PAS): cluster randomized trial of a parent and student intervention offered separately and simultaneouslyADDICTION, Issue 10 2009Ina M. Koning ABSTRACT Aims To evaluate the effectiveness of two preventive interventions to reduce heavy drinking in first- and second-year high school students. Design and setting Cluster randomized controlled trial using four conditions for comparing two active interventions with a control group from 152 classes of 19 high schools in the Netherlands. Participants A total of 3490 first-year high school students (mean 12.68 years, SD = 0.51) and their parents. Intervention conditions (i) Parent intervention (modelled on the Swedish Örebro Prevention Program) aimed at encouraging parental rule-setting concerning their children's alcohol consumption; (ii) student intervention consisting of four digital lessons based on the principles of the theory of planned behaviour and social cognitive theory; (iii) interventions 1 and 2 combined; and (iv) the regular curriculum as control condition. Main outcome measures Incidence of (heavy) weekly alcohol use and frequency of monthly drinking at 10 and 22 months after baseline measurement. Findings A total of 2937 students were eligible for analyses in this study. At first follow-up, only the combined student,parent intervention showed substantial and statistically significant effects on heavy weekly drinking, weekly drinking and frequency of drinking. At second follow-up these results were replicated, except for the effects of the combined intervention on heavy weekly drinking. These findings were consistent across intention-to-treat and completers-only analyses. Conclusions Results suggest that adolescents as well as their parents should be targeted in order to delay the onset of drinking, preferably prior to onset of weekly drinking. [source] The academic environment: the students' perspectiveEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2008K. Divaris (nci) Abstract Dental education is regarded as a complex, demanding and often stressful pedagogical procedure. Undergraduates, while enrolled in programmes of 4,6 years duration, are required to attain a unique and diverse collection of competences. Despite the major differences in educational systems, philosophies, methods and resources available worldwide, dental students' views regarding their education appear to be relatively convergent. This paper summarizes dental students' standpoint of their studies, showcases their experiences in different educational settings and discusses the characteristics of a positive academic environment. It is a consensus opinion that the ,students' perspective' should be taken into consideration in all discussions and decisions regarding dental education. Moreover, it is suggested that the set of recommendations proposed can improve students' quality of life and well-being, enhance their total educational experience and positively influence their future careers as oral health physicians. The ,ideal' academic environment may be defined as one that best prepares students for their future professional life and contributes towards their personal development, psychosomatic and social well-being. A number of diverse factors significantly influence the way students perceive and experience their education. These range from ,class size', ,leisure time' and ,assessment procedures' to ,relations with peers and faculty', ,ethical climate' and ,extra-curricular opportunities'. Research has revealed that stress symptoms, including psychological and psychosomatic manifestations, are prevalent among dental students. Apparently some stressors are inherent in dental studies. Nevertheless, suggested strategies and preventive interventions can reduce or eliminate many sources of stress and appropriate support services should be readily available. A key point for the Working Group has been the discrimination between ,teaching' and ,learning'. It is suggested that the educational content should be made available to students through a variety of methods, because individual learning styles and preferences vary considerably. Regardless of the educational philosophy adopted, students should be placed at the centre of the process. Moreover, it is critical that they are encouraged to take responsibility for their own learning. Other improvements suggested include increased formative assessment and self-assessment opportunities, reflective portfolios, collaborative learning, familiarization with and increased implementation of information and communication technology applications, early clinical exposure, greater emphasis on qualitative criteria in clinical education, community placements, and other extracurricular experiences such as international exchanges and awareness of minority and global health issues. The establishment of a global network in dental education is firmly supported but to be effective it will need active student representation and involvement. [source] A Culturally Informed Model of Academic Well-Being for Latino Youth: The Importance of Discriminatory Experiences and Social Support,FAMILY RELATIONS, Issue 3 2006David S. DeGarmo Abstract: This study tested a culturally informed model of academic well-being for 278 Latino youth. We examined detrimental effects of discriminatory experiences and protective effects of social support on self-reported academic outcomes. Models specified main and buffering effects of social support and compared contributions of support provided by parents, school, and peers. Data indicated that discrimination was associated with lower academic well-being, social support buffered effects of discrimination on academic well-being, and parental support was most predictive of greater academic well-being. Combined sources of social support were more important than any one source alone. Implications for culturally specified research, preventive interventions, and practitioners are discussed. [source] Health risk appraisal for older people in general practice using an expert system: a pilot studyHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2005S. Iliffe Abstract The prevention of disability in later life is a major challenge facing industrialised societies. Primary care practitioners are well positioned to maintain and promote health in older people, but the British experience of population-wide preventive interventions has been disappointing. Health risk appraisal (HRA), an emergent information-technology-based approach from the USA, has the potential for fulfilling some of the objectives of the National Service Framework for Older People. Information technology and expert systems allow the perspectives of older people on their health and health risk behaviours to be collated, analysed and converted into tailored health promotion advice without adding to the workload of primary care practitioners. The present paper describes a preliminary study of the portability of HRA to British settings. Cultural adaptation and feasibility testing of a comprehensive health risk assessment questionnaire was carried out in a single group practice with 12 500 patients, in which 58% of the registered population aged 65 years and over participated in the study. Eight out of 10 respondents at all ages found the questionnaire easy or very easy to understand and complete, although more than one-third had or would have liked assistance. More than half felt that the length of the questionnaire was about right, and one respondent in 10 disliked some questions. Of those who completed the questionnaire and received tailored, written health promotion advice, 39% provided feedback on this with comments that can be used for increasing the acceptability of tailored advice. These findings have informed a wider exploratory study in general practice. [source] Disorganized infant attachment and preventive interventions: A review and meta-analysisINFANT MENTAL HEALTH JOURNAL, Issue 3 2005Marian J. Bakermans-Kranenburg Infant disorganized attachment is a major risk factor for problematic stress management and later problem behavior. Can the emergence of attachment disorganization be prevented? The current narrative review and quantitative meta-analysis involves 15 preventive interventions (N = 842) that included infant disorganized attachment as an outcome measure. The effectiveness of the interventions ranged from negative to positive, with an overall effect size of d = 0.05 (ns). Effective interventions started after 6 months of the infant's age (d = 0.23). Interventions that focused on sensitivity only were significantly more effective in reducing attachment disorganization (d = 0.24) than interventions that (also) focused on support and parent's mental representations (d = ,0.04). Most sample characteristics were not associated with differences in effect sizes, but studies with children at risk were more successful (d = 0.29) than studies with at-risk parents (d = ,0.10), and studies on samples with higher percentages of disorganized attachment in the control groups were more effective (d = 0.31) than studies with lower percentages of disorganized children in the control group (d = ,0.18). The meta-analysis shows that disorganized attachments may change as a side effect of sensitivity-focused interventions, but it also illustrates the need for interventions specifically focusing on the prevention of disorganization. [source] Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairmentINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2005Linda Garand Abstract Background While the deleterious psychosocial and mental health effects of dementia caregiving are firmly established, very little is known about the burdens or psychiatric outcomes of providing care to a spouse with less severe cognitive impairment, such as mild cognitive impairment (MCI). We characterized the nature and level of caregiver burden and psychiatric morbidity in spouses of persons diagnosed with MCI. Methods Interview assessments were completed on a cohort of 27 spouses of persons with a recent diagnosis of MCI. Patient medical records were reviewed to collect information regarding the MCI patient's medical history. Results Respondents endorsed elevated levels of both task-related responsibilities and subjective caregiver burden. Depression and anxiety symptom levels also showed some elevations. Measures of caregiver burden were significantly associated with depression and anxiety levels. In particular, even after controlling for demographic risk factors for distress, nursing task burden was correlated with elevated depressive symptoms, and greater lifestyle constraints were correlated with higher anxiety levels. Conclusions Although caregiver burden and psychiatric morbidity levels were lower than those typically observed in family dementia caregiving samples, our findings suggest that MCI caregivers have already begun to experience distress in association with elevated caregiving burden. These individuals may be ideal targets for selective preventive interventions to maximize their psychological well-being as caregiving burdens related to their spouses' cognitive impairment increase. Copyright © 2005 John Wiley & Sons, Ltd. [source] Inpatient falls in adult acute care settings: influence of patients' mental statusJOURNAL OF ADVANCED NURSING, Issue 8 2010Huey-Ming Tzeng tzeng h.-m. (2010) Inpatient falls in adult acute care settings: influence of patients' mental status. Journal of Advanced Nursing,66(8), 1741,1746. Abstract Title.,Inpatient falls in adult acute care settings: influence of patients' mental status. Aim., This paper is a report of a study of fallers' mental status as one of the patient-related intrinsic risk factors for falls. Background., Whether confusion is one of the most important risk factors associated with risk of falling in hospital settings is unclear. Literature reviews have not identified consistent evidence for effective preventive interventions for patients with mental status deficits. Methods., This retrospective research was conducted in six adult acute care units in a community hospital in the United States of America. The data source was the 1017 fall incidents occurring between 1 July 2005 and 30 April 2009. Descriptive statistics and Pearson chi-square tests were used to analyse the data. Results., The presence of mental status deficits was identified as the dominant issue in 346 (34%) falls. The group of fallers with mental status deficits (32·1%, n = 111) seemed to have fewer toileting-related falls than those without mental status deficits (46·7%, n = 314). Fallers with mental status deficits tended to have more severe fall injuries than those without mental status deficits (,2 = 10·08, d.f. = 3, P = 0·018). Conclusion., Risk assessment and targeted surveillance should be used as part of falls prevention policy. Involving nursing staff and family members in assessing a patient's mental status may help to prevent falls caused by mental status deficits. [source] Reynolds Adolescent Depression Scale , Second Edition: initial validation of the Korean versionJOURNAL OF ADVANCED NURSING, Issue 3 2009Myung-Sun Hyun Abstract Title.,Reynolds Adolescent Depression Scale , Second Edition: initial validation of the Korean version. Aim., This paper is a report of a study conducted to test the validity and reliability of the Reynolds Adolescent Depression Scale , Second Edition in Korean culture. Background., Depression is a significant mental health problem in adolescents. The Reynolds Adolescent Depression Scale , Second Edition has been shown to be a useful tool to assess depression in adolescents, with extensive research on this measure having been conducted in western cultures. Measures developed in western cultures need to be tested and validated before being used in Asian cultures. Method., The participants were a convenience sample of 440 Korean adolescents with a mean age of 13·78 years (sd = 0·95) from grades 7 to 9 in three public middle schools in South Korea. A cross-sectional design was used. Back-translation was used to create the Korean version, with additional testing for cultural meaning and comprehension. The data were collected at the end of 2004. Results., Internal consistency reliability for the Korean version of the Reynolds Adolescent Depression Scale , Second Edition was 0·89, with subscale reliability ranging from 0·66 to 0·81. Evidence for criterion-related, convergent and discriminant validity for the Korean version of the Reynolds Adolescent Depression Scale , Second Edition was found. Confirmatory factor analysis supported the 4-factor structure of Reynolds Adolescent Depression Scale , Second Edition. Conclusion., Our results support the validity and reliability for the Korean version of the Reynolds Adolescent Depression Scale , Second Edition as a measure of depression and suggest that it can be used to screen students and to evaluate the effectiveness of preventive interventions in school settings. [source] Incidence of Loss of Ability to Walk 400 Meters in a Functionally Limited Older PopulationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2004Milan Chang PhD Objectives: To assess the incidence of and factors related to nondisabled but functionally limited older adults aged 75 to 85 years losing the ability to walk 400 m. Design: Observational study with average follow-up of 21 months. Setting: Community. Participants: At baseline, 101 persons with objective signs of functional limitations and intact cognitive function agreed to participate in the study. Of these, 81 were able to walk 400 m at baseline, and 62 participated in the follow-up examination. Measurements: Mobility disability was defined as an inability to complete a 400-m walk test. At baseline, eligible participants (n=81) had the ability to walk 400 m, scored between 4 and 9 on the Short Physical Performance Battery (SPPB; range 0,12), and scored 18 or more on the Mini-Mental State Examination. Demographics, difficulty in daily activities, disease status, behavioral risk factors, and muscle strength were assessed at baseline and follow-up. Results: Of 62 persons at follow-up, 21 (33.9%) developed incident mobility disability. The strongest predictors of loss of mobility were the time to complete the 400-m walk at baseline (odds ratio (OR)=1.6 per 1-minute difference, 95% confidence interval (CI)=1.04,2.45), and decline in SPPB score over the follow-up (OR=1.4 per 1-point difference, 95% CI=1.01,1.92). Conclusion: Older persons with functional limitations have a high rate of loss of ability to walk 400 m. The 400-m walk test is a highly relevant, discrete outcome that is an ideal target for testing preventive interventions in vulnerable older populations. [source] Risk of Hip Fracture in Disabled Community-Living Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2003Louise C. Walter MD OBJECTIVES: To determine the rate of hip fracture and risk factors associated with hip fractures in disabled older persons who enroll in the Program of All-Inclusive Care for the Elderly (PACE), a program providing comprehensive care to community-living nursing-home-eligible persons. DESIGN: Prospective cohort study between January 1990 and December 1997. SETTING: The twelve PACE demonstration sites: San Francisco, California; Columbia, South Carolina; Detroit, Michigan; Denver, Colorado; East Boston, Massachusetts; El Paso, Texas; Milwaukee, Wisconsin; Oakland, California; Portland, Oregon; Rochester, New York; Sacramento, California; and the Bronx, New York. PARTICIPANTS: Five thousand one hundred eighty-seven individuals in PACE; mean age 79, 71% female, 49% white, 47% with dementia. MEASUREMENTS: Functional status, cognitive status, demographics, and comorbid conditions were recorded on all the participants, who were tracked for occurrence of a hip fracture. The goals were to determine the rate of hip fracture and identify risk factors. RESULTS: Two hundred thirty-eight hip fractures (4.6%) occurred during follow-up. The rate of hip fracture was 2.2% per person-year. Four independent predictors of hip fracture were identified using Cox proportional hazard analysis: age of 75 and older (adjusted hazard ratio (HR) = 2.0, 95% confidence interval (CI) = 1.4,2.8); white ethnicity (HR = 2.1, 95% CI = 1.6,2.8); ability to transfer independently to and from bed, chair, and toilet (HR = 3.0, 95% CI = 1.2,7.2); and five or more Short Portable Mental Status Questionnaire errors (HR = 1.6, 95% CI = 1.3,2.1). The incidence of hip fracture ranged from 0.5% per person-year in persons with zero to one independent risk factors to 4.7% per person-year in those with all four independent risk factors. CONCLUSIONS: The rate of hip fracture in this cohort of disabled community-living older adults was similar to that reported in nursing home cohorts. Older age, white race, ability to transfer independently, and cognitive impairment were independent predictors of hip fracture. Persons with these risk factors should be targeted for preventive interventions, which should include strategies for making transferring safer. [source] | ||||||||||||||||||||||||||||