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Target Interventions (target + intervention)
Selected AbstractsPrevalence of the metabolic syndrome in secondary school adolescents in Beijing, ChinaACTA PAEDIATRICA, Issue 3 2008XU Yi-Qun Abstract Aim: To estimate the prevalence and distribution of the metabolic syndrome and to determine the risk factors associated with the metabolic syndrome in secondary school adolescents. Methods: In 2006, we conducted a school-based survey in Beijing, China. Questionnaire data, anthropometric, blood pressure, and biochemical measurements were available for 2020 adolescents aged 14,16 years. The metabolic syndrome was assessed using the National Cholesterol Education Program's (NCEP) Adult Treatment Panel (ATP) criteria modified for age. Results: The overall prevalence of the metabolic syndrome among adolescents was 3.3%. In Beijing, 4.2% of boys and 2.5% of girls were affected (p < 0.05). The syndrome was present in 28.1% of obese adolescents compared with 6.0% of overweight and 0.2% of normal status (p < 0.001). Abdominal obesity and elevated blood pressure were the most common components of the metabolic syndrome in boys, and elevated triglyceride (TG) and abdominal obesity were the most common in girls. The prevalence of the metabolic syndrome was influenced by body mass index (BMI) status, father's educational degree and pubertal development. Conclusion: The metabolic syndrome and its components are frequent in overweight and obese adolescents in Beijing. Early identification and treatment of these risk factors may help target intervention to improve future cardiovascular health. [source] The burden of kidney disease in Indigenous children of Australia and New Zealand, epidemiology, antecedent factors and progression to chronic kidney diseaseJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9 2010Andrew White Aims: To review and present the most important issues related to kidney disease in Aboriginal, Torres Strait Islander, Maori and Pacific Islander children from Australia and New Zealand. Methods: A review of medical literature about: 1. incidence of kidney disease in Indigenous children in Australia and New Zealand, especially where rates are different from the general populations, 2. factors in early life which increase risk for chronic kidney disease in adult life, and 3. early identification and primary and secondary interventions in childhood which may prevent chronic kidney disease in adults. Results: Kidney diseases, both acute and chronic are more common in Maori, Pacific Islander, Australian Aboriginal and Torres Strait Islander people. The reasons are multiple and include genetic, environmental and socio-economic factors. In childhood post streptococcal glomerulonephritis, haemolytic uraemic syndrome, renal stones and acute kidney injury all occur at higher frequency in at least some of the Indigenous populations. Chronic kidney disease CKD occurs more commonly, and at a younger age in Indigenous than non Indigenous people. Factors involved may include reduced nephron endowment at birth, and subsequent insults including nephritis, obesity, and early onset type 2 diabetes, as well as underlying socioeconomic and environmental determinants. Conclusion: A lifecourse understanding allows one to conceptualise multiple risk factors and target interventions. [source] Research prioritization based on expected value of partial perfect information: a case-study on interventions to increase uptake of breast cancer screeningJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 4 2008N. J. Welton Summary., We investigate whether Bayesian decision theory, in the form of expected value of partial perfect information (EVPPI) analysis, is a realistic and practical approach to research prioritization. We develop a simple cost-effectiveness analysis of breast cancer screening as a typical case-study, motivated by data from a cluster randomized 2 × 2 factorial trial of interventions to increase uptake. An EVPPI analysis is developed which shows that, on the basis of the evidence that was available beforehand, the trial was cost effective, but that after incorporating the results of the trial it would still be cost effective to carry out research that further reduced decision uncertainty. We identify key conceptual and technical issues: the relationship between the target interventions and the previous evidence, the distinction between variation and uncertainty and methods for correlated parameters. EVPPI methods have clear advantages over current methods of research prioritization, but we suggest that some specific sensitivity analyses are required before they can be used confidently in practice. These have limitations, and there is a need to develop robust methods to optimize research portfolios. [source] Psychological distress and concerns of elderly patients treated with palliative radiotherapy for lung cancerPSYCHO-ONCOLOGY, Issue 8 2007N. J. Turner Abstract We conducted a prospective observational cohort study of 83 elderly patients (aged 75 and above) being treated with palliative radiotherapy for lung cancer, with a comparison group of 49 younger patients (aged 65 and under). Psychological distress and concerns were measured before and after treatment using the Hospital Anxiety and Depression Scale (HADS) and a Concerns Checklist. Psychosocial morbidity was common, however, prevalence was similar in both age groups. There was a trend towards worsening of both anxiety and depression scores after treatment, but this did not reach statistical significance. Younger patients reported more concerns than the older group (median 12 vs 10) but this too was not statistically significant. Concerns about the illness and symptoms were more likely to have been addressed by the care team than were concerns about psychosocial issues such as the family and the future. People of all ages have similar concerns and levels of anxiety and depression whilst receiving palliative radiotherapy for lung cancer. Further research is needed to explore the use of screening tools, like those used in this study, to identify patients' difficulties and target interventions to improve their quality of life. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||