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Future Interventions (future + intervention)
Selected AbstractsThe potential association between fruit intake and body weight , a reviewOBESITY REVIEWS, Issue 6 2009S. Alinia Summary Both national and international bodies recommend an increased intake of fruits and vegetables in order to decrease the risk of overweight and obesity. However, there is a rationale to investigate the separate role of fruits. The aim of this paper was to systematically review and analyse published human intervention, prospective observational and cross-sectional studies on fruit intake and body weight in adults. We identified three intervention, eight prospective observational and five cross-sectional studies that explored this relationship. Two of the intervention studies showed that fruit intake reduced body weight, five of the prospective observational studies showed that fruit consumption reduced the risk of developing overweight and obesity, and four of the cross-sectional studies found an inverse association between fruit intake and body weight. Important methodological differences and limitations in the studies make it difficult to compare results. However, the majority of the evidence points towards a possible inverse association between fruit intake and overweight. Future intervention and prospective observational studies examining the direct and independent role of fruit in body-weight management in free-living individuals are needed. Moreover, important determinants such as energy density, energy content, fruit and vegetable consumption, physical form of fruit and preparation methods need to be included in future studies. [source] The relationship between busyness and research utilization: it is about timeJOURNAL OF CLINICAL NURSING, Issue 4 2008David S Thompson MN Aims and objectives., To explore the concept of busyness in nursing and to understand the relationship between busyness and nurses' research utilization better. Background., Lack of time and busyness are consistently reported as barriers to research utilization. Current literature fails to identify the dimensions of busyness and offers little insight into the relationship between busyness and nurses' research utilization. Design/Methods., We performed a secondary analysis of qualitative data and created a conceptual map of busyness in nursing. Results., Our results suggested that busyness consists of physical and psychological dimensions. Interpersonal and environmental factors influenced both dimensions. Cultural and intrapersonal factors contributed to psychological elements. The effects of busyness reported included missed opportunities, compromised safety, emotional and physical strain, sacrifice of personal time, incomplete nursing care and the inability to find or use resources. Conclusions., Our beginning description of busyness contributes to a greater understanding of the relationship between busyness and research utilization. Our findings suggest that lack of time as a barrier to research utilization is more complex than depicted in the literature. Instead, the mental time and energy required to navigate complex environments and a culture of busyness more accurately reflect what may be meant by ,lack of time' as a barrier to research utilization. Relevance to clinical practice., Future interventions aimed at increasing research utilization may be more effective if they focus on factors that contribute to a culture of busyness in nursing and address the mental time and energy required for nurses to use research in practice. [source] Menstrual disorders and their adverse symptoms at work: An emerging occupational health issue in the nursing professionNURSING & HEALTH SCIENCES, Issue 3 2008Derek R. SmithArticle first published online: 4 AUG 200 Abstract Menstrual disorders and their adverse symptoms represent an important health issue for many women of child-bearing age. Aside from a deleterious effect on the individual's private life, menstrual disorders are being increasingly recognized as having significant implications at work. This is particularly relevant in occupations such as nursing, where the majority of staff is female. Various investigations have identified the prevalence, distribution, and risk factors associated with menstrual disorders, both in the general community and within the nursing profession. Overall, it is clear that menstrual disorders and their adverse symptoms represent an important occupational health challenge for modern nursing. Future interventions specifically aimed at reducing the work-related burden of these issues should be urgently considered. A more dedicated commitment from higher management regarding the overall health of nurses at work is also required. [source] Impact of mother interactive style on infant affect among babies exposed to alcohol in uteroINFANT MENTAL HEALTH JOURNAL, Issue 4 2006Jean Lowe This study examined the ability of infants prenatally exposed to alcohol to regulate their affect during and after a stressor. Specifically, the Still-Face Paradigm (Tronick, Als, Adamson, Wise, ' Brazelton, 1978) was used as a stress induction paradigm to assess both mother-infant interaction and infant self-regulation. In addition to the mothers' interactive style, the effect of mothers' drinking during and after pregnancy on the infant was explored. Participants were 76 six-month-old infants and their mothers. Infant affect and maternal interaction style was coded second-by-second for the 6 min of the Still-Face Paradigm. Results indicated that infants whose mothers made fewer attempts at engaging them during the play portion of the still-face (e.g., either watched their infant or paid minimal attention to their infant) showed greater negative affect in contrast to infants whose mothers played in an interactive manner. A gender effect was found among female infants. That is, female infants whose mothers drank more during pregnancy showed greater negative affect. The study demonstrates the possibility of early identification of negativity in infants with prenatal alcohol exposure. The impact of mother-child relationship on emotional regulation of infants prenatally alcohol exposed may be a target of future intervention and further study. [source] Head injuries related to sports and recreation activities in school-age children and adolescents: Data from a referral centre in Victoria, AustraliaEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2010Louise M Crowe Abstract Objectives:, Head injuries (HI) in children are common and even mild HI can lead to ongoing cognitive and behavioural changes. We set out to determine the causes of sport-related HI in school-age children presenting to a large urban ED as a basis for future interventions. Method:, Identification and medical record review of all sport-related HI in children aged 6,16 years at a tertiary children's hospital ED in Victoria, Australia, over a 1 year period. Information was collected on demographics, injury variables and radiology findings. HI were classified as mild, moderate and severe based on GCS and radiography reports. Results:, Over 12 months there were 406 HI in school-age children. Seventy per cent were male. A large number of HI (129; 33%) were related to sports. Of these, most were classified as mild and 13% were classified as moderate or severe. Among a range of sports, Australian Rules football was associated with more than 30% of all HI attributable to a sport and recreation cause. Equestrian activities were the main cause of moderate HI. Conclusion:, The present study identified sports as a major cause of HI in the Victorian paediatric emergency setting with Australian Rules football the most commonly involved sport. Further prevention initiatives should consider targeting Australian Rules football and equestrian activities. [source] Estimating Hip Fracture Morbidity, Mortality and CostsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2003R. Scott Braithwaite MD OBJECTIVES: To estimate lifetime morbidity, mortality, and costs from hip fracture incorporating the effect of deficits in activities of daily living. DESIGN: Markov computer cohort simulation considering short- and long-term outcomes attributable to hip fractures. Data estimates were based on published literature, and costs were based primarily on Medicare reimbursement rates. SETTING: Postacute hospital facility. PARTICIPANTS: Eighty-year-old community dwellers with hip fractures. MEASUREMENTS: Life expectancy, nursing facility days, and costs. RESULTS: Hip fracture reduced life expectancy by 1.8 years or 25% compared with an age- and sex-matched general population. About 17% of remaining life was spent in a nursing facility. The lifetime attributable cost of hip fracture was $81,300, of which nearly half (44%) related to nursing facility expenses. The development of deficits in ADLs after hip fracture resulted in substantial morbidity, mortality, and costs. CONCLUSION: Hip fractures result in significant mortality, morbidity, and costs. The estimated lifetime cost for all hip fractures in the United States in 1997 likely exceeded $20 billion. These results emphasize the importance of current and future interventions to decrease the incidence of hip fracture. [source] Clinician attitudes towards prescribing and implications for interventions in a multi-specialty group practiceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 6 2008Robert J. Fortuna MD Abstract Background, Prescribing decisions are subject to a myriad of external forces, including patient requests for advertised medications. Although numerous factors influence prescribing, resources to support unbiased evidence-based prescribing are not widely available. Methods, To guide future interventions, we surveyed clinicians about influences on prescribing, awareness of pharmaceutical costs and attitudes towards computerized decision support. A 21-item survey was sent to 604 prescribing clinicians in a large multi-specialty group practice that employs a robust electronic medical record. Results, Surveys were returned from 405 clinicians (67%). Most respondents (87%) felt that direct-to-consumer (DTC) advertising prompts patients to request inappropriate medications, and more than one in five clinicians (22%) reported difficulty declining patients' requests for advertised medications. Providers with more clinical sessions per week reported greater difficulty. Although 93% of clinicians felt they have access to the information needed to guide prescribing, only about half (54%) reported they are aware of how much patients pay for prescription medications. Clinicians' awareness of medication costs varied considerably by specialty, with behavioural health clinicians being the most aware. The majority of providers (79%) stated that computerized prescribing alerts are a clinically useful source of information. Conclusions, Although the majority of clinicians reported that DTC advertising leads many patients to request medications that are inappropriate for their condition, a sizable proportion of clinicians reported difficulty declining these requests, and many are unaware of medication costs. Interventions to support prescribing decisions should provide the busiest clinicians with up-to-date, specialty-specific evidence and cost information. [source] The effect of development interventions on the use of indigenous range management strategies in the Borana Lowlands in EthiopiaLAND DEGRADATION AND DEVELOPMENT, Issue 4 2008S. Homann Abstract In the last three decades, the Borana rangelands of Southern Ethiopia have been deteriorating due to unsustainable utilization. This paper analyses the changes in indigenous range management among the Borana pastoralists and the role of development interventions. The fieldwork was carried out during 2000,2002, following a severe drought. Two locations, Dida Hara and Web, that once were part of a large grazing system with seasonally distinct herd movements, experienced differences in development interventions. Indigenous range management strategies and pastoralists' current use of key strategies before and after the last drought were compared based on pastoralists' information about land-use change collected through participatory appraisals, land-use mapping, and household surveys. Priorities for future interventions were discussed in multi-stakeholder workshops. Water development in rainy season grazing areas such as Dida Hara has resulted in year-round grazing and expansion of permanent encampments. This has affected the traditional dry-season areas like Web because it interrupted the organization of rangeland management. Herd mobility became less applicable and traditional land-use classifications have lost their function in range management. The introduction of government-imposed administration disturbed the indigenous institutional networks and negotiation procedures for controlled herd movements. Aggravated by human population growth, this reinforces a higher and more permanent grazing pressure, leading to the deterioration of rangelands. Despite the disturbance of pastoralists' range management practices considerable technical and management capabilities prevail. Innovative development approaches should integrate indigeneous knowledge-based (IK) strategies and formal legislation, but this requires strong external support and official recognition from the Ethiopian Government. Copyright © 2007 John Wiley & Sons, Ltd. [source] Self-rated health status in spinocerebellar ataxia,Results from a European multicenter study,MOVEMENT DISORDERS, Issue 5 2010Tanja Schmitz-Hübsch MD Abstract Patient-based measures of subjective health status are increasingly used as outcome measures in interventional trials. We aimed to determine the variability and predictors of subjective health ratings in a possible target group for future interventions: the spinocerebellar ataxias (SCAs). A consecutive sample of 526 patients with otherwise unexplained progressive ataxia and genetic diagnoses of SCA1 (117), SCA2 (163), SCA3 (139), and SCA6 (107) were enrolled at 18 European referral centers. Subjective health status was assessed with a generic measure of health related quality of life, the EQ-5D (Euroqol) questionnaire. In addition, we performed a neurological examination and a screening questionnaire for affective disorders (patient health questionnaire). Patient-reported health status was compromised in patients of all genotypes (EQ-5D visual analogue scale (EQ-VAS) mean 61.45 ± 20.8). Specifically, problems were reported in the dimensions of mobility (86.9% of patients), usual activities (68%), pain/discomfort (49.4%), depression/anxiety (46.4%), and self care (38.2%). Multivariate analysis revealed three independent predictors of subjective health status: ataxia severity, extent of noncerebellar involvement, and the presence of depressive syndrome. This model explained 30.5% of EQ-VAS variance in the whole sample and might be extrapolated to other SCA genotypes. © 2010 Movement Disorder Society [source] Community Violence and Urban Families: Experiences, Effects, and Directions for InterventionAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 3 2005Karyn Horowitz MD The purpose of this study was to understand the impact of community-level stressors (particularly violence), coping strategies, and resources to prevent exposure to violence or to mitigate its effects in an inner-city community. Parents and children participated in focus groups, and children also completed standardized instruments. In the focus groups, parents and children identified several areas of concern related to "helpers," schools, community safety, and emotional distress. They identified protective resources including intensive monitoring and social supports. Fifty percent of the children met criteria for Posttraumatic Stress Disorder (PTSD), and another 21% met criteria for partial PTSD. The mental health issues in children living with ongoing community violence necessitate that researchers use a qualitative approach to inform future interventions. [source] Opening up Australian preschoolers' lunchboxesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2010Bridget Kelly Abstract Objective: Early childhood services have been identified as key settings for promoting healthy eating and obesity prevention. However, little is known about the obesity-related behaviours of preschool-aged children or food-related policies in these settings. The purpose of this study was to describe the contents of preschoolers' lunchboxes to inform future interventions. Methods: Cross-sectional survey of 259 children attending preschools in the Sydney West and Sydney South West regions of New South Wales in 2008. Lunchbox data were collected using a purpose-designed audit tool. Food and beverages were classified as fruit, vegetables, dairy, breads and cereals, ,extra' (energy-dense) foods, ,extra' drinks or water. Results: Sandwiches and home-cooked meals were the most frequently identified food item, found in 92% of children's lunchboxes, followed by fresh fruit. However, 60% of lunchboxes contained more than one serve of extra food or drink. Conclusion: While nutrition guidelines allow one to two serves of extra foods per day for preschool-aged children, the majority of children appear to consume most of this allocation during their school day, potentially contributing to over-consumption of extra foods and excess kilojoule intake. Implications: Preschool food policies may help to guide the content of children's lunchboxes, however this study emphasises the need for better communication and enforcement of these policies, as well as broader public policy changes. [source] Evaluating and grading cystographic leakage: correlation with clinical outcomes in patients undergoing robotic prostatectomyBJU INTERNATIONAL, Issue 8 2009Nilesh Patil OBJECTIVE To classify cystographically detected urinary leaks in patients undergoing computer-assisted (robotic) radical prostatectomy (RP) and to evaluate its effect on postoperative outcomes. PATIENTS AND METHODS Between October 2001 and October 2007, 3327 patients had a RP using a technique described previously. The data were entered prospectively into an approved database. Before catheter removal, all patients had a gravity cystogram taken 7 days after RP. All patients who had a detectable urinary leak on cystography were stratified into three groups by two independent radiologists using a previously described grading system. Patients were evaluated with a validated International Prostate Symptom Score at 3-, 6-, 9- and 12-month intervals after RP. The continence status was determined based on a patient-reported questionnaire. Medical records in these patients were reviewed for the presence of complications requiring secondary interventions. RESULTS In all, 287 patients (8.6%) had a detectable leak on cystography, of which 179 (62.4%), 84 (29.3%) and 24 (8.4%) were grades I, II and III, respectively. Of the patients with a detectable leak 70% were continent within 3 months and 94% had no involuntary urinary leakage at 1 year. Eight of 287 (2.8%) patients required a secondary intervention to correct bladder neck contracture. All eight of these patients had a grade II or III leak on cystography. CONCLUSION The presence of a urinary leak might delay the time to continence, but has no adverse effect on long-term urinary control. Quantifying the gradation of leakage according to the described classification might provide the clinician with prognostic information about patients at risk for future interventions. [source] | ||||||||||