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Individual Treatment (individual + treatment)
Selected AbstractsFacilitating involvement in Alcoholics Anonymous during out-patient treatment: a randomized clinical trialADDICTION, Issue 3 2009Kimberly S. Walitzer ABSTRACT Aim This study evaluated two strategies to facilitate involvement in Alcoholics Anonymous (AA),a 12-Step-based directive approach and a motivational enhancement approach,during skills-focused individual treatment. Design Randomized controlled trial with assessments at baseline, end of treatment and 3, 6, 9 and 12 months after treatment. Participants, setting and intervention A total of 169 alcoholic out-patients (57 women) assigned randomly to one of three conditions: a directive approach to facilitating AA, a motivational enhancement approach to facilitating AA or treatment as usual, with no special emphasis on AA. Measurements Self-report of AA meeting attendance and involvement, alcohol consumption (percentage of days abstinent, percentage of days heavy drinking) and negative alcohol consequences. Findings Participants exposed to the 12-Step directive condition for facilitating AA involvement reported more AA meeting attendance, more evidence of active involvement in AA and a higher percentage of days abstinent relative to participants in the treatment-as-usual comparison group. Evidence also suggested that the effect of the directive strategy on abstinent days was mediated partially through AA involvement. The motivational enhancement approach to facilitating AA had no effect on outcome measures. Conclusions These results suggest that treatment providers can use a 12-Step-based directive approach to effectively facilitate involvement in AA and thereby improve client outcome. [source] Notes for a Cultural History of Family Therapy,FAMILY PROCESS, Issue 1 2002C. Christian Beels M.D. The official history of family therapy describes its beginnings as a daring technical and philosophical departure from traditional individual treatment in the 1960s, inspired especially by the "system thinking" of Gregory Bateson. This celebrated origin story needs to be supplemented with a longer and larger history of both practice and thought about the family, and that is the subject of this article. The longer history goes back to the founding of social work by Mary Richmond, of pragmatism by William James, and of the organic view of social systems intervention by John Dewey. Seen against this background, family therapy is, among other things, a consequence of the development of persistent elements of American professional culture, experience, and philosophy. The taking of this historical-anthropological view discloses also the origins of two other histories that have made their contribution to the development of family therapy: a science of observing communication processes that starts with Edward Sapir and leads to contemporary conversation analysis, and a history of mesmerism in the United States that culminates in Milton Erickson and his followers. [source] Effects of infection with the ectoparasite Argulus japonicus (Thiele) and administration of cortisol on cellular proliferation and apoptosis in the epidermis of common carp, Cyprinus carpio L., skinJOURNAL OF FISH DISEASES, Issue 3 2000A L Van Der Salm The host-parasite interaction between juvenile carp, Cyprinus carpio, and the ectoparasitic branchiuran, Argulus japonicus, together with the role of cortisol in this interaction, was examined at the level of the host skin epidermis. Epidermal mucous cell numbers, and proliferation and apoptosis of the epithelial cells were studied over 32 days. Apoptotic cell numbers in the uppermost epidermis were reduced at 26 days post-infection with A. japonicus, while the other parameters were unaffected. Administration of cortisol-containing food resulted in reduced apoptosis in the cells in the upper skin epidermis at 24 h and at 28 days post-feeding. Cortisol feeding combined with A. japonicus infection reduced numbers of apoptotic cells in the upper epidermis more than either individual treatment. Further, combining the treatments also significantly increased apoptosis in the lower epidermis in cells morphologically identified as leucocytes apparently migrating macrophages and lymphocytes. Using immunohistochemistry, we demonstrated cortisol receptor presence and cellular localization in the teleost epidermis. Receptors only occurred in pavement cells in the upper epidermis and in leucocytes in the lower parts of the epidermis. The ectoparasites, or administered cortisol, induced effects which may be functionally adaptive in the upper pavement cells, while combining the two treatments also induced changes indicative of immunosuppression. [source] Changes in brain biogenic amines and haem biosynthesis and their response to combined administration of succimers and Centella asiatica in lead poisoned ratsJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 4 2006Geetu Saxena This study was designed to investigate the therapeutic potential of meso 2,3-dimercaptosuccinic acid (DMSA) and one of its monoesters, monoisoamyl DMSA (MiADMSA), individually or when administered in combination with an extract of Centella asiatica against experimental lead intoxication in rats. Biochemical variables indicative of alterations in the central nervous system and haem biosynthesis were investigated to determine the toxicity in male Wistar rats. Thirty five rats were exposed to 0.2% lead acetate for 10 weeks, followed by 10 days of treatment with DMSA and MiADMSA (50 mg kg,1, i.p., once daily) alone and in combination with C. asiatica (200 mg kg,1, p.o., once daily). Biochemical variables indicative of oxidative stress and brain biogenic amines, along with lead concentration in blood and brain, were measured. Lead exposure caused a significant depletion of blood and brain ,-aminolevulinic acid dehydratase (ALAD) activity, an important enzyme of the haem biosynthesis pathway, and glutathione (GSH) level. These changes were accompanied by a marked increase in reactive oxygen species (ROS) level, thiobarbituric acid reactive substances (TBARS), ,-aminolevulinic acid synthase (ALAS) and oxidized glutathione (GSSG) activity in blood and brain. Significant depletion of brain noradrenaline (norepinephrine, NE), 5-hydroxytryptamine (5-HT), dopamine (DA) and acetylcholinesterase (AChE) also were observed following lead exposure. Also seen was a significant depletion in brain glutathione peroxidase (GPx), glutathione S-transferase (GST) and monoamine oxidase activity, as well as blood and brain superoxide dismutase (SOD) activity. These biochemical changes were correlated with an increased uptake of lead in blood and brain. Combined administration of MiADMSA and C. asiatica was most effective in reducing these alterations, including biogenic amines, besides reducing body lead burden, compared with individual treatment with MiADMSA. Certain other biochemical variables responded favourably to combination therapy and monotherapy with MiADMSA. Thus, supplementation of C. asiatica during chelation could be recommended for achieving optimum effects of chelation therapy. [source] State of the art in restless legs syndrome therapy: Practice recommendations for treating restless legs syndromeMOVEMENT DISORDERS, Issue S18 2007Wolfgang H. Oertel MD Abstract Dopaminergic agents are the best-studied agents and are considered first-line treatment of restless legs syndrome (RLS). Extensive data are available for levodopa, pramipexole, and ropinirole, which have approval for the indication RLS, and to a smaller extent for cabergoline, pergolide, and rotigotine. Apart from one recent study, comparing two active drugs (levodopa and cabergoline), no comparative studies have been published. The individual treatment regimen with the most appropriate agent concerning efficacy and side effects has to be selected by the treating physician. On the basis of these clinical trials and expert opinion of the authors, a treatment algorithm is proposed to support the search for the optimal individual treatment. Opioids and anticonvulsants such as gabapentine are second-line options in individual patients. Iron substitution is justified in people with iron deficiency related RLS (ferritin concentration lower than 50 ,g/L). © 2007 Movement Disorder Society [source] Evidence based guidelines and current practice for physiotherapy management of knee osteoarthritisMUSCULOSKELETAL CARE, Issue 1 2009Nicola E. Walsh MSc MCSP Abstract Objectives:,To document physiotherapy provision for patients with knee osteoarthritis (OA) in relation to the United Kingdom (UK) recently published National Institute of health and Clinical Excellence (NICE) guidelines for osteoarthritis. Design:,Questionnaire survey of chartered physiotherapists. Method:,300 postal questionnaires were distributed to Physiotherapy Departments requesting information regarding source of referrals, treatment aims, preferred methods of treatment and service delivery. Results:,Responses were received from 83 physiotherapists (28 %), predominantly working in the UK National Health Service. Approximately equal numbers of referrals came from primary and secondary care. Aims of physiotherapy management were to; encourage self-management; increase strength and range of movement; reduce pain; and improve function. To achieve these, exercise was utilised by 100% of practitioners, often supplemented with electrotherapeutic modalities (66%), manual therapy (64%) and acupuncture (60%). The majority of patients received individual treatment for a total contact time of 1,2 hours, whilst most group interventions lasted 5,6 hours. Approximately half (54%) of respondents reported using outcome measures to determine treatment efficacy. Conclusions:,Although knee OA is usually managed in primary care, the similar number of referrals from primary and secondary care may suggest a deviation from evidence-based management guidelines. The guidelines' recommendations of exercise, patient education and self-management are observed by physiotherapists, but other modalities are often used despite poor or no research evidence supporting their efficacy. Whether any of these interventions are clinically beneficial is speculative as treatment outcomes were frequently under-evaluated. Copyright © 2008 John Wiley & Sons, Ltd. [source] No differences between group versus individual treatment of childhood anxiety disorders in a randomised clinical trialTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 8 2008Juliette M. Liber Background:, The present study compares an individual versus a group format in the delivery of manualised cognitive-behavioural therapy (FRIENDS) for children with anxiety disorders. Clinically referred children (aged 8 to 12) diagnosed with Separation Anxiety Disorder (n = 52), Generalised Anxiety Disorder (n = 37), Social Phobia (n = 22) or Specific Phobia (n = 16) were randomly assigned to individual (n = 65) or group (n = 62) treatment. Method:, Analyses were conducted separately for the intent-to-treat sample and the sample of children who completed treatment. Analyses included chi-square comparisons and regression analyses with treatment format as a predictor. Results:, Forty-eight percent of the children in the individual versus 41% in the group treatment were free of any anxiety disorder at post-treatment; 62% versus 54% were free of their primary anxiety disorder. Regression analyses showed no significant difference in outcome between individual and group treatment. Conclusions:, Children improved in both conditions. Choice between treatments could be based on pragmatic considerations such as therapeutic resources, referral rates, and the preference of the parents and the child. [source] Therapists' adherence and competence and treatment discrimination in the NIDA Collaborative Cocaine Treatment StudyJOURNAL OF CLINICAL PSYCHOLOGY, Issue 1 2004Jacques P. Barber The National Institute on Drug Abuse Collaborative Cocaine Treatment Study was designed to assess the efficacy of four different psychosocial interventions (cognitive therapy, supportive,expressive dynamic therapy, and individual and group drug counseling) for cocaine dependence. This report addresses the treatment integrity and discriminability of the three individual treatments. Therapists' adherence and competence for all three individual treatments during early and late sessions were rated reliably by three sets of independent expert judges (one set of expert clinicians for each treatment condition). Results indicated that therapists and counselors made use of the therapeutic techniques described in their respective treatment manuals rather than those from different treatment manuals. Thus, treatments were easily discriminable by the independent judges. © 2003 Wiley Periodicals, Inc. J Clin Psychol. [source] Interpreting interactions between treatments that slow agingAGING CELL, Issue 1 2002David Gems Summary A major challenge in current research into aging using model organisms is to establish whether different treatments resulting in slowed aging involve common or distinct mechanisms. Such treatments include gene mutation, dietary restriction (DR), and manipulation of reproduction, gonadal signals and temperature. The principal method used to determine whether these treatments act through common mechanisms is to compare the magnitude of the effect on aging of each treatment separately with that when two are applied simultaneously. In this discussion we identify five types of methodological shortcomings that have marred such studies. These are (1) submaximal lifespan-extension by individual treatments, e.g. as a result of the use of hypomorphic rather than null alleles; (2) effects of a single treatment on survival through more than one mechanism, e.g. pleiotropic effects of lifespan mutants; (3) the difficulty of interpreting the magnitude of increases in lifespan in double treatments, and failure to measure and model age-specific mortality rates; (4) the non-specific effects of life extension suppressors; and (5) the possible occurrence of artefactual mutant interactions. When considered in the light of these problems, the conclusions of a number of recent lifespan interaction studies appear questionable. We suggest six rules for avoiding the pitfalls that can beset interaction studies. [source] Amelioration of Cadmium-Induced Oxidative Stress, Impairment in Lipids and Plasma Lipoproteins by the Combined Treatment with Quercetin and ,-Tocopherol in RatsJOURNAL OF FOOD SCIENCE, Issue 7 2010S. Milton Prabu Abstract:, Cadmium (Cd) exposure results in numerous pathological consequences including oxidative stress and dyslipidemia. The present study was designed to investigate the efficacy of combined treatment with quercetin (QE) and ,-tocopherol (AT) against Cd-induced oxidative stress and alterations in lipids and lipoproteins in the plasma and liver of rats. Oral administration of Cd (5 mg/kg bw/d) for 4 wk has shown a significant (P < 0.05) increase in thiobarbituric acid reactive substances (TBARS), lipid hydro peroxides (LOOH), total cholesterol, low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), free fatty acids (FFA), phospholipids (PL), triglycerides (TGs), and the activity of hydroxyl-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase) in plasma with a significant (P > 0.05) reduction in the levels of reduced glutathione (GSH), high density lipoprotein cholesterol (HDL-C), and the activity of lecithin cholesterol acyl transferase (LCAT) in plasma. In addition, the levels of hepatic thiobarbituric acid reactive substances (TBARS), LOOH, conjugated dienes (CD), protein carbonyls (PC), and the activity of HMG-CoA reductase, levels of cholesterol, FFA, and TGs were significantly (P > 0.05) increased and the level of PL is significantly (P > 0.05) decreased along with the decreased activity of LCAT in the liver of Cd-treated rats. Oral supplementation with QE (50 mg/kg bw/d) and AT (50 mg/kg bw/d) for 4 wk in Cd intoxicated rats significantly (P > 0.05) has reduced the plasma levels of TBARS, LOOH, GSH, cholesterol, FFA, TGs, VLDL-C, LDL-C, and the activity of HMG-CoA and significantly (P > 0.05) has increased the activity of LCAT and the plasma levels of HDL-C. The oral supplementation also significantly (P > 0.05) has reduced the hepatic oxidative stress markers, cholesterol, TGs, FFA, and significantly (P > 0.05) has increased the LCAT activity and the PL in liver. Our results indicate that the combined treatment with QE and AT has normalized all the previously mentioned biochemical parameters in Cd-intoxicated rats than the individual treatments. The combined treatment has provided remarkable protection against Cd-induced oxidative stress and alterations in lipid metabolism and, thereby, reduced the Cd-mediated cardiovascular diseases. [source] Effect of Combined Ozone and Organic Acid Treatment for Control of Escherichia coli O157:H7 and Listeria monocytogenes on LettuceJOURNAL OF FOOD SCIENCE, Issue 3 2006Hyun-Gyun Yuk ABSTRACT: This study was conducted to determine the effects of ozonated water (1, 3, and 5 ppm) alone with different exposure times (0.5,1,3, or5min), and combinations of 3 ppm ozone with 1% organic acids (acetic, citric, or lactic acids) during 1-min exposure for inactivating Escherichia coli O157:H7 and Listeria monocytogenes on lettuce and to observe the regrowth of these pathogenic bacteria on treated lettuce during storage for 10 d at 15°C. Results showed that 5 ppm ozone treatment for 5 min gave 1.09-log and 0.94-log reductions of E. coli O157:H7 and L. monocytogenes, respectively, indicating insignificant reductions compared with 3 ppm ozone treatment for 5 min. Treatment with 3 ppm ozone combined with 1 % citric acid for 1 min immersing resulted in 2.31 - and 1.84-log reductions (P < 0.05), respectively. During storage at 15°C for 10 d after combined treatment and packaging, populations of E. coli O157:H7 and L. monocytogenes increased to approximately 9.0-log colony forming unit (CFU) /g, indicating that this treatment did not have a residual antimicrobial effect during storage. Although the storage study did not show control of these pathogens, the combined ozone-organic acid treatment was more effective in reducing population levels of these pathogens on lettuce than individual treatments. [source] Enantioselectivity of thalidomide serum and tissue concentrations in a rat glioma model and effects of combination treatment with cisplatin and BCNUJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 1 2007Susan Murphy Thalidomide is currently under evaluation as an anti-angiogenic agent in cancer treatment, alone and in combination with cytotoxic agents. Thalidomide is a racemate with known pharmacologic and pharmacokinetic enantioselectivity. In a previous study with thalidomide combination chemotherapy, we found evidence of anti-tumour synergy. In this study, we examined whether the synergy involved altered pharmacokinetics of thalidomide enantiomers. Adult female F344 rats were implanted with 9L gliosarcoma tumours intracranially, subcutaneously (flank), or both. Effectiveness of oral thalidomide alone, and with intraperitoneal BCNU or cisplatin combination chemotherapy, was assessed after several weeks treatment. Presumed pseudo steady-state serum, tumour and other tissues, collected after treatment, were assayed for R - and S -thalidomide by chiral HPLC. Both serum and tissue concentrations of R -thalidomide were 40,50% greater than those of S -thalidomide. Co-administration of BCNU or cisplatin with thalidomide did not alter the concentration enantioselectivity. Poor correlation of concentration with subcutaneous anti-tumour effect was found for individual treatments, and with all treatments for intracranial tumours. The consistency of the enantiomer concentration ratios across treatments strongly suggests that the favourable anti-tumour outcomes from interactions between thalidomide and the cytotoxic agents BCNU and cisplatin did not have altered enantioselectivity of thalidomide pharmacokinetics as their basis. [source] THE IMPACT OF HOMOGENIZATION AND MICROFILTRATION ON RENNET-INDUCED GEL FORMATIONJOURNAL OF TEXTURE STUDIES, Issue 4 2008STEPHAN THOMANN ABSTRACT The effects of the independent variables, milk homogenization pressure (p1), concentration factor of milk microfiltration (i) and pH on the rheological properties of rennet milk gels were studied. Nondestructive oscillatory rheometry was used to determine rennet coagulation time (RCT), curd firming rate (CFR) and cutting time (CT). A central composite design, comprising two levels of i (1 and 2), pH (6.4 and 6.6) and p1 (0 and 8 MPa), was applied. Second-order polynomial models successfully described (R2 > 0.92) the relationship between processing parameters and rheological properties of the gels. pH had the most important influence on RCT, while CFR and CT were strongly influenced by i, pH and the interaction of i and pH. In contradiction to studies on active filler interactions for acid milk gels, a discrepancy was observed between results obtained by compression test and rheometry. Rennet gel firmness strongly decreased with a rise in p1 when measured using the compression test, whereby CFR increased with an increase in p1 when measured using rheometry. The latter result corresponds to higher storage modulus values after a certain time indicating higher gel stiffness. This effect was stronger for concentrated milk than for unconcentrated milk. PRACTICAL APPLICATIONS The use of microfiltration (MF) and homogenization may reduce raw material and processing time in conventional cheese manufacture. However, MF markedly influences milk composition, and homogenization alters the particle size distribution of fat globules. Hence, both technologies may influence rennet-induced gel formation, syneresis, cheese composition and quality. Curd firmness of homogenized milk is often too weak to resist the extensive curd treatment applied in semi-hard cheese manufacture which causes loss of curd fines during the syneresis process and finally decreases cheese yield. MF leads to high curd firmness if cutting is not performed at the appropriate time, which unnecessarily extends processing time. The study of the effect of the individual treatments, as well as of the combination of both on rennet-induced gel formation, is the first important step to evaluate their impact on further processing steps in cheese making. The combination of both technologies may overcome the antagonistic effect of the individual technology as low curd firmness due to homogenization can be compensated by MF that increases curd firmness and vice versa. [source] Folate deficiency followed by ionizing radiation perturbs hepatic dihydrofolate reducatse activityBIOFACTORS, Issue 4 2008Vipen Batra Abstract There is lot of interest in the folate metabolism because of the essential role of folate coenzymes in nucleic acid synthesis. Gamma (,) radiation is well known for inducing damage in the DNA. To counteract these damage, a variety of DNA repair pathways have evolved that require regular supply of DNA bases whose biosynthesis in turn depends on sufficient pools of folate dependent enzymes like dihydrofolate reductase (DHFR). In the present study, we examined the ionizing radiation mediated perturbation of DHFR activity in folate deficient and folate sufficient conditions. In folate deficient animals a potent inhibition of liver DHFR activity was observed. Our results showed that combination of folate starvation and ionizing radiation might adversely affect the DHFR activity, compared to their individual treatments. Measurement of apurinic/apyrimidinic sites (AP sites), a major type of DNA damage generated by radiation induced loss of purine and/or pyrimidine base, indicated a dose dependent DNA damage in folate deficient animals. In conclusion our data suggest an interactive role of folate deficiency and radiation injury in inhibiting DHFR activity. [source] Prevalence and relationship to delusions and hallucinations of anxiety disorders in schizophreniaDEPRESSION AND ANXIETY, Issue 2 2003F.R.C.P.C., Philip Tibbo M.D. Abstract We investigated the prevalence of anxiety disorders in a sample of individuals with chronic schizophrenia, controlling for anxiety symptoms that may be related to delusions and hallucinations, and the possible differences in clinical variables between the groups. Individuals with a diagnosis of schizophrenia and able to give informed consent were recruited from the community. The Mini International Neuropsychiatric Interview (MINI) was administered to both confirm the DSM-IV diagnosis of schizophrenia and screen for comorbid anxiety disorders. If a comorbid anxiety disorder was found, its relation to the individual's delusions and hallucinations was examined. Clinical rating scales for schizophrenia were administered as well as rating scales for specific anxiety disorders where appropriate. Overall, anxiety disorders ranged from 0% [ for Post Traumatic Stress Disorder (PTSD)] to 26.7% [ for generalized anxiety disorder (GAD) and agoraphobia without panic] with lower rates when controlled for anxiety symptoms related to delusions and hallucinations. In investigating clinical variables, the cohort was initially divided into schizophrenics with no anxiety disorders and those with an anxiety disorder; with further analyses including schizophrenics with anxiety disorders related to delusions and hallucinations and those with anxiety disorders not related to delusions and hallucinations. The most consistent difference between all the groups was on the PANSS-G subscale. No significant differences were found on the remaining clinical variables. Comorbid anxiety disorders in schizophrenia can be related to the individual's delusions and hallucinations, though anxiety disorders can occur exclusive of these positive symptoms. Clinicians must be aware that this comorbidity exists in order to optimize an individual's treatment. Depression and Anxiety 17:65,72, 2003. © 2003 Wiley-Liss, Inc. [source] | |||||||||||||||||||