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Intervention Period (intervention + period)
Selected AbstractsEFFECT OF A SOYBEAN PRODUCT ON SERUM LIPID LEVELS IN FEMALE UNIVERSITY STUDENTSCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 2004Kyoko Takahashi SUMMARY 1.,A dietary intervention study targeting female students by using cake containing soybean protein and isoflavone was conducted. Female students (n = 120) were divided into three Groups (A, 6.26 g of soybean protein and isoflavone at 50 mg/day; B, 1.36 g soybean protein and isoflavone 50 mg; and C, a wheat puff as placebo). Intervention period was 4 weeks. The ratio of hypercholesterol in each group indicated a high value; A: 25%, B: 17.9% and C: 24.4%. 2.,Total cholesterol as well as the rate of hypercholesterolemia decreased in Group A. The average total cholesterol significantly reduced (P < 0.001) from 242 ± 17 to 220 ± 25 mg/dL in Group A. 3.,Dietary intake of soy protein for 4 weeks could be effective in reducing CHD risk among Japanese female students with a high plasma cholesterol level. [source] Does stage-based smoking cessation advice in pregnancy result in long-term quitters?ADDICTION, Issue 1 200518-month postpartum follow-up of a randomized controlled trial ABSTRACT Aims To evaluate the effect on quitting smoking at 18 months postpartum of smoking cessation interventions based on the Transtheoretical Model (TTM) delivered in pregnancy compared to current standard care. It has been claimed that TTM-based interventions will continue to create quitters after the end of the intervention period. Design Cluster randomized trial. Setting Antenatal clinics in general practices in the West Midlands, UK. Participants A total of 918 pregnant smokers originally enrolled in the trial, of which 393 women were followed-up at 18 months postpartum. Interventions One hundred general practices were randomized into the three trial arms. Midwives in these practices delivered three interventions: A (standard care), B (TTM-based self-help manuals) and C (TTM-based self-help manuals plus sessions with an interactive computer program giving individualized smoking cessation advice). Measurements Self-reported continuous and point prevalence abstinence since pregnancy. Findings When combined together, there was a slight and not significant benefit for both TTM arms compared to the control, with an odds ratio (OR) 95% confidence interval (CI) of 1.20 (0.29,4.88) for continuous abstinence. For point prevalence abstinence, the OR (95%CI) was 1.15 (0.66,2.03). Seven of the 54 (13%) women who had quit at the end of pregnancy were still quit 18 months later, and there was no evidence that the TTM-based interventions were superior in preventing relapse. Conclusions The TTM-based interventions may have shown some evidence of a short-term benefit for quitting in pregnancy but no benefit relative to standard care when followed-up in the longer-term. [source] An evidence-based specialist breast nurse role in practice: a multicentre implementation studyEUROPEAN JOURNAL OF CANCER CARE, Issue 1 2003National breast cancer centre's specialist breast nurse project team The objective of this study was to examine the feasibility, implementation, acceptability and impact of an evidence-based specialist breast care nurse (SBN) model of care in Australia. Primary data were collected from four diverse Australian breast cancer treatment centres over a 12-month period. The design was a multicentre demonstration project. Information about the provision of care and patient needs was collected through prospective logs. Structured interviews were conducted with women who received the SBN intervention (N = 167) and with a control group of women treated prior to the intervention period (N = 133). Health professionals (N = 47) were interviewed about their experience of the SBN. Almost all women had contact with an SBN at five scheduled consultations and 67% of women in the intervention group requested at least one additional consultation with the SBN. Women in the intervention group were more likely to receive hospital fact sheets and to be told about and participate in clinical trials. Ninety-eight per cent of women reported that the availability of an SBN would affect their choice of hospital, with 48% indicating that they would recommend only a hospital with a SBN available. Health professionals reported that SBNs improved continuity of care, information and support for the women, and resulted in more appropriate referrals and use of the time of other members of the team. In conclusion, the SBN model is feasible and acceptable within diverse Australian treatment centres; there is evidence that some aspects of care were improved by the SBN. [source] Evaluation of the clinical efficacy of a mouthwash and oral gel containing the antimicrobial proteins lactoperoxidase, lysozyme and lactoferrin in elderly patients with dry mouth , a pilot studyGERODONTOLOGY, Issue 1 2008Jose Antonio Gil-Montoya Objectives:, To evaluate the clinical efficacy of a mouthwash and oral gel containing the antimicrobial proteins lactoperoxidase, lactoferrin and lysozyme, in a sample of elderly individuals with dry mouth. Material and methods:, Twenty elderly institutionalised subjects with dry mouth and with a certain degree of independence for daily life activities were included in this pilot study. A randomised, double blind and cross-over design was used. The study variables comprised subjective dry mouth sensation, the severity of discomfort assessed by means of a visual analogical scale (VAS), the Oral Health Impact Profile (OHIP), the presence of signs and symptoms of dry mouth, sialometry and Candida albicans culture. All the variables were recorded before and after each of the two periods of the study. Results:, The 20 selected subjects we made up of 16 women and four men, with a mean age of 81.3 years. Improvement was observed on analysing the data between the first and second intervention period in terms of the OHIP values, the presence of dry mouth, and the need to drink fluids to swallow. However, the improvement in certain variables before and after treatment did not take a positive course in all cases, and some subjects even improved with placebo. Conclusions:, The evaluated mouthwash and oral gel improved some subjective and clinical aspects in elderly individuals with dry mouth, though a placebo effect cannot be entirely discarded. [source] A consultation leaflet to improve an older patient's involvement in general practice care: a randomized trialHEALTH EXPECTATIONS, Issue 4 2005Raymond Wetzels MD Abstract Objective, To evaluate the effects of a programme to enhance the involvement of older patients in their consultations in general practice. Design, Cluster randomized trial, in which data was collected from different cohorts. Setting and participants, Twenty-five general practices in the south-east part of the Netherlands and their patients aged 70 years and over. Intervention, Patients in the intervention group received a leaflet to help them prepare for the consultation. General practitioners (GPs) received an outreach visit to optimize older patients' involvement when visiting their GP. Patients in the control group received usual care. Main outcome measures, Questionnaires measuring involvement (COMRADE), enablement (Patient Enablement Index) and satisfaction with their care (EUROPEP). Results, Pre-intervention 315 patients and post-intervention 263 patients were included. Subjects were satisfied with their involvement and the GP's behaviour during the consultation. No differences in effect as a result of the leaflet on involvement, enablement or satisfaction were found between the intervention and the control group. Of 318 patients who received the leaflet and visited their GP in the intervention period, 47 patients used the leaflet. These users were more accustomed to prepare themselves for consultations. Users reported more psychological problems than non-users. Conclusions, No relevant effects of the implementation programme on involvement, enablement or satisfaction were found. Other strategies are needed to enhance involvement of older patients in their care. Alternatively, older patients may perceive themselves sufficiently involved. [source] Enhancing mothers' interactions with toddlers who have sensory-processing disordersINFANT MENTAL HEALTH JOURNAL, Issue 3 2010Nurit Jaegermann The objective of the current study was to examine the effects of a brief Mediational Intervention for Sensitizing Caregivers (the MISC-SP) designed to enhance the quality of mothers' interaction with their toddlers who have sensory processing disorders (SPD). The basic assumption was that quality parent,child interactions can serve as a protective factor moderating the potential negative effects of toddlers' sensory processing and regulation difficulties on their development. The effects of the intervention were compared to those of another intervention designed to enhance children's sensory functioning (the SI group) and to a control group receiving no intervention. Participants were 86 toddlers (12,18 months old) with SPD and their mothers, who were randomly assigned to the aforementioned three research groups. Following the intervention period, mothers in the MISC-SP group showed more sensitive behavior, supported their toddlers' communication behavior better, and used teaching behaviors more appropriately than did mothers in the two other groups. [source] Oral colonization by Lactobacillus reuteri ATCC 55730 after exposure to probioticsINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 5 2009ESBER ÇAGLAR Objective., The aim of this study was to investigate whether Lactobacillus reuteri ATCC 55730 can be detected in the oral cavity after discontinuation of administration of a product prepared with this bacterium. Materials and Methods., The study consisted of three 2-week periods: clearance period, intervention period, and post-treatment period. Twenty-five volunteers consumed a chewable tablet of L. reuteri ATCC 55730 (108 cfu/tablet) during a 14-day trial period. Saliva samples were collected and cultured onto MRS agar after a clearance period of 2 weeks and then daily after a 2-week intervention period for as long as L. reuteri was found. Lactobacillus reuteri colonies were analysed in saliva samples. The analysis was performed using selective media for L. reuteri followed by confirmation using the specific detection of reuterin produced by L. reuteri. Results., The number of L. reuteri carriers decreased gradually, and after 1 week only 8% of the subjects harboured the bacterium. After 5 weeks, L. reuteri was not detected in any of the subjects. Conclusion., Consuming L. reuteri for 2 weeks does not seem to be sufficient for permanent colonization of L. reuteri in the oral cavity. [source] Pilot randomised controlled trial of community pharmacy administration of buprenorphine versus methadoneINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 4 2006Isobel M Cameron research fellow Objectives The established regime for opiate substitute prescribing for drug misusers is daily methadone administered under supervision in community pharmacies. Buprenorphine has recently been introduced as an alternative. However there is a lack of evidence of the effectiveness of buprenorphine maintenance therapy (BMT) in the UK treatment setting. This study aimed to assess methods for a randomised controlled trial (RCT) and the feasibility of pharmacy-based supervised self-administration (SSA) of buprenorphine compared to methadone. Setting Specialist substance misuse service, general practices and community pharmacies in Aberdeen, Scotland. Method The design was a pilot RCT. Opiate-dependent drug misusers, newly referred for maintenance treatment were randomised to receive BMT or methadone maintenance therapy (MMT). Clients and pharmacists were interviewed at baseline and at the end of a 12-week intervention period. Clients completed the quality of life measure EQ-5D. Pharmacy activities were timed. Key findings Twenty-one opiate-dependent clients were recruited (BMT = 11, MMT = 10). Recruitment levels improved as the trial progressed. Clients' treatment preferences were evident. Withdrawals occurred early with BMT. Clients found SSA of buprenorphine acceptable, but found daily administration more manageable than three times weekly. Pharmacists found the dispensing of buprenorphine to be an acceptable role, but felt less certain of ensuring against diversion with buprenorphine than they were with methadone. Pharmacy activities associated with buprenorphine took longer than those associated with methadone (mean = 7 min 25 s versus mean = 3 min 27 s, respectively). Conclusion Recruitment to a trial comparing MMT to BMT for opiate-dependent clients within a UK treatment setting is feasible. Clients and pharmacists found buprenorphine acceptable. [source] Evaluation of patient opinions in a pharmacy-level intervention studyINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2003M. C. M. Pronk PhD researcher ABSTRACT Objective To explore patients' satisfaction with their community pharmacy's services and to evaluate the effects of an intervention programme in which a trained technician organised patient education activities in the pharmacy. Method We surveyed patients visiting the participating pharmacies at three stages: at the start of the intervention period (0 months, T0), at the end (after 12 months, T1), and 12 months after the intervention had been completed (24 months from baseline, T2). At each stage, 500 questionnaires were distributed by each pharmacy. Setting 28 Dutch community pharmacies: 14 intervention and 14 controls. Key findings The response rates were 54%, 44% and 43% at T0, T1 and T2, respectively. Baseline data showed that patients reported satisfaction with helpfulness, waiting time, ease of asking questions, answers to questions, and patient leaflets provided. Around two thirds (59.5%) of the patients said they would ask a pharmacy employee questions if they were concerned about side effects of their medication. Asking questions was not reported to be difficult for most patients (88.9%). The reasons most often given for experiencing difficulties with asking questions were related to lack of privacy (16.9% of all patients), waiting time of other patients (8.8%) and busy pharmacy employees (6.7%). The most frequently reported reason for being less satisfied with the answers to questions was receiving too little information (7.5%). Our analyses showed a significant improvement only on the outcome variable "helpfulness" experienced by patients between 0 (T0) and 12 months (T1), and this was found to be sustained one year later (T2). Conclusion The overall findings on patient satisfaction showed that almost two-thirds of the respondents saw the pharmacy as a source of information about medication. Community pharmacies clearly have an important role in providing such information. Lack of privacy was the most common reason for patients reporting difficulties in asking questions about medicines and this needs pharmacists' attention. Our analysis showed that the intervention had an effect on "helpfulness" experienced by patients, which slightly increased in the intervention period (T0-T1 differences) and appeared to have remained at the higher level one year later (T2). [source] Childrens'and Adolescents'Use of Diaries for Sickle Cell PainJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 4 2001Virginia Egbert Maikler ISSUES AND PURPOSE. To evaluate the characteristics of vaso-occlusive episodes, home management of pain and its impact on the daily activities, and a diary as a method of data collection. DESIGN AND METHODS. Forty-six adolescents and 75 children were asked to complete daily diaries during the intervention period of a larger study. RESULTS. Mild pain was recorded 95% of the time; moderate pain, 3%; and severe pain, 1%. The pattern and location of pain varied greatly. Adolescents used more interventions than did children. When pain intensity was mild, 80% of the children/adolescents maintained school, social, and home activities, but decreased play/sport activities. When pain intensity was high, they decreased their participation in all activities. PRACTICE IMPLICATIONS. Sickle cell pain episodes are unpredictable and highly variable. Diaries can enhance children's and adolescents'documentation and communication about their pain experiences. [source] Effects of a Home Visiting Program for Older People with Poor Health Status: A Randomized, Clinical Trial in the NetherlandsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2008(See editorial comments by Drs. Andreas Stuck, Robert Kane, pp 56 OBJECTIVES: To evaluate the effectiveness of a home visiting program on health-related measures in a population of older people with poor health status. DESIGN: Randomized, clinical trial. SETTING: Community-dwelling citizens in the Netherlands. PARTICIPANTS: Three hundred thirty people aged 70 to 84 randomly assigned to an intervention group (n=160) or a control group (n=170). INTERVENTION: Eight home visits, lasting 1 hour or more, with telephone follow-up, over an 18-month period, conducted by experienced home nurses under supervision of a public health nurse; key elements of the (systematic) visits were assessment of health problems and risks, advice, and referral to professional and community services. MEASUREMENTS: Self-rated health, functional status, quality of life, and changes in self-reported problems. RESULTS: No differences were found between the intervention and control group in these and other outcome measures at the end of the intervention period (18 months). CONCLUSION: The home visiting program did not appear to have any effect on the health status of older people with poor health and are probably not beneficial for such persons. [source] An Educational Intervention to Improve Antimicrobial Use in a Hospital-Based Long-Term Care FacilityJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2007(See Editorial Comments by Dr. Lona Mody on pp 130, 1302) OBJECTIVES: To improve antimicrobial use in patients receiving long-term care (LTC). DESIGN: Prospective, quasi-experimental before,after assessment of the effects of physician education and guideline implementation. SETTING: Public LTC and acute care hospital. PARTICIPANTS: Twenty salaried internists who provided most of the medical care to LTC patients. INTERVENTION: National guidelines, hospital resistance data, and physician feedback were incorporated into a series of four teaching sessions presented over 18 months and into booklets detailing institutional guidelines on the optimal management of common LTC infection syndromes. MEASUREMENTS: One hundred randomly selected LTC patients treated with antimicrobials were reviewed before these interventions were implemented and 100 after, and measures of the quality of care were compared. The effect of the interventions on antimicrobial days and starts were also assessed using interrupted time series analysis. RESULTS: Charted clinical abnormalities met guideline diagnostic criteria (62% vs 38%, P=.006), and initial therapy agreed with guideline recommendations (39% vs 11%, P<.001), more often in the post- than in the preintervention cohort. Mean census-adjusted monthly LTC antimicrobial days fell 29.7%, and antimicrobial starts fell 25.9% during the intervention period; both decreases were sustained during the 2-year postintervention period. CONCLUSION: The teaching and guideline intervention improved the quality and reduced the quantity of antimicrobial use in LTC patients. [source] Reductions in Costly Healthcare Service Utilization: Findings from the Care Advocate ProgramJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2006George R. Shannon PhD OBJECTIVES: To determine whether a telephone care-management intervention for high-risk Medicare health maintenance organization (HMO) health plan enrollees can reduce costly medical service utilization. DESIGN: Randomized, controlled trial measuring healthcare services utilization over three 12-month periods (pre-, during, and postintervention). SETTING: Two social service organizations partnered with a Medicare HMO and four contracted medical groups in southern California. PARTICIPANTS: Eight hundred twenty-three patients aged 65 and older; eligibility was determined using an algorithm to target older adults with high use of insured healthcare services. INTERVENTION: After assessment, members in the intervention group were offered mutually agreed upon referrals to home- and community-based services (HCBS), medical groups, or Medicare HMO health plan and followed monthly for 1 year. MEASUREMENTS: Insured medical service utilization was measured across three 12-month periods. Acceptance and utilization of Care Advocate (CA) referrals were measured during the 12-month intervention period. RESULTS: CA intervention members were significantly more likely than controls to use primary care physician services (odds ratio (OR)=2.05, P<.001), and number of hospital admissions (OR=0.43, P<.01) and hospital days (OR=0.39, P<.05) were significantly more stable for CA group members than for controls. CONCLUSION: Results suggest that a modest intervention linking older adults to HCBS may have important cost-saving implications for HMOs serving community-dwelling older adults with high healthcare service utilization. Future studies, using a national sample, should verify the role of telephone care management in reducing the use of costly medical services. [source] Muscle Strength After Resistance Training Is Inversely Correlated with Baseline Levels of Soluble Tumor Necrosis Factor Receptors in the Oldest OldJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Helle Bruunsgaard MD Objectives:, To test the hypothesis that physical exercise induces an antiinflammatory response that is associated with reduced chronic activation of the tumor necrosis factor (TNF)-alpha system in frail elders and that the increase in muscle strength after resistance training is limited by systemic low-grade inflammation. Design:, A 12-week controlled resistance-training study. Setting:, Nursing homes in Copenhagen, Denmark. Participants:, Twenty-one frail nursing home residents aged 86 to 95 completed the study. Intervention:, Ten participants were randomized to a program of resistance training of knee extensors and flexors three times a week for 12 weeks; the remaining 11 participants served as a control group who joined social activities supervised by an occupation therapist. Measurements:, Muscle strength, plasma levels of TNF-,, soluble TNF receptor (sTNFR)-1, and interleukin (IL)-6 were measured before and at the end of the intervention period. Results:, The training program improved muscle strength but did not affect plasma levels of TNF-, and sTNFR-I or IL-6. However, plasma levels of sTNFR-I at baseline were inversely correlated with the increase in muscle strength. Conclusion:, Low-grade activation of the TNF system could limit the increase in muscle strength after resistance training in the oldest old. Furthermore, data suggest that theantiinflammatory response induced by 12 weeks of resistance training is not sufficient to reduce chronic activation of the TNF system, but the small sample size limited this interpretation. [source] Role of Music Therapy in Social Skills Development in Children with Moderate Intellectual DisabilityJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2000Barbara Duffy The present study investigated the effectiveness of a music therapy programme in the enhancement of the social skills of children with moderate intellectual disability. Thirty-two children (age range = 5,10 years) from four intellectual disability centres participated. At each centre, four children were randomly selected to participate in the music therapy programme, while four children were assigned to a non-music control group programme. One staff member was trained in each group procedure at each centre, and requested to run 30-min group sessions twice weekly over an 8-week intervention period. Five social skills were targeted for intervention: turn-taking, imitation, vocalization, initiation and eye contact. Measures of effectiveness involved comparison of pre- and post-intervention scores on five target skills using a brief social skills test specifically designed for the study. Evaluation forms completed by teachers also provided feedback on the effectiveness of the intervention. The results reflect significant improvements in the five target social skills across both conditions following the 8-week intervention. However, this difference was found to be independent of the music/non-music intervention. [source] Effectiveness of a Media Campaign to ReduceJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 3 2006Traffic Crashes Involving Young Drivers This article describes the evaluation of a 4-1/2-month multimedia traffic-safety campaign that targeted young drivers in northeastern Tennessee. Discussion groups with teenagers provided the basis for public-service announcements (TV, radio, and billboard), which were developed specifically for this intervention. To determine the impact on crash frequencies among drivers 16,19 years old, baseline, intervention, and follow-up crash data were obtained from statistics maintained by the state. A time-series analysis of these data indicated that during the intervention period, there was a 21.6% decrease in crashes for which 16,19-year-old drivers were at fault, whereas a control location in southeastern Tennessee exhibited no significant change. [source] Creating supportive clinical learning environments: an intervention studyJOURNAL OF CLINICAL NURSING, Issue 1-2 2010Amanda Henderson Aim., To assess the impact of an intervention aimed to build capacity of registered nurses to enhance the clinical learning environment for undergraduate nursing students. Workplace learning is vital for the development of skills, attributes and knowledge of student nurses. Registered nurses need to be appropriately prepared to maximise student learning during clinical placement. Background., The quality of student learning during clinical practicum is largely dependent on interactions with ward staff. Design., A quasi-experimental design. Method., Measurement of students' perceptions of the psycho social learning environment during and outside of the intervention period was used to evaluate the capacity building intervention. The capacity building intervention consisted of interactive education in clinical areas over a six-week period for registered nurses in two acute surgical wards. Results., First, second and third year students (n = 62) who undertook their clinical practicum in the two surgical wards, before, during and six months after the capacity building intervention assessed the psycho-social learning environment at the time of their clinical practicum. Findings showed that students who undertook their clinical practicum during the intervention period rated the psycho-social clinical learning environment significantly higher than students who undertook their practicum at times outside of the intervention period. Conclusions., An experienced researcher/educator conducting capacity building sessions can effectively assist and support registered nurses to engage with students. Relevance to clinical practice., Capacity building sessions can improve practice, however, structures and processes that ensure continuation of practice change need to be embedded for improvements to be sustained. [source] Longitudinal relations between employment and depressive symptoms in low-income, suicidal African American womenJOURNAL OF CLINICAL PSYCHOLOGY, Issue 6 2007Nathan Mascaro Unemployment and depression are problematic at both individual and societal levels, and research suggests that the two phenomena are related. More thorough and longitudinal analyses, particularly ones within low-income minority populations, are needed to guide the development of programs to increase employment in persons with mental health problems. The current study aimed to specify the relations over time between depressive symptoms and employment status within a sample of 46 low-income African American women participating in an intervention study for intimate partner violence and suicidal behavior. Hierarchical logistic regression analysis indicated that baseline levels of depressive symptoms predicted employment status at the end of a 10-week intervention period, controlling for baseline employment status. Chi-square analysis and qualitative analyses of trends in depression scores showed that changes in employment status during the 10-week intervention period predicted 6-month and one-year follow-up levels of depressive symptoms. Results imply that, for women in the currently sampled population, depressive symptoms create vulnerability for job loss, but the ability to gain employment despite high levels of depressive symptoms is linked to lowered depression levels over the long term. Community programs assisting such women could therefore not just lower the vulnerability to job loss by treating depressive symptoms, but they could potentially lower long-term depression levels through interventions that enhance employability and motivation to pursue work. © 2007 Wiley Periodicals, Inc. J Clin Psychol. [source] Internet-Based Interactive Support for Cancer Patients: Are Integrated Systems Better?JOURNAL OF COMMUNICATION, Issue 2 2008David H. Gustafson To compare the benefits of the Internet generally versus a focused system of services, 257 breast cancer patients were randomly assigned to a control group, access to the Internet with links to high-quality breast cancer sites, or access to an eHealth system (Comprehensive Health Enhancement Support System, CHESS) that integrated information, support, and decision and analysis tools. The intervention lasted 5 months, and self-report data on quality of life, health-care competence, and social support were collected at pretest and at 2-, 4-, and 9-month posttests. CHESS subjects logged on more overall than Internet subjects and accessed more health resources, but the latter used non health-related sites more. Subjects with access to the Internet alone experienced no better outcomes than controls at any of the 3 time points, compared to pretest levels. Subjects with CHESS experienced greater social support during the intervention period and had higher scores on all 3 outcomes at 9 months, 4 months after the intervention ended. CHESS subjects also scored higher than those with Internet access during the intervention period but not significantly after the intervention ended. Thus, CHESS (with one simple interface and integrated information, communication, and skills services) helped newly diagnosed breast cancer patients even after computers were removed. In contrast, patients received little benefit from Internet access, despite having links to a variety of high-quality sites. Résumé Le soutien interactif sur Internet des patients atteints du cancer : les systèmes intégrés sont-ils meilleurs? Afin de comparer les bénéfices de l'Internet en général par rapport à un système concentré de services, 257 patientes atteintes du cancer du sein furent assignées au hasard à l'un de trois groupes : un groupe témoin, un groupe ayant accès à Internet avec des liens vers des sites de haute qualité concernant le cancer du sein, ou un groupe ayant accès à un système eHealth (CHESS) qui intègre information, soutien et outils de décision et d'analyse. L'intervention a duré cinq mois et une collecte de données auto-évaluées (à propos de la qualité de vie, de la compétence en ce qui a trait aux soins de santé et du soutien social) fut faite avant le test et deux, quatre et neuf mois après le début du test. Les participantes ayant accès au CHESS se sont globalement connectées plus souvent que les participantes ayant accès à Internet et elles ont accédéà plus de ressources liées à la santé, mais les participantes ayant accès à Internet ont visité plus de sites non liés à la santé. Les participantes ayant seulement accès à Internet n'ont pas présenté de meilleurs résultats que le groupe témoin à aucun des trois moments de cueillette, en comparaison avec les niveaux pré-test. Les participantes ayant accès au CHESS ont reçu un meilleur soutien social pendant la période d'intervention et eurent des résultats plus élevés quant aux trois thèmes à l'évaluation de neuf mois, soit quatre mois après la fin de l'intervention. Les participantes CHESS ont également enregistré des résultats plus élevés que ceux avec Internet pendant la période d'intervention, mais pas de manière significative une fois que l'intervention s'est terminée. Ainsi, CHESS (avec une interface unique et simple et de l'information intégrée, des services de communication et de compétences) a aidé les patientes nouvellement diagnostiquées avec le cancer du sein, même lorsque les ordinateurs furent retirés. De façon constrastée, les patientes n'ont pas beaucoup bénéficié de l'accès à Internet, bien qu'elles aient été orientées vers une variété de sites de haute qualité. Abstract Internetbasierte interaktive Unterstützung für Krebspatienten: Sind integrierte Systeme besser? Um die Vorteile des Internets im allgemeinen mit den Vorteilen eines fokussierten Systems von Angeboten zu vergleichen wurden 257 Brustkrebspatienten zufällig auf eine von drei Gruppen verteilt: eine Kontrollgruppe, eine Versuchsgruppe mit Zugang zum Internet mit Links zu hochqualitativen Seiten zum Thema Krebs und eine zweite Versuchgruppe mit Zugang zu einem eHealth System (CHESS), welches Informationen, Betreuung und Entscheidungs- und Analysewerkzeuge integriert. Die Intervention dauerte 5 Monate. Selbstauskunftsdaten zur Lebensqualität, Gesundheitsfürsorgekompetenz und sozialer Unterstützung wurden vorher, und als 2-, 4- und 9-Monate Nachhermessung erhoben. CHESS-Nutzer griffen generell häufiger auf das Angebot zu als Internetnutzer und nutzten mehr Gesundheitsressourcen; allerdings griffen Internetnutzer häufiger auf Seiten ohne Gesundheitsbezug zu. Teilnehmer mit Internetzugang zeigten bezogen auf die Vorhermessung keine besseren Ergebnisse im Vergleich zur Kontrollgruppe. CHESS-Nutzer erlebten eine größere soziale Unterstützung während der Intervention und hatten höhere Werte für alle drei Ergebnismessungen zum Zeitpunkt 9 Monate, also 4 Monate nach Ende der Intervention. CHESS-Teilnehmer punkteten während aber nicht nach Ende der Intervention höher als jene mit Internet-Zugang. CHESS (mit einem einfachen Interface und integrierter Information, Kommunikation und Services) half neu diagnostizierten Brustkrebspatienten sogar nachdem die Computer entfernt wurden. Im Gegensatz dazu bekamen Patienten wenig Unterstützung vom Internet-Zugang, obwohl sie Links zu eine Vielzahl hochqualitativer Seiten hatten. Resumen Apoyo Interactivo a través del Internet para Pacientes con Cáncer: ¿Son Mejores los Sistemas Integrados? Para comparar los beneficios del Internet generalmente versus un sistema de servicios focalizados, 257 pacientes con cáncer de mama fueron asignados aleatoriamente a un grupo de control, acceso al Internet con conexiones a sitios de cáncer de mama de alta calidad, ó acceso a un sistema de Salud (CHESS) que integraba información, apoyo, y herramientas de decisión y análisis. La intervención que duró cinco meses, reportó datos individuales sobre la calidad de vida, la competencia de la asistencia médica y el apoyo social coleccionados a través de una prueba inicial y pruebas a los 2, 4, y 9 meses después. Los participantes de CHESS entablaron sesiones con más frecuencia que los sujetos de Internet y accedieron a más recursos sobre la salud, pero éstos últimos usaron más sitios no relacionados con la salud. Los sujetos que solamente accedieron al Internet no experimentaron mejores resultados que los grupos de control durante los tres puntos, comparados con los niveles de pruebas iniciales. Los sujetos con CHESS experimentaron un apoyo social mayor durante el período de intervención y tuvieron puntajes más altos en los 3 resultados a los 9 meses, 4 meses después que la intervención finalizara. Los sujetos de CHESS obtuvieron mayores puntajes que los participantes con acceso al Internet durante el período de la intervención, pero no significativamente después de que la intervención finalizara. Así, CHESS (con una interfase simple e información integrada, comunicación y servicios de habilidades) ayudaron a los pacientes recientemente diagnosticados con cáncer de mama aún después de que las computadoras fueron removidas. En contraste, los pacientes recibieron poco beneficio del acceso al Internet, a pesar de tener acceso a conexiones con una variedad de sitios de alta calidad. ZhaiYao Yo yak [source] Effectiveness of a lifestyle modification programme in weight maintenance in obese subjects after cessation of treatment with OrlistatJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 6 2007Jean Woo MD Abstract Objective, To examine the efficacy of a lifestyle modification programme in weight maintenance for obese subjects after cessation of treatment with Orlistat. Methods, Fifty-five subjects with and without diabetes mellitus were randomized to a lifestyle modification programme or to usual care at the end of 6 months' treatment with Orlistat. The intervention programme was nutritionist led, consisting of components of dietary management, physical activity, peer group support and discussion using techniques of self-monitoring, stimulus control and cognitive restructuring. Anthropometric indices, body composition, basal metabolic rate, blood pressure, fasting glucose, glycosylated haemoglobin, lipid profile, 24-hour urinary albumin excretion, dietary intake, physical activity level, and quality of life were assessed before and after the intervention period. Results, Subjects in the intervention group maintained their weight loss and favourable anthropometric, metabolic, dietary intake, physical activity and quality of life profiles, while most parameters deteriorated in the usual care group, being more marked in subjects with diabetes. The magnitude of weight gain was comparable to that lost during Orlistat treatment. Conclusion, A specially designed nutritionist-led lifestyle modification programme for obese subjects is effective in weight maintenance after treatment with Orlistat, in the absence of which the benefits of drug treatment were lost. The magnitude of the effect of lifestyle modification is comparable to that observed with Orlistat. [source] Specific insulin sensitivity and leptin responses to a nutritional treatment of obesity via a combination of energy restriction and fatty fish intakeJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 6 2008I. Abete Abstract Background, Nutritional strategies to treat obesity often influence neuroendocrine factors related to body weight control. The present study aimed to investigate whether the inclusion of three fatty fish servings per week within a hypocaloric diet may have specific healthy effects on insulin and leptin functions. Methods, Thirty-two subjects (body mass index = 31.6 ± 3.5 kg m,2) aged 36 ± 7 years, were assigned to a control or fish-based energy-restricted diet over an 8-week period. Anthropometry, body composition, lipid profile, leptin and insulin values were measured at the start and at the end of the dietary intervention. Results, Both experimental diets resulted in a similar mean weight loss (control = 5.3 ± 2.6% versus fish-based = 5.5 ± 2.5%; P = 0.783). A significant reduction in insulin resistance, as determined by the homeostatic model assessment index (HOMA-IR = insulin × glucose/22.5), was observed after the fish-based intervention. The change in circulating leptin was higher in the fish-based diet compared to the control group. Sixteen percent of the variability in the change of adjusted-leptin could be explained (P = 0.034) by the HOMA index change and the type of diet. Conclusions, Three servings a week of fatty fish included in an energy-restricted diet appears to be a valid strategy for specifically improving insulin sensitivity and leptin levels in obese subjects, which could involve a better body weight regulation after a nutritional intervention period. [source] Consumption of vegetables alters morning urinary 6-sulfatoxymelatonin concentrationJOURNAL OF PINEAL RESEARCH, Issue 1 2008Shino Oba Abstract:, Melatonin, which is contained in certain vegetables, may have an influence on circulatory melatonin concentrations. This study examined the effects of the consumption of vegetables on 6-sulfatoxymelatonin concentrations in morning urine. Ninety-four healthy women aged 24,55 were recruited through a city public health center in Japan. The women randomly allocated to the intervention group were requested to consume high amounts of six selected vegetables, with a target of 350 g/day for 65 days, while those in the control group were asked to avoid the same six vegetables during the same period. First-void morning urine was collected before and at the end of the intervention period, and creatinine-adjusted 6-sulfatoxymelatonin concentrations were measured. At the end of the intervention period, daily mean intake of melatonin from the six vegetables was 1288.0 ng in the intervention group and 5.3 ng in the control group. In the intervention group, the mean concentration of 6-sulfatoxymelatonin changed from 48.1 [95% confidence interval (CI): 40.4,57.2] ng/mg creatinine to 49.6 (95% CI: 42.8,57.3) ng/mg creatinine across the intervention period. In the control group, the mean concentration of 6-sulfatoxymelatonin changed from 55.5 (95% CI: 48.7,63.2) ng/mg creatinine to 50.8 (95% CI: 44.0,58.7) ng/mg creatinine across the intervention period. A comparison of the two groups with regard to the changes in the 6-sulfatoxymelatonin concentrations across the intervention period showed a significant difference (P = 0.03). The results indicate that increased consumption of vegetables raises circulatory melatonin concentrations. [source] Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2009E. A. WILLIAMS Summary Background, The efficacy of probiotics in alleviating the symptoms of irritable bowel syndrome (IBS) appears to be both strain- and dose-related. Aim, To investigate the effect of LAB4, a multistrain probiotic preparation on symptoms of IBS. This probiotic preparation has not previously been assessed in IBS. Methods, Fifty-two participants with IBS, as defined by the Rome II criteria, participated in this double blind, randomized, placebo-controlled study. Participants were randomized to receive either a probiotic preparation comprising two strains of Lactobacillus acidophilus CUL60 (NCIMB 30157) and CUL21 (NCIMB 30156), Bifidobacterium lactis CUL34 (NCIMB 30172) and Bifidobacterium bifidum CUL20 (NCIMB 30153) at a total of 2.5 × 1010 cfu/capsule or a placebo for 8 weeks. Participants reported their IBS symptoms using a questionnaire fortnightly during the intervention and at 2 weeks post-intervention. Results, A significantly greater improvement in the Symptom Severity Score of IBS and in scores for quality of life, days with pain and satisfaction with bowel habit was observed over the 8-week intervention period in the volunteers receiving the probiotic preparation than in the placebo group. Conclusion, LAB4 multistrain probiotic supplement may benefit subjects with IBS. [source] The effect of unfiltered coffee on potential biomarkers for colonic cancer risk in healthy volunteers: a randomized trialALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2000Grubben Background: Epidemiologic studies suggest that coffee use might protect against colorectal cancer. Inconsistencies as to the effect of coffee use and colorectal cancer between epidemiologic studies might be related to the type of coffee brew. Objective: We studied the effect of unfiltered coffee consumption on putative biomarkers for colonic cancer risk. Design: A total of 64 healthy volunteers (31 men and 33 women), with a mean age of 43 ± 11 years were randomly assigned to two groups in a crossover design, with two intervention periods of 2 weeks separated by a washout period of 8 weeks. Treatments were 1 L of cafetière (French press) coffee daily or no coffee. At the end of each intervention period, fasting blood samples, colorectal biopsies and 48 h faeces were collected. Results: No effect of coffee on colorectal cell proliferation, assayed by estimating the Proliferating Cell Nuclear Antigen labelling index, was seen. Additionally, no effects were seen on the concentrations of faecal soluble bile acids and colorectal mucosal glutathione S-transferase activity. However, unfiltered coffee significantly increased the glutathione content in the colorectal mucosa by 8% and in plasma by 15%. Other aminothiols in plasma also increased on coffee. Conclusion: Unfiltered coffee does not influence the colorectal mucosal proliferation rate, but might increase the detoxification capacity and anti-mutagenic properties in the colorectal mucosa through an increase in glutathione concentration. Whether this effect indeed contributes to a lower colon cancer risk remains to be established. [source] A lethal ovitrap-based mass trapping scheme for dengue control in Australia: II.MEDICAL AND VETERINARY ENTOMOLOGY, Issue 4 2009Impact on populations of the mosquito Aedes aegypti Abstract. In Cairns, Australia, the impacts on Aedes aegypti L. (Diptera: Culicidae) populations of two types of ,lure & kill' (L&K) lethal ovitraps (LOs), the standard lethal ovitrap (SLO) and the biodegradable lethal ovitrap (BLO) were measured during three mass-trapping interventions. To assess the efficacy of the SLO, two interventions (one dry season and one wet season) were conducted in three discrete areas, each lasting 4 weeks, with the following treatments: (i) SLOs (>200 traps, ,4/premise), BG-sentinel traps (BGSs; ,15, 1/premise) and larval control (container reduction and methoprene treatment) and (ii) larval control alone, and (iii) untreated control. Female Ae. aegypti populations were monitored for 4 weeks pre- and post-treatment in all three areas using BGSs and sticky ovitraps (SOs) or non-lethal regular ovitraps (ROs). In the dry season, 206 SLOs and 15 BGSs set at 54 and 15 houses, respectively, caught and killed an estimated 419 and 73 female Ae. aegypti, respectively. No significant decrease in collection size of female Ae. aegypti could be attributed to the treatments. In the wet season, 243 SLOs and 15 BGSs killed ,993 and 119 female Ae. aegypti, respectively. The mean number of female Ae. aegypti collected after 4 weeks with SOs and BGSs was significantly less than the control (LSD post-hoc test). The third mass-trapping intervention was conducted using the BLO during the wet season in Cairns. For this trial, three treatment areas were each provided with BLOs (>500, ,4/premise) plus larval control, and an untreated control area was designated. Adult female Ae. aegypti were collected for 4 weeks pre- and post-treatment using 15 BGSs and 20 SOs. During this period, 53.2% of BLOs contained a total of 6654 Ae. aegypti eggs. Over the intervention period, collections of Ae. aegypti in the treatment areas were significantly less than in the control area for BGSs but not SOs. An influx of relatively large numbers of young females may have confounded the measurement of changes in populations of older females in these studies. This is an important issue, with implications for assessing delayed action control measures, such as LOs and parasites/pathogens that aim to change mosquito age structure. Finally, the high public acceptability of SLOs and BLOs, coupled with significant impacts on female Ae. aegypti populations in two of the three interventions reported here, suggest that mass trapping with SLOs and BLOs can be an effective component of a dengue control strategy. [source] Longitudinal study of a health education program for Japanese women in menopauseNURSING & HEALTH SCIENCES, Issue 2 2009Masumi Ueda phd Abstract In this longitudinal intervention study, a 6 week health education program consisting of lectures and exercises was implemented for 39 Japanese menopausal women. The effects of the program were assessed by measuring their exercise participation, climacteric symptoms, and quality of life immediately before, 6 weeks after, and 1 year after the program. The Simplified Menopausal Index was used to assess the climacteric symptoms and the Medical Outcomes Study 36-Item Short-Form Health (SF-36) Survey was used to assess the quality of life. Significant improvements were observed in the subscale score for general health perception and the summary score for the physical component summary in the SF-36 Survey. Favorable results also were found for women without a previous exercise habit before the program but who participated in regular exercise 1 year after the program. No improvements were observed in the climacteric symptoms. We concluded that our program was effective for menopausal women in spite of the intervention period being relatively short. [source] Guiding Mothers' Management of Health Problems of Very Low Birth-Weight InfantsPUBLIC HEALTH NURSING, Issue 3 2006F.A.A.N., Karen A. Pridham Ph.D. ABSTRACT Objective: Explore the feasibility, usefulness, and outcomes of a pilot program to support mothers in developing competencies for managing health problems of their very low birth-weight (VLBW) infants in partnership with the primary care clinician (PCC). Design: In a randomized study, mothers who received guided participation (GP) and printed guidelines for managing VLBW infant health problems were compared with mothers who received only the guidelines and standard care (GL group). Sample: All mothers (GP=20; GL=11) were at least 18 years old and English speaking. Infants were all VLBW (,1,500 g). Intervention: GP began during the infant's neonatal intensive care unit stay and continued with public health nurses (PHNs) and a family service clinician through the infant's first 4 postterm months. Measurements: Intervention feasibility and usefulness were assessed with maternal and clinician feedback. Outcomes included maternal and clinician appraisal of mothers' use of clinical resources and mothers' perceptions of primary-care quality and the family-PCC relationship. Results: Intervention feasibility and usefulness were supported. GP and GL groups did not differ significantly on outcomes. Conclusions: Findings indicate a longer intervention period, GP organized by infant problem episodes, and enhancement of the PHN role in the context of interdisciplinary and interagency collaboration. [source] Multisensory intervention improves physical growth and illness rates in Korean orphaned newborn infants,RESEARCH IN NURSING & HEALTH, Issue 6 2003Tae Im Kim Abstract The purpose of this study was to evaluate the effectiveness of a multisensory intervention on the physical growth and health of Korean orphaned infants. Fifty-eight full-term infants were randomly assigned to a control (n,=,28) or an experimental (n,=,30) group within 14 days postbirth. In addition to receiving the routine orphanage care, infants in the experimental group received 15 min of auditory (female voice), tactile (massage), and visual (eye-to-eye contact) stimulation twice a day, 5 days a week, for 4 weeks. Compared to the control group, the experimental group had gained significantly more weight and had larger increases in length and head circumference after the 4-week intervention period and at 6 months of age. In addition, the experimental group had significantly fewer illnesses and clinic visits. These data demonstrate that multisensory intervention in conjunction with human/social contact may be effective in facilitating growth for newborn infants placed in orphanages. © 2003 Wiley-Liss, Inc. Res Nurs Health 26:424,433, 2003 [source] Equipment Dealers'Perceptions of a Community-based Rollover Protective Structures Promotion CampaignTHE JOURNAL OF RURAL HEALTH, Issue 2 2001Timothy W. Struttmann M.S.P.H ABSTRACT Farming is one of the most hazardous occupations, and tractor overturns are the leading cause of agricultural fatalities. This article examines a community-based injury intervention designed to increase the number of rollover protective structures (ROPS) and seat belts on tractors and to promote safe operation of farm tractors in two counties. Equipment dealers who sell retrofit ROPS kits to farmers were a critical component of the intervention. Interviews were conducted with dealers after the 31-month intervention period to understand their perceptions, any difficulties they experienced as a result of the project and how a similar project could be improved. Comments were analyzed in relation to theories of persuasion. Results indicated that dealers believed the intervention was successful in producing behavior change among some farmers. Dealers also provided important insights into why some farmers continued to resist retrofitting tractors with ROPS. Recommendations are offered for designers of community-based interventions beyond the ROPS project described here. [source] Cognitive-behavioral stress management improves stress-management skills and quality of life in men recovering from treatment of prostate carcinomaCANCER, Issue 1 2004Frank J. Penedo Ph.D. Abstract BACKGROUND The current study evaluated the efficacy of a 10-week, group-based, cognitive-behavioral stress management (CBSM) intervention relative to a half-day seminar in improving quality of life (QoL) among men who were treated for localized prostate carcinoma (PC) with either radical prostatectomy (RP) or radiation therapy. METHODS Ninety-two men were assigned randomly to either the 10-week CBSM group intervention or a 1-day seminar (control group). The intervention was designed to improve QoL by helping participants to identify and effectively manage stressful experiences and was focused on the treatment-related sequelae of PC. RESULTS A hierarchical regression model was used to predict postintervention QoL. The final model, including all predictors and relevant covariates (i.e., income, baseline QoL, ethnicity, and group condition), explained 62.1% of the variance in QoL scores. Group assignment was a significant predictor (, = , 0.14; P = 0.03) of QoL after the 10-week intervention period, even after controlling for ethnicity, income, and baseline QoL. Post-hoc analyses revealed that individuals in the CBSM intervention condition showed significant improvements in QoL relative to men in the 1-day control seminar. Improved QoL was mediated by greater perceived stress-management skill. CONCLUSIONS A 10-week cognitive-behavioral group intervention was effective in improving the QoL in men treated for PC, and these changes were associated significantly with intervention-associated increases in perceived stress-management skills. Cancer 2004;100:192,200. © 2003 American Cancer Society. [source] | ||||||||||||||||||||||||||||||||||