Multiple Interventions (multiple + intervention)

Distribution by Scientific Domains


Selected Abstracts


Treatment Completion in a Brief Motivational Intervention in the Emergency Department: The Effect of Multiple Interventions and Therapists' Behavior

ALCOHOLISM, Issue 2007
Janette Baird
Background:, The aim of this study was to identify therapist behaviors during a brief motivational intervention (BMI) given to injured emergency department patients that predicted participant return for a second BMI session and 12-month alcohol-related outcomes. Method:, This was a secondary data analysis of a randomized controlled trial (n = 539) previously demonstrating that random assignment to a BMI and booster session resulted in a significant reduction of 12-month postintervention alcohol-related injuries and negative consequences relative to standard care. Results:, Participants who actually received 2 BMI sessions had significantly less alcohol-related negative consequences than those who received only 1 BMI session. Therapists who reported a higher focus on emotional support and low focus on participant drinking behaviors during the initial BMI session were more likely to have assigned participants return for the second BMI session. Conclusion:, The results of these secondary analyses show that compliance with a 2-session therapeutic intervention (BIB) predicted fewer negative alcohol-related consequences, and that therapists' supportive emotional emphasis during the first BMI session was important in predicting participants returning for the second MI session. [source]


Early multiple intervention: a view from On Track

CHILDREN & SOCIETY, Issue 2 2005
Jean Hine
On Track started life in 2000 as part of the Crime Reduction Programme in the Home Office, but was shifted to the Children and Young People's Unit less than a year later. This paper describes tensions that emerged during the first phase of the evaluation of this innovative programme, designed to provide interventions for four to twelve year olds at risk of becoming involved in crime. Analysis of interventions and multiple intervention is presented, together with reflections on the need for a different kind of evaluation and a more positive approach to services for children and young people. [source]


Successful stent placement for hepatic venous outflow obstruction in pediatric living donor liver transplantation, including a case series review

PEDIATRIC TRANSPLANTATION, Issue 4 2009
Seisuke Sakamoto
Abstract:, HVOO may lead to graft dysfunction in LDLT. Balloon angioplasty is the first treatment for HVOO. However, some cases with recurrent HVOO need multiple interventions and require stent placement. The authors describe a pediatric case with recurrent HVOO requiring multiple stent placements. Her symptoms related to HVOO finally disappeared after the third stenting. A year later, follow-up liver biopsy did not show any dramatic change in perivenular fibrosis. From a review of our pediatric cases with HVOO requiring stent placement, the majority of them lost the grafts, because the timing of stent placement was too late to prevent the progression of fibrosis. In conclusion, stent placement should be considered in select cases of HVOO. Serial liver biopsies evaluating the degree of fibrosis are essential in determining the timing of stent placement. [source]


HP38P MANAGEMENT OF TRAUMATIC PANCREATIC INJURY

ANZ JOURNAL OF SURGERY, Issue 2007
A. M. Warwick
Background Trauma to the pancreas is a challenging area both in initial diagnosis and longer-term management. The retroperitoneal location makes clinical diagnosis of injury difficult and delayed diagnosis has morbid complications. Methods A review of patients with a diagnosis of traumatic pancreatic injury was performed, over a period of five years, from 2002 to 2006. We assessed the type of injury that occurred in the pancreas after both blunt and penetrating trauma; the diagnosis and timing of pancreatic injury; the need for operative/radiological intervention; and the complications of these injuries. Specifically patients with complex injuries were evaluated and these cases were critically reviewed. Results We identified 45 of cases of pancreatic trauma, aged 16,85, with a mean ISS of 27.8. Minor injury to the pancreas was found in 29 patients, and 16 patients had severe trauma to the pancreas, either major laceration or transection. Four particularly complex cases were identified, two of which required a Whipple's procedure following gunshot wounds involving the pancreatic head. Two patients with abdominal crush injuries required multiple interventions. Conclusions Patients with pancreatic trauma often have other significant injuries and one should have a high degree of suspicion of pancreatic injury in multiply injured patients. Penetrating injury to the pancreas can result in catastrophic injury requiring radical surgery. Blunt injury should be assessed by magnetic resonance cholangio-pancreatography or at laparotomy. The management of pancreatic trauma is complex and these patients should be managed in a tertiary hospital with involvement by both specialised pancreatic and trauma surgeons. [source]


Biliary access loops for intrahepatic stones: results of jejunoduodenal anastomosis

ANZ JOURNAL OF SURGERY, Issue 5 2003
Hariharan Ramesh
Background: Patients with intrahepatic calculi require multiple interventions following successful surgical stone clearance for recurrent stones and cholangitis. The present paper describes the results of a technique of in-continuity side-to-side jejunoduodenal anastomosis (JDA) that provides endoscopic access to the hepaticojejunostomy and intrahepatic ducts. This operation is compared to other techniques in a critical appraisal of various biliary access procedures described for long-term management of intrahepatic ­calculi. Methods: A retrospective analysis of clinical data of 13 patients who underwent biliary drainage procedures with access loops for intrahepatic calculi during the period March 1990 to December 2000 was performed. The postoperative course of patients and the feasibility of postoperative endoscopic access to the hepaticojejunostomy and intrahepatic ductal system in treatment of recurrent cholangitis were assessed. Nine patients underwent JDA, two underwent permanent-access hepaticojejunostomy (PAH) and two others underwent an interposition hepaticojejunoduodenostomy (IHJ). Results: The analysis revealed no major procedure-related complications or mortality. Endoscopic access (using forward-viewing gastroscope) was possible in 100% of cases following JDA, and with difficulty in both cases after PAH. Endoscopic access in the two patients with IHJ failed because of technical reasons. Recurrent cholangitis was seen in seven patients (54%) , two out of two patients in the PAH group, one out of two in the IHJ group and four out of nine in the JDA group. This required 12 endotherapy sessions (mean: 1.5 procedures per patient). Conclusion: In-continuity side-to-side JDA allows easy access of conventional gastroduodenoscopes to the biliary tree for removal of recurrent/residual intrahepatic stones. The technique has advantages over other access loop procedures in the long term management of recurrent intrahepatic stones. [source]


Valve Surgery in Congenital Heart Disease

ARTIFICIAL ORGANS, Issue 11 2009
Giovanni Battista Luciani
Abstract Congenital valve disease (CVD) occurs in isolated form or as part of complex malformations and presents distinct epidemiology, including: young age at onset; high prevalence of associated pathology; history of prior operations; critical clinical presentation. Therefore, multiple interventions are often needed, highlighting the palliative character of CVD surgery. At the same time, long-term survival and satisfactory quality of life expectations must be satisfied in a young, active patient population. The present study analyzes the unique aspects of surgery for CVD by reviewing clinical experience with 565 consecutive patients operated during a 7-year period. Treatment options and outcome are assessed with reference to the ability of respecting the unique demands of patients with CVD. In addition, future developments of CVD management are discussed. [source]