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New Interventions (new + intervention)
Selected AbstractsAnticipatory Pleasure Skills Training: A New Intervention to Reduce Anhedonia in SchizophreniaPERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2010Jérôme Favrod RN PURPOSE., Anhedonia is a challenging symptom of schizophrenia and remains largely recalcitrant to current pharmacological treatments. The goal of this exploratory pilot study was to assess if a cognitive,sensory intervention could improve anticipatory pleasure. DESIGN AND METHODS., Five participants meeting the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) criteria for schizophrenia, presenting severe anhedonia and stabilized on atypical antipsychotic medication, received between 10 hours and 25 hours of training. FINDINGS., Results show that the patients improved on the anticipatory scale of the Temporal Experience of Pleasure Scale. Daily activities of the patients were also increased. PRACTICE IMPLICATIONS., These preliminary data need to be interpreted with caution given the small sample of the study, but they offer promising paths to develop new interventions to alleviate anhedonia in schizophrenia. [source] ART HISTORY: CONTEMPORARY PERSPECTIVES ON METHODART HISTORY, Issue 4 2009DANA ARNOLD Dana Arnold is Professor of Architectural History at the University of Southampton, UK. She was editor of Art History from 1997 to 2002 and edits the book series New Interventions in Art History; Companions to Art History; and Anthologies in Art History, all published by Wiley-Blackwell. Her recent monographs include: Rural Urbanism: London Landscapes in the Early Nineteenth Century (2006); Reading Architectural History (2002); Re-presenting the Metropolis: Architecture, Urban Experience and Social Life in London 1800,1840 (2000). Her edited and co-edited volumes include: Biographies and Space (2007); Rethinking Architectural Historiography (2006); Architecture as Experience (2004); Cultural Identities and the Aesthetics of Britishness (2004); Tracing Architecture: The Aesthetics of Antiquarianism (2003); Art and Thought (2003). She is the author of the bestselling Art History: A Very Short Introduction (2004) which has been translated into many languages, including Chinese, Russian, Arabic, Japanese and Spanish and has been reprinted several times. Her monograph on the Spaces of the Hospital is forthcoming from Routledge. Professor Arnold has held research fellowships at Yale University, the University of Cambridge and the Getty Research Institute, Los Angeles and has held numerous visiting Professorships. She was a member of the Research Panel for the Arts and Humanities Research Council (AHRC) and now sits on the Advisory Board of the joint Engineering and Physical Sciences/AHRC initiative Science and Heritage. [source] Pancreatic Enzymes and Microvascular Cell Activation in Multiorgan FailureMICROCIRCULATION, Issue 1 2001GEERT W. SCHMID-SCHÖNBEIN ABSTRACT Cell activation in the microcirculation leads to an inflammatory cascade and is accompanied by many cardiovascular complications. There is a need to identify the trigger mechanisms that lead to the production of in vivo activating factors. We review here mechanisms for cell activation in the microcirculation and specifically the production of humoral cell activators in physiological shock. The elevated levels of activating factors in plasma could be traced to the action of pancreatic enzymes in the ischemic intestine. New interventions against the production of the activators are proposed. The evidence suggests that pancreatic enzymes in the ischemic intestine may attack several tissue components and generate cellular activators that are associated with multiorgan dysfunction in physiological shock. [source] Mapping Common Futures: Customary Communities, NGOs and the State in Indonesia's Reform EraDEVELOPMENT AND CHANGE, Issue 1 2005Carol Warren The post-Suharto ,Reform Era' has witnessed explosive revitalization movements among Indonesia's indigenous minorities or ,customary'(adat) communities attempting to redress the disempowerment they suffered under the former regime. This study considers the current resurgence of customary claims to land and resources in Bali, where the state-sponsored investment boom of the 1990s had severe social and environmental impacts. It focuses on recent experiments with participatory community mapping, aimed at reframing the relationship between state and local institutions in planning and decision-making processes. Closely tied to the mapping and planning strategy have been efforts to strengthen local institutions and to confront the problems of land alienation and community control of resources. The diversity of responses to this new intervention reflects both the vitality and limitations of local adat communities, as well as the contributions and constraints of non-governmental organizations that increasingly mediate their relationships to state and global arenas. This ethnographic study explores participants' experiences of the community mapping programme and suggests its potential for developing ,critical localism' through long-term, process-oriented engagements between communities, governments, NGOs, and academic researchers. [source] Rituximab in advanced rheumatoid arthritisFUTURE PRESCRIBER, Issue 2 2006Michael Guida BSc Rheumatoid arthritis (RA) continues to have a major impact on public health. Costs to the individual and to the NHS are high, and treatment options for RA are by no means perfect. This article reviews rituximab, an agent that interrupts inflammatory events via a novel mode of action, and shows promise as a new intervention in cases of moderate to severe RA. Copyright © 2006 John Wiley & Sons, Ltd. [source] Optimal clinical trial design using value of information methods with imperfect implementationHEALTH ECONOMICS, Issue 5 2010Andrew R. Willan Abstract Traditional sample size calculations for randomized clinical trials are based on the tests of hypotheses and depend on somewhat arbitrarily chosen factors, such as type I and II errors rates and the smallest clinically important difference. In response to this, many authors have proposed the use of methods based on the value of information as an alternative. Previous attempts have assumed perfect implementation, i.e. if current evidence favors the new intervention and no new information is sought or expected, all future patients will receive it. A framework is proposed to allow for this assumption to be relaxed. The profound effect that this can have on the optimal sample size and expected net gain is illustrated on two recent examples. In addition, a model for assessing the value of implementation strategies is proposed and illustrated. Copyright © 2009 John Wiley & Sons, Ltd. [source] The impact of using different costing methods on the results of an economic evaluation of cardiac care: microcosting vs gross-costing approachesHEALTH ECONOMICS, Issue 4 2009Fiona M. Clement (Nee Shrive) Abstract Background: Published guidelines on the conduct of economic evaluations provide little guidance regarding the use and potential bias of the different costing methods. Objectives: Using microcosting and two gross-costing methods, we (1) compared the cost estimates within and across subjects, and (2) determined the impact on the results of an economic evaluation. Methods: Microcosting estimates were obtained from the local health region and gross-costing estimates were obtained from two government bodies (one provincial and one national). Total inpatient costs were described for each method. Using an economic evaluation of sirolimus-eluting stents, we compared the incremental cost,utility ratios that resulted from applying each method. Results: Microcosting, Case-Mix-Grouper (CMG) gross-costing, and Refined-Diagnosis-Related grouper (rDRG) gross-costing resulted in 4-year mean cost estimates of $16,684, $16,232, and $10,474, respectively. Using Monte Carlo simulation, the cost per QALY gained was $41,764 (95% CI: $41,182,$42,346), $42,538 (95% CI: $42,167,$42,907), and $36,566 (95% CI: $36,172,$36,960) for microcosting, rDRG-derived and CMG-derived estimates, respectively (P<0.001). Conclusions: Within subject, the three costing methods produced markedly different cost estimates. The difference in cost,utility values produced by each method is modest but of a magnitude that could influence a decision to fund a new intervention. Copyright © 2008 John Wiley & Sons, Ltd. [source] A model for intervention research in late-life depressionINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2009George S. Alexopoulos Abstract Objective To serve as a conceptual map of the role of new interventions designed to reduce the burden of late-life depression. Methods We identified three needs to be addressed by intervention research: (1) the need for novel interventions given that the existing treatments leave many older adults depressed and disabled; (2) the need for procedures enabling community-based agencies to offer interventions of known efficacy with fidelity; and (3) the need to increase access of depressed older adults to care. Results Our model orders novel interventions according to their role in serving depressed older adults and according to their position in the efficacy, effectiveness, implementation, and dissemination testing continuum. We describe three interventions designed by our institute to exemplify intervention research at different level of the model. A common element is that each intervention personalizes care both at the level of the individuals served and the level of community agencies providing care. To this end, each intervention is designed to accommodate the strengths and limitations of both patients and agencies and introduces changes in the patients' environment and community agencies needed in order to assimilate the new intervention. Conclusions We suggest that this model provides conceptual guidance on how to shorten the testing cycle and bring urgently needed novel treatments and implementation approaches to the community. While replication studies are important, propose that most of the support should be directed to those projects that take rational risks, and after adequate preliminary evidence, make the next step along the testing continuum. Copyright © 2009 John Wiley & Sons, Ltd. [source] WILL THE DILEMMA OF EVIDENCE-BASED SURGERY EVER BE RESOLVED?ANZ JOURNAL OF SURGERY, Issue 9 2006Ned S. Abraham Exponents of evidence-based medicine do not undermine the importance of clinical expertise and skills, but they emphasize that decision-making in medicine should be based on the best available evidence derived from the systematic analysis of observations made in an objective, unbiased and a reproducible fashion. The randomized controlled trial (RCT) is the most scientifically rigorous means of hypothesis testing in epidemiology. Discrepancies between established surgical and other interventions and best available evidence are common. These can be in the form of significant delay in adopting a new intervention despite strong supportive evidence, adopting an intervention before supportive evidence becomes available for reasons of novelty or pear pressure and the lack of supportive evidence for many established common practices. This is compounded further by the paucity of good quality evidence for most surgical procedures. This is arguably because of the inherent difficulties in conducting surgical RCT. The practical, ethical and financial ramifications are complex and the nature of surgical disease often compromise the chances of success or completion of RCT. Carrying out surgical RCT may have more implications on the clinician's authority, autonomy and income and their results are more likely to be influenced by his/her expertise and competence than medical RCT. Furthermore, the success of surgical RCT is often jeopardized by very low recruitment rates. The aim of this study is to discuss the dilemma of producing evidence in surgery. [source] Event report training: An examination of the efficacy of a new intervention to improve children's eyewitness reports,APPLIED COGNITIVE PSYCHOLOGY, Issue 6 2010Elisa Krackow This study tested the efficacy of Event Report Training (ERT), a training procedure designed to improve children's memory reports and decrease suggestibility. Children (N,=,58) participated in two forensically relevant play events. Two weeks later, children received ERT or participated in control procedures, after which they received a memory interview. Results indicated that ERT decreased suggestibility to abuse-related questions in preschoolers; their responses were highly accurate and age differences were eliminated. ERT did not increase the amount of information preschoolers provided in response to open-ended questions. However, with ERT 7- to 8-year-olds reported 32% more information which included a 32% increase in actions, without an accompanying increase in incorrect information. Due to school-aged children's high accuracy rates, it was impossible to gauge the effectiveness of ERT in reducing suggestibility. The failure to obtain an effect of ERT in preschoolers' open-ended recall is discussed in terms of their cognitive-developmental limitations. Copyright © 2009 John Wiley & Sons, Ltd. [source] LiFE Pilot Study: A randomised trial of balance and strength training embedded in daily life activity to reduce falls in older adultsAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 1 2010Lindy Clemson Background:,Exercise as a falls prevention strategy is more complex with people at risk than with the general population. The Lifestyle approach to reducing Falls through Exercise (LiFE) involves embedding balance and lower limb strength training in habitual daily routines. Methods:,A total of 34 community-residing people aged ,70 years were randomised either into the LiFE programme or into a no-intervention control group and followed up for six months. Inclusion criteria were two or more falls or an injurious fall in the past year. Results:,There were 12 falls in the intervention group and 35 in the control group. Therelative risk (RR) analysis demonstrated a significant reduction in falls (RR = 0.23; 0.07,0.83). There were indications that dynamic balance (P = 0.04 at three months) and efficacy beliefs (P = 0.04 at six months) improved for the LiFE programme participants. In general, secondary physical and health status outcomes, which were hypothesised as potential mediators of fall risk, improved minimally and inconsistently. Conclusions:,LiFE was effective in reducing recurrent falls in this at-risk sample. However, there were minimal changes in secondary measures. The study was feasible in terms of recruitment, randomisation, blinding and data collection. A larger randomised trial is needed to investigate long-term efficacy, mechanisms of benefit and clinical significance of this new intervention. [source] The New Scramble for the African CountrysideDEVELOPMENT AND CHANGE, Issue 2 2003Vupenyu Dzingirai There is in Africa, as in other parts of the third world, a desire for environmental management that simultaneously incorporates and benefits all stakeholders, including private businesses and villagers. While these partnerships continue to displace the failed state-centric management of the African landscape, research to document their local-level impact is still formative and developing. This article is an attempt to examine the new environmental management partnerships emerging in southern Africa's countryside. It argues that these new interventions not only fail to deliver benefits to villagers: more importantly, they curtail the long-established rights to land and other natural resources of indigenous communities. While villagers may engage in a battle to recover these rights, it is a struggle in which the odds are stacked against them, and which the private sector and its partners are set to win. [source] Antiretroviral effects on HIV-1 RNA, CD4 cell count and progression to AIDS or death: a meta-regression analysisHIV MEDICINE, Issue 10 2008EJ Mills Objective Governments, clinicians and drug-licensing bodies have adopted changes in CD4 cell counts and HIV-1 RNA levels as evidence of effectiveness for new therapeutic interventions. We aimed to determine the strength of the association between the magnitude of the effect of changes in CD4 cell count and HIV-1 RNA and progression to AIDS or death in the highly active antiretroviral therapy (HAART) era. Methods We identified all randomized clinical trials (RCTs) evaluating the effect of HAART on both clinical and surrogate endpoints (1994 to September 2006). We performed a meta-regression and weighted linear regression. We additionally estimated potential RCT sample sizes that would be required to assess the effectiveness of new interventions in terms of clinical endpoints. Results We included data from 178 RCTs. We were unable to demonstrate a strong relationship at any time-point. Specifically, this was the case when CD4 T-cell change and clinical outcomes were examined at week 24 [coefficient ,0.01, 95% confidence interval (CI) ,0.03 to 0.001, P=0.54], week 48 (coefficient ,0.01, 95% CI ,0.02 to 0.001, P=0.83) and week 96 (coefficient 0.00, 95% CI ,0.03 to 0.04, P=0.76). This was also the case when viral load was examined as a surrogate marker. Given the small number of clinical events occurring in new interventional RCTs, any RCT aiming to evaluate clinical endpoints within these time-points would require an exceptionally large sample size. Conclusions Our findings indicate that, within short-term clinical trial settings, it is not possible to estimate the proportion of treatment effect associated with surrogate endpoints. [source] A model for intervention research in late-life depressionINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2009George S. Alexopoulos Abstract Objective To serve as a conceptual map of the role of new interventions designed to reduce the burden of late-life depression. Methods We identified three needs to be addressed by intervention research: (1) the need for novel interventions given that the existing treatments leave many older adults depressed and disabled; (2) the need for procedures enabling community-based agencies to offer interventions of known efficacy with fidelity; and (3) the need to increase access of depressed older adults to care. Results Our model orders novel interventions according to their role in serving depressed older adults and according to their position in the efficacy, effectiveness, implementation, and dissemination testing continuum. We describe three interventions designed by our institute to exemplify intervention research at different level of the model. A common element is that each intervention personalizes care both at the level of the individuals served and the level of community agencies providing care. To this end, each intervention is designed to accommodate the strengths and limitations of both patients and agencies and introduces changes in the patients' environment and community agencies needed in order to assimilate the new intervention. Conclusions We suggest that this model provides conceptual guidance on how to shorten the testing cycle and bring urgently needed novel treatments and implementation approaches to the community. While replication studies are important, propose that most of the support should be directed to those projects that take rational risks, and after adequate preliminary evidence, make the next step along the testing continuum. Copyright © 2009 John Wiley & Sons, Ltd. [source] Initial Validation of the Perioperative Nursing Data Set in FinlandINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2002Kristiina Junttilla MNSc PURPOSE. To explore the relevance of the Perioperative Nursing Data Set (PNDS) in Finland. METHODS. A three-round Delphi technique (10 participants) and content analysis of 134 articles from the Journal of the Finnish Operating Room Nurses Association. FINDINCS. All the PNDS outcomes, 86% of the diagnoses, and 87% of the interventions were found to be relevant. The Delphi panel suggested, and content analysis revealed, 6 new outcomes, 43 new diagnoses, and 11 new interventions. Consensus was achieved on 77%. The phrases used in perioperative articles corresponded with those of PNDS 56%-78% of the time. CONCLUSIONS.PNDS can be used to describe perioperative nursing in Finland. Further conceptualization and validation are needed before using the data set in perioperative practice. IMPLICATIONS FOR PRACTICE. Although PNDS cannot be implemented in Finland as is, it is a valid structure for further development of the terminology, contents, methods, and practice of Finnish perioperative documentation. Première validation d'une base de données concernant les soins infirmiers périopératoires en Finlande BUT.Explorer la pertinence d'une base de données concernant les soins infirmiers périopératoires en Finlande. MÉTHODE.La méthode de Delphi à 3 tours (10 participants) et l'analyse de contenu de 134 articles publiés dans le Journal de l'Association Finlandaise des Infirmières de bloc opératoire. RÉSULTATS.Tous les résultats, 86% des diagnostics et 87% des interventions de la BDSIP se sont révélés pertinents. Le panel Delphi et l'analyse de contenu ont permis d'identifier 6 nouveaux résultats, 43 nouveaux diagnostics, et 11 nouvelles interventions. Le consensus a atteint 77%. Les phrases utilisées dans les articles sur les soins périopératoires correspondaient à l'ensemble de la BDSIP avec un écart de 56%-78%. CONCLUSIONS.La BDSIP peut être utilisée pour décrire les soins périopératoires en Finlande. II faut cependant poursuivre le processus de conceptualisation et de validation avant d'utiliser cette base de données dans le milieu clinique périopératoire. IMPLICATIONS POUR LA PRATIQUE. It Serait prématuré d'utiliser la BDSIP actuelle, en Finlande, mais elle constitue une structure valide pour développer la terminologie, les contenus, les méthodes et la pratique, tels qu'ils pourraient apparaître dans les dossiers des patients en périopératoire. Mots-clés:Base de données de soins infirmiers, dossiers, nomenclature, soins périopératoires ValidaçãTo Inicial do Conjunto de Dados de Enfermagem Perioperatória na Finlàndia OBJETIVO.Explorar a relevância do Conjunto de Dados de Enfermagem Perioperatória (PNDS) na Finlândia. MÉTODO.Técnica de Delphi em três rodadas (10 participantes) e análise de conteúdo de 134 artigos da Revista da AssociaçãTo Finlandesa de Enfermeiras de Centro Cirúrgico. ACHADOS.Todos os resultados esperados do PNDS, 86% dos diagnósticos e 87% das intervenções foram considerados relevantes. O painel Delphi sugeriu, e a análise de conteúdo revelou, 6 novos resultados esperados, 43 novos diagnósticos e 11 novas intervenções. Foi obtido consenso em 77%. As frases utilizadas em artigos perioperatórios corresponderam àquelas do PNDS de 56%-78% das vezes. CONCLUSÕTES.O PNDS pode ser utilizado para descrever a enfermagem perioperatória na Finlândia. É preciso ampliar a conceptualizaçãTo e validaçãTo antes de usar o conjunto de dados na prática perioperatória. IMPLICAÇÕTES PARA A PRÁTICA.Embora o PNDS não possa ser implementado na Finlândia como está, trata-se de uma estrutura válida para um maior desenvolvimento da terminologia, conteúdo, método e prática da documentaçõo perioperatória Finlandesa. Palavras para busca:Conjunto de dados de enfermagem, documentaçõo, enfermagem perioperatória, nomenclatura Validación Inicial del Conjunto Mínimo de Datos de la Enfermeria de Quirófano en Finlandia PROPÓSITO.Explorar la relevancia del Conjunto Mínimo de Datos de la Enfermería de Quirófano (PNDS) en Finlandia métodos. Una técnica Delphi a tres vueltas (10 participantes) y el análisis de contenido de 134 artículos de la Revista de la Asociación Finlandesa de Enfermeras de Quirófano. RESULTADOS.Todos los resultados del PNDS se encontraron relevantes el 86% de los diagnósticos y el 87% de las intervenciones. El panel Delphi sugirió, y el unúlisis de contenido reveló, seis nuevos resultados, 43 nuevos diagnósticos, y 11 nuevas intervenciones. El consenso general se logró en el 77%. Las frases utilizadas en los artículos, correspondieron con el PNDS en el 56%-78% de las ocasiones. CONCLUSIONES. El PNDS puede ser utilizado para describir la Enfermería de Quirófano en Finlandia. Conceptualización y validación posterior, son necesarias antes de usar el conjunto de datos en la práctica de quirófano. IMPLICACIONES PARA LA PRÁCTICA.Aunque el PNDS no puede llevarse a cabo en Finlandia tal como está, es una estructura válida para desarrollos posteriores de la terminología, contenidos, métodos y práctica de la documentación de quirófano finlandesa. Términos de búsqueda:Conjunto Mínimo de Datos de Enfermería, enfermería de quirófano, documentación, nomenclatura Search terms:Documentation, nomenclature, nursing data set, perioperative nursing [source] Comparison of ventilator-dependent child reports of health-related quality of life with parent reports and normative populationsJOURNAL OF ADVANCED NURSING, Issue 1 2007Jane Noyes Abstract Title. Comparison of ventilator-dependent child reports of health-related quality of life with parent reports and normative populations Aims., This paper is a report of the first study of ventilator-dependent child and parent ratings of health-related quality of life using a validated instrument, which was undertaken as part of a case study of costs and consequences. Background., Advances in medical care and technologies such as the ventilator have extended childhood illness trajectories beyond our current range of knowledge and experience. These advances and their effects reinforce the need for further research to determine health-related quality of life as an outcome of ventilator-dependency in childhood. Methods., The KINDL was administered to ventilator-dependent children aged 4,18 years and parents as part of an in-depth case study. Twenty-seven parents and 17 children (including 17 child-parent pairs) completed questionnaires. Data were collected between 2001 and 2004. Findings were compared with normative values derived from a representative sample of children of a similar age in the general population. Results., Ventilator-dependent children reported significantly lower overall health-related quality of life, and significantly lower scores on all domains except about their friends, compared with school children, and chronically ill children in respect of their disease. Parents and children rated children's overall health-related quality of life the same but parents reported significantly lower scores for their child's disease and relationships with friends. There was a positive correlation between children and parents in all areas apart from self-esteem and school. Conclusions., Both child and parent perspectives are needed to understand the impact of ventilator-dependency and associated co-morbidity on the child. As new interventions and models of service delivery emerge it will be important for nurses to understand the impact on the child by evaluating physical, emotional and social consequences. [source] Combating prejudice and racism: new interventions from a functional analysis of racist languageJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 1 2003Bernard Guerin Abstract Based on a conversational model of language-use-in-social-context, this article focuses on one particular form of racist and prejudiced talking that has not received enough attention,conversations in which racist statements function to maintain groups and relationships rather than seriously promote racism. Despite their casualness, such statements are still pernicious, and a range of potential interventions are proposed for this language function. These involve actively altering a community's discursive resources to include more rejoinders to racist comments. Such rejoinders must be utilized in the most appropriate way for any relationship, and this might mean polite corrections, witty repartee, strong put-downs to silence someone making racist comments, or as counter-jokes to racist jokes, depending upon the social context and power relations involved. Copyright © 2003 John Wiley & Sons, Ltd. [source] An aging Interventions Testing Program: study design and interim reportAGING CELL, Issue 4 2007Richard A. Miller Summary The National Institute on Aging's Interventions Testing Program (ITP) has developed a plan to evaluate agents that are considered plausible candidates for delaying rates of aging. Key features include: (i) use of genetically heterogeneous mice (a standardized four-way cross), (ii) replication at three test sites (the Jackson Laboratory, TJL; University of Michigan, UM; and University of Texas, UT), (iii) sufficient statistical power to detect 10% changes in lifespan, (iv) tests for age-dependent changes in T cell subsets and physical activity, and (v) an annual solicitation for collaborators who wish to suggest new interventions for evaluation. Mice in the first cohort were exposed to one of four agents: aspirin, nitroflurbiprofen (NFP), 4-OH-,-phenyl-N-tert-butyl nitrone (4-OH-PBN), or nordihydroguiaretic acid (NDGA). An interim analysis was conducted using survival data available on the date at which at least 50% of the male control mice had died at each test site. Survival of control males was significantly higher, at the interim time-point, at UM than at UT or TJL; all three sites had similar survival of control females. Males in the NDGA group had significantly improved survival (P = 0.0004), with significant effects noted at TJL (P < 0.01) and UT (P < 0.04). None of the other agents altered survival, although there was a suggestion (P = 0.07) of a beneficial effect of aspirin in males. More data will be needed to determine if any of these compounds can extend maximal lifespan, but the current data show that NDGA reduces early life mortality risks in genetically heterogeneous mice at multiple test sites. [source] Single muscle fiber size and contractility after spinal cord injury in ratsMUSCLE AND NERVE, Issue 1 2006Walter R. Frontera MD Abstract Spinal cord injury (SCI) results in muscle weakness but the degree of impairment at the level of single fibers is not known. The purpose of this study was to examine the effects of T9,level SCI on single muscle fibers from the tibialis anterior of rats. Significant decreases in cross-sectional area (CSA), maximal force (Po), and specific force (SF = Po/CSA) were noted at 2 weeks. Atrophy and force-generating capacity were reversed at 4 weeks, but SF remained impaired. Maximum shortening velocity (Vo) did not change after injury. SCI thus appears to affect various contractile properties of single muscle fibers differently. Normal cage activity may partially restore function but new interventions are needed to restore muscle fiber quality. Muscle Nerve, 2006 [source] Anticipatory Pleasure Skills Training: A New Intervention to Reduce Anhedonia in SchizophreniaPERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2010Jérôme Favrod RN PURPOSE., Anhedonia is a challenging symptom of schizophrenia and remains largely recalcitrant to current pharmacological treatments. The goal of this exploratory pilot study was to assess if a cognitive,sensory intervention could improve anticipatory pleasure. DESIGN AND METHODS., Five participants meeting the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) criteria for schizophrenia, presenting severe anhedonia and stabilized on atypical antipsychotic medication, received between 10 hours and 25 hours of training. FINDINGS., Results show that the patients improved on the anticipatory scale of the Temporal Experience of Pleasure Scale. Daily activities of the patients were also increased. PRACTICE IMPLICATIONS., These preliminary data need to be interpreted with caution given the small sample of the study, but they offer promising paths to develop new interventions to alleviate anhedonia in schizophrenia. [source] The Monroe Doctrine: Meanings and ImplicationsPRESIDENTIAL STUDIES QUARTERLY, Issue 1 2006MARK T. GILDERHUS This article presents a brief history of the Monroe Doctrine since its articulation in 1823. First conceived as a statement in opposition to European intrusions in the Americas, it became under President Theodore Roosevelt a justification for U.S. intervention. To cultivate Latin American trade and goodwill during the Great Depression and the Second World War, Franklin Roosevelt's administration accepted the principle of nonintervention. Later with the onset of the Cold War, perceived international imperatives led to a series of new interventions in countries such as Guatemala, Cuba, the Dominican Republic, and Chile. Though typically couched in idealistic rhetoric emphasizing Pan-American commitments to solidarity and democracy, the various versions of the Monroe Doctrine consistently served U.S. policy makers as a means for advancing what they understood as national strategic and economic interests. [source] An ethical hierarchy for decision making during medical emergenciesANNALS OF NEUROLOGY, Issue 4 2010Patrick D. Lyden MD Evidence from well-designed clinical trials may guide clinicians, reduce regional variation, and lead to improved outcomes. Many physicians choose to ignore evidence-based practice guidelines. Using unproven therapies outside of a randomized trial slows recruitment in clinical trials that could yield information on clinical and economic efficacy. Using acute stroke therapy as an illustration, we present an ethical hierarchy for therapeutic decision making during medical emergencies. First, physicians should offer standard care. If no standard care option exists, the physician should consider enrollment in a randomized clinical trial. If no trial is appropriate, the physician should consider a nonrandomized registry, or consensus-based guidelines. Finally, only after considering the first 3 options, the physician should use best judgment based on previous personal experience and any published case series or anecdotes. Given the paucity of quality randomized clinical trial data for most medical decisions, the "best judgment" option will be used most frequently. Nevertheless, such a hierarchy is needed because of the limited time during medical emergencies for consideration of general principles of clinical decision making. There should be general agreement in advance as to the hierarchy to follow in selecting treatment for critically ill patients. Were more clinicians to follow this hierarchy, and choose to participate in clinical trials, the generation of new knowledge would accelerate, yielding rigorous data supporting or refuting the efficacy and safety of new interventions more quickly, thus benefiting far more patients over time. ANN NEUROL 2010;67:434-440 [source] Promoting stability and continuity of care for looked after children: a survey and critical reviewCHILD & FAMILY SOCIAL WORK, Issue 1 2005S. Holland ABSTRACT This paper reports on a two-pronged research study: a critical review of reported research concerning continuity and stability for children looked after away from home, and a telephone survey of UK managers responsible for looked after children. The review found limited research in this specific field that met the criteria of the critical review, but reports some evidence in favour of sibling co-placement, kinship care, parental participation, professional foster care and individualized, multidimensional support. The survey revealed a culture of innovation in this field in the UK voluntary and statutory sectors, but with little evaluation of the independent effects of new interventions. The paper places the research in the context of current policy initiatives in the UK and discusses the implications of the findings for research and practice. [source] Do immune responses to inhaled skin flakes modulate the expression of allergic disease?CLINICAL & EXPERIMENTAL ALLERGY, Issue 8 2007E. R. Tovey Summary We examine the nature of the immune responses to inhaled skin particles and query whether early exposure could play a role in providing protection against the development of allergic disease. Currently, the main hypothesis used to explain environmental modulation of allergic diseases, the ,hygiene hypothesis', is linked exclusively to microbial exposures acting upon the innate immune system. However, many of the exposures sustaining this hypothesis also involve co-exposure to skin flakes from humans or animals. Such skin flakes contain a complex mixture of antigens, glycolipids and small peptides that may induce immune responses. Should these responses prove relevant to the modulation of allergic diseases, it provides new opportunities to better understand the epidemic of allergic disease and to develop new interventions for its prevention. [source] | ||||||||||||||||||||||||||||