274 resultados para INTERVENTIONS


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Introduction. Interest has grown in how systems thinking could be used in obesity prevention. Relationships between key actors, represented by social networks, are an important focus for considering intervention in systems. Method. Two long day care centers were selected in which previous obesity prevention programs had been implemented. Measures showed ways in which physical activity and dietary policy are conversations and actions transacted through social networks (interrelationships) within centers, via an eight item closed-ended social network questionnaire. Questionnaire data were collected from (17/20; response rate 85%) long day care center staff. Social network density and centrality statistics were calculated, using UCINET social network software, to examine the role of networks in obesity prevention. Results. “Degree” (influence) and “betweeness” (gatekeeper) centrality measures of staff inter-relationships about physical activity, dietary, and policy information identified key players in each center. Network density was similar and high on some relationship networks in both centers but markedly different in others, suggesting that the network tool identified unique center social dynamics. These differences could potentially be the focus of future team capacity building. Conclusion. Social network analysis is a feasible and useful method to identify existing obesity prevention networks and key personnel in long day care centers.

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Background:
The use of pharmacological agents has been shown to slow down the progression of microvascular and 
macrovascular complications. Most clinical trials address one pharmacological intervention at a time. To date, only a few studies explored multi-factorial pharmacological interventions in T2DM individuals for preventing CVD related complications. Given the current therapeutic inertia in pharmacological management of CVD risk factors, it is important to establish the benefits of a more holistic approach. Therefore, the aim of this review is to assess the efficacy of multiple pharmacological interventions for cardiovascular diseases (CVD) risk factors with or without conventional care in reducing all cause mortality, CVD mortality, stroke and cardiovascular events among adults with type 2 diabetes. Current evidence fails to support the benefit of multiple pharmacological interventions on all cause mortality and death from cardiovascular causes. However, beneficial effects were seen on the reduction of the overall number of cardiovascular events and there were promising trends for secondary outcomes such as stroke, myocardial infarction, revascularisation and amputation.

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Objective

While there is evidence that depression training can improve the knowledge of staff in residential care facilities, there is an absence of research determining whether such training translates into practice change. This study aimed to evaluate the impact of staff training and the introduction of a protocol for routine screening and referral for depression on the numbers of residents detected and referred by care staff for further assessment.
Method:
A cluster randomized controlled design was used to compare the referral rates for residents in seven facilities randomly allocated into one of three conditions: staff training, staff training plus a screening and referral protocol and wait-list control. Participants were 216 aged care residents (M age = 87 years), who agreed to a 12-month audit of their facility file.
Results:
Staff training on its own did not increase the rate of referrals for depression; however, staff training plus the screening protocol and referral guidelines did lead to a significant increase in the number of residents who were referred to a medical practitioner for further assessment. However, this increase in care staff referrals did not result in substantial changes in the treatment prescribed for residents.
Conclusion:
Staff training in depression, supplemented with a protocol for routine screening and guidelines on referring residents, can improve pathways to care. However, strategies to overcome barriers to appropriate subsequent treatment of depression are required for staff-focused initiatives to translate into better outcomes for depressed older adults. Methodological limitations of this study are discussed.

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The research explored the effects of novel potential therapeutics interventions (made of genetically modified viral vectors) to improve skeletal muscle force, increase resistance to fatigue and promote muscle growth. The project tested wether these viruses could aid against non-degenerative muscle loss and enhance energy metabolism.

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Limiting gestational weight gain (GWG) to recommended levels is important to optimize health outcomes for mother and baby. Surprisingly, a recent review revealed that theory-based interventions to limit GWG were less effective than interventions that did not report a theory-base; however, strict criteria were used to identify theory-informed studies. We extended this review and others by systematically evaluating the theories of behaviour change informing GWG interventions using a generalized health psychology perspective, and meta-analysing behaviour change techniques reported in the interventions. Interventions designed to limit GWG were searched for using health, nursing and psychology databases. Papers reporting an underpinning theory were identified and the CALO-RE taxonomy was used to determine individual behaviour change techniques. Nineteen studies were identified for inclusion. Eight studies were informed by a behaviour change theory; six reported favourable effects on GWG. Overall, studies based on theory were as effective as non–theory-based studies at limiting GWG. Furthermore, the provision of information, motivational interviewing, behavioural self-monitoring and providing rewards contingent on successful behaviour appear to be key strategies when intervening in GWG. Combining these behaviour change techniques with dietary interventions may be most effective. Future research should focus on determining the exact combination of behaviour change techniques, or which underpinning theories, are most useful for limiting GWG.

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Objective

To review the empirical evidence that exists to support the delivery of the range of psycho-social interventions that have been implemented to improve social and emotional wellbeing (SEWB) in Aboriginal and Torres Strait Islander individuals and communities.

Methods:
A systematic review of the available literature, with relevant evaluations classified using the Maryland Scientific Methods Scale.

Results:
Despite a substantial literature on topics relevant to SEWB being identified, only a small number of program evaluations have been published that meet the criteria for inclusion in a systematic review, making it impossible to articulate what might be considered evidence-based practice in this area. Examples of those programs with the strongest empirical support are outlined.

Conclusions:
The results are discussed in terms of the need to develop key indicators of improvement in SEWB, such that more robust evidence about program outcomes can be gathered. The diversity of the identified programs further suggests the need to develop a broader and over-arching framework from which to approach low levels of SEWB, drawing on the concepts of 'grief and loss' and 'healing' and how high levels of social disadvantage have an impact on service utilisation and outcomes. Implications: From a public health perspective, the pressing need to implement programs that have positive impacts on low levels of social and emotional well-being in Aboriginal and Torres Strait Islander communities in Australia seems clear.

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This study, reported by Gregory Stuart and colleagues, offers empirical evidence to support the hypothesis that perpetrators of domestic violence who receive a brief intervention to address alcohol use in addition to a 40-hour group batterer programme will not only consume fewer drinks (and on fewer days) than those who only receive the batterer programme, but will also be less likely to be aggressive and violent.Although these effects fade over time, these findings are significant in the context of an area in which the efficacy of many behaviour change programmes has yet to be demonstrated adequately [2], and in which there is a pressing need to develop more effective interventions.