Combination Of Intervention Strategies Research Articles

Settings, populations, and time: a conceptual framework for public health interventions.

This paper presents a conceptual framework displaying how combinations of settings and populations seen in a long-term perspective may guide public health and health promotion planning and research. The notion of settings constitutes a key element of health promotion as stipulated by the Ottawa Charter from 1986. The setting approach highlights the individual, social and structural dimensions of health promotion. Likewise, the notion of populations and how they are selected forms a center pillar of public health. By joining the two perspectives, four combinations of intervention strategies appear by addressing: (1) a single population segment within a single setting, (2) multiple population segments within a single setting, (3) a single population segment within multiple settings or (4) multiple population segments within multiple settings. Furthermore, the addition of a time dimension inspired by the life-course perspective illustrates how trajectories of individuals and projects change settings and population segments as time goes by. The conceptual framework displays how systematic awareness of long-term, multi-setting, multi-population trajectories allow health promotion planners and researchers to systematically develop, plan and analyze their projects.

A Sensitivity Analysis of a Mathematical Model for the Transmission of Endemic Malaria under Periodic Climatic Conditions

We perform sensitivity analysis on a periodic mathematical model of endemic malaria transmission to determine the relative importance and impact of model parameters to disease transmission and prevalence. In this analysis, two sets of baseline parameter values are compiled: one for areas that exhibit high transmission rate and another one for areas with low transmission rates. Sensitivity indices for the basic reproductive number and the endemic equilibrium points are computed. The study established that in areas of low transmission, the reproductive number is most sensitive to the mosquito biting rate, but the equilibrium proportion of the infectious humans is most sensitive to the human recovery rate. Sensitivity analysis on all state variables was conducted. The results indicated that the most influential factors in the transmission and persistence of malaria in the society are those related to vectorial competence. These findings suggests that strategies that target the vector characteristics such as the mosquito biting rate and those that target the human recovery rate can be very successful in controlling malaria. These strategies include the use of insecticide-treated mosquito nets, indoor residual spraying, prompt diagnosis and treatment of infectious individuals. However, a combination of intervention strategies is more effective than application of a single intervention.

Saving the Devils Is in the Details: Tasmanian Devil Facial Tumor Disease Can Be Eliminated with Interventions.

Tasmanian Devils facial tumor disease (DFTD) is severely impacting the population of this wild animal. We developed a computational model of the population of Tasmanian Devils, and the change induced by DFTD. We use this model to test possible intervention strategies Tasmanian conservationists could do. We investigate bait drop vaccination programs, diseased animal removals programs, and evolution of natural immunity. We conclude that a combination of intervention strategies gives the most favorable outcome. An additional goal of this paper is reproducibility of our results. Our StochSS software platform features the ability to share and reproduce the computational notebooks that created all of the results in the paper. We endeavor that all readers should be able to reproduce our results with minimum effort.

Discrete Stochastic Optimization for Public Health Interventions with Constraints

Many public health threats exist, motivating the need to find optimal intervention strategies. Given the stochastic nature of the threats (e.g., the spread of pandemic influenza, the occurrence of drug overdoses, and the prevalence of alcohol-related threats), deterministic optimization approaches may be inappropriate. In this paper, we implement a stochastic optimization method to address aspects of the 2009 H1N1 and the COVID-19 pandemics, with the spread of disease modeled by the open-source Monte Carlo simulations, FluTE, and Covasim, respectively. Without testing every possible option, the objective of the optimization is to determine the best combination of intervention strategies so as to result in minimal economic loss to society. To reach our objective, this application-oriented paper uses the discrete simultaneous perturbation stochastic approximation method (DSPSA), a recursive simulation-based optimization algorithm, to update the input parameters in the disease simulation software so that the output iteratively approaches minimal economic loss. Assuming that the simulation models for the spread of disease (FluTE for H1N1 and Covasim for COVID-19 in our case) are accurate representations for the population being studied, the simulation-based strategy we present provides decision makers a powerful tool to mitigate potential human and economic losses from any epidemic. The basic approach is also applicable in other public health problems, such as opioid abuse and drunk driving.

Interprofessional Interventions to Improve Serious Illness Communication in the Intensive Care Unit: A Scoping Review.

Serious illness communication is fundamental to the provision of quality care for patients in the intensive care unit (ICU). Evidence suggests that including interprofessional team members in such communication is beneficial. This scoping review--conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines-maps existing evidence regarding interprofessional interventions to improve serious illness communication in the ICU. The review yielded 14 studies for inclusion, which were organized by 3 thematic categories of strategies implemented: training curriculum, scheduled meetings, and liaison role. Most used a combination of intervention strategies. Outcome measures varied across the studies but could be broadly categorized as patient/family-focused, provider-focused, or systems-focused. Great heterogeneity between studies exists. More research is needed.

Optimal Strategies for the Control of Cholera with Three Infection Routes

Cholera is an acute intestinal infection and water borne disease that has claimed and continue to claim the lives of millions of people in the developing countries. Its effects on developing countries cannot be ignored since most of the people who get infected or die from the disease are usually children and adults who are in their economically active years. This paper presents an epidemic mathematical model that is aimed at describing the dynamics of the spread of Cholera. In this paper, infection of the disease is considered to be through contact with Infectives or vibrio cholerae in the dry lands and the water bodies. The model is qualitatively analyzed to determine conditions for successful fight against cholera. It is shown that if the basic reproduction number , is less than unity, then the disease-free equilibrium is locally asymptotically stable and the disease dies out and when the basic reproduction number is greater than unity, the vibrio cholerae and the disease will persist in the population. Numerical simulations are also carried out and various combinations of intervention strategies are compared to determine the most effective strategy that should be employed in order to control the spread of the v.cholerae. It is observed that the strategy that adopts education on open defecation, environmental sanitation and water treatment are the most effective strategies in the fight against the spread of the disease Keywords and phrases: Mathematical model, local stability, basic reproduction number, optimal control. DOI: 10.7176/MTM/12-1-02 Publication date: January 31 st 2022

Home-Based Occupational Therapy for Adults With Dementia and Their Informal Caregivers: A Systematic Review

People with dementia require tailored interventions to support participation and performance in their desired occupations, and informal caregivers need interventions that reduce caregiving burden to enable them to continue with their roles. This systematic review investigated whether home-based occupational therapy interventions for adults with dementia and their informal caregivers optimized care recipients' performance of daily occupations and reduced caregiving burden and improved caregivers' sense of competence. Eight databases were searched from 1946 to November 2019 using MeSH terms, keywords, and subject headings as appropriate for each database. Inclusion criteria were quantitative studies investigating the effects of home-based therapy provided by a qualified occupational therapist for adults with dementia and their informal caregivers. Study selection, data collection, and methodological quality assessments using the Critical Appraisal Skills Programme criteria tool were performed independently by two reviewers. Data analysis involved a two-stage process. From 1,229 articles identified through searches, 970 titles and abstracts were screened for eligibility after removal of duplicates. Twenty studies reported in 22 articles were included. Moderate evidence supported interventions provided jointly for adults with dementia and their informal caregivers using a combination of intervention strategies. Included studies demonstrated high risk of bias, particularly in blinding of outcome assessments. Combining individualized interventions framed in client-centeredness can enhance occupational performance for adults with dementia, reduce caregiving burden, and improve informal caregivers' sense of competence. Further research on leisure and home management occupations is warranted. The findings provide evidence supporting the effectiveness of home-based occupational therapy for people with dementia and their informal caregivers for consideration by funders of services.

Quality of life of coronary artery disease patients after the implementation of planning strategies for medication adherence.

OBJECTIVE: to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL. METHOD: this was a controlled and randomized study. RESULTS: the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring. CONCLUSION: the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring.

Interventions for health care professionals, organizations and patients to enhance quality of life for people diagnosed with non-curative palliative esophago-gastric cancer: a systematic review protocol of the quantitative evidence

Review question/objective The overall objective of this systematic review is to establish best practice in relation to interventions targeted at health care professionals or the structures in which health care professionals deliver care (i.e. models of care and practice) and patients (diagnosed with non-curative esophago-gastric cancer), to enhance the quality of life for people diagnosed with non-curative palliative esophago-gastric cancer. More specifically, the objectives are to identify: •Which intervention strategy or parts of intervention strategies are the most effective? •Which intervention strategy or parts of intervention strategies deliver the most effective outcomes for people with palliative esophago-gastric cancer? •What do the strategies identified as being most effective have in common? Inclusion criteria Types of participants This review will consider studies that include adults aged 18 years and older with a diagnosis of palliative esophago-gastric cancer who are in hospital, at home or in a community setting. Studies of interventions targeted at adult participants with potentially curative esophago-gastric cancer or to those adult participants with curative treatment intent for esophago-gastric cancer will be excluded. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate any intervention or combination of intervention strategies aimed at health care professionals, organizations or patients to improve the quality of life for people diagnosed with palliative esophago-gastric cancer. 1. Professional interventions: This category includes strategies to provide professionals with information or training on appropriate practice. 2. Organizational and mode of delivery interventions: This category includes interventions that are predominantly about changes in organizational systems and mode of delivery, such as the introduction of multi-disciplinary teams, changes in skill mix, or in the setting or site of service delivery. 3. Patient and carer interventions: This category includes interventions for families and carers of people with palliative esophago-gastric cancer that provide support to enable them to fulfil the crucial role of carer and interventions that test mechanisms to ensure that users (patients and carers) are involved in service planning and delivery. Types of outcomes This review will consider studies that include the following outcome measures: objectively measured health professional performance or patient outcomes in a clinical setting and self-reported measures with known validity and reliability. Primary outcomes: • Quality of life Secondary outcomes: • Readmissions (planned and unplanned) to hospital • Adverse events / complications • Waiting times for procedures • Treatment for persistent or recurrent dysphagia • Median survival time • Time to disease progression • Preferred place of care • Preferred place of death • Cost (as reported in research papers - if available)

Abstract A13: A signaling pathway rationale for the design of combination therapies for cancer

Abstract Introduction: Cellular functions and activities are regulated by complex networks of signal transduction and regulatory pathways. Cancer diseases are attributed to abnormal behavior in these networks. Thus a critical problem in drug discovery and biomedical research is the identification of intervention strategies to repress a pathological behavior within these signal transduction networks while minimizing side-effects. Accordingly, combination or multicomponent interventions are necessary to cope with two of the fundamental challenges in targeted therapies: redundancy and multifunctionality of biological networks [1]. Furthermore, due to the inherent structural complexity of the networks in question, systemic and efficient methods to tackle such endeavor are necessary in particular when addressing large networks. Materials and Methods: In this work, we introduce OCSANA (Optimal Combinations of Intervention Strategies for Network Analysis), freely available software for the efficient identification and prioritization of optimal combinations of intervention strategies to induce the blockage of signaling from specified source nodes to specified targets. In addition, OCSANA identifies effects with respect to specified off-target nodes (side effects) to further optimize the combinations of intervention points. Our method is purely based on the topological structure of the signaling pathways (signed directed graph structure). We implemented OCSANA within the Cytoscape's plugin BiNoM -Biological Network Manager [2], to facilitate the assembling, usage and analysis of signaling networks in standard systems biology formats (such as Systems Biology Markup Language [SBML] and Biological Pathway Exchange [BioPAX]). Results: We have applied OCSANA to identify combination therapies from our cohort of human epidermal growth factor receptor overexpressing (Her2+) breast cancer tissues. We used transcriptome microarrays to compare Her2+ data with that obtained from normal breast tissue samples. We identified and assembled a signal transduction network of more than 2,500 nodes and 3,800 interactions that includes master regulators of the ERBB family pathways together with less expected molecular mechanisms, potentially involved in the molecular pathology of HER2+ breast cancer. With the assembled signal transduction network and with the aid of OCSANA, we tested in silico scenarios like those of the blocking effects of existent targeted therapies such as trastuzumab and lapatinib. We identified additional complementary combinations of therapeutic intervention points and validated our theoretical predictions with recently published literature. Conclusions: This work represents a cancer systems biology approach aiming at the discovering of combination of intervention therapies from a systematic analysis of signal transduction pathways. The suitability of our approach is demonstrated by a couple of in silico predictions validated in recent literature. Citation Format: Paola Vera-Licona, Andrei Zinovyev, Eric Bonnet, Inna Kupperstein, Olga Kel-Margoulis, Alexander Kel-Margoulis, Thierry Dubois, Gordon Tucker, Emmanuel Barillot. A signaling pathway rationale for the design of combination therapies for cancer [abstract]. In: Proceedings of the AACR Special Conference on Chemical Systems Biology: Assembling and Interrogating Computational Models of the Cancer Cell by Chemical Perturbations; 2012 Jun 27-30; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2012;72(13 Suppl):Abstract nr A13.

A Scoping Review of Self-Management Interventions for Adults With Multiple Sclerosis

The purpose of this scoping review is to identify self-management tasks and skills that are being taught in existing interventions for persons with multiple sclerosis and to describe intervention strategies used to facilitate the learning of self-management tasks and skills. Multiple strategies were used to search for studies published or in press between 1980 and 2008 that evaluated self-management interventions. The main exclusion criteria were case studies, inadequate description of the intervention, and traditional clinical patient education interventions. Two independent coders categorized the interventions by using Lorig and Holman's self-management framework and Abraham and Michie's taxonomy of behavior change techniques. Twenty-seven interventions were identified from 34 articles. Common intervention topics included fatigue management (n = 12), coping, depression, and stress management (n = 10), and medication management (n = 6). Also, no 2 interventions used the same delivery format to implement the same combination of intervention strategies. Furthermore, markedly different intervention strategies were used to improve the same outcomes. These results highlight a need to systematically test intervention strategies one at a time, or in a clear specified combination, as well as compare existing interventions to determine which are most effective in supporting persons with multiple sclerosis to learn and incorporate self-management tasks and skills.

Reducing the Carriage of Foodborne Pathogens in Livestock and Poultry

Several foodborne pathogens, including Salmonella species and campylobacters, are common contaminants in poultry and livestock. Typically, these pathogens are carried in the animal's intestinal tract asymptomatically; however, they can be shed in feces in large populations and be transmitted by other vectors from feces to animals, produce, or humans. A wide array of interventions has been developed to reduce the carriage of foodborne pathogens in poultry and livestock, including genetic selection of animals resistant to colonization, treatments to prevent vertical transmission of enteric pathogens, sanitation practices to prevent contamination on the farm and during transportation, elimination of pathogens from feed and water, feed and water additives that create an adverse environment for colonization by the pathogen, and biological treatments that directly or indirectly inactivate the pathogen within the host. To successfully reduce the carriage of foodborne pathogens, it is likely that a combination of intervention strategies will be required.

Patient education in the rheumatic diseases: A research agenda

Despite the explosion of research in patient education and compliance, little has been specific to rheumatology until the last few years. Many effective educational techniques can be borrowed from research on other chronic diseases. Research should be theory based, but it should also emphasize the testing of various combinations of intervention strategies. Fertile research areas include access to care, patient-provider interaction, adherence to medical regimens, and diffusion of practical educational skills among caregivers. Common limitations in research methodology are identified and addressed in this paper.