Improvements In Other Outcomes Research Articles

The effectiveness of interprofessional education in university based health professional programs: A systematic review

The effectiveness of interprofessional education in university based health professional programs: A systematic review

The effectiveness of interprofessional education in university based health professional programs: A systematic review.

The effectiveness of interprofessional education in university based health professional programs: A systematic review.

Prevention of bronchopulmonary dysplasia

Considerable effort has been devoted to the development of strategies to reduce the incidence of bronchopulmonary dysplasia (BPD), including use of medications, nutritional therapies, and respiratory care practices. Unfortunately, most of these strategies have not been successful. To date, the only two treatments developed specifically to prevent BPD whose efficacy is supported by evidence from randomized, controlled trials are the parenteral administration of vitamin A and corticosteroids. Two other therapies, the use of caffeine for the treatment of apnea of prematurity and aggressive phototherapy for the treatment of hyperbilirubinemia, were evaluated for the improvement of other outcomes and found to reduce BPD. Cohort studies suggest that the use of continuous positive airway pressure as a strategy for avoiding mechanical ventilation might also be beneficial. Other therapies reduce lung injury in animal models but do not appear to reduce BPD in humans. The benefits of the efficacious therapies have been modest, with an absolute risk reduction in the 7-11% range. Further preventive strategies are needed to reduce the burden of this disease. However, each will need to be tested in randomized, controlled trials, and the expectations of new therapies should be modest reductions of the incidence of the disease.

A review of the literature on the effectiveness of housing and support, assertive community treatment, and intensive case management interventions for persons with mental illness who have been homeless.

A review of 16 controlled outcome evaluations of housing and support interventions for people with mental illness who have been homeless revealed significant reductions in homelessness and hospitalization and improvements in other outcomes (e.g., well-being) resulting from programs that provided permanent housing and support, assertive community treatment (ACT), and intensive case management (ICM). The best outcomes for housing stability were found for programs that combined housing and support (effect size = .67), followed by ACT alone (effect size = .47), while the weakest outcomes were found for ICM programs alone (effect size = .28). The results of this review were discussed in terms of their implications for policy, practice, and future research.

“New Choices” for substance‐using mothers and their children: Preliminary evaluation

Setting, participants, intervention and measurement: New Choices is a centralized “one‐stop shop” in Hamilton, Ontario, Canada, that provides multiple services in a supportive environment for substance‐using women and their young children. Measures of substance use, social support, mental health, nutrition, parenting and child development were administered to 13 women (21–36 years old) and their 13 children (0–5 years old) when they entered the programme, and at 3 and 6 months thereafter.Findings: Results revealed a significant improvement in maternal empathy at 3 months and children's social competence at 6 months, and a decrease in maternal support of children's power and independence that was significant at 3 months but not at 6 months. Improvements in other outcomes were not statistically significant, but effect sizes were promising. Results showed more improvements after 6 than 3 months, suggesting that length of programme involvement may be an important factor in outcome.Conclusions: The findings from this small pilot study suggest that a “one‐stop” intervention for substance‐using mothers and their children might have a positive impact on many outcomes. This evaluation involved a small cohort sample, no comparison group and parent‐report measures only, so it should be viewed as exploratory and interpretation of findings made cautiously.

A Randomized Intervention to Improve Heart Failure Outcomes in Community-Based Home Health Care

ABSTRACT This study examines the effects of a home health intervention designed to standardize nursing care, strengthen nurses' support for patient self-management and yield better CHF patient outcomes. Participants were 371 Medicare CHF patients served by 205 nurses randomized to intervention and control groups in a large urban home health care agency (HHA). The intervention consisted of an evidence-based nursing protocol, patient self-care guide, and training to improve nurses' teaching and support skills. Outcome measures included home care, physician and emergency department (ED) use, hospital admission, condition-specific quality of life (QoL), satisfaction with home care services and survival at 90 days. The intervention was associated with a marginally significant reduction in the volume of skilled nursing visits (p = .074), and a reduction variation in the typical number of visits provided (p < .05), without a significant increase in physician or ED use or patient mortality. Hypothesized improvement in other outcomes did not occur.

Preliminary outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type 2 diabetes

The First Step Program uses simple and inexpensive pedometers to incrementally increase walking behaviors in sedentary individuals with type 2 diabetes. The pilot sample consisted of nine individuals (six women, three men; group mean age 53±6; group mean body mass index=32.9±3.4 kg/m 2). A timed self-paced walk while wearing the pedometer allowed for the conversion of changes in pedometer steps per day to time in minutes per day. There was an immediate and dramatic increase in walking behavior (an average of 34.3 min of walking a day) that was sustained even 2 months post-intervention and after withdrawal of contact (an average of 22.6 min of walking a day). Improvements in other outcomes (systolic blood pressure and waist girth) support a valid change in behavior. Although preliminary, these results warrant further investigation of such approaches.