Intervention Instrument Research Articles

Put to the test: For a new sociology of testing.

In an age defined by computational innovation, testing seems to have become ubiquitous, and tests are routinely deployed as a form of governance, a marketing device, an instrument for political intervention, and an everyday practice to evaluate the self. This essay argues that something more radical is happening here than simply attempts to move tests from the laboratory into social settings. The challenge that a new sociology of testing must address is that ubiquitous testing changes the relations between science, engineering, and sociology: Engineering is today in the very stuff of where society happens. It is not that the tests of 21st‐century engineering occur within a social context but that it is the very fabric of the social that is being put to the test. To understand how testing and the social relate today, we must investigate how testing operates on social life, through the modification of its settings. One way to clarify the difference is to say that the new forms of testing can be captured neither within the logic of the field test nor of the controlled experiment. Whereas tests once happened inside social environments, today’s tests directly and deliberately modify the social environment.

Exploring the roles of the AU and ECOWAS in West African conflicts

ABSTRACT The working relationship between the African Union (AU), on the one hand, and the regional economic communities and regional mechanisms, on the other, is one of the key components of the African Peace and Security Architecture (APSA). This article investigates how the AU and the Economic Community of West African States (ECOWAS) have attempted to define their respective roles for intervention in West African conflicts. There are three instruments of intervention: diplomacy, mediation and peace support operations. Empirical analysis of interventions in conflicts in Guinea, Niger, Côte d’Ivoire, Mali and Guinea-Bissau from 2008 to 2013 shows that, after disagreeing with ECOWAS regarding appropriate approaches, the AU has gradually refrained from taking a mediation role but has continued with its diplomatic efforts. ECOWAS has continued to initiate unilateral efforts at mediation and peace support, while it attempts to coordinate its diplomatic efforts with the AU and other actors. This article outlines the differing roles of these regional entities, and analyses their developing relationship in the context of continuing conflict in West Africa.

Personalized cardiovascular intervention simulation system

BackgroundThis study proposes a series of geometry and physics modeling methods for personalized cardiovascular intervention procedures, which can be applied to a virtual endovascular simulator. MethodsBased on personalized clinical computed tomography angiography (CTA) data, mesh models of the cardiovascular system were constructed semi-automatically. By coupling 4D magnetic resonance imaging (MRI) sequences corresponding to a complete cardiac cycle with related physics models, a hybrid kinetic model of the cardiovascular system was built to drive kinematics and dynamics simulation. On that basis, the surgical procedures related to intervention instruments were simulated using specially-designed physics models. These models can be solved in real-time; therefore, the complex interactions between blood vessels and instruments can be well simulated. Additionally, X-ray imaging simulation algorithms and realistic rendering algorithms for virtual intervention scenes are also proposed. In particular, instrument tracking hardware with haptic feedback was developed to serve as the interaction interface of real instruments and the virtual intervention system. Finally, a personalized cardiovascular intervention simulation system was developed by integrating the techniques mentioned above. ResultsThis system supported instant modeling and simulation of personalized clinical data and significantly improved the visual and haptic immersions of vascular intervention simulation. ConclusionsIt can be used in teaching basic cardiology and effectively satisfying the demands of intervention training, personalized intervention planning, and rehearsing.

An integrative review of interventions promoting health-related quality of life in patients with end-stage kidney disease undergoing continuous ambulatory peritoneal dialysis

Introduction: Improving health-related quality of life (HRQoL) among patients with end-stage kidney disease (ESKD) undergoing continuous ambulatory peritoneal dialysis (CAPD) has an important outcome of nursing care, but the strategies for promoting HRQoL and tools have not been conclusive. Purpose: To examine the intervention strategies, instruments and outcomes in studies in order to improve HRQoL in patients with ESKD undergoing CAPD. Method An integrative review following the guidelines of Whittemore and Knafl (2005). Results: Five studies met the criteria used to determine the eligibility of studies to be used in this review. The intervention strategies were discharge plans, patient education, telephone follow-up, peer support, home visits, and cognitive behaviour therapy. The instruments for measuring HRQoL were SF-36 and KDQOL. All interventions could improve HRQoL. Conclusion: The promotion of HRQoL in patients with ESKD undergoing CAPD should combine more than one strategy in the intervention. The findings can be used as a reference for nurses to develop nursing interventions or caregiving protocols for ESKD patients undergoing CAPD to improve HRQoL.

What Really Works in Intervention? Using Fidelity Measures to Support Optimal Outcomes.

A critical factor to move the field of physical therapy forward is the measurement of fidelity during comparisons of interventions. Fidelity translates as "faithfulness"; thus, fidelity of intervention means faithful and correct implementation of the key components of a defined intervention. Fidelity measurement guards against deviations from, or drift in, the delivery of a targeted intervention, a process necessary for evaluating the efficacy of rehabilitation approaches. Importantly, attention to fidelity measurement differentiates rehabilitation approaches from each other. However, earlier research comparing physical therapist interventions often reported findings without careful attention to fidelity measurement. The purpose of this paper is 2-fold: (1) to support the development of intervention-specific fidelity measures in physical therapy research as the gold standard for translating research findings to clinical practice, and (2) to describe the process of creating a multi-dimensional fidelity measurement instrument in rehabilitation intervention. Improved attention to fidelity measurement will allow the rehabilitation field to communicate interventions clearly with a direct link to outcomes and target the implementation of our improved intervention for the right patient problem with the right dose and the right ingredients at the right time.

Do adolescents understand what we are asking?

The transition from school to work or study is considered a stressful time. Especially with regard to the dyadic coping with this stress of adolescents and parents, there are hardly any findings. On one hand, this has to do with the fact that stress and coping, as scientific constructs, are difficult to operationalize. On the other hand, questionnaires for adults cannot be directly transferred to adolescents. Their linguistic abilities and their lived experiences sometimes differ considerably from those of adults. Especially adolescents with poor reading and writing skills, who are often threatened by dropping out, but also many adults are overstrained with the use of complex language as used in questionnaires. Research results derived from this can be problematic if answers are not truly trustworthy due to misunderstanding or attention fatigue. This is particularly serious when intervention instruments are constructed from the results. Particularly, young people with poor reading skills or cognitive difficulties need interventions more frequently and appropriate to their needs in the context of their vocational orientation. In this paper it is assumed that linguistically appropriate instruments can be helpful in surveys. This paper therefore describes an experiment in which a validated coping inventory (SACS Strategic Approach to Coping-Style, Hobfoll 1998) was semantically adapted to the career choice phase. About 300 respondents of career-choice age were asked about their experience and coping styles during this time. Half of the group were randomly presented with a questionnaire containing items in a simplified language. The scales obtained in this way show acceptable test quality criteria for both variants, so that, after further validation, they can be used for adapted surveys.

Remediation program with automatized naming and reading for students with dyslexia: elaboration and clinical significance.

Elaborate a remediation program with rapid automatized naming and reading, as well as to verify the clinical significance of the elaborated program for students with dyslexia. The study involved five students from 3rd to the 5th grade of elementary school, aged 8 to 12 years, of both genders, with an interdisciplinary diagnosis of dyslexia. All students were submitted to pre- and post-test application of metalinguistic skills and reading test, reading comprehension and rapid automatized naming test. The analysis was performed using the JT method that allowed to verify positive or negative change and clinical significance in the post-testing. The results showed clinical significance in the tests of identification, syllable addition and combination, final and medial phoneme; in addition to nonwords repetition, real words and pseudowords reading, reading comprehension and rapid automatized naming test when comparing the pre- and post-testing. The elaborated program was efficient and applicable as an intervention instrument based on scientific evidence for students with dyslexia since it showed clinical significance for reading performance.

La expedición científica al río Huallaga (Perú, 1948) y la búsqueda de la cohesión social

Un estudio de caso, la expedición científica al Huallaga en 1948, sirve de hilo conductor a un análisis de la especificidad de las políticas de cohesión social en el Perú. A partir de fuentes institucionales, literatura profesional, obras e informes científicos se analiza el papel de la UNESCO y los saberes expertos en la definición de políticas científicas y de intervención social tendentes a lograr la cohesión social y el desarrollismo. Se muestra la importancia que tendrá el indigenismo en moldear tales presupuestos, en un periodo en el cual se fueron definiendo los saberes expertos competentes en la resolución del problema indio y la colonización amazónica, que convergería en la consolidación de la antropología aplicada a manera de instrumento clave de intervención social.

Design and rationale for a pragmatic cluster randomized trial of the Cardiovascular Health Awareness Program (CHAP) for social housing residents in Ontario and Quebec, Canada

BackgroundThe Cardiovascular Health Awareness Program (CHAP) uses volunteers to provide cardiovascular disease (CVD) and diabetes screening in a community setting, referrals to primary care providers, and locally available programs targeting lifestyle modification. CHAP has been adapted to target older adults residing in social housing, a vulnerable segment of the population. Older adults living in social housing report poorer health status and have a higher burden of a multitude of chronic illnesses, such as CVD and diabetes. The study objective is to evaluate whether there is a reduction in unplanned CVD-related Emergency Department (ED) visits and hospital admissions among residents of social seniors’ housing buildings receiving the CHAP program for 1 year compared to residents in matched buildings not receiving the program.Methods/designThis is a pragmatic, cluster randomized controlled trial in community-based social (subsidized) housing buildings in Ontario and Quebec. All residents of 14 matched pairs (intervention/control) of apartment buildings will be included. Buildings with 50–200 apartment units with the majority of residents aged 55+ and a unique postal code are included. All individuals residing within the buildings at the start of the intervention period are included (intention to treat, open cohort). The intervention instrument consists of CHAP screens for high blood pressure using automated blood pressure monitors and for diabetes using the Canadian Diabetes Risk (CANRISK) assessment tool. Monthly drop-in sessions for screening/monitoring are held within a common area of the building. Group health education sessions are also held monthly. Reports are sent to family doctors, and attendees are encouraged to visit their family doctor. The primary outcome measure is monthly CVD-related ED visits and hospitalizations over a 1-year period post randomization. Secondary outcomes are all ED visits, hospitalizations, quality of life, cost-effectiveness, and participant experience.DiscussionIt is anticipated that CVD-related ED visits and hospitalizations will decrease in the intervention buildings. Using the volunteer-led CHAP program, there is significant opportunity to improve the health of older adults in social housing.Trial registrationClinicalTrials.gov,NCT03549845. Registered on 15 May 2018. Updated on 21 May 2019.

DEVELOPMENT OF PERFORMANCE EVALUATION THEME: A SYSTEMATIC ANALYSIS OF THE LITERATURE

This research aimed to identify the development of literature on performance evaluation. It is an exploratory and descriptive research study, with a quali-quantitative approach through bibliometric analysis, using the ProKnow-C intervention instrument. The analyses showed that the main featured article was by Neely, Gregory and Platts (1995). The most influential article in the portfolio was Bourne et al. (2000), with the highest level of betweenness. The Balanced Scorecard is the tool that predominates in 23% of studies; in 30% of the works, was developed by proposing models based on the literature while in 24% of them it was based on a proposal developed by the authors. The study contributed to broaden the knowledge about the subject in order to allow an overview of the literature, when knowing the main authors working on the theme, periodicals, articles, themes, tools and areas of practice. Emerging views on the subject are also presented.

Texture differentiation using audio signal analysis with robotic interventional instruments

Robotic minimally invasive surgery (RMIS) has played an important role in the last decades. In traditional surgery, surgeons rely on palpation using their hands. However, during RMIS, surgeons use the visual-haptics technique to compensate the missing sense of touch. Various sensors have been widely used to retrieve this natural sense, but there are still issues like integration, costs, sterilization and the small sensing area that prevent such approaches from being applied. A new method based on acoustic emission has been recently proposed for acquiring audio information from tool-tissue interaction during minimally invasive procedures that provide user guidance feedback. In this work the concept was adapted for acquiring audio information from a RMIS grasper and a first proof of concept is presented. Interactions of the grasper with various artificial and biological texture samples were recorded and analyzed using advanced signal processing and a clear correlation between audio spectral components and the tested texture were identified.

Saúde humanizada: questões de língua e discurso

El proyecto “El Diálogo como Instrumento de Intervención de Profesionales de la Salud en la Relación con Pacientes” fue ejecutado en Unidades Básicas de Salud del Programa de Salud de la Familia en cinco municipios del Ceará, con profesionales de salud y pacientes. La metodología adoptada fue la etnografía discursiva, fundamentada por el Análisis de Discurso Crítico, principal-mente por los trabajos de Fairclough (2001, 2003, 2010), Magalhães (2000, 2004, 2005, 2011) y Magalhães et al (2017). El objetivo de este artículo fue analizar problemas y soluciones en la interacción entre profesionales de salud y pacientes, em Crato y Salitre. Los resultados encontrados fueron: 1) hay un problema de comprensión de las recetas; 2) las prácticas humanizadas son casi inexistentes, perjudicando objetivos de HumanizaSUS; y 3) hay una preocupación de enfermeros/as en ofrecer una atención humana; 4) los discursos de la salud tienem uma relación importante con las práticas de salud.

The development of implementation management instruments for a new complex stroke caregiver intervention based on systematic stakeholder and risk analyses.

Stakeholders are important contributors in the implementation of a complex public health intervention. During the development phase of an implementation, alongside careful design of its components and investing in the exploration of the dynamic multi-stakeholder stroke rehabilitation setting, it is essential to assess possible implementation risks. Systematic stakeholder and risk analyses can guide the exploration process and enable teams involved in complex interventions to develop context-tailored implementation management instruments. To develop instruments that facilitate the implementation of the complex stroke caregiver intervention project in the real-life support system. Systematic stakeholder and risk analyses were conducted composing five activities. Project stakeholders were identified, classified and assessed using a top-down approach, while implementation risks were identified and assessed by applying a bottom-up approach. Data were collected through interviews and focus groups. Based on the knowledge provided by the stakeholders, two context-tailored implementation management instruments were designed with a top-down approach: (1) a comprehensive 'stakeholder-risk atlas' providing individual stakeholder information, such as role, access, contribution, power and interest, expectations, perceived risks and specific engagement activities and (2) an overall 'project implementation strategy' concentrating on communication, transparency, network building and professionalism. Complex interventions will benefit from early and comprehensive stakeholder and risk analyses. The early involvement of stakeholders, with their insightful knowledge, enables the research team to develop context-tailored implementation management instruments. Instruments will support the team during implementation and may impact positively on the outcome of the intervention. Knowledge can be obtained by combining top-down and bottom-up working approaches.

Between Competitiveness and Sustainability? Achievements and Dilemmas of Regional Policy in the Context of Economic Development of Rural Regions: the Case of Poland

A clear long-term economic trend is the concentration of capital and settlement. These processes increasingly include development centres located in cities and their functional areas. In turn, many peripheral areas, including rural areas, are subject to socio-economic marginalization. As a result, the inter-regional and intra-regional disparities in wealth and quality of life become more visible and deepen. Increasing spatial differences are confront with numerous scientific explanations and remedies, which usually are translated into different strategies and practices of regional policy. Regional policy actions assume a different scope, objectives, instruments of intervention and could be categorized as a policy based on the paradigm of competitiveness (polarisation) or sustainability. The aim of the paper was to determine the level of economic disparities between urban and rural regions in Poland in the context of assessment of implemented regional policy. In the paper selected approaches to supporting rural development in regional policy, namely the perspectives based on the paradigm of competitiveness and sustainability were characterised. The analyses carried out documented the differences in the intensity of support of EU Cohesion Policy tools per capita in favour of urban regions. Even though the value of financial support from EU funds was positively correlated with the level of regional development, there was no statistically significant impact of this intervention on the processes of economic convergence and divergence. The conclusions presented in the study were based on the analysis of the Eurostat data gathered for 72 Polish sub-regions in 2007-2015. For the purpose of the study the statistical methods (i.e. descriptive statistics, measures of economic convergence), as well as the content analysis of strategic documents were used. Key words: rural regions, competitiveness, sustainability, economic development, regional policy

Microalgal Derivatives as Potential Nutraceutical and Food Supplements for Human Health: A Focus on Cancer Prevention and Interception.

Epidemiological studies are providing strong evidence on beneficial health effects from dietary measures, leading scientists to actively investigate which foods and which specific agents in the diet can prevent diseases. Public health officers and medical experts should collaborate toward the design of disease prevention diets for nutritional intervention. Functional foods are emerging as an instrument for dietary intervention in disease prevention. Functional food products are technologically developed ingredients with specific health benefits. Among promising sources of functional foods and chemopreventive diets of interest, microalgae are gaining worldwide attention, based on their richness in high-value products, including carotenoids, proteins, vitamins, essential amino acids, omega-rich oils and, in general, anti-inflammatory and antioxidant compounds. Beneficial effects of microalgae on human health and/or wellness could in the future be useful in preventing or delaying the onset of cancer and cardiovascular diseases. During the past decades, microalgal biomass was predominately used in the health food market, with more than 75% of the annual microalgal biomass production being employed for the manufacture of powders, tablets, capsules or pastilles. In this review, we report and discuss the present and future role of microalgae as marine sources of functional foods/beverages for human wellbeing, focusing on perspectives in chemoprevention. We dissected this topic by analyzing the different classes of microalgal compounds with health outputs (based on their potential chemoprevention activities), the biodiversity of microalgal species and how to improve their cultivation, exploring the perspective of sustainable food from the sea.

High-Performance Continuous Hydraulic Motor for MR Safe Robotic Teleoperation

Magnetic resonance imaging (MRI) guided intervention has drawn increasing attention over the last decade. It is accredited to the capability of monitoring any physiological change of soft tissue with the high-contrast MR images. This also gives rise to the demand for precise tele-manipulation of interventional instruments. However, there is still lack of choices of MR safe actuators that provide high-fidelity robot manipulation. In this letter, we present a three-cylinder hydraulic motor using rolling-diaphragm-sealed cylinders, which can provide continuous bidirectional rotation with unlimited range. Both kinematics and dynamics models of the presented motor were studied, which facilitate its overall design optimization and position/torque control. Motor performance, such as step response, frequency response, and accuracy, were experimentally evaluated. We also integrate the motor into our catheter robot prototype designed for intra-operative MRI-guided cardiac electrophysiology (EP), which can provide full degree-of-freedom and precise manipulation of a standard EP catheter.

Ordenación de las actividades económicas tras las sentencias del Tribunal Constitucional sobre la Ley de Unidad de Mercado

El Tribunal Constitucional, a través de varias Sentencias dictadas en 2017, ha declarado la inconstitucionalidad de los artículos de la Ley de Garantía de la Unidad de Mercado reguladores del principio de eficacia en todo el territorio nacional de los medios de intervención administrativa sobre el acceso a las actividades económicas, así como otros preceptos por su conexión con el mismo. En la primera parte del trabajo se examinan los motivos de inconstitucionalidad alegados por el Tribunal y se hace una valoración del impacto y alcance fáctico que conlleva dicha anulación. En segundo lugar, se estudia el sistema de ordenación de las actividades económicas dispuesto en la mencionada Ley, –que en su mayor parte, por el contrario, ha sido avalado por el TC–, abordando la explicación del esquema de instrumentos de intervención de las actividades y sus límites, el ámbito de disposición de requisitos o condiciones materiales ligados al ejercicio de las mismas, finalizando con el examen de ciertas actuaciones específicas que la propia Ley califica como limitaciones no admitidas.

The instruments of public policy. A transdisciplinary look

The implementation of public policies involves knowing and analyzing the different instruments of public intervention from a transdisciplinary perspective involving legal, economic and political aspects, as this allows to broaden the understanding of the tools available to deal with public issues. In this sense, this paper seeks to present in an integrative and systematic way what have disciplines such as public law, the economy of the public sector and the political sciences, especially public policies, understood for public policy instruments. It takes a particular look at this latter approach and shows why this is the most comprehensive approach. Regarding the methodology, this text is the product of qualitative, theoretical, descriptive and exploratory research of a documentary nature. Among the main findings, intervention instruments were found to guide human behavior towards achieving certain public objectives, constitute the rules of the game and, therefore, serve as institutions that illuminate public action. They are also tools to correct market failures and achieve economic efficiency. Nevertheless, they are not limited to the formal technical and institutional two-dimensional nature of economics and law. Nowadays, the study of intervention instruments must be done in accordance with public policies; it must enable progressing towards context-sensitive governments, the diversity of actors, more active citizenship and the particularities of public affairs.

Systematic screening and assessment of psychosocial well-being and care needs of people with cancer.

Systematic screening and assessment of psychosocial well-being and care needs of people with cancer.

Complications of Corrective Surgery in Preterm Neonates with Congenital Heart Defects: What is the Solution?

Mild congenital heart defects require no treatment, while severe forms of these diseases need immediate interventions. There are several limits in preterm neonates on drug interventions, interventional procedures, and even heart surgery due to the prematurity of pulmonary, renal, and central nervous systems. Considering the mentioned points, the collaboration of other medical professions, particularly neonatologists, is needed in the treatment of these newborns. The application of surgical and interventional instruments are associated with limitations owing to the low birth weight in these neonates. Therefore, it is essential to review and modify the treatment program for this group of patients. By the advancement of surgical treatments mainly in fetal course and the approval of their efficiency, designing a new interdisciplinary field is necessary. In developing countries, such as Iran, the prenatal diagnosis of congenital heart diseases is difficult because of the lack of expertise in this area. On the other hand, abortion seems to be problematic due to the religious reasons. The legal gestational age for abortion is less than 20 weeks, and the probability of dealing with these kinds of diseases is more than developed countries. During several years, we encountered at least 15 cases with the above-mentioned criteria, five of whom required an immediate intervention. Three patients were dextro-Transpotion of the great arteries, one patient had pulmonary atresia with ventricular septal defect, and the two other ones were suffering from coarctation of the aorta and tricuspid atresia type 1A, who all underwent the palliative surgery.