Types Of Intervention Approaches Research Articles

Defining "successful" treatment outcomes in adolescent idiopathic scoliosis: a scoping review.

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis that affects children aged 10-18years old, manifesting in a three-dimensional spinal deformity. This study aimed to explore outcome measures used in defining AIS treatment success. Particularly, analyzing the extent of qualitative and quantitative (radiographic and quality of life domains) measures to evaluate AIS and whether AIS treatment approaches (surgical, bracing and physiotherapy) influences outcomes used as proxies of treatment success. EMBASE and MEDLINE databases were used to conduct a systematic scoping review with 654 search queries. 158 papers met the inclusion criteria and were screened for data extraction. Extractable variables included: study characteristics, study participant characteristics, type of study, type of intervention approach and outcome measures. All 158 studies measured quantitative outcomes. 61.38% of papers used radiographic outcomes whilst 38.62% of papers used quantitative quality of life outcomes to evaluate treatment success. Irrespective of treatment intervention utilized, the type of quantitative outcome measure recorded were similar in proportion. Moreover, of the radiographic outcome measures, the subcategory Cobb angle was predominantly used across all intervention approaches. For quantitative quality of life measures, questionnaires investigating multiple domains such as SRS were primarily used as proxies of AIS treatment success across all intervention approaches. This study identified that no articles employed qualitative measures of describing the psychosocial implications of AIS in defining treatment success. Although quantitative measures have merit in clinical diagnoses and management, there is increasing value in using qualitative methods such as thematic analysis in guiding clinicians to develop a biopsychosocial approach for patient care.

Self-Stigma Reduction Interventions for People Living with HIV/AIDS and Their Families: A Systematic Review.

Stigma is a primary concern for people living with human immunodeficiency virus (HIV)/AIDS (PLWHA), and has great impact on their and their family members' health. While previous reviews have largely focused on the public stigma, this systematic review aims to evaluate the impact of HIV/acquired immunodeficiency syndrome (AIDS)-related self-stigma reduction interventions among PLWHA and their families. A literature search using eight databases found 23 studies meeting the inclusion criteria. Five types of intervention approaches were identified: (1) psycho-educational intervention, (2) supportive intervention for treatment adherence (antiretroviral therapy), (3) psychotherapy intervention, (4) narrative intervention, and (5) community participation intervention. Overall, the reviewed articles suggested a general trend of promising effectiveness of these interventions for PLWHA and their family members. Psycho-educational interventions were the main approach. The results highlighted the need for more interventions targeting family members of PLWHA, and mixed-methods intervention studies.

Minimally invasive versus full sternotomy aortic valve replacement in low-risk patients: Which will stand against transcatheter aortic valve replacement?

BackgroundMinimally invasive aortic valve replacement using upper-hemisternotomy has been associated with improved results compared to full sternotomy aortic valve replacement. Given the likely expansion of transcatheter aortic valve replacement to low-risk patients, we examine contemporary outcomes after full sternotomy and minimally invasive aortic valve replacement in low-risk patients using our 15-year experience. MethodsTwo thousand ninety-five low-risk patients (Society of Thoracic Surgeons Predicted Risk of Mortality score <4) underwent elective isolated aortic valve replacement, including 1,029 (49%) minimally invasive and 1,066 (51%) full sternotomy, from 2002 to 2015. ResultsCompared to minimally invasive aortic valve replacement patients, full sternotomy aortic valve replacement patients had a greater burden of comorbidities, including diabetes, stroke, congestive heart failure, and predicted risk of mortality (all P ≤ .05). Operative mortality, stroke, and reoperation rates for bleeding were similar. There was a clinical trend toward shorter median intensive care unit stay and significantly shorter hospital length of stay among minimally invasive aortic valve replacement patients. Adjusted survival analysis identified age, chronic kidney disease, prior sternotomy, and congestive heart failure as predictors of decreased survival (all P ≤ .05), while type of intervention approach was nonsignificantly different. ConclusionIn low-risk patients, minimally invasive aortic valve replacement results in similar mortality, stroke, reoperation rates for bleeding, and midterm survival (after adjusting for confounders), but shorter hospital length of stay and a trend (P = .075) toward shorter intensive care unit stay, compared to full sternotomy aortic valve replacement. Therefore, minimally invasive aortic valve replacement should stand as a benchmark against transcatheter aortic valve replacement in these patients.

Effects of multimodal communication program on patients with chronic aphasia: a single-subject A-B-A design study.

Background and aimAphasia as a common consequence of stroke, is an acquired neurologic communication disorder that can affect symbol language processing. Different types of intervention approaches have been introduced. Multimodal Communication Program (MCP) is a new augmentative alternative communication approach in chronic aphasia. The aim of this study was to investigate the effect of MCP on communication skills of patients with chronic aphasia.MethodsThis prospective, single subject, A-B-A design study was done during 2016 in Semnan, Iran. Participants were two patients with severe aphasia with a single left-hemisphere stroke. Three phases, including baseline, intervention and follow-up were administered. The patients received nine-hour intervention, over 10 working days.ResultsThree different scores were calculated for each patient: verbal efforts, the frequency of each modality and the accuracy of switching between modalities and the reaction time. The frequency of verbal modality increased for both patients. They could switch between modalities more successfully than before the intervention. The results for the reaction time, however were challenging. The onset reaction time decreased for patient 1, and increased during switching between modalities, and patient 2 showed the opposite.ConclusionThe MCP can improve the communication skills in patients with chronic post stroke aphasia. However, some factors, such as reduction of the patients’ reaction time is probably related to the amount of allocated resources during intervention.Trial registrationThe trial was registered at IRCT center with ID: IRCT2016032325194N3.FundingThe study was financed by Semnan University of Medical Sciences (Grant no.: A-10-333-3).

Effects of telehealth by allied health professionals and nurses in rural and remote areas: A systematic review and meta-analysis.

To describe telehealth interventions delivered by allied health professionals and nurses in rural and remote areas, and to compare the effects of telehealth interventions with standard face-to-face interventions. CINAHL, Embase, PsycINFO and PubMed databases were searched. The content of relevant journals and published articles were also searched. Studies examining the effectiveness of allied health and nursing telehealth interventions for rural and remote populations were included in descriptive analyses. Studies comparing telehealth intervention with standard face-to-face interventions grouped by type of intervention approach were used to examine between-groups effect sizes. Methodological quality of studies was rated using the QualSyst critical appraisal tool and the National Health and Medical Research Council (NHMRC) Evidence Hierarchy levels. After quality ratings, 43 studies were included. A majority of studies had strong methodological quality. The disciplines of psychology and nursing were represented most frequently, as were studies using a cognitive intervention approach. Meta-analysis results slightly favoured telehealth interventions compared with face-to-face interventions, but did not show significant differences. Interventions using a combined physical and cognitive approach appeared to be more effective. Telehealth services may be as effective as face-to-face interventions, which is encouraging given the potential benefits of telehealth in rural and remote areas with regards to healthcare access and time and cost savings.

Interventions to increase adherence to medications for tobacco dependence.

Interventions to increase adherence to medications for tobacco dependence.

International review of the evidence on best practice in educational provision for children on the autism spectrum

There is considerable debate regarding the most appropriate and effective ways of supporting the learning of children and young people on the autism spectrum. This international review provides a synthesis of empirical research and expert evidence (dated 2002–2008) to identify best practice in educational provision for these children. Five bibliographic databases were systematically searched using clearly defined keywords, and abstracts assessed according to explicit inclusion and exclusion criteria; 92 research papers that focused on children and young people were included. Expert evidence was drawn from policy documents and government strategies, or research reports, from the UK and Ireland. Findings show that there is insufficiently strong evidence regarding the effectiveness of one type of intervention approach compared with another. A range of educational provision should be maintained in order to cater appropriately for a wide diversity of needs. Interventions most often researched were those involving intensive behavioural techniques and some studies showed these can be successful in teaching specific skills to some children. There was limited evidence regarding the needs of older children as well as consideration of educational provision more widely, including the effects of type of setting (as distinct from a specific type of intervention or learning approach). More research is needed on other types of educational interventions currently used by parents and in schools as well as greater collaboration between researchers and practitioners to establish what works best for children and young people on the autism spectrum.

International Perspectives On Individual And Community Approaches To The Prevention Of Sexually Transmitted Disease And Human Immunodeficiency Virus Infection

Risks for sexually transmitted disease (STD) and human immunodeficiency virus (HIV) infection have been addressed in two categories: the individual and the population. Emphasis in STD and HIV prevention has largely been placed on the first, with interventions that address individuals and attempt to bring about changes in individuals being the norm. The relative ease of evaluating these interventions and the ability to know that they have been delivered as intended make these interventions attractive. Community interventions are more difficult to manage and to evaluate but are nonetheless commonly used. Structural interventions that address the environment in which risk behavior takes place are also possible but used much less frequently. In a comprehensive intervention program for STD and HIV prevention, it is necessary to consider opportunities for all three types of intervention approaches.