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Results for “virtual intervention”

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At least 289 records · Page 16Linked to original sources

PubMed2026

Sustained effects of auricular point acupressure on chemotherapy-induced neuropathy: a randomized controlled trial follow-up study.

PURPOSE: Chemotherapy-induced neuropathy (CIN) is a persistent condition that impairs function and quality of life. Auricular point acupressure (APA) has shown short-term benefit for CIN, but the durability of these effects after treatment completion is unknown. This study evaluated the sustainability of symptom improvements for 3 months following a 4-week APA intervention. METHODS: This prespecified secondary analysis of a randomized wait-list controlled trial compared mobile-supported APA (mAPA) and virtual APA (vAPA) in adults with moderate or greater CIN who received APA during the initial treatment phase (mAPA, n = 80; vAPA, n = 75). Outcomes at 1, 2, and 3 months post-intervention were analyzed using generalized estimating equations with multiple imputation. The primary outcome was CIN severity, measured with an individualized composite outcome (ICO); the secondary outcome was CIN interference. RESULTS: Reductions in CIN severity and interference were maintained throughout follow-up in both groups (all p < .001). ICO scores decreased by 3.10, 3.36, and 3.61 points in mAPA and by 2.88, 2.90, and 3.21 points in vAPA at 1, 2, and 3 months, respectively. Benefits were maintained post-treatment, with higher retention in the mAPA group. CONCLUSIONS: Improvements in CIN severity and interference after APA were sustained for up to 3 months post-treatment, suggesting a durable benefit as a self-management strategy. Larger studies with longer follow-up and untreated comparison groups are needed. IMPLICATIONS FOR CANCER SURVIVORS: APA may offer survivors a durable, self-administered, nonpharmacologic option for managing CIN well beyond active treatment, without requiring ongoing clinical visits. TRIAL REGISTRATION: ClinicalTrials.gov, ID NCT04920097 registered on 3 June 2021.

Acupressure↗

PubMedDate not supplied

The three-year incidence of non-B viral hepatitis morbidity in a controlled trial of pre-exposure immune serum globulin prophylaxis.

A trial of pre-exposure immune serum globulin (ISG) vs. the prevailing policy of post-exposure ISG for the prevention of viral hepatitis was undertaken among 23,447 male and female military recruits in Israel, an endemic area for hepatitis A virus infection. We are reporting on the three-year follow-up of the incidence of non-B hepatitis among 12,835 male recruits, half of whom had been allocated to receive ISG on their first day of service, while the other half served as a non-vaccinated ("regular care") control group. Over the three-year period the overall cumulative incidence in the intervention group was half that of the control group (3.6 per 1000 vs. 7.2 per 1000; p = 0.0037). Protection was virtually absolute for up to nine months' follow-up. ISG may have provided prolonged partial protection well in excess of six to nine months. Between 10 to 18 months, half as many cases occurred in the intervention group as in the controls. By 18 months the difference in incidence between the study groups had reached a plateau and was highly significant (p = 0.002). Between 19 and 36 months the case increment in the two groups was similar. The benefit of receiving pre-exposure ISG remained evident three years after inception of the trial in this indigenous military population living in an endemic area.

Clinical Trials as Topic↗

PubMed2004

Preoperative evaluation of submucosal myoma by virtual hysteroscopy.

STUDY OBJECTIVE: To assess the utility of a new technique called virtual hysteroscopy in the evaluation of the size and location of submucosal myomas before hysteroscopic myomectomy. DESIGN: Retrospective analysis (Canadian Task Force classification II-1). SETTING: Department of gynecology at a general hospital. PATIENTS: Thirteen consecutive women. INTERVENTION: Sixteen-slice computed tomography (CT) scanner. MEASUREMENTS AND MAIN RESULTS: Thirteen women with submucosal myomas were examined by virtual hysteroscopy. The lesions were filmed by multislice CT scanner, immediately after CO2 injection into the uterine cavity with an intravenous dosage of iodide contrast media. The filmed image was subsequently reconstituted and analyzed by endoscopy mode and volume mode using three-dimensional computer graphics software. The size and depth of invasion of the submucosal myoma were clearly identified by the procedure. CONCLUSION: Accurate preoperative evaluation of the size and location of submucosal myomas before hysteroscopic myomectomy is important for a safe surgical procedure. Virtual hysteroscopy can provide such information with good reproducibility and is superior to previously described diagnostic procedures.

Adult↗

PubMed2003

A virtual reality system for the training of volunteers involved in health emergency situations.

In order to guarantee an effective and punctual medical intervention to injured people involved in health emergency situations, where usually both professional and non-professional health operators are involved, a fast and accurate treatment has to be carried out. In case of catastrophic or very critical situations, non-professional operators who did not receive proper training (volunteers are among them) could be affected by psychological inhibitions. Their performances could slow down in such way that would affect the quality of the treatment and increase both direct and indirect costs. Our virtual reality system that is currently in use at the health care emergency center of San Martino Hospital in Genoa, Italy, has been designed and developed to check health emergency operators' capabilities to adopt correct decision-making procedures, to make optimal use of new technological equipment and to overcome psychological barriers. Our system is composed of (1) a high-end simulation PC, whose main functions are execution of the main software module, rendering of 3D scenes in stereo mode, rendering of sound, and control of data transmission from/to VR devices; (2) a low-end control PC, which controls the VR simulation running on the simulation PC, manages medical emergency simulation scenarios, introduces unexpected events to the simulation and controls the simulation difficulty level; (3) a magnetic-based motion tracking device used for head and hand tracking; (4) a wireless pair of shutter glasses together with a cathode ray tube wall projector; and (5) a high-end surround sound system. The expected benefits have been verified through the design and implementation of controlled clinical trials.

Clinical Trials as Topic↗

PubMed1980

Complimentary roles of cardiac ultrasound and cardiovascular nuclear medicine.

This review is directed at the clinically useful highlights of ultrasound and radionuclide testing in adults with coronary and valvular heart disease, intracardiac shunts, and hypertrophic and congestive cardiomyopathies. As a clinical toto, the radionuclide procedures are currently more useful than ultrasound examination in evaluating patients with known or suspected coronary artery disease. This includes both primary diagnosis and the more accurate estimation of left ventricular function in the presence of segmental asynergy. In patients with valvular disease, the radionuclide procedures are only indirectly useful, while the ultrasound examination is more often diagnostic. These two techniques are complimentary to one another in their ability to noninvasively evaluate and monitor both chamber size and ventricular function in virtually all patients. Recent research involving noninvasive ventricular imaging during physiologic and pharmacologic intervention holds promise for a more sophisticated noninvasive approach to patient management.

Aortic Dissection↗

PubMed2001

An illustrated guide to the methods of meta-analysis.

Meta-analysis is now accepted as a necessary tool for the evaluation of health care. Such analyses have been carried out in virtually every area of medicine to evaluate a wide spectrum of health care interventions and policies. This paper has three broad aims: (1) to describe the basic principles of meta-analysis, using a meta-analysis of interventions intended to reduce hospital re-admission rates for illustration; (2) to consider threats to the internal validity of meta-analysis, and the measures which can be taken to minimize their impact; and (3) to present an overview of more specialist and developing methods for synthesizing data, with the intention of outlining the directions meta-analysis may take in the future. The methods used to synthesize studies, which take 'weighted averages' of effect sizes have been refined to a high degree, while the methods for dealing with threats to the validity of meta-analyses such as publication bias, and variations in quality of the primary studies, are at a less advanced stage. However, many consider this standard 'weighted average' approach to meta-analysis not to be 'state of the art' in at least some situations, where the use of more sophisticated methods, generally to explain variation in estimates from different studies and synthesize a broader base of evidence, would be advantageous. Currently, approaches which attempt to do this are mainly still in the experimental stage and, unfortunately, ideas which sound natural and appealing are often difficult to implement in practice. Clearly, it will be some time before they are used routinely, but significant steps have been made.

Bayes Theorem↗

PubMedDate not supplied

Computer addiction: implications for nursing psychotherapy practice.

TOPIC: Nurse psychotherapists will encounter the impact of today's technology on the daily lives of people including computer addiction. Computer addiction may also present with comorbidities such as depression, gambling, substance abuse, and marital infidelity and divorce. PURPOSE: This overview article presents what is currently documented in the literature regarding the incidence, symptomatology, and nursing psychotherapy interventions relevant to computer addiction and its treatment. Issues presented include computer addiction, virtual relationships, online marital infidelity, and compulsive online sexual behavior. SOURCES: Review of literature from Medline, Psychoinfo, CINAHL, and current texts. CONCLUSIONS: Given the increased use of computers in today's society, there is the potential for overuse of technology and neglect of others and self as a result of computer addiction. Computer disorders also present themselves as marital or couple discord with the potential for online extramarital affairs and compulsive sexual online behavior. A summary and an assessment tool are provided to guide the nurse psychotherapist in practice.

Behavior, Addictive↗

PubMed1994

An overview of nine decades of group psychotherapy.

Group psychotherapy has experienced unprecedented growth in the nine decades of its existence. Begun by a Boston physician in 1905 as a "class" for his patients with tuberculosis, it has achieved international recognition as an effective modality for the treatment of emotionally impaired children, adolescents, adults, and the elderly. Group psychotherapy's first growth spurt occurred during World War II, when understaffed military hospitals in both the United States and England were forced to use group treatment measures to attend to the large number of psychiatric casualties. In the 1960s the community mental health centers movement, with its mandate to serve many people in large catchment areas, became another impetus for the employment of group approaches in both remedial and preventive contexts. Group intervention measures, ranging from clinical group psychotherapy to derivative approaches, have expanded to virtually all human services. They are bound to play a major role in the current move toward managed health care, with its emphasis on cost containment and accountability.

Adolescent↗

PubMed2005

Treatment of adults with recurrent malignant glioma.

Virtually all malignant gliomas recur. Treatment options at recurrence have relied upon surgical intervention, radiation therapy or cytotoxic chemotherapy. Unfortunately, none are associated with significant improvements in survival. Advances in treatment options at recurrence have been dependent upon the combination of surgical resection, focal radiation and chemotherapy. Despite aggressive interventions, few patients have meaningful improvements. Current research focuses on novel targeted molecular therapy that will hopeful be able to take advantage of advances in our understanding of the biology of glial neoplasms.

Adult↗

PubMed2002

Assessing the environmental impact of WWTP expansion: odour nuisance and its minimization.

As part of the effort to provide proper wastewater disposal for the City of Milan, the expansion of the WWTP located in Peschiera Borromeo has been planned and is currently under completion. The plant, sized for a population of less than 300,000, will soon treat the wastes from the south-east areas of Milan for a total capacity of over 500,000 p.e. The paper describes the approach to find a satisfactory solution of an alleged odour problem that is slowing down the completion of the plant restructuring. This included a survey of the existing plant and analysis of its final design, identification of odour emission sources and their quantification, and the examination of different alternatives for odour abatement. These were carried out using air quality modelling techniques consisting of dynamic, continuous "puff" models capable of reproducing diffusion even at very low pollutant concentrations. Several intervention hypotheses were tested and compared with the few existing regulatory norms and guidelines for odour pollution. In all but the minimum and the no-action hypotheses, proposed actions would results in a drastic reduction of nuisance effects at the receptors. Under the strongest intervention hypothesis (the one adopted by the WWTP agency), odour impact would be virtually eliminated.

Data Collection↗

PubMed2003

[The small epidemiologic transition: further decrease in infant mortality due to medical intervention during pregnancy and childbirth, yet no decrease in childhood disabilities].

The small epidemiologic transition, which started to occur during the 1960s, was a continuation of the large epidemiologic transition. The large epidemiologic transition concerned a strong increase in the life expectancy as a result of the virtual disappearance of mortality during the early life years. During the most recent stage of this epidemiologic transition, two types of medical intervention in pregnancy and childbirth were introduced: antenatal screening and diagnosis followed by selective abortion, and neonatal intensive care for preterm babies. These two types of intervention have opposite epidemiologic effects. On the one hand these have led to a further decrease in the mortality. Yet, on the other hand the prevalence of childhood disabilities has scarcely decreased or has not decreased at all, because intensive interventions after childbirth can lead to more disabilities occurring in the population than those removed due to selective abortion. The small epidemiologic transition has arisen from an expansion in knowledge and possibilities to observe and intervene. These have indeed led to an increase in options before, during and after pregnancy, but not to a reduced morbidity at the start of life.

Child↗

PubMed2002

Magnetic resonance imaging-based virtual endoscopy of inner ear pathology.

OBJECTIVE: To study the feasibility of high-resolution magnetic resonance imaging (MRI)-based virtual endoscopy of the labyrinth to assess subtle inner ear pathology. STUDY DESIGN: A retrospective case review of patient with known inner ear pathology to determine the feasibility and clinical value of MRI-based virtual labyrinthoscopy. SETTING: Tertiary referral center. PATIENTS: Ten patients with symptoms of sensorineural hearing loss or vertigo who underwent high-resolution MRI between 1996 and 1999. INTERVENTION: Diagnostic image modality with three-dimensional (3-D) postprocessing to assess inner ear pathology. MAIN OUTCOME MEASURES: To evaluate how 3-D rendering with virtual labyrinthoscopy can depict subtle labyrinthine pathology. RESULTS: Cases with typical 3-D models and virtual labyrinthoscopic views are presented to illustrate this new image processing approach. CONCLUSION: The virtual endoscopic view of the labyrinth revealed subtle inner ear pathology. This 3-D postprocessing technique is able to render inner surface changes of tiny structures within the inner ear. It can be performed within a very short time using dedicated hybrid rendering techniques. It allows visualization of pathology in a comprehensive way for clinicians and is able to add 3-D information for troubleshooting in doubtful two-dimensional findings. We suggest the term virtual labyrinthoscopy for virtual intraluminal visualization of the labyrinth.

Adolescent↗

PubMedDate not supplied

Internet users becoming immersed in the virtual world. Implications for nurses.

Worldwide, people are using the Internet for computer-mediated communication (CMC) in increasing numbers. Nurse researchers have begun to examine the use of this medium for communication, education, and support of their clients. Therefore, it is important to know the experiences and meanings of CMC if the Internet is to be used for nursing interventions. The purpose of this study was to examine the experiences and meaning of online communications for frequent Internet users and discuss implications for nursing practice. Four virtual focus groups consisting of a total of 32 individuals were included in this study. Their stories of everyday Internet use were analyzed by hermeneutic interpretation. Six related themes and 1 constitutive pattern emerged from the data: (1) Internet as a resource for communication, information, and entertainment; (2) Internet as appealing, drawing one into frequent use; (3) developing dependencies; (4) Internet as frustrating; (5) learning the rules; and (6) developing physical and psychosocial effects. The constitutive pattern is immersion into the virtual world. This knowledge can be used to identify the potential effects of integrating the Internet into nursing interventions. Nurses who plan Internet-based interventions need to understand the appeal of this medium as well as the limitations and barriers to use.

Adult↗

PubMed2005

Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study.

OBJECTIVE: To investigate the effects of virtual reality (VR) on cortical reorganization and motor recovery. DESIGN: Nonparametric pre- and posttest design with experimenter blinded. SETTING: University medical center. PARTICIPANTS: Five patients with hemiparesis (age, 59.8+/-3.4y) were recruited. INTERVENTION: Five patients received VR for 60 minutes a day, 5 times a week for 4 weeks. VR was designed to provide a virtual rehabilitation scene where the intensity of practice and sensory feedback could be systematically manipulated to provide the most appropriate, individualized motor retraining program. MAIN OUTCOME MEASURES: Cortical activation and associated motor recovery were measured before and after VR using functional magnetic resonance imaging and standardized motor tests, respectively. Nonparametric tests were used at P less than .05. RESULTS: Prior to VR, the bilateral primary sensorimotor cortices (SM1s), contralesional premotor cortex, and contralesional or ipsilesional supplementary motor area were activated. After VR, the altered activations disappeared and predominantly the ipsilesional SM1 was activated (P<.05). Motor function was improved (P<.05). CONCLUSIONS: This is a novel demonstration of VR-induced neuroplastic changes and associated motor recovery in chronic stroke.

Adult↗

PubMed1997

Virtual reality in the operating room of the future.

In cooperation with the Max-Delbrück-Centrum/Robert-Rössle-Klinik (MDC/RRK) in Berlin, the Fraunhofer Institute for Computer Graphics is currently designing and developing a scenario for the operating room of the future. The goal of this project is to integrate new analysis, visualization and interaction tools in order to optimize and refine tumor diagnostics and therapy in combination with laser technology and remote stereoscopic video transfer. Hence, a human 3-D reference model is reconstructed using CT, MR, and anatomical cryosection images from the National Library of Medicine's Visible Human Project. Applying segmentation algorithms and surface-polygonization methods a 3-D representation is obtained. In addition, a "fly-through" the virtual patient is realized using 3-D input devices (data glove, tracking system, 6-DOF mouse). In this way, the surgeon can experience really new perspectives of the human anatomy. Moreover, using a virtual cutting plane any cut of the CT volume can be interactively placed and visualized in realtime. In conclusion, this project delivers visions for the application of effective visualization and VR systems. Commonly known as Virtual Prototyping and applied by the automotive industry long ago, this project shows, that the use of VR techniques can also prototype an operating room. After evaluating design and functionality of the virtual operating room, MDC plans to build real ORs in the near future. The use of VR techniques provides a more natural interface for the surgeon in the OR (e.g., controlling interactions by voice input). Besides preoperative planning future work will focus on supporting the surgeon in performing surgical interventions. An optimal synthesis of real and synthetic data, and the inclusion of visual, aural, and tactile senses in virtual environments can meet these requirements. This Augmented Reality could represent the environment for the surgeons of tomorrow.

Computer Simulation↗

PubMed2003

Prevention of bleomycin-induced lung fibrosis by aerosolization of heparin or urokinase in rabbits.

Bleomycin is a well known fibrogenic agent, provoking an initial adult respiratory distress syndrome-like injury with subsequent strong fibroproliferative response. Severe abnormalities of the alveolar surfactant system, which may be linked to the appearance of alveolar fibrin deposition, have been implicated in the pathogenetic sequence of events. Using a model of standardized aerosol delivery of 1.8 U bleomycin/kg body weight in rabbits, we investigated the influence of repetitive nebulization of heparin or urokinase-type plasminogen activator (u-PA) on the development of lung fibrosis. In an "early" (Days 2-12 postbleomycin) or "late" (Days 14-24 post-bleomycin) treatment protocol, approximately 3,500 U heparin or approximately 6,500 U u-PA was delivered to the bronchoalveolar space. Within four weeks, the bleomycin challenge provoked severe pulmonary fibrosis with reduction of lung compliance, marked increase in soluble collagen (bronchoalveolar lavage fluid) and hydroxyproline content (lung tissue), a typical reticular fibrosis pattern on high-resolution computed tomography, and typical histologic findings. Therapeutic intervention resulted in a far-reaching normalization of compliance, suppression of soluble collagen and hydroxyproline accumulation, and virtual abrogation of the computed tomography scan and histologic features of lung fibrosis, with most prominent effects seen in the early heparin and late u-PA administration. No bleeding complications occurred. These findings strongly support the concept that alveolar fibrin generation is an important event in the development of postbleomycin lung fibrosis. "Compartmentalized" anticoagulation and/or fibrinolysis via inhalational deposition of interventional agents in the alveolar compartment may thus offer a new therapeutic strategy for prevention of fibrosis.

Administration, Inhalation↗

PubMed2005

Case study: using a virtual reality computer game to teach fire safety skills to children diagnosed with fetal alcohol syndrome.

OBJECTIVE: To assess the effectiveness of a computer-based virtual reality (VR) game in teaching five children diagnosed with fetal alcohol syndrome (FAS) fire safety skills and to generalize these skills to a real world simulation. METHOD: Children participated in a study by using a multiple baseline, multiple probe design. Before the game, no child could correctly describe what actions to take during a home fire. A computerized game allowed them to learn the recommended safety steps in a virtual world. Skill learning and real-world generalization were tested immediately after the intervention and at 1-week post-test. RESULTS: All children reached 100% accuracy on the computer intervention, defined as successfully completing each of the safety steps. At the 1-week follow-up, all the children were able to perform the steps correctly in a real world simulation. CONCLUSIONS: The results suggest that this method of intervention warrants further study as an educational delivery system for children with FAS.

Child↗

PubMed1986

Economics of notification and medical screening for high-risk workers.

Measuring the economic impact of notification and intervention programs for workers at high risk of disease from workplace exposure has been virtually nonexistent for several reasons, which will be discussed, and should include a comprehensive view of costs and benefits. A framework for analysis is proposed defining four major clients: the business community, workers and their families, the local and regional public sector, and the federal government. For each client, the positive and negative, quantitative and nonquantitative, direct and indirect, short-run and long-run effects are probed and a summary analysis is made. To illustrate the process, the notification and screening program conducted by the National Institute for Occupational Safety and Health and the Workers' Institute for Safety and Health, Augusta, Georgia, for workers exposed to beta-naphthylamine is described.

Cost-Benefit Analysis↗