SEARCH · PubMed Health

Results for “virtual intervention”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources

PubMed1984

Use of nonexclusionary timeout for the elimination of a stereotyped behavior.

The purpose of the present study was to investigate the effectiveness of a nonexclusionary timeout procedure in reducing a high-frequency stereotyped behavior in a 28-year-old profoundly mentally retarded and autistic male. The experimental design consisted of baseline (A), treatment (B), and 1- and 6-month follow-up studies. After 2 weeks of treatment, the target behavior was reduced to a virtually zero rate of occurrence and the low rate of response was maintained throughout follow-up. Findings suggest that nonexclusionary timeout may prove to be a cost-effective intervention for reducing or eliminating disruptive stereotyped behaviors. The need for further research is indicated.

Adult↗

PubMed1992

The prevention of Indian childhood cirrhosis.

Previous studies have led to the hypothesis that the gross hepatic copper storage characteristic of Indian childhood cirrhosis (ICC) is due to the early introduction of animal milk feeds which have been contaminated with copper from brass household utensils. Amongst the families of 100 cases of ICC, the incidence of ICC in children born after dietary advice had been given (1/86) was significantly lower than in older siblings (12/125). This study attempted to document the incidence of ICC and the usage of brass before and after an intervention programme in Pune District advising against this pattern of infant feeding. The study encountered numerous difficulties in data gathering, but documented a fall in ICC prevalence resulting in its virtual disappearance in Pune District. This contrasted with an unchanged incidence in Chandigarh. Although a fall in brass usage was seen in Pune District, this was actually a spontaneous sociological change rather than a result of health education.

Alloys↗

PubMed1988

Hysteresis and the length dependence of calcium sensitivity in chemically skinned rat cardiac muscle.

1. The relationship between pCa (-log10[Ca2+]) and steady-state isometric tension has been investigated in saponin- or Triton-treated (chemically 'skinned') cardiac muscle of rat. 2. Hysteresis exists in the relationship such that the muscle is less sensitive to Ca2+ during increasing activation (as [Ca2+] is stepped upward) than during reducing activation (as [Ca2+] is stepped downward). 3. The extent of the hysteresis is insensitive to interventions that increase overall calcium sensitivity by chemical means, such as caffeine, carnosine or increased pH. 4. The extent of the hysteresis is sensitive to sarcomere length. The phenomenon is virtually absent above sarcomere lengths of about 2.2-2.3 microns but becomes progressively greater at shorter sarcomere lengths. 5. The effect of sarcomere length on calcium sensitivity is restricted to the upward-going (increasing activation) part of the pCa-tension loop below 2.2 microns. The downward-going (decreasing activation) part of the hysteretic relationship is virtually unaffected by sarcomere length up to 2.2 microns. 6. Significant alterations in sarcomere length do not occur during tension development in the experiments described here: the phenomenon is not attributable to experimental artifacts of this kind. 7. Hysteresis develops sufficiently rapidly to be consistent with a physiological relevance during the normal heart beat. 8. The effects of sarcomere length show that the phenomenon is not due to force per se since, for example, greater peak force produces less hysteresis as sarcomere length is increased towards 2.2 microns. 9. Tonicity increase (by high-molecular-weight dextran), which shrinks the myofilament lattice, increases calcium sensitivity but reduces the effect of sarcomere length on calcium sensitivity. 10. The results suggest that lattice shrinkage is the mechanism which accounts for hysteresis in, and the sarcomere length dependence of, calcium sensitivity in cardiac muscle.

Animals↗

PubMed1996

Homocystinuria: what about mild hyperhomocysteinaemia?

Hyperhomocysteinaemia is associated with an increased risk of atherosclerotic vascular disease and thromboembolism, in both men and women. A variety of conditions can lead to elevated homocysteine levels, but the relation between high levels and vascular disease is present regardless of the underlying cause. Pooled data from a large number of studies demonstrate that mild hyperhomocysteinaemia after a standard methionine load is present in 21% of young patients with coronary artery disease, in 24% of patients with cerebrovascular disease, and in 32% of patients with peripheral vascular disease. From such data an odds ratio of 13.0 (95% confidence interval 5.9 to 28.1), as an estimate of the relative risk of vascular disease at a young age, can be calculated in subjects with an abnormal response to methionine loading. Furthermore, mild hyperhomo-cysteinaemia can lead to a two- or three-fold increase in the risk of recurrent venous thrombosis. Elevated homocysteine levels can be reduced to normal in virtually all cases by simple and safe treatment with vitamin B6, folic acid, and betaine, each of which is involved in methionine metabolism. A clinically beneficial effect of such an intervention, currently under investigation, would make large-scale screening for this risk factor mandatory.

Cardiovascular Diseases↗

PubMed1993

Putative anticarcinogenic actions of carotenoids: nutritional implications.

This review provides an update on nutritional aspects of carotenoids (as distinct from retinoids), with specific relevance to anticarcinogenesis. Critical gaps remain in our knowledge of the nutritional functions of carotenoids despite an overwhelming accumulation of research data in areas tangential to human nutrition. In addition to their roles as precursors of retinol and retinoids, carotenoids have distinct functions of their own in animals and humans. In vitro they are antioxidants with a broad range of potencies. In vivo, they protect porphyrics against sunlight. The evidence for anticarcinogenic actions of beta-carotene in certain specified test situations is persuasive. Nevertheless, despite a large number of studies demonstrating protection by carotenoids, the characteristics that render a given carotenoid effective and the relative efficacy of the individual carotenoids are not known. Moreover, dose-response and pharmacokinetic relationships remain virtually unexplored. Research to uncover mechanisms of protection by carotenoids is, for technical reasons, painfully slow. Epidemiological studies reveal associations but not cause and effect. To explore cause and effect, intervention trials are underway, hampered by the paucity of data regarding optimal choice of carotenoid, dosage, and regimen. The in vitro test systems that would provide this information are not available because the molecular sites relevant to the chemopreventive action of carotenoids are obscure. Each of these problems has a solution, but not a simple one. Until these are resolved, blanket recommendations regarding supplementation will remain problematic. To this point, health authorities have not recommended dietary supplementation with carotenoids. Instead, they recommend increased consumption of yellow and dark green carotenoid-rich vegetables. In the future, an individual at risk for a particular carcinogenic process may be recommended a supplement of the most appropriate anticarcinogen, specific to their individual endowment of genetic and environmental risk factors. This review emphasizes not only what is known but also what is not known. Consequently we identify priorities for research that, if undertaken, will allow such recommendations to be made or discounted with more confidence.

Animal Nutritional Physiological Phenomena↗

PubMed1991

Depression and chronic fatigue in the patient with heart disease.

Depression and chronic fatigue are frequently associated with heart disease. They may precede the onset of myocardial infarction, singly or together, and increase the morbidity and mortality of patients with a history of MI. Virtually all such patients have a transient depression, usually accompanied by anxiety, with onset soon after hospitalization. Although this depression is transient and usually abates spontaneously, it frequently warrants therapeutic intervention. Psychosocial and personality factors play a significant role in the recovery of a patient with a cardiac condition. The clinician must be alert for the effects of changing roles within the family and behaviors that may lead to chronic invalidism. Anxiety disorders, often combined with depression, may mimic cardiac disease and may result from it, leading to chronic fatigue and weakness. Proper diagnosis usually leads to considerable improvement. Cardiac drugs, in addition to many others, may produce depression and fatigue that may be misdiagnosed. Often, discontinuing or changing a medication will lead to marked diminution of such symptoms. Observational and listening skills are key ingredients of the "art" of medicine; they can lead to interventions that are not only therapeutic, but which improve the "quality" of life.

Depression↗

PubMed1994

Hyperhomocysteinaemia: a newly recognized risk factor for vascular disease.

In the past decade significant progress has been made in understanding of hyperhomocysteinaemia and its association with the proneness to premature development of vascular disease. Pooled data from a large number of studies demonstrate that mild hyperhomocysteinaemia after standardized methionine loading is present in 21% of patients with coronary artery disease, in 24% of patients with cerebrovascular disease, and in 32% of patients with peripheral vascular disease. A relative risk of 13.0 (95% confidence interval 5.9-28.1) of vascular disease at relatively young age can be calculated in subjects with such abnormal response to methionine loading. Pathological homocysteine levels are affected by genetic defects in homocysteine metabolism which have still not been completely clarified and which are more complex than originally supposed. Furthermore, a variety of non-genetic determinants such as deficiency of folate or vitamin B12 has to be taken into account. Mild hyperhomocysteinaemia can be reduced to normal in virtually all cases by simple and safe treatment with vitamin B6, folic acid, and betaine, each of which is involved in methionine metabolism. A clinically beneficial effect of such an intervention, which is currently under investigation, could make large-scale screening mandatory for this risk factor.

Arteriosclerosis↗

PubMed2000

Experimental design and methods for school-based randomized trials. Experience from the Hutchinson Smoking Prevention Project (HSPP).

Nonadherence to accepted design principles for randomized trials has been a limitation of school-based intervention research. Designed to overcome these limitations, the Hutchinson Smoking Prevention Project (HSPP) is a 15-year randomized trial to determine the extent to which a school-based (grades 3-12) tobacco use prevention intervention can deter youth tobacco use throughout and beyond high school. This paper presents the HSPP experimental design, together with methods for its implementation, and an evaluation of the degree to which HSPP has adhered to principles of randomized trials. Results from the experimental design and its conduct include (1) a recruitment rate of 97.6% (40 of 41 targeted school districts), (2) full and active participation for the trial's duration by 100% of the 40 school districts recruited, (3) implementation by virtually all teachers (99%+), with 86% implementation fidelity, and (4) outcome determination for 94.3% (7910) of 8388 original study participants identified 12 years previously at baseline. The high degree of rigor achieved by the HSPP experimental design ensures confidence in the trial's soon-to-be available intervention effectiveness results. Equally important, for future school-based trials, the HSPP design and its execution have illustrated that school-based research can adhere to the principles of rigorous randomized trials, with high rates of implementation, and very high rates of recruitment, maintenance, and follow-up of study participants, even for studies with decade-long follow-up periods. Rigor in school-based trials can be achieved through a combination of (1) commitment to the principles of randomized trials, (2) attention to the special challenges of trials specific to the school setting, (3) adoption and meticulous execution of proven methods for trial conduct, and (4) establishment at the outset of principles for maintaining positive collaborative relationships with participating school districts for the duration of the trial. These findings are important in light of the great potential for using the nation's schools to access youth for health promotion/risk-factor prevention.

Adolescent↗

PubMed1990

Some links between successful implementation of primary health care interventions and the overall utilization of health services.

All societies have need of a sick care system into which the general population has easy access. Such a system is required for the coherent organization of any health care service which is to be effective. Virtually all people want curative care when ill, but generally are less interested in preventive activities. It follows that a sick care service should be as widely available as it is hoped will be a preventive one. An effective sick service provides the basis of sufficiently regular contact with the bulk of the population so as to allow for the successful fulfillment of preventive health care goals. A shift is required from conventional input planning methods--more doctors, more health centers, etc.--to output planning; that is, actual utilization by the population of the services offered. The concern here is with the overall contact rate between the health service and the entire (relevant) population and not just the rate for any one particular health care program. Planning for additional inputs should be based on the expected outputs (contacts) which are expected to flow from those inputs. An average, well distributed annual utilization level of three to four contacts per capita should provide an adequate basis for fulfillment of preventive (and curative) goals in the health sector.

Developing Countries↗

PubMed1990

Diagnosis, therapy, and outcome of ventricular septal defects in the 1st year of life: a two-dimensional colour-Doppler echocardiography study.

Between January 1987 and July 1989 a ventricular septal defect (VSD) as a single cardiac lesion was detected in 269 small infants aged less than 1 year. The diagnosis was achieved by two-dimensional echocardiography and Doppler colour flow mapping using subcostal, parasternal, apical, and suprasternal views. VSDs were divided into perimembraneous, muscular, malalignment, and subpulmonary defects. Septal defects in complex lesions and atrioventricular defects were excluded. In group 1 (174 infants up to 4 weeks of age, mean 10 days) 125 muscular (71.8%), 35 (20.1%) perimembraneous, 12 (6.9%) malalignment, and 2 (1.1%) subpulmonary defects were diagnosed. One baby had a combined perimembraneous and muscular defect. In another baby a malalignment defect was associated with an av-canal. In group 2 (95 infants aged 4 weeks to 1 year, mean 4.0 months), 57 (60%) muscular, 32 (33.6%) perimembraneous and 6 (6.3%) malalignment defects were found. Within the maximum observation period of 13 months, spontaneous closure occurred in 72 (42.6%) of 169 infants who had a sufficient follow up. Sixty-four had a muscular (88.9%) and 8 (11.1%) a perimembraneous defect. Surgical intervention was required in 11 patients: five perimembraneous defects were closed, one was palliated. Five infants with a malalignment defect were palliated. The malalignment defect frequently needed surgical intervention even in newborns; it never closed spontaneously. About 10% of patients with perimembraneous septal defect required surgery. Spontaneous closure rarely occurred in early infancy. Muscular VSDs were most frequent but virtually never required therapy. Spontaneous closure rate was about 50% during the 1st year of life.

Echocardiography, Doppler↗

PubMed1996

Energy expenditure and physical activity in subjects consuming full-or reduced-fat products as part of their normal diet.

It has been suggested that energy expenditure is higher in subjects consuming reduced-fat, high-carbohydrate diets than in subjects consuming full-fat, low-carbohydrate diets. In a 6-month randomized, controlled trial, seventeen women and twenty men (age 20-35 years; BMI 22-28 kg/m2) had free access either to a range of about forty-five reduced-fat products or the full-fat equivalents. At the end of the 6 months, energy intake, sleeping metabolic rate (SMR), average daily metabolic rate (ADMR), and physical activity (AO) were measured. The intervention resulted in a mean difference of the change of the fat content of the diet of 6% of energy (P < 0.01) between the two groups. SMR. ADMR and AO were virtually the same in both groups. The results suggest that the change in fat content of the diet has no effect on physical activity and energy expenditure. However, subjects with a higher activity level consumed more carbohydrate (ADMR/SMR: r = 0.49, P < 0.01: AO: r = 0.57, P < 0.001).

Adult↗

PubMed1996

Body weight and blood pressure regulation.

Excess body weight correlates closely with increased blood pressure. Virtually every prospective study of factors that influence blood pressure regulation has identified weight, or body mass index, as the strongest predictor of human blood pressure. In normotensive persons, longitudinal and intervention studies have documented that weight gain, over as short a period as 1-2 mo., is associated with predictable rises in arterial pressure. Conversely, in borderline hypertensive persons, similar types of studies have reported that weight reductions of as little as 4-5 kg result in normalization of blood pressure. During periods of weight loss, decreases in blood pressure are evident within the first 2-3 wk; the greatest proportionate blood pressure change occurs during the earliest phases of weight reduction. The decline in blood pressure with weight loss has been shown to be unrelated to variations in nutrient intake. However, the association between blood pressure decreases and increased amounts of physical activity, which generally accompany weight loss efforts, is less clear. For many overweight individuals, reductions in blood pressure that occur with weight loss may be due specifically to the initiation of a regular physical exercise regimen. Weight loss in hypertensive persons has been shown to dramatically reduce, and in many cases eliminate, antihypertensive medication requirements. It is estimated that in up to 50% of the adults in the United States whose hypertension is being pharmacologically managed, the need for drug therapy could be alleviated with only modest reductions in body weight.

Blood Pressure↗

PubMed2004

"Anti-aging" is an oxymoron.

No intervention will slow, stop, or reverse the aging process in humans. Whether anti-aging medicine is, or is not, a legitimate science is completely dependent upon the definition of key terms that define the finitude of life: longevity determination, aging, and age-associated diseases. Only intervention in the latter by humans has been shown to affect life expectancy. When it becomes possible to slow, stop, or reverse the aging process in the simpler molecules that compose inanimate objects, such as machines, then that prospect may become tenable for the complex molecules that compose life forms. Most of the resources available under the rubric "aging research" are not used for that purpose at all, thus making the likelihood of intervention in the process even more remote. If age changes are the greatest risk factor for age-associated diseases (an almost universal belief), then why is the study of aging virtually neglected?

Aged↗

PubMedDate not supplied

Effects of distraction on pain, fear, and distress during venous port access and venipuncture in children and adolescents with cancer.

This study evaluates the effect of self-selected distracters (ie, bubbles, I Spy: Super Challenger book, music table, virtual reality glasses, or handheld video games) on pain, fear, and distress in 50 children and adolescents with cancer, ages 5 to 18, with port access or venipuncture. Using an intervention-comparison group design, participants were randomized to the comparison group (n = 28) to receive standard care or intervention group (n = 22) to receive distraction plus standard care. All participants rated their pain and fear, parents rated participant fear, and the nurse rated participant fear and distress at 3 points in time: before, during, and after port access or venipuncture. Results show that self-reported pain and fear were significantly correlated (P = .01) within treatment groups but not significantly different between groups. Intervention participants demonstrated significantly less fear (P <.001) and distress (P = .03) as rated by the nurse and approached significantly less fear (P = .07) as rated by the parent. All intervention parents said the needlestick was better because of the distracter. The authors conclude that distraction has the potential to reduce fear and distress during port access and venipuncture.

Adolescent↗

PubMed1989

[Mesenteric venous thrombosis: a new case of favorable course using conservative treatment].

Mesenteric venous thrombosis (TVM) is an uncommon entity with a mortality without surgical treatment of virtually 100%. However, recently some cases have been reported of a good evolution with conservative treatment. We present a patient with mesenteric venous thrombosis diagnosed by arteriography who, after refusing surgical intervention, underwent parenteral nutrition and anticoagulant treatment. This case constitutes another proof that mesenteric venous thrombosis is not invariably fatal without surgical treatment.

Aged↗

PubMed2006

PelvicSim--a computational-experimental system for biomechanical evaluation of female pelvic floor organ disorders and associated minimally invasive interventions.

In this paper we describe the prototype of a new computational simulation system, PelvicSim. This system is being developed to simulate the in vivo biomechanics of the female pelvic floor organ system with the intent to provide clinical researchers, medical device designers with a virtual environment to understand the various biomechanical pathologies occurring in the pelvic floor. This information can then be used to develop new reconstructive surgical techniques, or design non surgical/surgical devices for the treatment of urinary incontinence and pelvic organ prolapse. In this paper, we provide the initial results from the development of the PelvicSim modules which combine in vivo sensing experiments, Ultrasound and MRI imaging datasets, and an inverse finite element modeling technology based on hyperviscoelastic constitutive modeling of the pelvic floor organs and tissues.

Biomechanical Phenomena↗

PubMed2004

Prevention of mother-to-child transmission of HIV infection.

PURPOSE OF REVIEW: Mother-to-child transmission of HIV infection is the primary cause of paediatric HIV infections worldwide. Although clinical trials show that antiretroviral therapy, elective caesarean section and formula feeding can significantly reduce the peripartum or postpartum risk of transmission, their application on a population basis is challenging. There is a need for alternative, easier and more effective interventions for population-based programmes. RECENT FINDINGS: This review addresses recent advances in our understanding of mother-to-child transmission risk factors, including maternal viral load (in plasma, genital tract and breast milk) and gender, and determinants and rates of postnatal transmission. New information on prophylactic antiretroviral therapy includes results from randomized trials in Africa and Thailand, in addition to new information on implementation of prevention of mother-to-child transmission programmes in nontrial settings, in both developed and developing countries. Two important issues relating to use of antiretroviral prophylaxis are discussed: safety and toxicity, including new findings on haemopoiesis, prematurity and mitochondrial abnormalities in antiretroviral therapy-exposed infants and children, and resistance. Recent trends and controversies relating to mode of delivery in HIV-infected pregnant women are outlined. Regarding infant feeding, preliminary results on use of mono-antiretroviral therapy to prevent postnatal transmission in breastfeeding HIV-exposed infants are discussed. SUMMARY: In resource-rich settings, virtual elimination of mother-to-child transmission is theoretically possible. Even in these settings, however, a substantial number of infected women are not being identified early enough for optimum application of prevention of mother-to-child transmission interventions. In developing country settings, focus is being directed towards scaling-up prevention programmes now that trials have established a variety of effective antiretroviral prophylactic approaches.

Antiretroviral Therapy, Highly Active↗

PubMed2005

Motion sickness.

PURPOSE OF REVIEW: The public's longstanding resigned tolerance to motion sickness threatens to change, due to the widespread introduction of nauseogenic tilting trains and the increasing use of virtual reality immersion. RECENT FINDINGS: Scientific effort over the last 5 years has focused on precise evaluation of the stimuli that provoke sickness and on the development of behavioural and new pharmacological interventions to suppress sickness. SUMMARY: The precise mechanical ride characteristics of vehicles that provoke sickness have been identified and this will lead to guidelines for future engineering design, especially for suspension systems that compensate for inertial tilt, and recommendations for passengers at risk. The frequency characteristics of motion provoking sickness have been defined with greater precision and identified with shifts in perception of motion versus orientation, and changes in the quality of reflex eye movements. Ability to modify readily the time constant of vestibular 'velocity store' has emerged as a potential candidate marker of successful motion sickness habituation. Behavioural 'autogenic' countermeasures to the development of sickness, such as controlled breathing, which can be implemented readily, are shown to have significant ameliorating effects on nausea and are of value for short term moderate exposures. New classes of pharmacological agents such as N-methyl-D-aspartate antagonists and 5HT1a receptor agonists show promise in animals but await trials in humans.

Antiemetics↗