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Results for “virtual intervention”

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PubMed2002

Reducing malaria by mosquito-proofing houses.

Sometimes, valuable lessons from history are forgotten, remain unknown, or worse, are ignored. This article reminds us of the pioneering work of Angelo Celli at the end of the 19th century, who demonstrated that people could be protected from malaria by screening their homes against mosquitoes. Since then, public health scientists have continued to show that simple changes in house design have the potential for protecting people against this life-threatening disease. Yet today, this type of intervention remains virtually ignored. The literature reviewed here demonstrates the enormous potential of these methods to reduce malaria, in the hope that it will stimulate scientific debate and further research.

Animals↗

PubMed1997

A health insurance scheme for hospital care in Bwamanda District, Zaire: lessons and questions after 10 years of functioning.

A voluntary insurance scheme for hospital care was launched in 1986 in the Bwamanda District in northwest Zaire. The paper briefly reviews the rationale, design and implementation of the scheme and discusses its results and performance over time. The scheme succeeded in generating stable revenue for the hospital in a context where government intervention was virtually absent and external subsidies were most uncertain. Hospital data indicate that hospital services were used by a significantly higher proportion of insured patients than uninsured people. The features of the environment in which the insurance scheme thrived are discussed and the conditions that facilitated its development reviewed. These conditions comprise organizational-managerial, economic-financial, social and political factors. The Bwamanda case study illustrates the feasibility of health insurance-at least for hospital-based inpatient care-at rural district level in sub-Saharan Africa, but also exemplifies the managerial and social complexity of such financing mechanisms.

Adult↗

PubMed2004

Population health management as a strategy for creation of optimal healing environments in worksite and corporate settings.

This paper provides an (OHE) overview of a population health management (PHM) approach to the creation of optimal healing environments (OHEs) in worksite and corporate settings. It presents a framework for consideration as the context for potential research projects to examine the health, well-being, and economic effects of a set of newer "virtual" prevention interventions operating in an integrated manner in worksite settings. The main topics discussed are the fundamentals of PHM with basic terminology and core principles, a description of PHM core technology and implications of a PHM approach to creating OHEs.

Health Education↗

PubMed1992

Some properties of Ca(2+)-induced Ca2+ release mechanism in single visceral smooth muscle cell of the guinea-pig.

1. Late transient outward Ca(2+)-dependent K+ current (ILTO) correlated with Ca(2+)-induced Ca2+ release mechanism was studied in relation to the calcium inward current (ICa) in single isolated smooth muscle cells of the guinea-pig ileum using the whole-cell patch-clamp technique. 2. The voltage dependencies of peak ICa and ILTO were both bell shaped. However, the I-V curve of the outward current was shifted toward more positive potentials by about 60 mV in comparison to that for ICa. 3. Reduction in the external Ca2+ concentration resulted in a decrease of peak amplitude of both ICa and ILTO. However, caffeine-induced outward current was also decreased abruptly suggesting a rapid loss of stored Ca2+ upon lowering the external Ca2+ concentration. 4. Investigation of the relation of ILTO to partially inactivated ICa showed that inactivation of ICa by approximately 65, 80 or 84% of control (produced by prepulse to -20 mV for 2 s, shifting the holding potential to -20 mV for 30 s or by the ramp voltage command from -50 to +10 mV, respectively) was without detectable effect on the ILTO generation. 5. Bath application of the Ca2+ antagonist nifedipine (300 nM) inhibited ICa by 81% without affecting ILTO peak amplitude (92.0 +/- 5.6% of control in six cells). The mean concentration-response curve for ICa inhibition was sigmoidal with the apparent dissociation constant of 86.9 nM, whereas that for the ILTO had a characteristic sharp transition indicating a definite threshold of Ca2+ influx for ILTO generation. 6. Application of Ca(2+)-free external solution during 500 ms of the time when ICa peaked inhibited the current by about 76% whereas the ILTO during such an intervention remained virtually unchanged. 7. In double-pulse experiments, with conditioning and test pulses to +10 mV from -50 mV and an interpulse interval of 600 ms, most of the cells (about 80%) showed larger outward current at the test pulse suggesting continued Ca2+ release triggered by Ca2+ influx during a short (50-200 ms) depolarizing prepulse. The outward current could also be evoked at large positive potentials (presumably near the calcium equilibrium potential) where it did not occur normally by a prepulse to +10 mV for 50 ms. The charge transferred by Ca2+ current necessary to activate Ca2+ release in most of the cells was estimated to be from 6 to 20 pC. 8. The data are interpreted to suggest that the Ca(2+)-induced Ca2+ release mechanism operates in single ileal cells in a regenerative manner.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed2004

Treatment of juveniles who sexually offend: an overview.

Juvenile sexual offending is increasingly being recognized as a serious crime among youth. The prevalence of sexual offending and sexual reoffending suggests that many juvenile sex offenders (JSOs) may repeat their offending behaviors if not treated. However, clinical trials evaluating specific interventions are virtually nonexistent. Instead, the literature on the treatment of JSOs is marked by discussions of strategies that are hypothesized to be beneficial, as well as descriptions of treatment programs that exist across the country. Further, while existing literature suggests that treatment for JSOs may deter future sexual offending behaviors, it is unclear which, if any, aspects of these treatments promote the development of positive behaviors. A discussion of existing treatment approaches, effectiveness, and treatment considerations follows.

Adolescent↗

PubMed1987

Neonatal hydronephrosis in the era of sonography.

During a 6-year period (1979-1985), 142 neonates with significant hydronephrosis were seen. Seventy-eight percent of the cases were discovered on fetal screening during obstetric sonography. Maternal/fetal intervention was virtually never indicated and most babies were asymptomatic. The most common conditions found were obstruction of the ureteropelvic junction (41%), obstruction of the distal ureter (usually primary megaureter) (23%), upper-pole hydronephrosis associated with duplex anomalies (13%), and posterior urethral valves (10%). Seventeen neonates with multicystic dysplastic kidney were seen (three per year or one for every eight with hydronephrosis). In comparison, during the 30-year period, 1947-1977, 146 neonates with significant hydronephrosis were seen. Most cases were discovered because the patients had signs and/or symptoms--either an abdominal mass (an enlarged kidney or bladder) or urosepsis. The three most common conditions were obstruction of the ureteropelvic junction (22%), posterior urethral valves (19%), and ectopic ureterocele (14%). During this period, 53 neonates with multicystic dysplastic kidney were discovered (two per year or one for every three with hydronephrosis). The dramatic increase in the number of neonates found to have hydronephrosis is primarily due to the widespread use of obstetric sonography and concomitant fetal screening. The pattern of causes before 1979 represented the incidence of symptomatic lesions. The current pattern more accurately reflects the true incidence of congenital anomalies of the urinary tract.

Humans↗

PubMed2005

[Development and evaluation of a Web-based support program for the maternal role of primiparas].

PURPOSE: This study was conducted to develop and evaluate a Web-based program for the maternal role of primiparas who use the internet. METHOD: The study process was a systems requirements analysis, design and development of a program, program testing by experts, program implementation, and program evaluation by users. A nonequivalent control group non-synchronized design was used. The data was collected from October 5th, 2002 to February 24th, 2003. RESULT: 1. Based on inquiries into mothers' needs, a Web-based support program was developed. The program was then modified from feedback received from experts. 2. In a sub-scale analysis of mothers' perception of a baby, amenability and persistence was significantly higher in the intervention group. The differences in the mean score of maternal self-confidence and maternal satisfaction were significant. 3. Cyber counseling was done for a total of 73 cases and the most frequent problems for counseling were feeding and nutrition (28.8%), followed by baby care, and health problems. CONCLUSION: It was proven that a Web-based support program provided appropriate support to primiparas and was effective in promoting their maternal role. Therefore, this study suggests that a Web-based support program for primiparas can become a powerful nursing intervention on virtually all mother and infant health concerns.

Adult↗

PubMed2001

GOLEM--multimedia simulator for medical education.

We created multimedia medical training simulator "GOLEM" for learning diagnostics and therapy of the critical clinical disorders. The theoretical basis of the simulator is the mathematical formulation of the relationship of homeostasis of the internal environment (acid/base and electrolyte equilibrium, of transport of blood gases, of osmotic and volume homeostasis), respiration, circulation and kidneys including regulatory influence of relevant hormones and the influence of some therapeutic procedures. Mathematical description consists of 39 non-linear differential equations and containing 89 input and 179 output variables. For the development of the simulation models developer's tools from MathWorks (Matlab and Simulink) has been used. The integration of the multimedia components, hypertext and simulation models interface was achieved by using Control Web, developed by Moravian Instruments, originally designed for long distance controls using PC and Internet. We have used our simulator as an efficient educational tool to help medical students learn circulatory, respiratory, acid-base, electrolyte, osmotic and volume disorders and train the diagnostic and therapeutic decisions by executing simulated interventions on virtual "patients".

Acid-Base Imbalance↗

PubMedDate not supplied

[Optimization of oxygen transport with perfluorane emulsion during surgery of lung cancer].

Perfluorane emulsion was included in infusion/transfusion therapy for optimization of oxygen transport. Central hemodynamics was analyzed during the intervention and immediate postoperative period in 80 patients operated on for lung cancer (pneumonectomy, lobectomy, bilobectomy) under conditions of one-lung ventilation. In the control group perfluorane (6 ml/kg) was infused during induction anesthesia. Increased oxygen delivery without increase of cardiac index was observed in the patients treated with perfluorane. Perfluorane had a positive impact on total peripheral resistance during and immediately after the intervention and virtually did not affect other central hemodynamic parameters. Addition of perfluorane to intraoperative infusion therapy improved oxygen budget of operated cancer patients with concomitant therapeutic diseases.

Aged↗

PubMed2002

Cytoarchitecture of the retinal ganglion cells in the rat.

PURPOSE: To determine the number and cytoarchitecture of retinal ganglion cells (RGCs) in the female Wistar rat, by using a newly devised procedure for rapid RGC counting in the entire retina that avoids assumptions about RGC spatial arrangement. METHODS: RGCs of normal female Wistar rats were retrogradely labeled with a fluorescent tracer. Automated counting was accomplished by applying standard imaging software to analysis of all labeled cells in retinal flatmounts. The method was validated by comparison of automated and manual counts of 70,000 RGCs in frames covering the density range in the normal rat retina of 600 to 3600 RGC/mm(2). RGC numbers were determined for each retina and compared with the contralateral retina of the same animal. RGC density maps were constructed for each retina. RGC size distribution was determined. RESULTS: Automated RGC counting showed a good linear correlation with manual counting (R(2) = 0.9416). Mean total RGC count in 10 rat eyes was 97,609 +/- 3,930 (SEM) per eye. Contralateral eyes differed by an average of 4.1% (3983 plus minus 5098 RGCs). Size analysis calculated from cell areas confirmed that the majority of rat RGCs are between 7 and 21.5 microm in equivalent diameter. The RGC counts for all frames at the same eccentricity in all 10 of the retinas showed that variability increased with eccentricity and increased further as the fractional area of the retina sampled at each eccentricity was reduced. There was also significant variability in the spatial density of the RGCs at the same eccentricity location between different eyes. Comparison of total RGC counts between left and right eyes estimated from RGC counts in sectors of the retina (hemiretinas or quadrants) showed increased variability compared with counting all the RGCs in a retina. CONCLUSIONS: RGCs in the Wistar rat display significant variability in their cytoarchitecture. Such variability can make quantification by sampling problematic for diffuse, and particularly, for focal RGC losses resulting from experimental interventions, unless virtually the entire RGC population is counted.

Animals↗

PubMed2003

The RCM virtual institute for birth: reducing interventions.

Explore the source record for details and available documents.

Adult↗

PubMed2003

[Anthrax].

Anthrax is a severe infectious disease by Bacillus anthracis. It can cause massacres among large herbivores, but means also a threat to humans. The latter develop mainly cutaneous anthrax, which they mostly survive. Inhalation can lead to more severe infections which, without medical intervention, are virtually always lethal. At the moment the disease draws much attention since it is thought to be a potential weapon in the hands of bioterrorists.

Anthrax↗

PubMed1984

Method of evaluating and improving ambulatory medical care.

The usefulness of an action-research model is demonstrated in the evaluation and improvement of ambulatory medical care in a variety of settings: solo office practice, prepaid capitation multiple-specialty group practice, and medical school hospital-based outpatient clinic practice. Improvements in the process of medical care are found to relate directly to the intensity and duration of planned interventions by the study group and are demonstrated to follow organizational changes in the participating sites--primarily managerial and support services initiated by policy decisions in each study site. Improvement in performance approaching one standard deviation results from the most intense intervention, about one-half standard deviation at the next level of intervention, and virtually no change from a simple feedback of performance measures. On the basis of these findings and other operational and research efforts to improve physician performance, it is unlikely that simple feedback of performance measures will elicit a change in behavior. However, noncoercive methods involving health care providers in problem identification, problem solving, and solution implementation are demonstrated to be effective.

Ambulatory Care↗

PubMed1998

Pharmacological evaluation of an epoxide as the putative hyperpolarizing factor mediating the nitric oxide-independent vasodilator effect of bradykinin in the rat heart.

A cytochrome P450-derived metabolite of arachidonic acid, namely an epoxyeicosatrienoic acid (EET), has many of the properties of a hyperpolarizing factor that mediates endothelium-dependent, nitric oxide-independent vasodilation. As there are four EET regioisomers, we used pharmacological criteria, based on previous observations with bradykinin (BK), to evaluate which, if any, of the EETs could be considered a potential mediator of vasodilator responses to BK in the rat isolated heart treated with indomethacin and nitroarginine to eliminate prostaglandin and nitric oxide components of the response. Nifedipine, used as a probe for dilator mechanisms dependent on closure of voltage-dependent Ca++ channels, almost abolished the vasodilator effect of cromakalim and attenuated those of BK and 5,6 EET. The vasodilator effects of the other EETs were not reduced and were excluded from consideration as mediators of BK-induced vasodilation. The vasodilator effect of 5,6 EET, as with that of BK, was markedly reduced by charybdotoxin but not iberiotoxin, suggesting the contribution of a similar type K+ channel to the vascular response to both agents. As expected for a putative endothelium- and cytochrome P450-derived mediator, the coronary vasodilator effect of 5,6 EET was not affected by either removal of the endothelium or inhibition of cytochrome P450 with clotrimazole, interventions that virtually abolished the vasodilator activity of BK. Thus, of the four EET regioisomers, 5,6 EET is the most likely mediator of the vasodilator effect of BK in the isolated heart under these experimental conditions.

8,11,14-Eicosatrienoic Acid↗

PubMed1998

[Perspectives of virtual control of visceral surgery interventions in open MRI].

Since July 1997 we have operated on 23 patients with different visceral surgical diagnoses in an open-configured Magnetic Resonance System (MRI). Among them we found 7 patients with benign soft tissue tumors, 5 patients with anal fistulas, 1 patient with an abscess on the pelvic wall, 1 patient with a rectocele, 1 patient with an inoperable, restrictive oesophageal carcinoma, and 8 patients with metastatic lesions in the liver. In the last 8 patients we performed MRI-guided laser-induced interstitial thermotherapy, in one patient in an open development. We did not face any postoperative complications. The median duration of the intervention was 2 hours, pre- and postscans included. Our experiences show that it is possible to carry out visceral surgical interventions in the open-configured MRI. The main indications we see now are anal fistulas, soft tissue tumors and MRI-guided laser-induced interstitial thermotherapy of liver metastases.

Abdomen↗

PubMed2026

Cost-effectiveness analysis of a virtually administered pain coping skills training intervention in women with breast cancer in underserved areas.

OBJECTIVES: Women with cancer who live in medically underserved areas could benefit from behavioral pain interventions, but access is limited. A randomized trial reported that a 4-session virtual program incorporating pain coping skills training (mPCST) was effective in improving pain outcomes compared to an attention-control condition. We performed a cost-effectiveness analysis of mPCST vs. control. METHODS: Data on medical resource use, therapist time, and participants' attendance at intervention sessions and time associated with travel and using a mobile app were collected. The 5-level EuroQol 5-Dimension (EQ-5D-5L), a preference-weighted measure of health-related quality of life (HRQOL), was administered at baseline, after the intervention period, and 3 and 6 months later. Medicare payments were used to value medical resource use and therapist time to deliver mPCST. Patient time was valued using the average US wage. RESULTS: Medical resource utilization was similar for both groups, but hospitalizations trended higher in the mPCST group. EQ-5D-5L preference weights were higher by an average of 0.066 (p = 0.04) with mPCST across the follow-up period, representing an incremental gain of 0.04 quality-adjusted life years (QALYs) (95% CI: 0.00-0.08). When including the base-case cost of mPCST of \$500 vs. \$0 for the control group, the incremental cost-effectiveness ratio (ICER) was \$12,725 per QALY (95% CI: 5,566-69,343). Including the value of patient time added \$303 to mPCST costs resulting in an ICER of \$20,438 per QALY (95% CI: 9,051-111,403). SIGNIFICANCE OF RESULTS: mPCST is a cost-effective program that improves HRQOL for women with cancer living in medically underserved areas.

Humans↗

PubMed2001

[Evaluation of an electromagnetic virtual target system (CT-guide) for CT-guided interventions].

PURPOSE: Evaluation of the accuracy of a new electromagnetic target system for interventional CT-guided procedures with virtual navigation in a previously acquired helical CT. MATERIAL AND METHODS: The new target system CT-Guide 1010 (Ultraguide, Tirat Hacarmel, Israel) for CT-guided interventions was adapted to the video signal of the Somatom Plus 4 and Volume Zoom (Siemens, Erlangen, Germany). A helical CT-dataset including skin-based sensor cubes was transferred to the integrated navigation system inside the scanner room. 50 image-guided interventions and biopsies were performed outside the gantry using virtual navigation to reach the lesion. The accuracy of the procedures was evaluated using documentation of the needle tip with CT-fluoroscopy, results of histology, and follow-up. RESULTS: The deviation between planned and documented needle tip was 2.2 +/- 2.1 mm in 50 procedures. Time between the end of planning-CT and needle positioning using the system was 13 minutes. There were no complications due to the use of the system. CONCLUSION: The CT-Guide allows for virtual real-time navigation with high accuracy. Advantages are the free needle angulation without gantry tilt, use of optimal CT perfusion phase for virtual navigation, and reduction of radiation exposure to the patient and interventionalist.

Adult↗

PubMed2003

Doing play: competency, control, and expression.

This qualitative study investigated the personal experiences of children with cerebral palsy engaging in a virtual reality play intervention program. The study involved in-depth, focused interviews that were conducted with 19 participants aged 8-13 who had a diagnosis of cerebral palsy. A constant comparative inductive method of analysis was used, and several themes emerged. Findings were interpreted using the theory of flow, the theory of self-efficacy, and the model of playfulness in virtual reality computer interactions. The three themes uncovered in the data include (a) doing play, (b) it's my way that matters, and (c) how I see me. The sub-theme safety also emerged. Findings from this study showed that children with physical disabilities are often limited in their play experience compared to their peers without physical disabilities. Children perceived engagement in a virtual reality play intervention program as an enjoyable experience which increased their self-competence and self-efficacy. Participants experienced a sense of control and mastery over the virtual environment and were provided a safe way to explore and challenge their abilities. Participants perceived experiencing flow and reported perceived physical changes and increased social acceptance from both peers and family. These findings provide evidence that virtual reality continues to show promise as a pediatric rehabilitation play intervention tool.

Adolescent↗