Interventions to enhance the Quality of Life of older people in residential long-term care: A systematic review
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Multilevel interventions, implemented at the individual, physician, clinic, health-care organization, and/or community level, increasingly are proposed and used in the belief that they will lead to more substantial and sustained changes in behaviors related to cancer prevention, detection, and treatment than would single-level interventions. It is important to understand how intervention components are related to patient outcomes and identify barriers to implementation. Designs that permit such assessments are uncommon, however. Thus, an important way of expanding our knowledge about multilevel interventions would be to assess the impact of interventions at different levels on patients as well as the independent and synergistic effects of influences from different levels. It also would be useful to assess the impact of interventions on outcomes at different levels. Multilevel interventions are much more expensive and complicated to implement and evaluate than are single-level interventions. Given how little evidence there is about the value of multilevel interventions, however, it is incumbent upon those arguing for this approach to do multilevel research that explicates the contributions that interventions at different levels make to the desired outcomes. Only then will we know whether multilevel interventions are better than more focused interventions and gain greater insights into the kinds of interventions that can be implemented effectively and efficiently to improve health and health care for individuals with cancer. This chapter reviews designs for assessing multilevel interventions and analytic ways of controlling for potentially confounding variables that can account for the complex structure of multilevel data.
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Summary The purpose of this study was to review existing behavioural interventions for preventing and treating obesity in adult population that were published between 2000 and September 2006. A total of 23 interventions were found. Most of these interventions targeted both physical activity and nutrition behaviours. Majority of the interventions were not based on any explicit behavioural theory. In terms of duration, the interventions ranged from 3 weeks to 9 years. Approximately half of the interventions were less than 6 months in duration. Most of the interventions were implemented by the researchers themselves. However, some interventions were implemented by nurse educators, nutritionists, trained public health nurses, dietitians, healthcare providers, fitness workers and certified diabetic educators. Most of the interventions used group sessions as the predominant method to deliver the programme. Three of the interventions used media. Majority of the interventions were implemented in patient care settings with some in community settings. The most common determinant for measuring impact of the interventions has been body mass index. Fifteen interventions showed positive change in adiposity indices while six showed no change in adiposity indices. Recommendations for enhancing the effectiveness of behavioural interventions for prevention of obesity are presented.
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Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews
Abstract Background Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. Objectives To compare search methods in systematic reviews of adverse effects with other reviews. Methods The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Results Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials ( RCT s). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. Conclusions The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE . However, reviews of adverse effects are more likely to include a range of study designs (not just RCT s) and search beyond MEDLINE .
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Cyberbullying intervention resources can be classified into school-based and stand-alone interventions.
The difference between both interventions will be described, but the focus of the presentation will be on the recently developed and theoretically based stand-alone interventions to combat and prevent cyberbullying. Five stand-alone interventions will be described that are based on theory and tested on effectivity. They are all tailored on personality characteristics, coping strategies and needs and have common core themes, but differ in their development and procedures.
Several lessons can be learned from research on the effectiveness of these five interventions regarding the usefulness of interventions and implementation pitfalls. In the presentation the necessity of tailored advice in interventions and important aspects of the content and the structure of interventions will be discussed, as well as the necessity of guidance. Several recommendations for future interventions will be provided.
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70% of medication errors occurring in the hospitals are preventable. The study was aimed to document, classify and examine interventions and examine reasons as to why pharmacists initiate changes in drug therapy and the outcomes of interventions, also examine the acceptability of interventions to analyze if intervention study can be a reliable learning process and to identify the areas of weakness in case of ineffective interventions. Interventions were broadly classified into Reactive interventions and Passive interventions. The study was conducted for six months. A total of 470 interventions were recorded in this study. Out of these 470 interventions, 104 were reactive interventions and 366 were passive interventions. Out of 92 outcome assessed interventions, the outcomes were beneficial in (91.30%) and had no effect in (8.70%). Active involvement of clinical pharmacists in the wards helps physicians in taking better therapeutic decisions which highlights areas where clinical pharmacists could prove their skill and knowledge to achieve better patient outcomes.
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Summary The purpose of this article was to review physical activity interventions done with Hispanic American girls and women that were published between 1994 and 2007, and suggest ways of enhancing these interventions. A total of 12 such interventions were found. Majority of the interventions focused on both physical activity and nutrition behaviours. Only half of the interventions were based on a behavioural theory. Social cognitive theory was the most popular theory, which was operationalized by four interventions. The interventions ranged from 3 weeks to 2 years in duration. The impact was not necessarily linked to the length of the intervention. The most popular physical activity that was promoted was walking, which was utilized by four interventions. Most of the interventions utilized a classroom format for imparting instruction in being physically active. All the interventions utilized individual‐level behaviour change as an approach, and none tried to address broader policy and environmental‐level changes. Process evaluation was done by very few interventions and must be done more systematically. In terms of the impact, half of the interventions were successful in influencing the outcomes. Recommendations for enhancing the effectiveness of physical activity interventions in Hispanic American girls and women are presented.
Social Cognitive Theory
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Summary The purpose of this article was to review international (excluding the United States) school‐based interventions for preventing obesity in children published between 1999 and 2005. A total of 21 such interventions were found from Australia (1), Austria (1), Canada (1), Chile (1), France (1), Germany (3), Greece (1), New Zealand (1), Norway (1), Singapore (1) and the United Kingdom (9). The grade range of these interventions was from pre‐school to high school with the majority (17) from elementary schools. Nine of these interventions targeted nutrition behaviours followed by seven aiming to modify both physical activity and nutrition behaviours. Only five interventions in international settings were based on any explicit behavioural theory which is different than the interventions developed in the United States. Majority of the interventions (9) were one academic year long. It can be speculated that if the interventions are behavioural theory‐based, then the intervention length can be shortened. All interventions that documented parental involvement successfully influenced obesity indices. Most interventions (16) focused on individual‐level behaviour change approaches. Most published interventions (16) used experimental designs with at least 1‐year follow‐up. Recommendations from international settings for enhancing the effectiveness of school‐based childhood obesity interventions are presented.
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