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"INTERVENTION STUDY"
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Development of a Web-based Family Intervention for BRCA Carriers and Their Biological Relatives: Acceptability, Feasibility, and Usability Study
Carriers of breast cancer gene (BRCA) mutations are asked to communicate genetic test results to their biological relatives to increase awareness of cancer risk and promote use of genetic services. This process is highly variable from family to family. Interventions that support communication of genetic test results, coping, and offer decision support in families harboring a pathogenic variant may contribute to effective management of hereditary cancer.
The aim of this paper was to describe the development of the Family Gene Toolkit, a Web-based intervention targeting BRCA carriers and untested blood relatives, designed to enhance coping, family communication, and decision making.
We present findings from focus groups regarding intervention acceptability and participant satisfaction and from a pre-post pilot study with random allocation to a wait-listed control group regarding intervention feasibility and usability.
The Family Gene Toolkit was developed by a multidisciplinary team as a psycho-educational and skills-building intervention. It includes two live webinar sessions and a follow-up phone call guided by a certified genetic counselor and a master's prepared oncology nurse. Each live webinar includes two modules (total four modules) presenting information about BRCA mutations, a decision aid for genetic testing, and two skill-building modules for effective coping and family communication. Participants in focus groups (n=11) were highly satisfied with the intervention, reporting it to be useful and describing clearly the important issues. From the 12 dyads recruited in the pre-post pilot study (response rate 12/52, 23%), completion rate was 71% (10/14) for intervention and 40% (4/10) for wait-listed control groups.
Acceptability and satisfaction with the Family Gene Toolkit is high. On the basis of the findings from usability and feasibility testing, modifications on timing, delivery mode, and recruitment methods have been implemented.
ClinicalTrials.gov NCT02154633; https://clinicaltrials.gov/ct2/show/NCT02154633 (Archived by WebCite at http://www.webcitation.org/6yYNvLPjv).
Journal Article
Humanitarian Intervention
The dilemma of how best to protect human rights is one of the most persistent problems facing the international community today. This unique and wide-ranging history of humanitarian intervention examines responses to oppression, persecution and mass atrocities from the emergence of the international state system and international law in the late sixteenth century, to the end of the twentieth century. Leading scholars show how opposition to tyranny and to religious persecution evolved from notions of the common interests of 'Christendom' to ultimately incorporate all people under the concept of 'human rights'. As well as examining specific episodes of intervention, the authors consider how these have been perceived and justified over time, and offer important new insights into ideas of national sovereignty, international relations and law, as well as political thought and the development of current theories of 'international community'.
eBook
Promoting academic success with English language learners : best practices for RTI
\"Educators and school psychologists throughout the country are working with growing numbers of English language learners (ELLs), but often feel unprepared to help these students excel. This highly informative book presents evidence-based strategies for promoting proficiency in academic English and improving outcomes in a response-to-intervention (RTI) framework. Illustrated with a detailed case example, the book describes best practices for working with K-5 ELLs in all stages of RTI: universal screening, progress monitoring, data collection, decision making, and intensifying instruction. In a large-size format with lay-flat binding for easy photocopying, the book includes 14 worksheets. Purchasers get access to a Web page where they can download and print the reproducible materials\"-- Provided by publisher.
Book
Fall Prevention Program Using Home Floor Plans in an Acute-Care Hospital: A Preliminary Randomized Controlled Trial
We provided fall prevention programs using home floor plans for older adult patients discharged from an acute-care hospital and verified the fall prevention measures’ effectiveness six months after discharge. The research design was a preliminary randomized controlled trial. Orthopedic patients with a falls’ history were randomized to the control (n = 30) or the intervention groups (n = 30). Before discharge, the control group was treated with general physiotherapy for their disease characteristics. The intervention group received the same programs before discharge; additionally, a simple house evaluation was conducted using the subject’s home floor plan. A six-month follow-up survey was conducted on falls and near-falls after discharge, completed by 51 of the 60 subjects (85%). Within two months, falls occurred in 7.7% of the control group but not in the intervention group, after which, falls occurred in the intervention group, and no significant difference was noted between the two groups (three-month (p = 0.322) and six-month (p = 0.931) follow-ups). The intervention group had significantly fewer near-falls than the control group within three months (p = 0.034), but no significant difference was observed after three months. The results suggested that our program effectively expanded the role of an acute care hospital for discharged patients who need to transition from hospital care to home health care.
Journal Article
Group Career Construction Counseling: A Mixed‐Methods Intervention Study With High School Students
This study investigated the value of group career construction counseling in a high school context. The author used purposive sampling to select participants who had sought career counseling. A mixed‐methods intervention study design was also used. Participants (N = 57) completed the Career Adapt‐Abilities Scale–South Africa (CAAS‐SA) before the 1st and after the 2nd intervention. The Career Interest Profile and the Maree Career Matrix were used to facilitate the intervention, and the CAAS‐SA was used to test the research hypotheses. The findings revealed that the boys’ and the girls’ career adaptability had improved meaningfully on all of the CAAS‐SA subscales. No gender‐based differences were found. However, differences were detected between both the boys’ and the girls’ pre‐ and posttest Control and Confidence subscale scores. The findings demonstrate the value of career construction counseling in group settings. More longitudinal research with diverse participants is needed.
Journal Article
The Impact of Nutrition and Oral Function Exercise on among Community-Dwelling Older People
Oral function (OF) decline in older people is associated with nutritional deficiencies, which increases frailty risk and the need for nursing care. We investigated whether the delivery of an oral function improvement program on a tablet device was as effective as delivery through a paper-based program. We also investigated the association between tongue pressure (TP) improvement and nutritional status at the baseline. The participants involved in the study were 26 community-dwelling older people with low TP, <30 kPa, aged ≥65 years, who were enrolled in a randomized controlled trial for a month in Itoshima City, Fukuoka, Japan. Oral and physical functions and body composition were measured at the baseline and at follow-up. Two-way analysis of variance revealed that body mass index (p = 0.004) increased, and maximum masticatory performance (p = 0.010), maximum TP (p = 0.035), and oral diadochokinesis /pa/ and /ka/ (p = 0.009 and 0.017, respectively) improved in a month. Participants with higher TP improvement showed an increased intake of animal proteins at the baseline: fish (p = 0.022), meat (p = 0.029), and egg (p = 0.009). OF exercises for improving TP were associated with higher animal protein intake at the baseline. This study has been registered with the UMIN Clinical Trials Registry (UMIN 000050292).
Journal Article
Effectiveness of a Tailored Fall-Prevention Program for Discharged Older Patients: A Multicenter, Preliminary, Randomized Controlled Trial
This multicenter, preliminary, randomized controlled trial investigated the effect of a tailored fall-prevention program using home floor plans for discharged orthopedic patients aged ≥65 years who experienced ≥1 fall(s) in the past year (n = 72) at five acute-care hospitals. The control group received standard care (exercise to prevent recurrent falls), whereas the intervention group received a tailored fall-prevention program in addition to usual care. A physical therapist conducted the tailored education program using each patient’s home floor plans before discharge. A follow-up survey of falls and near-falls at home was performed using a monthly fall calendar for the 1-month period after discharge. Data on 81.5% of participants remained for the final analyses. No falls occurred in the intervention group; however, 4.3% of those in the control group experienced a fall. Near-falls were reported by 3.7% and 26.9% of the participants in the intervention and control groups, respectively. The proportion of participants who did not experience near-falls in the 1st month after discharge was lower in the intervention than in the control group (p = 0.018). In conclusion, the tailored fall-prevention program using home floor plans in multiple acute-care hospitals was effective in reducing falls and near-falls in discharged orthopedic patients.
Journal Article
Cross-sectional and longitudinal relation between serum 25-hydroxyvitamin D and body mass index: the Tromsø study
Purpose
The serum 25-hydroxyvitamin D (25(OH)D) levels are lower in obese than lean subjects. The present study examines the cross-sectional and longitudinal relations between body mass index (BMI) and serum 25(OH)D, and the serum 25(OH)D response to vitamin D supplementation in relation to BMI.
Methods
The Tromsø study is a longitudinal population-based multipurpose study. The fourth survey was conducted in 1994 and the sixth in 2008. The intervention study was a 1-year placebo-controlled randomized intervention trial, where the results from the 93 subjects given 40,000 IU per week are presented.
Results
A total of 10,229 subjects were included in the 2008 cross-sectional study. There was a significant negative association between serum 25(OH)D levels and BMI which was also present during the winter months. Serum 25(OH)D levels varied through seasons, but not BMI. In the longitudinal study from 1994 to 2008 which included 2,656 subjects, change in BMI was a significant negative predictor of change in 25(OH)D. In the intervention study, there was a significant and negative correlation between BMI and serum 25(OH)D both at baseline and at the end of the study. The increase in serum 25(OH)D after 1 year was significantly and inversely related to baseline BMI.
Conclusions
We have confirmed the strong association between serum 25(OH)D and BMI. The very obese need higher vitamin D doses than lean subjects to achieve the same serum 25(OH)D levels.
Journal Article