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Статті в журналах з теми "Placebo interventions":
1
Linde, Klaus, Margrit Fässler, and Karin Meissner. "Placebo interventions, placebo effects and clinical practice." Philosophical Transactions of the Royal Society B: Biological Sciences 366, no. 1572 (June 27, 2011): 1905–12. http://dx.doi.org/10.1098/rstb.2010.0383.
Анотація:
This article reviews the role of placebo interventions and placebo effects in clinical practice. We first describe the relevance of different perspectives among scientists, physicians and patients on what is considered a placebo intervention in clinical practice. We then summarize how placebo effects have been investigated in randomized controlled trials under the questionable premise that such effects are produced by placebo interventions. We further discuss why a shift of focus from the placebo intervention to the overall therapeutic context is necessary and what research methods can be used for the clinical investigation of the relevance of context effects. In the last part of the manuscript, we discuss why placebo or context effects are seen as positive in clinical practice when they are associated with active treatments, while placebo interventions pose major ethical and professional problems and have to be avoided.
2
Staudacher, Heidi M., Peter M. Irving, Miranda C. E. Lomer, and Kevin Whelan. "The challenges of control groups, placebos and blinding in clinical trials of dietary interventions." Proceedings of the Nutrition Society 76, no. 3 (June 20, 2017): 203–12. http://dx.doi.org/10.1017/s0029665117000350.
Анотація:
High-quality placebo-controlled evidence for food, nutrient or dietary advice interventions is vital for verifying the role of diet in optimising health or for the management of disease. This could be argued to be especially important where the benefits of dietary intervention are coupled with potential risks such as compromising nutrient intake, particularly in the case of exclusion diets. The objective of the present paper is to explore the challenges associated with clinical trials in dietary research, review the types of controls used and present the advantages and disadvantages of each, including issues regarding placebos and blinding. Placebo-controlled trials in nutrient interventions are relatively straightforward, as in general placebos can be easily produced. However, the challenges associated with conducting placebo-controlled food interventions and dietary advice interventions are protean, and this has led to a paucity of placebo-controlled food and dietary advice trials compared with drug trials. This review appraises the types of controls used in dietary intervention trials and provides recommendations and nine essential criteria for the design and development of sham diets for use in studies evaluating the effect of dietary advice, along with practical guidance regarding their evaluation. The rationale for these criteria predominantly relate to avoiding altering the outcome of interest in those delivered the sham intervention in these types of studies, while not compromising blinding.
3
Addington, Donald, Richard Williams, Yvon Lapierre, and Nady El-Guebaly. "Placebos in Clinical Trials of Psychotropic Medication." Canadian Journal of Psychiatry 42, no. 3 (April 1997): 1–6. http://dx.doi.org/10.1177/070674379704200312.
Анотація:
This paper represents the position of the Canadian Psychiatric Association on the ethical and scientific issues related to the use of placebos in the evaluation of new psychotropic drugs. The position taken by the Association is that new psychotropic medications must be shown to be effective and must be weighed against the best current interventions. Placebo controls may be appropriate under certain circumstances, even when an established intervention is effective. These include situations in which placebo response rates are high, variable, or close to response rates for effective therapies. Placebo controls arc also appropriate when established interventions cany a high risk of side effects or are effective against only certain symptoms of the disorder.
4
Spiegler, Ran. "Placebo Reforms." American Economic Review 103, no. 4 (June 1, 2013): 1490–506. http://dx.doi.org/10.1257/aer.103.4.1490.
Анотація:
I study a dynamic model of strategic reform decisions that potentially affect the stochastic evolution of a publicly observed economic variable. Policy makers maximize their evaluation by a boundedly rational public. Specifically, the public follows a rule that attributes recent changes to the most recent intervention. I analyze subgame perfect equilibrium in this model when the economic variable follows a linear growth trend with noise. Equilibrium is essentially unique and stationary, bearing a subtle formal relation to optimal search models. Policy makers tend to act during crises, display risk aversion conditional on acting, and prefer interventions that induce permanent noise. (JEL D78, D83)
5
Deer, Rachel R., Jared M. Dickinson, Jacques Baillargeon, Steven R. Fisher, Mukaila Raji, and Elena Volpi. "A Phase I Randomized Clinical Trial of Evidence-Based, Pragmatic Interventions to Improve Functional Recovery After Hospitalization in Geriatric Patients." Journals of Gerontology: Series A 74, no. 10 (March 25, 2019): 1628–36. http://dx.doi.org/10.1093/gerona/glz084.
Анотація:
Abstract Background Physical function declines during hospitalization in geriatric patients, increasing the risk of loss of independence. There is a need for evidence-based, pragmatic interventions to improve functional recovery of older adults following acute hospitalization. Here, we report the results of a Phase I randomized clinical trial designed to determine safety and effect size of protein supplementation, exercise, and testosterone interventions on 30-day post-discharge functional recovery and readmissions in geriatric patients. Methods A total of 100 patients admitted to the University of Texas Medical Branch hospital for an acute medical illness were randomized to one of five intervention groups: isocaloric placebo, whey protein supplement, in-home rehabilitation + placebo, in-home rehabilitation + whey protein, or testosterone. Primary outcome measure was the change from baseline in short physical performance battery score at 1 and 4 weeks post-discharge. Secondary outcomes were changes in body composition, activities of daily living, and 30-day readmissions. Comparisons were made across study groups and between placebo and all active intervention groups. Results Four weeks post-discharge, the short physical performance battery total score and balance score increased more in active intervention groups than placebo group (p < .05). There were no significant differences in change in body composition or activities of daily living across groups or between active intervention groups and placebo group. Readmission rates were highest in placebo (28%), followed by rehabilitation + placebo (15%), whey protein (12%), rehabilitation + whey protein (11%), and testosterone (5%). There was a trend for lower readmission rates in all active intervention groups (11%) versus placebo group (28%). Conclusions Findings from this Phase I clinical trial suggest that pragmatic, evidence-based interventions may accelerate recovery from acute hospitalization in geriatric patients. These data provide essential information to design larger randomized controlled trials to test the effectiveness of these interventions.
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Addington, Donald, Richard Williams, Yvon Lapierre, and Nady el-Guebaly. "Les placebos dans les essais cliniques sur les psychotropes." Canadian Journal of Psychiatry 42, no. 5 (June 1997): i—vi. http://dx.doi.org/10.1177/070674379704200523.
Анотація:
Le présent document exprime la position adoptée par l'Association des psychiatres du Canada sur les questions éthiques et scientifiques que soulève l'utilisation de placebos dans l'évaluation de nouveaux psychotropes. Selon l'Association, il faut démontrer l'efficacité des nouveaux psychotropes et les comparer aux interventions qui sont actuellement plus efficaces. Les groupes témoins placebos peuvent être indiqués dans certaines circonstances, malgré l'efficacité d'une intervention établie, c.-à-d. dans les situations où les taux de réponse au placebo sont élevés, variables, ou proches des taux de réponse aux traitements efficaces. Les groupes témoins placebos sont également indiqués quand les interventions établies comportent un risque élevé d'effets secondaires ou lorsqu'elles sont efficaces seulement contre certains symptômes d'un trouble.
7
Macdonald, Clare, Anna Sternberg, and Paul Hunter. "A systematic review and meta-analysis of interventions used to reduce exposure to house dust and their effect on the development and severity of asthma." Ciência & Saúde Coletiva 13, no. 6 (December 2008): 1907–15. http://dx.doi.org/10.1590/s1413-81232008000600026.
Анотація:
We assessed whether any household dust reduction intervention has the effect of increasing or decreasing the development or severity of atopic disease. Electronic searches on household intervention and atopic disease were conducted in 2007 in EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials. We included randomized controlled trials comparing asthma outcomes in a household intervention group with either placebo intervention or no intervention. Meta-analyses on the prevention studies found that the interventions made no difference to the onset of wheeze but made a significant reduction in physician-diagnosed asthma. Meta-analysis of lung function outcomes indicated no improvement due to the interventions but found a reduction in symptom days. Qualitatively, health care was used less in those receiving interventions. However, in one study that compared intervention, placebo, and control arms, the reduction in heath care use was similar in the placebo and intervention arms. This review suggests that there is not sufficient evidence to suggest implementing hygiene measures in an attempt to improve outcomes in existing atopic disease, but interventions from birth in those at high risk of atopy are useful in preventing diagnosed asthma but not parental-reported wheeze.
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Donnelly, Gloria F. "The Placebo Effect and Holistic Interventions." Holistic Nursing Practice 18, no. 5 (September 2004): 238–41. http://dx.doi.org/10.1097/00004650-200409000-00006.
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Koudstaal, Stefan, Sophie L. Niemansburg, Nabil Dib, Justin Wallet, Pieter A. Doevendans, Annelien L. Bredenoord, and Steven A. J. Chamuleau. "Placebo in Autologous Cell-Based Interventions." Journal of the American College of Cardiology 63, no. 25 (July 2014): 2877–79. http://dx.doi.org/10.1016/j.jacc.2014.03.045.
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Nouchi, Rui, Qingqiang Hu, Toshiki Saito, Natasha Yuriko dos Santos Kawata, Haruka Nouchi, and Ryuta Kawashima. "Brain Training and Sulforaphane Intake Interventions Separately Improve Cognitive Performance in Healthy Older Adults, Whereas a Combination of These Interventions Does Not Have More Beneficial Effects: Evidence from a Randomized Controlled Trial." Nutrients 13, no. 2 (January 25, 2021): 352. http://dx.doi.org/10.3390/nu13020352.
Анотація:
Background: Earlier studies have demonstrated that a single-domain intervention, such as a brain-training (BT) game alone and a sulforaphane (SFN) intake, positively affects cognition. This study examined whether a combined BT and SFN intake intervention has beneficial effects on cognitive function in older adults. Methods: In a 12-week double-blinded randomized control trial, 144 older adults were randomly assigned to one of four groups: BT with SFN (BT-S), BT with placebo (BT-P), active control game (AT) with SFN (AT-S), and active control game with placebo (AT-P). We used Brain Age in BT and Tetris in AT. Participants were asked to play BT or AT for 15 min a day for 12 weeks while taking a supplement (SFN or placebo). We measured several cognitive functions before and after the intervention period. Results: The BT (BT-S and BT-P) groups showed more improvement in processing speed than the active control groups (AT-S and AT-P). The SFN intake (BT-S and AT-S) groups recorded significant improvements in processing speed and working memory performance unlike the placebo intake groups (BT-P and AT-P). However, we did not find any evidence of the combined intervention’s beneficial effects on cognition. Discussion: We discussed a mechanism to improve cognitive functions in the BT and SFN alone interventions.
Дисертації з теми "Placebo interventions":
1
Fenchel, Monika, and Therese Hermansen. "Omvårdnad med placeboeffekt : En litteraturstudie om hur omvårdnadsåtgärder kan skapa placebo och nocebo." Thesis, Röda Korsets Högskola, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2563.
Анотація:
BAKGRUND: Placebo som begrepp har förändrats över tid – från medeltidens betydelse ”jag skall göra gott” till en overksam substans som används i randomiserade kontrollerade studier. Tidigare forskning visar att placeboeffekt kan skapas genom förväntans- och betingningsmekanismer, som via hjärnan startar processer i kroppen som kan lindra symptom som exempelvis smärta och illamående. Placeboeffekter har ansetts förekomma vid upp till 90 procent av sjuksköterskans åtgärder, men forskningen som belyser dess potential inom omvårdnad är bristfällig. SYFTE: Att undersöka hur placeboeffekten skulle kunna användas vid omvårdnadsåtgärder. METOD: En litteraturstudie med induktiv ansats. RESULTAT: Placebo kan skapas genom bemötande, behandlingsritualer och vårdmiljö. Vårdpersonal kan använda placeboeffekten för att stödja patientens behandling, för att individanpassa vården och stärka relationen mellan patient och personal. SLUTSATS OCH FÖRSLAG PÅVIDARE FORSKNING: Många omvårdnadsåtgärder som kan bidra till att skapa placeboeffekter går att använda utan etiska konflikter, medan andra delar kräver merforskning och etiska riktlinjer innan de är genomförbara i klinisk praxis. Vidare forskning bör fokusera på klinisk miljö och knyta samman omvårdnadsforskning med andra forskningsområden. Individuella skillnader i placeborespons och vårdpersonalens syn på användning av placebo är några områden som behöver fördjupas inom omvårdnadsforskning.BACKGROUND: The concept placebo has changed over time – from the Middle Ages denotation of "I shall please" - into an inactive substance used in randomized controlled trials. Previous research shows that a placebo effect can be created through expectation and conditioning-mechanisms, which in turn trigger brain processes that can alleviate symptoms such as pain and nausea. Up to 90 percent of a nurse's actions have been considered to create placebo effects, but research that highlights its potential in nursing care is scarce. AIM OF STUDY: Examine how the placebo effect could be used in nursing interventions. METHOD: A literature study with inductive approach. RESULTS: Placebo effects can be created through verbal and non-verbal treatment, treatment rituals and by altering the context of the healthcare setting. Healthcare professionals can use the placebo effect to strengthen or replace active treatments. CONCLUSION AND SUGGESTIONS FOR FURTHER RESEARCH:Several nursing interventions that initiate a placebo effect can be used without ethical conflicts, while others require more research and ethical guidelines before being viable in clinical practice. Individual differences regarding placebo response, and healthcare professionals' views of the use of placebo, are some areas that need further research.
2
Geraghty, Adam William Alfred. "From placebo to self-help : investigating retention, outcome and mechanisms in self-directed gratitude interventions." Thesis, University of Plymouth, 2010. http://hdl.handle.net/10026.1/771.
Анотація:
The research presented in this thesis explored unguided self-help therapy, primarily using a gratitude technique. Psychological mechanisms that underlie the placebo response may also play a primary role in beneficial response to unguided selfhelp therapy. Retention (whether participants completed the intervention), outcome (whether the technique effectively reduced symptoms), and mechanisms (the psychological processes which antecede outcome and retention), were investigated with participants engaging in procedures to improve a diverse range of symptoms, namely, mood, sleep disturbance, body dissatisfaction, depression and anxiety. Studies one and two investigated the role of two placebo mechanisms, response expectancy and motivational concordance, as predictors of outcome following a gratitude technique. Response expectancy contributed to outcome to a greater extent in a laboratory setting, whereas motivational concordance explained greater outcome variance in a real-world setting. Studies three, four and five compared a gratitude technique to a problemfocused technique and a wait list control. Across all three studies, being randomly allocated to a gratitude technique resulted in greater retention than being a llocated to a problem-focused technique. Use of a gratitude technique resulted in equivalent significant reductions in body dissatisfaction (Study three), depression (Study four) and worry (Study five), compared to a problem-focused cognitive restructuring technique, and was significantly more effective than being on a waitlist in all three studies. There was some evidence that different mechanisms affect outcome and retention. Placebo theory and the contextual model of psychotherapy provide useful insight into the factors that affect outcome and retention in self-help therapy.
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Webb, Monica S. "Do expectancies influence outcomes for tailored smoking cessation messages? a placebo tailoring experiment." [Tampa, Fla.] : University of South Florida, 2005. http://purl.fcla.edu/fcla/etd/SFE0001165.
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Gaitan-Sierra, Linda Carolina. "Motivational factors in the placebo response : the role of effort and intrinsic motivation on well-being in therapeutic interventions." Thesis, University of Plymouth, 2011. http://hdl.handle.net/10026.1/890.
Анотація:
One of the most interesting aspects of human beings is their ability to choose a course of action and strive to achieve it. When participating in therapeutic interventions involving physical activities, people may allocate different amounts of effort, persistence and commitment to succeed in them. The reason for this difference lies in their motivation. The present thesis focuses on the energising of behaviour, that is, the differential effort and motivation that people put into therapeutic activities. Placebo responses are generally explained by the mechanisms of response expectancy, conditioning and motivational concordance. Findings presented in this thesis partially supported motivational concordance, testing for the first time that therapeutic outcome after engagement in intrinsically motivated tasks requiring physical activity was explained both by response expectancy and motivational concordance . The effects of response expectancy, perceptions of effort and intrinsic motivation on therapeutic benefit and mood change were investigated in both laboratory (Studies 1-4) and real-life therapeutic contexts (Study 5). Study 1 showed that effort mediated the effects of expectancy on perceived benefit, and effort predicted both positive and negative affect following the performance of a breathing exercise. Study 2 showed that differences in outcome between guided imagery and meditation were very small, but that non-specific factors play the major role in outcome. Study 3 showed that perceiving a task as difficult enhances effort perceptions, intrinsic motivation and therapeutic outcome. Motivated behaviour predicted therapeutic outcome but not expectancy. Study 4 showed that the provision of success feedback enhances outcome expectancies, motivated behaviour and mood change. Expectancies, motivation and effort predicted positive affect, whereas only effort predicted negative affect. Finally, results from Study 5 suggest that placebo responses may differ in real-life therapeutic interventions according to the strength motivational factors are elicited within the intervention. Both expectancy and motivated behaviour predicted change in positive affect, whereas motivated behaviour predicted change in negative affect and empowerment. Therapeutic outcome and its underlying mechanisms are likely to reflect a mixture of response expectancies and intervening motivational factors.
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Rabipour, Sheida. "Effects of Expectations on Cognitive Enhancement Interventions in Young and Older Adults." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/38157.
Анотація:
With increasing life expectancy and global population of older adults, preserving cog- nitive function throughout life represents a growing priority. Numerous approaches to cognitive enhancement exist, but few have scientific merit. Among the most preva- lent – and commercialized – approaches are cognitive training (“brain training”) and non-invasive brain stimulation through electric currents applied at the surface of the scalp. The present dissertation describes a collection of work contextualizing the appeal of these cognitive enhancement methods and addressing some of the most pervasive limitations of research in this field thus far.
One largely ignored issue in cognitive intervention research pertains to people’s expectations of programs and their relationship with intervention outcomes. In a series of initial studies, we developed and validated the Expectation Assessment Scale (EAS), a tool created to measure as well as prime expectations of outcomes in the context of cognitive enhancement interventions. In our first two studies, we probed expectations of cognitive training or non-invasive brain stimulation in over 1,000 young, middle-aged, and older adults. Ratings on the EAS suggested that older adults may have particularly high expectations of cognitive training, but that expectations can be primed to increase or decrease – at least in hypothetical scenarios. We used these data to assess the psychometric properties of the EAS with item-response theory, and confirmed its internal consistency.
Next, we incorporated the EAS into two cognitive enhancement trials, one in- vestigating a computerized cognitive training intervention in nearly 100 older adults and another examining non-invasive brain stimulation in nearly 100 young adults. Both trials had a double-blind balanced-placebo design in which participants were assigned to the intervention or control condition, and then subdivided to receive ei- ther high or low expectation priming (i.e., primed to have high or low expectations of the program’s effectiveness). Although expectation ratings replicated our previous findings, results from these trials suggest little, if any, effect of either expectations or the intervention on performance outcomes. We nevertheless found that participants enjoyed their assigned program and that those who received high expectation prim- ing tended to report a more positive experience. Our findings put into question the effectiveness of such interventions and support the need for more rigorous trials of cognitive enhancement.
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Qadir, Othman Kareem. "Growth of lettuce with different content of inorganic nitrate as a feeding strategy for placebo-controlled nutritional interventions to test the effects of inorganic nitrate on human health." Thesis, University of Newcastle upon Tyne, 2017. http://hdl.handle.net/10443/3916.
Анотація:
The chemical composition of vegetables is dependent on several growing conditions. This effect relates to phytochemical compounds including secondary metabolites and other bioactive non-nutritional compounds. This study aimed to use different nitrogen fertilizer regimes to produce vegetables with so large differences in nitrate content that they can be used as treatment and placebo to study the effect of nitrate on human health. Green leafy vegetables, such as lettuce or rocket, are rich in inorganic nitrate (NO3) and an increased consumption has been associated with beneficial effects on blood pressure (BP). The objective of this study was to compare whether two lettuce materials with controlled high and low NO3 content may have different effects on BP in healthy subjects. Firstly a gas chromatography mass spectrometry (GC-MS) method using pentafluorobenzyl bromide and chemical ionisation to determine nitrate and nitrite levels was modified to optimise the analytical process. This method has been used to measure samples of lettuce as well as samples of human plasma, urine and saliva obtained from this study and several other projects. In this study, two sets of lettuce were produced as a model vegetable with high and low nitrogen fertiliser in controlled growing conditions to manipulate nitrate concentration of the vegetable as a tool for investigating the effect of nitrate content of food on human health. This was tested by determining the correlations between nitrate intake and blood pressure (BP), by measuring the short effect on systolic and diastolic BP and nitrate and nitrite contents in blood, urine and saliva samples. The novelty of this study is that the placebo and the treatment (lettuce with low and high nitrate content, respectively) have similar appearance despite being very different in nitrate content, making it possible to blind the subjects to the treatment and control placebo effects of vegetable consumption. Using 26 and 154ppm ammonium nitrate in the fertigation solution, lettuce was produced with a high (~530 mg nitrate/50g FW portion) or low (~3 mg/50g) nitrate content. However not all confounding factors could be controlled, e.g. the low nitrate lettuce produced a high amount of phenolic acids which was 69.5 mg/50g FW and high nitrate lettuce produced a much lower amount which10.5mg/50g FW (P < 0.001). So while the nitrate content can be manipulated substantially via fertilizer treatments, the low-nitrate lettuce also differs from the high-nitrate lettuce in the content of other non-nutrient phytochemicals. An intervention trial was carried out with twenty healthy young volunteers (12 females and 8 males) in a randomised, double-blind placebo controlled cross-over design, with two 24-hour ii intervention phases separated by a 3-week washout period to avoid carry-over effects. Blood pressure was recorded by 24-hour ambulatory blood pressure monitoring (ABPM), every 30 mins during day-time and every 60 min at night-time. Consumption of high nitrate lettuce significantly increased plasma NO3 (3 hrs post-ingestion: 395±133 μM; P < 0.001), salivary NO3 (3 hrs post-ingestion: 7362±4666 μM; P < 0.001) and urinary NO3 (3 hrs post-ingestion: 2287±1233μM; P < 0.001) concentrations whereas non-significant changes were measured in the low nitrate lettuce group. High nitrate lettuce significantly reduced systolic BP (-2.80±4.43 mmHg and -6.85±4.91 mmHg after 3 and 6 hrs, respectively; P=0.003) and diastolic BP (-2.25±2.34mmHg and Δ3.85±3.01 mmHg after 3h and 6 hrs, respectively; P=0.002) compared to low nitrate lettuce. No significant difference was observed between high nitrate lettuce and low nitrate lettuce for TEAC (P = 0.32), FRAP (P = 0.26), cGMP (P = 0.19) and plasma concentrations of phenolic compounds. The results showed that the amount of urinary nitrate excreted during a 24-hour period increased from 104mg with low nitrate lettuce to 391mg (P < 0.001) with the high nitrate lettuce. In conclusion, ingestion of high nitrate lettuce significantly increases plasma, saliva and urinary nitrate and lowers systolic and diastolic BP compared to low nitrate lettuce. The development of NO3-enriched and NO3-depleted vegetable products with similar organoleptic characteristics could provide a unique opportunity to conduct double-blind nutritional interventions and advance knowledge on the role of dietary nitrate on human health.
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Haymann, Liora. "Interventions in public housing : in search of place." Thesis, Massachusetts Institute of Technology, 1985. http://hdl.handle.net/1721.1/74768.
Анотація:
Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Architecture, 1985.MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH.
Includes bibliographical references (p. 128-130).
This work searches to build a framework for a rehabilitation strategy for distressed urban Public Housing projects. It is argued that an appropriate approach needs to address both, the physical and the institutional aspects of the projects, and that the core of the distress can be seen as a matter of levels of control at the project level. In this light, the notion of "mediating structures" --as an intermediate level - of control to be built into the projects-- is proposed. The argument is developed through three stages: A search into the history of Public Housing and its decay, to pinpoint what built-in patterns of control --in physical and institutional terms-- support the projects' distress. A review of current rehabilitation attempts in relation to the issue of control. An examination of what a mediating structure means and what the necessary conditions are for its support through a rehabilitation plan. The basic principles for the rehabilitation strategy, are then outlined.
by Liora Haymann.
M.S.
8
Manning, R. "An Examination of Place, Identity and Bystander Intervention." Thesis, Lancaster University, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.745983.
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Miles, Martina. "Pain in Parallel Places: Interventions in Disability Studies and Science Fiction." Thesis, University of Oregon, 2015. http://hdl.handle.net/1794/19261.
Анотація:
Pain is a physical experience that is often imbued with metaphorical significance. Understanding better how pain operates as a cultural signifier can reveal assumptions about the status of different bodies and subjects. Even though pain is a nearly universal phenomenon, there is currently a dearth of sustained inquiry into pain as a literary, physical, and social phenomenon. What critical analysis there is about pain often metaphorizes the experience and forgets the lived, material realities of pain. At the same time, pain is a factor in virtually all cultural and social interactions, influencing everything from medical care to community acceptance. Thus, uncovering the functions of pain is a necessity. This dissertation reads for the ways pain forges intercorporeal relationships between bodies through the process of co-suffering, offering a new way of looking at the grotesque body. Using examples from a broad range of science fiction texts, from popular non-fiction science writing to superhero comics to novels to television, this dissertation explores the various ways that normative and non-normative pain response is witnessed and perceived. Putting forth a theory of co-suffering as a form of attention to and embodied translation of pain language, this dissertation examines the various ways in which listening to the voice of pain creates intercorporeal kinship between bodies. Through this kinship, bodies become subjects and gain access to community. Ultimately, this dissertation shows that, while pain can foster such kinship, predictable and standard pain responses are necessary for creating co-suffering. Thus co-suffering can be emancipatory, as it helps marginalized bodies gain subjectivity, but it can also be a way for cultures to enforce rigid behaviors on subjects, as it requires that bodies conform to those standard pain responses.
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Flositz, Jeffrey T. "Livable Streets: Establishing Social Place Through a Walkable Intervention." Scholar Commons, 2010. http://scholarcommons.usf.edu/etd/3432.
Анотація:
Some streets tend to lack a social sense of place. Since the invention of the automotive assembly line and post World War II development, street designs have shifted from centering around people and social situations to vehicular traffi c solutions. Streets are typically not thought of as social places, but rather as a means to effi ciently move automotive traffi c. The environment of these unlivable streets discourages social interaction. The majority of buildings are disconnected from the street with often nothing more than a parking lot.
A new model of streets is necessary, one that transforms streets into places that encourages social liveliness. Establishing the street as a social place through walkable conditions will regain lively interaction that is currently absent.
This thesis will begin to explore the conditions of the unlivable street and establish theories to transform them into socially interactive public places. The goal is to hierarchically re-orient the street in order create a sense of place that fosters social interaction.
Research by means of case studies and observation will examine the ways in which people interact within their built environment. Ideas will be derived from research and incorporated into the scheme in a way that is unique to Tampa. Ultimately, this thesis will conclude in a project that illustrates the potential of a street as a lively public place that is centered toward pedestrians rather than automobiles.
Книги з теми "Placebo interventions":
1
Karoly, Lynn A. Early childhood interventions: Proven results, future promise. Santa Monica: Rand, 2005.
2
Kuball, Mischa. No-Place: Eine Intervention im Sprengel Museum Hannover, 31.8. bis 30.10.1994. Hannover: Sprengel Museum, 1994.
3
Tiwari, Indra P. Employment creation and income generation in rural regions: Peoples, places, activities and interventions in Nepal. Lekhnath, Nepal: Center for Rural and Urban Studies and Transfiguration, 1998.
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Beregi, Jean-Paul. Urgences cardio-vasculaires: place de la radiologie interventionnelle. Paris: Springer Paris, 2009.
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Brehony, Eamonn G. Birds in different places do not speak one language: A study to determine a methodology for linking indigenous community practices in East Africa with outside development intervention strategies. Dublin: University College Dublin, 1998.
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Fitzgibbon, Marion. Birds in different places do not speak one language: A study to determine a methodology for linking indigenous community practices in East Africa with outside development intervention strategies. Dublin: University College Dublin, 1998.
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Carloni, Giovanna, Christopher Fotheringham, Anita Virga, and Brian Zuccala. Blended Learning and the Global South Virtual Exchanges in Higher Education. Venice: Fondazione Università Ca’ Foscari, 2021. http://dx.doi.org/10.30687/978-88-6969-529-2.
Анотація:
This volume collects a series of theoretical and practical interventions in the area of blended learning globally. It aims to present pedagogues working in higher education contexts in the developing world with models of successful blended learning initiatives designed and implemented by committed educators working with student bodies characterised by unequal access to technology and connectivity. The twelve individual chapters of this volume are an invaluable practical resource for educators but when taken as a whole the collection provides a counter to commonplace beliefs about blended learning originating within the institutions of wealthy countries. It offers theoretical, material and socially grounded currents for thinking about the place of blended learning in the Global South and is a work of resistance to pedagogical epistemologies with ‘first world’ and neoliberal biases.
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Silk, Kenneth R. Pharmacological Interventions for Borderline Personality Disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199997510.003.0013.
Анотація:
Although no medication is indicated to specifically treat symptoms of borderline personality disorder (BPD), medications are used frequently in the treatment of patients with BPD. This chapter reviews a number of reasons why medications are frequently prescribed in this patient population, then goes on to discuss eight systematic reviews or meta-analyses of 23 double-blind placebo-controlled randomized trials of the psychopharmacologic treatment of patients with BPD. The author attempts to make some sense of these reviews, which at times come to different conclusions despite examining essentially the same dataset. The chapter also addresses how to proceed with and manage the psychopharmacologic treatment of patients with BPD.
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Casey, Patricia. Treatment of adjustment disorders (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198786214.003.0007.
Анотація:
There are few randomized controlled studies of the treatment of AD. This is due to the transience of the symptoms, the difficulty obtaining a homogeneous population owing to the absence of diagnostic criteria, and the variable nature of the stressor, among others. Clinical guidelines specify that brief psychological interventions are preferred, and these incorporate elements from the many approaches now available on the assumption that their mechanism of action will also be effective in AD. Few have been tested specifically in AD. Low-intensity therapies specific to AD are being developed, such as biblio-therapy and online self-help. Pharmacological interventions have not been tested in quality trials, but despite this, antidepressants continue to be frequently prescribed. A few trials of anxiolytics have found some benefit for all the agents examined, but none used placebo. EMDR was found to be beneficial in a small pilot study and is worthy of further study.
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Taylor, Joseph J., and Robert Ostroff. National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program. Edited by Ish P. Bhalla, Rajesh R. Tampi, Vinod H. Srihari, and Michael E. Hochman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190625085.003.0024.
Анотація:
This chapter will summarize what is considered to be the first randomized controlled trial to directly compare psychotherapeutic and psychopharmacological interventions for unipolar nonpsychotic depression. More specifically, the authors were interested in the degree to which cognitive behavioral therapy, interpersonal therapy, imipramine and a placebo condition ameliorated symptoms of depression in patients from outpatient psychiatric clinics at three academic medical centers in the United States. The chapter will discuss the design and implementation of the study before focusing on the results and their implications. The last section of the chapter will list similar studies and present a hypothetical clinical case that requires the reader to apply basic concepts learned from the study.
Частини книг з теми "Placebo interventions":
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Iyama-Kurtycz, Tina. "Alternative Interventions and the Placebo Effect." In Diagnosing and Caring for the Child with Autism Spectrum Disorder, 121–30. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-26531-1_13.
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Toneatto, T., E. M. Sellers, L. C. Sobell, and M. B. Sobell. "Perception of Whether Drug or Placebo has been Administered is a Determinant of Drinking Reduction." In Novel Pharmacological Interventions for Alcoholism, 262–64. New York, NY: Springer New York, 1992. http://dx.doi.org/10.1007/978-1-4612-2878-3_24.
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Pelc, I., O. Le Bon, P. Verbanck, Ph Lehert, and L. Opsomer. "Calcium-Acetylhomotaurinate for Maintaining Abstinence in Weaned Alcoholic Patients: A Placebo-Controlled Double-Blind Multicenter Study." In Novel Pharmacological Interventions for Alcoholism, 348–52. New York, NY: Springer New York, 1992. http://dx.doi.org/10.1007/978-1-4612-2878-3_44.
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Annoni, Marco, and Franklin G. Miller. "Informed Consent and the Ethics of Placebo-Based Interventions in Clinical Practice." In Placebos and Nocebos in Headaches, 135–42. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-02976-0_12.
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Ackers, Louise, Gavin Ackers-Johnson, Joanne Welsh, Daniel Kibombo, and Samuel Opio. "Autonomy, Evidence and Methods in Global Health." In Anti-Microbial Resistance in Global Perspective, 11–36. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-62662-4_2.
Анотація:
AbstractThis chapter discusses the growing impact that funding bodies have on the design, delivery and evaluation of global health interventions with specific emphasis on the UK’s Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) funding programme. It explains the reasons for focusing the antimicrobial resistance intervention on maternal sepsis and describes the context within which the Maternal Sepsis Intervention took place; in a Regional Referral Hospital in Western Uganda.
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Khan, Matluba, Simon Bell, and Sarah McGeown. "School ground interventions for pedagogy and play." In Place, Pedagogy and Play, 143–62. New York: Routledge, 2020.: Routledge, 2020. http://dx.doi.org/10.4324/9780429023477-12.
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Murdock-Perriera, Lisel Alice, Kathryn L. Boucher, Evelyn R. Carter, and Mary C. Murphy. "Places of Belonging: Person- and Place-Focused Interventions to Support Belonging in College." In Higher Education: Handbook of Theory and Research, 291–323. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-03457-3_7.
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Lohle, Paul N. M. "Is There a Place for UAE in Adenomyosis?" In Radiological Interventions in Obstetrics and Gynaecology, 159–66. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/174_2012_626.
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Debenham, John. "Entrepreneurial Intervention in an Electronic Market Place." In Developments in Applied Artificial Intelligence, 335–45. Berlin, Heidelberg: Springer Berlin Heidelberg, 2002. http://dx.doi.org/10.1007/3-540-48035-8_33.
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Morris, Ian. "A Place for Well-Being in the Classroom?" In Research, Applications, and Interventions for Children and Adolescents, 185–98. Dordrecht: Springer Netherlands, 2013. http://dx.doi.org/10.1007/978-94-007-6398-2_11.
Тези доповідей конференцій з теми "Placebo interventions":
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Rungruanghiranya, S., S. Tulatammakit, K. Chittawattanarat, K. Preedapornpakorn, T. Wongphan, N. Sutanthavibul, S. Preechawong, and P. Petborom. "A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial of Community-Based Smoking Cessation Service Using Minimal Interventions in Thailand." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1648.
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Birch, Jack, Rebecca Jones, Julia Mueller, Matthew McDonald, Rebecca Richards, Michael Kelly, Simon Griffin, and Amy Ahern. "A systematic review of inequalities in the uptake of, adherence to and effectiveness of behavioural weight management interventions." In Building Bridges in Medical Science 2021. Cambridge Medicine Journal, 2021. http://dx.doi.org/10.7244/cmj.2021.03.001.1.
Анотація:
Background: It has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities. These intervention-generated inequalities may occur at different stages, including intervention uptake, adherence and effectiveness. We conducted a systematic review to synthesise evidence on how different measures of inequality moderate the uptake of, adherence to and effectiveness of behavioural weight management interventions in adults. Methods: We updated a previous systematic literature review from the US Preventive Services Taskforce to identify trials of behavioural weight management interventions in adults that could be conducted in or recruited from primary care. Medline, Cochrane database (CENTRAL) and PsycINFO were searched. Only randomised controlled trials and cluster-randomised controlled trials were included. Two investigators independently screened articles for eligibility and conducted risk of bias assessment. We curated publication families for eligible trials. The PROGRESS-Plus acronym (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other discriminating factors) was used to consider a comprehensive range of health inequalities. Data on trial uptake, intervention adherence, weight change, and PROGRESS-Plus related-data were extracted. Results: Data extraction in currently underway. A total of 108 studies are included in the review. Data will be synthesised narratively and through the use of Harvest Plots. A Harvest plot for each PROGRESS-Plus criterion will be presented, showing whether each trial found a negative, positive or no health inequality gradient. We will also identify potential sources of unpublished original research data on these factors which can be synthesised through a future individual participant data meta- analysis. Conclusions and implications: The review findings will contribute towards the consideration of intervention-generated inequalities by researchers, policy makers and healthcare and public health practitioners. Authors of trials included in the completed systematic review may be invited to collaborate on a future IPD meta-analysis. PROSPERO registration number: CRD42020173242
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Allan Johnston, Kevin, and Susan Benvenuti. "News You Can Use." In InSITE 2008: Informing Science + IT Education Conference. Informing Science Institute, 2008. http://dx.doi.org/10.28945/3241.
Анотація:
It is widely accepted that assessment determines learning: what is learnt, how the learning takes place, the extent to which the learning is retained, and the extent to which that learning can be further developed or applied (Biggs, 2003; Boud, Cohen, & Sampson, 1999; Entwistle & Entwistle, 1997; Rowntree, 1992). This paper examines an assessment intervention undertaken independently by two South African Universities in their first year Information Systems Courses, aimed at improving both the learning of content and the development of academic and career skills, within the constraints of curriculum, large classes and under-preparedness of students. Departing from a similar concept, the two universities designed and implemented the assessment tasks independently, with each experiencing different successes and challenges. Representing a first cycle in an Action Research study, the underlying rationale behind the interventions is presented, together with a detailed analysis of the two case studies and their shared lessons learned from the experience.
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Ladmia, Abdelhak, Martin Culen, Abdulla Bakheet Al Katheeri, Fahad Mustfa Ahmed Al Hosani, Graham F. J. Edmonstone, Alfonso Mantilla, Mohamed Ahmed Baslaib, et al. "Case Study of Underbalance Coiled Tubing Drilling to Increase Well Productivity and Ultimate Recovery in Tight Gas Reservoir Onshore Field, Abu Dhabi." In SPE/ICoTA Well Intervention Conference and Exhibition. SPE, 2021. http://dx.doi.org/10.2118/204436-ms.
Анотація:
Abstract Coiled Tubing Drilling (CTD) has been growing and developed rapidly through the last two decades. There have been numerous highly successful applications of CTD technology in Alaska, Canada, Oman and the United Arab Emirates (Sharjah Sajaa and Dubai Murgham fields), among other places. Currently, Saudi Arabia has undertaken a campaign for the last seven years that has shown successful results in gas reservoirs. ADNOC initiated a trial Coiled Tubing Underbalanced Drilling (CTUBD) project in the onshore tight gas reservoirs in Abu Dhabi, United Arab Emirates beginning operations 1-December-2019. The initial trial will consist of three (3) wells. The purpose of the trial is to assess the suitability of CTUBD for drilling the reservoir sections of wells in these fields, and further application in others. The reason for choosing coiled tubing for drilling the reservoir sections is based upon the high H2S content of the reservoir fluids and the premise that HSE can be enhanced by using a closed drilling system rather than an open conventional system. The three wells will be newly drilled, cased and cemented down to top reservoir by a conventional rig. The rig will run the completion and Christmas tree before moving off and allowing the coiled tubing rig to move onto the well. The coiled tubing BOPs will be rigged up on top of the Christmas tree and a drilling BHA will be deployed through the completion to drill the reservoir lateral. The wells will be drilled underbalanced to aid reservoir performance and to allow hole cleaning with returns being taken up the coiled tubing / tubing annulus. The returns will be routed to a closed separation system with produced gas and condensate being primarily exported to the field plant via the production line, solids sparge to a closed tank or pit and the drilling fluid re-circulated. The primary drilling fluid will be treated water; however, nitrogen may be required for drilling future wells in the field and will be required regardless for purging gas from the surface equipment during operations. A flare will also be required for emergency use and for start-up of drilling. If the trial proves a success, a continuous drilling plan will be put in place.
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Prior y Llombart, Jaime, Pablo García Borja, Joan Enric Palmer Broch, and Fermin Font Mezquita. "El Castell Vell de Castelló o el paradigma de la ocupación antrópica del territorio de La Plana hasta el siglo XIII." In FORTMED2020 - Defensive Architecture of the Mediterranean. Valencia: Universitat Politàcnica de València, 2020. http://dx.doi.org/10.4995/fortmed2020.2020.11372.
Анотація:
The Castelló’s old castle (Castell Vell), or the paradigm of the anthropic territory’s occupation in La Plana until the thirteenth centuryThe Castell Vell of Castelló (Castelló’s Old Castle) is an andalusian structure located at the top on a hill, placed on northern region of La Plana, in the land of Castellón. It’s organized on three interconnected platforms, as many andalusians castles: alcazaba, albacara and the village itself. With 1,1 hectares surface, it follows the pattern of “castle associated with a rural habitat” according the Bazzana’s classification. Its conservation status advises a series of interventions, the last one dated in 2018. Defensive structures have, in general, a high homogeneity in terms of construction techniques, but different moments and build phases can be identified. Its configuration is not uncommon in the almohad military structures of the Iberian land that can be dated between the twelfth and the thirteenth centuries. The presentation at this congress of this heritage piece and the description of the last intervention made is the objective of this study.
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Varanasi, Roja, Raju Kolli, Yogendra Rai, Ramesh Dubashi, G. Ravi Chandra Reddy, Tejaswini Patole, Priyanka Shrivastava, Arvind Dayal, Praveen Oberai, and Raj K. Manchanda. "Effects of Individualized Homeopathic Intervention in Stage I Essential Hypertension: A Single-Blind Randomized, Placebo-Controlled Trial." In HRI London 2019—Cutting Edge Research in Homeopathy: Presentation Abstracts. The Faculty of Homeopathy, 2020. http://dx.doi.org/10.1055/s-0040-1702091.
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Lovett, Tom, and Eamonn O'Neill. "Simulating user intervention for interactive semantic place recognition with mobile devices." In the 2012 RecSys workshop. New York, New York, USA: ACM Press, 2012. http://dx.doi.org/10.1145/2365946.2365950.
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Marlin, Stuart Graham, Tori English, Lewis Morley, Tahlia O'Keefe-Quinn, and Paige Whitfield. "Practice tests improve performance, increase engagement and protect from psychological distress." In Sixth International Conference on Higher Education Advances. Valencia: Universitat Politècnica de València, 2020. http://dx.doi.org/10.4995/head20.2020.11151.
Анотація:
The increasing prevalence of high levels of distress in university student populations has led academic and support staff to investigate options to help students cope with academic stress. Our research focused on investigating the benefit of early academic interventions for content engagement and feedback. In a 1st year psychology student sample of 547 we collected data on psychological measures (motivation and distress), practice test engagement and performance on assessment tasks. Assessment data from a baseline phase (practice tests were available) were compared to assessment data from an intervention (reward for undertaking practice tests). Our experiment also allowed an investigation of the type of benefit gained from practice tests engagement (content specific benefit vs general engagement effects). Results show that undertaking practice tests ahead of assessment quizzes is associated with significantly higher assessment performance. Practice test uptake significantly increased when an incentive was in place resulting in much higher assessment scores for students. Students who showed high levels of distress on the DASS performed significantly lower on assessments. However, highly distressed students who undertook practice testing showed performance at the same level as non-distressed students.
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Kusuma, Mutiara Tirta Prabandari Lintang. "Understanding the Contextual Idiosyncrasies of Stunting Prevention Program at District and Village Levels in Indonesia Using the Ecological Approach." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.34.
Анотація:
ABSTRACT Background: Despite rapid economic growth, stunting affects one third of the children under five population in Indonesia. The Government of Indonesia (GoI) realizing the problem, established the National Strategy to Accelerate Stunting Prevention as a national priority program for 2017 to 2021. The GoI plans to maximize the use of resources, policies, and programs that encompasses nutrition-specific and sensitive interventions directed to the first 100 days of life. This study aimed to explore the extent of program planning, budgeting, and implementation related to stunting prevention at district and village level as well as to understand the challenges presented to converge intervention. Subjects and Method: A case study with ecological approach was conducted in 10 villages from five districts in Indonesia. The study method included focus group discussions with 70 district officials and 100 village representatives, interviews with 12 key informants from district planning agency, document analysis, and reflective journaling. The data were reported descriptively. Results: Most head districts, officials from relevant departments and village leaders committed to stunting prevention following the vice president decree of stunting as a national priority. As a result, programs and budget were in place and local initiatives to prevent stunting were on the rise. Despite the commitment, many expressed ambivalences and disregarded the issue as a mere short stature (genetic variation). Thus, problems related to efficiency, coverage, and sustainability persists as maintaining motivation among staffs were difficult. In some settings, the situation was exacerbated by factors such as high financial dependency, misconception, and poor gender relation. Conclusion: The policy and programs to control stunting among children in Indonesia are in place. However, challenges occur due to the complexity in governance system as well as lack of political will. Better communication and cooperation are essential for well implemented policies. Keywords: stunting, ecological approach, case study, nutrition intervention, nutrition policy Correspondence: Mutiara Tirta Prabandari Lintang Kusuma. Department of Health Nutrition, Faculty of Medicine, Nursing, and Public Health, Universitas Gadjah Mada, Indonesia. Jl. Farmako, Sekip Utara Yogyakarta 55281. Email: mutiara.tirta@gmail.com. Mobile: +628139880320 DOI: https://doi.org/10.26911/the7thicph.04.34
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Dashash, Alaa A., Ataur R. Malik, A. E. Mukhliss, A. H. Al Yaseen, M. Albuali, and M. Haekal. "New Chemical Treatment Selectively Placed via Coiled Tubing to Isolate Depleted Upper Zone Allows for Access and Stimulation of Unproduced Lower Zone." In SPE/ICoTA Coiled Tubing and Well Intervention Conference and Exhibition. Society of Petroleum Engineers, 2014. http://dx.doi.org/10.2118/168237-ms.
Звіти організацій з теми "Placebo interventions":
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Dy, Sydney M., Arjun Gupta, Julie M. Waldfogel, Ritu Sharma, Allen Zhang, Josephine L. Feliciano, Ramy Sedhom, et al. Interventions for Breathlessness in Patients With Advanced Cancer. Agency for Healthcare Research and Quality (AHRQ), November 2020. http://dx.doi.org/10.23970/ahrqepccer232.
Анотація:
Objectives. To assess benefits and harms of nonpharmacological and pharmacological interventions for breathlessness in adults with advanced cancer. Data sources. We searched PubMed®, Embase®, CINAHL®, ISI Web of Science, and the Cochrane Central Register of Controlled Trials through early May 2020. Review methods. We included randomized controlled trials (RCTs) and observational studies with a comparison group evaluating benefits and/or harms, and cohort studies reporting harms. Two reviewers independently screened search results, serially abstracted data, assessed risk of bias, and graded strength of evidence (SOE) for key outcomes: breathlessness, anxiety, health-related quality of life, and exercise capacity. We performed meta-analyses when possible and calculated standardized mean differences (SMDs). Results. We included 48 RCTs and 2 retrospective cohort studies (4,029 patients). The most commonly reported cancer types were lung cancer and mesothelioma. The baseline level of breathlessness varied in severity. Several nonpharmacological interventions were effective for breathlessness, including fans (SMD -2.09 [95% confidence interval (CI) -3.81 to -0.37]) (SOE: moderate), bilevel ventilation (estimated slope difference -0.58 [95% CI -0.92 to -0.23]), acupressure/reflexology, and multicomponent nonpharmacological interventions (behavioral/psychoeducational combined with activity/rehabilitation and integrative medicine). For pharmacological interventions, opioids were not more effective than placebo (SOE: moderate) for improving breathlessness (SMD -0.14 [95% CI -0.47 to 0.18]) or exercise capacity (SOE: moderate); most studies were of exertional breathlessness. Different doses or routes of administration of opioids did not differ in effectiveness for breathlessness (SOE: low). Anxiolytics were not more effective than placebo for breathlessness (SOE: low). Evidence for other pharmacological interventions was limited. Opioids, bilevel ventilation, and activity/rehabilitation interventions had some harms compared to usual care. Conclusions. Some nonpharmacological interventions, including fans, acupressure/reflexology, multicomponent interventions, and bilevel ventilation, were effective for breathlessness in advanced cancer. Evidence did not support opioids or other pharmacological interventions within the limits of the identified studies. More research is needed on when the benefits of opioids may exceed harms for broader, longer term outcomes related to breathlessness in this population.
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Viswanathan, Meera, Jennifer Cook Middleton, Alison Stuebe, Nancy Berkman, Alison N. Goulding, Skyler McLaurin-Jiang, Andrea B. Dotson, et al. Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions. Agency for Healthcare Research and Quality (AHRQ), April 2021. http://dx.doi.org/10.23970/ahrqepccer236.
Анотація:
Background. Untreated maternal mental health disorders can have devastating sequelae for the mother and child. For women who are currently or planning to become pregnant or are breastfeeding, a critical question is whether the benefits of treating psychiatric illness with pharmacologic interventions outweigh the harms for mother and child. Methods. We conducted a systematic review to assess the benefits and harms of pharmacologic interventions compared with placebo, no treatment, or other pharmacologic interventions for pregnant and postpartum women with mental health disorders. We searched four databases and other sources for evidence available from inception through June 5, 2020 and surveilled the literature through March 2, 2021; dually screened the results; and analyzed eligible studies. We included studies of pregnant, postpartum, or reproductive-age women with a new or preexisting diagnosis of a mental health disorder treated with pharmacotherapy; we excluded psychotherapy. Eligible comparators included women with the disorder but no pharmacotherapy or women who discontinued the pharmacotherapy before pregnancy. Results. A total of 164 studies (168 articles) met eligibility criteria. Brexanolone for depression onset in the third trimester or in the postpartum period probably improves depressive symptoms at 30 days (least square mean difference in the Hamilton Rating Scale for Depression, -2.6; p=0.02; N=209) when compared with placebo. Sertraline for postpartum depression may improve response (calculated relative risk [RR], 2.24; 95% confidence interval [CI], 0.95 to 5.24; N=36), remission (calculated RR, 2.51; 95% CI, 0.94 to 6.70; N=36), and depressive symptoms (p-values ranging from 0.01 to 0.05) when compared with placebo. Discontinuing use of mood stabilizers during pregnancy may increase recurrence (adjusted hazard ratio [AHR], 2.2; 95% CI, 1.2 to 4.2; N=89) and reduce time to recurrence of mood disorders (2 vs. 28 weeks, AHR, 12.1; 95% CI, 1.6 to 91; N=26) for bipolar disorder when compared with continued use. Brexanolone for depression onset in the third trimester or in the postpartum period may increase the risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo (5% vs. 0%). More than 95 percent of studies reporting on harms were observational in design and unable to fully account for confounding. These studies suggested some associations between benzodiazepine exposure before conception and ectopic pregnancy; between specific antidepressants during pregnancy and adverse maternal outcomes such as postpartum hemorrhage, preeclampsia, and spontaneous abortion, and child outcomes such as respiratory issues, low Apgar scores, persistent pulmonary hypertension of the newborn, depression in children, and autism spectrum disorder; between quetiapine or olanzapine and gestational diabetes; and between benzodiazepine and neonatal intensive care admissions. Causality cannot be inferred from these studies. We found insufficient evidence on benefits and harms from comparative effectiveness studies, with one exception: one study suggested a higher risk of overall congenital anomalies (adjusted RR [ARR], 1.85; 95% CI, 1.23 to 2.78; N=2,608) and cardiac anomalies (ARR, 2.25; 95% CI, 1.17 to 4.34; N=2,608) for lithium compared with lamotrigine during first- trimester exposure. Conclusions. Few studies have been conducted in pregnant and postpartum women on the benefits of pharmacotherapy; many studies report on harms but are of low quality. The limited evidence available is consistent with some benefit, and some studies suggested increased adverse events. However, because these studies could not rule out underlying disease severity as the cause of the association, the causal link between the exposure and adverse events is unclear. Patients and clinicians need to make an informed, collaborative decision on treatment choices.
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Halker Singh, Rashmi B., Juliana H. VanderPluym, Allison S. Morrow, Meritxell Urtecho, Tarek Nayfeh, Victor D. Torres Roldan, Magdoleen H. Farah, et al. Acute Treatments for Episodic Migraine. Agency for Healthcare Research and Quality (AHRQ), December 2020. http://dx.doi.org/10.23970/ahrqepccer239.
Анотація:
Objectives. To evaluate the effectiveness and comparative effectiveness of pharmacologic and nonpharmacologic therapies for the acute treatment of episodic migraine in adults. Data sources. MEDLINE®, Embase®, Cochrane Central Registrar of Controlled Trials, Cochrane Database of Systematic Reviews, PsycINFO®, Scopus, and various grey literature sources from database inception to July 24, 2020. Comparative effectiveness evidence about triptans and nonsteroidal anti-inflammatory drugs (NSAIDs) was extracted from existing systematic reviews. Review methods. We included randomized controlled trials (RCTs) and comparative observational studies that enrolled adults who received an intervention to acutely treat episodic migraine. Pairs of independent reviewers selected and appraised studies. Results. Data on triptans were derived from 186 RCTs summarized in nine systematic reviews (101,276 patients; most studied was sumatriptan, followed by zolmitriptan, eletriptan, naratriptan, almotriptan, rizatriptan, and frovatriptan). Compared with placebo, triptans resolved pain at 2 hours and 1 day, and increased the risk of mild and transient adverse events (high strength of the body of evidence [SOE]). Data on NSAIDs were derived from five systematic reviews (13,214 patients; most studied was ibuprofen, followed by diclofenac and ketorolac). Compared with placebo, NSAIDs probably resolved pain at 2 hours and 1 day, and increased the risk of mild and transient adverse events (moderate SOE). For other interventions, we included 135 RCTs and 6 comparative observational studies (37,653 patients). Compared with placebo, antiemetics (low SOE), dihydroergotamine (moderate to high SOE), ergotamine plus caffeine (moderate SOE), and acetaminophen (moderate SOE) reduced acute pain. Opioids were evaluated in 15 studies (2,208 patients).Butorphanol, meperidine, morphine, hydromorphone, and tramadol in combination with acetaminophen may reduce pain at 2 hours and 1 day, compared with placebo (low SOE). Some opioids may be less effective than some antiemetics or dexamethasone (low SOE). No studies evaluated instruments for predicting risk of opioid misuse, opioid use disorder, or overdose, or evaluated risk mitigation strategies to be used when prescribing opioids for the acute treatment of episodic migraine. Calcitonin gene-related peptide (CGRP) receptor antagonists improved headache relief at 2 hours and increased the likelihood of being headache-free at 2 hours, at 1 day, and at 1 week (low to high SOE). Lasmiditan (the first approved 5-HT1F receptor agonist) restored function at 2 hours and resolved pain at 2 hours, 1 day, and 1 week (moderate to high SOE). Sparse and low SOE suggested possible effectiveness of dexamethasone, dipyrone, magnesium sulfate, and octreotide. Compared with placebo, several nonpharmacologic treatments may improve various measures of pain, including remote electrical neuromodulation (moderate SOE), magnetic stimulation (low SOE), acupuncture (low SOE), chamomile oil (low SOE), external trigeminal nerve stimulation (low SOE), and eye movement desensitization re-processing (low SOE). However, these interventions, including the noninvasive neuromodulation devices, have been evaluated only by single or very few trials. Conclusions. A number of acute treatments for episodic migraine exist with varying degrees of evidence for effectiveness and harms. Use of triptans, NSAIDs, antiemetics, dihydroergotamine, CGRP antagonists, and lasmiditan is associated with improved pain and function. The evidence base for many other interventions for acute treatment, including opioids, remains limited.
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McDonagh, Marian, Andrea C. Skelly, Amy Hermesch, Ellen Tilden, Erika D. Brodt, Tracy Dana, Shaun Ramirez, et al. Cervical Ripening in the Outpatient Setting. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepccer238.
Анотація:
Objectives. To assess the comparative effectiveness and potential harms of cervical ripening in the outpatient setting (vs. inpatient, vs. other outpatient intervention) and of fetal surveillance when a prostaglandin is used for cervical ripening. Data sources. Electronic databases (Ovid® MEDLINE®, Embase®, CINAHL®, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews) to July 2020; reference lists; and a Federal Register notice. Review methods. Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) and cohort studies of cervical ripening comparing prostaglandins and mechanical methods in outpatient versus inpatient settings; one outpatient method versus another (including placebo or expectant management); and different methods/protocols for fetal surveillance in cervical ripening using prostaglandins. When data from similar study designs, populations, and outcomes were available, random effects using profile likelihood meta-analyses were conducted. Inconsistency (using I2) and small sample size bias (publication bias, if ≥10 studies) were assessed. Strength of evidence (SOE) was assessed. All review methods followed Agency for Healthcare Research and Quality Evidence-based Practice Center methods guidance. Results. We included 30 RCTs and 10 cohort studies (73% fair quality) involving 9,618 women. The evidence is most applicable to women aged 25 to 30 years with singleton, vertex presentation and low-risk pregnancies. No studies on fetal surveillance were found. The frequency of cesarean delivery (2 RCTs, 4 cohort studies) or suspected neonatal sepsis (2 RCTs) was not significantly different using outpatient versus inpatient dinoprostone for cervical ripening (SOE: low). In comparisons of outpatient versus inpatient single-balloon catheters (3 RCTs, 2 cohort studies), differences between groups on cesarean delivery, birth trauma (e.g., cephalohematoma), and uterine infection were small and not statistically significant (SOE: low), and while shoulder dystocia occurred less frequently in the outpatient group (1 RCT; 3% vs. 11%), the difference was not statistically significant (SOE: low). In comparing outpatient catheters and inpatient dinoprostone (1 double-balloon and 1 single-balloon RCT), the difference between groups for both cesarean delivery and postpartum hemorrhage was small and not statistically significant (SOE: low). Evidence on other outcomes in these comparisons and for misoprostol, double-balloon catheters, and hygroscopic dilators was insufficient to draw conclusions. In head to head comparisons in the outpatient setting, the frequency of cesarean delivery was not significantly different between 2.5 mg and 5 mg dinoprostone gel, or latex and silicone single-balloon catheters (1 RCT each, SOE: low). Differences between prostaglandins and placebo for cervical ripening were small and not significantly different for cesarean delivery (12 RCTs), shoulder dystocia (3 RCTs), or uterine infection (7 RCTs) (SOE: low). These findings did not change according to the specific prostaglandin, route of administration, study quality, or gestational age. Small, nonsignificant differences in the frequency of cesarean delivery (6 RCTs) and uterine infection (3 RCTs) were also found between dinoprostone and either membrane sweeping or expectant management (SOE: low). These findings did not change according to the specific prostaglandin or study quality. Evidence on other comparisons (e.g., single-balloon catheter vs. dinoprostone) or other outcomes was insufficient. For all comparisons, there was insufficient evidence on other important outcomes such as perinatal mortality and time from admission to vaginal birth. Limitations of the evidence include the quantity, quality, and sample sizes of trials for specific interventions, particularly rare harm outcomes. Conclusions. In women with low-risk pregnancies, the risk of cesarean delivery and fetal, neonatal, or maternal harms using either dinoprostone or single-balloon catheters was not significantly different for cervical ripening in the outpatient versus inpatient setting, and similar when compared with placebo, expectant management, or membrane sweeping in the outpatient setting. This evidence is low strength, and future studies are needed to confirm these findings.
5
Blattman, Christopher, Donald Green, Daniel Ortega, and Santiago Tobón. Place-Based Interventions at Scale: The Direct and Spillover Effects of Policing and City Services on Crime. Cambridge, MA: National Bureau of Economic Research, October 2017. http://dx.doi.org/10.3386/w23941.
6
Dorr, Andrea, Eva Heckl, and Joachim Kaufmann. Evaluierung des Förderschwerpunkts Talente. KMU Forschung Austria, December 2020. http://dx.doi.org/10.22163/fteval.2020.495.
Анотація:
With the funding programme Talents, the Federal Ministry for Climate Action, Environment, Energy, Mobility, Innovation and Technology (BMK) supports people in applied research throughout their entire career. The overarching goal is to increase the utilisation of human potential in the application-oriented, scientific and technical RTI sector. The programme objectives are 1) to inspire young people for research and development, 2) to connect researchers with the economic sector, 3)to guarantee equal opportunities for all. Within the framework of three fields of intervention, there are various programme lines: 1) Intervention field Young Talents with the programme lines Internships for Students and Talents Regional, 2) Intervention field Female Talents with the programme lines FEMtech Internships for Female Students, FEMtech Career and FEMtech Career Check for SMEs (2015 and 2016), as well as FEMtech Research Projects; and 3) Intervention field Professional Talents with the programme lines The Austrian Job Exchange for Research, Development and Innovation as well as Career Grants for Interviews, Relocation and Dual Careers in Applied Research. After an interim evaluation in 2014, a final evaluation took place at the end of the programme period (end of 2020). The programme was analysed with regard to its conception, implementation, achievement of objectives and impact. Furthermore, conclusions and recommendations for the further development of the Talents programme have been drawn. The methodological basis of the evaluation is a document analysis, secondary data analysis (FFG monitoring data), interviews with experts, online surveys of funding recipients (FEMtech Career / FEMtech Career Check for SMEs and Career Grants), case studies (FEMtech Career projects) and workshops.
7
Koffi, Affoué Philomène. Avenir imaginé : insuffisances du soutien aux jeunes en milieu rural en Côte d’Ivoire. Institute of Development Studies (IDS), May 2021. http://dx.doi.org/10.19088/ids.2021.042.
Анотація:
Le manque à des débouchés professionnels pour les jeunes est une préoccupation majeure en Afrique, et a un impact sur de nombreux domaines stratégiques. En Côte d’Ivoire, la situation est difficile en raison des crises politiques et économiques qui ont frappé le pays au cours des dernières décennies et qui ont eu un impact négatif sur l’éducation et accentué la précarité de l’emploi, en particulier pour la jeunesse rurale. Afin de s’attaquer au problème dans les zones rurales, il faut une approche centrée sur les jeunes qui met en place des interventions à long terme, bien ciblées, coordonnées et basées sur les réalités des jeunes.
8
Thompson, Stephen, Brigitte Rohwerder, and Clement Arockiasamy. Freedom of Religious Belief and People with Disabilities: A Case Study of People with Disabilities from Religious Minorities in Chennai, India. Institute of Development Studies (IDS), June 2021. http://dx.doi.org/10.19088/creid.2021.003.
Анотація:
India has a unique and complex religious history, with faith and spirituality playing an important role in everyday life. Hinduism is the majority religion, and there are many minority religions. India also has a complicated class system and entrenched gender structures. Disability is another important identity. Many of these factors determine people’s experiences of social inclusion or exclusion. This paper explores how these intersecting identities influence the experience of inequality and marginalisation, with a particular focus on people with disabilities from minority religious backgrounds. A participatory qualitative methodology was employed in Chennai, to gather case studies that describe in-depth experiences of participants. Our findings show that many factors that make up a person’s identity intersect in India and impact how someone is included or excluded by society, with religious minority affiliation, caste, disability status, and gender all having the potential to add layers of marginalisation. These various identity factors, and how individuals and society react to them, impact on how people experience their social existence. Identity factors that form the basis for discrimination can be either visible or invisible, and discrimination may be explicit or implicit. Despite various legal and human rights frameworks at the national and international level that aim to prevent marginalisation, discrimination based on these factors is still prevalent in India. While some tokenistic interventions and schemes are in place to overcome marginalisation, such initiatives often only focus on one factor of identity, rather than considering intersecting factors. People with disabilities continue to experience exclusion in all aspects of their lives. Discrimination can exist both between, as well as within, religious communities, and is particularly prevalent in formal environments. Caste-based exclusion continues to be a major problem in India. The current socioeconomic environment and political climate can be seen to perpetuate marginalisation based on these factors. However, when people are included in society, regardless of belonging to a religious minority, having a disability, or being a certain caste, the impact on their life can be very positive.
9
Roschelle, Jeremy, Britte Haugan Cheng, Nicola Hodkowski, Julie Neisler, and Lina Haldar. Evaluation of an Online Tutoring Program in Elementary Mathematics. Digital Promise, April 2020. http://dx.doi.org/10.51388/20.500.12265/94.
Анотація:
Many students struggle with mathematics in late elementary school, particularly on the topic of fractions. In a best evidence syntheses of research on increasing achievement in elementary school mathematics, Pelligrini et al. (2018) highlighted tutoring as a way to help students. Online tutoring is attractive because costs may be lower and logistics easier than with face-to-face tutoring. Cignition developed an approach that combines online 1:1 tutoring with a fractions game, called FogStone Isle. The game provides students with additional learning opportunities and provides tutors with information that they can use to plan tutoring sessions. A randomized controlled trial investigated the research question: Do students who participate in online tutoring and a related mathematical game learn more about fractions than students who only have access to the game? Participants were 144 students from four schools, all serving low-income students with low prior mathematics achievement. In the Treatment condition, students received 20-25 minute tutoring sessions twice per week for an average of 18 sessions and also played the FogStone Isle game. In the Control condition, students had access to the game, but did not play it often. Control students did not receive tutoring. Students were randomly assigned to condition after being matched on pre-test scores. The same diagnostic assessment was used as a pre-test and as a post-test. The planned analysis looked for differences in gain scores ( post-test minus pre-test scores) between conditions. We conducted a t-test on the aggregate gain scores, comparing conditions; the results were statistically significant (t = 4.0545, df = 132.66, p-value < .001). To determine an effect size, we treated each site as a study in a meta-analysis. Using gain scores, the effect size was g=+.66. A more sophisticated treatment of the pooled standard deviation resulted in a corrected effect size of g=.46 with a 95% confidence interval of [+.23,+.70]. Students who received online tutoring and played the related Fog Stone Isle game learned more; our research found the approach to be efficacious. The Pelligrini et al. (2018) meta-analysis of elementary math tutoring programs found g = .26 and was based largely on face-to-face tutoring studies. Thus, this study compares favorably to prior research on face-to-face mathematics tutoring with elementary students. Limitations are discussed; in particular, this is an initial study of an intervention under development. Effects could increase or decrease as development continues and the program scales. Although this study was planned long before the current pandemic, results are particularly timely now that many students are at home under shelter-in-place orders due to COVID-19. The approach taken here is feasible for students at home, with tutors supporting them from a distance. It is also feasible in many other situations where equity could be addressed directly by supporting students via online tutors.
10
Dalglish, Chris, and Sarah Tarlow, eds. Modern Scotland: Archaeology, the Modern past and the Modern present. Society of Antiquaries of Scotland, September 2012. http://dx.doi.org/10.9750/scarf.09.2012.163.
Анотація:
The main recommendations of the panel report can be summarised under five key headings: HUMANITY The Panel recommends recognition that research in this field should be geared towards the development of critical understandings of self and society in the modern world. Archaeological research into the modern past should be ambitious in seeking to contribute to understanding of the major social, economic and environmental developments through which the modern world came into being. Modern-world archaeology can add significantly to knowledge of Scotland’s historical relationships with the rest of the British Isles, Europe and the wider world. Archaeology offers a new perspective on what it has meant to be a modern person and a member of modern society, inhabiting a modern world. MATERIALITY The Panel recommends approaches to research which focus on the materiality of the recent past (i.e. the character of relationships between people and their material world). Archaeology’s contribution to understandings of the modern world lies in its ability to situate, humanise and contextualise broader historical developments. Archaeological research can provide new insights into the modern past by investigating historical trends not as abstract phenomena but as changes to real lives, affecting different localities in different ways. Archaeology can take a long-term perspective on major modern developments, researching their ‘prehistory’ (which often extends back into the Middle Ages) and their material legacy in the present. Archaeology can humanise and contextualise long-term processes and global connections by working outwards from individual life stories, developing biographies of individual artefacts and buildings and evidencing the reciprocity of people, things, places and landscapes. The modern person and modern social relationships were formed in and through material environments and, to understand modern humanity, it is crucial that we understand humanity’s material relationships in the modern world. PERSPECTIVE The Panel recommends the development, realisation and promotion of work which takes a critical perspective on the present from a deeper understanding of the recent past. Research into the modern past provides a critical perspective on the present, uncovering the origins of our current ways of life and of relating to each other and to the world around us. It is important that this relevance is acknowledged, understood, developed and mobilised to connect past, present and future. The material approach of archaeology can enhance understanding, challenge assumptions and develop new and alternative histories. Modern Scotland: Archaeology, the Modern past and the Modern present vi Archaeology can evidence varied experience of social, environmental and economic change in the past. It can consider questions of local distinctiveness and global homogeneity in complex and nuanced ways. It can reveal the hidden histories of those whose ways of life diverged from the historical mainstream. Archaeology can challenge simplistic, essentialist understandings of the recent Scottish past, providing insights into the historical character and interaction of Scottish, British and other identities and ideologies. COLLABORATION The Panel recommends the development of integrated and collaborative research practices. Perhaps above all other periods of the past, the modern past is a field of enquiry where there is great potential benefit in collaboration between different specialist sectors within archaeology, between different disciplines, between Scottish-based researchers and researchers elsewhere in the world and between professionals and the public. The Panel advocates the development of new ways of working involving integrated and collaborative investigation of the modern past. Extending beyond previous modes of inter-disciplinary practice, these new approaches should involve active engagement between different interests developing collaborative responses to common questions and problems. REFLECTION The Panel recommends that a reflexive approach is taken to the archaeology of the modern past, requiring research into the nature of academic, professional and public engagements with the modern past and the development of new reflexive modes of practice. Archaeology investigates the past but it does so from its position in the present. Research should develop a greater understanding of modern-period archaeology as a scholarly pursuit and social practice in the present. Research should provide insights into the ways in which the modern past is presented and represented in particular contexts. Work is required to better evidence popular understandings of and engagements with the modern past and to understand the politics of the recent past, particularly its material aspect. Research should seek to advance knowledge and understanding of the moral and ethical viewpoints held by professionals and members of the public in relation to the archaeology of the recent past. There is a need to critically review public engagement practices in modern-world archaeology and develop new modes of public-professional collaboration and to generate practices through which archaeology can make positive interventions in the world. And there is a need to embed processes of ethical reflection and beneficial action into archaeological practice relating to the modern past.