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PubMed2006

Effects of a behavioural intervention on quality of life and related variables in angioplasty patients: results of the EXhaustion Intervention Trial.

OBJECTIVES: The EXhaustion Intervention Trial investigated the effect of a behavioural intervention programme on exhaustion, health-related quality of life (HRQL), depression, anxiety, hostility, and anginal complaints in angioplasty patients who felt exhausted after percutaneous coronary intervention (PCI). METHODS: Seven hundred ten patients were randomized into an intervention group and a usual care control group. The group intervention focused on stressors leading to exhaustion and on support of recovery. HRQL (measured by the MacNew questionnaire), exhaustion [measured by the Maastricht Questionnaire and the Maastricht Interview Vital Exhaustion (MIVE)], anxiety (measured by the State-Trait Inventory), and depression (measured by the structured clinical interview for DSM-IV) were assessed at intake and at 6 and 18 months. Presence of anginal complaints was assessed at 18 months. RESULTS: The intervention had a significant beneficial effect on all psychological factors except hostility and on the presence of anginal complaints. The effect of the intervention on exhaustion, as assessed by the MIVE, was modified by a previous history of coronary artery disease (CAD). Gender modified the effect of the intervention on exhaustion and on anxiety, the strongest effect being observed in women. CONCLUSIONS: The behavioural intervention improved HRQL and related psychological factors. Somatic comorbidity and a history of CAD limited the effect of the intervention.

Adaptation, Psychological↗
PubMed2004

Guiding the design and selection of interventions to influence the implementation of evidence-based practice: an experimental simulation of a complex intervention trial.

A consistent finding in health services research is the report of uneven uptake of research findings. Implementation trials have a variable record of success in effectively influencing clinicians' behaviour. A more systematic approach may be to conduct Intervention Modelling Experiments before service-level trials, examining intervention effects on 'interim endpoints' representing clinical behaviour, derived from empirically supported psychological theories. The objectives were to: (1) Design Intervention Modelling Experiments by backward engineering a 'real-world' randomised controlled trial (NEXUS); (2) examine the applicability of psychological theories to clinical decision-making; (3) explore whether psychological theories can illuminate how interventions achieve their effects. A 2 x 2 factorial randomised controlled trial was designed with pre- and post-intervention data collection by postal questionnaire surveys. The first survey was used to generate feedback data and the interventions were delivered in the second survey. General medical practitioners (GPs) in England and Scotland participated. First survey respondents were randomised twice to receive or not audit and feedback and educational reminder messages. The main outcome measures included behavioural intention (general plan to refer for lumbar X-rays) and simulated behaviour (specific, scenario-based, decisions to refer for lumbar X-ray). Predictors were attitude, subjective norm, perceived behavioural control (theory of planned behaviour), self-efficacy (social cognitive theory) and decision difficulty. Both interventions significantly influenced simulated behaviour, but neither influenced behavioural intention. There were no interaction effects. All theoretically derived cognitions significantly predicted simulated behaviour. Only subjective norm was not predictive of behavioural intention. The effect of audit and feedback on simulated behaviour was mediated through perceived behavioural control. The results of this study suggest that Intervention Modelling Experiments, using psychological models to help isolate mediators of clinical decision-making, may be a means of developing more potent interventions, and selecting implementation interventions with a greater likelihood of success in a service-level randomised controlled trial.

Analysis of Variance↗
PubMed1998

Maternal acceptability of a dietary intervention designed to lower children's intake of saturated fat and cholesterol: the Dietary Intervention Study in Children (DISC).

OBJECTIVE: This report examined the acceptability to mothers of a dietary educational and behavioral intervention for preadolescent children with elevated levels of serum low-density lipoprotein cholesterol (LDL-C) who were enrolled in the Dietary Intervention Study in Children (DISC). DESIGN: DISC is a randomized, controlled clinical trial. Subjects were randomly assigned to either an intervention or usual-care (control) group. SUBJECTS/SETTING: To be eligible for the study, participants were required to have the average of 2 fasting LDL-C values fall between the 80th and 98th sex-specific percentiles. Three hundred thirty-four 8-to 10-year-old children and their families were randomly assigned to an intervention group, and 329 were assigned to a usual-care (control) group. This study examined data from 232 subjects in the intervention group. Data were collected at 6 intervention sites around the United States. INTERVENTION: Those assigned to the intervention group participated in a multidisciplinary dietary intervention that included a series of group and individual sessions over a 3-year period. Children and their caretakers were taught to follow a nutritionally adequate diet that was low in total fat, saturated fat, and cholesterol and high in polyunsaturated fat. MAIN OUTCOME MEASURES: Three nonconsecutive 24-hour diet recalls were collected at baseline and at 1 year by trained and certified dietitians. A questionnaire designed to assess diet acceptability was administered at months 4, 8, 11, and 15. Demographic measures were collected at the onset of the study. STATISTICAL ANALYSIS PERFORMED: Statistical procedures included factor analysis and regression analysis. RESULTS: Regression analysis suggested that perceived effectiveness of the dietary intervention and mothers' having few concerns about disadvantages of the diet were significantly related to higher overall fat intake in children in one-parent families. Maternal willingness to implement the diet was significantly related to lower saturated fat intake. APPLICATIONS/CONCLUSIONS: In attempts to change eating behavior of children, interest and cooperation of the parents are essential to achieving successful results. These analyses further suggest that maternal acceptability translates into willingness to implement the diet and may facilitate changes that are associated with reduced saturated fat intake in children.

Child↗
PubMed2002

[Spanish Registry on Cardiac Catheterization Interventions. 11th official report of the Working Group on Cardiac Catheterization and Interventional Cardiology of the Spanish Society of Cardiology (years 1990-2001)].

The results of the Spanish Registry of the Working Group on cardiac catheterization and Interventional Cardiology of the Spanish Society of Cardiology (years 1990-2001) are presented. One-hundred-and-three centers contributed data, all the cardiac catheterization laboratories in Spain; 97 centers performed mainly adult catheterization and 6 carried out only pediatric procedures. In 2001, 95,430 diagnostic catheterization procedures were performed, with 79,607 coronary angiograms, representing a total increase of 8.4% over 2000. The population-adjusted incidence was 1947 coronary angiograms per 106 inhabitants. Coronary interventions increased by 15.4% compared with 2000, with a total of 31,290 procedures and an incidence of coronary interventions of 761 per 106 inhabitants. Coronary stents were the most frequently used devices with 39,356 implanted in 2001, and increase of 33.4% over 2000. Stenting accounted for 88.2% of procedures. Direct stenting was done in 11,280 procedures (40.9%). IIb-IIIa glycoprotein inhibitors were given in 7,012 procedures (22.4%). Multivessel percutaneous coronary interventions were performed in 8,445 cases (27%) and interventions were performed ad hoc during diagnostic study in 23,144 cases (74 %).A total of 3,845 percutaneous coronary interventions were carried out in patients with acute myocardial infarction, an increase of 22.9% over 2000 and 12.3% of all interventional procedures. Among non-coronary interventions, atrial septal defect closure was performed more often (161 cases, a 60% increase over 2000). Pediatric interventions increased by 15.4% (from 817 to 943 cases).Lastly, we would like to underline the high rate of reporting by laboratories, which allowed the Registry to compile data that are highly representative of hemodynamic interventions in Spain.

Adult↗
PubMed2006

The (cost-)effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on the recovery from neck and upper limb symptoms in computer workers.

BACKGROUND: Neck and upper limb symptoms are frequently reported by computer workers. Work style interventions are most commonly used to reduce work-related neck and upper limb symptoms but lifestyle physical activity interventions are becoming more popular to enhance workers health and reduce work-related symptoms. A combined approach targeting work style and lifestyle physical activity seems promising, but little is known on the effectiveness of such combined interventions. METHODS/DESIGN: The RSI@Work study is a randomised controlled trial that aims to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention to reduce neck and upper limb symptoms in computer workers. Computer workers from seven Dutch companies with frequent or long-term neck and upper limb symptoms in the preceding six months and/or the last two weeks are randomised into three groups: (1) work style group, (2) work style and physical activity group, or (3) control group. The work style intervention consists of six group meetings in a six month period that take place at the workplace, during work time, and under the supervision of a specially trained counsellor. The goal of this intervention is to stimulate workplace adjustment and to improve body posture, the number and quality of breaks and coping behaviour with regard to high work demands. In the combined (work style and physical activity) intervention the additional goal is to increase moderate to heavy physical activity. The control group receives usual care. Primary outcome measures are degree of recovery, pain intensity, disability, number of days with neck and upper limb symptoms, and number of months without neck and upper limb symptoms. Outcome measures will be assessed at baseline and six and 12 months after randomisation. Cost-effectiveness of the group meetings will be assessed using an employer's perspective. DISCUSSION: This study will be one of the first to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention in reducing neck and upper limb symptoms of computer workers. The results of the study are expected in 2007.

Adult↗
PubMed2002

Universal family-focused interventions in alcohol-use disorder prevention: cost-effectiveness and cost-benefit analyses of two interventions.

OBJECTIVE: Epidemiologic research suggests that significant public health benefits can accrue from preventive interventions that delay the initiation of youth alcohol use. This analysis compares the cost effectiveness of tvo interventions designed for general population families of adolescents. It also conservatively estimates their benefit-cost ratios and net benefits. METHOD: Cost-effectiveness and cost-benefit analyses were performed on data from a longitudinal prevention trial with families of sixth graders from 33 rural schools in a midwestern state. Schools were blocked on size and proportion of lower income families and then randomly assigned either to one of two interventions or to a control condition. Interventions included the Iowa Strengthening Families Program (ISFP), a seven-session intervention with parents and students together, and Preparing for the Drug Free Years (PDFY), a five-session intervention focusing primarily on parents. RESULTS: Conservative estimates for the ISFP intervention were a cost-effectiveness figure of $12,459 per case prevented, a benefit-cost ratio of S9.60 per $1 invested, and a net benefit of $5,923 per family. For PDFY, estimates were a cost effectiveness of $20,439 per case prevented, a benefit-cost ratio of $5.85 per $12 invested, and a net benefit of $2,697 per family. CONCLUSIONS: Family skills training interventions designed for general populations have the potential to delay the onset of alcohol use and may avoid substantial costs to society at a proportionally small intervention cost. Economic analysis of such interventions is a largely unexplored area that could provide valuable guidance in forming public policy.

Adolescent↗
PubMedDate not supplied

[A comparison of motivational intervention and knowledge-supplied intervention for weight control in female students living alone: focus on self-efficacy].

The purpose of this study was: 1) to verify if motivational intervention enhances self-efficacy and desire for weight control; and 2) to compare the performance of weight control, desire, and self-efficacy among subjects in the motivational intervention group with those in the knowledge-supplied intervention group. Subjects included twenty-two female students living alone. The participants were divided into two groups of motivational-intervention (experimental group) and knowledge-supplied intervention (control group), consisting of eleven subjects in each group selected at random. A pre-test/post-test control design was used. Intervention in the experimental group consisted of a confirmation of individual reasons for weight control, connecting weight control with a life worth living for, and self-monitoring. Intervention in the control group however, involved instructions, on physiological and biochemical basis of proper weight control. As the result, these are suggested that the motivational intervention associated with enhancement of self-efficacy in weight control and dietary behavior. Compared to knowledge-based intervention, motivational intervention was associated with higher chewing method performance ratios, longer terms of continuing the chewing method, self-efficacy of weight control, self-efficacy of dietary behavior, and desire to weight control.

Female↗
PubMed2001

Different outcomes for different interventions with different focus!--A cross-country comparison of community interventions in rural Swedish and US populations.

OBJECTIVES: There is a need among healthcare providers to acquire more knowledge about small-scale and low budget community intervention programmes. This paper compares risk factor outcomes in Swedish and US intervention programmes for the prevention of cardiovascular disease (CVD). The aim was to explore how different intervention programme profiles affect outcome. METHODS: Using a quasi-experimental design, trends in risk factors and estimated CVD risk in two intervention areas (Norsjö. Sweden and Otsego-Schoharie County, New York state) are compared with those in reference areas (Northern Sweden region and Herkimer County, New York state) using serial cross-sectional studies and panel studies. RESULTS: The programmes were able to achieve significant changes in CVD risk factors that the local communities recognized as major concerns: changing eating habits in the Swedish population and reducing smoking in the US population. For the Swedish cross-sectional follow-up study cholesterol reduction was 12%, compared to 5% in the reference population (p for trend differences <0.000). The significantly higher estimated CVD risk (as assessed by risk scores) at baseline in the intervention population was below that of the Swedish reference population after 5 years of intervention. The Swedish panel study provided the same results. In the US, both the serial cross-sectional and panel studies showed a > 10% decline in smoking prevalence in the intervention population, while it increased slightly in the reference population. When pooling the serial cross-sectional studies the estimated risk reduction (using the Framingham risk equation) was significantly greater in the intervention populations compared to the reference populations. CONCLUSIONS: The overall pattern of risk reduction is consistent and suggests that the two different models of rural county intervention can contribute to significant risk reduction. The Swedish programme had its greatest effect on reduction of serum cholesterol levels whereas the US programme had its greatest effect on smoking prevention and cessation. These outcomes are consistent with programmatic emphases. Socially less privileged groups in these rural areas benefited as much or more from the interventions as those with greater social resources.

Adult↗
PubMed2003

[Spanish Registry on Cardiac Catheterization and Coronary Interventions. Twelfth official report of the Working Group on Cardiac Catheterization and Interventional Cardiology of the Spanish Society of Cardiology (1990-2002)].

The results of the Registry of the Working Group on Cardiac Catheterization and Interventional Cardiology of the Spanish Society of Cardiology for 2002 are presented. Data were obtained from 101 centers representing all cardiac catheterization laboratories in Spain; 95 centers performed mainly adult catheterization and 6 carried out only pediatric procedures. In 2002, 97,609 diagnostic catheterization procedures were performed, including 83,667 coronary angiograms, representing a total increase of 5.1% in comparison to 2001. The population-adjusted rate was 2,053 coronary angiograms per 106 inhabitants. Coronary interventions increased by 11% in comparison to 2001, with a total of 34,723 procedures and a rate of coronary interventions of 850 per 106 inhabitants. Coronary stents were the devices used most frequently, with 47,249 implanted in 2002, for a total increase of 20% in comparison to 2001. Stenting accounted for 91.7% of all procedures. Direct stenting was done in 13 768 procedures (43.2%). IIb-IIIa glycoprotein inhibitors were used in 9966 procedures (28.7%). Multivessel percutaneous coronary interventions were performed in 9,830 patients (28%), and ad hoc interventions were done in the course of diagnostic coronary angiography in 26,341 patients (76%).A total of 4,766 percutaneous coronary interventions were done in patients with acute myocardial infarction, representing an increase of 23.9% in comparison to 2001, and accounting for 13.7% of all interventional procedures. Of the noncoronary interventions recorded, we note the decrease in percutaneous mitral valvuloplasties (21.2%) and atrial septal defect closures (11.1%), and the slight increase in pediatric interventions (3.7%). In conclusion, we emphasize the high rate of reporting by laboratories, which allows the Registry to compile data that are highly representative of the activity at cardiac catheterization laboratories in Spain

Adult↗
PubMed1990

An individualized cognitive intervention: does it increase the efficacy of behavioral interventions for obesity?

This study examined the effectiveness of the addition of a cognitive intervention based on individualized assessment to a behavioral intervention. Sixty-three subjects who were at least 15% overweight were randomly assigned to a behavioral intervention or a behavioral intervention and a cognitive intervention focused on changing specific maladaptive self-statements related to weight loss. It was predicted that the behavioral and cognitive intervention would result in greater weight loss and reduction in body fat than the behavioral alone intervention at posttest and at 3-month follow-up; results did not support this hypothesis. Support was found for the construct validity of the behavioral intervention with significant differences between time points on behavioral measures observed. On the cognitive measures, both treatment conditions showed changes over time on cognitive measures, but differences between the treatments were not significant. Based on the results of this study, it is suggested that future research examining the effectiveness of cognitive interventions in the area of weight loss include measures other than those that are weight-related, longer follow-ups to assess long-term maintenance, and sufficient amounts of cognitive therapy so that clients have fully integrated the newly learned cognitive dialogues into their everyday lives.

Adult↗
PubMed2005

Nurse administered telephone intervention for blood pressure control: a patient-tailored multifactorial intervention.

OBJECTIVES: A randomized controlled trial involving a nurse administered patient-tailored intervention is being conducted to improve blood pressure (BP) control. METHODS: Veterans with hypertension from an outpatient primary care clinic completed a baseline assessment and were randomly allocated to either a nurse administered intervention or to usual care. In this ongoing study, intervention patients receive the tailored intervention bi-monthly for 2 years via telephone; the goal of the intervention is to promote adherence with medication and improve health behaviors. Patient factors targeted for intervention include perceived risk of hypertension, memory, literacy, social support, patients' relationship with their health care provider, side effects of therapy, pill refill, missed appointments, and health behaviors. RESULTS: The sample randomized to the nurse intervention consisted of 294 veterans with hypertension (average age = 63 years; 41% African-American). A comparable sample of veterans was assigned to usual care (n = 294). We have maintained a 97% retention rate for the first 12 months of the study. The average phone call has lasted 3.7 min ranging from less than 1 to 40 min. At 6-month post-enrollment, individuals receiving the nurse intervention had a greater increase in confidence with following hypertension treatment (P < 0.007) than the usual care group. DISCUSSION: The intervention is easily implemented and is designed to enhance adherence with prescribed hypertension regimen. The study includes both general and patient-tailored information based upon need assessment. The study design ensures internal validity as well as the ability to generalize study findings to the clinic settings.

Attitude to Health↗
PubMed1999

A brief motivational intervention to improve dietary adherence in adolescents. The Dietary Intervention Study in Children (DISC) Research Group.

Motivational interviewing offers health care professionals a potentially effective strategy for increasing a patient's readiness to change health behaviors. Recently, elements of motivational interviewing and the stages of change model have been simplified and adapted for use with patients in brief clinical encounters. This paper describes in detail a brief motivational intervention model to improve and renew dietary adherence with adolescents in the Dietary Intervention Study in Children (DISC). DISC is a randomized, multi-center clinical trial assessing the efficacy and safety of lowering dietary fat to decrease low-density lipoprotein cholesterol in high-risk children. In the first 3 years of follow-up covering ages 8-13, intervention participants (n = 334) were exposed to a family-based group intervention approach to change dietary choices. To address adherence and retention obstacles as participants moved into adolescence (age 13-17), an individual-level motivational intervention was implemented. The DISC motivational intervention integrates several intervention models: stages of change, motivational interviewing, brief negotiation and behavioral self-management. A preliminary test of the intervention model suggests that it was acceptable to the participants, popular with interventionists and appeared to be an age-appropriate shift from a family-based intervention model.

Adolescent↗
PubMed2002

Taking a new course in research on the effectiveness of interventions. A study of physiotherapy interventions for people with musculoskeletal complaints.

Physiotherapy is a commonly employed intervention for people with musculoskeletal complaints. However, due to (methodological) limitations in previous research, the effectiveness of physiotherapy interventions has not yet been proven. The aim of the present study is twofold. First we try to solve some of the methodological problems, of which the most important are selection and endogeneity biases and state dependence. Secondly, the effect of a physiotherapy intervention on recovery from musculoskeletal complaints is investigated. The probability of receiving a physiotherapy intervention is estimated, as well as the probability of recovery as a result of this intervention. A longitudinal design is used. Analyses are performed using secondary data on a populational level. The analytical framework is provided by a Markov model. We use a logit model to estimate transition probabilities of this Markov model. Results show that experience with physiotherapy in the past is an important predictor for receiving physiotherapy in the future. Other predictors of the chance of receiving an intervention are also identified. Furthermore, results indicate that the effect of a physiotherapy intervention on recovery is negative. It is concluded that both the latter effect and the effect of intervention experience can partly be explained by medicalization, in spite of a presence of "severe" cases in the intervention group.

Adolescent↗
PubMed2006

Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents.

BACKGROUND: Only limited data are available on the development, implementation, and evaluation processes of weight gain prevention programs in adolescents. To be able to learn from successes and failures of such interventions, integral written and published reports are needed. METHODS: Applying the Intervention Mapping (IM) protocol, this paper describes the development, implementation, and evaluation of the Dutch Obesity Intervention in Teenagers (DOiT), a school-based intervention program aimed at the prevention of excessive weight gain. The intervention focussed on the following health behaviours: (1) reduction of the consumption of sugar-sweetened beverages, (2) reduction of energy intake derived from snacks, (3) decrease of levels of sedentary behaviour, and (4) increase of levels of physical activity (i.e. active transport behaviour and sports participation). The intervention program consisted of an individual classroom-based component (i.e. an educational program, covering 11 lessons of both biology and physical education classes), and an environmental component (i.e. encouraging and supporting changes at the school canteens, as well as offering additional physical education classes). We evaluated the effectiveness of the intervention program using a randomised controlled trial design. We assessed the effects of the intervention on body composition (primary outcome measure), as well as on behaviour, behavioural determinants, and aerobic fitness (secondary outcome measures). Furthermore, we conducted a process evaluation. DISCUSSION: The development of the DOiT-intervention resulted in a comprehensive school-based weight gain prevention program, tailored to the needs of Dutch adolescents from low socio-economic background.

Adolescent↗
PubMedDate not supplied

[Zurich Intervention Planning and Evaluation Form (ZIPEF): a procedure for quality control of therapeutic interventions].

This paper introduces the Zurich Intervention Planning and Evaluation Form (ZIPEF). The instrument covers (1) treatment problems, (2) interventions as to type, duration, and time expenditure, (3) treatment outcome and (4) causal factors. A total of 413 treatment problems were evaluated with the ZIPEF in a public child and adolescent psychiatric service. Depending on the target (e.g. symptoms, personality, relationship) the distribution of types of intervention differed. Time expenditures were significantly higher only for client-centred interventions than for parent counseling and similar for all other interventions. Treatment outcome and cooperation were independent from type of intervention. The main causal factor of treatment outcome for almost all types of interventions was cooperation followed by resources in some types of intervention. Complexity of the treatment problem tended to be another important determinant for treatment outcome. In summary, the ZIPEF can contribute to quality management in the area of intervention planning and evaluation of clienteles with mental health problems.

Adolescent↗
PubMed1989

Nursing interventions for addicted patient. Strategies for intervention.

The intervention process is a powerful tool in helping those affected by chemical dependency. Intervention presents reality in a manner that penetrates the maladaptive defense mechanisms that have developed around this illness, both in the person who is thought to be chemically dependent and in those significant in his or her life. The process begins with the nurse assessing the extent of the problem and the likelihood that chemical dependency is the cause, or at least the primary factor. The nurse assists in identifying the persons to be involved in the intervention and the ability of the individuals and the group to carry out the intervention process. Education and preparation of the group are the next steps. Once the group is adequately prepared, the intervention is implemented. Throughout the process, the nurse is cautioned to remember (1) the patient/client is the person seeking assistance, not the person thought to be chemically dependent, and (2) he or she is a facilitator, not an intervener. Follow-up to the actual intervention is also important, ensuring the evaluation is completed, encouraging the individuals in the group to follow through with the prepared plans, and assisting them in dealing with the feelings they experience as a result of the intervention. Nurses often function as intervention facilitators. Because intervention is so powerful, preparation as a facilitator requires sound knowledge of the illness and the process and supervised clinical experience.

Defense Mechanisms↗
PubMed2001

The current status of interventional radiology in Canada: results of a survey by the Canadian Interventional Radiology Association.

OBJECTIVE: To evaluate the current status of interventional radiology in Canada. METHODS: A questionnaire was sent to 28 Canadian interventional radiologists (defined as a physician who performs any type of interventional procedure, including biopsies, but excluding interventional neuroradiology) practising in both tertiary and community hospitals in the major centres in all provinces except Prince Edward Island. RESULTS: Twenty-two (79%) of 28 surveys were completed and returned, providing data about 86 interventional radiologists (IRs). IRs were performing almost all of the following procedures at their institutions: inferior vena cava filter placement, venous angioplasty, dialysis fistula angioplasty, diagnostic and therapeutic pulmonary and bronchial artery procedures, diagnostic and therapeutic procedures of the lower extremity and renal arteries, percutaneous abscess and biliary drainage procedures, percutaneous nephrostomy, and fibroid embolization. A second group of procedures, performed by both IRs and non-radiologists in most institutions, included: all types of central venous catheter placements, pleural drainage, and gastrostomy tube placement. Procedures not being performed by anyone in a number of institutions included: dialysis graft thrombolysis, varicocele embolization, transjugular intrahepatic portosystemic shunts, palliative stenting of the gastrointestinal tract, fallopian tube recannalization, and liver and prostate tumour treatments. The factors most often limiting the respondents' ability to provide a comprehensive interventional service were the interventional radiology inventory budget and the availability of interventional radiology rooms; 50% of respondents indicated the number of available nurses, technologists and IRs was also an important limiting factor. CONCLUSION: IRs in Canada still play a major role in many of the most commonly performed procedures. However, limited availability of resources and personnel in many institutions may be hampering the ability of IRs to develop new procedures.

Canada↗
PubMed1997

Early intervention improves intellectual development in asphyxiated newborn infants. Intervention of Asphyxiated Newborn Infants Cooperative Research Group.

OBJECTIVE: To evaluate the effect of early intervention on the intellectual development in asphyxiated newborn infants. METHODS: Full term asphyxiated infants (Apgar score < or = 6 at 5 minutes after birth) were randomly assigned to early intervention group (34 cases) and conventional care (30 cases) group. The normal control group consisted of 38 infants. Sex, mother's educational background, environmental condition and physical development were not significantly different in the 3 groups. Zero to two years early intervention program was compiled on basis of the national and foreign material about 1 month ahead of average development of the child. It included motor, cognitive, speech development and social behavior. Parents were instructed to carry out early intervention. RESULTS: At the age of 1.5 years, average score of mental development index (MDI) in early intervention group was 14.6 higher than that in conventional care group (F = 18.86, P < 0.0001). MDI score in early intervention group caught up with that in normal control group (F = 2.17, P > 0.05). Conventional care group was 9.7 lower than normal control group (F = 10.14, P < 0.01). Two of 30 cases (6.7%) in conventional care group was mentally retarded while none was mentally retarded in the early intervention group. CONCLUSIONS: The results showed that the early intervention could promote intellectual development of asphyxiated infants and be of much benefit to the prevention of mental retardation.

Asphyxia Neonatorum↗