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Implementation intentions

Juan Jose Saldaña Barrios, Luis Mendoza, Edgardo Pitti, Miguel Vargas
In this work, the authors present two eHealth platforms that are examples of how health systems are migrating from client-server architecture to the web-based and ubiquitous paradigm. These two platforms were modeled, designed, developed and implemented with positive results. First, using ambient-assisted living and ubiquitous computing, the authors enhance how palliative care is being provided to the elderly patients and patients with terminal illness, making the work of doctors, nurses and other health actors easier...
October 21, 2016: Health Informatics Journal
Allan Riis, Cathrine Elgaard Jensen, Flemming Bro, Helle Terkildsen Maindal, Karin Dam Petersen, Mette Dahl Bendtsen, Martin Bach Jensen
BACKGROUND: Guidelines are often slowly adapted into clinical practice. However, actively supporting healthcare professionals in evidence-based treatment may speed up guideline implementation. Danish low back pain (LBP) guidelines focus on primary care treatment of LBP, to reduce referrals from primary care to secondary care. The primary aim of this project was to reduce secondary care referral within 12 weeks by a multifaceted implementation strategy (MuIS). METHODS: In a cluster randomised design, 189 general practices from the North Denmark Region were invited to participate...
October 21, 2016: Implementation Science: IS
C Baeza, N Mottet, C Coppola, M Desmarets, R Ramanah, D Riethmuller
OBJECTIVE: To assess delivery mode, maternal morbidity including uterine rupture and scar dehiscence and neonatal outcome, during a pregnancy after a previous caesarean delivery before 32 weeks of amenorrhea. METHODS: A retrospective descriptive study was carried out at the Besançon University Hospital during an 8-year period. We identified 292 consecutive patients presenting a singleton pregnancy delivery before 32 weeks of amenorrhea. We analysed the next pregnancy...
October 17, 2016: Gynécologie, Obstétrique & Fertilité
Fabien Gagnon, Patrick Poulin, Jean-Marc Leclerc, Jean-Claude Dessau, Aryan Abab, Pamela Arsenault, Fady El-Turaby, Guillaume Lachance-Paquette, Félix-Antoine Vézina
OBJECTIVES: To invite and support managers of child care centres to measure radon concentrations in their buildings. Their ability to carry out a measurement protocol and communication plan was also evaluated as well as the intention of parents and educators to test for radon at home. PARTICIPANTS: Managers, parents and educators of child care centres. SETTING: 36 child care centres located in two priority investigation areas in Québec. INTERVENTION: A kit containing radon detectors with installation and recovery instructions was shipped by mail in addition to factsheets intended for parents and educators...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Sanaz Tabarestani, Marzieh Motallebi, Mohammad Esmaeil Akbari
CONTEXT: Breast cancer is the most common cancer in women worldwide. Estrogen receptor (ER) positive breast cancer constitutes the majority of these cancers. Hormone therapy has significantly improved clinical outcomes for early- and late-stage hormone receptor positive breast cancer. Although most patients with early stage breast cancer are treated with curative intent, approximately 20% - 30% of patients eventually experience a recurrence. During the last two decades, there have been tremendous efforts to understand the biological mechanisms of hormone therapy resistance, with the ultimate goal of implementing new therapeutic strategies to improve the current treatments for ER positive breast cancer...
August 2016: Iranian Journal of Cancer Prevention
S Kennedy, E L Davies, L Ryan, M E Clegg
BACKGROUND/OBJECTIVES: Breakfast skipping increases during adolescence and is associated with lower levels of physical activity and weight gain. Theory-based interventions promoting breakfast consumption in adolescents report mixed findings, potentially because of limited research identifying which determinants to target. This study aimed to: (i) utilise the Theory of Planned Behaviour (TPB) to identify the relative contribution of attitudes (affective, cognitive and behavioural) to predict intention to eat breakfast and breakfast consumption in adolescents and (ii) determine whether demographic factors moderate the relationship between TPB variables, intention and behaviour...
October 19, 2016: European Journal of Clinical Nutrition
Ryan J Heitmann, Alison L Batig, Gary Levy, Jonathan Novotney, Calvin Grubbs, Timothy S Batig, Joseph M Gobern, Eileen Hemman, Alicia Y Christy, Micah J Hill
Unintended pregnancy is a global issue and one that is reportedly to be higher in the military population. We sought to assess rates of unintended pregnancy among the active duty population in comparison to other military health care beneficiaries. Using a validated six-question survey, patients aged 18 to 42 were surveyed in five different clinics at three major tertiary hospitals from December 2013 to December 2014. Individual survey questions were scored 0, 1, or 2 and a total score was tabulated. A total score of 0 to 3 indicated unintended pregnancy, 4 to 9 indicated ambivalence toward pregnancy, and 10 to 12 indicated intended pregnancy...
October 2016: Military Medicine
Pedro Roldán, Sergio García, Josep González, Luis Alberto Reyes, Jorge Torales, Ricard Valero, Laura Oleaga, Joaquim Enseñat
OBJECTIVES: Intra-operative magnetic resonance imaging (iMRI) is a recently introduced tool in the most advanced neurosurgical operating rooms worldwide. We present our preliminary experience in brain tumour surgery with low field PoleStar N30® intraoperative MRI since its introduction in 2013 in the Barcelona Clinic Hospital. MATERIAL AND METHODS: A prospective non-randomised study was conducted on cases operated on using iMRI and intention of complete removal up to October 2015...
October 14, 2016: Neurocirugía
Estrella Romero, Concepción Rodríguez, Paula Villar, X Antón Gómez-Fraguela
The aim of this study is to evaluate the long-term effects of a manualised program which intervenes on children with early-onset conduct problems, their families and teachers. The program evaluation involved 14 primary schools which were randomly assigned to the intervention (45 participating families) and control (30 families) conditions during 2007-2008. After a screening process which identified children with significant conduct problems both at home with their family and at school, the program was implemented in eight schools...
September 29, 2016: Adicciones
Kay-Martin Johnsen, Rasmus Goll, Vegard Hansen, Trine Olsen, Renathe Rismo, Richard Heitmann, Mona D Gundersen, Jan M Kvamme, Eyvind J Paulssen, Hege Kileng, Knut Johnsen, Jon Florholmen
BACKGROUND: Anti-tumour necrosis factor (TNF) agents play a pivotal role in the treatment of moderate to severe ulcerative colitis (UC), and yet, no international consensus on when to discontinue therapy exists. OBJECTIVE: The aim of this study is to study the long-term performance of a treatment algorithm of repeated intensified induction therapy with infliximab (IFX) to remission, followed by discontinuation in patients with UC. PATIENTS AND METHODS: Patients with moderate to severe UC were enroled in an open prospective study design...
October 4, 2016: European Journal of Gastroenterology & Hepatology
Gow-Lieng Tseng, Cheng-Yu Chen
High myopia is a global eye health problem because of its high incidence of sight-threatening complications. Due to the role of awareness, self-examination, and preventive behavior in prevention of morbidity of high myopia complications, promoting knowledge, capabilities, and attitude of high myopic personnel are required in this regard.In this quasi-experiment study, 31 freshmen with high myopia in a national university were enrolled in 2014. The data were collected by validated and reliable questionnaire based on health belief model (HBM) and self-efficacy theory...
October 2016: Medicine (Baltimore)
Nikolaos Voulvoulis, Karl Dominic Arpon, Theodoros Giakoumis
The Water Framework Directive 2000/60/EC (WFD) is widely accepted as the most substantial and ambitious piece of European environmental legislation to date. It has been referred to as a once in a generation opportunity to restore Europe's waters and a potential template for future environmental regulations. However, fifteen years since it was adopted, and with many problems and delays in its implementation, the WFD has not delivered its main objectives of non-deterioration of water status and the achievement of good status for all EU waters...
October 13, 2016: Science of the Total Environment
Houlin Tang, Zunyou Wu, Yurong Mao, Javier Cepeda, Jamie Morano
BACKGROUND: Antiretroviral therapy (ART) and condom use have been proven to reduce the risk of sexual transmission of human immunodeficiency virus (HIV) among HIV sero-different couples, but its full implementation remains a challenge. This study aims to assess HIV seroconversion rate of HIV-negative spouse and its associated risk factors among HIV sero-different couples in rural China. METHODS: An open cohort of HIV sero-different couples enrolled in 30 counties in China between October 1, 2010, and September 30, 2012, and followed-up to December 31, 2012, was constructed retrospectively...
2016: PloS One
Rachel V van Schendel, Lieve Page-Christiaens, Lean Beulen, Catia M Bilardo, Marjon A de Boer, Audrey B C Coumans, Brigitte H Faas, Irene M van Langen, Klaske D Lichtenbelt, Merel C van Maarle, Merryn V E Macville, Dick Oepkes, Eva Pajkrt, Lidewij Henneman
OBJECTIVE: To evaluate preferences and decision-making amongst high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing. METHODS: Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice...
October 14, 2016: Prenatal Diagnosis
Alexandra Flynn, Rosalee Zackula, Nicole M Klaus, Liz McGinness, Susan Carr, Matthew Macaluso
OBJECTIVE: Yellow Ribbon is a gatekeeper-type suicide prevention program that is widely used in public schools. However, data on its effectiveness are limited. The purpose of our study was to evaluate self-reported changes in knowledge and comfort level communicating about suicide following Yellow Ribbon training for a large, representative sample of students from a public school system in the midwestern United States. METHODS: The program was administered to students within the same school district during 2006 through 2009...
2016: Primary Care Companion to CNS Disorders
Bradley C Johnston, Gordon H Guyatt
Among clinical trials of adequate size, randomization balances both known and unknown prognostic factors between trial arms, thus allowing an unbiased comparison of intervention and control. To preserve this benefit, all randomly assigned participants should be followed to study termination and analyzed in the arm to which they were allocated. There are 2 potential limitations in study implementation: 1) patients are nonadherent and continue with follow-up visits, or 2) patients are lost to follow-up and their outcome data are missing...
October 12, 2016: American Journal of Clinical Nutrition
Wade Skoien, Katie Page, William Parsonage, Sarah Ashover, Tanya Milburn, Louise Cullen
BACKGROUND: The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain...
October 12, 2016: Implementation Science: IS
Stephen Barnett, Sandra C Jones, Sue Bennett, Don Iverson, Laura Robinson
BACKGROUND: Professional isolation is an important factor in low rural health workforce retention. OBJECTIVE: The aim of this study was to gain insights to inform the development of an implementation plan for a virtual community of practice (VCoP) for general practice (GP) training in regional Australia. The study also aimed to assess the applicability of the findings of an existing framework in developing this plan. This included ascertaining the main drivers of usage, or usefulness, of the VCoP for users and establishing the different priorities between user groups...
August 18, 2016: JMIR Med Educ
Sang Geun Bae, Sin Kam, Ki Soo Park, Keon-Yeop Kim, Nam-Soo Hong, Ki-Su Kim, Yu-Mi Lee, Won Kee Lee, Michael Sung Pil Choe
PURPOSE: We assessed medication nonadherence, categorized as intentional or unintentional, and related factors in elderly patients with hypertension, correlating the data with measurement of blood pressure as the final target of medication adherence and other possible influencing factors, such as lifestyle. PATIENTS AND METHODS: Subjects were aged ≥65 years, resided in a rural area, and were taking antihypertensive drugs. The survey was conducted in July 2014...
2016: Patient Preference and Adherence
Garen J Wintemute, Laurel Beckett, Philip H Kass, Daniel Tancredi, David Studdert, Glenn Pierce, Anthony A Braga, Mona A Wright, Magdalena Cerdá
BACKGROUND AND OBJECTIVE: Too little is known about the effectiveness of efforts to prevent firearm violence. Our objective is to evaluate California's Armed and Prohibited Persons System (APPS), a law enforcement intervention that seeks to recover firearms from individuals who purchased them legally but subsequently became prohibited from having access to firearms. Prohibitions usually arise from events suggesting an increased risk for future violence. DESIGN AND STUDY POPULATION: This group-randomised trial involves approximately 20 000 APPS-eligible individuals in 1041 communities...
October 11, 2016: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
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