Indicated prevention and early intervention for childhood anxiety: a randomized trial with Caucasian and Hispanic/Latino youth.
(65/144)
OBJECTIVE: This trial of a randomized indicated anxiety prevention and early intervention explored initial program effects as well as the role of ethnicity and language on measured outcomes. METHOD: A total of 88 youth (M = 10.36 years; 45 girls, 52 Latino) received 1 of 2 protocols with varying degrees of parent involvement, and response was measured at posttest and 6-month follow-up. RESULTS: Findings showed that child anxiety symptoms improved significantly across protocols, although additional gains were found for children in the child plus parent condition. Program effects did not vary by Latino ethnicity or Spanish language use in the intervention. CONCLUSIONS: The cognitive and behavioral strategies established for Caucasian children may be promising for Hispanic/Latino children when applied in a culturally responsive manner. (+info)
Severe acute exacerbation of chronic hepatitis B during pegylated interferon treatment and early intervention with corticosteroid.
(66/144)
A low-effort, clinic-wide intervention improves attendance for HIV primary care.
(67/144)
BACKGROUND: Retention in care for human immunodeficiency virus (HIV)-infected patients is a National HIV/AIDS Strategy priority. We hypothesized that retention could be improved with coordinated messages to encourage patients' clinic attendance. We report here the results of the first phase of the Centers for Disease Control and Prevention/Health Resources and Services Administration Retention in Care project. METHODS: Six HIV-specialty clinics participated in a cross-sectionally sampled pretest-posttest evaluation of brochures, posters, and messages that conveyed the importance of regular clinic attendance. 10,018 patients in 2008-2009 (preintervention period) and 11,039 patients in 2009-2010 (intervention period) were followed up for clinic attendance. Outcome variables were the percentage of patients who kept 2 consecutive primary care visits and the mean proportion of all primary care visits kept. Stratification variables were: new, reengaging, and active patients, HIV RNA viral load, CD4 cell count, age, sex, race or ethnicity, risk group, number of scheduled visits, and clinic site. Data were analyzed by multivariable log-binomial and linear models using generalized estimation equation methods. RESULTS: Clinic attendance for primary care was significantly higher in the intervention versus preintervention year. Overall relative improvement was 7.0% for keeping 2 consecutive visits and 3.0% for the mean proportion of all visits kept (P < .0001). Larger relative improvement for both outcomes was observed for new or reengaging patients, young patients and patients with elevated viral loads. Improved attendance among the new or reengaging patients was consistent across the 6 clinics, and less consistent across clinics for active patients. CONCLUSION: Targeted messages on staying in care, which were delivered at minimal effort and cost, improved clinic attendance, especially for new or reengaging patients, young patients, and those with elevated viral loads. (+info)
Early versus delayed carotid endarterectomy in symptomatic patients.
(68/144)
Randomized comparison of radial versus femoral approach for patients with STEMI undergoing early PCI following intravenous thrombolysis.
(69/144)
BACKGROUND: Early percutaneous coronary intervention (PCI) following thrombolysis may be beneficial in patients with ST-segment elevation myocardial infarction (STEMI) who were admitted at a non-PCI hospital. The aim of this study was to evaluate the safety and efficacy of the radial artery as a vascular route for early PCI following thrombolysis in patients with STEMI. METHODS: All consecutive STEMI patients within 12 hours after thrombolysis were enrolled, and eligible patients were randomly assigned to either transfemoral (TFI group) or transradial catheterization (TRI group). Several time intervals were measured. The puncture success rate and ambulation time were assessed. The vascular access-site complications were also assessed after the PCI procedure, and the incidence of major adverse cardiac events (MACE) in hospital was observed. RESULTS: A total of 119 cases were enrolled, with 60 in the TRI group and 59 in the TFI group. There were no significant differences in transfer time and total procedure time. The puncture time in the TRI group was not significantly different compared to the TFI group. The time between PCI and ambulation in the TRI group was shorter than in the TFI group. There was a trend toward lower in the incidence of bleeding complications and vascular complications in the TRI group. CONCLUSION: TRI for STEMI patients following intravenous thrombolysis was as safe and feasible as TFI, with a trend toward lower incidence of bleeding complications and vascular complications. (+info)
Informing early intervention: preschool predictors of anxiety disorders in middle childhood.
(70/144)
Social-emotional problems in preschool-aged children: opportunities for prevention and early intervention.
(71/144)
OBJECTIVES: To estimate the prevalence of positive screens for social-emotional problems among preschool-aged children in a low-income clinical population and to explore the family context and receptivity to referrals to help guide development of interventions. DESIGN: Observational, cross-sectional study. SETTING: Two urban primary care clinics. PARTICIPANTS: A total of 254 parents of 3- and 4-year-old children at 2 urban primary care clinics. MAIN OUTCOME MEASURES: Score on a standardized screen for social-emotional problems (Ages and Stages Questionnaire: Social-Emotional) and answers to additional survey questions about child care arrangements, parental depressive symptoms, and attitudes toward preschool and behavioral health referrals. RESULTS: Twenty-four percent (95% CI, 16.5%-31.5%) of children screened positive for social-emotional problems. Among those screening positive, 45% had a parent with depressive symptoms, and 27% had no nonparental child care. Among parents of children who screened positive for social-emotional problems, 79% reported they would welcome or would not mind a referral to a counselor or psychologist; only 16% reported a prior referral. CONCLUSIONS: In a clinical sample, 1 in 4 low-income preschool-aged children screened positive for social-emotional problems, and most parents were amenable to referrals to preschool or early childhood mental health. This represents an opportunity for improvement in primary prevention and early intervention for social-emotional problems. (+info)
Modeling early bactericidal activity in murine tuberculosis provides insights into the activity of isoniazid and pyrazinamide.
(72/144)