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RESUMO O objetivo deste estudo de caso único é descrever e avaliar a aplicação de um modelo de Intervenção Comportamental Intensiva, realizado por meio da capacitação dos cuidadores, com uma criança com autismo gravemente comprometida e não falante. A intervenção ocorreu por 40 horas semanais em ambiente domiciliar e escolar, ao longo de cinco anos consecutivos. Instrumentos padronizados foram utilizados para medir o desenvolvimento da criança. Os resultados gerais indicaram ganhos no desenvolvimento da criança e a viabilidade da capacitação dos cuidadores para esse tipo de intervenção.
ABSTRACT The purpose of this single case study is to describe and evaluate the application of an Intensive Behavioral Intervention model, carried out through the training of caregivers, with a child with severely compromised and non-speaking autism. The intervention occurred for 40 hours a week in a home and school environment, during five consecutive years. Standardized instruments were used to measure child development. Overall results indicated gains in child development and the feasibility of training of caregivers for this type of intervention.
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Objective This study evaluated the effects of a systematic intensive health education intervention in community-dwelling elderly individuals with hypertension. Methods Using a cluster sampling method,we selected two neighborhoods in the Taiyuan Xiyu community,which were located 8 km apart.We randomly assigned all elderly community residents who were diagnosed with hypertension to one of two groups according to the inclusion and exclusion criteria:the intervention group(n=314)or the control group (n=319). The intervention group received a 1-year systematic intervention of intensive health education, whereas the control group only received 1 year of routine health education. After 1 year, blood pressure, body mass index, fasting blood glucose, blood lipid levels, and changes in poor health behaviors were evaluated in both groups. Results The systolic blood pressure of hypertensive patients in the intervention group decreased from(136.75±14.62)mmHg(1 mmHg=0.133 kPa)before the intervention to (131.11 ± 7.71) mmHg after the intervention. The diastolic blood pressure of hypertensive patients in the intervention group decreased from(81.22±7.71)mmHg before the intervention to(80.45±5.12)mmHg after the intervention. Body mass index, fasting blood glucose, total cholesterol, and low-density lipoprotein cholesterol decreased from(25.02±3.09)kg/m2,(5.85±1.50)mmol/L,(5.23±0.99)mmol/L,and(2.98±1.07) mmol/L before the intervention to(24.22±2.73)kg/m2,(5.23±1.50)mmol/L,(4.42±1.31)mmol/L,and(2.73±0.95)mmol/L after the intervention in the intervention group,respectively.The differences before and after the intervention were significant (P<0.05, P<0.01). The systolic blood pressure of hypertensive patients in the control group decreased from (137.83 ± 13.83) mmHg before the intervention to (133.14 ± 7.69) mmHg after the intervention. The diastolic blood pressure of hypertensive patients in the intervention group decreased from (82.04 ± 7.62) mmHg before the intervention to (81.22 ± 5.29) mmHg after the intervention. Fasting blood glucose and total cholesterol of hypertensive patients in the control group decreased from (5.67±1.49)mmol/L and(5.27±1.02)mmol/L before the intervention to(5.47±1.53)mmol/L and(4.70±1.25) mmol/L after the intervention,respectively.The differences before and after the intervention were significant (P<0.05,P<0.01).The difference between the two groups in systolic blood pressure,body mass index,fasting blood glucose, and total cholesterol were statistically significant (P<0.05, P<0.01). After the intervention, both groups showed statistically significant behavioral changes in smoking cessation, physical exercise, low-sodium diets, and weight control (P<0.01). Conclusion A systematically intensive health education intervention was effective in improving blood pressure and unhealthy lifestyles for community-dwelling elderly patients with hypertension.
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OBJECTIVES: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. METHODS: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. RESULTS: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. CONCLUSION: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.
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Child , Humans , Academies and Institutes , Autism Spectrum Disorder , Autistic Disorder , Diagnosis , Education , Education, Special , Korea , Running , Seoul , SpecializationABSTRACT
Objective To investigate the clinical effect of insulin on gestational diabetes mellitus(GDM).Methods GDM patients were randomly divided into group A and group B,group B were treated with short term intensive insulin pump therapy,and group A were treated with insulin pump in short term combined with biosynthetic human insulin therapy.Results The body mass index and diabetes family history rates pre-pregnancy in group B were significantly higher than group A(P<0.05).Logistic analysis showed that family history of BMI pre-pregnancy and diabetes family history were independent risk factors for GDM drug treatment(P<0.05).Compared with the group B,the improvement of blood glucose levels and the incidence of complications in patients with group A were better than the former(P<0.05).Conclusion Rational application of insulin can improve the efficacy of clinical treatment of GDM, reduce the incidence of complications, with high safety.