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Gustav Novikov
Gustav Novikov

The Intervention

A weekend getaway for four couples of old friends takes a sharp turn when one of the couples, Ruby and Peter, discover the entire trip was orchestrated with the intention of hosting an "intervention" on their marriage.

The Intervention

DuVall started writing The Intervention in 2012.[8] The idea for a story based around a marital intervention came partly from DuVall's own life; she said that she was too judgmental of her friends' lives and reluctant to face her own problems. She did not initially intend to direct the script she had written for The Intervention, but changed her mind while trying to find another director.[6] The film was produced by Sam Slater and Paul Bernon of Burn Later Productions, along with Sev Ohanian.[9] Bernon and Slater became involved after asking DuVall's agency if they had any film projects in need of financing, and Ohanian was brought to the project by Mel Eslyn, who served as an executive producer.[5] DuVall said that the process of finding investors was fast and relatively easy, which she attributed to the film's very low budget.[7] The film's financing was secured six months after DuVall had finished writing the script, and filming began three months later.[10] Four members of the main cast (Lynskey, Lyonne, Ritter and Shawkat) were friends of DuVall's, while the other three (Smulders, Piazza and Schwartz) were cast through "a connection to someone else in the cast".[11]

Interventions: Women with an intact uterus received conjugated equine estrogens (CEE; 0.625 mg/d) plus medroxyprogesterone acetate (MPA; 2.5 mg/d) (n = 8506) or placebo (n = 8102). Women with prior hysterectomy received CEE alone (0.625 mg/d) (n = 5310) or placebo (n = 5429). The intervention lasted a median of 5.6 years in CEE plus MPA trial and 7.2 years in CEE alone trial with 13 years of cumulative follow-up until September 30, 2010.

Conclusions and relevance: Menopausal hormone therapy has a complex pattern of risks and benefits. Findings from the intervention and extended postintervention follow-up of the 2 WHI hormone therapy trials do not support use of this therapy for chronic disease prevention, although it is appropriate for symptom management in some women.

Intervention data analysis helps the team to determine how well the plan is working and whether they need to make any changes in the intervention procedures. As they undertake their analysis, the team will determine whether:

To make this determination, the team compares the intervention data to the baseline data to determine whether the desired change in behavior is in fact occurring. They also analyze the intervention data to determine whether the student is making progress toward meeting the goal(s) stated in the function-based intervention plan.

To determine whether the teacher is following the intervention steps, an observer (e.g., behavior analyst, school psychologist) uses an implementation fidelity observation form. A percentage is calculated based on the number of steps completed with fidelity. Implementation fidelity issues should be addressed before changes in the intervention are considered.

The implementation fidelity checklist shows data collected during the first observation. As you can see on the form, the teacher did not implement the intervention with fidelity (i.e., greater than 80%) during the first observation. She receives additional instruction on the details of the implementation plan and subsequently implements the intervention with high fidelity during the remaining observations. Because she implemented the intervention with fidelity during the next two observations, the team determines that they can reduce the frequency of these observations to once per week.

Various conceptualizations of research on intervention development share the notion of phases or stages of intervention development, and most stress the importance of translational research. The models generally agree that efficacy and effectiveness research vary along a continuum, from maximizing internal validity to maximizing generalizability. Models differ in what stages they include and in the way they number and name the stages. Models also differ in terms of the relevance, importance, and role of theory and basic research in intervention development; and in terms of the point at which they emphasize a focus on implementation.

The NIH Stage Model was created to identify, define, and clarify the array of activities involved in behavioral intervention development to facilitate the scientific development of potent and implementable interventions. Because behavioral interventions frequently do not move beyond efficacy to effectiveness or implementation, several stages of intervention development are identified, defined, and clarified in this model to address this issue. For example, early-stage intervention development, refinement, and adaptation is broadened to include intervention modification to promote ease of implementation, and, where needed, the development of training materials (Stage I). Furthermore, two stages for different types of real-world testing are distinguished: One a hybrid efficacy-effectiveness stage to demonstrate that it is possible to administer an intervention correctly in the real-world (Stage III); another to conduct true effectiveness testing (Stage IV). Finally, the model is intended to emphasize both the scientific and practical value of determining the mechanism of action of interventions; 1) to help to create a cumulative, progressive field and; 2) to help identify principles of behavior change that can be imparted to those who are delivering interventions. This emphasis on mechanisms facilitates the ability to operationalize personalized interventions, tailored for different characteristics of individuals, couples, families, for broad range of behaviors and across settings.

The NIH Stage Model is an iterative, recursive, multidirectional model of behavioral intervention development. This model asserts that intervention development is not complete until an intervention reaches its maximum level of potency and is implementable with a maximum number of individuals in the population for which it was developed. In this model basic researchers, intervention developers, and community-oriented intervention and implementation researchers all have a significant role to play in every stage of developing potent and implementable interventions.

To argue that the current conflict in Libya is a result of the intervention, one would basically need to assume that the outbreak of civil war was inevitable, irrespective of anything that happened in the intervening 30 months.

What is the BRN's Intervention Program? The Intervention Program is a voluntary, confidential, rehabilitation program for registered nurses whose nursing practice may be impacted due to substance use disorder or mental illness. The goal of the Intervention Program is to protect the public. It does this by promoting early identification of RNs with substance use disorders and by providing these nurses intervention and treatment.

For those reasons, it is imperative that others who suspect a substance abuse problem or mental health problem in a registered nurse take action. Without intervention, these conditions have predictable courses and outcomes. The BRN's Intervention Program aims to identify symptoms, intervene, and change the outcomes. The Intervention Program also provides an effective alternative to the traditional disciplinary process.

Where can I get more information about the Intervention Program? For general program information, to schedule intake appointments or interventions, and for questions regarding monitoring nurses in the program, call (800) 522-9198.

Cochrane Reviews include an assessment of the risk of bias in each included study (see Chapter 7 for a general discussion of this topic). When randomized trials are included, the recommended tool is the revised version of the Cochrane tool, known as RoB 2, described in this chapter. The RoB 2 tool provides a framework for assessing the risk of bias in a single result (an estimate of the effect of an experimental intervention compared with a comparator intervention on a particular outcome) from any type of randomized trial.

If some patients do not receive their assigned intervention or deviate from the assigned intervention after baseline, these effects will differ, and will each be of interest. For example, the estimated effect of assignment to intervention would be the most appropriate to inform a health policy question about whether to recommend an intervention in a particular health system (e.g. whether to instigate a screening programme, or whether to prescribe a new cholesterol-lowering drug), whereas the estimated effect of adhering to the intervention as specified in the trial protocol would be the most appropriate to inform a care decision by an individual patient (e.g. whether to be screened, or whether to take the new drug). Review authors should define the intervention effect in which they are interested, and apply the risk-of-bias tool appropriately to this effect.

The effect of principal interest should be specified in the review protocol: most systematic reviews are likely to address the question of assignment rather than adherence to intervention. On occasion, review authors may be interested in both effects of interest.

The effect of assignment to intervention should be estimated by an intention-to-treat (ITT) analysis that includes all randomized participants (Fergusson et al 2002). The principles of ITT analyses are (Piantadosi 2005, Menerit 2012):

Trial authors often estimate the effect of intervention using more than one approach. They may not explain the reasons for their choice of analysis approach, or whether their aim is to estimate the effect of assignment or adherence to intervention. We recommend that when the effect of interest is that of assignment to intervention, the trial result included in meta-analyses, and assessed for risk of bias, should be chosen according to the following order of preference: 041b061a72


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