Interventions for the treatment of epibole on wound edges: a scoping review

How do different types of external intervention affect the likelihood of a negotiated settlement in civil conflicts? Drawing on the negotiation literature, which shows that the nature of the parties’ “best alternative to a negotiated agreement (BATNA)” influences the bargaining process between them, we argue different types of intervention affect governments’ and rebel groups’ BATNAs in different ways. This, in turn, affects the likelihood of a negotiated settlement. To test this argument, we address the fact that interventions are nonrandom, and that characteristics of civil conflicts that lead to different types of intervention also influence the likelihood of a negotiated settlement. We therefore use a two-stage statistical model. The first stage predicts the likelihood of different types of intervention, and drawing on those results, the second stage analyzes the likelihood of a negotiated settlement. The results provide insights into how different types of intervention affect civil conflict outcomes.

BackgroundEfficient performance of most daily activities requires intact and simultaneous execution of motor and cognitive tasks. To mitigate age-related functional decline, various combinations of motor and cognitive training have shown promising results. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy of different types of motor-cognitive training interventions (e.g., sequential and simultaneous) on selected functional outcomes in healthy older adults.MethodsSix online academic databases were used to retrieve eligible RCTs up to April 2021, following PRISMA guidelines and PICO criteria. A random-effects model was used for all meta-analyses conducted on selected functional outcomes: single- and dual-task gait speed, the Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) score. Effect size (ES) was calculated as Hedges' g and interpreted as: trivial: <0.20, small: 0.20–0.60, moderate: 0.61–1.20, large: 1.21–2.00, very large: 2.01–4.00 or extremely large >4.00.ResultsFrom 2,546 retrieved records, 91 RCTs were included for meta-analysis (n = 3,745 participants; 64.7–86.9 years). The motor-cognitive interventions included differed according to the type of training (e.g., sequential, simultaneous with additional cognitive task or exergame training. The results showed that motor-cognitive interventions can improve gait speed under single-task conditions (small ES = 0.34, P = 0.003). The effect of the intervention was moderated by the type of control group (Q = 6.203, P = 0.013): passive (moderate ES = 0.941, P = 0.001) vs. active controls (trivial ES = 0.153, P = 0.180). No significant effect was found for dual-task walking outcomes (P = 0.063). Motor-cognitive intervention had a positive effect on TUG (small ES = 0.42, P < 0.001), where the effect of intervention was moderated by control group [passive (moderate ES = 0.73, P = 0.001) vs. active (small ES = 0.20, P = 0.020)], but not by the type of training (P = 0.064). Finally, BBS scores were positively affected by motor-cognitive interventions (small ES = 0.59, P < 0.001) with however no significant differences between type of control group (P = 0.529) or intervention modality (P = 0.585).ConclusionsThis study provides evidence for the effectiveness of various types of motor-cognitive interventions on performance-based measures of functional mobility in healthy older adults. With respect to significant effects, gait speed under single-task condition was improved by motor-cognitive interventions, but the evidence shows that this type of intervention is not necessarily more beneficial than motor training alone. On the other hand, motor-cognitive interventions are better at improving multicomponent tasks of dynamic balance and mobility function, as measured by the TUG. Because of substantial heterogeneity and the current limited availability of different types of interventions, the conclusions should be interpreted with caution.

Survey research suggests that there are few, if any, gender differences in the types and frequency of informal drunk-driving intervention. This contrasts sharply with laboratory studies of helping behavior which report that men are more likely to help than are women. The present study examined the frequency and success rate of several different types of informal drunk-driving intervention for women and men. The influence of the gender of the intervenor and the intoxicated individual and the intervenor's familiarity with the individual on the use and success of the different interventions were also examined. Students (N = 388) at a major West Coast university completed a drinking and driving questionnaire. Of these subjects 303 (78%) reported having been in a DUI situation within the last year, and 68% at these students (n = 206) who reported having intervened at least once in the past year were used in the present study. Women were just as likely as men to intervene. There were few gender differences in the frequency and success rates of the different types of intervention examined. Familiarity with the intoxicated individual increased the frequency and success of intervention. However, intervention with strangers occurred under certain circumstances. These data indicate that there are few gender differences in the use and success rate of different types of informal drunk-driving intervention. However, since the interventions examined in this study were determined a priori, gender differences may still be operative. There is some research evidence that suggests that men and women approach potential drunk drivers differently. Furthermore, the role of familiarity in drunk-driving intervention needs to be further examined.

The authors report the results of a campaign aimed at increasing compliance to cervical cancer screening by promoting general practitioners' (GPs) cooperation. Different types of intervention were tested, namely mailing lists of non responders to the GP, visiting the GP at the office, or both. No active intervention was made in a sample of GPs who served as a control group. Overall 288 GPs assisting 75,853 women aged 25 to 59 were enrolled in the study. Compliance before and after the campaign was studied and the association between compliance and different variables such as age, residence and type of intervention was tested by univariate and multivariate analysis. The proportion of previous non responders who performed a Pap test after the campaign was 6.7%, the response being dependent on age (25-29 = 11.5%, 30-39 = 8.8%, 40-49 = 6.5%, 50-59 = 4.2%) and place of residence (urban = 7.2%, suburban = 5.9%, rural = 4.0%). Compliance was better in the case of the active campaign (list mailing = 8.3%, visit = 7.0%, list + visit = 7.2%) with respect to controls (2.9%) although no significant differences were detected between different types of active intervention. Compliance to cervical cancer screening may be increased by promoting GPs cooperation but the benefit is limited. Mailing lists of non responders was found the most cost effective policy in this study.

(1) Objective: To review the scientific literature on the impact of interventions to enhance the occupational health of health-care workers with overnutrition. (2) Methods: Scoping review with meta-analysis. Data were obtained by consulting the following bibliographic databases: MEDLINE (via PubMed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Literature on Health Sciences (LILACS), and Medicina en Español (MEDES). The terms used as descriptors and as text in the title and abstract fields of the records were "health workers", "overnutrition", and "occupational health", using the filters "human", "adult": 19+ years", and "clinical trial". The search update date was January 2023. The documentary quality of the articles was evaluated using the CONSORT questionnaire and the presence of bias was assessed using the Rob 2.0 tool. (3) Results: From the 611 digitally retrieved references, 17 clinical trials were selected after applying the inclusion and exclusion criteria. CONSORT scores ranged from a minimum of 14.6% to a maximum of 91.7%, with a median of 68.8%. According to the SIGN criteria, this review provided "1" evidence with a grade B recommendation. Six different types of intervention were tested, grouped into strategies ranging from a single intervention to a combination of four interventions. The summary effect of the meta-analysis showed significant weight loss, but no association with reduced body mass index. (4) Conclusions: While workplace interventions have been shown to be potentially effective, and strategies using different types of interventions have been proven to be useful in tackling overnutrition, an effective and sustainable solution for changing the behavior of health professionals to tackle overweight and obesity has yet to be identified.

Stroke is the most common cause of motor impairment worldwide. Therefore, many factors are being investigated for their predictive and facilitatory effects on recovery of motor function after stroke.Motor recovery can be predicted through several factors, such as clinical assessment, clinical biomarkers, and gene-based variations. As for interventions, many methods are under experimental investigation that aim to improve motor recovery, including different types of pharmacological interventions, non-invasive stimulation, and rehabilitation training by inducing cortical reorganization, neuroplasticity, angiogenesis, changing the levels of neurotransmitters in the brain, and altering the inflammatory and apoptotic processes occurring after stroke. Studies have shown that clinical biomarkers combined with clinical assessment and gene-based variations are reliable factors for predicting motor recovery after stroke. Moreover, different types of interventions such as pharmacological agents (selective serotonin reuptake inhibitors {SSRI}, noradrenaline reuptake inhibitors {NARIs}, levodopa, and amphetamine), non-invasive stimulation, and rehabilitation training have shown significant results in improving functional and motor recovery.

Background: Integrating healthcare and social care is necessary because a substantial proportion of primary care clients receive unnecessary healthcare (not tailored to their social needs) which can lead to undesirable costs. Social prescribing is an innovative approach for more holistic person-centered care and aims to address clients’ social determinants of health. Often social prescribing services include link workers who support primary care patients to access community and voluntary care services. The aim is to replace the medical approach with a social approach to address patients’ needs. Previous literature has provided basic insights into how social prescribing can be implemented, especially in the early stages of implementation. Though little is known about how social prescribing can be fully embedded. This study provides guiding principles by which social prescribing can be implemented and embedded successfully and identifies which contextual factors and mechanisms influence these guiding principles. Methods: We conducted a Rapid Realist Review to understand what works, for whom in which context. This review consisted of three steps. The first step was to align the research questions with those of health/cure and care organizations. A local reference panel consisting of national organizations gave advice on the research questions and search strategy. Then, based on these questions a systematic search of the international peer-reviewed literature was conducted. Finally, a panel discussion was organized, engaging Dutch health care professionals working with social prescribing, to discuss what the international insights mean for their local contexts. This input helped to refine the literature review’s findings. Results: Preliminary results provided insight into what is needed for implementing and embedding social prescribing after a pilot phase. For example, investing in a change of culture mindset, enabling trust between health/cure and care professionals, creating facilitative conditions for professionals to work with social prescribing in daily practice. In this paper more detailed insights will be presented on the facilitators and barriers mechanisms for implementing and embedding social prescribing in healthcare and how they operate in different contexts. Discussion: Internationally, social prescribing has gained more and more attention, and first implementation best practices have been identified. However, we found that different types of social prescribing interventions were implemented. We will reflect on how the guiding principles relate to the implementation and embedding of these different types of interventions. Conclusion: Implementation and embedding of social prescribing is experienced as challenging, because of local differences in context, such as different populations and the way in which care is organized. The retrieved insights demonstrate which principles can be followed for implementation and embedding of social prescribing, for whom and in which context. Lessons Learned: We developed guiding principles for the embedding of social prescribing, and we provided insight into what this means for the context in the Netherlands. Suggestions for future research: Despite the increase in implementation, there is little knowledge on the effectiveness of social prescribing on health and wellbeing outcomes of patients, and changes in healthcare use. Future research should focus on gaining insight into the effectiveness and impact of social prescribing.

Systematic review of the effect of psychological interventions on family caregivers of people with dementia

In 2004, the German federal state of Baden-Württemberg implemented a quality management system for pre-hospital emergency care. Since then, there has been a semi-annual assessment of the frequency of different types of emergency medical interventions and the quality of care. The frequencies of different types of intervention were determined and reported both in absolute numbers and as incidence figures, i.e., interventions per 1000 inhabitants per year. The quality of care was rated with the Mainz Emergency Evaluation Score (MEES), and analyses of resuscitation outcomes and guideline implementation were performed. From 2004 to 2008, there were a total of 524,833 pre-hospital emergency medical interventions in Baden-Württemberg. The annual incidence of emergency interventions rose by 22% over this period (from 16.2 to 19.9 interventions per 1000 inhabitants per year), and the percentage of patients who were severely ill or severely injured rose as well, from 47.3% to 51.1%. The percentage of patients over age 75 rose from 29.1% to 31.3%. 11,858 patients with myocardial infarction (MI) were treated in 2008; the incidence of treatment for MI rose by 60% from 2004 to 2008, from 0.907 to 1.448 interventions per 1000 inhabitants per year. A major improvement in the diagnostic evaluation of MI came about through the purchase of more 12-channel ECG machines. In 2008, the emergency medical teams succeeded in improving the patient's condition in 69.07% of all cases (77.9% for MI, 63.2% for stroke, 74.4% for multiple trauma). 21 patients per 100,000 inhabitants per year arrived in the hospital alive after out-of-hospital cardiac arrest and pre-hospital resuscitation. Even in the face of increasing utilization, the quality of emergency medical care in Baden-Württemberg has remained high. Since a quality management system was introduced in 2004, the physicians in charge of emergency medical teams have had access to the data that they need in order to evaluate and further develop the services that they provide.

BackgroundHigh prevalence rates of psychological distress in medical training and later professional life indicate a need for prevention. Different types of intervention were shown to have good effects, but little is known about the relative efficacy of different types of stress management interventions, and methodological limitations have been reported. In order to overcome some of these limitations, the present study aimed at evaluating the effect of a specifically developed mindfulness-based stress prevention training for medical students (MediMind) on measures of distress, coping and psychological morbidity.MethodsWe report on a prospective randomized controlled trial with three study conditions: experimental treatment (MediMind), standard treatment (Autogenic Training) and a control group without treatment. The sample consisted of medical or dental students in the second or eighth semester. They completed self-report questionnaires at baseline, after the training and at one year follow-up. Distress (Trier Inventory for the Assessment of Chronic Stress, TICS) was assessed as the primary outcome and coping (Brief COPE) as a co-primary outcome. Effects on the psychological morbidity (Brief Symptom Inventory, BSI) as a secondary outcome were expected one year after the trainings.ResultsInitially, N = 183 students were randomly allocated to the study groups. At one year follow-up N = 80 could be included into the per-protocol analysis: MediMind (n =31), Autogenic Training (n = 32) and control group (n = 17). A selective drop-out for students who suffered more often from psychological symptoms was detected (p = .020). MANCOVA’s on TICS and Brief COPE revealed no significant interaction effects. On the BSI, a significant overall interaction effect became apparent (p = .002, η2partial = .382), but post hoc analyses were not significant. Means of the Global Severity Index (BSI) indicated that MediMind may contribute to a decrease in psychological morbidity.ConclusionDue to the high and selective dropout rates, the results cannot be generalized and further research is necessary. Since the participation rate of the trainings was high, a need for further prevention programs is indicated. The study gives important suggestions on further implementation and evaluation of stress prevention in medical schools.Trial registrationThis trial is recorded at German Clinical Trials Register under the number DRKS00005354 (08.11.2013).

Computed tomography (CT) is widely used not only for diagnostic purposes but also for image guidance during different types of interventions. Therefore, radiation exposure of both patients and interventional radiologists remains a much-discussed topic. To quantify radiation exposure of interventional radiologists during multiple CT-guided interventions using dosimeters placed under and outside standard protective lead clothing. A total of 113 consecutive interventions covering three different types of procedures (grouped as periradicular infiltration therapy, biopsies, and drain placement) and performed using routine clinical protocols were prospectively analyzed. The interventions were performed by two radiologists of different experience levels with identically placed dosimeters outside and underneath their protective clothing. Personal doses (right hand, eye lens, thyroid gland, thorax, gonads) were cumulatively measured for each type of intervention and separately for the two radiologists. Personal dose was below the detection limit of the dosimeters during periradicular infiltration therapy. In the biopsy and drain placement groups, the highest dose was found for the right hand (maximum cumulative dose = 1.84 ± 1.30 mSv in 19 consecutive drain placements). Under the protective gear, exposure was only observed for drain placements performed by the less experienced radiologist (maximum = 0.05 ± 0.04 mSv for the eye lens). Personal doses measured here were far below annual thresholds published by the International Commission on Radiological Protection. Therefore, performing multiple CT-guided interventions appears to be safe for interventional radiologists in terms of radiation exposure.

Regardless of profession and area of practice, every health care provider must possess basic knowledge and skills to integrate genetics and genomics into practice. Nurses play a pivotal role in providing health care, and they should be well equipped to apply genetics and genomics to health care settings. This scoping review explored the existing literature of educational interventions to improve nurses' competencies, including knowledge, attitudes, and skills in genetics and genomics. A scoping review was conducted with the Joanna Briggs Institute method for scoping reviews. We searched PubMed, Web of Science, CINAHL, and ERIC in March 2021. We included original research studies published in English in peer-reviewed journals that reported findings on the effectiveness of an educational intervention to improve nurses' competencies in genetics or genomics. A total of 17 studies were included in the scoping review. Registered nurses, advanced practice nurses, and nursing faculty were targeted with different types of interventions, including face-to-face education, online/remote education, and written materials. Limited research shows that various educational interventions improved the competencies in genetics and genomics among nurses with different degrees and areas of practice. Research is needed to evaluate the long-term effects of educational interventions by reliable assessment methods for nurses with appropriate sample sizes. [J Contin Educ Nurs. 2022;53(1):13-20.].

Feeding disorders represent a common problem that affects children’s health and family routines and since information about non-pharmacological interventions is limited, a scoping review was conducted to identify and describe non-pharmacological interventions for pediatric feeding disorders. This review identified 74 studies. Behavioral strategies were the most common type of intervention. Most studies combined two or more different types of interventions, used an interdisciplinary approach was frequently observed and the profession with the highest frequency of occurrence is occupational therapy. Future research could focus on investigating a greater number of studies with higher levels of evidence and analyzing intervention effectiveness.

To review the scientific literature and identify dental plaque control strategies focussed on elderly people that improve plaque indices. Scoping review (Joanna Briggs protocol). Individual search strategies developed for six databases. The selection of the manuscripts in two phases: title and abstract review, and complete review. Studies on interventions for plaque control in elderly people (60y+). Epidemiological studies and those focussed on caregivers, health professionals and periodontal maintenance therapies were excluded. The initial search yielded 2803 studies, 26 were included. The results were classified into: exclusively chemical (10), educational (9), exclusively mechanical (6), and combined mechanical and chemical (1). The studies reported different types of interventions: sugarless chewing gum, chlorhexidine (CHX) in different preparations and concentrations, mouthwash based on essential oils, stannous/sodium fluoride dentifrice and lactoferrin/lactoperoxidase tablets. Additionally, conventional and alternative toothbrushes and professional brushing were tested. Educational interventions included oral hygiene guidance, verbal information, and demonstrations of dental and denture cleaning procedures, and lifestyle changes. Many studies have reported strategies that improve dental plaque indices but without statistical significance when compared to control groups. Promising results were found with the use of CHX, sugarless chewing gum, professional brushing and educational strategies with demonstration, but the results were not long-lasting. The literature reports that mechanical, chemical and educational strategies have some efficacy in dental plaque control in the elderly population. The results should be viewed with caution, considering the type of intervention (isolated or combined) and the maintenance of the results obtained.

Abstarct : In this study, we will talk on indended use of silver nitrate solution which has been used in various medical treatments for many years, being exposed to silver nitrate solution especially during preparation of a scientific study materials and the changes occuring in epidermis. The silver nitrate is the third element used after gold and copper. The silver nitrate is used in various fields; for gingivitis, oral hygiene, to clear up