Different Types Of Interventions Research Articles

The soft channels of policy diffusion: Insights from local climate change adaptation policy

AbstractDiffusion has become both an important concept for studying policy spread and a popular governance approach, particularly where direct coercion is unavailable or undesirable. However, the prevailing mechanism‐centered concept is difficult to measure and poorly captures the governance potential of policy diffusion. To address these issues, this article presents a new channel‐centered framework that distinguishes between six soft policy diffusion channels: autonomous, collaborative, exemplary, persuasive, organized, and funded diffusion. The framework is probed by studying local climate change adaptation policy using original survey data collected from the administrations of 190 municipalities located in the central German state of Hessen. The regression results indicate that the local institutionalization of adaptation in Hessen is associated with several interventions by higher levels of government, including the provision of a policy model, a municipal climate network, and grant programs. However, the density of concrete adaptation measures is associated with noninstitutionalized exchanges between municipalities. External grants are also found to be more effective in institutionalizing adaptation in larger municipalities. These results demonstrate the usefulness of the framework for distinguishing and comparing different diffusion channels and suggest that different types of interventions may be required to effectively support adaptation policy development at the local level.

Psychological Techniques in Crisis Negotiation

Aim: Crisis negotiation is a very effective police tool for the successful and peaceful resolution of various types of crisis interventions, with different types of interventions being the focus of this review. Materials and Methods: One of the most effective communication skills negotiators use is active listening. Active listening involves focusing attention on what the person is saying without judging, while non-verbally and verbally letting the person know that he is being listened to. In the negotiation context, it calms the perpetrator, encourages him to talk, enables rapport building between the negotiator and the perpetrator, and encourages a change in the perpetrator’s behaviour. Results: Techniques that are most effective in crisis negotiation are paraphrasing, mirroring, “I” messages, minimal encouragements, pause, open-ended questions and emotion labelling. The paper also describes important factors for the effective use of active listening in crisis negotiation. Conclusion: Important factors for the effective use of active listening in crisis negotiation are non-judgmental acceptance, rapport building, maintaining dignity, authenticity, and empathy.

Improving medication adherence among persons with cardiovascular disease through m-health and community health worker-led interventions in Kerala; protocol for a type II effectiveness-implementation research-(SHRADDHA-ENDIRA)

BackgroundCardiovascular disease (CVD) is the leading cause of mortality worldwide, and at present, India has the highest burden of acute coronary syndrome and ST-elevation myocardial infarction (MI). A key reason for poor outcomes is non-adherence to medication.MethodsThe intervention is a 2 × 2 factorial design trial applying two interventions individually and in combination with 1:1 allocation ratio: (i) ASHA-led medication adherence initiative comprising of home visits and (ii) m-health intervention using reminders and self-reporting of medication use. This design will lead to four potential experimental conditions: (i) ASHA-led intervention, (ii) m-health intervention, (iii) ASHA and m-health intervention combination, (iv) standard of care. The cluster randomized trial has been chosen as it randomizes communities instead of individuals, avoiding contamination between participants. Subcenters are a natural subset of the health system, and they will be considered as the cluster/unit. The factorial cluster randomized controlled trial (cRCT) will also incorporate a nested health economic evaluation to assess the cost-effectiveness and return on investment (ROI) of the interventions on medication adherence among patients with CVDs. The sample size has been calculated to be 393 individuals per arm with 4–5 subcenters in each arm. A process evaluation to understand the effect of the intervention in terms of acceptability, adoption (uptake), appropriateness, costs, feasibility, fidelity, penetration (integration of a practice within a specific setting), and sustainability will be done.DiscussionThe effect of different types of intervention alone and in combination will be assessed using a cluster randomized design involving 18 subcenter areas. The trial will explore local knowledge and perceptions and empower people by shifting the onus onto themselves for their medication adherence. The proposal is aligned to the WHO-NCD aims of improving the availability of the affordable basic technologies and essential medicines, training the health workforce and strengthening the capacity of at the primary care level, to address the control of NCDs. The proposal also helps expand the use of digital technologies to increase health service access and efficacy for NCD treatment and may help reduce cost of treatment.Trial registrationThe trial has been registered with the Clinical Trial Registry of India (CTRI), reference number CTRI/2023/10/059095.

Scoping review: Technology‐based nursing interventions for urinary incontinence for individuals 65 years and older

AbstractTo review and summarize the available evidence on technology‐based nursing interventions for urinary incontinence. Scoping review. A review of english and German research articles published up to April 2024 examining nursing interventions in older people (> = 65 years) was conducted. Studies were retrieved by searching the Medline electronic database via PubMed and CINAHL database. Eight studies met the inclusion criteria. The review followed the updated methodological guidance for the conduct of scoping reviews published in 2020. Eight studies and three different types of interventions based on digital technologies were identified: sensor‐based interventions, app‐based interventions and computer‐based digital expert systems. The interventions showed positive and no effects. The studies showed a high variety in terms of study designs, settings, measurement instruments, measured outcomes and were consequently not comparable. The current research density is too low to recommend interventions. Therefore, more high‐quality studies are needed. Studies should be designed to be comparable, if possible. The definition of a core outcome set is therefore indicated. There is a research gap that should be closed by high‐quality and comparable studies so that patients can benefit from evidence‐based incontinence care in the future. Defining core outcomes can help to better compare future studies. Technology‐based interventions should be investigated specifically for older people in the future as, in addition to the potential for improved incontinence care, they also have the potential to reduce the burden on caregivers and conserve staff resources. No patient or public contribution.

Addressing obstetric violence: a scoping review of interventions in healthcare and their impact on maternal care quality.

The mistreatment and abuse of women during childbirth have been recognized as a major global health challenge, impeding facility-based delivery and contributing to the high maternal mortalities globally. The World Health Organization has specifically called for interventions to deal with obstetric violence. This scoping review consolidates the existing literature on interventions aimed at reducing obstetric violence and synthesizes existing knowledge on their impact in promoting respectful maternity care. Thirteen electronic databases were searched for relevant articles from January 2001 to March 2023. A total of 863 records were identified, and 72 full-text articles were retrieved for further screening. The review includes 16 studies, particularly from low- and middle-income countries, with interventions implemented at medical facilities and involving both women and healthcare providers. Eight of the studies were quantitative, three were qualitative and five used a mixed-methods approach. The results reveal a promising trend in reducing obstetric violence through various interventions. Ten different types of interventions were identified, highlighting strategies to improve the quality of maternity care and enhance patient-centered care. Improved patient-provider communication skills, increased privacy measures, and reduced abuse and mistreatment emerged as common themes. Enhanced communication skills, including open discussions and the right to be informed, were crucial in reducing obstetric violence. Privacy measures, such as separate rooms, curtains, and birth companions effectively decreased incidents of non-confidential care. General abuse and mistreatment, including physical abuse and neglect, were also reduced, leading to improved perceptions of respectful care during childbirth. Overall, the interventions had a favorable impact on obstetric violence reduction and women's childbirth experiences. However, despite promising results, obstetric violence remains prevalent worldwide, necessitating more efforts to implement effective interventions. To the best of our knowledge, this is the first scoping review on obstetric violence interventions, providing a comprehensive overview of the state of the art. We suggest that further research is needed to explore new interventions, particularly gender-sensitive interventions, to contribute to a growing body of knowledge on the prevention of obstetric violence.

Interventions for preventing haemodialysis dysequilibrium syndrome.

Dialysis dysequilibrium syndrome (DDS) refers to neurological symptoms usually seen during or after new initiation or following reinitiation of haemodialysis (HD) after missing multiple sessions. DDS is associated with death and morbidity. We studied interventions aimed at preventing DDS. To evaluate the benefits and harms of different types of interventions for preventing DDS. We contacted the information specialist and searched the Cochrane Kidney and Transplant Register of Studies up to 8 May 2024 using search terms relevant to this review. Studies in the Register were identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal, and ClinicalTrials.gov. We included randomised controlled trials (RCTs) that compared any intervention against standard care, including individuals initiated on HD, regardless of age. Two authors independently determined study eligibility, assessed quality and extracted data. Data were collected on methods, interventions, participants, and outcomes (DDS incidence, severe DDS, death, adverse events). Risk ratios (RR) and confidence intervals (CI) were calculated. Study quality was assessed using the Cochrane Risk of Bias 2 (ROB2) tool. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We included two RCTs, enrolling 32 adult participants. Interventions included were slow dialysis, sodium modelling, standard sodium dialysate, and high sodium dialysate. The risk of bias was of some concern to high risk of bias in both studies. Slow dialysis compared to sodium modelling (1 study, 15 participants) may result in little to no difference in DDS, severe DDS, and death (low certainty evidence) and has uncertain effects on adverse events (RR 1.33, 95% CI 0.15 to 11.64; very low certainty evidence). Standard sodium dialysate compared to high sodium dialysate (1 study, 17 participants) has uncertain effects on the incidence of DDS (RR 0.07, 95% CI 0.00 to 1.12), severe DDS (RR 0.47, 95% CI 0.02 to 10.32), and adverse events (RR 0.29, 95% CI 0.08 to 1.02) (very low certainty evidence). In HD patients, sodium modelling, compared to slow dialysis, may result in little to no difference in DDS and death (low certainty evidence) and has uncertain effects on adverse events (very low certainty evidence). The evidence is very uncertain for the effect of high-sodium dialysate and standard sodium dialysate on DDS, death and adverse events (very low certainty evidence).

Network meta-analysis of probiotics, prebiotics, and synbiotics for the treatment of chronic constipation in adults.

To compare the outcomes associated with the use of probiotics, prebiotics, and synbiotics for the treatment of chronic constipation in adults. We searched eight electronic databases from database inception to July 11, 2023, to identify randomized controlled trials (RCTs) that report efficacy and safety for the treatment of chronic constipation. The risk of bias in the included RCTs was evaluated according to the Cochrane tool, and the certainty of the evidence was assessed using the Confidence in Network Meta-Analysis framework. The analysis was conducted using R version 4.3.0. Out of the 37 RCTs, a total of 21 different types of interventions were reported, involving 3,903 patients. This NMA demonstrated that both prebiotics and synbiotics resulted in an increase in frequency of stool movements per week. Compared to placebo, lactulose (Mean difference [MD] = 3.39, 95% Confdence interval [CI] [1.13, 5.65], moderate certainty), mix2 (consisting of Lactulose and Bacillus coagulans) (MD = 3.63, 95% CI [1.37, 5.89], moderate certainty), mix6 (consisting of Lactulose and Bifidobacterium coagulans) (MD = 4.30, 95% CI [1.04, 7.54], low certainty), and mix7 (consisting of Lactulose, Bifidobacterium subtilis, and Enterococcus faecium) (MD = 4.58, 95% CI [1.35, 7.78], moderate certainty) exhibited a significant effect. Notably, mix7 demonstrated the highest probability of being the most effective intervention (94.8%). Furthermore, when compared to L. plantarum, four probiotics and two synbiotics showed significant advantages in the Patient Assessment of Constipation Symptoms (PAC-SYM) score. L. reuteri (MD = -13.74, 95% CI [-22.20, -4.66], very low certainty) exhibited a significant effect in improving the Patient Assessment of Constipation Quality of Life (PAC-QoL) score. In terms of safety, there were no statistically significant differences between the intervention and control groups in all adverse event analyses. Moderate to very low evidence supports the use of lactulose and synbiotics to increase the number of weekly stool movements in patients, particularly highlighting the significant impact of synbiotics in increasing the number of weekly stool movements in patients with constipation. The use of L. paracasei showed improvements in PAC-SYM scores, while L. reuteri demonstrated enhancements in PAC-QoL scores.

Combined Aerobic Exercise with Intermittent Fasting Is Effective for Reducing mTOR and Bcl-2 Levels in Obese Females.

The integration of combined aerobic exercise and intermittent fasting (IF) has emerged as a strategy for the prevention and management of obesity, including its associated health issues such as age-related metabolic diseases. This study aimed to examine the potential of combined aerobic exercise and IF as a preventative strategy against cellular senescence by targeting mTOR and Bcl-2 levels in obese females. A total of 30 obese women, aged 23.56 ± 1.83 years, body fat percentage (FAT) 45.21 ± 3.73% (very high category), BMI 30.09 ± 3.74 kg/m2 were recruited and participated in three different types of interventions: intermittent fasting (IF), exercise (EXG), and a combination of intermittent fasting and exercise (IFEXG). The intervention program was carried out 5x/week for 2 weeks. We examined mTOR and Bcl-2 levels using ELISA kits. Statistical analysis used the one-way ANOVA test and continued with Tukey's HSD post hoc test, with a significance level of 5%. The study results showed that a combination of aerobic exercise and IF significantly decreased mTOR levels (-1.26 ± 0.79 ng/mL) compared to the control group (-0.08 ± 1.33 ng/mL; p ≤ 0.05). However, combined aerobic exercise and IF did not affect Bcl-2 levels significantly (-0.07 ± 0.09 ng/mL) compared to the control group (0.01 ± 0.17 ng/mL, p ≥ 0.05). The IF-only group, exercise-only group, and combined group all showed a significant decrease in body weight and fat mass compared to the control group (p ≤ 0.05). However, the combined aerobic exercise and IF program had a significant effect in reducing the total percentage of body fat and fat mass compared to the IF-only group (p ≤ 0.05). Therefore, it was concluded that the combined intermittent fasting and exercise group (IFEXG) undertook the most effective intervention of the three in terms of preventing cellular senescence, as demonstrated by decreases in the mTOR level, body weight, and fat mass. However, the IFEXG did not present reduced Bcl-2 levels.

Retaining Black Women in Computing: A Comparative Analysis of Interventions for Computing Persistence

Black women remain severely underrepresented in computing despite ongoing efforts to diversify the field. Given that Black women exist at the intersection of both racial and gendered identities, tailored approaches are necessary to address the unique barriers Black women face in computing. However, it is difficult to quantitatively evaluate the efficacy of interventions designed to retain Black women in computing, since samples of computing students typically contain too few Black women for robust statistical analysis. Using about a decade of student survey responses from an National Science Foundation–funded Broadening Participation in Computing alliance, we use regression analyses to quantitatively examine the connection between different types of interventions and Black women’s intentions to persist in computing and how this compares to other students (specifically, Black men, white women, and white men). This comparison allows us to quantitatively explore how Black women’s needs are both distinct from—and similar to—other students. We find that career awareness and faculty mentorship are the two interventions that have a statistically significant, positive correlation with Black women’s computing persistence intentions. No evidence was found that increasing confidence or developing skills/knowledge was correlated with Black women’s computing persistence intentions, which we posit is because Black women must be highly committed and confident to pursue computing in college. Last, our results suggest that many efforts to increase the number of women in computing are focused on meeting the needs of white women. While further analyses are needed to fully understand the impact of complex intersectional identities in computing, this large-scale quantitative analysis contributes to our understanding of the nuances of Black women’s needs in computing.

Effects of Two Online Mindfulness-Based Interventions for Early Adolescents for Attentional, Emotional, and Behavioral Self-Regulation.

(1) Background: Mindfulness-based interventions (MBIs) have shown interesting preliminary effects on self-regulation processes in early adolescence. However, programs have typically combined different types of interventions with no understanding of the specific effect of each intervention type on attentional, emotional, and behavioral regulation. The objective of this research was to evaluate the effect of two MBIs-one focused on classic attentional practices and another focused on the recognition and expression of emotions-on attentional, emotional, and behavioral self-regulation in early adolescents. (2) Method: An experimental paradigm was used. A sample of 74 children aged between 8 and 12 years old were randomly assigned to three experimental conditions: (1) an MBI with a focus on attentional practices, (2) an MBI with a focus on recognition and expression of emotions, and (3) a control group. The interventions lasted 8 weeks, with a weekly, 1 h online synchronous session plus home practices. Children were evaluated before starting the intervention and at the end of the 8-week period. The assessed outcomes were (1) mindfulness; (2) emotional regulation; (3) attentional regulation, and (4) behavioral regulation. (3) Results: Children who participated in both intervention programs increased their mindfulness and emotional and behavioral regulation scores. Only children who participated in the MBI with a focus on attention showed significant changes in their ability to self-regulate attention. (4) Conclusions: The use of online MBIs, with attention to external and internal stimuli practices, can be a good strategy to strengthen self-regulation skills for attention, emotions, and behavior in early adolescence.

Non-pharmacological interventions on quality of life in stroke survivors: A systematic review and meta-analysis.

Non-pharmacological interventions have been used in the rehabilitation of stroke survivors, but their effects on stroke survivors' quality of life (QoL) are unknown. This review aimed to summarize the existing evidence regarding non-pharmacological interventions for QoL in stroke survivors and to evaluate the effectiveness of different types of interventions. We systematically searched databases including PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese BioMedical Literature Database, China Science and Technology Journal Database, and Wanfang data from the earliest available records to March 2023. Randomized controlled trials which explored the effects of non-pharmacological interventions on QoL in stroke patients were included. The meta-analysis was conducted to evaluate the effectiveness of different interventions on QoL. The Review Manager 5.3 was used to conduct the meta-analysis and the revised Cochrane risk-of-bias tool was used to assess the methodological quality of trials. A total of 93,245 records were identified, and 34 articles were reviewed and summarized, of which 20 articles were included in the meta-analysis. The summary of the findings of the included studies revealed fitness training, constraint-induced movement therapy (CIMT), physical exercise, music therapy (MT), and art-based interventions may have positive effects on QoL. The fitness training improved total QoL, especially in physical domains including physical functioning (mean difference [MD] = 10.90; 95% CI [7.20, 14.59]), role physical (MD = 10.63; 95% CI [6.71, 14.55]), and global health (MD = 8.76; 95% CI [5.14, 12.38]). The CIMT had a slight effect on general QoL (standardized mean difference [SMD] = 0.48, 95% CI [0.16, 0.80]), whereas significantly improved strength (MD = 8.84; 95% CI [1.31, 16.38]), activities of daily living/instrumental activities of daily living (ADL/IADL; MD = 10.42; 95% CI [2.98, 17.87]), and mobility (MD = 8.02; 95% CI [1.21, 14.83]). MT had a positive effect on the mental health domain (SMD = 0.54; 95% CI [0.14, 0.94]). Our findings suggest that fitness training and CIMThave a significant effect on improving physical QoL, while MThas a positive effect on improving psychological QoL. Future studies may use comprehensive and multicomponent interventions to simultaneously improve the patients' physical, psychological, and social QoL.

Best supportive care in advanced pancreas cancer: a systematic review to define a patient-care bundle.

The majority of patients with pancreatic adenocarcinoma (PDAC) have advanced disease at presentation, preventing treatment with curative intent. Management of these patients is often provided by surgical teams for whom there are a lack of widely accepted strategies for care. The aim of this study was to conduct a systematic review to identify key issues in patients with advanced PDAC and integrate the evidence to form a care bundle checklist for use in surgical clinics. A systematic review of the literature was performed regarding best supportive care for advanced PDAC according to the PRISMA guidelines. Interventions pertaining to supportive care were included whilst preventative and curative treatments were excluded. A narrative review was planned. Forty-four studies were assessed and four themes were developed: (i) Pain is an undertreated symptom, requiring escalating analgesics and sometimes invasive modalities. (ii) Health-related quality of life necessitates optimisation by involving family, carers and multi-disciplinary teams. (iii) Malnutrition and weight loss can be mitigated with early assessment, replacement therapies and resistance exercise. (iv) Biliary and duodenal obstruction can often be relieved by endoscopic/radiological interventions with surgery rarely required. This is the first systematic review to evaluate the different types of interventions utilized during best supportive care in patients with advanced PDAC. It provides a comprehensive care bundle for surgeons that informs management of the common issues experienced by patients within a multidisciplinary environment.

Is Acute Lower Back Pain Associated with Heart Rate Variability Changes? A Protocol for Systematic Reviews

Acute lower back pain (ALBP) is an extremely common musculoskeletal problem. ALBP consists of a sudden onset of short-duration pain in the lower back. However, repeated attacks can make the pain chronic. It can be measured through a self-report scale as well as through physical and physiological evaluations. Heart Rate Variability (HRV) has been used to evaluate the body’s response to pain. However, to the best of our knowledge, no clear consensus has been reached regarding the relationship between both variables and on an optimal protocol for ALBP evaluation based on HRV. The objective of this review is to analyze the relationship and effectiveness of HRV as an instrument for measuring ALBP. Furthermore, we consider the influence of different types of interventions in this relationship. The protocol of this review was previously recorded in the International Prospective Register of Systematic Reviews (number CRD42023437160). The PRISMA guidelines for systematic reviews and PubMed, WOS and Scopus databases are employed. Studies with samples of adults with ALBP are included. This study sets out a systematic review protocol to help identify the relationship between HRV and ALBP. Understanding this relationship could help in designing early detection or action protocols that alleviate ALBP.

Effects of the mental health promotion seminar ‘Coping with stress’ in the undergraduate medical curriculum of the Medical University of Vienna

BackgroundHigh prevalence rates of distress and burnout in medical students are well-documented in mental health literature. Different types of interventions have been developed in the past in order to reduce stress in medical undergraduate students and promote better coping skills. There is, however, a paucity of studies that have tested the effectiveness of these interventions. This study aimed to examine the effect of different versions of the seminar ‘Coping with stress’, which was implemented in the first year of the undergraduate curriculum of the Medical University of Vienna in the summer semester of 2018, on students’ mental health.MethodsInvitations to participate in the study were sent via email to six cohorts of students from the Medical University of Vienna. Two cohorts participated in the onsite version of the seminar ‘Coping with stress’, whereas two cohorts participated in the online version of the seminar, and two cohorts received no intervention (control group). Data on burnout risk, life satisfaction, stress, and knowledge about available help resources were collected via online questionnaires from n = 137 students before and after the curriculum module that contained the seminar.ResultsMedical students who participated in the onsite seminar reported a reduction of some aspects of burnout, a decrease in stress, and an increase in knowledge about available help resources. No such effect was seen in the control group. Participants of the online seminar experienced a similar increase in knowledge about available help resources, but no changes in other outcomes.ConclusionsThe findings support the notion that the onsite seminar of ‘Coping with stress’ had a positive impact on medical students’ mental health and is a useful addition to the medical curriculum by promoting mental health literacy.Trial registrationThis research has been registered in the German Clinical Trial Registry with the registration number DRKS00018981 and the registration date 14/11/2019.

HIV Prevention among Young People in Sub-Saharan Africa

Purpose: The commitment to getting to epidemic control by 2030, places the prevention of Human Immune Virus at the center of the response. With the disease affecting young people disproportionately, reducing HIV infections among this group is vital. This paper seeks to review data on the different types of interventions used in the prevention of HIV amongst young people in Sub-Saharan Africa. Method: Data search was done by reviewing journals through PubMed and Google scholar. Findings: Reviews found that school based approach improved on knowledge, attitude and reduced risky sexual behaviors among young people. Adolescent-responsive strategy was seen to be effective, sustainable and scalable. The percentage of condom use increased from 32% to 45% for females (p<.05) and from 44% to 61% for males (p<.01) with regular partners among Cameroonian youths. Condom use among sexually active students decreased from 61% in 2009 to 54% in 2019.HIV testing had low rates among young people. Oral PrEP demonstrated over 90% risk reduction of HIV. Circumcised men had a 60% HIV protection effect and cash transfers reduced HIV risk significantly among adolescent girls and young women with positive behavioral outcomes. Conclusion: HIV prevention approaches when integrated can achieve maximum effectiveness, but it’s important for these interventions to be tailored towards meeting the needs of young people. Knowing that they have unique developmental needs and challenges, prevention programs should be contextualized depending on the geographical location and environment to meet specific needs.

Non-pharmacological interventions for the reduction and maintenance of blood pressure in people with prehypertension: a systematic review protocol

IntroductionPrehypertension is defined as blood pressure that is above the normal range but not high enough to be classed as hypertension. Prehypertension is a warning of development of hypertension as...

Intervenções da Fonoaudiologia nas áreas de respiração, mastigação, deglutição e fala: uma revisão de escopo

ABSTRACT There are several types of approaches that can be used to achieve therapeutic goals in disorders related to the functions of mastication, swallowing, speech, and breathing. However, the literature lacks evidence to support their use in speech-language clinical practice. The objective of this review was to map the syntheses of evidence on speech-language pathology intervention in the areas of breathing, mastication, swallowing and speech in adults and the elderly. Only studies classified by their authors as a systematic review, studies that addressed therapy for orofacial disorders in individuals over 18 years of age were included. The procedures performed included: electronic and manual search; selection of studies; data extraction; evaluation of the quality of studies and data analysis. It was possible to observe different types of interventions mainly aimed at the swallowing function, ranging from traditional therapy to the use of devices. However, due to the limitations of the studies, the data must be interpreted with caution.

Implementing and embedding Social Prescribing successfully: what works, for whom and in which context?

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.
 
 
 

Interventions for gender equality in STEM education: A meta‐analysis

AbstractBackgroundAlthough gender inequality in education is gaining increasing attention, female underrepresentation remains pervasive in STEM fields. Many studies have applied various interventions to narrow the gender gap in STEM education.ObjectivesIn this study, we conducted a systematic meta‐analysis to examine the effectiveness of various interventions for gender equality in STEM education and tested the influence of moderator variables.MethodsTen databases—ERIC, IEEE, JSTOR, ProQuest‐Education, SAGE Journals, Scopus, Springer Link, Taylor & Francis, Web of Science, and Wiley Online Library—and seven high‐quality journals in related fields were selected as literature resources. The Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) process was used to identify eligible articles for the random‐effects meta‐analysis.Results and ConclusionsThe overall effect size (Hedges' g) was 0.434, indicating that the interventions promoting gender equality in STEM education had a near‐medium positive effect. There were significant differences by the type of intervention, but not by the type of intervention outcome. The results of the moderator analysis showed a significant difference in moderator variables, including country, educational level, form of experiment, intervention level, and different measurement methods, whereas there was no significant difference in the moderator variables, including economic development level and sample size.ImplicationsThis study examined the effectiveness of gender equality interventions and the impact on it of different types of intervention, intervention outcomes, and moderator variables. These results have implications for the design of gender equality interventions in STEM education.

Clinical effectiveness of treatments for the management of anxiety in community dwelling people living with dementia: a systematic review and meta‐analysis

AbstractBackgroundPeople living with dementia commonly experience distress or behavioural and psychological symptoms, such as anxiety, which are associated with worse outcomes in this population. Symptoms of anxiety can be challenging to manage, as there is limited evidence supporting the prescription of psychotropic medications and it is unclear if conventional psychological treatments, such as cognitive behavioural therapy, are effective. The aim of this systematic review and meta‐analysis was therefore to investigate the effectiveness of pharmacological and non‐pharmacological treatments for the management of anxiety in community dwelling people living with dementia.MethodA systematic review and meta‐analysis was conducted of randomised controlled trials until January 2022, searching EMBASE, CINAHL, MEDLINE and PsycInfo. This is currently being updated to Jan 2023. Standardised mean differences were estimated at follow‐up between treatments and pooled across studies using random‐effects models. The Cochrane risk‐of‐bias tool for randomized trials assessed risk of bias and meta‐analysis was performed if three or more studies of a treatment group were available.ResultTwenty‐seven studies (comprising 2517 participants) were included. We categorised these as pharmacological interventions (n = 8), non‐pharmacological group interventions (n = 8) and non‐pharmacological individual interventions (n = 11). Pharmacological interventions with evidence of potential effectiveness included olanzapine, loxapine, citalopram, buspirone and risperidone; and those with no evidence of effectiveness were thioridazine and haloperidol. Meta‐analyses was not performed due to study heterogeneity.Some non‐pharmacological treatments were found to be effective in reducing anxiety in people living with dementia, compared to usual care or active controls. For interventions aimed at individuals the pooled standardised mean difference was ‐0.41 (CI: ‐0.71, ‐0.11) and for those aimed at groups it was ‐0.44 (CI: ‐0.79, ‐0.09). When examining different type of intervention, results suggest music therapy and muscular approaches (e,g, relaxing massage) were effective in reducing anxiety symptoms, while cognitive approaches and sensory stimulation were not. We will present additional findings from updated searches.ConclusionResults suggest non‐pharmacological interventions can be effective in reducing anxiety in community‐dwelling people living with dementia. This supports the development and use of more group‐based non‐pharmacological interventions to help reduce anxiety among people living with dementia in the community and their carers.