Range Of Potential Interventions Research Articles

Dental Visits for Autistic Children: A Qualitative Focus Group Study of Parental Perceptions.

Patient groups who pose behavioral challenges during dental attendance may be offered more restricted dental treatment options. Unsuccessful participation with dental visit tasks and demands has been commonly reported for autistic children. This study aimed to examine parental perceptions of difficulties associated with dental attendance and oral care for autistic children and young adults, to highlight reported challenges and potential adaptations, and to identify interventions that will encourage positive experiences of dental attendance. Qualitative data were gathered through 2 focus groups with parents of primary school and secondary school pupils with autism, interviewed in separate groups. Questions about parents' perceptions of dental attendance and oral care were asked. The groups were audio-recorded and transcribed verbatim. The transcripts were analyzed and initial codes generated. Development of subthemes and themes followed a process of thematic analysis. Parental perceptions, which confirmed data from other studies, included the need for understanding and training, awareness of sensory issues, recognition of the individuality of autistic traits, time and clarity for communication, and factors affecting the confidence of parents to advocate in the clinical environment. Focus group participants identified the critical value of empathizing with an autistic perspective and highlighted the importance of positive oral health messages. They also noted the lack of understanding regarding the complexity of altering self-imposed, ritualistic dietary regimes and attempting to enact good dental preventive habits for their children. Analysis of data from parent focus groups provided a greater understanding of the needs and responsivity required for successful dental visits for autistic children and young adults. A range of potential interventions was identified and incorporated within a model of needs. Interventions based on Partnership Working, System Change, and Training of Dental Staff could be effective in reducing challenges posed by dental attendance for many children with autism. Sensory sensitivities, communication difficulties, comorbid intellectual disability, and dental anxiety are barriers to successful participation during dental attendance for autistic children. This research proposes that interventions supporting Partnership Working, System Change, and Training of Dental Staff can reduce challenges posed by dental attendance. The model of interventions developed as part of this project can be used by oral care teams to help reduce barriers and improve the success of dental visits for autistic children.

Interventions for Post-Stroke Shoulder Pain: An Overview of Systematic Reviews.

BackgroundShoulder pain following stroke leads to poorer quality of life and daily functioning. Whilst many treatment approaches exist, there is currently no systematic overview of the evidence base for these. This review addressed the question “What is the evidence for interventions for treating hemiplegic shoulder pain?”MethodsAn overview of systematic reviews was performed according to PROSPERO protocol (CRD42020140521). Five electronic databases including Cochrane, MEDLINE, Embase and EmCare were searched to June 2019. Included systematic reviews were those of comparative trials of interventions for hemiplegic shoulder pain in adults, reporting pain outcomes using a validated pain scale. Review quality was assessed with AMSTAR2 and those considered at high risk of bias for four or more items were excluded. The most recent, comprehensive review for each intervention category was included. Outcomes of function and quality of life were also extracted.ResultsSeven systematic reviews of 11 interventions were included, with varied quality. Reviews showed significant benefits in terms of pain reduction for many interventions including acupuncture (conventional 19 trials, electroacupuncture 5 trials, fire needle 2 trials, warm needle 1 trial and bee venom 3 trials), orthoses (1 trial), botulinum toxin injection (4 trials), electrical stimulation (6 trials) and aromatherapy (1 trial). However, the majority of trials were small, leading to imprecise estimates of effect. Findings were often inconsistent across outcome measures or follow-up times. Outcomes from trials of acupuncture were heterogenous with likely publication bias.ConclusionA number of systematic reviews indicate significant reductions in pain, with a wide range of treatments appearing promising. However, significant limitations mean the clinical importance of these findings are uncertain. Due to complex etiology, practitioners and health systems must consider the range of potential interventions and tailor their approach to individual presentation, guided by their local circumstances, expert opinion and the growing literature base.

Estimating compensation payments for on-farm conservation of agricultural biodiversity in developing countries

This paper examines the role of direct compensation payments for agrobiodiversity conservation, using minor millet landraces in India as an example. The cost of farmer participation in a hypothetical ‘payments for agrobiodiversity conservation services’ (PACS) scheme is estimated using a stated preference valuation approach. Significant inter-crop and inter-varietal differences are observed with respect to consumption values, upon which the compensation demanded by farm households is shown to primarily depend. Drawing on a categorisation of consumption values and farmer preferences, the paper points to the importance of simultaneously considering a range of potential interventions in order to conserve a priority portfolio of agrobiodiverse resources in predominantly subsistence-based agricultural systems.

Combating prejudice and racism: new interventions from a functional analysis of racist language

AbstractBased on a conversational model of language‐use‐in‐social‐context, this article focuses on one particular form of racist and prejudiced talking that has not received enough attention—conversations in which racist statements function to maintain groups and relationships rather than seriously promote racism. Despite their casualness, such statements are still pernicious, and a range of potential interventions are proposed for this language function. These involve actively altering a community's discursive resources to include more rejoinders to racist comments. Such rejoinders must be utilized in the most appropriate way for any relationship, and this might mean polite corrections, witty repartee, strong put‐downs to silence someone making racist comments, or as counter‐jokes to racist jokes, depending upon the social context and power relations involved. Copyright © 2003 John Wiley & Sons, Ltd.

Living in a Walking World: Rural Mobility and Social Equity Issues in Sub-Saharan Africa

Accessibility and mobility are embedded in the development nexus in far-reaching ways. Field studies of mobility among women and men in rural settlements with poor road access illustrate the frustrations and costs of living off-road. They are frequently marginalized and invisible, even to local administrations. State decentralization appears to have had little positive impact in reducing “tarmac bias” and improving rural service delivery. A range of potential interventions, from Intermediate Means of Transport to electronic communications is reviewed, and opportunities for building social capital in off-road areas through nurturing improvements in state–civil society relations are considered.