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This final chapter proposes a more reflective stance on the overall project of a regional, dialogical case study and considers the many ways by which it can be said to be dialogical. First, it recalls that research itself is always emerging as part of many collaborative dialogues around a theme, which itself can be evolving over time. Second, it highlights that a regional case study entails per definition a collective dialogue with a region and its actors, often beyond the specific project itself. Third, it summarises the deliberate use of techniques mobilised to catalyse dialogue with the region – here, participatory and art-based methods, among others. It also clarifies the type of intervention led when adopting a dialogical epistemological and ethical stance. Finally, the chapter closes with the more general implications of the present study to reflect upon dialogical approaches.
While the environment almost always suffers in conflict, it can also present opportunities for cooperation – this is the key premise and promise of environmental peacebuilding. Harnessing shared environmental risks and challenges for collective and cooperative action has the potential to foster relationship development that can prevent conflict and/or restore peace. Environmental peacebuilding and methods of intervention, such as impact assessments and peace agreements, have the potential to be an antidote to any or all of the environment-conflict intersections. This chapter explores the literature on environmental peacebuilding and key tools of the trade.
Edited by
Katherine Warburton, California Department of State Hospitals, University of California, Davis, USA,Stephen M. Stahl, University of California, Riverside, USA
This chapter delves into the ethical dimensions of treating individuals with schizophrenia, emphasizing the need for a new perspective that integrates neuroethics into interventions. The author proposes a bio-systemic model to understand how schizophrenia impacts different levels of consciousness and freedom, highlighting the necessity for tailored interventions that restore autonomy rather than coercive measures. The chapter calls for a shift in policy towards early and assertive treatment, focusing on rebuilding autonomy and dignity for individuals with schizophrenia. Ultimately, the chapter serves as a call to action for a neuroethically informed approach to care that prioritizes the restoration of freedom and dignity for those affected by schizophrenia.
Food insecurity (FI), defined as unreliable access to healthy, nutritious food, is a major health concern in higher-income countries, primarily due to its association with an increased risk of obesity. Supermarket-based interventions may influence population-level food purchasing behaviour, an antecedent to consumption. It is unclear whether there are specific characteristics that these interventions should employ to resonate with vulnerable groups. This scoping review aimed to explore the characteristics of supermarket-based interventions that sought to support healthier and/or more environmentally sustainable food purchasing for people living with obesity, overweight (PLWO/Ow), and/or FI.
A systematic literature search, conducted in Medline, Embase, CINAHL, Scopus, and Web of Science databases, identified 35 eligible studies, representing 43 interventions. Title and abstract screening and data extraction were conducted independently by two reviewers. Most interventions focused on supporting the purchase of healthy food items. No study applied a validated measure of FI. Area-level demographic data were used to identify FI-related characteristics (i.e., area of low income, low socio-economic status) and, in some cases, those living with obesity. Interventions utilised the behaviour change levers of price (n = 8), promotion (n = 2), placement (n = 7), nudges (n = 4), and education (n = 2), or a combination of these (n = 20). High heterogeneity in the way behavioural change levers were operationalised and combined, alongside the use of proxy measures to identify FI and PLWO/Ow, makes it difficult to determine the most supportive intervention characteristics. This presents challenges in understanding how to best facilitate changes in purchasing patterns in favour of heathy, sustainable food items in this population.
Internet-delivered parent-led interventions can be useful for treating anxiety in children and adolescents, and they also help increase access to services while reducing time and cost.
Aims
This review aimed to investigate the effects of internet-delivered parent-led interventions on reducing anxiety in children and adolescents.
Method
A search of PubMed, PsycArticles, Cochrane Library, and Google Scholar databases identified 13 studies published between 2013 and 2024, which examined internet-delivered, parent-led interventions targeting anxiety in children.
Results
Internet-delivered parent-led interventions had overall positive effects on reduced anxiety in children and adolescents that could be maintained through follow-up. Interventions directly targeting anxiety symptoms had significant treatment effects.
Discussion
Internet-delivered parent-led interventions may be effective in reducing anxiety symptoms in children and adolescents, particularly when the intervention directly targets anxiety rather than focusing solely on parenting approaches. Interventions supplemented with therapist support, such as telephone consultations, appear to enhance treatment outcomes and help maintain effects over time. Two-thirds of the included studies had a moderate risk of bias, and one-third had a serious risk of bias. Further studies using rigorous methodologies are needed to strengthen the evidence base.
When undertaking a community intervention, interventionists frequently recruit the help of community members who serve as key opinion leaders (KOLs). However, selecting a team of KOLs can be challenging because the evaluation of potential teams must balance considerations of members’ availability and diversity, as well as the team’s breadth of network coverage and cost of recruitment. This paper has two goals: to review the practical challenges that arise in the selection of KOLs for community interventions, and to facilitate the selection of KOLs when some of these practical challenges are present by introducing and demonstrating the KOLaide R package. We conclude by discussing future directions for facilitating the selection of KOLs in community intervention contexts.
Older men face significant health inequities compared to women, with the transition to retirement often exacerbating these differences.
Objective
This study explored the benefits of participation in the Squamish Men’s Shed (SMS) in British Columbia, Canada.
Methods
Using a case study design, semistructured interviews were conducted with 12 members aged 55 and older.
Findings
Thematic analysis identified four overarching themes: A Meaningful Use of Time, The Desire to Give Back, Finding Friendship Within the Shed, and Well-Being as a By-Product. Findings described the Shed as a valuable space to maintain structure and purpose postretirement, foster community engagement, and cultivate social connection. While mental health was rarely an explicit motivation for participation, members described enhanced well-being as an indirect outcome. The Shed also provided opportunities for intergenerational contribution, reinforcing a sense of usefulness and generativity.
Discussion
The findings highlight the Shed’s potential as a community-based model that promotes men’s mental health rather than formalized interventions.
Naturally occurring retirement communities (NORCs) are geographic areas that have come to house a high proportion (≥30%) of older residents. Implementing onsite social programming in NORCs, or other places where older adults are clustered, can support aging in place. As such it is important to be able to identify sites that could benefit. We describe a data and equity-driven process used to select NORC and social housing sites for a program aimed at empowering older adults and strengthening aging in place in Toronto, Canada. We (1) created a data-driven shortlist of buildings with population-level data, (2) prioritized equity by targeting buildings with high health needs and neighbourhood-level diversity, and (3) facilitated building and resident engagement to assess interest and suitability. This process offers a novel and replicable approach for selecting sites for enhanced, place-based programming that can inform site selection for other community-based programming for older adults across diverse contexts.
To pilot a registry to evaluate the use and effectiveness of interventional cancer pain management.
Methods
Upon interventional pain procedure scheduling, patient demographics, cancer, and pain information were entered into the longitudinal clinical registry in 2 tertiary hospitals in Sydney, Australia (Royal Prince Alfred Hospital and Chris O’Brien Lifehouse). Details of the procedure (including proceduralist, nature of the intervention, and site of treatment), post-procedure patient-reported outcomes and quality of life surveys, adverse events, and mortality data (when known) were collected longitudinally.
Results
Between October 2021 and March 2023, 48 patients underwent 55 procedures. Procedures included treatment targeting autonomic plexuses, peripheral nerves, fascial planes, and neuraxial structures. Celiac plexus neurolysis was the most frequently reported procedure (33.3%). Post-procedure, there was a trend in reduction in pain intensity on the Patient-Reported Outcome Measurement Information System (p < 0.01), reduction in opioid consumption, and improvement in quality of life on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core-15-Palliative Care.
Significance of results
This is a vital first step in creating a more widely applicable registry evaluating cancer pain intervention. It provided valuable information on the range of available pain intervention procedures and data on patient-reported outcome measures using validated instruments. This will facilitate a timely review of clinical practice to improve future patient care. An Australian-wide database of cancer pain will be a valuable next step in the improvement of cancer pain management.
Maternal obesity delays mammary gland maturation, influencing milk composition and neonatal growth. This study investigated whether supplementation of obese rats with resveratrol (Res) improves mammary gland differentiation, milk composition and offspring development. Female Wistar rats were fed either a high-fat diet to induce maternal obesity (MO) or standard chow as control (C). One month before mating, and throughout gestation, half the rats received 20 mg/kg/day Res orally creating two additional experimental groups (CRes and MORes). Milk nutrients and fatty acids were analysed at postnatal day 21 (PND21); maternal body composition, mammary gland weight and fat pad weight were also obtained. Mammary gland morphology and indices of apoptosis were determined. Offspring metabolic parameters were studied at PND36. MO s had increased adiposity, mammary gland weight and showed elevated glucose, TAG and cholesterol levels compared with controls. MORes reduced all these parameters except mammary gland weight. Mammary gland development was delayed and apoptosis increased in MO v. C. Res improved mammary gland development in obese dams. Milk protein/fat ratio, milk, protein and DHA intake decreased in the MO group compared with C; whereas, fat, saturated fat, monosaturated fat and ω-6 fatty acid were increased in MO. Reveratrol treatment restored these parametes in obese dams and significantly reduced adiposity in their offspring. TAG, insulin and HOMA-IR increased in MO offspring but was prevented by Res, which also increased milk intake in controls. In conclusion, preconceptional Res supplementation protects against the negative effects of maternal obesity on mammary gland differentiation, milk composition and offspring metabolism.
To evaluate the impact of a tailored organizational intervention on the support for family caregivers.
Methods
A convergent mixed-methods study was conducted in 17 organizations (6 hospices, 5 home care organizations, 3 nursing homes, 2 hospitals, 1 transmural organization) between November 2021 and August 2023. The intervention comprised a structured practice improvement trajectory during which each organization conducted a structured workshop to define organization-specific goals to improve their support for family caregivers and to develop an action plan to achieve those goals. The action plan was implemented over 1 year with intermittent evaluations. Pre- and post-intervention surveys were distributed among healthcare professionals (paired) and bereaved family caregivers (non-paired) to assess provided and received support. Data were analyzed with mixed models and regression analyses. Post-intervention focus groups with project team members and final evaluation reports were analyzed with qualitative content analysis.
Results
Survey respondents were 97 healthcare professionals (83% nursing staff), 123 family caregivers pre-intervention, and 99 family caregivers post-intervention. Only healthcare professionals of home care organizations reported a significant increase in attending to family caregivers’ wellbeing and needs (scale 0–20; β = 3.65; 95%CI: 1.33–5.97). Family caregivers’ reports of healthcare professionals attending to their wellbeing and needs did not change (scale 0–2; β = 0.17; 95%CI: −0.04–0.38). Across settings, healthcare professionals evaluated the care they provided more positively post-intervention (scale 0–8; β = 0.65, 95%CI: 0.38–0.97). In home care, family caregivers also evaluated care more positively (scale 0–8; β = 2.12; 95%CI: 0.89–3.34). Four focus groups and 17 evaluation reports indicated improvements at 3 levels: the support for family caregivers (increased awareness of healthcare professionals, changes in work processes, more structured support), the healthcare team (more skills, confidence, available tools), and the organization (fostering sustainability).
Significance of results
A tailored organizational intervention can strengthen the support of family caregivers in healthcare organizations.
This chapter describes the Mental Health Gap Action Programme (mhGAP) and the mhGAP-Intervention Guide (mhGAP-IG) developed by the World Health Organization (WHO), aimed at scaling up suicide prevention and management services to bridge unmet need.The mhGAP-IG is an evidence-based tool for mental disorders with structured and operationalised guidelines for clinical decision-making targeting non-specialist community and primary care workers in low and middle-income countries (LMICs).
Patients in the re-entry phase (that is, the first 18 months after curative cancer treatment) may use meaning-making to deal with existential concerns imposed by cancer and related changes in life. The purpose of the current study was to conduct a formative evaluation of an intervention aimed at supporting patients’ meaning-making process and motivating them to pick up life during the re-entry phase.
Methods
Patients were included after finishing systemic treatment for breast cancer or melanoma. The intervention comprised a single one-hour conversation guided by a spiritual counselor who explored patients’ sources of meaning, in order to support them in dealing with existential concerns and changes in life in the re-entry phase. The evaluation included semi-structured interviews concerning the intervention and questionnaires assessing mental adjustment to cancer, psycho-spiritual wellbeing and meaning in life.
Results
Qualitative interviews with 14 participants demonstrated an overall positive experience and appreciation of the intervention. Patients reported several benefits: reflection on existential concerns and sources of meaning, validation of sources of meaning, insights regarding the use of sources of meaning, and motivation to pick up life; and to a lesser extent: prioritizing, identifying meaningful goals, or undertaking specific action. Patients made suggestions on how to tailor the intervention more to their needs. Quantitative data showed increases on the subscales autonomy, goal-orientedness, and fairness of life with small effect sizes.
Significance of the results
This study showed that an intervention to support patients with breast cancer or melanoma in the process of meaning-making in the re-entry phase after systemic treatment was positively experienced and well appreciated. It supported meaning-making, particularly through reflection on, validation and utilization of sources of meaning, and supporting motivation to pick up life. The results of the current study can be used to optimize the intervention, which can be further evaluated in a multicenter study.
Reviews the empirical and conceptual findings, makes forecasts about the future likelihood of the use of force in each category of conflict, the role of learning and non-learning in the decline of war, why the great powers are still more committed to the use of force than other states, and the prospects for weaning them from violence.
An overview and justification of the project, differentiation from previous book on war, description of research methods and data set, and discussion of theoretical and empirical premises.
The modern world has been shaped by imperialism, a practice engaged in by all great powers and some lesser ones. Empires are history but their consequences are not. Their dissolution has given rise to a multitude of new states, restored independence to formerly independent units, and reduced the size and influence of former metropoles. Decolonization, whether peacefully or violently accomplished, has given rise to a series of new conflicts among successor states, among neighboring states, and between metropoles and former colonies. We might lump these conflicts together as post-imperial. If so, many kinds of conflicts would fit under this rubric. They could encompass colonial and postcolonial conflicts, rump states, partitioned countries, and arguably other categories as well like revenge and regional rivalries. I have accordingly opted for a finer-grained analysis.
Drawing on an original data set of interventions and wars from 1945 to the current day, as well as numerous short case studies, Richard Ned Lebow offers a novel account of their origins and outcomes – one that emphasises miscalculation, failure to conduct meaningful risk assessments, and cultural and political arrogance. In a successive work to Why Nations Fight (2010), he explains why initiators routinely lose militarily and politically when they resort to force, as well as accounting for why the great powers, in particular, have not learned from their failures. Lebow offers both type- and region-specific forecasts for the future likelihood of interventions and wars. His account reveals the inapplicability of theories nested in the realist and rationalist paradigms to the study of war. He argues what is needed instead is an “irrationalist” theory, and he takes the initial steps in this direction.