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There is growing interest in and support for the development of disease prevention measures in free-living wildlife and for the rescue, treatment and rehabilitation of wild animals that are sick and injured. In some cases these endeavours may be of importance to the conservation of populations but frequently they are undertaken for welfare rather than conservation reasons. There are circumstances in which wildlife welfare can be improved by therapeutic intervention but the difficulties, and their potentially harmful consequences, should not be underestimated. Interventions for the welfare of free-living wild animals whose fate we control or influence and which are therefore, to some extent, under our stewardship, are consistent with the tradition of humanity for and stewardship of domesticated or captive animals. However, it is suggested here that the decision to treat sick or injured free-living wild animals should not be based on welfare grounds alone.
The process of driving improvement in animal welfare has three stages: 1) assessment of animal welfare, 2) identification of the risk factors potentially leading to a compromise in animal welfare, and 3) interventions, in response to the risk factors, to bring about improvement in animal welfare. This process is applicable to animals farmed in commercial situations and for individual animals kept or worked in isolated environments. An impressive weight of knowledge has accumulated in the science of animal welfare assessment and this needs to be counterbalanced by development of mechanisms to actively improve welfare. In the case of animal welfare, interventions have to motivate the animal owner or carer to make changes to their own behaviour on behalf of a third party; the animal. This is a different situation from that described in the human health literature where interventions encourage people to take steps to improve their own well-being, thus benefiting themselves directly. The development of strategies to improve animal welfare require a multi-disciplinary approach including social scientists, psychologists and economists, however, the skills of animal welfare scientists are essential to ensure that interventions truly achieve improvements in animal welfare.
A patent ductus arteriosus in patients with transposition of the great arteries is usually beneficial to allow shunting between pulmonary and systemic circulations. However, if the duct is too large, it can cause haemodynamic instability, pulmonary oedema and compromised organ perfusion. We present a neonate in whom a 5 mm short and tubular ductus arteriosus was causing significant cardiac failure with necrotising enterocolitis and liver impairment, leaving him too unstable for the arterial switch operation. At day 14 of life (3.1 kg), the baby underwent successful transcatheter closure using an Amplatzer vascular plug (Abbott, Chicago, Il, USA) delivered through a 5Fr catheter from the aortic side. The procedure was uncomplicated and successful as the neonate was extubated 2 days later. He subsequently underwent successful arterial switch surgery.
Chapter 5 is the first part of our analytic narrative. We describe equilibrium selection in the immediate aftermath of the Maidan events. The first theater was Crimea. The question was whether Russian-speaking elites in peripheral communities would accept the first storyline (“Dignity”) and remain loyal to the Ukrainian state, or accept the second storyline (“coup”) and opt for sedition. Elites in Crimea coordinated rapidly on sedition. The only militias in the streets were pro-Russia (though a brave pro-Ukraine demonstration by Crimean Tatars is described). Russian soldiers arrived to secure parliament. The Party of Regions networks served a coordinating function, repurposing state institutions to legitimize the Russian presence and ensuring institutional continuity. Crimeans voted, Russia claimed self-determination, and the government in Kyiv was checkmated. Coordinated sedition was a fait accompli.
Beneficence is the act of doing good, while benevolence is being willing to do good. Walmart is cited as a case where, despite its founder’s belief that businesses do sufficient good simply by fueling wealth through commerce and employment, the company is nevertheless highly involved in community projects. Corporate philanthropy may be used strategically to increase future profits, while many corporations see themselves as morally responsible for stakeholders – employees, communities, consumers, and the wider environment – without requiring a clear return on investment. Corporate intervention is discussed historically in terms of apartheid, where some companies applied pressure for social change whereas others felt firms should abide by local norms despite violating human rights. Corporate intervention in the political affairs of Central America are discussed, as well as businesses that supply biased educational materials. The final case describes the sponsorship of an artistic production that becomes politically embroiled and asks what an appropriate level of corporate involvement in the community should be.
Risky behaviors such as substance use, unsafe sexual interactions, aggression, and antisocial behavior are often elevated during adolescence and can serve as powerful influences on both youth adjustment and long-term mental and physical health outcomes. The various stages of adolescence, from early adolescence to emerging adulthood, present novel opportunities and challenges, often introducing new risk-taking opportunities. Underlying adolescents’ risk behaviors during this developmental period are extensive cognitive, biological, and social factors including brain development, new and renegotiated relationships, and contextual considerations such as socioeconomic status, community resources, and identity-related stress. Current interventions target risk behaviors at a variety of levels, focusing on individuals, families, schools, and communities, with many of these efforts demonstrating success with different populations. Future research and prevention efforts will continue to benefit from targeting multiple co-occurring behaviors, considering social influences of underserved groups facing disparities in risk-taking behaviors, culturally adapting interventions, and including other caregivers such as fathers.
Childhood obesity prevention is critical to reducing the health and economic burden currently experienced by the Australian economy. System science has emerged as an approach to manage the complexity of childhood obesity and the ever-changing risk factors, resources and priorities of government and funders. Anecdotally, our experience suggests that inflexibility of traditional research methods and dense academic terminology created issues with those working in prevention practice. Therefore, this paper provides a refined description of research-specific terminology of scale-up, fidelity, adaptation and context, drawing from community-based system dynamics and our experience in designing, implementing and evaluating non-linear, community-led system approaches to childhood obesity prevention.
Design:
We acknowledge the importance of using a practice lens, rather than purely a research design lens, and provide a narrative on our experience and perspectives on scale-up, fidelity, context and adaptation through a practice lens.
Setting:
Communities.
Participants:
Practice-based researcher experience and perspectives.
Results:
Practice-based researchers highlighted the key finding that community should be placed at the centre of the intervention logic. This allowed communities to self-organise with regard to stakeholder involvement, capacity, boundary identification, and co-creation of actions implemented to address childhood obesity will ensure scale-up, fidelity, context and adaptation are embedded.
Conclusions:
We need to measure beyond primary anthropometric outcomes and focus on evaluating more about implementation, process and sustainability. We need to learn more from practitioners on the ground and use an implementation science lens to further understand how actions work. This is where solutions to sustained childhood obesity prevention will be found.
How does international law impact the behavior of states? This book designed for students in multiple disciplines offers a comprehensive, accessible introduction to the 'law of nations,' detailing the evolution of state practice in response to an ever-changing, diverse world. In this new edition of William Slomanson's foundational text, the new authors, Professors Slagter and Van Doorn, trace how states manage their sovereignty in myriad ways, working through treaties, international organizations, and international courts to secure their own as well as global interests. With special emphasis on five key areas-human rights, the use of force, human security and humanitarian intervention, environmental protection, and economic relations-the authors illustrate both the power and limits of international law to provide structure and predictability on a globalized planet. Real-world problem sets, annotated bibliographies, and a practical guide to studying international law make this a text that students and instructors alike will appreciate.
Aorto-right-atrial fistula is an uncommon condition with an unclear pathogenesis. We present the case of a 3-year-old girl with a giant omphalocele repaired days after birth and incidentally discovered with a celiacomesenteric trunk-to-right atrium fistula. Three-dimensional reconstruction CT unveiled its anatomical pattern, and the fistula was successfully closed using a Amplatzer vascular plug II percutaneously.
Justice-involved women from rural Appalachia face significant barriers to the utilization of evidence-based HIV prevention interventions in spite of high rates of injection drug use and risky sexual practices. Adapting evidence-based practices to incorporate the cultural uniqueness of the target population is needed in order to advance translational and clinical science in this area. This study provides a descriptive overview of indicators of feasibility and acceptability of an adapted version of the National Institute on Drug Abuse Standard HIV prevention intervention for delivery using Facebook through a small randomized controlled pilot study with rural Appalachian women.
Method:
Study methods include the random selection of rural Appalachian women from two local jails, screening for study eligibility, baseline data collection, random assignment to study interventions, and follow-up in the community three months post-release.
Results:
Results indicate that the feasibility of the approach was supported through study enrollment of the target population who reported regular Facebook use and HIV risk behaviors including drug use and sex. Acceptability of the intervention was demonstrated through enrollment in the study intervention, engagement in the intervention through Facebook, and indicators of HIV/HCV knowledge.
Conclusions:
Study findings contribute to the critical and unmet need to advance translational science on the delivery of evidence-based prevention interventions in real-world rural Appalachian settings to understudied, vulnerable individuals who are often overlooked in targeted prevention efforts.
Research and clinical expertise have emphasized the mental health needs of parents and caregivers of medically complex children. Evidence-based interventions are available for adult mental health, including those designed specifically for caregivers caring for children with a variety of health-care needs. This paper describes practical and legal considerations of 3 possible pathways for psychologists to address the needs of caregivers within pediatric hospital settings.
Methods
Literature regarding the mental health needs of caregivers of children with medical conditions, evidence-based interventions, and pediatric subspecialty psychosocial guidelines was reviewed. Relevant legal and ethical obligations for psychologists were also summarized.
Results
The mental health needs of caregivers of medically complex children are often high, yet programmatic, institutional, legal, and ethical barriers can limit access to appropriate care.
Significance of the results
Integration of screening and treatment of caregivers’ mental health within the pediatric hospital setting is one pathway to addressing caregivers’ needs. The development of programs for caregiver mental health screening and treatment within pediatric hospital settings will enhance the well-being of children and families and reduce legal and ethical risks for pediatric psychologists. Consultation with institutional compliance, legal/risk, and medical records departments and the creation of electronic medical records for the caregiver may be useful and practical opportunities for integration.
The conflict in Ukraine indicates some of the features of a potential post-liberal order and raises several potential ethical issues that may arise for international interventions as the world changes. What types of interventions, if any, are justifiable in response to situations such as the one in Ukraine? Can interventions be permissible given the potential undermining of universalist claims that are often used to support them? How should states prioritize between situations if there is an even greater number of global challenges in a post-liberal order? Three new books—Solferino 21 by Hugo Slim, Decolonizing Human Rights by Abdullahi Ahmed An-Naim, and Promoting Justice across Borders by Lucia Rafanelli—can help to navigate these questions. Drawing on their insights, this essay argues that reform interventions can be justified to defend the liberal international order, that intervention can be defended from a relativist basis, and that socioeconomic rights should be given greater priority.
Indian adolescents experience body dissatisfaction. However, empirically supported interventions are lacking, particularly in lower socio-economic regions of India. This paper describes the acceptability testing of a six-session teacher-led comics-based intervention, aiming to improve body image and related outcomes among adolescents in Indian Hindi medium schools.
Methods
Thirty-five students (50% girls; Mage, girls = 12.3 years; Mage, boys = 13 years) and nine teachers (11% women) from Hindi medium schools in Rajasthan, India, completed a quantitative acceptability questionnaire regarding comics that target body dissatisfaction and associated risk factors. They also participated in online or telephone semi-structured interviews to share in-depth feedback, with teachers providing additional feedback on an accompanying teacher guide. The quantitative data were analysed descriptively, with the interviews analysed using qualitative codebook thematic analysis.
Results
Quantitative analyses revealed that 73% of students felt the comics made them feel good about themselves. Qualitative analyses revealed four themes: (1) body dissatisfaction is a concern; (2) the comics are powerful; (3) increasing ease of understanding; (4) a teacher guide to aid delivery.
Conclusion
This study demonstrates acceptability of a novel teacher-led comics-based body image intervention for adolescents in Indian Hindi medium schools from lower socio-economic settings. These findings are currently informing intervention optimizations, which will be evaluated in a randomized controlled effectiveness trial. If found to be effective, this intervention will be disseminated across eight Indian states by UNICEF. Trial registration. This trial has been registered with ClinicalTrials.gov; a database of privately and publicly funded studies conducted around the world. Registration date: 2nd May 2020; Registration ID: (NCT04317755). https://clinicaltrials.gov/ct2/show/NCT04317755?term=NCT04317755&draw=2&rank=1.
Despite an elevated risk of psychopathology stemming from COVID-19-related stress, many essential workers stigmatise and avoid psychiatric care. This randomised controlled trial was designed to compare five versions of a social-contact-based brief video intervention for essential workers, differing by protagonist gender and race/ethnicity.
Aims
We examined intervention efficacy on treatment-related stigma (‘stigma’) and openness to seeking treatment (‘openness’), especially among workers who had not received prior mental healthcare. We assessed effectiveness and whether viewer/protagonist demographic concordance heightened effectiveness.
Method
Essential workers (N = 2734) randomly viewed a control video or brief video of an actor portraying an essential worker describing hardships, COVID-related anxiety and depression, and psychotherapy benefits. Five video versions (Black/Latinx/White and male/female) followed an identical 3 min script. Half the intervention group participants rewatched their video 14 days later. Stigma and openness were assessed at baseline, post-intervention, and at 14- and 30-day follow-ups. Trial registration: NCT04964570.
Results
All video intervention groups reported immediately decreased stigma (P < 0.0001; Cohen's d = 0.10) and increased openness (P < 0.0001; d = 0.23). The initial increase in openness was largely maintained in the repeated-video group at day 14 (P < 0.0001; d = 0.18), particularly among viewers without history of psychiatric treatment (P < 0.0001; d = 0.32). Increases were not sustained at follow-up. Female participants viewing a female protagonist and Black participants viewing a Black protagonist demonstrated greater openness than other demographic pairings.
Conclusions
Brief video-based interventions improved immediate stigma and openness. Greater effects among female and Black individuals viewing demographically matched protagonists emphasise the value of tailored interventions, especially for socially oppressed groups. This easily disseminated intervention may proactively increase care-seeking, encouraging treatment among workers in need. Future studies should examine intervention mechanisms and whether linking referrals to psychiatric services generates treatment-seeking.
To increase access to support, an online psychosocial support tool for adults with visible differences was adapted for use without referral or supervision. This intervention combines a cognitive behavioural and social skills model of support. This study aimed to assess the usability and acceptability of Face IT@home as a self-help intervention. Eighty-one participants were recruited (32 with visible differences). Stage 1 included 14 participants (11 female, all with visible differences) who viewed two sessions of Face IT@home and undertook a semi-structured telephone interview. Stage 2 consisted of 14 think-aloud sessions (13 female, none with visible differences) with participants, supervised by researchers. Stage 3 employed 53 participants (47 female; 19 with visible differences), to view one session of Face IT@home and complete an online survey to evaluate usability and acceptability. User interviews, think-aloud studies and questionnaires identified usability and acceptability factors of Face IT@home that make it fit for purpose as a self-help tool. Participants suggested some changes to the Face IT@home program to improve usability. Participants reported that Face IT@home was a useful tool for people with visible differences and could be effective. The CBT-based model was considered a useful approach to addressing psychosocial concerns. The online self-help format will increase access to psychological support for adults with visible differences.
Key learning aims
(1) The paper outlines an important cognitive behavioural framework for supporting adults with visible differences.
(2) The paper demonstrates the importance of user testing and client involvement in developing intervention models.
(3) The studies highlight one approach to the process of user testing that can produce a robust online intervention.
Insomnia symptoms are common during the postpartum period, yet interventions remain scarce. This trial aimed to simultaneously examine the efficacy of cognitive behavioural therapy (CBT) and light dark therapy (LDT), targeting different mechanisms, against treatment-as-usual (TAU), in reducing maternal postpartum insomnia symptoms.
Methods
This three-arm randomised controlled trial recruited from the general community in Australia. Nulliparous females 4–12 months postpartum with self-reported insomnia symptoms [Insomnia Severity Index (ISI) scores >7] were included; severe medical/psychiatric conditions were excluded. Participants were randomised 1:1:1 to CBT, LDT, or TAU stratified by ISI (< or ⩾14) and infant age (< or ⩾8 months). Participants and principal investigators were unblinded. Six-week interventions were delivered via digital materials and telephone. The primary outcome was insomnia symptoms (ISI), assessed pre-, midpoint-, post- (primary endpoint), and one-month post-intervention. Analyses were intention-to-treat using latent growth models.
Results
114 participants (CBT = 39, LDT = 36, TAU = 39; Mage = 32.20 ± 4.62 years) were randomised. There were significantly greater reductions in ISI scores in CBT and LDT (effect sizes −2.01 and −1.52 respectively, p < 0.001) from baseline to post-intervention compared to TAU; improvements were maintained at follow-up. Similar effects were observed for self-reported sleep disturbance. There were greater reductions in fatigue in CBT (effect size = 0.85, p < 0.001) but not LDT (p = 0.11) compared to TAU. Changes in sleepiness, depression, and anxiety were non-significant compared to TAU (all p > 0.08). Four participants (11%) in the LDT group reported headaches, dizziness, or nausea; no others reported adverse events.
Conclusions
Therapist-assisted CBT and LDT were feasible during the first postpartum year; data at post-intervention and 1-month follow-up support their safety and efficacy in reducing postpartum insomnia symptoms.
To explore changes in plant-based and meat product sales during and after implementation of a multi-component in-store intervention implemented by a major UK food retailer. Secondary objectives included exploring differences by store format and area affluence.
Design:
The intervention increased the visibility, accessibility, affordability and availability of a selection of plant-based products. Unit sales of plant-based and meat products during the intervention (January 2021) were compared with pre- (November 2020) and post-intervention (February and March 2021). Non-meat product sales were assessed as a control. Negative binomial mixed models were used to explore sales changes and differences by store format or affluence.
Setting:
The intervention was applied in a real-world supermarket setting during Veganuary.
Participants:
Stores that applied the full intervention (n 154) were included for analysis. Weekly sales data for each store were obtained from the retailer.
Results:
Average weekly unit sales of plant-based products increased significantly (57 %) during the intervention period (incidence rate ratio (IRR) 1·52 (95 % CI1·51, 1·55)). Plant-based product sales decreased post-intervention but remained 15 % higher than pre-intervention (IRR 1·13 (95 % CI 1·12, 1·14)). There was no significant change in meat sales according to time period. The increase in plant-based product sales was greatest at superstores (58 %), especially those located in below average affluence areas (64 %).
Conclusions:
Results suggest that increasing visibility, accessibility, affordability and availability of plant-based products led to increased sales, with evidence of lasting effects. No significant changes in meat sales were observed. Variation according to store format and area affluence indicates targeted intervention approaches are needed.
The perinatal period constitutes a unique individual and family experience, involved in multifaceted transformations and adaptations at the physical, psychological, social, and emotional levels. This is the period in women’s life cycle where there is a higher risk for the development of mental illness.
Objectives
To introduce the perinatal mental health programme of the Hospital do Espírito Santo de Évora. The main objective is to structure an intervention with the woman and her support network to promote healthy parenting.
Methods
Implementing secondary and tertiary intervention approaches in a general and public hospital in the Alentejo region of Portugal. The programme is composed of the following components and domains of intervention in the pre-conception, pregnancy, and post-partum periods: individual consultation; brief intervention consultation; mindfulness sessions in the immediate postpartum period; home-based interventions; empowerment interventions for hospital and community healthcare professionals.
Results
It is expected that the project will result in a multidisciplinary approach to perinatal mental health, with significant impact, improved perinatal mental health of the women integrated in the project, as well as improved level of satisfaction in the provision of care in the woman/family.
Conclusions
Considering the prevalence and impact of mental health issues in the perinatal period, it is desirable to structure interventions with a holistic and multidisciplinary approach. Perinatal mental health should be prioritized during the entire process of pregnancy and postnatal period. A network of primary and secondary care systems may allow mitigating and/or overcoming vulnerabilities.
Trauma, stress, and attachment problems are negatively related to the development of mentalization. Children raised in institutional care are more exposed to these difficulties, therefore the development of population-specific interventions that aim to improve mentalization skills would be highly desirable.
Objectives
Our goal is to develop mentalization-based intervention programs for specific age groups (9-13 years, 14-18 years, and adult staff members of institutional care centers) - that support children’s and adolescents’ social functioning and conflict resolution skills.
Methods
The mentalization-based intervention targeting institutional care staff was launched first. Due to the pandemic, this intervention was executed online with two intervention (N = 17) and two passive control (N = 15) groups. Before and after the intervention, participants completed a demographic questionnaire, the Parenting Sense of Competence Scale, the Reflective Functioning Questionnaire, the Mini Oldenburg Burnout Inventory, The Strengths, and Difficulties Questionnaire, and the Ways of Coping Questionnaire.
Results
The intervention protocol and our results will be shown at the conference. There was no significant difference between the two intervention and two passive control groups in the demographic features. Mentalization uncertainty and burnout was positively related(rs(23) = .42, p = .034), while mentalization uncertainty and parental competence was negatively associated (rs(23) = - .41, p = .041).
Conclusions
The intervention program will be fine-tuned and optimized based on the results of the pilot study. In the next interventions, we plan to focus on the issues that the staff perceived as most difficult and to conduct interventions among the children.
Social contact-based video interventions effectively reduce stigma toward individuals with psychosis.
Objectives
We recently demonstrated the efficacy of a 90-second social contact–based video intervention in reducing stigma. The current randomized controlled study presents four briefer videos differing in presenter’s gender and race, with baseline, postintervention, and 30-day follow-up assessments. The study aimed to examine whether people changing their attitudes following the intervention.
Methods
Using a crowdsourcing platform (CloudResearch), we recruited and assigned 1,993 race and gender-balanced participants ages 18–35 years to one of four brief video-based interventions (Black female, White female, Black male, and White male presenters) or a nonintervention control condition. In the videos, a young presenter with psychosis humanized their illness through an evocative description of living a meaningful and productive life.
Results
Five-by-three ANOVA showed a significant group-by-time interaction for the total score of all five stigma domains: social distance, stereotyping, separateness, social restriction, and perceived recovery. A one-way ANOVA showed greater reductions in video intervention groups than control at post-intervention and 30-day follow-up, but no differences between video groups.
Conclusions
This randomized controlled study replicated and extended previous research findings by showing stigma reduction across videos that differ in the presenter’s gender and race, thus enhancing generalizability. The videos described the experience of psychosis and reduced stigma, suggesting their potential utility on social media platforms to increase the likelihood of seeking services and ultimately may improve access to care among young individuals with psychosis. Future research should address intersectional stigma experienced by culturally tailoring the narrative.