Psychosocial interventions for pain management in older adults with dementia: A systematic review of randomized controlled trials

Aim: To assess the effectiveness of psychosocial interventions on pain in older adults living with dementia. Design: A systematic review with meta-analysis of randomized controlled trials. Data sources: Scopus, ProQuest, EBSCO (CINAHL and MEDLINE), PubMed, OVID (PsycINFO), Web of Science, and Cochrane Library were searched from their inception up to 2 May 2018. Review Methods: Risk of bias assessment and meta-analysis were conducted according to the Cochrane methods using RevMan 5.3 and findings were generated using the GRADE profiler software. Results: Eight studies met the inclusion criteria, but the quality of the current evidence was low to moderate. Results showed that psychosocial interventions significantly reduced the observational pain score and pain medication. Subgroup analyses indicated that sensory stimulation and individual interventions showed a reduction in observational pain in people with dementia. Conclusion: Findings suggest that psychosocial interventions may be potentially effective alternatives for pain management in people with dementia. However, caution is needed in interpreting these results due to limited studies, risk of bias and heterogeneity across studies. Furthermore, well-designed research is needed on psychosocial interventions to strengthen quality of pain management in people with dementia. Impact: This review synthesized current evidence using psychosocial interventions to manage pain in people with dementia. Findings suggest that psychosocial interventions may lead to a potential reduction in pain and pain medication in people with dementia. Healthcare providers may wish to integrate psychosocial interventions as part of the multimodal approach to the management of pain in people living with dementia.No Full Tex

A Content Analysis of Youth Internet Safety Programs: Are Effective Prevention Strategies Being Used?

ABSTRACT: Almost half of youth in the U.S. report receiving internet safety education (ISE) in their schools. Unfortunately, we know little about what educational messages make a difference in problems such as cyberbullying, sexting, or online predators. To consider directions for improving effectiveness, a content analysis was conducted on materials from four ISE programs. Results indicate that ISE programs are mostly not incorporating proven educational strategies. Common ISE messages have proliferated without a clear rationale for why they would be effective. It is recommended that program developers and other stakeholders reconsider ISE messages, improve educational strategies, and participate in evaluation. The field must also consider whether ISE messages would be better delivered through broader youth safety prevention programs versus stand-alone lessons

A Systematic Review of Effective Youth Prevention Education: Implications for Internet Safety Education.

ABSTRACT: Over the past two decades, a wide array of internet safety education materials and programs have developed to increase positive youth behavior and safety online. Although it is a new area of prevention, programs should incorporate practices that prior prevention evaluation studies tell us work best. To inform internet safety education, 31 youth prevention education meta-analyses across a wide range of youth prevention (substance abuse, risky sex behavior, delinquency, etc.) were coded to identify prevention program characteristics shown by research to be most effective. The review identified that active, skill-based lessons, focused on research based causal and risk factors, and provided with adequate dosage were key. Such strategies must be included as a starting place when developing prevention in new areas of youth risk concerns. Implications of the finding suggest some need for reevaluating how internet safety education is delivered in the future

The ‘Insider Outsider’ in Iris Murdoch’s Bruno’s Dream and Kazuo Ishiguro’s The Remains of the Day

This paper compares and contrasts two novels that take as their theme the reflections and regrets of a lonely male protagonist entering the final phase of his life. The eponymous Bruno in Iris Murdoch’s Bruno’s Dream (1969) and the butler Stevens in Kazuo Ishiguro’s The Remains of the Day (1990) resemble each other in living only peripherally in the present. Bruno and Stevens are mainly preoccupied in old age with memories of times past and of family and friends who are dead or simply absent. The novels are of similar length. They were both published in the latter half of the twentieth century, and both take place in England although written by authors who were actually born in other countries: Murdoch in Ireland and Ishiguro in Japan. Murdoch was taken to England as a baby and Ishiguro when he was six. This paper argues that Murdoch and Ishiguo both present life as a dream from which their protagonists struggle to awaken as they realize they are approaching their end. It is also apparent that Murdoch and Ishiguro both wrote their stories out of a sense of personal need, an attempt to deal with demons or insecurities that were related in part to their feeling of being ‘insider outsiders’ in their adopted country. Ishiguo has admitted impatience with critics who try to identify him as a Japanese author simply because he was born in Japan. He claims that, in The Remains of the Day, he was trying to write as someone more English than the English. His sense of ambivalence about his nationality arises in part from the fact that, from an early age, he was thoroughly immersed in English culture outside the family home while within it he was raised as a Japanese by parents who intended, one day, to return to their home country. In Stevens, with his obsession about work, Ishiguro managed to create a curiously Japanese figure. Iris Mudoch was similarly conflicted about her identity. She liked to think of herself as Irish despite living in England almost all her life. In Bruno’s Dream, she wrote of an old man possessed by memories and regrets. At the time of writing this novel, she was worried about losing or becoming estranged from friends and also hurt by criticism that the two novels she had just published, set in Ireland, betrayed a fundamental incomprehension of Irish history and culture. In being both ‘insiders’ and ‘outsiders’, Ishiguro and Murdoch were uniquely placed to describe Stevens and Bruno, characters who embody some of their own thoughts and feelings, who wrestle with their own concerns

Valuing the benefits from preserving threatened native fauna and flora from invasive animal pests

Invasive animal pests inflict many kinds of damage on the environment, and threaten native fauna and flora. We attempt to value the benefits from the extra biodiversity that is protected if these threats were removed. The NSW Rural Lands Protection Board is a major agency that undertakes pest control, and is organised into 48 districts across the state. A cross-sectional set of data on Board expenditures, pest abundance, and environmental and climatic characteristics, was compiled by district and analysed. The number of threatened native plant and animal species increases with pest abundance and with the total number of native species present in the district. But the number of threatened species decreases as Board expenditures on pest control increase. The value of preserving an extra species is derived from these changes in expenditure, following conventional economic principles. Then the potential gain in economic surplus is estimated if the threats to biodiversity were removed. The results so far suggest that the value of the total benefit of protecting an extra species is at least $44,250 per year, and the potential gain in surplus for New South Wales if the threats were removed is at least$132m per year. This change in surplus is also the total economic loss because invasive pests threaten native flora and fauna. If only half the native species could be protected, the avoidable economic loss is at least $95.7m per year. The assumptions and limitations of these estimates are discussed.Invasive animal pests, unpriced values, biodiversity gains, native flora and fauna, Environmental Economics and Policy, Political Economy,

Using trabecular architecture of the proximal femur to determine age at death: an accuracy test of two methods

Osteologists and forensic researchers are often called upon to determine age at death for skeletal remains. Although there are common methods in wide use, new methods are always sought. This study evaluates the accuracy of two radiographic methods of determining age by looking at the changes in the trabecular architecture of the proximal femur. These two methods are the Szilvassy and Kritscher (1990) method and the Walker and Lovejoy (1985) method. Samples were taken from four skeletal collections. Radiographs were taken of each individual and both Szilvassy and Kritscher’s (1990) phases of trabecular change and Walker and Lovejoy’s (1985) phases of trabecular change were applied. The Szilvassy and Kritscher (1990) standards yielded a higher percentage of accurate results than the Walker and Lovejoy (1985) standards. Neither method produced results that were accurate enough to be used reliably. The Szilvassy and Kritscher (1990) technique, however, proved more accurate than the Walker and Lovejoy (1985) technique. The low accuracy of the Walker and Lovejoy (1985) technique does not appear to be explained by factors such as race and sex. This method also assigned age categories that were greater than 20 years away from true age at death for more individuals than it assigned correct age categories. In contrast, this researcher found several trends in the accuracy of the Szilvassy and Kritscher (1990) method to different groups. This method tended to be more accurate when assigning ages to black individuals than white individuals. When separated on the basis of sex, the Szilvassy and Kritscher (1990) method assigned more accurate ages to females than to males. When age was taken into account, this method applied better to younger individuals than to older individuals. Thus, the Szilvassy and Kritcher (1990) method, with recalibration and new standards for separate groups, may become a useful technique for researchers

Contemporary context of Alexander Pope's correspondence

Even quite recent critical evaluations of the letters Pope published in his own lifetime have continued to remain obstinately rooted, whether consciously or not, in the moral indignation experienced by Pope's Victorian editors on their discovery that he had not only surreptitiously engineered the publication of a selection of his letters but also had mis¬ directed a number of letters, conflated or spliced or even fabricated others. This thesis holds that the response of moral indignation is not only generally misleading and unproductive but unfair. It arises from three areas of shortsightedness. There is, first, the failure firmly to place Pope's letters in the humanist tradition of the published 'familiar' letter dating from Cicero, through Pliny and Seneca, up to the letters of the Renaissance humanists, Erasmus and Petrarch. Second, there is the failure to appreciate sufficiently the revival of interest in the familiar letter whic'h, in seventeenth and eighteenthcentury Britain, precipitated a great number of diverse experiments in the letter form. And, third, Pope's own motives in publishing a selection of his letters have either been described too cynically, as compounded in the idea that vanity alone drove him to this step, or the letters them¬ selves have not been seen, as Pope undoubtedly meant them to be, in the context of his other published work. This thesis will seek to redress the balance or, at least, to pave the way towards a more balanced appraisal of the literary achievement the published letters represent by focusing on these three largely neglected areas

Domestic Violence Court Intervention Project

This research study examines the effectiveness of two domestic violence interventions to increase shelter use among women in a court advocacy program in upstate New York. The study found a significant advantage to offering a brief counseling component during an intervention, as opposed to only handing out an agency brochure and verbalizing shelter services to participants. Through qualitative inquiry rooted in Grounded Theory, the study accesses the impact of the criminal justice setting, direct observation, and the unstructured interview in acquiring pertinent screening information from victims. The study also uses Prochaska and DiClemente=s (1982) AStages of Change@ to better gage the readiness of each victim to make substantial and lasting changes in their relationship with the abuser. The study uncovered three potential areas for future research such as expanding service options for those victims who are not ready or willing to extricate themselves from the abuser. Second, preventing domestic violence earlier by directing preventative programs at children. Third, expanding what domestic violence workers look for during the screening process to measure the feasibility of including both family systems in the treatment plan especially if children are involved