Interventions

End-stage chronic obstructive pulmonary disease (COPD) is a debilitating, life-limiting condition. A palliative approach is appropriate for individuals with end-stage COPD, yet currently few interventions embrace this holistic, multidisciplinary and inclusive perspective. To describe interventions to support a palliative care approach in patients with end-stage COPD. Integrative review. DATA SOURCES AND REVIEW METHOD: Peer reviewed articles meeting the search criteria were accessed from Medline, PsychINFO, CINAHL and Google Scholar databases as well as Caresearch online resource. The domains of quality palliative care developed by Steinhauser were used as the conceptual framework to synthesise information. This review has shown that a range of palliative interventions are used to address the needs of individuals with end-stage COPD. Although evidence exists for discrete elements of palliative management in this patient group, there is limited evidence for health service coordination...

The pandemic has resulted in an inordinate amount of stress on everyone across the globe and particularly on children with Autism.

Children in India have been in home isolation and lockdown for over 15 months. They have had no access to their schools, play areas, public spaces, or outings. Children with Autism have been affected significantly as they are unable to access therapy centers and schools. Families were also under significant amounts of pressure of multiple kinds, adding to the complexity of the situation.

A review of the literature that was emerging during this time
highlighted the challenges that were being faced on the Autism community; however, there was very little being highlighted in terms of changing practices to suit the current need or any information on how interventions were being provided during the pandemic.

This paper outlines measures taken to provide ongoing interventions through an online platform for children with Autism between the ages of 2.5 and 9 years. It documents the need for improvisations made to traditional interdisciplinary models so that they can be effectively adapted to an online platform. It also highlights the advantages that these adaptions can have in the long term, as well as this being an additional way of providing services for children with Autism.





the interdisciplinary knowledge and insights we have gained with parent
communities and clinicians who work with young children with ASD (Age- 2.5 to 9 years)
with the hope that during the pandemic, clinicians and families will consider alternatives to
face-to-face therapies and will consider online interventions as an effective way of
intervention implementation.

In markets with high levels of financial exclusion, actors in the financial system, financial service providers (FSPs), consumers, providers of financial system infrastructure and other market supporting functions, regulators and other policy makers, often face capacity limitations. These include insufficient or inexperienced staff, lack of knowledge or understanding of the market, and limited financial literacy. Building sustainable and inclusive financial markets will require building the capacity of these actors. Funders that work to promote financial inclusion can play a very useful role in tackling capacity challenges, particularly if they provide support in a way that facilitates the development of a capacity building services market. This approach can benefit the whole financial market as opposed to the more common approach of providing direct support to one or a few actors in the market. This focus note builds on the ideas discussed in ‘facilitating market development to adv...

Purpose:  The purposes of this review were to provide an updated report of intervention studies designed to enhance mobility in older adults and discuss the strengths and limitations of existing intervention studies and their implications for practice.Data sources:  Medline, CINAHL, and PsychInfo were searched to identify original research articles reporting interventions for promoting mobility in community-dwelling older adults.Conclusion:  Effective interventions for enhancing mobility in older adults include walking, aerobic exercise, and resistance training focusing on strength, balance, and flexibility. Group-based interventions show significant beneficial effects in increasing mobility. To obtain significant effects of physical activity interventions, the patient should participate in the exercise programs for at least 12 weeks. Strengths of existing clinical trials for promoting mobility in older adults include testing of various types of physical activity and training interventions and the use of an experimental design with a control group. The major challenges of creating mobility enhancement recommendations for older adults include detailing a mobility enhancement program will delay disability, creating a specific program dose for different populations by gender and ethnicity, and developing culturally appropriate mobility enhancement programs to improve adherence over time.Implications for practice:  Prescribing regular physical activity including aerobic exercise and resistance training in a primary care setting can be a beneficial approach to minimize progression of impaired mobility in older adults. The typical dose of the physical activity prescription is 20–60 min of aerobic activity three times weekly. Adherence to mobility enhancement recommendations by older patients can be followed up by in-person interview or use of mobility monitoring tools such as exercise diary or log.

In this study we present a bottom up approach to developing interventions to shorten lengths of stay. Between 1999 and 2009 we applied the approach in 21 Dutch clinical wards in 12 hospitals. We present the complete inventory of all interventions. We organised, on the hospital ward level, structured meetings with the staff in order to first identify barriers to reduce the length of stay and then later to link them to interventions. The key components of the approach were a benchmark with the fifteenth percentile and the use of a matrix, that on one side was arranged along the main phases of the care process--the admission, stay and discharge--and on the other side to the degree to which the length of stay could be shortened by the medical specialists and nurses themselves or by involving others. The matrix consists of a wide variety of interventions that mainly cover what we found in published research. As a bottom up approach is more likely to succeed, we would advise wards that have to reduce length of stay to make the inventory themselves, using appropriate benchmark data, and by using the matrix.