Benefits Of Program Research Articles

Temporal trends in organ donation among cardiac arrest patients treated with extracorporeal cardiopulmonary resuscitation

AimsThis study explores the evolution of organ donation from patients treated with extracorporeal-cardiopulmonary-resuscitation (ECPR) for refractory out-of-hospital-cardiac-arrest (OHCA) and evaluates the public health benefits of a mature ECPR program. MethodsThis retrospective, single-center study included OHCA patients (2016–2023) who had mostly initial shockable rhythms and were treated with ECPR. Organ donation rates from non-survivors through these years were analyzed. The public health benefit of ECPR was determined by the ratio of the sum of survivors with Cerebral Performance Category 1–2 and non-survivors who donated at least 1 solid organ, to the total ECPR patients. Temporal trends were analyzed yearly using linear regression. ResultsOut of 419 ECPR patients presenting with refractory OHCA over the study period, 116 survived neurologically intact (27.7%). Among non-survivors (n = 303), families of 41 (13.5%) consented to organ donation (median age 51 years, 75.6% male) and organs from 38 patients were harvested, leading to 74 organ transplants to 73 recipients. The transplanted organs included 43 kidneys (58.1%), 27 livers (36.5%), 3 lungs (4%), and 1 heart (1.4%), averaging 2.4 ± 0.9 accepted organs/donor. The number of organ donors and successful transplants correlated positively with the years since the ECPR program’s initiation (ptrend = 0.009, ptrend = 0.01). Overall, 189 patients (116 survivors, 73 organ recipients) benefited from ECPR, achieving organ-failure-free survival. The cumulative public health benefit of ECPR, considering the 116 survivors and 38 donors was 36.8%. ConclusionThe public health benefits of an established ECPR program extend beyond individual ECPR patient survival, forming a new, previously under-recognized source of transplant donors.

Using technology to reduce learning costs and improve program comprehension: Lessons from a survey experiment on Supplemental Nutrition Assistance Program

AbstractThe Supplemental Nutrition Assistance Program (SNAP) provides food assistance to those in need, and while the program reaches many who are eligible, program participation falls short of reaching all who are eligible. One factor contributing to this gap in participation is difficulty understanding program eligibility, a common challenge with means‐tested benefit programs. Governments have attempted to improve public understanding of these complex programs using a range of tools to reduce learning costs, yet we know little about the extent to which these tools work and why. This preregistered survey experiment tests three commonly used methods of communicating SNAP program information, including a flyer, screening tool, and video. Cumulatively, our findings demonstrate that efforts to reduce SNAP learning costs are generally effective at improving comprehension recall and that the type of intervention matters, with the video increasing comprehension scores more than the flyer and screening tool. However, the impact of the intervention does not vary substantially according to household income.

Effects of Melatonin on Exercise-Induced Oxidative Stress in Adults with Obesity Undergoing a Multidisciplinary Body Weight Reduction Program.

Background: Obesity is characterized by increased oxidative stress, which, in a vicious circle, promotes chronic low-grade inflammation. Melatonin, a well-documented antioxidant, might be useful as a supplement to enhance the cardiometabolic benefits of any body weight reduction program (BWRP). Objectives/Methods: The present study aimed to evaluate the post-exercise oxidative stress and inflammation in a group of subjects with obesity treated with melatonin (2 mg/die) or placebo, undergoing a 2-week BWRP, with the administration of a single bout of acute exercise at the start and the end of the protocol (G1-G15). Results: Eighteen adults with obesity were enrolled and distributed to the two arms of the study: the melatonin group (F/M: 7/2; age: 27.8 ± 5.6 years; body mass index [BMI]: 43.0 ± 4.9 kg/m2) and the placebo group (F/M: 6/3; age: 28.8 ± 5.0 years; BMI: 42.8 ± 4.0 kg/m2). BWRP induced a decrease in BMI and waist circumference (WC) in both groups; plasma glucose, blood glycated hemoglobin (HbA1c), and neutrophil to lymphocyte ratio (NLR) were reduced only in the placebo group. Importantly, plasma biological antioxidant potential (BAP) increased throughout BWRP. Paradoxically, melatonin enhanced post-exercise production of plasma derivatives of reactive oxygen metabolites (d-ROMs) and erythrocytic glutathionyl-Hb (HbSSG) (at G1 and G15). Finally, differently from the placebo group, melatonin-treated subjects did not exhibit the BWRP-induced decrease in plasma levels of interleukin-6 (IL-6), before and after exercise, at the end of two weeks (G15). Conclusions: Melatonin is presumably an antioxidant with "conditional" prooxidant actions. The use of melatonin as a supplement in subjects with obesity might be deleterious due to the abolishment of BWRP-induced cardiometabolic benefits.

Validation of a Bluetooth Self-Fitting Device for People With Mild-to-Moderate Hearing Loss in Quiet or Noisy Environments.

The purpose of this study was to evaluate the benefits of a Bluetooth self-fitting device using an in situ hearing screening test and self-fitting processes. Thirty Mandarin-speaking individuals (16 men and 14 women) with mild-to-moderate hearing loss participated in this study. The hearing screening test was conducted using neckband earphones of a Bluetooth self-fitting device controlled by a smartphone app. The hearing screening tests were compared with the pure-tone audiometry in an audiometric booth. The amplification benefits of the self-fitting program-aided condition were evaluated and compared with those of unaided and preset program-aided conditions using the Mandarin Hearing in Noise Test (MHINT) and questionnaires. The pure-tone audiometry and hearing screening test results exhibited strong positive correlations at all test frequencies. In the environment with 90° noise, the sentence reception thresholds (SRTs) obtained for the self-fitting program-aided condition were significantly lower (p = .032) than those obtained for the unaided condition, whereas no significant difference was observed between the preset program-aided and the unaided conditions. Moreover, the participants' satisfaction ratings for the devices were consistent with their MHINT results, with a strong positive correlation observed between satisfaction with self-fitting and user satisfaction in smartphone app's control, functionality, and learning. Younger participants were significantly more satisfied in learning to use the app. Bluetooth self-fitting devices can be used for simplified in situ hearing screenings with a sensitivity of 90.4%. The satisfaction ratings and improvements in SRTs indicate significant clinical benefits of the self-fitting program compared with the preset program, particularly in the 90°-noise environments.

Structural inequality modifies midlife outcomes of a multisystemic early childhood program.

The role of structural inequalities in the long-term benefits of early childhood programs has not been assessed. Previous findings in the Chicago Longitudinal Study, an early childhood cohort investigation with low-income families, indicate that Child-Parent Center (CPC) participation beginning in preschool was associated with a variety of positive health behaviors. In this secondary analysis, we assessed if structural inequalities (neighborhood poverty, history of discrimination) modified the magnitude of associations between CPC and health and education outcomes (cardiovascular health, body mass index, educational attainment) 30 years later. The Chicago Longitudinal Study cohort of 1,539 children (93% Black, 7% Hispanic) grew up in high-poverty neighborhoods and attended CPCs or the usual district programs. At midlife (ages 32-37, M = 34.9 years, 2012-2017), 1,073 participants completed telephone interviews on structural inequalities, health, and education. Regression analyses were conducted with inverse propensity score weighting. After accounting for structural inequality, CPC participation was significantly associated with outcomes. Mean differences on Framingham risk scores, for example, were significant for CPC preschool at ages 3 and 4 (coefficient = -2.15, p = .004, standardized difference = -0.20). Neighborhood poverty moderated (reduced) the association between CPC and cardiovascular health. Neighborhood poverty and perceived discrimination had independent contributions with outcomes. Findings show that structural inequalities, especially poverty, directly influence and/or moderate long-term effects of CPC participation. Increasing neighborhood resources and socioeconomic status may help comprehensive programs sustain their impacts. Early childhood and sociostructural influences reflect the increasing importance of community contexts to health promotion. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Hybrid Type III Effectiveness-Implementation Trial to Optimize Medication Safety With Oral Antitumor Therapy in Real-World: The AMBORA Competence and Consultation Center.

Implementation science endeavors to facilitate the translation of evidence-based research into clinical routine. The clinical pharmacological/pharmaceutical care program evaluated in the randomized AMBORA trial on medication safety with oral antitumor therapeutics (OAT) optimizes care delivery and provides significant benefits for patients, treatment teams, and health care systems. Thus, we aimed to investigate the implementation of this care program within the AMBORA Competence and Consultation Center (AMBORA Center). The AMBORA Center within a University Comprehensive Cancer Center offered several services (eg, patient consultations) and was evaluated according to the RE-AIM framework. This multicenter hybrid type III trial focused on implementation outcomes (eg, patient recruitment, referring units, evaluation of services) while concurrently investigating effectiveness (eg, side effects, medication errors). Quantitative and qualitative assessments were combined. The AMBORA Center conducted over 800 consultations with 420 patients in seven institutions. The primary end point of counseling 70% of patients treated with OAT was not reached. Patients were referred by 15 treatment units compared with 11 units in the AMBORA trial. On the basis of heterogeneous referral rates and characteristics across the institutions, barriers and facilitators of the implementation process were derived. Several survey results (eg, stakeholder interviews, online/paper-based questionnaires) reflected a high appreciation of services by patients and health care professionals. The severity of 60.1% (178 of 296) of detected side effects improved, and 86.3% (297 of 344) of medication errors were resolved. Despite not reaching the primary implementation outcome, the AMBORA Center included more treatment units and demonstrated patient benefit of the AMBORA care program by meeting all effectiveness outcomes. We outlined quantitative and qualitative implementation characteristics to enhance outreach and foster further dissemination of centers to optimize medication safety with OAT.

Education Research: Establishing a Postgraduate Year-1 Director Enhances Well-Being for Adult Neurology Residents.

Adult neurology clinical trainees in Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs spend their postgraduate year (PGY)-1 within the internal medicine department, potentially causing a perceived disconnect with their neurology program. Our Adult Neurology Clinical Competency Committee found this disconnect may decrease resident well-being. We hypothesized implementing a novel PGY-1 Director role focusing on unique aspects of this first year would improve resident well-being and connection to the neurology program. The PGY-1 Director was established as an associate program director in the adult neurology residency program with goals to improve wellness, advocacy, compliance with ACGME requirements, education, and communication. Anonymous surveys compared preintervention (before the PGY-1 Director role) with postintervention resident opinions on PGY-1 experience, assessing wellness, burnout, and perception of advocacy. A total of 15 (75%) preintervention residents and 23 (96%) postintervention residents completed the study surveys. 53.7% of preintervention residents agreed or strongly agreed to feeling burned out, while only 17.4% of postintervention residents agreed they felt burned out and none strongly agreed. Significant improvement occurred in feeling supported clinically and emotionally and feeling validated. Most postintervention residents felt the PGY-1 Director was valuable and directly led to positive change. The relationship between the neurology and internal medicine departments was improved. A dedicated PGY-1 Director position can improve trainee wellness outcomes and relationships between preliminary and matched departments. This mutually benefits both programs but requires substantial resources. We propose this as a best practice when feasible for ACGME programs with the following suggestions: (1) provide dedicated full-time equivalent time, (2) meet with preliminary program leadership regularly, (3) meet with PGY-1 trainees during orientation and at least quarterly, (4) serve as an advocate, and (5) facilitate mentorship in areas of interest.

Expanding community-based participatory action research practices to clubhouses through sustainable research activities.

There is growing utilization and acknowledgement of the benefits of community-based participatory action research (CBPAR) in advancing health practices and equity. However, the sustainability and full impact of CBPAR in health care settings faces many obstacles and limitations. The present article examines the synergies between CBPAR and Clubhouse programs, presents the demonstration and ongoing implementation of sustainable CBPAR practices at Fountain House in New York City, and offers lessons learned for other Clubhouses and similar programs seeking to integrate CBPAR. Alignment in practice and principles between CBPAR and Clubhouse programs are presented. The innovation and ongoing sustainable CBPAR practices in the Fountain House Clubhouse program are examined with a contribution of practice guidance for other Clubhouse and similar programs in further adopting and learning CBPAR into participatory health practices. Clubhouse psychosocial rehabilitation programs present structurally conducive settings for the success and sustainability of CBPAR activities and projects. The Fountain House examination and demonstration of integrating CBPAR sustainably into core Clubhouse programming presents opportunities for further integration, research, and practice guidance in uniquely leveraging features of the Clubhouse model to advance health equity and rehabilitative outcomes through CBPAR. The opportunity for incorporating structural CBPAR activities within Clubhouse programs can be informed by the experience, processes, and lessons applied in the Fountain House example. Further research into the rehabilitation, program, and equity benefits of Clubhouse and CBPAR integration could uniquely contribute to the advancement of sustainable participatory research practices across the mental health field generally. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reconstruction of Death Insurance Regulations for Non-Wage Workers and the Sustainability of the Death Social Security Fund

This journal explores the reconstruction of death insurance regulations for workers who are not wage recipients, aimed at maintaining the sustainability of the death social security fund in Indonesia. The background of this study stems from the challenges faced by non-wage workers in accessing adequate social security benefits, particularly in the event of death, which is a critical aspect of social protection. The objective of the research is to evaluate the current regulatory framework and propose reforms that ensure equitable access and sustainability of the death benefit program for all workers, regardless of their wage status. The study employs a qualitative research method, utilizing legal analysis and case studies to assess the effectiveness of existing regulations and identify gaps that hinder the optimal functioning of the death insurance system. The results indicate significant disparities in the protection provided to wage and non-wage workers, highlighting the need for a more inclusive approach. The proposed regulatory reconstruction emphasizes the importance of expanding coverage, enhancing contributions, and improving the management of the social security fund to ensure long-term sustainability. The conclusions drawn from this research underscore the urgency of regulatory reforms that align with the principles of social justice and financial viability, ensuring that all workers, particularly those who are non-wage recipients, are adequately protected under the death social security program. This study provides a roadmap for policymakers and stakeholders to address the existing challenges and strengthen the social security framework in Indonesia.

8-Week Online Fitness Intervention on Muscle Strength, Flexibility, Body Composition and Physical-Self Perception: A Randomized Controlled Trial

This research examines the effect of an online physical fitness intervention plan on health-related components, and self-perception with randomized controlled trial. A total of 43 individuals completed the study, 21 of them were in the experimental group, and 22 were in the control group. Muscle strength was assessed using push-ups and sit-ups, while flexibility was determined through sit-and-reach tests. Fat and muscle mass in the arms, legs, trunk, android, gynoid regions, and total body were measured in grams by using Dual Energy X-Ray Absorptiometry. Health, body fat, strength, flexibility, endurance sub-dimensions of Marsh Physical Self-Description Inventory was used for self-perception. Results showed that group and time interaction had a significant effect on self-perception of body fat and push-ups, flexibility left and right, total fat, body fat mass in the arm, leg, and gynoid regions. Although the muscle mass of the experimental group increased in the 8-week period, this situation was not statistically significant. The implemented physical fitness intervention program has a significant impact, particularly in terms of fat burning. The findings obtained in strength tests can be associated with a decrease in fat mass, especially in the upper body. In conclusion, these findings underscore the potential of online fitness interventions in achieving positive health outcomes, emphasizing the multifaceted benefits of such programs on both perceived and measured physical well-being.

Impact Asessment of One Pesantren One Product (OPOP) as a Government Economic resilient Program to Improve the Pesantren Small Enterprises in the East Java Province

Abstract. One Pesantren One Product (OPOP) is one of economic development priority programs initiated by the government of the province of East Java, Indonesia, under the Governor regulation No. 62, 2020, aiming to improve the entepreneurship of Pesantren (an Indonesian term for traditional Islamic school) to raise the society resilient in economy and develop Sharia economic ecosystem through out the region of East Java Province. Up to 2022, there are 750 Pesantren of which 174 Pesantren has been provided both trainings and funds as the benefits of the program. This study is aimed to evaluate the impacts of this 4 year ongoing program by surveying and collecting the primary data of Pesantren enterprise condition prior and subsequent to accepting the benefits of this OPOP program to assess how significance the program affects the growth of the Pesantren enterprise. The method used in this study is content analysis of an in-depth guided interview assessing seven research variables used in this study ; legality, human resources, products/services, marketing, cash flow, internal impacts and external impacts. All of these variables are the result of a Delphi consensus by inter-diciplinary academicians and inter-sectoral government officers. There are 34 samples is taken out of the 174 population with the method of multi-stage cluster random sampling, choosing 8 region in the province by cluster sampling and then choosing ten typologies of the enterprise by non-proportional stratified random sampling. The analysis technique used is a likert scale, to score each research variable in the context of both prior and subsequent conditions to receiving the benefits of the OPOP program resulting in categorization of 3 different classes, and how significance the impacts of the program to the seven variables research lead to the escalation of the class of the studied samples. The result is 62% of the Pesantren enterprise experienced class ascension with 4 enterprise typologies, which are Food raw material, processed food products, farming and beverage products, that is affected the most by this OPOP program.

Cost–benefit analysis of the National Immunization Program in Spain

ABSTRACT Broad benefits of vaccination programs are well acknowledged but difficult to measure, especially when considering all vaccines included in a National Immunization Program (NIP). The aim was to conduct a cost–benefit analysis of the entire NIP in Spain, and an expanded NIP including four potential additional programs. A cost–benefit analysis was performed in Excel to assess the economic and health benefits (€) of vaccinating a single cohort of newborns over a lifetime horizon compared to no vaccination, from a societal perspective: firstly, according to the 2020 NIP in Spain (including 2021 recommendation for herpes zoster in 65-year-olds); and secondly, with an expanded NIP (adding rotavirus and meningococcal B in infants, and pertussis booster in adults aged >65 years and herpes zoster in all adults >50 years). The main inputs were taken from published literature and Spanish databases. Results were presented as a benefit–cost ratio (economic benefit per €1 invested). A cohort of 343,126 newborns were included in the analysis. The total investment needed to vaccinate the cohort throughout their lifetime, according to the 2020 NIP and the expanded NIP, was estimated at €168.5 million and €275.5 million, respectively. Potential economic benefits were €772.2 million and €803.0 million, respectively. The societal benefit–cost ratio was €4.58 and €2.91 per €1 invested, respectively. Even with the addition of new vaccination programs, the Spanish NIP yielded positive benefit–cost ratios from the societal perspective, demonstrating that NIPs spanning the full life course are an efficient public health measure.

The Functional, the Imperative, and the Sudoku: Getting Good, Bad, and Ugly to Get Along (Functional Pearl)

Conventional wisdom suggests that the benefits of functional programming no longer apply in the presence of even a small amount of imperative code, as if the addition of imperative code effectively subtracts. And yet, as we show in this paper, combining functional programming with the special imperative language Esterel provides a multiplicative improvement to the benefits of functional programming. The key to the benefit of both Esterel and functional programming stems from a restriction that both share. As in functional programming, where only the inputs to a function determine its outputs, the state of an Esterel computation is fully determined by the program’s input and the state that the computation had in the previous time step, where the notion of a time step is explicit in the language. Esterel’s guarantee holds even though Esterel programs feature concurrent threads, mutable state, and the ability to create, suspend, and even terminate threads as the computation proceeds. This similarity is the root of the benefits that programmers accrue as they informally reason about their program’s behavior. To illustrate these benefits, the bulk of this paper consists of an in-depth exploration of HipHop code (a mashup of JavaScript and Esterel) that implements a Sudoku solver, showing how it is possible to write code that is as easy to understand as if it were written in a pure functional programming style, even though it uses multiple threads, mutable state, thread preemption, and even thread abortion. Even better, concurrent composition and task canceling provide significant program structuring benefits that allow a clean decomposition and task separation in the solver.

Benefits of an online group dance program for adolescents' social bonding and wellbeing.

The Covid-19 pandemic and its ensuing effects on mental health made it clearer than ever that social bonds are critical for survival, flourishing, and mental wellbeing. Experimental laboratory-based research with children and adults shows that activities involving movement alignment and joint action, such as dance, can facilitate social bonds. This study examined whether an online group dance intervention positively affects social bonding and wellbeing using a randomized control design. Participants were 58 UK adolescents aged 11-16 years (N = 52 girls, 75% White, 7% Asian/Asian British, 18% Mixed-Other), randomly assigned to an online intervention or waitlist control group. Participants in the intervention group completed an online 5-week hip-hop dance program during the Covid-19 pandemic in January to February 2021. Measures of social bonding, wellbeing, and future orientation were taken at the beginning and end of the program. Linear mixed model analyses examining group × timepoint interaction showed greater increase in social bonding (p < .0001), and wellbeing (p < .0001) in the intervention vs control group. Moreover, increases in bonding significantly predicted increases in wellbeing (p < .0001), and increases in bonding (p = .03) and wellbeing (p = .0002) significantly predicted increases in the adolescents' hope for the future. These data, collected at a time of mass social isolation, show that a 5-week-long online dance activity can help adolescents forge stronger social bonds, and improve their wellbeing and future orientation. Our findings suggest that the wellbeing and future orientation benefits of group dance may stem from having stronger social connectedness, opening up avenues for future research and interventions.

Perceptions of a naloxone leave behind program among emergency medical services personnel in Michigan, USA

IntroductionIn 2020, Michigan implemented its first Naloxone Leave-Behind Program for Emergency Medical Service (EMS) field providers. Under the program, EMS field providers leave naloxone kits to individuals aged 15 or older they encounter in the field who have overdosed, who indicate they have a substance use disorder, or exhibit signs of opioid use and/or to bystanders, friends, or family that are present at the encounter. MethodsSurvey of EMS field providers and administrators to assess perspectives on the Michigan NLB program. Comparisons of perspectives between field providers and administrators working in EMS agencies operating in medical control authorities (MCAs) participating in the NLB program (i.e., participating agencies) with field providers and administrators working for EMS agencies serving non-participating MCAs. ResultsMost EMS field providers and administrators supported the Michigan NLB program. However, some were concerned about the unintended consequences of leaving behind naloxone, including the potential for recipients to use more drugs or be less likely to seek treatment. Perspectives of NLB program effectiveness were similar between EMS administrators and field providers. Participating administrators’ top-cited barrier to implementation was convincing field providers to leave behind naloxone, while non-participating administrators were concerned with stocking naloxone kits. ConclusionsAdditional engagement and training to address concerns by EMS field providers and administrators about the benefits of the NLB program are needed to expand program participation intensity. Streamlining naloxone procurement and increasing messaging about free access to naloxone for participating in the program may help increase adoption.

Association Between Food Insecurity and Developmental Delay and Behavioral Problems in US Children 2 to 5 Years of Age.

To investigate the relationship between food insecurity and developmental delay and/or behavior problems (DD/PB) in US children aged 2 to 5 years before the COVID-19 pandemic. Data from 14,464 children aged 2 to 5 years from the National Survey of Children's Health from 2016 to 2017 were analyzed. Children with food insecurity came from families reporting they sometimes or often could not afford nutritious meals. Diagnosis of DD/PB by a professional was obtained through a caregiver report. A quarter of children aged 2 to 5 years lived in food insecure homes, and 9% were diagnosed with DD/PB. Children in food insecure households were more likely to be from minoritized populations publicly insured, with single parents, without high school education, living =< 130% Federal poverty line, and receiving supplemental nutrition assistance program (SNAP) benefits (all p < 0.001). Adjusting for age, sex, race, ethnicity, poverty, family structure, and parent education, children in food insecure households had 1.57 times the odds of being diagnosed with DD/PB compared with children in food secure households. In similarly adjusted models excluding poverty and stratified by SNAP use, homes not receiving SNAP maintained this association between food insecurity and diagnosis of DD/PB, whereas in homes receiving SNAP, the association was not significant. In this population-based study, US children aged 2 to 5 years in food insecure households were more likely to be diagnosed with DD/PB compared with those in food secure households. When stratified, there was no association between food insecurity and DD/PB among those receiving SNAP; the association remained for those not receiving SNAP. The potential long-term impact of this safety net program on our most vulnerable citizens must be considered as policymakers contemplate federal spending priorities.

The Effect of Paid Maternity Leave on Fertility and Mothers’ Labor Force Participation

AbstractThis study examines how paid maternity leave (ML) impacted fertility and mothers’ labor force participation in Romania. The ML gives mothers the right to paid leave until the child turns one year old, and it offers $${65{\%}}$$ 65 % of monthly income before birth. I examine the effects of this policy change using a regression discontinuity design and census data. I show that mothers who are eligible for ML are 2.5 percentage-points more likely to have an additional child than those ineligible. The effect is persistent for seven years after the policy was implemented. I find no significant results regarding the mother’s labor force participation. These results have important implications regarding the shrinking working-age population and the ability to fund benefits programs.

The Mediating Role of Work Motivation in the Impact of Training on Teachers’ Digital Literacy

It is importance of improving the digital literacy of teachers is crucial with the rapid integration of technology in education, effective training programs are critical. However, their success largely depends on the motivation of the participants. The purpose of this study is to determine the mediating role of the work motivation variable on the effect of the training variable on the digital literacy variable so that there are two independent variables and one dependent variable. The number of samples used was 73 teachers in Palembang. To collect data, a questionnaire technique was used. Using the Smart PLS 3.0 structural equation modeling technique, the hypothesized relationships in this study were tested. This study found that: 1) training had a positive and significant effect on teacher motivation; 2) work motivation had a positive and significant effect on teacher digital literacy; 3) training had a positive and significant effect on teacher digital literacy; and 4) work motivation had a mediating effect on the relationship between training and teacher digital literacy. These results highlight the importance of fostering a motivational climate to maximize the benefits of training programs. Implications for educational policy and practice are discussed, emphasizing the need for strategies that not only provide training but also actively engage and motivate teachers to enhance their digital competencies.

Supplemental Nutrition Assistance Program participation gaps within a pediatric leukemia clinical trial cohort.

Poverty-exposed children with cancer are more likely to experience adverse outcomes. Supplemental Nutrition Assistance Program (SNAP) benefits improve food insecurity and child health outcomes, and could be used to mitigate disparities. We conducted a secondary analysis of parent-reported data collected in a frontline pediatric leukemia trial (NCT03020030) to assess SNAP eligibility (proxied by other means-tested program participation) and participation. At diagnosis, 105/287 families (37%) were SNAP-eligible, of whom 53 (50%) were SNAP participants. At 6months, 104/257 families (41%) were SNAP-eligible, and 59 (57%) were SNAP participants. Interventions to increase benefits participation during childhood cancer treatment represent an immediate opportunity to reduce disparities.

Outcomes of a Virtual 10-Week COVID-19 and Psychosis Program in an HMO: A Mixed Methods Quality Improvement Project.

Virtual clinical services became the primary treatment modality in a large U.S. HMO psychiatry department during the COVID-19 pandemic. A mixed methods quality improvement project was developed to address psychosis, severe anxiety, and stressors unique to COVID-19 and sheltering in place. The purpose was to determine if a virtual 10-week pilot program combining psychoeducation, skills-based training, experiential exercises using third-wave CBT, and process questions would decrease symptoms and hospitalization rates and improve quality of life. Pre- and postmeasure scores on pandemic-related stress (the PRSF), perceived stress (PSS), and general patient health (PHQ-9) were gathered from five patients in the Department of Psychiatry at Kaiser Permanente in Oakland, California. Qualitative interviews explored patients' perceptions of program benefits. Mean, median, and range on the pre- and postprogram assessments and paired samples t tests for means were calculated. Quantitative results were not statistically significant: p = 0.32 (Revised PRSF), p = 0.34 (PSS), p = 0.94 (PHQ-9). In interviews, most participants reported a decrease in pandemic-related stress. Half reported a decrease in general perceived stress. Half reported no change. Self-assessment reflected perceptions of benefits from this 10-week program, using words such as useful and important. The virtual program helped relieve pandemic-related stress and improved overall quality of life. The results show promise for expanding the program to other hospitals providing services for this diagnostic population.