Effective Support Strategy Research Articles

Cannabis use amongst students attending an alternative provision in the United Kingdom

ABSTRACT For reasons explored within the paper, adolescents excluded from mainstream education are more likely to use cannabis regularly. Research into the cannabis use (CU) of adolescents excluded from mainstream school in the United Kingdom (UK) is limited and seldom focuses on what students perceive as effective support. In this exploratory study, information from 55 students attending an alternative provision (AP) in the North of England was gathered via electronic survey. Questions were asked about patterns of student CU, motivations for use, perceived impact on mental health and educational outcomes, and effective support. Current users reported CU was motivated by enhancement and coping motives, while conformity motives were less significant than expected. Past users endorsed coping motives less than expected. Support of trusted adults was perceived as the most effective support strategy. Findings are explored in relation to discussions with key staff prior to and after the survey. These reflect previous research into adolescent CU motives, and the positive impact of school connectedness on student CU. Recommendations include early intervention for high-risk youth based on accurate identification of CU motives. Staff should focus on building trusting relationships with students as a platform to support the management of adolescent CU.

Cultivating support during COVID-19 through clinical supervision: A discussion article.

This article aims to discuss how clinical supervision is an important approach in supporting frontline nurses and students during and post COVID-19 through the lens of the nursing metaparadigms. Discussion article. Discourse of the literature considering the importance of working collaboratively with healthcare and educational organisations in operationalising clinical supervision. The evidence base supporting clinical supervision as an effective support strategy for nurses exists, however, its implementation and practice has become sporadic. A resurgence is required to support student's and nurse's during this pandemic. It is timely for nurse educators to creatively engage with clinical partners in supporting clinical supervision to enhance both nurses and students pandemic practice experiences. Clinical supervision is proposed as one strategy to support and guide both nurses and students to develop, strengthen and challenge the effectiveness of their care during COVID-19.

Optimizing informal non pharmacological care by therapeutic tayloring

Improving of wellbeing and quality of life in people with dementia is conditioned by the quality of the management of behavioral and psychological symptoms. In the latter, informal non pharmacological care occupies a prominent place but its lack of formalization makes its use more complex by the care teams. We propose a non systematic review of guidelines and recommendations for good professional practice. The results allowed us to draw up an inventory of relational strategies and to collect the essential elements to be taken into account in the development of a non-medicinal intervention. It appears that these elements concern both aspects relating to the person (needs, identity, capacities) and the context of the intervention (circumstances of onset, type of symptoms, feasibility of the intervention). We propose to integrate these elements within the same clinical reasoning to orient the care teams towards the most effective non-drug support strategy. These considerations invite further research on the specific characteristics of the different support strategies and question the priorities in terms of training for caregivers working with this population.

Psychoeducation and group acceptance and commitment therapy as psychological support strategies for informal caregivers of patients with a first psychotic episode: an experimental study

ABSTRACT Background This article reports the results of a study designed to describe and analyze the effect of a psychological intervention with psychoeducational components and Acceptance and Commitment Therapy techniques in a sample of informal primary caregivers of patients with a first psychotic episode. Method The experimental study involved 37 subjects, 18 of whom received the intervention and 19 of whom were on the waiting list. Pre- and post-intervention measurements were performed of the variables: perceived overload, burnout syndrome and stress coping. Treatment consisted of eight weekly group sessions. Results Prior to treatment, the scores of the variables studied in the control and experimental groups were equivalent. After the intervention, compared to the control group and after the possible influence of time on the results had been analyzed, it was found that those who had received treatment reported a significant decrease in “perceived overload” and “burnout syndrome”, as well as an increase in the use of “active coping” strategies. The changes were found to have small and medium effect sizes. Discussion Clinicians working in early care services for psychosis may consider this multi-component intervention an effective support strategy for enhancing the psychological well-being of caregivers.

Ventricular Assist Devices Are a Viable Method to Support Patients to Multi-Organ Transplant

<h3>Purpose</h3> While ventricular assist devices (VADs) are known to improve survival in patients awaiting heart transplant, there are limited data describing the use of VADs in patients listed for multi-organ transplant or evaluating these patients' outcomes. <h3>Methods</h3> This retrospective cohort study identified patients from the UNOS database listed for heart transplant in combination with another solid organ from 2004-2019 and identified those with VADs at the time of listing and at transplant. Mortality was compared between patients with and without VAD using χ2 tests. Linear regression was used to assess changes in VAD use over time. <h3>Results</h3> Over 15 years, 22% (n=700) of heart-kidney (HK), 4% (n=20) of heart-liver (HLi), and 3% (n=25) of heart of heart-lung (HLu) patients were on VADs at listing. The median age of HK-VAD was 55y (IQR 47, 62), of HLi-VAD 52y (IQR 43, 55), and HLu-VAD 47y (IQR 33, 58). The majority of multi-organ VAD patients survived to transplant; 64% of HK-VAD, 70% of HLi-VAD, and 44% of HLu-VAD. Survival to transplant was higher in HK-VAD compared to HK-no VAD (72% vs 67%, p<0.05), while there was no difference between HLi-VAD and HLi-no VAD (80% vs 71%, p=0.38) or HLu-VAD and HLu-no VAD (52% vs 61%, p=0.37). One year post-transplant survival did not differ based on the presence of a VAD; HK-VAD (86.0%) vs HK-no VAD (88.9%) <i>p=0.11,</i> HLi-VAD (85.0%) vs HLi-no VAD (89.1%) <i>p=0.48</i>, and HLu-VAD (82.7%) vs HLu-no VAD (79.1%) <i>p=0.71.</i> <b>Figure</b> HK-VAD increased from 4 in 2004 to 94 in 2019 (<i>p for trend<0.001).</i> There were no changes over time in HLi-VAD or HLu-VAD <i>(p for both>0.05)</i>. <h3>Conclusion</h3> VADs are being used to support a substantial proportion of multi-organ patients, with an increase in patients waiting for heart-kidney transplant. The majority of these patients survive to transplant, and waitlist survival is higher in HK-VAD vs HK-no VAD. There is no difference in 1 year mortality when compared to patients without VADs, suggesting that this may be an effective support strategy for certain patients with multi-organ failure.

Simplified solution for viscoelastic-plastic interaction between tunnel support and surrounding rock based on MC and GZZ strength criteria

The surrounding rock often show obvious rheological characteristics when tunneling in high geostress environment, accompanied by large deformation, slow convergence and increasing support pressure. “Yielding-resistance combination” support inspired by the concept of NATM is widely employed in squeezing tunnels which has been successfully implemented to control the large deformation in many high geostress soft rock tunnels. However, some failure cases indicate that all kinds of “yielding-resistance combination” support strategies are not universally applicable to all squeezing tunnels. To seek an effective support strategy for squeezing tunnels, different kinds of “yielding – resistance combination” supports are summarized into three categories, i.e., “yield before resist” support, “yield – resist” support, and “control – yield – resist” support, which are simplified to different stress paths. A simplified two-stage calculation method, referring the first stage “yielding stage” and the second stage “resist stage”, is proposed to derive the time-dependent rock stresses, strains, displacements, displacement rates, and support pressures based on Mohr-Coulomb (MC) criterion and the generalized Zhang-Zhu (GZZ) strength criterion, respectively. Results show that the deformability of plastic rock will be underestimated if the stress path is not considered, the calculated rock displacement will be larger if the actual stress path is considered. The duration of the first stage t0, the deformation at the first stage Δu0 and the primary support pressure pi0, and the allowable displacement rate u̇c are major parameters for the design of tunnel support in squeezing rocks. The allowable displacement rate u̇c cannot be very high to ensure the stability of permanent support at the second stage. However, the construction period would be long if the allowable displacement rate u̇c is very low which would increase the construction cost. It is suggested that the duration of the first stage t0 be as short as possible if a relatively low value of u̇c is ensured.

Application of high-flow nasal cannula in hypoxemic patients with COVID-19: a retrospective cohort study

BackgroundIt had been shown that High-flow nasal cannula (HFNC) is an effective initial support strategy for patients with acute respiratory failure. However, the efficacy of HFNC for patients with COVID-19 has not been established. This study was performed to assess the efficacy of HFNC for patients with COVID-19 and describe early predictors of HFNC treatment success in order to develop a prediction tool that accurately identifies the need for upgrade respiratory support therapy.MethodsWe retrospectively reviewed the medical records of patients with COVID-19 treated by HFNC in respiratory wards of 2 hospitals in Wuhan between 1 January and 1 March 2020. Overall clinical outcomes, the success rate of HFNC strategy and related respiratory variables were evaluated.ResultsA total of 105 patients were analyzed. Of these, 65 patients (61.9%) showed improved oxygenation and were successfully withdrawn from HFNC. The PaO2/FiO2 ratio, SpO2/FiO2 ratio and ROX index (SpO2/FiO2*RR) at 6h, 12h and 24h of HFNC initiation were closely related to the prognosis. The ROX index after 6h of HFNC initiation (AUROC, 0.798) had good predictive capacity for outcomes of HFNC. In the multivariate logistic regression analysis, young age, gender of female, and lower SOFA score all have predictive value, while a ROX index greater than 5.55 at 6 h after initiation was significantly associated with HFNC success (OR, 17.821; 95% CI, 3.741-84.903 p<0.001).ConclusionsOur study indicated that HFNC was an effective way of respiratory support in the treatment of COVID-19 patients. The ROX index after 6h after initiating HFNC had good predictive capacity for HFNC outcomes.

Filling in some gaps: A pre-nursing bioscience and study skills intervention

BackgroundMultiple issues exist with the learning of bioscience in undergraduate nursing education. However, there are gaps in the literature for studies that have addressed this problem. AimsThis study aimed to investigate the impact of providing early innovative support for study skills and self-efficacy in basic bioscience. MethodsThe study involved the provision of a five-day pre-nursing bioscience and study skills intervention. It was evaluated with a 20-item survey where participants (n = 51) rated their self-efficacy to complete the Bachelor of Nursing, to learn bioscience and to use their study skills over the intervention and later bioscience unit. Students also responded to a list of concerns and were compared to the general cohort (n = 111). FindingsParticipants reported increased self-efficacies after the intervention and this improvement was maintained to the end of the bioscience unit. Concerns changed from having a lack of bioscience and study skills, to those that were more externally based such as their impending clinical placement. In contrast, the general cohort remained focused on their lack of bioscience knowledge. DiscussionThe intervention was shown to be an effective support strategy for student learning. Furthermore, despite a significant number of participants having less prior learning in high school bioscience, they performed to the same level as the general cohort in the final exam of the bioscience unit. ConclusionThe provision of early support for study skills and self-efficacy improvement is an investment to the learning of bioscience in undergraduate nursing education.

Renewable energy policies in Europe: Converging or diverging?

Nations today are urgently challenged with achieving a significant increase in the deployment of renewable energies. In Europe that need has given rise to a debate about the most effective and efficient support strategy. Whilst the different interests debate whether full European harmonisation or strengthening of national support policies for electricity from renewable energy sources (RES-E) is the best way forward, individual national support schemes are rapidly evolving. This study investigates how the EU member states have applied support policy types over the last decade. By identifying predominant developments in the application of feed-in tariffs, premiums, tradeable green certificates, tax incentives, investment grants, and financing support for specific technologies (wind, biomass, PV), this study shows that Europe is currently experiencing certain tendencies towards a ‘bottom-up’ convergence of how national policy-makers design RES-E policy supports. While some outliers remain, the policy supports of most countries become more similar in the policy types applied (dominance of feed-in tariffs) and in their scope of implementation (differentiation for installation sizes and ‘stacking’ of multiple instruments). These trends in national decision-making, which show tendencies of convergence, could make an EU-driven ‘top-down’ harmonisation of support either dispensable or at least (depending on the agreement) less controversial.

The Scottish adult support and protection legal framework

Scotland now has three key statutes that provide a legal framework for the support and protection of adults at risk of harm: Adults with Incapacity (Scotland) Act (2000), Mental Health (Care and Treatment) (Scotland) Act (2003) and Adult Support and Protection (Scotland) Act (2007). This article provides details of the 2007 act and highlights its interaction with the other two. The author argues that an effective adult support and protection strategy will need to address all three acts. A pyramid of intervention is used to explain the increasing levels of intervention that are now available in Scotland. The article also highlights how Scotland continues to diverge from the rest of the UK. It argues that comparative studies within the UK as well as the wider world, using tools such as the pyramid, could improve our understanding of this important and rapidly changing area of law.

Breastfeeding Trends at a Community Breastfeeding Center: An Evaluative Survey

To evaluate the Community Breastfeeding Center's (CBC) impact on clients' breastfeeding experiences. Retrospective survey; participants were mailed a questionnaire. A hospital-based drop-in center operated jointly by the Wellington-Dufferin-Guelph Health Unit and Headwaters Health Care Center and offering professional breastfeeding support and peer interaction. The 164 mothers of singleton births, both inpatients and community clients, who attended the CBC during a 10-month period in 1996-1997 and completed a survey. A mailed survey with forced-choice and open-ended questions. Of the respondents, 90.9% rated their overall CBC experience as excellent or good. Seventy-three percent of respondents breastfed for 4 months or longer. Primiparae and mothers of preterm infants tended to visit the CBC more frequently, while achieving duration rates similar to other subgroups. Returning to work was the reason most frequently cited for stopping breastfeeding (35%). The CBC is an effective community support strategy to lengthen breastfeeding duration and enhance clients' satisfaction with their breastfeeding experience.