Effectiveness Of Support Interventions Research Articles

The roles of preparation, location, and palliative care involvement in parent-perceived child suffering at the end of life

PurposeParents' perceptions of their child's suffering affect their bereavement experience. Identifying factors that shape parental perceptions of suffering could help build effective supportive interventions for children and parents navigating EOL and grief. We aimed to compare parent-perceived child suffering between diagnostic groups and identify related factors. Design and methodsWe combined databases from 3 surveys of parents whose children who died following cancer, a complex chronic condition (CCC), or advanced heart disease. We built multivariable logistic regression models to identify relationships between parent-perceived child suffering and parent/child, illness experience, and care-related factors. ResultsAmong 277 parents, 41% rated their child's suffering as moderate or high. Fifty-seven percent of parents whose child died from cancer reported that their child suffered “a lot” or “a great deal” at EOL, compared to 33% whose child died from a CCC, and 17% whose child died from heart disease (P < 0.001). Preparation for EOL symptoms was associated with decreased parent-perceived child suffering in multivariable modeling, with parents who were prepared for EOL 68% less likely to rate their child's suffering as high compared to those who felt unprepared (AOR: 0.32, CI [0.13–0.77], P = 0.013). ConclusionsPreparing families for their child's EOL may help mitigate lingering perceptions of suffering. Operationalizing preparation is crucial to optimizing family support during EOL care. Implications to practicePreparation for symptoms, and access to resources, including medical/psychosocial interventions and staff, may help ease parental perception of EOL suffering. Clinicians should prioritize preparing families for what to expect during a child's dying process.

Resilience among laid-off employees in banking sector: evidence from Lebanon

In light of extensive research examining job termination and its effects on the economy, organizations, and individuals (Anger et al. 2017, Deb et al. 2011, Hanisch 1999, Leana and Feldman 1988), this study aims to specifically explore the impact of fear and resilience on reemployment among laid-off employees from the Lebanese banking sector. Given the significant challenges faced by the Lebanese banking sector recently, resulting in a substantial number of employee layoffs, it is essential to investigate the extent to which these emotions influence the reemployment outcomes of affected individuals. To note that this paper is a conceptual paper intended to lay the groundwork for future analysis in the areas of fear and resilience, specifically in the time after job termination in the Lebanese banking sector. This paper will adopt a mixed-methods approach, combining quantitative surveys and qualitative interviews to gather comprehensive data. The sample will consist of former employees who were laid off from various Lebanese banks during one of the most severe economic collapses. The quantitative phase will involve administering a standardized survey instrument to measure the emotions of fear and resilience experienced by the participants. Fear will be assessed by examining anxiety levels, concerns about financial stability, and worries about career prospects. Resilience will be evaluated by exploring coping mechanisms, self-efficacy, and adaptability to change. The survey will also include demographic and employment-related questions. In the qualitative phase, semi-structured interviews will be conducted with a subset of participants to gain a deeper understanding of their experiences. The interviews will explore the specific fears encountered, the strategies employed to cope with the layoff, and the impact of these emotions on the participants' job search process. The collected data will be analyzed using both quantitative and qualitative techniques. Statistical analyses, such as correlation and regression analyses, will be conducted to examine the relationships between fear, resilience, and reemployment outcomes. The qualitative data will be analyzed thematically to identify recurring patterns, emerging themes, and narratives related to the research question. The findings of this research will contribute to the existing literature on the impact of emotions on reemployment following job loss, particularly within the context of the Lebanese banking sector. The results will shed light on the extent to which fear and resilience influence individuals' ability to secure new employment after being laid off. Furthermore, the study will provide valuable insights into the coping mechanisms and strategies that laid-off employees utilize to navigate the challenging job market. The implications of this research are twofold. First, it will inform policymakers and practitioners about the emotional experiences of laid-off employees in the Lebanese banking sector and highlight the importance of addressing their fears and enhancing their resilience during the transition to reemployment. Second, it will contribute to the development of effective support programs and interventions aimed at facilitating the successful reintegration of laid-off individuals into the workforce. Overall, this research will deepen our understanding of the emotions of fear and resilience among laid-off employees and their impact on reemployment outcomes. By examining these factors in the specific context of the Lebanese banking sector, it will provide valuable insights into the challenges faced by individuals in a turbulent economic environment and offer recommendations to promote their successful reemployment.

Understanding the support needs of parents of children with obsessive-compulsive disorder: a qualitative descriptive study in the UK

IntroductionCaring for a child with obsessive-compulsive disorder (OCD) can be extremely difficult, yet evidence-based support strategies for parents/carers are limited. A detailed understanding of parent support needs is an important first step in intervention development and qualitative research with this focus is currently lacking. In this study, the viewpoints of parents and professionals were used to understand support needs and preferences when caring for a child with OCD. This qualitative descriptive study formed part of a wider UK-based project aimed at developing better support for parents of children with OCD.MethodIndividual semi-structured interviews (and an optional one-week journal) with a purposive sample of parents of children and young people (CYP) with OCD, aged 8–18, and focus groups (or individual interviews where preferred) with a purposive sample of professionals supporting CYP with OCD. Data comprised transcripts of audio-recorded interviews and focus groups, and text from journals. Analysis was informed by the Framework approach involving inductive and deductive coding, supported by NVivo 12.0 software. Co-production methods were adopted throughout the research process, including the involvement of a parent co-researcher and charity collaborators.ResultsInterviews were undertaken with 20 parents, of which 16 completed a journal. Twenty-five professionals took part in a focus group or interview. Five key themes relating to parent support challenges and support needs/preferences were identified (1) Coping with the impact of OCD; (2) Getting help for my child; (3) Understanding parents’ role; (4) Making sense of OCD; (5) Joined-up care.ConclusionParents caring for children with OCD have clear caregiver support needs which are currently not being met. Through triangulation of parent and professional accounts, this study has identified parent support challenges (e.g., emotional impact of OCD, visibility of caring role, misunderstanding about OCD) and support needs/ preferences (e.g., headspace/respite, compassion/sensitivity, guidance on accommodation) to lay the vital foundations for the development of effective parent support interventions. There is now an urgent need to develop and test an intervention to support parents in their caregiving role, with the aim of preventing and/or reducing their levels of burden and distress and ultimately, improving their quality of life.

Effect of Fetal Surgery on Maternal Mental Health [ID: 1376946

INTRODUCTION: Perinatal mental illness imparts a significant health burden. A multitude of factors are hypothesized to increase the incidence of perinatal mood and anxiety disorders (PMADs) in the fetal surgical population, including uncertain fetal prognosis and the inherent risks of surgery and preterm delivery. We sought to determine the disease course of PMADs in the fetal surgery population. METHODS: A retrospective chart review was conducted of fetal surgery patients from 2017 to 2021 at a tertiary care center. Demographics, surgical, obstetric, and psychiatric diagnoses were recorded. Standard descriptive analyses were performed. RESULTS: One hundred nineteen eligible patients were identified. Fetal surgery was performed at a median gestational age of 23.0 (range 16.0–34.0) weeks. Laser ablation of placental anastomoses (n=51) and in utero myelomeningocele repair (n=22) were the most common procedures. 26.8% (32/119) had preexisting mood disorders, with 59.3% (19/32) and 53.1% (17/32) on a baseline medication for depression or anxiety, respectively, prior to surgery. 26.4% (23/87) of patients without a history of anxiety or depression had a new diagnosis of PMAD. Two patients experienced suicidal ideation. 6.7% (8/119) and 10.1% (12/119) initiated a new psychiatric medication during or post-pregnancy, respectively. 19.8% (21/113) received a therapy referral. Among patients with baseline anxiety or depression, 62.5% (20/32) experienced an exacerbation postpartum with 25.0% (8/32) referred for therapy, and 34.3% (11/32) changing dose or medication for anxiety and 37.5% (12/32) for depression. CONCLUSION: Among patients undergoing fetal surgery, a high incidence of PMAD was identified. Most patients with prepregnancy anxiety or depression experienced an exacerbation postpartum. Further research into effective supportive interventions is warranted.

A Randomized Controlled Trial for a Digital Peer Support Platform to Translate Online Peer Support for Emerging Adult Mental Well-being.

Emerging adulthood (ages 19 to 25) is a developmental phase that is marked by increased mental health conditions, especially depression and anxiety. A growing body of work indicates that digital peer emotional support has positive implications for the psychological functioning of emerging adults. These is burgeoning interest among healthcare professionals, educational stakeholders and policy makers in understanding the implementation and clinical effectiveness, as well as the associated mechanism of change, of digital peer support as an intervention. This randomized controlled trial (RCT) examined the effectiveness of digital peer support intervention over a digital platform-Acceset-for emerging adult psychological well-being with three primary aims. First, we evaluated the implementation effectiveness of digital peer support training for individuals providing support (befrienders), and digital platform for peer support. Second, we assessed the clinical outcomes of digital peer support, in terms of the intervening effect on emerging adult psychological well-being. Third, we investigated the mechanism of change linking digital peer support intervention to emerging adult psychological well-being. The RCT involving 100 emerging adults from the National University of Singapore follows the published protocol on this trial [29]. The RCT found effectiveness of digital peer support training-specifically, befrienders' peer support responses demonstrating significantly higher post- than pre-training scores in selfhood (post-training: M = 62.83, SE = 10.18; pre-training: M = 54.86, SE = 7.32), t(34) = 3.88, P < .0001. The digital peer support intervention demonstrated clinical effectiveness in enhancing selfhood, compassion and mindfulness, and in lowering depressive and anxiety symptoms among seekers in the intervention group at post intervention (M = 7.15, SE = 0.88) than seekers in the waitlist control group prior to intervention (M = 11.75, SE = 0.89), t(89) = 3.44, P = 0.0009. The effect of the intervention on seekers' psychological well-being was sustained beyond the period of the intervention. The mechanism of change revealed that seekers' engagement of the intervention had both immediate and prospective implications for their psychological well-being. This RCT on digital peer support intervention for emerging adult psychological well-being harnesses the interventional potential of four components of psychological well-being and elucidated a mechanism of change. By incorporating and validating the digital features and process of a peer support platform, our RCT provide the parameters and conditions in deploying effective and novel digital peer support intervention for emerging adult psychological well-being in real-world settings. ClinicalTrials.gov NCT05083676.

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications.

The opioid overdose epidemic is exacerbated by the emergence of Xylazine as an illicit drug adulterant. Xylazine, a veterinary sedative, can potentiate opioid effects while also causing toxic and potentially fatal side effects. This systematic review aims to assess the impact of Xylazine use and overdoses within the opioid epidemic context. A systematic search was conducted following PRISMA guidelines to identify relevant case reports, and case series related to Xylazine use. A comprehensive literature search included databases like Web of Science, PubMed, Embase, and Google Scholar, utilizing keywords and Medical Subject Headings (MeSH) terms related to Xylazine. Thirty-four articles met the inclusion criteria for this review. Intravenous (IV) administration was a common route for Xylazine use among various methods, including subcutaneous (SC), intramuscular (IM), and inhalation, with overall doses ranging from 40 mg to 4300 mg. The average dose in fatal cases was 1,200 mg, compared to 525 mg in non-fatal cases. Concurrent administration of other drugs, primarily opioids, occurred in 28 cases (47.5%). Intoxication was identified as a notable concern in 32out of 34 studies, and treatments varied, with the majority experiencing positive outcomes. Withdrawal symptoms were documented in one case study, but the low number of cases with withdrawal symptoms may be attributed to factors such as a limited number of cases or individual variation. Naloxone was administered in eight cases (13.6%), and all patients recovered, although it should not be misconstrued as an antidote for Xylazine intoxication. Of the 59 cases, 21 (35.6%) resulted in fatal outcomes, with 17 involving Xylazine use in conjunction with other drugs. The IV route was a common factor in six out of the 21 fatal cases (28.6%). This review highlights the clinical challenges associated with Xylazine use and its co-administration with other substances, particularly opioids. Intoxication was identified as a major concern, and treatments varied across the studies, including supportive care, naloxone, and other medications. Further research is needed to explore the epidemiology and clinical implications of Xylazine use. Understanding the motivations and circumstances leading to Xylazine use, as well as its effects on users, is essential for developing effective psychosocial support and treatment interventions to address this public health crisis.

Psychological Well-being of Patients in Reproductive Medicine Center: Clinicians’ Perspectives

ABSTRACT Objectives This qualitative study aimed to comprehend the psychological well-beings and available interventions of current Chinese infertile patients, as well as investigate more integrated and effective patient support interventions, if necessary. Background It is well known that infertility is a difficult struggle. Assisted reproductive technologies (ART) provide patients with the hope of having a child, but they also cause them pain and stress. There is a dearth of research on the mental health of infertile patients, particularly in developing nations such as China. Method Individual interviews were conducted with eight experienced clinicians at the Reproductive Medicine Center from five different hospitals. On the basis of the grounded theory, interviews were transcribed and recursively analysed with the NVivo 12 Plus software by a research team. Results 73 categories were created, which were then grouped into 12 subthemes that were combined to form the following themes: Theme I: Psychological Distress; Theme II: Sources of Distress; Theme III: Protective Factors; and Theme IV: Interventions. Conclusions The themes of subjective experience identified in the study reveal infertile patients’ emotional disturbance and resources of distress, consistent with previous related studies. Despite limitations such as the relatively small number of participants and the exclusively self-report nature of qualitative study, the findings of the study imply the importance of emotional and physical support networks for infertile patients at Reproductive Medicine Centers, consistency of psychological awareness and adequate professional supports.

Depression among inpatients at Hospital of Transportation in 2021 and associated factors

Objectives: To describe the depression situation and determine the associated factors of depression among inpatients at Hospital of Transportation. Methods: A cross-sectional study was conducted in December, 2021 with 170 inpatients at Hospital of Transportation using whole sampling techniques. Study information was obtained via the prepared administered questionnaire. The data was entered and analyzed in SPSS version 22.0. Results: The proportion of depression among study subjects was 37.6%, of which 21.1% was the rate of borderline abnormal cases, and 16.5% was of abnormal cases. The depression was found significantly associated with gender, occupation and alcohol consumption. Female inpatients were 2.1 times more likely to experience depression than male (OR = 2.1; CI95%: 1.1 – 4.2; p&lt;0.05). Inpatients who are government officials/businessmen were only 0.44 times more likely to suffer from depression than inpatients who are farmer/self-employed/retired/housewife/no job (OR =0.44; CI95%: 0.2 – 0.9; p&lt;0.05. Inpatients who use alcohol were only 0.43 times more likely to have depression than inpatients who do not use alcohol (OR = 0.43; CI95%: 0.1-0.99, p &lt; 0.05). Conclusions: The study strongly suggested an in-depth investigation to explore the vital identification of the potential risk factors in mental health disorders among patients in the hospital such as acohol consumption, disease situation, duration of disease treatment etc. Also, screening and early detection of cases with signs of depression in order to develop appropriate and effective supportive measures, counseling, and treatment interventions

Facilitating healthcare practitioners to deliver self-management support in adult cancer survivors: A realist review.

Supporting cancer survivors in self-management can empower them to take an active role in managing the long-term physical and psychosocial consequences of cancer treatment. Healthcare practitioners are key to supporting patients to self-manage, however, they do not routinely engage in these discussions. This review aimed to establish what works for whom and in what circumstances in relation to facilitating healthcare practitioners to provide self-management support in people living with long-term consequences of cancer treatment. The review follows five steps: define the review's scope, develop initial programme theories, evidence search, selection and appraisal, and data extraction and synthesis. Database searches of Medline, EMBASE, CINAHL, Scopus, PsycINFO, ERIC and AMED databases, to September 2019 were supplemented with practitioner surveys. Insights into the mechanisms that operate in particular contexts to produce successful outcomes were illustrated using realist programme theories, developed using the Theoretical Domains Framework. Data selection was based on relevance and rigour. Data were extracted and synthesised iteratively to illuminate causal links between contexts, mechanisms and outcomes. Five programme theories were identified from 20 included articles and seven practitioner surveys: practitioners will engage patients in discussions about self-management if they have appropriate (1) knowledge and (2) consultations skills, (3) a clear understanding of their self-management support role and responsibilities, and if (4) organisational strategies and (5) health system configuration enable integration into routine care. The mechanisms facilitating practitioners to support self-management were practitioner confidence, mutual trust and shared responsibility between practitioners and cancer survivors, organisational prioritisation and ease of delivery of self-management support. The findings articulate the necessary components for embedding self-management support into routine cancer care. Operationalisation of these components into effective self-management support interventions will require reconfiguration of pathways and adaptation for local context, using strategies such as quality improvement and co-design to guide intervention development, implementation and evaluation.

Examining pathways between family or peer factors and smoking cessation in a nationally representative US sample of adults with mental health conditions who smoke: a structural equation analysis

BackgroundSupportive family or peer behaviors positively impact smoking cessation in people with mental health problems who smoke. However, the limited understanding of the pathways through which family or peer factors impact quitting limits the development of effective support interventions. This study examined pathways through which family or peer views on tobacco use, family or peer smoking status, and rules against smoking in the home influenced quitting in adults with mental health problems who smoke.MethodsWe used data from the Population Assessment of Tobacco and Health Study, a national longitudinal survey. Baseline data were collected in 2015, and follow-up data in 2016. We included adults’ current smokers who had experienced two or more mental health symptoms in the past year (unweighted n = 4201). Structural equation modeling was used to test the relationships between family and peer factors, mediating factors, and smoking cessation.ResultsWe found that having family or peers with negative views on tobacco use had a positive indirect effect on smoking cessation, mediated through the individual’s intention to quit (regression coefficient: 0.19) and the use of evidence-based approaches during their past year quit attempt (regression coefficient: 0.32). Having rules against smoking in the home (regression coefficient: 0.33) and having non-smoking family members or peers (regression coefficient: 0.11) had a positive indirect effect on smoking cessation, mediated through smoking behaviors (regression coefficient: 0.36). All paths were statistically significant (p < 0.01). The model explained 20% of the variability in smoking outcomes.ConclusionFamily or peer-based cessation interventions that systematically increase intentions to quit and monitor smoking behavior may be able to assess the efficacy of family and peer support on quitting in people with mental health problems who smoke.

Adult safeguarding managers' understandings of self-neglect and hoarding.

Self-neglect and hoarding are behaviours that are hard to define, measure and address. They are more prevalent among older people because of bio-psycho-social factors, which may be exacerbated by advancing age. This paper aims to further understandings of self-neglect and hoarding in England's Care Act 2014 context, drawing on a study involving qualitative interviews with local authority adult safeguarding managers who play an important role in determining interventions with individuals who self-neglect and/or hoard. Online interviews were conducted with adult safeguarding leads and managers from 31 English local authorities in 2021. Interview data were subject to thematic analysis. This paper explores the commonalities and differences in adult safeguarding managers' understandings of the causes and consequences of self-neglect and/or hoarding among older people, which are likely to have tangible impacts on service provision in their local authority, and influencing of wider changes to policies and procedures. Most participants understood these phenomena as caused by a range of bio-psycho-social factors, including chronic physical conditions, bereavement, isolation. A minority took a more clinical or psycho-medical perspective, focusing on mental ill-health, or referred to the social construction of norms of cleanliness and tidiness. Whatever their understanding, by the time such behaviours are brought to the attention of safeguarding professionals a crisis response may be all that is offered. The implications of the findings are that other agencies should be encouraged to provide more early help to older people at risk of self-neglect and/or of developing harmful hoarding behaviours, and that sustained engagement with those affected may help to understand some of the causes of these behaviours to enable effective support or practice interventions.

Effectiveness of interventions to support the transition home after acute stroke: a protocol for a systematic review.

Background Despite advances in the quality of acute stroke management, there are gaps in knowledge about effective support interventions to better manage the transition of care to home for patients with this complex condition. The goal of this systematic review is to explore the literature around support interventions available for patients as they navigate from acute hospital, rehabilitation or early supported discharge (ESD) services to independent living at home; and toestablish if, in comparison with usual care or other comparative active interventions, support services offered to patients as they transition from acute hospital, inpatient rehabilitation/ESD to home, can achieve better patient and / or process outcomes. Protocol In June 2021, we will carry out, on electronic peer-reviewed databases, a comprehensive literature search based on a pre-defined search strategy, developed and conducted in collaboration with an Information Specialist. In an effort to identify all published trials we will perform citation tracking of included studies, check reference lists of relevant articles, review grey literature, and extend our search to google scholar. We will include randomised controlled trials (including cluster and quasi-randomisation) recruiting stroke patients transitioning to home, to receive either usual care or any support intervention designed to improve outcomes after stroke. The primary clinical outcome will be functional status. Two review authors will scrutinise trials, categorise them on their eligibility, and extract data. We will analyse the results for all trials and perform meta-analyses where possible. We will assess risk of bias for the included trials and use GRADE to assess the quality of the body of evidence. Patient and public involvement (PPI)engaged in the development of the research questions, and will participate in co-design of a strategy for dissemination of findings. Conclusions: The findings from this review will be used to identify knowledge gaps to direct future research.

Post-traumatic stress disorder, depression and anxiety symptoms in COVID-19 outpatients with different levels of respiratory and ventilatory support in the acute phase undergoing three months follow-up.

The well-known COVID-19 pandemic totally transformed people's lives, paving the way to various psychopathological symptoms. In particular, patients may experience a short- and long-term decreasing in their wellbeing. In this vein, the aim of this paper was to assess the COVID-19 patients' psychopathological profile (post-traumatic stress disorder, distress, anxiety and depression symptoms), detecting possible differences linked to the ventilatory treatments. Outpatients who recovered from COVID-19 were asked to provide socio-demographic and clinical information, and to complete a brief psychological screening evaluation (Impact of Event Scale-Revised [IES-R], Depression Anxiety Stress Scale [DASS-21]). Overall, after informed consent, 163 Italian patients took part in this research. Of them, 31.9% did not undergo any ventilatory therapy, 27.6% undertook oxygen therapy, 28.2% underwent noninvasive mechanical ventilation, and 12.3% received invasive mechanical ventilation. Although no statistically significant differences were revealed among patients stratified by spontaneous breathing or ventilatory therapies, they reported statistically significant more depression (4.5+5.2 vs. 3.5+3.2; P=0.017) and anxiety (4.3+4.5 vs. 2.4+2.6; P<0.00001) symptoms than normative groups. Moreover, patients experiencing COVID-19 disease as a trauma, complained statistically significant higher levels of depression, anxiety and stress symptoms than who did not describe a clinically relevant traumatic experience (P<0.001). Thus, this study suggests to healthcare professionals to consider COVID-19 experience as a potential real trauma for patients, and underlines the necessity to define patients' psychopathological profile in order to propose tailored and effective preventive and supportive psychological interventions.

Effectiveness of interventions to support the transition home after acute stroke: a protocol for a systematic review

Background Despite advances in the quality of acute stroke management, there are gaps in knowledge about effective support interventions to better manage the transition of care to home for patients with this complex condition. The goal of this systematic review is to explore the literature around support interventions available for patients as they navigate from acute hospital, rehabilitation or early supported discharge (ESD) services to independent living at home; and to establish if, in comparison with usual care or other comparative active interventions, support services offered to patients as they transition from acute hospital, inpatient rehabilitation/ESD to home, can achieve better patient and / or process outcomes. Protocol In June 2021, we will carry out, on electronic peer-reviewed databases, a comprehensive literature search based on a pre-defined search strategy, developed and conducted in collaboration with an Information Specialist. In an effort to identify all published trials we will perform citation tracking of included studies, check reference lists of relevant articles, review grey literature, and extend our search to google scholar. We will include randomised controlled trials (including cluster and quasi-randomisation) recruiting stroke patients transitioning to home, to receive either usual care or any support intervention designed to improve outcomes after stroke. The primary clinical outcome will be functional status. Two review authors will scrutinise trials, categorise them on their eligibility, and extract data. We will analyse the results for all trials and perform meta-analyses where possible. We will assess risk of bias for the included trials and use GRADE to assess the quality of the body of evidence. Patient and public involvement (PPI) engaged in the development of the research questions, and will participate in co-design of a strategy for dissemination of findings. Conclusions: The findings from this review will be used to identify knowledge gaps to direct future research.

Online student support: a framework for embedding support interventions into the online learning cycle

Support is one of the crucial elements of online students’ success. Although many support strategies have been documented in the past, less is known at what stages of the learning cycle suggested interventions can be embedded into the online learning curriculum. This paper offers a systematic review of the 28 empirical studies on effective support strategies and interventions that are indexed by the SCOPUS database between 2010 and 2020. Following an Inclusive Student Services Process Model framework, identified strategies are allocated across different phases of student learning to indicate where and when they can be delivered to online students. The analysis suggests that the effectiveness of the support provision depends on the time when support is offered. Furthermore, it was found that two areas support delivery, namely support at transitions and measurement of support interventions, remain under-researched. Finally, the analysis showed two emerging trends in online students support: an increasing role of technology and social network sites to design support interventions and a shift to a more personalised yet holistic approach to student support.

Investigation and Analysis of the Psychological Status of Medical Staff during the COVID-19

Objectives: To investigate the psychological state of front-line medical staff during the prevention and control of COVID-19, in order to provide effective psychological support and social intervention, and to provide reference ideas. Methods The research method was a cross-sectional research method. The convenience sampling method was adopted to select 156 first-line medical staff during the prevention and control period of the COVID-19. The online survey scale developed by the "Questionnaire Star" was used to investigate the psychological state of the first-line medical staff. Results There were significant differences in the overall status of depression, anxiety, and stress among front-line medical staff in terms of gender, education level, professional title status, children’s status, and working years (P&lt;0.05); among the five dimensions of mental state, the fear and worry dimension scored the highest. The overall confidence dimension score was the lowest (P&lt;0.05). According to Pearson correlation analysis, the overall confidence of front-line medical staff is related to the dimensions of fear and worry, hospital support, and psychological support (P&lt;0.05); while fear and worry are mainly related to hospital support and psychological support (P&lt;0.05). Front-line medical staff all have different degrees of depression and anxiety. The incidence of depression is 71.15%, and the incidence of depression is 30.77%. The incidence of anxiety is 74.36%, and the incidence of anxiety is 58.97%. Conclusion During the prevention and control of COVID-19, the psychological conditions of front-line medical staff are worrying. Therefore, it is advisable to formulate corresponding management and intervention measures to help medical staff survive the psychological crisis and ensure the smooth progress of the prevention and control of the new crown pneumonia epidemic.

Effectiveness of interventions to support the transition home after acute stroke: a protocol for a systematic review.

Background Despite advances in the quality of acute stroke management, there are gaps in knowledge about effective support interventions to better manage the transition of care to home for patients with this complex condition. The goal of this systematic review is to explore the literature around support interventions available for patients as they navigate from acute hospital, rehabilitation or early supported discharge (ESD) services to independent living at home; and toestablish if, in comparison with usual care or other comparative active interventions, support services offered to patients as they transition from acute hospital, inpatient rehabilitation/ESD to home, can achieve better patient and / or process outcomes. Protocol In September 2021, we will carry out, on electronic peer-reviewed databases, a comprehensive literature search based on a pre-defined search strategy, developed and conducted in collaboration with an Information Specialist. In an effort to identify all published trials we will perform citation tracking of included studies, check reference lists of relevant articles, review grey literature, and extend our search to google scholar. We will include randomised controlled trials (including cluster and quasi-randomisation) recruiting stroke patients transitioning to home, to receive either usual care or any support intervention designed to improve outcomes after stroke. The primary clinical outcome will be functional status. Two review authors will scrutinise trials, categorise them on their eligibility, and extract data. We will analyse the results for all trials and perform meta-analyses where possible. We will assess risk of bias for the included trials and use GRADE to assess the quality of the body of evidence. Patient and public involvement (PPI)engaged in the development of the research questions, and will participate in co-design of a strategy for dissemination of findings. Conclusions: The findings from this review will be used to identify knowledge gaps to direct future research.

Co-developing peer interventions in health-related contexts: A case study from exercise referral

Objective: Peer support interventions can be successful in enhancing physical activity (PA) in a variety of health-related contexts. However, the evidence base remains equivocal, and ways to integrate structured peer support within the context of exercise referral schemes (ERSs) remain unexplored. In this regard, few studies consider the prospective acceptability of peer support interventions. Prior qualitative exploration can elicit insight into factors likely to influence peer intervention success, thus maximising the likelihood of developing and implementing effective peer support interventions. This study assessed the prospective acceptability of a peer support intervention for exercise referral. Design/Setting: Individual semi-structured interviews were conducted with 14 ERS clients ( n = 10) and providers ( n = 4) across two ERS sites in the North West of England, UK. Method: Interviews covered preferred demographic and personal characteristics of ERS peers and prospective peer roles. Interviews were analysed using thematic analysis. Results: A desirable ERS peer was perceived as someone who was positive and empathetic, with good interpersonal skills. ERS peers were considered to present a promising opportunity to enhance the accessibility of emotional, motivational and informational support among ERS clients while alleviating burden on ERS providers. Conclusion: Study findings have relevance to the integration of peer support in comparable ERS contexts, highlighting the value of developmental research to refine peer recruitment criteria and to facilitate ownership and support among providers across a variety of health-related contexts.

Risk of adverse perinatal outcomes in infants born to mothers with mental health conditions.

Maternal mental health conditions have been shown to affect perinatal outcomes negatively. However, knowledge on the impact of different types and severities of maternal mental health conditions is needed. The objective of this study was to determine the association between maternal mental health status and perinatal health outcomes in the infant. This register-based cohort study included all live-born infants in Denmark born between 2000 and 2016. Exposed infants were grouped based on whether the mothers received mental health care in primary care settings only (minor conditions) or required specialized psychiatric intervention (moderate-severe conditions) within 12months before childbirth. Modified Poisson regression analyses were applied to produce adjusted risk ratios (aRRs) for each perinatal outcome of interest. The primary outcomes were neonatal mortality, 5-minute Apgar scores <7 and <4 and newborn hospital admission during the neonatal period. Secondary outcomes included several neonatal morbidities such as respiratory distress syndrome and abstinence syndrome. A total of 952071 infants were included in the analysis; 4.0% had mothers with minor mental health conditions and 2.9% had mothers with moderate-severe conditions. The risk of neonatal death in exposed infants was aRR 1.08 (95% CI 0.93-1.27) for minor mental health conditions and aRR 0.93 (95% CI 0.78-1.11) for moderate-severe conditions. Both exposure groups had increased risks of 5-minute Apgar scores <7 (minor: aRR 1.28, 95% CI 1.16-1.41; moderate-severe: aRR 1.49, 95% CI 1.34-1.66); 5-minute Apgar scores <4 (minor: aRR 1.10, 95% CI 0.93-1.30; moderate-severe: aRR 1.18, 95% CI 0.98-1.43), and hospital admission during the neonatal period (minor: aRR 1.20, 95% CI 1.17-1.23; moderate-severe: aRR 1.22, 95% CI 1.19-1.26) along with several neonatal morbidities. An explicit high risk was seen for abstinence syndrome (minor: aRR 10.30, 95% CI 8.40-12.63; moderate-severe: aRR 12.13, 95% CI 10.17-15.67). Infants of mothers with moderate-severe and minor mental health conditions were at increased risks of multiple adverse perinatal outcomes. Effective supportive interventions to improve outcomes in both groups are needed.

Chirurgische Behandlung und Strahlentherapie von Hirnmetastasen

The aim of this work is to outline the principles of interdisciplinary treatment of brain metastases. Interdisciplinary treatment is determined by the clinical situation, anatomical conditions and tumor entity and has the goal of reducing toxicity. Magnetic resonance imaging, computed tomography (CT) and positron emission tomography-CT are used to diagnose brain metastases. Neurosurgery is used for accessible, symptomatic metastases. For localized metastases, including multiple metastases, that are surgically inaccessible, radiosurgery is used. If possible, partial brain irradiation is preferred to whole-brain irradiation. Protection of the hippocampus during whole-brain radiotherapy reduces therapy toxicity. In emergency situations, steroids provide effective support and aneurosurgical intervention may be life-saving. The options for systemic drug therapy are increasing.