Encounter Groups Research Articles

Impact of Pharmacist Transitions of Care on 30-Day Readmissions Within a Primary Care-Based Accountable Care Organization.

Previous studies in the ambulatory care setting have shown inconsistent results in regard to, or with respect to pharmacist telephonic transitions of care (TOC) encounters and reduction in 30-day readmission rates. No studies that have been completed within an accountable care organization (ACO) evaluating the impact of telephonic TOC encounters performed by a pharmacist have been identified. The objective of this study was to analyze the impact of clinical pharmacy telephonic TOC encounters on readmission rates within a primary care-based ACO. In this retrospective chart review, data for those who had a pharmacist telephonic TOC encounter and those who had an attempt were collected. The primary outcome of this study was all-cause 30-day readmission rate. Secondary outcomes included 30-day readmission rate for targeted disease states, time to readmission, and readmission reason the same as previous discharge reason. For subjects who received a telephonic TOC encounter, pharmacist intervention type and provider acceptance of intervention(s) were described. For the final analysis, 154 encounters were included, 83 encounters in the telephonic TOC encounter group, and 71 did not receive a telephonic TOC encounter. The 30-day readmission rates were similar among those who received a telephonic TOC encounter and those who did not: the difference was not significant (15.7% vs. 28.2%; P = 0.059). There was also no statistical difference in the secondary outcomes. Even so, the results of this study suggest that performing a pharmacist telephonic TOC encounter in a primary care-based ACO setting has the potential to reduce 30-day readmission rates and further research appears to be warranted in this important area of practice.

Developing relational resilience in the midst of conflict

AbstractThis article presents an approach to encounter group interventions in the midst of protracted, entrenched conflict, that has relational resilience as its focus. Through a constructionist grounded theory analysis, interviews with 31 alumni of the Artsbridge program from 2008 through 2019, former staff, and parents of alumni, were analyzed in order to explore how they understand their experience of the Artsbridge program and the impact it has had on their lives. This analysis of interviews led to the primary theme of relational resilience. The Artsbridge model of relational resilience will be introduced. While many programs exist that work with youth in conflict, the Artsbridge program is unique in its use of Transformative Reflecting Dialogue, artistic modalities, and collaborative art. Through decades of violence and separation, Israeli and Palestinian narratives have become negatively interdependent and mutually exclusive. Artsbridge methodology encourages the development of more inclusive narratives and an appreciation of and tolerance for complexity. The research discussed in this article suggests that encouraging the development of relational resilience may lead to more constructive and sustainable outcomes when working within communities continuing to live in the midst of intractable conflict.

Care-full data, care-less systems: making sense of self-care technologies for mental health with humanistic practitioners in the United Kingdom

IntroductionThe days of dusty couches in therapists' offices behind closed doors are long gone. Now, personalized mood tracking, therapy appointments and breathing exercises are just mere clicks (or taps) away: Technologies for self-care (SCTs) that focus on mental health are both a flourishing industry and an academic field of interest. As societal, and cultural artifacts, SCTs for mental health are imbued with values, worldviews, and assumptions about these concepts by their designers and developers. Here, current SCTs tend to lean toward a more medical(ised) approach due to being shaped by dominant views of mental health as an individualized issue. However, this approach is only one of many potential pedagogies and approaches. As an alternative, we explore what SCTs for mental health could be like, from a humanistic, person-centered standpoint: We conceptualize mental health in holistic terms, as an experiential quality of everyday life.MethodsTo this end, we report on two engagements with humanistic practitioners and the person-centered approach as a guiding principle: First, we ran a workshop informed by the Rogerian “encounter group”. This approach is focused on providing the space to meaningfully meet and relate to people. Inspired by this concept, we brought together humanistic practitioners to openly explore what technology for (self-)care means for them. Second, we build on the insights from the aforementioned study by organizing an asynchronous, online whiteboard for humanistic practitioners—counselors, students-in-training, therapists, and researchers—to explore their utopian, realistic and dystopian visions of SCTs.ResultsThrough thematic analysis and affinity-clustering these engagements, we construct an understanding that technology within a person-centered, humanistic context is a constrained, ambiguous undertaking, yet also one full of potential.DiscussionWe conclude the paper by sketching out three design opportunities for how the person-centered approach, and humanistic psychology in general could be integrated into caring technologies.

False killer whales (Pseudorca crassidens Cetacea: Delphinidae) along the Pacific coast of Central America and Mexico: Long-term movements, association patterns and assessment of fishery interactions

Introduction: Worldwide, false killer whales (Pseudorca crassidens) are infrequently encountered, yet long-term studies have shown strong site fidelity as well as long-term associations among individuals in several locations. Detailed studies of this species have primarily been conducted around tropical oceanic islands or in the subtropical southern hemisphere.
 Objectives: We assess movements and association patterns among false killer whales along the Pacific coasts of the USA, Mexico, Guatemala, Nicaragua, Costa Rica including Isla del Coco, and Panama, representing one of the longest-running (albeit non-continuous) studies of this species. We also examine photos for evidence of interactions with fisheries, a known source of mortality to false killer whales.
 Methods: From Central America, we selected 212 individuals (50 encounter groups) out of 244 individuals (56 encounters) for inclusion in analyses based on photo quality and distinctiveness. Photos were collected on dedicated surveys from 1991-1994 and dedicated and opportunistic surveys from 1998-2022. Other than the effort off the oceanic Isla del Coco (1993-1994), surveys were undertaken in continental shelf waters. Additionally, we selected by photo quality and distinctiveness 124 (33 encounter groups) out of 189 individuals from southern California and Mexico for inclusion in these analyses. Association patterns were analyzed in SOCPROG and movements were analyzed in R.
 Results: Of the 328 total individuals, 158 (48.2 %) were encountered more than once, and 114 (34.8 %) were re-sighted after a year or more. The longest individual sighting history spanned 26.2 years with six re-sightings over that period between southern Costa Rica and Panama. Association and movement analyses revealed that individuals identified off southern Costa Rica and Panama linked into a single social network, with extensive movements between the two countries. Three individuals encountered off northern Costa Rica were re-sighted off northern Nicaragua, and individuals encountered off Nicaragua were encountered off Guatemala and central mainland Mexico. Nine matches were found among false killer whales between central mainland Mexico and Central America. There were no matches between the mainland coastal waters and the 33 individuals encountered around Isla del Coco. Dorsal fin disfigurements consistent with interactions with line fisheries ranged from 0 to 21 % for individuals within social clusters identified by community division.
 Conclusions: The infrequency of sightings combined with a high re-sighting rate of individuals and groups from the same area, suggests multiple small populations with large home ranges that include coastal waters. Small populations are sensitive to environmental changes, and as the human population grows, so do the demands on fisheries and ecotourism, which could directly impact the different populations. Additional effort in offshore areas is needed to determine the population status of false killer whales in pelagic waters, how often false killer whales using coastal waters move into pelagic waters, and the relationship between whales in the two habitats.

Predicting Cuvier’s (Ziphius cavirostris) and Mesoplodon beaked whale population density from habitat characteristics in the eastern tropical Pacific Ocean

Temporally dynamic environmental variables and fixed geographic variables were used to construct generalised additive models to predict Cuvier’s (Ziphius cavirostris) and Mesoplodon beaked whale encounter rates (number of groups per unit survey effort) and group sizes in the eastern tropical Pacific Ocean. The beaked whale sightings and environmental data were collected simultaneously during the Southwest Fisheries Science Center’s cetacean line-transect surveys conducted during the summers and autumns of 1986-90 and 1993. Predictions from the encounter rate and group size models were combined with previously published estimates of line-transect sighting parameters to describe patterns in beaked whale population density (number of individuals per unit area) throughout the study area. Results provide evidence that the previously proposed definition of beaked whale habitat may be too narrow and that beaked whales may be found from the continental slope to the abyssal plain, in waters ranging from well-mixed to highly stratified. Areas with the highest predicted population densities were the Gulf of California, the equatorial cold tongue and coastal waters, including the west coast of the Baja Peninsula and the Costa Rica Dome. Offshore waters in the northern and southern subtropical gyres had the lowest predicted Mesoplodon densities, but density predictions were high for Cuvier’s beaked whales in the waters southeast of the Hawaiian Islands. For both encounter rate and group size models, there was no geographic pattern evident in the residuals as measured by the ratio of pooled predicted to pooled observed values within geographic strata.

Association of Recent Violence Encounters With Suicidal Ideation Among Adolescents With Depression

Suicide prevention is an important component of depression management. Knowledge about depressed adolescents with increased risk for suicide can inform suicide prevention efforts. To describe the risk of documented suicidal ideation within a year following a diagnosis of depression and to examine how the risk of documented suicidal ideation differed by recent violence encounter status among adolescents with new depression diagnoses. Retrospective cohort study in clinical settings including outpatient facilities, emergency departments, and hospitals. Using IBM's Explorys database containing electronic health records from 26 US health care networks, this study observed a cohort of adolescents with new depression diagnoses from 2017 to 2018 for up to 1 year. Data were analyzed from July 2020 to July 2021. Recent violence encounter was defined by a diagnosis of child maltreatment (physical, sexual, or psychological abuse or neglect) or physical assault within 1 year before depression diagnosis. The main outcome was diagnosis of suicidal ideation within 1 year following depression diagnosis. Multivariable adjusted risk ratios of suicidal ideation were calculated for overall recent violence encounters and for individual forms of violence. Among a total of 24 047 adolescents with depression, 16 106 (67.0%) were female and 13 437 (55.9%) were White. A total of 378 had experienceda violence (hereafter, encounter group) and 23 669 had not (hereafter, nonencounter group). Following the diagnosis of depression, 104 adolescents with any past-year violence encounter (27.5%) documented suicidal ideation within 1 year. In contrast, 3185 adolescents in the nonencounter group (13.5%) experienced thoughts of suicide following the diagnosis of depression. In multivariable analyses, those with any violence encounter had 1.7 times (95% CI 1.4-2.0) higher risk of documented suicidal ideation compared with those in the nonencounter group (P < .001). Among different forms of violence, sexual abuse (risk ratio, 2.1; 95% CI, 1.6-2.8) and physical assault (risk ratio, 1.7; 95% CI, 1.3-2.2) were associated with significantly increased risk of suicidal ideation. Among adolescents with depression, persons who experienced past-year violence encounters showed a higher rate of suicidal ideation than those who had not. These findings highlight the importance of identifying and accounting for past violence encounters when treating adolescents with depression to reduce risk of suicide. Public health approaches to prevent violence may help to avert morbidity associated with depression and suicidal ideation.

Conducting psychological support groups online during the war in Ukraine

ABSTRACT Since the full-scale Russian invasion on 24 February 2022, Ukrainians have experienced grief and uncertainty about the future. Many people feel psychologically exhausted and seek psychological help. However Ukrainian psychologists are also experiencing the trauma of the war. May they work with clients? The article reviews and reflects on my experience of conducting online person-centered support groups in wartime. Thirty-nine groups have now been held, starting two weeks after the full-scale invasion. In this article, I discuss the structure and course of these groups, and describe several difficult cases in detail. Based on my experience, I conclude that the most effective support is provided by the sincere interpersonal relationships between group members, which facilitators maintain. Shared traumatic reality of living in war conditions gives facilitators a deeper understanding of what participants feel. This is accepted by participants and increases the therapeutic effect of the group. I argue that, in war conditions, Carl Rogers' classical encounter group structure can benefit from more support.It is also helpful to offer psychological techniques, such as breathing, bodily practices, and focusing, as practical ways of coping with stressful events.

S2701 Economic Costs and Trends in Inflammatory Bowel Disease-Related Hospitalizations and Surgery in the United States

Introduction: Limited data are available on hospitalization, surgery, and cost trends over time in patients with Crohn’s disease (CD) and ulcerative colitis (UC) in the United States. This analysis describes real-world trends in hospitalizations, surgery, and costs among patients with CD and UC. Case Description/Methods: Data from patients with CD and UC in the IBM MarketScan Databases (2007–2019) were evaluated. Eligible patients for each year had to have ≥1 inpatient claim or 2 outpatient claims for either CD or UC within that year and medical benefits for the entire year. For hospitalizations, an encounter group algorithm for all inpatient claims was utilized to determine the principal diagnosis and duration of each hospital episode. The surgery encounter was defined as either a hospitalization with a CD/UC-related surgery procedure code (principal procedure type) with a CD or UC diagnosis code in the first 2 diagnosis positions of the hospital encounter or an outpatient visit. Proportions of CD and UC patients with ≥1 hospitalization or surgery, the average cost per surgery or hospitalization episode, and mean length of stay (LOS) in days were reported for each year. Costs were adjusted to 2020 US dollars. Over time, prevalence of hospitalizations decreased from 11.8% and 7.7% in 2007 to 7.1% and 4.8% in 2019 in patients with CD and UC, respectively ( Figurea). The annual proportion of patients with a CD/UC-related surgery decreased from 2.3% and 1.2% in 2007 to 1.6% and 0.9% in 2019 in patients with CD and UC, respectively. Conversely, mean medical costs per CD/UC hospitalization episode increased from $22,346/$23,002 in 2007 to $28,586/$28,069 in 2019 (Figureb). Additionally, mean medical costs per CD/UC surgery increased from $41,300 and $47,286 in 2007 to $55,870 and $61,698 in 2019. In patients with CD and UC, the average LOS per hospitalization reduced from 5.8 and 6.6 days in 2007 to 4.6 and 5.6 days in 2019. Discussion: Despite a decrease in CD- and UC-related hospitalizations and surgery from 2007 to 2019, as well as reduced mean LOS, the average cost per hospitalization and surgery increased. Additional research is warranted to better understand these trends so that medical costs can be further reduced and management of patients in the outpatient setting can be improved.Figure 1.: Prevalence of (a) Hospitalization and Surgery and (b) Mean Costs by Year *Includes all associated costs except medication costs. CD, Crohn’s disease; K, thousand; UC, ulcerative colitis.

Effects of an intergenerational program on adolescent self-concept clarity: A pilot study.

This pilot study examined the effects of a newly developed intergenerational program on self-concept clarity (SCC) of adolescent participants. In 12 encounter groups, 58 secondary school students and 50 nursing home residents shared their life stories and discussed existential questions about life (e.g., important values in life, how to deal with failure and regret). The life story encounter program (LSEP) is based on the dyadic Life Story Interview and was expanded into a group format consisting of ten 90-min sessions. SCC was measured with the SCC Scale before, shortly after, and three months after the end of the LSEP. Analyses suggest that adolescent LSEP participants' SCC improved compared to a control group (no LSEP participation). Findings also indicate that increases in SCC were associated with LSEP participants' extraversion and agreeableness. The LSEP is a promising program for fostering SCC in adolescence. Implications for the application of the LSEP are discussed.

Procedural Justice Concerns and Technologically Mediated Interactions with Legal Authorities

The use of surveillance technologies by legal authorities has intensified in recent years. As new data collection technologies expand into law enforcement spaces previously dominated by interpersonal interactions, questions emerge about whether the public will evaluate interpersonal and technologically mediated interactions with legal authorities in the same ways. In an analysis guided by procedural justice theory, we examine whether and how legal authorities’ use of decision-making technology affects public evaluations of an authority-subordinate interaction and its outcome in the context of airport border crossings. Using an experimental vignette design (N = 278), we varied whether an encounter between a traveller and border security “agent” that produced a secondary search was described as interpersonal (conducted by a human agent) or technologically mediated (conducted by a machine agent). We also varied the traveller’s group membership relative to the nation-state, describing the traveller as either born in the country in question and a member of the nation’s most common racial group (in-group) or not born in the country and a racial minority (out-group). Both encounter type and group membership independently affected perceptions of the interaction (procedural justice judgements) and its outcome (distributive justice judgments). Technologically mediated encounters improved perceptions of procedural and distributive justice. Further, procedural justice judgments mediated the relationship between encounter type and distributive justice, demonstrating how perceptions of interactions influence perceptions of the outcomes of those interactions. Out-group members were evaluated as having worse experiences across all measures. The findings underscore the importance of extending tests of procedural justice theory beyond interpersonal interactions to technologically mediated interactions.

Telemedicine in Malignant and Nonmalignant Hematology: Systematic Review of Pediatric and Adult Studies.

BackgroundTelemedicine, including video-, web-, and telephone-based interventions, is used in adult and pediatric populations to deliver health care and communicate with patients. In the realm of hematology, telemedicine has recently been used to safely and efficiently monitor treatment side-effects, perform consultations, and broaden the reach of subspecialty care.ObjectiveWe aimed to synthesize and analyze information regarding the feasibility, acceptability, and potential benefits of telemedicine interventions in malignant and nonmalignant hematology, as well as assess the recognized limitations of these interventions.MethodsStudies were identified through a comprehensive Medical Subject Headings (MeSH) search on the PubMed MEDLINE, Controlled Register of Clinical Trials (Cochrane CENTRAL from Wiley), Embase, and CINAHL (EBSCO) databases on February 7, 2018. A second search, utilizing the same search strategy, was performed on October 1, 2020. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the reporting of included evidence. Included studies were original articles researching the feasibility, acceptability, and clinical outcomes of telemedicine or telehealth interventions in pediatric or adult populations with malignant or nonmalignant hematological conditions. Data items in the extraction form included first author name, publication year, country, malignant or nonmalignant hematological condition or disease focus of the study, participant age, participant age subgroup (pediatric or adult), study design and setting, telemedicine intervention type and description, study purpose, and main study outcomes.ResultsA total of 32 articles met the preset criteria and were included in this study. Most (25/32) studies were conducted in adults, and the remaining (7/32) were conducted in the pediatric population. Of the 32 studies, 12 studied malignant hematological conditions, 18 studied nonmalignant conditions, and two studied both malignant and nonmalignant conditions. Study types included pilot study (11/32), retrospective study (9/32), randomized controlled trial (6/32), cross-sectional study (2/32), case study (1/32), pre-post study (1/32), noncomparative prospective study (1/32), and prospective cohort study (1/32). The three main types of telemedicine interventions utilized across all studies were video-based (9/32), telephone-based (9/32), and web-based interventions (14/32). Study results showed comparable outcomes between telemedicine and traditional patient encounter groups across both pediatric and adult populations for malignant and nonmalignant hematological conditions.ConclusionsEvidence from this review suggests that telemedicine use in nonmalignant and malignant hematology provides similar or improved health care compared to face-to-face encounters in both pediatric and adult populations. Telemedicine interventions utilized in the included studies were well received in both pediatric and adult settings. However, more research is needed to determine the efficacy of implementing more widespread use of telemedicine for hematological conditions.

The Study on the Encounter Group Experience of Graduate Students Majoring in Social Welfare: Focusing on Difficulties and Coping

The Study on the Encounter Group Experience of Graduate Students Majoring in Social Welfare: Focusing on Difficulties and Coping

A project report on the switch from in-class to online tuition in the preparatory course for the knowledge examination for foreign physicians - guidelines for the organization of the online summer semester 2020 at the faculty of medicine of the Westfälische Wilhelms-Universität of Münster.

Introduction: In Germany, foreign physicians are a fixed component of the medical profession. According to the German Medical Licensure Act, physicians having completed their qualification in another country are required to pass a knowledge examination which falls within the competence of examination offices or the regional governments.Project outline: The preparatory course consists of 10 modules. On Fridays, individual cases are discussed in small groups and specific examination techniques are trained. On Saturdays, illnesses are simulated by simulated patients. After each encounter, faculty experts, psychologists and peer group members provide the participants with 360° feedback.Due to the COVID-19 pandemic, the course which had been established 2 years beforehand has now been switched to an online class within one week. Friday units were visualized in power-point presentations and tutorial videos were discussed. On Saturdays, the cases were simulated by simulated patients and transmitted via a telemedicine platform.Results: The course could be conducted without interruptions (75 hours of in-class tuition and 75 hours of online tuition). In the oral evaluation the participants criticized telemedicine as a medium for imparting of practical skills. 7/22 (32%) of the participants underwent the knowledge examination and 6/7 (86%) of them passed it (versus 18/19 of the participants of in-class tuition (95%)).Discussion: There was a clear preference for in-class tuition. It was noted that the telemedical setting entailed some restrictions. However, the switch to online classes did not affect the pass rate.Conclusion: The switch from in-class to online units was feasible. The gained insights were taken into account when conceiving the online semester at our faculty and especially the tuition with the support of simulated patients.

My perception of Japanese-style basic encounter groups ~ learning from facilitating encounter groups~

ABSTRACT Since the first Japanese encounter group was held in 1970, numerous encounter groups with many participants have been held. In addition, countless studies have been conducted on encounter groups. In this paper, Japanese-style encounter groups are described. An encounter group facilitator needs to be aware of both the physical and psychological elements that comprise a group. Unlike physical structures which are fixed, psychological elements evolve as the group progresses. There are psychological elements of which both the facilitator and participants may not even be aware. The role of the group facilitator is to strive to understand and appreciate those structures.

Experiencia intensiva de grupos de encuentro: un espacio de crecimiento personal que fortalece el tejido social

Experiencia intensiva de grupos de encuentro: un espacio de crecimiento personal que fortalece el tejido social

Introversion and Social Engagement: Scale Validation, Their Interaction, and Positive Association With Self-Esteem.

Learning through social interaction has been documented widely; however, how introverted people are socially engaged in learning is largely unknown. The aim of this study was, first, to examine the reliability and validity of the social engagement scale among students at Finnish comprehensive schools. Then, we aimed to examine the interaction effect of introversion and social engagement on self-esteem, schoolwork engagement, and school burnout. Based on a sample of 862 ninth grade students in Finland, we found that a two-factor model best fitted the social engagement scale (i.e., social engagement and social disengagement). Further, we found that introverts with high social engagement have higher self-esteem than introverts with low social engagement. Our results implied that introverts should be given extra support when they encounter group work in school.

Specialist palliative cancer care in acute hospitals and place of death: a population study

ObjectiveThis study compares the characteristics and place of death of patients with cancer receiving specialist palliative care in acute hospitals with those who do not.MethodsAll patients with incident invasive cancer...

Contextual and Spatial Associations Between Objects Interactively Modulate Visual Processing.

Much of what we know about object recognition arises from the study of isolated objects. In the real world, however, we commonly encounter groups of contextually associated objects (e.g., teacup and saucer), often in stereotypical spatial configurations (e.g., teacup above saucer). Here we used electroencephalography to test whether identity-based associations between objects (e.g., teacup–saucer vs. teacup–stapler) are encoded jointly with their typical relative positioning (e.g., teacup above saucer vs. below saucer). Observers viewed a 2.5-Hz image stream of contextually associated object pairs intermixed with nonassociated pairs as every fourth image. The differential response to nonassociated pairs (measurable at 0.625 Hz in 28/37 participants) served as an index of contextual integration, reflecting the association of object identities in each pair. Over right occipitotemporal sites, this signal was larger for typically positioned object streams, indicating that spatial configuration facilitated the extraction of the objects’ contextual association. This high-level influence of spatial configuration on object identity integration arose ~ 320 ms post-stimulus onset, with lower-level perceptual grouping (shared with inverted displays) present at ~ 130 ms. These results demonstrate that contextual and spatial associations between objects interactively influence object processing. We interpret these findings as reflecting the high-level perceptual grouping of objects that frequently co-occur in highly stereotyped relative positions.

看護学生のための研修型エンカウンター・グループの試み ー学生の状態により適応的なグループ・プログラムを提供するためにー

看護学生のための研修型エンカウンター・グループの試み ー学生の状態により適応的なグループ・プログラムを提供するためにー

Psychotherapists’ experiences of co-facilitating large encounter PCEP groups: an interpretative phenomenological analysis of six interviews

ABSTRACT Despite the available literature on facilitative conditions noted in numerous writings on encounter groups, cofacilitators’ experiences are substantially under-researched. This present study aimed to explore psychotherapists’ experiences co- 10 facilitating encounter groups with two or more co-facilitators. A subsidiary question was: How do therapists who have facilitated large encounter groups make sense of their experience of the encounter process? A large group in this study group is described as 30 to 300 individuals. Semi-structured interviews were conducted with six psychotherapists who had experience of facilitating large encounter groups. Their accounts were analyzed using interpretative phenomenological analysis (IPA). Three main superordinate themes 20 emerged from analyzing the data. (1) Facilitator’s role identity; (2) Importance of managing dynamics between the encounter cofacilitation team members; (3) Working within the encounter group space and process. Future research should investigate the experience of encounter 25 group participants and compare it to that of co-facilitators.