Intensive Program Research Articles

P98: Effects of A Brief Intensive Home-based Discharge Support Program on Older Patients’ Recovery and Family Carers’ Psychological Wellbeing

Background:Seamless transition to the community and a shorter Length of Stay (LOS) at hospitals are considered priorities in many health care systems. In Hong Kong, Hospital Admission Risk Reduction Program for the Elderly (HARRPE)1 - a risk prediction tool has been used by hospitals to facilitate discharge of older patients and minimize the need for hospital or emergency re-admission. Older patients score > 0.2 and present greater social-care needs than medical issues will be followed up by a community NGO, in service partnership with the hospital, through an 8-week, home-based, Intensive Discharge Support Program (IDSP)2. Apart from evaluating the success in admission risk reduction, this study was also to assess the program’s effects on patients’ health status and well-being for both discharged patients and family carers, and to understand the underlying supportive mechanism of IDSP.Methods:A mixed-method approached was used, as establishing control groups was not feasible due to both ethical and practical concerns. Structured interviews integrating standardized instruments were employed to evaluate changes in outcome variables pre-and-post IDSP intervention for both the discharged patients and their carers. To complement the quantitative data, two focus groups involving 9 carers were organized to explore the essential and critical service elements of the discharge program, including their effects on promoting patients’ wellbeing or alleviating caregiver burden.Results:48 patient-carer dyads were recruited from the discharge program, with 35 pairs (73%) successfully completed both pre-and-post IDSP interviews. 68.6% of the discharged elders had no hospital readmission during the 8-week in IDSP. While there were statistically significant improvement in ADL, IADL (p<0.001), the environment domain of WHOQOL(p<0.05), and 3 other domains measured by the Health Status Questionnaire (HSQ-12), namely social functioning, role limitation due to mental health and level of fatigue (p<0.05) among the patient group, there was only one outcome variable – the environment domain of WHOQOL showed significant improvement (p≤0.01) among carers. Focus group discussions also highlighted the importance of using a family-based approach in providing discharge support.Conclusion:This Discharge support program which emphasizes hospital-community collaboration seems beneficial to older patients’ timely recovery and smooth transition back to community.

Changes in cognitive impairment after multidimentional rehabilitation in Neuro COVID severe respiratory failure patients

AbstractBackgroundA Post Intensive Care Syndrome Unit (PICSU) was developed during COVID 19 pandemic. The aim of this study was to evaluate Cognitive Impairment (CI) evolution after PICSU treatment in Neuro COVID patients.MethodsProspective observational study. Population: Neuro COVID patients treated in a PICSU. CI was achieved by means of the Spanish version of the MoCA at ICU discharge and one month after, muscle function was evaluated by means of Medical Research Council test for Intensive Care Acquired Weakness (ICUAW). Statistical analysis was performed by ANOVA and Chi squared test. Age, sex, comorbidities, mechanical ventilation days and length of stay at the PICSU wre also measured.Patients were submitted to an intensive rehabilitation program that included physical, swallowing, speech therapy, occupational therapy ones, as well as nutritional and psychological support.Results27 patients were admitted to PICSU, 5 were female, average age was 57 yo. 30% of them presented normal cognition. Regarding CI patients mean initial MoCA value was 18 and improved to 23 (p < 0.05), MRC values were 42 y 52 respectively (p < 0.05). According MoCA values using a cutoff point of 26 to determinate normal cognition, 16 to 25 for MCI and 15 for Mild Dementia, 26% had MCI and 74% at ICU discharge that evolved to normal (26%), MCI (58%) and MD (16%) (p < 0.05). There was a close relationship between MoCA and MCR enhancement, CI and ICUAW improved simultaneously (p < 0.05).ConclusionPICSU rehabilitation program was useful for cognition and motor function improvement. The close relationship between cognition and motor function could be explained by the myokines and neurotrophic factors release toward muscle activity. This could be an opportunity for future research.

Enabling Population Biology Studies of Stemphylium vesicarium from Onion with Microsatellites.

Stemphylium leaf blight (SLB), caused by the fungus Stemphylium vesicarium, is dominant within the foliar disease complex affecting onion production in New York (NY). The disease causes premature defoliation and significant reductions in bulb weight and quality. Foliar diseases of onion are usually managed by an intensive fungicide program, but SLB management is complicated by resistance to multiple single-site modes of action. The design of integrated disease management strategies is limited by incomplete knowledge surrounding the dominant sources of S. vesicarium inoculum. To facilitate genomic-based studies of S. vesicarium populations, nine microsatellite markers were developed. The markers were multiplexed into two PCR assays containing four and five fluorescently labeled microsatellite markers. Initial testing of the S. vesicarium isolates found the markers were highly polymorphic and reproducible with an average of 8.2 alleles per locus. The markers were used to characterize 54 S. vesicarium isolates from major NY onion production regions in 2016 (n = 27) and 2018 (n = 27). Fifty-two multilocus genotypes (MLGs) were identified between these populations. Genotypic and allelic diversities were high in both the 2016 and 2018 populations. A greater degree of genetic variation was observed within populations than between years. No distinct pattern of MLGs according to population was identified and some MLGs were closely related between 2016 and 2018. The lack of evidence for linkage among loci also was strongly suggestive of clonal populations with only minor differences between the two populations. These microsatellite markers will be a foundational resource for the testing of hypotheses surrounding the population biology of S. vesicarium and therefore informing disease management.

Preliminary Investigation of the Influence of Treatment Regimen on Outcomes in Behavioral Parent Training

Caregiver engagement and implementation of behavioral strategies are essential to effective interventions targeting childhood behavior problems. The aim of this preliminary investigation was to better understand caregiver decision-making when selecting different treatment regimens in an open trial format. Treatment packages included: (1) an intensive treatment program (ITP), involving a compressed 20-hour intervention occurring 2 hours per day for 10 days; and (2) a standard dosage treatment as usual (TAU) behavioral treatment program, involving weekly 50-minute appointments. Sixty-seven families with a child between 4–11 years old (M age = 5.82) with clinically significant problem behaviors self-referred to a hospital-based outpatient behavior therapy program. Results suggest that while caregivers chose a standard treatment regimen at a ratio of 2:1, compressed treatment (ITP) was associated with increased caregiver engagement and more significant reductions in child target behavior using both direct and indirect measures. Findings provide preliminary support for the use of high dosage treatment regimens as a means of increasing caregiver engagement and in the reduction of problem behavior in young children.

Dynamic written corrective feedback: A scoping review

In this paper, I present a literature review of the published empirical studies that have thus far been conducted on Dynamic Written Correct Feedback (DWCF), an approach to written corrective feedback (WCF) that utilizes a coding system on short, student-produced texts and routine self-editing that promises to be “manageable, meaningful, timely, and constant” (Hartshorn & Evans, 2012, p. 30). Much of the current research on DWCF consists of ecologically sound studies in authentic classroom contexts in Intensive English Programs or developmental writing classes, with occasional studies in secondary schools, first year composition, graduate student writing courses, or English as a foreign language contexts. By and large, the growing body of research around the topic has identified various strengths DWCF can bring for particular students producing short texts in certain contexts, especially regarding measures of increased accuracy for a number of error types and fluency. DWCF may also be easily adaptable to various student/programmatic needs.

Voice Outcomes of Intensive Voice Feminization Therapy for Transgender Women Delivered via Telepractice: Pilot Study

ObjectivesThe aim of this pilot study is to investigate the efficacy of an intensive voice feminization therapy program provided via telepractice. MethodsA total of 10 transgender women participated, with 9 completing the therapy program. All participants received 12 sessions of resonant voice therapy in combination with Vocal Function Exercises and voice hygiene, which were completed within four weeks. Acoustic and aerodynamic measures, auditory-perceptual ratings, Trans Woman Voice Questionnaire (TWVQ) and self-rated voice femininity were conducted before and after treatment. ResultsStatistical analysis showed significant improvements in acoustic measures such as fundamental frequency and semitones, TWVQ scores, auditory-perceptual ratings and self-perception of voice femininity after intensive voice therapy. ConclusionsThis study provides preliminary evidence to suggest that transgender women can benefit from intensive voice therapy when provided via telepractice, with a more feminine voice and better self-perceived voice-related quality of life. The limitations of this study were that the single-group study design lacked a control group for comparison, and the small sample size. Therefore, a randomize controlled and follow-up study with a larger sample size, exploring the effects of different treatment modalities on transgender women's voices is warranted.

Employment outcome among cardiac patients following phase two intensive outpatient cardiac rehabilitation program in Sarawak Heart Centre

Employment outcome among cardiac patients following phase two intensive outpatient cardiac rehabilitation program in Sarawak Heart Centre

Analysis on intensive program of vaname shrimp (Litopenaeus vannamei) enlargement in the technical implementation unit of brackish and sea water cultivation (UPT BAPL) Bangil, Pasuruan Regency, East Java

Vannamei shrimp (L. vannamei) is one of the popular aquaculture commodities in Indonesia. This is because vaname shrimp has various advantages compared to other species, such as fast growth rate, can be cultivated with high stocking density, tolerant of high salinity ranges, relatively uniform harvest size, and easy to cultivate. Vannamei shrimp also has many benefits. For example, its meat can be processed as nuggets or food and the shell can be used for medical, cosmetic and even biotechnology. This study aims to determine the production of vaname shrimp at UPT Bangil, one of the largest shrimp productions in East Java. The results of this study showed that the average daily gain of vaname shrimp at UPT Bangil had a yield of 0.33 g/day, and the weight of each shrimp increased to 15.7 g/head. Vannamei shrimp could be harvested at DOC 83 and yields 193.5 kg, with a size of 58. This shows good performance of vaname shrimp enlargement in UPT Bangil.

Predicting suicidal ideation 3 months following intensive posttraumatic stress disorder treatment.

This study examined whether posttraumatic stress disorder (PTSD) symptom change during a 3- and 2-week intensive treatment program (ITP)-based in cognitive processing therapy was predictive of reduced suicidal ideation (SI) following treatment. Veterans completed either a 3-week (n = 274, Mage = 42.35, SD = 9.43, 64.23% male, 65.33% White) or 2-week (n = 177, Mage = 42.90, SD = 9.81, 57.63% male, 66.67% White) ITP and self-reported PTSD, depression, and SI symptoms prior to, during, and 3 months following treatment. Mixed-effects-based two-stage location scale models assessed change in both overall PTSD severity over the course of the 3- and 2-week ITPs, as well as how this change predicted 3-month follow-up SI. Veterans in both programs reported moderate reductions in SI from baseline to posttreatment (3 weeks: d = 0.49; 2 weeks: d = 0.48). Of the 210 veterans across both programs who endorsed at least some SI at baseline, two-thirds (65.24%) reported reductions in SI posttreatment; three-quarters (74.45%) of these maintained posttreatment SI at 3-month follow-up that was lower than baseline levels. Both baseline SI and greater individual improvement in PTSD symptom severity during the ITPs were associated with lower SI at 3-month follow-up. Overall, study findings suggest that veterans with PTSD who also endorse SI can be successfully treated using the intensive delivery format and are likely to experience a reduction in SI both during and following treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Teaching positive psychology lessons in an intensive English program

Abstract This article investigates the effectiveness of positive psychology interventions (PPIs) in an intensive English program for non-matriculated university students. Interventions based on the PERMA model were implemented through weekly 65-minute lessons given during the first class of each week. These were followed by short daily activities during the rest of the week. Using positive psychology topics as the content, students concurrently engaged in language learning activities. Each participant was asked to complete a questionnaire at the end of the semester consisting of five open-ended questions relating to the PPIs, the lessons, the activities, the topics, and how they felt the PPIs affected their language learning and their life outside of class. Two raters individually reviewed each student response and marked them as positive, neutral, or negative. On the whole, the learners viewed the PPIs as being helpful for their well-being without detracting from their linguistic development.

Incidence, Prevalence, and Disease Management Impactability of High Utilization in an Adult Sickle Cell Medical Home

Background: Utilization in adults with sickle cell disease (SCD) is driven by a biopsychosocial mix of predictors. Disease management intervenes on the biopsychosocial determinants of health, partly to drive down avoidable ED visits and hospitalizations. We previously reported the effect of disease management interventions on SCD utilization among adults enrolled in an Adult Sickle Cell Medical Home (Blood)[i]. To further understand the impact of these interventions, we evaluated the incidence, prevalence, and impactability of case management within our Medical Home. Method: The sample includes distinct individuals enrolled in the Adult SCD Medical Home (N=537 in 2017, N=621 in 2018, N=558 in 2019, N=677 in 2020, N=577 in 2021, and N=604 in 2022). We analyzed the “CoVID Years” (2020-2022) separately from the “Pre-CoVID” years (2017-2019). Interventions in the Adult SCD Medical Home included: medical care by MDs, NPs, and nurses; behavioral health counseling by a licensed clinical social worker; case management by Community Health Workers (Patient Navigators), and prior authorization management by a reimbursement specialist, a licensed pharmacy tech. To perform the analysis, we defined High utilizers (vs moderate or low utilizers) as those with >$200,000 in annual medical charges each year between the years 2017-2021. We used the definition threshold to calculate the annual incidence of high utilization: the percentage of moderate or low utilizers in an index year who became high utilizers in the subsequent year. Similarly, the annual prevalence of high utilization was the percentage of all patients who were high utilizers in an index year. And the impactability of high utilization was the percentage of high utilizers in an index year who became moderate or low utilizers in the subsequent year. We calculated the annual high-utilization incidence, prevalence, and impactability for 2018-2022. Results: The annual program high-utilizer incidence, prevalence, and impactability are shown in Table 1. Utilization was stable from year to year, except at the intersection of pre-COVID and COVID years. The impactability score was 0-3.5%. We could not find good literature showing comparative annual changes in rates of impactability in diabetes, congestive heart failure, or vulnerable Medicaid populations. The graphs show individual patients' index and multiple subsequent utilization costs for those remaining in the cohorts (Classes) starting from 2017-2022 (Class of 2018), 2018-2022 (Class of 2019), 2019-2022 (Class of 2020), and 2020-2022 (Class of 2021). No statistical analyses were performed, but the trends were numerically down for all periods. Conclusion: An intense disease management program, as part of an Adult Sickle Cell Medical Home was associated with stable year-over-year high-utilizer percentage. It was also associated with a stable, low annual incidence of ‘new’ high utilizers, and a stable, low impactability among current high utilizers. We could not determine how these program rates compare with analogous rates in other chronic diseases. [i] Intensive Case Management in an Adult Sickle Cell Medical Home: Annual Effects on Utilization Efficiency Using Community Health Workers; Shirley Johnson, BA, LSW1*, Daniel M Sop, BS, MS2, Yue May Zhang, MS3*,Benjamin Jaworowski, BS 1*and Wally R Smith, MD4

Efficacy of morning versus afternoon aerobic exercise training on reducing metabolic syndrome components: A randomized controlled trial.

A supervised intense aerobic exercise program improves the health of individuals with metabolic syndrome (MetS). However, it is unclear whether the timing of training within the 24h day would influence those health benefits. The present study aimed to determine the influence of morning vs. afternoon exercise on body composition, cardiometabolic health and components of MetS. One hundred thirty-nine individuals with MetS were block randomized into morning (AMEX; n=42) or afternoon (PMEX; n=59) exercise training groups, or a non-training control group (Control; n=38). Exercise training was comprised of 48supervised high-intensity interval sessions distributed over 16weeks. Body composition, cardiorespiratory fitness (assessed by ), maximal fat oxidation (FOmax ), blood pressure and blood metabolites were assessed before and after the intervention. Compared with the non-training Control, both exercise groups improved similarly body composition (-0.7% fat loss; P=0.002), waist circumference (-2.1 cm; P<0.001), diastolic blood pressure (-3.8mmHg; P=0.004) and (3.5mLkg-1 min-1 ; P<0.001) with no differences between training groups. AMEX, in comparison with PMEX, reduced systolic blood pressure (-4% vs. -1%; P=0.019), plasma fasting insulin concentration (-12% vs. -5%; P=0.001) and insulin resistance (-14% vs. -4%; P=0.006). Furthermore, MetS Zscore was further reduced in the AMEX compared to PMEX (-52% vs. -19%; P=0.021) after training. In summary, high-intensity aerobic exercise training in the morning in comparison to training in the afternoon is somewhat more efficient at reducing cardiometabolic risk factors (i.e. systolic blood pressure and insulin sensitivity). KEY POINTS: The effect of exercise time of day on health promotion is an area that has gained interest in recent years; however, large-scale, randomized-control studies are scarce. People with metabolic syndrome (MetS) are at risk of developing cardiometabolic diseases and reductions in this risk with exercise training can be precisely gauged using a compound score sensitive to subtle evolution in each MetS component (i.e. Z score). Supervised aerobic exercise for 16weeks (morning and afternoon), without dietary restriction, improved cardiorespiratory and metabolic fitness, body composition and mean arterial pressure compared to a non-exercise control group. However, training in the morning, without changes in exercise dose or intensity, reduced systolic blood pressure and insulin resistance further compared to when training in the afternoon. Thus, high-intensity aerobic exercise training in the morning is somewhat more efficient in improving the health of individuals with metabolic syndrome.

Breast cancer surveillance in BRCA positive Sri Lankan women: health equity for a high-risk group at a limited resource setting

BackgroundBRCA1 and BRCA2 pathogenic variants account for 90% of hereditary breast malignancies, incurring a lifetime breast cancer risk of 85% and 40–45% respectively, in affected individuals. Well-resourced health care settings offer genetic counselling and genetic screening for susceptible individuals, followed by intense breast cancer surveillance programmes for those identified at high risk of breast cancer. Such high standards of care are not available in countries with limited resources. This study assessed breast cancer surveillance behaviors among a cohort of BRCA positive Sri Lankan women.MethodsA retrospective case review of all patients diagnosed with pathogenic variants in BRCA1 and BRCA2 genes from 2015 to 2022 at the Human Genetics Unit, Faculty of Medicine, University of Colombo was carried out followed by telephone interviews of the respondents. Patients who were not contactable, deceased, undergone bilateral mastectomy and males were excluded from the interview component of the study. Standard descriptive statistics were used to analyze the data using SPSS statistics version 25.ResultsOnly 25 patients were diagnosed during the study period:14/25 women responded (6/25 deceased, 3/25 non-contactable; 2/25 excluded). 71.4% (10/14) had performed breast self-examination during the preceding month; 35.7% (5/14) had a clinical breast examination (CBE), and 50% (7/14) had undergone a screening/diagnostic mammogram during the last one year. 28.5% (4/14) had undergone both mammography and CBE; 21.45% (3/14) mammogram only, 7.1% (1/14) had CBE only. 42.8%(6/14) had not undergone any surveillance(mammography, CBE or MRI). None had dual screening with mammogram and MRI. 85.71% (12/14) women expressed willingness to participate in a regular screening programme if made available.ConclusionFifty percent of BRCA1/2 positive women in our study had not undergone annual imaging-based surveillance by mammography or MRI, and none had undergone annual dual screening with mammography and MRI, indicating inadequate breast cancer surveillance in this high-risk group.

Religious Exemptions and the Constitutionality of Vaccine Mandates in the Philippines

Abstract Government responses to the covid-19 pandemic raise various legal concerns otherwise inconceivable in recent memory. One of the many implemented policies is the requirement of inoculation or vaccination to achieve herd immunity, similar to other diseases that have been eradicated by intensive vaccination programmes. Vaccine hesitancy, nevertheless, remains a persistent State concern which is complicated by reference to constitutionally protected rights. Refusal to be vaccinated on religious grounds has led various countries to provide religious exemptions to avoid judicial scrutiny. The Philippines, as the largest Christian nation in Asia, has a complex legal relationship with the church. This article discusses the State-church relationship from a constitutional and human rights law perspective and, using approaches formulated by the Philippine Supreme Court in religion clause analysis, attempts to assess, and possibly bridge, the perceived conflict between religious freedom and the Philippine government’s covid-19 vaccination policies.

Using the Personalized Advantage Index to determine which veterans may benefit from more vs. less comprehensive intensive PTSD treatment programs

ABSTRACT Background: Intensive PTSD treatment programs (ITPs) are highly effective but tend to differ greatly in length and the number of adjunctive services that are provided in conjunction with evidence-based PTSD treatments. Individuals’ treatment response to more or less comprehensive ITPs is poorly understood. Objective: To apply a machine learning-based decision-making model (the Personalized Advantage Index (PAI)), using clinical and demographic factors to predict response to more or less comprehensive ITPs. Methods: The PAI was developed and tested on a sample of 747 veterans with PTSD who completed a 3-week (more comprehensive; n = 360) or 2-week (less comprehensive; n = 387) ITP. Results: Approximately 12.32% of the sample had a PAI value that suggests that individuals would have experienced greater PTSD symptom change (5 points) on the PTSD Checklist for DSM-5 in either a more- or less comprehensive ITP. For individuals with the highest 25% of PAI values, effect sizes for the amount of PTSD symptom change between those in their optimal vs. non-optimal programs was d = 0.35. Conclusions: Although a minority was predicted to have benefited more from a program, there generally was not a substantial difference in predicted outcomes. Less comprehensive and thus more financially sustainable ITPs appear to work well for most individuals with PTSD.

Increasing the likelihood of kinship Placements: Testing the effectiveness of an intensive family search and engagement intervention

Kinship care, both formal and informal, is a practice that has received more attention in the past two decades due to the benefits found for children paced with kin, rather than in foster care with strangers. Placements with kin are often facilitated by utilizing intensive family search and engagement programs to identify and engage relatives. Methods:Using a retrospective longitudinal quasi-experimental design the present study evaluates the effectiveness of 30 Days to Family® Ohio intervention, an intervention that utilizes family search and engagement practices to place children who enter foster care in kinship placements as quickly as possible. A matched comparison group was constructed using Coarsened Exact Matching (CEM) to assess differences between the intervention and comparison groups onplacement with kin, proportion of time spent with kin, exit from care type, placement stability, placement in restrictive setting, time to case exit, and reentry. Findings: Multivariate models accounting for child and case characteristics and nesting within counties found differences between the intervention and comparison group on placement with kin, proportion of time with kin and exit from care type. Specifically,children served by 30 Days to Family® Ohio have 2.4 times greater odds of being placed with kin (OR 2.42,p<.001),9% increase in time spent with kin (p<.001),an increased likelihood of custody/guardianship (RRR 1.67, p<.01), and decreased likelihood of adoption (RRR 0.52, p<.001).Results confirm prior findings of interventions’ effectiveness at improving kinship related outcomes.

A novel open pollinated seed production strategy to exploit both additive and non-additive genetic effects in Eucalyptus dunnii

Eucalyptus dunnii, an important plantation species, is deployed either as clones or open-pollinated (OP) seed. OP seed lots are mainly sourced from seed orchards, where the mothers are known and the pollen is an uncontrolled mix of orchard genotypes. Seed Energy’s current E. dunnii clonal seed orchards have been established using genotypes selected for their general combining ability (GCA), an approach that exploits additive genetic effects. OP progeny trials of the seed orchard parents have been used to increase genetic gain deployed via backward selection. The best parents have demonstrated growth gains of up to 19.3% over unimproved native forest collections. Evaluation of control pollinated (CP) progeny trials, established from crosses of the best seed orchard parents, have shown growth traits to be under a degree of non-additive genetic control. The presence of non-additive variance in these traits suggests that additional genetic gain can be made by specific combinations of mother and pollen parent, known as specific combining ability (SCA). Capturing and deploying the gains from GCA and SCA effects into plantations at commercial scale currently require capital intensive clonal propagation programmes. Here we present a new strategy to exploit both additive and non-additive genetic effects through a novel open-pollinated seed orchard design called micro-orchards. This strategy aims to increase the frequency of the best performing combinations of mother and pollen in an OP environment. These orchards are structured with a central mother genotype tree initially surrounded by ten pollen parent genotypes, which is replicated in a repeated block design. The pollen parents are culled over several years to retain only the best specific combinations with the mother genotype. The culling of pollen parents is based on the results of iterative genetic evaluations of data from the CP trials, which contain families of the mother-pollen combinations present in the micro-orchards. The number of pollen parents culled increases with trial assessment age, concluding with a cull utilising age 6 trial data. The cost and productivity of this strategy allow gains from GCA and SCA effects to be accessible to a significant portion of the Uruguayan market at lower costs and complexity than operating a clonal propagation program.

A Study on the Factors and Prediction Model of Triple-Negative Breast Cancer for Public Health Promotion.

This study was conducted to identify the risk causes and predictive models based on the clinical features of patients with breast cancer classified as triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (non-TNBCs) using Korean cancer statistics. A total of 2045 cases that underwent three types of hormone receptor tests were obtained from Korean cancer data in 2016. Research data were analyzed with the software SPSS Ver. 26.0. TNBC and non-TNBCs accounted for 12.4% and 87.6% of the data, respectively. Tubular and lobular tumors occurred most frequently in the external quadrant of the breast (C50.4-C50.5; 43.1%). Compared to non-TNBCs, the incidence of TNBC was the most common in patients under the age of 39 (19.5%), followed by those over the age of 70 (17.3%). Tumors larger than 2 cm accounted for 16.0%, which was higher than the number of tumors smaller than 2 cm. Cases in stage IV cancer represented 21.7% of the data. Additionally, 21.0% of the patients were in the SEER stage of distant metastasis, which was the most prevalent SEER (surveillance, epidemiology, and end outcomes) stage. Neoadjuvant therapy was administered more frequently, with a rate of 24.1%. In the logistic regression and decision-making tree model, the variables that affected TNBC were age, differentiation grade, and neoadjuvant therapy. The predictive accuracies of logistic regression and decision-making tree models were 87.8% and 87.6%, respectively. In a decision-marking tree model, the differentiation grades of TNBC affect neoadjuvant therapy, and neoadjuvant therapy affects the cancer stage. Therefore, in order to promote the health of breast cancer patients, it is urgent to apply an intensive early health check-up program for those in their 40s and 50s with a high prevalence of TNBC. For patients with breast cancer, in TNBC cases, except for poorly differentiated cases, neoadjuvant therapy must be applied first at all differentiation grades. The establishment of a policy system is necessary for the success of this process.

Understanding the Emotional Labor of English Language Teaching while Black in the United States

ABSTRACTThere is a robust literature examining emotional labor as it is experienced by English language teachers and how it is prompted by the emotional rules of their employers. However, it has not been sufficiently inclusive of native English‐speaking Black English language teachers (BELTs). Using the method of autoethnography I examine my experiences with emotional labor as I struggle to manage feelings stemming from race‐related stress to present feelings that are aligned with the emotional rules of an intensive English program (IEP) in the United States. Ultimately, this study highlights some of the unique challenges and emotional labor experienced by BELTs, including the endured triggering of race‐related stress in response to workplace racial microaggression and how and why, through the process of emotional labor, outward responses are constructed. I argue that enduring emotional labor brings about implicit oppressive messages for BELTs to either detach from their racial identity to some extent or to leave their field. Additionally, I provide suggestions for how TESOL programs housed in U.S. higher education contexts can address anti‐Black racism.

Outcomes at the Motherhood Center: A Comparison of Virtual and On-Site Versions of a Specialized Perinatal Partial Hospitalization Program.

Remotely administered mental health care is becoming increasingly common for treatment of a range of psychiatric disorders; however, there is a dearth of literature overviewing direct comparisons between remote and in-person interventions for treatment of Perinatal Mood and Anxiety Disorders (PMADs). The sudden advent of the Covid-19 pandemic in New York City forced an abrupt conversion for an intensive day treatment program for new mothers with PMADs, from an on-site to a remote program. The current report compares outcomes of 81 women who completed the program in-person to those of 60 women who completed the program remotely. Improvement in depression scores was statistically superior in the remote program, and improvement in mother-infant bonding was statistically equivalent between the on-site and remote programs. These findings indicate that specialized partial hospitalization treatment for individuals with moderate to severe psychiatric illness can be effectively provided via telehealth, thus offering improved convenience, accessibility, and safety without compromising care. We conclude that remotely administered group psychotherapy is an effective intervention for women with moderate to severe PMADs.